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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 We will search for published and unpublished studies in electronic databases, trial registries and we will hand-search references of published papers.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
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- Citations: 16
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
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- Citations: 11
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
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- Citations: 42
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
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- Citations: 13
Paraskevaidi M, Martin-Hirsch PL, Martin FL, 2018, Vibrational spectroscopy: a promising approach to discriminate neurodegenerative disorders, MOLECULAR NEURODEGENERATION, Vol: 13, ISSN: 1750-1326
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- Citations: 8
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
Paraskevaidi M, Martin-Hirsch PL, Martin FL, 2018, Progress and Challenges in the Diagnosis of Dementia: A Critical Review, ACS CHEMICAL NEUROSCIENCE, Vol: 9, Pages: 446-461, ISSN: 1948-7193
Kyrgiou M, Athanasiou A, Kalliala IEJ, et al., 2017, Obstetric outcomes after conservative treatment for cervical intraepithelial lesions and early invasive disease., Cochrane Database of Systematic Reviews, Vol: 11, ISSN: 1469-493X
BACKGROUND: The mean age of women undergoing local treatment for pre-invasive cervical disease (cervical intra-epithelial neoplasia; CIN) or early cervical cancer (stage IA1) is around their 30s and similar to the age of women having their first child. Local cervical treatment has been correlated to adverse reproductive morbidity in a subsequent pregnancy, however, published studies and meta-analyses have reached contradictory conclusions. OBJECTIVES: To assess the effect of local cervical treatment for CIN and early cervical cancer on obstetric outcomes (after 24 weeks of gestation) and to correlate these to the cone depth and comparison group used. SEARCH METHODS: We searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library, 2017, Issue 5), MEDLINE (up to June week 4, 2017) and Embase (up to week 26, 2017). In an attempt to identify articles missed by the search or unpublished data, we contacted experts in the field and we handsearched the references of the retrieved articles and conference proceedings. SELECTION CRITERIA: We included all studies reporting on obstetric outcomes (more than 24 weeks of gestation) in women with or without a previous local cervical treatment for any grade of CIN or early cervical cancer (stage IA1). Treatment included both excisional and ablative methods. We excluded studies that had no untreated reference population, reported outcomes in women who had undergone treatment during pregnancy or had a high-risk treated or comparison group, or both DATA COLLECTION AND ANALYSIS: We classified studies according to the type of treatment and the obstetric endpoint. Studies were classified according to method and obstetric endpoint. Pooled risk ratios (RR) and 95% confidence intervals (CIs) were calculated using a random-effects model and inverse variance. Inter-study heterogeneity was assessed with I2 statistics. We assessed maternal outcomes that included preterm birth (PTB) (spontaneous a
Paraskevaidi M, Morais CLM, Lima KMG, et al., 2017, Differential diagnosis of Alzheimer's disease using spectrochemical analysis of blood, PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, Vol: 114, Pages: E7929-E7938, ISSN: 0027-8424
Jin N, Paraskevaidi M, Semple KT, et al., 2017, Infrared Spectroscopy Coupled with a Dispersion Model for Quantifying the Real-Time Dynamics of Kanamycin Resistance in Artificial Microbiota, ANALYTICAL CHEMISTRY, Vol: 89, Pages: 9814-9821, ISSN: 0003-2700
Bury D, Faust G, Paraskevaidi M, et al., 2017, Spectrochemical analysis highlights similarities in adenocarcinomas irrespective of primary tissue origins., 53rd Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO), Publisher: AMER SOC CLINICAL ONCOLOGY, ISSN: 0732-183X
Paraskevaidi M, Morais CLM, Raglan O, et al., 2017, Spectroscopy of blood samples for the diagnosis of endometrial cancer and classification of its different subtypes., 53rd Annual Clinical Science Meeting of the American-Society-of-Clinical-Oncology (ASCO) / Symposium on Old Targets, New Drugs - Her2 and MET, Publisher: AMER SOC CLINICAL ONCOLOGY, ISSN: 0732-183X
Angouri J, Paraskevaidi M, Wodak R, 2017, Discourses of cultural heritage in times of crisis: The case of the Parthenon Marbles, JOURNAL OF SOCIOLINGUISTICS, Vol: 21, Pages: 208-237, ISSN: 1360-6441
Paraskevaidi M, Martin-Hirsch PL, Kyrgiou M, et al., 2016, Underlying role of mitochondrial mutagenesis in the pathogenesis of a disease and current approaches for translational research, Mutagenesis, Vol: 32, Pages: 335-342, ISSN: 1464-3804
Mitochondrial diseases have been extensively investigated over the last three decades, but many questions regarding their underlying aetiologies remain unanswered. Mitochondrial dysfunction is not only responsible for a range of neurological and myopathy diseases but also considered pivotal in a broader spectrum of common diseases such as epilepsy, autism and bipolar disorder. These disorders are a challenge to diagnose and treat, as their aetiology might be multifactorial. In this review, the focus is placed on potential mechanisms capable of introducing defects in mitochondria resulting in disease. Special attention is given to the influence of xenobiotics on mitochondria; environmental factors inducing mutations or epigenetic changes in the mitochondrial genome can alter its expression and impair the whole cell’s functionality. Specifically, we suggest that environmental agents can cause damage in mitochondrial DNA and consequently lead to mutagenesis. Moreover, we describe current approaches for handling mitochondrial diseases, as well as available prenatal diagnostic tests, towards eliminating these maternally inherited diseases. Undoubtedly, more research is required, as current therapeutic approaches mostly employ palliative therapies rather than targeting primary mechanisms or prophylactic approaches. Much effort is needed into further unravelling the relationship between xenobiotics and mitochondria, as the extent of influence in mitochondrial pathogenesis is increasingly recognised.
