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University of Ioannina

EducationIoannina, Greece
About: University of Ioannina is a education organization based out in Ioannina, Greece. It is known for research contribution in the topics: Population & Large Hadron Collider. The organization has 7654 authors who have published 20594 publications receiving 671560 citations. The organization is also known as: Panepistimio Ioanninon.


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Journal ArticleDOI
TL;DR: There was high quality evidence that natalizumab and IFNß-1a (Rebif) were effective against recurrence of relapses in RRMS during the first 24 months of treatment compared to placebo, and the quality of evidence for these treatments was graded as moderate.
Abstract: BACKGROUND: Different therapeutic strategies are available for treatment of multiple sclerosis (MS) including immunosuppressants, immunomodulators, and monoclonal antibodies. Their relative effectiveness in the prevention of relapse or disability progression is unclear due to the limited number of direct comparison trials. A summary of the results, including both direct and indirect comparisons of treatment effects, may help to clarify the above uncertainty. OBJECTIVES: To estimate the relative efficacy and acceptability of interferon s-1b (IFNs-1b) (Betaseron), interferon s-1a (IFNs-1a) (Rebif and Avonex), glatiramer acetate, natalizumab, mitoxantrone, methotrexate, cyclophosphamide, azathioprine, intravenous immunoglobulins, and long-term corticosteroids versus placebo or another active agent in participants with MS and to provide a ranking of the treatments according to their effectiveness and risk-benefit balance. SEARCH METHODS: We searched the Cochrane Database of Systematic Reviews, the Cochrane MS Group Trials Register, and the Food and Drug Administration (FDA) reports. The most recent search was run in February 2012. SELECTION CRITERIA: Randomized controlled trials (RCTs) that studied one of the 11 treatments for use in adults with MS and that reported our pre-specified efficacy outcomes were considered for inclusion. DATA COLLECTION AND ANALYSIS: Identifying search results and data extraction were performed independently by two authors. Data synthesis was performed by pairwise meta-analysis and network meta-analysis that was performed within a Bayesian framework. The body of evidence for outcomes within the pairwise meta-analysis was assessed according to GRADE, as very low, low, moderate, or high quality. MAIN RESULTS: Forty-four trials were included in this review, in which 17,401 participants had been randomised. Twenty-three trials included relapsing-remitting MS (RRMS) (9096 participants, 52%), 18 trials included progressive MS (7726, 44%), and three trials included both RRMS and progressive MS (579, 3%). The majority of the included trials were short-term studies, with the median duration being 24 months. The results originated mostly from 33 trials on IFNs, glatiramer acetate, and natalizumab that overall contributed outcome data for 9881 participants (66%).From the pairwise meta-analysis, there was high quality evidence that natalizumab and IFNs-1a (Rebif) were effective against recurrence of relapses in RRMS during the first 24 months of treatment compared to placebo (odds ratio (OR) 0.32, 95% confidence interval (CI) 0.24 to 0.43; OR 0.45, 95% CI 0.28 to 0.71, respectively); they were more effective than IFNs-1a (Avonex) (OR 0.28, 95% CI 0.22 to 0.36; OR 0.19, 95% CI 0.06 to 0.60, respectively). IFNs-1b (Betaseron) and mitoxantrone probably decreased the odds of the participants with RRMS having clinical relapses compared to placebo (OR 0.55, 95% CI 0.31 to 0.99; OR 0.15, 95% CI 0.04 to 0.54, respectively) but the quality of evidence for these treatments was graded as moderate. From the network meta-analysis, the most effective drug appeared to be natalizumab (median OR versus placebo 0.29, 95% credible intervals (CrI) 0.17 to 0.51), followed by IFNs-1a (Rebif) (median OR versus placebo 0.44, 95% CrI 0.24 to 0.70), mitoxantrone (median OR versus placebo 0.43, 95% CrI 0.20 to 0.87), glatiramer acetate (median OR versus placebo 0.48, 95% CrI 0.38 to 0.75), IFNs-1b (Betaseron) (median OR versus placebo 0.48, 95% CrI 0.29 to 0.78). However, our confidence was moderate for direct comparison of mitoxantrone and IFNB-1b vs placebo and very low for direct comparison of glatiramer vs placebo. The relapse outcome for RRMS at three years' follow-up was not reported by any of the included trials.Disability progression was based on surrogate markers in the majority of included studies and was unavailable for RRMS beyond two to three years. The pairwise meta-analysis suggested, with moderate quality evidence, that natalizumab and IFNs-1a (Rebif) probably decreased the odds of the participants with RRMS having disability progression at two years' follow-up, with an absolute reduction of 14% and 10%, respectively, compared to placebo. Natalizumab and IFNs-1b (Betaseron) were significantly more effective (OR 0.62, 95% CI 0.49 to 0.78; OR 0.35, 95% CI 0.17 to 0.70, respectively) than IFNs-1a (Avonex) in reducing the number of the participants with RRMS who had progression at two years' follow-up, and confidence in this result was graded as moderate. From the network meta-analyses, mitoxantrone appeared to be the most effective agent in decreasing the odds of the participants with RRMS having progression at two years' follow-up, but our confidence was very low for direct comparison of mitoxantrone vs placebo. Both pairwise and network meta-analysis revealed that none of the individual agents included in this review were effective in preventing disability progression over two or three years in patients with progressive MS.There was not a dose-effect relationship for any of the included treatments with the exception of mitoxantrone. AUTHORS' CONCLUSIONS: Our review should provide some guidance to clinicians and patients. On the basis of high quality evidence, natalizumab and IFNs-1a (Rebif) are superior to all other treatments for preventing clinical relapses in RRMS in the short-term (24 months) compared to placebo. Moderate quality evidence supports a protective effect of natalizumab and IFNs-1a (Rebif) against disability progression in RRMS in the short-term compared to placebo. These treatments are associated with long-term serious adverse events and their benefit-risk balance might be unfavourable. IFNs-1b (Betaseron) and mitoxantrone probably decreased the odds of the participants with RRMS having relapses, compared with placebo (moderate quality of evidence). The benefit-risk balance with azathioprine is uncertain, however this agent might be effective in decreasing the odds of the participants with RRMS having relapses and disability progression over 24 to 36 months, compared with placebo. The lack of convincing efficacy data shows that IFNs-1a (Avonex), intravenous immunoglobulins, cyclophosphamide and long-term steroids have an unfavourable benefit-risk balance in RRMS. None of the included treatments are effective in decreasing disability progression in patients with progressive MS. It is important to consider that the clinical effects of all these treatments beyond two years are uncertain, a relevant point for a disease of 30 to 40 years duration. Direct head-to-head comparison(s) between natalizumab and IFNs-1a (Rebif) or between azathioprine and IFNs-1a (Rebif) should be top priority on the research agenda and follow-up of the trial cohorts should be mandatory.

