Publications by authors named "Kazakou P"

Giant parathyroid adenoma (GPA) is an extremely rare cause of primary hyperparathyroidism (PHPT) and may sometimes mimic parathyroid carcinoma (PC). Parathyroid carcinoma is also a very rare entity. Both preoperative and postoperative diagnosis of the two conditions remains a challenge.

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Introduction: Currently approved SARS-CoV-2 vaccines have been proven effective in protecting against severe COVID-19; however, they show variable efficacy against symptomatic infection and disease transmission. We studied the breakthrough COVID-19 infection (BTI) after booster vaccination against SARS-CoV-2 in people living with HIV (PWH).

Methods: This was a retrospective, single-center, descriptive cohort study involving PWH, who were followed in the HIV Clinic of "Attikon" University Hospital in Athens, Greece.

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  • * Research indicates that low glycemic index (GI) and glycemic load (GL) diets can help stabilize blood sugar levels and may aid in weight management for those with T2DM.
  • * Despite promising results, clinical practice guidelines reveal inconsistencies regarding the strength of evidence for adopting low-GI/GL dietary patterns in diabetes management, prompting this review to assess the effectiveness of these diets.
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Background: Type 2 diabetes mellitus (T2DM) is often complicated by steatotic liver disease, cardiovascular disease (CVD), and extrahepatic cancer. We investigated whether FIB-4, an indicator of liver fibrosis, is associated with a higher risk of CVD and extrahepatic cancer history in T2DM.

Methods: Two hundred and nine of 244 diabetics admitted to our center in one year were included and retrospectively evaluated.

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  • - Struma ovarii is a type of ovarian teratoma found in 2-5% of cases, and malignant transformation is rare (<5%), with two cases presented where benign struma ovarii evolved into highly differentiated follicular carcinoma of the ovary (HDFCO) years later.
  • - The first case involved a 37-year-old woman who had multiple metastases after being previously diagnosed with benign struma ovarii 14 years ago, while the second case was a 26-year-old woman whose condition re-emerged 4 years after a benign diagnosis.
  • - Both patients underwent surgery along with total thyroidectomy and radioactive iodine therapy, highlighting the challenges in diagnosing HDFCO due to its histological similarities
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It is well known that both type 1 and type 2 diabetes mellitus (DM) are related to increased risk for cardiovascular (CV) and chronic kidney disease (CKD). However, besides these prominently presented complications, DM has also been associated with reproductive dysfunctions. It seems that these disorders are met in up to 40% of women with DM and consist of delayed menarche, all types of menstrual disorders, such as amenorrhea, oligomenorrhea, menstrual irregularity, as well as menorrhagia, infertility, characteristics of polycystic ovary syndrome (PCOS) and early (or rarely late) menopause.

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Immune checkpoint inhibitors (ICIs) are a revolutionary class of drugs that powerfully contribute to cancer therapy by harnessing the immune system to fight malignancies. However, their successful use as anti-cancer drugs is accompanied by a wide spectrum of immune-related adverse effects (irAEs), including endocrinopathies. Among them, thyroid dysfunction stands out as one of the most common endocrinopathies induced by ICI therapy and surfaces as a prominent concern.

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  • - The study aimed to compare glycemic control and outcomes in women with gestational diabetes treated with either insulin detemir or insulin NPH.
  • - It included 192 women, with no significant differences in insulin dosage or maternal weight gain between the two treatment groups, but a slightly lower HbA1c was observed in the detemir group.
  • - Overall, insulin detemir was found to be equally effective and safe compared to NPH for managing gestational diabetes without causing hypoglycemia or allergic reactions.
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Remdesivir was the first antiviral approved for treating COVID-19. We investigated its patterns of use, effectiveness and safety in clinical practice in Greece. This is a retrospective observational study of hospitalized adults who received remdesivir for COVID-19 in September 2020-February 2021.

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  • The study aimed to explore if maternal cigarette smoking during pregnancy increases the risk of gestational diabetes mellitus (GDM).
  • A systematic review and meta-analysis of 35 studies, involving over 23 million pregnant women, were conducted to assess this association.
  • The findings showed no significant link between smoking and GDM, suggesting a need for standardized diagnostic criteria to better understand potential relationships.
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Autoimmune thyroid disease (AITD) is the most common adverse effect in alemtuzumab (ALZ) treated relapsing-remitting (RR) multiple sclerosis (MS) patients. The objective of this prospective study was to analyze the occurrence, timing of onset, clinical course, and laboratory characteristics of AITD post-ALZ. We evaluated 35 RRMS patients treated with ALZ at a single academic MS center; clinical and laboratory data were collected before ALZ initiation and thereafter quarterly on follow-up with a median of 43.

