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Nikolaidis I, Karakasi MV, Pilalas D, Boziki MK, Tsachouridou O, Kourelis A, Skoura L, Pavlidis P, Gargalianos-Kakoliris P, Metallidis S, Daniilidis M, Trypsiannis G, Nikolaidis P. Association of cytokine gene polymorphisms with peripheral neuropathy susceptibility in people living with HIV in Greece. J Neurovirol 2023; 29:626-639. [PMID: 37695541 DOI: 10.1007/s13365-023-01169-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 08/02/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
Relatively little research has been done in recent years to understand what leads to the unceasingly high rates of HIV sensory neuropathy despite successful antiretroviral treatment. In vivo and in vitro studies demonstrate neuronal damage induced by HIV and increasingly identified ART neurotoxicity involving mitochondrial dysfunction and innate immune system activation in peripheral nerves, ultimately all pathways resulting in enhanced pro-inflammatory cytokine secretion. Furthermore, many infectious/autoimmune/malignant diseases are influenced by the production-profile of pro-inflammatory and anti-inflammatory cytokines, due to inter-individual allelic polymorphism within cytokine gene regulatory regions. Associations of cytokine gene polymorphisms are investigated with the aim of identifying potential genetic markers for susceptibility to HIV peripheral neuropathy including ART-dependent toxic neuropathy. One hundred seventy-one people living with HIV in Northern Greece, divided into two sub-groups according to the presence/absence of peripheral neuropathy, were studied over a 5-year period. Diagnosis was based on the Brief Peripheral Neuropathy Screening. Cytokine genotyping was performed by sequence-specific primer-polymerase chain reaction. Present study findings identify age as an important risk factor (p < 0.01) and support the idea that cytokine gene polymorphisms are at least involved in HIV peripheral-neuropathy pathogenesis. Specifically, carriers of IL1a-889/rs1800587 TT genotype and IL4-1098/rs2243250 GG genotype disclosed greater relative risk for developing HIV peripheral neuropathy (OR: 2.9 and 7.7 respectively), while conversely, carriers of IL2+166/rs2069763 TT genotype yielded lower probability (OR: 3.1), all however, with marginal statistical significance. The latter, if confirmed in a larger Greek population cohort, may offer in the future novel genetic markers to identify susceptibility, while it remains significant that further ethnicity-oriented studies continue to be conducted in a similar pursuit.
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Affiliation(s)
- Ioannis Nikolaidis
- Second Department of Neurology, AHEPA University General Hospital - Department of neurosciences, Aristotle University - School of Medicine, GR 54124, Thessaloniki, Greece.
| | - Maria-Valeria Karakasi
- Third Department of Psychiatry, AHEPA University General Hospital - Department of mental health, Aristotle University - School of Medicine, GR 54124, Thessaloniki, Greece
| | - Dimitrios Pilalas
- First Department of Internal Medicine, AHEPA University General Hospital, Aristotle University - School of Medicine, GR 54124, Thessaloniki, Greece
| | - Marina-Kleopatra Boziki
- Second Department of Neurology, AHEPA University General Hospital - Department of neurosciences, Aristotle University - School of Medicine, GR 54124, Thessaloniki, Greece
| | - Olga Tsachouridou
- First Department of Internal Medicine, AHEPA University General Hospital, Aristotle University - School of Medicine, GR 54124, Thessaloniki, Greece
| | - Andreas Kourelis
- Laboratory of Immunology, Department of Microbiology, Aristotle University - School of Medicine, GR 54124, Thessaloniki, Greece
| | - Lemonia Skoura
- Laboratory of Immunology, Department of Microbiology, Aristotle University - School of Medicine, GR 54124, Thessaloniki, Greece
| | - Pavlos Pavlidis
- Laboratory of Forensic Sciences, Democritus University of Thrace - School of Medicine, GR 68100, Dragana, Alexandroupolis, Greece
| | | | - Symeon Metallidis
- First Department of Internal Medicine, AHEPA University General Hospital, Aristotle University - School of Medicine, GR 54124, Thessaloniki, Greece
| | - Michail Daniilidis
- First Department of Internal Medicine, AHEPA University General Hospital, Aristotle University - School of Medicine, GR 54124, Thessaloniki, Greece
| | - Grigorios Trypsiannis
- Laboratory of Medical Statistics, Democritus University of Thrace - School of Medicine, GR 68100, Dragana, Alexandroupolis, Greece
| | - Pavlos Nikolaidis
- First Department of Internal Medicine, AHEPA University General Hospital, Aristotle University - School of Medicine, GR 54124, Thessaloniki, Greece
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Tsachouridou O, Pilalas D, Nanoudis S, Antoniou A, Bakaimi I, Chrysanthidis T, Markakis K, Kassomenaki A, Mantzana P, Protonotariou E, Skoura L, Metallidis S. Mortality due to Multidrug-Resistant Gram-Negative Bacteremia in an Endemic Region: No Better than a Toss of a Coin. Microorganisms 2023; 11:1711. [PMID: 37512883 PMCID: PMC10383448 DOI: 10.3390/microorganisms11071711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/07/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
The incidence of multidrug-resistant (MDR) bloodstream infections (BSIs) is associated with high morbidity and mortality. Little evidence exists regarding the epidemiology of BSIs and the use of appropriate empirical antimicrobial therapy in endemic regions. Novel diagnostic tests (RDTs) may facilitate and improve patient management. Data were assessed from patients with MDR Gram-negative bacteremia at a university tertiary hospital over a 12-month period. In total, 157 episodes of MDR Gram-negative BSI were included in the study. The overall mortality rate was 50.3%. Rapid molecular diagnostic tests were used in 94% of BSI episodes. In univariate analysis, age (OR 1.05 (95% CI 1.03, 1.08) p < 0.001), Charlson Comorbidity Index (OR 1.51 (95% CI 1.25, 1.83) p < 0.001), procalcitonin ≥ 1(OR 3.67 (CI 95% 1.73, 7.79) p < 0.001), and monotherapy with tigecycline (OR 3.64 (95% CI 1.13, 11.73) p = 0.030) were the only factors associated with increased overall mortality. Surprisingly, time to appropriate antimicrobial treatment had no impact on mortality. MDR pathogen isolation, other than Klebsiella pneumoniae and Acinetobacter baumanii, was associated with decreased mortality (OR 0.35 (95% CI 0.16, 0.79) p = 0.011). In multivariate analysis, the only significant factor for mortality was procalcitonin ≥ 1 (OR 2.84 (95% CI 1.13, 7.11) p = 0.025). In conclusion, in an endemic area, mortality rates in MDR BSI remain notable. High procalcitonin was the only variable that predicted death. The use of rapid diagnostics did not improve mortality rate.
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Affiliation(s)
- Olga Tsachouridou
- Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Dimitrios Pilalas
- Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Sideris Nanoudis
- Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Athanasios Antoniou
- Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Isidora Bakaimi
- Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Theofilos Chrysanthidis
- Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Konstantinos Markakis
- Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Angeliki Kassomenaki
- Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Paraskevi Mantzana
- Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Efthymia Protonotariou
- Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Lemonia Skoura
- Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
| | - Symeon Metallidis
- Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
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Kostaki EG, Limnaios S, Adamis G, Xylomenos G, Chini M, Mangafas N, Lazanas M, Patrinos S, Metallidis S, Tsachouridou O, Papastamopoulos V, Chatzidimitriou D, Antoniadou A, Papadopoulos A, Protopapas K, Tsiara C, Psichogiou M, Basoulis D, Pilalas D, Paraskeva D, Chrysos G, Paparizos V, Kourkounti S, Sambatakou H, Bolanos V, Sipsas NV, Lada M, Barbounakis E, Kantzilaki E, Panagopoulos P, Petrakis V, Drimis S, Katsarolis I, Lagiou P, Hatzakis A, Magiorkinis G, Skoura L, Paraskevis D. Estimation of the determinants for HIV late presentation using the traditional definition and molecular clock-inferred dates: Evidence that older age, heterosexual risk group and more recent diagnosis are prognostic factors. HIV Med 2022; 23:1143-1152. [PMID: 36258653 PMCID: PMC10092532 DOI: 10.1111/hiv.13415] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/15/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES HIV late presentation (LP) has been increasing in recent years in Europe. Our aim was to investigate the characteristics of LP in Greece using in addition to the traditional definition for LP, the time interval between HIV infection and diagnosis. METHODS Our nationwide sample included HIV-1 sequences generated from 6166 people living with HIV (PLWH) in Greece during the period 1999-2015. Our analysis was based on the molecularly inferred HIV-1 infection dates for PLWH infected within local molecular transmission clusters of subtypes A1 and B. RESULTS Analysis of the determinants of LP was conducted using either CD4 counts or AIDS-defining condition at diagnosis or the time from infection to diagnosis. Older age, heterosexual transmission risk group and more recent diagnosis were associated with increased risk for LP. In contrast to previous studies, people who inject drugs (PWID) had a shorter median time to diagnosis (0.63 years) compared to men who have sex with men (MSM) (1.72 years) and heterosexuals (2.43 years). Using HIV infection dates that provide an unbiased marker for LP compared to CD4 counts at diagnosis, which are age-dependent, we estimated that the time to diagnosis increased gradually with age. Migrants infected regionally do not differ with respect to LP status compared to native Greeks. CONCLUSIONS We demonstrate that older people and heterosexuals are among those at higher risk for LP; and given the growing number of older people among newly diagnosed cases, tailored interventions are needed in these populations.
