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Article ; Online: The role of the PLGF in the management of pregnancies complicated with fetal microsomia.

Souka, Athena P / Chatziioannou, M I / Pegkou, A / Antsaklis, P / Daskalakis, G

2023 Volume 309, Issue 4, Page(s) 1369–1376

Abstract: Purpose: To explore the contribution of maternal and fetal parameters in predicting the time interval between diagnosis and development of adverse events leading to delivery in singleton pregnancies complicated with fetal microsomia.: Methods: ... ...

Abstract	Purpose: To explore the contribution of maternal and fetal parameters in predicting the time interval between diagnosis and development of adverse events leading to delivery in singleton pregnancies complicated with fetal microsomia. Methods: Prospective study on singleton pregnancies referred to a tertiary center because of suspicion of fetal smallness in the third trimester. The study cohort included cases with fetal abdominal circumference (AC) ≤ 10th centile or estimated fetal weight ≤ 10th centile or umbilical artery pulsatitlity index ≥ 90th centile. Development of pre-eclampsia, fetal demise, and fetal deterioration diagnosed by fetal Doppler studies or fetal heart rate monitoring and leading to delivery were considered as adverse events. Maternal demographics, obstetric history, blood pressure, serum PLGF, and fetal Doppler studies were explored as predictors of the time interval between the first visit to the clinic and the diagnosis of complications. Results: In 59 women, the median incubation period from presentation to the clinic to an adverse event was 6, 2 weeks, whereas half of the pregnancies (52.5%) did not develop any adverse event. PLGF was the strongest predictor of adverse events. Both PLGF in raw values and PLGF MOM had equally good predictive ability (AUC 0.82 and 0.78 respectively). Optimal cut-off points were 177.7 pg/ml for PLGF raw values (sensitivity 83% and specificity 66.7%) and 0.277 MoM (sensitivity 76% and specificity 86.7%). On multiple Cox regression analysis, maternal systolic blood pressure, PLGF, fetal increased umbilical artery PI, and reduced CP ratio were independently associated with adverse events. Half of the pregnancies with low PLGF and only one in ten with high PLGF were delivered within two weeks after the initial visit. Conclusion: Half of the pregnancies carrying a small fetus in the third trimester will not develop maternal or fetal complications. PLGF is a strong predictor of adverse events that can be used to customize antenatal care.
MeSH term(s)	Infant, Newborn ; Pregnancy ; Female ; Humans ; Prenatal Care ; Prospective Studies ; Placenta Growth Factor ; Infant, Small for Gestational Age ; Biomarkers ; Fetal Growth Retardation/diagnosis ; Fetus/blood supply ; Pre-Eclampsia ; Ultrasonography, Prenatal ; Predictive Value of Tests
Chemical Substances	Placenta Growth Factor (144589-93-5) ; Biomarkers
Language	English
Publishing date	2023-03-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	896455-5
ISSN	1432-0711 ; 0932-0067
ISSN (online)	1432-0711
ISSN	0932-0067
DOI	10.1007/s00404-023-07012-w
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Article ; Online: Differences in cervical length during the second trimester among normal weight, overweight and obese women: A systematic review and meta-analysis.

Panagiotopoulos, Michail / Pergialiotis, Vasilios / Trimmi, Konstantina / Varthaliti, Antonia / Koutras, Antonios / Antsaklis, Panagiotis / Daskalakis, Georgios

European journal of obstetrics & gynecology and reproductive biology: X

2024 Volume 21, Page(s) 100291

Abstract: Objective: Maternal obesity has been previously linked to increased risk of preterm birth; however, the actual pathophysiology behind this observation remains unknown. Cervical length seems to differentiate among overweight, obese and extremely obese ... ...