Kyrgiou M, Athanasiou A, Paraskevaidi M, et al., 2016, Adverse obstetric outcomes after local treatment for cervical preinvasive and early invasive disease according to cone depth: systematic review and meta-analysis. Editorial Comment, Obstetrical & Gynecological Survey, Vol: 71, Pages: 646-648, ISSN: 1533-9866
Local cervical treatment for preinvasive cervical disease such as cervical intraepithelial neoplasia (CIN) has been associated with an increased risk of preterm birth, perinatal morbidity, and mortality in a later pregnancy. This meta-analysis aimed to investigate the impact of treatment for cervical preinvasive and early invasive disease on obstetric outcomes and to see how this risk could be modified by the cone depth and comparison group.
Kyrgiou M, Mitra A, Athanasiou A, et al., 2016, The risk of preterm birth after treatment for cervical pre-invasive and early invasive disease increases with increasing cone depth: a systematic review and meta-analysis, Blair Bell Research Society Annual Academic Meeting, Publisher: Wiley, Pages: E8-E8, ISSN: 1470-0328
Kyrgiou M, Athanasiou A, Paraskevaidi M, et al., 2016, Adverse obstetrical outcomes after local treatment for cervical pre-invasive and early invasive disease according to the cone depth: a systematic review and meta-analysis, BMJ, Vol: 354, Pages: 1-15, ISSN: 0959-8138
Objective: To assess the effect of treatment for CIN on obstetric outcomes and to correlate this to the cone depth and comparison group used.MethodsDesign: Systematic review and meta-analysisData Sources: CENTRAL, MEDLINE, EMBASE from 1948 to April 2016.Eligibility Criteria: Studies assessing obstetric outcomes in women with or without a previous local cervical treatment.Data Extraction & Synthesis: Independent reviewers extracted the data and performed quality assessment using the Newcastle-Ottawa criteria. Studies were classified according to method and obstetric endpoint. Pooled risk ratios (RR) were calculated using a random-effect model and inverse variance. Inter-study heterogeneity was assessed with I2 statistics.Main outcomes and measures: Obstetric outcomes; preterm birth (PTB) (spontaneous and threatened), premature rupture of the membranes (pPROM), chorioamnionitis, mode of delivery, length of labour, induction of delivery, oxytocin use, haemorrhage, analgesia, cervical cerclage & cervical stenosis. Neonatal outcomes; low birth weight (LBW), neonatal intensive care unit (NICU) admission, stillbirth, APGAR scores and perinatal mortality.Results: Seventy-one studies were included (6338982 participants: 65082 treated-6292563 untreated). Treatment significantly increased the risk of overall (<37weeks)(10.7 v 5.4%, RR=1.78[1.60 to 1.98]), severe (<34/32weeks)(3.5 v 1.4%, RR=2.40[1.92 to 2.99]) and extreme (<30/28weeks)(1.0 v 0.3%, RR=2.54[1.77 to 3.63]) PTB. The magnitude of the effect was higher for techniques removing or ablating more tissue (<37weeks: CKC (RR=2.70[2.14 to 3.40]), LC (RR=2.11[1.26 to 3.54)], excision not otherwise specified (NOS) (RR=2.02[1.60 to 2.55]), LLETZ (RR=1.56[1.36 to 1.79]), ablation NOS (RR=1.46[1.27 to 1.66]). The risk of PTB increased with repeat treatment (13.2 v 4.1%, RR=3.78[2.65 to 5.39]) and with increasing cone depth (≤12/10mm: 7.1 v 3.4%, RR=1.54[1.09 to 2.18]; ≥10/12mm: 9.8 v 3.4%, RR=1.93[1.62
Kyrgiou M, Pouliakis A, Panayiotides JG, et al., 2016, Personalised management of women with cervical abnormalities using a clinical decision support scoring system, Gynecologic Oncology, Vol: 141, Pages: 29-35, ISSN: 1095-6859
