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Rapti I, Asimakopoulos A, Liontos A, Kosmidou M, Christaki E, Biros D, Milionis O, Tsourlos S, Ntotsikas E, Ntzani E, Evangelou E, Gartzonika K, Georgiou I, Tzoulaki I, Tsilidis K, Milionis H. Association of patient characteristics with clinical outcomes in a cohort of hospitalised patients with SARS-CoV-2 infection in a Greek referral centre for COVID-19 - Corrigendum. Epidemiol Infect 2023; 151:e91. [PMID: 37288502 DOI: 10.1017/s0950268823000857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Affiliation(s)
- I Rapti
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - A Asimakopoulos
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - A Liontos
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - M Kosmidou
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - E Christaki
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - D Biros
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - O Milionis
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - S Tsourlos
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - E Ntotsikas
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - E Ntzani
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
- Center for Evidence-Based Medicine, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA
| | - E Evangelou
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - K Gartzonika
- Microbiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina45110, Greece
| | - I Georgiou
- Genetics and IVF Unit, Department of Obstetrics and Gynaecology, Medical School, University of Ioannina, Ioannina45110, Greece
| | - I Tzoulaki
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - K Tsilidis
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - H Milionis
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
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Katsanos AH, Palaiodimou L, Price C, Giannopoulos S, Lemmens R, Kosmidou M, Georgakis MK, Weimar C, Kelly PJ, Tsivgoulis G. Colchicine for stroke prevention in patients with coronary artery disease: a systematic review and meta-analysis. Eur J Neurol 2020; 27:1035-1038. [PMID: 32134555 DOI: 10.1111/ene.14198] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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: 01/28/2020] [Accepted: 02/28/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Although clinical trials suggest that colchicine may reduce the risk of vascular events in patients with a history of coronary artery disease, its effect on the prevention of cerebrovascular events still remains unclear. METHODS A systematic review and meta-analysis was performed of all available randomized controlled trials (RCTs) reporting on incident strokes during the follow-up of patients with a history of cardiovascular disease randomized to colchicine treatment or control (placebo or usual care). RESULTS Four RCTs were identified, including a total of 5553 patients (mean age 61 years, 81% males), with a follow-up ranging from 1 to 36 months. Colchicine treatment was associated with a significantly lower risk of incident stroke during follow-up compared to control (risk ratio 0.31, 95% confidence interval 0.13-0.71), without heterogeneity across included studies (I2 = 0%). Based on the pooled incident stroke rate of control groups (0.9%) in the included RCTs, it was estimated that administration of low-dose colchicine to 161 patients with coronary artery disease would prevent one stroke during a follow-up of 23 months. CONCLUSION Colchicine treatment decreases stroke risk in patients with a history of coronary artery disease. The effect of colchicine in secondary stroke prevention is currently being evaluated in an ongoing RCT.
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Affiliation(s)
- A H Katsanos
- Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, ON, Canada.,Second Department of Neurology, School of Medicine, 'Attikon University Hospital', National and Kapodistrian University of Athens, Athens, Greece
| | - L Palaiodimou
- Second Department of Neurology, School of Medicine, 'Attikon University Hospital', National and Kapodistrian University of Athens, Athens, Greece
| | - C Price
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - S Giannopoulos
- Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece
| | - R Lemmens
- Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), KU Leuven - University of Leuven, Leuven, Belgium.,Center for Brain and Disease Research, Laboratory of Neurobiology, VIB, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - M Kosmidou
- First Department of Internal Medicine, University of Ioannina School of Medicine, Ioannina, Greece
| | - M K Georgakis
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - C Weimar
- Department of Neurology, University of Duisburg-Essen, Essen, Germany
| | - P J Kelly
- Health Research Board Stroke Clinical Trials Network Ireland and Mater University Hospital/University College Dublin, Dublin, Ireland
