29 results on '"Vlachogiannakos, John"'
Search Results
2. Effect of infliximab on the healing of intestinal anastomosis. An experimental study in rats
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Papaconstantinou, Ioannis, Zeglinas, Christos, Gazouli, Maria, Nastos, Konstantinos, Yiallourou, Anneza, Lykoudis, Panagis, Evangelou, Konstantinos, Papalois, Apostolos, Papaioannou, Marilena, Vlachogiannakos, John, and Tzathas, Charalampos
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- 2014
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3. Sedation during endoscopic procedures: a Hellenic Society of Gastroenterology Position Statement.
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Viazis, Nikolaos, Vlachogiannakos, John, Apostolopoulos, Periklis, Mimidis, Konstantinos, Tzouvala, Maria, Tsionis, Theocharis, Goulas, Spyros, Thomopoulos, Konstantinos, Paraskeva, Konstantina, Paspatis, Grigorios, Kofokotsios, Alexandros, Liatsos, Christos, Manolakis, Anastasios, Christodoulou, Dimitrios, Rokkas, Theodoros, Michopoulos, Spyridon, Papatheodoridis, George, Tassios, Periklis, and Mantzaris, Gerasimos
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GASTROENTEROLOGY , *DRUG utilization , *GASTROENTEROLOGISTS - Abstract
Administration of sedation by non-anesthesiologists during gastrointestinal endoscopy remains highly controversial in Greece. The aim of this set of 16 position statements prepared by experts in the field on behalf of the Hellenic Society of Gastroenterology is to aid gastroenterologists in their everyday clinical practice and provide evidence for the best use of drugs for the sedation of patients who undergo an endoscopy. The statements address issues such as the level of sedation required, the best drugs used, their mode of action, their side-effects and possible ways to counter their action, and were adopted if at least 80% of all participants agreed upon them. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Serum zonulin levels in patients with liver cirrhosis: Prognostic implications
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Voulgaris, Theodoros A, primary, Karagiannakis, Dimitrios, additional, Hadziyannis, E, additional, Manolakopoulos, Spilios, additional, Karamanolis, Georgios P, additional, Papatheodoridis, George, additional, and Vlachogiannakos, John, additional
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- 2021
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5. Serum zonulin levels in patients with liver cirrhosis: Prognostic implications
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Voulgaris, Theodoros A. Karagiannakis, Dimitrios Hadziyannis, E. and Manolakopoulos, Spilios Karamanolis, Georgios P. and Papatheodoridis, George Vlachogiannakos, John
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BACKGROUNDIncreased gut permeability and bacterial translocation play an important role in liver cirrhosis. Zonulin is a recently recognized protein involved in the disintegration of the intestinal barrier.AIMTo investigate possible differences in serum zonulin levels among patients with different cirrhosis stages and their potential prognostic implications.METHODSConsecutive cirrhotic patients who attended our liver clinic were included in the study. Serum zonulin levels, clinical, radiological and biochemical data were collected at baseline. Patients who accepted participation in a regular surveillance program were followed-up for at least 12 mo.RESULTSWe enrolled 116 cirrhotics [mean Child-Turcotte-Pugh (CTP) score: 6.2 & PLUSMN; 1.6; model for end-stage liver disease score: 11 & PLUSMN; 3.9]. The causes of cirrhosis were viral hepatitis (39%), alcohol (30%), non-alcoholic fatty liver disease (17%), and other (14%). At baseline, 53% had decompensated cirrhosis, 48% had ascites, and 32% had history of hepatic encephalopathy. Mean zonulin levels were significantly higher in patients with CTP-B class than CTP-A class (4.2 & PLUSMN; 2.4 ng/dL vs 3.5 & PLUSMN; 0.9 ng/dL, P = 0.038), with than without ascites (P = 0.006), and with than without history of encephalopathy (P = 0.011). Baseline serum zonulin levels were independently associated with the probability of decompensation at 1 year (P = 0.039), with an area under the receiving operating characteristic of 0.723 for predicting hepatic decompensation. Higher CTP score (P = 0.021) and portal vein diameter (P = 0.022) were independent predictors of mortality.CONCLUSIONSerum zonulin levels are higher in patients with more advanced chronic liver disease and have significant prognostic value in identifying patients who will develop decompensation.
