Papers by Michalis Leotsinidis
PNEUMON, 2011
... 13 Η προσωπική συμβουλή μπορεί να παρέχεται με διάφορους τρόπους: Μέσω video, 14 ... Όμως δεν... more ... 13 Η προσωπική συμβουλή μπορεί να παρέχεται με διάφορους τρόπους: Μέσω video, 14 ... Όμως δεν θεωρούνται όλα τα προγράμματα διακοπής καπνίσματος του διαδικτύου αξιόπιστα εύχρηστα και ... από τη μετά- ανάλυση των Μelvin και συνεργατών η συμβουλευτική έχει βασιστεί ...
Neuroepidemiology, 2008
Background: The frequency of multiple sclerosis (MS) in Greece remains speculative, as data from ... more Background: The frequency of multiple sclerosis (MS) in Greece remains speculative, as data from many parts are still lacking. Objective: To estimate trends in MS prevalence and annual incidence in western Greece from January 1, 1984 to December 31, 2006. Methods: Patients were identified from the patient records of the Department of Neurology at Patras University Hospital in Rion-Patras. Only patients with a definite MS diagnosis according to Poser’s criteria and retrospective application of the McDonald’s criteria were included. We calculated age- and sex-specific prevalence rates for patients living in the study area on December 31, 2006. Annual incidence rates were calculated for the period 1984–2006. Results: The crude prevalence rate of definite MS cases increased significantly in 23 years from 10.1/100,000 recorded in northeastern Greece in 1984 to 119.61/100,000 on December 31, 2006 in western Greece for the 780 cases still alive. The mean annual incidence rate increased from 2.71/100,000 recorded during the period 1984–1989 to 10.73/100,000 in the 5-year period of 2002–2006. Conclusion: The prevalence rates were higher than expected, but closer than in previous surveys conducted in Greece to those reported recently in Sicily and Istanbul. These findings place the area in the high-risk zone.
Aim: Hypoxia has a key role in cancer progression and metastasis. Low tissue oxygen availability ... more Aim: Hypoxia has a key role in cancer progression and metastasis. Low tissue oxygen availability induces the activity of HIFs (Hypoxia-Inducible Factors) to up-regulate a panel of invasion related genes, in a plethora of solid tumors. MMPs (matrix metalloproteinases) are enzymes produced from normal and cancerous cells with the ability to degrade extracellular stroma, priming invasion. The aim of this study was to identify possible gene and protein associations between HIF-1α and MMP-9 in invasive breast cancer. A total of 96 FFPE (Formalin-Fixed Paraffin-Embedded) breast cancer samples were evaluated for HIF-1α and MMP-9 protein expression. Publicly available gene expression datasets for breast cancer were analyzed for HIF-1a and MMP-9 gene expression. Results were correlated with clinicopathological parameters and patient clinical outcome. Results: MMP-9 and HIF-1α showed a positive correlation both at the mRNA (p<0.001) and protein (p=0.01) expression levels, in samples from breast cancer patients. This correlation was specific because HIF-2b, another member of the HIF family, presented with a negative correlation with MMP-9 gene expression. Furthermore, mRNA and protein expression of MMP-9 had a negative correlation (p<0.01) with relapse-free survival (RFS) and a positive correlation (p<0.01) with lymph node status (N1), respectively. In addition, patients with high mRNA expression of HIF-1α had significantly (p<0.001) shorter OS and RFS than did patients with low levels of HIF-1a.
