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Search Results: 1 - 10 of 256 matches for " Pavlos Myrianthefs "
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Circulating cytokines and outcome prediction of burned children with concomitant inhalation injury
Pavlos M Myrianthefs, George J Baltopoulos
Critical Care , 2008, DOI: 10.1186/cc6920
Abstract: In this issue of Critical Care, Dr Gauglitz and colleagues [1] present their prediction equation for outcome of burned children with concomitant inhalation injury based on serum cytokine measurements.Prediction of outcome is very important in the intensive care unit (ICU) and, for this purpose, intensivists have created illness severity scores (Acute Physiology and Chronic Health Evaluation (APACHE), Simplified Acute Physiology Score (SAPS), and Mortality Probability Model (MPM)). These scores are calculated from data collected on the first ICU day and comprise two parts: the score itself, reflecting illness severity; and a probability model, which is an equation giving the probability of hospital death [2]. Accordingly, illness severity scores applicable for paediatric populations are widely used to assess severity and estimate probability of death [3,4].The probability of death after burns can be easily predicted on the basis of simple, objective clinical criteria: age greater than 60 years; more than 40% of body-surface area burned; and inhalation injury [5]. With regard to burn injury in children, only demographics and injury variables have been used to predict outcome [6,7]. In the later of these studies, an effort to take into account the effects of treatment on several variables to predict outcomes was attempted [7].The activation of the host immune system and the release of inflammatory mediators have been linked to physiological derangements observed in burn injury and other inflammatory conditions, increasing according to illness severity and the progression of systemic inflammatory response syndrome to multiple organ failure. Thus, it has been assumed that increased physiological responses parallel the intensity of cytokine production and the development of multiple organ failure and death. Since the production or depression of several cytokines is related to physiological derangements commonly used in scoring systems, it seems reasonable to measure these
Pulmonary Fibrosis Due to Nitrofurantoin Therapy: A Case Report  [PDF]
Leonidas Grigorakos, Garyphallia Poulakou, Daria Lazarescu, Pavlos Myrianthefs, Nikolaos Markou, Maria Bikou, Adamantia Petineli, Konstantinos Kokkinis
Open Journal of Respiratory Diseases (OJRD) , 2017, DOI: 10.4236/ojrd.2017.73012
Abstract: We report the case of a patient with pulmonary fibrosis, developed as an adverse reaction to nitrofurantoin therapy received for totally 6 months for the prevention of recurrent urinary tract infections. Chest X-ray and CT scan revealed extensive elements of interstitial pulmonary fibrosis. After diagnosis, administration of nitrofurantoin was immediately stopped; and specific prolonged therapy with low-dose corticosteroids per os and inhaled steroids were administered. The patient responded successfully both clinically and biochemically and possible digestive system side effects were prevented through the administration of gastroprotection medication. For the prevention of urinary tract infection, the patient received well tolerated therapy with fosfomycin which was further continued as a prophylactic agent.
Is Routine Ultrasound Examination of the Gallbladder Justified in Critical Care Patients?
Pavlos Myrianthefs,Efimia Evodia,Ioanna Vlachou,Glykeria Petrocheilou,Alexandra Gavala,Maria Pappa,George Baltopoulos,Dimitrios Karakitsos
Critical Care Research and Practice , 2012, DOI: 10.1155/2012/565617
Abstract: Objective. We evaluated whether routine ultrasound examination may illustrate gallbladder abnormalities, including acute acalculous cholecystitis (AAC) in the intensive care unit (ICU). Patients and Methods. Ultrasound monitoring of the GB was performed by two blinded radiologists in mechanically ventilated patients irrespective of clinical and laboratory findings. We evaluated major (gallbladder wall thickening and edema, sonographic Murphy’s sign, pericholecystic fluid) and minor (gallbladder distention and sludge) ultrasound criteria. Measurements and Results. We included 53 patients (42 males; mean age years; APACHE II score ; mean ICU stay days). Twenty-five patients (47.2%) exhibited at least one abnormal imaging finding, while only six out of them had hepatic dysfunction. No correlation existed between liver biochemistry and ultrasound results in the total population. Three male patients (5.7%), on the grounds of unexplained sepsis, were diagnosed with AAC as incited by ultrasound, and surgical intervention was lifesaving. Patients who exhibited ≥2 ultrasound findings (30.2%) were managed successfully under the guidance of evolving ultrasound, clinical, and laboratory findings. Conclusions. Ultrasound gallbladder monitoring guided lifesaving surgical treatment in 3 cases of AAC; however, its routine application is questionable and still entails high levels of clinical suspicion. 