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Affiliation(s)
- Evangelia Georgia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stefanos Limnaios
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Adamis
- 1st Department of Internal Medicine, G. Gennimatas General Hospital, Athens, Greece
| | - Georgios Xylomenos
- 1st Department of Internal Medicine, G. Gennimatas General Hospital, Athens, Greece
| | - Maria Chini
- 3rd Department of Internal Medicine-Infectious Diseases Unit, "Korgialeneio-Benakeio" Red Cross General Hospital, Athens, Greece
| | - Nikos Mangafas
- 3rd Department of Internal Medicine-Infectious Diseases Unit, "Korgialeneio-Benakeio" Red Cross General Hospital, Athens, Greece
| | - Marios Lazanas
- 3rd Department of Internal Medicine-Infectious Diseases Unit, "Korgialeneio-Benakeio" Red Cross General Hospital, Athens, Greece
| | | | - Simeon Metallidis
- 1st Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Olga Tsachouridou
- 1st Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Papastamopoulos
- 5th Department of Internal Medicine and Infectious Diseases, Evaggelismos General Hospital, Athens, Greece
| | - Dimitrios Chatzidimitriou
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Antoniadou
- 4th Department of Medicine, Attikon General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonios Papadopoulos
- 4th Department of Medicine, Attikon General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Protopapas
- 4th Department of Medicine, Attikon General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Mina Psichogiou
- 1st Department of Medicine, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Basoulis
- 1st Department of Medicine, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Pilalas
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Paraskeva
- Department of Internal Medicine, Tzaneio General Hospital, Piraeus, Greece
| | - Georgios Chrysos
- Department of Internal Medicine, Tzaneio General Hospital, Piraeus, Greece
| | - Vasileios Paparizos
- HIV/AIDS Unit, A. Syngros Hospital of Dermatology and Venereology, Athens, Greece
| | - Sofia Kourkounti
- HIV/AIDS Unit, A. Syngros Hospital of Dermatology and Venereology, Athens, Greece
| | - Helen Sambatakou
- HIV Unit, 2nd Department of Internal Medicine, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasileios Bolanos
- HIV Unit, 2nd Department of Internal Medicine, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos V Sipsas
- Department of Pathophysiology, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Malvina Lada
- 2nd Department of Internal Medicine, Sismanogleion General Hospital, Athens, Greece
| | - Emmanouil Barbounakis
- Department of Internal Medicine, University Hospital of Heraklion "PAGNI", Medical School, University of Crete, Heraklion, Greece
| | - Evrikleia Kantzilaki
- Department of Internal Medicine, University Hospital of Heraklion "PAGNI", Medical School, University of Crete, Heraklion, Greece
| | - Periklis Panagopoulos
- Department of Internal Medicine, University General Hospital, Democritus University of Thrace, Alexandroupolis, Greece
| | - Vasilis Petrakis
- Department of Internal Medicine, University General Hospital, Democritus University of Thrace, Alexandroupolis, Greece
| | - Stelios Drimis
- Department of Internal Medicine, Tzaneio General Hospital, Piraeus, Greece
| | | | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Lemonia Skoura
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Nikolaidis I, Karakasi MV, Bakirtzis C, Skoura L, Pilalas D, Boziki MK, Tsachouridou O, Voultsos P, Nikolaidis P, Gargalianos-Kakoliris P, Daniilidis M, Grigoriadis N, Metallidis S, Taskos N. Epidemiology of HIV-associated peripheral neuropathy in people living with human immunodeficiency virus infection in Greece. Int J STD AIDS 2022; 33:978-986. [PMID: 35975977 DOI: 10.1177/09564624221119305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Peripheral neuropathy is among the most common complications among people with HIV with prevalence rates varying widely among studies (10-58%). OBJECTIVE This study aims to assess the prevalence of HIV-associated peripheral neuropathy among HIV-positive people in Northern Greece monitored during the last 5-year period and investigate possible correlations with antiretroviral therapy, disease staging, and potential risk factors, as there is no prior epidemiological record in Greek patients. METHODS Four hundred twenty patients were divided into a group with peripheral neuropathy (n = 269), and those without (n = 151). Peripheral neuropathy was assessed with a validated Peripheral Neuropathy Screening tool. Statistical analyses were performed with SPSS, were two-tailed, and p-value was set at 0.05. RESULTS The incidence of peripheral neuropathy was estimated at 35.9%. Age was found to correlate with higher odds of developing HIV-peripheral neuropathy, rising by 4%/year. Females encountered 77% higher probability to develop peripheral neuropathy. Stage 3 of the disease associated with higher occurrence of peripheral neuropathy (96% as compared to stage-1 patients). Among patients with peripheral neuropathy, the duration of antiretroviral therapy was found to be longer than in those without. CONCLUSIONS Peripheral neuropathy remains one of the most common complications regardless of the antiretroviral-therapy type, indicating the involvement of other risk factors in its occurrence, such as the stage of the disease, age and gender. Therefore, the treating physician should screen patients as early and frequently as possible upon HIV-diagnosis to prevent the progression of this debilitating condition so that prolonged life-expectancy is accompanied by a good quality of life.
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Affiliation(s)
- Ioannis Nikolaidis
- Second Department of Neurology, AHEPA University General Hospital--Department of Neurosciences, Aristotle University--School of Medicine, Thessaloniki, Greece
| | - Maria-Valeria Karakasi
- Third Department of Psychiatry, AHEPA University General Hospital-Department of Mental Health, Aristotle University--School of Medicine, Thessaloniki, Greece
| | - Christos Bakirtzis
- Second Department of Neurology, AHEPA University General Hospital--Department of Neurosciences, Aristotle University--School of Medicine, Thessaloniki, Greece
| | - Lemonia Skoura
- First Department of Internal Medicine, AHEPA University General Hospital--Aristotle University--School of Medicine, Thessaloniki, Greece
| | - Dimitrios Pilalas
- First Department of Internal Medicine, AHEPA University General Hospital--Aristotle University--School of Medicine, Thessaloniki, Greece
| | - Marina-Kleopatra Boziki
- Second Department of Neurology, AHEPA University General Hospital--Department of Neurosciences, Aristotle University--School of Medicine, Thessaloniki, Greece
| | - Olga Tsachouridou
- First Department of Internal Medicine, AHEPA University General Hospital--Aristotle University--School of Medicine, Thessaloniki, Greece
| | - Polychronis Voultsos
- Bioethics, Department of Forensic Medicine and Toxicology, Aristotle University--Faculty of Medicine, Thessaloniki, Greece
| | - Pavlos Nikolaidis
- First Department of Internal Medicine, AHEPA University General Hospital--Aristotle University--School of Medicine, Thessaloniki, Greece
| | | | - Michail Daniilidis
- First Department of Internal Medicine, AHEPA University General Hospital--Aristotle University--School of Medicine, Thessaloniki, Greece
| | - Nikolaos Grigoriadis
- Second Department of Neurology, AHEPA University General Hospital--Department of Neurosciences, Aristotle University--School of Medicine, Thessaloniki, Greece
| | - Symeon Metallidis
- First Department of Internal Medicine, AHEPA University General Hospital--Aristotle University--School of Medicine, Thessaloniki, Greece
| | - Nikolaos Taskos
- Second Department of Neurology, AHEPA University General Hospital--Department of Neurosciences, Aristotle University--School of Medicine, Thessaloniki, Greece
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Daios S, Anogeianaki A, Kaiafa G, Kontana A, Veneti S, Gogou C, Karlafti E, Pilalas D, Kanellos I, Savopoulos C. Telomere Length as a marker of biological aging: A critical review of recent literature. Curr Med Chem 2022; 29:5478-5495. [PMID: 35838223 DOI: 10.2174/0929867329666220713123750] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/10/2022] [Accepted: 04/01/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Aging is characterized as a syndrome of deleterious, progressive, universal, and irreversible function changes affecting every structural and functional aspect of the organism and accompanied by a generalized increase in mortality. Although a substantial number of candidates for biomarkers of aging have been proposed, none has been validated or universally accepted. Human telomeres constitute hexameric repetitive DNA sequence nucleoprotein complexes that cap chromosome ends, regulating gene expression and modulating stress-related pathways. Telomere length (TL) shortening is observed both in cellular senescence and advanced age, leading to the investigation of TL as a biomarker for aging and a risk factor indicator for the development and progression of the most common age-related diseases. OBJECTIVE The present review underlines the connection between TL and the pathophysiology of the diseases associated with telomere attrition. METHODS We performed a structured search of the PubMed database for peer-reviewed research of the literature regarding leukocyte TL and cardiovascular diseases (CVD), more specifically stroke and heart disease, and focused on the relevant articles published during the last 5 years. We also applied Hill's criteria of causation to strengthen this association. RESULTS We analyzed the recent literature regarding TL length, stroke, and CVD. Although approximately one-third of the available studies support the connection, the results of different studies seem to be rather conflicting as a result of different study designs, divergent methods of TL determination, small study samples, and patient population heterogeneity. After applying Hill's criteria, we can observe that the literature conforms to them weakly, with chronology being the only Hill criterion of causality that probably cannot be contested. CONCLUSION The present review attempted to examine the purported relation between leukocyte TL and age-related diseases such as CVD and more specific stroke and heart disease in view of the best established, comprehensive, medical and epidemiological criteria that have characterized the focused recent relevant research. Although several recommendations have been made that may contribute significantly to the field, a call for novel technical approaches and studies is mandatory to further elucidate the possible association.
