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Article: Growing challenge of post-liver transplantation non-alcoholic fatty liver disease.

Kalogirou, Maria Styliani / Giouleme, Olga

World journal of transplantation

2022 Volume 12, Issue 9, Page(s) 281–287

Abstract: Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma worldwide, with an estimated prevalence of 25%. Post-liver transplantation (LT) recurrent ... ...

Abstract	Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma worldwide, with an estimated prevalence of 25%. Post-liver transplantation (LT) recurrent or
Language	English
Publishing date	2022-09-19
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2220-3230
ISSN	2220-3230
DOI	10.5500/wjt.v12.i9.281
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Article ; Online: Effectively addressing cardiovascular risk in people with metabolic-dysfunction associated fatty liver disease: not yet ready for prime time!

Koufakis, Theocharis / Popovic, Djordje S / Papadopoulos, Christodoulos / Giouleme, Olga / Doumas, Michael

Expert opinion on pharmacotherapy

2024 Volume 25, Issue 2, Page(s) 123–126

MeSH term(s)	Humans ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/prevention & control ; Risk Factors ; Heart Disease Risk Factors ; Non-alcoholic Fatty Liver Disease/complications
Language	English
Publishing date	2024-01-30
Publishing country	England
Document type	Editorial
ZDB-ID	2001535-5
ISSN	1744-7666 ; 1465-6566
ISSN (online)	1744-7666
ISSN	1465-6566
DOI	10.1080/14656566.2024.2312239
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Zs.A 5130: Show issues

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Article: Barriers to and requirements for a successful transition in inflammatory bowel disease from pediatric to adult care in Greece.

Giouleme, Olga / Koutsoumourakis, Anastasios / Katsoula, Anastasia / Katsaros, Marios / Soufleris, Konstantinos / Vasilaki, Konstantina / Xinias, Ioannis

Annals of gastroenterology

2023 Volume 36, Issue 5, Page(s) 541–548

Abstract: Background: The incidence of pediatric-onset inflammatory bowel disease (IBD) is rising, while the relapsing and often severe nature of IBD, and its impact on emotional and pubertal development and social maturation underline the need for a successful ... ...

Abstract	Background: The incidence of pediatric-onset inflammatory bowel disease (IBD) is rising, while the relapsing and often severe nature of IBD, and its impact on emotional and pubertal development and social maturation underline the need for a successful transition from pediatric to adult care. Methods: A web-based survey was distributed via the Hellenic Group for the Study of IBD, the Hellenic Society of Gastroenterology Department of North Greece, and the Hellenic Society of Pediatric Gastroenterology, Hepatology, and Nutrition. Results: The questionnaire was answered by 98 individuals (78 adult and 20 pediatric gastroenterologists, out of 357 and 30, respectively). The response rate was 25.3%. A higher response rate was found among pediatric (66.6%) vs. adult gastroenterologists 21.8% (P<0.001). Pediatric gastroenterologists believed that the appropriate age for transition was either 16-17 or 17-18 years, whereas 59% of the adult gastroenterologists chose the age group of 16-17 years. Both adult and pediatric gastroenterologists stated that the most significant initiators for a successful transition process were cognitive maturity and patients' ability to manage their disease independently. The lack of communication and collaboration between pediatric and adult gastroenterologists was the main barrier to the transition process, as identified by adult gastroenterologists (27.7%). In contrast, 43.5% of pediatric gastroenterologists suggested that differences in the follow up of patients with IBD between pediatric and adult clinics were the main restrictions. Conclusion: These results highlight the need for a transitional education program for pediatric IBD patients, and the importance of improving collaboration among adult and pediatric gastroenterologists.
Language	English
Publishing date	2023-07-03
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2032850-3
ISSN	1108-7471
ISSN	1108-7471
DOI	10.20524/aog.2023.0817
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Article ; Online: Short

Kasparian, Karampet / Christou, Chrysanthos D / Petidis, Konstantinos / Doumas, Michail / Giouleme, Olga

World journal of gastroenterology

2023 Volume 29, Issue 19, Page(s) 3027–3039

Abstract: Background: Acute cholangitis (AC) constitutes an infection with increased mortality rates in the past. Due to new diagnostic tools and therapeutic methods, the mortality of AC has been significantly reduced nowadays. The initial antibiotic treatment of ...

Abstract	Background: Acute cholangitis (AC) constitutes an infection with increased mortality rates in the past. Due to new diagnostic tools and therapeutic methods, the mortality of AC has been significantly reduced nowadays. The initial antibiotic treatment of AC has been oriented to the most common pathogens connected to this infection. However, the optimal duration of the antibiotic treatment of AC is still debatable. Aim: To investigate if shorter-course antibiotic treatments could be similarly effective to long-course treatments in adults with AC. Methods: This study constitutes a systematic review and meta-analysis of the existing literature concerning the duration of antibiotic therapy of AC and an assessment of the quality of the evidence. The study was conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analyses. Fifteen studies were included in the systematic review, and eight were eligible for meta-analysis. Due to heterogeneous duration cutoffs, three study-analysis groups were formed, with a cutoff of 2-3, 6-7, and 14 d. Results: A total of 2763 patients were included in the systematic review, and 1313 were accounted for the meta-analysis. The mean age was 73.66 ± 14.67 years, and the male and female ratio was 1:08. No significant differences were observed in the mortality rates of antibiotic treatment of 2-3 d, compared to longer treatments (odds ratio = 0.78, 95% confidence interval: 0.23-2.67, Conclusion: Short- and long-course antibiotic treatments may be similarly effective concerning the mortality and recurrence rates of AC. Safe conclusions cannot be extracted concerning the hospitalization duration.
MeSH term(s)	Humans ; Male ; Adult ; Female ; Middle Aged ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Cholangitis/drug therapy ; Hospitalization
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-05-26
Publishing country	United States
Document type	Systematic Review ; Meta-Analysis ; Journal Article
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v29.i19.3027
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Article: Red cell distribution width as a marker of activity in inflammatory bowel disease: a narrative review.

