Publications by Year: 2011

2011
Rizos D, Karababa P, Nikolou C, Sarandakou A, Panagiotakis O, Ferderigou A, Haliassos A, Makris K, Psarra K, Bairaktari E, et al. The Greek way to the Register: The establishment and operation of the Register for Clinical Chemists-Clinical Biochemists in Greece. Clinical Chemistry and Laboratory Medicine. 2011;49(12):1975 - 1978.Abstract
In Greece, there is no officially organized training in clinical chemistry for scientists. The Greek Society of Clinical Chemistry-Clinical Biochemistry (GSCC-CB), following the encouragement of the EC4/RC decided to organize a voluntary Register for specialists in clinical chemistry. The following criteria for registration were defined: 1) University degree in Chemistry, Biochemistry, Biology, Medicine, Pharmacy or other relevant subject. 2) A total of 9 years of university studies and postgraduate specialization in clinical chemistry-clinical biochemistry. 3) A minimum of 4 years of postgraduate specialization in clinical chemistry-clinical biochemistry on the job. 4) The candidate must be practicing clinical chemistry-clinical biochemistry in a laboratory in a medical environment in Greece. The postgraduate specialization in clinical chemistry-clinical biochemistry includes the laboratory training and the theoretical education. The laboratory training is organized by the GSCC-CB according to the Professional Training Dossier. The theoretical education was organized in a series of 18 "Seminars" which was the content of the "Educational program" of the GSCC-CB. Successful completion of the Educational program leads to a Certificate of Competence. The Greek Register has gained equivalence with the EC4 Register and it has 218 members, more than 80 of whom are European clinical chemists. © 2011 by Walter de Gruyter.
Markopoulos MC, Rizos D, Valsamakis G, Deligeoroglou E, Grigoriou O, Chrousos GP, Creatsas G, Mastorakos G. Hyperandrogenism in women with polycystic ovary syndrome persists after menopause. Journal of Clinical Endocrinology and Metabolism. 2011;96(3):623 - 631.Abstract
Context: Ovarian and adrenal hyperandrogenism characterize premenopausal women with polycystic ovary syndrome (PCOS). Androgens decline with age in healthy and PCOS women. Objective: The objective of the study was to investigate hyperandrogenism in PCOS after menopause. Design: This was a case-control, cross-sectional study. Setting: The study was conducted at a university hospital endocrinology unit. Patients: Twenty postmenopausal women with PCOS and 20 age- and body mass index-matched controls participated in the study. Interventions: Serum cortisol, 17-hydroxyprogesterone (17-OHP), Δ4- androstenedione (Δ4A), dehydroepiandrosterone sulfate (DHEAS), total testosterone (T), and free androgen index (FAI) levels were measured at baseline, after ACTH stimulation, and after 3-d dexamethasone suppression. The ACTH and cortisol levels were measured during the CRH test. Main Outcome Measures: Androgen profile at baseline, after ACTH stimulation, and 3-d dexamethasone suppression tests were the main outcome measures. Results: Postmenopausal PCOS women had higher 17-OHP, Δ4A, DHEAS, total T, FAI (P < 0.05) and lower SHBG (P<0.05) baseline levels than control women. ACTH and cortisol responses during the CRH test were similar in the two groups. After ACTH stimulation, Δ4A, DHEAS, and total T levels were equally increased in both groups. After dexamethasone suppression, LH levels did not change in either group; 17-OHP-, Δ4A-, and FAI-suppressed levels remained higher in PCOS than in control women (P < 0.05), whereas total T and DHEAS levels were suppressed to similar values in both groups. Conclusions: In postmenopausal PCOS women, ACTH and cortisol responses to CRH are normal. Androgen levels at baseline are higher in PCOS than control women and remain increased after ACTH stimulation. The dexamethasone suppression results in postmenopausal PCOS women suggest that DHEAS and total T are partially of adrenal origin. Although the ovarian contribution was not fully assessed, increased Δ4A production suggests that the ovary also contributes to hyperandrogenism in postmenopausal PCOS women. In conclusion, postmenopausal PCOS women are exposed to higher adrenal and ovarian androgen levels than non-PCOS women. Copyright © 2011 by The Endocrine Society.
