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Betsikos A, Paschou E, Geladari V, Magaliou S, Sabanis N. Abiraterone-Induced Secondary Hypertension: Two Wrongs Don't Make a Right. Cureus 2024; 16:e60299. [PMID: 38746488 PMCID: PMC11093521 DOI: 10.7759/cureus.60299] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 05/16/2024] Open
Abstract
Abiraterone, an inhibitor of both 17α-hydroxylase and 17,20-lyase, is considered a novel, state-of-the-art, life-prolonging therapy in the urologists' arsenal when treating prostate cancer. Despite its efficacy, it is linked with an increased risk of cardiovascular adverse effects. Herein, we report a case in which the administration of abiraterone resulted in a full-blown syndrome of apparent mineralocorticoid excess despite the concomitant administration of prednisolone; that is, secondary hypertension, hypokalemia, metabolic alkalosis, as well as elevated levels of adrenocorticotropic hormone (ACTH).
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Affiliation(s)
- Achilleas Betsikos
- First Department of Internal Medicine, General Hospital of Trikala, Trikala, GRC
| | - Eleni Paschou
- General Practice and Family Medicine, 10th Local Medical Unit of Giannouli, Larisa, GRC
| | - Virginia Geladari
- First Department of Internal Medicine, General Hospital of Trikala, Trikala, GRC
| | | | - Nikolaos Sabanis
- Nephrology Department, General Hospital of Trikala, Trikala, GRC
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2
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Tsiogka A, Paschou E, Koumaki D, Vakirlis E, Gregoriou S. Interleukin antagonists for atopic dermatitis: a new era of therapy. Expert Opin Investig Drugs 2024. [PMID: 38656240 DOI: 10.1080/13543784.2024.2347294] [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: 12/26/2023] [Accepted: 04/22/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Over the last decade, increasing understanding of the immunopathogenesis of atopic dermatitis (AD) enabled the recognition of multiple therapeutic targets and subsequently the development of novel, highly effective systemic treatments, including interleukin (IL)-antagonists. To date, the IL-4Ra-inhibitor dupilumab, and the IL-13 inhibitor tralokinumab, have gained regulatory approval in Europe for the treatment of moderate-to-severe AD, while more than 70 new therapeutics are currently in development. AREAS COVERED In this review, we address the role of ILs in the pathogenesis of AD and provide an overview of the novel and investigational IL-antagonists, as regards their efficacy and safety on moderate-to-severe AD. EXPERT OPINION Current data have established IL-4 and IL-13 inhibitors as effective and safe for the treatment of moderate-to-severe AD, as regards the rapid control of flares as well as the long-term remission of the disease. Data regarding the efficacy and safety of other IL-inhibitors, including those targeting IL-31, IL-22, IL-33, IL-36 and IL-18, are accumulating. There is still an unmet need for real-world-evidence studies and head-to-head studies for both currently available and future agents in AD treatment. Establishing predictive biomarkers of treatment response in a disorder of such considerable heterogenicity might help physicians pursue a patient-tailored therapeutic response.
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Affiliation(s)
- Aikaterini Tsiogka
- National and Kapodistrian University of Athens, Faculty of Medicine, 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Athens, Greece
| | - Eleni Paschou
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Koumaki
- Dermatology Department, University Hospital of Heraklion, Heraklion, Greece
| | - Efstratios Vakirlis
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stamatios Gregoriou
- National and Kapodistrian University of Athens, Faculty of Medicine, 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Athens, Greece
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Laskou S, Kountouri I, Paschou E, Topalidis C, Axi P, Petrakis G, Kosmidis C, Sapalidis K. Tertiary hyperparathyroidism masking an atypical parathyroid tumor. Clin Case Rep 2024; 12:e8753. [PMID: 38617065 PMCID: PMC11014803 DOI: 10.1002/ccr3.8753] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/06/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024] Open
Abstract
Atypical parathyroid tumors represent a group of parathyroid neoplasms of uncertain malignant potential. In view of preoperative diagnostic difficulties, suspicious features for malignancy may guide the surgeon to perform a radical surgical approach.
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Affiliation(s)
- Styliani Laskou
- 3rd Surgical DepartmentAristotle University of Thessaloniki, AHEPA HospitalThessalonikiGreece
| | - Ismini Kountouri
- 3rd Surgical DepartmentAristotle University of Thessaloniki, AHEPA HospitalThessalonikiGreece
| | - Eleni Paschou
- 3rd Surgical DepartmentAristotle University of Thessaloniki, AHEPA HospitalThessalonikiGreece
| | - Christos Topalidis
- Department of Pathology, Faculty of MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Paraskevi Axi
- 3rd Surgical DepartmentAristotle University of Thessaloniki, AHEPA HospitalThessalonikiGreece
| | - Georgios Petrakis
- Department of Pathology, Faculty of MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Christoforos Kosmidis
- 3rd Surgical DepartmentAristotle University of Thessaloniki, AHEPA HospitalThessalonikiGreece
| | - Konstantinos Sapalidis
- 3rd Surgical DepartmentAristotle University of Thessaloniki, AHEPA HospitalThessalonikiGreece
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Mantalovas S, Paschou E, Kountouri I, Sevva C, Papadopoulos K, Roulia P, Dagher M, Laskou S, Lagopoulos V, Koulouris C, Louloudopoulou F, Kopsidas P, Sapalidis K, Kesisoglou I, Kosmidis C. A Unique Case of Appendiceal Intussusception (Inversion): A Case in Bloom. Diagnostics (Basel) 2024; 14:555. [PMID: 38473027 DOI: 10.3390/diagnostics14050555] [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: 11/21/2023] [Revised: 02/18/2024] [Accepted: 03/02/2024] [Indexed: 03/14/2024] Open
Abstract
A 40-year-old female patient presented to a secondary facility with dull lower abdominal pain and a persistent low-grade fever. Her laboratory results showed elevated inflammation markers. A CT scan revealed two abscesses in the lesser pelvic region in direct contact with the apex of the appendix, the posterior wall of the uterus, and the right-side appendages. The patient responded well to intravenous antibiotics, and an MRI scan revealed the cause to be an appendiceal rupture. The patient was scheduled for an appendectomy. The procedure started laparoscopically but had to be converted to an open one with a midline infra-umbilical incision in order to protect the right appendages. A standard appendectomy was conducted, and the histology report revealed rupture of the appendix with concomitant wall inversion in the context of fibrous adhesions as well as obstruction due to a fecalith. Patient recovery and follow-up were excellent. Acute appendicitis, while frequently encountered in surgical practice, can present a diagnostic conundrum when it manifests in an atypical manner. This unique form of inversion appeared to confer a protective role against peritonitis, primarily through the mechanism of obstruction occurring centrally to the rupture. We suggest that this case should be included in current classifications as a partial inversion of the appendix after rupture and inflammation.
