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Article ; Online: Association between ventilatory ratio and mortality persists in patients with ARDS requiring prolonged mechanical ventilation.

Papoutsi, Eleni / Giannakoulis, Vassilis G / Routsi, Christina / Kotanidou, Anastasia / Siempos, Ilias I

2023 Volume 49, Issue 7, Page(s) 876–877

MeSH term(s)	Humans ; Respiration, Artificial ; Intensive Care Units ; Hospital Mortality ; Respiratory Distress Syndrome/therapy
Language	English
Publishing date	2023-05-31
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-023-07107-7
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Zs.A 1089: Show issues

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Article ; Online: Postoperative acute respiratory distress syndrome in randomized controlled trials.

Giannakoulis, Vassilis G / Papoutsi, Eleni / Kaldis, Vassileios / Tsirogianni, Athanasia / Kotanidou, Anastasia / Siempos, Ilias I

Surgery

2023 Volume 174, Issue 4, Page(s) 1050–1055

Abstract: Background: Acute respiratory distress syndrome is a potentially fatal postoperative complication. We aimed to estimate temporal trends of the representation of patients with postoperative acute respiratory distress syndrome in clinical trials, ... ...

Abstract	Background: Acute respiratory distress syndrome is a potentially fatal postoperative complication. We aimed to estimate temporal trends of the representation of patients with postoperative acute respiratory distress syndrome in clinical trials, determine their distinct clinical features, and identify predictors of mortality. Methods: This is a secondary analysis of 7 randomized controlled clinical trials conducted by the Acute Respiratory Distress Syndrome Network and the Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury. Patients with acute respiratory distress syndrome were classified into a postoperative acute respiratory distress syndrome group (ie, patients who had undergone elective surgery in the immediate period before trial enrollment) and a non-postoperative acute respiratory distress syndrome group. Results: Out of 5,316 patients with acute respiratory distress syndrome, 256 (4.8%) had postoperative acute respiratory distress syndrome. Representation of postoperative acute respiratory distress syndrome in trials gradually declined from 2000 to 2011, but it remained stable afterward at 2.7%. Postoperative acute respiratory distress syndrome was associated with lower 90-day mortality (24.6% vs 30.9%, P = .032) than non-postoperative acute respiratory distress syndrome, even after adjusting for age, acute respiratory distress syndrome severity, usage of vasopressors at baseline, and the study publication year (hazard ratio 0.63, 95% confidence interval 0.49-0.82). Age (odds ratio 1.07, 95% confidence interval 1.04-1.09), immunosuppression (odds ratio 4.12, 95% confidence interval 1.43-11.86), and positive fluid balance (odds ratio 1.09, 95% confidence interval 1.04-1.14) were associated with 90-day mortality among patients with postoperative acute respiratory distress syndrome. Conclusion: Representation of postoperative acute respiratory distress syndrome in trials of the Acute Respiratory Distress Syndrome Network and the Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury gradually declined from 2000 to 2011 but remained stable afterward. Postoperative acute respiratory distress syndrome was associated with lower mortality than non-postoperative acute respiratory distress syndrome. These findings may put both temporal trends and the prognosis of postoperative acute respiratory distress syndrome in perspective. Also, positive fluid balance was associated with the mortality of patients with postoperative acute respiratory distress syndrome.
MeSH term(s)	Humans ; Randomized Controlled Trials as Topic ; Acute Lung Injury/diagnosis ; Acute Lung Injury/etiology ; Elective Surgical Procedures/adverse effects ; Immunosuppression Therapy ; Respiratory Distress Syndrome/etiology
Language	English
Publishing date	2023-06-29
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2023.06.019
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Article ; Online: Effect of Cancer on Clinical Outcomes of Patients With COVID-19: A Meta-Analysis of Patient Data.

Giannakoulis, Vassilis G / Papoutsi, Eleni / Siempos, Ilias I

JCO global oncology

2020 Volume 6, Page(s) 799–808

Abstract: Purpose: Whether cancer is associated with worse prognosis among patients with COVID-19 is unknown. We aimed to quantify the effect (if any) of the presence as opposed to absence of cancer on important clinical outcomes of patients with COVID-19 by ... ...

