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Exercise Intolerance and Excessive Chronotropic Response Due to Possible Autonomic Dysfunction Post COVID-19 Infection

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International Journal of Clinical Medicine 2023年第12期14卷 540-551页

作者： Stefanos Archontakis Dimitrios Venetsanos Nikias Milaras eirini beneki Panagiotis Dourvas Epameinondas Triantafyllou Konstantinos Sideris Konstantina Aggeli Petros Arsenos Athanasios Kordalis Konstantinos Gatzoulis Skevos Sideris Department of Cardiology Hippokration General Hospital Athens Greece First Cardiology Division Hippokration General Hospital Medical School University of Athens Athens Greece

Introduction and Objectives: In patients with Post-Acute Sequelae of Coronavirus 2 infection (PASC), a post infectious autonomic dysfunction may be one of the underlying mechanisms. Patients often present with exercise intolerance and exaggerated heart rate response to exercise. We report a single centre experience of patients with PACS and suspected autonomic dysfunction. Methods: Forty-two patients evaluated in the Outpatient Cardiology Department with suspected PASC were included in the study. Patients complained of compromised exercise performance persisting >3 months after recovery from COVID-19 infection, compared to the pre-COVID-19 period. The patients were evaluated with 12-lead electrocardiogram, echocardiography, 24-hour ECG ambulatory monitoring and either exercise stress test or a 6-minute walk test. Results: All 42 patients demonstrated an exaggerated chronotropic response, defined as the inappropriate increase in heart rate before the 6th minute of exercise >100% of the age-predicted maximal heart rate value with reproduction of clinical symptoms. In addition, 24-hour ambulatory electrocardiography revealed an increased mean heart rate of 92 beats/minute and decreased mean standard deviation of sequential 5-minute N-N interval (SDNN) of 74.4 ms. Pharmaceutical treatment with b-blockers, ivabradine or both was administrated in 29 (69%) resulting in symptomatic improvement in 82.8% of those under treatment. However, residual symptoms persisted in 69% of patients after 3 months. Conclusions: In patients with “Post-acute COVID-19” syndrome, we found an excessive chronotropic response to exercise suggesting autonomic dysfunction as the underlying mechanism of symptoms. Treatment with beta blockers or ivabradine resulted in clinical improvement but a substantial proportion of patients remained symptomatic.

关键词： COVID-19 Autonomic Neuropathy Exertional Intolerance Exaggerated Chronotropic Response POTS Dysautonomia

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Current remarks and future directions on the interactions between metabolic dysfunction-associated fatty liver disease and COVID-19

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World Journal of Gastroenterology 2024年第11期30卷 1480-1487页

作者： Leonidas Brilakis eirini Theofilogiannakou Panagis M Lykoudis School of Medicine National&Kapodistrian University of AthensAthens 11527Greece Division of Surgery&Interventional Science University College LondonLondon WC1E 6BTUnited Kingdom

During the outbreak of the coronavirus disease 2019(COVID-19)pandemic,particular interest rose regarding the interaction between metabolic dysfunctionassociated fatty liver disease(MAFLD)and the COVID-19 *** studies highlighted the fact that individuals with MAFLD had higher probability of severe acute respiratory syndrome coronavirus 2 infection and more severe adverse clinical *** of the proposed mechanisms is the inflammatory response pathway,especially the one involving cytokines,such as interleukin 6,which appeared particularly elevated in those patients and was deemed responsible for additional insult to the already damaged *** should increase our vigilance in terms of early detection,close follow up and early treatment for individuals with MAFLD and COVID-19 *** the direction of early diagnosis,biomarkers such as cytokeratin-18 and scoring systems such as Fibrosis-4 index score are ***-19 is a newly described entity,expected to be of concern for the years to come,and MAFLD is a condition with an ever-increasing *** the interaction between these two entities should be brought into the focus of *** morbidity and mortality of patients with COVID-19 and MAFLD should be the ultimate objective,and the optimal way to achieve this is by designing evidence-based prevention and treatment policies.