| | - G Tsivgoulis
- Second Department of Neurology, School of Medicine, 'Attikon University Hospital', National and Kapodistrian University of Athens, Athens, Greece.,Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
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Katsanos AH, Kosmidou M, Konitsiotis S, Tsivgoulis G, Fiolaki A, Kyritsis AP, Giannopoulos S. Restless legs syndrome and cerebrovascular/cardiovascular events: Systematic review and meta-analysis. Acta Neurol Scand 2018; 137:142-148. [PMID: 28948600 DOI: 10.1111/ane.12848] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 09/11/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE We performed a systematic review and meta-analysis to evaluate the proposed association of restless legs syndrome (RLS) with cerebrovascular/cardiovascular outcomes. METHODS We calculated the corresponding odds ratios on the prevalence of cerebrovascular/cardiovascular risk factors and standardized mean differences on the reported mean age at baseline between RLS patients and controls. We also calculated the corresponding risk ratios and adjusted for potential confounders hazard ratios (HRsadjusted ) on the reported outcomes of interest between RLS patients and controls. RESULTS We identified 8 eligible studies (644 506 patients, mean age: 60.2 years, 36.2% males; 3.3% with RLS). RLS patients were found to have significantly higher prevalence of hypertension (P = .002), diabetes (P = .003) and hyperlipidemia (P = .010) compared to controls. In the unadjusted analyses of prospective observational studies, RLS patients were found to have significantly higher risk for cerebrovascular ischaemia (P = .01) and all-cause mortality (P = .04) compared to controls during follow-up, while in the adjusted for potential confounders analyses RLS patients were only found to have a higher risk of all-cause mortality (HR adjusted=1.52, 95% CI: 1.17-1.97, P = .002). CONCLUSIONS The present report does not provide evidence for an increased risk of cerebrovascular and cardiovascular events in RLS patients, which highlights the vast presence of confounding factors.
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Affiliation(s)
- A. H. Katsanos
- Department of Neurology; School of Medicine; University of Ioannina; Ioannina Greece
- Neurosurgical Research Institute; University of Ioannina; Ioannina Greece
| | - M. Kosmidou
- Department of Internal Medicine; School of Medicine; University of Ioannina; Ioannina Greece
| | - S. Konitsiotis
- Department of Neurology; School of Medicine; University of Ioannina; Ioannina Greece
| | - G. Tsivgoulis
- Second Department of Neurology; School of Medicine; University of Athens; Athens Greece
- Department of Neurology; University of Tennessee Health Science Center; Memphis TN USA
| | - A. Fiolaki
- Department of Neurology; School of Medicine; University of Ioannina; Ioannina Greece
| | - A. P. Kyritsis
- Department of Neurology; School of Medicine; University of Ioannina; Ioannina Greece
- Neurosurgical Research Institute; University of Ioannina; Ioannina Greece
| | - S. Giannopoulos
- Department of Neurology; School of Medicine; University of Ioannina; Ioannina Greece
- Neurosurgical Research Institute; University of Ioannina; Ioannina Greece
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Abstract
BACKGROUND It has been estimated that 1.3-6.4% of patients with inflammatory bowel diseases (IBD) are complicated by cerebral venous thrombosis (CVT) at some point of time during the course of their disease. METHODS We retrospectively reviewed and subsequently analyzed data from 65 case reports of IBD patients with CVT. Our sources included MEDLINE and EMBASE, and the references of retrieved articles were also screened. RESULTS Patients with CVT and IBD were significantly younger than CVT patients without IBD. Female patients were complicated more frequently but at an older age when compared with males. The incidence of ulcerative colitis was almost double compared with Crohn's disease. Active disease was detected in 78.4% of the cases and the proportions of patients with active ulcerative colitis or active Crohn's disease were almost equal. The predominant neurological symptom in these patients was persistent headache (80%) and the most common site of CVT was the superior sagittal sinus (50.7%). Severe iron deficiency anemia was highlighted as a significant risk factor for thrombosis in nearly half of the patients. Transient coagulation abnormalities and hereditary thrombogenic mutations were identified in 23 and 20% of the case reports, respectively. CONCLUSION The overall outcome was very good, especially in those patients who were treated acutely with heparin or low molecular weight heparin, suggesting that heparin administration is related with improved neurological outcome and decreased mortality rates even in IBD patients complicated with CVT.
