Publications by authors named "Christos Damaskos"

149 Publications

COVID-19 and Acute Pancreatitis: A Systematic Review of Case Reports and Case Series.

Ann Saudi Med 2022 Jul-Aug;42(4):276-287. Epub 2022 Aug 4.

From the Renal Transplantation Unit, Laiko General Hospital, Athens, Greece.

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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http://dx.doi.org/10.5144/0256-4947.2022.276DOI Listing
August 2022

Pleural involvement in cryptococcal infection.

World J Clin Cases 2022 Jun;10(16):5510-5514

Department of Infectious Diseases, Laiko General Hospital, Athens 11527, Greece.

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 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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http://dx.doi.org/10.12998/wjcc.v10.i16.5510DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210898PMC
June 2022

COVID-19-associated acute appendicitis in adults. A report of five cases and a review of the literature.

Exp Ther Med 2022 Jul 1;24(1):482. Epub 2022 Jun 1.

Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece.

The novel coronavirus has negatively affected patients and healthcare systems globally. Individuals with coronavirus disease 2019 (COVID-19) experience a wide range of respiratory symptoms, from mild flu-like symptoms to severe and potentially fatal pneumonia. Some patients report gastrointestinal symptoms, such as nausea, vomiting and abdominal pain in addition to the respiratory symptoms or as a separate presentation. Even though abdominal pain syndrome indicates acute appendicitis, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection should be considered as a possible diagnosis during this pandemic. However, there have been reports of a few cases of acute abdominal pain revealing acute appendicitis associated with SARS-CoV-2 infection. Appendectomy is challenging in COVID-19-infected patients with acute appendicitis as it includes high surgical risks for the patients, as well as hazards for healthcare professionals who are exposed to SARS-CoV-2. The present study reports five cases of adult patients with COVID-19 with simultaneous acute appendicitis. In addition, the present study aims to provide the framework for the diagnosis and management of adult patients with COVID-19 with acute appendicitis.
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http://dx.doi.org/10.3892/etm.2022.11409DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9214594PMC
July 2022

Immunotherapy as a Therapeutic Strategy for Gastrointestinal Cancer-Current Treatment Options and Future Perspectives.

Int J Mol Sci 2022 Jun 15;23(12). Epub 2022 Jun 15.

Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

Gastrointestinal (GI) cancer constitutes a highly lethal entity among malignancies in the last decades and is still a major challenge for cancer therapeutic options. Despite the current combinational treatment strategies, including chemotherapy, surgery, radiotherapy, and targeted therapies, the survival rates remain notably low for patients with advanced disease. A better knowledge of the molecular mechanisms that influence tumor progression and the development of optimal therapeutic strategies for GI malignancies are urgently needed. Currently, the development and the assessment of the efficacy of immunotherapeutic agents in GI cancer are in the spotlight of several clinical trials. Thus, several new modalities and combinational treatments with other anti-neoplastic agents have been identified and evaluated for their efficiency in cancer management, including immune checkpoint inhibitors, adoptive cell transfer, chimeric antigen receptor (CAR)-T cell therapy, cancer vaccines, and/or combinations thereof. Understanding the interrelation among the tumor microenvironment, cancer progression, and immune resistance is pivotal for the optimal therapeutic management of all gastrointestinal solid tumors. This review will shed light on the recent advances and future directions of immunotherapy for malignant tumors of the GI system.
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http://dx.doi.org/10.3390/ijms23126664DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224428PMC
June 2022

Inhaled Bronchodilators and Corticosteroids in the Management of Bronchiolitis Obliterans due to Allogenic Hematopoietic Stem Cell Transplantation.

Oman Med J 2022 May 31;37(3):e388. Epub 2022 May 31.

Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

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http://dx.doi.org/10.5001/omj.2022.90DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096802PMC
May 2022

Increased Influenza Vaccination Coverage among Members of the Athens Medical Association Amidst COVID-19 Pandemic.

Vaccines (Basel) 2022 May 18;10(5). Epub 2022 May 18.

Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Lariss, Greece.