关键词： Metabolic dysfunction-associated fatty liver disease COVID-19 Liver fibrosis Cytokine storm Drug induced liver injury

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Probiotics: Shaping the gut immunological responses

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World Journal of Gastroenterology 2024年第15期30卷 2096-2108页

作者： eirini Filidou Leonidas Kandilogiannakis Anne Shrewsbury George Kolios Katerina Kotzampassi Faculty of Medicine Laboratory of PharmacologyDemocritus University of ThraceAlexandroupolis 68100Greece Department of Surgery Aristotle University of ThessalonikiThessaloniki 54636Greece

Probiotics are live microorganisms exerting beneficial effects on the host’s health when administered in adequate *** the most popular and adequately studied probiotics are bacteria from the families Lactobacillaceae,Bifidobacteriaceae and *** of them have been shown,both in vitro and in vivo studies of intestinal inflammation models,to provide favorable results by means of improving the gut microbiota composition,promoting the wound healing process and shaping the immunological *** intestinal conditions,such as inflammatory bowel diseases(IBD),are characterized by an imbalance in microbiota composition,with decreased diversity,and by relapsing and persisting inflammation,which may lead to mucosal *** the results of the clinical studies investigating the effect of probiotics on patients with IBD are still controversial,it is without doubt that these microorganisms and their metabolites,now named postbiotics,have a positive influence on both the host’s microbiota and the immune system,and ultimately alter the topical tissue *** influence is achieved through three axes:(1)By dis-placement of potential pathogens via competitive exclusion;(2)by offering protection to the host through the secretion of various defensive mediators;and(3)by supplying the host with essential *** will analyze and discuss almost all the in vitro and in vivo studies of the past 2 years dealing with the possible favorable effects of certain probiotic genus on gut immunological responses,highlighting which species are the most beneficial against intestinal inflammation.

关键词： Probiotics Lactobacillaceae Bifidobacteriaceae Saccharomyces Intestinal inflammation Immune responses

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A Dimensional Reduction Approach Based on Essential Constraints in Linear Programming

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American Journal of Operations Research 2024年第1期14卷 1-31页

作者： eirini I. Nikolopoulou George S. Androulakis Department of Mathematics University of Patras Patras Greece Department of Business Administration University of Patras Patras Greece

This paper presents a new dimension reduction strategy for medium and large-scale linear programming problems. The proposed method uses a subset of the original constraints and combines two algorithms: the weighted average and the cosine simplex algorithm. The first approach identifies binding constraints by using the weighted average of each constraint, whereas the second algorithm is based on the cosine similarity between the vector of the objective function and the constraints. These two approaches are complementary, and when used together, they locate the essential subset of initial constraints required for solving medium and large-scale linear programming problems. After reducing the dimension of the linear programming problem using the subset of the essential constraints, the solution method can be chosen from any suitable method for linear programming. The proposed approach was applied to a set of well-known benchmarks as well as more than 2000 random medium and large-scale linear programming problems. The results are promising, indicating that the new approach contributes to the reduction of both the size of the problems and the total number of iterations required. A tree-based classification model also confirmed the need for combining the two approaches. A detailed numerical example, the general numerical results, and the statistical analysis for the decision tree procedure are presented.

关键词： Linear Programming Binding Constraints Dimension Reduction Cosine Similarity Decision Analysis Decision Trees

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Translation and cross-cultural adaptation of the Kidney Transplant Questionnaire 25 to Greek

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World Journal of Transplantation 2024年第2期14卷 148-154页

作者： Vasileios Koutlas eirini Tzalavra Vasileios Tatsis Charalampos Pappas Stavroula Vovlianou Stefanos Bellos Anila Duni Eleni Stamellou Konstantinos I Tsamis Michail Mitsis Evangelia Dounousi Department of Surgery and Kidney Transplant Unit University Hospital of IoanninaIoannina 45500EpirusGreece Department of Surgery Faculty of MedicineSchool of Health SciencesUniversity of IoanninaIoannina 45110EpirusGreece Department of Nephrology University Hospital of IoanninaIoannina 45500EpirusGreece Department of Nephrology General Hospital of KavalaKavala 65500Greece Department of Physiology Faculty of MedicineSchool of Health SciencesUniversity of IoanninaIoannina 45110EpirusGreece Department of Nephrology Faculty of MedicineSchool of Health SciencesUniversity of IoanninaIoannina 45110EpirusGreece

