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CURRICULUM VITAE
Name:
Maria (Marianna)
Surname: Dalamaga
Date of birth: 8th of May 1971
Place of birth: Athens, Greece
Citizenship: Greek
Marital Status: Married, two children
Address: 29, Karyotaki street, Pallini
TK. 153 44 Athens, Greece
Tel/FAX: +306977440344, FAX: +302106082467
e-mail: madalamaga@med.uoa.gr; madalamaga@post.harvard.edu;
madalamaga@gmail.com
Current Occupation: Associate Professor in Biological Chemistry-Clinical Biochemistry
Physician-Clinical Pathologist (Medical Biopathologist), Laboratory of Biological
Chemistry, University of Athens School of Medicine.
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EDUCATION
1. University and Postgraduate studies
2002:
PhD degree from University of Athens, School of Medicine (Department of
Epidemiology-University of Athens and Department of Diagnostic Virology, Institut
Pasteur of Athens). Grade: Magna Cum Laude. PhD thesis: The contribution of virusesinfectious agents (EBV, CMV, HHV-6, Influenza viruses A, B, Parainfluenza viruses, RSV,
Adenoviruses, Parvovirus B19 and Mycoplasma pneumoniae) and low herd immunity to
the etiology of Acute Childhood Lymphoblastic Leukemia). Supervisor: Professor
Dimitrios Trichopoulos.
1999-2000:
MSc in Epidemiology, Harvard School of Public Health, Boston, Massachusetts-USA.
Grade: 3.7/4. MS thesis: Chronic immune stimulation and the occurrence of de novo
myelodysplastic syndromes. Supervisors: Professor Dimitrios Trichopoulos & Professor E.
Francis Cook.
1999:
Certificate in Clinical Effectiveness-Program in Clinical Effectiveness, Joint Program of
Harvard School of Public Health, Harvard Medical School, Massachusetts General
Hospital and Brigham and Women’s Hospital, Boston, Massachusets-USA.
1996-1997 :
MPH (Master’s in Public Health), National School of Public Health, Athens Grade:
Excellent. MPH thesis: Pesticides implications in Public Health.
1989-1995
MD, Ioannina University, School of Medicine. Grade: Very Good (8.3/10).
2. Secondary-High School
1983-1988 Collège Catholique-Centre Scolaire “Sacré-Coeur ”de Lindthout- Bruxelles
(Brussels, Belgium) with grade A
1988-1989 Second Public High School of Zographou-Athens, Greece.
Degree: High School Diploma, with grade Excellent
MEDICAL SPECIALTY
1996-1997:
Title of Medical Officer in Public Health-Hygiene from the National School of Public
Health, Ministry of Health, Athens, Greece
1997-2002:
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Specialty in Clinical Pathology (Medical Biopathology-Laboratory Medicine).
Resident at NIMTS (Veteran’s General Hospital-Army Share Fund Hospital
Athens, Greece) in Clinical Chemistry (1 year), Internal Medicine (1 year), Laboratory
Hematology and Transfusion (1 year), Clinical Microbiology (1.3 years).
Resident at Evangelismos General Hospital (Athens, Greece) in Immunology (1 year)
2008:
Fellowship in Clinical Chemistry, European Board of Medical Biopathology. Union
of European Medical Specialists (UEMS)
MEDICAL LICENSURE AND SPECIALTY CERTIFICATION
Medical Licensure
 Prefecture of Ioannina, Greece, License 14386/10-20-1995
 Ioannina Medical Association (10-20-1995 to 7-14-1997)
 Athens Medical Association (7-29-1997 till today) #043169
Specialty Certifications
2008
Foundation Fellowship in the Specialty of Clinical Chemistry, European Board of Medical
Biopathology. Union of European Medical Specialists (UEMS), Certificate number: 122, 126-2008 .
2002
Clinical Pathology (Medical Biopathology), Greek Board of Medical Biopathology,
Certificate 19123/12-2-2002, Hellenic Republic, Prefecture of Athens.
1997
Medical Officer in Hygiene (Public Health), Certificate 1330/12-17-1997, National School
of Public Health, Ministry of Health, Greece.
ACADEMIC & CLINICAL PROFESSIONAL POSITIONS
2015-:
Associate Professor in Biological Chemistry-Clinical Biochemistry, Laboratory of Biologic
Chemistry, University of Athens, School of Medicine.
25.07.2014-26.11.2014:
Director of Clinical Biochemistry Laboratory, Attikon General University Hospital,
University of Athens School of Medicine (750 beds).
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2009 – 2015:
Assistant
Professor
in
Biological
Chemistry-Clinical
Biochemistry,
University
of
Athens,
School
of
Medicine,
Laboratory
of
Clinical
Biochemistry Attikon General University Hospital (750 beds), Athens, Greece.
23.04.2013
Tenure of Assistant Professor in Biological
University of Athens, School of Medicine.
Chemistry-Clinical
Biochemistry,
2005-2009:
Lecturer/Instructor
in
Biopathology-Biochemistry,
University
of
Athens,
School of Medicine, Laboratory of Clinical Biochemistry, Attikon General University
Hospital, Athens, Greece.
2003-2005:
Consultant (Greek National Health System) in Clinical Microbiology, Attikon General
University Hospital.
2003:
Consultant in Central Laboratories of IASO General Hospital (private hospital of 200
beds), Athens, Greece.
2002-2003
University Assistant, Department
School of Medicine. Athens, Greece
of
Epidemiology,
University
of
Athens,
1997-2002:
Resident in Clinical Pathology at NIMTS General Hospital (450 beds) and Evangelismos
General Hospital (1000 beds), Athens, Greece.
1995-1996:
One-year mandatory service in the countryside (Milea- Metsovo City Health Center) as a
general physician. Medical Officer and President of the Committee on vaccination against
tuberculosis (BCG), tetanos and hepatitis B of the Ioannina Prefecture-Department of
Public Health, Ioannina, Greece.
TEACHING ACTIVITIES
 Undergraduate studies
1) Lectures and Courses, in Biologic Chemistry II-School of Medicine and
Dentistry, University of Athens (2012-).
2) Lectures, Courses and Laboratories, Elective Course in Clinical Biochemistry,
School of Medicine, University of Athens (2013-).
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3) Lectures, Courses, Laboratories and Intensive Courses in Biochemistry-School of
Medicine and Dentistry, University of Athens (2005-).
4) Lectures, Elective Course in Laboratory Diagnostic Biochemistry and
Immunobiochemistry (2008-2010).
5) Lectures, Courses, Laboratories and Intensive Courses in Biochemistry-School of
Infirmary, University of Athens (2006-2009).
6) Courses in Preventive Medicine and Epidemiology, School of Medicine,
University of Athens (2002-2003).
7) Courses in Hygiene and Endonosocomial Infections as Main Instructor, Public
Institute of Professional Formation, Ioannina-Greece (1996).
8) Courses in Hygiene and Environmental Hygiene, Anagnostopoulos
Agricultural Institute of Professional Formation, Konitsa-Greece (1996-1997).
9) Authorship in two books for undergraduate studies
 Postgraduate studies
1) Lectures in Clinical Biochemistry, Laboratory of Clinical Biochemistry,
Residency Mentorship Program, General University Hospital “Attikon”, School
of Medicine, University of Athens (2005-2015)
2) Lectures in Clinical Biochemistry, Laboratory Hematology, Immunology,
Clinical Microbiology and Internal Medicine, Residency Mentorship Program,
NIMTS Army Share Fund Hospital and General Hospital “Evangelismos” (19972002)
3) Lectures and postgraduate courses in Medical Biochemistry for residents in
Medical Biopathology organized by the Greek Society of Medical Biochemistry
and Medical Biopathology (2007-).
4) Participation in the postgraduate progam of Athens University School of
Medicine “Research in female reproduction”as supervisor of MSc theses.
 Lectures, Seminars in Public Health for the general public, Milea Metsovo
and Metsovo, Prefecture of Ioannina, Greece (1995-1996).
 Participation in the Supervision Committee of PhD, MSc and diploma theses:
20
 Supervision of PhD theses: 4
 Attendance in scientific seminars, congresses, symposia and meetings: 170
 Continuing Medical Education Activities:
1) Association of Greek Medical Societies: 570 credits which are recognized
by the European Accreditation Council for CME (EACCME), an
institution of the European Union of Medical Specialists (UEMS)
2) Physician’s Recognition Award by the American Medical Association
(AMA PRA Category 1 Credits): 106.75
3) Total credits: 676.75
 Organization of seminars and meetings: 20
HONORS/AWARDS/SCHOLARSHIPS
2015 First Award in Clinical Biochemistry, 6th Greek Congress of Medical
Biochemistry
2014 First Award in Clinical Biochemistry, 8th Greek Congress of
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2014
2013
2013
2011
2011
2011
2009
2008
2008
2007
2001
2000
2000
1999
1999
1999
1997
1997
1996
1996
1994
1988
Medical Biopathology (Clinical Pathology-Laboratory Medicine)
Award for poster presentation, 8th Greek Congress of
Medical Biopathology (Clinical Pathology-Laboratory Medicine)
Certificate of appreciation as a member of the International Editorial Board
of IBIMA Publishing, USA. October, 2013.
First Award in Clinical Biochemistry-5th Greek Congress of Medical
Biochemistry and Laboratory Hematology
Prestigious Reviewer for the Diabetes & Metabolism Journal, 2011
First Award in Clinical Biochemistry, 4th Greek Congress of
Medical Biochemistry
Certificate of Recognition, College of American Pathologists
2 Awards in Clinical Biochemistry-3rd Greek Congress of
Medical Biochemistry
Award in Clinical Biochemistry- XVI Meeting of Balkan Clinical Laboratory
Federation
Scholarship/Award from the Greek Society of Microbiology
First Award in Clinical Biochemistry-2nd Greek Congress of
Medical Biochemistry
First Class Award in Science from Athens Academy, Greece
First Prize Award-Choremio Epathlo
Scholarship from Harvard Foundation, Boston, USA
Scholarship from Onassis Public Foundation, Athens, Greece
Scholarship from Louis Gerondelis Foundation, Boston, MA-USA
Miltiadis Empiricos Award in medical science, Athens, Greece
Award for Distinguished Practice, Scientific Committee of Epirus, Greece
Award from Ioannina Medical Association
Honorary citizenship award by the Mayor and the Council of Milea Metsovo
Medal of Recognition, City Hall of Metsovo
First Award and Medal from Ioannina University, School of Medicine
Belgian Shell Scientific Contest, Brussels, Belgium
BIBLIOGRAPHY AND RESEARCH ACTIVITIES
1) Books-Monographs-Book chapters: 24
2) Total peer-reviewed publications in International journals: 129
(48 of them in supplements of journals)
1st or 2nd author in 95
Total Impact Factor: 457.147 Mean Impact Factor: 3.5
Citations: >1000 (Scopus); >1400 (Google Scholar)
h-index (Scopus): 15; h-index (Google Scholar): 17; i-10 index: 29
3) Peer-reviewed publications in International Journals not indexed in pubmed: 4
4) Peer-reviewed publications in Greek Journals: 21 (10 of them in supplements)
5) Other peer-reviewed scholarly works: 3
6) English/French abstracts presented in congresses: 62
7) Greek abstracts presented in congresses: 206
8) Other publications: 24
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9) Scientific Editor in one book
10) Participation in research project grants: 19
11) Scientific Awards and Prizes: 23
12) Scholarships: 5
13) Participation in European and International Committees for Evaluation of Grant
Applications: 3
14) Invited presentations in Congresses-seminars-symposia: 45
Research interests and collaborations
My research covers the spectrum of diagnostic clinical biochemistry. The main research
focus is the pathophysiology, potential diagnostic and therapeutic significance, and public
health implications of: 1) novel adipose tissue secreted hormones including leptin,
adiponectin, resistin, visfatin/Nampt, etc; 2) hepatokines including fetuin-A; 3) myokines;
4) thyroid hormones; 5) insulin in human disease (obesity and associated comorbidities,
metabolic syndrome, psoriasis, malignancies, cardiovascular disease, etc). As a clinical
pathologist, Dr Dalamaga’s research focused also: 1) on the biochemical identification and
isolation of emerging Gram (-) bacteria related to nosocomial infections and 2) the
pathogenesis of chemical burns.
Towards my main research focus, I collaborate with: 1) the Endocrinology, Diabetes and
Metabolism Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
Massachusetts, USA (Professor C.S. Mantzoros); 2) the College for Public Health, Saint
Louis University, Missouri, USA (Professor K. Stamatakis); 3) the Hematology Laboratory,
NIMTS/Army Share Fund Hospital, Athens, Greece (Director A. Lekka); 4) the 1st and
2nd Internal Medicine Department, NIMTS/Army Share Fund Hospital, Athens, Greece
(Directors: I. Migdalis, K. Karmaniolas); 5) the Hematologic Clinic and Laboratory, Hygeia
Melathron Hospital, TYPET- National Bank of Greece (Director L. Tzianoumis); 6) Attikon
General University Hospital: 3rd Department of Obstetrics & Gynecology (Consultant: E.
Trakakis); 2nd Department of Dermatology (Ass. Professor E. Papadavid) and the
Nephrology Unit (Professor D. Vlahakos).
CLINICAL AND LABORATORY EXPERIENCE
1) Clinical and Laboratory Experience after MD degree
1995-1996:
As a general physician during the one-year mandatory service in the countryside (MileaMetsovo City Health Center), I organized the clinic with all the required supplies:
electrocardiogram, first aid and pharmaceutical supplies. Central heating was installed
and the patient reception area was modernized. Seminars on hygiene and preventive
medicine (breast cancer, cervical cancer, osteoporosis, etc.) were organized as well as
vaccinations for tetanus and hepatitis B. Preventive check-ups were performed: cervical
smear test and Pap tests for women and laboratory determinations of serum lipids:
cholesterol, HDL, LDL and triglycerides. Several health inspections of water were
performed in oredr to investigate an outbreak of gastroenteritis. I write and presented the
manual "Preventive Guide for Infectious Diseases in Rural Areas" with special emphasis
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on the prevention of zoonoses. For the abovementioned social work, I received the
Honorary citizenship award and the golden key by the Mayor and the Council of Milea
Metsovo as well as the Medal of Recognition by the City Hall of Metsovo. During that
chronic period, I was also Medical Officer and President of the Committee on
vaccination against tuberculosis (BCG), tetanos and hepatitis B of the Ioannina PrefectureDepartment of Public Health, Ioannina, Greece.
1997-2002:
Resident in Clinical Pathology (Medical Biopathology/Laboratory Medicine: Clinical
Biochemistry-1 year, Clinical Microbiology-1.5 year, Internal Medicine-1 year,
Immunology-6 months, Hematology and Transfusion-1 year) at NIMTS General Hospital
(450 beds) and Evangelismos General Hospital (1000 beds), Athens, Greece. I also realized
a part of the specialty in Massachusetts General Hospital and Brigham and Women's
Hospital, Harvard Medical School, Boston, USA after exams and educational leave from
KESY/Ministry of Health. During this period, in addition to my clinical work with
inpatients and outpatients, I performed many night shifts.
2) Clinical and Laboratory Experience after medical specialty
2002-2003:
Consultant Biopathologist in Central Laboratories of IASO General Hospital (private
hospital of 200 beds), Athens, Greece. I took part in the organization of the Central
Laboratory of the new private tertiary hospital IASO General (former HPA) with Director
Catherine Angelopoulos.
2003-2005:
Consultant (Greek National Health System) in Clinical Microbiology, Attikon General
University Hospital. In particular, I took part in the organization of the Laboratory of
Clinical Microbiology with my other colleagues (total number of physicians: 3). I was
responsible of Bacterial Cultures section for six months and the Serology Laboratory for
approximately one year, performing a big number of night shifts (9-10 active night shifts
per month due to the lack of medical staff).
2005-2015:
Lecturer/Instructor (2005-2009), Assistant Professor (2009-2015) in Biologic ChemistryClinical Biochemistry and Director (25.07.2014-26.11.2014) of the Laboratory of Clinical
Biochemistry, Attikon General University Hospital, Athens University, School of
Medicine, Greece. I took part in the organization of the new Laboratory of Clinical
Biochemistry with other colleagues and the directors: Associate Professor Amalia
Dionyssiou-Asteriou and Assistant Professor Kleanthi Dima. Indifferent chronic periods, I
was responsible in the following sections of the department: Clinical Chemistry,
Immunochemistry (determination of hormones, tumor and anemia markers) and
Chromatography. I was the Laboratory Quality Manager for Accreditation of the
Laboratory following the standard ISO 15189. Finally, I was responsible for overseeing the
implementation and customization of the Information System BioLis, Biochem (protocol #
7700/24/4/2007). This configuration was further combined with the standard ISO 15189.
Software solutions designed specifically for medical laboratories can aid in achieving ISO
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15189 based accreditation. In particular, document control software can help by improving
turnaround time for document reviews, increasing efficiency of staff and improving
overall quality. At the time of my tenure as faculty member, I received excellent
evaluation by the Manager of the "Attikon" General University Spyridon Apostolopoulos
and the Medical Service Director Prof. John Vergados (protocol # 13938 / 09.07.2008).
Furthermore, I was responsible for the preparation and implementation of the Educational
Program of the Laboratory and the main Training Program for residents in
Biopathology/Biochemistry. I was responsible for medical issues, I participated in issuing
certificates for recruitment in the public and private sector, and I collaborated with several
hospital clinics. I performed many night shifts following the regulation of the Ministry of
Health for physicians. During the last chronic period (2012-), the laboratory was equipped
with a highly advanced mixed pre-analytical and analytical modular analyzer (Cobas
8000, Roche) which includes immunochemical (Cobas 602, Roche) and clinical chemistry
section (Cobas 702, Roche).
MANAGERIAL AND ADMINISTRATIVE SKILLS
1) Director of Clinical Biochemistry Department, Attikon General University Hospital
(25.07.2014-26.11.2014)
 The highly advanced mixed pre-analytical and analytical modular analyzer (Cobas
8000, Roche) which includes immunochemical (Cobas 602, Roche) and clinical
chemistry section (Cobas 702, Roche) continued its operation.
 The training program for the residents in Medical Biopathology was organized and
implemented. The residents have participated with 30 abstracts in the 6th National
Congress of Medical Biochemistry and 3 manuscripts in international peerreviewed journals.
 Cyclosporine determination was added in the analyzer Cobas e411 (Roche) and
carried out 3 times per week.
 Personnel was trained for the certification of the laboratory according to the standard
ISO 9001
 I was responsible for the shift programs of medical, scientific and technicians staff of
the Laborator.
 I was responsible for the scientific information in terms of new tests and assays for
the hospital clinics.
 Despite the economic crisis, the laboaratory maintained the same number of medical,
scientific and technicians staff.
 The files and forms of responses were further organized and corrected.
 I participated in the Councils of the Laboratory Sector of Attikon General University
Hospital.
 According to the official statistics regarding the mixed pre-analytical and analytical
modular analyzer (Cobas 8000, Roche), the mean turn around time was optimized.
The software was upgraded (Cobas IT middleware) in order to have an overview of
the whole laboratory work at a glance, control, real-time monitoring and
traceability of all processes. The flow of the samples was optimized, the time of
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results issue and the manual handling were further decreased, increasing the safety
in the samples management.
 The Clinical Biochemistry Laboratory of the Attikon University Hospital is a modern
fully automated which manages in average 10,000 tests per day, covering a wide
range of biochemical determinations (57% Clinical Chemistry tests, 33%
immunochemistry tests and 10% electrolyte tests), 90% of which are completed on a
daily basis so that physicians and patients receive daily results.
2) General organizational and managerial skills
 As a general physician during the one-year mandatory service in the countryside
(Milea- Metsovo City Health Center), I organized the clinic with all the required
supplies: electrocardiogram, first aid and pharmaceutical supplies. Central heating
was installed and the patient reception area was modernized. Seminars on hygiene
and preventive medicine (breast cancer, cervical cancer, osteoporosis, etc.) were
organized as well as vaccinations for tetanus and hepatitis B. Preventive check-ups
were performed: cervical smear test and Pap tests for women and laboratory
determinations of serum lipids: cholesterol, HDL, LDL and triglycerides. Several
health inspections of water were performed in oredr to investigate an outbreak of
gastroenteritis. I write and presented the manual "Preventive Guide for Infectious
Diseases in Rural Areas" with special emphasis on the prevention of zoonoses. For
the abovementioned social work, I received the Honorary citizenship award and
the golden key by the Mayor and the Council of Milea Metsovo as well as the
Medal of Recognition by the City Hall of Metsovo. During that chronic period, I
was also Medical Officer and President of the Committee on vaccination against
tuberculosis (BCG), tetanos and hepatitis B of the Ioannina Prefecture-Department
of Public Health, Ioannina, Greece (1995-1997).
 As resident in Medical Biopathology at NIMTS General Hospital, I organized and
coordinated a pilot program for the assessment of the provided medical care
expressed as degree of satisfaction for health service users (patients) on hygiene
issues, hotel infrastructure, equipment, services and behavior of health
professionals in clinics, outpatient departments and laboratories (1997-2002).
 As a Consultant Physician-Biopathologist in the Central Laboratories
(Biochemistry-Hematology-Microbiology-Transfusion) of IASO General Hospital, I
participated in the organization of Central Laboratories of this new private tertiary
hospital (formerly HPA) together with the Director of the Department Catherine
Angelopoulou (2002-2003).
 During my tenure to Attikon General University Hospital (2003-2015), I was amid
the first six Consultants appointed to the medical staff of the hospital. 1) Together
with my colleagues, I participated actively in the organization of the Clinical
Microbiology Laboratory as Consultant physician (2003-2005) and the Clinical
Biochemistry Laboratory as Lecturer and Assistant Professor (2005-2015). During
that chronic period, I received an excellent assessment by the Hospital Manager Sp.
Apostolopoulos and the Medical Service Director Prof. John Vergados (protocol#
13938/09.07.2008); 2) I was responsible for the Clinical Chemistry,
Immunochemistry and Chromatography Department for 2 years; 3) More
importantly, I was the Clinical Biochemistry Laboratory Quality Manager for the
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Accreditation of the Laboratory according to the standard ISO 15189; 4) Also, I was
the deputy director of the department (Director Assistant Professor Kleanthi Dima).
5) As a physician and faculty member, I was responsible for the organization and
implementation of the Educational Program of the Laboratory and the training
courses of residents in Medical Biopathology; 6) I participated in the meetings of
the first Scientific Committee of Attikon General University Hospital as an elected
member of the Consultants (protocol # 1466 / 01.26.2004); 7) I participated in more
than 10 tenders as president or member of the committee for reagents, technologic
equipment and other supplies for laboratories in the hospital; 8) I participated in
the supervision committee of maintenance and repair of the laboratory equipment;
9) I participated in the pptimization of the laboratory information system (LIS of
BioLis, Biochem) [protocol # 7700/24.04.2007]; 9) I participated in the three-member
Committee of Accreditation and Calibration for the Laboratory of Clinical
Biochemistry (protocol # 4823, 113/2011, 14.2.2011); 10) I partcipated in the
formation of the Internet site regarding the Clinical Biochemistry Laboratory and its
offered services in two languages (Greek and English) - www.attikonhospital.gr;
11) I participated in the Electoral Committees of faculty members at the ranks of
Lecturer and Assistant Professor of Athens University School of Medicine.
3) Organization of seminars, symposia, market research panels, round tables,
meetings, congresses and conferences: 20
I participate as a member in the Scientific Committee of Medical Biopathology and
Medical Biochemistry Congresses. I also participate in the meetings of the Greek Society
of Medical Biochemistry.
4) Fellow:
1. FCAP, Fellow of the College of American Pathologists (2009-)
2. FASCP, Fellow of the American Society of Clinical Pathology (2007-)
3. Fellow of the European Board of Medical Biopathology, Section of Clinical
Chemistry, Union of European Medical Specialists (2008-).
5) Member of Scientific Societies: 30
6) Academic Consultant of Alexander Onasis Foundation for scholarships in medicine
(clinical and laboaratory medicine) during the years 215-2017.