Healthcare workers are at high risk of influenza virus infection as well as of transmitting the infection to vulnerable patients who may be at high risk of severe illness. The aim of this cross-sectional study was to investigate the prevalence and related factors of influenza vaccination coverage (2020-2021flu season), among members of the Athens Medical Association in Greece. This survey employed secondary analysis data from a questionnaire-based dataset on COVID-19 vaccination coverage and associated factors from surveyed doctors, registered within the largest medical association in Greece. All members were invited to participate in the anonymous online questionnaire-based survey over the period of 25 February to 13 March 2021. Finally, 1993 physicians (60% males; 40% females) participated in the study. Influenza vaccination coverage was estimated at 76%. Logistic regression analysis demonstrated that older age (OR = 1.02; 95% C.I. = 1.01-1.03), history of COVID-19 vaccination (OR = 2.71; 95% C.I. = 2.07-3.56) and perception that vaccines in general are safe (OR = 16.49; 95% C.I. = 4.51-60.25) were found to be independently associated factors with the likelihood of influenza vaccination coverage. Public health authorities should maximize efforts and undertake additional actions in order to increase the percentage of physicians/health care workers (HCWs) being immunized against influenza. The current COVID-19 pandemic offers an opportunity to focus on tailored initiatives and interventions aiming to improve the influenza vaccination coverage of HCWs in a spirit of synergy and cooperation.
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http://dx.doi.org/10.3390/vaccines10050797DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9148125PMC
May 2022

An Insight into the Novel Immunotherapy and Targeted Therapeutic Strategies for Hepatocellular Carcinoma and Cholangiocarcinoma.

Life (Basel) 2022 Apr 30;12(5). Epub 2022 Apr 30.

Division of Molecular Oncology, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) constitute highly malignant forms of primary liver cancers. Hepatocellular and bile duct carcinogenesis is a multiplex process, caused by various genetic and epigenetic alterations, the influence of environmental factors, as well as the implication of the gut microbiome, which was undervalued in the previous years. The molecular and immunological analysis of the above malignancies, as well as the identification of the crucial role of intestinal microbiota for hepatic and biliary pathogenesis, opened the horizon for novel therapeutic strategies, such as immunotherapy, and enhanced the overall survival of cancer patients. Some of the immunotherapy strategies that are either clinically applied or under pre-clinical studies include monoclonal antibodies, immune checkpoint blockade, cancer vaccines, as well as the utilization of oncolytic viral vectors and Chimeric antigen, receptor-engineered T (CAR-T) cell therapy. In this current review, we will shed light on the recent therapeutic modalities for the above primary liver cancers, as well as on the methods for the enhancement and optimization of anti-tumor immunity.
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http://dx.doi.org/10.3390/life12050665DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146702PMC
April 2022

The Role of SNHG15 in the Pathogenesis of Hepatocellular Carcinoma.

J Pers Med 2022 May 6;12(5). Epub 2022 May 6.

Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

Long non-coding RNAs (lncRNAs) are transcripts of more than 200 nucleotides which cannot be translated into proteins. Small nucleolar RNA host gene 15 (SNHG15) is a lncRNA whose dysregulation has been found to have an important impact on carcinogenesis and affect the prognosis of cancer patients in various cancer types. Hepatocellular carcinoma (HCC) is one of the most common cancers with a poor long-term prognosis, while the best prognostic factor of the disease is its early diagnosis and surgery. Consequently, the investigation of the mechanisms of hepatocarcinogenesis, as well as the discovery of efficient molecular markers and therapeutic targets are of great significance. An extensive literature search was performed in MEDLINE in order to identify clinical studies that tried to reveal the role of SNHG15 in HCC. We used keywords such as 'HCC', 'hepatocellular carcinoma', 'SNHG15' and 'clinical study'. Finally, we included four studies written in English, published during the period 2016-2021. It was revealed that SNHG15 is related to the appearance of HCC via different routes and its over-expression affects the overall survival of the patients. More assays are required in order to clarify the potential role of SNHG15 as a prognostic tool and therapeutic target in HCC.
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http://dx.doi.org/10.3390/jpm12050753DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145272PMC
May 2022

Characteristics and outcomes of cancer patients who develop pulmonary embolism: A cross-sectional study.