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- 2021
6. Predictive performance of newer Asian hepatocellular carcinoma risk scores in treated Caucasians with chronic hepatitis B
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Yurdaydın, Cihan (ORCID 0000-0002-5419-7158 & YÖK ID 189330), Papatheodoridis, George, V; Dalekos, George N.; İdilman, Ramazan; Sypsa, Vana; Van Boemmel, Florian; Buti, Maria; Calleja, Jose Luis; Goulis, John; Manolakopoulos, Spilios; Loglio, Alessandro; Papatheodoridi, Margarita; Gatselis, Nikolaos; Veelken, Rhea; Lopez-Gomez, Marta; Hansen, Bettina E.; Savvidou, Savvoula; Kourikou, Anastasia; Vlachogiannakos, John; Galanis, Kostas; Esteban, Rafael; Janssen, Harry L. A.; Berg, Thomas; Lampertico, Pietro, Yurdaydın, Cihan (ORCID 0000-0002-5419-7158 & YÖK ID 189330), and Papatheodoridis, George, V; Dalekos, George N.; İdilman, Ramazan; Sypsa, Vana; Van Boemmel, Florian; Buti, Maria; Calleja, Jose Luis; Goulis, John; Manolakopoulos, Spilios; Loglio, Alessandro; Papatheodoridi, Margarita; Gatselis, Nikolaos; Veelken, Rhea; Lopez-Gomez, Marta; Hansen, Bettina E.; Savvidou, Savvoula; Kourikou, Anastasia; Vlachogiannakos, John; Galanis, Kostas; Esteban, Rafael; Janssen, Harry L. A.; Berg, Thomas; Lampertico, Pietro
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Background and aims: recently, several risk scores for prediction of hepatocellular carcinoma (HCC) were developed in cohorts of treated Asian patients with chronic hepatitis B (CHB), but they have not been assessed in non-Asian patients. We evaluated the predictability and comparative utility of our PAGE-B and recent Asian HCC risk scores in nucleos(t)ide analogue (NA)-treated adult Caucasian patients with CHB, with or without well-documented compensated cirrhosis but not previous diagnosis of HCC. Methods: we included 1,951 patients treated with entecavir/tenofovir and followed up for a median of 7.6 years. The c-statistic was used to estimate the predictability of PAGE-B, HCC-Rescue, CAMD, mPAGE-B, and AASL score for HCC development within 5 or 10 years. The low- and high-risk group cut-offs were used for estimation of negative (NPV) and positive predictive values (PPV), respectively. Results: HCC developed in 103/1,951 (5.3%) patients during the first 5 years and in another 39/1,428 (2.7%) patients between years 5 and 10. The 3-, 5-, and 10-year cumulative HCC rates were 3.3%, 5.9%, and 9.6%, respectively. All scores offered good 5- and 10-year HCC prediction (c-statistic: 0.78-0.82). NPVs were always >99% (99.3-100%), whereas PPV ranged between 13% and 24%. Conclusions: in NA-treated Caucasian patients with CHB including compensated cirrhosis, HCC risk scores developed in NA-treated Asian patients offer good 5- and 10-year HCC predictability, similar to that of PAGE-B. PAGE-B and mPAGE-B scores are simpler in clinical practice, as they do not require an accurate diagnosis of cirrhosis, but the addition of albumin in mPAGE-B score does not seem to offer an advantage in patients with well compensated liver disease. Lay summary: several risk scores for prediction of hepatocellular carcinoma (HCC) were recently developed in cohorts of treated Asian patients with chronic hepatitis B (CHB). In Caucasian patients with CHB treated with oral antivirals, newer Asian HCC
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- 2021
7. Tu1720 ADRENAL INSUFFICIENCY IN CIRRHOTIC PATIENTS WITH STABLE DISEASE.THE ROLE OF BACTERIAL TRANSLOCATION.
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Vlachogiannakos, John, primary, Papadomichelakis, Michalis, additional, Karamanolis, Georgios, additional, Karlaftis, Anastasios, additional, Voulgaris, Theodoros, additional, Karagiannakis, Dimitrios, additional, Papatheodoridis, George, additional, and Ladas, Spiros D., additional
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- 2020
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8. Clinical and epidemiological characteristics of hepatitis C virus-infected people who inject drugs: a Greek descriptive analysis
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Kranidioti, Hariklia Chatzievagelinou, Christina Protopapas, Adonis Papatheodoridi, Margarita Zisimopoulos, Konstantinos and Evangelidou, Eftychia Antonakaki, Pinelopi Vlachogiannakos, John and Triantos, Christos Elefsiniotis, Ioannis Goulis, John and Mela, Maria Anagnostou, Olga Tsoulas, Christos Deutsch, Melanie Papatheodoridis, George Manolakopoulos, Spilios
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Background It is estimated that 17,000 people who inject drugs (PWID) in Greece have hepatitis C virus (HCV) viremia. The aim of our study was to explore the characteristics of the HCV-infected, direct acting antiviral (DAA)-naive PWID. Methods This is a retrospective analysis of PWID with HCV infection. We selected data from six liver clinics during the period from 1st May 2014 to 31st May 2017 in order to record the characteristics of infected PWID. Results We included 800 PWID with HCV infection (78.5% male, mean age 42 +/- 10 years) who had not received DAAs before 1st June 2017. One third of the patients had comorbidities (diabetes mellitus, arterial hypertension and psychological disorders); 70% were smokers, 27% alcohol users, 67% unemployed, 29% married, and 34% had education >12 years; 65% were attending addiction programs; 57% were receiving methadone and 36% buprenorphine. Sporadic or systemic drug use was reported by 37% while 1.4% and 2.9% had HIV and HBV coinfection, respectively. The genotype distribution was 20.5%, 4.6%, 3.3%, 61% and 10% for genotypes 1a, 1b, 2, 3 and 4, respectively. Mean (+/- SD) liver stiffness was 9 +/- 7 kPa and 21% of the patients had cirrhosis. Half of the patients were in the F0-F1 stage of liver disease, defined as stiffness
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- 2018
9. Su1090 – The Role of Zonulin in Bacterial Translocation and in the Prognosis of Patients with Liver Cirrhosis
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Vlachogiannakos, John, primary, Karagiannakis, Dimitrios, additional, Voulgaris, Theodoros, additional, Siakavellas, Spyros I., additional, Angelopoulos, Theodoros, additional, Karamanolis, Georgios, additional, and Papatheodoridis, George, additional
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- 2019
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10. Tu1586 – Do Ppis Affect the Incidence of Liver-Related Complications and Overall Survival in Patients with Cirrhosis? the Experience of a Greek Tertiary Hospital
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Vlachogiannakos, John, primary, Voulgaris, Theodoros, additional, Karagiannakis, Dimitrios, additional, Papageorgiou, Maria-Vasiliki, additional, Ioannidou, Panagiota, additional, Karamanolis, Georgios, additional, and Papatheodoridis, George, additional
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- 2019
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11. Successful recanalization of portal vein thrombosis before liver transplantation using transjugular intrahepatic portosystemic shunt
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Liatsos, Christos, Vlachogiannakos, John, Patch, David, Tibballs, John, Watkinson, Anthony, Davidson, Brian, Rolles, Keith, and Burroughs, Andrew K.
