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  1. Article ; Online: Risk of pregnancy complications in living kidney donors: A systematic review and meta-analysis.

    Bellos, Ioannis / Pergialiotis, Vasilios

    European journal of obstetrics, gynecology, and reproductive biology

    2022  Volume 270, Page(s) 35–41

    Abstract: Living kidney donation is associated with glomerular hyperfiltration, predisposing for the development of chronic kidney disease. The present meta-analysis aims to gather current evidence and clarify whether kidney donors are at increased risk of future ... ...

    Abstract Living kidney donation is associated with glomerular hyperfiltration, predisposing for the development of chronic kidney disease. The present meta-analysis aims to gather current evidence and clarify whether kidney donors are at increased risk of future pregnancy complications. Medline, Scopus, Web of Science, CENTRAL and Google Scholar were systematically searched from inception to August 29, 2021. Observational studies comparing the rates of adverse pregnancy outcomes among kidney donors and non-donors were selected. Random-effects models were fitted to provide meta-analysis estimates, while the quality of evidence was appraised with the Grading of Recommendations Assessment, Development and Evaluation approach. Five studies were included, comprising 430 donors and 23,540 non-donors. Living kidney donation was associated with significantly higher risk of preeclampsia (OR: 2.86, 95% CI: 1.62-5.05, moderate quality of evidence), gestational hypertension (OR: 2.53, 95% CI: 1.11-5.74, low quality of evidence) and preterm birth (OR: 1.32, 95% CI: 1.01-1.74, moderate quality of evidence). The anticipated absolute rates of preeclampsia, gestational hypertension and preterm birth were 7.4%, 5.4% and 8.3%, respectively. The risk of gestational diabetes, cesarean delivery, low birthweight and fetal death was similar between the two groups (low quality of evidence). In conclusion, women with history of kidney donation are at significantly increased risk of preeclampsia, gestational hypertension and preterm birth in subsequent pregnancies, although the absolute rate of complications remains below 10%. Future studies should confirm these effects and improve potential donor counseling by individualizing the risk of adverse perinatal outcomes.
    MeSH term(s) Female ; Humans ; Infant, Newborn ; Kidney ; Kidney Transplantation/adverse effects ; Pregnancy ; Pregnancy Complications/epidemiology ; Pregnancy Complications/etiology ; Pregnancy Outcome ; Premature Birth/epidemiology ; Premature Birth/etiology
    Language English
    Publishing date 2022-01-03
    Publishing country Ireland
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 190605-7
    ISSN 1872-7654 ; 0301-2115 ; 0028-2243
    ISSN (online) 1872-7654
    ISSN 0301-2115 ; 0028-2243
    DOI 10.1016/j.ejogrb.2021.12.037
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Reply: Prophylactic tranexamic acid in cesarean delivery: synthesis of evidence.

    Bellos, Ioannis / Pergialiotis, Vasilios

    American journal of obstetrics and gynecology

    2021  Volume 226, Issue 5, Page(s) 756–757

    MeSH term(s) Antifibrinolytic Agents/therapeutic use ; Cesarean Section ; Female ; Humans ; Postpartum Hemorrhage/prevention & control ; Pregnancy ; Tranexamic Acid/therapeutic use
    Chemical Substances Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
    Language English
    Publishing date 2021-12-28
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2021.12.040
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Tranexamic acid for the prevention of postpartum hemorrhage in women undergoing cesarean delivery: an updated meta-analysis.

    Bellos, Ioannis / Pergialiotis, Vasilios

    American journal of obstetrics and gynecology

    2021  Volume 226, Issue 4, Page(s) 510–523.e22

    Abstract: Objective: This study aimed to assess the efficacy and safety of prophylactic tranexamic acid administration vs standard uterotonic agents alone among women undergoing cesarean delivery.: Data sources: MEDLINE, Scopus, Web of Science, Cochrane ... ...