Oncol Lett 2022 May 4;23(5):168. Epub 2022 Apr 4.

Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41334 Larissa, Greece.

Pulmonary embolism (PE), along with deep vein thrombosis, are collectively known as venous thromboembolism (VTE). Predisposing factors for PE include post-operative conditions, pregnancy, cancer and an advanced age; of note, a number of genetic mutations have been found to be associated with an increased risk of PE. The association between cancer and VTE is well-established, and cancer patients present a higher risk of a thrombotic event compared to the general population. In addition, PE is a significant cause of morbidity and mortality among cancer patients. The aim of the present study was to illustrate the clinical characteristics, laboratory findings, radiology features and outcomes of cancer patients who developed PE, collected from an anticancer hospital. For this purpose, adult cancer patients diagnosed with PE by imaging with computed tomography pulmonary angiography were enrolled. The following data were recorded: Demographics, comorbidities, type of cancer, time interval between cancer diagnosis and PE occurrence, the type of therapy received and the presence of metastases, clinical signs and symptoms, predisposing factors for PE development, laboratory data, radiological findings, electrocardiography findings, and the type of therapy received for PE and outcomes in a follow-up period of 6 months. In total, 60 cancer patients were enrolled. The majority of the cancer patients were males. The most common type of cancer observed was lung cancer. The majority of cases of PE occurred within the first year from the time of cancer diagnosis, while the majority of patients had already developed metastases. In addition, the majority of cancer patients had received chemotherapy over the past month, while they were not receiving anticoagulants and had central obstruction. A large proportion of patients had asymptomatic PE. The in-hospital mortality rate was 13.3% and no relapse or mortality were observed during the follow-up period. The present study demonstrates that elevated levels of lactic acid and an increased platelet count, as well as low serum levels of carcinoembryonic antigen, albumin and D-dimer, may be potential biomarkers for asymptomatic PE among cancer patients.
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http://dx.doi.org/10.3892/ol.2022.13288DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019772PMC
May 2022

Evaluation of Knowledge, Attitudes and Practices Related to Self-Testing Procedure against COVID-19 among Greek Students: A Pilot Study.

Int J Environ Res Public Health 2022 04 10;19(8). Epub 2022 Apr 10.

N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

The COVID-19 pandemic has had a major impact on health, economy, society and education. In the effort to return to normalcy, according to the instructions of the Greek Government for the resumption of the operation of schools, a screening Rapid Antigen Detection Test with the method of self-testing is required for students twice per week, for the early identification and isolation of positive cases. We aimed to pivotally investigate the knowledge, attitudes and practices related to self-testing procedures against COVID-19 among Greek students. A questionnaire was distributed to a convenient sample of students in the region of Athens. Information about the vaccination coverage against SARS-CoV-2 was also obtained. Our study included 1000 students, with 70% of them having an average grade at school. Most of the participants were aware of coronavirus (98.6%) and the self-test (95.5%). The vast majority of students (97%) performed self-testing twice per week, with the 70% them being assisted by someone else. Nearly one sixth of the participants had been infected by COVID-19 (14%) while 36% of them have already been vaccinated against SARS-CoV-2. In conclusion, we report high compliance with the COVID-19 self-testing procedure among students in Attica, Greece. Older age adolescents are more likely to not comply with the regulations of self-testing. Consequently, tailored interventions targeted at older age adolescents are warranted in order to increase the acceptability of self-testing.
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http://dx.doi.org/10.3390/ijerph19084559DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9026819PMC
April 2022

Favorable outcomes of patients with sickle cell disease hospitalized due to COVID-19: A report of three cases.

Exp Ther Med 2022 May 21;23(5):338. Epub 2022 Mar 21.

Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, 11527 Athens, Greece.

