Publications by authors named "Tryfon Stavros"

Background: Clinical trials and real-world experience have provided evidence for the clinical benefits of mepolizumab, an anti-IL-5 biologic, in severe asthma. However, limited data exist regarding the impact of mepolizumab on airway remodeling.

Objective: We sought to investigate the effect of mepolizumab on airway structural remodeling in patients treated for severe asthma in routine clinical care.

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Sickle cell disease is the most common genetic hemoglobinopathy worldwide, characterized by a single-nucleotide mutation that predisposes to hemoglobin polymerization and erythrocyte sickling in hypoxic states. This report describes a 62-year-old male obese patient with a history of sickle cell disease, who presented with worsening nocturnal pain crises without any apparent triggering factor. A thorough evaluation at the outpatient department revealed obstructive sleep apnea.

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This meta-analysis compares the efficacy and safety of inhaled systemic corticosteroids for COPD exacerbations.Following a pre-registered protocol, we appraised eligible randomised controlled trials (RCTs) according to Cochrane methodology, performed random-effects meta-analyses for all outcomes prioritised in the European Respiratory Society COPD core outcome set and rated the certainty of evidence as per Grading of Recommendations Assessment, Development and Evaluation methodology.We included 20 RCTs totalling 2140 participants with moderate or severe exacerbations.

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Background: Smoking poses the most common risk factor for chronic obstructive pulmonary disease (COPD) and aggravates disease progression. Tobacco dependence inhibits smoking cessation and may affect smoking patterns that increase tobacco exposure and predispose to lung function decline.

Aims And Objectives: We aimed to assess tobacco dependence in current smokers with and without COPD and evaluate its role in disease development.

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Despite advances, few therapeutics have shown efficacy in severe coronavirus disease 2019 (COVID-19). In a different context, virus-specific T cells have proven safe and effective. We conducted a randomized (2:1), open-label, phase 1/2 trial to evaluate the safety and efficacy of off-the-shelf, partially human leukocyte antigen (HLA)-matched, convalescent donor-derived severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific T cells (CoV-2-STs) in combination with standard of care (SoC) in patients with severe COVID-19 compared to SoC during Delta variant predominance.

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Background: Some patients with severe asthma do not achieve sufficient symptom control despite guideline-based treatment, and therefore receive oral (OCS) and systemic corticosteroids (SCS) on regular basis. The side effects of corticosteroid use negatively impact patients' health-related quality of life (HRQoL) and increase the disease burden. Biologics have shown promise in asthma therapy; however, identifying patients who might benefit from biologic therapy is complex due to the heterogeneous pathophysiology of the disease.

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This meta-analysis explored the safety and effectiveness of mucolytics as an add-on treatment for chronic obstructive pulmonary disease (COPD) exacerbations. Based on a pre-registered protocol and following Cochrane methods, we systematically searched for relevant randomised or quasi-randomised controlled trials (RCTs). We used the Risk of Bias v2 tool for appraising the studies and performed random-effect meta-analyses when appropriate.

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Article Synopsis
  • COPD is a prevalent respiratory disease that can be effectively managed and prevented through early interventions and newer treatment strategies.
  • The Hellenic Thoracic Society's Working Group compiled updated information on COPD management, including prevalence data, diagnostic approaches, and disease severity classification.
  • A comprehensive treatment strategy for COPD includes not just medication, but also pulmonary rehabilitation, physical activity, patient education, and self-assessment to enhance patients' quality of life and minimize exacerbations.
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Background And Objective: There remains a paucity of large databases for patients with idiopathic pulmonary fibrosis (IPF) and lung cancer. We aimed to create a European registry.

Methods: This was a multicentre, retrospective study across seven European countries between 1 January 2010 and 18 May 2021.

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Article Synopsis
  • Lane-Hamilton Syndrome (LHS) is a serious medical condition that has a 14% mortality rate due to associated Idiopathic Pulmonary Hemosiderosis (IPH), and there is currently a lack of published research which leads to delayed diagnoses.
  • A study reviewed 80 LHS cases from 1971 to 2020, analyzing clinical presentations and outcomes in both children and adults, highlighting common symptoms like hemoptysis, dyspnea, and anemia.
  • Diagnosis often involves multiple methods, with treatments including prednisone and gluten-free diet (GFD), while some cases may require urgent interventions like intubation; understanding LHS better could improve diagnostic accuracy and patient outcomes.*
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Article Synopsis
  • The study aimed to observe the risks of COVID-19 in patients with severe asthma who are treated with biologics during the pandemic.
  • Data was collected from 591 severe asthmatics across Greece, revealing that only 4.4% tested positive for SARS-CoV-2, with a small number requiring hospitalization.
  • Findings suggest that severe asthma patients on biologics do not have a higher risk of COVID-19 infection or adverse outcomes compared to the general population.
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We present a case of a 65-year-old male with a difficulty to diagnose mesothelioma. To be specific, three attempts were made to diagnose the disease, and only with a large sample performed with robot-assisted surgery, our pathologists were able to identify the malignancy. The novelty for our case is mostly based on the timeline of the diagnosis along with the tissue samples where we present the course of the transformation from benign to malignancy.