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Affiliation(s)
- Stylianos Daios
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Antonia Anogeianaki
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Georgia Kaiafa
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Anastasia Kontana
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Stavroula Veneti
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Christiana Gogou
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Eleni Karlafti
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Ilias Kanellos
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
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Pilalas D, Daios S, Kachrimanidou M, Kaiafa G, Avgeri S, Ztriva E, Kontana A, Keramari S, Karlafti E, Kanellos I, Savopoulos C. Diabetic Patient Adherence to Yearly Influenza Vaccination in Northern Greece. Cureus 2022; 14:e22250. [PMID: 35340457 PMCID: PMC8930191 DOI: 10.7759/cureus.22250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/07/2022] Open
Abstract
Background Influenza virus infection is associated with increased morbidity and mortality in patients with diabetes mellitus. Public health authorities recommend yearly vaccination of diabetic patients against seasonal influenza. Methods We surveyed to define the adherence to influenza vaccination and associated factors among diabetic patients in Thessaloniki, Greece. Predictors of adherence to yearly influenza vaccination were assessed with logistic regression models. Results A total of 206 patients were enrolled, with 47.1% reporting yearly vaccination against influenza (95% confidence interval, CI:40.3% to 53.9%). In univariate models, the absence of additional indications for vaccination was associated with a decreased likelihood of vaccination uptake (OR:0.29, 95% CI:0.11 to 0.68, p=0.007); older diabetic patients were more likely to receive influenza vaccination (34% increase per 10 years of age). These associations were attenuated in multivariable analysis. Conclusion Our study demonstrates a significant gap in influenza vaccination coverage rate in diabetic patients. Our data could be extrapolated to enhance the uptake of vaccines against SARS-CoV-2: emphasis should be placed on patient education.
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7
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Limnaios S, Kostaki EG, Adamis G, Astriti M, Chini M, Mangafas N, Lazanas M, Patrinos S, Metallidis S, Tsachouridou O, Papastamopoulos V, Kakalou E, Chatzidimitriou D, Antoniadou A, Papadopoulos A, Psichogiou M, Basoulis D, Gova M, Pilalas D, Paraskeva D, Chrysos G, Paparizos V, Kourkounti S, Sambatakou H, Bolanos V, Sipsas NV, Lada M, Barbounakis E, Kantzilaki E, Panagopoulos P, Maltezos E, Drimis S, Sypsa V, Lagiou P, Magiorkinis G, Hatzakis A, Skoura L, Paraskevis D. Dating the Origin and Estimating the Transmission Rates of the Major HIV-1 Clusters in Greece: Evidence about the Earliest Subtype A1 Epidemic in Europe. Viruses 2022; 14:v14010101. [PMID: 35062305 PMCID: PMC8782043 DOI: 10.3390/v14010101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/20/2021] [Accepted: 12/30/2021] [Indexed: 12/16/2022] Open
Abstract
Our aim was to estimate the date of the origin and the transmission rates of the major local clusters of subtypes A1 and B in Greece. Phylodynamic analyses were conducted in 14 subtype A1 and 31 subtype B clusters. The earliest dates of origin for subtypes A1 and B were in 1982.6 and in 1985.5, respectively. The transmission rate for the subtype A1 clusters ranged between 7.54 and 39.61 infections/100 person years (IQR: 9.39, 15.88), and for subtype B clusters between 4.42 and 36.44 infections/100 person years (IQR: 7.38, 15.04). Statistical analysis revealed that the average difference in the transmission rate between the PWID and the MSM clusters was 6.73 (95% CI: 0.86 to 12.60; p = 0.026). Our study provides evidence that the date of introduction of subtype A1 in Greece was the earliest in Europe. Transmission rates were significantly higher for PWID than MSM clusters due to the conditions that gave rise to an extensive PWID HIV-1 outbreak ten years ago in Athens, Greece. Transmission rate can be considered as a valuable measure for public health since it provides a proxy of the rate of epidemic growth within a cluster and, therefore, it can be useful for targeted HIV prevention programs.
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Affiliation(s)
- Stefanos Limnaios
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.L.); (E.G.K.); (M.G.); (V.S.); (P.L.); (G.M.); (A.H.)
| | - Evangelia Georgia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.L.); (E.G.K.); (M.G.); (V.S.); (P.L.); (G.M.); (A.H.)
| | - Georgios Adamis
- 1st Department of Internal Medicine, G. Gennimatas General Hospital, 11527 Athens, Greece; (G.A.); (M.A.)
| | - Myrto Astriti
- 1st Department of Internal Medicine, G. Gennimatas General Hospital, 11527 Athens, Greece; (G.A.); (M.A.)
| | - Maria Chini
- 3rd Department of Internal Medicine-Infectious Diseases Unit, “Korgialeneio-Benakeio” Red Cross General Hospital, 11526 Athens, Greece; (M.C.); (N.M.); (M.L.)
| | - Nikos Mangafas
- 3rd Department of Internal Medicine-Infectious Diseases Unit, “Korgialeneio-Benakeio” Red Cross General Hospital, 11526 Athens, Greece; (M.C.); (N.M.); (M.L.)
| | - Marios Lazanas
- 3rd Department of Internal Medicine-Infectious Diseases Unit, “Korgialeneio-Benakeio” Red Cross General Hospital, 11526 Athens, Greece; (M.C.); (N.M.); (M.L.)
| | | | - Simeon Metallidis
- 1st Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (S.M.); (O.T.)
| | - Olga Tsachouridou
- 1st Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (S.M.); (O.T.)
| | - Vasileios Papastamopoulos
- 5th Department of Internal Medicine and Infectious Diseases, Evaggelismos General Hospital, 10676 Athens, Greece; (V.P.); (E.K.)
| | - Eleni Kakalou
- 5th Department of Internal Medicine and Infectious Diseases, Evaggelismos General Hospital, 10676 Athens, Greece; (V.P.); (E.K.)
| | - Dimitrios Chatzidimitriou
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.C.); (L.S.)
| | - Anastasia Antoniadou
- 4th Department of Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (A.A.); (A.P.)
| | - Antonios Papadopoulos
- 4th Department of Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (A.A.); (A.P.)
| | - Mina Psichogiou
- 1st Department of Medicine, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.P.); (D.B.)
| | - Dimitrios Basoulis
- 1st Department of Medicine, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.P.); (D.B.)
| | - Maria Gova
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.L.); (E.G.K.); (M.G.); (V.S.); (P.L.); (G.M.); (A.H.)
| | - Dimitrios Pilalas
- Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Dimitra Paraskeva
- Department of Internal Medicine, Tzaneio General Hospital, 18536 Piraeus, Greece; (D.P.); (G.C.); (S.D.)
| | - Georgios Chrysos
- Department of Internal Medicine, Tzaneio General Hospital, 18536 Piraeus, Greece; (D.P.); (G.C.); (S.D.)
| | - Vasileios Paparizos
- HIV/AIDS Unit, A. Syngros Hospital of Dermatology and Venereology, 16121 Athens, Greece; (V.P.); (S.K.)
