Publications by authors named "Livadas Sarantis"

Purpose Of Review: Atherosclerotic cardiovascular disease (ASCVD) is one of the most common causes of death globally and the leading one in the US. Elevated low-density lipoprotein (LDL) cholesterol is one of the main modifiable disease risk factors and statin therapies have been extensively studied in that regard. The present work presents the clinical trials derived evidence supporting the use of statins in primary and secondary cardiovascular disease prevention.

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  • Polycystic Ovarian Syndrome (PCOS) is a widespread endocrine disorder in women of reproductive age, marked by symptoms like excess androgens, irregular ovulation, and cystic ovaries.
  • PCOS not only impacts reproductive health but also poses long-term risks for heart and metabolic issues, leading to conditions like arterial stiffness and potential cardiovascular disease.
  • The review explores the causes of PCOS, its connection to insulin resistance and cardiovascular health, along with diagnostic challenges and treatment options, emphasizing the need for a holistic approach to manage both reproductive and cardiometabolic health.
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  • The study evaluates the effectiveness of EU-TIRADS and ACR-TIRADS in identifying benign vs. malignant thyroid nodules that are 20 mm or larger, as current risk assessments may not be very accurate for TIRADS 3 nodules.
  • A total of 308 nodules from 267 patients were analyzed, revealing 22 cancers and 286 benign cases, with modified TIRADS thresholds showing potential to significantly reduce unnecessary fine needle aspirations (FNAs).
  • While both systems performed similarly when using a 25 mm threshold, increasing the cutoff could lessen unnecessary procedures but poses a risk of missing some malignancies, affecting patient care.
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Resting metabolic rate (RMR) is an important contributor of energy balance and displays a well-documented relationship with sex, age, race and fat-free mass (FFM) in the existing scientific literature. However, the impact of other body composition components such as fat and liver fat on RMR remains unclear. This study aims to investigate the correlation of RMR with body composition parameters in a sample of patients with overweight and obesity.

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  • PCOS is a common hormonal disorder with diagnostic and management complexities, prompting a study on European endocrinologists' understanding of it.
  • An online survey of 505 endocrinologists revealed that 85% use the Rotterdam criteria for diagnosis, with most patient referrals occurring between ages 20 and 40.
  • The findings highlight the importance of metabolic profiling and lifestyle changes in managing PCOS, along with consensus on using treatments like metformin and oral contraceptives.
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Infertility among women, particularly those living with obesity, presents a multifaceted challenge with implications for reproductive health worldwide. Lifestyle interventions, mainly focusing on weight loss, have emerged as promising strategies to improve fertility outcomes in this population. This review aims to explore the effectiveness of various lifestyle interventions, encompassing dietary modifications and exercise regimens, in enhancing fertility outcomes among women with obesity and associated conditions such as polycystic ovary syndrome, congenital adrenal hyperplasia, type 2 diabetes mellitus, premenopause, hypothyroidism and eating disorders.

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(1) Background: After thyroid malignancy is ruled out, treatment options for multinodular goiter patients include surgery, levothyroxine suppressive therapy, and 131-I therapy. Surgery effectively reduces goiter size but carries risks of surgical and anesthetic complications. 131-I therapy is the only nonsurgical alternative, but its effectiveness diminishes with goiter size and depends on iodine sufficiency.

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Background: The first phase of the GAIL study ("Girls treated with an Aromatase Inhibitor and Leuprorelin," ISRCTN11469487) has shown that the combination of anastrozole and leuprorelin for 24 months is safe and effective in improving the predicted adult height (PAH) in girls with early puberty and compromised growth prediction by +1.21 standard deviation score (SDS; +7.51 cm) compared to inhibition of puberty alone, +0.

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Aims: While hormonal assays are commonly used for thyroid function assessment, Doppler sonography provides valuable information on vascularization and blood flow. This study aimed to examine the potential associations between Doppler parameters and clinical characteristics of hypothyroid patients, such as the autoimmune nature of the disease and adequacy of LT4 replacement.

Methods: A total of 338 patients with hypothyroidism, primarily caused by autoimmune thyroiditis (AT), were enrolled in this study.

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Background: Parathyroid adenoma is the most common cause of hypercalcemia and rarely leads to a hypercalcemic crisis, which is an unusual endocrine emergency that requires timely surgical excision.

Case Presentation: A 67-year-old male was admitted to the ER of the Euroclinic Hospital, Athens, Greece, because of elevated calcium levels and a palpable right-sided neck mass, which were accompanied by symptoms of nausea, drowsiness, and weakness for six months that increased prior to our evaluation. A gradual creatinine elevation and decreasing mental state were observed as well.

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  • Vitamin D testing and supplement usage have increased significantly, yet many patients still remain deficient in vitamin D (less than 30 ng/mL).
  • A study analyzed data from 6,912 patients between 2014 and 2022, finding that while testing rates rose from 42.1% to 92.7%, only 25.5% achieved adequate vitamin D levels by 2022.
  • Current users of high-dose supplements for over 12 months showed the best results, but overall, only a minority of patients reached sufficient vitamin D levels despite increased testing and usage.
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Achieving optimal glucose control in individuals with type 1 diabetes (T1DM) continues to pose a significant challenge. While continuous insulin infusion systems have shown promise as an alternative to conventional insulin therapy, there remains a crucial need for greater awareness regarding the necessary adaptations for various special circumstances. Nutritional choices play an essential role in the efficacy of diabetes management and overall health status for patients with T1DM.

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Purpose: This study aimed to evaluate various therapeutic approaches, identify potential predictive factors for the recurrence and development of hypothyroidism, and examine specific clinical and laboratory characteristics of patients with subacute thyroiditis (SAT) due to SARS-CoV-2 infection.