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- 2001
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12. Fecal calprotectin measurement is a marker of short-term clinical outcome and presence of mucosal healing in patients with inflammatory bowel disease
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Kostas, Athanasios Siakavellas, Spyros I. Kosmidis, Charalambos and Takou, Anna Nikou, Joanna Maropoulos, Georgios and Vlachogiannakos, John Papatheodoridis, George V. and Papaconstantinou, Ioannis Bamias, Giorgos
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AIM To evaluate the utility of fecal calprotectin (FC) in predicting relapse and endoscopic activity during follow-up in an inflammatory bowel disease (IBD) cohort. METHODS All FC measurements that were obtained during a 3-year period from patients with inflammatory bowel disease in clinical remission were identified. Data regarding the short-term (6 mo) course of the disease were extracted from the medical files. Exclusion criteria were defined as: (1) An established flare of the disease at the time of FC measurement, (2) Loss to follow up within 6 mo from baseline FC measurement, and, (3) Insufficient data on file. Statistical analysis was performed to evaluate whether baseline FC measurement could predict the short term clinical relapse and/or the presence of mucosal healing. RESULTS We included 149 [Crohn’s disease (CD) = 113, Ulcerative colitis (UC) = 36, male = 77] IBD patients in our study. Within the determined 6-month period post-FC measurement, 47 (31.5%) had a disease flare. Among 76 patients who underwent endoscopy, 39 (51.3%) had mucosal healing. Baseline FC concentrations were significantly higher in those who had clinical relapse compared to those who remained in remission during follow up (481.0 mu g/g, 286.0-600.0 vs 89.0, 36.0-180.8, P < 0.001). The significant predictive value of baseline median with IQR FC for clinical relapse was confirmed by multivariate Cox analysis [HR for 100 mu g/g: 1.75 (95% CI: 1.28-2.39), P = 0.001]. Furthermore, lower FC baseline values significantly correlated to the presence of mucosal healing in endoscopy (69.0 mu g/g, 30.0-128.0 vs 481.0, 278.0-600.0, in those with mucosal inflammation, median with IQR, P < 0.001). We were able to extract cut-off values for FC concentration with a high sensitivity and specificity for predicting clinical relapse (261 mu g/g with AUC = 0.901, sensitivity 87.2%, specificity 85.3%, P < 0.001) or mucosal healing (174 mu g/g with AUC = 0.956, sensitivity 91.9%, specificity 87.2%, P < 0.001). FC was better than CRP in predicting either outcome; nevertheless, having a pathological CRP (> 5 mg/L) in addition to the cutoffs for FC, significantly enhanced the specificity for predicting clinical relapse (95.1% from 85.3%) or endoscopic activity (100% from 87.2%). CONCLUSION Serial FC measurements may be useful in monitoring IBD patients in remission, as FC appears to be a reliable predictor of short-term relapse and endoscopic activity.
