Michael B Anthracopoulos

University of Patras | UP · Department of Paediatrics

Kingella kingae is a cause of bacteremia, endocarditis, and the leading cause of osteoarticular infections between 6 and 48 months of life. We report on a rare case of K. kingae meningitis in the absence of endocarditis and immune deficiency in a 26-month-old boy emphasizing the distinct genomic determinants of the strain which may be of importance...

Data on exercise tolerance of children born non-extremely preterm are sparse. We aimed to explore the cardiopulmonary exercise testing (CPET) characteristics in this population. We studied 63 children (age 7–12 years) born at 290/7–366/7 weeks of gestation (34 were late preterm, 29 were preterm) and 63 age-matched, term-born controls. All performed...

Objective: Environmental tobacco smoke exposure is a well-recognized risk factor for asthma development and poor asthma control in children. However, the relationship between changes in parental smoking habits over time and the prevalence of childhood asthma remains largely unknown. Our objective was to investigate the trends of parental smoking b...

Nocturnal pulse oximetry (NOx) is an alternative diagnostic test for obstructive sleep apnea syndrome (OSAS) in childhood yet with variable diagnostic performance. Our aim was to apply advanced signal analysis to develop novel and more accurate NOx indices. We studied 45 children aged 3–10 years who underwent adenotonsillectomy for adenotonsillar h...

Background Children with uncontrolled asthma are less tolerant to exercise due to ventilatory limitation, exercise-induced bronchoconstriction (EIB), or physical deconditioning. The contribution of these factors in children with controlled mild-to-moderate asthma is unknown. Objective To explore the underlying mechanisms of reduced exercise capaci...

Background: The prevalence of childhood asthma, rhinoconjunctivitis, and eczema in the city of Patras, Greece, has been followed in four consecutive surveys since 1991. After a continuous rise in the prevalence of all three of these disorders, a plateau was reached for asthma between 2003 and 2008, whereas the prevalence of rhinoconjunctivitis and...

In a cross-sectional study, with the use of molecular methods, we aimed to gain insight into oropharyngeal pneumococcal colonization over time in 1212 Greek children recruited in general pediatric settings throughout the country; they were fully vaccinated with PCV13 (3 + 1 schedule). A single sample was obtained from each child at a time interval...

Background: A series of repeated questionnaire surveys among 8- to 9-year-old school children in the city of Patras, Greece, demonstrated a continuous rise in the prevalence of wheeze/asthma from 1978 to 2003, with a plateau between 2003 and 2008. We further investigated wheeze/asthma trends within the same environment over the last decade. Metho...

As the COVID-19 pandemic is still evolving, guidelines on pulmonary function testing that may dynamically adapt to sudden epidemiologic changes are required. This paper presents the recommendations of the Hellenic Pediatric Respiratory Society (HPRS) on pulmonary function testing in children and adolescents during the COVID-19 era. Following an ext...

Background The surveillance of emm types and macrolide susceptibility of group A streptococcus (GAS) in various areas and time periods enhances the understanding of the epidemiology of GAS infections and may guide treatment strategies and the formulation of type-specific vaccines. Greece has emerged as a country with high macrolide use. However, st...

The defining feature of asthma is loss of normal post-natal homeostatic control of airways smooth muscle (ASM). This is the key feature that distinguishes asthma from all other forms of respiratory disease. Failure to focus on impaired ASM homeostasis largely explains our failure to find a cure and contributes to the widespread excessive morbidity...

Background Variability analysis of peak expiratory flow (PEF) and forced expiratory volume at 1 s (FEV1) has been used in research to predict exacerbations in adult individuals with asthma. However, there is a paucity of data regarding PEF and FEV 1 variability in healthy or asthmatic children and adolescents. The objective of the present study is...

Respiratory medicine relies both on clinical information and on complementary, laboratory tests results. However, despite today’s technological wonders, a proper history and a sound physical examination have no substitute as the initial step in making a correct diagnosis and, by consequence, providing the appropriate treatment. Respiratory complain...

Background: Epidemiological evidence suggests the existence of a direct link between allergic rhinitis (AR) and asthma. Several studies also support the presence of small-airway dysfunction (SAD) in non-asthmatic children with AR. However, it remains unknown whether SAD can predict the progression of AR to asthma. Our objective was to explore the...

