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Papers by Athanasia Milioni

Research paper thumbnail of Varicella zoster virus meningitis with hypoglycorrhachia in the absence of rash in an immunocompetent woman

Journal of Neurovirology, 2009

We report varicella-zoster virus (VZV) meningitis in a healthy adult woman with no antecedent ras... more We report varicella-zoster virus (VZV) meningitis in a healthy adult woman with no antecedent rash and with hypoglycorrhachia. Cerebrospinal fluid (CSF) examination revealed the presence of VZV DNA, anti-VZV immunoglobulin G (IgG) antibody, and intrathecal production of anti-VZV IgG antibody.

Research paper thumbnail of Differentiating Rhinitis in the Paediatric Population by Giving Focus on Medical History and Clinical Examination

Medical Sciences

Chronic rhinitis is defined as an inflammation of the nasal epithelium, and is characterized by t... more Chronic rhinitis is defined as an inflammation of the nasal epithelium, and is characterized by the presence of two or more specific nasal symptoms including obstruction, rhinorrhea, sneezing, and/or itching for at least 12 weeks. In childhood, this clinical entity is very common and carries a significant socioeconomic burden. The impact on the physical, social, and psychological well-being of family cannot be underestimated. Rhinitis is an umbrella term which includes different phenotypes of rhinitis with distinct underlying pathophysiologic mechanisms. In most cases the diagnosis of rhinitis is rather straightforward; however, sometimes when based on clinical symptomatology, characterization may be challenging. Herein, we provide guidance for getting all the data needed for the differential diagnosis of rhinitis based on medical history and clinical examination.

Research paper thumbnail of The impact of seasonal influenza vaccination uptake on COVID-19 vaccination attitudes in a rural area in Greece

Research paper thumbnail of Assessing quality of life and burden of disease in chronic rhinosinusitis: a review

Rhinology Online, 2019

Background: Chronic rhinosinusitis has been shown to have a significant impact on patients' quali... more Background: Chronic rhinosinusitis has been shown to have a significant impact on patients' quality of life (QoL). We present and summarize current knowledge on assessment methods of Chronic Rhinosinusitis (CRS) burden and QoL. Methodology: Review of the literature using the PubMed database (search of terms "chronic rhinosinusitis", "CRS", "quality of life", "QoL", "outcome measures", "assessment of CRS", "CRS burden" separately or combined) limited to articles published in the English language. Results: Despite the plethora of objective methods available to assess and quantify burden of CRS, discrepancies are occasionally encountered when correlation with subjective measures of QoL is attempted via numerous patient self-reporting tools. Conclusion: CRS has a detrimental effect on QoL and assessing disease severity and burden is a difficult goal. The applicability of known assessment methodologies should be re-evaluated and validated according to research findings on CRS pathophysiology, and new tools should be developed based on the emerging knowledge and the need for personalized treatment and evaluation methods.

Research paper thumbnail of Prevalence and impact of nasal hyperreactivity in chronic rhinosinusitis

Allergy, 2020

Although bronchial hyperreactivity was first reported in 1859, it was only in 1960s that nasal hy... more Although bronchial hyperreactivity was first reported in 1859, it was only in 1960s that nasal hyperreactivity (NHR) emerged as a field of interest in medicine (1). NHR is defined as an overall hyperresponsiveness of the nasal mucosa to non-specific daily physical and/or chemical stimuli such as humidity, temperature changes, exercise, cigarette smoke, and perfumes (2). There is evidence for NHR being present in allergic (AR) and non-allergic rhinitis (non-AR) (3). The prevalence and pathophysiology of NHR in chronic rhinosinusitis (CRS), however, remains uncertain. CRS is a multifactorial disorder with different underlying pathophysiologic mechanisms contributing to disease development. Up to 20% of patients with CRS fail to achieve disease control, even after guideline-based treatment (4,5). Given that CRS and NHR may give rise to similar nasal symptoms, the presence of NHR in CRS has not yet been documented. The aim of this study was to investigate the prevalence of self-reported NHR in patients with CRS with/without nasal polyps (CRRwNP and CRSsNP) and to determine the most common triggers.

Research paper thumbnail of Microscopic polyangiitis after streptococcal pharyngitis in a young woman

Postgraduate Medical Journal, 2018

Research paper thumbnail of Contemporary Use of Corticosteroids in Rhinology

Current allergy and asthma reports, 2017

Exogenously administered corticosteroids are widely used today in the field of rhinology. Allergi... more Exogenously administered corticosteroids are widely used today in the field of rhinology. Allergic rhinitis (AR), non-allergic rhinitis (NAR), acute rhinosinusitis (ARS), chronic rhinosinusitis with (CRSwNP) and without (CRSsNP) nasal polyps, and autoimmune disorders with nasal manifestations are common diseases treated effectively with intranasal and oral glucocorticoids. We focus on physiological pathways, therapeutic benefits, indications, contra-indications, and side effects of glucocorticoid utilization in the treatment of rhinologic disorders such as AR, NAR, ARS, CRSsNP, and CRSwNP. Second-generation intranasal steroid (INS) agents have pharmacokinetic characteristics that minimize their systemic bioavailability, resulting in minimum risk for systemic adverse events. Several studies have demonstrated the symptomatic efficacy of both intranasal and oral corticosteroids in ARS. Moreover, intranasal and systemic steroid administration has been repeatedly proven beneficial in the...