Nutrition Journal, Feb 5, 2009
Background: The use of food frequency questionnaires (FFQs) has become increasingly important in ... more Background: The use of food frequency questionnaires (FFQs) has become increasingly important in epidemiologic studies. During the past few decades, a wide variety of nutritional studies have used the semiquantitative FFQ as a tool for assessing and evaluating dietary intake. One of the main concerns in a dietary analysis is the validity of the collected dietary data. Methods: This paper discusses several methodological and statistical issues related to the validation of a semiquantitative FFQ. This questionnaire was used to assess the nutritional habits of schoolchildren in western Greece. For validation purposes, we selected 200 schoolchildren and contacted their respective parents. We evaluated the relative validity of 400 FFQs (200 children's FFQs and 200 parents' FFQs). Results: The correlations between the children's and the parents' questionnaire responses showed that the questionnaire we designed was appropriate for fulfilling the purposes of our study and in ranking subjects according to food group intake. Conclusion: Our study shows that the semiquantitative FFQ provides a reasonably reliable measure of dietary intake and corroborates the relative validity of our questionnaire.
Cureus, May 29, 2023
Background Olive gathering involves tree climbing, carrying heavy loads, navigating rough terrain... more Background Olive gathering involves tree climbing, carrying heavy loads, navigating rough terrain, and using sharp tools. However, little is known about occupational injuries among olive workers. The aim of this study is to evaluate the prevalence and risk factors of occupational injuries among olive workers in a rural Greek area and to assess the financial burden on the health system and insurance funds. Methods A questionnaire was administered to 166 olive workers in the Aigialeia municipality in the Achaia region, Greece. The questionnaire contained detailed information on demographic characteristics, medical history, working environment, protective measures, gathering tools, and type and site of injuries. Moreover, data were recorded about the duration of hospitalization, medical examinations and treatment received, sick leaves, complications, and rate of re-injury. Direct economic costs were calculated for hospitalized and nonhospitalized patients. The associations between olive workers' characteristics, risk factors, and occupational injury within the last year were examined using log-binomial regression models. Results In total, 85 injuries were recorded in 50 workers. The prevalence of one or more injuries in the last year was 30.1%. Factors associated with a higher rate of injury were male gender, age > 50 years, working experience > 24 years, history of arterial hypertension and diabetes mellitus, climbing habits, and non-use of protective gloves. The average cost of agricultural injuries was more than 1400 € per injury. The cost seems to be associated with the severity of the injury, as injuries requiring hospitalization were associated with increased costs, higher cost of medication, as well as more days of sick leave. Losses due to sick leave cause the greatest financial costs. Conclusions Farm-related injuries are quite usual among olive workers in Greece. Injury risk is influenced by gender, age, working experience, medical history, climbing habits, and use of protective gloves. Days off work have the greatest financial cost. These findings can be useful as a starting point to train olive workers to reduce the incidence of farm-related injuries in Greece. Knowledge of risk factors for farm-related injuries and diseases could help the development of proper interventions to minimize the problem.
Water Research, May 1, 2007
The quality of harvested rainwater which is used for domestic and drinking purposes in the northe... more The quality of harvested rainwater which is used for domestic and drinking purposes in the northern area of Kefalonia Island in SW Greece and the factors affecting it were assessed through 3-year surveillance. In 12 seasonal samplings, 156 rainwater and 144 ground-or mixed water samples were collected from ferroconcrete storage tanks (300-1000 m 3 capacity), which are adjacent to cement-paved catchment areas (600-3000 m 2). Common anions and major cations as well as the metals Fe, Mn, Cd, Pb, Cu, Cr, Ni and Zn were tested. The presence of three major groups of organic compounds, polycyclic aromatic hydrocarbons (PAHs), organochloride pesticides (OCPs) and volatile organic compounds (VOCs), was screened by common analytical techniques. All of the rainwater samples were within the guidelines for chemical parameters established by the 98/93/EU directive. As far as microbiological quality is concerned, total coliforms, Escherichia coli and enterococci were detected in 80.3%, 40.9% and 28.8% of the rainwater samples, respectively, although they were found in low concentrations. Chemical and microbiological parameters showed seasonal fluctuations. Principal component analysis revealed that microbiological parameters were affected mainly by the cleanness level of catchment areas, while chemical parameters were influenced by the sea proximity and human activities. Disinfection should be applied into the tanker trucks which distribute the water to the consumers and not into the big storage tanks in order to avoid by-products formation. Due to the lack of fluoride in rainwater samples, the consumers must become aware of the fact that the supplementation of this element is needed.