EDITORIAL ACTIVITIES
 Member of the Editorial Board of International peer-reviewed journals
Editorial Board of Metabolism: Clinical and Experimental (2011-)
Editorial Board of World Journal of Experimental Medicine (2011-)
Editorial Board of World Journal of Dermatology (2011-)
Editorial Board of Open Journal of Epidemiology (2011-)
International Editorial Board of IBIMA Publishing, USA-Journal of Research in
Obesity (2013-)
Editorial Board of Journal of Geriatric Cardiology (2014-)
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Editorial Board of International Journal of Diabetes & Clinical Diagnosis (2014-)
Editorial Board Autoimmune Disorders and Therapy (2014-)
Editorial Board of Austin Journal Endocrinology and Diabetes (2014-)
Editorial Board of Acta Microbiologica Hellenica (2009-)
Editorial Board, Image Magazine, 2002-2009
Editorial Board, Orraon Magazine (Epirus), 2003 Reviewer for the following journals:
1. JAMA
2. International Journal of Cancer
3. European Journal of Endocrinology
4. European Journal of Cancer
5. British Journal of Cancer
6. Metabolism in more than 65 manuscipts
7. PLOS One
8. Current Medicinal Chemistry
9. Cancer Letters
10. Clinical Nutrition
11. Diagnostic Microbiology and Infectious Diseases
12. European Journal of Dermatology
13. Dermatology
14. Burns
15. Journal of Hematology and Oncology
16. BMC Cancer
17. International Journal of Cardiology
18. Journal of Orthopaedic Research
19. Disease Markers
20. Journal of European Academy of Dermatology&Venereology
21. The Journal of Diabetes and Its Complications
22. International Journal of Medical Sciences
23. Biologics: Targets and Therapy
24. Journal of Diabetes and Metabolism
25. Clinical Biochemistry
26. Tumor Biology
27. Platelets
28. Current Pharmaceutical Biotechnology
29. World Journal of Gastroenterology
30. Endocrine Research
31. International Journal of Endocrinology
32. Journal of Clinical & Experimental Oncology
33. Allergy, Asthma & Clinical Immunology
34. Experimental Biology and Medicine
35. Molecular Biology Reports
36. Acta Haematologica
37. Gynecological Endocrinology
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38. Obesity Facts-The International Journal of Obesity
39. Journal of Medicinal Food
40. Colorectal Cancer
41. Journal of Obstetrics and Gynaecology Research
42. Journal of Geriatric Cardiology
43. Journal of Applied Biomedicine
44. International Journal of Genomic Medicine
45. British Journal of Medicine and Medical Research
46. Asia-Pacific Journal of Clinical Oncology
47. World Journal of Experimental Medicine
48. World Journal of Nephrology
49. Open Journal of Epidemiology
50. Biomarkers in Medicine
51. Expert Review of Endocrinology and Metabolism
52. Acta Medica
53. Journal of Global Antimicrobial Resistance
54. Medical Science Monitor
55. Brazilian Journal of Infectious Diseases
56. Endocrinology and Metabolic Syndrome: Current Research
57. World Journal of Diabetes
58. World Journal of Pharmacology
59. World Journal of Dermatology
60. Journal of Research in Obesity
61. Cancer Therapy
62. Journal of Metabolic Syndrome
63. Journal of the Egyptian National Cancer Institute
64. International Blood Research & Reviews
65. Medical Journals-OMICS Group
66. Journal of Physiobiochemical Metabolism
67. British Journal of Applied Science & Technology
68. Journal of Cancer Research & Therapy
69. Cardiology and Angiology: An International Journal
70. World Journal of Clinical Cases
71. World Journal of Radiology
72. World Journal of Gastrointestinal Endoscopy
73. World Journal of Psychiatry
74. Annual Research & Review in Biology
75. International Journal of Biochemistry Research & Review
76. International Medical Case Reports Journal
77. Journal of Scientific Research and Reports
78. World Journal of Gastrointestinal Pathophysiology
79. Chronic Diseases-International
80. Journal of Obesity & Weight Loss Therapy
81. Scientia Pharmaceutica
82. Journal of Obstetrics and Gynaecology Research
83. Journal of Obesity & Weight Loss Therapy
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84. Acta Biochimica et Biophysica Sinica
85. African Journal of Biotechnology
86. Acta Microbiologica Hellenica
87. Gene Therapy and Molecular Biology
88. Cardiovascular Diabetology Journal
89. Medical Sciences
90. Obesity & Control Therapies
 Evaluator/Reviewer, Grant Applications National Science Center Poland, 2013.
 Evaluator/Reviewer, Grant Applications, Medical Research Council, South
Africa, 2012
 Evaluator/Reviewer, Grant Applications EU Marie Curie COFUND programme
for post-doc researchers in Life Sciences.
 Reviewer of Abstracts, Congresses in Medical Biochemistry, Greece (#6).
 Reviewer of Abstracts, Congresses in Medical Biopathology/Section
Biochemistry, Greece (#5).
 Member of the Scientific Committee of Congresses in Medical Biochemistry and
Congresses in Medical Biopathology, Greece
 Participation in the Scientific and Organizing Committee, Congress in
Cutaneous lymphoma, EORTC (European Organisation for Research and
Treatment of Cancer), Athens, 23-25 October, 2009.
MEMBERSHIP IN PROFESSIONAL AND SCIENTIFIC SOCIETIES
(in different chronic periods)
 Member of Athens Medical Association (1997-).
 Member of Ioannina Medical Association (1995-1997).
 Member of Ioannina Medical Society (1996-1998).
 Federation of Epirot Scientists (1997-)
 Member of the Greek Society of Virology (1998-).
 Member of the Greek Society of Microbiology (1998-).
 Affiliate Member of the Greek Society of Medical Biopathology (Western Greece)
(2000-)
 Member of the Greek Society of Immunology (2004-).
 Member of the Greek Society of Medical Biochemistry (2004-).
 Alexandros Onassis Foundation Association of Scholars (2001-).
 Harvard Alumni Association (2000-)
 Harvard Club of Greece (2000-)
 Member of the American Society of Microbiology (2007-2008)
 Member of the American College of Epidemiology (2007-)
 Member of the International Complement Society (2008-)
 Member of the American Society of Hematology (2008-2009)
 Member of the Society of Leukaemia and Lymphoma (2007-)
 Member of the Greek Society of Breast Imaging (2012-)
 Member of the Chemical Pathology Group (2010-)
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Member of the American Society for Clinical Laboratory Science Group (2010)
Member of the American Association of Clinical Chemistry Group (2010)
Member of the Clinical and Laboratory Standards Institute Group (2010)
Member of the Clinical Laboratory Management Association Group (2010-)
Fellow of the American Society for Clinical Pathology (2007-), FASCP
International Fellow of the College of American Pathologists (2007-), IFCAP
Fellow of the European Board of Medical Biopathology, Section Clinical ChemistryUnion of European Medical Specialists-UEMS (2008-)
Elected Member of the Scientific Committee of General University Hospital “Attikon”
as Consultant, Athens, Greece (2004-2006).
-Who’s Who in Medicine and Healthcare for the years 2007-Who’s Who in Science and Engineering for the years 2010-Who’s Who in Greece for the years from 2013-
ADDITIONAL EDUCATION-LANGUAGES
English
 Proficiency in English, Higher Diploma (Oxford University) 1993.
 TOEFL, 1998.
 Graduate Record Examination, GRE, 1998.
French
 Diplôme de Langue Française, Alliance Française de Belgique, 1985 with high
distinction.
 Diplôme d’Etudes Françaises Modernes et de Civilisation, Alliance Française de
Belgique, 1985, with high distinction.
 Etudes Secondaires (1983-1988) au Collège Centre Scolaire Sacré-Coeur de Lindthout,
Bruxelles- Belgium (modèle A).
Knowledge of Statistical packages and laboratory softwares: SAS®, SPSS, STATA,
TreeAge (DATA), Medilab, Medlink, BioLis (Biochem), Hospital Information System.
Piano: Diploma of Instrumental Music of Schaerbeek, Brussels-Belgium 1986.
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PUBLICATIONS IN INTERNATIONAL PEER-REVIEWED JOURNALS INDEXED
IN PUBMED (as DALAMAGA M and DALAMANGA M).
With * the most important manuscripts
1. *Dalamaga M, Petridou E, Cook FE, Trichopoulos D. Risk factors for myelodysplastic
syndromes: a case-control study in Greece. Cancer Causes and Control 2002; 13:602608.
The etiology of most cases of myelodysplastic syndromes (MDS) has not been elucidated. We have
undertaken an investigation in Greece to determine the risk profile of adult de-novo MDS. A case-control
16
investigation was conducted in a large Veterans' hospital over a five-year period, covering 84 MDS cases
and 84 age- and gender-matched controls with minor non-neoplastic non-infectious conditions from the
same study base. Cases and controls reported to the medically trained principal investigator lifestyle
characteristics and medical histories, with emphasis on autoimmune disorders and allergic conditions.
Alcohol intake and tobacco smoking jointly increased significantly the risk of MDS (odd ratio contrasting
ever smokers and regular drinkers of at least one glass per day to never smokers and drinkers of less
than one glass per day: 9.54. 95% CI 3.52-25.82) whereas each of these factors alone had limited effect.
There was also evidence that autoimmune conditions, but not allergic disorders, were positively
associated with MDS risk, irrespective of their occurrence during the recent (less than ten years) or the
remote (more than ten years) past (OR 3.34, 95% CI 1.15-9.74; OR 3.50, 95% CI 1.19-10.26, respectively).
We found evidence that both exogenous and endogenous factors may play a role in the etiology of the
so-called "de novo" myelodysplastic syndromes, but these findings need further confirmation.
2. *Petridou E, Dalamaga M, Mentis A, Skalkidou A, Moustaki M, Karpathios T,
Trichopoulos D and the Childhood Haematologists-Oncologists Group. Evidence in
support of the infectious aetiology of acute childhood leukaemia: the role of low
immunity to a range of agents. Cancer Causes and Control 2001; 12: 645-652.
Acute lymphoblastic leukemia (ALL) among children may be a rare outcome of a delayed non-specific
infection in situations of overall low herd immunity. We evaluated the hypothesis as to whether newly
diagnosed ALL cases, compared to their controls, are characterized by lower herd immunity, as reflected
in a more seronegative spectrum to several agents, with the exception of a strongly positive response to a
single infectious agent, assumed to trigger ALL. The study included 94 incident cases of ALL, from all
pediatric hematology-oncology units of Greece, and 94, matched for age and gender, controls
hospitalized with minor non-infectious conditions. The past exposure to common infections was assessed
using 10 serological markers using immunochemistry assays.There was little evidence for an association
of ALL with the serology of any of the studied infectious agents among the very young children. In
contrast, among children aged 5 years or older, leukemia was inversely associated with seropositivity to
Epstein-Barr virus, human herpes virus-6, Mycoplasma pneumoniae and parvovirus B19. Among
children aged 5 years or older the risk of leukemia may be higher when the low herd immunity for
several agents is challenged by late infection from an agent that, as a rule, would attack children at a
younger age.
3. Karmaniolas K, Ioannidis P, Liatis S, Dalamanga M, Papalambros T, Migdalis I.
Carnitine deficiency in a male adult. Journal of Medicine (J Med) 2002; 33 (1-4): 105-110.
This reports describes the case of a 36 year-old man who presented with progressive proximal muscle
weakness and weight loss. His serum creatine phosphokinase (CPK) levels were markedly elevated. The
muscle biopsy showed lipid storage myopathy. The muscle carnitine concentration was extremely low
(5.6% of normal levels), establishing the diagnosis of myopathic carnitine deficiency. The disorder was
considered as primary because there were no indications of any other identifiable condition which could
result in a secondary carnitine deficiency. The patient was treated with oral L-carnitine (2 g per day) and
showed rapid improvement. Primary myopathic carnitine deficiency is a curable disorder and therefore
it should always be considered as a potential diagnosis in cases of myopathy in young adults.
4. Iakovakis I, Dessypris N, Dalamaga M, Petridou E. A cluster analysis of road trafficrelated childhood knee injuries. Child: Care, Health & Development 2003; 29 (4); 297301.
Knee injuries represent an important category of road traffic injuries among children, and they are
heterogeneous in their aetiology. The aims of this study were to estimate the incidence of road traffic
childhood knee injuries in Greece by age and gender, point out their time, place and person co-ordinates
and identify clusters with distinct characteristics with a view to potential preventive interventions.
During a 3-year period, 305 children with knee injuries resulting from a road traffic accident were
identified among the 66,870 children with injuries recorded in the Emergency Department Injury
17
Surveillance System (EDISS) of Greece. Using previously derived sampling ratios and national data on
childhood population, incidence data by age and gender were estimated. Hierarchical analysis was
undertaken for cluster identification. The incidence of road traffic knee injuries was 97.5 per 100,000
children-years. The incidence increased with age and was higher among boys than among girls. Most
childhood knee injuries (50.2%) occur among pedestrians, and the majority (90.9%) of the children or
their guardians admitted responsibility in crossing the road. Of the 31 children injured as car passengers,
the vast majority (87.1%) were unrestrained, and a large fraction (38.7%) were front seat passengers. Two
clusters were identified: the first consisted of younger children who resided mostly in the Athens area
and suffered less serious knee injuries as pedestrians or car passengers during the colder months; the
second consisted of older children, frequently tourists, who suffered more serious injuries as cyclists
while vacationing. Many of the children who suffered road traffic knee injuries as pedestrians admitted
responsibility in road crossing, whereas a large proportion of children who were injured as car
passengers were injured while improperly seated in the front and without seatbelt protection. Older
children, frequently tourists, were at high risk of knee injuries while using motorcycles and bicycles.
5. Dalamaga M, Karmaniolas K, Chavelas C, Liatis S, Matekovits H, Migdalis I.
Stenotrophomonas maltophilia: a serious and rare complication in patients suffering from
burns. Burns 2003; 29 (7): 711-713.Stenotrophomonas maltophilia is rarely implicated in clinical
infections but it constitutes a significant nosocomial pathogen, especially in immunocompromised
patients. This report describes the first case of a generalised infection caused by S. maltophilia that
included bacteremia, wound and respiratory tract infection in a patient suffering from burns. Special
emphasis is given on the biochemical identification of S. maltophilia. Given the emergence of S.
maltophilia nosocomial infections, especially in patients with burns, isolation of the bacterium from
blood cultures should prompt the commencement of adequate antibiotic treatment.
6. Dalamaga M, Karmaniolas K, Chavelas C, Liatis S, Matekovits H, Migdalis I.
Fusobacterium necrophorum septicemia following Epstein-Barr virus infectious
mononucleosis. Anaerobe 2003; 9: 285-287. We report herein a case of a 20-year-old previously
healthy man who presented, 25 days after the onset of clinically and serologically confirmed Epstein-Barr
virus (EBV) infectious mononucleosis, Fusobacterium necrophorum septicemia. The diagnosis of
postanginal septicemia was confirmed by repeated demonstration of fusiform, obligate anaerobic, Gramnegative bacilli in anaerobic blood cultures, identified as F. necrophorum 15 days after admission.
Particular emphasis is given on the biochemical identification of F. necrophorum and the perturbated
hepatobiochemistry presented during Epstein-Barr virus (EBV) infectious mononucleosis. This case
report aims at underlining the need of taking into consideration the possibility of severe Fusobacterium
septicemia in previously healthy patients following EBV infectious mononucleosis in order to prevent
increased mortality and morbidity.
7. Dalamaga M, Karmaniolas K, Chavelas C, Liatis S, Matekovits H, Migdalis I.
Coexistence of primary refractory anemia with ringed sideroblasts (RARS) and T-cell
lymphoblastic non-Hodgkin lymphoma. Acta Haematologica (Basel) 2004; 111(3): 171172.
The development of myelodysplastic syndrome (MDS) secondary to treatment of non-Hodgkin
lymphoma is a common phenomenon. We report here a case of T-lymphoblastic non-Hodgkin
lymphoma presenting after three years with de novo MDS-refractory anemia with ringed sideroblasts,
an unusual finding. Absence of prior chemotherapy and cytogenetic confirmation establish the true
coexistence of the two hematologic disorders. The mechanisms responsible for the appearance of nonHodgkin lymphoma in a patient with primary MDS are diverse: the neoplastic transformation of a
common progenitor, the immunodeficiency induced by MDS and the consideration that MDS could be a
18
paraneoplastic syndrome preceding therefore the development of lymphoproliferative disorders.
Emphasis is given on serum biochemical markers and cytogenetic findings.
8. Dalamaga M, Karmaniolas K, Chavelas C, Liatis S, Ioannidis P, Matekovits E-A,
Migdalis I. Generalised infection associated with ECHO virus. European Journal of
Internal Medicine 2004; 15: 68.
We described a case of generalized ECHOvirus infection that included a febrile exanthematous illness,
aseptic meningitis accompanied by a sequential involvement and rapid resolution of cardiac, hepatic and
pancreatic abnormalities. Emphasis is given on serum biochemical markers of cardiac, hepatic and
pancreatic function.To our knowledge, this is a very unusual, not previously reported presentation of
acute ECHOvirus infection in an immunocompetent adult.
9. Dalamaga M, Karmaniolas K, Chavelas C, Liatis S, Matekovits H, Migdalis I.
Pseudomonas fluorescens cutaneous abscess and recurrent bacteremia following a dog
bite. International Journal of Dermatology 2005; 44(4): 347-349.
A common complication of dog bite wounds is bacterial infection. Pseudomonas fluorescens is rarely
implicated in clinical infections but it constitutes a significant nosocomial pathogen causing mainly
transfusion-associated bacteremias. This report describes the first recorded case, to our knowledge, of a
P. fluorescens strain that infected and caused cutaneous abscess and recurrent bacteremia in a patient
following a dog bite. Particular emphasis is given on the biochemical identification of P. fluorescens.This
case report further expands the spectrum of disease caused by this microorganism and points out the
need to recognize P. fluorescens as a potential zoonotic pathogen.
10.
Dalamaga M, Karmaniolas K, Chavelas C, Liatis S, Matekovits H, Migdalis I.
Pseudomonas luteola cutaneous abscess and bacteremia in a previously healthy man.
Scandinavian Journal of Infectious Diseases 2004; 36(6-7): 495-497. Pseudomonas luteola is
uncommonly implicated in clinical infections, but it constitutes a significant nosocomial pathogen
causing mainly infections associated with foreign material. Special emphasis is given on the biochemical
identification of P.luteola. This report describes an unusual case of a Pseudomonas luteola strain that
infected and caused cutaneous abscess and bacteraemia in a previously healthy man.
11.
*Mantzoros C, Petridou E, Dessypris N, Chavelas C, Dalamaga M, Delia MA,
Papadiamantis Y, Markopoulos C, Spanos E, Chrousos G, Trichopoulos D. Adiponectin
and Breast Cancer Risk. Journal of Clinical Endocrinology and Metabolism 2004; 89(3):
1102-1107.Adiponectin, an adipocyte-secreted hormone, is closely and inversely associated with
insulin resistance and was recently found to be inversely and independently associated with endometrial
cancer. Because insulin resistance in the setting of obesity has also been associated with the development
of breast cancer, we have hypothesized that decreased adiponectin levels might underlie the association
between breast cancer and obesity/insulin resistance. We evaluated the association of adiponectin with
the occurrence of breast cancer in a case-control study comprising 174 women with newly diagnosed,
histologically confirmed breast cancer and 167 controls. We found an inverse, fairly strong, and
statistically significant association of serum adiponectin with breast cancer (odds ratio, 0.84; 95%
confidence interval, 0.71-0.99). Importantly, despite a fairly robust inverse association of adiponectin
with breast cancer risk among postmenopausal women (odds ratio, 0.82; 95% confidence interval, 0.671.00), no such significant association between adiponectin and breast cancer was found among
premenopausal women. The observed associations were independent of possible effects of major
components of the IGF system, leptin, body mass index, sociodemographic variables, and known risk
factors for breast cancer. Future studies are needed to prove causality and provide further insights into
both the mechanisms underlying the actions of this hormone and its potential role in breast cancer.
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12. Petridou E, Kouri N, Vadala H, Dalamaga M, Sege R. Frequency and nature of
recorded childhood immunization related errors in Greece. Journal of ToxicologyClinical Toxicology (succeeded by Clin Toxicol) 2004; 42(3): 273-276.
While routine immunizations are very safe, their administration to healthy children requires
minimization of immunization programmatic errors. In order to estimate the incidence and ascertain the
nature of reported immunization errors in the Greek childhood population, we have undertaken a study
using data from the National Poison Information Center in Greece, which also has the responsibility to
address medication-induced errors. All immunization errors concerning children and reported to the
National Poison Information Center during the 2-yr period 1999-2000 were retrieved and the conditions
of their occurrence were examined. The incidence of reported errors was calculated under the
assumption that during each year 100,000 children are born in Greece, and during their childhood they
receive a total of about 20 immunization doses of all childhood immunizations. There were 40
immunization errors reported, corresponding to a reported incidence of about 11 per million
immunization doses. Of these errors, 20 concerned OPV, 13 DTP, 5 MMR, 1 Haemophilus influenza and
1 Hepatitis B immunizations. In 12 instances an erroneous route was used (out of which 11 concerned
OPV), whereas overdose was documented in 13 instances (out of which 8 concerned OPV). The third
most common error was administration of DTP instead of the recommended Td vaccine. No adverse
patient outcomes were reported. In Greece, reported errors in immunization practice are relatively rare.
Packaging modifications (about one in three errors in this study) of the OPV and DTP could further
reduce their incidence.
13. Moustaki M, Pitsos N, Dalamaga M, Dessypris N, Petridou E. Home and leisure
activities and childhood knee injuries. Injury 2005; 36 (5): 644-650.
To assess the relative occurrence of non motor-vehicle knee injuries and identify important clusters that
can be targeted for preventive interventions. The study subjects covered 2167 children (0-14 years) who
suffered non motor-vehicle knee injuries out of 66870 registered during a three-year period in an
established Emergency Department Injury Surveillance System (EDISS). A more serious joint injury was
identified in 263 (12%) children, whereas the remaining 1904 children had only soft tissue knee injuries.
The incidence of non motor-vehicle knee injuries was estimated at 6.5 per 1000 children-years. Both the
incidence of knee injuries and the male-to-female ratio increase with increasing age, reflecting the gender
and age pattern of physical activity. Three clusters were identified: The first consisted of more serious
knee injuries among older children, frequently resulting after a fall from stairs or a collision in school
during winter months; the second cluster consisted of rather minor knee injuries occurring mostly among
younger girls at home or in playgrounds, following a fall after stumbling or hit by an object while
playing, especially during the summer; the third cluster comprised injuries among older boys, sustained
mainly subsequent to overexertion in a sports area. Knee injuries tend to be more common among boys
but more serious among girls. More and less serious knee injuries tend to fall into distinct clusters that
could facilitate prioritization of preventive measures.
14.
Dalamaga M, Chavelas C, Kostoula A, Matekovits E-A, Liatis S, Karmaniolas K,
Migdalis I. Leptospirosis presenting as acute pancreatitis and cholecystitis Journal of
Medicine (J Med) 2004; 35 (1-6):181-185. We report a rare case of a 21-year-old man with
leptospirosis mimicking acute pancreatitis and cholecystitis. This case report aims at pointing out the
need of taking into consideration the possibility of leptospirosis in patients with an influenza-like
syndrome, headache accompanied by acute abdominal pain and a suspicious exposure in order to
prevent unnecessary surgical interventions. Emphasis is given on serum biochemical markers of cardiac,
hepatic and pancreatic function.
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15.
Dalamaga M, Karmaniolas K, Kontos F, Migdalis I, Dionyssiou-Asteriou A. Clinical
study on the serum carcinoembryonic antigen, CA 19-9, CA 50 and α-fetoprotein levels
in patients with myelodysplastic syndromes Leukemia and Lymphoma 2006; 47(9):
1782-1787. The present study aimed to determine the serum carcinoembryonic antigen (CEA), CA 19-9,
CA 50 and alpha-fetoprotein (alpha-FP) levels between patients with myelodysplastic syndromes (MDS)
at diagnosis and controls to clarify their potential clinical significance. A case-control investigation was
conducted over a three year period, covering 95 MDS cases and 95 age- and gender-matched controls.
Mean serum CEA levels were significantly higher (P = 0.0002) in MDS patients at diagnosis than in
hospital controls. Adjusting for age, gender, tobacco consumption, serum CA 19-9, CA 50 and alpha-FP
levels, there is statistically significant evidence that serum CEA values are associated with increased risk
of MDS (odds ratio = 2.33, 95% confidence interval = 1.56 - 3.49). Six patients with MDS developed
malignancies 4-9 months after the diagnosis of myelodysplasia. Serum CEA could be used as marker
together with other important diagnostic tools for evaluating an underlying or developing malignancy in
patients suffering from MDS.
16.
Dalamaga M, Karmaniolas K, Pantelaki M, Daskalopoulou K, Kavatha D, Migdalis I.
Spontaneous peritonitis caused by Leminorella grimontii. Diagn Microbiol Infect Dis
2006; 56:83-85. A case of spontaneous peritonitis caused by Leminorella grimontii in a 63-year-old
man with cirrhosis is reported. To our knowledge, L. grimontii has never been reported as a cause of
spontaneous bacterial peritonitis. The patient responded to antimicrobial therapy. Clinical and
therapeutic implications are discussed. Special emphasis is given on the biochemical identification of L.
grimontii as well as on biochemical markers of the peritoneal fluid.
17.
Karmaniolas K, Liatis S, Dalamaga M, Mourouti G, Digeni A, Migdalis I. A case of
ovarian sarcoidosis mimicking malignancy. Eur J Gynaecol Oncol 2005; 26 (2): 231-232.
We present a case of systemic sarcoidosis with ovarian and peritoneal involvement. The atypical clinical
presentation of the disease has lead to a problem of the differential diagnosis with ovarian cancer. A 72year-old female was admitted because of low grade fever, fatigue and dilatation of the abdomen. Clinical
and laboratory evaluation of the patient revealed moderate right pleural effusion, ascites, diffuse ovarian
infiltration, presence of enlarged intraabdominal lymph nodes and a substantially high value of serum
CA 125. The elevated value of serum CA 125 is particularly discussed. Histological examination after
laparotomy was indicative of ovarian sarcoidosis.
18. Papadavid E, Gazi S, Dalamaga M, Stavrianeas N, Ntelis V. Palmoplantar and scalp
psoriasis occurring during anti-tumour necrosis factor-α: a case series of four patients
and guidelines for management. Journal of the European Academy of Dermatology
and Venereology 2008; 22: 380-2.
Biological therapy with the introduction of TNF-a inhibitors has revolutionised the treatment of several
organ-specific localised autoimmune conditions in gastroenterology, initially Crohn’s disease and later
ulcerative colitis as well as in chronic arthritic diseases such as rheumatoid arthritis, ankylosing
spondylitis, juvenile idiopathic arthritis and psoriatic arthritis and more recently in dermatology for the
treatment of moderate to severe plaque psoriasis. Controlled clinical trials have shown that anti-tumor
necrosis factor (anti-TNF) agents are efficacious in decreasing the disease activity of skin lesions in
patients with moderate to severe psoriasis vulgaris. It seems that all anti-TNF agents such as the
monoclonal anti-TNFa antibodies infliximab (RemicadeR) and adalimumab (HumiraR) as well as the
soluble TNFa receptor etanercept (EnbrelR) decrease not only joint but also skin inflammation in patients
with PsA with a favourable safety profile. During the last year several anecdotal case reports and some
case series reported that all TNF-a antagonists used mainly for arthritis or CD can induce or exacerbate
psoriasis but this association and the exact mechanism remain still debatable and unclear,
21
respectively.We describe 4 patients with different autoimmune diseases treated and followed in two
very large out patient specialist clinics that developed de novo 2-8 months after initiation of TNFa
inhibitors treatment, whereas the primary condition responded well to anti-TNFa therapy. In our case
series two variants of psoriasis mainly predisposed as adverse effect from TNF antagonists
independently of the underlying condition: palmoplantar pustulosis and scalp psoriasis. In one case,
scalp psoriasis was severe progressing to extensive diffuse hair loss despite discontinuation of the TNFa
antagonist and the use of potent topical steroids and responded only to early initiation of cyclosporine A
treatment. Particular emphasis is given on clinical biochemistry and immunologic serum markers.
