Association between smoking cessation and alterations in forced expiratory volume in one second (FEV1). A Follow-Up Study from a Greek Tobacco Cessation Clinic

Background: Cigarette smoking is the most important preventable cause of several diseases such as malignancies, pulmonary and cardiovascular diseases. Smoking cessation is now supported by both behavioral counseling and medical pharmacotherapy and is the only effective approach for slowing down an accelerated decline in forced expiratory volume in one second (FEV1). Our study aims to examine changes in forced expiratory volume in one second (FEV1) after smoking cessation for smokers attending our smoking cessation clinic their correlation to smokers’ demographic characteristics.Methods: 114 smokers (48 males and 66 females), with a mean age of 48.36±10.49 years, were enrolled. They were classified in 4 groups, according to their age; 60 years (Group D) and underwent Spirometry on the 1st day of visit, one month (2nd visit) and, 3 months later (3rd visit).Findings: Statistically significant increase in FEV1 values at the 2nd and 3rd visit compared to the 1st visit was observed in smokers who quit smoking in Group Α, B and C (p<0.05). In addition, a statistically significant decrease in FEV1 values at the 2nd and 3rd visit compared to the 1st visit was noticed in smokers who continued smoking in Group B, C and D (p<0.05).Conclusion: Smoking cessation achieved through smoking cessation support led to the improvement of FEV1 values within 3 months. The greatest benefit was observed in smokers under the age of 60