    Abstract Objective: This study aimed to assess the efficacy and safety of prophylactic tranexamic acid administration vs standard uterotonic agents alone among women undergoing cesarean delivery.
    Data sources: MEDLINE, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and Google Scholar were systematically searched from inception to June 30, 2021.
    Study eligibility criteria: Randomized controlled trials comparing intravenous tranexamic acid administration with placebo in women undergoing cesarean delivery and receiving standard prophylactic uterotonic agents were held eligible.
    Study appraisal and synthesis methods: The risk of bias of individual studies was appraised with the Risk of Bias 2 tool. Meta-analysis was conducted by fitting random-effects models using restricted maximum likelihood. Subgroup analysis was performed on the basis of country, protocol availability, double-blinding, risk of bias, sample size, and tranexamic acid dose. A 1-stage meta-analysis was performed as a sensitivity analysis. The credibility of outcomes was appraised with the Grading of Recommendations Assessment, Development and Evaluation approach.
    Results: Overall, 36 studies with 10,659 women were included. Tranexamic acid administration was associated with significantly lower total blood loss (mean difference, -189.44 mL; 95% confidence intervals, -218.63 to -160.25), lower hemoglobin drop (mean difference, 8.22%; 95% confidence interval, 5.54-10.90), decreased risk of blood loss of >1000 mL (odds ratio, 0.37; 95% confidence interval, 0.22-0.60), transfusion requirement (odds ratio, 0.41; 95% confidence interval, 0.26-0.65), and need of additional uterotonics (odds ratio, 0.36; 95% confidence interval, 0.25-0.52). Subgroup analysis indicated a greater effect of tranexamic acid on total blood loss reduction in low-middle income countries. The outcomes remained stable by separately evaluating women at low bleeding risk. The 1-stage meta-analysis demonstrated similar outcomes with the primary analysis. The quality of evidence was judged to be moderate regarding total blood loss and hemoglobin percentage change and low for the other outcomes.
    Conclusion: This meta-analysis suggested that prophylactic tranexamic acid administration is effective among women undergoing cesarean delivery in lowering postpartum blood loss and limiting hemoglobin drop. Further research is needed to test its efficacy in high-risk populations and verify its safety profile.
    MeSH term(s) Administration, Intravenous ; Antifibrinolytic Agents/therapeutic use ; Blood Transfusion ; Cesarean Section ; Female ; Humans ; Postpartum Hemorrhage/drug therapy ; Postpartum Hemorrhage/prevention & control ; Pregnancy ; Tranexamic Acid/therapeutic use
    Chemical Substances Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
    Language English
    Publishing date 2021-09-25
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Review
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2021.09.025
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  4. 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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  5. Article ; Online: Doppler parameters of renal hemodynamics in women with preeclampsia: A systematic review and meta-analysis.

    Bellos, Ioannis / Pergialiotis, Vasilios

    Journal of clinical hypertension (Greenwich, Conn.)

    2020  Volume 22, Issue 7, Page(s) 1134–1144

    Abstract: The present meta-analysis aims to compare renal arterial and venous Doppler parameters in women with preeclampsia and healthy pregnant controls. Medline, Scopus, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, and Google Scholar ... ...

    Abstract The present meta-analysis aims to compare renal arterial and venous Doppler parameters in women with preeclampsia and healthy pregnant controls. Medline, Scopus, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, and Google Scholar databases were systematically searched from inception to December 04, 2019. All observational studies reporting renal resistive index, pulsatility index, renal interlobar vein impedance, or pulse transit time among preeclamptic and healthy pregnant women were held eligible. Subgroup analysis was conducted on the basis of disease onset and side of measurement. Both pair-wise and network meta-analysis were performed using Review Manager 5.3 and R-3.4.3 software. Fourteen studies were included, with a total of 1118 women. No difference of renal resistive (MD: 0.00, 95% CI: [-0.03, 0.04]) and pulsatility index (MD: -0.01, 95% CI: [-0.14, 0.12]) was evident between the two groups. Renal interlobar vein impedance was estimated to be significantly higher in preeclampsia (MD: 0.07, 95% CI: [0.06, 0.09]), while venous pulse transit time was significantly lower (MD: -0.10, 95% CI: [-0.14, -0.05]) in women with the disease. Subgroup analysis indicated that early-onset preeclampsia was associated with significantly elevated renal interlobar vein impedance and lower venous pulse transit time than late-onset disease. The outcomes of the present meta-analysis suggest that preeclampsia is characterized by venous hemodynamic dysfunction as it is associated with significantly elevated renal interlobar vein impedance and shorter venous pulse transit time. Future large-scale prospective studies should introduce cutoff values and determine the optimal timing of measurement in order to achieve optimal predictive accuracy.
    MeSH term(s) Female ; Hemodynamics ; Humans ; Kidney/diagnostic imaging ; Pre-Eclampsia/diagnostic imaging ; Pregnancy ; Prospective Studies
    Language English
    Publishing date 2020-07-09
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 2077222-1
    ISSN 1751-7176 ; 1524-6175
    ISSN (online) 1751-7176
    ISSN 1524-6175
    DOI 10.1111/jch.13940
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  6. Article ; Online: Comparative efficacy of fixed-dose statin and antihypertensive agent combinations: A network meta-analysis of randomized controlled trials.