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- 2017
13. Tu1558 - An External Validation of the Baveno VI and Expanded Baveno VI Criteria on Attempting to Transform them into a One Stop Liver Shop
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Vlachogiannakos, John, primary, Karagiannakis, Dimitrios, additional, Voulgaris, Theodoros, additional, Siakavellas, Spyros I., additional, Kalogera, Despina, additional, Angelopoulos, Theodoros, additional, Choupi, Elissavet, additional, Manolakopoulos, Spilios, additional, and Papatheodoridis, George, additional
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- 2018
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14. Tu1562 - Increased Frequency of Peptic Ulcers Diagnosed During Screening Endoscopy in Asymptomatic Patients with Advanced Chronic Liver Disease
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Vlachogiannakos, John, primary, Voulgaris, Theodoros, additional, Karagiannakis, Dimitrios, additional, Kalogera, Despina, additional, Angelopoulos, Theodoros, additional, Choupi, Elissavet, additional, Karamanolis, Georgios, additional, and Papatheodoridis, George, additional
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- 2018
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15. Mo1512 - Treatment of Functional Chest Pain: Citalopram, Amitriptylin or no Treatment
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Karamanolis, Georgios, primary, Katopodi, Konstantina, additional, Denaxas, Konstantinos, additional, Kamberoglou, Dimitrios, additional, Viazis, Nikos, additional, Papatheodoridis, George, additional, and Vlachogiannakos, John, additional
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- 2018
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16. Fecal calprotectin measurement is a marker of short-term clinical outcome and presence of mucosal healing in patients with inflammatory bowel disease
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Kostas, Athanasios, primary, Siakavellas, Spyros I, additional, Kosmidis, Charalambos, additional, Takou, Anna, additional, Nikou, Joanna, additional, Maropoulos, Georgios, additional, Vlachogiannakos, John, additional, Papatheodoridis, George V, additional, Papaconstantinou, Ioannis, additional, and Bamias, Giorgos, additional
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- 2017
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17. Predictors of Sustained Virological Response (SVR) in Patients with Advanced Chronic Hepatitis C (CHC) Treated with Current Direct Acting Antiviral(s) (DAA). Heraclis: Hellenic Multicenter Real-Life Cohort Study
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Papatheodoridis, George, primary, Manolakopoulos, Spilios, additional, Kapatais, Andreas, additional, Sinakos, Emanuel, additional, Elefsiniotis, Ioannis, additional, Goulis, John, additional, Deutsch, Melanie, additional, Vlachogiannakos, John, additional, Dalekos, George, additional, Koskinas, John, additional, Karatapanis, Stylianos, additional, Schina, Maria, additional, Manesis, Emanuel, additional, Ketikoglou, Ioannis, additional, Sevastianos, Vassilios, additional, Triantos, Christos, additional, Cholongitas, Evangelos, additional, Papageorgiou, Maria-Vasiliki, additional, Kourikou, Anastasia, additional, Karaoulani, Theofanie, additional, Evangelidou, Eftychia, additional, Koukoufiki, Argyro, additional, Karagiannakis, Dimitrios, additional, Gatselis, Nikolaos, additional, Tampaki, Maria, additional, Ntetskas, Georgios, additional, Tsolias, Chrisostomos, additional, Voulgaris, Theodoros, additional, Ioannidou, Panagiota, additional, and Akriviadis, Evangelos, additional
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- 2017
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18. High prevalence of asymptomatic peptic ulcers diagnosed during screening endoscopy in patients with cirrhosis.
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Voulgaris, Theodoros, Karagiannakis, Dimitrios, Siakavellas, Spyridon, Kalogera, Despina, Angelopoulos, Theodoros, Chloupi, Elissavet, Karamanolis, George, Papatheodoridis, George, and Vlachogiannakos, John
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PEPTIC ulcer ,CIRRHOSIS of the liver ,LIVER disease etiology ,PORTAL hypertension ,HELICOBACTER pylori infections ,ESOPHAGEAL varices ,ENDOSCOPY ,DISEASE prevalence - Abstract
Background Peptic ulcer disease (PUD) is more prevalent in cirrhotics and this may aggravate prognosis. We investigated the prevalence of PUD in cirrhotics and its potential association with Helicobacter pylori (H. pylori) infection, the underlying etiology and severity of liver disease, and other manifestations of portal hypertension (PH). Methods We enrolled consecutive asymptomatic cirrhotic patients who underwent screening endoscopy in a tertiary hospital during a 12-month period. We recorded the presence of PUD and the endoscopic findings associated with PH. H. pylori infection was documented through either histology or CLO-test. The diagnosis of cirrhosis was based on elastography, liver biopsy or a combination of clinical, biochemical and imaging data. Results One hundred patients (M/F: 54/46, mean age: 61±14 years) were included in the analysis. Viral hepatitis (37%) and alcohol (22%) were the most common causes of cirrhosis. Child-Pugh stage was A/B/C: 60/35/5. PUD was found in 19 patients (14 gastric, 5 duodenal). H. pylori infection was diagnosed in 54%. Varices were detected in 59% (39% needed treatment). PH gastropathy was present in 81% (severe in 33%). The presence of PUD was unrelated to the etiology and the severity of liver disease or to other endoscopic manifestations of PH. No correlation was found between PUD and H. pylori infection. Conclusions A high prevalence of PUD was observed in our cirrhotic patients, although they were asymptomatic and had no known risk factors of ulcerogenicity. The value of screening endoscopy for the early diagnosis and treatment of PUD in cirrhotics deserves further investigation. [ABSTRACT FROM AUTHOR]
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- 2019
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19. Elevated Serum Levels of the Antiapoptotic Protein Decoy-Receptor 3 Are Associated with Advanced Liver Disease
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Bamias, Giorgos, primary, Gizis, Michalis, additional, Delladetsima, Ioanna, additional, Laoudi, Eyfrosyni, additional, Siakavellas, Spyros I., additional, Koutsounas, Ioannis, additional, Kaltsa, Garyfallia, additional, Vlachogiannakos, John, additional, Vafiadis-Zouboulis, Irene, additional, Daikos, George L., additional, Papatheodoridis, George V., additional, and Ladas, Spiros D., additional
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- 2016
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20. Hepatocellular carcinoma in chronic hepatitis B patients under antiviral therapy
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Vlachogiannakos, John Papatheodoridis, George
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neoplasms ,digestive system diseases - Abstract
Patients with chronic hepatitis B are at increased risk of hepatocellular carcinoma (HCC), while the inhibition of viral replication can represent a reasonable target for HCC prevention. Interferon-alpha therapy results in decreased HCC risk, which is more evident in patients with high baseline HCC risk. The majority of chronic hepatitis B patients are treated with a nucleos(t)ide analogue (NA) for several reasons including the non-sustained response after interferon-alpha. The effect of the first licensed and low genetic barrier NA, lamivudine, on HCC incidence, has been repeatedly evaluated. Lamivudine, compared to no treatment, reduces the HCC incidence, which may increase again in cases with lamivudine resistance. Emerging data with the currently first-line NAs, entecavir and tenofovir, suggest that they also reduce the HCC incidence. The treatment benefit in reduction of the HCC incidence is always greater in patients with high baseline HCC risk, particularly cirrhotics, and without virological remission under entecavir/tenofovir. However, the HCC risk is not eliminated even in the vast majority of patients who remain in virological remission under entecavir/tenofovir. Therefore, patients at increased baseline HCC risk should continue to undergo HCC surveillance even if they have achieved complete long-term inhibition of viral replication and improvements in liver histology. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.