BMC Primary Care, Mar 4, 2023
Background The disability burden of common mental health disorders is enormous and should be face... more Background The disability burden of common mental health disorders is enormous and should be faced at the first point of contact in the healthcare system. General Practitioners (GPs) are called to recognize, diagnose, and manage patients with mental health disorders, a task which is not always addressed successfully. The study aims at examining the relationship between mental health education of GPs and self-reported opinions on the care they provide to patients with mental disorders in Greece. Methods A questionnaire investigating GPs' viewpoints regarding diagnostic methods, referral rates and overall management of patients with mental disorders, and how these are impacted by their education on mental health, was employed, in a randomly selected sample of 353 GPs in Greece. Suggestions and proposals about improvement of ongoing mental health training, along with organizational reforming were also recorded. Results Received Continuing Medical Education (CME) is characterized as insufficient by 56.1% of the GPs. More than half of the GPs participate in clinical tutorials and mental health conferences once per three years or less. The level of educational score on mental health is associated positively with decisiveness on management of patients and increases self-confidence. A percentage of 77.6% states knowledge of the appropriate treatment and 56.1% agree to initiate treatment without referring to a specialist. However, low to moderate self-confidence about diagnosis and treatment is stated by 47.5%. According to GPs, critical points for improving mental health primary care are the liaison psychiatry and high degree of CME. Conclusion Greek GPs are calling for focused and continuing medical education, in the field of psychiatry, along with essential structural and organizational reforming of the healthcare system, including an efficient liaison psychiatry.
European Psychiatry, 2021
IntroductionThe coronavirus pandemic has challenged the world with an unprecedented situation. So... more IntroductionThe coronavirus pandemic has challenged the world with an unprecedented situation. Social distancing, self or quarantine isolation, personal hand hygiene, self-protection, and the fear of becoming infected with the virus, come with a psychological fallout. The COVID-19 pandemic has affected students around the world, in terms of their education and lifestyle.ObjectivesTo investigate the impact of COVID-19 pandemic on the students’ mental health and well-being at the University of Patras, in Western Greece.MethodsAn online questionnaire was prepared to collect responses from students during April 2020. Socio-demographic data, academic status, opinions about distance learning, changes in daily routine during the lockdown and anxiety and depression scores, according to the Greek version of the Hospital Anxiety and Depression Scale (HADS), were gathered.ResultsThe total number of responders was 2009, of which 67.3% women. During lockdown, the 68% of the students returned to ...
Aquatic Toxicology, 2017
Mussel exposure to Cu or Hg increases 8OHG in rRNA more strongly than 8OHdG in DNA Oxidative ... more Mussel exposure to Cu or Hg increases 8OHG in rRNA more strongly than 8OHdG in DNA Oxidative damages in 5S rRNA appear both in paired regions and loops A, B, C, and E Among the affected regions in 18S rRNA, some are implicated in principal functions Cd induces rRNA oxidative lesions at 5 days, which are abated by day 15 Numerous studies have shown the ability of trace metals to accumulate in marine organisms and to cause oxidative stress that leads to perturbations in many important intracellular processes, including protein synthesis. This study is mainly focused on the exploration of structural changes, like base modifications, scissions, and conformational changes, caused in 18S and 5S ribosomal RNA (rRNA) isolated from the mussel Mytilus galloprovincialis exposed to 40 μg/L Cu, 30 μg/L Hg, or 100 μg/L Cd, for 5 or 15 days. 18S rRNA and 5S rRNA are components of the small and large ribosomal subunit, respectively, found in complex with ribosomal proteins, translation factors and other auxiliary components (metal ions, toxins etc). 