    Bellos, Ioannis / Pergialiotis, Vasilios / Perrea, Despina N

    Vascular pharmacology

    2021  Volume 141, Page(s) 106900

    Abstract: Background: The concurrent administration of statins and antihypertensive agents has been associated with improved cardiovascular outcomes, although the optimal fixed-dose combination remains unclear. This meta-analysis aims to compare the blood ... ...

    Abstract Background: The concurrent administration of statins and antihypertensive agents has been associated with improved cardiovascular outcomes, although the optimal fixed-dose combination remains unclear. This meta-analysis aims to compare the blood pressure and lipid-lowering effects of various statin and antihypertensive drug combinations.
    Methods: PubMed, Scopus, Web of Science, CENTRAL and Clinicaltrials.gov were systematically searched from inception to 20 March 2021. Randomized controlled trials evaluating the effects of statin-antihypertensive agent combinations on systolic blood pressure or serum lipids were held eligible. A random-effects frequentist model was applied to provide estimates of mean difference of percentage change.
    Results: Overall, 18 studies were included, comprising 4450 patients. Compared to statin monotherapy no significant difference in the percentage change of low-density lipoprotein cholesterol was achieved by adding any antihypertensive agent. Compared to amlodipine monotherapy, the addition of moderate-intensity statin resulted in a significantly greater percentage reduction of systolic blood pressure (-2.22%, 95% confidence intervals: [-3.82 to -0.62]). Combined high-intensity statin and amlodipine lead to significant increase of high-density lipoprotein cholesterol (8.34%, 95% confidence intervals: [0.73 to 15.95]), while effective triglyceride reduction was achieved by adding amlodipine and telmisartan to high-intensity statin (-14.68%, 95% confidence intervals: [-28.48 to -0.89]). No significant difference of adverse effects was observed.
    Conclusion: The present network meta-analysis suggests that the administration of fixed-dose combinations of statins and antihypertensive agents is safe and effective in reducing blood pressure and serum lipids. The optimal dosing strategy to prevent cardiovascular events remains to be determined.
    MeSH term(s) Antihypertensive Agents/therapeutic use ; Blood Pressure ; Drug Combinations ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Hypertension/chemically induced ; Hypertension/diagnosis ; Hypertension/drug therapy ; Network Meta-Analysis ; Randomized Controlled Trials as Topic
    Chemical Substances Antihypertensive Agents ; Drug Combinations ; Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2021-07-31
    Publishing country United States
    Document type Journal Article ; Meta-Analysis
    ZDB-ID 2082846-9
    ISSN 1879-3649 ; 1537-1891 ; 1879-3649
    ISSN (online) 1879-3649 ; 1537-1891
    ISSN 1879-3649
    DOI 10.1016/j.vph.2021.106900
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  7. Article ; Online: Kidney biopsy findings in vancomycin-induced acute kidney injury: a pooled analysis.

    Bellos, Ioannis / Pergialiotis, Vasilios / Perrea, Despina N

    International urology and nephrology

    2021  Volume 54, Issue 1, Page(s) 137–148

    Abstract: Background: Acute kidney injury represents a major adverse effect of vancomycin administration. The aim of the present study is to accumulate all biopsy-proven cases of vancomycin nephrotoxicity and assess the association of histopathological features ... ...

    Abstract Background: Acute kidney injury represents a major adverse effect of vancomycin administration. The aim of the present study is to accumulate all biopsy-proven cases of vancomycin nephrotoxicity and assess the association of histopathological features with renal prognosis.
    Methods: Medline, Scopus, CENTRAL, Web of Science, and Clinicaltrials.gov were systematically searched from inception to 29 September 2020. All case reports/series providing individual data of patients with biopsy-proven vancomycin nephrotoxicity were held eligible. A time-to-event analysis was performed evaluating the effects of histological diagnosis on renal recovery.
    Results: Overall, 18 studies were included, comprising 21 patients. Acute tubulointerstitial nephritis was the predominant pattern in 9 patients and was associated with a significantly higher risk of permanent renal dysfunction (HR: 5.08, 95% CI: [1.05-24.50)] compared to acute tubular necrosis. Tubulitis and eosinophilic infiltration were the most common histopathological findings, while interstitial fibrosis was linked to significantly worse renal prognosis (HR: 5.55, 95% CI: 1.13-27.27). Immunofluorescence and electron microscopy features were non-specific. Obstruction by tubular casts composed of vancomycin aggregates and uromodulin has been identified as a new mechanism of nephrotoxicity.
    Conclusions: Acute tubular necrosis and tubulointerstitial nephritis represent the main histological patterns of vancomycin-induced acute kidney injury. The presence of fibrosis in the context of interstitial inflammation may be linked to lower recovery rates and worse long-term renal outcomes. A novel cast nephropathy obstructive mechanism has been suggested, necessitating further confirmation. Large-scale studies should define the exact indications of kidney biopsy in cases with suspected vancomycin nephrotoxicity.
    MeSH term(s) Acute Kidney Injury/chemically induced ; Acute Kidney Injury/pathology ; Anti-Bacterial Agents/adverse effects ; Biopsy ; Humans ; Kidney/pathology ; Prognosis ; Vancomycin/adverse effects
    Chemical Substances Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU)
    Language English
    Publishing date 2021-03-14
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 204048-7
    ISSN 1573-2584 ; 0301-1623 ; 0042-1162
    ISSN (online) 1573-2584
    ISSN 0301-1623 ; 0042-1162
    DOI 10.1007/s11255-021-02831-9
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  8. Article: Maximal Effort Cytoreduction in Epithelial Ovarian Cancer: Perioperative Complications and Survival Outcomes from a Retrospective Cohort.