19. Dalamaga M, Karmaniolas K, Matekovits A, Migdalis I, Papadavid E. Cutaneous
manifestations in relation to immunologic parameters in a cohort of primary
myelodysplastic syndrome patients. Journal of the European Academy of Dermatology
and Venereology 2008; 22: 543-8.
Cutaneous lesions in myelodysplastic syndrome (MDS) may be specific or not and may reveal bone
marrow transformation. Our purpose was to investigate in a cohort of 84 MDS patients the correlation of
cutaneous findings with immunologic parameters and prognostic features of MDS in order to clarify
their potential clinical significance. We studied a cohort of 84 newly diagnosed MDS patients in order to
assess the cutaneous findings present at the time of diagnosis and during 1 to 3 years of follow-up. We
described the clinical variety of cutaneous findings ascertained by histology. We also looked for any
association between the group of MDS patients with skin manifestations and MDS subtype,
immunologic and prognostic features highlighting transformation to acute leukaemia. Twenty-one
patients presented cutaneous manifestations: 1 patient developed leukaemia cutis, 6 patients
photosensitivity not associated with autoimmune disease, 3 prurigo nodularis, 2 Sweet's syndrome, 6
leucocytoclastic vasculitis, 2 ecchymoses and purpura associated with preexisting relapsing
polychondritis, 1 patient subcutaneous nodules associated with Wegener's granulomatosis and 1 patient
with malar rash and oral ulcers associated with preexisting systemic lupus erythematosus. Adjusted for
age and gender, the presence of skin findings constitutes a significant predictor of the high-risk MDS
subgroup (odds ratio, 3.59; 95% confidence interval, 1.18-10.92). Hypergammaglobulinemia was
significantly higher in the MDS subgroup with skin manifestations (P = 0.03). Most MDS patients with
cutaneous manifestations belong to the high-risk MDS subgroup and present hypergammaglobulinemia.
Early biopsy of skin lesions in myelodysplasia is indicated. Particular emphasis is given on serum
immunochemical and biochemical markers of autoimmune disorders.
20. Dalamaga M, Nikolaidou A, Karmaniolas K, His A, Chamberland J, DionyssiouAsteriou A, Mantzoros C. Circulating adiponectin and leptin in relation to
myelodysplastic syndrome: a case-control study. Oncology (Basel) 2007; 73 (1-2): 26-32.
Adiponectin plays a protective role in several malignancies, including myeloblastic leukemia, whereas
leptin may increase the proliferation of progenitor cells and may stimulate leukemic cell growth in vitro.
We investigated the role of adiponectin and leptin levels in the etiopathogenesis of myelodysplastic
syndromes (MDS), a preleukemic condition with increasing incidence which has recently been associated
with obesity. In a case-control study, 101 cases with incident, histologically confirmed primary MDS and
101 controls matched on gender and age were studied between 2004 and 2007, and blood samples were
collected. Higher serum adiponectin levels were associated with lower risk of MDS by bivariate analysis
and after adjusting for age, gender, body mass index and serum levels of leptin (p < 0.001). Subjects in
the third quartile for leptin levels had a lower risk of MDS than controls, and low leptin concentrations
were observed in low-risk MDS patients with normal or good prognostic karyotype after adjusting for
age, gender and body mass index. Circulating adiponectin and leptin may play an important role in
MDS etiopathogenesis. Future studies are needed to confirm these associations and to explore
underlying mechanisms.
22
21. Dalamaga M, Karmaniolas K, Arsenis G, Pantelaki M, Daskalopoulou K, Papadavid E,
Migdalis I. Cedecae lapagei bacteremia following cement-related chemical burn injury.
Burns 2008; 34: 1205-1207.
Cedecae lapagei is rarely implicated in clinical infections. To the best of our knowledge, this report
describes the first case of bacteremia and knee wound infection due to C. lapagei in a 47-year-old worker
suffering from cement-related chemical burn injuries. Given the expansive spectrum of infections in
patients with burn injuries and the microorganism potential resistance to antimicrobial therapy, isolation
of the bacterium from blood and wound cultures should prompt the commencement of adequate
antibiotic treatment. Special emphasis is given on the biochemical identification of C. lapagei as well as
on the biochemical and pathological mechanisms associated with the chemical burn injury.
22.
Dalamaga M, Karmaniolas K, Nikolaidou A, Papadavid E. Hypocalcemia,
hypomagnesemia and hypokalemia following hydrofluoric acid chemical injury.
Journal of Burn Care & Rehabil (succeeded by J Burn Care & Res) 2008; 29: 541-543.
Dermal exposure to hydrofluoric acid could potentially result in severe serum calcium and magnesium
depletion induced by binding with fluoride anion. This report describes the case of a 48-year-old man
who developed hypocalcemia and hypomagnesemia accompanied by hypokalemia-an interesting
finding-following a chemical injury with exposure to 70% hydrofluoric acid. Successful treatment
included administration of calcium gluconate and magnesium both intravenously and topically.
23. Dalamaga M, Lekka A, Karmaniolas K, Stathopoulou E, Dionyssiou-Asteriou A. Is
thyroid autoimmunity a risk factor for developing primary myelodysplastic
syndrome? Cancer Causes and Control 2008; 19: 371-8.
Thyroid disease has been associated with leukemia and lymphoma. No previous study using clinical and
laboratory data has explored whether thyroid disease and especially autoimmune thyroid disease (ATD)
is associated with myelodysplastic syndrome (MDS) risk. In this case-control study, we investigated the
association of ATD with MDS. Our study included 101 cases with incident primary MDS confirmed by
histology and cytogenetics, and 101 controls matched on gender and age, admitted for non-neoplastic
and non-infectious diseases. All subjects were submitted to clinical, ultrasound thyroid evaluation and
serum free T3, free T4, TSH, thyroglobulin, and thyroperoxidase antibodies determination. Adjusting for
age, gender, and body mass index, there was statistically significant evidence that ATD is associated
with increased risk of MDS (OR = 2.58, 95% CI 1.29-5.16). Interestingly, ATD starting from the remote
past (more than 10 years from MDS onset) was positively associated with MDS risk (OR = 5.73. 95% CI
2.03-16.16). Mean serum levels of fT3, fT4, and thyroid antibodies were significantly higher in MDS
patients and mean TSH serum levels were significantly lower in MDS patients than in controls (p < 0.05).
Biological plausibility and empirical evidence highlights the importance of ATD in MDS
etiopathogenesis. Further studies are needed to explore underlying mechanisms associating thyroid
autoimmunity with leukemogenesis.
24. Papadavid E, Psyrri A, Pectasides D, Katoulis A, Belamoti E, Dalamaga M, Stavrianeas
N. How to manage melanoma in a psoriatic patient. Dermatology 2008; 216: 277-278.
Psoriasis concurrence with malignant melanoma (MM) may cause difficulties in disease management as most
modalities, especially photo- chemo- therapy, Cyclosporine A (CyA) and anti-TNF
agents, are
contraindicated and the use of retinoids and methotrexate may not always apply to the biochemistry or blood
profile of the patients, respectively. Additionally the therapeutic use of IFN-α for MM can exacerbate
autoimmune disorders such as psoriasis or trigger off its onset.Recent reports suggest a mechanism trough
which IFN-α derived from plasmacytoid predendritic cells has a role in this autoimmune downstream. In this
article we report a case of exacerbation of psoriasis due to IFN-α administration and review the current
literature with a particular focus on biochemical mechanisms.
23
25. Dalamaga M, Pantelaki M, Karmaniolas K, Matekovits A, Daskalopoulou K. Leg ulcer
and bacteremia due to Cedecea davisae. Eur J Dermatol 2008; 18: 204-5.
Cedecea davisae is rarely implicated in infections and has been rarely isolated from environmental and
clinical specimens. To the best of our knowledge, this report describes a very unusual case of bacteremia
and leg ulcer due to C. davisae in a 67-year-old man with uncomplicated diabetes. Clinical and
therapeutic implications are discussed. Isolation of the bacterium from blood as well as wound cultures
should prompt the commencement of adequate antibiotic treatment. Special emphasis is given on the
biochemical identification of C. davisae as well as on serum biochemical markers of bacteremia.
26. Dalamaga M, Pantelaki M, Karmaniolas K, Matekovits A, Daskalopoulou K.
Cutaneous abscess and bacteremia due to Serratia ficaria. Journal of the European
Academy of Dermatology and Venereology 2008; 22: 1388-89.
Serratia ficaria is a Gram-negative rod involved in the fig tree ecosystem. Although S. ficaria is very
rarely isolated from clinical specimens with a questionable role as a pathogen, it has been associated with
infections in compromised individuals. We describe the first recorded case of a S. ficaria strain that
caused generalized infection including cutaneous abscess and bacteremia in a previously healthy man
following a wild dog bite. Special emphasis is given on the biochemical identification of S. ficaria as well
as on serum biochemical markers of bacteremia.
27. Dalamaga M, Pantelaki M, Karmaniolas K, Daskalopoulou K, Migdalis I. Isolation of
Leclercia adecarboxylata from blood and burn wound after a hydrofluoric acid
chemical injury. Burns 2009; 35: 443-445.
An unusual case of wound infection and bacteremia due to Leclercia adecarboxylata in an
immunocompetent man suffering from hydrofluoric acid burn injuries is reported. To our knowledge, L.
adecarboxylata has been rarely isolated from environmental and clinical specimens. The patient
responded to antimicrobial therapy. Clinical and therapeutic implications are discussed. Special
emphasis is given on the biochemical identification of L. adecarboxylata as well as on biochemical and
pathological mechanisms associated with the chemical burn injury.
28. Hroussalas G, Kassi E, Dalamaga M, Delimaris I, Zachari A, Dionyssiou-Asteriou A.
Leptin, soluble leptin receptor, adiponectin and resistin in relation to OGTT in
overweight/obese postmenopausal women. Maturitas 2008; 59: 339-349.
In obese postmenopausal women with normal glucose metabolism (NGT) and impaired glucose
tolerance (IGT) we assessed serum leptin, adiponectin, resistin, soluble leptin receptor (sOB-R) during
oral glucose tolerance test (OGTT) in order to investigate their response to acute changes in glucose and
insulin in the abnormal glucose metabolism, as it is early detected by IGT. Thirty in total,
overweight/obese postmenopausal women, were included in the study: 15 with NGT and 15 with IGT as
it was diagnosed by OGTT. Serum glucose and insulin levels were measured at 30 min intervals, leptin,
sOB-R, adiponectin and resistin at 60 min intervals during the 120 min OGTT. In fasting state, leptin,
adiponectin, resistin and sOB-R levels did not differ between the two groups. In women with NGT,
leptin was positively correlated with BMI, insulin and HOMA, and negatively correlated with QUICKI
and with sOB-R; adiponectin was negatively correlated with insulin and HOMA and positively
correlated with QUICKI. In women with IGT, resistin was positively correlated with BMI and waist
circumference. In both groups, sOB-R was negatively correlated with insulin. During OGTT, in both
groups, leptin concentration increased significantly and fasting glucose predicts significantly serum
leptin change; there was no change in adiponectin, resistin and sOB-R concentrations. In
overweight/obese postmenopausal women fat distribution does not affect leptin and adiponectin
production. Abnormal glucose metabolism is not accompanied by disturbance in adipokines production.
Leptin secretion is acutely regulated by glucose levels in insulin presence.
24
29. Karmaniolas K, Dalamaga M, Liatis S, Kaskara A, Rigopoulos A, Migdalis IN.
Hematological malignancies are associated with a lower interferon-α blocking activity
than solid tumors. Res Comm Mol Pathol Pharmacol 2005; 117-118: 65-75.
Interferon (IFN) and especially IFN-alpha exhibit clinical anti-tumor activity against various types of
malignant diseases. Natural inhibitors to various cytokines and IFNs have been documented in vitro as
well as in vivo. IFN inhibitors have been implicated for the ineffectiveness of IFN treatment in malignant
neoplasias. The aim of this study was to investigate the incidence of the IFN inhibiting activity in serum
from patients with haematological malignancies versus patients with solid tumours, as an effort to
explain, just in part, the different response of these patients to IFN treatment. Ninety patients with a
clinically evident solid tumour and forty-six patients with haematological malignancies were included in
the study. Serum samples from all patients were collected before any treatment and stored at -70 degrees
until use. Controls sera were selected from 50 apparently healthy blood donors. Interferon-inhibiting
activity as well as endogenous IFN-like activity were determined in all serum samples in a cell line
highly sensitive to IFN. There was no endogenous IFN-like activity in any of the patients' group or
controls' group. Sera from patients with haematological malignancies exhibited IFN-blocking activity at a
lower percentage (21.7%) in comparison to sera from patients with solid tumours (56.6%, P<0.001), but at
a significantly higher percentage in comparison to sera from controls (P<0.01). The fact that IFN
inhibitors were detected at a significantly lower percentage in sera from patients with haematological
malignancies versus patients with solid tumours, could explain in part the better response of the
haematological malignancies to IFN treatment.
30. *Dalamaga M, Karmaniolas K, Nikolaidou A, Chamberland J, Hsi A, DionyssiouAsteriou A, Mantzoros C. Adiponectin and resistin are associated with risk for
myelοdysplastic syndrome, independently from the IGF-I system. Eur J Cancer 2008;
44: 1744-53.
Obesity has been implicated in the aetiology of myelogenous leukaemia and myelodysplasia (MDS). We
hypothesised that altered secretion of adiponectin and resistin may underlie this association. We thus
investigated the role of both total and high molecular weight (HMW) adiponectin and resistin in MDS. In
a case-control study, we studied 101 cases with incident, histologically confirmed primary MDS and 101
controls matched on gender and age between 2004 and 2007. Total and HMW adiponectin, resistin,
insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein (IGFBP-3) were
determined. Lower serum total or HMW adiponectin and/or resistin levels were independently
associated with higher risk of MDS controlling for age, gender, BMI and serum levels of leptin, IGF-I and
IGFBP-3 (p<0.002). Although total and HMW adiponectin were both significantly inversely associated
with MDS when modelled either in quartiles or continuously, HMW did not offer any substantial
additional predictive value over total adiponectin (Odds ratio (OR)=0.91 versus 0.93 for a 1 microg/ml
change, respectively). IGF-I was positively associated with MDS by bivariate analysis and both IGF-I and
IGFBP-3 were higher in advanced MDS and higher risk stages, but were not significantly and
independently associated with MDS. Total and HMW adiponectin may have a protective role in MDS,
whereas resistin levels may be decreased via a compensatory mechanism.
31.
Dalamaga M, Karmaniolas K, Papadavid E, Pelecanos N, Migdalis I. Association of
thyroid disease and thyroid autoimmunity with multiple myeloma risk: a case-control
study. Leukemia and Lymphoma 2008; 49: 1545-52. Thyroid disease has been associated with
lymphohematopoietic cancer (LHC). No previous study using clinical, sonographic and laboratory data
has explored whether thyroid disease and specifically autoimmune thyroid disease (ATD) is associated
with multiple myeloma (MM) risk. 73 patients with incident primary MM and 73 hospital controls
admitted for non-neoplastic and non-infectious conditions, matched on gender and age were studied
between 2001 and 2007. Blood samples were collected. All subjects were submitted to clinical, ultrasound
and laboratory thyroid evaluation. The prevalence of clinical thyroid disease in MM patients was
significantly higher than in controls (p = 0.002). ATD was associated with increased risk of MM,
adjusting for age, gender, body mass index and familial history of LHC [OR = 5.68, 95% confidence
25
interval (CI): 1.69-19.13]. Controlling for the above variables, an individual suffering from any thyroid
disease more than 10 years has about 2.41 times more likely the risk to develop MM than an individual
without any thyroid disease (OR = 2.41, 95% CI: 1.35-4.29). Also, adjusting for age, gender, BMI and
family history of LHC, a familial history of thyroid disease is associated with increased risk of MM (OR =
3.23, 95% CI: 1.25-8.31). Further studies are needed to explore underlying mechanisms associating
thyroid autoimmunity with plasma cell transformation.
32.
Papadavid E, Dalamaga M, Stavrianeas N, Papiris SA. Subcutaneous sarcoidosis
masquerading as cellulitis. Dermatology 2008 ; 217 : 212-214. Sarcoidosis is a multisystem
disease encountered by general physicians as well as medical specialists. Subcutaneous sarcoidosis is not
an uncommon clinical presentation of sarcoidosis and is challenging for physicians because it can mimic
cellulitis or several chronic infections. Our patient presented with a swollen forearm and hand which
were initially treated as acute cellulitis with antibiotics by general physicians but without any
improvement. A skin biopsy showed granulomatous panniculitis but confirmation of the diagnosis of
systemic sarcoidosis was based on the characteristic chest roentgenogram, the high CD4/CD8 ratio of T
lymphocytes in bronchoalveolar lavage, and the typical 'panda' and 'lambda' signs on the (67)Ga scan.
Such cases with atypical clinical presentation cause some difficulty in reaching the diagnosis but a skin
biopsy as well as typical imaging and laboratory signs are usually important to establish the diagnosis of
sarcoidosis, when invasive procedures cannot be performed to get confirmation from a second target
organ.
33.
*Dalamaga M, Karmaniolas K, Panagiotou A, Hsi A, Chamberland J, Dimas C, Lekka
A, Mantzoros C. Low circulating adiponectin and resistin, but not leptin, levels are
associated with multiple myeloma risk: a case-control study. Cancer Causes Control
2009; 20: 193-199. Accumulating evidence supports a role for obesity in the etiology of multiple
myeloma (MM). The distinct possibility exists that obesity may be linked to MM through altered
adipokine secretion and circulating levels, one of which, adiponectin, has a protective role in several
malignancies, including leukemia. In this case-control study, we investigated the role of serum
adiponectin, resistin, and leptin levels in the etiopathogenesis of MM and we explored their association
with several established prognostic factors. Seventy three patients with incident, histologically confirmed
MM and 73 controls matched on gender and age were studied between 2001 and 2007, and blood
samples were collected. Serum adiponectin, leptin, resistin, as well as MM prognostic parameters were
determined. Statistical analysis of the data was performed using univariate and multivariate analyses.
Lower serum adiponectin and resistin levels were associated with higher risk of MM by bivariate
analysis and after adjusting for age, gender, BMI, and serum levels of leptin (p < 0.0001). Adiponectin
may have a protective role in MM, whereas leptin was not associated with risk for MM at a comparable
level of significance and resistin levels may be decreased via a compensatory mechanism. Further studies
are needed to confirm these associations and to explore the mechanisms underlying adiponectin's role in
MM and plasma cell dyscrasias.
34. Dalamaga M, Pantelaki M, Papadavid E, Daskalopoulou K, Karmaniolas K. Orchiépididymite et bactériémie à Leclercia adecarboxylata. Epididymo-orchitis and
bacteremia caused by Leclercia adecarboxylata. Médecine et Maladies Infectieuses)
Med Mal Inf 2008; 38: 674-675.
Leclercia adecarboxylata is rarely implicated in clinical infections and has been rarely isolated from
environmental and clinical specimens. To the best of our knowledge, this is the first reported case of
acute epididymo-orchitis due to L. adecarboxylata in a young man. Diagnostic, clinical and therapeutic
implications are discussed. This case illustrates a novel site of involvement of L. adecarboxylata and
underscores its role in human infections. Isolation of the bacterium from urine and/or blood cultures in
patients with genito-urinary symptoms should prompt the commencement of adequate antibiotic
26
treatment. Special emphasis is given on the biochemical identification of L. adecarboxylata as well as on
serum biochemical markers in bacteremia.
35. *Kassi E, Dalamaga M, Faviou E, Hroussalas G, Kazanis K, Nounopoulos Ch,
Dionyssiou-Asteriou A. Circulating oxidized LDL levels, current smoking and obesity
in postmenopausal women. Atherosclerosis 2009; 205: 279-283.
The aim of the present study was to estimate circulating oxidized low-density lipoprotein (oxLDL) levels
in postmenopausal women and evaluate their association with obesity and smoking status. The study
included 135 postmenopausal women aged 52-75 years. Forty of them were overweight (BMI 32.4+/-6.4)
and non-smokers (Group A), 40 non-overweight (BMI 22.6+/-1.8) and smokers (Group B) and 55 nonoverweight (BMI 23.5+/-1.4) and non-smokers (Group C). oxLDL and antibodies against them (antioxLDL) were measured using ELISA. Serum total cholesterol, LDL, HDL and triglycerides were
measured in an automated analyzer. Total cholesterol, LDL, HDL and oxLDL serum levels were
significantly elevated in Group A as compared to Group B or C, as well as oxLDL in Group B in
comparison to Group C (p<0.001). Triglycerides and anti-oxLDL were increased in Group A in
comparison to Group C (p=0.043 and 0.023). Total cholesterol, LDL, triglycerides and anti-oxLDL did not
differ between Groups B and C, while HDL was decreased in Group B as compared to Group C
(p<0.001). A significant positive correlation was found between oxLDL and LDL in Group A (r=0.53,
p<0.001) as well as in Group C (r=0.955, p<or=0.001) and a negative one between oxLDL and HDL in
Group C (r=-0.933, p<0.001). Regression analysis revealed that obesity was a stronger predictor of LDL
oxidation than smoking. Postmenopausal obesity is involved in the process of LDL oxidation and
appears to be a stronger predictor of LDL oxidation than smoking. Future studies are needed to confirm
these associations.
36.
*Dalamaga M, Migdalis I, Fargnoli JL, Papadavid E, Bloom E, Mitsiades N,
Karmaniolas K, Pelecanos N, Tseleni-Balafouta S, Dionyssiou-Asteriou A, Mantzoros
C. Pancreatic cancer expresses adiponectin receptors and is associated with
hypoleptinemia and hyperadiponectinemia: a case-control study. Cancer Causes
Control 2009; 20: 625-633. Obesity and insulin resistance have been implicated in the etiology of
pancreatic cancer (PC). Whether adiponectin and/or leptin, two adipocyte-secreted hormones important
in metabolic regulation, are associated with PC pathogenesis and whether adiponectin receptors are
expressed in PC remains unknown. In a hospital-based case-control study, we studied 81 cases with
incident, histologically confirmed PC and 81 controls matched on gender and age between 2000 and 2007
to investigate the role of adiponectin and leptin adjusting for risk factors linked to PC. In a separate
study, we also studied for the first time whether adiponectin receptors 1 and 2 are expressed in PC by
studying 16 PC tumor tissue samples which were analyzed using immunohistochemistry. When subjects
were divided into control-defined quartiles of adiponectin and leptin, lower leptin but higher
adiponectin levels were associated with PC (p = 0.001 and p = 0.05 respectively) before and after
controlling for age, gender, BMI, smoking status, alcohol consumption, history of diabetes, and family
history of pancreatic cancer. Of the PC tumor tissue samples analyzed, 87.5% had positive or strong
positive expression of AdipoR1 and 93.7% had positive or strong positive expression of AdipoR2.
Further prospective studies are needed to determine whether the elevated adiponectin and low leptin
levels reported in this study reflect compensatory changes during PC progression and thus can be used
as markers for PC or whether they are causally implicated in PC.
37. Papadavid E, Makris M, Dalamaga M, Kalogeromitros D, Stavrianeas N. Recall
injection-site reactions to etanercept in a patient with psoriasis. Clin Exp Dermatol
2009; 34: 414-415.
We described the case of a 50-year-old woman with a 40-year history of psoriasis who developed an
erythemato-oedematous plaque at her second injection of etanercept and simultaneously at the previous
injection site. Both injection sites were on the abdomen. The lesions regressed after 1 week with topical
treatment with steroids and oral antihistamines and discontinuation of etanercept. After resolution of the
27
ISR, etanercept was reinitiated and well tolerated with no further local reactions. Particular emphasis is
given on biochemical mechanisms.
38. Papadavid E, Kapsimali V, Psarra A, Antoniou C, Papasteriadi C, Ekonomidou J,
Anagnostou D, Nikolaou V, Kounaki D, Dalamaga M, Bamia C, Stratigos A,
Stavrianeas N, Katsambas A. TCRVb repertoire abnormalities in patients with
cutaneous T-cell lymphoma. Leuk Lymph 2009; 50: 1-3.
A profound disruption in T-cell repertoire has been observed in patients with advanced cutaneous T cell
lymphoma (CTCL) as well as 50% of early stages have been associated with repertoire disturbance. The
purpose of this study was to compare the presence of T-cell tissue clonality studied with PCR techniques
to TCRVb repertoire abnormalities analysed by flow cytometry (FC) in the peripheral blood T cells from
patients with early and late stages CTCL. Special emphasis is given on immunochemical mechanisms.
39. *Kazanis K, Dalamaga M, Nounopoulos C, Manolis A, Sakellaris N, Jullien G,
Dionyssiou-Asteriou A. Ischemia modified albumin, high sensitivity C-reactive protein
and natriuretic peptide in patients with coronary atherosclerosis. Clinica Chemica Acta
2009; 408: 65-9.
Ischemia modified albumin (IMA), is a new biomarker of oxidative processes involved with coronary
artery disease (CAD). We determined serum IMA, high-sensitivity C-reactive protein (hsCRP), and
natriuretic peptide (NT-proBNP), and evaluated their correlation with severity of coronary
atherosclerosis in patients undergoing coronary angiography (CA). Cardiac troponin T (cTnT), CK-MB
mass, albumin and Total Antioxidant Status (TAS) were also evaluated. The study included 114 patients
(88 men and 30 women) aged 43-80 years with documented CAD without evidence of acute coronary
syndrome undergoing CA and 163 controls (131 men and 32 women) similarly aged. IMA, hsCRP and
NT-proBNP were higher (p<0.001 and p=0.008 for NT-proBNP) while TAS was lower (p<0.001) in
patients than in controls. IMA and TAS were negatively correlated in all subjects (p<0.01). Among
patients, there was no correlation between IMA and the number of diseased vessels. For CAD diagnosis
the best cut-off point for IMA was 101.5 KU/L with a sensitivity and a specificity of 87.7% and a negative
predictive value of 83.3%. IMA was associated with an increased risk for CAD (OR=1.23, 95% CI: 1.161.31; p<0.001). IMA determination may provide earlier information of CAD presence before hsCRP or
NT-proBNP elevation, contributing to early assessment of overall patient risk.
