Publications by authors named "Kallianos A"

Background: A number of studies report small airways involvement in patients with systemic sclerosis (SSc). Furthermore, small airways dysfunction is increasingly recognized in patients with interstitial lung disease (ILD) of idiopathic or autoimmune etiology. The objectives of this study were to evaluate small airways function in SSc patients with ILD and explore the effect of treatment on small airways function by using conventional and contemporary pulmonary function tests (PFTs).

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Background: Lung involvement in AL amyloidosis is not very common, but post-mortem data and retrospective studies suggest it is likely underrecognized.

Aim: To perform a comprehensive evaluation of lung function with pulmonary function tests (PFTs) in patients with newly diagnosed AL amyloidosis.

Methods: A prospective, non-interventional study of 139 consecutive patients with newly diagnosed AL amyloidosis.

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Background: Cardiopulmonary exercise testing (CPET) has been widely used for the functional evaluation of patients with heart failure. Patients with amyloidosis and cardiac involvement typically present with heart failure with preserved or mildly reduced ejection fraction. We sought to evaluate the use of CPET parameters in patients with AL amyloidosis for the assessment of disease severity and prognosis and their association with cardiac imaging findings.

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This is a case description of a patient with previously diagnosed rapid eye movement sleep behavior disorder (RBD) and nocturnal enuresis, who complained about a "peculiar sound" while sleeping and, occasionally, while awake during intensive exercise, for the last three months. A home audio recording, which his wife obtained while he was sleeping, showed a high-pitched sound identified as stridor. Full video polysomnography revealed no apneas or hypopneas.

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Objective: The first wave of coronavirus pandemic and concomitant restrictive measures affected sleep. We slept more than usual, but the quality was worse. As the pandemic continues, a second period of restrictive measures was initiated, and no data exist about their impact on sleep.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with a high incidence of arterial and venous thrombotic complications. However, thromboembolic events in unusual sites such as limb and visceral arterial ischemia are reported rarely in the literature. Herein, we describe a rare case of a patient with severe coronavirus disease 2019 (COVID-19) infection who experienced severe abdominal pain during the hospitalization and presented simultaneously renal artery, splenic artery and vein as well as aortic thrombi despite prophylactic antithrombotic treatment.

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As the COVID-19 pandemic spreads across the globe, it will undoubtedly cross paths with long endemic infectious diseases in different areas. Interactions between SARS-CoV2 and well-known pathogens will likely give rise to unfamiliar clinical presentations, depending on complex and as yet unknown immunological interactions. We present a case of coinfection with COVI19 and visceral leishmaniasis and discuss recent reports regarding coexistence of SARS-CoV2 and spp.

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Article Synopsis
  • Cardiopulmonary Exercise Testing (CPET) is a non-invasive method used to evaluate the health of the heart, lungs, blood, and muscles during exercise, but its prognostic value in Systemic Sclerosis (SSc) has been minimally studied.
  • In a study involving 62 SSc patients without existing pulmonary hypertension, results showed that lower baseline oxygen uptake (VOmax) was a significant predictor of pulmonary function decline and linked to a 10-year survival rate of 88%.
  • Other factors like lower DLCO, male gender, and older age were associated with an increased risk of death, suggesting that CPET metrics can help predict outcomes for SSc patients over nearly a decade.
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  • - Obstructive sleep apnea (OSA) is linked to visceral obesity and often presents with depression and anxiety symptoms, but the direct impact on fat tissue dysfunction is uncertain.
  • - A study evaluated 10 men with severe OSA and matched controls, examining various health metrics and taking fat biopsies to assess inflammation and other changes in adipose tissue.
  • - Results showed a positive correlation between anxiety symptoms and macrophage accumulation in fat, along with significant relationships between fat fibrosis and body measurements, indicating complex interactions between OSA, obesity, and mental health.
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Patients with serious psychiatric diseases (major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia and psychotic disorder) often complain about sleepiness during the day, fatigue, low energy, concentration problems, and insomnia; unfortunately, many of these symptoms are also frequent in patients with Obstructive Sleep Apnea (OSA). However, existing data about the clinical appearance of OSA in Psychiatric Disease are generally missing. The aim of our study was a detailed and focused evaluation of OSA in Psychiatric Disease, in terms of symptoms, comorbidities, clinical characteristics, daytime respiratory function, and overnight polysomnography data.

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  • Pre-existing lung conditions can influence the treatment and survival rates of patients with multiple myeloma (MM), but there's limited knowledge about how pulmonary function tests (PFTs) impact these outcomes at diagnosis.
  • In a study involving 121 newly diagnosed MM patients, about 44.6% had lung function issues, which affected survival times, with those having obstructive defects showing significantly lower overall survival rates compared to those with restrictive defects or normal lung function.
  • Key lung function metrics (like forced vital capacity and carbon monoxide diffusion capacity) were found to be important predictors of survival, suggesting that incorporating respiratory evaluations into initial assessments for MM patients could be beneficial for treatment planning.
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Objective: Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea (OSA) are separately associated with several comorbidities. The coexistence of the two diseases, referred to as overlap syndrome, may act as a predisposing factor for a higher prevalence of comorbidities compared to those associated with each disease separately. The objective of the study was to evaluate the relative prevalence of cardiovascular as well as other comorbidities, in patients with the overlap syndrome, as compared to patients that are diagnosed solely with OSA.