| | - Sofia Kourkounti
- HIV/AIDS Unit, A. Syngros Hospital of Dermatology and Venereology, 16121 Athens, Greece; (V.P.); (S.K.)
| | - Helen Sambatakou
- HIV Unit, 2nd Department of Internal Medicine, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (H.S.); (V.B.)
| | - Vasileios Bolanos
- HIV Unit, 2nd Department of Internal Medicine, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (H.S.); (V.B.)
| | - Nikolaos V. Sipsas
- Department of Pathophysiology, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Malvina Lada
- 2nd Department of Internal Medicine, Sismanogleion General Hospital, 15126 Marousi, Greece;
| | - Emmanouil Barbounakis
- Department of Internal Medicine, University Hospital of Heraklion “PAGNI”, Medical School, University of Crete, 71110 Heraklion, Greece; (E.B.); (E.K.)
| | - Evrikleia Kantzilaki
- Department of Internal Medicine, University Hospital of Heraklion “PAGNI”, Medical School, University of Crete, 71110 Heraklion, Greece; (E.B.); (E.K.)
| | - Periklis Panagopoulos
- Department of Internal Medicine, University General Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (P.P.); (E.M.)
| | - Efstratios Maltezos
- Department of Internal Medicine, University General Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (P.P.); (E.M.)
| | - Stelios Drimis
- Department of Internal Medicine, Tzaneio General Hospital, 18536 Piraeus, Greece; (D.P.); (G.C.); (S.D.)
| | - Vana Sypsa
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.L.); (E.G.K.); (M.G.); (V.S.); (P.L.); (G.M.); (A.H.)
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.L.); (E.G.K.); (M.G.); (V.S.); (P.L.); (G.M.); (A.H.)
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.L.); (E.G.K.); (M.G.); (V.S.); (P.L.); (G.M.); (A.H.)
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.L.); (E.G.K.); (M.G.); (V.S.); (P.L.); (G.M.); (A.H.)
| | - Lemonia Skoura
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.C.); (L.S.)
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.L.); (E.G.K.); (M.G.); (V.S.); (P.L.); (G.M.); (A.H.)
- Correspondence:
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8
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Balaska S, Pilalas D, Takardaki A, Koutra P, Parasidou E, Gkeka I, Tychala A, Meletis G, Fyntanidou B, Metallidis S, Protonotariou E, Skoura L. Evaluation of the Advanta Dx SARS-CoV-2 RT-PCR Assay, a High-Throughput Extraction-Free Diagnostic Test for the Detection of SARS-CoV-2 in Saliva: A Diagnostic Accuracy Study. Diagnostics (Basel) 2021; 11:1766. [PMID: 34679464 PMCID: PMC8534356 DOI: 10.3390/diagnostics11101766] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/29/2022] Open
Abstract
Nasopharyngeal swab specimen (NPS) molecular testing is considered the gold standard for SARS-CoV-2 detection. However, saliva is an attractive, noninvasive specimen alternative. The aim of the study was to evaluate the diagnostic accuracy of Advanta Dx SARS-CoV-2 RT-PCR saliva-based assay against paired NPS tested with either NeumoDxTM SARS-CoV-2 assay or Abbott Real Time SARS-CoV-2 assay as the reference method. We prospectively evaluated the method in two settings: a diagnostic outpatient and a healthcare worker screening convenience sample, collected in November-December 2020. SARS-CoV-2 was detected in 27.7% (61/220) of diagnostic samples and in 5% (10/200) of screening samples. Overall, saliva test in diagnostic samples had a sensitivity of 88.5% (77.8-95.3%) and specificity of 98.1% (94.6-99.6%); in screening samples, the sensitivity was 90% (55.5-99.7%) and specificity 100% (98.1-100%). Our data suggests that the Fluidigm Advanta Dx RT-PCR saliva-based assay may be a reliable diagnostic tool for COVID-19 diagnosis in symptomatic individuals and screening asymptomatic healthcare workers.
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Affiliation(s)
- Sofia Balaska
- Department of Microbiology, AHEPA University Hospital, Medical School, Aristotle University οf Thessaloniki, 54636 Thessaloniki, Greece; (S.B.); (A.T.); (P.K.); (E.P.); (I.G.); (A.T.); (G.M.); (E.P.)
| | - Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Anna Takardaki
- Department of Microbiology, AHEPA University Hospital, Medical School, Aristotle University οf Thessaloniki, 54636 Thessaloniki, Greece; (S.B.); (A.T.); (P.K.); (E.P.); (I.G.); (A.T.); (G.M.); (E.P.)
| | - Paraskevoula Koutra
- Department of Microbiology, AHEPA University Hospital, Medical School, Aristotle University οf Thessaloniki, 54636 Thessaloniki, Greece; (S.B.); (A.T.); (P.K.); (E.P.); (I.G.); (A.T.); (G.M.); (E.P.)
| | - Eleftheria Parasidou
- Department of Microbiology, AHEPA University Hospital, Medical School, Aristotle University οf Thessaloniki, 54636 Thessaloniki, Greece; (S.B.); (A.T.); (P.K.); (E.P.); (I.G.); (A.T.); (G.M.); (E.P.)
| | - Ioanna Gkeka
- Department of Microbiology, AHEPA University Hospital, Medical School, Aristotle University οf Thessaloniki, 54636 Thessaloniki, Greece; (S.B.); (A.T.); (P.K.); (E.P.); (I.G.); (A.T.); (G.M.); (E.P.)
| | - Areti Tychala
- Department of Microbiology, AHEPA University Hospital, Medical School, Aristotle University οf Thessaloniki, 54636 Thessaloniki, Greece; (S.B.); (A.T.); (P.K.); (E.P.); (I.G.); (A.T.); (G.M.); (E.P.)
| | - Georgios Meletis
- Department of Microbiology, AHEPA University Hospital, Medical School, Aristotle University οf Thessaloniki, 54636 Thessaloniki, Greece; (S.B.); (A.T.); (P.K.); (E.P.); (I.G.); (A.T.); (G.M.); (E.P.)
| | - Barbara Fyntanidou
- Emergency Department, AHEPA University Hospital, 54636 Thessaloniki, Greece;
| | - Simeon Metallidis
- First Department of Internal Medicine, Infectious Diseases Division, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Efthymia Protonotariou
- Department of Microbiology, AHEPA University Hospital, Medical School, Aristotle University οf Thessaloniki, 54636 Thessaloniki, Greece; (S.B.); (A.T.); (P.K.); (E.P.); (I.G.); (A.T.); (G.M.); (E.P.)
| | - Lemonia Skoura
- Department of Microbiology, AHEPA University Hospital, Medical School, Aristotle University οf Thessaloniki, 54636 Thessaloniki, Greece; (S.B.); (A.T.); (P.K.); (E.P.); (I.G.); (A.T.); (G.M.); (E.P.)
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Kaiafa G, Pilalas D, Koletsa T, Daios S, Arsos G, Hatzidakis A, Protopapas A, Stamatopoulos K, Savopoulos C. Diagnosing a Patient with Erdheim-Chester Disease during the COVID-19 Pandemic. ACTA ACUST UNITED AC 2021; 57:medicina57101001. [PMID: 34684037 PMCID: PMC8540257 DOI: 10.3390/medicina57101001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/14/2021] [Accepted: 09/19/2021] [Indexed: 11/16/2022]
Abstract
Background: Erdheim-Chester disease (ECD) is a rare hematopoietic neoplasm of histiocytic origin characterized by an insidious course. The coronavirus disease 2019 (COVID-19) pandemic has put an enormous strain on healthcare systems worldwide both directly and indirectly, resulting in the disruption of healthcare services to prevent, diagnose and manage non-COVID-19 disease. Case Presentation: We describe the case of a 58-year-old male patient with sporadic episodes of self-resolving mild fever and anemia of chronic disease with onset two years before the current presentation. Positron emission/computed tomography scan revealed the presence of moderately hypermetabolic perirenal tissue masses. In order to achieve diagnosis, repeated perirenal tissue biopsies were performed, and the diagnostic evaluation was complicated by the strain put on the healthcare system by the COVID-19 pandemic. The patient contracted SARS-CoV-2 and required hospitalization, but recovered fully. No further ECD target organ involvement was documented. Treatment options were presented, but the patient chose to defer treatment for ECD. Conclusion: A high index of suspicion and multidisciplinary team collaboration is paramount to achieve diagnosis in rare conditions such as ECD. Disruptions in healthcare services in the pandemic milieu may disproportionately affect people with rare diseases and further study and effort is required to better meet their needs in the pandemic setting.
