45 results found
Kechagias K, Katsikas-Triantafyllidis K, Kyriakidou M, et al., 2021, The relation between caffeine consumption and endometriosis: An updated systematic review and meta-analysis, Nutrients, ISSN: 2072-6643
Mitra A, MacIntyre D, Paraskevaidi M, et al., 2021, The Vaginal Microbiota and Innate Immunity After Local Excisional Treatment for Cervical Intraepithelial Neoplasia, Genome Medicine: medicine in the post-genomic era, ISSN: 1756-994X
Kyrgiou M, Bowden SJ, Athanasiou A, et al., 2021, Morbidity after local excision of the transformation zone for cervical intra-epithelial neoplasia and early cervical cancer, Best Practice and Research: Clinical Obstetrics and Gynaecology, Vol: 75, Pages: 10-22, ISSN: 1521-6934
The awareness that cervical intra-epithelial neoplasia (CIN) treatment increases the risk of preterm birth has led to major changes in clinical practice. Women with CIN have a higher baseline risk of prematurity but local treatment further increases this risk. The risk further increases with increasing cone length and multiplies for repeat excisions; it is unclear whether small cones confer any additional risk to CIN alone. There is no evidence to suggest that fertility is affected by local treatment, although this increases the risk of mid-trimester loss. Caution should prevail when deciding to treat women with CIN of reproductive age. If treatment is offered, this should be conducted effectively to optimise the clearance of disease and minimise the risk of recurrence. Colposcopists should alert women undergoing treatment that this may increase the risk of preterm birth and that they may be offered interventions when pregnant. The cone length should be clearly documented and used as a risk stratifier.
Luo Y, Liu H, Wu C, et al., 2021, Diagnostic segregation of human breast tumours using Fourier-transform infrared spectroscopy coupled with multivariate analysis: Classifying cancer subtypes, SPECTROCHIMICA ACTA PART A-MOLECULAR AND BIOMOLECULAR SPECTROSCOPY, Vol: 255, ISSN: 1386-1425
Paraskevaidis E, Athanasiou A, Kalliala I, et al., 2021, Invasive cervical cancer following treatment of pre-invasive lesions: A potential theory based on a small case series, European Journal of Obstetrics Gynecology and Reproductive Biology, Vol: 264, Pages: 56-59, ISSN: 0301-2115
PURPOSE: The aim of this study is to present a single department's experience on cervical cancer cases following previous excision of cervical intraepithelial neoplasia (CIN) and to discuss potential pathogenesis. METHODS: Nine cervical cancer cases meeting the inclusion criteria, with available pathological and follow-up data, were considered eligible for this study. RESULTS: The majority (7/9) have had clear excisional margins. The interval between initial treatment and cancer diagnosis ranged from 7 to 17 years. In all cases cancer diagnosis was "unexpected", as the prior cytological and/or colposcopic evaluation was not suggestive of significant cervical pathology. All cancers were squamous, and 5/9 at stage I. CONCLUSION: The long interval between initial CIN treatment and final diagnosis as well as the normal post-treatment follow-up may suggest a 'de novo' underlying but 'hidden' carcinogenesis process. It might be that dysplastic cells entrapped within crypts (or normal metaplastic affected by the same predisposing factors) continue undergoing their evolution, undetectable by cytology and colposcopy until they invade stroma and surfaces (endo- and/or ectocervical) approximately a decade later. Heavy cauterisation of cervical crater produced post excision might be a potential culprit of this entrapment.
Kechagias KS, Semertzidou A, Athanasiou A, et al., 2020, Bisphenol-A and polycystic ovary syndrome: a review of the literature, Reviews on Environmental Health, Vol: 35, Pages: 323-331, ISSN: 0048-7554
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age with reproductive, metabolic and endocrine implications. While the exact pathophysiological mechanisms of the syndrome are unknown, its heterogeneity suggests a multifactorial causal background. In the last two decades, numerous environmental chemicals, including Bisphenol-A (BPA) that is used in the synthesis of polycarbonate plastics, have been proposed as potential contributors to the aetiology of PCOS. This review provides a holistic overview of the available data regarding the possible relation of PCOS with BPA exposure. We have included a total number of 24 studies. Eleven human case-control and 13 animal studies provided data regarding this potential relation. Accumulating evidence suggests that a correlation between high levels of BPA and the presence of PCOS may exist. Contradicting results from human and animal studies, however, render it difficult to conclude on the exact role of BPA in the pathogenesis of PCOS. BPA may constitute a consequence of the syndrome rather than a cause, but further research is still needed to clarify this. Continued efforts to study the early origins of PCOS, using prospective-designed studies, are required to identify the exact effect of BPA on women with PCOS.
