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Kyriazopoulou E, Hasin-Brumshtein Y, Midic U, Poulakou G, Milionis H, Metallidis S, Astriti M, Fragkou A, Rapti A, Taddei E, Kalomenidis I, Chrysos G, Angheben A, Kainis I, Alexiou Z, Castelli F, Serino FS, Bakakos P, Nicastri E, Tzavara V, Ioannou S, Dagna L, Dimakou K, Tzatzagou G, Chini M, Bassetti M, Kotsis V, Tsoukalas DG, Selmi C, Konstantinou A, Samarkos M, Doumas M, Masgala A, Pagkratis K, Argyraki A, Akinosoglou K, Symbardi S, Netea MG, Panagopoulos P, Dalekos GN, Liesenfeld O, Sweeney TE, Khatri P, Giamarellos-Bourboulis EJ. Transitions of blood immune endotypes and improved outcome by anakinra in COVID-19 pneumonia: an analysis of the SAVE-MORE randomized controlled trial. Crit Care 2024; 28:73. [PMID: 38475786 PMCID: PMC10935809 DOI: 10.1186/s13054-024-04852-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Endotype classification may guide immunomodulatory management of patients with bacterial and viral sepsis. We aimed to identify immune endotypes and transitions associated with response to anakinra (human interleukin 1 receptor antagonist) in participants in the SAVE-MORE trial. METHODS Adult patients hospitalized with radiological findings of PCR-confirmed severe pneumonia caused by SARS-CoV-2 and plasma-soluble urokinase plasminogen activator receptor levels of ≥ 6 ng/ml in the SAVE-MORE trial (NCT04680949) were characterized at baseline and days 4 and 7 of treatment using a previously defined 33-messenger RNA classifier to assign an immunological endotype in blood. Endpoints were changes in endotypes and progression to severe respiratory failure (SRF) associated with anakinra treatment. RESULTS At baseline, 23.2% of 393 patients were designated as inflammopathic, 41.1% as adaptive, and 35.7% as coagulopathic. Only 23.9% were designated as the same endotype at days 4 and 7 compared to baseline, while all other patients transitioned between endotypes. Anakinra-treated patients were more likely to remain in the adaptive endotype during 7-day treatment (24.4% vs. 9.9%; p < 0.001). Anakinra also protected patients with coagulopathic endotype at day 7 against SRF compared to placebo (27.8% vs. 55.9%; p = 0.013). CONCLUSION We identify an association between endotypes defined using blood transcriptome and anakinra therapy for COVID-19 pneumonia, with anakinra-treated patients shifting toward endotypes associated with a better outcome, mainly the adaptive endotype. Trial registration ClinicalTrials.gov, NCT04680949, December 23, 2020.
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Affiliation(s)
- Evdoxia Kyriazopoulou
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Garyfallia Poulakou
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Haralampos Milionis
- 1st Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Simeon Metallidis
- 1st Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Myrto Astriti
- 1st Department of Internal Medicine, G. Gennimatas General Hospital of Athens, Athens, Greece
| | | | - Aggeliki Rapti
- 2nd Department of Pulmonary Medicine, Sotiria General Hospital of Chest Diseases, Athens, Greece
| | - Eleonora Taddei
- Dipartimento Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Ioannis Kalomenidis
- 1st Department of Critical Care and Pulmonary Medicine, Medical School, National and Kapodistrian University of Athens, Evangelismos General Hospital, Athens, Greece
| | - Georgios Chrysos
- 2nd Department of Internal Medicine, Tzaneio General Hospital of Piraeus, Athens, Greece
| | - Andrea Angheben
- Department of Infectious - Tropical Diseases and Microbiology, IRCSS Sacro Cuore Hospital, Negrar, Verona, Italy
| | - Ilias Kainis
- 10th Department of Pulmonary Medicine, Sotiria General Hospital of Chest Diseases of Athens, Athens, Greece
| | - Zoi Alexiou
- 2nd Department of Internal Medicine, Thriasio General Hospital of Eleusis, Athens, Greece
| | - Francesco Castelli
- Spedali Civili, Brescia ASST Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | | | - Petros Bakakos
- 1st Department of Chest Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Emanuele Nicastri
- Department of Internal Medicine, Spallanzani Institute of Rome, Rome, Italy
| | - Vasiliki Tzavara
- 1st Department of Internal Medicine, Korgialeneion-Benakeion General Hospital, Athens, Greece
| | - Sofia Ioannou