Sickle cell disease (SCD) is one of the most frequent and severe monogenic disorders, affecting millions of individuals worldwide. SCD represents a fatal hematological illness, characterized by veno-occlusive events and hemolytic anemia. Hemolytic anemia is caused by abnormal sickle-shaped erythrocytes, which induce parenchymal destruction and persistent organ damage, resulting in considerable morbidity and mortality. During the coronavirus disease 2019 (COVID-19) pandemic, patients with SCD were characterized as a 'high-risk' group due to their compromised immune system, caused by functional hyposplenism, as well as systemic vasculopathy. COVID-19 is characterized by endothelial damage and a procoagulant condition. The present study describes the clinical features, management and outcomes of 3 patients with SCD who were hospitalized due to COVID-19, who all had favorable outcomes despite the complications.
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http://dx.doi.org/10.3892/etm.2022.11268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988160PMC
May 2022

COVID-19 induced hypoparathyroidism: A case report.

Exp Ther Med 2022 May 23;23(5):346. Epub 2022 Mar 23.

Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece.

Low levels of serum calcium, elevated levels of serum phosphorus and absent or abnormally low levels of serum parathyroid hormone characterize hypoparathyroidism, a rare endocrine deficiency illness. Hypoparathyroidism is caused by injury to the parathyroid gland as a result of surgery or autoimmune disease. In addition, hypoparathyroidism may develop due to genetic causes or infiltrative diseases. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is characterized by multi-organ involvement, including the dysfunction of endocrine glands. Previous studies have demonstrated that SARS-CoV-2 infection induces endocrine tissue damage via various mechanisms, including direct cell damage from viral entry to the glands by binding to the angiotensin converting enzyme 2 receptors and replication, vasculitis, arterial and venous thrombosis, hypoxic cell damage, immune response and the cytokine storm. The effects of the new coronavirus, coronavirus disease 2019 (COVID-19) on the parathyroid glands have received limited attention. Hypoparathyroidism has been observed in a small number of individuals as a result of SARS-CoV-2 infection. The present study describes the case of a patient with primary hypoparathyroidism induced by COVID-19. Clinicians should also keep in mind that, despite the fact that SARS-CoV-2 has no known tropism for the parathyroid glands, it can result in primary hypoparathyroidism and decompensation of old primary hypoparathyroidism.
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http://dx.doi.org/10.3892/etm.2022.11276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988155PMC
May 2022

Transarterial Chemoembolization for Hepatocellular Carcinoma: Why, When, How?

J Pers Med 2022 Mar 10;12(3). Epub 2022 Mar 10.

First Department of Surgery, National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", AgiouThoma 17, 11527 Athens, Greece.

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. It is principally associated with liver cirrhosis and chronic liver disease. The major risk factors for the development of HCC include viral infections (HBV, HCV), alcoholic liver disease (ALD,) and non-alcoholic fatty liver disease (NAFLD). The optimal treatment choice is dictated by multiple variables such as tumor burden, liver function, and patient's health status. Surgical resection, transplantation, ablation, transarterial chemoembolization (TACE), and systemic therapy are potentially useful treatment strategies. TACE is considered the first-line treatment for patients with intermediate stage HCC. The purpose of this review was to assess the indications, the optimal treatment schedule, the technical factors associated with TACE, and the overall application of TACE as a personalized treatment for HCC.
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http://dx.doi.org/10.3390/jpm12030436DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8955120PMC
March 2022

Concomitant Existence of Bilateral Adrenal Adenomas. To Operate or Not?

Maedica (Bucur) 2021 Dec;16(4):723-728

Academic Department of Internal Medicine, Endocrinology Unit, General Oncology Hospital of Kifisia Agioi Anargyroi, National and Kapodistrian University of Athens, Athens, Greece.

