Environmental pollution

Loutradis Dimitris

1st Department of Obstetrics and Gynecology School of Medicine National and Kapodistrian University of Athens



Environmental pollution became a matter of significant concern during the last decades. Dietary consumption of natural and chemical pollutants is considered to be primarily regulated by drinking water. Recently, the United States Environmental Protection Agency performed more than 20 million tap water tests in 45 states and revealed that it may be contaminated by more than 200 unregulated chemicals. Nitrate is an important inorganic compound that is considered to be one of the most frequent groundwater pollutants in inhabited areas …


Natural Methods to Assist Delivery during the Second Stage of Labour: Part I: Positioning and the Role of Intrapartum Ultrasound

Maria Papamichail, Panos Antsaklis, Marianna Theodora, Michael Syndos, George Daskalakis, Dimitrios Loutradis



Labour has high importance for every woman’s life but also is the moment when many complications might appear increasing significantly morbidity and mortality. Therefore obstetricians have to help women in labour to give birth to their babies naturally, with the highest satisfaction possible. Western standards suggest that women should experience their partirution in the lithotomy or the supine position. However, upright positions have the potential to reduce second stage of labour and to improve neonatal outcomes …


Natural Methods to Assist Delivery during the Second Stage of Labour: Part II: Timing and Type of Pushing

Panos Antsaklis, Maria Papamichail, Marianna Theodora, Michael Syndos, George Daskalakis, Dimitris Loutradis



As women experience their partirution in health care facilities, they expect the best possible outcomes for them and their newborn, as interventions are supposed to be made accurately. Women in labour, are often directed to push as soon as the cervix reaches full dilation but this technique contradicts normal physiology. In contrast, when a woman is free to follow her instincts, by making spontaneous bearing down efforts, the time spending for pushing might be decreased and also urodynamic parameters after delivery are improved …


Nitrate levels in drinking water and their impact on the risk of developing gynecological diseases and adverse pregnancy outcomes

Vasilios Pergialiotis, Dimitrios Loutradis



Nitrate is a nitrogen oxoanion formed by loss of a proton from nitric acid. It is an important source of nitrogen which is essential for protein formation. Regular levels of nitrate in the environment do not exceed 2-5 mg/L. Fertilizers, herbicides and pesticides increase, however, the amount of nitrate in drinking water. In 2011 the World Health Organization (WHO) has issued a revised document on nitrate and nitrite levels in drinking water to help establish a common guideline that will help countries …


Minimal invasive procedures for the treatment of genitourinary syndrome of menopause (GSM). Un update

Dimitrios Zacharakis, Eleni Pitsouni, Themos Grigoriadis, Christos Kalantzis, Dimitrios Loutradis, Stavros Athanasiou



Genitourinary syndrome of menopause (GSM) is a new term for a condition more renowned as atrophic vaginitis. It is used to describe a variety of menopausal symptoms and signs that are related to the physical changes of the vulva, vagina and lower urinary tract. The etiology of GSM is secondary to decreased levels of endogenous estrogens and represents a common but underreported condition. In this update we present novel minimal invasive procedures that may benefit GSM …


Myo-inositol supplementation as a preventive consideration for gestational diabetes mellitus

George Asimakopoulos, Panagiotis Antsaklis, Mariana Theodora, Michael Sindos, Alexandros Rodolakis, Dimitrios Loutradis, George Daskalakis



Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance with onset or first recognition during pregnancy, which is characterized by increased insulin resistance. GDM affects about 10% of pregnancies and its prevalence is rising worldwide mainly due to the advancing maternal age and the increased prevalence of obesity. GDM is associated with pregnancy-related maternal and fetal morbidity (both antenatal and perinatal). Traditional treatments for the GDM include diet and, if it is necessary, insulin …

Case Report

Prenatal diagnosis of a large suprasellar arachnoid cyst

George Asimakopoulos, Panagiotis Antsaklis, Mariana Theodora, Michael Sindos, Alexandros Rodolakis, Dimitrios Loutradis, George Daskalakis


Arachnoid cysts represent 1% of all intracranial lesions and appear on the arachnoid membrane (subarachnoid space). The etiology and pathogenesis of arachnoid cysts remain unclear and in their majority they are asymptomatic. Due to the developmental origin of arachnoid cysts, these formations can be identified on prenatal fetal imaging. In this report we presented a case of an enlarged suprasellar arachnoid cyst detected incidentally during a routine fetal sonographic examination at 33 weeks of gestation …

Case Report

Nerve tissue into mastectomy scar. Its trap may lead to chronic pain?

Aris Giannos, Sofoklis Stavros, Ioannis Thanopoulos, Emmanouil Stamatakis, Konstantinos Dimitrakakis, Peter Drakakis, Dimitrios Loutradis



The purpose of the present article is to present a case of a 64-year old woman that underwent mastectomy and presented with severe pain and palpable nodes on the mastectomy scar 2 years following the operation. Excision of the mastectomy scar and histological evaluation revealed nerve branches that were in contact with the muscular tissue and that resided between the fibrous and adipose tissue. Following the second procedure the pain was alleviated …