Chatzicharalampous C, Rizos D, Pliatsika P, Leonardou A, Hasiakos D, Zervas I, Alexandrou A, Creatsa M, Konidaris S, Lambrinoudaki I. Reproductive hormones and postpartum mood disturbances in Greek women. Gynecological Endocrinology. 2011;27(8):543 - 550.Abstract
Aim.?Postpartum mood disturbances are common among Greek women, with postpartum depression (PPD) being as high as 19%. This study aimed to investigate whether sex steroid hormone levels affect the incidence of postpartum mood disturbances. Materials and methods.?Fifty-seven women were evaluated for postpartum mood disturbances using the Postpartum Blues Questionnaire and the Edinburgh Postnatal Depression Scale on the 1st and 6th week. Serum estradiol, progesterone and testosterone concentrations were measured upon admission for delivery and daily until the fourth postpartum day. We then studied the association between hormone levels and the scores in the two psychometric scales. Results.?Testosterone was the only hormone that was marginally associated with psychometric scoring in simple regression analysis. (Postpartum Blues during days 14: b = 4.291, 95% C.I. -0.796 to 9.377 and p-value = 0.096). Women with lower testosterone drops had higher scores in Postpartum Blues Questionnaire. This association, however, lost statistical significance in the multivariable analysis after adjusting for pregnancy duration. In multiple regression analysis, only pregnancy duration had the most constant adverse effect on psychometric scores: The shorter the duration of pregnancy, the higher the scores for Postpartum Blues. (r = -0.39, p < 0.01). Conclusions.?Our findings do not indicate an association between the occurrence of postpartum mood disorders and sex steroid hormone levels. Preterm labour may be associated with a higher risk of postpartum mood disturbances. © 2010 Informa UK Ltd.
Vitoratos N, Lambrinoudaki I, Rizos D, Armeni E, Alexandrou A, Creatsas G. Maternal circulating osteoprotegerin and soluble RANKL in pre-eclamptic women. European Journal of Obstetrics Gynecology and Reproductive Biology. 2011;154(2):141 - 145.Abstract
Objective: To evaluate alterations in the concentrations of osteoprotegerin (OPG), RANKL and the OPG/RANKL ratio in pre-eclamptic women during the puerperium. Study design: This cross-sectional study was performed in the maternity ward of Aretaieio Hospital in Athens, Greece. Fifteen pregnant women with severe pre-eclampsia and 15 matched controls with premature rupture of the membranes were recruited. Fasting blood samples were obtained antepartum, immediately after diagnosing pre-eclampsia (median: 32nd gestational week), and during the 3rd-6th day postpartum, to estimate levels of circulating OPG and RANKL as well as the OPG/RANKL ratio. The anthropometric parameters evaluated included body mass index and blood pressure. Results: Mean circulating OPG levels decreased significantly in both groups in the postpartum period (controls: 43.7 ± 19.1 ng/ml vs 22.9 ± 9.1 ng/ml, p = 0.008; pre-eclamptic group: 72.3 ± 49.9 vs 49.7 ± 40.9 ng/ml, p = 0.002). The antepartum OPG/RANKL ratio was elevated in hypertensive pregnancies (2.41 ± 1.72) compared to normotensive pregnancies (1.45 ± 0.63), but the difference did not reach statistical significance (p = 0.1). The OPG/RANKL ratio decreased in the control group (0.76 ± 0.30, NS) following delivery, while it remained unchanged in the pre-eclamptic women (1.63 ± 1.40, p = 0.13). Consequently, the postpartum OPG/RANKL ratio was significantly higher in the pre-eclamptic women compared to control women (1.63 ± 1.40 vs 0.76 ± 0.30, p = 0.01). Levels of RANKL demonstrated no significant alterations during puerperium in both cases. Conclusion: Pregnancies complicated with pre-eclampsia exhibit higher OPG levels and OPG/RANKL ratios, compared to control pregnancies, which might be compatible with lower bone turnover. The significance of this finding with respect to bone metabolism remains to be elucidated in larger studies. © 2010 Elsevier Ireland Ltd.