Nowadays, through the wide use of both magnetic resonance imaging and computed tomography, the diagnosis of adrenal incidentaloma is becoming increasingly frequent. Pheochromocytomas are neuroendocrine tumors which produce catecholamine, and they are characterized by headaches, palpitations, sweating and hypertension. Aldosterone-secreting adrenal cortical adenomas can cause various metabolic and cardiovascular diseases due to aldosterone excess. Our aim is to present a rare case of a concomitant existence of pheochromocytoma in the right adrenal and a functioning adrenal cortical adenoma in the left, worthwhile mentioning since the appearance of these two entities in different location in the same patient is unprecedented. The treatment remains challenging.
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http://dx.doi.org/10.26574/maedica.2020.16.4.723DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8897775PMC
December 2021

Targeting the Endocannabinoid System: From the Need for New Therapies to the Development of a Promising Strategy. What About Pancreatic Cancer?

In Vivo 2022 Mar-Apr;36(2):543-555

National and Kapodistrian University of Athens, Athens, Greece.

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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http://dx.doi.org/10.21873/invivo.12736DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8931882PMC
March 2022

Daniel's Lymph Node Biopsy: Why We Must Not Forget History.

Oman Med J 2022 Jan 31;37(1):e334. Epub 2022 Jan 31.

Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

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http://dx.doi.org/10.5001/omj.2022.64DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804153PMC
January 2022

Cholangiocarcinoma: the role of genetic and epigenetic factors; current and prospective treatment with checkpoint inhibitors and immunotherapy.

Am J Transl Res 2021 15;13(12):13246-13260. Epub 2021 Dec 15.

Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens 11527 Athens, Greece.

Cholangiocarcinoma (CCA) represents 3% of all gastrointestinal cancers worldwide and is the second most common primary liver tumor after hepatocellular carcinoma. CCA is an aggressive tumor that involves the intrahepatic, perihilar and distal biliary tree, with a poor prognosis and an increasing incidence worldwide. Various genetic and epigenetic factors have been implicated in CCA development. Gene mutations involving apoptosis control and cell cycle evolution, histone modifications, methylation dysregulation and abnormal expression of non-coding RNA are the most important of these factors. Regarding treatment, surgical resection, cisplatin and gemcitabine have long been the most common treatment options, but 5-year survival (7-20%) is disappointing. For that reason, inhibitors and small molecules related to specific mutations and molecular pathways have been introduced. Among them, immunotherapy seems to be a promising treatment in CCA, with multiple regimens being under clinical trial studies. The combinatorial therapy of traditional CCA treatment with tyrosine kinase inhibitors and/or immunotherapy seem to be the future, depending on the molecular profile of each patient's tumor.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8748131PMC
December 2021

Prognostic value of the immunohistochemistry markers CD56, TTF-1, synaptophysin, CEA, EMA and NSE in surgically resected lung carcinoid tumors.

Mol Clin Oncol 2022 Feb 14;16(2):31. Epub 2021 Dec 14.

Oncology Department, Athens Medical Group, Athens 15125, Greece.

Lung carcinoid tumor is a type of neuroendocrine tumor, which is subdivided into typical carcinoid (TC) and atypical carcinoid (AT), based on the rate of mitosis and the presence of necrosis. Several prognostic factors for lung carcinoids have been reported in the literature, including the type, Ki67 index, stage, chemotherapy and radiation therapy. In the present study, 108 cases with resected carcinoid lung tumors were enrolled and the expression of CD56, thyroid transcription factor 1, synaptophysin, carcinoembryonic antigen, epithelial membrane antigen and neuron-specific enolase (NSE) in the resected tissue specimens was immunohistochemically analyzed. Patients with positive staining for NSE had an unfavorable survival prognosis compared with patients with negative staining for NSE (137.2 vs. 150.0 months, P=0.044). According to univariate analysis, none of the above immunohistochemistry markers was associated with survival, and according to multivariate analysis, NSE was an independent influencing factor for survival inpatients with AT (P=0.046) and furthermore, the stage was an independent factor of survival in patients with TC (P=0.005).
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http://dx.doi.org/10.3892/mco.2021.2464DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719249PMC
February 2022

The Implication of Autophagy in Gastric Cancer Progression.

Life (Basel) 2021 Nov 27;11(12). Epub 2021 Nov 27.

Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

Gastric cancer is the fifth most common malignancy and the third leading cause of cancer-related death worldwide. The three entirely variable entities have distinct epidemiology, molecular characteristics, prognosis, and strategies for clinical management. However, many gastric tumors appear to be resistant to current chemotherapeutic agents. Moreover, a significant number of gastric cancer patients, with a lack of optimal treatment strategies, have reduced survival. In recent years, multiple research data have highlighted the importance of autophagy, an essential catabolic process of cytoplasmic component digestion, in cancer. The role of autophagy as a tumor suppressor or tumor promoter mechanism remains controversial. The multistep nature of the autophagy process offers a wide array of targetable points for designing novel chemotherapeutic strategies. The purpose of this review is to summarize the current knowledge regarding the interplay between gastric cancer development and the autophagy process and decipher the role of autophagy in this kind of cancer. A plethora of different agents that direct or indirect target autophagy may be a novel therapeutic approach for gastric cancer patients.
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http://dx.doi.org/10.3390/life11121304DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705750PMC
November 2021

Comment on renal autotransplantation: A final option to preserve the kidney after an iatrogenic ureteral injury.

Arch Ital Urol Androl 2021 Dec 22;93(4):497-498. Epub 2021 Dec 22.

Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens.

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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http://dx.doi.org/10.4081/aiua.2021.4.497DOI Listing
December 2021

Asymptomatic SARS-CoV-2 infection in an unvaccinated 97-year-old woman: A case report.

Biomed Rep 2021 Dec 28;15(6):107. Epub 2021 Oct 28.

Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece.

Coronavirus disease (COVID-19) is an infection caused by the newly detected coronavirus, SARS-CoV-2. The majority of individuals will exhibit mild to moderate illness. Older individuals, and those suffering from co-existing diseases have a greater probability of experiencing a serious illness. Moreover, elderly patients have higher mortality rates than younger patients, especially those who are unvaccinated. Asymptomatic infection is mostly observed in individuals who are younger, as younger patients are more likely to exhibit a stronger immune response to the infection; aging is characterized by the decline immune function. In this article, a rare case of an unvaccinated 97-year-old woman is described who was admitted to Laiko General Hospital due to altered levels of consciousness, hypotension and a hematoma of the thoracic region, and tested positive for SARS-CoV-2 nucleic acid in a nasopharyngeal specimen and positive for IgG antibodies against the SARS-CoV-2 spike protein without a history of consistent manifestations, indicating a past asymptomatic infection.
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http://dx.doi.org/10.3892/br.2021.1483DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576401PMC
December 2021

mediastinitis following a skin infection in a non-immunocompromised patient: A case report.

Biomed Rep 2021 Dec 21;15(6):104. Epub 2021 Oct 21.

1st Pulmonology Department Sismanogleio Hospital, 15126 Athens, Greece.

Mediastinitis is a severe inflammation of the structures located in the mid-chest cavity. Three main causes of infective mediastinitis are traditionally recognized: Deep infection of a sternal wound following cardiothoracic surgery, perforation of the esophagus, and the descending necrotizing mediastinitis as a result of odontogenic, pharyngeal or cervical infections. Mediastinitis, as a complication of skin infection with hematogenous spread is infrequent. Methicillin-resistant (MRSA) is a gram-positive bacteria, and is responsible for numerous severe infections. MRSA mediastinitis is a rare infection and is typically associated with complications of sternotomy and retropharyngeal abscesses. Here, the second known case of mediastinitis of a hematogenous origin in a non-immunocompromised 41-year-old patient following primary skin infection, accompanied by sternal osteomyelitis, lung consolidation and pleural effusion is described; MRSA was the responsible pathogen. The clinical course was favorable after 6 weeks of antibiotics administration without drainage or surgical intervention.
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http://dx.doi.org/10.3892/br.2021.1480DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8567464PMC
December 2021

Exacerbation of bronchiectasis by complicating COVID-19 disease: A case report.

Exp Ther Med 2021 Dec 15;22(6):1452. Epub 2021 Oct 15.

Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece.