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- 2013
21. Clinical and epidemiological characteristics of hepatitis C virusinfected people who inject drugs: a Greek descriptive analysis.
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Kranidioti, Hariklia, Chatzievagelinou, Christina, Protopapas, Adonis, Papatheodoridi, Margarita, Zisimopoulos, Konstantinos, Evangelidou, Eftychia, Antonakaki, Pinelopi, Vlachogiannakos, John, Triantos, Christos, Elefsiniotis, Ioannis, Goulis, John, Mela, Maria, Anagnostou, Olga, Tsoulas, Christos, Deutsch, Melanie, Papatheodoridis, George, and Manolakopoulos, Spilios
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HEPATITIS C virus ,VIREMIA - Abstract
Background It is estimated that 17,000 people who inject drugs (PWID) in Greece have hepatitis C virus (HCV) viremia. The aim of our study was to explore the characteristics of the HCVinfected, direct acting antiviral (DAA)-naïve PWID. Methods This is a retrospective analysis of PWID with HCV infection. We selected data from six liver clinics during the period from 1st May 2014 to 31st May 2017 in order to record the characteristics of infected PWID. Results We included 800 PWID with HCV infection (78.5% male, mean age 42±10 years) who had not received DAAs before 1st June 2017. One third of the patients had comorbidities (diabetes mellitus, arterial hypertension and psychological disorders); 70% were smokers, 27% alcohol users, 67% unemployed, 29% married, and 34% had education >12 years; 65% were attending addiction programs; 57% were receiving methadone and 36% buprenorphine. Sporadic or systemic drug use was reported by 37% while 1.4% and 2.9% had HIV and HBV coinfection, respectively. The genotype distribution was 20.5%, 4.6%, 3.3%, 61% and 10% for genotypes 1a, 1b, 2, 3 and 4, respectively. Mean (±SD) liver stiffness was 9±7 kPa and 21% of the patients had cirrhosis. Half of the patients were in the F0-F1 stage of liver disease, defined as stiffness =7 kPa. Conclusions Our real-life data suggest that HCV genotype 3 remains the predominant genotype among PWID. One third of PWID had comorbidities and one-fifth cirrhosis. Half of PWID had earlystage liver disease and remained without access to DAAs according to the Greek prioritization criteria. [ABSTRACT FROM AUTHOR]
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- 2018
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22. Sa1512 - Predictors of Sustained Virological Response (SVR) in Patients with Advanced Chronic Hepatitis C (CHC) Treated with Current Direct Acting Antiviral(s) (DAA). Heraclis: Hellenic Multicenter Real-Life Cohort Study
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Papatheodoridis, George, Manolakopoulos, Spilios, Kapatais, Andreas, Sinakos, Emanuel, Elefsiniotis, Ioannis, Goulis, John, Deutsch, Melanie, Vlachogiannakos, John, Dalekos, George, Koskinas, John, Karatapanis, Stylianos, Schina, Maria, Manesis, Emanuel, Ketikoglou, Ioannis, Sevastianos, Vassilios, Triantos, Christos, Cholongitas, Evangelos, Papageorgiou, Maria-Vasiliki, Kourikou, Anastasia, Karaoulani, Theofanie, Evangelidou, Eftychia, Koukoufiki, Argyro, Karagiannakis, Dimitrios, Gatselis, Nikolaos, Tampaki, Maria, Ntetskas, Georgios, Tsolias, Chrisostomos, Voulgaris, Theodoros, Ioannidou, Panagiota, and Akriviadis, Evangelos
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- 2017
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23. Hepatocellular carcinoma in chronic hepatitis B patients under antiviral therapy
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Vlachogiannakos, John, primary
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- 2013
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24. Boceprevir for chronic HCV genotype 1 infection in treatment-experienced patients with severe fibrosis or cirrhosis: The Greek real-life experience.