The Forced Oscillation Technique (FOT) is a lung function modality based on the application of an external oscillatory signal in order to determine the mechanical response of the respiratory system. The method is in principal noninvasive and requires minimal patient cooperation, which makes it suitable for use in young paediatric patients. The FOT...

Background/Aims: Tracheomalacia (TM) is a rather usual paediatric clinical condition but difficult to confirm. The aim of our study was to assess the accuracy of expiratory helical CT scan (HCT) in detecting TM. Methods: We performed flexible bronchoscopy (FB) in 21 school-age children suspected of TM on the grounds of clinical symptoms, namely vib...

Background: Virus-induced wheeze in preschoolers is characterized by reversible airflow limitation which persists several days after the remission of the symptoms. Aims and objectives: To explore whether prolonged bronchodilator responsiveness (BDR) after virus-induced wheezing episodes can predict persistence of asthma at school age. Methods: Seve...

β-Glucuronidase is a lysosomal enzyme released into the extracellular fluid during inflammation. Increased β-glucuronidase activity in the cerebrospinal and peritoneal fluid has been shown to be a useful marker of bacterial inflammation. We explored the role of β-glucuronidase in the detection of bacterial infection in bronchoalveolar lavage fluid...

Acute bronchiolitis is a common paediatric disease of infancy. Its association with subsequent asthma development has puzzled clinicians and epidemiologists for decades. This article reviews the current state of knowledge regarding the role of acute bronchiolitis in the inception of asthma. There is little doubt that acute bronchiolitis is associat...

Objective: To investigate the role of the Mediterranean diet and physical activity with relation to living environment and childhood asthma. Methods: 1125 children (529 boys), 10 to 12 years old were recruited either in an urban environment (Athens, n = 700) or rural environment (n = 425) in Greece. A path analytic model was developed to assess...

In this paper we propose a new framework for the in- and out-hospital homogeneous management of childhood asthma through a combination of official clinical guidelines for asthma management. The main indicator used for the assessment of the child's asthma is the measurement and interpretation of Fraction of exhaled Nitric Oxide (FeNO). As a whole, t...

The use of Fraction of Exhaled Nitric Oxide (FeNO) for measurement of inflammation in the respiratory system is a good way to assess the level of asthma in children. In this paper we present a new Clinical Decision Support System (CDSS) for Childhood Asthma Management based on FeNO, which is named RespDoc. The core of RespDoc is a decision making a...

Objectives: To investigate the potential mediating effect of parental education on the association between adherence to the Mediterranean diet and obesity, in 10-12 years old children. Methods: A cross-sectional survey was performed among 1,125 (529 male) children in Greece. Children and their parents completed standardized questionnaires, which...

To investigate the association between physical activity and exercise-induced bronchoconstriction (EIB) in an urban population sample of schoolchildren, taking into account potential confounders such as asthma symptoms and overweight. Children aged 10-12 years answered validated questionnaires on physical activity (Physical Activity and Lifestyle Q...

Chronic illness per se, including asthma, may cause retardation of linear growth and this confounding factor is often difficult to separate from the potential stunting effect of inhaled corticosteroids (ICS) on children’s height. It has been proposed that the vast majority of asthmatic children will attain a normal adult height, and that most perce...

Background: Protracted bacterial bronchitis is a major cause of persistent cough in childhood. The organisms most commonly isolated are nontypable Haemophilus influenzae and Streptococcus pneumoniae . There are no studies addressing typing of these organisms when recovered from the lower airways. Methods: Isolates of these two organisms (identif...

This study evaluated the interrelationships of living environment, physical activity, lifestyle/dietary habits, and nutritional status on the prevalence of childhood asthma. In a cross-sectional survey 1125 children (529 boys), 10 to 12 years old, were selected from 18 schools located in an urban environment (Athens, n = 700) and from 10 schools lo...

Increased meal frequency and daily breakfast consumption have been inversely associated with childhood obesity. The purpose of the study was to examine the possible interaction effect between meal frequency and breakfast consumption on childhood obesity. Seven hundred children (323 boys) aged 10-12 years were enrolled in this cross-sectional study....

