Dimitrios Peschos

Trends in suicide mortality in the deprived region of Epirus (north-west Greece) during the period 1998-2002.

This study determines the risk factors associated with suicide rates and the investigation of time trends in the deprived region of Epirus, north-west Greece, which is considered to be one of the least developed prefectures of the EU. Data selected demonstrated: (1) a mean age-standardized suicide rate per year of 4.00/100,000 for males, 1.29/100,000 for females and 2.65/100,000 for the total population; (2) a significant rising trend of male suicides in the 35-44 and 65-74 age groups; (3) a low female suicide rate in <35 years age group and a relatively stable rate in the other age groups; (4) a significantly higher suicide rate in men than in women from both urban and rural areas and in older men from rural areas; (5) higher rates of suicide among widowed men and unmarried women; (6) the use of predominantly violent suicide methods, especially self-shooting, hanging and drowning; (7) a significant peak in the total suicide rate in the spring and summer months and a decreased rate in September; and (8) three out of four of the suicide victims had consumed alcohol and/or other drugs before the act. Data reported here shows some remarkable trends compared to previous reports on suicide in Greece and other countries, probably due to cultural and life style characteristics of the study population.

Physiology and Pathophysiology of Selectins, Integrins, and IgSf Cell Adhesion Molecules Focusing on Inflammation. A Paradigm Model on Infectious Endocarditis

Abstract The development of adhesion bonds, either among cells or among cells and components of the extracellular matrix, is a crucial process. These interactions are mediated by some molecules collectively known as adhesion molecules (CAMs). CAMs are ubiquitously expressed proteins playing a central role in controlling cell migration, proliferation, survival, and apoptosis. Besides their key function in physiological maintenance of tissue integrity, CAMs play an eminent role in various pathological processes such as cardiovascular disorders, atherogenesis, atherosclerotic plaque progression and regulation of the inflammatory response. CAMs such as selectins, integrins, and immunoglobulin superfamily take part in interactions between leukocyte and vascular endothelium (leukocyte rolling, arrest, firm adhesion, migration). Experimental data and pathologic observations support the assumption that pathogenic microorganisms attach to vascular endothelial cells or sites of vascular injury initiating intravascular infections. In this review a paradigm focusing on cell adhesion molecules pathophysiology and infective endocarditis development is given.

Intravitreal Dirofilariasis: A Rare Ocular Infection

Human ocular dirofilariasis is a zoonotic disease, rare in Europe, caused by filarial nematodes. The parasite is either encysted in a subcutaneous nodule or located under the bulbar conjunctiva. We report the case of a 62-year-old man with intravitreal dirofilariasis, which is a rare site of presentation of the nematode in the human eye. It was located in the fundus area and was surgically removed. The nematode was identified as Dirofilaria repens (D. conjuctiva) by two different Microbiology Departments, making this the fifth report of identified intravitreal dirofilariasis caused by D. repens in the relative literature.

Immunohistochemical study of angiogenesis and proliferative activity in epiretinal membranes

Formation of epiretinal membranes (ERMs) is a serious complication of retinal diseases, the most important being proliferative diabetic retinopathy (PDR) and proliferative vitreoretinopathy (PVR). In this study, our goal was to (i) calculate the microvessel density (MVD), (ii) evaluate vascular endothelial growth factor (VEGF) expression and (iii) correlate angiogenesis with the proliferative activity as expressed by the expression of Ki67 marker, in both membrane types.

Sudden Death Due to an Unrecognized Cardiac Hydatid Cyst

Echinococcosis is an endemic disease, most common in sheep-raising communities, usually caused by the larval or cyst stage of the tapeworm Echinococcus granulosus. Isolated cardiac hydatid cyst is uncommon at any age, occurs through the coronary circulation, and accounts for less than 3% of all hydatid disease. We describe a case of an 1%-year-old female, who died suddenly. The post-mortem examination revealed an isolated cyst in the left ventricle of the heart with intact wall. The cytologic examination of the cyst fluid demonstrated the presence of the characteristic scolices and hooklets and established the diagnosis of cardiac hydatid cyst. The present case is of special interest because of the rare primary localization and the onset of sudden death in a young person as the initial manifestation of the disease.

CEA levels in serum and BAL in patients suffering from lung cancer: correlation with individuals presenting benign lung lesions and healthy volunteers.

BackgroundCarcinoembryonic antigen (CEA) is a tumor marker belonging to the immunoglobulin gene superfamily of adhesion molecules. CEA is synthesized by epithelial and tumor cells. In this study, CEA levels in sera and bronchoalveolar lavage fluid (BAL) were measured in patients with malignant lung cancer and benign lung diseases.MethodsIn the present study CEA was measured in serum using IRMA methods and in bronchoalveolar lavage of individuals undergoing fiberoptic bronchoscopy. Fifty patients with lung cancer (G1), 20 patients with benign lung lesions (G2), and a control group consisted of 20 individuals (G3) were enrolled in the study.ResultsWe found that serum CEA levels were significantly higher in G1 compared to G2 and G3 (p < 0.01). No significant difference in serum CEA levels was found between smokers and nonsmokers in any of the three groups studied. CEA was significantly higher in G1 BAL (p < 0.05) compared to G2 and G3 BAL. Furthermore, a statistically significant difference was found in CEA levels in BAL between smokers and nonsmokers of G2.ConclusionsCEA levels in BAL of normal individuals may be influenced by smoking and other factors that affect lung epithelial cell function. Thus, CEA measurement in BAL alone has little value in the diagnosis of malignancy. BAL CEA levels in smokers of G2 are found significantly higher compared with nonsmokers of the same group and healthy individuals. Smokers of G2 have to be followed up carefully for the possibility of lung cancer growth.

