Cardiovascular risk factors in HIV infected individuals: Comparison with general adult control population in Greece.

BACKGROUND: Although combined antiretroviral therapy has substantially improved the prognosis of people living with HIV (PLHIV), mortality remains higher compared to the general population, mainly due to higher prevalence of non-HIV-related comorbidities, including cardiovascular diseases (CVD). We assessed the prevalence of CVD risk and its contributing factors in adult PLHIV versus general population controls in Greece. SETTINGS: Cross-sectional comparison of PLHIV (Athens-Multicenter-AIDS-Cohort-Study; AMACS) versus general population controls (National health examination survey; EMENO). METHODS: All HIV-infected adults with ≥1 measurement of interest (blood pressure, lipids, glucose, weight, height) between 2012-2014 and all EMENO participants (2014-2016) were included. Ten-year total CVD risk was estimated using the Framingham (FRS) or the Systematic Coronary Risk Evaluation (SCORE) equations. RESULTS: 5839 PLHIV (median age:41.6 years, 85.4% males) and 4820 controls (median age:48 years, 48.4% males) were included. Adjusting for age, sex and origin, PLHIV were more likely to be current smokers (adjusted OR:1.53 [95% CI:1.35-1.74]) and dyslipidemic (aOR:1.18; [1.04-1.34]), less likely to be obese (aOR:0.44 [0.38-0.52], with no differences in hypertension, diabetes or high (≥20%) FRS but with greater odds of high (≥5%) SCORE (aOR:1.55 [1.05-2.30]). Further adjustment for educational level, anti-HCV positivity and BMI showed higher prevalence of hypertension in PLHIV. CONCLUSIONS: Despite the relative absence of obesity, PLHIV have higher prevalence of traditional CVD risk factors and higher risk of fatal CVD compared to general population. Regular screening and early management of CVD risk factors in PLHIV should be of high priority for CVD prevention.

PTTG-1 (Securin) immunoexpression in meningiomas correlates with tumor grade and proliferation rate: potential use as a diagnostic marker of malignancy.

This study essentially aims to contribute to the immunohistochemical investigation of the use of pituitary tumor transforming gene (PTTG) as a marker of cell proliferation or advanced tumor grade in meningiomas of various WHO grades. In all, 51 cases were recovered in total, 21 Grade-I, 23 Grade-II and 7 Grade-III meningiomas. Mitotic index (MI), Ki-67/MiB-1 positivity percentage and PTTG expression were analyzed in correlation to each other as well as to the tumor WHO grades. All three biomarkers showed a high diagnostic significance and a strong association with WHO grades. In comparison, PTTG expression was on a par with the other two indices, and performed very well regarding identification of advanced grade tumors. PTTG may be considered an important diagnostic tool and serve in the future as a novel prognosticator of the biological behavior of all grade meningiomas as well as a useful high-risk patient selection tool.

Co-expression of survivin, c-erbB2, and cyclooxygenase-2 (COX-2): prognostic value and survival of endometrial cancer patients.

AIM: The purpose of this study was to investigate the co-expression of survivin, c-erbB2, and COX-2 in endometrial cancer tissues and evaluate its prognostic significance in endometrial cancer METHODS: Tumor tissue biopsies from 110 patients with primary untreated endometrial carcinomas were studied by immunohistochemistry. Statistical analysis evaluated correlation of antigen expression with tumor stage, grade, myometrial invasion, and histologic type. Association with disease outcome was also investigated RESULTS: The results showed that expression of the three antigens was independently associated with histological grade, disease stage, and myometrial invasion. Clinicopathological parameters were also associated with the number of antigens expressed by each tumor, the expression of more antigens correlating with advanced stage disease and deep myometrial invasion. In a 10-year follow-up, patients with tumors expressing more of these three antigens had significantly lower survival rate that those with smaller expression score CONCLUSIONS: Our results indicate that the co-expression score has independent prognostic value for endometrial cancer.

Laparoscopic cholecystectomy in elderly patients.

BACKGROUND: Surgery for cholelithiasis is more common in ageing patients. The use of laparoscopic cholecystectomy (LC) in older patients may pose problems because of the comorbid conditions that are concomitant with advanced age and may increase the postoperative LC complications and the frequency of conversion to open surgery. The purpose of this study was to evaluate the outcome of LC in the treatment of gallstones in the elderly (> or = 75 years old). METHODS: A retrospective study was conducted in patients who had undergone LC for symptomatic cholelithiasis: out of these, 153 patients were older than 75 years. Conversion rate to open cholecystectomy, complication rate, operative time, and length of stay were compared with those younger than 75 years. Multivariate analysis was used as a control for baseline differences. RESULTS: Conversion rate to open cholecystectomy in elderly was 13.1% vs 5.8% (p<0.001). Complication rate was 3.9% vs 1.6%. Operative time was 50 min vs 45 min. No significant difference was found in the hospital stay of both younger and elderly patients who had underwent a successful LC (p=0.079). The presence of inflammation was the only independent risk factors for conversion (p=0.014) and had a marginal independent effect on the development of complications (p=0.079) among elderly patients. CONCLUSION: Even though older patients are more likely to present with diseases in more advanced states, LC is safe and should be regarded as the gold-standard approach for elderly patients with cholelithiasis.