- Department of Therapeutics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
| | - Katerina Dimakou
- 5th Department of Pulmonary Medicine, Sotiria General Hospital of Chest Diseases, Athens, Athens, Greece
| | - Glykeria Tzatzagou
- 1st Department of Internal Medicine, Papageorgiou General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Maria Chini
- 3rd Department of Internal Medicine and Infectious Diseases Unit, Korgialeneion-Benakeion General Hospital, Athens, Greece
| | - Matteo Bassetti
- Infectious Diseases Clinic, Ospedale Policlinico San Martino IRCCS and Department of Health Sciences, University of Genova, Genova, Italy
| | - Vasileios Kotsis
- 3rd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dionysios G Tsoukalas
- 4th Department of Pulmonary Medicine, Sotiria General Hospital of Chest Diseases, Athens, Greece
| | - Carlo Selmi
- Department of Biomedical Sciences, Humanitas University and IRCCS Humanitas Research Hospital, Milan, Italy
| | - Alexandra Konstantinou
- 1st Department of Internal Medicine, Asklepieio General Hospital of Voula, Voula, Greece
| | - Michael Samarkos
- 1st Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Doumas
- 2nd Department of Propedeutic Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Masgala
- 2nd Department of Internal Medicine, Konstantopouleio General Hospital, Athens, Greece
| | | | - Aikaterini Argyraki
- Department of Internal Medicine, Sotiria General Hospital of Chest Diseases, Athens, Greece
| | | | - Styliani Symbardi
- 1st Department of Internal Medicine, Thriasio General Hospital of Eleusis, Athens, Greece
| | - Mihai G Netea
- Department of Internal Medicine and Center for Infectious Diseases, Radboud University, Nijmegen, The Netherlands
- Department of Immunology and Metabolism, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany
| | - Periklis Panagopoulos
- 2nd Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - George N Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, European Reference Network on Hepatological Diseases (ERN RARE-LIVER), General University Hospital of Larissa, Larissa, Greece
| | | | | | - Purvesh Khatri
- Institute for Immunity, Transplantation and Infection, School of Medicine, Stanford University, Stanford, CA, USA
- Center for Biomedical Informatics Research, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Evangelos J Giamarellos-Bourboulis
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
- 4th Department of Internal Medicine, ATTIKON University Hospital, 1 Rimini Street, 124 62, Athens, Greece.
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Athanassiou L, Kostoglou-Athanassiou I, Nikolakopoulou S, Konstantinou A, Mascha O, Siarkos E, Samaras C, Athanassiou P, Shoenfeld Y. Vitamin D Levels as a Marker of Severe SARS-CoV-2 Infection. Life (Basel) 2024; 14:210. [PMID: 38398719 PMCID: PMC10890332 DOI: 10.3390/life14020210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/21/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
The SARS-CoV-2 virus may cause severe infection, which is associated with diverse clinical manifestations. Vitamin D has immunomodulating properties and may enhance the body's defense system against invading pathogenic organisms. The aim was to assess 25(OH)D3 levels in patients hospitalized for severe infection from the SARS-CoV-2 virus and explore the relationship between 25(OH)D3 and outcomes. In a group of 88 patients hospitalized for severe infection from the SARS-CoV-2 virus and a control group matched for age and sex, the levels of 25(OH)D3 were analyzed. Levels of 25(OH)D3 were 17.36 ± 8.80 ng/mL (mean ± SD) compared with 24.34 ± 10.34 ng/mL in patients with severe SARS-CoV-2 infection and the control group, respectively, p < 0.001 (Student's t-test). 25(OH)D3 levels were significantly related to outcomes, i.e., survival as opposed to non-survival, as more patients with 25(OH)D3 deficiency (0-10 ng/mL) and insufficiency (10-20 ng/mL) had a fatal outcome as compared with those with vitamin D sufficiency (p < 0.001, chi-square test, p < 0.001, Fisher's exact test). Levels of 25(OH)D3 were inversely related to C-reactive protein (CRP), ferritin, d-dimer, and fibrinogen levels (p < 0.001, linear regression analysis, beta coefficient of variation, -0.176, -0.160, -0.178, and -0.158, respectively). Vitamin D deficiency observed in severe SARS-CoV-2 infection was related to disease outcomes.