OBJECTIVES: To develop a clinical decision support scoring system (DSSS) based on artificial neural networks (ANN) for personalised management of women with cervical abnormalities. METHODS: We recruited women with cervical abnormalities and healthy controls that attended for opportunistic screening between 2006 and 2014 in 3 University Hospitals. We prospectively collected detailed patient characteristics, the colposcopic impression and performed a series of biomarkers using a liquid-based cytology sample. These included HPV DNA typing, E6&E7 mRNA by NASBA or flow cytometry and p16INK4a immunostaining. We used ANNs to combine the cytology and biomarker results and develop a clinical DSSS with the aim to improve the diagnostic accuracy of tests and quantify the individual's risk for different histological diagnoses. We used histology as the gold standard. RESULTS: We analysed data from 2267 women that had complete or partial dataset of clinical and molecular data during their initial or followup visits (N=3565). Accuracy parameters (sensitivity, specificity, positive and negative predictive values) were assessed for the cytological result and/or HPV status and for the DSSS. The ANN predicted with higher accuracy the chances of high-grade (CIN2+), low grade (HPV/CIN1) and normal histology than cytology with or without HPV test. The sensitivity for prediction of CIN2 or worse was 93.0%, specificity 99.2% with high positive (93.3%) and negative (99.2%) predictive values. CONCLUSIONS: The DSSS based on an ANN of multilayer perceptron (MLP) type, can predict with the highest accuracy the histological diagnosis in women with abnormalities at cytology when compared with the use of tests alone. A user-friendly software based on this technology could be used to guide clinician decision making towards a more personalised care.
Mitra A, Paraskevaidi M, Lai J, et al., 2016, Cervical Antimicrobial Peptides Are Decreased Following Excisional Treatment for Cervical Intraepithelial Neoplasia., 63rd Annual Scientific Meeting of the Society-for-Reproductive-Investigation, Publisher: SAGE PUBLICATIONS INC, Pages: 96A-97A, ISSN: 1933-7191
Kyrgiou M, Mitra A, Arbyn M, et al., 2015, Fertility and early pregnancy outcomes after conservative treatment for cervical intraepithelial neoplasia, Cochrane Database of Systematic Reviews, Vol: 9, ISSN: 1469-493X
BACKGROUND: Cervical intra-epithelial neoplasia (CIN) typically occurs in young women of reproductive age. Although several studies have reported the impact that cervical conservative treatment may have on obstetric outcomes, there is much less evidence for fertility and early pregnancy outcomes. OBJECTIVES: To assess the effect of cervical treatment for CIN (excisional or ablative) on fertility and early pregnancy outcomes. SEARCH METHODS: We searched in January 2015 the following databases: the Cochrane Gynaecological Cancer Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library, Issue 12, 2014), MEDLINE (up to November week 3, 2014) and EMBASE (up to week 52, 2014). SELECTION CRITERIA: We included all studies reporting on fertility and early pregnancy outcomes (less than 24 weeks of gestation) in women with a history of CIN treatment (excisional or ablative) as compared to women that had not received treatment. DATA COLLECTION AND ANALYSIS: Studies were classified according to the treatment method used and the fertility or early pregnancy endpoint. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated using a random-effects model and inter-study heterogeneity was assessed with I(2). Two review authors (MK, AM) independently assessed the eligibility of retrieved papers and risk of bias. The two review authors then compared their results and any disagreements were resolved by discussion. If still unresolved, a third review author (MA) was involved until consensus was reached. MAIN RESULTS: Fifteen studies (2,223,592 participants - 25,008 treated and 2,198,584 untreated) that fulfilled the inclusion criteria for this review were identified from the literature search. The meta-analysis demonstrated that treatment for CIN did not adversely affect the chances of conception. The overall pregnancy rate was higher for treated (43%) versus untreated women (38%; RR 1.29, 95% CI 1.02 to 1.64; 4 studies, 38,050
Theophilou G, Paraskevaidi M, Lima KMG, et al., 2015, Extracting biomarkers of commitment to cancer development: potential role of vibrational spectroscopy in systems biology, EXPERT REVIEW OF MOLECULAR DIAGNOSTICS, Vol: 15, Pages: 693-713, ISSN: 1473-7159
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- Citations: 15
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