After a continuous increase of asthma, hay fever, and eczema during 1991-2003 among schoolchildren in Patras, Greece, the prevalence of current wheeze/asthma (diagnosed wheezing and/or asthma in the past 2 years) has reached a plateau (6.9%) during the period 2004-2008. Using methodology identical to the three previously conducted cross-sectional,...

Background and aims: The aim of the present work was to evaluate the validity of a food frequency questionnaire (FFQ) that could be used for children aged 10-12 years living in urban areas in Greece.

The introduction of pulse oximetry in clinical practice has allowed for simple, noninvasive, and reasonably accurate estimation of arterial oxygen saturation. Pulse oximetry is routinely used in the emergency department, the pediatric ward, and in pediatric intensive and perioperative care. However, clinically relevant principles and inherent limit...

Epidemiological studies have revealed several associations between asthma symptoms and environmental and dietary factors, but the potential environment- diet interactions on asthma incidence have rarely been investigated. The aim of this work was to evaluate the interrelationships between urban/rural environment, adherence to a healthy dietary patt...

Artificial Neural Network (ANN) models were developed and applied in order to predict the total weekly number of Childhood Asthma Admission (CAA) at the greater Athens area (GAA) in Greece. Hourly meteorological data from the National Observatory of Athens and ambient air pollution data from seven different areas within the GAA for the period 2001-...

To cite this article: Arvaniti F, Priftis KN, Papadimitriou A, Papadopoulos M, Roma E, Kapsokefalou M, Antracopoulos MB, Panagiotakos DB. Adherence to the Mediterranean type of diet is associated with lower prevalence of asthma symptoms, among 10–12 years old children: the PANACEA study. Pediatr Allergy Immunol 2011; 22: 283–289. Epidemiological st...

 According to four surveys conducted during 1978-2003, the prevalence of childhood asthma and wheezing has risen in the city of Patras, Greece, albeit at a decelerating rate. We examined sex-specific wheeze and asthma prevalence in the same urban environment in 2008. A cross-sectional parental questionnaire survey was performed in 2008 among third...

Chronic wet cough strongly suggests endobronchial infection, which, if left untreated, may progress to established bronchiectasis. Our aim was to compare the effectiveness of chest high-resolution CT (HRCT) scanning and flexible bronchoscopy (FB) in detecting airway abnormalities in children with chronic wet cough and to explore the association bet...

Salty-snack consumption, as well as the amount of time children spend watching television or playing video games, have been implicated in the development of asthma; however, results are still conflicting. The aim of this work was to evaluate the association of salty-snack eating and television/video-game viewing with childhood asthma symptoms. Cros...

The objective of this study was to assess the knowledge on pulse oximetry among health care professionals involved in pediatric care. A multiple-choice questionnaire was distributed to 505 pediatric health care professionals from 19 hospitals and health centers throughout Greece. Exploratory factor analysis was performed to identify underlying fact...

This book provides an in-depth 'state-of-the-art' critical review of the technique and the applications of flexible and rigid bronchoscopy to infants and children. Written by an international panel of experts, it reviews the technical aspects of the procedure, its common and highly specialized applications as well as its potential alternatives. The...

Particulate matter with diameter less than 10 micrometers (PM10) that originates from anthropogenic activities and natural sources may settle in the bronchi and cause adverse effects possibly via oxidative stress in susceptible individuals, such as asthmatic children. This study aimed to investigate the effect of outdoor PM10 concentrations on chil...

Flexible bronchoscopy (FB) is the only method that permits real-time direct visualization and dynamic evaluation of the tracheobronchial system. Multidetector computed tomography (MDCT) scanners can generate accurate 2-dimensional (multiplanar reformation) and 3-dimensional (multiplanar volume reconstruction, external volume rendering, VR, and virt...

The development of asthma and allergy appears to be the result of gene-environment interaction. Potential environmental risk factors such as outdoor and indoor air pollution, infections, allergen exposure, diet, and lifestyle patterns may trigger respiratory symptoms and compromise lung function in children. Specific features of urban and rural lif...

