Publications by authors named "Panayiotis Ziakas"

: The Mediterranean diet has been widely suggested to exert significant beneficial effects on endothelial oxidative status and cardiometabolic health. Greek Orthodox monasteries, due to their specific nutritional and sartorial habits, comprise a population thatstrictly adheres to nutritional patterns with restricted eating and a plant-based subset of the Mediterranean diet, often accompanied by profound hypovitaminosis D. Time-restricted eating (TRE) is also adopted bya large part of the general lay Greek population for health-promoting reasons, without restrictions on animal product consumption, as imposed by Orthodox religious fasting.

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Google Trends provides spatiotemporal data for user-specific terms scaled from less than 1 (lowest relative popularity) to 100 (highest relative popularity) as a proxy for the public interest. Here we use US state-level data for COVID-19 to examine popularity trends during the pandemic evolution. We used "coronavirus" and "covid" search terms and set the period up from January 1st, 2020, to November 12, 2022.

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Fluvoxamine, a selective serotonin reuptake inhibitor with anti-inflammatory properties, has gained attention as a repurposed drug to treat COVID-19. We aimed to explore the potential benefit of fluvoxamine on outpatients with early SARS-CoV-2 infection. We performed a retrospective study of fluvoxamine adult outpatients with symptomatic COVID-19 disease of early onset (<5 days), in the context of an infectious diseases private practice, between September-December 2021, in Greece.

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Article Synopsis
  • The study investigates how web search trends for Covid-19 in six Western nations correlate with pandemic waves, mortality, and new cases.
  • The research utilizes Google Trends and "Our World in Data" to analyze search popularity and Covid-19 statistics over time, focusing on specific search terms like "coronavirus" and "covid."
  • Findings reveal a strong agreement in Covid-19 search interest patterns across countries, peaking in March 2020 and showing similar declining trends, with a high concordance score of 0.88, indicating a significant alignment in public interest and epidemic severity.
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Article Synopsis
  • Staphylococcus aureus bacteremia leads to high mortality rates and healthcare costs, with infectious disease consultations potentially lowering these outcomes.
  • A decision-analytic model assessed the cost-effectiveness of consultations compared to no consultations among hospitalized adults with positive blood cultures.
  • The analysis found that while the consultation strategy had slightly lower survival rates and costs, it was still deemed more cost-effective, highlighting the value of infectious disease expertise in managing this condition.
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Background: Mortality is a critical measure of disease impact. The European Union (EU) countries share the same regulatory framework but different implementation policies.

Methods: We extracted cumulative COVID-19 mortality data across the EU countries.

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Background: Methicillin-sensitive (MSSA) bacteremia is associated with significant morbidity, mortality, and hospitalization costs. Cefazolin and antistaphylococcal penicillins (ASPs), such as nafcillin, are the preferred treatments for MSSA bacteremia. The aim of this study was to compare the cost-effectiveness of each approach.

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Article Synopsis
  • Nosocomial infections pose serious public health risks and can have severe consequences for patients.
  • Economic analysis can help healthcare organizations make informed decisions about resource allocation for preventing these infections, though it's a relatively new approach in this field.
  • The article also highlights current challenges in managing antimicrobial use, which is crucial for controlling these infections.
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Background: There is increasing demand for post-acute care services, which is amplified by the COVID-19 pandemic.

Aims: We studied the pattern of spatial association between post-acute care services and acute care facilities and evaluated how geographic variability could influence their use.

Methods: We compiled data on CMS-certified acute care and critical access hospitals and post-acute health care services (nursing homes, home health care services, inpatient rehabilitation facilities, long-term care hospitals, and hospice facilities).

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Purpose: Drug cost is a significant factor in the ever-increasing expenditures for cancer health care.

Methods: We used Medicare Part D administrative data to explore prescribing patterns and attributed drug costs of oncologists from 2013 to 2017. We highlighted regional variation in spending and potential associations.

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Purpose: Febrile neutropenia has a significant clinical and economic impact on cancer patients. This study evaluates the cost-effectiveness of different current empiric antibiotic treatments.

Methods: A decision analytic model was constructed to compare the use of cefepime, meropenem, imipenem/cilastatin, and piperacillin/tazobactam for treatment of high-risk patients.

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We aimed to study the changing popularity of oral anticoagulants and the potential association between media coverage and real-world utilization practice, using time series analysis.In this STROBE-compliant study, we used Google Trends data to study public interest for direct oral anticoagulants (DOACs) (dabigatran, rivaroxaban, apixaban, and edoxaban) and warfarin in the United States (10-year coverage, beginning July 1st, 2008 ending June 30th, 2018). We validated our findings on a sample of 50 consecutive datasets (accumulated between July 6th, 2018 and October 19th, 2018), using the same search criteria.