40. Dalamaga M, Crotty BH, Fargnoli J, Papadavid E, Lekka A, Triantafilli M,
Karmaniolas K, Migdalis I, Dionyssiou-Asteriou A, Mantzoros CS. B-cell Chronic
Lymphocytic Leukemia risk in association with serum leptin and adiponectin levels: a
case-control study in Greece. Cancer Causes Control 2010; 21: 1451-9.
Leptin and adiponectin are two well-studied adipokines in relation to malignancies. In this study, we
examined the association between leptin/adiponectin and risk of B-cell chronic lymphocytic leukemia
(B-CLL), as well as the relationships between adipokines and several established prognostic factors of BCLL. Ninety-five patients with incident B-CLL and 95 hospital controls matched on age and gender were
studied between 2001 and 2007, and blood samples were collected. Leptin, total and high molecular
weight adiponectin, and prognostic markers of B-CLL were determined. Cases had a higher body mass
index (BMI) than controls (p = 0.01) and lower levels of leptin (p < 0.01). Significantly more cases than
controls presented a family history of lymphohematopoietic cancer (LHC) (p = 0.01). Higher serum
leptin levels were associated with lower risk of B-CLL adjusting for age, gender, family history of LHC,
BMI and serum adiponectin; the multivariate odds ratio comparing highest to lowest tertile was 0.05
(95% CI 0.01-0.29, p trend < 0.001); Adiponectin was not significantly different between cases and
controls. Leptin was found to be inversely associated with risk of CLL but in contrast to prior studies of
CLL and hematologic malignancies, this study found no significant association between CLL and
adiponectin.
28
41. Kassi E∂, Dalamaga Μ∂, Hroussalas G, Kazanis K, Merantzi G, Zachari A, GiamarellosBourboulis EJ, Dionyssiou-Asteriou A. Adipocyte factors, high-sensitive C-reactive
protein levels and lipoxidative stress products in overweight postmenopausal women
with normal and impaired OGTT. Maturitas 2010; 67: 72-7. [∂ authors have contributed
equally to this work].
In obese postmenopausal women we assessed leptin and adiponectin, high-sensitive C-reactive protein
(hsCRP), serum lipids and lipoxidative stress products: oxidized LDL (oxLDL) and malondialdehyde
(MDA), in relation to impaired glucose tolerance (IGT). Thirty-eight overweight/obese postmenopausal
women were included in the study. Eighteen with normal glucose metabolism (NGT) and twenty with
IGT, as it is diagnosed by OGTT. Serum leptin, adiponectin, hsCRP and MDA were measured at time 0
and 120 min of OGTT while total-cholesterol, LDL, HDL, triglycerides, oxLDL and anti-oxLDL
autoantibodies at time 0. Insulin resistance (HOMA)/sensitivity (QUICKI) indexes were estimated. In
subjects with NGT, hsCRP was positively correlated with fasting leptin and HOMA, while in subjects
with IGT negatively with QUICKI. In both groups, hsCRP was positively correlated with fasting insulin,
body mass index and waist circumference. Fasting adiponectin was positively associated with HDL in
both groups and negatively with triglycerides in subjects with NGT as well as with serum glucose levels
at time 120 min of OGTT in subjects with IGT. No association was observed between oxLDL and
adipokines. A significant positive association was found between oxLDL and HOMA in subjects with
IGT. During OGTT there was a significant increase of leptin and MDA levels in both groups. A
relationship exists between obesity, insulin and sub-clinical inflammation. Leptin and lipid peroxidation
are linked to hyperglycaemic state while oxLDL might be considered as a predictor of insulin resistance.
Adiponectin could exert its antiatherogenic effect through HDL independently of the presence of IGT.
42. Dalamaga M, Karmaniolas K, Lekka A, Antonakos G, Thrasyvoulides A, Papadavid E,
Spanos N, Dionyssiou-Asteriou A. Platelet markers correlate with glycemic indices in
diabetic, but not diabetic-myelodysplastic patients with normal platelet count. Disease
Markers 2010; 29: 55-61.
Altered thrombocyte morphology and function have been reported in patients with diabetes mellitus
(DM) type 2. The aim of the present study was to determine the associations between platelet
morphology markers and hemoglobin A1C (HbA(1c)), fasting glucose (FG), hypertension and coronary
heart disease (CHD) in patients with myelodysplastic syndromes (MDS) and DM, in patients with DM
and in controls. This cross-sectional study included 30 cases with primary MDS with normal platelet
count and non-insulin dependent diabetes, 30 non-insulin dependent diabetic patients and 30 nondiabetic, non-MDS controls matched on age and gender. After adjusting for body mass index, platelet
number, CHD and hypertension, HbA(1c) and FG were significant predictors of mean platelet volume
(MPV) and platelet distribution width (PDW) in diabetic patients. There was no correlation between
platelet parameters and HbA(1c) or FG in diabetic MDS patients. In controls, FG and hypertension
predicted significant differences in platelet morphology. Platelet count correlated with platelet
morphology in diabetic MDS and control groups, but not in diabetics. MPV and PDW are associated
with glycemic indices in diabetic patients but not in diabetic MDS patients with normal platelet counts.
Non-diabetic controls also exhibit FG related changes in platelet morphology. This suggests other factors
inherent to bone marrow dysplasia, platelet turnover and biochemistry, or vascular environment affect
platelet morphology in diabetic MDS patients even with normal platelet count. Platelet morphology in
this population may be an early marker for myelodysplasia. These findings also support platelet
morphology change as a marker for elevated macrovascular disease risk.
43. Kroupis C, Theodorou M, Chaidaroglou A, Dalamaga M, Oliveira SC, Cokkinos DV,
Degiannis D, Manginas A. The association between a common FcγRIIa polymorphism
and CRP and coronary artery disease revisited. Genetic Testing and Molecular
Biomarkers 2010; 14: 839-846.
29
The FcγRIIa receptor is responsible for the clearance of large immune complexes and recently has been
proved to be a C-reactive protein (CRP) receptor as well. A polymorphism in the corresponding
FCG2RA gene resulting in an amino acid change (R131H) has been implicated, with conflicting results in
the pathogenesis of various autoimmune or inflammatory disorders (e.g., atherosclerosis and coronary
artery disease [CAD]). We recently developed a real-time polymerase chain reaction and melting curve
analysis method for the genotyping of the above polymorphism. We further looked at its validity with
bioinformatics study and DNA sequencing. Then we genotyped 134 CAD patients and 45
angiographically normal controls and determined serum high-sensitivity CRP by nephelometry (DadeBehring). Also, we used apparently healthy platelet donors (n = 206) as a larger control group. Our
method is accurate and devoid of problems with homologs and copy number variants. The need for
reference materials is stressed. There were statistically significant differences (p < 0.05) between the CAD
patients and each of the two other control groups, with the percentage of RR genotype rising from 6.5%
and 11% in the control groups to an average of 19% in all CAD patients (17%, 24%, and 18.5% in stable
angina, unstable angina, and myocardial infarction, respectively). In a logistic regression model that
included known risk factors for CAD including CRP, the RR genotype remained a significant predictor
for CAD (odds ratio: 6.3 [1.1-36.3]). Also after linear regression analysis, CRP levels were reduced in the
RR carriers (vs. HH + HR), controlling for age, sex, and disease (marginal p = 0.07). With our accurate
genotyping method, the RR genotype was correlated with atherothrombotic CAD events. The inverse
correlation found between CRP levels and genotype supports the in vitro data of RR cells binding CRP
stronger than HH.
44. Papadavid E, Panayiotides I, Dalamaga M, Katoulis A, Economopoulos T, Stavrianeas
N. Cutaneous involvement in angioimmunoblastic T-cell lymphoma. Indian J Dermatol
2010; 55: 279-80. Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive non-Hodgkin's nodal
peripheral T-cell lymphoma characterized by general lymphadenopathy, night sweats, fever,
hepatosplenomegaly, polyclonal hypergammaglobulinemia, and cutaneous involvement. We present a
rare case of AITL cutaneous involvement mimicking toxic erythema recurring with AITL relapse and
suggesting a precursor of disease progression. Special emphasis is given on biochemical mechanismsas
as well as on serum markers.
45. Papadavid E, Mistidou M, Katoulis A, Zambacos G, Stavrianeas N, Panayiotides I,
Dalamaga M, Dinopoulos A. Familial occurrence of calcifying epithelioma of
Malherbe. Int J Dermatol 2010; 49: 1456-7.
Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a benign skin neoplasm of hair
follicle origin. The greatest incidence is found in patients between 8 and 13 years of age. The majority
occur in the head and neck region (52%), followed by limbs (32%) and trunk (10%). No cases have been
reported on the palms, soles, or genital region. There may be a history of previous trauma to the tumor
site. There appears to be a 3:2 female-to-male incidence ratio, and Caucasians are primarily affected.
However, familial incidence is very rare. We present a rare familial occurrence of pilomatrixoma in two
siblings. Emphasis is given on biochemical mechanisms.
46. Pavlidou A, Dalamaga M, Kroupis C, Konstantoudakis G, Belimezi M, Athanasas G,
Dimas K. Survivin isoforms and clinicopathological characteristics in colorectal
adenocarcinomas using real time qPCR. World J Gastroenterol 2011; 17: 1614-1621.
To investigate three isoforms of survivin in colorectal adenocarcinomas. We used the LightCycler
Technology (Roche), along with a common forward primer and reverse primers specific for the splice
variants and two common hybridization probes labeled with fluorescein and LightCycler-Red
fluorophore (LC-Red 640). Real time quantitative polymerase chain reaction (PCR) was performed on
cDNAs from 52 tumor specimens from colorectal cancer patients and 10 unrelated normal colorectal
tissues. In the patients group, carcinoembryonic antigen (CEA) and CA19-9 tumor markers were also
measured immunochemically. Wild type survivin mRNA isoform was expressed in 48% of the 52 tumor
samples, survivin-2b in 38% and survivin-ΔΕx3 in 29%, while no expression was found in normal tissues.
30
The mRNA expression of wild type survivin presented a significant correlation with the expression of
the ratio of survivin-2b, survivin-ΔΕx3, survivin-2b/wild type survivin and survivin-ΔΕx3/wild type
survivin (P < 0.001). The mRNA expression of wild-survivin and survivin-ΔΕx3 was related with tumor
size and invasion (P = 0.006 and P < 0.005, respectively). A significant difference was found between
survivin-2b and morphologic cancer type. Also, the ratio of survivin-ΔEx3/wild-survivin was
significantly associated with prognosis. No association was observed between the three isoforms and
grade, metastasis, Dukes stage and gender. The three isoforms were not correlated with CEA and CA199. Survivin isoforms may play a role in cell apoptosis and their quantification could provide information
about clinical management of patients suffering from colorectal cancer.
47.
*Dalamaga M, Srinivas SK, Elovitz M, Chambreland J, Mantzoros CS. Serum
adiponectin and leptin in relation to risk for preeclampsia: results from a large casecontrol study. Metabolism 2011; 60 (11): 1539-44. Conditions resulting in insulin resistance, as
well as metabolic, immune, and angiogenic perturbations, have been associated with an increased risk of
preeclampsia (PE). Our purpose was to assess whether the adipose tissue-secreted hormones
adiponectin, which has immune-modulating, metabolic, and angiogenic properties, and leptin, which
reflects overall fat mass, are associated with PE risk. We performed a case-control design study within a
hospital-based cohort of 368 pregnant women (106 with PE and 262 controls; mean age, 26.6 ± 6.8 years;
mean gestational age at admission, 38.2 ± 2.8 weeks) between March 2005 and August 2007 at the
Hospital of Pennsylvania University. Serum adiponectin and leptin were measured by
radioimmunoassay. Statistical analysis of data was performed using simple and multiple regression
analyses. No significant differences in adiponectin or leptin levels between preeclamptic and control
pregnant women emerged in univariate analyses (P = .57 and P = .15, respectively). Among preeclamptic
women, there were also no differences in adipokines between those with mild and severe disease. Serum
adiponectin and leptin were not associated with higher risk of PE before and after adjustment for
maternal age, race, primigravida, smoking status, body mass index at screening, gestational age at
admission, history of PE, chronic hypertension, and gestational diabetes (odds ratio, 0.93; 95%
confidence interval, 0.83-1.04 and odds ratio, 1; 95% confidence interval, 0.97-1.03, respectively).
Maternal serum adiponectin and leptin levels, drawn at the time of PE diagnosis, were not associated
with PE.
48. *Dalamaga M, Karmaniolas K, Papadavid E, Pelekanos N, Sotiropoulos G, Lekka A.
Elevated serum visfatin/Nampt levels are associated with postmenopausal breast
cancer risk independently from adiponectin, leptin, anthropometric and metabolic
parameters. Menopause 2011; 18(11): 1198-204.
Obesity has been implicated in the etiology of postmenopausal breast cancer (PBC). We hypothesized
that altered secretion of visfatin may underlie this association. We thus investigated the association of
serum visfatin with PBC risk, taking into account known risk factors including adipokines and
anthropometric and metabolic parameters. In a case-control study, we studied 102 postmenopausal
women with pathologically confirmed, incident invasive breast cancer and 102 control women matched
on age and time of diagnosis between 2003 and 2010 at Army Share Fund Hospital, Veterans' Hospital
(NIMTS). Levels of serum visfatin, adiponectin, leptin, metabolic parameters, carcinoembryonic antigen,
and CA 15-3 were determined. The mean serum visfatin level was significantly higher in case than in
control participants (P < 0.001). Women in the highest quartile of visfatin concentration presented
significantly higher odds for PBC, adjusting for age, date of diagnosis, education, body mass index, waist
circumference, years with menstruation, parity/age at first full-term pregnancy, breast-feeding, family
history of cancer, use of exogenous hormones, alcohol consumption, smoking status, homeostasis model
assessment score, and serum leptin and adiponectin concentrations (odds ratio, 7.93; 95% CI, 2.52-24.9).
In case participants, the visfatin level correlated significantly with the tumor marker CA 15-3 (P = 0.03)
but not with metabolic and anthropometric variables (P > 0.05). Further prospective studies are needed
to determine whether an elevated serum visfatin level is implicated in the etiopathogenesis of PBC or
reflects changes during PBC progression and could therefore be used as a biomarker for PBC.
31
49. Kazanis K, Dalamaga M, Kassi E, Nounopoulos C, Manolis AS, Merantzi G, Jullien G,
Dionyssiou-Asteriou A. Serum levels of Ischemia Modified Albumin in
overweight/obese postmenopausal women: a potential biomarker of atherosclerotic
burden associated with oxidative stress. Maturitas 2011; 70: 182-7.
Menopause is associated with weight gain and an increase of cardiovascular risk. The aim of the present
study was to estimate serum ischemia-modified albumin (IMA) levels in postmenopausal women and
evaluate their association with body mass index (BMI) and coronary artery disease (CAD). The study
included 130 non-smoker postmenopausal women aged 43-80: 40 with BMI 26-32kg/m(2) (Group A), 60
with BMI 21-25kg/m(2) (Group B), and 30 with documented CAD and BMI 23-29kg/m(2) (Group C).
Serum IMA, albumin, hsCRP and NT-proBNP, glucose and insulin were measured. Homeostasis
assessment model score (HOMA) and Quantitative insulin sensitivity index (QUICKI) were coestimated. Serum IMA and IMA to albumin ratio were significantly elevated in Group A as compared to
Group B (p<0.001) and similar to those of Group C. hsCRP and NT-proBNP did not differ between
Groups A and B while they were lower in comparison to Group C (p<0.001). Glucose, insulin and
HOMA were elevated in Group A compared to Group B (p<0.001) while QUICKI was lower (p<0.001).
In Group A, IMA was positively correlated with BMI, hsCRP, insulin, HOMA and negatively with
QUICKI. In postmenopausal women, multivariable regression analysis revealed that obesity was the
strongest significant determinant of circulating IMA levels (p<0.001) contributing, therefore, to the
elevated serum IMA concentration. Postmenopausal obesity is associated with elevated serum IMA
possibly due to obesity associated oxidative stress. IMA measurement could provide an assessment of
atherosclerotic burden in postmenopausal women. Further clinical evaluation is under investigation.
50. Dalamaga M, Archondakis S, Sotiropoulos G, Karmaniolas K, Pelekanos N, Papadavid
E, Lekka A. Could serum visfatin be a potential biomarker for postmenopausal breast
cancer? Maturitas 2012; 71: 301-308.
Previous studies have shown that visfatin is significantly elevated in patients with gastric carcinoma and
postmenopausal breast cancer (PBC). We thus explored whether serum visfatin could be used as a
potential diagnostic and prognostic tool for PBC, taking into account clinicopathological features, serum
tumor markers, anthropometric and metabolic parameters. Serum visfatin, tumor marker CA 15-3,
carcinoembryonic antigen, metabolic and anthropometric parameters were determined in 103
postmenopausal women with pathologically confirmed, incident invasive breast cancer, 103 controls
matched on age and time of diagnosis, and 51 patients with benign breast lesions (BBL). Mean serum
visfatin was significantly higher in cases than in controls and patients with BBL (p<0.001). In cases,
visfatin was significantly associated with CA 15-3 (p=0.03), hormone-receptor status (p<0.001), lymph
node invasion (p=0.06) but not with metabolic and anthropometric variables (p>0.05). Multivariable
regression analysis revealed that absence of estrogen and progesterone receptors (ER-PR-) was the
strongest significant determinant of serum visfatin (p<0.001) in cases adjusting for demographic,
metabolic and clinicopathological features. Based upon receiver operator characteristic analysis, serum
visfatin outperformed CA 15-3 only in discriminating between PBC cases with early cancer stage than
those with late stage, and in differentiating particularly patients with ER-PR- breast tumors.Further
prospective and longitudinal studies are needed to determine whether serum visfatin could be used as a
prognostic tool in the armamentarium of PBC monitoring and management in conjunction with other
biomarkers.
51. *Dalamaga M, Diakopoulos KN, Mantzoros CS. The role of Adiponectin in Cancer: a
review of current evidence. Endocrine Reviews 2012; 33(4):547-594.
Excess body weight is associated not only with an increased risk of type 2 diabetes and cardiovascular
disease (CVD) but also various types of malignancies. Adiponectin, the most abundant protein secreted
32
by adipose-tissue, exhibits insulin-sensitizing, anti-inflammatory, anti-atherogenic, pro-apoptotic and
anti-proliferative properties. Circulating adiponectin levels, which are determined predominantly by
genetic factors, diet, physical activity and abdominal adiposity, are decreased in patients with diabetes,
CVD and several obesity-associated cancers. Also, adiponectin levels are inversely associated with the
risk of developing diabetes, CVD and several malignancies later in life. Many cancer cell lines express
adiponectin receptors, and adiponectin in vitro limits cell proliferation and induces apoptosis. Recent in
vitro studies demonstrate adiponectin’s anti-angiogenic and tumor growth limiting properties. Studies in
both animals and humans have investigated adiponectin and adiponectin receptor regulation and
expression in several cancers. Current evidence supports a role of adiponectin as a novel risk factor and
potential diagnostic and prognostic biomarker in cancer. In addition, either adiponectin per se or
medications that increase adiponectin levels or upregulate signaling pathways downstream of
adiponectin may prove to be useful anti-cancer agents. This review presents the role of adiponectin in
carcinogenesis and cancer progression, and examines the pathophysiological mechanisms that underlie
the association between adiponectin and malignancy in the context of a dysfunctional adipose tissue in
obesity. Understanding of these mechanisms may be important for the development of preventive and
therapeutic strategies against obesity-associated malignancies.
52. Papadavid E, Vlami K, Dalamaga M, Giatrakou S, Theodoropoulos K, Gyftopoulos S,
Stavrianeas N, Papiris S, Rigopoulos D. Sleep Apnea as a comorbidity in obese
psoriasis patients: a cross sectional study. Do psoriasis characteristics and metabolic
parameters play a role? Journal of the European Academy of Dermatology and
Venereology 2013; 27(7): 820-6.
Background: Psoriasis, a chronic autoimmune inflammatory skin condition, is associated with a variety
of comorbidities such as obesity and cardiovascular disease.
Objective: In a cross-sectional study, we explored whether Obstructive Sleep Apnea and Hypopnea
Syndrome (OSAHS) is associated with psoriasis characteristics and metabolic parameters in psoriasis
patients.
Methods: Initially 38 patients with chronic plaque psoriasis were recruited but 3 withdrew for personal
reasons. The study population included 35 patients assessed at the Dermatology Department psoriasis
outpatient clinic who underwent a nocturnal polysomnography study at the sleep laboratory. They
were analysed for Apnea-Hypopnea index to assess OSAHS severity and Framigham score to predict
the absolute risk of coronary artery disease at 10 years. The association of OSAHS with psoriasis was
examined according to psoriasis characteristics (PASI and DLQI scores, disease duration and previous
use of systemic classical or biological treatments), metabolic parameters (body mass index-BMI, waist to
hip ratio-WHR, lipid profile) and other comorbidities (obesity, hypertension, arthritis and
cardiovascular disease).
Results: There was no correlation between psoriasis characteristics and OSAHS. Psoriatic patients with
OSAHS presented more frequent snoring and lower sleep quality compared to those without OSAHS.
In univariate analyses, OSAHS was associated with increased BMI and hypertension in psoriasis
patients. In multivariable logistic regression models, there was statistically significant evidence that only
BMI and presence of hypertension were associated with increased risk of OSAHS, adjusting for
psoriasis characteristics, age and gender. Presence of metabolic syndrome, WHR, and smoking were not
significant risk factors for OSAHS. In subgroup analyses, OSAHS correlated with duration of psoriasis
(>8 years) in women (p=0.021) and with Framigham score in men (p=0.035).
Conclusion: OSAHS may be a comorbidity in obese psoriasis patients with hypertension. Treatment
with the use of continuous positive airway pressure as well as weight loss interventions should be
initiated.
53. Trakakis E, Papadavid E, Dalamaga M, Koumaki V, Stavrianeas N, Rigopoulos D,
Creatsas G, Kassanos D. Prevalence of non classical congenital adrenal hyperplasia due
to 21-hydroxylase deficiency in Greek women with acne: a hospital-based cross-
33
sectional study. Journal of the European Academy of Dermatology and Venereology
2013; 27(11): 1448-51.
Aim: To determine the prevalence and frequency of non classical congenital adrenal hyperplasia (NCCAH) due to 21-OHD at the time of clinical presentation and at the peripubertal period in a substantial
sample of Greek women with acne and to investigate the correlation of serum T, 17-OHP and DHEA-S
with acne appearance at the time of clinical presentation.
Methods: One hundred and twenty three unselected women with hyperandrogenemic symptoms were
examined. After the ACTH stimulation test, 6 (4.9%) women were diagnosed with NC-CAH due to 21OHD.
Results: There was not any statistical significant difference in the frequency of peripubertal acne
between NC-CAH group of patients (6.4%) and patients with hyperandrogenemia of other etiology
(93%), mainly ovarian (p=0.41). However, there was a statistical significant difference in the prevalence
of acne at the time of clinical examination between the two groups (p=0.04). Acne was present in 83.3%
of women with NC-CAH versus 41.02% of women in the hyperandrogenic group without NC-CAH. A
statistically significant decrease of acne from the peripubertal time to the time of clinical examination in
the group of women with hyperandrogenemia of other etiology (-21.37%) was observed compared to
women with NC-CAH (p<0.001).
Conclusion: We have shown that acne persists from peripubertal period to adult life in NC-CAH
women whereas it tends to diminish in women with hyperandrogenemia of other etiology. Acne is a
prominent finding in women with NC-CAH. Serum concentrations of 17-OHP after ACTH stimulation
(17-OHP6O) should be investigated in women with persistent acne in adult life.
54. Dalamaga M, Papadavid E, Vlami K. Unmasking the Janus face of the association
between psoriasis, metabolic syndrome and obstructive sleep apnea. Sleep and
Breathing 2013; 7(2): 449-50.
Psoriasis represents a chronic immune-mediated inflammatory skin disease that has been associated
with a range of comorbidities including metabolic syndrome (Mets) and obesity. Very few studies have
explored the association between psoriasis and Obstructive Sleep Apnea/Hypopnea syndrome
(OSAHS). OSAHS is associated with obesity and Mets. Given the established relationship of psoriasis to
Mets, it is logical to anticipate that an association may exist between psoriasis and OSAHS.
In a recent study published in Sleep and Breathing, Karaca et al examined the potential association of
psoriasis with OSAHS in 33 psoriasis patients, and found that OSAHS frequency in psoriasis patients
was higher than that seen in normal population, and that psoriasis might represent a risk factor for
OSAHS. However, this study presents main limitations due to the lack of a control group, the small
number of patients, and particularly the absence of any adjustment accounting for important
confounders such as obesity and Mets parameters underlying the association. In our recent study, we
were not able to show that psoriasis represents a risk factor for OSAHS but in multivariable statistical
models, we found significant evidence that only obesity and hypertension were associated with
increased risk of OSAHS, adjusting for psoriasis characteristics, metabolic parameters, age and gender.
In order to unmask the association between psoriasis, Mets and OSAHS, evidence is needed from
adequately powered large long-term prospective cohort studies examining psoriatics, taking into
account in multivariable statistical models important parameters such as anthropometric, metabolic
variables, habits and psoriasis systematic treatment.
55. Papadavid Ε∂, Dalamaga M∂, Kapniari I, Pantelidaki E, Papageorgiou S, Pappa V,
Tsirigotis P, Dervenoulas I, Stavrianeas N, Rigopoulos D. Lobomycosis: A case from
Southeastern Europe and review of the literature. Journal of Dermatological Case
Reports 2012; 6(3): 65-69. [∂ authors have contributed equally to this work].