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Affiliation(s)
- Lambros Athanassiou
- COVID-19 Department, Asclepeion Hospital, Voula, GR16673 Athens, Greece; (L.A.); (S.N.); (A.K.); (E.S.); (C.S.)
| | | | - Sofia Nikolakopoulou
- COVID-19 Department, Asclepeion Hospital, Voula, GR16673 Athens, Greece; (L.A.); (S.N.); (A.K.); (E.S.); (C.S.)
| | - Alexandra Konstantinou
- COVID-19 Department, Asclepeion Hospital, Voula, GR16673 Athens, Greece; (L.A.); (S.N.); (A.K.); (E.S.); (C.S.)
| | - Olga Mascha
- Department of Biochemistry, Asclepeion Hospital, Voula, GR16673 Athens, Greece;
| | - Evangelos Siarkos
- COVID-19 Department, Asclepeion Hospital, Voula, GR16673 Athens, Greece; (L.A.); (S.N.); (A.K.); (E.S.); (C.S.)
| | - Charilaos Samaras
- COVID-19 Department, Asclepeion Hospital, Voula, GR16673 Athens, Greece; (L.A.); (S.N.); (A.K.); (E.S.); (C.S.)
| | | | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Reichman University, Herzelya 4610101, Israel;
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Konstantinou A. Telecommunication and neuropsychiatric symptoms in long term care dementia patients during the COVID-19 lockdown ERA. Eur Psychiatry 2021. [PMCID: PMC9528358 DOI: 10.1192/j.eurpsy.2021.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Ippokrateio Therapeutirio in the city of Larissa, Thessaly, Greece is a private for-profit psychogeriatric hospital focusing on Long Term Care on patients with dementia. During the COVID-19 era lockdown visits by carers/relatives/friends were forbidden due to the preventive government measures. At that same time appearance and/or exaggeration of neuropsychiatric symptoms was observed. In order to restore communication issues we performed telecommunication sessions (videocalls) and measured, among other factors, neuropsychiatric symptoms before and after sessions. Objectives
Primary objective was to check for relations between video-calls and changes in neuropsychiatric symptoms using NeuroPsychiatric Inventory (NPI). Secondary objective was to check for carers and patients satisfaction, mainly through qualitative information. Methods 120 patients with diagnosis of minor or major neuroconitive disorder of any type participated in the video call sessions. Two video calls per patient took place (1 per week) with a 10-inches tablet. Neuropsychiatric Inventory (NPI) was performed before the start of the video-calls. NPI had been performed again the week after both sessions were completed. Satisfaction of carers and patients was recorded, mostly as qualitative data. Results Neuropsychiatric symptoms improved in patients with mild or moderate neurocognitive decline. In more severe cases though anxiety, irritability and sleep problems worsened. Satisfaction reached almost 95% of the carers. Conclusions
Video calls could be a very good way to surpass the communication burden during the pandemic restrictions for LTC dementia patients. Caution should be given to severely demented patients since clinical observations show that a cluster of symptoms worsens.
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Konstantinou A, Bordignon S, Tohoku T, Chen S, Bologna F, Tsianakas N, Urbanek L, Trolesse L, Lindhoff-Last E, Schmidt B, Chun K. Real world experience from 1000 patients. Preprocedural DOAC interruption impacts detectable DOAC serum levels but not adverse events after catheter ablation of atrial fibrillation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Direct oral anticoagulation (DOAC) therapy represents the standard of care in patients with atrial fibrillation (AF) and increased stroke risk. In a real world setting withholding DOAC medication before elective AF ablation is considered to reduce procedural bleeding risks. The aim of this study was to determine the individual DOAC level prior to the ablation procedure, to identify predisposing factors affecting traceable DOAC levels and to screen for associated severe adverse events.
Methods
Between September 2016 and March 2019 blood samples were obtained from patients on DOAC before an elective AF ablation. Per institutional standard all patients have been instructed to pause DOAC medication prior ablation for one or two doses depending on the patient profile and type of medication. The time interval between ablation and last DOAC intake was calculated in hours. Patient characteristics, procedural data and in-hospital complications were noted from all patients.