18S rRNA plays crucial roles in all stages of protein synthesis, while 5S rRNA serves as a master signal transducer between several functional regions of 28S rRNA. Therefore, structural changes in these ribosomal constituents could affect the basic functions of ribosomes and hence the normal metabolism of cells. Especially, 18S rRNA along with ribosomal proteins forms the decoding centre that ensures the correct codon-anticodon pairing. As exemplified by ELISA, primer extension analysis and DMS footprinting analysis, each metal caused oxidative damage to rRNA, depending on the nature of metal ion and the duration of exposure. Interestingly, exposure of mussels to Cu or Hg caused structural alterations in 5S rRNA, localized in paired regions and within loops A, B, C, and E, leading to a continuous progressive loss of the 5S RNA structural integrity. In contrast, structural impairments of 5S rRNA in mussels exposed to Cd were accumulating for the initial 5 days, and then progressively decreased to almost the normal level by day 15, probably due to the parallel elevation of metallothionein content that depletes the pools of free Cd. Regions of interest in 18S rRNA, such as the decoding centre, sites implicated in the binding of tRNAs (A-and P-sites) or translation factors, and areas related tο translation fidelity, were found to undergo significant metal-induced conformational alterations, leading either to loosening of their structure or to more compact folding. These modifications were associated with parallel alterations in the translation process at multiple levels, a fact suggesting that structural perturbations in ribosomes, caused by metals, pose significant hurdles in translational efficiency and fidelity.
Journal of Geriatric Oncology, 2014
Vulnerability assessment of geriatric patients with cancer may contribute to improved anti-cancer... more Vulnerability assessment of geriatric patients with cancer may contribute to improved anti-cancer treatment with maximal results and minimal side effects. The aim of the present study was to evaluate whether the Vulnerable Elders Survey-13 (VES-13) score is associated with completion of radiotherapy among elderly patients with cancer. Materials and Methods: This was a prospective observational study that included patients greater than age 75 with histologically confirmed cancer disease, referred to the Department of Radiation Oncology to receive radical or palliative radiotherapy, from 2010 to 2012. VES-13 forms were filled in before the initiation of radiotherapy and scores were assigned according to a standardized scoring procedure. Results: Of a total of 230 participants (median age 78.5 years), 41 (17.8%) did not complete radiotherapy. These patients had higher VES-13 scores (median with interquartile range: 5 [2-8.5]) compared to those who completed the treatment (3 [1-7]; P = 0.008). A VES-13 score >3 was associated with 2.14 times higher probability of not completing radiotherapy, whereas in patients with scores >7 this probability was 3.34 times higher. The association between higher VES-13 scores and non-completion of radiotherapy was independent of other factors, such as age, sex, comorbidities, type of radiotherapy, and presence of side effects. Conclusion: Patients with higher VES-13 scores had increased probability of not completing radiotherapy in our study, and this effect was independent of other factors that might affect radiotherapy completion.
Clinical & Experimental Metastasis, 2007
To investigate the association between the clinical status of patients with metastatic bone disea... more To investigate the association between the clinical status of patients with metastatic bone disease and the type of bone metastases. 80 patients with skeletal metastases underwent both clinical and radiological assessments. Bone lesions were evaluated with computed tomography (CT), and patients were separated into three groups: lytic, mixed, sclerotic. Bone density of each lesion was measured in Hounsfield units (HU). Patients with osteolytic lesions had the highest mean pain score with 8.1 +/- 2.2 points, the least mean scores for quality of life (QoL) and performance status (PS) with 31.4 +/- 14.6 and 58.6 +/- 9.7 points respectively, the highest percentage and mean opioid consumption (100% and 220.9 mg of oral daily morphine equivalent respectively), and the least mean bone density (116.3 +/- 40.4 HU). On the contrary, the group with sclerotic metastases had the least mean pain score with 4.6 +/- 1.3 points, the highest mean scores of QoL and PS (61.1 +/- 15.5 and 66.6 +/- 10 points respectively), the least percentage and mean opioid requirement (55.5% and 170.6 mg respectively), and the highest mean bone density (444 +/- 86.6 HU). The differences between the three groups were statistically significant for all parameters evaluated, apart from performance status between the sclerotic and mixed groups. The correlation coefficients were statistically significant between all parameters investigated. Bone density had a strong negative correlation with pain. Our results show a clear correlation between the type of bone metastases and the clinical status of patients. Patients with excessive bone resorption suffer the most, and may be given priority in treatment. CT proved to be a practical and efficient method to investigate and classify metastatic bone lesions.