Paraskevaidi M, Cameron SJS, Whelan E, et al., 2020, Laser-assisted rapid evaporative ionisation mass spectrometry (LA-REIMS) as a metabolomics platform in cervical cancer screening, EBioMedicine, Vol: 60, ISSN: 2352-3964
BackgroundThe introduction of high-risk human papillomavirus (hrHPV) testing as part of primary cervical screening is anticipated to improve sensitivity, but also the number of women who will screen positive. Reflex cytology is the preferred triage test in most settings but has limitations including moderate diagnostic accuracy, lack of automation, inter-observer variability and the need for clinician-collected sample. Novel, objective and cost-effective approaches are needed.MethodsIn this study, we assessed the potential use of an automated metabolomic robotic platform, employing the principle of laser-assisted Rapid Evaporative Ionisation Mass Spectrometry (LA-REIMS) in cervical cancer screening.FindingsIn a population of 130 women, LA-REIMS achieved 94% sensitivity and 83% specificity (AUC: 91.6%) in distinguishing women testing positive (n = 65) or negative (n = 65) for hrHPV. We performed further analysis according to disease severity with LA-REIMS achieving sensitivity and specificity of 91% and 73% respectively (AUC: 86.7%) in discriminating normal from high-grade pre-invasive disease.InterpretationThis automated high-throughput technology holds promise as a low-cost and rapid test for cervical cancer screening and triage. The use of platforms like LA-REIMS has the potential to further improve the accuracy and efficiency of the current national screening programme.
Tzafetas M, Mitra A, Paraskevaidi M, et al., 2020, The intelligent knife (iKnife) and its intraoperative diagnostic advantage for the treatment of cervical disease (vol 117, pg 7338, 2020), PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, Vol: 117, Pages: 18892-18892, ISSN: 0027-8424
Paraskevaidi M, Allsop D, Karim S, et al., 2020, Diagnostic biomarkers for Alzheimer's disease using non-invasive specimens, Journal of Clinical Medicine, Vol: 9, Pages: 1-19, ISSN: 2077-0383
Studies in the field of Alzheimer’s disease (AD) have shown the emergence of biomarkers in biologic fluids that hold great promise for the diagnosis of the disease. A diagnosis of AD at a presymptomatic or early stage may be the key for a successful treatment, with clinical trials currently investigating this. It is anticipated that preventative and therapeutic strategies may be stage-dependent, which means that they have a better chance of success at a very early stage—before critical neurons are lost. Several studies have been investigating the use of cerebrospinal fluid (CSF) and blood as clinical samples for the detection of AD with a number of established core markers, such as amyloid beta (Aβ), total tau (T-tau) and phosphorylated tau (P-tau), being at the center of clinical research interest. The use of oral samples—including saliva and buccal mucosal cells—falls under one of the least-investigated areas in AD diagnosis. Such samples have great potential to provide a completely non-invasive alternative to current CSF and blood sampling procedures. The present work is a thorough review of the results and analytical approaches, including proteomics, metabolomics, spectroscopy and microbiome analyses that have been used for the study and detection of AD using salivary samples and buccal cells. With a few exceptions, most of the studies utilizing oral samples were performed in small cohorts, which in combination with the existence of contradictory results render it difficult to come to a definitive conclusion on the value of oral markers. Proteins such as Aβ, T-tau and P-tau, as well as small metabolites, were detected in saliva and have shown some potential as future AD diagnostics. Future large-cohort studies and standardization of sample preparation and (pre-)analytical factors are necessary to determine the use of these non-invasive samples as a diagnostic tool for AD.