Results
A total of 1000 patients (60% male, age: 68y, GFR 83.25: BMI: 28, CHADSVASC score 3) undergoing AF ablation were included. Two groups were defined. Group A (n=416, 41.6%): patients treated with “single pill” DOAC (Rivaroxaban (n=288, 28.8%) and Edoxaban (n=128, 12.8%)). Group B (n=584, 58.4%): patients treated with twice a day DOAC (Apixaban (n=505, 50.5%) and Dabigatran (n=79, 7.9%)). The only difference in patient characteristics was an increased prior bleeding history in group B. The DOAC pause was significantly longer in group A (mean 40h) compared to group B (mean 32h), p=0.026. In a total of 217 patients (21.7%) DOAC levels where traceable prior to AF ablation. Traceable DOAC levels were significantly more common in group B (n=144/584, 24.7%) compared to group A (n=73/416, 17.5%). Adverse events occurred in 5.7% of patients (0.4% stroke, 0.3% tamponade, 2.5% hematoma, 1.9% AV-fistel, 0.7% pseudoaneurysma). T-Test analysis showed no significant difference in the occurrence of adverse events between both groups.
Conclusion
Despite of interrupting DOACs before an elective AF ablation therapeutic substance levels can be detected in >20% of patients. The rate of adverse events was not different between “single pill” vs. twice a day DOAC intake.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Konstantinou
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - S Bordignon
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - T Tohoku
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - S Chen
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - F Bologna
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - N Tsianakas
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - L Urbanek
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - L Trolesse
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - E Lindhoff-Last
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - B Schmidt
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - K.R.J Chun
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
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Tsianakas N, Bordignon S, Bologna F, Tohoku S, Chen S, Konstantinou A, Chun KRJ, Schmidt B. Holter ECG diagnosis of nicotine-spray induced ventricular fibrillation. An unusual case of Prinzmetal variant angina. J Electrocardiol 2020; 63:17-20. [PMID: 33022429 DOI: 10.1016/j.jelectrocard.2020.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/06/2020] [Accepted: 09/15/2020] [Indexed: 10/23/2022]
Abstract
We report on an interesting case of resuscitated sudden cardiac death (SDC) in a 51-year-old with hypertension and positive family history for SDC. The patient was resuscitated and an emergency angiogram ruled out coronary artery disease. Cardio-MRT ruled structural disease or infection. Holter and telemetry monitoring revealed premature ventricular complexes and transient ST-changes followed by anginaepisodes in correlation with the use of the nicotine-replacement-spray. The patient was urged to quit smoking and smoking-substitutes. Medical therapy with calcium-channelblocker and a long acting nitrate was administered. One-month follow up reported no arrhythmic or angina events.
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Affiliation(s)
- N Tsianakas
- Cardioangiologisches Centrum Bethanien, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Germany.
| | - S Bordignon
- Cardioangiologisches Centrum Bethanien, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Germany
| | - F Bologna
- Cardioangiologisches Centrum Bethanien, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Germany
| | - S Tohoku
- Cardioangiologisches Centrum Bethanien, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Germany
| | - S Chen
- Cardioangiologisches Centrum Bethanien, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Germany
| | - A Konstantinou
- Cardioangiologisches Centrum Bethanien, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Germany
| | - K R J Chun
- Cardioangiologisches Centrum Bethanien, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Germany
| | - B Schmidt
- Cardioangiologisches Centrum Bethanien, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Germany
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Alexopoulos P, Novotni A, Novotni G, Vorvolakos T, Vratsista A, Konsta A, Kaprinis S, Konstantinou A, Bonotis K, Katirtzoglou E, Siarkos K, Bekri ES, Kokkoris I, Como A, Gournellis R, Stoyanov DS, Politis A. Old age mental health services in Southern Balkans: Features, geospatial distribution, current needs, and future perspectives. Eur Psychiatry 2020; 63:e88. [PMID: 32921324 PMCID: PMC7576530 DOI: 10.1192/j.eurpsy.2020.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/06/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Healthcare services are increasingly confronted with challenges related to old age mental disorders. The survey aimed to provide an overview of existing psychogeriatric services in Albania, Bulgaria, Greece, and North Macedonia. METHODS After identification of psychogeriatric units across the four countries, their head physicians were asked to provide data on their clinical, teaching, and research activity, as well as staff composition. Moreover, the attitudes of head physicians to current needs and future service development were explored. RESULTS A total of 15 psychogeriatric units were identified (3 in Bulgaria, 8 in Greece, and 4 in North Macedonia). Results show wide variation regarding the location, team size and composition, service availability, numbers of patients attending, and inpatient treatment length. Most head physicians underscored the urgent need for breakthroughs in the graduate and postgraduate education in psychogeriatrics of medical and nonmedical professionals, as well as in the interconnection of their units with community primary healthcare services and long-term care facilities for seniors via telemedicine. They would welcome the development of national standards for psychogeriatric units, potentially embodying clear pointers for action. A number of head physicians advocated the development of nationwide old age mental health registries. CONCLUSIONS Regional disparities in resources and services for seniors' mental health services were unveiled. These data may enrich the dialogue on optimizing psychogeriatric services through planning future cross-border collaborations mainly based on telemedicine services, especially in the era of the novel coronavirus pandemic, and training/education in psychogeriatrics of mental health professionals.
