Nicoletta Iacovidou

Nicoletta Iacovidou
National and Kapodistrian University of Athens | uoa · Division of Obstetrics - Gynecology II

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206
Publications
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Publications

Publications (206)
Article
Full-text available
Background Mean circulatory filling pressure (Pmcf) provides information on stressed volume and is crucial for maintaining venous return. This study investigated the Pmcf and other determinants of venous return in dysrhythmic and asphyxial circulatory shock and arrest. Methods Twenty Landrace/Large-White piglets were allocated into two groups of 1...
Article
Full-text available
Neonatal platelet hemostasis, although it has been well described over the recent years, remains elusive in specific patient populations, including neonates from high-risk pregnancies, such as those complicated with gestational diabetes mellitus (GDM). We aimed at evaluating the platelet function of neonates born to mothers with GDM using the plate...
Article
Full-text available
Combined pituitary hormone deficiency (CPHD) is characterized by deficiency of growth hormone and at least one other pituitary hormone. Pathogenic variants in more than 30 genes expressed during the development of the head, hypothalamus, and/or pituitary have been identified so far to cause genetic forms of CPHD. However, the etiology of around 85%...
Article
Objectives: To investigate the agreement between the EXTEM and NATEM measurements. Methods: In this retrospective observational study, EXTEM and NATEM analysis were performed on blood samples from 162 ill neonates, providing 324 paired measurements. The agreement between EXTEM and NATEM measurements was evaluated by the non-parametric spearman's...
Article
Full-text available
The detection of NT-proBNP levels both in umbilical cord blood (UCB) samples and in serum samples collected from healthy term neonates during the neonatal period. A systematic review of relevant literature in accordance with PRISMA guidelines was conducted. For quality appraisal, the potential risk of bias was assessed using the BIOCROSS evaluation...
Article
Full-text available
Background The role of partially hydrolyzed formulas (pHF) as part of nutritional interventions to prevent the development of allergic manifestations (AM) is questioned, and efficacy of each specific pHF should be substantiated. Objective To investigate the risk-reduction effect of a whey-based pHF on the development of cow's milk protein allergy...
Article
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Normal levels of thyroid hormones (THs) are essential for a normal pregnancy outcome, fetal growth and the normal function of the central nervous system. Hypothyroidism, a common endocrine disorder during pregnancy, is a significant metabolic factor leading to cognitive impairments. It is essential to investigate whether patients with thyroid dysfu...
Article
Although fresh frozen plasma (FFP) transfusions are common practice in neonatology, robust evidence on their use is lacking. The aim of this study was to systematically review the literature for data on the practice of FFP transfusions in neonates and their association with neonatal morbidity and mortality. The authors identified 40 studies, which...
Article
Full-text available
The non-activated thromboelastometry (NATEM) assay is a point-of-care assay that can provide a comprehensive insight into the actual hemostatic mechanism. However, there are very limited data about its use in clinical practice. The aim of this study was to systematically review the literature for any data regarding the use of NATEM in several clini...
Article
Background End-of-life decision-making for terminally ill neonates raises important legal and ethical issues. In Greece, no recent data on nurses’ attitudes and involvement in end-of-life decisions are available. Research question/aim To investigate neonatal nurses’ attitudes and involvement in end-of-life decisions and the relation to their socio...
Article
Full-text available
Abstract: Purpose: The composition and the metabolic activity of the gut microbiota of breastfed and formula-fed infants has been the focus of several studies over the last two decades. Gene sequencing techniques and metabolomics in biological samples have led to expansion of our knowledge in this field. A more thorough comprehension of the metabol...
Article
Full-text available
The microbiome is vital for the proper function of the gastrointestinal tract (GIT) and the maintenance of overall wellbeing. Gut ischemia may lead to disruption of the intestinal mucosal barrier, resulting in bacterial translocation. In this systematic review, according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis)...
Article
Full-text available
Abstract: Background: ROTEM assay has gained increasing acceptance as a method for rapid and specific coagulation pathway assessment. However, its use in the neonatal population remains limited since reference ranges have not yet been established. Aims: (1) to determine reference ranges for healthy term neonates of ROTEM parameters using non-activa...
Chapter
Advances in neonatology enabled significant improvements in neonatal survival, often at the expense of long-term morbidity. End-of-life decisions concern neonatal patients with fatal congenital anomalies, severe neurological deficits, and extreme prematurity at the limits of viability, presenting a complex issue for both healthcare professionals an...