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Affiliation(s)
- Stylianos Mantalovas
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Eleni Paschou
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Ismini Kountouri
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Christina Sevva
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Konstantinos Papadopoulos
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Panagiota Roulia
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Marios Dagher
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Styliani Laskou
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Vasileios Lagopoulos
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Charilaos Koulouris
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Fedra Louloudopoulou
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Periklis Kopsidas
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Konstantinos Sapalidis
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Isaak Kesisoglou
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Christoforos Kosmidis
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
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Vakirlis E, Gregoriou S, Bakirtzi K, Paschou E, Tsiogka A, Papadimitriou I, Sotiriou E. Insights into Early Systemic Treatment in Atopic Dermatitis: Scientific Facts and Practical Considerations. Dermatol Ther (Heidelb) 2024; 14:563-568. [PMID: 38411895 DOI: 10.1007/s13555-024-01110-6] [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: 11/27/2023] [Accepted: 02/02/2024] [Indexed: 02/28/2024] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized clinically by pruritus, and pathophysiologically by immune dysregulation, and compromised skin barrier function. While topical therapies are currently the cornerstone of AD management, especially in mild disease, recent advancements in systemic treatments and a deeper understanding of similar skin diseases, such as psoriasis, have highlighted the importance of early intervention. In this commentary, we explore the potential benefits of early systemic intervention in AD, with pruritus determining such a decision. Building on this concept, we assume that, through the timely systemic treatment that targets the immune dysregulation present in AD, the progression of the disease could be modified, improving overall patient outcomes. Early systemic intervention may minimize systemic inflammation, halting the "atopic march" and disrupting the "itch-scratch" cycle. Managing pruritus at its root could prevent secondary complications and reduce the psychosocial burden of the disease. This paradigm shift fosters a collaborative healthcare approach that empowers patients with long-term disease control strategies. In conclusion, the safety and efficacy of novel systemic treatments offer a compelling scenario for early intervention in atopic dermatitis care.
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Affiliation(s)
- Efstratios Vakirlis
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Stamatios Gregoriou
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece.
| | - Katerina Bakirtzi
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Eleni Paschou
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Aikaterini Tsiogka
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Ilias Papadimitriou
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Eleni Sotiriou
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
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Betsikos A, Gazouni E, Bika S, Paschou E, Sabanis N. Antisynthetase Syndrome: The Classical Phenotype With a Twist. Cureus 2023; 15:e42360. [PMID: 37621814 PMCID: PMC10445298 DOI: 10.7759/cureus.42360] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Antisynthetase syndrome is a systemic autoimmune rheumatic disease characterized by multiple organ involvement, including interstitial lung disease, myositis, non-erosive arthritis, fever, Raynaud's phenomenon, "mechanic's hands," and the presence of autoantibodies against aminoacyl-tRNA synthetases, mainly anti-Jo1 (histidyl) antibodies. Patients with antisynthetase syndrome and active muscle inflammation are usually presented with elevated creatine phosphokinase levels, even in the range of acute rhabdomyolysis. Despite that, the presence of myoglobinuric acute kidney injury is rarely seen in patients with myositis-associated rhabdomyolysis. Herein, we report the case of a 64-year-old man who presented with acute kidney injury due to severe rhabdomyolysis in the setting of antisynthetase syndrome diagnosed by the classical clinical triad of (1) interstitial lung disease, (2) non-erosive arthritis, and (3) active myositis and the presence of anti-Jo1 antibodies. The diagnosis was confirmed by muscle biopsy histological findings as well as electromyography. In this case report, we also discuss the classical clinical manifestations of antisynthetase syndrome and a twist toward this unusual complication associated with active muscle inflammation.
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Affiliation(s)
- Achilleas Betsikos
- First Department of Internal Medicine, General Hospital of Trikala, Trikala, GRC
| | - Evanthia Gazouni
- First Department of Internal Medicine, General Hospital of Trikala, Trikala, GRC
| | - Spyridoula Bika
- First Department of Internal Medicine, General Hospital of Trikala, Trikala, GRC
| | - Eleni Paschou
- Department of General Practice and Family Medicine, 10th Local Health Unit of Giannouli, Larisa, GRC
| | - Nikolaos Sabanis
- Department of Nephrology, General Hospital of Trikala, Trikala, GRC
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Paschou E, Sabanis N. Mediastinal lipomatosis in a patient with Bardet-Biedl syndrome: more diverse than previously thought. Pan Afr Med J 2023; 45:82. [PMID: 37663628 PMCID: PMC10474804 DOI: 10.11604/pamj.2023.45.82.35582] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/07/2023] [Indexed: 09/05/2023] Open
Affiliation(s)
- Eleni Paschou
- Department of General Practice and Family Medicine, Health Center of Aliartos, Levadia, Greece
| | - Nikolaos Sabanis
- Department of Nephrology, General Hospital of Trikala, Trikala, Greece
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8
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Sabanis N, Paschou E. Erythropoietin resistance-secondary to watermelon stomach: a forgotten story in chronic kidney disease patients. Pan Afr Med J 2023; 44:40. [PMID: 37034485 PMCID: PMC10080296 DOI: 10.11604/pamj.2023.44.40.36839] [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] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Affiliation(s)
- Nikolaos Sabanis
- Department of Nephrology, General Hospital of Trikala, Trikala, Greece
- Corresponding author: Nikolaos Sabanis, Department of Nephrology, General Hospital of Trikala, Trikala, Greece.
| | - Eleni Paschou
- Department of General Practice and Family Medicine, General State Hospital of Nikaia, Nikaia, Greece
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Paschou E, Betsikos A, Zagkotsis G, Sabanis N. The unique landscape of coronavirus disease 2019 coagulopathy and imminent bleedings at unusual sites: Pathophysiology matters. Curr Urol 2022; 16:262-264. [PMID: 36714235 PMCID: PMC9875208 DOI: 10.1097/cu9.0000000000000153] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/08/2022] [Indexed: 02/01/2023] Open
Affiliation(s)
- Eleni Paschou
- Department of General Practice & Family Medicine, Medical Center of Nikaia, Larisa, Greece,Corresponding Author: Eleni Paschou, Department of General Practice & Family Medicine, Medical Center of Nikaia, Larisa, 41222, Greece. E-mail address:
| | - Achilleas Betsikos
- 1st Department of Internal Medicine, General Hospital of Trikala, Trikala, Greece
| | - Georgios Zagkotsis
- Department of Nephrology, General Hospital of Levadeia, Levadeia, Greece
| | - Nikolaos Sabanis
- Department of Nephrology, General Hospital of Trikala, Trikala, Greece
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10
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Sabanis N, Paschou E, Drylli A, Papanikolaou P, Zagkotsis G. Uremic Leontiasis Ossea: Theoretical Concepts and Practical Considerations. Saudi J Kidney Dis Transpl 2022; 33:702-715. [PMID: 37955462 DOI: 10.4103/1319-2442.389430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
Leontiasis ossea (LO) in chronic kidney disease patients, also known as Sagliker syndrome, is an exceptionally uncommon uremic complication of long-lasting and severe secondary hyperparathyroidism. The prominent features of uremic LO (ULO) encompass the characteristic clinical trial of massive thickening of maxillary and mandibular bones, widening of interdental spaces, and flattening of nasal bridges and nares. Moreover, during the transformation of craniofacial architecture, significant structural and functional consequences may appear, including upper airway patency, visual and hearing acuity, oral phase of swallowing as well as various neurological and psychiatric disorders. Only few cases of ULO have been reported in the literature until now, making challenging not only the traditional diagnostic procedures but also the optimal therapeutic approach. In this narrative review, we aim to explore the underlying pathophysiological mechanisms, summarize the evidence for adverse outcomes, and highlight the current therapeutic strategies for ULO prevention and treatment, given that precise genetic determinants remain elusive.