Novel coronavirus infection presents with greater severity in individuals with comorbid chronic lung diseases. Bronchiectasis is an illness characterized by permanent enlargement of the airways, presenting with chronic cough and sputum production and vulnerability to lung infections. Bronchiectasis is not a common comorbid disease in patients with COVID-19 disease and bronchiectasis exacerbation rates were decreased during the pandemic. However, COVID-19 disease is associated with worse outcomes in patients with bronchiectasis and patients with bronchiectasis are more susceptible to SARS-CoV-2 infection development. is an opportunistic pathogen, causing infections mostly in immunocompromised hosts and is not a frequent bacterial colonizer in patients with bronchiectasis. This present study reports a rare case of exacerbation of bronchiectasis by complicating COVID-19 disease in an immunocompetent 70-year-old woman. Clinicians should be aware that SARS-CoV-2 infection is probably a precipitating factor of bronchiectasis exacerbation while bronchiectasis is a risk factor for greater severity of SARS-CoV-2 infection.
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http://dx.doi.org/10.3892/etm.2021.10887DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8549101PMC
December 2021

Reported COVID-19 Vaccination Coverage and Associated Factors among Members of Athens Medical Association: Results from a Cross-Sectional Study.

Vaccines (Basel) 2021 Oct 4;9(10). Epub 2021 Oct 4.

Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece.

There are limited data on the prevalence and determinants of COVID-19 vaccination coverage among physicians. A cross-sectional, questionnaire-based, online study was conducted among the members of the Athens Medical Association (I.S.A.) over the period 25 February to 13 March 2021. All members of I.S.A. were invited to participate in the anonymous online survey. A structured, anonymous questionnaire was used. Overall, 1993 physicians participated in the survey. The reported vaccination coverage was 85.3%. The main reasons of no vaccination were pending vaccination appointment followed by safety concerns. Participants being informed about the COVID-19 vaccines by social media resulted in lower COVID-19 vaccination coverage than health workers being informed by other sources. Logistic regression analysis demonstrated that no fear over COVID-19 vaccination-related side effects, history of influenza vaccination for flu season 2020-2021, and the perception that the information on COVID-19 vaccination from the national public health authorities is reliable, were independent factors of reported COVID-19 vaccination coverage. Our results demonstrate a considerable improvement of the COVID-19 vaccination uptake among Greek physicians. The finding that participants reported high reliability of the information related to COVID-19 vaccination provided by the Greek public health authorities is an opportunity which should be broadly exploited by policymakers in order to combat vaccination hesitancy, and further improve COVID-19 vaccination uptake and coverage among physicians/HCWs, and the general population.
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http://dx.doi.org/10.3390/vaccines9101134DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540685PMC
October 2021

Pulmonary adverse events due to immune checkpoint inhibitors: A literature review.

Monaldi Arch Chest Dis 2021 Oct 11;92(2). Epub 2021 Oct 11.

1st Pulmonology Department Sismanogleio Hospital, Athens.

Cancer immunotherapy aims to stimulate the immune system to fight against tumors, utilizing the presentation of molecules on the surface of the malignant cells that can be recognized by the antibodies of the immune system. Immune checkpoint inhibitors, a type of cancer immunotherapy, are broadly used in different types of cancer, improving patients' survival and quality of life. However, treatment with these agents causes immune-related toxicities affecting many organs. The most frequent pulmonary adverse event is pneumonitis representing a non-infective inflammation localized to the interstitium and alveoli. Other lung toxicities include airway disease, pulmonary vasculitis, sarcoid-like reactions, infections, pleural effusions, pulmonary nodules, diaphragm myositis and allergic bronchopulmonary aspergillosis. This review aims to summarize these pulmonary adverse events, underlining the significance of an optimal expeditious diagnosis and management.
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http://dx.doi.org/10.4081/monaldi.2021.2008DOI Listing
October 2021

Histone Deacetylases and their Inhibitors in Colorectal Cancer Therapy: Current Evidence and Future Considerations.

Curr Med Chem 2022 ;29(17):2979-2994

Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

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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http://dx.doi.org/10.2174/0929867328666210915105929DOI Listing
May 2022

The role of miR-101 in esophageal and gastric cancer.