Paraskevaidi M, Morais CLM, Ashton KM, et al., 2020, Detecting endometrial cancer by blood spectroscopy: a diagnostic cross-sectional study, Cancers, Vol: 12, Pages: 1-17, ISSN: 2072-6694
Endometrial cancer is the sixth most common cancer in women, with a rising incidence worldwide. Current approaches for the diagnosis and screening of endometrial cancer are invasive, expensive or of moderate diagnostic accuracy, limiting their clinical utility. There is a need for cost-effective and minimally invasive approaches to facilitate the early detection and timely management of endometrial cancer. We analysed blood plasma samples in a cross-sectional diagnostic accuracy study of women with endometrial cancer (n = 342), its precursor lesion atypical hyperplasia (n = 68) and healthy controls (n = 242, total n = 652) using attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy and machine learning algorithms. We show that blood-based infrared spectroscopy has the potential to detect endometrial cancer with 87% sensitivity and 78% specificity. Its accuracy is highest for Type I endometrial cancer, the most common subtype, and for atypical hyperplasia, with sensitivities of 91% and 100%, and specificities of 81% and 88%, respectively. Our large-cohort study shows that a simple blood test could enable the early detection of endometrial cancer of all stages in symptomatic women and provide the basis of a screening tool in high-risk groups. Such a test has the potential not only to differentially diagnose endometrial cancer but also to detect its precursor lesion atypical hyperplasia—the early recognition of which may allow fertility sparing management and cancer prevention.
Prophylactic vaccines have been found to be highly effective in preventing infection and pre-invasive and invasive cervical, vulvovaginal and anal disease caused by the vaccine types. HPV vaccines contain virus-like particles that lack the viral genome and produce high titres of neutralising antibodies. Although the vaccines are highly effective in preventing infections, they do not enhance clearance of existing infections. Vaccination programmes target prepubertal girls and boys prior to sexual debut as efficacy is highest in HPV naïve individuals. School-based programmes achieve higher coverage, although implementation is country specific. Vaccination of older women may offer some protection and acceleration of impact, although this may not be cost-effective. HPV-based screening will continue for vaccinated cohorts, although intervals may increase.
Paraskevaidis E, Athanasiou A, Paraskevaidi M, et al., 2020, Cervical pathology following HPV vaccination in Greece: A 10-year HeCPA observational cohort study, In Vivo: international journal of experimental and clinical pathophysiology and drug research, Vol: 34, Pages: 1445-1449, ISSN: 0258-851X
Background: In Greece the population-level impact of HPV vaccination is unknown due to lacking official registries. This study presents in a pragmatic frame the comparison of cervical pathology data between HPV-vaccinated and unvaccinated women referred for colposcopy.Materials and Methods: This is an observational prospective cohort study performed in 7 academic Obstetrics & Gynaecology departments across Greece between 2009-2019. Cases were women that had completed HPV vaccination before coitarche and were referred for colposcopy due to abnormal cytology. For each vaccinated woman an unvaccinated matched control was selected. Results: A total of 849 women who had been vaccinated before coitarche and 849 unvaccinated controls were recruited. The combination of cytological, colposcopic and molecular findings necessitated treatment in only a single case among vaccinated (0.1%) and in 8.4% among unvaccinated. Conclusion: Despite potential bias, this study’s message is clear: HPV vaccination at a proper age can markedly reduce development of severe cervical precancer and consequently, the need for treatments with their long-term related obstetrical morbidity.