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Affiliation(s)
- Nikolaos Sabanis
- Department of Nephrology, General Hospital of Livadia, Livadia, Greece
| | - Eleni Paschou
- Department of General Practice and Family Medicine, Medical Unit of St George, Livadia, Greece
| | - Aikaterini Drylli
- Department of Otorhinolaryngology, National and Kapodistrian University of Athens, Athens, Greece
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Sabanis N, Paschou E, Gavriilaki M. Difficulties in the Differential Diagnosis of Thrombotic Microangiopathy. Iran J Kidney Dis 2022; 1:66-67. [PMID: 35271502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
No Abstract. DOI: 10.52547/ijkd.6916.
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Affiliation(s)
- Nikolaos Sabanis
- Department of Nephrology, General Hospital of Trikala, Trikala, Greece.
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12
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Sabanis N, Paschou E, Drylli A, Papanikolaou P, Zagkotsis G. Rosuvastatin and Colchicine combined myotoxicity: lessons to be learnt. CEN Case Rep 2021; 10:570-575. [PMID: 34028728 DOI: 10.1007/s13730-021-00598-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 03/23/2021] [Indexed: 10/21/2022] Open
Abstract
Statins and colchicine co-administration consists of a potentially catastrophic drug-drug interaction since it provokes myotoxicity, myopathy and various degrees of rhabdomyolysis. Lipophilic statins and colchicine are biotransformed in the liver, primarily via CYP3A4 enzyme system leading to elevated blood levels of both agents and resulting in increased potential for combined myotoxicity. Hence, it would be of great clinical importance not only the awareness of this devastating complication but also the more advantageous type of statin that we should choose to achieve the recommended therapeutic goals regarding LDL levels with minimal myopathy risk. Therefore, once colchicine's use is commenced, a hydrophilic statin selection, such as rosuvastatin, seems favorable regarding the risk of myotoxicity. Herein, we aim to describe a patient with chronic kidney disease stage III and nephrotic syndrome that developed acute rhabdomyolysis soon after the administration of rosuvastatin while receiving colchicine. To the best of our knowledge, this is the first report of the combined effect of rosuvastatin and colchicine in the setting of chronic kidney disease leading to myotoxicity.
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Affiliation(s)
- Nikolaos Sabanis
- Department of Nephrology, General Hospital of Livadeia, Livadeia, Greece.
| | - Eleni Paschou
- Medical Unit of St Georgios, Department of General Practice & Family Medicine, Livadeia, Greece
| | - Aikaterini Drylli
- Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | | | - Georgios Zagkotsis
- Department of Nephrology, General Hospital of Livadeia, Livadeia, Greece
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13
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Sotiriou E, Bakirtzi K, Papadimitriou I, Paschou E, Vakirlis E, Lallas A, Ioannides D. COVID-19 vaccination intention among patients with psoriasis compared with immunosuppressed patients with other skin diseases and factors influencing their decision. Br J Dermatol 2021; 185:209-210. [PMID: 33609286 PMCID: PMC8014832 DOI: 10.1111/bjd.19882] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/07/2021] [Accepted: 02/15/2021] [Indexed: 12/24/2022]
Affiliation(s)
- E Sotiriou
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Bakirtzi
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - I Papadimitriou
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Paschou
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Vakirlis
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Ioannides
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Lallas A, Paschou E, Manoli SM, Papageorgiou C, Spyridis I, Liopyris K, Bobos M, Moutsoudis A, Lazaridou E, Apalla Z. Dermatoscopy of melanoma according to type, anatomic site and stage. Ital J Dermatol Venerol 2020. [PMID: 33314891 DOI: 10.23736/s0392-0488.20.06784-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The indisputable contribution of dermatoscopy in early diagnosis of melanoma is widely recognized. In the last quinquennium, new data concerning specific melanoma subtypes have come to light. The dermatoscopic morphology of superficial spreading melanoma (SSM) has been extensively investigated in the literature. Atypical network, irregular dots, irregular globules, irregular streaks and irregular blotch correspond to histopathologic alterations at the level of the junction, blue-white veil and atypical vessels suggest intradermal growth, whereas regression structures, negative network and white shiny streaks might reflect junctional or dermal alterations. The list of melanoma specific criteria has been recently updated to include features that typify early melanoma, such as irregular hyperpigmented areas and prominent skin markings and features seen in melanoma on sun damaged skin such as angulated lines. Nodular melanoma lacks most of the aforementioned criteria and is typified by the coexistence of blue and black color, atypical vessels and pink color. Lentigo maligna dermatoscopic criteria mainly develop at the outline of the follicular openings. However, at an early stage these features might be very subtle and the diagnosis should be based on the exclusion of benign tumors (inverse approach). Acral lentiginous melanoma is typified by a parallel ridge pattern, but also SSM criteria should be taken into consideration. The diagnosis of subungual melanoma is based on the assessment of the color and characteristics of the pigmented nail band. For the diagnosis of mucosal melanoma, the assessment of colors is more informative than the assessment of structures and the detection of blue, white or gray should raise the suspicion of melanoma. White shiny streaks and regression structures are the most common features of desmoplastic melanoma. The diagnosis of nevoid melanoma might be highly challenging and require information on the lesion's history. Melanoma on small- and medium-sized congenital nevi is typified by an eccentric location of the suspicious area, negative network and gray angulated lines. Recent advances in knowledge on the dermatoscopic characteristics of peculiar subtypes of the tumor significantly enrich the diagnostic armamentarium of clinicians. The challenge of the forthcoming years is to better characterize biologically aggressive melanomas and to optimize the screening strategies so as to identify them.