Background: Lobomycosis, also known as Jorge Lobo’s disease, represents a rare chronic subcutaneous
mycosis caused by the fungus Lacazia loboi, an organism that is found within lesions but has not been
cultured to date. The natural reservoir of L.Loboi is unknown but it is believed to be aquatic, or
associated with soil and vegetation. More than 550 human cases have been reported, especially in
34
patients with a history of travel or residence in endemic areas (Central and South America, particularly
Brazil) or in communities along rivers.
Main observations: We describe a 64 year-old Greek female farmer living in a coastal region, who
presented with an erythematous plaque on her left inner thigh resembling a keloid. The diagnosis was
based on the triad: 1) absence of fungal growth in cultures, 2) positive direct microscopic examination of
the lesion and 3) histopathology, all consistent with lobomycosis. Particularly, skin biopsy showed deep
cutaneous fungal infection with granulomatous reaction. Fungal cells were found inside giant cells. The
fungi were thick-walled with some budding, isolated or in short chains. Dermal fibrosis was present.
Our patient had a medical history of common variable immunodeficiency but no history of travel to
South or Central America. She probably acquired this rare infection by injury during her agricultural
works.
Conclusion: Our case represents probably the first documented case of human lobomycosis in
Southeastern Europe. This case is unusual due to the rarity of lobomycosis in Mediterranean countries,
particularly in Southeastern Europe.
56. Dalamaga M. Nicotinamide phosphoribosyl-transferase/visfatin: a missing link
between overweight/obesity and postmenopausal breast cancer? Potential preventive
and therapeutic perspectives and challenges. Medical Hypotheses 2012; 79(5):617-21.
Worldwide breast cancer (BC) constitutes a significant public health concern. Excess body weight is
associated with postmenopausal BC (PBC) risk. Recent studies have shown that the constellation of
obesity, insulin resistance and serum adipokine levels are associated with the risk and prognosis of PBC.
Nicotinamide phosphoribosyl-transferase (Nampt), also known as visfatin and pre-B-cell-colonyenhancing factor, found in the visceral fat, represents a novel pleiotropic adipokine acting as a cytokine,
a growth factor and an enzyme. It plays an important role in a variety of metabolic and stress responses
as well as in the cellular energy metabolism, particularly NAD biosynthesis. Nampt exhibits
proliferative, anti-apoptotic, pro-inflammatory and pro-angiogenic properties. Nampt’s insulin-mimetic
function remains a controversial issue. Circulating Nampt levels are increased in obese women. Also,
Nampt levels are significantly elevated in women suffering from PBC than in healthy controls
independently from known risk factors of BC, anthropometric and metabolic parameters as well as
serum concentrations of well known adipokines. High expression of Nampt in BC tissues was reported
to be associated with more malignant cancer behavior as well as adverse prognosis.Taking into account
the mitogenicity of Nampt as well as its proliferative, anti-apoptotic and pro-angiogenic properties, a
novel hypothesis is proposed whereas Nampt may be involved in the etiopathogenesis of PBC and may
represent a missing link between overweight/obesity and PBC. Nampt could exert its effects on the
normal and neoplastic mammary tissue by endocrine and paracrine mechanisms; Nampt could also be
secreted by tumor epithelial cells in an autocrine manner. It could stimulate mammary epithelial cell
proliferation, invasion, metastasis, and angiogenesis, which is essential for BC development and
progression. Serum Nampt might be a novel risk factor as well as a potential diagnostic and prognostic
biomarker in PBC. In addition, pharmacologic agents that neutralize biochemically Nampt or
medications that decrease Nampt levels or downregulate signaling pathways downstream of Nampt
may prove to be useful anti-cancer agents. The potential harmful effect on PBC risk due to vitamin B3
(nicotinic acid, a natural NAD precursor in the biosynthetic route leading to NAD) intake is speculated
for the first time. In this hypothesis, the role of Nampt in BC carcinogenesis and progression is explored
as well as the pathophysiological mechanisms that underlie the association between Nampt and PBC in
the context of a dysfunctional adipose tissue in obesity. Understanding of these mechanisms may be
important for the development of preventive and therapeutic strategies against PBC.
57. Papadavid E, Panayiotides I, Makris M, Giatrakou S, Dalamaga M, Stavrianeas N,
Rigopoulos D. Pityriasis Rosea-like eruption associated with lamotrigine. Journal of the
American Academy of Dermatology 2013; 68(6):e180-1. Erratum in names: Evangelia P,
Ioannis P, Michael M, Sophia G, Maria D, Stavrianeas N, Dimitrios R.
Pityriasis rosea (PR) a common, acute, self-limited eruption is characterized by an initial herald patch
followed by a diffuse papulosquamous rash without systemic manifestations. Occasionally a lesional
skin biopsy is important to rule out other papulosquamous and erythematous disorders 1. PR like drug
35
eruptions from angiotensin-converting enzyme-inhibitors, nonsteroidal anti-inflammatory drugs,
barbiturates, beta-blockers but not from lamotrigine have been reported. A 33-year old female with a
history of a seizure disorder presented with a 5 month history of widespread slightly pruritic,
erythematous papulosquamous eruption starting as a solitary lesion initially on her breast and with the
appearance of numerous smaller lesions on the trunk, proximal, distal extremities and body within the
following days. Two months later she developed cervical and axillary adenopathy without fever.
Medical history included Juvenile Myoclonic Epilepsy treated with valproic acid for the last 14 years,
replaced by lamotrigine 6 months ago as she was planning for family. Skin eruption started 2 weeks
after introduction of lamotrigine and withdrawal of valproic acid. Family history was unremarkable.
During the last 5 months she was treated unsuccessfully as PR with topical corticosteroids, emollients,
oral antihistamines and erythromycin. Clinical examination revealed 2-5 cm erythematous, oval and
round patches, with a central scale or collarette of desquamation following Langer’s lines of cleavage
and confined to the trunk, limbs and arms. Tender cervical and axillary lymph nodes were present.
Laboratory workup including eosinophil counts, CRP, thyroid function, serologic screening for syphilis,
markers for hepatitis A, B, C, HIV, EBV, HSV1-2, CMV, parvovirus B19, and toxoplasma Golgi were
unremarkable. A punch biopsy showed a slight perivascular lymphocytic and histiocytic infiltrate
around vessels of the superficial dermal plexus, as well as focal infiltration of the overlying epidermis
by small, mature lymphocytes. This nonspecific histologic aspect is, amongst others, compatible with
either Gibert’s PR or a drug eruption. Histopathological findings and reactive lymphadenopathy
supported the diagnosis of PR-like hypersensitivity eruption due to lamotrigine. Replacement of
lamotrigine by Valproic acid resulted in resolution of the rash within 3 days and adenopathy within 10
days. Patch tests with lamotrigine (Lamictal tabl 100mg) in standard preparations of 10% and 30%
(weight/volume) in both the 48h and 72-hours reading performed 3 months after the rash resolution
were negative. This case is an unusual non-immediate drug hypersensitivity reaction associated with a
widely used anti-epileptic drug such as lamotrigine. Drug-Induced Hypersensitivity Syndrome (DIHS)
is a potentially life-threatening systemic reaction characterized by rash, fever, hepatitis,
lymhadenopathy and leukocytosis with eosinophilia. It is triggered by various medications (more
commonly anti-epileptic drugs), 3 weeks to 3 months after the introduction of the medication. DIHS has
been associated with reactivation of HHV-6 or other members of the HHV family harboured in T cells.
Interestingly HHV-6 and 7 are also reported in the pathogenesis of PR but we have no data on HHV- 6
reactivation in our case. Although our case does not fulfil the criteria for DIHS, may be a partial
expression of DIHS presenting with rash and lymphadenopathy.This is the first report of PR-like
cutaneous eruption due to non-immediate hypersensitivity reaction to lamotrigine. Physician awareness
to such an adverse event of this widely used drug is advised.
58. *Dalamaga M, Karmaniolas K, Papadavid E, Pelekanos N, Sotiropoulos G, Lekka A.
Hyperresistinemia is associated with postmenopausal breast cancer. Menopause 2013;
20(8): 845-51.
Objective: The constellation of obesity, insulin resistance and serum adipocytokine levels is associated
with the risk and prognosis of postmenopausal breast cancer (PBC). Altered secretion of resistin may
underlie the association between overweight/obesity and PBC. We thus explored the association of
serum resistin with PBC, taken into account established risk factors including adipokines,
anthropometric, metabolic and inflammatory markers.
Methods: In a case-control study, we studied 102 postmenopausal women with pathologically
confirmed, incident invasive breast cancer and 102 controls matched on age and time of diagnosis
between 2003 and 2010 at NIMTS Hospital. Serum resistin, adiponectin, leptin, metabolic (HOMA-IR)
and inflammatory parameters (TNF-α, IL-6, hsCRP), and tumor markers (CEA, CA 15-3) were
determined.
Results: The mean serum resistin level was significantly higher in case than in control participants
(p<0.001) both in univariate and multivariable analyses adjusting for age, date of diagnosis, education,
family history of cancer, use of exogenous hormones, alcohol consumption, smoking status, physical
activity, reproductive, metabolic, anthropometric (body mass index and weight circumference),
inflammatory markers and adipokines (OR=1.17, 95% C.I. 1.03-1.34, p=0.02). In case participants,
36
resistin level correlated significantly with tumor markers and inflammatory parameters but not with
metabolic and anthropometric variables.
Conclusion: Further prospective, longitudinal and mechanistic studies are needed to determine whether
hyperresistinemia is involved in the development of PBC or reflect changes during PBC progression,
and therefore, could be used as a biomarker for PBC. Targeting resistin inhibition could be an effective
therapeutic strategy in BC by downregulating the inflammatory microenvironment in breast tissue.
59. *Moon HS∂, Dalamaga Μ∂, Kim SY, Polyzos SA, Hamnvik OP, Magkos F, Paruthi J,
Mantzoros CS. Leptin’s role in lipodystrophic and non-lipodystrophic insulin resistant
and diabetic individuals. Endocrine Reviews 2013; 34: 377-412 [∂ authors have
contributed equally to this work].
Leptin is an adipocyte-secreted hormone that has been proposed to regulate energy homeostasis as well
as metabolic, reproductive, neuroendocrine, and immune functions. In the context of open-label
uncontrolled studies, leptin administration has demonstrated insulin-sensitizing effects in patients with
congenital lipodystrophy associated with relative leptin deficiency. Leptin administration has also been
shown to decrease central fat mass and improve insulin sensitivity and fasting insulin and glucose levels
in HIV-infected patients with highly active antiretroviral therapy (HAART)-induced lipodystrophy,
insulin resistance, and leptin deficiency. On the contrary, the effects of leptin treatment in leptin-replete
or hyperleptinemic obese individuals with glucose intolerance and diabetes mellitus have been minimal
or null, presumably due to leptin tolerance or resistance that impairs leptin action. Similarly, the
experimental data provide evidence for a potential null or even adverse role of leptin treatment in nonlipodystroplic patients with nonalcoholic fatty liver disease. In this review, we present a description of
leptin biology and signaling; we summarize leptin’s contribution to glucose metabolism in animals and
humans in vitro, ex vivo and in vivo; and we provide insights into the emerging clinical applications
and therapeutic uses of leptin in humans with lipodystrophy and/or diabetes.
60. Marouga A∂, Dalamaga M∂, Kastania AN, Antonakos G, Thrasyvoulides A, Kontelia G,
Dimas C, Vlahakos DV. Correlates of serum resistin in elderly, non-diabetic patients
with chronic kidney disease. Clinical Laboratory 2013; 2013; 59: 1121-1128 [∂ authors
have contributed equally to this work].
BACKGROUND: Renal function may be a major determinant of resistin levels, since most studies
revealed association between elevated resistin levels and decreased glomerular filtration rate (GFR) in
patients with chronic kidney disease (CKD). The aim of the present study was to test the hypothesis
whether serum resistin is associated with markers of malnutrition and inflammation in elderly nondiabetic adults in different stages of CKD including hemodialysis.
METHODS: This was a cross-sectional study of 80 elderly patients divided in four groups of 20 patients
each, according to eGFR and matched for age (± 5 years) and gender. Patients with eGFR more than 1.5
mL/s served as controls. Multivariate regression was used to evaluate the association of resistin with
eGFR, demographic, metabolic and inflammatory markers, and insulin resistance. Hematological,
biochemical and immunochemical analyses were performed using commercially available enzyme
immunoassays.
RESULTS: Our results showed that: 1) serum resistin levels were two times higher in patients with
advanced CKD especially those undergoing hemodialysis compared to controls, 2) in univariate
analysis, resistin levels correlated directly with Tumor Necrosis Factor-α (TNF-α), high sensitive CReactive Protein (hsCRP) and serum phosphate, and inversely correlated with albumin, eGFR, and
hematocrit levels. We failed to reveal any relationship between resistin levels and Homeostasis Model
Assessment Score of Insulin Resistance (HOMA-IR), body mass index (BMI), cholesterol and leptin
levels, 3) in multivariate analysis, only TNF-α (Ρ<0.001) and hsCRP (Ρ=0.032) were the most important
independent determinants of serum resistin levels.
CONCLUSIONS: These results indicate that resistin increases as GFR declines and may be involved in
the malnutrition-inflammation state and the reverse epidemiology phenomenon present in elderly nondiabetic patients with CKD.
37
61. Dalamaga M, Sotiropoulos G, Karmaniolas K, Pelekanos N, Papadavid E, Lekka A.
Serum resistin: a biomarker of breast cancer in postmenopausal women? Association
with clinicopathological characteristics, tumor markers, inflammatory and metabolic
parameters. Clinical Biochemistry 2013; 46 (7-8): 584-90.
Objective: Previous few studies have shown that resistin is significantly elevated in breast cancer (BC)
patients. Therefore, we investigated whether serum resistin could be used as a potential diagnostic and
prognostic tool for postmenopausal BC (PBC), taking into account clinicopathological features, serum
tumor markers, anthropometric, metabolic, and, for the first time, inflammatory parameters.
Methods: Serum resistin, tumor markers (CA 15-3 and CEA), metabolic, anthropometric and
inflammatory parameters (TNF-α, IL-6, hsCRP) were determined in 103 postmenopausal women with
incident, pathologically confirmed, invasive BC, 103 controls matched on age and time of diagnosis, and
51 patients with benign breast lesions (BBL).
Results: Mean serum resistin was significantly higher in cases than in controls and patients with BBL
(p<0.001). In patients, resistin was significantly associated with tumor and inflammatory markers, cancer
stage, tumor size, grade and lymph node invasion but not with anthropometric, metabolic parameters
and hormone receptor status. Multivariable regression analysis revealed that serum IL-6 (p=0.02) and
cancer stage (p=0.048) were the strongest determinants of serum resistin in cases adjusting for
demographic, metabolic and clinicopathological features. Although resistin’s diagnostic performance
was low based on ROC curve analysis [0.72, 95% CI: 0.64-0.79], it could, however, represent a BC
biomarker reflecting advanced disease stage and inflammatory state.
Conclusion: Further prospective and longitudinal studies are needed to evaluate whether serum resistin
could be used as a prognostic tool in BC monitoring and management. More research is essential to
elucidate resistin’s ontological role in the association between obesity, representing a chronic low-grade
subclinical inflammation, and PBC.
62. Dalamaga M, Kousoulis AA. Remembering Louis Tribondeau (1872-1918). JAMA
Dermatology 2013; 149(8): 934.
French physician Louis Tribondeau (1872-1918) has been an important name in biochemical and
dermatological research for 100 years. His study of infectious diseases, particularly syphilis and
mycoses, marks some important chapters in the history of dermatology. Most notably, he ameliorated
the Wassermann reaction and described a method for staining Treponema pallidum and other spirochetes
by silver impregnation using ammoniacal silver nitrate solution, named “Fontana-Tribondeau silver
stain”. However, despite his excellent contributions, he has largely been ignored by published literature.
This is also the case in Corfu, Greece, where he served as Chief Medical Officer of the Navy and Head of
the department of bacteriology and infectious diseases for about one year until his death in the line of
duty in 1918 influenza pandemic. The hospital he worked in had been named the “Achilleion Tribondeau
Hospital” as seen on the left pillar plate of the Achilleion Palace (Figure 1). This commemorative plaque
lies today hidden and forgotten behind tree branches.
63. *Dalamaga M, Chou SH, Papageorgiou P, Shields K, Polyzos SA, Mantzoros CS.
Leptin at the intersection of neuroendocrinology and metabolism: current evidence and
therapeutic perspectives. Cell Metabolism 2013; 18(1): 29-42.
Since its discovery as an adipocyte-secreted hormone leptin has been implicated in the regulation of
food intake, energy homeostasis, and metabolism through its effects in the central nervous system and
peripheral organs. Recent findings indicate that leptin may also be involved in cognition, immune
function, and bone metabolism. These diverse and numerous roles place leptin at the intersection of
neuroendocrinology and metabolism, and possibly immune function, and render it an appealing
therapeutic target for several niche areas of unmet clinical need. Notably, while most patients with
garden-variety obesity and hyperleptinemia are leptin resistant and consequently experience blunted
leptin action, leptin seems to be more efficacious in modulating metabolic and neuroendocrine
outcomes in energy-deficient or leptin-deficient states. Current evidence regarding classic and emerging
roles of leptin as well as the pros and cons of its potential clinical use are summarized herein.
38
64. Evangelopoulos AA, Dalamaga M, Panoutsopoulos K, Dima K. Nomenclature and
basic concepts in automation in the clinical laboratory setting: a practical glossary.
Clinical Laboratory 2013; 59:1197-1214.
In the early 80s, the word automation was used in the clinical laboratory setting referring only to
analyzers. But in late 80s and afterwards, automation found its way in all aspects of the diagnostic
process, embracing not only the analytical but also the pre- and post- analytical phase. While
laboratories in the eastern world, mainly Japan, paved the way for laboratory automation, US and
European laboratories soon realized the benefits and were quick to follow. Clearly, automation and
robotics will be a key survival tool in a very competitive and cost-concious healthcare market. What sets
automation technology apart from so many other efficiency solutions are the dramatic savings that
brings to the clinical laboratory. Further standardization will assure the success of this revolutionary
new technology.One of the main difficulties laboratory managers and personnel have to deal with when
studying solutions to reengineer a laboratory is familiarizing themselves with the multidisciplinary and
technical terminology of this new and exciting field. The present review/glossary aims at giving an
overview of the most frequently used terms within the scope of laboratory automation and to put
laboratory automation on a sounder linguistic basis.
65. Papadavid E, Panayiotides I, Dalamaga M, Giatrakou S, Stavrianeas N, Rigopoulos D,
Makris M. Pityriasis rosea and pityriasis rosae like drug eruptions. Journal of the
American Academy of Dermatology 2014; 70(1):196-7.
We appreciate the interest of Drago and colleagues in our article and we are pleased that they present
their cases with Pityriasis rosea (PR) and PR-like eruptions. However, we would like to response with
two short comments as follows: 1. Herpesviruses are highly adapted to lifelong infection of their human
hosts and thus can be considered a component of the human “microbiome” in addition to their role to
illness triggered by primary infection. Besides, the role of herpes virus reactivation (HHV) and
especially HHV6 and HHV7 according to recent findings has been well proven in Drug Reaction with
Eosinophilia and Systemic Symptoms (DRESS) syndrome. On the other hand the hypothesis of viral
origin in PR has been presented in many recent epidemiological and microbial surveys, Human Herpes
virus being the most likely etiological agent according to studies even from Drago et al. Our case does
not fulfill the criteria of DRESS but represents a well documented case of PR-like drug-induced
exanthema associated with adenopathy. We certainly do not propose a pathogenic mechanism but we
emphasize on the possible role of HHV6 and HHV7 in this unique case of drug hypersensitivity that
shares futures of the two above mentioned entities. The sample of patients with PR like eruptions is
quite small to reach conclusions. To our opinion, one out of ten (10%) of HHV-6 activation in this
sample cannot either support or disprove any hypothesis. We believe that the regulation of virusencoded and host encoded cytokines as well as other aspects of interaction between viral gene
expression and innate immune and regulatory genes in patients with hypersensitivity reactions to drugs
is an important and fascinating area for further study.
66. Kouloulias V, Papadavid E, Mosa E, Platoni K, Papadopoulos O, Rigopoulos, D,
Georgakopoulos J, Beli I, Karantonis F, Castana O, Dalamaga M, Kelekis N. A new
hypofractionated schedule of weekly irradiation for basal cell carcinoma of the head
and neck skin area in elderly patients. Dermatologic Therapy 2013; in press.
The effectiveness of radiotherapy in patients with basal cell carcinoma (BCC) has been already reported
in the literature. However, there is little information about the irradiation of BCC in elderly patients,
especially due to the low conformity of them to daily irradiation. Thirty-eight retrospectively selected
elderly patients (78 years as median age) diagnosed with skin BCC of the head and neck area were
treated with five weekly fractions of 600 cGy by three-dimensional conformal radiotherapy (3DCRT) as
an adjuvant treatment. The primary endpoint was the relapse free survival. Acute toxicity, as secondary
endpoint, was assessed according to EORTC/RTOG criteria. Among our patients, there were only three
local recurrences at 15, 32 and 38 months post-3DCRT. There was no severe toxicity, while only 10 out
of 38 patients presented grade II/III skin toxicity. Our proposed irradiation schedule seems effective in
39
terms of local control and acute toxicity and could be an alternative scheme for elderly patients unfit for
daily irradiation.
67. Dalamaga M, Kousoulis AA. Uncovering the life and work of Louis Tribondeau: a
pioneer in dermatology and biochemistry. International Journal of Dermatology 2014;
53 (8): 1045-1047.
This manuscript deals with the work of Louis Tribondeau (1872-1918), a French physician who was an
early contributor to dermatology and biochemistry. However, little is known about him, and until
recently, published literature has largely ignored his contributions. His name is linked to the law of
Bergonié-Tribondeau and the Fontana-Tribondeau stain, but his contributions extended well beyond
these two breakthroughs. Pioneer of medical biochemistry, radiobiology and bacteriology, and focused
on infectious diseases, particularly syphilis and mycoses, Tribondeau’s work marks some important
chapters in the history of dermatology. He died during the 1918 influenza pandemic in Greece, where
he was appointed as Chief Medical Officer at the Naval Hospital of Corfu.
68. *Dalamaga M, Papadavid E, Basios G, Vaggopoulos V, Rigopoulos D, Kassanos D,
Trakakis E. Ovarian SAHA syndrome is associated with a more insulin resistant profile
and represents an independent risk factor for glucose abnormalities in women with
polycystic ovary syndrome: a prospective controlled study. Journal of the American
Academy of Dermatology 2013; 69 (6): 922-930.
Background: SAHA syndrome is characterized by the tetrad: seborrhea, acne, hirsutism and
androgenetic alopecia. No previous study has examined the prevalence of glucose abnormalities in
ovarian SAHA and explored whether it may be an independent risk factor for glucose abnormalities.
Objective: In a prospective controlled study, we investigated the spectrum of glucose abnormalities in
ovarian SAHA and explored whether it is associated with a more insulin resistant profile.
Methods: Three hundred and sixteen patients with a diagnosis of polycystic ovary syndrome-PCOS (56
of whom with SAHA) and 102 age-matched healthy women were examined and underwent a 2-hour
Oral Glucose Tolerance Test. Serum glucose homeostasis parameters, hormones and adipokines were
determined.
Results: SAHA prevalence was 17.7% in PCOS patients with predominance of the severe PCOS
phenotype. Ovarian SAHA was independently associated with a more insulin resistant profile (higher
HOMA-IR, lower QUICKI and MATSUDA indices, and relative hypoadiponectinemia), and
represented an independent risk factor for glucose abnormalities regardless of anthropometric features,
age and PCOS phenotype.
Limitation: No performance of skin biopsies.
Conclusion: The prompt recognition of SAHA syndrome in PCOS women permits an earlier diagnosis
and surveillance of metabolic abnormalities, especially in Mediterranean PCOS population exhibiting a
lower prevalence of glucose abnormalities.
69. *Dalamaga M. Resistin as a biomarker linking obesity and inflammation to cancer:
potential clinical perspectives. Biomark Med 2014; 8 (1): 1-12 (invited).
Excess body weight is associated with various types of malignancies. Resistin, originally described as an
adipocyte-specific hormone modulating insulin resistance in rodents, may exhibit proliferative, antiapoptotic, pro-inflammatory, pro-angiogenic and metastatic properties. Accumulating evidence supports
a role of resistin as a risk factor and potential diagnostic and prognostic biomarker in cancer. In this
report, the current knowledge about resistin’s properties and pathophysiological implications in cancer in
the context of a dysregulated adipose tissue in obesity is summarized; clinical translations, preventive
and therapeutic considerations, and future perspectives in the field of resistin research are discussed. At
the same time, several enigmatic issues involving resistin receptor and signaling pathways remain to be
clarified in order to unmask its ontological role in cancer pathophysiology.
40
70. *Dalamaga M, Karmaniolas K, Chamberland J, Nikolaidou A, Lekka A, DionyssiouAsteriou A, Mantzoros CS. Higher fetuin-A, lower adiponectin and free leptin levels
mediate effects of excess body weight on insulin resistance and risk for
myelodysplastic syndrome. Metabolism 2013; 62 (12): 1830-1839.
Objective: Excess body weight has been implicated in the pathogenesis of myelodysplastic syndrome
(MDS). We thus explored the role of serum fetuin-A reflecting ectopic hepatic fat deposition when storage
capacity of adipocytes has been exceeded, free leptin reflecting overall fat mass and adiponectin reflecting
visceral fat mass, all potential mediators of the effects of obesity on insulin resistance and, consequently,
to MDS risk.
Material & Methods: In a hospital-based case-control study, we studied 101 cases with incident,
histologically confirmed primary MDS and 101 controls matched on gender, age and date of diagnosis,
between 2004 and 2007. Serum fetuin-A, adiponectin, leptin, leptin receptor, free leptin and insulin were
determined.