Abstract	Objective: Maternal obesity has been previously linked to increased risk of preterm birth; however, the actual pathophysiology behind this observation remains unknown. Cervical length seems to differentiate among overweight, obese and extremely obese patients, compared to normal weight women. However, to date the actual association between body mass index and cervical length remains unknown. In this systematic review, accumulated evidence is presented to help establish clinical implementations and research perspectives. Methods: We searched Medline, Scopus, the Cochrane Central Register of Controlled Trials CENTRAL, Google Scholar, and Clinicaltrials.gov databases from inception till February 2023. Observational studies that reported on women undergone ultrasound assessment of their cervical length during pregnancy were included, when there was data regarding their body mass index. Statistical meta-analysis was performed with RStudio. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Results: Overall, 20 studies were included in this systematic review and 12 in the meta-analysis. Compared to women with normal weight, underweight women were not associated with increased risk of CL < 15 mm or < 30 mm and their mean CL was comparable (MD -1.51; 95% CI -3.07, 0.05). Overweight women were found to have greater cervical length compared to women with normal weight (MD 1.87; 95% CI 0.52, 3.23) and had a lower risk of CL < 30 mm (OR 0.65; 95% CI 0.47, 0.90). Conclusion: Further research into whether BMI is associated with cervical length in pregnant women is deemed necessary, with large, well-designed, prospective cohort studies with matched control group.
Language	English
Publishing date	2024-02-15
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	2590-1613
ISSN (online)	2590-1613
DOI	10.1016/j.eurox.2024.100291
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Article ; Online: The prognostic role of CRL discordance in first trimester ultrasound.

Fasoulakis, Zacharias / Sapantzoglou, Kimonas / Theodora, Marianna / Daskalakis, George / Kurjak, Asim / Antsaklis, Panagiotis

Journal of perinatal medicine

2024 Volume 52, Issue 3, Page(s) 294–297

Abstract: Objectives: In the first trimester, intertwin crown-rump length (CRL) discordance has emerged as a notable factor linked to adverse perinatal health effects. It is frequently employed as a basis for counseling parents regarding potential adverse ... ...

Abstract	Objectives: In the first trimester, intertwin crown-rump length (CRL) discordance has emerged as a notable factor linked to adverse perinatal health effects. It is frequently employed as a basis for counseling parents regarding potential adverse pregnancy outcomes. Despite its established association with adverse outcomes, the significance of CRL discordance in substantially predicting pregnancy problems and its efficacy in pregnancy screening remain subjects of ongoing discussion. The aim of this manuscript is to present current knowledge on CRL discordance. Methods: PubMed was searched for related articles with terms "Crown-Rump length", "Prenatal Screening", "Twin pregnancy", "Discordance". Results: Twenty-two studies were included in our study with six reporting data on monochorionic and 16 assessing the correlation between CRL discordance and adverse pregnancy outcomes. Fetal loss at the 20th and 24th week of the pregnancy, SGA neonates, pre-term delivery (32 weeks), perinatal death (24 weeks) are all reported adverse outcomes associated with CRL discordance. The reported cut-off for increased risk of adverse perinatal outcomes is a discordance of at least 10% or more. Conclusions: Increased CRL (>10 %) discordance is linked to a higher risk of sFGR in both monochorionic and dichorionic pregnancies, fetal loss, and preterm delivery.
MeSH term(s)	Infant, Newborn ; Female ; Pregnancy ; Humans ; Pregnancy Trimester, First ; Crown-Rump Length ; Prognosis ; Ultrasonography, Prenatal ; Pregnancy Outcome ; Pregnancy, Twin ; Retrospective Studies ; Fetal Growth Retardation
Language	English
Publishing date	2024-01-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123512-6
ISSN	1619-3997 ; 0300-5577 ; 0936-174X
ISSN (online)	1619-3997
ISSN	0300-5577 ; 0936-174X
DOI	10.1515/jpm-2023-0132
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Article ; Online: Antibiotic therapy in patients with amniotic fluid sludge and risk of preterm birth: a meta-analysis.

Sapantzoglou, I / Pergialiotis, V / Prokopakis, I / Douligeris, A / Stavros, S / Panagopoulos, P / Theodora, M / Antsaklis, P / Daskalakis, G

Archives of gynecology and obstetrics

2023 Volume 309, Issue 2, Page(s) 347–361

Abstract: Purpose: Amniotic Fluid Sludge (AFS) has been theorized to be sonographic evidence of an underlying infection/inflammation and studies have concluded that approximately 10% of the patients who show signs of preterm labor with intact membranes have an ... ...