Article
Full-text available
Background: Galactagogues are substances that promote lactation, although data on their effects on humans remain limited. We investigated the efficacy of Silitidil to increase milk supply and duration of breastfeeding of a specific subgroup of mothers in need of lactation support. Methods: 161 mothers from November 2018 until January 2021 were t...
Article
Full-text available
Background: Neonatal respiratory distress syndrome (NRDS) is strongly associated with premature birth, but it can also affect term neonates. Unlike the extent of research in preterm neonates, risk factors associated with incidence and severity of NRDS in term neonates are not well studied. In this study, we examined the association of maternal and...
Article
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Background: To compare the prognostic accuracy of the most commonly used indexes of mortality over time and evaluate the potential of adding thromboelastometry (ROTEM) results to these well-established clinical scores. Methods: The study population consisted of 473 consecutive term and preterm critically-ill neonates. On the first day of critica...
Preprint
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Platelet function in IUGR neonates remain a field of debate, especially in preterm subgroup. Platelet Function Analyzer (PFA-100) offers a quantitative in vitro assessment of primary, platelet-related hemostasis. Our aim was to examine platelet function using PFA-100 in term and preterm IUGR neonates and associate our results with several perinatal...
Poster
Introduction: Neonatal brain injury (NBI) is a serious adverse outcome in premature neonates. Early detection of neonates at high risk to develop NBI is still ineffective. Many biomarkers have been tested but none is used currently in clinical practice. Nevertheless, one of the most promising seems to be the S100 Calcium Binding Protein B (S100B)....
Article
Background and aim: Dysregulation of glucose metabolism is a common complication of transfusions in Transfusion Dependent Thalassemia (TDT) patients. For early diagnosis of glucose disturbances, screening is recommended. The age of starting and the type of screening vary; the more common methods are assessment of RPG, FPG, 2h PG and 2 hours OGTT....
Article
Human milk is the best possible nutrition for infants, as it supplies them with nutrients, bioactive molecules as well as antibodies, which contribute to immune maturation, organ development, and healthy microbial colonisation. Few situations are considered definitive contraindications for breastfeeding. The disastrous Coronavirus Disease-2019 (COV...
Article
Full-text available
Neonatal brain injury is a serious adverse outcome of prematurity. Early detection of high risk premature neonates to develop neonatal brain injury is not currently feasible. The predictive value of many biomarkers has been tested, but none is used currently in clinical practice. The purpose of this study was to determine the levels and predictive...
Article
The aim of the present study was to assess the coagulation profile in neonatal critical illness using rotational thromboelastometry (ROTEM), and to investigate its association with disease severity and its potential prognostic role in this clinical setting. Over a period of 67 months (July 2014–February 2020) 423 critically ill neonates with confir...
Article
Introduction The European Resuscitation Council Newborn Life Support Course (ERC- NLS) aims at training healthcare professionals, involved in perinatal care, in order to intervene efficiently and promptly to assist transition or resuscitate neonates who require help at birth. However, limited data exists for the retention of the theoretical knowled...
Article
Full-text available
Intrauterine growth restriction (IUGR) is a fetal adverse condition, ascribed by limited oxygen and nutrient supply from the mother to the fetus. Management of IUGR is an ongoing challenge because of its connection with increased fetal mortality, preterm delivery and postnatal pathologies. Untargeted nuclear magnetic resonance (1H NMR) metabolomics...
Conference Paper
Full-text available
OBJECTIVE While coagulation and fbrinolysis disorders appear to play an important role in the pathogenesis of neonatal respiratory distress syndrome (RDS) and are associated with its severity, little has been studied in the acute phase of the disease. The aim of our study was to investigate alterations in thromboelastometry (TEM) variables in neona...
Article
Full-text available
Background: Thromboelastometry (ROTEM), as a point of care test, is an attractive tool for rapid evaluation of hemostasis. Currently, no reference ranges exist for all ROTEM assays in neonates, limiting its use in this vulnerable population. The aim of the present study was: (1) to establish reference ranges for standard extrinsically activated (E...
Article
Full-text available
Background End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in Neonatal Intensiv...
Article
Full-text available
Bronchopulmonary dysplasia (BPD) is a common cause of respiratory illness in preterm newborns with high morbidity and mortality rates. At present, there are no early prognostic biomarkers that can be used in clinical practice to predict the development of BPD. In this review, we critically appraise evidence regarding the use of serum N-terminal pro...