Results: Higher serum fetuin-A, lower adiponectin and lower free leptin were all individually and
independently associated with higher risk of MDS before and after controlling for matching and risk
factors, such as age, gender, date of diagnosis, body mass index (BMI), family history of
lymphohematopoietic cancer, smoking history and serum insulin. Interestingly, we have shown that these
associations were prominent among overweight/obese individuals and persisted after controlling for
BMI and serum insulin indicating that their effects are above and beyond insulinemia only.
Conclusion: Elevated serum fetuin-A but lower adiponectin and free leptin are associated with higher risk
of MDS particularly among overweight/obese individuals. These findings suggest that the association
between excessive weight gain and the risk of MDS could be mediated by fetuin-A, adiponectin and free
leptin, which may have potential clinical and preventive implications.
71. Kassi E, Dimas C∂, Dalamaga M∂, Panagiotou A, Papoutsi Z, Spilioti Z, Moutsatsou P.
Sideritis euboea extract lowers total cholesterol but not LDL cholesterol in humans: a
randomized controlled trial. Clinical Lipidology 2013; 8 (6): 627-634. [∂authors have
contributed equally to this work].
Aim: Sideritis euboea is a widely consumed beverage, known as mountain tea. We evaluated the biological
activity of S.euboea in healthy human subjects focusing on serum cardiovascular factors including lipids,
inflammation and glucose homeostasis markers.
Patients & Methods: In a double-blind study, 54 participants were randomly assigned to consume
S.euboea aqueous extract food (n=27, intervention group) or a placebo food (n=27, control group) for one
month period. Forty-seven participants were finally included in the analysis. Serum lipids [total
cholesterol, HDL-C, LDL-C, triglycerides, Lp (a)], HOMA and inflammatory markers were determined.
Results: Total cholesterol was reduced significantly in the intervention group while no beneficial effects
on other lipid parameters and inflammatory markers were observed. In females, S.euboea ameliorated
significantly HOMA index.
Conclusions: The consumption of S. euboea induces only a significant total cholesterol lowering effect
while it exerts insulin-sensitizing actions in females. Larger studies with a longer intervention period
should be performed.
72. Dalamaga M, Papadavid E. Adipocytokines and psoriasis: Insights into mechanisms
linking obesity and inflammation to psoriasis. World J Dermatol 2013; 2(4): 27-31
(invited).
Psoriasis has been lately seen as a potential systemic inflammatory disease associated with a range of comorbidities exhibiting an overlapping pathology and presenting a great social health impact such as
cardiovascular disease and metabolic diseases, including obesity. Adipose tissue is considered a genuine
endocrine organ producing a variety of bioactive adipocytokines, such as leptin, adiponectin, resistin and
visfatin, participating in physiological and pathological processes, such as energy balance, insulin
sensitivity and resistance, immunity, inflammation, hematopoiesis and angiogenesis. Adipocytokines
could serve as a missing link in the association between psoriasis, obesity and metabolic co-morbidities.
In chronic inflammatory disease states such as psoriasis, adipocytokines may be implicated in psoriasis
41
onset, progression, severity as well as in the pathogenesis of co-morbidities. Measuring serum
adipocytokine levels in the future may be useful in predicting psoriasis severity, progression, treatment
outcome and risk of any co-morbidities. Interventions to decrease pro-inflammatory adipocytokine levels
could offer preventive and therapeutic options for improving psoriasis severity and protecting against its
co-morbidities. Candidate strategic interventions incorporate increased physical activity, weight control
and pharmacologic approaches such as metformin. However, the mechanisms underlying the actions of
adipocytokines in psoriasis as well as their potential diagnostic, prognostic and/or therapeutic utility
require further investigation with larger prospective, longitudinal and mechanistic studies.
73. Dalamaga M. Obesity, insulin resistance, adipocytokines and breast cancer: New
biomarkers and attractive therapeutic targets. World J Exp Med 2013; 3(3): 34-42
(invited).
Worldwide, breast cancer represents the most common type of non-skin human malignancy and the
second leading cause of cancer-related deaths amid women in Western countries. Obesity and its
metabolic complications have rapidly become major global health issues and are associated with
increased risk for cancer, especially breast cancer (BC) in postmenopausal women. Adipose tissue is
considered as a genuine endocrine organ secreting a variety of bioactive adipokines, such as leptin,
adiponectin, resistin and nicotinamide phosphoribosyl-transferase/visfatin. Recent evidence has
indicated that the constellation of obesity, insulin resistance and adipokines is associated with the risk
and prognosis of postmenopausal BC. Direct evidence is growing rapidly supporting the stimulating
and/or inhibiting role of adipokines in the process of development and progression of BC. Adipokines
could exert their effects on the normal and neoplastic mammary tissue by endocrine, paracrine and
autocrine mechanisms. Recent studies support a role of adipokines as novel risk factors and potential
diagnostic and prognostic biomarkers in BC.
This editorial aims at providing important insights into the potential pathophysiological mechanisms
linking adipokines to the etiopathogenesis of BC in the context of a dysfunctional adipose tissue and
insulin resistance in obesity. Understanding of these mechanisms may be important for the development
of attractive preventive and therapeutic strategies against obesity-related breast malignancy.
74. Dalamaga M. Interplay of adipokines and myokines in cancer pathophysiology:
Emerging therapeutic implications. World J Exp Med 2013; 3(3): 26-33 (invited).
Excess body weight constitutes a worldwide health problem with epidemic proportions impacting on the
risk and prognosis of several disease states including malignancies. It is believed that the metabolic
changes associated with weight gain, particularly visceral obesity, and physical inactivity could lead to
dysfunctional adipose and muscle tissues causing insulin resistance, low-grade chronic inflammation and
abnormal secretion of adipokines and myokines. The complex paracrine and endocrine interconnection
between adipokines and myokines reflects a yin-yang balance with important implications in processes
such as lipolysis control, insulin sensitivity and prevention from obesity-driven chronic low-grade
inflammation and cancer promotion through anti-inflammatory adipokines and myokines. Furthermore,
the complex pathophysiology of cancer cachexia is based on the interplay between muscle and adipose
tissue mediated by free fatty acids, various adipokines and myokines. The purpose of this editorial is to
explore the role of the adipose and muscle tissue interplay in carcinogenesis, cancer progression and
cachexia, and to examine the mechanisms underpinning their association with malignancy.
Understanding of the mechanisms connecting the interplay of adipokines and myokines with cancer
pathophysiology is expected to be of importance in the development of therapeutic strategies against
cancer cachexia. Advances in the field of translational investigation may lead to tangible benefits to obese
and inactive persons who are at increased risk of cancer as well as to cancer patients with cachexia.
75. Dalamaga M, Papadavid E. Metabolic co-morbidities and psoriasis: the chicken or the
egg? World J Dermatol 2013; 2 (4): 32-35 (invited).
Accumulating evidence supports that psoriasis may be a potential multisystem inflammatory disease
associated with a range of co-morbidities showing an overlapping pathology and an important health
impact such as metabolic diseases. Psoriasis is associated with an increased risk of obesity, metabolic
syndrome (Mets) and diabetes mellitus type 2 (t2DM), following a “dose-response” relationship from
42
mild to severe psoriasis. Conversely, recent evidence from large prospective studies suggests that obesity
constitutes a risk factor for psoriasis and psoriatic arthritis. Also, a dyslipidemic profile may precede
psoriasis onset. Both obesity, Mets and psoriasis, characterized as chronic inflammatory states, stem from
a shared underlying pathophysiology exhibiting common genetic predisposition and risk factors such as
high caloric intake, physical inactivity and psychological stress. Excess weight may potentiate the
inflammation of psoriasis through the deregulation of adipocytokines while, at the same time, it may help
the development of Mets. Interestingly, recent translational data has shown that psoriasis, through
increased T-helper inflammatory cytokines in skin and sera, may exert a plethora of effects on insulin
regulation and lipid metabolism. Larger population-based prospective cohort and longitudinal studies
are needed to unravel the association between psoriasis and metabolic co-morbidities. The recognition of
the intricate complex interplay between psoriasis and metabolic co-morbidities may help dermatologists
to be aware of associated metabolic co-morbidities in order to screen for metabolic diseases and manage
holistically and effectively the psoriatic patient.
76. Pavlidou A, Kroupis C, Goutas N, Dalamaga M, Dimas K. Validation of a real-time
quantitative PCR (qPCR) method for the quantification of three survivin transcripts
and evaluation in breast cancer tissues. Clin Breast Cancer 2013; 14 (2): 122-131.
Background Survivin is a novel antiapoptotic gene, which is a member of the inhibitor of apoptosis
protein (IAP) family. Recently, three splice variants of this gene, differing in their anti-apoptotic
properties, were cloned and characterized. This study aimed at validating a sensitive and specific method
for the detection of survivin variants in breastcancer.
Methods: RNA was extracted from breast cancer tissues (n=60) and then cDNA was synthesized. Real
time qPCR was performed to the cDNAs with a reverse primer specific for each splice variant and a pair
of common hybridization probes. For the validation of the assay, we synthesized external standards of
known concentration (copies/μL) for the three survivin isoforms.
Results: By using qPCR, high sensitivity for wild-survivin wild-type-survivin, survivin-2b and survivinΔΕx3-mRNA detection was achieved. The expression of wild-survivin wild type-survivin was
significantly correlated with survivin-2b, survivin-ΔΕx3 and the ratio of survivin-ΔΕx3 (P<0.001). The
ratio of survivin-2b was strongly associated with the ratio of survivin-ΔΕx3/wild-survivin wild-typesurvivin (P<0.001). There was a strong positive association between the grade of the tumour and
survivin-2b mRNA, survivin-ΔΕx3 mRNA and ratio of survivin-ΔΕx3 mRNA (P<0.05). The ratio of
survivin-2b/wild survivin wild-type-survivin was significantly associated with the presence of estrogen
receptors (P=0.05).
Conclusions: Our validated data suggest that survivin isoforms may be related to clinicopathological
features. Further studies are needed in order to confirm our findings and to explore the role and
mechanisms of survivin transcripts in the etiopathogenesis of breast cancer as well as their potential use
as molecular prognostic tools or as new therapy targets.
77. Papadavid E, Ferra D, Koumaki D, Dalamaga M, Stamou C, Theodoropoulos K.,
Rigopoulos D. Ustekinumab induces fast response and maintenance of very severe
refractory scalp psoriasis: results in two Greek patients from the psoriasis hospitalbased clinic. Dermatology 2014; 228 (2): 107-111.
Background Scalp psoriasis, one of the most common sites of psoriasis involvement, is often difficult to
control with topical agents. There is lack of substantial evidence-based data for the efficacy and safety of
systemic therapies.
Methods Two patients from our university based psoriasis clinic with chronic plaque psoriasis and severe
recalcitrant scalp involvement were assessed by PASI and PSSI scores respectively, and quality of life by
DLQI.
Results We report two psoriasis patients with very severe scalp psoriasis that developed fast clinical
response of scalp psoriasis to ustekinumab in 8 weeks with excellent patient adherence up to 28 week of
follow up and positive impact on quality of life due to rapid and long term clearing.
Conclusion Ustekinumab produces fast clinical response of recalcitrant scalp psoriasis with excellent
patient adherence and positive impact on quality of life due to rapid and long term clearing in patients
with very severe scalp involvement who failed conventional topical and systemic treatment.
43
78. Dalamaga M, Kazanis K, Triantafyllidi H, Vagionas I, Dionyssiou –Asteriou A.
Kinetics of serum ischemia-modified albumin during cardiopulmonary exercise testing
in relation to metabolic and cardiac markers: a pilot study. Metabolism 2014; 63 (4): e56.
Aim: To explore the effect of skeletal muscle ischemia on the kinetics of serum ischemia modified albumin
(IMA) during cardiopulmonary exercise testing (CPET) in treated hypertensive patients in relation to
cardiac markers, lactate and CPET metabolic parameters.
Patients & Methods: Twelve patients with essential hypertension under treatment underwent a CPET.
Serum IMA, cardiac troponin T, high sensitive C-Reactive Protein (hsCRP), NT-proBNP and lactate were
determined at pre-, peak and after one-hour post-CPET.
Results: Serum IMA, albumin, NT-proBNP, glucose and lactate significantly changed throughout the
exercise protocol (p<0.05). Specifically, peak IMA significantly decreased by 7.8%, and subsequently
increased by 8.7% one-hour after CPET (p=0.001), being associated negatively with peak lactate (p=0.047).
Interestingly, peak IMA correlated also positively with the anaerobic threshold and negatively with the
respiratory exchange ratio (p<0.05).
Conclusion: Skeletal but not myocardial ischemia may influence the kinetics of serum IMA levels in
treated hypertensive patients undergoing a CPET.
79. Christodoulatos GS, Dalamaga M. Micro-RNAs as promising clinical biomarkers and
therapeutic targets in breast cancer: quo vadis? World J Clin Oncol 2014; 5(2): 71-81.
Breast cancer (BC) is the most frequent type of non-skin cancer among women and a major leading cause
of cancer-related deaths in Western countries. It is substantial to discover novel biomarkers with
diagnostic, prognostic or predictive usefulness as well as therapeutic value for BC. Micro-RNAs
(miRNAs) belong to a novel class of endogenous interfering RNAs that play a crucial role in post
transcriptional gene silencing, through mRNA targeting and, thus, are involved in many biologic
processes encompassing apoptosis, cell-cycle control, cell proliferation, DNA repair, immunity,
metabolism, stress, aging, etc. MiRNAs exert their action mainly in a tumor suppressive or oncogenic
manner. The specific aberrant expression patterns of miRNAs in BC, that are detected with the use of
high-throughput technologies, reflect their key role in cancer initiation, progression, migration, invasion
and metastasis. The detection of circulating extracellular miRNAs in plasma of BC patients may provide
novel, non-invasive biomarkers in favor of BC diagnosis and prognosis and, at the same time,
accumulating evidence has underscored the possible contribution of miRNAs as valuable biomarkers to
predict response to chemotherapy or radiotherapy. Data from in vitro and in vivo studies on BC have
revealed promising therapeutic approaches via miRNA delivery and miRNA inhibition. The purpose of
this review is to explore the ontological role of miRNAs in BC etiopathogenesis as well as to highlight
their potential not only as non-invasive circulating biomarkers with diagnostic and prognostic
significance, but also as treatment response predictors and therapeutic targets aiding BC management.
80. Nikolaou V, Papadavid E, Economidi A, Dalamaga M, Marinos L, Stratigos A,
Papadaki T, Antoniou C. Associations of clinicopathological characteristics with
secondary neoplastic lymphoproliferative disorders in lymphomatoid papulosis
patients. Leukemia and Lymphoma 2014; 5: 1-5.
Lymphomatoid papulosis (LyP) refers to an indolent cutaneous lymphoma. The association of prognostic
clinicopathological risk factors with a second hematologic malignancy have not been determined.
We investigated the prognostic effect of clinicopathological characteristics on the occurrence of a second
lymphoma as well as the first line treatment in 24 patients diagnosed with LyP using logistic regression
models. We have shown that lymphoma occurrence was associated with a lower mean age of initial LyP
44
symptoms, histological types B and C, head-located LyP lesions and a higher frequency of LyP
exacerbations. In multivariate analyses, histologic type-A was associated with a lower risk of second
lymphoma (OR=0.12, 95%C.I. 0.014-0.98; p=0.045) adjusting for age of LyP first symptomatology, and an
important increased lymphoma-free survival rate (long-rank test; p=0.06). Clinicopathological characteristics are important in defining the clearance or persistence of LyP lesions and
may predict the occurrence of a second lymphoma.
81. Dalamaga M, Polyzos SA, Karmaniolas K, Chamberland J, Lekka A, Migdalis I,
Papadavid E, Dionyssiou-Asteriou A, Mantzoros CS. Circulating Fetuin-A in patients
with pancreatic cancer: A hospital-based case-control study. Biomarkers 2014: 19(8):660-6.
Objective: A comparative proteomic analysis has recently proposed fetuin-A as a new potential tumor
marker for pancreatic cancer (PC), a cancer not infrequently associated with insulin resistance and diabetes.
The purpose of this study was to evaluate serum fetuin-A levels in patients with PC compared with
matched controls, as well as in patients within different stages of PC.
Methods: In a hospital-based case-control study, we studied 81 cases with incident, histologically
confirmed pancreatic adenocarcinoma and 81 controls matched on gender and age between 2000 and 2007.
Serum fetuin-A, adiponectin, leptin, insulin, tumor and inflammatory markers, and standard tests were
measured in samples collected before the initiation of any treatment.
Results: PC patients presented a non-significant trend towards lower circulating fetuin-A levels than
controls. Although there seemed to be a trend with higher fetuin-A levels across PC stages, comparisons of
serum fetuin-A in patients within different PC prognostic stages revealed no significant differences. Serum
fetuin-A levels were not independently associated with the presence of PC in logistic regression analyses.
Serum fetuin-A was positively correlated: with albumin levels in both patients and controls; with leptin
levels in patients; and adiponectin levels in controls.
Conclusions: Circulating fetuin-A levels were similar between patients and controls and could not
differentiate them or the disease severity. Prospective studies are needed to fully elucidate the value of
serum fetuin-A as an early diagnostic and prognostic tool for PC.

PUBLICATIONS IN INTERNATIONAL PEER-REVIEWED JOURNALS NOT
INDEXED IN PUBMED
1. Karmaniolas K, Papavassiliou E, Ioannidis P, Dalamaga M, Liatis S, Mandalaki E,
Papalampros T, Migdalis I. Differential expression of interferon blocking activities in
sera from patients with hepatocellular carcinoma. Annals of Gastroenterology 2000;
13(4): 312-315.
Natural inhibitors to various cytokines and IFNs have been documented in vitro as well as in vivo. IFN
inhibitors have been implicated for the ineffectiveness of IFN treatment in malignant neoplasias. The aim
of this study was to investigate the existence of IFN inhibitors in the serum of patients with
hepatocellular carcinoma (HCC) and to explore their possible clinica significance. 16 patients with HCC
were included in the study. Serum samples from all patients were collected before any treatment and
stored at -70 degrees until use. Controls sera were selected from 24 apparently healthy blood donors.
Interferon-inhibiting activity as well as endogenous IFN-like activity were determined in all serum
samples in a cell line highly sensitive to IFN. There was no endogenous IFN-like activity in any of the
patients' group or controls' group. Sera from patients with HCC exhibited IFN-blocking activity at a
moderate percentage (37.5%) while no IFN-blocking activity was detected in controls. IFN-blocking
activity was detected in two cell lines highly sensitive to IFN: Intestine-407 (93.7%) and Chang liver cells
(12.5%).The results support a cytokine and cytokine inhibitor network mediating pathophysiolgical
events in the cellular level as well as in the whole organism. The limited responsiveness of HCC to rIFN
may potentially be due to the presence of such inhibitors.
45
2. Kostoula A, Dalamaga M, Deska E, Papadopoulou C. The evaluation of rose bengal
test in the laboratory diagnosis of human brucellosis. Mediterranean Journal of
Infectious and Parasitic Diseases 1995; 10(2): 95-96.
Five hundred and fifty-nine human sera were examined using the Rose Bengal test (RBT), the Wright test
and the immunofluorescence technique. Analysis of the collected data is indicative of the high sensitivity
of the RBT, which is proved to be a very useful screening test. The inadequacy of the Wright test for an
accurate diagnosis of chronic brucellosisis obvious and the need to be replaced or supplemented by
another technique is suggested and discussed.
3.
Koumaki V and Dalamaga M∂. Nicotinamide phopshoribosyltranferase (NAMPT_
7q22.3). Atlas Genet Cytogenet Oncol Haematol 2012; 16(12): 909-912 (∂equal
contribution of authors).
Because of its pivotal role in the recycling pathway allowing NAD generation from nicotinamide,
NAMPT occupies a central position in controlling the activity of several NAD-dependent enzymes.
NAD, a universal energy-and signal-carrying molecule and its phosphorylated form, NADP, are
required in several intracellular processes such as redox reactions, DNA repair, G-protein coupled
receptor signaling, intra-cellular calcium-mobilizing molecules, transcriptional regulation, monoadenosine diphosphate (ADP)-ribosylation in immune response, and activity of poly-ADP
ribosyltransferases and deacetylases (sirtuins) with roles in regulating cell survival and cytokine
responses. Under the influence of NAMPT, adequate levels of NAD control SIRT-6 (sirtuin) activity,
which in turn positively regulates TNF-α mRNA translation favoring cell survival. NAMPT activity
enhances cellular proliferation, tips the balance toward cellular survival following a genotoxic insult
and controls the circadian clock machinery of some key transcriptions factors.
4. Dalamaga M and Koumaki V. Adiponectin & Cancer: deep insight. Atlas Genet
Cytogenet Oncol Haematol 2014; in press.
A growing body of evidence suggests that adiponectin presents anti-neoplastic effects via two
mechanisms. First, adiponectin can act directly on tumor cells by enhancing receptor-mediated signaling
pathways. Secondly, adiponectin may act indirectly by regulating inflammatory responses, influencing
cancer angiogenesis and regulating insulin sensitivity at the target tissue site

PUBLICATIONS IN INTERNATIONAL PEER-REVIEWED SUPPLEMENTS OF
JOURNALS
1. Dalamaga M, Kostoula A, Chavelas C, Matekovits A, Antoniades G. Persistent
abdominal pain caused by Leptospira interrogans. Clinical Microbiology and
Infection 2000; 6(S): 197-198.
2. Dalamaga M, Karmaniolas K, Kaloudi S, Kaloudis G, Chavelas C, Triantafylli M,
Lekka A, Aslanidou M, Parara Z, Mygdalis H. Mean platelet volume, platelet
distribution width and maturation characteristics of reticulocytes in
myelodysplastic patients. European Journal of Internal Medicine 2001; 12: 287.
3. Karmaniolas K, Migdalis I, Dalamaga M, Ioannidis P, Papalampros T, Chavelas C,
Lekka A, Triantafylli M, Parara Z, Koutantos I. Differential expression of
interferon blocking activities in serum from patients with haematologic
malignancies and solid tumors. European Journal of Internal Medicine 2001; 12:
288.
46
4. Kroupis C, Moussama A, Pantou E, Theodorou M, Dalamaga M, Lianidou E,
Manginas A, Degiannis D. Investigation of a possible correlation of FcγRIIA
polymorphism and CRP in coronary artery disease (CAD). Clinical Chemistry and
Laboratory Medicine 2007; 45 (S): 236.
5. Antonakos G, Dalamaga M, Giannaris D, Kontelia G, Geromeriati K, Xenos N,
Lefteriotou A, Capourou L, Dimas K. Relationship between cytokines
concentrations (IL-6, IL-8, MCP1, FGF, TNFa) and number of follicules >17mm in
subfertile women undergoing IVF program. Clinical Chemistry and Laboratory
Medicine 2007; 45 (S): 97.
6. Hroussalas G, Kassi E, Delimaris I, Dalamaga M, Kazanis K, Zachari A,
Dionyssiou-Asteriou A. Association of adiponectin with HDL and triglycerides
serum levels in women with normal and impaired OGTT. Atherosclerosis 2007; 8
(1S): 145.
7. Dalamaga M, Sotiropoulos G, Matekovits A, Lekka A, Papadavid E. Cutaneous
lesions associated with high risk primary myelodysplasia. Haematologica
(Haematol-Hematol J) 2007; 92 (S1): 515.
8. Dalamaga M, Karmaniolas K, Antonakos G, Triantafilli M, Dimas K, Lekka A.
Glycohemoglobin and platelet indices in primary myelodysplasia and diabetes.
Haema 2007; 10(S1):238.
9. Dalamaga M, Lekka A, Karmaniolas K, Stathopoulou E, Aslanidou M,
Dionyssiou-Asteriou A. Association of autoimmune thyroiditis with de novo
myelodysplastic syndrome risk. Haema 2007; 10(S1): 236-237.
10. Dalamaga M, Triantafilli M, Sotiropoulos G, Karmaniolas K, Antonakos G, Dimas
K, Lekka A. Association of cholesterol, HDL and LDL with primary
myelodysplastic syndromes. Haema 2007; 10(S1): 237-238.
11. Dalamaga M, Aslanidou M, Sotiropoulos G, Karmaniolas K, Antonakos G, Dimas
K, Lekka A. Association of iron and ferritin in patients with primary
myelodysplastic syndromes. Haema 2007; 10(S1): 292-293.
12. Kassi E, Hroussalas G, Delimaris I, Dalamaga M, Kazanis K, Zachari A,
Dionyssiou-Asteriou A. Changes in circulating levels of leptin and soluble leptin
receptor during OGTT in overweight/obese postmenopausal women.
Diabetologia 2007; 50(S1): 268.
13. Dalamaga M, Pantelaki M, Karmaniolas K, Daskalopoulou K. Platelet parameters
and Gram negative bacteremias: a case-control study. Clinical Microbiology and
Infection 2008; 14: (Supl 7).
14. Kassi E, Dalamaga M, Faviou E, Hroussalas G, Kazanis K, Dionyssiou-Asteriou
A. Oxidized LDL and postmenopausal obesity. Atherosclerosis 2008; 9 (1S): 143.
15. Dalamaga M, Lekka A, Triantafilli M, Karmaniolas K, Hsi A, Panagiotou A,
Dimas K, Mantzoros C. Hypoadiponectinemia is associated with multiple
myeloma risk. Haematologica (Haematol-Hematol J) 2008; 93 (Supl 1): 266-267.
16. Dalamaga M, Lekka A, Karmaniolas K, Chamberland J, Hsi A, Triantafilli M,
Dionyssiou-Asteriou A, Mantzoros C. IGF-I and IGFBP-3 and the risk of
myelodysplastic syndrome. Haematologica (Haematol-Hematol J) 2008; 93 (Supl
1): 448.
47
17. Dalamaga M, Triantafilli M, Karmaniolas K, Pelekanos N, Sotiropoulos G, Lekka
A. Thyroid autoimmunity and the occurrence of multiple myeloma.
Haematologica (Haematol-Hematol J) 2008; 93 (Supl 1): 267.