Retrospective study of prognostic markers in breast cancer

Introduction: Breast cancer is a complex disease with variability in clinical manifestation, response to current therapy, and biochemical and histological features among various subgroups. Histologic grading and immunohistochemical evaluation of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 proliferation index play a crucial role in increasing the differential diagnostic value among various types of breast carcinoma. Purpose: The aim of this study was to determine the histopathological and immunohistochemical characteristics of breast tumors from a University Laboratory of Pathology in Greece and the determination of the predictive and prognostic value of the main immunohistochemical biomarkers in breast cancer. Method: The study included female patients over 18 years of age, whose histopathological and immunohistochemical reports were stored in the archives of the First Department of Pathology of National and Kapodistrian University of Athens. The study involved 197 female patients with a median age of 70 years and median tumor size of 2.6 cm. Results: Most tumors were located at the left breast and ductal carcinoma was the most common histologic type (35.5%). Most tumors had histologic grade 2 (106, 53.8%), and were classified as TNM stage IIA (65, 33%). Most grade 1 and 2 tumors exhibited high expression of PR, whereas most grade 3 tumors had no PR expression. Moreover, patients with triple-negative cancer presented with grades 2 and 3 at a lower percentage compared to patients without a triple-negative phenotype (p=0.001). Conclusions: The study provided valuable insights into the molecular mechanisms involved in the development and progression of breast cancer. Our findings highlight the significance of tumor analysis carried out using immunohistochemistry and histopathological analysis. Moreover, our findings indicate that molecular and immunohistochemical analyses can be helpful in advancing biological understanding and enhance the treatment of breast cancer patients, but also in use of specific prognostic and predictive biomarkers of breast cancer such as ER, PR, HER-2, Ki-67, e-cadherin that they can direct the form of treatment and determine the treatment response of each female patient individually.Εισαγωγή: Ο καρκίνος του μαστού είναι μια πολύπλοκη ασθένεια με μεταβλητότητα στην κλινική εκδήλωση, την ανταπόκριση στην τρέχουσα θεραπεία και στα βιοχημικά και ιστολογικά χαρακτηριστικά μεταξύ των διαφόρων υποομάδων. Η ιστολογική ταξινόμηση και η ανοσοϊστοχημική αξιολόγηση του υποδοχέα οιστρογόνου (ER), του υποδοχέα προγεστερόνης (PR), του υποδοχέα ανθρώπινου επιδερμικού αυξητικού παράγοντα 2 (HER-2) και του δείκτη πολλαπλασιασμού Ki-67 διαδραματίζουν κρίσιμο ρόλο στην αύξηση της διαφορικής διαγνωστικής αξίας μεταξύ των διαφόρων τύπων καρκινώματος του μαστού. Σκοπός: Σκοπός της παρούσας μελέτης ήταν ο προσδιορισμός των ιστοπαθολογικών και ανοσοϊστοχημικών χαρακτηριστικών των όγκων του μαστού από Πανεπιστημιακό Εργαστήριο Παθολογικής Ανατομικής στην Ελλάδα και ο προσδιορισμός της προβλεπτικής και προγνωστικής αξίας των κυριότερων ανοσοϊστοχημικών βιοδεικτών στον καρκίνο του μαστού. Μέθοδος: Η μελέτη μας περιλάμβανε γυναίκες ασθενείς άνω των 18 ετών, των οποίων οι ιστοπαθολογικές και ανοσοϊστοχημικές εκθέσεις φυλάσσονταν στο αρχείο του Α' Εργαστηρίου Παθολογικής Ανατομικής, του Εθνικού και Καποδιστριακού Πανεπιστημίου Αθηνών. Στη μελέτη συμμετείχαν 197 γυναίκες ασθενείς με διάμεση ηλικία τα 70 έτη και διάμεσο μέγεθος όγκου, τα 2,6 εκατοστά. Αποτελέσματα: Οι περισσότεροι όγκοι εντοπίστηκαν στον αριστερό μαστό και το πορογενές καρκίνωμα του μαστού ήταν ο πιο κοινός ιστολογικός τύπος (35,5%). Οι περισσότεροι όγκοι είχαν ιστολογικό βαθμό 2 (106, 53,8%) και ταξινομήθηκαν ως TNM σταδίου ΙΙΑ (65, 33%). Οι περισσότεροι όγκοι βαθμού 1 και 2 εμφάνισαν υψηλή έκφραση PR, ενώ οι περισσότεροι όγκοι βαθμού 3 δεν είχαν έκφραση PR. Επιπλέον, οι ασθενείς με τριπλά αρνητικό καρκίνο παρουσίασαν βαθμούς 2 και 3 σε χαμηλότερο ποσοστό, σε σύγκριση με ασθενείς χωρίς τριπλά αρνητικό φαινότυπο (p=0,001). Συμπεράσματα: Η έρευνά μας παρείχε πολύτιμες γνώσεις σχετικά με τους μοριακούς μηχανισμούς που εμπλέκονται στην ανάπτυξη και την εξέλιξη του καρκίνου του μαστού. Τα ευρήματά μας υπογραμμίζουν τη σημασία της ανάλυσης του όγκου που πραγματοποιείται με τη χρήση της ανοσοϊστοχημείας και της ιστοπαθολογικής ανάλυσης. Επιπλέον, τα ευρήματά μας καταδεικνύουν ότι οι μοριακές και ανοσοϊστοχημικές αναλύσεις μπορούν να βοηθήσουν στην προώθηση της βιολογικής κατανόησης και στην ενίσχυση της θεραπείας των ασθενών με καρκίνο του μαστού, αλλά και στη χρήση συγκεκριμένων προγνωστικών και προγνωστικών βιοδεικτών του καρκίνου του μαστού, όπως οι βιοδείκτες ER, PR, HER-2, Ki-67, e-cadherin, οι οποίοι μπορούν να κατευθύνουν τη μορφή της θεραπείας και να καθορίσουν τη θεραπευτική ανταπόκριση κάθε γυναίκας ασθενούς, ξεχωριστά

Knowledge and Attitudes of Healthcare Professionals Regarding Perinatal Influenza Vaccination during the COVID-19 Pandemic

Immunizations during pregnancy are an important aspect of perinatal care. Although the influenza vaccine during pregnancy is safe, vaccination rates are low. According to research data, one of the reasons for the low vaccination rates among pregnant women is that they do not receive a clear recommendation from healthcare providers. This study aims to record the knowledge and attitudes about influenza vaccination and investigate healthcare professionals’ recommendations during the perinatal period. A cross-sectional study was conducted with convenience sampling in Athens, Greece. Our purposive sample included 240 midwives, Ob/Gs, and pediatricians. Data were collected using an appropriate standardized questionnaire with information about demographics, attitudes towards influenza vaccination, and knowledge about the influenza virus and peripartum vaccination. Statistical analysis was conducted using IBM SPSS-Statistics version 26.0. This study identifies the reasons for the lack of vaccine uptake including a wide range of misconceptions or lack of knowledge about influenza infection, lack of convenient access to get vaccinated, etc. Misconceptions about influenza and influenza vaccines could be improved by better education of healthcare workers. Continuing professional education for health professionals is necessary to improve the level of knowledge, prevent negative beliefs, and promote preventive and therapeutic practices