Abstract	Purpose: Amniotic Fluid Sludge (AFS) has been theorized to be sonographic evidence of an underlying infection/inflammation and studies have concluded that approximately 10% of the patients who show signs of preterm labor with intact membranes have an underlying intraamniotic infection, mostly subclinical, carrying an increased risk for preterm birth with its subsequent neonatal and maternal complications. The purpose of the present systematic review is to evaluate the impact of antibiotic therapy on preterm birth rates of women diagnosed with AFS. Methods: We searched Medline, Scopus, the Cochrane Central Register of Controlled Trials CENTRAL, Google Scholar, and Clinicaltrials.gov databases for relevant articles published until the 30th of September 2022. Observational studies (prospective and retrospective) that evaluated the impact of antibiotics on preterm delivery rates of patients with AFS were considered eligible for inclusion. Statistical meta-analysis was performed with RStudio and we calculated pooled risk ratios (OR) and 95% confidence intervals (CI). To evaluate the information size, we performed trial sequential analysis (TSA) and the methodological quality of the included studies was assessed using RoBINS tools. Results: Overall, four retrospective cohort studies were included in the present systematic review and 369 women were enrolled. We demonstrated that preterm delivery prior to 34, 32 and 28 weeks of gestational age was comparable among the groups of women that had antibiotics and those that did not (OR: 0.34, 95% CI 0.05, 2.14, 0.40 [0.09, 1.66], 0.35 [0.08, 1.58], respectively) but the statistical heterogenicity of the studies included was high for every gestational period that was examined. Conclusions: According to our study, we cannot conclude that the use of antibiotics in women with amniotic fluid sludge benefit the prognostic risk to deliver prematurely. It is quite clear that data from larger sample sizes and more well adjusted and designed studies are needed.
MeSH term(s)	Female ; Humans ; Infant, Newborn ; Amniotic Fluid ; Anti-Bacterial Agents/therapeutic use ; Premature Birth/drug therapy ; Prospective Studies ; Retrospective Studies
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-04-25
Publishing country	Germany
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	896455-5
ISSN	1432-0711 ; 0932-0067
ISSN (online)	1432-0711
ISSN	0932-0067
DOI	10.1007/s00404-023-07045-1
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Article: Choriocarcinoma After Term Pregnancy With a Subsequent Successful Pregnancy: A Rare Entity.

Sapantzoglou, Ioakeim / Giourga, Maria / Psarris, Alexandros / Daskalakis, George / Domali, Ekaterini

Cureus

2023 Volume 15, Issue 10, Page(s) e47583

Abstract: Gestational trophoblastic neoplasia (GTN) is a group of pregnancy-related disorders that arise from the cells of conception. They include gestational choriocarcinoma (CC), placental site trophoblastic tumor, and epithelioid trophoblastic tumor with these ...

Abstract	Gestational trophoblastic neoplasia (GTN) is a group of pregnancy-related disorders that arise from the cells of conception. They include gestational choriocarcinoma (CC), placental site trophoblastic tumor, and epithelioid trophoblastic tumor with these forms arising from a molar pregnancy, abortion, or a normal genetic pregnancy. Most cases of GTN are diagnosed when the serum hCG levels plateau or rise in patients being followed up after the diagnosis of hydatidiform mole but can also be suspected due to persistent vaginal bleeding after a normal pregnancy and delivery. Early diagnosis and treatment are pivotal for ensuring optimal outcomes and given the rarity of the disease, clinical management and treatment should be provided in specialized centers. Here, we present a rare case of a 31-year-old woman diagnosed with choriocarcinoma with pulmonary metastasis following an uncomplicated full-term pregnancy. After the suction evacuation and curettage, she underwent six cycles of chemotherapy with an excellent response, a fact that resulted in a subsequent pregnancy and birth without complications, occurring 18 months thereafter.
Language	English
Publishing date	2023-10-24
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.47583
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Article: Congenital Heart Block and Its Association With Anti-Ro and Anti-La Antibodies in Pregnancy: A Case Report of a Rare Entity and a Review of the Current Evidence.

Sapantzoglou, Ioakeim / Fasoulakis, Zacharias / Daskalakis, George / Theodora, Marianna / Antsaklis, Panagiotis

Cureus

2023 Volume 15, Issue 9, Page(s) e45832

Abstract: Systemic lupus erythematosus (SLE) is a heterogeneous chronic, multisystem, inflammatory autoimmune disorder with variable clinical features, with its manifestations being attributed to the presence of multiple autoantibodies and their subsequent ... ...