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Affiliation(s)
- Georgia Kaiafa
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.D.); (A.P.); (C.S.)
- Correspondence: ; Tel.: +30-231-099-4779
| | - Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.D.); (A.P.); (C.S.)
| | - Triantafyllia Koletsa
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Stylianos Daios
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.D.); (A.P.); (C.S.)
| | - Georgios Arsos
- 3rd Department of Nuclear Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece;
| | - Adam Hatzidakis
- Radiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Adonis Protopapas
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.D.); (A.P.); (C.S.)
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Center for Research and Technology Hellas, 57001 Thessaloniki, Greece;
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.D.); (A.P.); (C.S.)
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Pantelidou D, Pilalas D, Daios S, Polychronopoulos G, Papadopoulou D, Perifanis V, Savopoulos C, Kaiafa G. Hyperhaemolytic transfusion reaction in two β-thalassaemia major patients: The role of eculizumab. J Clin Pharm Ther 2021; 47:411-414. [PMID: 34397109 DOI: 10.1111/jcpt.13510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/26/2021] [Accepted: 08/05/2021] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Hyperhaemolytic transfusion reactions are rare life-threatening events predominantly affecting patients with haemoglobinopathies. We report two cases in β-thalassaemia major patients on chronic transfusion therapy and highlight the role of eculizumab in its management. CASE SUMMARY Patient 1 presented with intravascular haemolysis on day 7 (D7) post-transfusion and responded to treatment with corticosteroids and intravenous immunoglobulin. However, patient 2 presented with severe symptomatic anaemia (D4 post-transfusion) unresponsive to the aforementioned measures. Eculizumab administration led to resolution of the hyperhaemolysis. WHAT IS NEW AND CONCLUSION We report the successful management of hyperhaemolysis with eculizumab in a β-thalassemia major patient.
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Affiliation(s)
| | - Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stylianos Daios
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Polychronopoulos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Vassilios Perifanis
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Kaiafa
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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11
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Ztriva E, Neokosmidis G, Papadopoulos A, Pilalas D, Polychronopoulos G, Protopapas A, Satsoglou S, Stogiannou D, Tzavelas M, Valanikas E, Veneti S, Vergou M, Savopoulos C, Tziomalos K. Hepatic fibrosis is associated with higher in-hospital mortality in patients admitted with acute ischemic stroke. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Daios S, Kaiafa G, Pilalas D, Nakou I, Kanellos I, Kirdas K, Despoudi K, Papanas N, Savopoulos C. Endothelial Dysfunction and Platelet Hyperaggregation in Type 2 Diabetes Mellitus: The Era of Novel Anti-diabetic Agents. Curr Med Chem 2021; 28:3935-3963. [PMID: 33038906 DOI: 10.2174/0929867327666201009143816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The incidence of diabetes mellitus (DM) is ever-increasing and along with its microvascular and macrovascular complications, it is associated with a high morbidity and mortality burden globally. Major components of diabetes pathophysiology include glucotoxicity, lipotoxicity and insulin resistance, disturbing the vascular wall integrity and leading to endothelial dysfunction and platelet hyper aggregation. OBJECTIVE This review aims to identify and summarize the effect of novel anti-diabetic agents (glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter -2 inhibitors) on endothelial (EF) and platelet function (PF) and evaluate the consistency with the results of cardiovascular outcomes studies. METHODS We performed a structured search of the PubMed database for peer-reviewed research of the literature between 1981 and 2020 regarding the effect of DM and novel antidiabetic agents on EF and PF. RESULTS We analyzed data regarding the effect of novel anti-diabetic agents on EF and PF as well as the pathophysiological interplay between DM, PF, and EF. The available studies use different methods to evaluate these outcomes and the results of different studies are rather conflicting as a result of different study designs, combinations of drugs tested, small study samples and patient population heterogeneity. CONCLUSION The currently available data do not unequivocally support a consistent effect of novel antidiabetic agents on EF and PF. Further study is required ideally for the validation of the results with clinical outcomes.
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Affiliation(s)
- Stylianos Daios
- First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Georgia Kaiafa
- First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Ifigeneia Nakou
- Internal Medicine Department, General Hospital of Serres, Serres, Greece
| | - Ilias Kanellos
- First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | | | | | - Nikolaos Papanas
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
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Pilalas D, Daios S, Fotiadou A, Markou KD, Savopoulos C, Kaiafa G. Richter transformation of chronic lymphocytic leukemia presenting as otitis externa. Pol Arch Intern Med 2021; 131:469-470. [PMID: 33769000 DOI: 10.20452/pamw.15898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Dimitrios Pilalas
- 1st Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stylianos Daios
- 1st Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Konstantinos D Markou
- 2nd Department of Otorhinolaryngology, Head and Neck Surgery, Papageorgiou University General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Savopoulos
- 1st Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Kaiafa
- 1st Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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14
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Daios S, Savopoulos C, Kanellos I, Goudis CA, Nakou I, Petalloti S, Hadjidimitriou N, Pilalas D, Ziakas A, Kaiafa G. Circadian Pattern of Acute Myocardial Infarction and Atrial Fibrillation in a Mediterranean Country: A study in Diabetic Patients. Medicina (Kaunas) 2021; 57:medicina57010041. [PMID: 33418926 PMCID: PMC7825022 DOI: 10.3390/medicina57010041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 05/13/2023]
Abstract
Background and objectives: The circadian pattern seems to play a crucial role in cardiovascular events and arrhythmias. Diabetes mellitus is a complex metabolic disorder associated with autonomic nervous system alterations and increased risk of microvascular and macrovascular disease. We sought to determine whether acute myocardial infarction (AMI) and atrial fibrillation (AF) follow a circadian pattern in diabetic patients in a Mediterranean country. Materials and Methods: This retrospective study included 178 diabetic patients (mean age: 67.7) with AMI or AF who were admitted to the coronary care unit. The circadian pattern of AMI and AF was identified in the 24-h period (divided in 3-h and 1-h intervals). Patients were also divided in 3 groups according to age; 40-65 years, 66-79 years and patients older than 80 years. A chi-square goodness-of-fit test was used for the statistical analysis. Results: AMI seems to occur more often in the midnight hours (21:00-23:59) (p < 0.001). Regarding age distribution, patients between 40 and 65 years were more likely to experience an AMI compared to other age groups (p < 0.001). Autonomic alterations, working habits, and social reasons might contribute to this phenomenon. AF in diabetic patients occurs more frequently at noon (12:00-14:59) (p = 0.019). Conclusions: Diabetic patients with AMI and AF seem to follow a specific circadian pattern in a Mediterranean country, with AMI occurring most often at midnight hours and AF mostly at noon. Autonomic dysfunction, glycemic fluctuations, intense anti-diabetic treatment before lunch, and patterns of insulin secretion and resistance may explain this pattern. More studies are needed to elucidate the circadian pattern of AMI and AF in diabetic patients to contribute to the development of new therapeutic approaches in this setting.
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Affiliation(s)
- Stylianos Daios
- First Propedeutic Department of Internal Medicine, Department of Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi Street, 54636 Thessaloniki, Greece; (S.D.); (I.K.); (S.P.); (N.H.); (D.P.); (G.K.)
- Cardiology Department, Serres General Hospital, 62120 Serres, Greece; (C.A.G.); (I.N.)
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, Department of Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi Street, 54636 Thessaloniki, Greece; (S.D.); (I.K.); (S.P.); (N.H.); (D.P.); (G.K.)
- Correspondence: ; Tel.: +30-2310994783; Fax: +30-2310285128
| | - Ilias Kanellos
- First Propedeutic Department of Internal Medicine, Department of Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi Street, 54636 Thessaloniki, Greece; (S.D.); (I.K.); (S.P.); (N.H.); (D.P.); (G.K.)
| | | | - Ifigeneia Nakou
- Cardiology Department, Serres General Hospital, 62120 Serres, Greece; (C.A.G.); (I.N.)
| | - Stergiani Petalloti
- First Propedeutic Department of Internal Medicine, Department of Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi Street, 54636 Thessaloniki, Greece; (S.D.); (I.K.); (S.P.); (N.H.); (D.P.); (G.K.)
- Cardiology Department, Serres General Hospital, 62120 Serres, Greece; (C.A.G.); (I.N.)
| | - Nicolas Hadjidimitriou
- First Propedeutic Department of Internal Medicine, Department of Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi Street, 54636 Thessaloniki, Greece; (S.D.); (I.K.); (S.P.); (N.H.); (D.P.); (G.K.)
| | - Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, Department of Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi Street, 54636 Thessaloniki, Greece; (S.D.); (I.K.); (S.P.); (N.H.); (D.P.); (G.K.)
| | - Antonios Ziakas
- First Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, 54636 Thessaloniki, Greece;
| | - Georgia Kaiafa
- First Propedeutic Department of Internal Medicine, Department of Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi Street, 54636 Thessaloniki, Greece; (S.D.); (I.K.); (S.P.); (N.H.); (D.P.); (G.K.)
