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Panagopoulos PK, Georgakopoulou VE, Pezoulas VC, Malagari K, Fotiadis DI, Goules AV, Vassilakopoulos T, Tzioufas AG. Comparison of pulmonary and small airways function between idiopathic inflammatory myopathies patients with and without interstitial lung disease. Clin Exp Rheumatol 2024; 42:337-343. [PMID: 37382448 DOI: 10.55563/clinexprheumatol/v22yge] [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] [Received: 03/27/2023] [Accepted: 06/12/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To evaluate pulmonary and small airway function in patients with idiopathic inflammatory myopathies (IIM) and make comparisons between patients with and without interstitial lung disease (ILD). METHODS Newly diagnosed IIM patients with and without ILD determined by high resolution computed tomography were included in the study. Pulmonary and small airway function was assessed by spirometry, diffusing capacity for carbon monoxide (DLCO), body plethysmography, single and multiple breath nitrogen washout, impulse oscillometry and measurement of respiratory resistance by the interrupter technique (Rint) using the Q-box system. We used discrepancies between lung volumes measured by multiple breath nitrogen washout and body plethysmography to evaluate for small airway dysfunction. RESULTS Study cohort comprised of 26 IIM patients, 13 with and 13 without ILD. IIM-ILD patients presented more frequently with dyspnoea, fever, arthralgias and positive anti-synthetase antibodies, compared to IIM patients without ILD. Classic spirometric parameters and most lung physiology parameters assessing small airway function did not differ between the two groups. Predicted total lung capacity and residual volume (TLCN2WO, RVN2WO) measured by multiple breath nitrogen washout and the TLCN2WO/TLCpleth ratio were significantly lower in IIM-ILD patients compared to those without ILD (mean: 111.1% vs. 153.4%, p=0.034, median: 171% vs. 210%, p=0.039 and median: 1.28 vs. 1.45, p=0.039, respectively). Rint tended to be higher among IIM-ILD patients (mean:100.5% vs. 76.6%, p=0.053). CONCLUSIONS Discrepancies between lung volumes measured by multiple breath nitrogen washout and body plethysmography in IIM-ILD patients indicate an early small airways dysfunction in these patients.
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Affiliation(s)
- Panagiotis K Panagopoulos
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Vasiliki E Georgakopoulou
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Vasileios C Pezoulas
- Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Greece
| | - Katerina Malagari
- 2nd Department of Radiology, University of Athens, Attikon Hospital, Chaidari, Athens, Greece
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Greece
| | - Andreas V Goules
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Theodoros Vassilakopoulos
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Athanasios G Tzioufas
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Greece.
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Arvanitakis K, Papadakos SP, Lekakis V, Koufakis T, Lempesis IG, Papantoniou E, Kalopitas G, Georgakopoulou VE, Stergiou IE, Theocharis S, Germanidis G. Meeting at the Crossroad between Obesity and Hepatic Carcinogenesis: Unique Pathophysiological Pathways Raise Expectations for Innovative Therapeutic Approaches. Int J Mol Sci 2023; 24:14704. [PMID: 37834153 PMCID: PMC10572430 DOI: 10.3390/ijms241914704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
The escalating global prevalence of obesity and its intricate association with the development of hepatocellular carcinoma (HCC) pose a substantial challenge to public health. Obesity, acknowledged as a pervasive epidemic, is linked to an array of chronic diseases, including HCC, catalyzing the need for a comprehensive understanding of its molecular underpinnings. Notably, HCC has emerged as a leading malignancy with rising incidence and mortality. The transition from viral etiologies to the prominence of metabolic dysfunction-associated fatty liver disease (MAFLD)-related HCC underscores the urgent need to explore the intricate molecular pathways linking obesity and hepatic carcinogenesis. This review delves into the interwoven landscape of molecular carcinogenesis in the context of obesity-driven HCC while also navigating using the current therapeutic strategies and future prospects for combating obesity-related HCC. We underscore the pivotal role of obesity as a risk factor and propose an integrated approach encompassing lifestyle interventions, pharmacotherapy, and the exploration of emerging targeted therapies. As the obesity-HCC nexus continues to challenge healthcare systems globally, a comprehensive understanding of the intricate molecular mechanisms and innovative therapeutic strategies is imperative to alleviate the rising burden of this dual menace.
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Affiliation(s)
- Konstantinos Arvanitakis
- First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.A.); (E.P.); (G.K.)
- Basic and Translational Research Unit (BTRU), Special Unit for Biomedical Research and Education (BRESU), Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Stavros P. Papadakos
- First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.P.P.); (S.T.)
| | - Vasileios Lekakis
- Department of Gastroenterology, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece;
| | - Theocharis Koufakis
- Division of Endocrinology and Metabolism and Diabetes Centre, First Department of Internal Medicine, Medical School, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Ioannis G. Lempesis
- Institute of Metabolism and Systems Research (IMSR), College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK;
| | - Eleni Papantoniou
- First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.A.); (E.P.); (G.K.)
| | - Georgios Kalopitas
- First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.A.); (E.P.); (G.K.)
- Basic and Translational Research Unit (BTRU), Special Unit for Biomedical Research and Education (BRESU), Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | | | - Ioanna E. Stergiou
- Pathophysiology Department, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Stamatios Theocharis
- First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.P.P.); (S.T.)
| | - Georgios Germanidis
- First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.A.); (E.P.); (G.K.)
- Basic and Translational Research Unit (BTRU), Special Unit for Biomedical Research and Education (BRESU), Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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3
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Basoulis D, Tsakanikas A, Gkoufa A, Bitsani A, Karamanakos G, Mastrogianni E, Georgakopoulou VE, Makrodimitri S, Voutsinas PM, Lamprou P, Kontos A, Tsiakas S, Gamaletsou MN, Marinaki S, Sipsas NV. Effectiveness of Oral Nirmatrelvir/Ritonavir vs. Intravenous Three-Day Remdesivir in Preventing Progression to Severe COVID-19: A Single-Center, Prospective, Comparative, Real-Life Study. Viruses 2023; 15:1515. [PMID: 37515201 PMCID: PMC10383489 DOI: 10.3390/v15071515] [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: 06/20/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Nirmatrelvir/ritonavir (NMV/r) and three-day course remdesivir (3RDV) have been approved as early treatments for COVID-19 outpatients not requiring supplemental oxygen. Real-life data on the efficacy of antivirals among immunocompromised patients or directly comparing their effectiveness in preventing hospitalization and/or death are scarce. METHODS Prospective, observational study conducted in a tertiary care hospital, from 1 January 2022 until 15 March 2023, during the prevalence of the Omicron variant. Inverse probability of treatment weighting (IPTW) was used to account for differences between treatment groups. RESULTS We included 521, mainly immunocompromised (56%), patients in our analysis; 356 (68.3%) received 3RDV and 165 (31.7%) NMV/r. Overall, 15/521 (2.9%) patients met the primary end-point of hospitalization at 30 days (3RDV arm: 10/356, 2.8% vs. NMV/r arm: 5/165, 3%, p = 1). On IPTW-adjusted univariable analysis, the choice of treatment did not affect outcomes. In multivariable logistic regression analysis, we found that one (OR 0.26, 95%CI 0.07-0.99, p = 0.049) or two (OR 0.06, 95%CI 0.01-0.55, p = 0.014) vaccine booster shots reduced the risk for adverse outcomes. CONCLUSION In our patient population of high-risk, mainly immunocompromised, vaccinated patients during the prevalence of the Omicron variant, NMV/r and 3RDV were equally effective early treatments for the prevention of hospitalization and/or death.
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Affiliation(s)
- Dimitrios Basoulis
- Infectious Diseases Unit, Laiko General Hospital, 115 27 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, 115 27 Athens, Greece
| | | | - Aikaterini Gkoufa
- Infectious Diseases Unit, Laiko General Hospital, 115 27 Athens, Greece
| | - Aikaterini Bitsani
- Infectious Diseases Unit, Laiko General Hospital, 115 27 Athens, Greece
- Haematology Clinic and Bone Marrow Transplantation Unit, Laiko General Hospital, 115 27 Athens, Greece
| | | | | | - Vasiliki E Georgakopoulou
- Infectious Diseases Unit, Laiko General Hospital, 115 27 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, 115 27 Athens, Greece
| | | | | | - Panagiota Lamprou
- Pulmonology Department, Laiko General Hospital, 115 27 Athens, Greece
| | - Athanasios Kontos
- Department of Pathophysiology, Laiko General Hospital, 115 27 Athens, Greece
| | - Stathis Tsiakas
- Department of Nephrology and Renal Transplantation, Laiko General Hospital, 115 27 Athens, Greece
| | | | - Smaragdi Marinaki
- Department of Nephrology and Renal Transplantation, Laiko General Hospital, 115 27 Athens, Greece
- Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Nikolaos V Sipsas
- Infectious Diseases Unit, Laiko General Hospital, 115 27 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, 115 27 Athens, Greece
- Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
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4
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Lempesis IG, Georgakopoulou VE. Physiopathological mechanisms related to inflammation in obesity and type 2 diabetes mellitus. World J Exp Med 2023; 13:7-16. [PMID: 37396883 PMCID: PMC10308320 DOI: 10.5493/wjem.v13.i3.7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/15/2023] [Accepted: 04/10/2023] [Indexed: 06/16/2023] Open
Abstract
Overweight, obesity, and type 2 diabetes mellitus pose global health problems that are ever-increasing. A chronic low-grade inflammatory status and the presence of various pro-inflammatory markers either in circulation or within dysfunctional metabolic tissues are well established. The presence of these factors can, to some extent, predict disease development and progression. A central role is played by the presence of dysfunctional adipose tissue, liver dysfunction, and skeletal muscle dysfunction, which collectively contribute to the increased circulatory levels of proinflammatory factors. Weight loss and classical metabolic interventions achieve a decrease in many of these factors’ circulating levels, implying that a better understanding of the processes or even the modulation of inflammation may alleviate these diseases. This review suggests that inflammation plays a significant role in the development and progression of these conditions and that measuring inflammatory markers may be useful for assessing disease risk and development of future treatment methods.
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Affiliation(s)
- Ioannis G Lempesis
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Athens 11527, Greece
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5
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Korkontzelos I, Mpourazanis G, Goshi F, Vogiatzis R, Theodorou DJ, Korkontzelou PD, Balassi E, Georgakopoulou VE, Papamitsou T. Giant Ulcerated Fibroepithelial Stromal Polyp of the Vulva: A Case Report. Cureus 2023; 15:e40017. [PMID: 37425539 PMCID: PMC10323151 DOI: 10.7759/cureus.40017] [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: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Fibroepithelial stromal polyps (FEPs) are benign skin tumors or lesions of mesenchymal and ectodermal origin, also referred to as acrochordons. Herein, we report the case of a 45-year-old woman with a large ulcerated fibroepithelial stromal polyp extending from the right labium of the vulva. No known predisposing factor was recorded to justify the presence and rapid growth of the polyp. Antibiotic treatment was given due to inflammation, and magnetic resonance imaging was useful in establishing a diagnosis. A wide surgical excision was performed, and a histopathological examination confirmed the initial diagnosis, revealing no nuclear atypia or mitoses. The patient recovered well, and follow-up after one year showed no evidence of complications or recurrence.
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Affiliation(s)
- Ioannis Korkontzelos
- Department of Obstetrics and Gynecology, Ioannina State General Hospital G. Chatzikosta, Ioannina, GRC
| | - George Mpourazanis
- Department of Obstetrics and Gynecology, Ioannina State General Hospital G. Chatzikosta, Ioannina, GRC
| | - Fatma Goshi
- Department of Obstetrics and Gynecology, Ioannina State General Hospital G. Chatzikosta, Ioannina, GRC
| | - Romanos Vogiatzis
- Department of Dermatology, Ernst-Moritz-Arndt University, Greifswald, DEU
| | - Daphne J Theodorou
- Department of Radiology, Ioannina State General Hospital G. Chatzikosta, Ioannina, GRC
| | | | - Eufemia Balassi
- Department of Pathology, Ioannina State General Hospital G. Chatzikosta, Ioannina, GRC
| | - Vasiliki E Georgakopoulou
- Department of Pulmonology, Laiko General Hospital, Athens, GRC
- Department of Pulmonology, Sismanoglio Hospital, Athens, GRC
| | - Theodora Papamitsou
- Department of Histology-Embryology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
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6
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Lempesis IG, Georgakopoulou VE. Implications of obesity and adiposopathy on respiratory infections; focus on emerging challenges. World J Clin Cases 2023; 11:2925-2933. [PMID: 37215426 PMCID: PMC10198078 DOI: 10.12998/wjcc.v11.i13.2925] [Citation(s) in RCA: 3] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/17/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
Obesity is characterized by excessive adipose tissue accumulation, which impacts physiological, metabolic, and immune functions. Several respiratory infections, including bacterial pneumonia, influenza, and coronavirus disease 2019, appear to be linked to unfavorable results in individuals with obesity. These may be attributed to the direct mechanical/physiological effects of excess body fat on the lungs’ function. Notably, adipose tissue dysfunction is associated with a low-grade chronic inflammatory status and hyperleptinemia, among other characteristics. These have all been linked to immune system dysfunction and weakened immune responses to these infections. A better understanding and clinical awareness of these risk factors are necessary for better disease outcomes.