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Affiliation(s)
- P. Alexopoulos
- Department of Psychiatry, Patras University General Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Faculty of Medicine, Technische. Technische Universität München, Munich, Germany
| | - A. Novotni
- University Clinic of Psychiatry, Medical Faculty, University “Ss Cyril and Methodius”, Skopje, North Macedonia
| | - G. Novotni
- University Clinic of Neurology, Medical Faculty, University “Ss Cyril and Methodius”, Skopje, North Macedonia
| | - T. Vorvolakos
- Department of Psychiatry, Alexandroupolis University General Hospital, Faculty of Medicine, School of Health Sciences, Democritus University of Thrace, Alexandroupolis, Greece
| | - A. Vratsista
- Department of Psychiatry, Arta General Hospital, Arta, Greece
| | - A. Konsta
- 1 Department of Psychiatry, “Papageorgiou” General Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S. Kaprinis
- 3 Department of Psychiatry. Psychiatric Hospital of Thessaloniki, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A. Konstantinou
- Department of Psychiatry, Larissa University General Hospital, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - K. Bonotis
- Department of Psychiatry, Larissa University General Hospital, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - E. Katirtzoglou
- 1st Department of Psychiatry, “Eginition” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - K. Siarkos
- 1st Department of Psychiatry, “Eginition” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - E. S. Bekri
- Environmental Engineering Laboratory, Department of Civil Engineering, School of Engineering, University of Patras, Patras, Greece
| | - I. Kokkoris
- Division of Plant Biology, Department of Biology, School of Basic Sciences, University of Patras, Patras, Greece
| | - A. Como
- Psychiatry Division, Department of Neuroscience, Tirana University Hospital Center “Mother Teresa”, Tirana Medical University, Tirana, Albania
| | - R. Gournellis
- 2nd Department of Psychiatry, “Attikon” University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - D. S. Stoyanov
- Department of Psychiatry and Medical Psychology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - A. Politis
- 1st Department of Psychiatry, “Eginition” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Medical School, Baltimore, USA
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Konstantinou A, Bordignon S, Hilbert M, Bologna F, Tsianakas N, Nagase T, Chen S, Perrotta L, Weise FK, Lindhoff-Last E, Schmidt B, Chun KRJ. P384Plasma level of DOACS in patients undergoing catheter ablation for atrial fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Konstantinou
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - S Bordignon
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - M Hilbert
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - F Bologna
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - N Tsianakas
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - T Nagase
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - S Chen
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - L Perrotta
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - F K Weise
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - E Lindhoff-Last
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - B Schmidt
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
| | - KRJ Chun
- Cardiology Centre Bethanien (CCB), Cardiology, Frankfurt am Main, Germany
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Bordignon S, Hibert M, Nagase T, Chen S, Bologna F, Perrotta L, Weise FK, Konstantinou A, Schmidt B, Chun KRJ. P349Catheter ablation of AF recurrences after PVI: only Re-PVI or further substrate modification? A retrospective long term follow up analysis. Europace 2018. [DOI: 10.1093/europace/euy015.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Bordignon
- Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany
| | - M Hibert
- Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany
| | - T Nagase
- Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany
| | - S Chen
- Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany
| | - F Bologna
- Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany
| | - L Perrotta
- Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany
| | - F K Weise
- Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany
| | - A Konstantinou
- Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany
| | - B Schmidt
- Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany
| | - KRJ Chun
- Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany