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Pilalas D, Koletsa T, Arsos G, Panselinas G, Exadaktylou P, Polychronopoulos G, Savopoulos C, Kaiafa GD. Dasatinib associated lymphadenopathy in a chronic myeloid leukemia patient: A case report. Medicine (Baltimore) 2020; 99:e22791. [PMID: 33157925 PMCID: PMC7647569 DOI: 10.1097/md.0000000000022791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
RATIONALE Dasatinib associated lymphadenopathy (DAL) is a rare adverse event in chronic myeloid leukemia patients (CML). A case of voluminous lymphadenopathy in the context of DAL is presented. PATIENT CONCERNS A 40-year-old male patient was diagnosed with BCR-ABL1 positive chronic stage CML 2 years ago and achieved complete molecular response on nilotinib, which was switched to dasatinib due to nilotinib intolerance. After 5 months on dasatinib, the patient presented with a large mass in the axillary region. DIAGNOSIS Common infectious and autoimmune etiologies of lymphadenopathy were ruled out. The positron emission tomography/computed tomography (PET/CT) demonstrated a hypermetabolic lymphadenopathy highly suspicious of lymphoma. The subsequent biopsy excluded lymphoma or extramedullary blastic transformation of CML and revealed reactive lymphadenopathy with mixed (cortical and paracortical) pattern. Clinical history and clinicopathological correlation suggested the diagnosis of DAL. INTERVENTION Dasatinib was discontinued and the patient remained in close follow-up. TKI treatment with nilotinib was reinitiated. OUTCOMES Lymphadenopathy resolved clinically at 4 weeks and normalization of PET/CT findings was documented at 9 weeks after cessation of the drug. TKI treatment with nilotinib was reinitiated with good tolerance. LESSONS DAL may present with voluminous lymphadenopathy consistent with malignancy in clinical and imaging workup. We describe the spectrum of lesions associated with DAL and identify common features with drug-induced lymphadenopathy.
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Affiliation(s)
- Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School
| | | | - Georgios Arsos
- 3rd Department of Nuclear Medicine, Papageorgiou Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | | | - Paraskevi Exadaktylou
- 3rd Department of Nuclear Medicine, Papageorgiou Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - George Polychronopoulos
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School
| | - Georgia D. Kaiafa
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School
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Kaiafa G, Veneti S, Polychronopoulos G, Pilalas D, Daios S, Kanellos I, Didangelos T, Pagoni S, Savopoulos C. Is HbA1c an ideal biomarker of well-controlled diabetes? Postgrad Med J 2020; 97:380-383. [PMID: 32913038 DOI: 10.1136/postgradmedj-2020-138756] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 08/15/2020] [Indexed: 12/16/2022]
Abstract
HbA1c is a biomarker with a central role in the diagnosis and follow-up of patients with diabetes, although not a perfect one. Common comorbidities encountered in patients with diabetes mellitus, such as renal insufficiency, high output states (iron deficiency anaemia, haemolytic anaemia, haemoglobinopathies and pregnancy) and intake of specific drugs could compromise the sensitivity and specificity of the biomarker. COVID-19 pandemic poses a pressing challenge for the diabetic population, since maintaining optimal blood glucose control is key to reduce morbidity and mortality rates. Alternative methods for diabetes management, such as fructosamine, glycosylated albumin and device-based continuous glucose monitoring, are discussed.
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Affiliation(s)
- Georgia Kaiafa
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Stavroula Veneti
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - George Polychronopoulos
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Stylianos Daios
- Internal Medicine Department, General Hospital of Serres, Greece
| | - Ilias Kanellos
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Triantafyllos Didangelos
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Stamatina Pagoni
- 3rd Department of Internal Medicine, "G. Gennimatas" General Hospital of Athens, Greece.,Hellenic Society of Internal Medicine, Athens, Greece
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
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Daios S, Polychronopoulos G, Pilalas D, Nakou I, Tegos T, Kanellos I, Vagropoulos I, Savopoulos C, Kaiafa G. West Nile neuroinvasive disease: Could ESR/CRP ratio be a screening biomarker? J Med Virol 2020; 92:925-926. [DOI: 10.1002/jmv.25979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/04/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Stylianos Daios
- Internal Medicine DepartmentGeneral Hospital of Serres Serres Greece
| | - George Polychronopoulos
- First Propedeutic Department of Internal Medicine, Medical School, AHEPA University HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, Medical School, AHEPA University HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Ifigeneia Nakou
- Internal Medicine DepartmentGeneral Hospital of Serres Serres Greece
| | - Thomas Tegos
- First Neurology Department, Medical School, AHEPA University HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Ilias Kanellos
- First Propedeutic Department of Internal Medicine, Medical School, AHEPA University HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | | | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, Medical School, AHEPA University HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Georgia Kaiafa
- First Propedeutic Department of Internal Medicine, Medical School, AHEPA University HospitalAristotle University of Thessaloniki Thessaloniki Greece
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Savopoulos C, Pilalas D, Kaiafa GD, Panagiotou G, Grammenou MC, Kouskouras K, Tegos T, Psomas E, Papa A, Foroglou N, Hatzitolios AI. West Nile virus neuroinvasive disease. QJM 2020; 113:125-126. [PMID: 31593223 DOI: 10.1093/qjmed/hcz255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 09/25/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Savopoulos
- From the First Propedeutic Department of Internal Medicine, Thessaloniki, Greece
| | - D Pilalas
- From the First Propedeutic Department of Internal Medicine, Thessaloniki, Greece
| | - G D Kaiafa
- From the First Propedeutic Department of Internal Medicine, Thessaloniki, Greece
| | - G Panagiotou
- From the First Propedeutic Department of Internal Medicine, Thessaloniki, Greece
| | - M-C Grammenou
- From the First Propedeutic Department of Internal Medicine, Thessaloniki, Greece
| | | | - T Tegos
- First Department of Neurology, AHEPA University Hospital, Medical School, Aristotle University, Thessaloniki, Greece
| | - E Psomas
- From the First Propedeutic Department of Internal Medicine, Thessaloniki, Greece
| | - A Papa
- Department of Microbiology, Medical School, Aristotle University, Thessaloniki, Greece
| | - N Foroglou
- First Department of Neurosurgery, AHEPA University Hospital, Medical School, Aristotle University, Thessaloniki, Greece
| | - A I Hatzitolios
- From the First Propedeutic Department of Internal Medicine, Thessaloniki, Greece
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Pilalas D, Chatzopoulos G, Kaiafa GD, Ztriva E, Spyridonakou S, Bisbinas V, Ioannidis P, Hatzitolios AI, Savopoulos C. Systemic lupus erythematosus in a patient with multiple system atrophy: A case report. Medicine (Baltimore) 2019; 98:e18005. [PMID: 31725670 PMCID: PMC6867731 DOI: 10.1097/md.0000000000018005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Multiple system atrophy is a late-onset rare neurodegenerative movement disorder which results in debilitating disease. Fever frequently ensues in the context of infections which can be associated with significant morbidity and mortality, but among alternative diagnostic possibilities neoplasms and autoimmune disorders should be considered. PATIENT CONCERNS We describe a case of a prolonged febrile syndrome in a 55-year-old female patient with onset of multiple system atrophy two years before presentation. Patient history and symptoms were not contributive to guide the diagnostic work-up. DIAGNOSIS Initial evaluation provided no specific findings. Repeat testing of auto-antibodies revealed positive antinuclear and anti-ds DNA antibodies coupled with low complement which in conjunction with renal biopsy substantiated the diagnosis of systemic lupus erythematosus flare. INTERVENTION Pending the biopsy result, treatment with hydroxychloroquine and corticosteroids was initiated. Due to failure to achieve remission, azathioprine was added, but symptoms persisted. Following the diagnosis of lupus nephritis, azathioprine was discontinued and induction treatment with cyclophosphamide in accordance with the Euro-Lupus regimen was initiated and upon completion followed by maintenance therapy with mycophenolate mofetil. OUTCOMES The patient achieved remission after cyclophosphamide was added to treatment with corticosteroids and has not experienced new flares during the next two years. The neurological syndrome has remained stable during this period. LESSONS To our knowledge, we report the first case of concurrent systemic lupus erythematosus and multiple system atrophy. Prolonged fever presents unique challenges in patients with rare diseases.