    Haidopoulos, Dimitrios / Pergialiotis, Vasilios / Zachariou, Eleftherios / Sapantzoglou, Ioakim / Thomakos, Nikolaos / Stamatakis, Emmanouil / Alexakis, Nikolaos

    Journal of clinical medicine

    2023  Volume 12, Issue 2

    Abstract: ... ...

    Abstract Background
    Language English
    Publishing date 2023-01-12
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12020622
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  9. Article ; Online: Correction to: The effect of endometriosis on fertility in an animal model.

    Kanellopoulos, Dimitrios / Karagianni, Dimitra / Pergialiotis, Vasilios / Nikiteas, Nikolaos / Lazaris, Andreas C / Iliopoulos, Dimitrios

    Journal of medicine and life

    2023  Volume 16, Issue 2, Page(s) 330

    Abstract: This corrects the article DOI: 10.25122/jml-2021-0391.]. ...

    Abstract [This corrects the article DOI: 10.25122/jml-2021-0391.].
    Language English
    Publishing date 2023-02-15
    Publishing country Romania
    Document type Published Erratum
    ZDB-ID 2559353-5
    ISSN 1844-3117 ; 1844-3117 ; 1844-3109
    ISSN (online) 1844-3117
    ISSN 1844-3117 ; 1844-3109
    DOI 10.25122/jml-2023-1010
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  10. Article: The impact of maternal diabetes on the future health and neurodevelopment of the offspring: a review of the evidence.

    Rodolaki, Kalliopi / Pergialiotis, Vasilios / Iakovidou, Nikoleta / Boutsikou, Theodora / Iliodromiti, Zoe / Kanaka-Gantenbein, Christina

    Frontiers in endocrinology

    2023  Volume 14, Page(s) 1125628

    Abstract: Maternal health during gestational period is undoubtedly critical in shaping optimal fetal development and future health of the offspring. Gestational diabetes mellitus is a metabolic disorder occurring in pregnancy with an alarming increasing incidence ... ...

    Abstract Maternal health during gestational period is undoubtedly critical in shaping optimal fetal development and future health of the offspring. Gestational diabetes mellitus is a metabolic disorder occurring in pregnancy with an alarming increasing incidence worldwide during recent years. Over the years, there is a growing body of evidence that uncontrolled maternal hyperglycaemia during pregnancy can potentially have detrimental effect on the neurodevelopment of the offspring. Both human and animal data have linked maternal diabetes with motor and cognitive impairment, as well as autism spectrum disorders, attention deficit hyperactivity disorder, learning abilities and psychiatric disorders. This review presents the available data from current literature investigating the relationship between maternal diabetes and offspring neurodevelopmental impairment. Moreover, possible mechanisms accounting for the detrimental effects of maternal diabetes on fetal brain like fetal neuroinflammation, iron deficiency, epigenetic alterations, disordered lipid metabolism and structural brain abnormalities are also highlighted. On the basis of the evidence demonstrated in the literature, it is mandatory that hyperglycaemia during pregnancy will be optimally controlled and the impact of maternal diabetes on offspring neurodevelopment will be more thoroughly investigated.
    MeSH term(s) Pregnancy ; Female ; Animals ; Humans ; Diabetes, Gestational ; Prenatal Exposure Delayed Effects/epidemiology ; Autism Spectrum Disorder ; Iron Deficiencies ; Hyperglycemia
    Language English
    Publishing date 2023-07-03
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2023.1125628
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