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Perrotta L, Bordignon S, Weise F, Konstantinou A, Bologna F, Chun JKR, Schmidt B. P489Percutaneous LAA closure without contrast media application. Europace 2017. [DOI: 10.1093/ehjci/eux141.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bordignon S, Perrotta L, Bologna F, Konstantinou A, Dugo D, Chun KRJ, Schmidt B. P1423PVI non responder: who are them? An analysis of repeat procedures. Europace 2017. [DOI: 10.1093/ehjci/eux158.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bordignon S, Perrotta L, Bologna F, Konstantinou A, Weise FK, Hilbert M, Schmidt B, Chun KRJ. P1422Impact of left atrial electroanatomical scar on outcome after an index pulmonary vein isolation procedure: the scar AF study. Europace 2017. [DOI: 10.1093/ehjci/eux158.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Bordignon S, Perrotta L, Bologna F, Konstantinou A, Hilbert M, Chun KRJ, Schmidt B. 757Role of durable isolation of the left atrial appendage: data from remapping procedures. Europace 2017. [DOI: 10.1093/ehjci/eux147.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nagase T, Bordignon S, Perrotta L, Bologna F, Weise F, Konstantinou A, Schmidt B, Chun J. P1397Pulmonary vein stenosis after pulmonary vein isolation -- lessons from invasive repeat studies comparing irrigated radiofrequency current, big cryoballoon, and visually guided laser balloon ablation. Europace 2017. [DOI: 10.1093/ehjci/eux158.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Bordignon S, Furnkranz A, Perrotta L, Dugo D, Konstantinou A, Nowak B, Schulte-Hahn B, Schmidt B, Chun KRJ. High rate of durable pulmonary vein isolation after second-generation cryoballoon ablation: analysis of repeat procedures. Europace 2015; 17:725-31. [DOI: 10.1093/europace/euu331] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/28/2014] [Indexed: 12/27/2022] Open
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Bordignon S, Fuernkranz A, Konstantinou A, Schulte-Hahn B, Nowak B, Schmidt B, Chun KRJ. High rates of single shot pulmonary vein isolation and real time pulmonary vein potential visualization using the second generation 28mm Cryoballoon. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fuernkranz A, Bordignon S, Schmidt B, Konstantinou A, Urban V, Boehmer MC, Schulte-Hahn B, Nowak B, Chun JKR. Incidence and characteristics of phrenic nerve palsy following pulmonary vein isolation with the novel second-generation cryoballoon as compared to the first-generation balloon. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Grekas D, Balaskas E, Kampouris H, Benos A, Konstantinou A, Sioullis A, Tourkantonis A. Effective treatment of secondary hyperparathyroidism in hemodialysis patients by titration of intravenous calcitriol dosage. Clin Nephrol 1999; 52:167-71. [PMID: 10499312] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
AIM Effective treatment of secondary hyperparathyroidism (HPTH) with intravenous (i.v.) administration of calcitriol in hemodialysis patients. PATIENTS AND METHODS The current study evaluates the use of i.v. calcitriol dosing in relation to the severity of the HPTH in 35 hemodialysis patients with serum phosphate < 6.5 mg/dl. Arbitrarily, patients with plasma IPTH levels (intact PTH) between 288 and 576 pg/ml (288 pg/ml = four-fold the upper normal limit) were given initially 1 microg i.v. calcitriol at the end of each dialysis (group A, n = 15). Patients with IPTH between 577 and 864 pg/ml received 2 microg i.v. calcitriol (group B, n = 10) and patients with IPTH more than 865 pg/ml were given 3 - 4 microg i.v. calcitriol (group C, n = 10). As IPTH levels decreased, the dose of i.v. calcitriol was also decreased gradually. Patients were followed-up for 4 months after the end of calcitriol treatment. RESULTS During the i.v. calcitriol treatment period, the observed plasma IPTH concentrations compared with the baseline values were significantly lower (p < 0.01 for A and B group and p < 0.05 for C group) from the sixth month onwards in group A and C and from the third month onwards in group B. At the 12th month of follow-up, all patients being off i.v. calcitriol treatment for four months, a sharp and significant increase (p < 0.01 for group A and B and p < 0.05 for group C) of plasma IPTH was recorded in all three groups of patients. Alkaline phosphatase was also gradually decreased in all studied groups. Serum Ca and P remained unchanged in most patients. CONCLUSION In conclusion, the study presented here demonstrates that the titration of i.v. calcitriol dosage according to the severity of HPTH is an effective and safe treatment of HPTH in chronic hemodialysis patients. It also shows that parathyroidectomy could be avoided in the majority of patients with severe HPTH, if an appropriate dose of calcitriol not aggravating hyperphosphatemia is administered.
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Affiliation(s)
- D Grekas
- First Medical Department, University Hospital AHEPA, Thessaloniki, Greece
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