18. Lekka A, Dalamaga M, Triantafilli M, Sotiropoulos G, Poulou D. Correlation of
coagulation markers, platelet parameters and respiratory indexes in patients with
chronic obstructive pulmonary disease. Haematologica (Haematol-Hematol J)
2008; 93 (Supl 1): 409.
19. Dalamaga M, Lekka A, Pantelaki M, Karmaniolas K, Sotiropoulos G,
Daskalopoulou K. Association of serum complement and platelet parameters with
Escherichia coli bacteraemia: a cross-sectional study. Molecular Immunology 2008;
45 (16): 4165-4166.
20. Kazanis K, Dalamaga M, Nounopoulos Ch, Manolis AS, Antonellis I, Jullien G,
Dionyssiou-Asteriou A. Ischemia Modified Albumin and high-sensitivity Creactive protein in coronary atherosclerosis. Clinical Lipidology 2008; 2(55): S6061.
21. Panagiotou A, Dalamaga M, Lefteriotis D, Flevari P, Nikolaou M, Parisis K, Xenos
N, Antonakos A, Kassi E, Kroupis C, Dimas C. Diagnosis and prognosis of acute
myocardial infarction with novel cardiac markers. Clinical Chemistry and
Laboratory Medicine 2009; 47 (S): 134.
22. Pavlidou A, Kroupis C, Athanasas G, Konstantoudakis G, Rallis G, Antonakos G,
Spathis A, Dalamaga M, Dimas C. Correlation between transcriptional expression
of survivin isoforms and clinicopathological findings in colorectal cancer using
real time PCR. Clinical Chemistry and Laboratory Medicine 2009; 47 (S): 164.
23. Pavlidou A, Kroupis C, Goutas N, Antonakos G, Athanasas G, Dalamaga M,
Dimas C. Quantification of three isoforms of the survivin mRNA in breast cancer
tissues with real time PCR-clinical application. Clinical Chemistry and Laboratory
Medicine 2009; 47 (S): 164.
24. Panagiotou A, Dimas C, Dalamaga M, Zerva A, Kassanos D, Chrelias H,
Akalestos T. Comparison and concordance analysis of pregnancy-associated
plasma protein A (PAPP-A) and free beta human chorionic gonadotrophin (free BHCG) on Siemens Immulite 1000 and Roche Cobas e411 analyzers. Clinical
Chemistry and Laboratory Medicine 2009; 47 (S): 340.
25. Dalamaga M, Lekka A, Karmaniolas K, Chamberland J, Hsi A, Triantafilli M,
Sotiropoulos G, Dionyssiou-Asteriou A, Mantzoros C. Serum adiponectin and
resistin levels and the occurrence of myelodysplastic syndrome. Haematologica
(Haematol-Hematol J) 2009; 94 (Supl 2): 531.
26. Dalamaga M, Lekka A, Crotty BH, Fargnoli J, Triantafilli M, Karmaniolas K,
Sotiropoulos G, Dionyssiou-Asteriou A, Mantzoros C. Hypoadiponectinemia is
associated with B-cell chronic lymphocytic leukemia risk. Haematologica
(Haematol-Hematol J) 2009; 94 (Supl 2): 634.
27. Dalamaga M, Lekka A, Crotty BH, Fargnoli J, Triantafilli M, Karmaniolas K,
Sotiropoulos G, Dionyssiou-Asteriou A, Mantzoros C. Lower serum leptin levels
are associated with B-cell chronic lymphocytic leukemia occurrence.
Haematologica (Haematol-Hematol J) 2009; 94 (Supl 2): 605.
28. Dalamaga M, Karmaniolas K, Antonakos G, Thrasyvoulides A, Spanos N,
Triantafilli M, Papadavid E, Dimas C, Lekka A. Association of platelet parameters
48
with glycosylated hemoglobin in diabetic patients with myelodysplasia and
normal platelet count. Haematologica (Haematol-Hematol J) 2010; 95 (s2): 413-414.
29. Dalamaga M, Triantafilli M, Karmaniolas K, Panagiotou A, Papadavid E,
Sotiropoulos G, Dimas C, Lekka A. Circulating levels of visfatin and high
molecular weight adiponectin in multiple myeloma: a case-control study.
Haematologica (Haematol-Hematol J) 2010; 95 (s2): 582.
30. Dalamaga M, Lekka A, Triantafilli M, Karmaniolas K, His A, Papadavid E,
Panagiotou A, Dimas C, Mantzoros CS. Association of serum leptin and resistin
levels with multiple myeloma risk. Haematologica (Haematol-Hematol J) 2010; 95
(s2): 586.
31. Dalamaga M, Pantelaki M, Lekka A, Karmaniolas K, Sotiropoulos G,
Daskalopoulou G. Association of platelet parameters and serum complement with
coagulase-negative staphylococcal bacteremia: a cross-sectional study.
Haematologica (Haematol-Hematol J) 2010; 95 (s2): 747.
32. Kassi E, Hroussalas G, Dalamaga M, Kazanis K, Merantzi G, Zachari A,
Giamarellos-Bourboulis EJ, Dionyssiou-Asteriou A. Adipocyte factors, hsCRP and
malondealdehyde levels in overweight postmenopausal women with normal and
impaired OGTT. Atherosclerosis 2010; 11 (2S): 127-128.
33. Lagiou M, Dalamaga M, Kroupis C, Marouga A, Vlahakos D, Dimas C.
Nephelometric measurement of cystatin C, homocysteine and C-Reactive Protein
in patients with chronic kidney disease and association with cardiovascular risk.
Clinical Chemistry and Laboratory Medicine 2010; 48 (9): A171-A172.
34. Kassi E, Dimas C, Dalamaga M, Panagiotou A, Parisi K, Papoutsi Z, Spilioti E,
Moutsatsou P. Sideritis Euboea extract may improve risk factors of cardiovascular
risk. Clinical Chemistry and Laboratory Medicine 2010; 48 (9): A168-A169.
35. Dalamaga M, Daskalopoulou K, Pantelaki M, Triantafilli M, Sotiropoulos G,
Karmaniolas K, Lekka A. Association of platelet indices with thyroid stimulating
hormone and thyroid hormones in euthyroidic healthy subjects. Haematologica
(Haematol-Hematol J) 2011; 96 (s2): 328-329.
36. Dalamaga M, Karmaniolas K, Daskalopoulou K, Pantelaki M, Triantafilli M,
Sotiropoulos G, Lekka A. Platelet parameters in patients with subclinical
hyperthyroidism. Haematologica (Haematol-Hematol J) 2011; 96 (s2): 329.
37. Kazanis K, Dalamaga M, Kassi E, Merantzi G, Vagionas I, Jullien G, Dionyssiou–
Asteriou A. Ischemia modified albumin (ΙΜΑ) in postmenopausal women with or
without coronary artery disease (CAD) in relation to BMI and OGTT: a potential
biomarker of atherosclerosis burden associated with oxidative stress.
Atherosclerosis 2011 (S).
38. Dalamaga M, Sotiropoulos G, Karmaniolas K, Triantafilli M, Pantelaki M,
Daskalopoulou K, Lekka A. Platelet morphologic indices in patients with primary
hyperparathyroidism. Haematologica (Haematol-Hematol J) 2012; 97 (s1): 685.
39. Dalamaga M, Daskalopoulou K, Sotiropoulos G, Karmaniolas K, Pantelaki M,
Lekka A. Platelet morphology in patients with subclinical hypothyroidism: results
from a cross-sectional study. Haematologica (Haematol-Hematol J) 2012; 97 (s1):
432.
40. Dalamaga M, Triantafilli M, Karmaniolas K, Daskalopoulou K, Pantelaki M,
Sotiropoulos G, Lekka A. Hemostatic parameters and lipid profile in patients with
49
primary hyperparathyroidism: associations with parathyroid hormone.
Haematologica (Haematol-Hematol J) 2012; 97 (s1): 420.
41. Dalamaga M, Daskalopoulou K, Sotiropoulos G, Pantelaki M, Karmaniolas K,
Triantafilli M, Lekka A. Hemostatic parameters and metabolic parameters in
patients with subclinical hypothyroidism: is there a relationship with thyroid
stimulating hormone? Haematologica (Haematol-Hematol J) 2012; 97 (s1): 195.
42. Koumaki D, Kontos F, Papadavid E, Dalamaga M, Pittaras T, Koumaki V. A case
report of reactivation of tuberculosis during etarnecept (anti-tumor necrosis factor
antagonist) treatment in a psoriatic patient. Journal of Investigative Dermatology
2013; 133: S193.
43. Dalamaga Μ, Lekka A, Karmaniolas K, Chamberland J, Triantafilli M, DionyssiouAsteriou A, Mantzoros CS. The association of free leptin index and insulin levels
with the occurrence of myelodysplastic syndromes. Haematologica (HaematolHematol J) 2013; 98 (s1): 309.
44. Dalamaga Μ, Lekka A, Triantafilli M, Chamberland J, Karmaniolas K, DionyssiouAsteriou A, Mantzoros CS. Serum free leptin, leptin receptor and insulin in relation
to B-cell chronic lymphocytic leukemia risk. Haematologica (Haematol-Hematol J)
2013; 98 (s1): 764.
45. Dalamaga Μ, Lekka A, Triantafilli M, Karmaniolas K, Chamberland J, DionyssiouAsteriou A, Mantzoros CS. Circulating fetuin-A/α2HS–glycoprotein levels in
myelodysplastic syndrome. Haematologica (Haematol-Hematol J) 2013; 98 (s1):
578.
46. Dalamaga Μ, Lekka A, Triantafilli M, Chamberland J, Karmaniolas K, DionyssiouAsteriou A, Mantzoros CS. Serum fetuin-A/α2HS–glycoprotein levels in patients
with B-cell chronic lymphocytic leukemia. Haematologica (Haematol-Hematol J)
2013; 98 (s1): 764.
47. Kazanis K, Dalamaga M, Kassi E, Vagionas I, Jullien G, Dionyssiou-Asteriou A.
Ischemia modified albumin in postmenopausal women with coronary disease in
relation to NT-proBNP and hsCRP: a biomarker of atherosclerosis burden?
Atherosclerosis 2013 (S).
48. Marouga A, Kroupis C, Dimas K, Dalamaga M, Lagiou M, Vlahakos D. Serum
resistin levels are independently associated with all-cause and cardiovascular
mortality in elderly non diabetic patients with chronic kidney disease. Clin Chem
Lab Med 2014; 52, Special Suppl, pp S1 – S1760.

CHAPTERS IN INTERNATIONAL PEER-REVIEWED BOOKS
1.
Dalamaga M and Vrioni G. Cedecea spp. In Molecular detection of human
pathogens. Dongyou Liu (editor). CRC Press, Taylor and Francis edition Group. New
South Wales. Australia, 2011. ISBN: 9781439812389.
Koumaki V and Dalamaga M. Nicotinamide phopshoribosyltranferase (NAMPT_
7q22.3). In Atlas of Genetics and Cytogenetics in Oncology and Haematology 2012.
http://AtlasGeneticsOncology.org/Genes/NAMPTID43890ch7q22.html
2.
50
3.
Dalamaga M and Koumaki V. Adiponectin & Cancer: deep insight. In Atlas of
Genetics and Cytogenetics in Oncology and Haematology 2013 in press.
http://atlasgeneticsoncology.org/Deep/AdiponectinandCancerID20128.html

ABSTRACTS IN INTERNATIONAL CONGRESSES
1) Kostoula A, Dalamaga M, Bobojianni C, Michailidis M. The Rose Bengal Plate Test
(RBPT) in the serodiagnosis of Human Brucellosis. XIIIe Session des Journées
Médicales Balkaniques, Jοannina, 8-10 Juillet 1993.
2) Dalamaga M, Chavelas C, Kostoula A, Zoannou A, Hatzis J. Formation des
organisations volontaires des étudiants de médecine pour la lutte contre le SIDA.
XIIIe Session des Journées Médicales Balkaniques, Joannina, 8-10 Juillet 1993.
3) Κοstoula A, Dalamaga M, Deska E, Papadopoulou C. The evaluation of Rose Bengal
Test in the Laboratory Diagnosis of Human Brucellosis. ΙΙ Congress of the
Mediterranean Society of Infectious and Parasitic Diseases, Marrakech, November
21-27, 1993.
4) Dalamaga M, Kostoula A, Chavelas C, Matekovits A, Antoniades G. Persistent
abdominal pain caused by Leptospira interrogans. 10th European Congress of
Clinical Microbiology and Infectious Diseases, Stockholm, May 28-31, 2000.
5) Dalamaga M, Petridou E, Trichopoulos D, Mentis A, Skalkidou A, Karpathios T,
Kalmanti M, Koliouskas D, Kosmidis H, Panagiotou J, Piperopoulou F, Tzortzatou F.
Acute childhood Leukemia: The role of low immunity to a range of infectious agents.
41st Annual Meeting. European Society for Pediatric Research, Rhodes, September 2327, 2000.
6) Dalamaga M, Karmaniolas K, Kaloudi S, Kaloudis G, Chavelas C, Triantafylli M,
Lekka A, Aslanidou M, Parara Z, Mygdalis H. Mean platelet volume, platelet
distribution width and maturation characteristics of reticulocytes in myelodysplastic
patients. 3rd Congress of the European Federation of Internal Medicine, Edinburgh,
May 9-12, 2001.
7) Karmaniolas K, Migdalis I, Dalamaga M, Ioannidis P, Papalampros T, Chavelas C,
Lekka A, Triantafylli M, Parara Z, Koutantos I. Differential expression of interferon
blocking activities in serum from patients with haematologic malignancies and solid
tumors. 3rd Congress of the European Federation of Internal Medicine, Edinburgh,
May 9-12, 2001.
8) Dalamaga M, Karmaniolas K, Chavelas C, Lekka A, Aslanidou M, Triantafylli M,
Parara Z, Mygdalis H. Disturbed immune homeostasis in patients with
myelodysplastic syndromes. 3rd Balkan Congress of Immunology, Athens, October
30-November 1, 2001.
9) Tarpatzi A, Dalamaga M, Pantelaki M, Chaniotaki S, Masselou K, Zerva L. Urinary
tract pathogenes and their susceptibilities among patients of a new hospital. 14th
Mediterranean Congress of Chemotherapy and 3rd Pancyprian Congress of
Chemotherapy and Infectious Diseases, Limasol, Cyprus, November 25-28, 2004.
10) Thrasyvoulides A, Dalamaga M, Marouga A, Stathopoulou E, Antonakos G,
Kontelia G, Kontos F, Pavlidou A, Nikolaidou A, Dimas C. Correlation of
51
glycosylated hemoglobin and platelet parameters in patients with diabetes mellitus.
XXX Nordic Congress in Clinical Chemistry, Copenhagen, Denmark, June 14-17,
2006.
11) Antonakos G, Dimas C, Giannaris D, Dalamaga M, Kassanos D, Salamalekis E,
Dionissiou-Asteriou A. Detection of LIF and VEGF in the follicular fluid and serum
of subfertile women. XXX Nordic Congress in Clinical Chemistry, Copenhagen,
Denmark, June 14-17, 2006.
12) Kroupis C, Moussama A, Pantou E, Theodorou M, Dalamaga M, Lianidou E,
Manginas A, Degiannis D. Investigation of a possible correlation of FcγRIIA
polymorphism and CRP in coronary artery disease (CAD).17th IFCC-FESCC
European Congress of Clinical Chemistry and Laboratory Medicine & 60 th National
Congress of the Netherlands Society for Clinical Chemistry and Laboratory
Medicine. Amsterdam, The Netherlands, June 3-7, 2007.
13) Antonakos G, Dalamaga M, Giannaris D, Kontelia G, Geromeriati K, Xenos N,
Lefteriotou A, Capourou L, Dimas K. Relationship between cytokines concentrations
(IL-6, IL-8, MCP1, FGF, TNFa) and number of follicules >17mm in subfertile women
undergoing IVF program.17th IFCC-FESCC European Congress of Clinical Chemistry
and Laboratory Medicine & 60th National Congress of the Netherlands Society for
Clinical Chemistry and Laboratory Medicine. Amsterdam, The Netherlands, June 37, 2007.
14) Hroussalas G, Kassi E, Delimaris I, Dalamaga M, Kazanis K, Zachari A,
Dionyssiou-Asteriou A. Association of adiponectin with HDL and triglycerides
serum levels in women with normal and impaired OGTT. 76th Congress of the
European Atherosclerosis Society. Helsinki, Finland, June 10-13, 2007.
15) Dalamaga M, Sotiropoulos G, Matekovits A, Lekka A, Papadavid E. Cutaneous
lesions associated with high risk primary myelodysplasia. 12th Congress of the
European Hematology Association. Vienna, Austria, June 7-10, 2007.
16) Dalamaga M, Karmaniolas K, Antonakos G, Triantafilli M, Dimas K, Lekka A.
Glycohemoglobin and platelet indices in primary myelodysplasia and diabetes. 18th
Panhellenic Congress of Hematology and 2nd Balkan Day of Haematology.
Thessaloniki, Greece, November 14-17, 2007.
17) Dalamaga M, Lekka A, Karmaniolas K, Stathopoulou E, Aslanidou M,
Dionyssiou-Asteriou A. Association of autoimmune thyroiditis with de novo
myelodysplastic syndrome risk. 18th Panhellenic Congress of Hematology and 2nd
Balkan Day of Haematology. Thessaloniki, Greece, November 14-17, 2007.
18) Dalamaga M, Triantafilli M, Sotiropoulos G, Karmaniolas K, Antonakos G, Dimas
K, Lekka A. Association of cholesterol, HDL and LDL with primary myelodysplastic
syndromes. 18th Panhellenic Congress of Hematology and 2nd Balkan Day of
Haematology. Thessaloniki, Greece, November 14-17, 2007.
19) Dalamaga M, Aslanidou M, Sotiropoulos G, Karmaniolas K, Antonakos G, Dimas
K, Lekka A. Association of iron and ferritin in patients with primary myelodysplastic
syndromes. 18th Panhellenic Congress of Hematology and 2nd Balkan Day of
Haematology . Thessaloniki, Greece, November 14-17, 2007
20) Kassi E, Hroussalas G, Delimaris I, Dalamaga M, Kazanis K, Zachari A,
Dionyssiou-Asteriou A. Changes in circulating levels of leptin and soluble leptin
receptor during OGTT in overweight/obese postmenopausal women.
52
21) Dalamaga M, Pantelaki M, Karmaniolas K, Daskalopoulou K. Platelet parameters
and Gram negative bacteremias: a case-control study. ECCMID. Barcelona, Spain.
April 19-22, 2008.
22) Kassi E, Dalamaga M, Faviou E, Hroussalas G, Kazanis K, Dionyssiou-Asteriou A.
Oxidized LDL and postmenopausal obesity. 77th Congress of the European
Atherosclerosis Society. Istanbul, Turkey, April 26-29, 2008.
23) Dalamaga M, Lekka A, Triantafilli M, Karmaniolas K, Hsi A, Panagiotou A,
Dimas K, Mantzoros C. Hypoadiponectinemia is associated with multiple myeloma
risk. 13th Congress of the European Hematology Association. Copenhagen, Denmark,
June 12-15, 2008.
24) Dalamaga M, Lekka A, Karmaniolas K, Chamberland J, Hsi A, Triantafilli M,
Dionyssiou-Asteriou A, Mantzoros C. IGF-I and IGFBP-3 and the risk of
myelodysplastic syndrome. 13th Congress of the European Hematology Association.
Copenhagen, Denmark, June 12-15, 2008.
25) Dalamaga M, Triantafilli M, Karmaniolas K, Pelekanos N, Sotiropoulos G, Lekka
A. Thyroid autoimmunity and the occurrence of multiple myeloma. 13th Congress of
the European Hematology Association. Copenhagen, Denmark, June 12-15, 2008.
26) Lekka A, Dalamaga M, Triantafilli M, Sotiropoulos G, Poulou D. Correlation of
coagulation markers, platelet parameters and respiratory indexes in patients with
chronic obstructive pulmonary disease. 13th Congress of the European Hematology
Association. Copenhagen, Denmark, June 12-15, 2008.
27) Panagiotou A, Dalamaga M, Lefteriotis D, Flevari P, Nikolaou M, Parisi K,
Thrasivoulidis A, Antonakos G, Kroupis C, Dimas C. Diagnosis of acute myocardial
infarction with novel cardiac markers. XXXI Nordic Congress in Clinical Chemistry.
Helsinki, Finland, June 14-18, 2008.
28) Panagiotou A, Dalamaga M, Lefteriotis D, Flevari P, Nikolaou M, Geromeriati K,
Sthathopoulou E, Parisi K, Kontelia G, Dimas C. Association of coronary heart
disease risk factors with novel cardiac markers. XXXI Nordic Congress in Clinical
Chemistry. Helsinki, Finland, June 14-18, 2008.
29) Dalamaga M, Lekka A, Pantelaki M, Karmaniolas K, Sotiropoulos G,
Daskalopoulou K. Association of serum complement and platelet parameters with
Escherichia coli bacteraemia: a cross-sectional study. XXII International Complement
Workshop. Basel, Switzerland, September 28-October 2, 2008.
30) Kazanis K, Dalamaga M, Nounopoulos Ch, Manolis AS, Antonellis I, Jullien G,
Dionyssiou-Asteriou A. Ischemia Modified Albumin and high-sensitivity C-reactive
protein in coronary atherosclerosis. 7th International Symposium on Multiple Risk
Factors in Cardiovascular Diseases-Prevention-Intervention-Health Policy. Venice
Lido, Italy, October 22-25, 2008.
31) Parisi K, Ntzifa A, Panagiotou A, Kontelia G, Spanos N, Saounatsou K, Marouga
A, Geromeriati K, Dalamaga M, Antonakos G, Dimas C. Comparative study of
serum troponin T and troponin I levels measured at three automated immunological
analyzers. XVI Meeting of Balkan Clinical Laboratory Federation & 7 th Hellenic
Congress of Clinical Chemistry. Athens, Greece, October 16-18, 2008.
32) Parisi K, Ntzifa A, Panagiotou A, Stathopoulou E, Kroupis C, Thrasivoulides A,
Kontelia G, Antonakos G, Dalamaga M, Geromeriati K, Dimas C. Comparative
evaluation of serum homocysteine levels measured at two automated analyzers. XVI
53
Meeting of Balkan Clinical Laboratory Federation & 7th Hellenic Congress of Clinical
Chemistry. Athens, Greece, October 16-18, 2008.
33) Parisi K, Ntzifa A, Panagiotou A, Lagiou M, Thrasivoulides A, Stathopoulou E,
Kroupis C, Antonakos G, Geromeriati K, Dalamaga M, Dimas C. Comparative
evaluation of serum BNP and NT-proBNP levels measured on a randomized group
of patients. XVI Meeting of Balkan Clinical Laboratory Federation & 7 th Hellenic
Congress of Clinical Chemistry. Athens, Greece, October 16-18, 2008.
34) Poumpouridou N, Tsionou C, Panagiotou A, Dalamaga M, Dimas C, Kroupis C.
Mutation screening in PALB2 gene in BRCA negative Greek cancer breast and
ovarian cancer families. XVI Meeting of Balkan Clinical Laboratory Federation & 7 th
Hellenic Congress of Clinical Chemistry. Athens, Greece, October 16-18, 2008.
35) Pavlidou A, Kroupis C, Goutas N, Antonakos G, Dalamaga M, Dimas C.
Development of real time PCR for the quantification of three isoforms of the survivin
m-RNA in breast cancer tissues-clinical application. XVI Meeting of Balkan Clinical
Laboratory Federation & 7th Hellenic Congress of Clinical Chemistry. Athens, Greece,
October 16-18, 2008.
36) Pavlidou A, Dalamaga M, Konstantoudakis G, Kroupis C, Rallis G, Antonakos G,
Dimas C, Athanasas G. Detection of survivin isoforms in pairs of cancerous and
adjacent tissues from patients with colorectal cancer using real time PCR. XVI
Meeting of Balkan Clinical Laboratory Federation & 7th Hellenic Congress of Clinical
Chemistry. Athens, Greece, October 16-18, 2008.
37) Panagiotou A, Dalamaga M, Lefteriotis D, Flevari P, Nikolaou M, Antonakos G,
Parisi K, Spanos N, Saounatsou K, Dimas C. New cardiac markers and risk factors in
patients with acute myocardial infarction (AMI). XVI Meeting of Balkan Clinical
Laboratory Federation & 7th Hellenic Congress of Clinical Chemistry. Athens, Greece,
October 16-18, 2008.
38) Panagiotou A, Dalamaga M, Lefteriotis D, Flevari P, Nikolaou M, Parisis K, Xenos
N, Antonakos A, Kassi E, Kroupis C, Dimas C. Diagnosis and prognosis of acute
myocardial infarction with novel cardiac markers. 18th IFCC-EFCC European
Congress of Clinical Chemistry and Laboratory Medicine . Innsbruck, Austria 7-11
June, 2009.
39) Pavlidou A, Kroupis C, Athanasas G, Konstantoudakis G, Rallis G, Antonakos G,
Spathis A, Dalamaga M, Dimas C. Correlation between transcriptional expression of
survivin isoforms and clinicopathological findings in colorectal cancer using real
time PCR. 18th IFCC-EFCC European Congress of Clinical Chemistry and Laboratory
Medicine. Innsbruck, Austria 7-11 June, 2009.
40) Pavlidou A, Kroupis C, Goutas N, Antonakos G, Athanasas G, Dalamaga M,
Dimas C. Quantification of three isoforms of the survivin mRNA in breast cancer
tissues with real time PCR-clinical application. 18th IFCC-EFCC European Congress
of Clinical Chemistry and Laboratory Medicine . Innsbruck, Austria 7-11 June, 2009.