The present review highlights adrenal function in the context of endocrine-immune interactions and hypothalamic-pituitary-adrenal (HPA) axis activity in asthmatic children on long-term treatment with inhaled corticosteroids (ICS). Activation of the HPA axis by specific cytokines increases the release of cortisol, which in turn feeds back and suppre...

Eosinophil granulocytes (eosinophils) are white blood cells that develop from bone marrow precursor cells. Their major morphological characteristic is eosinophilic granules within the cytoplasm, which are divided into specific and small granules. Four cationic proteins have been recognized within the eosinophil specific granules that include eosino...

Eosinophil granulocytes (eosinophils) are white blood cells that develop from bone marrow precursor cells. Their major morphological characteristic is eosinophilic granules within the cytoplasm, which are divided into specific and small granules. Four cationic proteins are recognized within the specific granules: one of them is eosinophil cationic...

The purpose of the present study was to determine the prevalence of overweight and obesity in a sample of Greek children aged 10-12 years, and to evaluate these rates in relation to parental weight and birthweight. During the 2005-2006 school period, 700 schoolchildren (323 boys, 377 girls) were randomly recruited from 18 schools, in Athens. Height...

Eating behaviours and obesity status among children have already been evaluated in several studies, with conflicting results. The aim of this study is to assess the correlation of breakfast cereal with childhood obesity. A representative sample of 700 children (323 male) selected from 18 schools located in Athens greater area were enrolled. Childre...

Inhaled corticosteroids (ICS) are currently the mainstay of therapy in persistent childhood asthma. However, systemic adverse effects of various available agents-particularly on growth, bone metabolism, and the hypothalamic-pituitary-adrenal (HPA) axis-continue to concern the families of asthmatic children, and are debated within the medical commun...

The prevalence of allergic rhinitis, hay fever and eczema has risen worldwide during the last four decades but may have reached a plateau in some westernized societies. We examined time trends in the prevalence of childhood chronic or recurrent rhinitis, rhinoconjunctivitis and eczema in urban Greece. Using identical methodology, three population-b...

The purpose of the present retrospective study was to investigate the association of school-age asthma with acute-bronchiolitis and examine the influence of potential risk factors. One hundred and eighty-nine children aged 7.5 +/- 2.2 years consecutively hospitalized for respiratory syncytial virus (RSV)-positive acute bronchiolitis during infancy...

Measurement of the response of acute bronchiolitis (AB) to bronchodilators relies on clinical signs and pulse oximetry. We hypothesized that Doppler ultrasonographic indices of hepatic venous flow may prove to be an objective tool in the assessment of the effect of inhaled salbutamol in infants hospitalized for AB. Previously healthy infants hospit...

To evaluate whether dietary habits and anthropometric and lifestyle characteristics are associated with the prevalence of asthma symptoms, a sample of 700 Greek schoolchildren were evaluated through a standardized questionnaire. Body height and weight were measured, and body mass index was calculated. Multiple logistic regression and multivariate t...

We have previously shown that long-term exposure of children to a highly polluted urban compared with a rural environment is associated with subclinical airway narrowing and increased prevalence of atopy. To test the hypothesis that sensitization to indoor perennial, compared with seasonal, aeroallergens has distinct effects on asthma symptoms and/...

Pulmonary artery sling is frequently accompanied by tracheal anomalies other than local compression, including focal/segmental or extensive stenosis (ring-sling complex). Recent advances in computed tomography technology, such as multidetector computed tomography with 3-dimensional imaging (3-D) and virtual bronchoscopy (VB), offer important and ac...

Timing and duration of linear growth suppression in children on long-term inhaled corticosteroids (ICS) are not entirely clear; we undertook a “pragmatic” study to determine growth of asthmatic children on long-term ICS managed by a flexible dosing step-down approach. Standard deviation scores of height (HSDS), height velocity (HVSDS), and body mas...

In a population-based longitudinal cohort study, we tested the hypothesis that children growing up in a high-traffic polluted urban area (UA) in the Athens' basin have higher prevalence of allergies and sensitization when compared with those growing up in a Greek provincial rural area (RA). We recruited 478 and 342 children aged 8-10 living in the...