Tzafetas M, Mitra A, Paraskevaidi M, et al., 2020, The intelligent-Knife (i-Knife) and its intraoperative diagnostic advantage for the treatment of cervical disease, Proceedings of the National Academy of Sciences of USA, Vol: 117, Pages: 7338-7346, ISSN: 0027-8424
Clearance of surgical margins in cervical cancer prevents the need for adjuvant chemoradiation and allows fertility preservation. In this study, we determined the capacity of the rapid evaporative ionization mass spectrometry (REIMS), also known as intelligent knife (iKnife), to discriminate between healthy, preinvasive, and invasive cervical tissue. Cervical tissue samples were collected from women with healthy, human papilloma virus (HPV) ± cervical intraepithelial neoplasia (CIN), or cervical cancer. A handheld diathermy device generated surgical aerosol, which was transferred into a mass spectrometer for subsequent chemical analysis. Combination of principal component and linear discriminant analysis and least absolute shrinkage and selection operator was employed to study the spectral differences between groups. Significance of discriminatory m/z features was tested using univariate statistics and tandem MS performed to elucidate the structure of the significant peaks allowing separation of the two classes. We analyzed 87 samples (normal = 16, HPV ± CIN = 50, cancer = 21 patients). The iKnife discriminated with 100% accuracy normal (100%) vs. HPV ± CIN (100%) vs. cancer (100%) when compared to histology as the gold standard. When comparing normal vs. cancer samples, the accuracy was 100% with a sensitivity of 100% (95% CI 83.9 to 100) and specificity 100% (79.4 to 100). Univariate analysis revealed significant MS peaks in the cancer-to-normal separation belonging to various classes of complex lipids. The iKnife discriminates healthy from premalignant and invasive cervical lesions with high accuracy and can improve oncological outcomes and fertility preservation of women treated surgically for cervical cancer. Larger in vivo research cohorts are required to validate these findings.
Kalliala I, Athanasiou A, Veroniki AA, et al., 2020, Incidence and mortality from cervical cancer and other malignancies after treatment of cervical intraepithelial neoplasia: a systematic review and meta-analysis of the literature., Annals of Oncology, Vol: 31, Pages: 213-227, ISSN: 0923-7534
Background: While local treatments for cervical intraepithelial neoplasia (CIN) are highly effective, it has been reported that treated women remain at increased risk of cervical and other cancers. Our aim is to explore the risk of developing or dying from cervical cancer and other HPV- and non-HPV-related malignancies after CIN treatment and infer about its magnitude compared to general population.Materials and methods:Design: Systematic review and meta-analysis.Eligibility criteria: Studies with registry-based follow-up reporting cancer incidence or mortality after CIN treatment. Data synthesis: Summary effects were estimated using random-effects models.Outcomes: Incidence rate of cervical cancer among women treated for CIN (per 100,000 woman-years). Relative risk (RR) of cervical cancer, other HPV-related anogenital tract cancer (vagina, vulva, anus), any cancer, and mortality, for women treated with CIN versus the general population.Results: Twenty-seven studies were eligible. The incidence rate for cervical cancer after CIN treatment was 39 per 100,000 woman-years (95% CI 22 to 69). RR of cervical cancer was elevated compared to the general population (3·30, 2·57 to 4·24; P<0·001). RR was higher for women over 50 years old and remained elevated for at least 20 years after treatment. RR of vaginal (10·84, 5·58 to 21·10; P<0·001), vulvar (3·34, 2·39 to 4·67; P<0·001), and anal cancer (5·11, 2·73 to 9·55; P<0·001) was also higher. Mortality from cervical/vaginal cancer was elevated, but our estimate was more uncertain (RR 5·04, 0·69 to 36·94; P=0·073).Conclusions: Women treated for CIN have considerably higher risk to be later diagnosed with cervical and other HPV-related cancers compared to general population. The higher risk of cervical cancer lasts for at least 20 years after treatment and is higher for women
Paraskevaidi M, Hook PD, Morais CLM, et al., 2020, Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy to diagnose osteoarthritis in equine serum, EQUINE VETERINARY JOURNAL, Vol: 52, Pages: 46-51, ISSN: 0425-1644