41) Dalamaga M, Lekka A, Karmaniolas K, Chamberland J, Hsi A, Triantafilli M,
Sotiropoulos G, Dionyssiou-Asteriou A, Mantzoros C. Serum adiponectin and
resistin levels and the occurrence of myelodysplastic syndrome. 14th Congress of the
European Hematology Association. Berlin, Germany June 4-7, 2009.
42) Dalamaga M, Lekka A, Crotty BH, Fargnoli J, Triantafilli M, Karmaniolas K,
Sotiropoulos G, Dionyssiou-Asteriou A, Mantzoros C. Hypoadiponectinemia is
54
associated with B-cell chronic lymphocytic leukemia risk. 14th Congress of the
European Hematology Association. Berlin, Germany June 4-7, 2009.
43) Dalamaga M, Lekka A, Crotty BH, Fargnoli J, Triantafilli M, Karmaniolas K,
Sotiropoulos G, Dionyssiou-Asteriou A, Mantzoros C. Lower serum leptin levels are
associated with B-cell chronic lymphocytic leukemia occurrence. 14th Congress of the
European Hematology Association. Berlin, Germany June 4-7, 2009.
44) Dalamaga M, Karmaniolas K, Antonakos G, Thrasyvoulides A, Spanos N,
Triantafilli M, Papadavid E, Dimas C, Lekka A. Association of platelet parameters
with glycosylated hemoglobin in diabetic patients with myelodysplasia and normal
platelet count. 15th Congress of the European Hematology Association. Barcelona,
Spain. June 10-13, 2010.
45) Dalamaga M, Triantafilli M, Karmaniolas K, Panagiotou A, Papadavid E,
Sotiropoulos G, Dimas C, Lekka A. Circulating levels of visfatin and high molecular
weight adiponectin in multiple myeloma: a case-control study. 15th Congress of the
European Hematology Association. Barcelona, Spain. June 10-13, 2010.
46) Dalamaga M, Lekka A, Triantafilli M, Karmaniolas K, His A, Papadavid E,
Panagiotou A, Dimas C, Mantzoros CS. Association of serum leptin and resistin
levels with multiple myeloma risk. 15th Congress of the European Hematology
Association. Barcelona, Spain. June 10-13, 2010.
47) Dalamaga M, Pantelaki M, Lekka A, Karmaniolas K, Sotiropoulos G,
Daskalopoulou G. Association of platelet parameters and serum complement with
coagulase-negative staphylococcal bacteremia: a cross-sectional study. 15th Congress
of the European Hematology Association. Barcelona, Spain. June 10-13, 2010.
48) Kassi E, Hroussalas G, Dalamaga M, Kazanis K, Merantzi G, Zachari A,
Giamarellos-Bourboulis EJ, Dionyssiou-Asteriou A. Adipocyte factors, hsCRP and
malondealdehyde levels in overweight postmenopausal women with normal and
impaired OGTT. 78th European Atherosclerosis Society. Hamburg, Germany. June 2023, 2010.
49) Dalamaga M, Daskalopoulou K, Pantelaki M, Triantafilli M, Sotiropoulos G,
Karmaniolas K, Lekka A. Association of platelet indices with thyroid stimulating
hormone and thyroid hormones in euthyroidic healthy subjects. 16th Congress of the
European Hematology Association. London, United Kingdom. June 9-12, 2011.
50) Dalamaga M, Karmaniolas K, Daskalopoulou K, Pantelaki M, Triantafilli M,
Sotiropoulos G, Lekka A. Platelet parameters in patients with subclinical
hyperthyroidism. 16th Congress of the European Hematology Association. London,
United Kingdom. June 9-12, 2011.
51) Kazanis K, Dalamaga M, Kassi E, Merantzi G, Vagionas I, Jullien G, Dionyssiou–
Asteriou A. Ischemia modified albumin (ΙΜΑ) in postmenopausal women with or
without coronary artery disease (CAD) in relation to BMI and OGTT: a potential
biomarker of atherosclerosis burden associated with oxidative stress. 79th European
Atherosclerosis Society. Gothenburg, Sweden. June 26-29, 2011.
52) Dalamaga M, Sotiropoulos G, Karmaniolas K, Triantafilli M, Pantelaki M,
Daskalopoulou K, Lekka A. Platelet morphologic indices in patients with primary
hyperparathyroidism. 17th Congress of the European Hematology Association.
Amsterdam, The Netherlands. June 14-17, 2012.
55
53) Dalamaga M, Daskalopoulou K, Sotiropoulos G, Karmaniolas K, Pantelaki M,
Lekka A. Platelet morphology in patients with subclinical hypothyroidism: results
from a cross-sectional study.
17th Congress of the European Hematology
Association. Amsterdam, The Netherlands. June 14-17, 2012.
54) Dalamaga M, Triantafilli M, Karmaniolas K, Daskalopoulou K, Pantelaki M,
Sotiropoulos G, Lekka A. Hemostatic parameters and lipid profile in patients with
primary hyperparathyroidism: associations with parathyroid hormone. 17th
Congress of the European Hematology Association. Amsterdam, The Netherlands.
June 14-17, 2012.
55) Dalamaga M, Daskalopoulou K, Sotiropoulos G, Pantelaki M, Karmaniolas K,
Triantafilli M, Lekka A. Hemostatic parameters and metabolic parameters in patients
with subclinical hypothyroidism: is there a relationship with thyroid stimulating
hormone? 17th Congress of the European Hematology Association. Amsterdam, The
Netherlands. June 14-17, 2012.
56) Koumaki D, Kontos F, Papadavid E, Dalamaga M, Pittaras T, Koumaki V. A case
report of reactivation of tuberculosis during etarnecept (anti-tumor necrosis factor
antagonist) treatment in a psoriatic patient. 2013 International Investigative
Dermaology Meeting. Edinburgh, Scotland, UK. May 8-11, 2013.
57) Dalamaga Μ, Lekka A, Karmaniolas K, Chamberland J, Triantafilli M,
Dionyssiou-Asteriou A, Mantzoros CS. The association of free leptin index and
insulin levels with the occurrence of myelodysplastic syndromes. 18th Congress of
the European Hematology Association. Stockholm, Sweden. June 13-16, 2013.
58) Dalamaga Μ, Lekka A, Triantafilli M, Chamberland J, Karmaniolas K,
Dionyssiou-Asteriou A, Mantzoros CS. Serum free leptin, leptin receptor and insulin
in relation to B-cell chronic lymphocytic leukemia risk. 18th Congress of the
European Hematology Association. Stockholm, Sweden. June 13-16, 2013.
59) Dalamaga Μ, Lekka A, Triantafilli M, Karmaniolas K, Chamberland J,
Dionyssiou-Asteriou A, Mantzoros CS. Circulating fetuin-A/α2HS–glycoprotein
levels in myelodysplastic syndrome. 18th Congress of the European Hematology
Association. Stockholm, Sweden. June 13-16, 2013.
60) Dalamaga Μ, Lekka A, Triantafilli M, Chamberland J, Karmaniolas K,
Dionyssiou-Asteriou A, Mantzoros CS. Serum fetuin-A/α2HS–glycoprotein levels in
patients with B-cell chronic lymphocytic leukemia. 18th Congress of the European
Hematology Association. Stockholm, Sweden. June 13-16, 2013.
61) Kazanis K, Dalamaga M, Kassi E, Vagionas I, Jullien G, Dionyssiou-Asteriou A.
Ischemia modified albumin in postmenopausal women with coronary disease in
relation to NT-proBNP and hsCRP: a biomarker of atherosclerosis burden? 81st
European Atherosclerosis Society Congress. Lyon, France June 2-5, 2013.
62) Marouga A, Kroupis C, Dimas K, Dalamaga M, Lagiou M, Vlahakos D. Serum
resistin levels are independently associated with all-cause and cardiovascular
mortality in elderly non diabetic patients with chronic kidney disease. 22nd
International Congress of Clinical Chemistry and Laboratory Medicine. 22nd Balkan
Clinical Laboratory Federation Meeting (BCLF 2014). 26th National Congress of the
Turkish Biochemical Society (TBS 2014). Constantinople, Turkey June 22-26, 2014.
56

PUBLICATIONS IN PEER-REVIEWED GREEK JOURNALS
1. Dalamaga M, Matekovis H, Foteinou A, Katsianou E, Chavelas C, Kaloudi S, Lioulios
P, Karmaniolas K, Peraki A, Chronopoulos P. Evaluation of health service quality at
the 417 Army Share Fund Hospital (Veteran’s Hospital of Athens). Iatriki Epitheorisis
Enoplon Dynameon 2001; 35: 37-42 (Greek).
The aim of the present study was to assess NIMTS health services and the degree of patient satisfaction
regarding hygiene conditions, hospital amenities, medical supplies and the behavior, interest and
competence of the nurses and the medical staff. The evaluation of hospital health care quality constitutes
a factor of major significance in Public Health Policy. A random sample of 100 patients was selected for
this study and the research was carried out by the filling of a special epidemiologic questionnaire.
According to the statistical analysis of the data, the results showed that the overall rating of the hospital
and the rating concerning several issues of NIMTS health services such as laboratories and clinical
departments were very satisfactory, without any significant divergences between patients from different
insurance coverages. Despite the satisfactory results, a continuous effort to improve health care quality is
required in order to increase clinical effectiveness and diminish health care expenses.
2. Dalamaga M, Petridou E, Trichopoulos D, Mentis A, Skalkidou A, Karpathios Th,
Kalmanti M, Koliouskas D, Kosmidi E, Panagiotou I, Piperopoulou F, Tzortzatou F.
Infectious agents and low herd immunity in the etiology of childhood leukemia.
Paediatriki-Hellenic Paediatric Society 2001; 64: 136-144 (Greek).
It has been suggested that acute lymphoblastic leukaemia (ALL) among children may be a rare outcome
of a delayed non specific infection in situations of low herd immunity to a relatively wide range of agents.
The aim of this study was to assess whether newly diagnosed acute lymphoblastic leukaemia cases, in
comparison to their controls, would be characterised by lower herd immunity, as reflected in a more
seronegative spectrum to a wide range of agents, with the exception of a strongly positive response to a
single infectious agent, assumed to trigger ALL. In a case control study whereas all six paediatric
haematology-oncology units and the respective paediatric hospitals in Greece participated, 94 incident
cases of ALL and an equal number of hospital controls with minor non-infectious conditions, individually
matched for age and gender were included. The aim of the study was to assess past exposures against
a range of infectious agents, a battery of 10 serological tests was used. There was little evidence for an
association of childhood leukaemia with the serology of any of the ten studied infectious agents among
the very young children. In contrast, among children five years or older, there was a statistically
significant positive association of leukaemia with Parainfluenza and a series of inverse associations with
Epstein Barr Virus, Human Herpes Virus-6, Mycoplasma pneumonia and Parvovirus B19. Conclusions:
Among children five years or older, the risk of leukaemia is higher when the low herd immunity for several
agents is challenged by late infection from an infectious agent, that, as a rule, attacks children at a
younger age.
3. Ioannidis P, Dalamaga M, Liatis S, Vlachopoulou A, Kaskara A, Papalambros T,
Karmaniolas K. Primary myopathic carnitine deficiency in an adult male. Archives of
Hellenic Medicine 2001; 18(6): 597-600 (Greek).
We report the case of a young man who presented with progressive proximal muscle weakness and
weight loss. His serum creatine phosphokinase (CPK) levels were markedly elevated. The muscle biopsy
showed lipid storage myopathy. The muscle carnitine concentration was extremely low (5.6% of normal
levels), establishing the diagnosis of myopathic carnitine deficiency. The disorder was considered as
primary because there were no indications of any other identifiable condition which could result in a
secondary carnitine deficiency. The patient was treated with oral L-carnitine (2 g per day) and showed
rapid improvement. Primary myopathic carnitine deficiency is a curable disorder and therefore it should
always be considered as a potential diagnosis in cases of myopathy in young adults.
57
4. Dalamaga M. Karmaniolas K, Vlachopoulou A, Ioannidis P, Chavelas C, Papalambros
T, Peraki A. Coexistence of primary myelodysplastic syndrome-RARS with Tlymphoblsatic non-Hodgkin lymphoma. Archives of Helenic Medicine 2000; 17(4): 407410 (Greek).
The development of myelodysplastic syndrome (MDS) secondary to treatment of non-Hodgkin lymphoma
is a common phenomenon. We report a case of T-lymphoblastic non-Hodgkin lymphoma presenting after
three years with de novo MDS-refractory anemia with ringed sideroblasts, an unusual finding. Absence of
prior chemotherapy and cytogenetic confirmation establish the true coexistence of the two hematologic
disorders. The mechanisms responsible for the appearance of non-Hodgkin lymphoma in a patient with
primary MDS are discussed
5. Dalamaga M, Chavelas C, Kostoula A. Acute abdominal pain in leptospirosis. Acta
Microbiologica Hellenica 2002; 47 (6): 466-471 (Greek).
We report herein a case of a white man, 21 years old, performing his military service, who presented at
the Emergency Unit of 406 Military Hospital of Ioannina, complaining of nausea and strong, acute
abdominal pain in the umbilical region for the last two days. He was admitted to the Surgical Unit of
Ioannina University Hospital and was submitted to a thorough clinical examination, concluding that there
was no need for surgical intervention. Later on the pain localized in the right upper quadrant abdominal
region mimicking cholecystitis and the patient mentioned headache, perspiration, myalgias and
arthralgias. Nuchal rigidity was noticed on reexamination. The diagnosis of leptospirosis was confirmed
by detection of IgM antibodies against Leptospira interrogans, using the ELISA immunosorbent assay
(BIOS). Dark-field microscopic examination of fresh urine sediment revealed the presence of leptospires
with their characteristic hooked ends. The patient received doxycycline for 15 days and recovered without
any complication completely. This case report aims at pointing out the need of taking into consideration
the possibility of leptospirosis in the differential diagnosis of acute and persistent abdominal pain. A high
level of awareness and appropriate laboratory studies should allow early diagnosis and may prevent
unnecessary surgical intervention.
6. Karmaniolas K,Liatis S, Dalamaga M, Ioannidis P, Papalambros T. Ovarian sarcoidosis:
a rare location of the disease. Iatriki 2003; 84 (1-2):95-98 (Greek).
We present a case of systemic sarcoidosis with ovarian and peritoneal involvement. A 72-year-old female
was admitted because of low grade fever, fatigue and dilatation of the abdomen. Clinical and laboratory
evaluation of the patient revealed moderate right pleural effusion, ascites, diffuse ovarian infiltration,
presence of enlarged intraabdominal lymph nodes and a substantially high value of serum CA 125. The
elevated value of serum CA 125 is particularly discussed. Histological examination after laparotomy was
indicative of ovarian sarcoidosis.
7. Nikolaidou AN, Dalamaga M. Adipose tissue hormones and malignant neoplasms.
Acta Microbiologica Hellenica 2006; 51(4): 142-152 (Greek).
Adipokines, defined as biologically active polypeptides produced by adipose tissue, significantly affect
metabolism of carbohydrates and lipids as well as numerous other processes in human body. It is known
that endocrine dysfunction of adipose tissue may represent one of the causal links between insulin
resistance/diabetes and obesity. Furthermore, adipokines have been implicated in a number of
carcinogenic mechanisms, including cell proliferation, metastasis and angiogenesis. A number of
emerging epidemiological studies underlined that obesity represents an important risk factor for cancer
development, although the exact mechanism of this relationship remains to be elucidated. Other
mechanisms may involve adipokines, that may serve as signaling devices in the pathogenesis of
malignant neoplasia. This review explores the specific roles of adipokines as putative mediating factors
between obesity and cancer as well as the current knowledge about possible relationship of leptin and
adiponectin to the etiopathogenesis of different malignant tumors. Most of the studies indicated that while
leptin may activate the growth of cancer cells in vitro, adiponectin appears to present the opposite effects.
Further studies are needed to examine whether obesity-induced endocrine dysfunction of adipose tissue
can directly trigger carcinogenesis in different tissues and organs.
58
8. Dalamaga M. Etiology of childhood leukemia: review of the epidemiologic evidence
Iatriki Epitheorisis Enoplon Dynameon 2007; 41 (1-2): 25-33 (Greek).
Leukemia is the most common cancer affecting children, accounting for approximately a third of all
chlildhood cancers. The major morphological subtype of childhood leukemia is common acute
lymphoblastic leukemia (c-ALL). Greater risks of childhood leukemia were observed among children with
Down’s syndrom, Bloom’s syndrom, Fanconi’s anemia and other chromosomal abnormailities as well as
among children exposed to ionizing radiation including diagnostic X-rays in pregnancy. With respect to
environmental exposures, this review investigates risk factors associated with childhood leukemia in
general such as exposure to pesticides and other chemical products, exposure to varying degrees of
electromagnetic fields, maternal and paternal smoking during pregnancy, maternal diet, etc. Exposures
acting before birth and early in life has long been thought to be important determinants of leukemia, and
the list of suspected chemical, physical and biological agents continues to increase. Unfortunately, the
evidence regarding the majority of suggested risk factors is limited and often contradictory, and there are
areas which clearly warrant further investigation in order to clarify the understanding of the etiology of
childhood leukemia.
9. Dalamaga M, Leftheriotou T, Karmaniolas K, Kaskara A, Migdalis I. Generalized
infection with ardiac, hepatic, and pancreatic disorder due to enterovirus. Galenus
2007; 49(3): 239-244 (Greek).
We described a case of generalized ECHOvirus infection that included a febrile exanthematous illness,
aseptic meningitis accompanied by a sequential involvement and rapid resolution of cardiac, hepatic and
pancreatic abnormalities. To our knowledge, this is a very unusual, not previously reported presentation
of acute ECHOvirus infection in an immunocompetent adult.
10. Dalamaga M, Sotiropoulos GP, Vrioni G. Cedeceα, an "unknown" Enterobacteriaceae:
clinical significance-biochemical and molecular diagnostic approaches. Acta
Microbiologica Hellenica 2014; 59 (1): 17-28.
Bacterial members belonging to the family of Enterobacteriaceae such as Cedecea continue to play an
important role as causes of health care-associated infections. Several new members of the family
Enterobacteriaceae have been described over the past 30 years; however, most of these members
constitute rare causes of human infections. Cedecea strains may be found in aqueous environment,
agricultural dust, soil, plants, and also in animals, ranging from insects to humans. Most of them are
inhabitants of the intestinal tract and therefore their presence in the environment reflect fecal excretion
by animals and humans. However, the natural habitat of Cedecea remains unknown. Cedecea spp.
constitutes a rare pathogen with rising importance. A significant majority of Cedecea strains have been
isolated from clinical specimens, mostly from blood in patients with bacteraemia and septicaemia
(Cedecea davisae, C. neteri and C. lapagei), from sputum, BAL specimens and lung tissue, from gall
bladder (C. davisae), hand wounds, burn wounds (C. lapagei), cutaneous ulcer, eye swabs (C. davisae),
stool, urine, throat cultures, from peritoneal fluid (C. neteri and C. lapagei), from scrotal abscess (C.
davisae) and from veined catheters. Because of their inherent resistance to some antibiotics, the clinical
response could be unpredictable making management of Cedecea infection in immunocompromised
patients challenging. The purpose of the present review is to present new epidemiological, diagnostic
and clinical data regarding Cedecea, a relatively new member of the family of Enterobacteriaceae.
Nowadays, the isolation of Cedecea species from clinical specimens in hospitals has been more and more
frequent, so that their role in human disease as well as their ecologic niches must be better defined.
11. Dalamaga M, Dionyssiou-Asteriou Α. Microparticles and Cardio-Vascular Disease.
Editorial. Atheroma 2014; 14 (4): 1-7.
Microparticles present important roles in coagulation, inflammation, and endothelial function. These
roles are mandatory to safeguard the integrity of the organism, and their derangements contribute to the
development of cardiovascular disease. More recently, the presumed solely harmful role of
microparticles has been challenged because microparticles could also be involved in the maintenance
59
and preservation of cellular homeostasis. In this review, we summarize recent studies revealing the two
faces of microparticles in cardiovascular disease.

BOOKS, MONOGRAPHS AND CHAPTERS IN BOOKS
1.
Dalamaga M and Chavelas C. HIV and AIDS. Supervision : Professor G. Antoniades.
University of Ioanina Editions, Ioannina 1995 (214 pages, Greek).
2.
Dalamaga M. Tentatives de recherche d’un vaccin et d’un traitement contre le SIDA.
Concours Européen Belgian Shell, Bruxelles 1988 (60 pages, French).
3.
Dalamaga M, Chavelas C. In the quest of the history of modern plague-AIDS.
University of Ioannina, School of Medicine, Ioannina 1991 (104 pages, Greek).
4.
Dalamaga M. The social impact of AIDS (translation) University of Ioannina, School of
Medicine, Ioannina 1989 (77 pages, Greek).
5.
Dalamaga M. The implications of pesticides in Public Health. National School of
Public Health. Athens 1997. Master’s thesis in Public Health (52 pages, Greek).
6.
Dalamaga M. Chronic immune stimulation and the occurrence of de novo
myelodysplastic syndromes. Harvard School of Public Health, Boston, Massachusetts
2000. Master’s thesis in Epidemiology (MSc) (85 pages, English).
7.
Dalamaga M. The contribution of viruses-infectious agents (EBV, CMV, HHV-6,
Influenza viruses A, B, Parainfluenza viruses, RSV, Adenoviruses, Parvovirus Β19 and
Mycoplasma pneumoniae) and low herd immunity to he etiology of childhood
leukemia. Laboratory of Hygiene and Epidemiology. University of Athens, School of
Medicine and Diagnostic Department of Virology, Pasteur Hellenic Institute. Athens,
2002. Doctoral thesis (193 pages, Greek).
8.
Dalamaga M and Petridou E. Infectious agents and low herd immunity in the etiology
of childhood leukemia. Laboratory of Hygiene and Epidemiology. University of
Athens, School of Medicine First Class Award in Science (Vassiliki G. Notara prize).
Academy of Athens, Athens 2001 (22 pages, Greek).
9.
Dalamaga M. A preventive guide for special infections in rural areas. Cultural
Association of Milea Metsovou. Metsovo, Epirus 1996 (15 pages).
10. Dalamaga M. Agricultural Chemicals and Public Health. Anagnostopoulios
Agricultural School-Michael Anagnos Schools. Konitsa 1996 (50 pages, Greek).
60
11. Katsikarou S, Kommatas T, Milonis T, Dalamaga M, Pappas A, Chrysovelidi A,
Psaraki G. Health Centers of Attiki: Koropi, Vari, Elefsina and Lavrio: inequalities and
polymorphisms. National School of Public Health. Athens 1997 (30 pages, Greek).
12. Dalamaga M. An essay for the investigation of HIV-seropositivity in Greek
population. National School of Public Health. Athens 1997 (12 pages, Greek).
13. Dalamaga M, Antonakos G, Geromeriati K, Thrasyvoulides A, Kroupis C,
Stathopoulou E, Kontelia G, Dima K. Hot Issues in Clinical Biochemistry for the
modern clinical laboratory practice. Editors: Dalamaga M, Dima K, Kroupis C.
General University Hospital “Attikon”, Sponsorhip: BIOCHEM. Athens 2007 (110
pages, Greek) ISBN: 978-960-930090-2.
14. Dalamaga M. Quality Asurance Manual according to the ISO 15189 for the Laboratory
of Clinical Biochemistry, General University Hospital “Attikon”, Chaidari, 2007 (31
pages, Greek).
15. Dalamaga M. Procedures and Guideines according to the ISO 15189 for the
Laboratory of Clinical Biochemistry, General University Hospital “Attikon”, Chaidari,
2007 (125 pages, Greek).
16. Dalamaga M and Vrioni G. Cedecea spp. In Molecular detection of human pathogens.
Dongyou Liu (editor). CRC Press, Taylor and Francis edition Group. New South
Wales. Australia, 2011. ISBN: 9781439812389.
17. Koumaki V and Dalamaga M. Nicotinamide phopshoribosyltranferase (NAMPT_
7q22.3). In Atlas of Genetics and Cytogenetics in Oncology and Haematology 2012
(invited contribution).
http://AtlasGeneticsOncology.org/Genes/NAMPTID43890ch7q22.html
18. Dalamaga M and Koumaki V. Adiponectin and Cancer: deep insight. In Atlas of
Genetics and Cytogenetics in Oncology and Haematology 2013 (invited contribution).
19. Three chapters in Obesity for the electronic and printed manual «Clinical
Endocrinology», Greek Society of Endocrinology. Authors: Stergios A. Polyzos, Maria
Dalamaga, Dimitrios G. Goulis and Christos S. Mantzoros (invited contribution).
20. Dalamaga M. Emerging novel cardiovascular biomarkers in cardiovascular diseases.
In “Cardiovascular Diseases, Dyslipidemia, Endothelial Dysfunction, Molecular and
Serum Biomarkers” Seminar Proceedings Book. 5th Congress of Clinical Biochemistry
and Laboratory Hematology. Athens, October 2013.
21. Papadavid E, Dalamaga M, Rigopoulos D. Psoriasis and metabolic co-morbidities. In
the Internal Medicine Book dedicated to the memory of Professor Arapakis (in press).
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22. Christodoulatos GS, Dalamaga M. Adiponectin and hematologic malignancies. In the
Internal Medicine Book dedicated to Professor John Meletis (in press).

RESEARCH MONOGRAPHS
1. Dalamaga M, Logan L. Access to care for HIV-infected patients: Lowering the lid on
Pandora’s box? Harvard School of Public Health, Boston, Massachusetts 1999. (11
pages)
2. Dalamaga M. A randomized, double-blind, placebo controlled, phase III clinical trial
using r-HuEPO versus ATRA and rIL-2 versus a combination of r-HuEPO, ATRA and
rIL-2 versus placebo in low risk myelodysplastic syndrome with a 2x2 factorial design.
Harvard School of Public Health, Boston, Massachusetts 2000 (10 pages).
3. Dalamaga M, Davis B, Szucs T. A randomized trial of idarubicin versus daunorubicin
in combination chemotherapy for acute myelogenous leukemia: an analysis. Harvard
School of Public Health, Boston, Massachusetts 2000 (24 pages).