Mucinous breast carcinoma presenting as Paget's disease of the nipple in a man: A case report

IntroductionMale breast cancer is rare compared to its female counterpart representing less than 1% of cancer in men. Moreover, mucinous carcinoma of the male breast is an extremely rare histological subtype of malignancy. Pagets disease of the nipple is rarely observed in males.Case reportHerein, we describe a unique case of an 86 years old man with mucinous breast cancer presenting as Pagets disease of the nipple. According to the immunohistochemical evaluation the neoplastic cells were positive for estrogen (ER) and progesterone receptors (PR).ConclusionTo our best knowledge this is the first case of mucinous male breast cancer presenting as Pagets disease of the nipple.

Subcutaneous Metastasis of Peritoneal Mesothelioma Diagnosed by Fine-Needle Aspiration

Mesothelioma is a rare malignant neoplasm of the serosal membranes, which can give distant metastases in various organs in advanced stages of its course. Subcutaneous tissue is an unusual metastatic site. In the literature, only one case of metastatic mesothelioma to the skin of the face has been reported. We present a case of a 60-year-old female with a prior history of peritoneal malignant mesothelioma, who 6 months after the initial diagnosis presented with a subcutaneous nodule in the lateral chest wall. Cytological examination of the material obtained by FNA from the nodule revealed metastatic mesothelioma. Although subcutaneous metastasis of malignant mesothelioma is a rare entity, one must always keep this possibility in mind and proceed to further investigation of such lesions. In these cases, FNA is a simple diagnostic procedure for the identification of metastatic disease in patients with a prior history of malignancy.

Cytotoxic and anticancer effects of the triorganotin compound [(C6H5)3Sn(cmbzt)]: An in vitro, ex vivo and in vivo study

Since the initial success of cisplatin, metal complexes and organometallic compounds have been gaining growing interest in cancer therapy. It is well known that organotin(IV) compounds display strong biological activity. The triorganotin compound [(C(6)H(5))(3)Sn(cmbzt)] (cmbzt=5-chloro-2-mercaptobenzothiazole) (SnCMB), was tested for its antiproliferative and antitumour activities. Two sets of experimental procedures were followed: (1) In vitro and ex vivo procedures included the study of the cytotoxic activity of the complex against leiomyosarcoma cells (LMS) and on a normal human fibroblast line (MRC5) by the MTT assay (cell proliferation), colony formation efficiency and flow cytometric analysis with Annexin V-FITC. The anticoagulation properties of the complex were also studied. (2) In vivo procedures included acute toxicity studies and finally administration of the complex to tumour bearing Wistar rats. The results showed that the complex exhibited potent cytotoxic activity (LMS IC(50)=155 nM) and induced significant apoptosis against LMS cells. Acute toxicity studies on Wistar rats presented kidney and liver toxicity at a single dose of 40 mg/kg body wt. Furthermore, antitumour activity studies on sarcoma bearing Wistar rats revealed that SnCMB complex, administrated in two different therapeutic schemes (treated with 4 × 2 mg/kg body wt every 5 days and 3 × 2.67 mg/kg body wt every 10 days of SnCMB complex), prolonged mean survival time (by 50% and 70% respectively), but failed to decrease the mean tumour growth rate (MTGR) compared to the control group (p<0.01). In conclusion, the organic complex SnCMB possess potent cytotoxic and antimetastatic effects, and low toxicity introducing it as possible successor of organometallic compounds used nowadays in chemotherapy.

Correlation of bioelectrical impedance analysis phase angle with changes in oxidative stress on end-stage renal disease patients, before, during, and after dialysis

Abstract Chronic kidney disease is a condition that promotes oxidative stress. There are conflicting evidence about the role of hemodialysis on oxidative stress, that are mostly related with the various types of membrane materials used, the quality and type of dialysate, the method used, etc. The phase angle (PhA), which is determined with bioelectrical impedance analysis (BIA), measures the functionality of cell membranes. In this study, the correlation of the PhA with parameters of oxidative stress is attempted for the first time. We evaluated parameters of oxidative status as total antioxidant capacity (TAC) in erythrocytes (RBCs) and plasma of patients with ESRD undergoing hemodialysis with low flux synthetic polysulfone membranes. Measurements were recorded from 30 patients (16 men and 14 women) aged 64 ± 14 years before, during, and after dialysis, and in 15 healthy volunteers aged 56 ± 12 years The PhA was obtained by BIA. The plasma TAC increased significantly (41%, p < 0.05). Intracellular TAC noted a non-significant increase. Total antioxidant capacity of the patients before and after hemodialysis was significantly lower from the healthy volunteers (p < 0.05) showing that ESRD patients are at the state of increased oxidative stress. The PhA increased in significantly positive correlation with plasma TAC at the end of hemodialysis. The process of hemodialysis with biocompatible synthetic membranes and bicarbonate dialysate improved plasma TAC. The positive correlation of PhA with extracellular TAC could evolve to a method of oxidative stress estimation by BIA but further research is needed.