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Affiliation(s)
- Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece -
| | - Eleni Paschou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | | | - Ioannis Spyridis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | | | - Andreas Moutsoudis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Elizabeth Lazaridou
- Second Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Zoe Apalla
- Second Department of Dermatology, Aristotle University, Thessaloniki, Greece
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15
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Papadimitriou I, Bakirtzi K, Sideris N, Paschou E, Vrani F, Vakirlis E, Lallas A, Ioannides D, Sotiriou E. Has the migratory wave altered the fungal landscape in Greece? A 5-year epidemiological study from a mycological reference centre in Northern Greece. J Eur Acad Dermatol Venereol 2020; 35:e278-e280. [PMID: 33222282 DOI: 10.1111/jdv.17042] [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: 11/30/2022]
Affiliation(s)
- I Papadimitriou
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Bakirtzi
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - N Sideris
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Paschou
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - F Vrani
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Vakirlis
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Ioannides
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Sotiriou
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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16
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Kartas A, Samaras A, Vasdeki D, Dividis G, Fotos G, Paschou E, Forozidou E, Tsoukra P, Kotsi E, Goulas I, Karagiannidis E, Karvounis H, Tzikas A, Giannakoulas G. Mortality in patients with atrial fibrillation with or without heart failure following hospital discharge. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The association of heart failure (HF) with the prognosis of atrial fibrillation (AF) remains unclear.
OBJECTIVES
To assess all-cause mortality in patients following hospitalization with comorbid AF in relation to the presence of HF.
Methods
We performed a cross-sectional analysis of data from 977 patients discharged from the cardiology ward of a single tertiary center between 2015 and 2018 and followed for a median of 2 years. The association between HF and the primary endpoint of death from any cause was assessed using multivariable Cox regression.
Results
HF was documented in 505 (51.7%) of AF cases at discharge, including HFrEF (17.9%), HFmrEF (16.5%) and HFpEF (25.2%). A primary endpoint event occurred in 212 patients (42%) in the AF-HF group and in 86 patients (18.2%) in the AF-no HF group (adjusted hazard ratio [aHR] 2.27; 95% confidence interval [CI], 1.65 to 3.13; P<0.001). HF was associated with a higher risk of the composite secondary endpoint of death from any cause, AF or HF-specific hospitalization (aHR 1.69; 95% CI 1.32 to 2.16 p<0.001). The associations of HF with the primary and secondary endpoints were significant and similar for AF-HFrEF, AF-HFmrEF, AF-HFpEF.
Conclusions
HF was present in half of the patients discharged from the hospital with comorbid AF. The presence of HF on top of AF was independently associated with a significantly higher risk of all-cause mortality than did absence of HF, irrespective of HF subtype.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Kartas
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - A Samaras
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - D Vasdeki
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - G Dividis
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - G Fotos
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - E Paschou
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - E Forozidou
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - P Tsoukra
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - E Kotsi
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - I Goulas
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | | | - H Karvounis
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - A Tzikas
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
| | - G Giannakoulas
- Ahepa University Hospital, Cardiology, Thessaloniki, Greece
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17
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Tzikas A, Samaras A, Kartas A, Vasdeki D, Fotos G, Dividis G, Paschou E, Forozidou E, Tsoukra P, Kotsi E, Goulas I, Karvounis H, Giannakoulas G. Motivational Interviewing to Support Oral AntiCoagulation adherence in patients with non-valvular Atrial Fibrillation (MISOAC-AF): a randomised clinical trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Oral anticoagulation (OAC) is paramount to effective thromboprophylaxis; yet adherence to OAC remains largely suboptimal in patients with atrial fibrillation (AF).
Purpose
We aimed to assess the impact of an educational, motivational intervention on the adherence to OAC in patients with non-valvular AF.
Methods
Hospitalised patients with non-valvular AF who received OAC were randomly assigned to usual medical care or a proactive intervention, comprising motivational interviewing and tailored counseling on medication adherence. The primary study outcome was adherence to OAC at 1-year, evaluated as Proportion of Days Covered (PDC) by OAC regimens and assessed through nationwide prescription registers. Secondary outcomes included the rate of persistence to OAC, gaps in treatment, proportion of VKA-takers with labile INR (defined as time to therapeutic range<70%) and clinical events.
Results
A total of 1009 patients were randomised, 500 in the intervention group and 509 in the control group. At 1-year follow-up, 77.2% (386/500) of patients in the intervention group had good adherence (PDC>80%), compared with 55% (280/509) in the control group (adjusted odds ratio 2.84, 95% confidence interval 2.14–3.75; p<0.001). Mean PDC±SD was 0.85±0.26 and 0.75±0.31, respectively (p<0.001). Patients that received the intervention were more likely to persist in their OAC therapy at 1 year, while usual medical care was associated with more major (≥3 months) treatment gaps [Figure]. Among 212 VKA-takers, patients in the intervention group were less likely to have labile INR compared with those in the control group [21/120 (17.1%) vs 34/92 (37.1%), OR 0.33 95% CI 1.15–0.72, p=0.005]. Clinical events over a median follow-up period of 2 years occurred at a numerically lower, yet non-significant, rate in the intervention group [Table].
Conclusions
In patients receiving OAC therapy for non-valvular AF, a motivational intervention significantly improved patterns of medication adherence, without significantly affecting clinical outcomes.
Primary and secondary outcomes
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Tzikas
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - A Samaras
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - A Kartas
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - D Vasdeki
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - G Fotos
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - G Dividis
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - E Paschou
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - E Forozidou
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - P Tsoukra
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - E Kotsi
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - I Goulas
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - H Karvounis
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - G Giannakoulas
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
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18
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Manoli SM, Moutsoudis A, Papageorgiou C, Lallas K, Rigas HM, Kyrmanidou E, Papadimitriou I, Paschou E, Spyridis I, Gkentsidi T, Sotiriou E, Vakirlis E, Ioannidis D, Apalla Z, Lallas A. Real-life data on basal cell carcinoma treatment: Insights on clinicians' therapeutic choices from an institutional hospital registry. Dermatol Ther 2020; 33:e14414. [PMID: 33064345 DOI: 10.1111/dth.14414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 12/19/2022]
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer in white skin individuals. The treatment of choice is surgical excision, but several other therapeutic choices are available and might also be efficient and cost-effective in selected cases of low-risk BCC or when surgery is complicate or contraindicated. The aim of the current study was to analyze the applied treatments for BCC in the real-life practice of a tertiary hospital, and investigate factors associated to the tumor and the patients that might influence the treatment selection of clinicians. Data on all BCCs treated from 1st January 2018 to 31st December 2019 were extracted. A total of 751 BCCs from 585 patients were included. The baseline characteristics of patients and tumors, the type of applied treatment and the histopathologic report when available were analyzed. Most tumors were located on the head/neck (64.2%). The most frequently applied treatment was surgical excision (580/751, 77.2%). In 22.8% of tumors a nonsurgical treatment was selected. The most frequently selected alternative treatments were, imiquimod, cryosurgery, their combination (immunocryosurgery), and vismodegib. A pretreatment diagnosis of superficial BCC was associated with a 12-fold increased probability of selecting a nonsurgical treatment except of vismodegib. Every added year of age increased the probability of selecting a nonsurgical treatment by 3-fold. Every added mm of diameter increased the possibility of vismodegib use by 4%. Surgery is the most frequently applied BCC treatment, but nonsurgical modalities do also have an essential role in real settings.