Methods: We retrospectively analyzed the medical records of 226 patients with confirmed SAT diagnosed from January 2020 to November 2022.

Results: The mean age was 48.

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Purpose: Polycystic ovary syndrome (PCOS) is an endocrine, metabolic, and reproductive disorder which, according to the Rotterdam criteria, affects up to 24% of women of childbearing age. Although the prevalence of infertility in this subpopulation of women is high, the optimal treatment has not been fully established yet. Insulin resistance is considered to be an important mechanism involved in the development of PCOS; hence, the aim of this narrative review is to present an overview of the current pharmacological insulin-sensitizing treatment modalities for infertile women with PCOS.

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Background: In the last decade, the combination of the widespread use of streptavidin-biotin technology and biotin-containing supplements (BCS) in the daily clinical practice, have led to numerous reports of erroneous hormone immunoassay results. However, there are no studies assessing the clinical and biochemical significance of that phenomenon, when treating patients with hypothyroidism. Therefore, a prospective study was designed to investigate the potential alterations in the measurement of thyroid hormone concentrations and clinical consequences in patients with hypothyroidism using low -dose BCS containing less than 300 μg/day.

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  • Chronic lymphocytic thyroiditis (Hashimoto thyroiditis) has been thought to increase the risk of differentiated thyroid cancer (DTC), but this study aims to challenge that idea by examining the relationship between thyroid peroxidase antibodies (TPO-Abs) and DTC.
  • The research involved collecting data from 8,461 thyroid surgeries over several years at different clinical sites in the USA and Greece, analyzing TPO-Abs levels in 1,635 patients, with a focus on those with DTC and benign cases.
  • Results showed that higher TPO-Ab levels were associated with a lower incidence of DTC, indicating a protective effect, as the frequency of DTC decreased as TPO-Ab titers increased in a
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  • * A total of 105 participants were divided into three groups: lifestyle modification alone, lifestyle modification with 3 mg of monacolin K, and lifestyle modification with 10 mg of monacolin K, over an 8-week period.
  • * The results showed a significant reduction in LDL cholesterol levels, with an average decrease of 26.46% for the high-dose group and 16.77% for the low-dose group, while no serious side effects were reported.
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Women with polycystic ovary syndrome (PCOS) are at increased risk for dysglycemia and type 2 diabetes compared to healthy BMI-matched women of reproductive age: robust evidence exists supporting this notion. The presence of altered glycemic status in young women with the syndrome presents a distinct challenge for the clinician for several reasons. Firstly, the reported incidence of this disorder varies among the limited available studies.

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Inconsistency exists across studies conducted in postmenopausal women regarding the effect of vitamin D deficiency (VDD) and supplementation on several aspects of menopausal health, such as fractures, vasomotor symptomatology, cardiovascular disease (CVD), cancer and infections, including coronavirus disease 2019 (COVID-19). The aim of this review is to critically summarize the evidence provided by observational studies and randomized controlled trials (RCTs) of vitamin D supplementation in postmenopausal women with VDD. Observational studies have found that VDD is associated with an increased risk of falls and fractures after the menopause.

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Introduction: There is increasing evidence that vitamin D has widespread tissue effects. In addition to osteoporosis, vitamin D deficiency has been associated with cardiovascular disease, diabetes, cancer, infections and neurodegenerative disease. However, the effect of vitamin D supplementation on non-skeletal outcomes requires clarification, especially in postmenopausal women.

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Context: Thyroid nodules' size should not be the sole criterion for thyroidectomy; however, many patients undergo surgery for large or slowly growing nodules.

Objective: We evaluated risk for clinically significant thyroid cancer in patients with large or slowly growing nodules.

Methods: We reviewed data from 2 prospectively collected databases of patients undergoing thyroidectomies in tertiary referral centers in the USA and Greece over 14 consecutive years.

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Background: Polycystic ovary syndrome (PCOS) is considered a risk factor for the development of type 2 diabetes mellitus (T2DM). However, which is the most appropriate way to evaluate dysglycemia in women with PCOS and who are at increased risk are as yet unclear.

Aim Of The Study: To determine the prevalence of T2DM, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) in PCOS women and potential factors to identify those at risk.

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Beyond being aging-related diseases, atherosclerosis and osteoporosis share common pathogenetic pathways implicated in bone and vascular mineralization. However, the contributory role of dyslipidemia in this interplay is less documented. The purpose of this narrative review is to provide epidemiological evidence regarding the prevalence of bone disease (osteoporosis, fracture risk) in patients with dyslipidemias and to discuss potential common pathophysiological mechanisms linking osteoporosis and atherosclerosis.

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Polycystic ovary syndrome (PCOS) often coexists with a wide spectrum of dysglycemic conditions, ranging from impaired glucose tolerance to type 2 diabetes mellitus (T2D), which occur to a greater extent compared to healthy body mass index-matched women. This concurrence of disorders is mainly attributed to common pathogenetic pathways linking the two entities, such as insulin resistance. However, due to methodological flaws in the available studies and the multifaceted nature of the syndrome, there has been substantial controversy as to the exact association between T2D and PCOS which has not yet been elucidated.

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  • Adequate vitamin D levels are crucial for the health of pregnant women and their babies, but many refugees have vitamin D deficiency (VDD).
  • A study in Greece found that VDD was significantly more prevalent among pregnant refugee women (92.2%) compared to local Greek women (67.3%).
  • The high rates of VDD in refugees were linked to poor neonatal health, indicating a need for screening and interventions for pregnant refugees and their newborns in host countries.
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