Rizos D, Karababa P, Sarandakou A, Panagiotakis O, Haliassos A, Makris K, Psarra K, Bairaktari E, Spyropoulou P, Nikolou C, et al. The organization of an educational program for specialists in Clinical Chemistry by the Greek Society of Clinical Chemistry-Clinical Biochemistry. Biochemia Medica. 2011;21(1):30 - 37.Abstract
In Greece, there is no officially organized training in clinical chemistry for scientists. The Greek Society of Clinical Chemistry-Clinical Biochemistry decided to organize an intensive educational program of 18 seminars on clinical chemistry content as it is described in the EC4 Syllabus. The duration of each seminar was about 6 hours and consisted of 6 to 9 lectures. At the end of each seminar there was a voluntary written examination, comprised of 24 multiple choice questions. Successful completion of the Educational program was leading to a Certificate of Competence. Two cycles of the 18 seminars were performed: 1st cycle from October 2003 to December 2005 and 2nd cycle from March 2005 to October 2007. One hundred eighty nine colleagues was the mean attendance per seminar for the seminars of the 1st cycle and 38 colleagues for the seminars of the 2nd cycle. The mean participation to the examination for each seminar was almost 80% for the 1st cycle and 68% for the 2nd cycle. More than 80% of the participants performed Good or Very good in the examination in both cycles. It is estimated that more than 40% of the scientists who practice Clinical Chemistry in Greece, participated to this educational activity. This program is now provided as an e-learning application, and it is open for all scientists who want to follow the discipline of clinical chemistry.
Lambrinoudaki I, Armeni E, Rizos D, Deligeoroglou E, Kofinakos P, Kaparos G, Alexandrou A, Creatsa M, Logothetis E, Kouskouni E. Sex hormones in postmenopausal women receiving low-dose hormone therapy: The effect of BMI. Obesity. 2011;19(5):988 - 993.Abstract
The aim of our study was to evaluate the effect of BMI on the change in circulating sex hormone in postmenopausal women during 6 months of oral continuous combined low-dose hormone therapy (HT). Fifty postmenopausal women were allocated to receive daily one tablet containing combination of 17Β-estradiol (1mg)/norethindrone acetate (0.5mg) for 6 months. Serum levels of follicle-stimulating hormone (FSH), estradiol, total testosterone, sex hormone-binding globulin (SHBG), free androgen index (FAI), free estrogen index (FEI), Δ4-androstendione (Δ4A), and dehydroepiandrosterone sulfate were assessed at baseline and at the end of 6 months. Mean absolute values and percent changes from baseline were compared between lean and overweight women. Mean FSH decreased and mean 17Β-estradiol increased significantly in both groups (FSH lean: 82.3 26.7 decreased to 45.0±17.0mIU/ml, P = 0.0001; FSH overweight: 85.5±22.1 decreased to 52.3±23.8mIU/ml, P = 0.003; P between groups = 0.661; E2 lean: 23.24±12.55 increased to 53.62±28.29pg/ml, P = 0.006; E2 overweight: 24.17±10.88 increased to 68.36± 53.99pg/ml, P = 0.0001; P between groups = 0.619). Lean individuals had statistically significant higher increments of FAI and specifically FEI compared to overweight (FEI lean; 0.14±0.09 increased to 0.29±0.14, P = 0.009; overweight 0.23±0.18 increased to 0.52±0.40, P = 0.126; P between groups = 0.034). Although BMI does not affect total 17Β-estradiol changes, free sex steroid concentrations increase more steeply in lean compared to overweight women receiving oral low-dose HT. © 2011 The Obesity Society.
Kontos M, Roy P, Rizos D, Hamed H. An evidence based strategy for follow up after breast conserving treatment for breast cancer. Journal of Surgical Oncology. 2011;104(3):223 - 227.Abstract
Background and Objectives Follow up for breast cancer patients aims at the timely detection of loco-regional recurrences and contralateral breast cancers (LRR). This study investigates the annual risk of LRR after breast conserving treatment (BCT) and the potential value of mammographic surveillance and/or routine clinical examination. Methods Data on 650 women who underwent BCT were obtained and LRR was divided into parenchymal and non-parenchymal. LRR-free and cumulative LRR-free rates were calculated. In patients where recurrence was diagnosed at a routine clinic visit and had negative mammography ("clinical detection only" group) were also separately examined. Results Median follow up was 115 months, range 9-196. Seventy-three patients had parenchymal and 16 nodal recurrence. The median probability of LRR was 1.4% and of parenchymal LRR was 1.32% per year, remaining constant for up to 168 months. The 16 patients in the "clinical detection only" group relapsed mainly during the first 2 years (annual risk 0.77% and 0.80%, respectively). Conclusions This study shows that the risk of parenchymal LRR remains constant for at least 14 years and is significant enough to warrant routine long-term follow up mammography. Routine clinical examination contributes significantly to the detection of LRR only for the first 2 years. © 2011 Wiley-Liss, Inc.