Per Med 2021 09 17;18(5):491-499. Epub 2021 Aug 17.

First Department of Surgery, National & Kapodistrian University of Athens, Laikon General Hospital, Athens, 11527, Greece.

miR-101 is downregulated in various types of cancer, leading to the notion that miR-101 acts as a suppressor in cancer cell progression. The comprehensive mechanisms underlying the effects of miR-101 and the exact role of miR-101 dysregulations in esophagogastric tumors have not been fully elucidated. This review aims to summarize all current knowledge on the association between miR-101 expression and esophagogastric malignancies and to clarify the pathogenetic pathways and the possible prognostic and therapeutic role of miR-101 in those cancer types. miR-101 seems to play crucial role in esophageal and gastric cancer biology and tumorigenesis. It could also be a promising novel diagnostic and therapeutic target, as well as it may serve as a significant predictive biomarker in esophagogastric cancer.
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http://dx.doi.org/10.2217/pme-2021-0024DOI Listing
September 2021

Atypical Fibroxanthoma: An unexpected cause of hemoptysis.

Acta Med Litu 2021 29;28(1):165-169. Epub 2021 Apr 29.

1 Pulmonology Department Sismanogleio Hospital, Athens, Greece.

Atypical fibroxanthoma is an infrequent, low-grade superficial cutaneous neoplasm, usually presenting as a nodule or plaque of red color. It is considered as a superficial variant of pleomorphic dermal sarcoma. Although atypical fibroxanthoma has similar histologic features to pleomorphic dermal sarcoma, it has less aggressive behavior. Atypical fibroxanthoma usually occurs on sun-exposed regions of the head and neck of elderly patients. Ultraviolet light, specific genetic mutations and administration of immunosuppressive agents to transplant recipients have been associated with the pathogenesis of the tumor. The prognosis is typically excellent when treated with complete excision of the primary lesion. This report describes the rare case of a 84-year-old man with hemoptysis due to metastatic cutaneous atypical fibroxanthoma.
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http://dx.doi.org/10.15388/Amed.2021.28.1.16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311850PMC
April 2021

First Detection of in Greece, in an Immunocompromised Patient With Severe Lower Respiratory Tract Infection.

Acta Med Litu 2021 14;28(1):121-126. Epub 2021 May 14.

1 Pulmonology Department Sismanogleio Hospital, Athens, Greece.

() is a RNA virus which gets in the human cells by binding to the receptor of N-acetyl-9-O-acetylneuraminic acid. ), including , are globally found. is responsible for upper and lower respiratory tract infections, usually with mild symptoms. In severe cases, can cause life-threatening respiratory illness especially in vulnerable hosts such as elderly, children and immunocompromised patients. In Greece, and are the most common viruses causing respiratory tract infections. Traditionally, are responsible for less than 3% of respiratory infections in Greek population. HCoVs 229E and OC43 have been shown to circulate in Greece. We report the first case of lung infection in an immunocompromised woman due to that has never been before detected in Greece. is related to severe disease even in healthy individuals and must be considered in the differential diagnosis of severe respiratory infections.
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http://dx.doi.org/10.15388/Amed.2021.28.1.21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311844PMC
May 2021

Firstcase of pneumonia-parapneumonic effusion due to .

IDCases 2021 24;25:e01239. Epub 2021 Jul 24.

1st Pulmonology Department Sismanogleio Hospital, Athens, Greece.

is a fungus belonging to the genus Trichoderma. is not thought as a pathogenic for healthy individuals. However, it has the ability to produce toxic peptides and extracellular proteases and has been described to cause invasive infections in immunocompromised hosts. has been reported as the causative microorganism of lung infections, skin infections, sinus infections, otitis, stomatitis endocarditis, pericarditis, gastrointestinal infections, mediastinitis and peritonitis. We report the first case of pneumonia with parapneumonic effusion in an old woman with diabetes mellitus due to .
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http://dx.doi.org/10.1016/j.idcr.2021.e01239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329512PMC
July 2021
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