Athanasiou A, Veroniki AA, Efthimiou O, et al., 2019, Comparative fertility and pregnancy outcomes after local treatment for cervical intra-epithelial neoplasia and stage 1a1 cervical cancer: protocol for a systematic review and network meta-analysis from the CIRCLE Group, BMJ Open, Vol: 9, ISSN: 2044-6055
Introduction: There are several local treatment methods for cervical intra-epithelial neoplasia that remove or ablate a cone-shaped part of the uterine cervix. There is evidence to suggest that these increase the risk of preterm birth and that this is higher for techniques that remove larger parts of the cervix, although the data is conflicting. We present a protocol for a systematic review and network meta-analysis that will update the evidence and compare all treatments in terms of fertility and pregnancy complications. Methods and Analysis: We will search electronic databases (CENTRAL, MEDLINE, EMBASE) from inception till October 2019, in order to identify randomised controlled trials (RCTs) and cohort studies comparing the fertility and pregnancy outcomes amongst different excisional and ablative treatment techniques and/or to untreated controls. The primary outcome will be preterm birth (PTB; <37weeks). Secondary outcomes will include severe or extreme PTB, prelabour rupture of membranes, low birth weight (<2500gr), neonatal intensive care unit admission, perinatal mortality, total pregnancy rates, 1st and 2nd trimester miscarriage. We will search for published and unpublished studies in electronic databases, trial registries and we will hand-search references of published papers. We will assess the risk of bias in RCTs and cohort studies using tools developed by the Cochrane Collaboration. Two investigators will independently assess the eligibility, abstract the data and assess the risk of bias of the identified studies. For each outcome, we will perform a meta-analysis for each treatment comparison and a network meta-analysis once the transitivity assumption holds, using the odds ratio for dichotomous data. We will use CINEMA to assess the quality of the evidence for the primary outcome.Ethics and dissemination: Ethical approval is not required. Results will be disseminated to academic beneficiaries, medical practitioners, patients and the public.PROSPE
Athanasiou A, Veroniki A, Efthimiou O, et al., 2019, Comparative efficacy and complication rates after local treatment for cervical intra-epithelial neoplasia and stage 1a1 cervical cancer: protocol for a systematic review and network meta-analysis from the CIRCLE Group, BMJ Open, Vol: 9, Pages: 1-7, ISSN: 2044-6055
Introduction: Local treatments for cervical intra-epithelial neoplasia (CIN) and microinvasive disease remove or ablate a cone-shaped part of the uterine cervix containing theabnormal cells. A trend towards less radical techniques has raised concerns that this mayadversely impact the rates of precancerous and cancerous recurrence. However, there hasbeen no strong evidence to support such claims. We hereby describe a protocol of asystematic review and network meta-analysis that will update the evidence and compare allrelevant treatments in terms of efficacy and complications.Methods and Analysis: Literature searches in electronic databases (CENTRAL, MEDLINE,EMBASE) or trial registries will identify published and unpublished randomised controlledtrials (RCTs) and cohort studies comparing the efficacy and complications amongst differentexcisional and ablative techniques. The excisional techniques include cold knife, laser orfischer cone, large loop or needle excision of the transformation zone and the ablative radicalpoint diathermy, cryotherapy, cold coagulation or laser ablation. The primary outcome willbe residual/recurrent disease defined as abnormal histology or cytology of any grade, whilesecondary outcomes will include treatment failure rates defined as high-grade histology orcytology, histologically-confirmed CIN1+ or histologically-confirmed CIN2+, HPVpositivity rates, involved margins rates, bleeding and cervical stenosis rates. We will assessthe risk of bias in RCTs and observational studies using tools developed by the CochraneCollaboration. Two authors will independently assess study eligibility, abstract the data, andassess the risk of bias. Random-effects meta-analyses and network meta-analyses will beconducted using the odds ratio for dichotomous outcomes and the mean difference forcontinuous outcomes. The quality of the evidence for the primary outcome will be assessedusing the CINEMA tool.