Article
Background Our aim was to investigate the role of thromboelastometry (ROTEM) parameters, including maximum clot elasticity (MCE) and platelet component (PLTEM MCE and PLTEM MCF), in early prediction of bleeding events in thrombocytopenic critically ill neonates. Material and methods This single‐center, prospective cohort study included 110 consecu...
Article
Full-text available
Background: We aimed to assess whether nucleated red blood cells (NRBCs) count could serve as a diagnostic and prognostic biomarker for morbidity and mortality in critically ill neonates. Methods: The association between NRBCs count and neonatal morbidity and mortality was evaluated in an observational cohort of critically ill neonates hospitali...
Article
Congenital depression of the neonatal skull is a rare entity. Most of the cases have been attributed to obstetric trauma, mainly due to use of forceps, while the minority of cases occurs from intrauterine moulding of the fetal skull due to pressure against maternal bone structures. In the majority of uncomplicated depressions there is gradual resol...
Article
Full-text available
Advances in neonatology enabled significant improvements in neonatal survival, often at the expense of long-term morbidity. End-of-life decisions concern neonatal patients with fatal congenital anomalies, severe neurological deficits, and extreme prematurity at the limits of viability, presenting a complex issue for both healthcare professionals an...
Article
Full-text available
Introduction and objectives Bacterial translocation (BT) is the passage of viable bacteria or endotoxins from the gastrointestinal lumen to extra-luminal tissues and is usually observed after intestinal ischaemia-reperfusion injury. The aim of this study was to investigate post-resuscitation BT after cardiac arrest and resuscitation in a swine anae...
Article
The aim of the study was to develop and validate a prediction model for hemorrhage in critically ill neonates which combines rotational thromboelastometry (ROTEM) parameters and clinical variables. This cohort study included 332 consecutive full-term and preterm critically ill neonates. We performed ROTEM and used the neonatal bleeding assessment t...
Article
Full-text available
OBJECTIVE: Intravenous lipid emulsions (ILE) were developed many decades ago to supply nutritional requirements to patients unable to obtain adequate enteral nutrition. The utility of ILE was extended to therapeutics, facilitating the delivery of drugs. More recently, the potential for ILE to act as an antidote for inversion of drug toxicity has be...
Article
Perinatal hypoxia is associated with an increased risk of coagulation disorders by enhancing the consumption of platelets and some clotting factors due to the associated severe hypoxemia, acidemia, and compromised oxygen and blood supply to the neonatal liver and bone marrow. Thromboelastometry (TEM), which estimates the dynamics of blood coagulati...
Article
Background Hypofibrinolysis has been demonstrated in several studies in adult sepsis. Although fibrinolysis is an important and integral part of the hemostatic system, few data are available regarding its role in neonatal sepsis. Our purpose was to define fibrinolytic profiles across neonatal sepsis spectrum using rotational thromboelastometry (ROT...
Article
Background Hypofibrinolysis has been demonstrated in several studies in adult sepsis. Although fibrinolysis is an important and integral part of the hemostatic system, few data are available regarding its role in neonatal sepsis. Our purpose was to define fibrinolytic profiles across neonatal sepsis spectrum using rotational thromboelastometry (ROT...
Preprint
Full-text available
Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in neonatal intensi...
Preprint
Full-text available
Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in neonatal intensi...
Preprint
Full-text available
Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in neonatal intensi...
Article
Fluid resuscitation, vasopressors and inotropes are the first line medication for the different types of shock due to their mechanism of action and their well-established clinical outcome. However, as experimental research and clinical trials are constantly being published, new suggestions appear regarding alterations and novelties in the use of th...
Article
Full-text available
Objective: Stress in healthcare personnel involved in adult/children resuscitation has been extensively evaluated, but respective data in neonatal resuscitation (NR) is limited. This review aims at collecting available data on stress in healthcare personnel involved in NR. Study Design: This systematic review was conducted under the PRISMA guidelin...
Article
Cardiomyopathies are the leading cause of heart failure (HF) in children with anatomically intact hearts. A retrospective data analysis of a tertiary cardiac surgery and cardiology center cohort was performed. Our objectives were to analyze demographic, clinical, echocardiographic and hemodynamic data of children with HF due to cardiomyopathy – myo...
