Publications by authors named "Ioanna Dimopoulou"

Hypoxia-inducible factors (HIFs) are central regulators of gene expression in response to oxygen deprivation, a common feature in critical illnesses. The significant burden that critical illnesses place on global healthcare systems highlights the need for a deeper understanding of underlying mechanisms and the development of innovative treatment strategies. Among critical illnesses, impaired lung function is frequently linked to hypoxic conditions.

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Aquaporins (AQPs) are membrane proteins facilitating water and other small solutes to be transported across cell membranes. They are crucial in maintaining cellular homeostasis by regulating water permeability in various tissues. Moreover, they regulate cell migration, signaling pathways, inflammation, tumor growth, and metastasis.

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This study sought to evaluate the effectiveness of lactate/albumin ratio for ICU mortality prediction in a large cohort of patients with severe Coronavirus Disease-2019 (COVID-19) admitted to an intensive care unit (ICU). This is a single-center retrospective cohort study of prospectively collected data derived from the COVID-19 dataset for all critically ill patients admitted to an academic ICU. Data were used to determine the relation between lactate/albumin ratio and other laboratory parameters measured on the first day of the ICU stay and to evaluate the prognostic performance for ICU mortality prediction.

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Post-intensive care syndrome (PICS) encompasses persistent physical, psychological, and cognitive impairments. The coronavirus disease of 2019 (COVID-19) pandemic highlighted parallels between PICS and "long COVID". There is an overlap between the 2 in risk factors, symptoms, and pathophysiology.

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Endothelin-1 (ET-1) is a potent vasoconstrictor produced by endothelial cells and cleared from circulating blood mainly in the pulmonary vasculature. In a healthy pulmonary circulation, the rate of local production of ET-1 is less than its rate of clearance. In the present study, we aimed to investigate whether the abnormal pulmonary circulatory handling of ET-1 relates to poor clinical outcomes in patients with coronavirus disease 2019 (COVID-19)-induced acute respiratory distress syndrome (ARDS).

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Article Synopsis
  • Aging affects how driving pressure impacts mortality in patients with ARDS, particularly highlighting that this relationship may be stronger in older individuals, especially those aged 80 and above.!* -
  • A study analyzed data from over 4,500 ARDS patients and found that the difference in driving pressure between those who survived and those who did not varied significantly with age, indicating a critical age-related factor in mortality risk.!* -
  • The results suggest that a personalized approach to mechanical ventilation based on a patient's age could be beneficial for managing ARDS, as certain thresholds for driving pressure may have different implications for older populations.!*
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Objective: Critically ill patients, including those with brain injuries (BI), are frequently hospitalized in an intensive care unit (ICU). As with other critical states, an adequate stress response is essential for survival. Research on the hypothalamic-pituitary-adrenal gland (HPA) axis function in BI has primarily focused on assessing ACTH and cortisol levels.

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Pulmonary arterial hypertension (PAH) is a chronic disease characterized by a progressive increase in mean pulmonary arterial pressure. Mutations in the and genes have been described in familial PAH. The bone morphogenetic proteins BMP9 and BMP10 bind with high affinity to BMPR2.

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Objectives: Optimal timing of tracheostomy in severe traumatic brain injury (TBI) is unknown due to lack of clinical trials. We emulated a target trial to estimate the effect of early vs. delayed tracheostomy strategy on functional outcome of patients with severe TBI.

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  • Post-COVID-19 syndrome affects millions, and while rehabilitation is important, studies show mixed results due to variations in participant characteristics and factors like age and disease severity that are not well understood.
  • This non-randomized case-control study involved participants with post-COVID-19 symptoms, comparing those who attended an 8-week supervised rehabilitation program to those who did not, with measurements taken at the start and after the program.
  • Results indicated that participants in rehabilitation showed significant improvements in various health metrics, including walking distance, physical performance, quality of life, and cognitive function, further highlighting the potential benefits of rehabilitation for post-COVID-19 recovery.
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Acute hypoxemic respiratory failure (AHRF) is defined as acute and progressive, and patients are at a greater risk of developing acute respiratory distress syndrome (ARDS). Until now, most studies have focused on prognostic and diagnostic biomarkers in ARDS. Since there is evidence supporting a connection between dysregulated coagulant and fibrinolytic pathways in ARDS progression, it is plausible that this dysregulation also exists in AHRF.

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  • - The study examined serum levels of GFAP, s100b, and total Tau in long-COVID patients to investigate links to symptoms, cognitive decline, mental health issues, and quality of life.
  • - It included 65 long-COVID patients and 20 controls, finding that GFAP levels were higher in patients but didn’t correlate with long-COVID symptoms; other biomarkers like s100b and total Tau showed no significant difference.
  • - The research highlighted high rates of cognitive decline (65.9%), depression (32.2%), anxiety (47.5%), and PTSD (44.1%) among long-COVID patients, with most participants scoring below normal on quality of life assessments.
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Pupillometry, an integral component of neurological examination, serves to evaluate both pupil size and reactivity. The conventional manual assessment exhibits inherent limitations, thereby necessitating the development of portable automated infrared pupillometers (PAIPs). Leveraging infrared technology, these devices provide an objective assessment, proving valuable in the context of brain injury for the detection of neuro-worsening and the facilitation of patient monitoring.