Callary EL, Morais CLM, Paraskevaidi M, et al., 2019, New approach to investigate Common Variable Immunodeficiency patients using spectrochemical analysis of blood, SCIENTIFIC REPORTS, Vol: 9, ISSN: 2045-2322
Morais CLM, Paraskevaidi M, Cui L, et al., 2019, Standardization of complex biologically derived spectrochemical datasets, Nature Protocols, Vol: 14, Pages: 1546-1577, ISSN: 1750-2799
Spectroscopic techniques such as Fourier-transform infrared (FTIR) spectroscopy are used to study interactions of light with biological materials. This interaction forms the basis of many analytical assays used in disease screening/diagnosis, microbiological studies, and forensic/environmental investigations. Advantages of spectrochemical analysis are its low cost, minimal sample preparation, non-destructive nature and substantially accurate results. However, an urgent need exists for repetition and validation of these methods in large-scale studies and across different research groups, which would bring the method closer to clinical and/or industrial implementation. For this to succeed, it is important to understand and reduce the effect of random spectral alterations caused by inter-individual, inter-instrument and/or inter-laboratory variations, such as variations in air humidity and CO2 levels, and aging of instrument parts. Thus, it is evident that spectral standardization is critical to the widespread adoption of these spectrochemical technologies. By using calibration transfer procedures, in which the spectral response of a secondary instrument is standardized to resemble the spectral response of a primary instrument, different sources of variation can be normalized into a single model using computational-based methods, such as direct standardization (DS) and piecewise direct standardization (PDS); therefore, measurements performed under different conditions can generate the same result, eliminating the need for a full recalibration. Here, we have constructed a protocol for model standardization using different transfer technologies described for FTIR spectrochemical applications. This is a critical step toward the construction of a practical spectrochemical analysis model for daily routine analysis, where uncertain and random variations are present.
Paraskevaidi M, Martin-Hirsch PL, Martin FL, 2019, Need for early, minimally invasive cancer diagnosis., Proc Natl Acad Sci U S A, Vol: 116, Pages: 4752-4752
Bury D, Faust G, Paraskevaidi M, et al., 2019, Phenotyping Metastatic Brain Tumors Applying Spectrochemical Analyses: Segregation of Different Cancer Types, ANALYTICAL LETTERS, Vol: 52, Pages: 575-587, ISSN: 0003-2719
Bury D, Morais CLM, Paraskevaidi M, et al., 2019, Spectral classification for diagnosis involving numerous pathologies in a complex clinical setting: A neuro-oncology example, SPECTROCHIMICA ACTA PART A-MOLECULAR AND BIOMOLECULAR SPECTROSCOPY, Vol: 206, Pages: 89-96, ISSN: 1386-1425
Tsagkas N, Siafaka V, Tzallas A, et al., 2019, Knowledge and beliefs about HPV infection and the relevant vaccination in Greek young population, EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY, Vol: 40, Pages: 557-562, ISSN: 0392-2936
Paraskevaidi M, Morais CLM, Freitas DLD, et al., 2018, Blood-based near-infrared spectroscopy for the rapid low-cost detection of Alzheimer's disease, ANALYST, Vol: 143, Pages: 5959-5964, ISSN: 0003-2654
Paraskevaidi M, Morais CLM, Halliwell DE, et al., 2018, Raman Spectroscopy to Diagnose Alzheimer's Disease and Dementia with Lewy Bodies in Blood, ACS CHEMICAL NEUROSCIENCE, Vol: 9, Pages: 2786-2794, ISSN: 1948-7193
Paraskevaidi M, Ashton KM, Stringfellow HF, et al., 2018, Raman spectroscopic techniques to detect ovarian cancer biomarkers in blood plasma, TALANTA, Vol: 189, Pages: 281-288, ISSN: 0039-9140
Paraskevaidi M, Morais CLM, Lima KMG, et al., 2018, Potential of mid-infrared spectroscopy as a non-invasive diagnostic test in urine for endometrial or ovarian cancer, ANALYST, Vol: 143, Pages: 3156-3163, ISSN: 0003-2654
Paraskevaidi M, Morais CLM, Raglan O, et al., 2018, Aluminium foil as an alternative substrate for the spectroscopic interrogation of endometrial cancer, JOURNAL OF BIOPHOTONICS, Vol: 11, ISSN: 1864-063X
Paraskevaidi M, Martin-Hirsch PL, Martin FL, 2018, Vibrational spectroscopy: a promising approach to discriminate neurodegenerative disorders, MOLECULAR NEURODEGENERATION, Vol: 13, ISSN: 1750-1326
Cui L, Yang K, Li H-Z, et al., 2018, Functional Single-Cell Approach to Probing Nitrogen-Fixing Bacteria in Soil Communities by Resonance Raman Spectroscopy with N-15(2) Labeling, ANALYTICAL CHEMISTRY, Vol: 90, Pages: 5082-5089, ISSN: 0003-2700
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