BACKGROUND Kidney transplantation leads to continuous improvement in the survival rates of kidney transplant recipients(KTRs)and has been established as the treatment of choice for patients with end-stage kidney ***-related quality of life(HRQoL)has become an important outcome *** is highly important to develop reliable methods to evaluate HRQoL with disease-specific *** To translate the disease-specific instrument Kidney Transplant Questionnaire 25(KTQ-25)to the Greek language and perform a cross-cultural *** The translation and adaptation of the original English version of the KTQ-25 to the Greek language were performed based on the International Quality of Life RESULTS Eighty-four KTRs(59 males;mean age 53.5±10.7 years;mean estimated glomerular filtration rate 47.7±15.1 mL/min/1.73 m2;mean transplant vintage 100.5±83.2 months)completed the Greek version of the KTQ-25 and the 36-item Short-Form Health Survey,and the results were used to evaluate the reliability of the Greek *** Cronbach alpha coefficients for all the KTQ-25 dimensions were satisfactory(physical symptoms=0.639,fatigue=0.856,uncertainty/fear=0.661,appearance=0.593,emotions=0.718,total score=0.708).The statistically significant correlation coefficients among the KTQ-25 dimensions ranged from 0.226 to *** correlation coeffi-cients of the KTQ-25 dimensions with the SF-36 physical component summary(PCS)ranged from 0.196 to 0.550;the correlation coefficients of the KTQ-25 with the SF-36 mental component summary(MCS)ranged from 0.260 to 0.655;and the correlation coefficients of the KTQ-25 with the total scores with the SF-36 PCS and MCS were 0.455 and 0.613,*** According to the findings,the Greek version of the KTQ-25 is valid and reliable for administration among kidney transplant patients in Greece.

关键词： Kidney Transplant Questionnaire 25 Kidney transplantation Kidney transplant recipients Health-related quality of life Quality of life

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Impact of bisphosphonate treatment on bone mineral density after kidney transplant

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World Journal of Transplantation 2024年第3期14卷 102-109页

作者： Georgia Andriana Georgopoulou Marios Papasotiriou Theodoros Ntrinias eirini Savvidaki Dimitrios S Goumenos Evangelos Papachristou Department of Nephrology and Kidney Transplantation University Hospital of PatrasPatras 26504Greece

BACKGROUND Mineral bone disease is associated with chronic kidney disease and persists after kidney *** treatment contributes to the patho-genesis of this *** treatments have shown positive but inde-finite *** To evaluate the effectiveness and safety of bisphosphonate treatment on post kidney transplantation bone mineral density(BMD).METHODS We included kidney transplant recipients(KTRs)whose BMD was measured after the operation but before the initiation of treatment and their BMD was measured at least one year *** also evaluated the BMD of KTRs using two valid mea-surements after transplantation who received no treatment(control group).RESULTS Out of 254 KTRs,62(39 men)were included in the *** were initiated in 35 KTRs in total(20 men),1.1±2.4 years after operation and for a period of 3.9±2.3 years while 27(19 men)received no *** improved significantly in KTRs who received bisphosphonate treatments(from-2.29±1.07 to-1.66±1.09,P<0.0001).The control group showed a non-significant decrease in BMD after 4.2±1.4 years of follow-up after *** function was not affected by bisphosphonate *** KTRs with established osteoporosis,active treatment had a similar and significant effect on those with osteopenia or normal bone *** In this retrospective study of KTRs receiving bisphosphonate treatment,we showed that active treatment is effective in preventing bone loss irrespective of baseline BMD.

关键词： Mineral and bone disorders Chronic kidney disease Kidney transplant recipients Bisphosphonates Bone mineral density

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获得第二次机会

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科学新闻 2024年第1期 57-58页

作者： eirini Tsekitsidou 倪伟波斯坦福大学

这是一个和平常一样的工作日——直到第二天，我的日历上突然出现了一个标题模糊得令人怀疑的会议。我立刻意识到自己即将从咨询顾问的工作中被解雇。9个月前完成博士学位时，我确信自己不是当科学家的料。所以，我转为在私营部门谋求...