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Sepsis is an inflammatory disorder caused by the host's dysfunctional response to infection. Septic patients present diverse clinical characteristics, and in the recent years, it has been the main cause of death in intensive care units (ICU). Aquaporins, membrane proteins with a role in water transportation, have been reported to participate in numerous biological processes.

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The prevalence of antibiotic-resistant urogenital mycoplasmas and ureaplasmas has been gradually increasing over the years, leading to greater concern for accurate diagnosis and treatment. In this study, the antimicrobial resistance trends in Greece were analyzed using 2992 Ureaplasma spp. and 371 M.

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Objective: To investigate hormonal status in patients with long-COVID and explore the interrelationship between hormone levels and long-COVID symptoms.

Design: Prospective observational study.

Participants: Patients who visited our long-COVID outpatients' clinic due to long-COVID symptoms from February 2021 to December 2022.

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Severe COVID-19 is related to hyperinflammation and multiple organ injury, including respiratory failure, thus requiring intensive care unit (ICU) admission. Galectin-3, a carbohydrate-binding protein exhibiting pleiotropic effects, has been previously recognized to participate in inflammation, the immune response to infections and fibrosis. The aim of this study was to evaluate the relationship between galectin-3 and the clinical severity of COVID-19, as well as assess the prognostic accuracy of galectin-3 for the probability of ICU mortality.

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Since the beginning of the pandemic, both COVID-19-associated coagulopathy biomarkers and a plethora of endothelial biomarkers have been proposed and tested as prognostic tools of severity and mortality prediction. As the pandemic is gradually being controlled, attention is now focusing on the long-term sequelae of COVID-19. In the present study, we investigated the role of endothelial activation/dysfunction in long COVID syndrome.

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Article Synopsis
  • - Sepsis leads to abnormal cortisol levels due to initial increased secretion from adrenal glands, followed by a decline as adrenal function worsens; this results in relative adrenal insufficiency.
  • - The dysregulation of cortisol impacts the body's inflammatory response, raising interest in corticosteroids as a potential treatment, though results from clinical trials have been inconsistent.
  • - The review will cover cortisol changes in critically ill sepsis patients, including COVID-19 cases, and discuss the implications for corticosteroid use in treating both COVID-19 and non-COVID-19 associated sepsis.
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  • Aging negatively impacts the endothelium, which is critical for vascular health, and the study focuses on endocan (ESM-1), a protein linked to endothelial function in critically ill patients.
  • ESM-1 levels were found to be significantly higher in critically ill COVID-19 patients compared to non-septic and septic patients, and older septic patients had higher levels of ESM-1 compared to younger ones.
  • The research revealed that while ESM-1 is a potential prognostic biomarker, its effectiveness varies with age and the degree of endothelial dysfunction, particularly in the younger septic patient demographic.
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Hypoxia is characterized as one of the main consequences of sepsis, which is recognized as the leading cause of death in intensive care unit (ICU) patients. In this study, we aimed to examine whether the expression levels of genes regulated under hypoxia could be utilized as novel biomarkers for sepsis prognosis in ICU patients. Whole blood expression levels of hypoxia-inducible factor-1α (), interferon-stimulated gene 15 (), hexokinase 2 (), lactate dehydrogenase (), heme oxygenase-1 (), erythropoietin (), and the vascular endothelial growth factor A () were measured on ICU admission in 46 critically ill, initially non-septic patients.

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Article Synopsis
  • The pulmonary endothelium is crucial for various functions and is affected by conditions like sepsis and acute respiratory distress syndrome.
  • Endothelial dysfunction has been linked to severe cases of COVID-19, particularly influencing coagulopathy and other injury markers.
  • A comprehensive literature search was conducted up to March 2023 to explore the connection between endothelial biomarkers and the severity of acute and long COVID-19 outcomes.
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The mineralocorticoid receptor (MR) has two ligands, aldosterone and cortisol. Hydroxysteroid 11-beta dehydrogenase (HSD11B) isoenzymes regulate which ligand will bind to MR. In this study we aimed to evaluate the expression of the MR and the HSD11B isozymes in peripheral polymorphonuclear cells (PMNs) in critical illness for a 13-day period.

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  • COVID-19 severity markers include inflammatory molecules and neural injury biomarkers, indicating that SARS-CoV-2 can affect the central nervous system.
  • The study compared the predictive abilities of neural injury biomarkers, like S100b and neuron-specific enolase (NSE), with inflammatory markers to determine their relation to mortality in critically ill COVID-19 patients.
  • S100b showed the strongest correlation with mortality, outperforming other biomarkers, and suggested significant nervous system involvement due to COVID-19.
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Introduction: Post intensive care syndrome (PICS) affects an increasing number of critical illness survivors and their families, with serious physical and psychological sequelae. Since little is known about the burden of critical illness on ICU survivor families, we conducted a prospective observational study aiming to assess this, and investigate correlations of the patients' psychometric and health-related quality of life (HRQOL) scores with family burden.

Materials And Methods: Twenty-nine patients were evaluated in the presence of a family member.

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