Research paper thumbnail of Varicella zoster virus meningitis with hypoglycorrhachia in the absence of rash in an immunocompetent woman

Journal of Neurovirology, 2009

We report varicella-zoster virus (VZV) meningitis in a healthy adult woman with no antecedent ras... more We report varicella-zoster virus (VZV) meningitis in a healthy adult woman with no antecedent rash and with hypoglycorrhachia. Cerebrospinal fluid (CSF) examination revealed the presence of VZV DNA, anti-VZV immunoglobulin G (IgG) antibody, and intrathecal production of anti-VZV IgG antibody.

Research paper thumbnail of Differentiating Rhinitis in the Paediatric Population by Giving Focus on Medical History and Clinical Examination

Medical Sciences

Chronic rhinitis is defined as an inflammation of the nasal epithelium, and is characterized by t... more Chronic rhinitis is defined as an inflammation of the nasal epithelium, and is characterized by the presence of two or more specific nasal symptoms including obstruction, rhinorrhea, sneezing, and/or itching for at least 12 weeks. In childhood, this clinical entity is very common and carries a significant socioeconomic burden. The impact on the physical, social, and psychological well-being of family cannot be underestimated. Rhinitis is an umbrella term which includes different phenotypes of rhinitis with distinct underlying pathophysiologic mechanisms. In most cases the diagnosis of rhinitis is rather straightforward; however, sometimes when based on clinical symptomatology, characterization may be challenging. Herein, we provide guidance for getting all the data needed for the differential diagnosis of rhinitis based on medical history and clinical examination.

Research paper thumbnail of The impact of seasonal influenza vaccination uptake on COVID-19 vaccination attitudes in a rural area in Greece

Research paper thumbnail of Assessing quality of life and burden of disease in chronic rhinosinusitis: a review

Rhinology Online, 2019

Background: Chronic rhinosinusitis has been shown to have a significant impact on patients' quali... more Background: Chronic rhinosinusitis has been shown to have a significant impact on patients' quality of life (QoL). We present and summarize current knowledge on assessment methods of Chronic Rhinosinusitis (CRS) burden and QoL. Methodology: Review of the literature using the PubMed database (search of terms "chronic rhinosinusitis", "CRS", "quality of life", "QoL", "outcome measures", "assessment of CRS", "CRS burden" separately or combined) limited to articles published in the English language. Results: Despite the plethora of objective methods available to assess and quantify burden of CRS, discrepancies are occasionally encountered when correlation with subjective measures of QoL is attempted via numerous patient self-reporting tools. Conclusion: CRS has a detrimental effect on QoL and assessing disease severity and burden is a difficult goal. The applicability of known assessment methodologies should be re-evaluated and validated according to research findings on CRS pathophysiology, and new tools should be developed based on the emerging knowledge and the need for personalized treatment and evaluation methods.

Research paper thumbnail of Prevalence and impact of nasal hyperreactivity in chronic rhinosinusitis

Allergy, 2020

Although bronchial hyperreactivity was first reported in 1859, it was only in 1960s that nasal hy... more Although bronchial hyperreactivity was first reported in 1859, it was only in 1960s that nasal hyperreactivity (NHR) emerged as a field of interest in medicine (1). NHR is defined as an overall hyperresponsiveness of the nasal mucosa to non-specific daily physical and/or chemical stimuli such as humidity, temperature changes, exercise, cigarette smoke, and perfumes (2). There is evidence for NHR being present in allergic (AR) and non-allergic rhinitis (non-AR) (3). The prevalence and pathophysiology of NHR in chronic rhinosinusitis (CRS), however, remains uncertain. CRS is a multifactorial disorder with different underlying pathophysiologic mechanisms contributing to disease development. Up to 20% of patients with CRS fail to achieve disease control, even after guideline-based treatment (4,5). Given that CRS and NHR may give rise to similar nasal symptoms, the presence of NHR in CRS has not yet been documented. The aim of this study was to investigate the prevalence of self-reported NHR in patients with CRS with/without nasal polyps (CRRwNP and CRSsNP) and to determine the most common triggers.

Research paper thumbnail of Microscopic polyangiitis after streptococcal pharyngitis in a young woman

Postgraduate Medical Journal, 2018

Research paper thumbnail of Contemporary Use of Corticosteroids in Rhinology

Current allergy and asthma reports, 2017

Exogenously administered corticosteroids are widely used today in the field of rhinology. Allergi... more Exogenously administered corticosteroids are widely used today in the field of rhinology. Allergic rhinitis (AR), non-allergic rhinitis (NAR), acute rhinosinusitis (ARS), chronic rhinosinusitis with (CRSwNP) and without (CRSsNP) nasal polyps, and autoimmune disorders with nasal manifestations are common diseases treated effectively with intranasal and oral glucocorticoids. We focus on physiological pathways, therapeutic benefits, indications, contra-indications, and side effects of glucocorticoid utilization in the treatment of rhinologic disorders such as AR, NAR, ARS, CRSsNP, and CRSwNP. Second-generation intranasal steroid (INS) agents have pharmacokinetic characteristics that minimize their systemic bioavailability, resulting in minimum risk for systemic adverse events. Several studies have demonstrated the symptomatic efficacy of both intranasal and oral corticosteroids in ARS. Moreover, intranasal and systemic steroid administration has been repeatedly proven beneficial in the...