Exploring the Role of ACE2 as a Connecting Link between COVID-19 and Parkinson’s Disease

Coronavirus disease 2019 (COVID-19) is frequently accompanied by neurological manifestations such as headache, delirium, and epileptic seizures, whereas ageusia and anosmia may appear before respiratory symptoms. Among the various neurological COVID-19-related comorbidities, Parkinson’s disease (PD) has gained increasing attention. Some cases of PD disease have been linked to COVID-19, and both motor and non-motor symptoms in Parkinson’s disease patients frequently worsen following SARS-CoV-2 infection. Although it is still unclear whether PD increases the susceptibility to SARS-CoV-2 infection or whether COVID-19 increases the risk of or unmasks future cases of PD, emerging evidence sheds more light on the molecular mechanisms underlying the relationship between these two diseases. Among them, angiotensin-converting enzyme 2 (ACE2), a significant component of the renin-angiotensin system (RAS), seems to play a pivotal role. ACE2 is required for the entry of SARS-CoV-2 to the human host cells, and ACE2 dysregulation is implicated in the severity of COVID-19-related acute respiratory distress syndrome (ARDS). ACE2 imbalance is implicated in core shared pathophysiological mechanisms between PD and COVID-19, including aberrant inflammatory responses, oxidative stress, mitochondrial dysfunction, and immune dysregulation. ACE2 may also be implicated in alpha-synuclein-induced dopaminergic degeneration, gut–brain axis dysregulation, blood–brain axis disruption, autonomic dysfunction, depression, anxiety, and hyposmia, which are key features of PD

The Uncharted Landscape of Rare Endocrine Immune-Related Adverse Events

Immune checkpoint inhibitors (ICIs) have been approved for the treatment of many cancers, either in adjuvant or metastatic settings. Regarding safety, endocrine adverse events (AEs) are some of the most common AEs in ICI-treated patients, with thyroid dysfunction and hypophysitis being the most frequent disorders. However, there are also some rare and very rare immune-related (ir) endocrine complications (incidence between ≥1/10,000 to <1/1000 and <1/10,000, respectively, according to the established classification) that have been reported in isolated case reports, with limited data about their management. In this systematic review, we summarize all published cases with primary adrenal insufficiency, central diabetes insipidus, primary hypoparathyroidism, lipodystrophy, osteoporosis, hypergonadotrophic hypogonadism, or Cushing disease and discuss their diagnostic and therapeutic approaches as well as the current knowledge on their pathophysiology. In these ICI-treated cancer patients, the presentation of symptoms unrelated to their underlying malignancy has led to further diagnostic tests, including hormonal profile and functional assays which subsequently confirmed endocrinopathy, while the assessment of autoantibodies was rarely available. In most of these cases, the exact pathogenesis remained unknown, and the endocrine dysfunction was permanent, requiring lifelong supplementation. Although endrocine irAEs are rare, physicians must be aware of these irAEs to recognize them on time and treat them appropriately

A Rare Case of Multiple Gastrointestinal Stromal Tumors Coexisting with a Rectal Adenocarcinoma in a Patient with Attenuated Familial Adenomatous Polyposis Syndrome and a Mini Review of the Literature

Background: Multiple gastrointestinal stromal tumors (GISTs) are extremely rare entities that exist either as spontaneous GISTs or as part of various syndromes, such as Carney&rsquo;s triad and type I neurofibromatosis (NF1). Attenuated familial adenomatous polyposis (AFAP) is a variant of familial adenomatous polyposis (FAP) with a milder clinical presentation. Both GISTs and AFAP have been reported to coexist with colorectal cancer, but the coexistence of GISTs and AFAP has never been reported in the literature before. Case report: A 45-year-old male patient with known AFAP arrived scheduled for a total colectomy and ileo-rectal anastomosis due to the malignancy of one of the previously biopsied polyps of the upper rectum. Intraoperatively, multiple nodular tumors were found at the jejunum within a length of 45 cm, for which an enterectomy and enteroanastomosis were performed. A histopathological examination of the whole colectomy specimen confirmed the presence of multiple polyps in the large intestine along with a rectal invasive adenocarcinoma. At the same time, in the examined part of the small intestine, 15 GISTs sized from 0.5 to 2.0 cm of prognostic group I, were identified. The patient&rsquo;s postoperative course was uncomplicated. Conclusion: Multiple GISTs may present as an asymptomatic disease, and the same thing is true for colorectal cancer. Therefore, the appropriate screening is crucial for entities such as AFAP, since the surgery was performed because of the malignant transformation in one of the polyps and revealed multiple GISTs, as well