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Affiliation(s)
- Ioannis G Lempesis
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Athens 11527, Greece
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7
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Lempesis IG, Karlafti E, Papalexis P, Fotakopoulos G, Tarantinos K, Lekakis V, Papadakos SP, Cholongitas E, Georgakopoulou VE. COVID-19 and liver injury in individuals with obesity. World J Gastroenterol 2023; 29:908-916. [PMID: 36844135 PMCID: PMC9950870 DOI: 10.3748/wjg.v29.i6.908] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/18/2022] [Accepted: 01/09/2023] [Indexed: 02/10/2023] Open
Abstract
Coronavirus disease 2019 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 that manifests as a variety of clinical manifestations, including liver damage commonly detected by a hepatocellular pattern from liver function tests. Liver injury is associated with a worse prognosis overall. Conditions associated with the severity of the disease include obesity and cardiometabolic comorbidities, which are also associated with nonalcoholic fatty liver disease (NAFLD). The presence of NAFLD, similarly to obesity, is associated with an unfavourable impact on the coronavirus disease 2019 outcome. Individuals with these conditions could present with liver damage and elevated liver function tests due to direct viral cytotoxicity, systemic inflammation, ischemic or hypoxic liver damage or drug side effects. However, liver damage in the setting of NAFLD could also be attributed to a pre-existing chronic low-grade inflammation associated with surplus and dysfunctional adipose tissue in these individuals. Here we investigate the hypothesis that a pre-existing inflammatory status is exacerbated after severe acute respiratory syndrome coronavirus 2 infection, which embodies a second hit to the underestimated liver damage.
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Affiliation(s)
- Ioannis G Lempesis
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht 616 6200, Netherlands
| | - Eleni Karlafti
- Department of Emergency, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki 546 21, Greece
| | - Petros Papalexis
- Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece
- Department of Biomedical Sciences, University of West Attica, Athens 12243, Greece
| | - George Fotakopoulos
- Department of Neurosurgery, General University Hospital of Larisa, Larisa 41221, Greece
| | | | - Vasileios Lekakis
- Department of Gastroenterology, Laiko General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Stavros P Papadakos
- Department of Gastroenterology, Laiko General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Evangelos Cholongitas
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
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Karampitsakos T, Sotiropoulou V, Katsaras M, Tsiri P, Georgakopoulou VE, Papanikolaou IC, Bibaki E, Tomos I, Lambiri I, Papaioannou O, Zarkadi E, Antonakis E, Pandi A, Malakounidou E, Sampsonas F, Makrodimitri S, Chrysikos S, Hillas G, Dimakou K, Tzanakis N, Sipsas NV, Antoniou K, Tzouvelekis A. Post-COVID-19 interstitial lung disease: Insights from a machine learning radiographic model. Front Med (Lausanne) 2023; 9:1083264. [PMID: 36733935 PMCID: PMC9886681 DOI: 10.3389/fmed.2022.1083264] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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] [Received: 10/28/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction Post-acute sequelae of COVID-19 seem to be an emerging global crisis. Machine learning radiographic models have great potential for meticulous evaluation of post-COVID-19 interstitial lung disease (ILD). Methods In this multicenter, retrospective study, we included consecutive patients that had been evaluated 3 months following severe acute respiratory syndrome coronavirus 2 infection between 01/02/2021 and 12/5/2022. High-resolution computed tomography was evaluated through Imbio Lung Texture Analysis 2.1. Results Two hundred thirty-two (n = 232) patients were analyzed. FVC% predicted was ≥80, between 60 and 79 and <60 in 74.2% (n = 172), 21.1% (n = 49), and 4.7% (n = 11) of the cohort, respectively. DLCO% predicted was ≥80, between 60 and 79 and <60 in 69.4% (n = 161), 15.5% (n = 36), and 15.1% (n = 35), respectively. Extent of ground glass opacities was ≥30% in 4.3% of patients (n = 10), between 5 and 29% in 48.7% of patients (n = 113) and <5% in 47.0% of patients (n = 109). The extent of reticulation was ≥30%, 5-29% and <5% in 1.3% (n = 3), 24.1% (n = 56), and 74.6% (n = 173) of the cohort, respectively. Patients (n = 13, 5.6%) with fibrotic lung disease and persistent functional impairment at the 6-month follow-up received antifibrotics and presented with an absolute change of +10.3 (p = 0.01) and +14.6 (p = 0.01) in FVC% predicted at 3 and 6 months after the initiation of antifibrotic. Conclusion Post-COVID-19-ILD represents an emerging entity. A substantial minority of patients presents with fibrotic lung disease and might experience benefit from antifibrotic initiation at the time point that fibrotic-like changes are "immature." Machine learning radiographic models could be of major significance for accurate radiographic evaluation and subsequently for the guidance of therapeutic approaches.
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Affiliation(s)
| | - Vasilina Sotiropoulou
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Matthaios Katsaras
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Panagiota Tsiri
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | | | | | - Eleni Bibaki
- Laboratory of Molecular and Cellular Pneumonology, Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Ioannis Tomos
- 5th Department of Respiratory Medicine, Hospital for Thoracic Diseases, ‘SOTIRIA’, Athens, Greece
| | - Irini Lambiri
- Laboratory of Molecular and Cellular Pneumonology, Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Ourania Papaioannou
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Eirini Zarkadi
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | | | - Aggeliki Pandi
- Department of Respiratory Medicine, Corfu General Hospital, Corfu, Greece
| | - Elli Malakounidou
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Fotios Sampsonas
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Sotiria Makrodimitri
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Athens, Greece
| | - Serafeim Chrysikos
- 5th Department of Respiratory Medicine, Hospital for Thoracic Diseases, ‘SOTIRIA’, Athens, Greece
| | - Georgios Hillas
- 5th Department of Respiratory Medicine, Hospital for Thoracic Diseases, ‘SOTIRIA’, Athens, Greece
| | - Katerina Dimakou
- 5th Department of Respiratory Medicine, Hospital for Thoracic Diseases, ‘SOTIRIA’, Athens, Greece
| | - Nikolaos Tzanakis
- Laboratory of Molecular and Cellular Pneumonology, Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Nikolaos V. Sipsas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Athens, Greece,Medical School, National and Kapodistrian University of Athens, Zografou, Greece
| | - Katerina Antoniou
- Laboratory of Molecular and Cellular Pneumonology, Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Argyris Tzouvelekis
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece,*Correspondence: Argyris Tzouvelekis, ,
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9
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Karampitsakos T, Sotiropoulou V, Katsaras M, Tsiri P, Georgakopoulou VE, Papanikolaou IC, Bibaki E, Tomos I, Lambiri I, Papaioannou O, Zarkadi E, Antonakis E, Pandi A, Malakounidou E, Sampsonas F, Makrodimitri S, Chrysikos S, Hillas G, Dimakou K, Tzanakis N, Sipsas NV, Antoniou K, Tzouvelekis A. Corrigendum: Post-COVID-19 interstitial lung disease: Insights from a machine learning radiographic model. Front Med (Lausanne) 2023; 10:1194925. [PMID: 37122328 PMCID: PMC10134070 DOI: 10.3389/fmed.2023.1194925] [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: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 05/02/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fmed.2022.1083264.].
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Affiliation(s)
| | - Vasilina Sotiropoulou
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Matthaios Katsaras
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Panagiota Tsiri
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | | | | | - Eleni Bibaki
- Laboratory of Molecular and Cellular Pneumonology, Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Ioannis Tomos
- 5th Department of Respiratory Medicine, Hospital for Thoracic Diseases, ‘SOTIRIA', Athens, Greece
| | - Irini Lambiri
- Laboratory of Molecular and Cellular Pneumonology, Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Ourania Papaioannou
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Eirini Zarkadi
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | | | - Aggeliki Pandi
- Department of Respiratory Medicine, Corfu General Hospital, Corfu, Greece
| | - Elli Malakounidou
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Fotios Sampsonas
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Sotiria Makrodimitri
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Athens, Greece
| | - Serafeim Chrysikos
- 5th Department of Respiratory Medicine, Hospital for Thoracic Diseases, ‘SOTIRIA', Athens, Greece
| | - Georgios Hillas
- 5th Department of Respiratory Medicine, Hospital for Thoracic Diseases, ‘SOTIRIA', Athens, Greece
| | - Katerina Dimakou
- 5th Department of Respiratory Medicine, Hospital for Thoracic Diseases, ‘SOTIRIA', Athens, Greece
| | - Nikolaos Tzanakis
- Laboratory of Molecular and Cellular Pneumonology, Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Nikolaos V. Sipsas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Athens, Greece
- Medical School, National and Kapodistrian University of Athens, Zografou, Greece
| | - Katerina Antoniou
- Laboratory of Molecular and Cellular Pneumonology, Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Argyris Tzouvelekis
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
- *Correspondence: Argyris Tzouvelekis ;
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10
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Bali T, Georgakopoulou VE, Kamiliou A, Vergos I, Adamantou M, Vlachos S, Ermidis G, Sipsas NV, Samarkos M, Cholongitas E. Abnormal liver function tests and coronavirus disease 2019: A close relationship. J Viral Hepat 2023; 30:79-80. [PMID: 36369662 PMCID: PMC9878169 DOI: 10.1111/jvh.13772] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/02/2022] [Indexed: 11/14/2022]
Affiliation(s)
- Triada Bali
- First Department of Internal Medicine, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece
| | - Vasiliki E. Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Medical SchoolNational and Kapodistrian University of AthensAthensGreece,Infectious Diseases and COVID‐19 Unit, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece
| | - Aikaterini Kamiliou
- First Department of Internal Medicine, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece
| | - Ioannis Vergos
- First Department of Internal Medicine, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece
| | - Magdalini Adamantou
- First Department of Internal Medicine, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece
| | - Stefanos Vlachos
- First Department of Internal Medicine, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece
| | - George Ermidis
- First Department of Internal Medicine, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece
| | - Nikolaos V. Sipsas
- Infectious Diseases and COVID‐19 Unit, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece,Pathophysiology Department, Medical SchoolNational and Kapodistrian University of Athens, and General Hospital of Athens LaikoAthensGreece
| | - Michael Samarkos
- First Department of Internal Medicine, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece,Infectious Diseases and COVID‐19 Unit, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece
| | - Evangelos Cholongitas
- First Department of Internal Medicine, Laiko General HospitalMedical School of National and Kapodistrian University of AthensAthensGreece
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11
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Panagopoulos PK, Goules AV, Georgakopoulou VE, Kallianos A, Chatzinikita E, Pezoulas VC, Malagari K, Fotiadis DI, Vlachoyiannopoulos P, Vassilakopoulos T, Tzioufas AG. Small airways dysfunction in patients with systemic sclerosis and interstitial lung disease. Front Med (Lausanne) 2022; 9:1016898. [PMID: 36452897 PMCID: PMC9702077 DOI: 10.3389/fmed.2022.1016898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/11/2022] [Accepted: 10/24/2022] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND A number of studies report small airways involvement in patients with systemic sclerosis (SSc). Furthermore, small airways dysfunction is increasingly recognized in patients with interstitial lung disease (ILD) of idiopathic or autoimmune etiology. The objectives of this study were to evaluate small airways function in SSc patients with ILD and explore the effect of treatment on small airways function by using conventional and contemporary pulmonary function tests (PFTs). METHODS This single-center, prospective, observational study included a total of 35 SSc patients, with and without ILD based on HRCT scan, evaluated by a special radiologist blindly. Clinical data were collected from all patients who were also assessed for HRCT findings of small airways disease. Small airways function was assessed by classic spirometry, measurement of diffusing capacity for carbon monoxide, body plethysmography, single breath nitrogen washout (N2SBW) and impulse oscillometry (IOS). The prevalence of small airways dysfunction according to R5-R20, phase III slopeN2SBW and CV/VC methodologies was calculated in the total SSc population. Pulmonary function tests were compared between: (a) SSc-ILD and non-ILD patients and (b) two time points (baseline and follow up visit) in a subset of SSc-ILD patients who received treatment for ILD and were re-evaluated at a follow up visit after 12 months. RESULTS Phase III slopeN2SBW and R5-R20 showed the highest diagnostic performance for detecting small airways dysfunction among SSc patients (61 and 37.5%, respectively). Twenty three SSc patients were found with ILD and 14 of them had a 12-month follow up visit. SSc-ILD patients compared to those without ILD exhibited increased phase III slopeN2SBW ≥120% (p = 0.04), R5-R20 ≥0.07 kPa/L/s (p = 0.025), airway resistance (Raw) (p = 0.011), and special airway resistance (sRaw) (p = 0.02), and decreased specific airway conductance (sGaw) (p = 0.022), suggesting impaired small airways function in the SSc-ILD group. Radiographic features of SAD on HRCT were observed in 22% of SSc-ILD patients and in none of SSc-non-ILD patients. Comparison of PFTs between baseline and follow-up visit after 12 months in the 14 SSc-ILD treated patients, showed improvement of phase III slopeN2SBW (p = 0.034), R5-R20 (p = 0.035) and Raw (p = 0.044) but not sRaw and sGaw parameters. CONCLUSION Phase III slopeN2SBW and R5-R20 may reveal small airways dysfunction in SSc associated ILD before structural damage and may be partially improved in a subset of patients receiving treatment for ILD.