Abstract	Purpose: Whether cancer is associated with worse prognosis among patients with COVID-19 is unknown. We aimed to quantify the effect (if any) of the presence as opposed to absence of cancer on important clinical outcomes of patients with COVID-19 by carrying out a systematic review and meta-analysis. Methods: We systematically searched PubMed, medRxiv, COVID-19 Open Research Dataset (CORD-19), and references of relevant articles up to April 27, 2020, to identify observational studies comparing patients with versus without cancer infected with COVID-19 and to report on mortality and/or need for admission to the intensive care unit (ICU). We calculated pooled risk ratios (RR) and 95% CIs with a random-effects model. The meta-analysis was registered with PROSPERO (CRD42020181531). Results: A total of 32 studies involving 46,499 patients (1,776 patients with cancer) with COVID-19 from Asia, Europe, and the United States were included. All-cause mortality was higher in patients with versus those without cancer (2,034 deaths; RR, 1.66; 95% CI, 1.33 to 2.07; Conclusion: The synthesized evidence suggests that cancer is associated with worse clinical outcomes among patients with COVID-19. However, elderly patients with cancer may not be at increased risk of death when infected with COVID-19. These findings may inform discussions of clinicians with patients about prognosis and may guide health policies.
MeSH term(s)	Aged ; Betacoronavirus/pathogenicity ; COVID-19 ; Cause of Death ; Coronavirus Infections/diagnosis ; Coronavirus Infections/mortality ; Coronavirus Infections/therapy ; Coronavirus Infections/virology ; Critical Care ; Female ; Hospital Mortality ; Host-Pathogen Interactions ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Neoplasms/diagnosis ; Neoplasms/mortality ; Neoplasms/therapy ; Observational Studies as Topic ; Pandemics ; Patient Admission ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; Risk Assessment ; Risk Factors ; SARS-CoV-2 ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2020-06-08
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ISSN	2687-8941
ISSN (online)	2687-8941
DOI	10.1200/GO.20.00225
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Article ; Online: Author reply - Letter to the editor "The challenges of quantifying the psychological burden of COVID-19 on heathcare workers".

Pappa, Sofia / Giannakoulis, Vassilis G / Papoutsi, Eleni / Katsaounou, Paraskevi

Brain, behavior, and immunity

2020 Volume 92, Page(s) 209–210

MeSH term(s)	Anxiety ; Benchmarking ; COVID-19 ; Health Personnel ; Humans ; SARS-CoV-2
Language	English
Publishing date	2020-11-23
Publishing country	Netherlands
Document type	Letter ; Comment
ZDB-ID	639219-2
ISSN	1090-2139 ; 0889-1591
ISSN (online)	1090-2139
ISSN	0889-1591
DOI	10.1016/j.bbi.2020.11.025
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Zs.A 2276: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 327: Show issues

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Article ; Online: PROLONGED MECHANICAL VENTILATION IN ACUTE RESPIRATORY DISTRESS SYNDROME.

Andrianopoulos, Ioannis / Giannakoulis, Vassilis G / Papoutsi, Eleni / Papathanakos, Georgios / Koulouras, Vasilios / Thompson, B Taylor / Siempos, Ilias I

Shock (Augusta, Ga.)

2023 Volume 61, Issue 2, Page(s) 240–245

Abstract: Abstract: Purpose: Trajectory of acute respiratory distress syndrome (ARDS) spans from rapidly improving cases to cases receiving prolonged mechanical ventilation (PMV). We attempted to estimate temporal trends of prevalence and mortality of PMV and to ... ...

Abstract	Abstract: Purpose: Trajectory of acute respiratory distress syndrome (ARDS) spans from rapidly improving cases to cases receiving prolonged mechanical ventilation (PMV). We attempted to estimate temporal trends of prevalence and mortality of PMV and to identify risk factors associated with mortality of patients with ARDS receiving PMV. Methods: We performed a secondary analysis of individual patient data from six randomized controlled clinical trials conducted by the ARDS Network. Prolonged mechanical ventilation was defined as the need for mechanical ventilation for >21 consecutive days. Results: Of 4,216 patients with ARDS, 646 (15.3%) received PMV. Prevalence of PMV gradually declined from 18.4% in the ARDS Network: Low-Tidal-Volume Trial (published in 2000) trial to 10.9% in the SAILS (2014) trial ( R2 = 0.728, P = 0.031). Ninety-day mortality of patients receiving PMV did not change over time ( R2 = 0.271, P = 0.290) and remained as high as 36.8%. Ιn the three most recent trials, risk factors associated with mortality among the 250 patients with ARDS receiving PMV included age, malignancy, pneumonia as the cause of ARDS, coagulation dysfunction, and hepatic dysfunction during the first 21 days after trial enrollment. Conclusion: Although prevalence of PMV among patients enrolled in ARDS Network trials gradually declined, mortality did not change. Risk factors associated with mortality were mostly nonmodifiable.
MeSH term(s)	Humans ; Infant, Newborn ; Respiration, Artificial/adverse effects ; Respiratory Distress Syndrome/drug therapy
Language	English
Publishing date	2023-11-15
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1185432-7
ISSN	1540-0514 ; 1073-2322
ISSN (online)	1540-0514
ISSN	1073-2322
DOI	10.1097/SHK.0000000000002248
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Zs.A 3985: Show issues