Drug-Induced Liver Injury in Hospitalized Patients during SARS-CoV-2 Infection

In the last few years, the world has had to face the SARS-CoV-2 infection and its multiple effects. Even though COVID-19 was first considered to be a respiratory disease, it has an extended clinical spectrum with symptoms occurring in many tissues, and it is now identified as a systematic disease. Therefore, various drugs are used during the therapy of hospitalized COVID-19 patients. Studies have shown that many of these drugs could have adverse side-effects, including drug-induced liver injury—also known as DILI—which is the focus of our review. Despite the consistent findings, the pathophysiological mechanism behind DILI in COVID-19 disease is still complex, and there are a few risk factors related to it. However, when it comes to the diagnosis, there are specific algorithms (including the RUCAM algorithm) and biomarkers that can assist in identifying DILI and which we will analyze in our review. As indicated by the title, a variety of drugs are associated with this COVID-19-related complication, including systemic corticosteroids, drugs used for the therapy of uncontrolled cytokine storm, as well as antiviral, anti-inflammatory, and anticoagulant drugs. Bearing in mind that hepatotoxicity is very likely to occur during COVID-19, especially in patients treated with multiple medications, we will also refer to the use of other drugs used for DILI therapy in an effort to control and prevent a severe and long-term outcome

Exacerbation of bronchiectasis by Pseudomonas putida complicating COVID-19 disease: A case report

Novel coronavirus infection presents with greater severity in individuals with comorbid chronic lung diseases. Bronchiectasis is an illness characterized by permanent enlargement of the airways, presenting with chronic cough and sputum production and vulnerability to lung infections. Bronchiectasis is not a common comorbid disease in patients with COVID-19 disease and bronchiectasis exacerbation rates were decreased during the pandemic. However, COVID-19 disease is associated with worse outcomes in patients with bronchiectasis and patients with bronchiectasis are more susceptible to SARS-CoV-2 infection development. Pseudomonas putida is an opportunistic pathogen, causing infections mostly in immunocompromised hosts and is not a frequent bacterial colonizer in patients with bronchiectasis. This present study reports a rare case of exacerbation of bronchiectasis by Pseudomonas putida complicating COVID-19 disease in an immunocompetent 70-year-old woman. Clinicians should be aware that SARS-CoV-2 infection is probably a precipitating factor of bronchiectasis exacerbation while bronchiectasis is a risk factor for greater severity of SARS-CoV-2 infection

Investigation of the health effects on workers exposed to respirable crystalline silica during outdoor and underground construction projects

Chronic exposure of workers to powder containing crystalline silica (Silicon dioxide; SiO2) can lead to chronic lung diseases (lung cancer, silicosis, etc.). Aim of this study was to evaluate the exposure of Greek construction workers to SiO(2)and describe their pulmonary function. The study involved 86 outdoor and underground workers. Medical and professional history was obtained, and breath samples were collected at morning hours through a mask for the determination of SiO(2)levels. Pulmonary function tests, radiological examination and evaluation of radiographs were also performed. Pulmonary function examination showed that the majority of the workers were within normal range (61.4%) while the rest were diagnosed with mild (26.5%) and more severe impairment (7.24%). Working conditions (underground-outdoor) were statistically significantly related to the categorization of pulmonary function (P=0.038). During radiological examination, the type of working activity/ conditions (underground-outdoor) were statistically significantly related to the categorization of these findings (P=0.044). Of the 69 employees, 52 did not present findings (75.4%) and 5 were diagnosed with findings specific to occupational diseases (7.23%). Environmental exposure to respirable crystalline silica (RCS) was detected at 0.0125 mg/m(3)in the workplace, which is not beyond the legal limits. Underground workers with more than 15 years of exposure to SiO(2)are more likely to present chronic silicosis compared to the workers of outdoor activities