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Affiliation(s)
- Panagiotis K. Panagopoulos
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas V. Goules
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Research Institute of Systemic Autoimmune Diseases, Athens, Greece
| | - Vasiliki E. Georgakopoulou
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Kallianos
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Eirini Chatzinikita
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasileios C. Pezoulas
- Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Ioannina, Greece
| | - Katerina Malagari
- 2nd Department of Radiology, “Attikon” Hospital, University of Athens, Athens, Greece
| | - Dimitrios I. Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, University of Ioannina, Ioannina, Greece
| | - Panayiotis Vlachoyiannopoulos
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Research Institute of Systemic Autoimmune Diseases, Athens, Greece
| | - Theodoros Vassilakopoulos
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios G. Tzioufas
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Research Institute of Systemic Autoimmune Diseases, Athens, Greece
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12
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Kyriakos G, Patsouras A, Voutyritsa E, Gravvanis C, Papadimitriou E, Farmaki P, Quiles-Sánchez LV, Georgakopoulou VE, Damaskos C, Ríos-Vergara A, Marín-Martínez L, Diamantis E. The Role of TPOAb in Thyroid-Associated Orbitopathy: A Systematic Review. Ocul Immunol Inflamm 2022; 30:1740-1746. [PMID: 34214014 DOI: 10.1080/09273948.2021.1942498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Thyroid-associated orbitopathy (TAO) is one of the most common autoimmune inflammatory disorders of the orbit. The presence of anti-thyroid antibodies is believed to play a role in the pathogenesis and clinical status of the TAO patients. Herein, we review the usefulness of TPOAb as a biomarker for TAO. METHODS A systematic search in MEDLINE library was conducted. Results: Twenty studies were included. TPO is expressed in orbital tissues, and the polymorphism rs11675434 SNP has proven to be associated with clinically evident TAO. Studies in pediatric patients have shown a positive correlation between high TPOAb levels and TAO. In contrast, results in adults are inconsistent. Some studies imply a protective role of TPOAb, yet the majority did not find any association. Some authors have suggested an implication of TPOAb in the pathophysiology of TAO in TRAb-negative patients. CONCLUSIONS The role of TPOAb in TAO remains unclear and controversial.
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Affiliation(s)
- Georgios Kyriakos
- Sección de Endocrinología y Nutrición, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Alexandros Patsouras
- Second Department of Internal Medicine, Tzanio General Hospital, Piraeus, Greece
| | - Errika Voutyritsa
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Gravvanis
- Unit of Endocrinology and Diabetes Center, Athens General Hospital ¨G. Gennimatas¨, Athens, Greece
| | - Eirini Papadimitriou
- Unit of Endocrinology and Diabetes Center, Athens General Hospital ¨G. Gennimatas¨, Athens, Greece
| | - Paraskevi Farmaki
- First Department of Pediatrics, Agia Sofia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonio Ríos-Vergara
- Sección de Endocrinología y Nutrición, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Luis Marín-Martínez
- Sección de Endocrinología y Nutrición, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Evangelos Diamantis
- Unit of Endocrinology and Diabetes Center, Athens General Hospital ¨G. Gennimatas¨, Athens, Greece
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13
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Konstantinos F, Tsolaki V, Georgakopoulou VE, Aravantinou A, Fotakopoulos G. Value of Combination Therapy With Antiepileptic Drugs (AEDs) for Migraine to Prevent Ischemic Stroke in Young Women. Cureus 2022; 14:e26972. [PMID: 36000114 PMCID: PMC9389468 DOI: 10.7759/cureus.26972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2022] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to systematically assess the efficacy of a combination of levetiracetam and sumatriptan as a preventive treatment for migraine and stroke in young women. This was a retrospective study with 342 female patients, who experienced migraines. All patients were divided into three groups: Group A (124 patients (36.2%) with triptan (sumatriptan) monotherapy), Group B (111 patients (32.4%) with a combined triptan and antiepileptic drug (AED) therapy with levetiracetam (LEV)), and Group C (107 (31.2%) patients with placebo treatment), in a 1.4:1.1:1 ratio respectively. Significant differences were found in Group B when compared with Groups A and C with respect to the use of combination hormonal contraception, smoking, a family history of migraine, and seizures. The results of this study suggested that combination treatment with levetiracetam and sumatriptan was more effective in preventing migraines and reducing the risk of stroke in young women than sumatriptan monotherapy.
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14
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Georgakopoulou VE, Gkoufa A, Garmpis N, Makrodimitri S, Papageorgiou CV, Barlampa D, Garmpi A, Chiapoutakis S, Sklapani P, Trakas N, Damaskos C. COVID-19 and Acute Pancreatitis: A Systematic Review of Case Reports and Case Series. Ann Saudi Med 2022; 42:276-287. [PMID: 35933608 PMCID: PMC9357298 DOI: 10.5144/0256-4947.2022.276] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) presents mainly with mild symptoms and involvement of the respiratory system. Acute pancreatitis has also been reported during the course of COVID-19. OBJECTIVE Our aim is to review and analyze all reported cases of COVID-19 associated acute pancreatitis, reporting the demographics, clinical characteristics, laboratory and imaging findings, comorbidities and outcomes. DATA SOURCES We conducted a systematic search of Pubmed/MEDLINE, SciELO and Google Scholar to identify case reports and case series, reporting COVID-19 associated acute pancreatitis in adults. STUDY SELECTION There were no ethnicity, gender or language restrictions. The following terms were searched in combination:"COVID-19" OR "SARS-CoV-2" OR "Coronavirus 19" AND "Pancreatic Inflammation" OR "Pancreatitis" OR "Pancreatic Injury" OR "Pancreatic Disease" OR "Pancreatic Damage". Case reports and case series describing COVID-19 associated acute pancreatitis in adults were included. COVID-19 infection was established with testing of nasal and throat swabs using reverse transcription polymerase chain reaction. The diagnosis of acute pancreatitis was confirmed in accordance to the revised criteria of Atlanta classification of the Acute Pancreatitis Classification Working Group. Exclusion of other causes of acute pancreatitis was also required for the selection of the cases. DATA EXTRACTION The following data were extracted from each report: the first author, year of publication, age of the patient, gender, gastrointestinal symptoms due to acute pancreatitis, respiratory-general symptoms, COVID-19 severity, underlying diseases, laboratory findings, imaging features and outcome. DATA SYNTHESIS Finally, we identified and analyzed 31 articles (30 case reports and 1 case series of 2 cases), which included 32 cases of COVID-19 induced acute pancreatitis. CONCLUSION COVID-19 associated acute pancreatitis affected mostly females. The median age of the patients was 53.5 years. Concerning laboratory findings, lipase and amylase were greater than three times the ULN while WBC counts and CRP were elevated in the most of the cases. The most frequent gastrointestinal, respiratory and general symptom was abdominal pain, dyspnea and fever, respectively. The most common imaging feature was acute interstitial edematous pancreatitis and the most frequent comorbidity was arterial hypertension while several patients had no medical history. The outcome was favorable despite the fact that most of the patients experienced severe and critical illness. LIMITATIONS Our results are limited by the quality and extent of the data in the reports. More specifically, case series and case reports are unchecked, and while they can recommend hypotheses they are not able to confirm robust associations. CONFLICT OF INTEREST None.
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Affiliation(s)
| | - Aikaterini Gkoufa
- From the First Department of Internal Medicine, Laiko General Hospital, Athens, Greece
| | - Nikolaos Garmpis
- From the Second Department of Propedeutic Surgery, Laiko General Hospital, Athens, Greece
| | | | | | - Danai Barlampa
- From the Department of Internal Medicine, Medical Center of Megalopolis, Arcadia, Greece
| | - Anna Garmpi
- From the First Department of Internal Medicine, Laiko General Hospital, Athens, Greece
| | - Serafeim Chiapoutakis
- From the Department of Thoracic Surgery, Agios Savvas General Cancer and Oncology Hospital of Athens, Athens, Greece
| | - Pagona Sklapani
- From the Department of Cytology, Mitera Maternity Hospital, Athens, Greece
| | - Nikolaos Trakas
- From the Department of Biochemistry, Sismanogleio General Hospital, Athens, Greece
| | - Christos Damaskos
- From the Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
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15
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Garmpi A, Damaskos C, Garmpis N, Georgakopoulou VE, Kaminiotis VV, Diamantis E, Patsouras A, Syllaios A, Dimitroulis D. All that Glitters is not Cholecystitis. A Rare Presentation of Acute Pericarditis Mimicking Cholecystitis and Review of the Literature. Acta Med Litu 2022; 29:217-224. [PMID: 37733419 PMCID: PMC9798999 DOI: 10.15388/amed.2022.29.2.8] [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: 06/13/2022] [Revised: 06/26/2022] [Accepted: 06/28/2022] [Indexed: 11/22/2022] Open
Abstract
Acute pericarditis is the most common inflammatory disorder of the pericardium, responsible for approximately 5% of visits to the emergency departments, concerning chest pain without myocardial infarction. We report a case of a 41-year-old man who presented to our hospital, complaining about retrosternal and epigastrium pain. The transthoracic echocardiogram showed pericardial effusion while the electrocardiogram and laboratory findings revealed acute pericarditis. An abdominal ultrasound revealed gallbladder edema. The pericardial effusion was treated with pericardial catheter insertion, diuretics, and nonsteroidal anti-inflammatory drugs. This case shows that acute pericarditis can be clinically presented with many ways, one of them being gallbladder edema. Furthermore, in this case-based review we present all cases of simultaneous appearance of pericarditis and acalculous cholecystitis or gallbladder edema.
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Affiliation(s)
- Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Garmpis
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Evangelos Diamantis
- Academic Department of Internal Medicine - Endocrinology Unit, Agioi Anargyroi General Oncology Hospital of Kifisia, National and Kapodistrian University of Athens Athens Greece
| | | | - Athanasios Syllaios
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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16
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Prevezanos D, Garmpis N, Dimitroulis D, Garmpi A, Georgakopoulou VE, Damaskos C. Polycystic Horseshoe Kidney: A Rare Coexistence as a Challenge for the Surgeons. Case Report. Acta Med Litu 2022; 29:211-216. [PMID: 37733436 PMCID: PMC9799004 DOI: 10.15388/amed.2022.29.2.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 11/22/2022] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) with concomitant horseshoe kidney is an extremely rare entity. In this case, we report a 45-year-old male patient with ADPKD and a horseshoe kidney who demonstrated hypertension, urological complications, and discomfort symptoms such as pain, breathing difficulties, and abdominal meteorism. After preoperative assessment and planning, the patient underwent nephrectomy. Bilateral nephrectomy without dividing the isthmus was performed successfully. The isthmus, which had complicated vasculature and was full of cysts, remained intact, avoiding severe bleeding and infection. The postoperative course was uneventful. Keeping the isthmus intact in such cases is a challenge for the surgeon. The rarity of polycystic horseshoe kidney in combination with the altered abdominal anatomy requires the proper preoperative strategy in order to avoid intraoperative complications.
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Affiliation(s)
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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17
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Mpourazanis G, Konschake W, Vogiatzis R, Papalexis P, Georgakopoulou VE, Ntritsos G, Sklapani P, Trakas N. The Role and Effectiveness of Photodynamic Therapy on Patients With Actinic Keratosis: A Systematic Review and Meta-Analysis. Cureus 2022; 14:e26390. [PMID: 35911353 PMCID: PMC9332024 DOI: 10.7759/cureus.26390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 11/05/2022] Open
Abstract
Actinic keratoses (AKs) are the most common neoplastic lesions and are recognized as a precursor to squamous cell skin cancer. Photodynamic therapy (PDT) is a therapeutic option for multiple AKs in line with field cancerization. The aim of this study was to assess the effectiveness of PDT on patients with AKs using a meta-analysis, in order to evaluate the possible superiority of one treatment over the others. For this purpose, the PubMed, MEDLINE, Scopus, OVID, Science Direct, British Journal of Dermatology, Research Gate, and Embase databases were searched in March 2022. The search terms used were 'photodynamic therapy' and 'actinic keratosis'. We utilized the random-effects meta-analysis model to compare methyl aminolevulinate PDT (MAL-PDT) and the combination of a nanoscale-lipid vesicle formulation with the prodrug 5-aminolevulinic acid (BF-200 ALA) on a complete response (CR) of the lesions. Our meta-analysis indicated that the comparison of BF-200 ALA versus MAL-PDT showed marginally higher CRs than MAL-PDT.