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Article ; Online: Effect of Different Early Oxygenation Levels on Clinical Outcomes of Patients Presenting in the Emergency Department With Severe Traumatic Brain Injury.

Vrettou, Charikleia S / Giannakoulis, Vassilis G / Gallos, Parisis / Kotanidou, Anastasia / Siempos, Ilias I

Annals of emergency medicine

2022 Volume 81, Issue 3, Page(s) 273–281

Abstract: Study objective: Despite the almost universal administration of supplemental oxygen in patients presenting in the emergency department (ED) with severe traumatic brain injury, optimal early oxygenation levels are unknown. Therefore, we aimed to examine ... ...

Abstract	Study objective: Despite the almost universal administration of supplemental oxygen in patients presenting in the emergency department (ED) with severe traumatic brain injury, optimal early oxygenation levels are unknown. Therefore, we aimed to examine the effect of different early oxygenation levels on the clinical outcomes of patients presenting in the emergency department with severe traumatic brain injury. Methods: We performed a secondary analysis of the Resuscitation Outcomes Consortium Traumatic Brain Injury Hypertonic Saline randomized controlled trial by including patients with Glasgow Coma Scale ≤8. Early oxygenation levels were assessed by the worst value of arterial partial pressure of oxygen (PaO Results: A total of 910 patients were included. In unadjusted (crude) analysis, a PaO Conclusion: High oxygenation levels as early as the first 4 hours of presentation in the emergency department may not be adversely associated with the long-term neurologic status of patients with severe traumatic brain injury. Therefore, during the early phase of trauma, clinicians may focus on stabilizing patients while giving low priority to the titration of oxygenation levels.
MeSH term(s)	Humans ; Brain Injuries, Traumatic ; Emergency Service, Hospital ; Glasgow Coma Scale ; Patients ; Oxygen
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2022-11-17
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2022.09.026
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Zs.A 1344: Show issues

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Article ; Online: Hybrid pediatric and adolescent gynecology telemedicine consultation in the era of COVID-19: Evaluation and feasibility.

Giannakoulis, Vassilis G / Giannakodimos, Ilias / Kalampalikis, Andreas / Migklis, Kyriaki / Roidi, Stella / Michala, Lina

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2021 Volume 156, Issue 2, Page(s) 370–371

MeSH term(s)	Adolescent ; COVID-19 ; Child ; Feasibility Studies ; Gynecology ; Humans ; Referral and Consultation ; SARS-CoV-2 ; Telemedicine
Language	English
Publishing date	2021-10-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.13995
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Zs.A 355: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Membranous CD44v6 is upregulated as an early event in colorectal cancer: Downregulation is associated with circulating tumor cells and poor prognosis.

Kataki, Agapi / Giannakoulis, Vassilis G / Derventzi, Anastasia / Papiris, Konstantinos / Koniaris, Eythimios / Konstadoulakis, Manousos

Oncology letters

2021 Volume 22, Issue 6, Page(s) 820

Abstract: Previous studies have reported that CD44 variant 6 (CD44v6) and metastasis-associated protein 1 (MTA1) are contributing factors to cancer progression. The present study aimed to evaluate the expression profiles for associations with patients' demographic ...

Abstract	Previous studies have reported that CD44 variant 6 (CD44v6) and metastasis-associated protein 1 (MTA1) are contributing factors to cancer progression. The present study aimed to evaluate the expression profiles for associations with patients' demographic data, clinicopathological characteristics, the presence of partial epithelial-to-mesenchymal transition (pEMT), metastatic potential based on the presence of CK20
Language	English
Publishing date	2021-10-08
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2573196-8
ISSN	1792-1082 ; 1792-1074
ISSN (online)	1792-1082
ISSN	1792-1074
DOI	10.3892/ol.2021.13081
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Article: Senescence in HBV-, HCV- and NAFLD- Mediated Hepatocellular Carcinoma and Senotherapeutics: Current Evidence and Future Perspective.