Abstract	Systemic lupus erythematosus (SLE) is a heterogeneous chronic, multisystem, inflammatory autoimmune disorder with variable clinical features, with its manifestations being attributed to the presence of multiple autoantibodies and their subsequent autoimmune reactions. Multiple organs may be involved, with the kidneys, the joints, and the skin being the most common, increasing maternal and fetal morbidity and mortality. Our current article describes the case of a 32-year-old primigravida who was referred to our department after the detection of fetal bradycardia and the strong suspicion of an underlying cardiac abnormality. After a detailed fetal and maternal assessment, the diagnosis of SLE-associated fetal congenital heart block was established, and the appropriate management and treatment were provided, factors that led to the uncomplicated delivery and prompt successful management of an otherwise severely affected fetus. Our work, also, includes a detailed review of the accumulated evidence regarding the association between autoantibodies and congenital heart block, the available screening modalities of the condition, and its potential therapeutic interventions.
Language	English
Publishing date	2023-09-23
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.45832
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Article: Temporal restrictions on emissions trading and the implications for the carbon futures market: Lessons from the EU emissions trading scheme

Daskalakis, George

Energy policy. 2018 Apr., v. 115

2018

Abstract: Prohibiting the intertemporal trading of emission allowances induces positive risk premia in futures prices when the trading of the contracts and their expiry take place in time periods separated by this trading ban. In Phase I of the EU Emissions ... ...

Abstract	Prohibiting the intertemporal trading of emission allowances induces positive risk premia in futures prices when the trading of the contracts and their expiry take place in time periods separated by this trading ban. In Phase I of the EU Emissions Trading Scheme (EU ETS) these were in the order of about 28% of the futures price on average, depending on the contract's expiry in Phase II. Environmental policy makers should avoid such restrictions as they result in increased hedging costs for polluters that are, since emission allowances represent opportunity costs, potentially borne by consumers.
Keywords	European Union ; carbon ; environmental markets ; environmental policy ; futures trading ; opportunity costs ; risk
Language	English
Dates of publication	2018-04
Size	p. 88-91.
Publishing place	Elsevier Ltd
Document type	Article
ISSN	0301-4215
DOI	10.1016/j.enpol.2018.01.008
Database	NAL-Catalogue (AGRICOLA)

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Book ; Thesis: Der Alterungsprozeß der Bioprothesen

Daskalakis, Georgios

eine experimentelle Analyse der Strukturveränderungen von explantierten biologischen Herzklappen vom Typ Carpentier-Edwards, Hancock und Xenomedica unter Berücksichtigung der klinischen Daten

1995

Author's details	vorgelegt von Georgios Daskalakis
Language	German
Size	92 S. : Ill., graph. Darst.
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Aachen, Techn. Hochsch., Diss., 1995
HBZ-ID	HT006637142
Database	Catalogue ZB MED Medicine, Health

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Shelf mark	Loan status	Location
95 D 3104	order for loan	Magazin

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Article ; Online: Safety of non-steroidal anti-inflammatory drugs in postpartum period in women with hypertensive disorders of pregnancy: systematic review and meta-analysis.

Bellos, I / Pergialiotis, V / Antsaklis, A / Loutradis, D / Daskalakis, G

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology

2020 Volume 56, Issue 3, Page(s) 329–339

Abstract: Objective: To assess the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure when administered for postpartum analgesia in women with hypertensive disorders of pregnancy.: Methods: MEDLINE, Scopus, CENTRAL, Clinicaltrials.gov ... ...