1. Introduction Abnormalities of the gallbladder (GB) are frequent in the intensive care unit (ICU) [1, 2]. Critical care patients have many risk factors for acute acalculous cholecystitis (AAC) which is an acute inflammation of the GB in the absence of gallstones and accounts for 2–14% of all cases of acute cholecystitis [3–5]. AAC is an insidious complication that has been increasingly recognized in the critically ill with an incidence ranging from 0.2 to 3% [6–8]. Although the etiology is uncertain, AAC in the ICU has been associated with prolonged enteral fasting, total parenteral nutrition (TPN), duration of mechanical ventilation (MV) and the use of positive end-expiratory pressure (PEEP), activation of factor XII, trauma, sepsis, drugs (opiates, sedatives, and vasopressors), multiple transfusions, dehydration, and shock states [6, 9, 10]. Ultimately these factors may lead to bile stasis and GB hypoperfusion/ischemia resulting in acute inflammation of the GB. AAC is an emergency condition, and without immediate treatment there may be rapid progression to gangrenous cholecystitis (approximately 50%) or perforation (approximately 10%), with mortality rates as high as
The effects of IgM-enriched immunoglobulin preparations in patients with severe sepsis: another point of view
Stylianos Karatzas, Eleni Boutzouka, Kyriaki Venetsanou, Pavlos Myrianthefs, George Fildisis, George Baltopoulos
Critical Care , 2002, DOI: 10.1186/cc1837
Abstract: It is well known that the immunotherapy in sepsis is still a gray zone, and it will remain so as long as the relevant literature presents conflicting results [2]. From our understanding and the interim analysis of our data, it seems that we could expect some definitive immunotherapy informationin the near future.In our study, we have presently included 34 patients in the treatment group (IgM + IgG + IgA) and 34 in the control group. Analyzing our data in a manner comparable with that of Tugrul et al. [1], we reach a different conclusion regarding the results.The only difference that exists between our protocol and that of Tugrul et al. regarding the study design and the inclusion criteria is that we include only adults older than 18 years old (the lower age limit of Tugrul et al.'s study is 10 years, and adolescents are probably included).The number of patients needed per arm of the study in order to achieve a safe conclusion (statistical power analysis, 80%; P < 0.05 for a mortality decrease of 17%, which was the mortality decrease in our preliminary analysis) is 120 patients in each arm. In a study with a smaller number of patients, therefore, such as those of Tugrul et al. (21 patients in each arm) or ourselves (34 patients in each arm to the present time), any conclusion may be unsafe.Although the data in both studies (in our opinion) are so far not sufficient, a significant difference trend is recorded. The mean age in Tugrul et al.'s study is 42.0 ± 18 years in the IgM + IgG + IgA group and 49.3 ± 20.6 years in the control group. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score in that same study is 10.5 ± 4.6 in the IgM + IgG + IgA group and 14.0 ± 8.5 in the control group. Although there is no statistically significant difference, there is a strong tendency for the two means to become different (P = 0.10).In our preliminary data analysis, the mean age is 50.5 ± 3.33 years in the IgM + IgG + IgA group and 50.7 ± 7.36 years in the contro
High CO2 Levels Impair Alveolar Epithelial Function Independently of pH
Arturo Briva, István Vadász, Emilia Lecuona, Lynn C. Welch, Jiwang Chen, Laura A. Dada, Humberto E. Trejo, Vidas Dumasius, Zaher S. Azzam, Pavlos M. Myrianthefs, Daniel Batlle, Yosef Gruenbaum, Jacob I. Sznajder
PLOS ONE , 2007, DOI: 10.1371/journal.pone.0001238
Abstract: Background In patients with acute respiratory failure, gas exchange is impaired due to the accumulation of fluid in the lung airspaces. This life-threatening syndrome is treated with mechanical ventilation, which is adjusted to maintain gas exchange, but can be associated with the accumulation of carbon dioxide in the lung. Carbon dioxide (CO2) is a by-product of cellular energy utilization and its elimination is affected via alveolar epithelial cells. Signaling pathways sensitive to changes in CO2 levels were described in plants and neuronal mammalian cells. However, it has not been fully elucidated whether non-neuronal cells sense and respond to CO2. The Na,K-ATPase consumes ~40% of the cellular metabolism to maintain cell homeostasis. Our study examines the effects of increased pCO2 on the epithelial Na,K-ATPase a major contributor to alveolar fluid reabsorption which is a marker of alveolar epithelial function. Principal Findings We found that short-term increases in pCO2 impaired alveolar fluid reabsorption in rats. Also, we provide evidence that non-excitable, alveolar epithelial cells sense and respond to high levels of CO2, independently of extracellular and intracellular pH, by inhibiting Na,K-ATPase function, via activation of PKCζ which phosphorylates the Na,K-ATPase, causing it to endocytose from the plasma membrane into intracellular pools. Conclusions Our data suggest that alveolar epithelial cells, through which CO2 is eliminated in mammals, are highly sensitive to hypercapnia. Elevated CO2 levels impair alveolar epithelial function, independently of pH, which is relevant in patients with lung diseases and altered alveolar gas exchange.