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Manolakopoulos, Spilios, Kranidioti, Hariklia, Goulis, John, Vlachogiannakos, John, Elefsiniotis, John, Kouroumalis, Elias A., Koskinas, John, Kontos, George, Evangelidou, Eftychia, Doumba, Polyxeni, Sinakos, Emmanuel, Vafiadou, lrini, Koulentaki, Mairi, Papatheodoridis, George, and Akriviadis, Evangelos
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HEPATITIS C treatment ,BOCEPREVIR ,FIBROSIS - Abstract
Background: The aim of our study was to evaluate the safety and efficacy of triple therapy using boceprevir (BOC) with pegylated interferon (pIFN)/ribavirin (RBV) in chronic hepatitis C (CHC) genotype 1 (G1) treatment-experienced patients with advanced fibrosis or compensated cirrhosis. Methods: We report the Greek experience on the first CHC patients who received BOC-based regimen. From September 2011 to June 2012, 26 treatment-experienced CHC patients and G1 with bridging fibrosis or compensated cirrhosis received 48 weeks of BOC+pIFN+RBV antiviral therapy. Data on complete blood counts and HCV RNA levels were obtained prior to therapy, at treatment weeks 4, 8, 12, 24, 36, 48 and 24 weeks after the end of treatment. Results: A full set analysis was performed in 25 of 26 patients. Nine patients (36%) achieved sustained viral response (SVR). Ten patients (40%) stopped the therapy because of futility rules and 3 (12%) due to adverse events. Four patients (16%) developed a virological breakthrough (3 of those presented futility rules as well) and 2 (8%) relapse. All patients who achieved SVR had G 1b, 6 (67%) were non-cirrhotic and 5 (55%) had >1 log decline in baseline HCV RNA levels at week 4 of the treatment. There were no deaths, while two patients were hospitalized due to side eff ects. Conclusion: The triple therapy with BOC+pIFN+RBV in this cohort of real-life treatmentexperienced CHC G1 patients and advanced liver disease was safe off ering cure in the majority of those who could tolerate and complete treatment under a close monitoring. [ABSTRACT FROM AUTHOR]
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- 2015
25. The impact of newer nucleos(t)ide analogues on patients with hepatitis B decompensated cirrhosis.
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Cholongitas, Evangelos, Papatheodoridis, George V., Goulis, John, Vlachogiannakos, John, Karatapanis, Stylianos, Ketikoglou, John, Vasiliadise, Themistoklis, Kontos, George, Karlaftis, Anastasios, and Akriviadis, Evangelos
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NUCLEOTIDES ,HEPATITIS B ,CIRRHOSIS of the liver ,PATIENTS - Abstract
Background/aim Patients with HBV-related decompensated cirrhosis (HBV-DeCi) should be treated with potent nucleos(t)ide analogues (NA)[entecavir (ETV) or tenofovir (TDF)]. The aim was the evaluation of safety and efficacy in terms of changes in liver disease course in HBV-DeCi patients treated with ETV or TDF. Methods In 52 HBV-DeCi patients clinical and laboratory data, including glomerular filtration rates (GFR), were recorded. The changes in MELD (DMELD) and Child-Pugh (DCTP) scores between baseline and after 6 months of treatment were evaluated. The independent factors associated with survival were evaluated. Results 31 patients under TDF and 21 under ETV were evaluated. During a median follow-up of 22.5 months (range: 6-68), there were no differences between the two groups in GFR and serum phosphate levels. At the end of follow up, in the TDF group, 2 patients died and 3 received liver transplantations (LT), while in the ETV group, 1 patient died and 3 received LT. In multivariable Cox regression analysis, DMELD was independently associated with the outcome in the total cohort (HR: 1.78, 95%C.I.:1.12-2.79, P=0.013) as well as in the subgroup of naïve (n=37) patients (HR: 1.8, 95%C.I.:1.19-4.5, P=0.03). Finally, in the non-hepatocellular carcinoma patients, the DCTP score was independently associated with the outcome in the total cohort (HR: 2.64, 95%C.I.: 1.21-7.29, P=0.015). Conclusions TDF and ETV appear to have similar renal safety profile in HBV-DeCi patients. DMELD score in the total cohort and DCTP score in non-HCC patients were independently associated with the outcome; these findings need confirmation in larger studies. [ABSTRACT FROM AUTHOR]
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- 2015
26. Predictive performance of newer Asian hepatocellular carcinoma risk scores in treated Caucasians with chronic hepatitis B