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  • * The article reviews OSA as an independent risk factor for T2DM development and progression, along with related cardiovascular complications like hypertension and heart disease.
  • * Coexisting OSA and T2DM significantly raise the risk of cardiovascular mortality, emphasizing the need for clinicians to screen for OSA in T2DM patients and consider targeted therapies for better health outcomes.
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A 59-year-old woman presented with flushing attacks accompanied by tachycardia and hypotension, which lasted approximately 30 to 60 minutes, underwent 18 years ago a gastrointestinal tumor resection. The histologic examination revealed a poorly differentiated mixed neuroendocrine/adenocarcinoma located in the caecum with regional metastases. Postoperatively, the patient received combined chemotherapy of 5-fluorouracil with interferon for six months and since has remained asymptomatic.

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Background: Human organisms have to cope with a large number of external or internal stressful stimuli that threaten - or are perceived as threatening - their internal dynamic balance or homeostasis. To face these disturbing forces, or stressors, organisms have developed a complex neuroendocrine system, the stress system, which consists of the hypothalamic-pituitary-adrenal axis and the locus caeruleus/norepinephrine-autonomic nervous system.

Summary: Upon exposure to stressors beyond a certain threshold, the activation of the stress system leads to a series of physiological and behavioral adaptations that help achieve homeostasis and increase the chances of survival.

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There seems to be a bidirectional interplay between Diabetes mellitus (DM) and coronavirus disease 2019 (COVID-19). On the one hand, people with diabetes are at higher risk of fatal or critical care unit-treated COVID-19 as well as COVID-19 related health complications compared to individuals without diabetes. On the other hand, clinical data so far suggest that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may result in metabolic dysregulation and in impaired glucose homeostasis.

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Cardiovascular disease (CVD) remains the leading cause of death worldwide, representing a major health, social, and economic issue. Thyroid disorders are very common and affect >10% of the adult population in total. The aim of this review is to describe the physiologic role of thyroid hormones on cardiovascular system, to present cardiovascular manifestations in patients with thyroid disorders, emphasizing in molecular mechanisms and biochemical pathways, and to summarize current knowledge of treatment options.

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Background: Therapeutic options for hospitalized patients with severe coronavirus disease 2019 (sCOVID-19) are limited. Preliminary data have shown promising results with baricitinib, but real-life experience is lacking. We assessed the safety and effectiveness of add-on baricitinib to standard-of-care (SOC) including dexamethasone in hospitalized patients with sCOVID-19.

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: The effects of gender differences on cardiac parameters have been well-established. In this study, we aimed to evaluate the possible associations of plasma levels of different sex hormones with premature atrial or ventricular contractions in premenopausal women. : We conducted a prospective study which included women in late reproductive age who presented with palpitations during an eight-month period.

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We aimed to determine whether Alemtuzumab-induced immune reconstitution affects immunoglobulin and complement levels in the serum of Relapsing-Remitting Multiple Sclerosis (RRMS) patients. IgG4-levels were increased 24-months after treatment initiation compared to baseline levels in twenty-nine patients. Alemtuzumab-treated patients with the highest IgG4-levels were more prone to thyroid-related autoimmune manifestations and specific autoimmune adverse events such as Crohn's disease, Graves' disease, and hemolytic anemia.

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Article Synopsis
  • - The summary discusses two cases of medullary thyroid carcinoma (MTC) with atypical metastatic locations, emphasizing the unpredictable progression of the disease and the potential for metastases to develop years after the initial diagnosis.
  • - In one case, a patient developed breast metastasis 23 years post-diagnosis and achieved long-term stabilization with vandetanib treatment, while the second case involved pancreatic metastasis followed by a painful mandible mass, leading to disease progression despite therapy.
  • - The learning points highlight the necessity for rapid identification of unexpected MTC metastases, the importance of thorough investigation in cases with low calcitonin levels, and the potential effectiveness of tyrosine kinase inhibitors for treating unusual metastases related to M
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Endocrine system plays a vital role in controlling human homeostasis. Understanding the possible effects of COVID-19 on endocrine glands is crucial to prevent and manage endocrine disorders before and during hospitalization in COVID-19-infected patients as well as to follow them up properly upon recovery. Many endocrine glands such as pancreas, hypothalamus and pituitary, thyroid, adrenal glands, testes, and ovaries have been found to express angiotensin-converting enzyme 2 receptors, the main binding site of the virus.

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Aims: SARS-CoV-2 infection may lead to endothelial and vascular dysfunction. We investigated alterations of arterial stiffness, endothelial coronary and myocardial function markers 4 months after COVID-19 infection.

Methods And Results: In a case-control prospective study, we included 70 patients 4 months after COVID-19 infection, 70 age- and sex-matched untreated hypertensive patients (positive control) and 70 healthy individuals.

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Context: Association of central diabetes insipidus (CDI) and pituitary stalk thickening (PST) may have several etiologies (including malignancies) and differential diagnosis remains often difficult.

Objective: The purpose of this study was to identify which clinical, biochemical or radiological features could help clinicians to make an etiological diagnosis, especially distinguishing neoplastic from non-neoplastic pituitary stalk lesions.

Designs And Methods: We retrospectively analyzed clinical, biochemical, radiological and histological data of 38 adult patients diagnosed with CDI and PST of proven etiology.

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