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18
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Georgakopoulou VE, Damaskos C, Sklapani P, Trakas N, Gkoufa A. Pleural involvement in cryptococcal infection. World J Clin Cases 2022; 10:5510-5514. [PMID: 35812673 PMCID: PMC9210898 DOI: 10.12998/wjcc.v10.i16.5510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/30/2022] [Accepted: 04/30/2022] [Indexed: 02/06/2023] Open
Abstract
Pleural involvement of cryptococcal infection is uncommon and is more commonly observed in immunocompromised hosts than in immunocompetent ones. Pleural involvement in cryptococcal infections can manifest with or without pleural effusion. The presence of Cryptococcus spp. in the effusion or pleura is required for the diagnosis of cryptococcal pleural infection, which is commonly determined by pleural biopsy, fluid culture, and/or detection of cryptococcal antigen in the pleura or pleural fluid.
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Affiliation(s)
| | - Christos Damaskos
- Department of Infectious Diseases, Laiko General Hospital, Athens 11527, Greece
| | - Pagona Sklapani
- Department of Infectious Diseases, Laiko General Hospital, Athens 11527, Greece
| | - Nikolaos Trakas
- Department of Infectious Diseases, Laiko General Hospital, Athens 11527, Greece
| | - Aikaterini Gkoufa
- Department of Infectious Diseases, Laiko General Hospital, Athens 11527, Greece
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19
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Georgakopoulou VE, Vlachogiannis NI, Basoulis D, Eliadi I, Georgiopoulos G, Karamanakos G, Makrodimitri S, Samara S, Triantafyllou M, Voutsinas PM, Ntziora F, Psichogiou M, Samarkos M, Sfikakis PP, Sipsas NV. A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients. J Clin Med 2022; 11:jcm11071810. [PMID: 35407418 PMCID: PMC8999885 DOI: 10.3390/jcm11071810] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 12/15/2022] Open
Abstract
We aimed to search for laboratory predictors of critical COVID-19 in consecutive adults admitted in an academic center between 16 September 2020−20 December 2021. Patients were uniformly treated with low-molecular-weight heparin, and dexamethasone plus remdesivir when SpO2 < 94%. Among consecutive unvaccinated patients without underlying medical conditions (n = 241, 49 year-old median, 71% males), 22 (9.1%) developed critical disease and 2 died (0.8%). White-blood-cell counts, neutrophils, neutrophil-to-lymphocyte ratio, CRP, fibrinogen, ferritin, LDH and γ-GT at admission were each univariably associated with critical disease. ROC-defined cutoffs revealed that CRP > 61.8 mg/L, fibrinogen > 616.5 mg/dL and LDH > 380.5 U/L were each associated with critical disease development, independently of age, sex and days from symptom-onset. A score combining higher-than-cutoff CRP (0/2), LDH (0/1) and fibrinogen (0/1) predicted critical disease (AUC: 0.873, 95% CI: 0.820−0.926). This score performed well in an unselected patient cohort (n = 1228, 100% unvaccinated) predominantly infected by the alpha variant (AUC: 0.718, 95% CI: 0.683−0.753), as well as in a mixed cohort (n = 527, 65% unvaccinated) predominantly infected by the delta variant (AUC: 0.708, 95% CI: 0.656−0.760). Therefore, we propose that a combination of standard biomarkers of acute inflammatory response, cell death and hypercoagulability reflects the severity of COVID-19 per se independently of comorbidities, age and sex, being of value for risk stratification in unselected patients.
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Affiliation(s)
- Vasiliki E. Georgakopoulou
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Nikolaos I. Vlachogiannis
- First Department of Propaedeutic Internal Medicine and Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (N.I.V.); (F.N.); (P.P.S.)
| | - Dimitrios Basoulis
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Irene Eliadi
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Georgios Georgiopoulos
- Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Georgios Karamanakos
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Sotiria Makrodimitri
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Stamatia Samara
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Maria Triantafyllou
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Pantazis M. Voutsinas
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Fotinie Ntziora
- First Department of Propaedeutic Internal Medicine and Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (N.I.V.); (F.N.); (P.P.S.)
| | - Mina Psichogiou
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Michael Samarkos
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Petros P. Sfikakis
- First Department of Propaedeutic Internal Medicine and Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (N.I.V.); (F.N.); (P.P.S.)
| | - Nikolaos V. Sipsas
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
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Georgakopoulou VE, Lembessis P, Skarlis C, Gkoufa A, Sipsas NV, Mavragani CP. Hematological Abnormalities in COVID-19 Disease: Association With Type I Interferon Pathway Activation and Disease Outcomes. Front Med (Lausanne) 2022; 9:850472. [PMID: 35372456 PMCID: PMC8968418 DOI: 10.3389/fmed.2022.850472] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/21/2022] [Indexed: 12/29/2022] Open
Abstract
Increased expression of interferon (IFN)-stimulated genes (ISGs) in peripheral blood, has been previously reported in viral infections, as well as in autoimmune disorders, in association with reduced leukocyte and platelet counts. Though cytopenias are common in patients with COVID-19 disease and predict severe outcomes, the underlying mechanisms have not been fully elucidated. In the current study, we aimed to determine the prevalence of hematological abnormalities in the setting of active COVID-19 infection and to explore whether they associate with disease outcomes and activation of type I IFN pathway. One-hundred-twenty-three consecutive SARS-CoV2 infected patients were included in the study. Clinical and laboratory parameters were recorded for all study participants. In 114 patients, total RNA was extracted from whole peripheral blood and subjected to real time PCR. The relative expression of three interferon stimulated genes (ISGs; IFIT1, MX-1, and IFI44) was determined and a type I IFN score reflecting peripheral type I IFN activity was calculated. The rates of anemia, leukopenia, and thrombocytopenia were 28.5, 14.6, and 24.4%, respectively. Among leukocytopenias, eosinopenia, and lymphopenia were the most prominent abnormalities being found in 56.9 and 43.1%, respectively. Of interest, patients with either eosinopenia and/or thrombocytopenia but no other hematological abnormalities displayed significantly increased peripheral type I IFN scores compared to their counterparts with normal/high eosinophil and platelet counts. While eosinopenia along with lymphopenia were found to be associated with increased risk for intubation and severe/critical disease, such an association was not detected between other hematological abnormalities or increased type I IFN scores. In conclusion, hematological abnormalities are commonly detected among patients with COVID-19 infection in association with severe disease outcomes and activation of the type I IFN pathway.
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Affiliation(s)
- Vasiliki E. Georgakopoulou
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Lembessis
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalampos Skarlis
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Gkoufa
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos V. Sipsas
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Clio P. Mavragani
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Fourth Department of Internal Medicine, School of Medicine, University Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
- Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
- *Correspondence: Clio P. Mavragani
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21
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Garmpis N, Damaskos C, Dimitroulis D, Garmpi A, Diamantis E, Sarantis P, Georgakopoulou VE, Patsouras A, Prevezanos D, Syllaios A, Kyriakos G, Koustas E, Despotidis M, Vallilas C, Papalexis P, Antoniou EA, Kontzoglou K, Kouraklis G. Targeting the Endocannabinoid System: From the Need for New Therapies to the Development of a Promising Strategy. What About Pancreatic Cancer? In Vivo 2022; 36:543-555. [PMID: 35241505 DOI: 10.21873/invivo.12736] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/12/2021] [Accepted: 12/18/2021] [Indexed: 02/08/2023]
Abstract
Pancreatic cancer is one of the most fatal malignancies, and therefore, new strategies, which aim at the improvement of the prognosis of this lethal disease, are needed. Many clinical trials have failed to improve overall survival. Nowadays, research is focused on advances provided by novel potential targets to efficiently enhance life expectancy. Cannabinoids, the active components of Cannabis sativa L., and their derivatives, have been reported as palliative adjuvants to conventional chemotherapeutic regimens. Cannabinoid effects are known to be mediated through the activation of cannabinoid receptors. To date, two cannabinoid receptors, cannabinoid receptor 1 and 2, have been cloned and identified from mammalian tissues. Cannabinoids exert a remarkable antitumoral effect on pancreatic cancer cells, due to their ability to selectively induce apoptosis of these cells. This review strengthens the perception that cannabinoid receptors might be useful in clinical testing to prognose and treat pancreatic cancer. Many studies have tried to describe the mechanism of cell death induced by cannabinoids. The aim of this review is to discuss the effects of cannabinoid receptors in pancreatic cancer in order to provide a brief insight into cannabinoids and their receptors as pancreatic cancer biomarkers and in therapeutic strategies.
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Affiliation(s)
- Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece; .,Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Diamantis
- Academic Department of Internal Medicine - Endocrinology Unit, Agioi Anargyroi General Oncology Hospital of Kifisia, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Sarantis
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | - Athanasios Syllaios
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Kyriakos
- Seccion de Endocrinologia y Nutrition, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Evangelos Koustas
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Christos Vallilas
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros Papalexis
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Department of Biomedical Sciences, University of West Attica, Athens, Greece
| | - Efstathios A Antoniou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kontzoglou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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22
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Damaskos C, Dimitroulis D, Garmpi A, Georgakopoulou VE, Patsouras A, Syllaios A, Garmpis N. Daniel’s Lymph Node Biopsy: Why We Must Not Forget History. Oman Med J 2022; 37:e334. [PMID: 35136663 PMCID: PMC8804153 DOI: 10.5001/omj.2022.64] [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: 06/16/2021] [Accepted: 12/09/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Alexandros Patsouras
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Syllaios
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Gkoufa A, Sklapani P, Trakas N, Georgakopoulou VE. A Challenging Cutaneous Lesion in a Patient With Chronic Idiopathic Neutropenia. Cureus 2022; 14:e21225. [PMID: 35186525 PMCID: PMC8844289 DOI: 10.7759/cureus.21225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 12/02/2022] Open
Abstract
Ecthyma gangrenosum (EG) is an uncommon necrotizing vasculitis that affects mainly immunocompromised and burn patients, and it is frequently associated with Pseudomonas aeruginosa bacteremia. However, cases of EG with other related pathogens and cases of EG affecting immunocompetent hosts have also been described in the literature. Besides, less common cases of EG without bacteremia have been reported. Herein, we describe a rare case of EG due to Pseudomonas aeruginosa without bacteremia in a patient with chronic idiopathic neutropenia (CIN). Considering the high mortality rate associated with EG, early diagnosis and appropriate effective treatment are crucial.
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Gkoufa A, Georgakopoulou VE, Lakiotaki E, Cholongitas E. An Unusual Presentation of Diffuse Large B-Cell Lymphoma. Cureus 2022; 14:e20927. [PMID: 35154918 PMCID: PMC8815724 DOI: 10.7759/cureus.20927] [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] [Accepted: 01/04/2022] [Indexed: 11/05/2022] Open
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Cholongitas E, Bali T, Georgakopoulou VE, Giannakodimos A, Gyftopoulos A, Georgilaki V, Gerogiannis D, Basoulis D, Eliadi I, Karamanakos G, Mimidis K, Sipsas NV, Samarkos M. Prevalence of abnormal liver biochemistry and its impact on COVID-19 patients’ outcomes: a single-center Greek study. Ann Gastroenterol 2022; 35:290-296. [PMID: 35599935 PMCID: PMC9062840 DOI: 10.20524/aog.2022.0709] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/14/2022] [Indexed: 12/31/2022] Open
Abstract
Background Abnormalities in aminotransferases are frequently observed in hospitalized COVID-19 patients, but their clinical impact is poorly characterized. Methods A total of 1046 patients hospitalized to the non-intensive care unit ward with documented COVID-19 were included retrospectively. Demographic, clinical and laboratory characteristics on admission and during hospital stay, including the presence of liver injury (LI), defined as aspartate aminotransferase (AST) >200 IU/L, were recorded. Results On admission, 363 (34.7%) and 269 (25.7%) patients had abnormal AST and ALT values (i.e., >40 IU/L), respectively, while during hospitalization 53 (5%) patients fulfilled the criteria for LI. In multivariate logistic regression analysis, AST (odds ratio [OR] 1.023, 95% confidence interval [CI] 1.016-1.029; P<0.001), and ferritin (OR 1.01, 95%CI 1.001-1.02; P<0.001) were the baseline factors independently associated with the development of LI during hospital stay. One hundred twenty-three (11.7%) patients died during hospitalization. The independent variables associated with mortality were: age (hazard ratio [HR] 1.043, 95%CI 1.029-1.056; P<0.001), ferritin (HR 1.1, 95%CI 1.05-1.2; P<0.001), platelets (HR 0.996, 95%CI 0.994-0.999; P=0.003), and administration of remdesivir (HR 0.50, 95%CI 0.30-0.85; P=0.009). The patients with abnormal baseline AST (i.e., >40 IU/L), compared to those with normal AST values, had worse outcomes (log rank test: 8.8, P=0.003). Conclusions Elevated aminotransferases are commonly seen in COVID-19 patients. They possibly reflect disease severity and may be associated with in-hospital mortality.