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Affiliation(s)
| | - Andreas Moutsoudis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | | | | | - Eirini Kyrmanidou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Eleni Paschou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Ioannis Spyridis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Elena Sotiriou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | | | - Zoe Apalla
- Second Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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Sabanis N, Zagkotsis G, Krikos VD, Paschou E, Tapanlis A. Central Retinal Artery Occlusion Secondary to Patent Foramen Ovale: The Unexpected Journey of a Paradoxical Embolus. Cureus 2020; 12:e9496. [PMID: 32879820 PMCID: PMC7458701 DOI: 10.7759/cureus.9496] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Central retinal artery occlusion (CRAO) represents one of the most devastating ophthalmic emergencies, since the inner two-thirds of the retina lose their blood supply. The acute obstruction of the central retinal artery is characterized by severe, sudden and unilateral painless visual loss and usually occurs secondary to an embolus of cardiovascular origin. A paradoxical thromboembolic event of the central retinal artery through patent foramen ovale is an exceptionally unusual clinical entity as well as a great diagnostic challenge since the source of initial thrombus formation requires extensive investigation. Herein, we aim to describe a patient with no significant comorbidities who experienced a paradoxical thromboembolic episode of central retinal artery associated with patent foramen ovale.
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Affiliation(s)
- Nikolaos Sabanis
- Department of Nephrology, General Hospital of Livadeia, Livadeia, GRC
| | | | | | - Eleni Paschou
- Department of Family Medicine, Medical Unit of Saint George, Livadeia, GRC
| | - Angelos Tapanlis
- Department of Emergency Medicine, General Hospital of Livadeia, Livadeia, GRC
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20
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Abstract
Rectus sheath hematoma (RSH), an exceptionally rare clinical entity, results from the rupture of epigastric arteries or tear of the rectus abdominis muscle itself. Spontaneous RSH represents a potentially life-threatening bleeding complication in anticoagulated patients with distinct characteristics. The non-specific nature of RSH clinical manifestations renders RSH a kaleidoscopic disease that may be misdiagnosed. The widespread use of anticoagulants for deep vein thrombosis (DVT) prophylaxis or therapy is among the most commonly documented risk factors. To the best of our knowledge, this is the first report of a fondaparinux-associated giant RSH in a 58-year-old Caucasian man who presented with severe pain at the right abdominal quadrant accompanied with a large ecchymosis secondary to violent cough due to a respiratory infection. The aim of our study is to broaden current knowledge regarding the predisposing factors, the pathophysiological mechanisms, and the management of this bleeding disorder.
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21
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Tzikas A, Samaras A, Kartas A, Vasdeki D, Fotos G, Dividis G, Paschou E, Forozidou E, Tsoukra P, Kotsi E, Goulas I, Karvounis H, Giannakoulas G. Motivational Interviewing to Support Oral AntiCoagulation adherence in patients with non-valvular Atrial Fibrillation (MISOAC-AF): a randomized clinical trial. Eur Heart J Cardiovasc Pharmacother 2020; 7:f63-f71. [PMID: 32339234 DOI: 10.1093/ehjcvp/pvaa039] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/05/2020] [Accepted: 04/21/2020] [Indexed: 12/13/2022]
Abstract
AIMS We aimed to assess the impact of an educational, motivational intervention on the adherence to oral anticoagulation (OAC) in patients with non-valvular atrial fibrillation (AF). METHODS AND RESULTS Hospitalized patients with non-valvular AF who received OAC were randomly assigned to usual medical care or a proactive intervention, comprising motivational interviewing, and tailored counselling on medication adherence. The primary study outcome was adherence to OAC at 1 year, which was evaluated according to proportion of days covered (PDC) by OAC regimens and was assessed through nationwide registers of prescription claims. Secondary outcomes included the rate of persistence to OAC, gaps in treatment, and clinical events. A total of 1009 patients were randomized, 500 in the intervention group and 509 in the control group. At 1-year follow-up, 77.2% (386/500) of patients in the intervention group were adherent (PDC > 80%), compared with 55% (280/509) in the control group [adjusted odds ratio (aOR) 2.84, 95% confidence interval (CI) 2.14-3.75; P < 0.001]. Mean PDC ± standard deviation was 0.85 ± 0.26 and 0.75 ± 0.31, respectively (P < 0.001). Patients that received the intervention were more likely to persist in their OAC therapy at 1 year (aOR 2.42, 95% CI 1.71-3.41; P < 0.001). Usual medical care was associated with more major (≥3 months) treatment gaps (aOR 2.39, 95% CI 1.76-3.26; P < 0.001). Clinical events over a median follow-up period of 2 years did not differ among treatment groups. CONCLUSION In patients receiving OAC therapy for non-valvular AF, a multilevel motivational intervention significantly improved medication adherence and rate of therapy persistence, and reduced major gaps in treatment. No significant impact on clinical outcomes was observed. TRIAL REGISTRATION NUMBER NCT02941978.
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Affiliation(s)
- Apostolos Tzikas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece.,Department of Cardiology, Interbalkan European Medical Center, Asklipiou 10, Pylaia, Thessaloniki 55535, Greece
| | - Athanasios Samaras
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - Anastasios Kartas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - Dimitra Vasdeki
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - George Fotos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - George Dividis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - Eleni Paschou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - Evropi Forozidou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - Paraskevi Tsoukra
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - Eleni Kotsi
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - Ioannis Goulas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - Haralambos Karvounis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - George Giannakoulas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
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22
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Samaras A, Kartas A, Vasdeki D, Dividis G, Forozidou E, Fotos G, Kotsi E, Paschou E, Tsoukra P, Goulas I, Karvounis H, Giannakoulas G, Tzikas A. Rationale and design of a randomized study comparing Motivational Interviewing to Support Oral Anticoagulation adherence versus usual care in patients with nonvalvular atrial fibrillation: The MISOAC-AF trial. Hellenic J Cardiol 2020; 61:453-454. [PMID: 32259588 DOI: 10.1016/j.hjc.2020.02.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/18/2020] [Accepted: 02/27/2020] [Indexed: 02/05/2023] Open
Affiliation(s)
- A Samaras
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - A Kartas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - D Vasdeki
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - G Dividis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - E Forozidou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - G Fotos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - E Kotsi
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - E Paschou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - P Tsoukra
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - I Goulas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - H Karvounis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - G Giannakoulas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - A Tzikas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece; Interbalkan European Medical Center, Asklipiou 10, Pylaia, Thessaloniki, Greece.