Giannakoulis, Vassilis G / Dubovan, Peter / Papoutsi, Eleni / Kataki, Agapi / Koskinas, John

Cancers

2021 Volume 13, Issue 18

Abstract: Cell senescence constitutes a physiological process that serves as protection from malignant transformation of cells. However, recent scientific discoveries also identify cell senescence as pivotal in hepatocellular cancer (HCC) biology. The review ... ...

Abstract	Cell senescence constitutes a physiological process that serves as protection from malignant transformation of cells. However, recent scientific discoveries also identify cell senescence as pivotal in hepatocellular cancer (HCC) biology. The review herein aimed to accumulate evidence on senescence as a mediator of HCC occurrence in hepatitis B (HBV), C (HCV) virus infections, and non-alcoholic fatty liver disease (NAFLD). In HBV infection, the carcinogenic HBV X protein frequently mutates during chronic infection, and subsequently exhibits different effects on senescence. In HCV infection, senescent non-functional T-cells do not effectively clear pre-malignant hepatocytes. Furthermore, the HCV Core protein inhibits the occurrence of normal stress-induced hepatocyte senescence, allowing damaged cells to maintain their proliferative potential. In NAFLD-mediated HCC, current data point towards the gut microbiome and hepatic stellate cell senescence. Additionally, senescence contributes in the development of resistance in targeted therapies, such as sorafenib. Finally, the promising role of senotherapeutics in HCC was also explored. Overall, although we may still be at a primitive stage in fully unraveling the role of senescence in cancer, it seems that understanding and harnessing senescence may have the potential to revolutionize the way we treat hepatocellular cancer.
Language	English
Publishing date	2021-09-21
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers13184732
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Article ; Online: Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies.

Papoutsi, Eleni / Giannakoulis, Vassilis G / Xourgia, Eleni / Routsi, Christina / Kotanidou, Anastasia / Siempos, Ilias I

Critical care (London, England)

2021 Volume 25, Issue 1, Page(s) 121

Abstract: Background: Although several international guidelines recommend early over late intubation of patients with severe coronavirus disease 2019 (COVID-19), this issue is still controversial. We aimed to investigate the effect (if any) of timing of ... ...

Abstract	Background: Although several international guidelines recommend early over late intubation of patients with severe coronavirus disease 2019 (COVID-19), this issue is still controversial. We aimed to investigate the effect (if any) of timing of intubation on clinical outcomes of critically ill patients with COVID-19 by carrying out a systematic review and meta-analysis. Methods: PubMed and Scopus were systematically searched, while references and preprint servers were explored, for relevant articles up to December 26, 2020, to identify studies which reported on mortality and/or morbidity of patients with COVID-19 undergoing early versus late intubation. "Early" was defined as intubation within 24 h from intensive care unit (ICU) admission, while "late" as intubation at any time after 24 h of ICU admission. All-cause mortality and duration of mechanical ventilation (MV) were the primary outcomes of the meta-analysis. Pooled risk ratio (RR), pooled mean difference (MD) and 95% confidence intervals (CI) were calculated using a random effects model. The meta-analysis was registered with PROSPERO (CRD42020222147). Results: A total of 12 studies, involving 8944 critically ill patients with COVID-19, were included. There was no statistically detectable difference on all-cause mortality between patients undergoing early versus late intubation (3981 deaths; 45.4% versus 39.1%; RR 1.07, 95% CI 0.99-1.15, p = 0.08). This was also the case for duration of MV (1892 patients; MD - 0.58 days, 95% CI - 3.06 to 1.89 days, p = 0.65). In a sensitivity analysis using an alternate definition of early/late intubation, intubation without versus with a prior trial of high-flow nasal cannula or noninvasive mechanical ventilation was still not associated with a statistically detectable difference on all-cause mortality (1128 deaths; 48.9% versus 42.5%; RR 1.11, 95% CI 0.99-1.25, p = 0.08). Conclusions: The synthesized evidence suggests that timing of intubation may have no effect on mortality and morbidity of critically ill patients with COVID-19. These results might justify a wait-and-see approach, which may lead to fewer intubations. Relevant guidelines may therefore need to be updated.
MeSH term(s)	COVID-19/mortality ; COVID-19/therapy ; Cohort Studies ; Critical Illness ; Humans ; Intubation, Intratracheal/statistics & numerical data ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2021-03-25
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-021-03540-6
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