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Article Synopsis
  • * For mild asthma, new recommendations suggest using inhaled corticosteroids combined with fast-acting bronchodilators on an as-needed basis, leading to improved control and fewer flare-ups according to various studies.
  • * In severe asthma, there’s a strong push to limit the use of oral corticosteroids (OCS) and instead use biologic treatments for certain patients, aiming to reduce or stop OCS, which should mainly be a temporary solution for flare-ups rather than a long-term strategy.
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Drug-induced lupus erythematosus (DILE) accounts for 10-15% of systemic lupus erythematosus (SLE) cases, with more than 100 pharmaceutical agents implicated in its development. Depending on the offending drug, clinical and serological manifestations present great variability and, thus, DILE may be overlooked in clinical practice. Valproic acid (VPA) - induced lupus erythematosus has not been analytically reported in the literature, rendering the recognition of such cases even more difficult.

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Background: Although asthmatics may present reduced exercise capacity, data on their cardiovascular responses during exercise testing have been scarcely investigated. The aim of this pilot case-control study is to test: a) whether double product (DP), an index of cardiovascular reserve, differs among patients with severe and mild-moderate asthma, and b) whether DP is associated with asthma control level, physical activity (PA) and exercise capacity, in asthmatics population.

Materials And Methods: A group of patients with severe asthma (group S) and a matched group of patients with mild-moderate asthma (group M) was studied.

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Endoscopic techniques have been upgraded in the recent 10 years. We can use the radial endobronchial ultrasound to reach distal nodules in the periphery of the lungs, but also we can use it in order to make biopsies in lesions without endobronchial findings. We included in our study 248 patients with pulmonary nodules up to 4 cm.

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Background: Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory lung disease characterized by airflow limitation that is not completely reversible. The fixed-dose combination of salmeterol and fluticasone propionate (SFC) has been approved as a treatment for COPD patients with a history of recurrent exacerbations and significant symptoms despite regular bronchodilator therapy. In the present study, we evaluated the change in FEV, mMRC dyspnea score and satisfaction in COPD patients with at least one comorbidity versus those without comorbidities treated with a fixed-dose SFC via the Elpenhaler device for 12 months.

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Bronchogenic cysts are rare congenital anomalies that they are usually diagnosed prenatally during the routine second trimester scan. We present such a rare case of bronchogenic cyst in a fetus. Our initial scan demonstrated a big cystic mass, which enlarged progressively causing shifting of the mediastinum and compression of the fetal heart.

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A report a case of a 63 year old male diagnosed with lung cancer adenocarcinoma. The patient had a right paratracheal mass diagnosed with EBUS-TBNA 22G. The patient had surgery, however 7 days after the billau catheter was removed pneumothorax was diagnosed which did not resolved.

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Endobronchial ultrasound (EBUS) is a very useful tool for the diagnosis of lymphadenopathy of the mediastinum. Nowadays, EBUS can substitute video-assisted thoracic surgery when a 19G needle is used. Several studies have provided data for efficient diagnosis not only for lung cancer, but for also sarcoidosis, tuberculosis and lymphoma.

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Article Synopsis
  • Valproic acid is often used to treat seizure disorders and manic episodes but has been linked to valproate-induced pleural effusion, a condition with an unclear mechanism.
  • The study aimed to analyze cases of pleural effusion related to valproate use, categorizing them by clinical features and types of immune response.
  • The majority of identified cases (60.7%) involved exudative eosinophilic pleural effusion, indicating a possible hypersensitivity reaction or inflammation caused by the medication.
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Introduction: Drug-induced diffuse alveolar hemorrhage (DAH) has been associated with the administration of various medications, among which levonorgestrel (LN) has not been reported until now.

Case Presentation: This case study describes a 42-year-old woman who presented with hemoptysis, hypoxemia, and radiological depiction of ground glass opacities, 3 days after she had received emergency contraceptive medication containing levonorgestrel. Emergent bronchoscopy was performed, and BAL was diagnostic of diffuse alveolar hemorrhage (DAH).

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A fifty year old male was diagnosed with bronchial HPV. He was treated with local interventional treatment argon plasma coagulation and subcutaneous injections bevacizumab. Spraying of the regions followed with a specially designed catheter with interferon-α (2b).

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Bronchogenic cysts are rare congenital malformations which derive from primitive ventral foregut. They are usually observed in intrathoracically. A fifty year old male was admitted for the investigation of a three month chest pain.

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