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Sabanis N, Paschou E, Papanikolaou P, Zagkotsis G. Purple Urine Bag Syndrome: More Than Eyes Can See. Curr Urol 2019; 13:125-132. [PMID: 31933590 PMCID: PMC6944938 DOI: 10.1159/000499281] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 09/03/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Purple urine bag syndrome (PUBS) is an uncommon clinical entity characterized by purple urine discoloration in the setting of urinary tract infections. Pa-thophysiology of PUBS has been correlated to aberrant metabolism of tryptophan. Multiple predisposing factors have been recognized, namely: female gender, advanced age, constipation, institutionalization, long-term catheter-ization, dementia and chronic kidney disease. Herein, we present a comprehensive review of all PUBS cases reported in PubMed, focusing on the predisposing factors and the microorganisms related to PUBS. METHODS We performed a search in PubMed database for articles referring to PUBS, published in English, French, Spanish and German from January 1978 until November 2017. The literature recruitment strategy was based on several keywords and Medical Subject Heading combination such as "purple urine bag syndrome" or PUBS or "urine discoloration". The finally selected articles were categorized into case reports/series (88 articles including 112 patients) and studies (10 articles including 134 patients). Demographical data as well as predisposing factors were recorded and further analyzed. RESULTS According to our findings, mean age of PUBS patients was 78.9 ± 12.3 years, 70.7% were female while 90.1% were suffering from constipation, 76.1% were in a bedridden situation, 45.1% were experiencing long-term catheterization, 42.8% had been diagnosed with dementia, 14.3% had recurrent urinary tract infections and 14.1% were chronic kidney disease patients. 91.3% of patients presenting with PUBS alkaline urine were observed while the most common microbe in urine cultures was E. coli. CONCLUSIONS PUBS is considered benign process in the majority of catheterized patients. Clinicians should be aware of the syndrome that may indicate serious comorbidities.
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Affiliation(s)
| | - Eleni Paschou
- Department of General Practice & Family Medicine, General Hospital of Livadeia, Voiotia, Greece
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24
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Samaras A, Kartas A, Fotos G, Vasdeki D, Dividis G, Paschou E, Tsoukra P, Forozidou E, Kotsi E, Goulas I, Karvounis H, Giannakoulas G, Tzikas A. P1869A novel risk score to predict mortality in patients with atrial fibrillation: the BLACCK (AF) death risk score. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0619] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Prior risk stratification schemes for atrial fibrillation (AF) have extensively focused on stroke as the principal outcome. However, an accurate estimation of the risk of death in patients with AF has received disproportional attention.
Purpose
The aim of this study was to develop and validate a risk score for predicting mortality in patients with AF who underwent a hospitalization for cardiac reasons.
Methods
The new risk score was developed and internally validated in 887 patients with AF, who were followed up for a median of 2 years. The outcome measure was all-cause mortality. Biomarker samples, echocardiographic data and renal function values were obtained at the date closest to hospital discharge. A Cox-model that determined the variables that significantly contributed to the prediction of all-cause mortality, was adapted to a risk points system through weighting of the model coefficients. The model was internally validated by bootstrapping, assessing both discrimination and calibration.
Results
311 all-cause deaths were reported during 1755 person-years of follow-up (incidence rate 17.7 events per 100 person-years). The most important predictors of death were N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin-T (hs-TnT), left atrial area indexed to body surface area (LAAi), prior cardiac arrest, kidney impairment, congestive heart failure and age, and were included in the BLACCK (AF) death risk score. The score was well-calibrated (observed probabilities adjusted to predicted probabilities) and showed good discriminative ability [c-index 0.87 (95% CI 0.85–0.90)]. The internal validation of the score reported minimal over-fitting (optimism-corrected c-index of 0.85). The 1, 2 and 3-year risk of death derived by the score's total points may be calculated immediately through the nomogram (Figure 1).
BLACCK (AF) risk score nomogram
Conclusions
We developed a simple, well-calibrated and internally validated novel risk score for predicting 1, 2 and 3-year risk of death in patients with AF after a hospitalization for cardiac reasons. The BLACCK (AF) death risk score included both cardiac biomarkers and clinical information, performed well and may assist physicians in decision-making when treating patients with AF.
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Affiliation(s)
- A Samaras
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - A Kartas
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - G Fotos
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - D Vasdeki
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - G Dividis
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - E Paschou
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - P Tsoukra
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - E Forozidou
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - E Kotsi
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - I Goulas
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - H Karvounis
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - G Giannakoulas
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
| | - A Tzikas
- Ahepa University Hospital, 1st Cardiology department, Thessaloniki, Greece
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Kartas A, Samaras A, Vasdeki D, Dividis G, Fotos G, Paschou E, Forozidou E, Tsoukra P, Kotsi E, Goulas I, Efthimiadis G, Giamouzis G, Karvounis H, Tzikas A, Giannakoulas G. Hospitalization affects the anticoagulation patterns of patients with atrial fibrillation. J Thromb Thrombolysis 2019; 48:225-232. [DOI: 10.1007/s11239-019-01832-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Sabanis N, Paschou E, Zagkotsis G. Sodium thiosulfate in calciphylaxis: Make a long story short. JAAD Case Rep 2019; 5:19-20. [PMID: 30662931 PMCID: PMC6323651 DOI: 10.1016/j.jdcr.2018.09.023] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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27
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Kartas A, Samaras A, Vasdeki D, Dividis G, Fotos G, Paschou E, Forozidou E, Tsoukra P, Kotsi E, Goulas I, Efthimiadis G, Karvounis H, Tzikas A, Giannakoulas G. Flaws in Anticoagulation Strategies in Patients With Atrial Fibrillation at Hospital Discharge. J Cardiovasc Pharmacol Ther 2019; 24:225-232. [DOI: 10.1177/1074248418821712] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Proper anticoagulation is a crucial therapeutic regimen in atrial fibrillation (AF). Objectives: To evaluate the real-life anticoagulation prescriptions of AF patients upon hospital discharge. Methods: We studied 768 patients with comorbid AF who were discharged from the cardiology ward of a tertiary hospital. We assessed the appropriateness of oral anticoagulation (OAC) regimens at discharge based on stroke risk (CHA2DS2-Vasc score), SAMe-TT2R2 (sex, age, medical history, treatment, tobacco, race) score for vitamin K antagonists (VKA), and European labeling for nonvitamin K oral anticoagulant (NOAC) dosing. Logistic regression identified factors associated with suboptimal OAC use. Results: Of 734 patients at significant (moderate or high) stroke risk, 107 (14.6%) were not prescribed OAC, which was administered to 23 (67.6%) of 34 patients at low risk. Nonprescribing of OAC to high-risk patients was associated with paroxysmal AF (adjusted odds ratio [OR]: 2.42, 95% confidence interval [CI]: 1.47-3.99, P < .001), history of major bleeding (adjusted OR: 1.89, 95% CI: 1.03-3.47, P = .039), and concomitant antiplatelet use (adjusted OR: 5.78, 95% CI: 3.51-9.51, P < .001). Anticoagulation control was inadequate (SAMe-TT2R2 score > 2) in 102 (50.2%) VKA-treated patients. Off-label dosing was evident in 118 (28.9%) NOAC-treated patients and was associated with a prior stroke/transient ischemic attack (adjusted OR: 2.06, 95% CI: 1.10-3.85, P = .023). Both outcomes were independently associated with low creatinine clearance. Conclusions: One of 6 patients with AF newly discharged from the hospital was treated discordantly for the corresponding risk of stroke. Suboptimal OAC use was evident in half of VKA regimens, twice as common compared to NOACs, and could be predicted by several clinical parameters.