Abstract	Objective: To assess the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure when administered for postpartum analgesia in women with hypertensive disorders of pregnancy. Methods: MEDLINE, Scopus, CENTRAL, Clinicaltrials.gov and Google Scholar databases were searched systematically from inception to 5 December 2019 for studies evaluating the safety of postpartum NSAIDs in women with any gestational hypertensive disorder. Randomized controlled trials (RCTs) and cohort studies were eligible for inclusion. Case-control studies, case series and case reports were excluded. The primary outcomes of interest were the incidence of severe hypertension and systolic, diastolic and mean arterial blood pressure. Pooled estimates were obtained by fitting a random-effects statistical model. The quality of evidence was assessed according to Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines. Results: Ten studies were included, comprising five RCTs and five retrospective cohort studies and involving a total of 1647 women. All studies were evaluated qualitatively and eight of them were included in the quantitative meta-analysis. Administration of NSAIDs was not associated with a significantly higher risk of severe postpartum hypertension (odds ratio, 1.52 (95% CI, 0.77-3.01)). Similarly, no significant differences were found in postpartum systolic blood pressure (mean difference (MD), -3.03 mmHg (95% CI, -6.21 to 0.15 mmHg)) and mean arterial pressure (MD, -0.38 mmHg (95% CI, -1.88 to 1.11 mmHg)) between women who received NSAIDs and those who did not, whereas postpartum diastolic blood pressure was marginally lower in women treated with NSAIDs (MD, -2.28 mmHg (95% CI, -4.44 to -0.13 mmHg)). The same effects were observed when studies with a large sample size, RCTs, women with severe pre-eclampsia and studies using ibuprofen as the study drug and acetaminophen as the control treatment were examined separately. The credibility of evidence was judged to be very low according to GRADE, owing to concerns about study limitations, inconsistency and imprecision. Conclusions: This meta-analysis suggests that postpartum administration of NSAIDs is not associated with elevated blood pressure in women with hypertensive disorders of pregnancy. However, the existing evidence is of very low quality, thus future large-scale RCTs are warranted to verify the safety of postpartum NSAIDs in this population. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
MeSH term(s)	Anti-Inflammatory Agents, Non-Steroidal/administration & dosage ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Blood Pressure ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Postpartum Period ; Pregnancy
Chemical Substances	Anti-Inflammatory Agents, Non-Steroidal
Language	English
Publishing date	2020-02-17
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1073183-0
ISSN	1469-0705 ; 0960-7692
ISSN (online)	1469-0705
ISSN	0960-7692
DOI	10.1002/uog.21997
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Article ; Online: Metabolic rewiring is associated with HPV-specific profiles in cervical cancer cell lines.

Pappa, Kalliopi I / Daskalakis, George / Anagnou, Nicholas P

Scientific reports

2021 Volume 11, Issue 1, Page(s) 17718

Abstract: Both HPV-positive and HPV-negative cervical cancers are associated with aberrant metabolism, although the oncogenic drivers remain elusive. Here we show the assessment of the metabolomic profiles of four distinct cervical cell lines, a normal and three ... ...

Abstract	Both HPV-positive and HPV-negative cervical cancers are associated with aberrant metabolism, although the oncogenic drivers remain elusive. Here we show the assessment of the metabolomic profiles of four distinct cervical cell lines, a normal and three cancer cell lines, one HPV-negative (C33A) and two HPV-positive (SiHa HPV16+, HeLa HPV18+), employing an ultra performance liquid chromatography and a high resolution mass spectrometry. Out of the total 462 metabolites, 248 to 326 exhibited statistically significant differences, while Random Forests analysis identified unique molecules for each cell line. The two HPV+ cell lines exhibited features of Warburg metabolism, consistent with the role of the HPV E6 protein. SiHa and HeLa cells displayed purine salvage pathway activity, while C33A cells revealed synthesis of cytidine, via a novel mechanism. These data document a highly dynamic HPV-specific rewiring of metabolic pathways occurring in cervical cancer. Therefore, this approach can eventually provide novel mechanistic insights into cervical carcinogenesis.
MeSH term(s)	Cell Line, Tumor ; Cervix Uteri/metabolism ; Cervix Uteri/pathology ; Cervix Uteri/virology ; Female ; HeLa Cells ; Humans ; Niacin/metabolism ; Nucleic Acids/metabolism ; Papillomavirus Infections/metabolism ; Papillomavirus Infections/pathology ; Papillomavirus Infections/virology ; Proteomics ; Uterine Cervical Neoplasms/metabolism ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/virology
Chemical Substances	Nucleic Acids ; Niacin (2679MF687A)
Language	English
Publishing date	2021-09-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-96038-8
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