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Affiliation(s)
- Evangelos Cholongitas
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
- Correspondence to: Evangelos Cholongitas, MD, PhD, Associate Professor, First Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Agiou Thoma 17, Athens 11527, Greece, e-mail:
| | - Triada Bali
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
| | - Vasiliki E. Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Vasiliki E. Georgakopoulou)
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
| | - Alexios Giannakodimos
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
| | - Argyrios Gyftopoulos
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
| | - Vasiliki Georgilaki
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
| | - Dimitrios Gerogiannis
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
| | - Dimitrios Basoulis
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
| | - Irene Eliadi
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
| | - Georgios Karamanakos
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
| | - Konstantinos Mimidis
- First Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece (Konstantinos Mimidis)
| | - Nikolaos V. Sipsas
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, and Laiko General Hospital of Athens, Athens, Greece (Nikolaos V. Sipsas)
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
| | - Michael Samarkos
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
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Damaskos C, Garmpis N, Nikolettos K, Patsouras A, Schizas D, Garmpi A, Georgakopoulou VE, Syllaios A, Dimitroulis D. Comment on renal autotransplantation: A final option to preserve the kidney after an iatrogenic ureteral injury. Arch Ital Urol Androl 2021; 93:497-498. [PMID: 34933543 DOI: 10.4081/aiua.2021.4.497] [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] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/12/2021] [Indexed: 11/23/2022] Open
Abstract
To the Editor, Autologous Renal Transplantation (ART) since firstly described in 1963 by Hardy, has been used in various cases. There are various reasons for the transplantation such as iatrogenic ureteral damage, chronic kidney pain, unresectable renal tumors or renovascular diseases. Indications concerning the suitable patients for this kind of procedure are gradually increasing. Nevertheless, each case is unique, and the treatment must be personalized [...].
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Affiliation(s)
- Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens; N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens.
| | - Nikolaos Garmpis
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens and Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens.
| | - Konstantinos Nikolettos
- Obstetric and Gynecologic Clinic, Medical School, Democritus University of Thrace, Alexandroupolis.
| | - Alexandros Patsouras
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens.
| | - Dimitrios Schizas
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens.
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens.
| | | | - Athanasios Syllaios
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens.
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens.
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Aravantinou-Fatorou A, Andrikopoulou A, Liontos M, Fiste O, Georgakopoulou VE, Dimopoulos MA, Gavriatopoulou M, Zagouri F. Pembrolizumab in endometrial cancer: Where we stand now. Oncol Lett 2021; 22:821. [PMID: 34691248 PMCID: PMC8527559 DOI: 10.3892/ol.2021.13082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 07/02/2021] [Indexed: 12/18/2022] Open
Abstract
Recently, immunotherapy has shown promising results in solid tumors. To the best of our knowledge, this is the first systematic review of published literature synthesizing all the available data and evaluating both the efficacy and safety of pembrolizumab in endometrial cancer. The present study was performed in accordance with the PRISMA guidelines. Eligible articles were identified by searching the MEDLINE and ClinicalTrials.gov databases, using a predefined combination of the terms 'endometrial cancer' and 'pembrolizumab'. Overall, nine articles incorporating data from 712 patients were eligible. Pembrolizumab was demonstrated to be an effective and safe therapeutic option for the management of advanced/metastatic endometrial cancer. Results of ongoing trials evaluating either pembrolizumab alone or in combination with other antineoplastic regimens are expected to confirm its efficacy in this setting of patients. Pembrolizumab appears to be both durable and robust in endometrial cancer. However, there is an emerging need for novel predictive biomarkers to guide clinical practice.
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Affiliation(s)
- Aikaterini Aravantinou-Fatorou
- First Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Laiko General Hospital, Athens 11527, Greece
| | - Angeliki Andrikopoulou
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece
| | - Michael Liontos
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece
| | - Oraianthi Fiste
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece
| | - Vasiliki E. Georgakopoulou
- First Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Laiko General Hospital, Athens 11527, Greece
| | - Meletios-Athanasios Dimopoulos
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece
| | - Flora Zagouri
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece
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Karakousis N, Kostakopoulos NA, Georgakopoulou VE, Pyrgioti EE, Georgakopoulos PN. A Rare Case of Dulaglutide-Associated Angioedema in a Male Patient. Cureus 2021; 13:e20041. [PMID: 34987924 PMCID: PMC8717822 DOI: 10.7759/cureus.20041] [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] [Accepted: 11/30/2021] [Indexed: 11/05/2022] Open
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Papageorgiou CV, Savourdos P, Douna E, Georgakopoulou VE, Makrodimitri S, Dounias G. Respiratory Symptoms and Pulmonary Function of Workers in the Waste Management Industry. Cureus 2021; 13:e17027. [PMID: 34522508 PMCID: PMC8425493 DOI: 10.7759/cureus.17027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Waste handling workers are exposed to air pollutants and toxic compounds produced during waste management and processing that can cause respiratory symptoms and lung function impairment. This study aimed to evaluate the respiratory health of exposed workers in a waste management plant in Attica, Greece. Methods: 50 field workers exposed to outdoor pollutants (exposure group) and 32 office clerks with no exposure (control group) were evaluated. Upper and lower respiratory symptoms were documented and spirometry was performed. Results: There was no statistically significant difference between the exposure and the control group in forced expiratory volume in one second (FEV1)%, forced vital capacity (FVC)%, FEV1/FVC% predicted values. Workers had lower maximal mid-expiratory flow (MMEF)% predicted values compared to controls (82% vs 94%, p=0.019). No difference was observed regarding the respiratory symptoms between the two groups. Conclusion: Lower MMEF values were observed in the exposure group. Low MMEF can be indicative of small airway disease, thus smoking cessation, close follow-up, and the use of personal protective equipment are recommended.
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Affiliation(s)
| | - Petros Savourdos
- Department of Occupational & Industrial Hygiene, National School of Public Health, Athens, GRC
| | - Eleni Douna
- Department of Occupational & Industrial Hygiene, National School of Public Health, Athens, GRC
| | | | | | - Georgios Dounias
- Department of Occupational & Industrial Hygiene, National School of Public Health, Athens, GRC
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30
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Garmpis N, Damaskos C, Garmpi A, Nonni A, Georgakopoulou VE, Antoniou E, Schizas D, Sarantis P, Patsouras A, Syllaios A, Vallilas C, Koustas E, Kontzoglou K, Trakas N, Dimitroulis D. Histone Deacetylases and their Inhibitors in Colorectal Cancer Therapy: Current Evidence and Future Considerations. Curr Med Chem 2021; 29:2979-2994. [PMID: 34525905 DOI: 10.2174/0929867328666210915105929] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/07/2021] [Accepted: 08/11/2021] [Indexed: 02/08/2023]
Abstract
Colorectal cancer (CRC) comprises a heterogeneous group of gastrointestinal tract tumors. It is a multifactorial disease, and a plethora of distinct factors are involved in its pathogenesis and pathophysiology. The development of CRC is not limited to genetic changes, but epigenetic and environmental factors are also involved. Among the epigenetic factors, histone deacetylases (HDACs), a group of epigenetic enzymes that regulate gene expression, have been reported to be over-expressed in CRC. HDACs and their inhibitors seem to play an important role in the molecular pathophysiology of CRC. The aim of this review was to define the role of HDAC inhibitors as potential anticancer agents against CRC.
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Affiliation(s)
- Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens. Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens. Greece
| | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens. Greece.,Renal Transplantation Unit, Laiko General Hospital, Athens. Greece
| | - Anna Garmpi
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens. Greece
| | - Afroditi Nonni
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Efstathios Antoniou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens. Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens. Greece
| | - Dimitrios Schizas
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Sarantis
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Patsouras
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens. Greece
| | - Athanasios Syllaios
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Vallilas
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Koustas
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kontzoglou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens. Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens. Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, Athens. Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens. Greece
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31
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Gkoufa A, Maneta E, Ntoumas GN, Georgakopoulou VE, Mantelou A, Kokkoris S, Routsi C. Elderly adults with COVID-19 admitted to intensive care unit: A narrative review. World J Crit Care Med 2021; 10:278-289. [PMID: 34616662 PMCID: PMC8462023 DOI: 10.5492/wjccm.v10.i5.278] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/19/2021] [Accepted: 08/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In the context of the Coronavirus disease 2019 (COVID-19) pandemic, it has been reported that elderly patients are particularly at risk of developing severe illness and exhibiting increased mortality. While many studies on hospitalized elderly patients with COVID-19 have been published, limited information is available on the characteristics and clinical outcomes of those elderly patients admitted to intensive care unit (ICU).
AIM To review the available evidence of the clinical data of elderly patients admitted to the ICU due to COVID-19.
METHODS We searched for published articles available in English literature to identify those studies conducted in critically ill patients admitted to the ICU due to COVID-19, either exclusively designed for the elderly or for the whole ICU population with COVID-19, provided that analyses according to the patients’ age had been conducted.
RESULTS Only one study exclusively focusing on critically ill elderly patients admitted to the ICU due to COVID-19 was found. Eighteen additional studies involving 17011 ICU patients and providing information for elderly patients as a subset of the whole study population have also been included in the present review article. Among the whole patient population, included in these studies, 8310 patients were older than 65 years of age and 2630 patients were older than 70 years. Clinical manifestations were similar for all patients; however, compared to younger ones, they suffered from more comorbidities and showed a varied, albeit high mortality.
CONCLUSION In summary, at present, although elderly patients constitute a considerable proportion of critically ill patients admitted to the ICU due to severe COVID-19, studies providing specific information are limited. The evidence so far suggests that advanced age and comorbidities are associated with worse clinical outcome. Future studies exclusively designed for this vulnerable group are needed.
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Affiliation(s)
- Aikaterini Gkoufa
- First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Eleni Maneta
- First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Georgios N Ntoumas
- First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Vasiliki E Georgakopoulou
- First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Athina Mantelou
- First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Stelios Kokkoris
- First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Christina Routsi
- First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
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32
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Garmpis N, Damaskos C, Garmpi A, Georgakopoulou VE, Sakellariou S, Liakea A, Schizas D, Diamantis E, Farmaki P, Voutyritsa E, Syllaios A, Patsouras A, Sypsa G, Agorogianni A, Stelianidi A, Antoniou EA, Kontzoglou K, Trakas N, Dimitroulis D. Inflammatory Fibroid Polyp of the Gastrointestinal Tract: A Systematic Review for a Benign Tumor. In Vivo 2021; 35:81-93. [PMID: 33402453 DOI: 10.21873/invivo.12235] [Citation(s) in RCA: 9] [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: 09/01/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND/AIM Inflammatory fibroid polyp (IFP) is a rare, usually solitary and intraluminal polypoid benign tumor that can affect any part of the gastrointestinal (GI) tract, although in the majority of cases it affects the stomach. This lesion is characterized by proliferation of highly vascular fibrous tissue and infiltration by a variable number of different inflammatory cells. Its etiology is unknown. Our aim was to describe all the reported data concerning IFP. MATERIALS AND METHODS An extensive search of the PubMed Index was performed for publications with titles or abstracts containing the terms: "inflammatory fibroid polyp" with/without "Vanek". Results were filtered for publications in English and concerning only humans. One hundred and twenty-four publications were finally included in this review. RESULTS IFP has a female predominance. It affects patients in their 5th decade of life, although there are cases of patients from 4 to 84 years of age. IFP usually affects the stomach and more specifically the gastric antrum but can be detected throughout the GI tract. A significant number of cases remain asymptomatic but the most frequent presentations of IFP are abdominal pain, acute abdomen and GI bleeding. Most cases are treated by endoscopic resection of the lesion. No recurrence nor IFP-specific complications have been reported. Histopathology of IFP varies. CONCLUSION It is relatively safe to conclude that both the etiology and the timing of diagnosis might change the histopathology, immunohistological staining and tissue structure of IFP. Suggested theories should be taken into consideration with caution as the etiology and pathophysiological mechanisms of IFP are unknown.
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Affiliation(s)
- Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, Greece; .,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki E Georgakopoulou
- Department of Pulmonology, Laiko General Hospital, Athens, Greece.,First Department of Pulmonology, Sismanogleio Hospital, Athens, Greece
| | - Stratigoula Sakellariou
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aliki Liakea
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Diamantis
- Department of Endocrinology and Diabetes Center, G. Gennimatas General Hospital, Athens, Greece
| | - Paraskevi Farmaki
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Errika Voutyritsa
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Syllaios
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Patsouras
- Second Department of Internal Medicine, Tzanio General Hospital, Piraeus, Greece
| | - Georgia Sypsa
- Department of Pulmonology, Laiko General Hospital, Athens, Greece
| | | | - Athanasia Stelianidi
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios A Antoniou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kontzoglou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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33
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Kostakis ID, Feretis T, Damaskos C, Garmpis N, Liapis G, Pateras I, Garmpi A, Georgakopoulou VE, Antoniou EA. Nuchal-type Fibroma: Single-Center Experience and Systematic Literature Review. In Vivo 2021; 34:2217-2223. [PMID: 32871744 DOI: 10.21873/invivo.12032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/10/2020] [Revised: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Nuchal-type fibroma is a rare benign tumor arising from the connective tissue. Our aim was to present our experience via two cases of this tumor and a comprehensive review of the literature. PATIENTS AND METHODS We report a case of a 23-year-old female with a mass located in the posterior neck and the upper back and a case of a 50-year-old male with a mass located in the posterior neck, which were proved to be nuchal-type fibromas in the histopathological examination. We also searched the PubMed/Medline database for published cases of nuchal-type fibromas. RESULTS AND DISCUSSION Nuchal-type fibroma is a rare benign tumor arising from the connective tissue, usually in the posterior neck, which affects different ages, with most patients being male. It is a poorly circumscribed tumor consisting of hypocellular, thick, dense and haphazardly arranged collagen bundles with entrapped adipocytes, nerve fibers and muscle fascicles and a few scattered spindle cells, which are CD34 positive. Its excision is curative, and the recurrence risk is generally low. However, patients with Gardner's syndrome may experience recurrence more frequently. CONCLUSION Nuchal-type fibroma should be included in the differential diagnosis of subcutaneous, soft-tissue masses, especially when these involve the posterior neck.