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Affiliation(s)
- Anastasios Kartas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Samaras
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Vasdeki
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Dividis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Fotos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Paschou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evropi Forozidou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paraskevi Tsoukra
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Kotsi
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Goulas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Efthimiadis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Haralambos Karvounis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Tzikas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Cardiology, Interbalkan European Medical Center, Thessaloniki, Greece
| | - George Giannakoulas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Paschou E, Samaras A, Goulas I, Dividis G, Fotos G, Vasdeki D, Forozidou E, Tsoukra P, Kotsi E, Kartas A, Karvounis H, Tzikas A, Giannakoulas G. P6232ABC-death risk score predicts mortality better than CHA2DS2-VASc score in a contemporary population of hospitalised patients with atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6232] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- E Paschou
- AHEPA General Hospital, Thessaloniki, Greece
| | - A Samaras
- AHEPA General Hospital, Thessaloniki, Greece
| | - I Goulas
- AHEPA General Hospital, Thessaloniki, Greece
| | - G Dividis
- AHEPA General Hospital, Thessaloniki, Greece
| | - G Fotos
- AHEPA General Hospital, Thessaloniki, Greece
| | - D Vasdeki
- AHEPA General Hospital, Thessaloniki, Greece
| | - E Forozidou
- AHEPA General Hospital, Thessaloniki, Greece
| | - P Tsoukra
- AHEPA General Hospital, Thessaloniki, Greece
| | - E Kotsi
- AHEPA General Hospital, Thessaloniki, Greece
| | - A Kartas
- AHEPA General Hospital, Thessaloniki, Greece
| | - H Karvounis
- AHEPA General Hospital, Thessaloniki, Greece
| | - A Tzikas
- AHEPA General Hospital, Thessaloniki, Greece
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Zagkotsis G, Markou M, Paschou E, Papanikolaou P, Sabanis N. Preventing the development and progression of diabetic kidney disease: Where do we stand? Diabetes Metab Syndr 2018; 12:585-590. [PMID: 29602760 DOI: 10.1016/j.dsx.2018.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/15/2018] [Indexed: 01/07/2023]
Abstract
Diabetic kidney disease (DKD) is a major factor associated with increased cardiovascular (CV) and all-cause mortality and morbidity in patients with diabetes. Current standard therapy includes intensive management of hyperglycemia and blood pressure control with renin-angiotensin-aldosterone system (RAAS) blockers. Despite the implementation of this strategy, DKD remains the leading cause of end-stage renal disease (ESRD), mainly because of the increasing burden of diabetes mellitus. The aim of this review is to evaluate the available evidence, focusing on the benefit of current treatment in the development and progression of DKD.
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Affiliation(s)
- Georgios Zagkotsis
- Department of Nephrology, General Hospital of Livadeia, Livadeia, Greece.
| | - Maria Markou
- Department of Endocrinology, "Evaggelismos" General Hospital of Athens, Athens, Greece.
| | | | | | - Nikos Sabanis
- Department of Nephrology, General Hospital of Livadeia, Livadeia, Greece.
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30
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Samaras A, Fotos G, Dividis G, Paschou E, Thomaidou E, Goulas J, Vasdeki D, Forozidou E, Tsoukra P, Kotsi E, Kartas A, Giannakoulas G, Karvounis H, Tzikas A. P386Factors associated with the prescription practices of non-vitamin K antagonists in non valvular atrial fibrillation in daily clinical practice. Europace 2018. [DOI: 10.1093/europace/euy015.197] [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: 11/13/2022] Open
Affiliation(s)
- A Samaras
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - G Fotos
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - G Dividis
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - E Paschou
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - E Thomaidou
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - J Goulas
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - D Vasdeki
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - E Forozidou
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - P Tsoukra
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - E Kotsi
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - A Kartas
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - G Giannakoulas
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - H Karvounis
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
| | - A Tzikas
- Ahepa University Hospital, 1st Cardiology department , Thessaloniki, Greece
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Paschou E, Gavriilaki E, Papaioannou G, Tsompanakou A, Kalaitzoglou A, Sabanis N. Febuxostat hypersensitivity: another cause of DRESS syndrome in chronic kidney disease? Eur Ann Allergy Clin Immunol 2016; 48:251-255. [PMID: 27852432] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Febuxostat is a xanthine oxidase inhibitor that during the last years has successfully replaced allopurinol treatment in patients with chronic kidney disease (CKD) and hyperuricemia. Several adverse events have been observed during therapy with febuxostat. DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome induced by febuxostat has been poorly described, mainly in patient with CKD who previously developed allopurinol hypersensitivity syndrome. DRESS syndrome is characterized by manifold cutaneous reactions and systemic disorders with potential devastating consequences. The underlying pathogenetic mechanisms remain unidentified, though immune responses are often complicated. P-i concept can partially explain the phenomenon. The role of renal insufficiency appears to be crucial and further investigation is required. The present article describes the case of a CKD patient that developed febuxostat-related DRESS syndrome.
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Affiliation(s)
- E Paschou
- Department of General Practice and Family Medicine, General Hospital of Pella, Edessa, Greece. E-mail:
| | - E Gavriilaki
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Papaioannou
- Hematology Department and Hematopoietic Cell Transplantation (HCT) Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - A Tsompanakou
- Hematology Department and Hematopoietic Cell Transplantation (HCT) Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - A Kalaitzoglou
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - N Sabanis
- Department of Nephrology, General Hospital of Pella, Edessa, Greece
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Sabanis N, Gavriilaki E, Paschou E, Tsotsiou E, Kalaitzoglou A, Kavlakoudis C, Vasileiou S. Renal manifestations of human brucellosis: First report of minimal change disease. Saudi J Kidney Dis Transpl 2016; 27:590-4. [PMID: 27215256 DOI: 10.4103/1319-2442.182413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Human brucellosis is considered a great example of the complexity of clinical manifestations possibly affecting multiple organs or systems. Renal manifestations of human brucellosis have been documented in few case reports and one case series. Herein, we present a case of Nephrotic syndrome (NS) due to minimal change disease in the course of acute brucellosis. A 53-year-old male farmer was admitted to our department with acute brucellosis and NS. Renal biopsy revealed minimal change disease. Combined treatment with prednisone (1 mg/kg), rifampicin (600 mg/day), and doxycycline (200 mg/day) was initiated. Complete remission of NS was achieved at the end of the fourth week. One year later, the patient remained in complete remission of NS without any sign of relapse of brucellosis.