A note on a paper by Brenner
Pavlos Tzermias
International Journal of Mathematics and Mathematical Sciences , 2002, DOI: 10.1155/s0161171202202197
Abstract: We note that a result of Brenner (1962) follows from a theorem of Lerch (1896) which also extends it.
Strong magnetic field asymptotic behaviour for the fermion-induced effective energy in the presence of a magnetic flux tube
Pavlos Pasipoularides
Physics , 2003, DOI: 10.1103/PhysRevD.67.107301
Abstract: In Ref. 3, we presented an asymptotic formula for the fermion-induced effective energy in 3+1 dimensions in the presence of a cylindrically symmetric inhomogeneous strong magnetic field. However, there are some points which were not clearly explained. In fact, the arguments, which led us to the asymptotic formula, are based on a numerical study of the integral of Eq. (10), as we will see in the main part of this paper. The aim of this work is to present this study in detail.
Domain wall fermions and applications
Pavlos Vranas
Physics , 2000, DOI: 10.1016/S0920-5632(01)00948-3
Abstract: Domain wall fermions provide a complimentary alternative to traditional lattice fermion approaches. By introducing an extra dimension, the amount of chiral symmetry present in the lattice theory can be controlled in a linear way. This results in improved chiral properties as well as robust topological zero modes. A brief introduction on the subject and a discussion of chiral properties and applications, such as zero and finite temperature QCD, N = 1 super Yang-Mills, and four-fermion theories, is presented.
Symmetry algebra of discrete KdV equations and corresponding differential-difference equations of Volterra type
Pavlos Xenitidis
Physics , 2011, DOI: 10.1088/1751-8113/44/43/435201
Abstract: A sequence of canonical conservation laws for all the Adler-Bobenko-Suris equations is derived and is employed in the construction of a hierarchy of master symmetries for equations H1-H3, Q1-Q3. For the discrete potential and Schwarzian KdV equations it is shown that their local generalized symmetries and non-local master symmetries in each lattice direction form centerless Virasoro type algebras. In particular, for the discrete potential KdV, the structure of its symmetry algebra is explicitly given. Interpreting the hierarchies of symmetries of equations H1-H3, Q1-Q3 as differential-difference equations of Yamilov's discretization of Krichever-Novikov equation, corresponding hierarchies of isospectral and non-isospectral zero curvature representations are derived for all of them.
Fermion-induced effective action in the presence of a static inhomogeneous magnetic field
Pavlos Pasipoularides
Physics , 2000, DOI: 10.1103/PhysRevD.64.105011
Abstract: We present a numerical study of the fermion-induced effective action in the presence of a static inhomogeneous magnetic field for both 3+1 and 2+1 dimensional QED using a novel approach. This approach is appropriate for cylindrically symmetric magnetic fields with finite magnetic flux $\Phi$. We consider families of magnetic fields, dependent on two parameters, a typical value $B_{m}$ for the field and a typical range d. We investigate the behavior of the effective action for three distinct cases: 1) keeping $\Phi$ (or $B_{m}d^{2}$) constant and varying d, 2) keeping $B_{m}$ constant and varying d and 3) keeping d constant and varying $\Phi$ (or $B_{m}d^{2}$). We note an interesting difference as d tends to infinity (case 2) between smooth and discontinuous magnetic fields. In the strong field limit (case 3) we also derive an explicit asymptotic formula for the 3+1 dimensional action. We study the stability of the magnetic field and we show that magnetic fields of the type we examine remain unstable, even in the presence of the fermions. In the appropriate regions we check our numerical results against the Schwinger formula (constant magnetic field), the derivative expansion and the numerical work of M. Bordag and K. Kirsten. The role of the Landau levels for the effective action, and the appearance of metastable states for large magnetic flux, are discussed in an appendix.
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