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Affiliation(s)
- Ioannis D Kostakis
- Department of Transplantation, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - Themistoklis Feretis
- First Department of Endoscopic Surgery, Metropolitan General Hospital, Athens, Greece
| | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, Greece .,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Garmpis
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Liapis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Pateras
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki E Georgakopoulou
- Department of Pulmonology, Laiko General Hospital, Athens, Greece.,First Department of Pulmonology, Sismanogleio Hospital, Athens, Greece
| | - Efstathios A Antoniou
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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34
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Quiles-Sanchez LV, Baroutas I, Kyriakos G, Gravvanis N, Georgakopoulou VE, Trakas N, Damaskos C, Garmpi A, Garmpis N, Antoniou V, Farmaki P, Patsouras A, Voutyritsa E, Diamantis E. Medical Flossing and the Pilates Method: Their Effectiveness on the Strength, Endurance, and Functionality of Healthy Individuals. Cureus 2021; 13:e14758. [PMID: 34084682 PMCID: PMC8164438 DOI: 10.7759/cureus.14758] [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] [Indexed: 12/03/2022] Open
Abstract
The flossing method is an emerging therapeutic intervention based on the use of a floss-band that is circumnavigated at the various points of the body being treated. It is optimally combined with an appropriate exercise program to induce ischemia and release the fascia by applying pressure and movement to functional models. The Pilates method teaches the person to focus on the muscles, especially those responsible for the correct posture. It also helps the individual to become aware of the way he/she breathes. Both methods have positive effects on exercise and rehabilitation. However, medical flossing has not been as well researched as the Pilates method. This study aims to examine the effectiveness of both methods on the strength, endurance, and functionality of healthy individuals. A review of the literature on medical flossing and Pilates was conducted. A systematic research took place from 2014 to 2019. Publications in non-English or non-Greek language were excluded. The articles were retrieved from not only PubMed, Scielo, and Elsevier databases, but also Google Scholar. Both methods are understudied in relation to their effectiveness on the strength, endurance, and functionality of healthy individuals. More studies are required to estimate the effects of both methods on healthy individuals.
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Affiliation(s)
| | | | - Georgios Kyriakos
- Seccion de Endocrinologia y Nutrition, Hospital General Universitario Santa Lucia, Cartagena, ESP
| | | | - Vasiliki E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Athens, GRC.,1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
| | | | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, GRC.,Department of Surgery, N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Nikolaos Garmpis
- Department of Surgery, N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | | | - Paraskevi Farmaki
- First Department of Pediatrics, Agia Sofia Children's Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Alexandros Patsouras
- Second Department of Internal Medicine, Tzanio General Hospital of Piraeus, Athens, GRC
| | - Errika Voutyritsa
- Department of Surgery, N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Evangelos Diamantis
- Department of Endocrinology and Diabetes Center, G. Gennimatas General Hospital, Athens, GRC
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35
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Georgakopoulou VE, Damaskos C, Mantzouranis K, Melemeni D, Gkoufa A, Chlapoutakis S, Garmpis N, Sklapani P, Aravantinou A, Garmpi A, Trakas N, Tsiafaki X. Invasive methods for the diagnosis and management of intrathoracic extramedullary hematopoiesis: A literature review. Respir Med Res 2021; 79:100815. [PMID: 33610912 DOI: 10.1016/j.resmer.2021.100815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Extramedullary hematopoiesis is defined as hematopoiesis occurring outside of the bone marrow. It usually compensates insufficient bone marrow function or ineffective erythropoiesis and is observed mostly in hematological disorders. Most common locations of extramedullary hematopoiesis are the spleen, the liver and the lymph nodes. Intrathoracic extramedullary hematopoiesis is rare presenting as bilateral lobulated masses of lower paravertebral regions. This review summarizes the role of invasive techniques in the diagnosis and management of intrathoracic EMH and its complications. METHODS An electronic search in PubMed and Google Scholar was conducted with the keywords "intrathoracic extramedullary hematopoiesis" AND "surgery" OR "video-assisted thoracic surgery (VATS)" OR "medical thoracoscopy" OR "biopsy" OR "thoracotomy" OR "image-guided biopsy" OR "median sternotomy", within 1970 to 2020 with the limitation of English language to include those articles reporting data on invasive techniques in intrathoracic extramedullary hematopoiesis. RESULTS Overall, 93 articles were originally identified using our search criteria and from the reference list of the previously identified documents. Following elimination of duplicates, 29 were excluded after title, abstract or full text screening, since they did not report the use of invasive techniques in the diagnosis and management of intrathoracic extramedullary hematopoiesis. CONCLUSIONS Although in some cases radiological features are typical for the diagnosis of intrathoracic extramedullary hematopoeisis, invasive methods such as bronchoscopy with transbronchial biopsy, ιmage-guided fine needle aspiration, endobronchial ultrasound-guided fine needle aspiration of the mass and mediastinoscopy, medical thoracoscopy, median sternotomy, video-assisted thoracoscopic surgery and thoracotomy, are essential for definite diagnosis and management.
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Affiliation(s)
- V E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, 17 Agiou Thoma Street, 11527, Athens, Greece.
| | - C Damaskos
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - K Mantzouranis
- 1st Pulmonology Department Sismanogleio Hospital, Athens, Greece
| | - D Melemeni
- 1st Pulmonology Department Sismanogleio Hospital, Athens, Greece
| | - A Gkoufa
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - S Chlapoutakis
- Department of Thoracic Surgery, Agios Savvas Hospital, Athens, Greece
| | - N Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - P Sklapani
- Department of Cytology, Mitera Hospital, Athens, Greece
| | - A Aravantinou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - A Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - N Trakas
- Department of Biochemistry, Sismanogleio Hospital, Athens, Greece
| | - X Tsiafaki
- 1st Pulmonology Department Sismanogleio Hospital, Athens, Greece
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36
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Georgakopoulou VE, Garmpis N, Damaskos C, Valsami S, Dimitroulis D, Diamantis E, Farmaki P, Papageorgiou CV, Makrodimitri S, Gravvanis N, Velonias S, Sklapani P, Trakas N, Antoniou EA, Kontzoglou K, Nikolidakis L, Damaskou Z, Syllaios A, Marinos G, Vogiatzi G, Korrou GE, Kyriakos G, Quiles-Sanchez LV, Patsouras A, Lamprinos D, Stelianidi A, Savvanis S, Garmpi A. The Impact of Peripheral Eosinophil Counts and Eosinophil to Lymphocyte Ratio (ELR) in the Clinical Course of COVID-19 Patients: A Retrospective Study. In Vivo 2021; 35:641-648. [PMID: 33402521 DOI: 10.21873/invivo.12303] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND/AIM Eosinophils are blood cells responsible for response against parasites and allergens. Eosinophil to lymphocyte ratio (ELR) is a biomarker for inflammatory conditions. Our aim was to evaluate the role of eosinophils and ELR in COVID-19 patients. PATIENTS AND METHODS The study included 96 patients hospitalized with COVID-19. They were classified into moderate to severe cases and critical cases. Eosinophils and ELR were determined in both groups, in patients that died or survived and were correlated to duration of hospitalization. RESULTS There was a statistically significant decrease in eosinophils and ELR between patients that died and patients that survived (p<0.05), and in mean values of the two biomarkers (p<0.05 for eosinophils and p<0.05 for ELR) between patients hospitalized for more or less than 15 days among those with moderate to severe disease. CONCLUSION Lower eosinophil counts and ERL could probably predict worse outcome in COVID-19 patients.
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Affiliation(s)
- Vasiliki E Georgakopoulou
- Department of Pulmonology, Laiko General Hospital, Athens, Greece.,First Department of Pulmonology, Sismanogleio Hospital, Athens, Greece
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece; .,Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
| | - Serena Valsami
- Blood Transfusion Department, Aretaieion Hospital, Medical School, National and Kapodistrian Athens University, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Diamantis
- Department of Endocrinology and Diabetes Center, G. Gennimatas General Hospital, Athens, Greece
| | - Paraskevi Farmaki
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | | | - Pagona Sklapani
- Department of Cytology, Mitera-Hygeia Hospital, Athens, Greece
| | - Nikolaos Trakas
- Biochemistry Department, Sismanogleio Hospital, Athens, Greece
| | - Efstathios A Antoniou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kontzoglou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Zoi Damaskou
- Department of Internal Medicine, Ygeias Melathron Hospital, Athens, Greece
| | - Athanasios Syllaios
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | - Georgios Kyriakos
- Seccion de Endocrinologia y Nutrition, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | | | - Alexandros Patsouras
- Second Department of Internal Medicine, Tzanio General Hospital, Piraeus, Greece
| | | | - Athanasia Stelianidi
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Savvanis
- Department of Internal Medicine, Elpis General Hospital, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Chlapoutakis S, Garmpi A, Trakas N, Damaskos C, Georgakopoulou VE. Recurrent Exacerbations of Chronic Obstructive Pulmonary Disease Reveal Swyer-James-MacLeod Syndrome in a 63-year-old Patient. Cureus 2021; 13:e12601. [PMID: 33585091 PMCID: PMC7872489 DOI: 10.7759/cureus.12601] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Swyer-James-Macleod syndrome is an infrequent clinical condition characterized by unilateral hyperlucent lung as a complication following infectious bronchiolitis obliterans, typically diagnosed during childhood. However, in some patients, the diagnosis may be confirmed in adulthood. The syndrome can be misdiagnosed with other lung disorders such as asthma, pulmonary embolism, and pneumothorax, leading to inappropriate management and worse outcome. We present a case of Swyer-James-MacLeod syndrome, diagnosed in a 63-year-old man, with frequent hospitalisations due to chronic obstructive pulmonary disease (COPD) exacerbations without a history of significant lung infection in childhood. Complications of Swyer-James-MacLeod syndrome include recurrent infections, lung abscess, pneumothorax, and pulmonary hypertension. The syndrome should always be considered in adults with recurrent respiratory infections or pulmonary hyperlucency on chest imaging to prevent a delay in correct diagnosis and improper treatment.
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Affiliation(s)
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | | | - Christos Damaskos
- Surgery, Laiko General Hospital, Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", Athens Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Vasiliki E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Athens, GRC.,First Pulmonology Department, Sismanogleio Hospital, Athens, GRC
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38
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Garmpis N, Damaskos C, Angelou A, Garmpi A, Georgakopoulou VE, Valsami S, Schizas D, Voutyritsa E, Syllaios A, Diamantis E, Farmaki P, Kyriakos G, Patsouras A, Psifis M, Antoniou EA, Kontzoglou K, Trakas N, Dimitroulis D. Animal Models for the Calculation of Circulating Tumor Cells for Experimental Demonstration. Anticancer Res 2020; 40:6599-6607. [PMID: 33288554 DOI: 10.21873/anticanres.14684] [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: 09/05/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 11/10/2022]
Abstract
Metastasis is a process which is characterized by the existence of tumor cells in the bloodstream. This is a necessary situation in order for the malignant cells to be transported to other organs. Thus, the importance of circulating tumor cells (CTCs) in the study of carcinogenesis is widely accepted. These tumor cells are nowadays a topic of intensive research all over the world. CTCs are expressed from tumor cells and the clinical analysis of this expression may help the recognition of a tumor in an earlier stage and also there is an effort to monitor the tumor burden according to these cells. Although a plethora of clinical studies has been conducted, it is still unclear whether the use in clinical aspect will prove to be beneficial in the near future. Few animal models with neoplasia have been studied concerning the circulating tumor cells and it is likely that CTCs may have a predictive, diagnostic or therapeutic value. Herein, the authors review all studies in which human CTCs were transplanted into animals. Therefore, more clinical studies using standardized methods for measuring CTCs are required to elucidate these issues.