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George V. Papatheodoridis, Harry L.A. Janssen, Florian van Boemmel, Margarita Papatheodoridi, Anastasia Kourikou, Cihan Yurdaydin, Bettina E. Hansen, Pietro Lampertico, John Vlachogiannakos, Ramazan Idilman, Savvoula Savvidou, John Goulis, Marta López-Gómez, Spilios Manolakopoulos, Thomas Berg, Nikolaos K. Gatselis, Maria Buti, Jose Luis Calleja, Rafael Esteban, George N Dalekos, Rhea Veelken, Vana Sypsa, Kostas Galanis, Alessandro Loglio, Yurdaydın, Cihan (ORCID 0000-0002-5419-7158 & YÖK ID 189330), Papatheodoridis, George, V, Dalekos, George N., İdilman, Ramazan, Sypsa, Vana, Van Boemmel, Florian, Buti, Maria, Calleja, Jose Luis, Goulis, John, Manolakopoulos, Spilios, Loglio, Alessandro, Papatheodoridi, Margarita, Gatselis, Nikolaos, Veelken, Rhea, Lopez-Gomez, Marta, Hansen, Bettina E., Savvidou, Savvoula, Kourikou, Anastasia, Vlachogiannakos, John, Galanis, Kostas, Esteban, Rafael, Janssen, Harry L. A., Berg, Thomas, Lampertico, Pietro, School of Medicine, Institut Català de la Salut, [Papatheodoridis GV] Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens 'Laiko', Athens, Greece. [Dalekos GN] Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece. [Idilman R] Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey. [Sypsa V] Department of Hygiene, Epidemiology & Medical Statistics, Medical School of National and Kapodistrian University of Athens, Athens, Greece. [Van Boemmel F] Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany. [Buti M, Esteban R] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Ciberehd, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, and Gastroenterology & Hepatology
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Cirrhosis ,RC799-869 ,Gastroenterology ,Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores] ,ULN, upper limit of normal ,Fetge - Càncer - Prognosi ,Other subheadings::/diagnosis [Other subheadings] ,Immunology and Allergy ,Hazard ratio ,Entecavir ,Diseases of the digestive system. Gastroenterology ,Predictive value ,NPV, negative predictive value ,Hepatology ,Hepatocellular carcinoma ,CHB, chronic hepatitis B ,medicine.drug ,Research Article ,Digestive System Diseases::Liver Diseases::Hepatitis::Hepatitis, Viral, Human::Hepatitis B [DISEASES] ,medicine.medical_specialty ,Tenofovir ,neoplasias::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias hepáticas::carcinoma hepatocelular [ENFERMEDADES] ,ETV, entecavir ,Otros calificadores::/diagnóstico [Otros calificadores] ,AUROC, area under receiver operating characteristic ,Chronic hepatitis ,SDG 3 - Good Health and Well-being ,Internal medicine ,ALT, alanine aminotransferase ,Internal Medicine ,medicine ,In patient ,Hepatitis B - Complicacions ,TDF, tenofovir disoproxil fumarate ,business.industry ,Càncer - Propensió ,Prediction ,medicine.disease ,HR, hazard ratio ,digestive system diseases ,PPV, positive predictive value ,Neoplasms::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Liver Neoplasms::Carcinoma, Hepatocellular [DISEASES] ,enfermedades del sistema digestivo::enfermedades hepáticas::hepatitis::hepatitis viral humana::hepatitis B [ENFERMEDADES] ,NA, nucleos(t)ide analogue ,business ,HCC, hepatocellular carcinoma ,Other subheadings::Other subheadings::/complications [Other subheadings] - Abstract
Background & Aims Recently, several risk scores for prediction of hepatocellular carcinoma (HCC) were developed in cohorts of treated Asian patients with chronic hepatitis B (CHB), but they have not been assessed in non-Asian patients. We evaluated the predictability and comparative utility of our PAGE-B and recent Asian HCC risk scores in nucleos(t)ide analogue (NA)-treated adult Caucasian patients with CHB, with or without well-documented compensated cirrhosis but not previous diagnosis of HCC. Methods We included 1,951 patients treated with entecavir/tenofovir and followed up for a median of 7.6 years. The c-statistic was used to estimate the predictability of PAGE-B, HCC-Rescue, CAMD, mPAGE-B, and AASL score for HCC development within 5 or 10 years. The low- and high-risk group cut-offs were used for estimation of negative (NPV) and positive predictive values (PPV), respectively. Results HCC developed in 103/1,951 (5.3%) patients during the first 5 years and in another 39/1,428 (2.7%) patients between years 5 and 10. The 3-, 5-, and 10-year cumulative HCC rates were 3.3%, 5.9%, and 9.6%, respectively. All scores offered good 5- and 10-year HCC prediction (c-statistic: 0.78–0.82). NPVs were always >99% (99.3–100%), whereas PPV ranged between 13% and 24%. Conclusions In NA-treated Caucasian patients with CHB including compensated cirrhosis, HCC risk scores developed in NA-treated Asian patients offer good 5- and 10-year HCC predictability, similar to that of PAGE-B. PAGE-B and mPAGE-B scores are simpler in clinical practice, as they do not require an accurate diagnosis of cirrhosis, but the addition of albumin in mPAGE-B score does not seem to offer an advantage in patients with well compensated liver disease. Lay summary Several risk scores for prediction of hepatocellular carcinoma (HCC) were recently developed in cohorts of treated Asian patients with chronic hepatitis B (CHB). In Caucasian patients with CHB treated with oral antivirals, newer Asian HCC risk scores offer good 5- and 10-year HCC predictability, similar to that of PAGE-B. For clinical practice, PAGE-B and mPAGE-B scores are simpler, as they do not require an accurate diagnosis of cirrhosis., Graphical abstract, Highlights • In treated Caucasian patients with chronic hepatitis B, newer Asian hepatocellular carcinoma risk scores offer good 5- and 10-year predictability, similar to that of PAGE-B. • PAGE-B and mPAGE-B scores are simpler in clinical practice, as they do not require an accurate diagnosis of cirrhosis. • The addition of albumin in mPAGE-B does not seem to offer an advantage in patients with well-compensated liver disease.