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Article Synopsis
  • Patients with Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea (OSA) experience symptoms like sleepiness, fatigue, anxiety, and depression, but commonly used screening questionnaires have not been evaluated specifically for those with both conditions compared to OSA alone.
  • In this study, 38 patients with both COPD and OSA were compared to 38 patients with OSA only and 28 control subjects; they were assessed before and after three months of treatment with Continuous Positive Airways Pressure (CPAP) therapy.
  • Results showed that while anxiety and depression levels were similar between the two groups, those with overlap syndrome reported significantly more fatigue, which did not improve after treatment with CPAP.
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Nowadays we use novel diagnostic equipment for lung cancer. Bronchoscopy was the tip of the arrow for diagnosis, however; ultrasound systems have brought a revolution. We have the radial-endobronchial ultrasound for peripheral lesions and the convex probe endobronchial ultrasound for central lesions.

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Pneumomediastinum is a rare clinical entity that concerns the clinicians in the emergency department. We present a case of a patient with spontaneous pneumomediastinum (Hamman's syndrome) that presented to our hospital's emergency department with cervical subcutaneous emphysema. A conservative treatment with observation was performed.

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Lung cancer is still underdiagnosed mainly due to lack of symptoms. Most patients are diagnosed in a late stage where unfortunately only systematic therapy can be applied. Fortunately in the last five years several novel therapies and combinations have emerged.

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  • Pulmonary embolism is a serious medical condition that causes a significant number of deaths each year, with estimates between 200,000 to 300,000 fatalities.
  • The article details a case where a patient developed a massive pulmonary embolism two days after a surgery to remove a blood clot from the left femoral artery.
  • Treatment included extracorporeal life support (ECLS) and catheter thrombolysis, which successfully stabilized the patient, allowing them to be weaned off ECLS and discharged in good health after recovery.
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Non-small cell lung cancer is still diagnosed at late stage due to the lack of early symptoms and methods of diagnostic prevention. In the past ten years several targeted therapies have been introduced or explored. Tyrosine kinase inhibitors and immunotherapy are currently considered the most effective and safe therapies in comparison to the non-specific cytotoxic agents.

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In this decade a "bloom" of novel therapies has been observed for non-small cell lung cancer. We have new tools for the diagnosis of lung cancer and also we can re-biospy easier than before in different lesions and obtain tissue samples in order to investigate whether a patient can receive new targeted therapies. Immunotherapy has been well established previously for other forms of cancer, and nowadays it is also available for lung cancer.

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Endobronchial ultrasound endoscopy is a state of the art diagnostic endoscopic procedure for the thorax. Firstly it was designed mainly for the staging of lung cancer and of course for the diagnosis of suspicious findings in large central airways. The main limitation of the equipment is the diameter of the instrument and therefore it can only be guided through large airways.

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Targeted therapies are on the market for the past five years and recently pembrolizumab was approved as first line treatment for patients with PD-L1 >50%. We present three cases of patients which had epidermal growth factor receptor positive expression and programmed death-ligand 1 (PD-L1), PD-L1 >50% overexpression.

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  • Over the last ten years, new treatments for non-small cell lung cancer adenocarcinoma have emerged based on pharmacogenomics, highlighting the importance of specific genetic tests in everyday clinical practice.
  • Key genetic factors to investigate include mutations in the epidermal growth factor receptor, anaplastic lymphoma kinase, and programmed death-ligand 1 to guide therapy choices for cancer patients.
  • The case series will discuss the adverse effects experienced by patients treated with the immunotherapies nivolumab and pembrolizumab, along with insights on their treatment and follow-up care.
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Non-small cell lung cancer adenocarcinoma in the past decade has targeted therapies as the cornerstone for therapy. In specific patients with epidermal growth factor receptor mutation have three different therapy approaches with the tyrosine kinase inhibitors: erlotinib, gefitinib and afatinib. Nowadays we can use tyrosine kinase inhibitors as second line treatment for squamous cell carcinoma.

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Article Synopsis
  • Guidelines recommend using tyrosine kinase inhibitors for treating non-small cell lung cancer adenocarcinoma with positive epidermal growth factor mutations.
  • Three main tyrosine kinase inhibitors—gefitinib, erlotinib, and afatinib—are available as first-line treatments, with dosage adjustments for severe side effects.
  • In cases of disease relapse, testing for the T790M mutation is necessary, and if diagnosed, osimertinib should be administered as the best treatment approach.
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