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Affiliation(s)
- Nikolaos Sabanis
- Department of Nephrology, General Hospital of Edessa, Edessa, Greece
| | - Eleni Gavriilaki
- Department of Nephrology, General Hospital of Edessa, Edessa, Greece
| | - Eleni Paschou
- Department of Nephrology, General Hospital of Edessa, Edessa, Greece
| | - Eleni Tsotsiou
- Department of Nephrology, General Hospital of Edessa, Edessa, Greece
| | - Asterios Kalaitzoglou
- Postgraduate Program, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Sampanis N, Gavriilaki E, Paschou E, Kalaitzoglou A, Vasileiou S. Ossification of the cervical ligamentum flavum and osseous brown tumor: late manifestations of primary hyperparathyroidism misdiagnosed in a case of parathyroid carcinoma. ACTA ACUST UNITED AC 2016; 13:54-6. [PMID: 27252748 DOI: 10.11138/ccmbm/2016.13.1.054] [Citation(s) in RCA: 2] [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] [Indexed: 11/17/2022]
Abstract
Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations. Herein we aimed at presenting an unique case of a young patient with late manifestations of parathyroid cancer and reviewing the relevant literature. A 45-year-old male patient presented in the Outpatient Clinic with an episode of nephrolithiasis. His personal medical history includes: recurrent episodes of nephrolithiasis, laminectomy in the cervical spine due to ossification of the cervical ligamentum flavum and surgical resection of a giant cell tumor of the brain. Laboratory testing revealed findings of primary hyperparathyroidism (serum calcium 16,0 mmol/l phosphorus 1,46 mg/dl and parathyroid hormone/PTH 8560 pg/ml). Neck ultrasound and technetium-99 m sestamibi scan were performed showing a parathyroid tumor. Due to the persistently high serum calcium and PTH levels, the high alkaline phosphatase levels (440 IU/L) and the late manifestations of HPT, surgical excision of the tumor was performed. The tumor was identified as parathyroid carcinoma. Immediately after surgery serum calcium and phosphorus levels were normalized. The patient is on a regular follow-up program with no signs of recurrence or metastasis one year after the excision. We describe the coexistence of rare late manifestations of HPT, which had not been adequately investigated at their onset in this young patient. Therefore, increased awareness is needed in order to recognize and further investigate signs or symptoms of HPT.
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Affiliation(s)
| | - Eleni Gavriilaki
- Nephrology Department, General Hospital of Edessa, Edessa, Greece
| | - Eleni Paschou
- Nephrology Department, General Hospital of Edessa, Edessa, Greece
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Sabanis N, Paschou E, Gavriilaki E, Kalaitzoglou A, Papanikolaou D, Vasileiou S, Amplianitis I. Acquired reactive perforating collagenosis and pseudoporphyric bullous dermatosis in a hemodialysis patient. Hemodial Int 2016; 20:E14-E18. [DOI: 10.1111/hdi.12402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Nikos Sabanis
- Department of Nephrology; General Hospital of Pella; Edessa Greece
| | - Eleni Paschou
- Department of General Practice and Family Medicine; General Hospital of Pella; Edessa Greece
| | - Eleni Gavriilaki
- Medical School, Aristotle University of Thessaloniki; Thessaloniki Greece
| | | | | | | | - Ioannis Amplianitis
- Department of Pathology; General Hospital Hippokrateion; Thessaloniki Greece
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35
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Gavriilaki E, Paschou E, Kalaitzoglou A, Papaioannou G, Sabanis N. B12 deficiency in chronic kidney disease: early recognition matters. Intern Med J 2015; 45:1195-6. [PMID: 26563692 DOI: 10.1111/imj.12892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/25/2015] [Indexed: 01/13/2023]
Affiliation(s)
- E Gavriilaki
- Medical School Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Paschou
- Medical School University of Thessaly, Larisa, Greece
| | - A Kalaitzoglou
- Medical School Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Papaioannou
- Hematology Department and Hematopoietic Cell Transplantation (HCT) Unit G. Papanicolaou Hospital, Thessaloniki, Greece
| | - N Sabanis
- Nephrology Department General Hospital of Pella, Edessa, Greece
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Sabanis N, Paschou E, Gavriilaki E, Kalaitzoglou A, Vasileiou S. Hypofibrinogenemia induced by tigecycline: a potentially life-threatening coagulation disorder. Infect Dis (Lond) 2015; 47:743-6. [PMID: 25951751 DOI: 10.3109/23744235.2015.1043942] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A 74-year-old female patient with end-stage renal disease, undergoing periodic hemodialysis, was hospitalized due to infection by multidrug-resistant Acinetobacter baumannii after hip replacement surgery. She was treated with tigecycline, a glycylcycline agent. Subsequently she developed coagulation disorders as substantiated by increased international normalized ratio (INR), prolonged partial thromboplastin time (aPTT), and severe hypofibrinogenemia, followed by transaminasemia, cholestasis, and anemia. Ultrasonography and computed tomography revealed no underlying pathological entities. Tigecycline was discontinued and the patient underwent daily hemodialysis and received multiple fresh frozen plasma transfusions. Additionally, she was treated with colistin. Her clinical and laboratory status improved. We suggest that patients treated with tigecycline should be monitored for changes in INR, aPTT, and fibrinogen levels to avoid severe, life-threatening coagulation disturbances.
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Affiliation(s)
- Nikolaos Sabanis
- From the 1 Nephrological Department, General Hospital of Pella , Edessa , Greece
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37
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Gavriilaki E, Sabanis N, Paschou E, Kalaitzoglou A, Michalaki K, Zarampoukas T. Disseminated tuberculosis: A neglected entity in immunocompromised hemodialysis patients. Hemodial Int 2014; 19:E8-E11. [DOI: 10.1111/hdi.12228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Eleni Gavriilaki
- Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Nikos Sabanis
- Nephrology Department; General Hospital of Edessa; Edessa Greece
| | - Eleni Paschou
- Nephrology Department; General Hospital of Edessa; Edessa Greece
| | | | | | - Thomas Zarampoukas
- Department of Pathology; Aristotle University of Thessaloniki; Thessaloniki Greece
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Gavriilaki E, Sabanis N, Paschou E, Grigoriadis S, Mainou M, Gaitanaki A, Skargani-Koraka M. Splenic infarction as a rare complication of infectious mononucleosis due to Epstein-Barr virus infection in a patient with no significant comorbidity: case report and review of the literature. ACTA ACUST UNITED AC 2013; 45:888-90. [PMID: 23957538 DOI: 10.3109/00365548.2013.821627] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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]
Abstract
We report the case of a 17-y-old boy diagnosed with infectious mononucleosis due to Epstein-Barr virus infection who complained of left upper quadrant pain. A magnetic resonance imaging scan showed a splenic infarct in the enlarged spleen. Other causes of splenic infarction were excluded. Thus, infectious mononucleosis may cause splenic infarction in patients without other comorbidities.
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Affiliation(s)
- Eleni Gavriilaki
- From the Department of Internal Medicine, General Hospital of Edessa , Edessa , Greece
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