Article
Primary hemostasis, similar to other systems in the adjusting and transitioning neonate, undergoes developmental adaptations in the first days of life. Although platelets of neonates do not differ quantitatively compared with those of adults, they functionally present with major differences, thus supporting the theory of a “hypofunctional” phenotyp...
Article
Full-text available
Purpose: To investigate the effects of the combination of centhaquin and 6% hydroxyethyl starch 130/0.4 (HES 130/0.4) in a swine model of hemorrhagic shock. Methods: Twenty Landrace-Large White pigs were instrumented and subjected to hemorrhagic shock. The animals were randomly allocated in two experimental groups, the control (group CO, n = 10)...
Article
Full-text available
Abstract: Perineal groove is a well-defined clinical entity that belongs to a broader group of anorectal malformations. It is characterized by a non-epithelialized mucous membrane that appears as an erythematous sulcus in the perineal midline, extending from the posterior vaginal fourchette to the anterior anal orifice. The defect is gradually cica...
Article
Hemostasis is a dynamic age-related process, which gradually evolves from fetal life throughout childhood until adulthood. Although at birth there is a hemostatic deficit of most coagulation factors, studies have shown that this “hemostatic immaturity” is functionally counterbalanced in healthy term or preterm newborns. This delicate hemostatic bal...
Article
Full-text available
Scarce data exists about the hemostatic status of small for gestational age (SGA) neonates. We aimed at evaluating the hemostatic profile of SGA neonates, using thromboelastometry (TEM). This is an observational study performed in a Greek tertiary General Hospital during an 18-month period. Ninety-three neonates were included in the study: 48 appro...
Article
Full-text available
Children born with IUGR develop features of the metabolic syndrome and exhibit deranged markers of hepatorenal physiology. Metabolic and hepatorenal biochemistry and the rs9939609 FTO polymorphism were investigated in prepubertal children born with IUGR. Ninety-eight prepubertal children (46 IUGR and 52 AGA), subdivided in <5 years and >5 years old...
Article
Background. The 2015 European Resuscitation Council (ERC) Guidelines for Resuscitation and support of transition of babies at birth stress the importance of adequate preparation by the healthcare professionals who are going to receive the newborn immediately after birth in order to avoid preventable neonate deterioration. Midwives and pediatricians...
Article
Full-text available
Conclusions: A ROTEM hypocoagulable profile at admission seems promising for the early detection of sepsis in neonates while the degree of hypocoagulation may be associated with sepsis severity. What is Known: • The early phase of septicemia might be difficult to be recognized in neonates. In adult septic patients, the diagnostic and prognostic ro...
Article
We present a case of a term male neonate born with congenital diaphragmatic hernia (CDH), double-outlet right ventricle (DORV) and a “picture of genetic syndrome”, antenatally diagnosed, without any confirmation of a particular syndrome as no amnioparacentesis was performed. The postnatal chromosomal analysis revealed trisomy 18.
Article
Full-text available
Cardiac arrest (CA) is not a uniform condition and its pathophysiology strongly depends on its cause. In this work we have used a metabolomics approach to study the dynamic metabolic changes occurring in the plasma samples of a swine model following two different causes of CA, namely asphyxia (ACA) and ventricular fibrillation (VFCA). Plasma sample...
Article
Full-text available
Patients with thalassemia major who received allogeneic hematopoietic cell transplantation are at increased risk of gonadal insufficiency and reduced fertility due to the toxicity of both the transfusional iron overload and the gonadotoxic effects of drugs used in the conditioning regimen. We present a case of an ex-thalassemic patient with spontan...
Article
Full-text available
Chronic obstructive pulmonary disease (COPD) is a major health problem worldwide, with co-morbidities contributing to the overall severity and mortality of the disease. The incidence and prevalence of cardiovascular disease among COPD patients are high. Both disorders often co-exist, mainly due to smoking, but they also share common underlying risk...
Poster
Full-text available
Introduction: Perinatal hypoxia is associated with increased risk of coagulation disorders. Hypoxia, among other effects, has an impact on hepatic and bone marrow function, resulting in further derangement of the immature production of coagulation factors and platelets. Hypoxic neonates may present with hemorrhagic disorders. The prevention and tim...
Poster
Full-text available
Background. Hemostasis is a dynamic process which gradually evolves during development from fetal stage into adulthood. Healthy neonates are born with an intrinsic hemostatic deficit directly dependent on gestational age, birth weight, and maturation of hepatic function. All factors of the coagulation- fibrinolysis system differ in neonates. Howeve...