173 citations

Journal ArticleDOI
TL;DR: This cross-sectional study compared endothelial function in young women with PCOS and regularly menstruating control women to identify the determinants of endothelium-dependent and -independent vascular function and investigate its relationship with body mass index in women withPCOS.
Abstract: Context: Women with polycystic ovary syndrome (PCOS) may be at increased risk for cardiovascular disease. Endothelial dysfunction is an early marker of atherosclerosis. Objectives: The objectives of this study were to 1) compare endothelial function in young women with PCOS and regularly menstruating control women, and 2) to identify the determinants of endothelial function and investigate its relationship with body mass index in women with PCOS. Design: This was a cross-sectional study. Setting: This study was conducted at a tertiary cardiovascular research center. Patients: Sixty-two young women with PCOS (mean age, 22.7 yr) and 17 control women, matched as a group for age and body mass index, were studied. Twenty-three women with PCOS were lean, 21 were overweight, and 18 were obese. Main Outcome Measures: Endothelium-dependent and -independent vascular function was assessed by measuring flow-mediated dilation (FMD) and nitrate-mediated dilation in the brachial artery (diameter change during hand hyper...

173 citations

Journal ArticleDOI
TL;DR: In patients undergoing PCI, GP IIb/IIIa receptor antagonists confer a significant and sustained decrease (20% to 30%) in the risk of death.

173 citations

Journal ArticleDOI
TL;DR: In this paper, the authors present a comprehensive investigation of the solar cycle dependence on the CME mass and energy over a full solar cycle (1996-2009) including the first in-depth discussion of the mass-and energy analysis methods and their associated errors.
Abstract: The LASCO coronagraphs, in continuous operation since 1995, have observed the evolution of the solar corona and coronal mass ejections (CMEs) over a full solar cycle with high quality images and regular cadence. This is the first time that such a dataset becomes available and constitutes a unique resource for the study of CMEs. In this paper, we present a comprehensive investigation of the solar cycle dependence on the CME mass and energy over a full solar cycle (1996-2009) including the first in-depth discussion of the mass and energy analysis methods and their associated errors. Our analysis provides several results worthy of further studies. It demonstrates the possible existence of two event classes; 'normal' CMEs reaching constant mass for $>10$ R$_{\sun}$ and 'pseudo' CMEs which disappear in the C3 FOV. It shows that the mass and energy properties of CME reach constant levels, and therefore should be measured, only above $\sim 10 R_\sun$. The mass density ($g/R_\sun^2$) of CMEs varies relatively little ($<$ order of magnitude) suggesting that the majority of the mass originates from a small range in coronal heights. We find a sudden reduction in the CME mass in mid-2003 which may be related to a change in the electron content of the large scale corona and we uncover the presence of a six-month periodicity in the ejected mass from 2003 onwards.

172 citations

Journal ArticleDOI
TL;DR: The CT60 polymorphism of CTLA-4 maps an important genetic determinant for the risk of both GD and HT across diverse populations.
Abstract: Context: Cytotoxic T-lymphocyte associated antigen 4 (CTLA-4) polymorphisms have been widely examined for their associations with autoimmune thyroid diseases [Graves’ disease (GD) and Hashimoto thyroiditis (HT)], but their relative population effect remains unclear. Objective: The aim was to generate large-scale evidence on whether the CTLA-4 polymorphisms (A49G and CT60) and haplotypes thereof increase the susceptibility to GD and/or HT. Design, Setting, and Participants: Meta-analyses of group-level data were reviewed from 32 (11,019 subjects) and 12 (4,479) published and unpublished studies for the association of the A49G polymorphism with GD and HT, respectively (PubMed and HuGeNet search until July 2006). There were 15 (n = 7246) and six (n = 3086) studies available for the CT60 polymorphism, respectively. Meta-analyses of individual-level data from 10 (4906 subjects) and five (2386) collaborating teams for GD and HT, respectively, were also reviewed. Main Outcome Measures: Association of gene varian...

172 citations


Authors

Showing all 7724 results

NameH-indexPapersCitations
John P. A. Ioannidis1851311193612
Kay-Tee Khaw1741389138782
Elio Riboli1581136110499
Mercouri G. Kanatzidis1521854113022
Dimitrios Trichopoulos13581884992
Gyorgy Vesztergombi133144494821
Niki Saoulidou132106581154
Apostolos Panagiotou132137088647
Ioannis Evangelou131122582178
Ioannis Papadopoulos129120185576
Nikolaos Manthos129125681865
Panagiotis Kokkas128123481051
Costas Foudas128111283048
Zoltan Szillasi128121484392
Matthias Schröder126142182990
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
202335
2022131
20211,222
20201,203
20191,125
20181,003