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Background: The use of corticosteroids as adjunct treatment for community-acquired pneumonia (CAP) is associated with potential clinical benefits. The aim of this study was to evaluate the cost-effectiveness of this approach.

Methods: We constructed a decision-analytic model comparing the use of corticosteroids + antibiotics with that of placebo + antibiotics for the treatment of CAP.

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Background: Antimicrobial lock solutions are a low-cost strategy that can reduce the incidence of central line-associated bloodstream infection (CLABSI). The aim of this study was to evaluate the cost-effectiveness of antimicrobial locks for the prevention of CLABSI.

Methods: We constructed a decision-analytic model comparing antimicrobial lock solutions to heparin locks for the prevention of CLABSI in 3 settings: hemodialysis, cancer treatment, and home parenteral nutrition.

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Introduction: Direct oral anticoagulants (DOAC) have gained an increased share over warfarin for prevention and treatment of thromboembolic disease. We studied DOAC adoption across providers and medical specialties.

Methods: Retrospective, cross-sectional analysis of Medicare Part D public use files (PUF), 2013 to 2015.

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Bloodstream infections are associated with considerable morbidity and health care costs. Molecular rapid diagnostic tests (mRDTs) are a promising complement to conventional laboratory methods for the diagnosis of bloodstream infections and may reduce the time to effective therapy among patients with bloodstream infections. The concurrent implementation of antimicrobial stewardship programs (ASPs) may reinforce these benefits.

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Sjögren's syndrome (SS) patients manifest high cell-free DNA (cf-DNA) levels in serum, associated with impaired DNaseI activity. Undegraded DNA may accumulate in tissues and act as an inflammasome-activating signal. Herein, we investigated the occurrence of aberrant DNA build-up in various biologic compartments of SS patients and its correlation with the activity of NLRP3 and AIM2 inflammasomes.

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Purpose: Local thermal ablation may extend the scope of palliative therapy in patients with colorectal liver metastasis. We performed a retrospective, case-controlled study to compare patients with colorectal liver metastases that were treated with percutaneous radiofrequency (RF) or microwave (MW) thermal ablation, against the control group of chemotherapy alone.

Methods: We described baseline demographics, ablation sessions, procedure duration and related complications.

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Purpose: Low-affinity variants FcγRIIIa-V158F and FcγRIIa- H131R may alter response to rituximab-based chemotherapy in diffuse large B-cell lymphoma (DLBCL) but available clinical evidence is inconclusive. Our purpose was to explore their association in terms of treatment response.

Methods: We performed a meta-analysis of published literature to associate these variants with complete remission after upfront immunochemotherapy in DLBCL, and summarized the genetic risk using the model-free approach of generalized odds ratio (OR).

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The elderly population is particularly vulnerable to Clostridium difficile infection (CDI), but the epidemiology of CDI in long-term care facilities (LTCFs) is unknown.We performed a retrospective cohort study and used US 2011 LTCF resident data from the Minimum Data Set 3.0 linked to Medicare claims.

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Article Synopsis
  • Clinical guidelines are important for everyday medical practice, but many do not include cost analyses, with 57% lacking any cost justification.
  • On average, only 6% of available cost analyses are incorporated into guidelines, with some specialties like cardiology and infectious diseases performing better than others such as hematology/oncology and urology.
  • Cost analyses that are included are more likely to adhere to guidelines for reporting and to establish links between cost reductions and healthcare outcomes, suggesting room for improvement in integrating cost-effectiveness into practice.
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Three common polymorphic variants, namely Factor V Leiden (FVL), Prothrombin G20210A (PT G20210A) and Methylenetetrahydrofolate Reductase (MTHFR) C677T are candidate genes for venous thromboembolism (VTE) in pregnancy. We performed a literature review and meta-analysis of pertinent genetic association studies (GAS) in pregnancy, to quantify the genetic risk of VTE in pregnancy. We used the model-free approach of generalized odds ratio (ORG) to estimate gene-to-disease association and explored the mode of inheritance using the degree of dominance h index.

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Hepatocellular cancer ranks fifth among cancers and is related to chronic viral hepatitis, alcohol abuse, steatohepatitis and liver autoimmunity. Surgical resection and orthotopic liver transplantation have curative potential, but fewer than 20% of patients are suitable candidates. Interventional treatments are offered to the vast majority of patients.

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