The prevalence of asthma and wheezing has risen during the past four decades. Recent reports suggest that the "asthma epidemic" has reached a plateau. To examine further trends in the prevalence of childhood diagnosed asthma and wheezing in an urban environment in Greece. A population-based cross-sectional parental questionnaire survey was repeated...

To determine the prevalence of asthma symptoms in a sample of Greek children aged 10-12 years, and to evaluate these rates in relation to anthropometric, lifestyle characteristics and dietary habits. During 2006, 700 schoolchildren (323 male and 377 female), aged 10-12 years (4th to 6th school grade), were selected from 18 schools located in the gr...

We hypothesized that asthma symptoms and lung function of schoolchildren living in Athens urban area are adversely affected as compared to others living in a rural environment, over a period of 8 years. We recruited 478 and 342 children aged 8-10 years living within a short radius around the urban and rural area monitoring stations, respectively. R...

Transfusional iron overload may occur in the lungs. We hypothesized that quantitating siderophages in the bronchoalveolar fluid (BALF) of heavily transfused patients may prove to be a useful tool in determining lung iron overload in transfusion-dependent patients. The study included six patients (7–20 years) with thalassemia major (TM) who had rece...

Most cases of middle lobe syndrome (MLS) in children are considered to be due to asthma and may recover spontaneously; however, in persistent MLS, repeated episodes of infection often institute a vicious cycle that may lead to persistent symptoms and bronchial hyperresponsiveness (BHR). The present study was undertaken to investigate whether asthma...

Asthmatic children on long-term treatment with inhaled corticosteroids (ICS) may exhibit mild adrenal suppression. We aimed to test the hypothesis that baseline adrenal function of some asthmatic children might be lower than that of others and that this difference might be accentuated by ICS therapy. A low-dose Synacthen test was performed in 41 pr...

Middle lobe syndrome (MLS) in children is characterized by a spectrum of clinical and radiographic presentations, from persistent or recurrent atelectasis to pneumonitis and bronchiectasis of the right middle lobe (RML) and/or lingula. This study was undertaken to evaluate the effect of early intervention, including fiberoptic bronchoscopy (FOB), i...

Analysis of heart rate variability (HRV) has been used to evaluate changes in sympathovagal balance. The present study was designed to investigate the influence of two therapeutic regimens on autonomic cardiovascular regulation during acute asthma exacerbations (AAE). Twenty children, 7-13 years of age, with moderate or severe AAE were randomized i...

Although considerable information is available on the effects of bracing on lung function in kyphoscoliosis, there is a paucity of data on idiopathic juvenile kyphosis (IJK). The present study was designed to investigate the immediate effect of bracing on lung function in children and adolescents with mild-to-moderate IJK. Spirometry, measurement o...

Chlamydia pneumoniae has been recognized as a cause of respiratory tract infection in humans, and its prevalence has been shown to vary among different age groups and populations. The prevalence of Chlamydia pneumoniae antibody was determined by serological investigation in 343 healthy children and in 77 children consecutively hospitalised for pneu...

The aim of the present study was to compare the prevalence of asthma among schoolchildren in 1978, 1991, and 1998 in Patras, Greece. The study populations of the three comparable cross sectional surveys comprised third and fourth grade public school children in Patras, Greece. Sample sizes in 1978, 1991, and 1998 were 3735, 2952 and 3397 children a...

BACKGROUND The aim of the present study was to compare the prevalence of asthma among schoolchildren in 1978, 1991, and 1998 in Patras, Greece. METHODS The study populations of the three comparable cross sectional surveys comprised third and fourth grade public school children in Patras, Greece. Sample sizes in 1978, 1991, and 1998 were 3735, 2952...

Auditory event-related potentials (AERP) were elicited in 68 epileptic patients and 30 age-matched controls. Epileptic patients had significantly prolonged N2 and P300 (P3) latencies compared with controls. Seven patients were above the range of 3 standard deviations from the control mean values. Amongst epileptics, patients with temporal lobe epil...

Auditory Event-Related Potentials (AERP) were elicited in 25 beta-thalassemic patients, three days before and three days after a blood transfusion. The amplitude, latency and topographic distribution of P300 (P3) as well as N1, P2, N2 components were measured for the two assessment times. No significant differences in either amplitude, latency or t...