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Affiliation(s)
| | | | | | | | | | | | - Panagiotis Ioannidis
- Second Department of Neurology, Medical School, Aristotle University, Thessaloniki, Greece
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Pilalas D, Kaiafa GD, Kouskouras K, Savopoulos C. Darier-Roussy sarcoidosis in a 53-year-old patient. Postgrad Med J 2019; 96:233. [PMID: 31597789 DOI: 10.1136/postgradmedj-2019-137134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 09/25/2019] [Accepted: 09/30/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Georgia D Kaiafa
- First Propedeutic Department of Internal Medicine, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Kouskouras
- Department of Radiology, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece
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21
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Tsachouridou O, Papagianni M, Pilalas D, Gogou C, Chrysanthidis T, Chatzidimitriou D, Skoura L, Germanidis G, Zempekakis P, Metallidis S. Sero-epidemiological study of adherence to vaccine and humoral response against hepatitis A virus in patients living with HIV-1. J Virus Erad 2018. [DOI: 10.1016/s2055-6640(20)30381-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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22
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Pilalas D, Skoura L, Margariti A, Chatzopoulou F, Chatzidimitriou D, Tsachouridou O, Zebekakis P, Metallidis S, Papaioannou M. Prevalence and correlates of persistent intracellular HIV transcription in individuals on efavirenz versus atazanavir-based regimens: A prospective cohort study. PLoS One 2018; 13:e0194262. [PMID: 29534103 PMCID: PMC5849343 DOI: 10.1371/journal.pone.0194262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 02/28/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Despite successful virological suppression, HIV transcription frequently persists intracellularly. In this study, we hypothesize that HIV persistent transcription(HIVpt) may affect to a different extent patients on stable efavirenz(EFV) versus atazanavir(ATV)-based regimens. The role of the expression of drug efflux transporters in HIVpt was also investigated. METHODS We prospectively enrolled 51 virologically suppressed patients on first-line treatment for one year with EFV or ATV combined with emtricitabine and tenofovir and followed them up for one year. Simultaneous ultrasensitive subpopulation staining/hybridization in situ(SUSHI) was performed to identify HIVpt in CD4+ T-cells and in the CD4+CD45RO+ T-cell subpopulation. The differential mRNA expression of P-glycoprotein(P-gp/ABCB1) and multidrug resistance-associated protein-1(MRP1/ABCC1) was also evaluated. Univariate logistic regression models were used to evaluate predictors of HIVpt. RESULTS In the CD4+ T-cell population, HIVpt affected 13/30 of patients on EFV versus 10/21 on ATV. In the CD4+CD45RO+ T-cell population, HIVpt was present in 14/30 of patients on EFV versus 15/21 on ATV. A trend for association was observed between the risk of HIVpt and ATV treatment in the CD4+CD45RO+ T-cell population (OR 2.86, 95% CI 0.87-9.37, p = 0.083). HIVpt status was not associated with loss of virological suppression or CD4 evolution. We found no evidence of differential expression of the drug efflux transporters P-gp and MRP1. CONCLUSIONS Further study is required to evaluate whether the HIVpt profile in specific cell populations may differ across different antiretroviral regimens and to elucidate the potential clinical impact.
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Affiliation(s)
- Dimitrios Pilalas
- 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Lemonia Skoura
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, Aristotle University Medical School, Thessaloniki, Greece
| | - Apostolia Margariti
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, Aristotle University Medical School, Thessaloniki, Greece
| | - Fani Chatzopoulou
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, Aristotle University Medical School, Thessaloniki, Greece
| | - Dimitrios Chatzidimitriou
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, Aristotle University Medical School, Thessaloniki, Greece
| | - Olga Tsachouridou
- 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Pantelis Zebekakis
- 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Simeon Metallidis
- 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Maria Papaioannou
- 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
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Pilalas D, Skoura L, Margariti A, Chatzidimitriou D, Sarantopoulos A, Tsachouridou O, Papa A, Metallidis S. West Nile virus meningitis in a patient with human immunodeficiency virus type 1 infection. New Microbes New Infect 2017; 19:126-128. [PMID: 28831299 PMCID: PMC5554934 DOI: 10.1016/j.nmni.2017.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 05/30/2017] [Indexed: 11/16/2022] Open
Abstract
The emergence of West Nile virus lineage 2 in central Macedonia, Greece, in 2010 resulted in large outbreaks for 5 consecutive years. We report a case of viral meningitis in an individual infected with human immunodeficiency virus type 1, which preceded the recognition of the outbreak and was confirmed retrospectively as West Nile virus neuroinvasive disease.
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Affiliation(s)
- D Pilalas
- Infectious Diseases Division, 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - L Skoura
- National AIDS Reference Centre of Northern Greece-Aristotle University Medical School, Thessaloniki, Greece
| | - A Margariti
- National AIDS Reference Centre of Northern Greece-Aristotle University Medical School, Thessaloniki, Greece
| | - D Chatzidimitriou
- National AIDS Reference Centre of Northern Greece-Aristotle University Medical School, Thessaloniki, Greece
| | - A Sarantopoulos
- Clinical Immunology Unit, 2nd Department of Internal Medicine, Hippokration General Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - O Tsachouridou
- Infectious Diseases Division, 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - A Papa
- National Reference Laboratory for Arboviruses-Aristotle University Medical School, Thessaloniki, Greece
| | - S Metallidis
- Infectious Diseases Division, 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
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Tsachouridou O, Skoura L, Zebekakis P, Margariti A, Georgiou A, Bougiouklis D, Pilalas D, Galanos A, Daniilidis M, Metallidis S. Antiretroviral naive and treated patients: Discrepancies of B cell subsets during the natural course of human immunodeficiency virus type 1 infection. World J Virol 2016; 5:155-160. [PMID: 27878102 PMCID: PMC5105048 DOI: 10.5501/wjv.v5.i4.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/24/2016] [Accepted: 08/18/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate alterations of memory B cell subpopulations during a 48-wk period in human immunodeficiency virus type 1 (HIV-1) patients.
METHODS Forty-one antiretroviral naïve and 41 treated HIV-1 patients matched for age and duration of HIV infection were recruited. All clinical, epidemiological and laboratory data were recorded or measured. The different B cell subsets were characterized according to their surface markers: Total B cells (CD19+), memory B cells (CD19+CD27+, BMCs), resting BMCs (CD19+CD27+CD21high, RM), exhausted BMCs (CD19+CD21lowCD27-, EM), IgM memory B (CD19+CD27+IgMhigh), isotype-switched BMCs (CD19+CD27+IgM-, ITS) and activated BMCs (CD19+CD21low+CD27+, AM) at baseline on week 4 and week 48.
RESULTS Mean counts of BMCs were higher in treated patients. There was a marginal upward trend of IgM memory B cell proportions which differed significantly in the treated group (overall trend, P = 0.004). ITS BMC increased over time significantly in all patients. Naive patients had of lower levels of EM B cells compared to treated, with a downward trend, irrespectively of highly active antiretroviral therapy (HAART) intake. Severe impairment of EM B cells was recorded to both treated (P = 0.024) and naive (P = 0.023) and patients. Higher proportions of RM cells were noted in HAART group, which differed significantly on week 4th (P = 0.017) and 48th (P = 0.03). Higher levels of AM were preserved in HAART naive group during the whole study period (week 4: P = 0.018 and 48: P = 0.035). HIV-RNA viremia strongly correlated with AM B cells (r = 0.54, P = 0.01) and moderately with RM cells (r = -0.45, P = 0.026) at baseline.
CONCLUSION HIV disrupts memory B cell subpopulations leading to impaired immunologic memory over time. BMC, RM, EM and ITS BMC were higher in patients under HAART. Activated BMCs (AM) were higher in patients without HAART. Viremia correlated with AM and RM. Significant depletion was recorded in EM B cells irrespectively of HAART intake. Perturbations in BMC-populations are not fully restored by antiretrovirals.
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Margariti A, Chatzidimitriou D, Metallidis S, Pilalas D, Kourelis A, Papadimitriou E, Haidich AB, Malisiovas N, Skoura L. Comparing Abbott m2000 RealTime HIV test and Roche COBAS Ampliprep/COBAS Taqman HIV test, v2.0 in treated HIV-1 B and non-B subjects with low viraemia. J Med Virol 2015; 88:724-7. [PMID: 26331699 DOI: 10.1002/jmv.24369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 11/09/2022]
Abstract
Viral load testing is a valuable tool in HIV clinical care and research. Discrepancies among diverse viral load assays, especially with regard to non-B HIV-1 subtypes have been reported. Our study aimed to explore the impact of HIV subtype (B versus non-B) on the agreement between CAP/CTM, v2.0 and m2000 RealTime in treated HIV patients, focusing on low viral loads (<200 copies/ml). Our findings indicate that there is a significant difference in the performance of the compared assays in the low-viremic range and non-B subtypes, suggesting that a single assay should be used for follow-up.