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Affiliation(s)
- A H Katsanos
- Department of Neurology, University of Ioannina School of Medicine, University Campus, 45110 Ioannina, Greece
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Abstract
Hepatitis E virus (HEV) is a common cause of waterborne epidemics of acute hepatitis worldwide, but its natural history, ecology, clinical significance and presentation are entirely different in the developed world, where, apart from the typical travel-associated imported cases, the majority of the observed cases involve older adults with comorbidities or forms of immune compromise who acquire HEV genotype 3, mostly through direct or indirect (consumption of meat products) contact with pigs. Thus, HEV is zoonotic in the developed world, a fact that has been recently recognized, and is of major importance in medical, veterinary and public health terms. The present article evaluates the current knowledge about the zoonotic nature of HEV in the industrialized world, outlines the numerous questions that still exist regarding the role of pigs in viral ecology, summarizes knowledge about clinical disease in its zoonotic form, and discusses where future scientific efforts should focus.
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Affiliation(s)
- L Christou
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
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Milionis HJ, Giannopoulos S, Kosmidou M, Panoulas V, Manios E, Kyritsis AP, Elisaf MS, Vemmos K. Statin therapy after first stroke reduces 10-year stroke recurrence and improves survival. Neurology 2009; 72:1816-22. [DOI: 10.1212/wnl.0b013e3181a711cb] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kosmidou M, Hatzitolios A, Adamidou A, Giannopoulos S, Raikos N, Parharidis G, Milionis H. EFFECTS OF ATORVASTATIN ON RED BLOOD CELL NA+/LI- COUNTETRANSPORT IN HYPERLIPIDEMIC PATIENTS WITH AND WITHOUT HYPERTENSION. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70817-1] [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: 11/26/2022]
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Hatzitolios A, Savopoulos C, Ntaios G, Papadidaskalou F, Dimitrakoudi E, Kosmidou M, Baltatzi M, Karamitsos D. Stroke and conditions that mimic it: a protocol secures a safe early recognition. Hippokratia 2008; 12:98-102. [PMID: 18923652 PMCID: PMC2464301] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Certain disorders may be falsely diagnosed as stroke. We examined the efficacy of the diagnostic protocol that is followed in our stroke unit and was designed in order to early differentiate more efficiently between stroke and conditions that mimic it. METHODS-PATIENTS: Three hundred sixty-two elderly patients (196 male, 166 female with average age 74.56 years), who were hospitalized at our stroke center between January of 2005 and June of 2007 and diagnosed at admission as stroke patients, were retrospectively studied in order to investigate if the final diagnosis agreed with the initial diagnosis of stroke on admission.Our diagnostic protocol included medical history of the patient, assessment of state of consciousness, blood pressure, electrocardiogram, complete blood cell count (hematocrit/hemoglobin, leukocytes, platelets), clotting mechanism (prothrombin time, activated partial thromboplastin time), glucose, electrolytes (Na, K, Ca), renal (blood urea nitrogen, creatinine) and liver function (SGOT, SGPT), as well as imaging methods like chest X-Ray and brain CT scan. RESULTS In 95% of patients, the final diagnosis agreed with the initial diagnosis of stroke at admission. According to final diagnosis, 344 (95%) of them had stroke -either hemorrhagic or ischemic-, while from the rest 18 (5%), 12 (66.7%) were found to have metastatic neoplasm of brain, 3 (18.7%) had primal tumour of brain, whereas 3 (18.7%) suffered from other diseases (respiratory infection, meningoencephalitis, thyrotoxicosis). The principal symptoms of the conditions that mimicked a stroke were: aphasic disturbances (27.3%), dizziness/fainting (27.3%), headache/diplopia (11.1%), dysarthria (11.1%), hiccup and/or swallow disturbances (5.6%). CONCLUSION Our diagnostic protocol seems to ensure a high degree of differential diagnosis between stroke and conditions that mimic it.
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Affiliation(s)
- A Hatzitolios
- First Propedeutic Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Savopoulos C, Hatzitolios A, Panagopoulou P, Kosmidou M, Tsirogianni E, Konstantinou V. Hypothyroidism in Prader-Willi syndrome: a case report and review of the literature. J Endocrinol Invest 2007; 30:804-5. [PMID: 17993776 DOI: 10.1007/bf03350822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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