Curēus, May 21, 2024
This study investigates the overall survival (OS) of elderly patients who underwent total larynge... more This study investigates the overall survival (OS) of elderly patients who underwent total laryngectomy for laryngeal cancer (LC) and examines the impact of tumor-node-metastasis (TNM) staging on survival rates. A retrospective cohort study utilized data from the Otorhinolaryngology Clinic at the University Hospital of Patras, including 75 elderly patients (>65 years) who underwent total laryngectomy for LC between 2000 and 2015. Survival analysis was performed using the Kaplan-Meier estimator, with comparisons made using the Log-rank test. Statistical significance was defined as the p-value being less than or equal to 0.05. Over the 16-year period, new LC cases were predominantly male (97.3%) with a mean age of 73.88 years (range: 65-89 years). Most patients were smokers (96%) and alcohol users (54.7%). Histologically, 18.7% of tumors were classified as poorly differentiated, 65.3% as moderately differentiated and 16% as well differentiated. Post-surgical TNM staging indicated 10.7% stage II, 37.3% stage III and 52% stage IV, primarily located in the glottis (62.7%) and followed by supraglottis (34.7%). All patients underwent total laryngectomy, with 69.3% and 37.3% receiving neck dissection and adjuvant therapy (chemotherapy or radiotherapy), respectively. During follow-up, 39 patients died, with 74.3% due to disease-related causes. Five-year OS rates were 44.6%, with variations by stage (stage II: 62.5%, stage III: 55.8%, stage IV: 32.4%; p=0.039) and age (65-75 years: 51.7%, >75 years: 34.7%; p=0.039). TNM staging of the laryngeal cancer significantly influences the overall survival of elderly patients undergoing total laryngectomy for LC. Early diagnosis of the disease is crucial for patient survival.
Analytical chemistry insights, May 1, 2014
A rapid, simple, and specific method based on ultra performance liquid chromatography (UPLC) with... more A rapid, simple, and specific method based on ultra performance liquid chromatography (UPLC) with mass spectrometry detection has been developed for quantitative analysis of ofloxacin in human aqueous humor using tobramycin as internal standard (IS). Chromatographic separation was achieved on a Waters Acquity UPLC BEH C18 Shield column (150 × 2.1 mm, 1.7 μm) eluted with 95:5 water: acetonitrile (v/v) containing 0.1% formic acid and a flow rate of 0.3 mL/minute. The total analysis time was three minutes with ofloxacin eluting at 1.67 ± 0.03 minutes. The linearity of the method ranged from 0.1 to 8 μg/mL with r 2 = 0.998. The method was validated according to FDA guidelines with respect to linearity, accuracy, precision, specificity, and stability. The limits of detection and quantification were 0.03 and 0.10 μg/mL, respectively. The developed method was successfully applied to the analysis of samples that have been obtained from patients.