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Affiliation(s)
- Apostolia Margariti
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Chatzidimitriou
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Simeon Metallidis
- 1st Internal Medicine Department, Infectious Diseases Division, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Pilalas
- 1st Internal Medicine Department, Infectious Diseases Division, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Kourelis
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia Papadimitriou
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene and Epidemiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nicolaos Malisiovas
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lemonia Skoura
- National AIDS Reference Centre of Northern Greece, Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Tsachouridou O, Skoura L, Zebekakis P, Margariti A, Galanos A, Pilalas D, Daniilidis M, Malisiovas N, Metallidis S. Alterations in memory B cell subsets upon immunization against Streptococcus pneumoniae in HIV-1 infected adults. HIV & AIDS Review 2015. [DOI: 10.1016/j.hivar.2015.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Alexandropoulos T, Haidich AB, Pilalas D, Dardavessis T, Daniilidis M, Arvanitidou M. Characteristics of patients with allergic rhinitis in an outpatient clinic: a retrospective study. Allergol Immunopathol (Madr) 2013; 41:194-200. [PMID: 22405467 DOI: 10.1016/j.aller.2011.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 11/23/2011] [Accepted: 12/03/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Allergic rhinitis affects a significant proportion of the European population. Few surveys have investigated this disorder in Greek adults. Our objective was to describe the characteristics of patients with allergic rhinitis in an adult outpatient clinic in Thessaloniki, Greece. METHODS We studied the medical records of adult patients referred to a Clinical Immunology outpatient clinic from 2001 to 2007. The diagnostic procedure was not changed during the whole study period, including the same questionnaire used at the time of diagnosis, skin prick tests, and serum specific IgE. RESULTS A total of 1851 patient files with diagnosed allergies were analysed and allergic rhinitis was confirmed in 711 subjects (38.4%). According to ARIA classification, persistent allergic rhinitis was more prevalent than intermittent (54.9% vs. 45.1%), while 60.8% of subjects suffered from moderate/severe disease. In multivariable analysis, factors associated with allergic rhinitis were age (for every 10 years increase, OR: 0.84, 95% CI: 0.77-0.91; p<0.001); working in school environment (teachers or students) (OR: 1.46, 95% CI: 1.05-2.02; p=0.023); parental history of respiratory allergy (OR: 2.41, 95% CI: 1.69-3.43; p<0.001); smoking (OR: 0.71, 95% CI: 0.55-0.91; p=0.007); presence of allergic conjunctivitis (OR: 6.16, 95% CI: 4.71-8.06; p<0.001); and asthma (OR: 2.17, 95% CI: 1.57-3.01; p<0.001). Analysis after multiple imputation corroborated the complete case analysis results. CONCLUSIONS Allergic rhinitis was documented in 38.4% of studied patients and was frequently characterised by significant morbidity. Factors associated with allergic rhinitis provide insight into the epidemiology of this disorder in our region. Further studies on the general population would contribute to evaluating allergic rhinitis more comprehensively.
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Affiliation(s)
- T Alexandropoulos
- Department of Hygiene and Epidemiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Haidich AB, Pilalas D, Contopoulos-Ioannidis DG, Ioannidis JPA. Most meta-analyses of drug interventions have narrow scopes and many focus on specific agents. J Clin Epidemiol 2013; 66:371-8. [PMID: 23384590 DOI: 10.1016/j.jclinepi.2012.10.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 10/24/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To assess the extent to which meta-analysis publications of drugs and biologics focus on specific named agents or even only a single agent, and identify characteristics associated with such focus. STUDY DESIGN AND SETTING We evaluated 499 articles with meta-analyses published in 2010 and estimated how many did not cover all the available comparisons of tested interventions for a given condition (not all-inclusive); focused on specific named agent(s), or focused strictly on comparisons of only one specific active agent vs. placebo/no treatment or different doses/schedules. RESULTS Of 499 eligible articles, 403 (80.8%) were not all-inclusive, 214 (42.9%) covered only specific named agent(s), and 74 (14.8%) examined only comparisons with one active agent vs. placebo/no treatment or different doses/schedules. Only 39 articles (7.8%) covered all possible indications for the examined agent(s). After adjusting for type of treatment/field, focus on specific named agent(s) was associated with publication in journal venues (odds ratio [OR]: 1.95; 95% confidence interval [CI]: 1.17-3.26) vs. Cochrane, industry sponsoring (OR: 3.94; 95% CI: 1.66-10.66), and individual patient data analyses (OR: 6.59; 95% CI: 2.24-19.39). Individual patient data analyses primarily (29/34) focused on specific named agent(s). CONCLUSION The scope of meta-analysis publications frequently is narrow and shaped to serve particular agents.
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Affiliation(s)
- Anna-Bettina Haidich
- Department of Hygiene and Epidemiology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Skoura L, Metallidis S, Pilalas D, Kourelis A, Margariti A, Papadimitriou E, Antoniadou ZA, Chrysanthidis T, Tsachouridou O, Kollaras P, Nikolaidis P, Malisiovas N. High rates of transmitted drug resistance among newly-diagnosed antiretroviral naïve HIV patients in Northern Greece, data from 2009-2011. Clin Microbiol Infect 2013; 19:E169-72. [PMID: 23331664 DOI: 10.1111/1469-0691.12124] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 12/02/2012] [Accepted: 12/04/2012] [Indexed: 11/27/2022]
Abstract
We conducted a retrospective study on the prevalence and correlates of transmitted drug resistance among newly-diagnosed antiretroviral naive human immunodeficiency virus (HIV) patients in Northern Greece, during the period 2009-11. Transmitted drug resistance was documented in 21.8% of patients enrolled, affecting approximately 40% of subtype A HIV-1-infected individuals. Overcoming challenges due to the ongoing financial crisis, effective preventive measures should be implemented to control further dissemination of resistant HIV strains.
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Affiliation(s)
- L Skoura
- National AIDS Reference Centre of Northern Greece, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Skoura L, Metallidis S, Buckton AJ, Mbisa JL, Pilalas D, Papadimitriou E, Papoutsi A, Haidich AB, Chrysanthidis T, Tsachouridou O, Antoniadou ZA, Kollaras P, Nikolaidis P, Malisiovas N. Molecular and epidemiological characterization of HIV-1 infection networks involving transmitted drug resistance mutations in Northern Greece. J Antimicrob Chemother 2011; 66:2831-7. [PMID: 21933785 DOI: 10.1093/jac/dkr386] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine the contribution of transmission clusters to transmitted drug resistance (TDR) in newly diagnosed antiretroviral-naive HIV-1-infected patients in Northern Greece during 2000-07. METHODS The prevalence of TDR was estimated in 369 individuals who were diagnosed with HIV-1 infection in the period 2000-07 at the National AIDS Reference Laboratory of Northern Greece. Phylogenetic analysis was performed using a maximum likelihood method on partial pol sequences. TDR was defined in accordance with the surveillance drug resistance mutation list (2009 update). RESULTS The overall prevalence of TDR in our population was 12.5% [46/369, 95% confidence interval (CI) 9.1%-15.8%], comprising 7.6% (28/369) resistant to nucleoside reverse transcriptase inhibitors, 5.4% (20/369) resistant to non-nucleoside reverse transcriptase inhibitors and 3.3% (12/369) resistant to protease inhibitors. Dual class resistance was identified in 3.8% (14/369). Infection with subtype A was the sole predictor associated with TDR in multivariate analysis (odds ratio 2.15, 95% CI 1.10-4.19, P = 0.025). Phylogenetic analyses revealed three statistically robust transmission clusters involving drug-resistant strains, including one cluster of 12 patients, 10 of whom were infected with a strain carrying both T215 revertants and Y181C mutations. CONCLUSIONS Our findings underline the substantial impact of transmission networks on TDR in our population.
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Affiliation(s)
- Lemonia Skoura
- National AIDS Reference Centre of Northern Greece, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Skoura L, Metallidis S, Buckton AJ, Mbisa JL, Pilalas D, Papadimitriou E, Papoutsi A, Haidich AB, Valagouti D, Tsachouridou O, Antoniadou ZA, Kollaras P, Nikolaidis P, Malisiovas N. Transmitted drug resistance associated with transmission clusters in newly diagnosed antiretroviral-naïve patients in Northern Greece. J Int AIDS Soc 2010. [PMCID: PMC3112900 DOI: 10.1186/1758-2652-13-s4-p125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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