这是一个和平常一样的工作日——直到第二天，我的日历上突然出现了一个标题模糊得令人怀疑的会议。我立刻意识到自己即将从咨询顾问的工作中被解雇。9个月前完成博士学位时，我确信自己不是当科学家的料。所以，我转为在私营部门谋求职业生涯。我的自信刚刚开始恢复——现在却发生了这样的事。更复杂的是，我只有3个月时间找一份新工作，否则就会被驱逐出这个11年来被我称之为“家”的国家。我当时并不知道，我职业生涯的最低谷是要重新获得科学家的身份。

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Overview of the Association Between Non-Alcoholic Fatty Liver Disease and Hypertension

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Cardiology Discovery 2024年第1期4卷 30-37页

作者： Niki S.Kakouril Costas G.Thomopoulos eirini P.Siafi Angeliki E.Valatsoul Kyriakos S.Dimitriadis Iliana P.Mani Sotirios P.Patsilinakos Dimitrios M.Tousoulis Konstantinos P.Tsioufis First Department of Cardiology Medical SchoolNational and Kapodistrian University of AthensHippokration HospitalAthens 11527Greece Department of Cardiology Elena Venizelou HospitalAthens 11521Greece Department of Cardiology General Hospital Agia OlgaAthens 14233Greece

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, and its prevalence is rising. NAFLD is closely associated with metabolic syndrome, with both conditions sharing common clinical characteristics such as obesity, insulin resistance, type 2 diabetes mellitus, hypertension, and hypertriglyceridemia. Several observational studies have evaluated the relationship between NAFLD and hypertension, with the overall evidence suggesting a bidirectional relationship. It is hypothesized that activation of the sympathetic nervous and renin-angiotensin systems, observed in NAFLD with or without insulin resistance promotes the development of hypertension. In patients with hypertension, activation of these systems can lead to hepatic fibrosis and progressive inflammation through increased oxidative stress and activation of hepatic stellate cells and Kupffer cells. The present review examines the pathophysiologic and clinical evidence supporting the bidirectional association between NAFLD and hypertension.

关键词： Hypertension Non-alcoholic fatty liver disease Insulin resistance Sympathetic nervous system Metabolic syndrome

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Exercise Intolerance and Excessive Chronotropic Response Due to Possible Autonomic Dysfunction Post COVID-19 Infection

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International Journal of Clinical Medicine（临床医学国际期刊） 2023年第12期

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Resuspension of spherical particles due to surface vibration

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Particuology 2021年第1期19卷 126-135页

作者： Sofia eirini Chatoutsidou Mihalis Lazaridis School of Environmental Engineering Technical University of Crete73100 ChaniaGreece

In this study,particle resuspension due to surface vibration was investigated.A spherical particle was assumed to rest on top of a thin plate,and an external vibrating force was applied normal on the plate at t=0 and at distance R from the *** external driving force created a displacement field in both time and space domains,where deformations in the body of the plate were considered small elastic oscillations that are perpendicular to the propagation of the *** oscillations were introduced via the theory of elasticity and the creation of waves on thin plates,i.e.,bending *** motion in the vertical direction was initiated through plate displacement,provided that inertia due to particle mass is *** particular,the particle was assumed to oscillate with a force(of oscillation)estimated via Newton’s second law of motion,comprising of two components:the acceleration due to the plate displacement and the particle ***,a simple force balance method was used to determine the conditions for ***,resuspension occurs when the oscillation force exceeds the couple of the adhesive and gravitational *** results suggest that the plate displacement depends on the characteristics of the applied force,material properties,and plate *** addition,it was found that the oscillation force is substantially lower than the applied force and that it depends on plate displacement and particle ***,the particle size significantly influencedthe outcome of ***,resuspension is favorable for large particles,strong applied forces,and high forcing frequencies.

关键词： Particle resuspension Vibration Bending waves

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