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Affiliation(s)
- Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, Greece .,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece;
| | | | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki E Georgakopoulou
- Department of Pulmonology, Laiko General Hospital, Athens, Greece.,First Department of Pulmonology, Sismanogleio Hospital, Athens, Greece
| | - Serena Valsami
- Blood Transfusion Department, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Errika Voutyritsa
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Syllaios
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Diamantis
- Department of Endocrinology and Diabetes Center, G. Gennimatas General Hospital, Athens, Greece
| | - Paraskevi Farmaki
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Kyriakos
- Seccion de Endocrinologia y Nutrition, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Alexandros Patsouras
- Second Department of Internal Medicine, Tzanio General Hospital, Piraeus, Greece
| | - Markos Psifis
- Orthopaedic Department, Venizeleion General Hospital, Heraklion, Greece
| | - Efstathios A Antoniou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kontzoglou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Gkoufa A, Sakellariou S, Katsoulas N, Georgakopoulou VE, Lazaris A, Cholongitas E. Henoch-Schönlein purpura associated with ciprofloxacin. Dermatol Ther 2020; 34:e14591. [PMID: 33244823 DOI: 10.1111/dth.14591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/12/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Aikaterini Gkoufa
- First Department of Internal Medicine, Laiko General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, Greece
| | - Stratigoula Sakellariou
- First Department of Pathology, Laiko General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Katsoulas
- First Department of Pathology, Laiko General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki E Georgakopoulou
- First Department of Internal Medicine, Laiko General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, Greece
| | - Andreas Lazaris
- First Department of Pathology, Laiko General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Cholongitas
- First Department of Internal Medicine, Laiko General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, Greece
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40
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Damaskos C, Georgakopoulou VE, Garmpis N, Garmpi A, Dimitroulis D. Triple Renal Arteries in a Cadaveric Kidney Donor: A Case Report. Cureus 2020; 12:e11639. [PMID: 33376651 PMCID: PMC7755657 DOI: 10.7759/cureus.11639] [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] [Indexed: 11/05/2022] Open
Abstract
Variation in the number of renal arteries is rare and is the most frequent and clinically important variation in the renal vascular system. Typically, this variant represents an immature form of complicated development of the renal arteries resulting from the persistence of more than one mesonephric artery during the transition period from mesonephros to metanephros in embryogenesis. The knowledge of this anatomical variation will allow the best healthcare to be provided for patients undergoing kidney surgical procedures and may reduce or eliminate avoidable postoperative complications. Although a double renal artery consists of a common anatomical variation, three or more arteries in a single kidney is less common. Herein, we report a case of a 42-year-old healthy cadaveric donor whose left kidney was found to have three renal arteries.
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Affiliation(s)
- Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Vasiliki E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Athens, GRC.,First Pulmonology Department, Sismanogleio Hospital, Athens, GRC
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Dimitrios Dimitroulis
- Second Department of Propaedeutic Surgery, Laiko Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, GRC.,Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens Medical School, National and Kapodistrian University of Athens, Athens, GRC
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41
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Kyriakos G, Quiles-SÁnchez LV, Diamantis E, Farmaki P, Garmpis N, Damaskos C, Savvanis S, Patsouras A, Stelianidi A, Voutyritsa E, Georgakopoulou VE, Garmpi A. Lipid-lowering Drugs and Neurocognitive Function: A Systematic Review. In Vivo 2020; 34:3109-3114. [PMID: 33144414 DOI: 10.21873/invivo.12144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/20/2020] [Accepted: 07/24/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Lipid-lowering drugs have been suggested to affect neurocognitive function. This review aimed to give the latest evidence on the way these agents affect neurocognitive function based on clinical trials. MATERIALS AND METHODS A systematic search concerning original studies from 2015 to 2020 was performed through the databases PubMed, EMBASE and Cochrane, according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. The trials enrolled numerous patients and were conducted in different areas of the world. The terms used are cholesterol, lipid-lowering drugs, statins and cognitive function. RESULTS Eleven randomized trials met the inclusion criteria. The trials included patients suffering from cardiovascular conditions. In particular, patients with coronary heart disease, coronary heart disease risk equivalents and hypercholesterolemia were tested. The trials included evolocumab, alirocumab, statin, ezetimibe or placebo. CONCLUSION Lipid-lowering drugs seem to have no significant effect on neurocognitive function, but further research specifically focused on this matter is needed.
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Affiliation(s)
- Georgios Kyriakos
- Seccion de Endocrinologia y Nutrition, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | | | - Evangelos Diamantis
- Department of Endocrinology and Diabetes Center, G. Gennimatas General Hospital, Athens, Greece
| | - Paraskevi Farmaki
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece .,Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
| | - Spyridon Savvanis
- Internal Medicine Department, Elpis General Hospital, Athens, Greece
| | - Alexandros Patsouras
- Second Department of Internal Medicine, Tzanio General Hospital, Piraeus, Greece
| | - Athanasia Stelianidi
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Errika Voutyritsa
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki E Georgakopoulou
- Department of Pulmonology, Laiko General Hospital, Athens, Greece.,First Department of Pulmonology, Sismanogleio Hospital, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Damaskos C, Garmpis N, Garmpi A, Georgakopoulou VE, Tomos P. Multilocular Thymic Cyst in a Young, Otherwise Healthy Woman: A Case Report. Cureus 2020; 12:e11210. [PMID: 33269141 PMCID: PMC7704160 DOI: 10.7759/cureus.11210] [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] [Indexed: 11/15/2022] Open
Abstract
Thymic cysts are rare lesions, accounting approximately for 1% of all mediastinal masses. We report a case of a 36-year old woman who presented preoperatively with a calcified mass shadow found on a routine chest radiograph X-ray. After further investigation with chest computed tomography (CT), magnetic resonance imaging (MRI), and tests for Myasthenia gravis, a benign mediastinal cyst was diagnosed and the patient underwent median sternotomy and complete surgical excision of the lesion. The histological examination described a multilocular thymic cyst. Thymic cysts are usually associated with thymic epithelial tumors, such as thymomas, or multisystemic morbid conditions such as human immunodeficiency virus (HIV) infection, rheumatologic disease, and Myasthenia gravis. At all follow-up examinations to date, the patient remains healthy.
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Affiliation(s)
- Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, GRC.,Medicine, N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens, Athens, GRC
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Athens, GRC.,Medicine, National and Kapodistrian University of Athens, Athens, GRC
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Athens, GRC.,Medicine, National and Kapodistrian University of Athens, Athens, GRC
| | - Vasiliki E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Athens, GRC.,First Pulmonology Department, Sismanogleio Hospital, Athens, GRC
| | - Periklis Tomos
- Department of Thoracic Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC
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43
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Diamantis E, Charalampopoulos V, Damaskos C, Farmaki P, Garmpis N, Garmpi A, Patsouras A, Kyriakos G, Savvanis S, Georgakopoulou VE, Trakas N, Kounetas K. Government Debt Crisis and the Impact on National Health Systems: A Retrospective Study and Policy Recommendations to Greece. Cureus 2020; 12:e10786. [PMID: 33154853 PMCID: PMC7608093 DOI: 10.7759/cureus.10786] [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: 11/06/2022] Open
Abstract
This article aims to explore the impact of the government debt crisis on the national health system (NHS) using a representative sample of respondents in Greek hospitals and provides certain suggestions regarding health policies that could be implemented at the national or local level. This study was conducted at the Evangelismos & Eye Polyclinic of Athens General Hospital in Athens, Greece. The study period was January and February of 2016, and the study included 600 outpatients who frequently submitted to follow-ups and consented to participate. Based on the results of this study, the participants had an average health status, while 94.2% of them had medical insurance. The predominant reason (88%) for choosing public hospitals instead of private practices was insufficient income. Further investigation revealed a significant positive correlation between the participant’s age and the number of hospital visits, the number of medical tests performed, and their satisfaction from the health services provided. Finally, a probit-model was used in order to study factors that could potentially influence their level of satisfaction from the services they used.
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Affiliation(s)
- Evangelos Diamantis
- Internal Medicine: Diabetes and Endocrinology, Evangelismos Hospital, Athens, GRC
| | - Vasileios Charalampopoulos
- Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Christos Damaskos
- Surgery, Renal Transplantation Unit, Laiko General Hospital, Athens, GRC.,Surgery, N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Paraskevi Farmaki
- Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Nikolaos Garmpis
- Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Anna Garmpi
- Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | | | - Georgios Kyriakos
- Internal Medicine: Diabetes and Endocrinology, Hospital General Universitario Santa Lucia, Cartagena, ESP
| | | | - Vasiliki E Georgakopoulou
- Internal Medicine: Pulmonology, Laiko General Hospital, Athens, GRC.,Internal Medicine: Pulmonology, Sismanogleio Hospital, Athens, GRC
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44
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Georgakopoulou VE, Zygouris E, Nikokiris C, Damaskos C, Pierrakou A, Garmpis N, Garmpi A, Sklapani P, Aravantinou A, Trakas N, Janinis J, Dahabreh J. Predictive Indicators of Survival in Patients With Surgically Resected Lung Carcinoid Tumors at a Greek Medical Center. Cureus 2020; 12:e10300. [PMID: 32923302 PMCID: PMC7478793 DOI: 10.7759/cureus.10300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction Lung carcinoid tumors are neuroendocrine neoplasms, less frequent than other lung tumors. They are subdivided into typical carcinoids (TC) and atypical carcinoids (AC), according to the rate of mitosis and the presence of necrosis. Lung carcinoids are often asymptomatic and only discovered incidentally. They may also present with cough, wheezing, asthma, and chronic obstructive pulmonary disease, chest pain, and hemoptysis depending on the location of the tumor and, less commonly, present with carcinoid syndrome. In our study, we describe the clinical and pathological features of patients with surgically resected lung carcinoids at our institution over a period of 14 years. We also examine if these features, including age, gender, tumor size, type of carcinoid, stage, nodal involvement, and Ki-67 expression are associated with patients' survival. Materials and methods We retrospectively reviewed patients that underwent surgery with a final histologic diagnosis of a pulmonary carcinoid tumor from March 2005 to March 2019. The evaluation included history, physical examination, chest radiographs, computerized tomography of the chest, upper abdomen, and brain, and bone scintiscan. All specimens resected during the surgical procedures were sent for pathological examination, including mediastinal and hilar lymph nodes. The patients' age, gender, tumor size, type of carcinoid, nodal involvement, stage, and Ki-67 expression were recorded and correlated to the patients' survival rates. Results The study included 108 patients - 52 males and 56 females - with a mean age of 51.5 years (range 11-80 years). Atypical carcinoid was the diagnosis in 28 patients (16 males and 12 females) and 80 patients had the diagnosis of typical carcinoid (36 males and 44 females). Tumor size was ≤3.7 cm in 84 patients (68 with TC and 16 with AC) and >3.7 cm in 22 patients (12 with TC and 10 with AC). Sixteen patients had nodal deposits, 12 in N1 nodes and four in N2 nodes. Eighty patients were classified in stage I, 18 patients in stage II, and 10 patients in stage III. None of the patients had distant metastases. The Ki-67 proliferation index was examined in 84 specimens and Ki-67 was <2.5 in 50 patients and ≥2.5 in 34 patients. Of the 108 patients, eight died, all with disease-related death. According to the Cox regression univariate analysis, four factors were correlated to shorter survival: atypical histology, tumor size >3.7 cm, nodal involvement, and advanced stage Conclusions In conclusion, we found that histological type, tumor size, nodal involvement, and stage are associated with survival in patients with surgically resected lung carcinoids without distant metastases. Other parameters, such as age at operation, gender, and Ki-67 index, did not have a role in survival in these patients according to the Cox regression univariate analysis.
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Affiliation(s)
- Vasiliki E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Athens, GRC.,1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
| | | | | | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | | | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | | | | | | | - Jim Janinis
- Oncology, Athens Medical Center, Athens, GRC
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Georgakopoulou VE, Kourtelesi E, Mermigkis D, Trakas N, Tsiafaki X. Bronchial Fibroepithelial Polyp With Severe Hemoptysis as First Manifestation: A Case Report. Cureus 2020; 12:e10261. [PMID: 33042699 PMCID: PMC7536118 DOI: 10.7759/cureus.10261] [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: 08/24/2020] [Accepted: 09/05/2020] [Indexed: 11/05/2022] Open
Abstract
Fibroepithelial polyps are uncommon benign tumors that mostly occur in skin, oral cavity and genitourinary tract. These lesions have common morphological features with other mesenchymal tumors such as angiomyofibroblastoma, aggressive angiomyxoma, and cellular angiofibroma and present with numerous histological appearances. Benign endobronchial tumors are rare. These neoplasms have a slow growth and usually are related to bronchial obstruction. Only a few cases of bronchial fibroepithelial polyps have been reported. Bronchial fibroepithelial polyps might present with airway stenosis resulting in atelectasis and bronchiectasis and the most frequent manifestations are recurrent infection, refractory asthma, dyspnea and hemoptysis. Chronic inflammation is associated with the pathogenesis of fibroepithelial polyps. Treatment varies according to mainly to the size and symptoms. Small lesions presenting with few symptoms can be treated with corticosteroids and antibiotics while invasive techniques including bronchoscopic resection of the polyp or lobectomy are used for larger lesions. We report a case of a bronchial fibroepithelial polyp with severe hemoptysis as the first manifestation. Physicians should always suspect these lesions in the differential diagnosis of hemoptysis and with initial right diagnosis surgical procedures can be avoided.