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- 2021
27. Tenofovir-associated Fanconi syndrome in a patient with chronic hepatitis B.
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Samarkos, Michael, Theofanis, Vassileios, Eliadi, Irene, Vlachogiannakos, John, and Polyzos, Aris
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DRUG side effects , *FANCONI syndrome , *HEPATITIS B virus , *THERAPEUTICS - Abstract
A letter to the editor is presented in response to the article "Tenofovir-associated Fanconi syndrome in patients with chronic hepatitis B monoinfection," by D. M. Gracey and colleagues in the 2013 issue.
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- 2014
28. Clinical and epidemiological characteristics of hepatitis C virus-infected people who inject drugs: a Greek descriptive analysis.
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Kranidioti H, Chatzievagelinou C, Protopapas A, Papatheodoridi M, Zisimopoulos K, Evangelidou E, Antonakaki P, Vlachogiannakos J, Triantos C, Elefsiniotis I, Goulis J, Mela M, Anagnostou O, Tsoulas C, Deutsch M, Papatheodoridis G, and Manolakopoulos S
- Abstract
Background: It is estimated that 17,000 people who inject drugs (PWID) in Greece have hepatitis C virus (HCV) viremia. The aim of our study was to explore the characteristics of the HCV-infected, direct acting antiviral (DAA)-naïve PWID., Methods: This is a retrospective analysis of PWID with HCV infection. We selected data from six liver clinics during the period from 1
st May 2014 to 31st May 2017 in order to record the characteristics of infected PWID., Results: We included 800 PWID with HCV infection (78.5% male, mean age 42±10 years) who had not received DAAs before 1st June 2017. One third of the patients had comorbidities (diabetes mellitus, arterial hypertension and psychological disorders); 70% were smokers, 27% alcohol users, 67% unemployed, 29% married, and 34% had education >12 years; 65% were attending addiction programs; 57% were receiving methadone and 36% buprenorphine. Sporadic or systemic drug use was reported by 37% while 1.4% and 2.9% had HIV and HBV coinfection, respectively. The genotype distribution was 20.5%, 4.6%, 3.3%, 61% and 10% for genotypes 1a, 1b, 2, 3 and 4, respectively. Mean (±SD) liver stiffness was 9±7 kPa and 21% of the patients had cirrhosis. Half of the patients were in the F0-F1 stage of liver disease, defined as stiffness ≤7 kPa., Conclusions: Our real-life data suggest that HCV genotype 3 remains the predominant genotype among PWID. One third of PWID had comorbidities and one-fifth cirrhosis. Half of PWID had early-stage liver disease and remained without access to DAAs according to the Greek prioritization criteria., Competing Interests: Conflict of Interest: Gilead Sciences- Published
- 2018
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29. Serum leptin and ghrelin in chronic hepatitis C patients with steatosis.
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Pavlidis C, Panoutsopoulos GI, Tiniakos D, Koutsounas S, Vlachogiannakos J, and Zouboulis-Vafiadis I
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- Adult, Antiviral Agents therapeutic use, Fatty Liver pathology, Fatty Liver virology, Female, Genotype, Hepacivirus genetics, Hepatitis C, Chronic drug therapy, Hepatitis C, Chronic virology, Humans, Male, RNA, Viral blood, Retrospective Studies, Fatty Liver blood, Fatty Liver etiology, Ghrelin blood, Hepatitis C, Chronic blood, Hepatitis C, Chronic complications, Leptin blood
- Abstract
Aim: To determine the associations between leptin and ghrelin concentrations and sustained virological response (SVR) in chronic hepatitis C patients with steatosis., Methods: We retrospectively assessed 56 patients infected with hepatitis C virus (HCV) genotype-1 and 40 with HCV genotype-3. Patients with decompensated cirrhosis, and those with other causes of chronic liver disease, were excluded. Serum HCV-RNA concentrations were measured before the initiation of treatment; at weeks 12 (for genotype 1 patients), 24 and 48 during treatment; and 24 wk after the end of treatment. Genotype was determined using INNO-LIPA HCV assays, and serum leptin and ghrelin concentrations were measured using enzyme-linked immunosorbent assay. Biopsy specimens were scored according to the Ishak system and steatosis was graded as mild, moderate, or severe, according to the Brunt classification., Results: Overall, SVR was positively related to the presence of genotype-3, to biopsy-determined lower histological stage of liver disease, and lower grade of steatosis. Patients ≥ 40 years old tended to be less responsive to therapy. In genotype-1 infected patients, SVR was associated with a lower grade of liver steatosis, milder fibrosis, and an absence of insulin resistance. Genotype-1 infected patients who did not achieve SVR had significantly higher leptin concentrations at baseline, with significant increases as the severity of steatosis worsened, whereas those who achieved SVR had higher ghrelin concentrations. In genotype-3 infected patients, SVR was associated only with fibrosis stage and lower homeostasis model assessment insulin resistance at baseline, but not with the degree of steatosis or leptin concentrations. Genotype-3 infected patients who achieved SVR showed significant decreases in ghrelin concentration at end of treatment. Baseline ghrelin concentrations were elevated in responders of both genotypes who had moderate and severe steatosis., Conclusion: Increased serum leptin before treatment may predict non-SVR, especially in HCV genotype-1 infected patients, whereas increased ghrelin may predict SVR in genotype-1.
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- 2011
- Full Text
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