ISEE Conference Abstracts
Journal of Trace Elements in Medicine and Biology, 2017
An epidemiological cross-sectional study was conducted in a Greek population, being orally expose... more An epidemiological cross-sectional study was conducted in a Greek population, being orally exposed to Ni via food consumption, in order to investigate possible health effects and to evaluate hair Ni concentration as a biomarker of exposure. The study population consisted of 139 men and 155 women, aged 25-69. Socio-demographics, lifestyle, dietary habits, occupational and medical history data were recorded through a personal interview. Hematological and biochemical examinations were conducted in blood specimens. Metals-Ni, Cr, Cd, Pb, Hg, Cu and Zn-were determined in hair samples. Women were characterized by higher Ni and Cu hair concentrations, while men by higher Cr and Hg. Factors affecting hair metal concentrations were identified to be dietary habits, consumption of local crops, occupation and smoking. Hair element content in the study population was comparable to the "reference ranges" reported in Europe, except for Ni, found higher in a fraction of our population. Men in the upper quartile of hair Ni distribution are at higher risk for abnormal high cholesterol, LDL, albumin and calcium, with odds ratios (OR) varying between 3.5 and 6.2. Accordingly, high hair Ni content in women is associated with abnormal glucose (OR = 3.9), triglycerides (OR = 3.1) and low abnormal sodium (OR = 4.3). The study provides evidence of the suitability of hair analysis in assessing environmental exposure to Ni and supports the use of hair Ni content as a valuable and relatively inexpensive tool of biomonitoring, to identify people at risk for certain biochemical alterations.
Acta Neurologica Scandinavica, 2010
OBJECTIVES - We report the prevalence and incidence rates of multiple sclerosis (MS) in Oppland C... more OBJECTIVES - We report the prevalence and incidence rates of multiple sclerosis (MS) in Oppland County, Norway. METHODS - Records from all patients diagnosed with MS at the two Oppland County hospitals, Gjøvik and Lillehammer during 1989-2001 were evaluated. In addition, all general practitioners in Oppland County reported their patients into the study. RESULTS - The age-adjusted prevalence rate of definite MS was 174.4/ 100 000 on the prevalence day 1 January 2002. When the probable cases were included, the prevalence rate rose to 185.6/100 000. The highest prevalence rates were detected in the northern mountain areas, thus corroborating the results from previous local surveys 30-50 years ago. The prevalence of MS was statistically significantly associated with climatic, socioeconomic and geographic variables in the county. The age-adjusted incidence of definite and probable MS in Oppland County was 6.6/100 000 during 1989-1993 increasing to 7.6/100 000 during 1994-1998. DISCUSSION - We found the highest prevalence rates of MS ever reported in Norway. Our findings indicate a possible influence of environmental factors.
European Journal of Clinical Nutrition, 2001
Objective: To assess the relative validity of a semi-quantitative food frequency questionnaire (S... more Objective: To assess the relative validity of a semi-quantitative food frequency questionnaire (SQFFQ) against 28 day weighed diet records (WDRs). Subjects and methods: The SQFFQ was administered to 106 (21 male and 85 female) Japanese dietitians in Aichi Prefecture in autumn, 1996 and four-season consecutive 7 day WDRs were carried out during 1996-1997. We evaluated validity of intakes of 15 foods and 31 macro-and micro-nutrients based on the SQFFQ against those according to 28 day WDRs among 79 Japanese female dietitians. Results: Mean daily intakes of selected foods and nutrients determined by the SQFFQ were generally equivalent to those measured by 28 day WDRs. Pearson's de-attenuated correlation coefficients (CCs) with log-transformation and energy-adjustment between intakes of selected foods and nutrients quantified by the SQFFQ and 28 day WDRs (minimum-median-maximum) ranged from 0.17 (beverages)-0.52 to 0.74 (rice), and Spearman's rank CCs with energy-adjustment ranged from 0.28 (confectionery)-0.42 to 0.68 (rice). Respective Pearson's CCs for intakes of nutrients were 0.28 (PUFAs)-0.51 to 0.73 (magnesium), and Spearman's rank CCs ranged from 0.23 (n-3 PUFAs)-0.45 to 0.71 (magnesium). Favorably higher agreement for intakes of foods=nutrients was achieved along with lower disagreement. Conclusions: Satisfactorily higher relative validity was attained in Japanese female dietitians with the SQFFQ. This calibrated questionnaire seems therefore appropriate for administration to Japanese dietitians to clarify associations between diet and health=disease.
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Papers by Michalis Leotsinidis