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Affiliation(s)
- Vasiliki E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Athens, GRC
- 1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
| | | | | | | | - Xanthi Tsiafaki
- 1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
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46
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Georgakopoulou VE, Mermigkis D, Kairi O, Garmpi A, Tsiafaki X. Simultaneous Pleural and Pericardial Effusion as First Clinical Manifestations of Giant Cell Arteritis: A Case Report. Cureus 2020; 12:e10163. [PMID: 33014658 PMCID: PMC7526968 DOI: 10.7759/cureus.10163] [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
Giant cell arteritis (GCA) is a chronic granulomatous vasculitis of unknown aetiology occurring in the older patients and affecting mostly the cranial branches of the arteries originating from the aortic arch. GCA is associated with polymyalgia rheumatica (PMR). Clinical features of the disorder include headache, scalp tenderness, jaw claudication, temporal artery abnormalities on physical examination, vision changes, and symptoms associated to PMR. Systemic manifestations include fever, anorexia and weight loss while less rare manifestations are related to the nervous system, the respiratory system, the pericardium and extra-cranial large vessels. Here we report a rare case of simultaneous pleural and pericardial effusion as the first manifestations of GCA. The diagnosis was made with a temporal artery biopsy. Such a diagnosis should, therefore, be considered in older patients presenting with pleuropericardial manifestations, even in the absence of typical clinical features.
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Affiliation(s)
- Vasiliki E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Athens, GRC.,1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
| | | | - Ourania Kairi
- Intensive Care Unit, Sismanogleio Hospital, Athens, GRC
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Xanthi Tsiafaki
- 1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
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47
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Georgakopoulou VE, Trakas N, Damaskos C, Garmpis N, Karakou E, Chatzikyriakou R, Lambrou P, Tsiafaki X. Neutrophils to Lymphocyte Ratio as a Biomarker in Bronchiectasis Exacerbation: A Retrospective Study. Cureus 2020; 12:e9728. [PMID: 32944447 PMCID: PMC7489568 DOI: 10.7759/cureus.9728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/04/2023] Open
Abstract
Introduction Bronchiectasis is a disorder resulting mainly from bronchial inflammation caused by recurrent or chronic infections. It is characterized by permanently dilated airways due to bronchial wall destruction. Exacerbations have a key role in bronchiectasis as they are associated with a negative impact on patient prognosis. Exacerbations are generally infectious events caused mostly by bacterial microorganisms. Infective or inflammatory agents cause neutrophil recruitment into the airways, which leads to proteolytic enzymes such as neutrophil elastase and matrix metalloproteinases release, resulting in airway matrix destruction. Neutrophil to lymphocyte ratio (NLR) is used as a biomarker of inflammation. It is calculated by dividing the number of neutrophils by the number of lymphocytes. Our aim is to evaluate Neutrophils to Lymphocyte Ratio in patients with bronchiectasis exacerbation and its correlation to microbiological data. Methods The study involved patients with a diagnosis of bronchiectasis based on high-resolution computerised tomography (HRCT) of the chest who fulfilled the criteria of bronchiectasis exacerbation. Complete blood counts with differential counts, which included total white blood cells, neutrophils and lymphocytes, were obtained. NLR and C-reactive protein (CRP) levels were measured in patients with bronchiectasis exacerbation and in healthy controls. NLR was calculated as the ratio of the neutrophils to lymphocytes. The mean NLR values in patients with bronchiectasis exacerbation were compared to mean NLR values in healthy controls. The NLR values were compared to CRP levels in patients with bronchiectasis exacerbation. Sputum cultures were performed in all patients. The mean NLR values in patients with positive sputum cultures were compared with mean NLR values in patients with negative sputum cultures, and mean NLR values in patients with isolated Pseudomonas aeruginosa in sputum cultures were compared to mean NLR values in patients with other infectious agents isolated. Results The study population consisted of 80 patients with bronchiectasis exacerbation - 54 males and 26 females - with a mean age of 77.3±8.4 years, and 64 healthy controls - 36 males and 28 females - with a mean age of 62.9±15.3 years. The mean CRP levels in patients with bronchiectasis exacerbation were 75.03±73.87 mg/l. The mean NLR value in patients with bronchiectasis exacerbation was 9.2±7.8 and the mean NLR value of controls was 3.1±2.9 (p<0.001). The NLR values in patients with bronchiectasis exacerbation had no linear correlation with CRP values in these patients (r=0.002, p=0.992). Fifty-two patients had positive sputum cultures and 28 patients had negative sputum cultures. The mean NLR value in patients with positive sputum cultures was 10.5±9.1, and in patients with negative sputum cultures, it was 6.7±3.6 (p<0.012). The mean NLR value in patients with P.aeruginosa was 10.1±9.5, and in patients with other microorganisms isolated, it was 10.8±8.9 (p=0.784). Conclusions Neutrophil to lymphocyte ratio values are statistically greater in patients with bronchiectasis exacerbation compared to healthy controls. There is no linear correlation between NLR and CRP in these patients. NLR values are statistically greater in patients with positive sputum cultures compared to those with negative sputum cultures. Therefore, NLR can be used for predicting positive cultures in patients with bronchiectasis exacerbation.
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Affiliation(s)
- Vasiliki E Georgakopoulou
- Department of Pulmonology, Laiko General Hospital, Athens, GRC.,1st Department of Pulmonology, Sismanogleio Hospital, Athens, GRC
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, Athens, GRC
| | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, GRC.,Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Nikolaos Garmpis
- 2nd Department of Propedeutic Surgery, Laiko General Hospital, Athens, GRC
| | - Evgenia Karakou
- Department of Biochemistry, Sismanogleio Hospital, Athens, GRC
| | | | | | - Xanthi Tsiafaki
- 1st Department of Pulmonology, Sismanogleio Hospital, Athens, GRC
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Georgakopoulou VE, Mermigkis D, Mantzouranis K, Damaskos C, Melemeni D, Alafaki EA, Petsinis G, Garmpis N, Karakou E, Garmpi A, Lekkakou A, Sklapani P, Trakas N, Chatzikyriakou R, Tsiafaki X. Evaluation of Immature Platelet Fraction in Lower Respiratory Tract Infections: A Retrospective Study. Cureus 2020; 12:e9227. [PMID: 32821576 PMCID: PMC7430542 DOI: 10.7759/cureus.9227] [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] [Indexed: 11/23/2022] Open
Abstract
Introduction Immature platelet fraction (IPF) is a parameter of an automated hematologic analyzer and is related to platelet size and cytoplasmic RNA content. It reflects thrombopoiesis and is often used as the marker of platelet activity. IPF has been evaluated mostly in hematologic disorders and has also been evaluated in patients with gestational hypertension, sepsis, autoimmune diseases and in hospitalised patients with neutrophilia. Platelets, asides from the maintenance of hemostasis, release inflammatory mediators that can modify leukocyte and endothelial responses to various inflammatory stimuli. Lower respiratory tract infections are the leading cause of death from infections worldwide. The role of platelets in lower respiratory tract infections has been reported in many studies. IPF, which is related to platelet activation, has not been evaluated in patients with lower respiratory tract infections. Methods The study involved patients who fulfilled the criteria of community-acquired pneumonia (CAP) and aspiration pneumonia (AP). In addition, age and sex-matched healthy controls were involved. Whole blood samples were collected from healthy controls and from the patients on admission. The mean IPF% and C-reactive protein (CRP) levels were measured in patients with CAP, in patients with AP and in healthy controls. The mean IPF% values in patients with infection were compared to mean IPF% values in healthy controls. The mean IPF% values were compared to mean CRP levels in patients with infection. Additionally, the mean IPF% values in patients that died in the first 14 days were compared to the mean IPF% values in patients that were alive. The statistical analysis of data was performed with the Statistical Package for the Social Sciences (SPSS) for Windows, Version 13.0 (SPSS Inc, Chicago, IL). Results The study population consisted of 45 patients (27 patients with CAP and 18 patients with AP), 27 males and 18 females, with a mean age of 72.11 ± 16.4 years and 39 healthy controls, 22 males and 17 females with a mean age of 64.2 ± 14.8 years. The mean CRP levels in patients with infection were 155.2±119.1 mg/dl. The mean IPF% value of patients with infection was 2.76 ± 2.27 and the mean IPF% value of controls was 1.72 ± 0.77 (p < 0.006). The IPF% value in patients with CAP was 2.55 ± 2.02 and in patients with AP 3.07 ± 2.64 (p = 0.595). The mean IPF% value in patients with infection had no linear correlation with CRP value in these patients (r = 0.076, p = 0.62). The mean IPF% value in all patients that died in the first 14 days was 3.75 ± 2.44 and the mean IPF% value in all patients alive was 2.35 ± 2.11 (p = 0.06). The mean IPF% value in patients with CAP who died in the first 14 days of hospitalisation was 5.54 ± 3.17 and in patients with CAP who were alive was 1.87 ± 0.72 (p = 0.06). The mean IPF% value in patients with AP who died was 2.63 ± 0.85 and in patients with AP who were alive was 3.41 ± 3.51 (p = 0.554). Conclusions Mean IPF% value is greater in patients with lower respiratory tract infections, including CAP and AP, compared to healthy controls. There is no linear correlation between IPF values and CRP values in patients with lower respiratory tract infections. In addition, there is a difference in mean IPF% value between patients who died in the first 14 days of hospitalisation compared to those who were alive, but not statistically significant.
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Affiliation(s)
- Vasiliki E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Athens, GRC.,1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
| | | | | | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, GRC.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | | | | | | | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | | | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Agathi Lekkakou
- 1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
| | | | | | | | - Xanthi Tsiafaki
- 1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
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Georgakopoulou VE, Mantzouranis K, Damaskos C, Karakou E, Melemeni D, Mermigkis D, Petsinis G, Sklapani P, Trakas N, Tsiafaki X. Correlation Between Serum Levels of 25-Hydroxyvitamin D and Severity of Community-Acquired Pneumonia in Hospitalized Patients Assessed by Pneumonia Severity Index: An Observational Descriptive Study. Cureus 2020; 12:e8947. [PMID: 32765992 PMCID: PMC7398711 DOI: 10.7759/cureus.8947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/15/2020] [Accepted: 07/01/2020] [Indexed: 01/26/2023] Open
Abstract
Introduction Pneumonia severity index (PSI) is a prognostic index used for estimating the possibility of death due to community-acquired pneumonia. Vitamin D is a fat-soluble vitamin, essential for calcium and phosphate homeostasis. Vitamin D also has antimicrobial properties and according to recent studies, its deficiency may be correlated to an increased frequency of respiratory infections. The serum concentration of 25-hydroxyvitamin D (25(OH)D) is the best vitamin D status index reflecting vitamin D produced in the skin and offered from food and dietary supplements. Methods The study involved patients, who fulfilled the criteria of community-acquired pneumonia. The exclusion criteria were: patients <18 years old, severely immunocompromised patients, patients with tuberculosis, patients with malabsorption disorders, nursing home residents, patients with a history of malignancy, chronic renal or liver disease, patients with congestive health failure or cerebrovascular disease, and patients receiving vitamin D as a supplement. The following parameters, recorded on admission, were evaluated: age, sex, co-morbidity, residence in a nursing home, duration of symptoms, clinical symptoms, confusion, blood gas analysis, chest radiograph (pleural effusion), and laboratory parameters. The patients were classified in risk classes according to the PSI. Blood samples were collected within the first 48 hours of hospitalization. The serum levels of 25-hydroxyvitamin D were determined by electrochemiluminescence binding assay in Roche Cobas 601 immunoassay analyzer and mean serum levels of 25-hydroxyvitamin D in each risk class were calculated. For statistical analysis, the statistical program SPSS for Windows version 17.0 (Statistical Package for the Social Sciences, SPSS Inc., Chicago, IL) was used. Results A total of 46 patients, 28 males and 18 females, with a mean age of 71.5±17.57 years, hospitalized with community-acquired pneumonia, were included. Sixteen patients (35%) had a severe deficiency, with 25(OH)D levels <10 ng/ml, 17 patients (37%) had moderate deficiency with 25(OH)D levels between 10-20 ng/ml, and 13 patients (28%) had insufficiency with 25(OH)D levels between 20-29 ng/ml. According to the PSI, four (8.7%) patients with a mean age of 53.75±15.43 years were classified as risk class I, 10 (21.7%) patients with a mean age of 54.7±14.82 years as class II, 10 (21.7%) patients with a mean age of 68.41±3.96 years as class III, 17 (37%) patients with a mean age of 84.82±9.73 years as class IV, and five (10.9%) patients with a mean age of 80.2±9.41 years as class V. The mean levels of 25(OH)D were 19.11±11.24 ng/ml in class I, 16.81±8.94 ng/ml in class II, 16.65±9.18 ng/ml in class III, 14.76±10.22 ng/ml in class IV, and 7.49±4.41 ng/ml in class V. There was a positive correlation between low levels of 25(OH)D and the pneumonia severity and statistically significant difference between the mean levels of 25(OH)D in class V (7.49±4.41 ng/ml) compared to overall mean levels in classes I, II, III and IV (16.15±9.49 ng/ml), with p<0.05. Conclusions According to our results, there was a positive association between low levels of 25-hydroxyvitamin D and community-acquired pneumonia severity assessed by PSI. The determination of 25-hydroxyvitamin-D status, mostly in patients >60 years old, may prevent severe community-acquired pneumonia.
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Affiliation(s)
- Vasiliki E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Athens, GRC
- 1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
| | | | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, GRC
- "N.S. Christeas" Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens Medical School, Athens, GRC
| | | | | | | | | | | | | | - Xanthi Tsiafaki
- 1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC
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