Katsaros, Marios / Paschos, Paschalis / Giouleme, Olga

Annals of gastroenterology

2020 Volume 33, Issue 4, Page(s) 348–354

Abstract: Red blood cell distribution width is a parameter measured automatically in every complete blood count that actually reflects the degree of anisocytosis of the red blood cell population. It is a cost-effective tool used in everyday clinical practice along ...

Abstract	Red blood cell distribution width is a parameter measured automatically in every complete blood count that actually reflects the degree of anisocytosis of the red blood cell population. It is a cost-effective tool used in everyday clinical practice along with other parameters to define and narrow the cause of anemia. In a series of pathologic entities, such as cardiovascular diseases, autoimmune diseases, malignancy, chronic renal diseases and chronic respiratory diseases, where inflammation and oxidative stress comprise the major pathophysiologic insults, red cell distribution width behaves as a significant and competent marker able to predict and assess disease activity and severity. A number of clinical studies based on these observations have aimed to evaluate its potential utility as an index of activity in inflammatory bowel disease. In this narrative review we present data from the international literature regarding its ability to express disease activity and we look into its relation with clinical, laboratory and endoscopic indices used to identify active disease. According to the results of published clinical trials, red cell distribution width is considerably correlated with disease activity and might serve as an index to differentiate Crohn's disease from ulcerative colitis.
Language	English
Publishing date	2020-05-10
Publishing country	Greece
Document type	Journal Article ; Review
ZDB-ID	2032850-3
ISSN	1108-7471
ISSN	1108-7471
DOI	10.20524/aog.2020.0486
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Article ; Online: Non-Celiac Gluten Sensitivity and Irritable Bowel Disease: Looking for the Culprits.

Koumbi, Lemonica / Giouleme, Olga / Vassilopoulou, Emilia

Current developments in nutrition

2020 Volume 4, Issue 12, Page(s) nzaa176

Abstract: During the last 30 y, a gluten-free diet has been classified among the most popular fad diets mainly due to the ambiguous notion that gluten avoidance promotes health. Gluten intolerance has been implicated in non-celiac gluten sensitivity (NCGS) and ... ...

Abstract	During the last 30 y, a gluten-free diet has been classified among the most popular fad diets mainly due to the ambiguous notion that gluten avoidance promotes health. Gluten intolerance has been implicated in non-celiac gluten sensitivity (NCGS) and irritable bowel syndrome (IBS), 2 disorders with overlapping symptoms and increasing trend. Together with gluten, other wheat components; fermentable oligo-, di-, monosaccharide, and polyols (FODMAPs); and amylase trypsin inhibitors (ATIs), are implicated in the pathogenesis of both disorders. Gut microflora alterations in IBS and NCGS have been described, while microbiota manipulations have been shown to be promising in some IBS cases. This literature review summarizes our current knowledge on the impact of wheat ingredients (gluten, FODMAPs, and ATIs) in IBS and NCGS. In both disorders, FODMAPs and ATIs trigger gut dysbiosis, suggesting that gluten may not be the culprit, and microbiota manipulations can be applied in diagnostic and intervention approaches.
Language	English
Publishing date	2020-12-31
Publishing country	United States
Document type	Journal Article
ISSN	2475-2991
ISSN (online)	2475-2991
DOI	10.1093/cdn/nzaa176
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Article ; Online: Anti-obesity Medications for the Management of Nonalcoholic Fatty Liver Disease.

Polyzos, Stergios A / Goulis, Dimitrios G / Giouleme, Olga / Germanidis, Georgios S / Goulas, Antonis

Current obesity reports

2022 Volume 11, Issue 3, Page(s) 166–179

Abstract: Purpose of review: Obesity is closely associated with nonalcoholic fatty liver disease (NAFLD), a highly prevalent disease without any approved medication. The aim of this review was to summarize the evidence on the effect of anti-obesity medications on ...

Abstract	Purpose of review: Obesity is closely associated with nonalcoholic fatty liver disease (NAFLD), a highly prevalent disease without any approved medication. The aim of this review was to summarize the evidence on the effect of anti-obesity medications on NAFLD, especially focusing on hepatic histology. Recent findings: Orlistat and some glucagon-like peptide-1 receptor analogs, including liraglutide and semaglutide, have beneficial effects on hepatic steatosis and inflammation, but not fibrosis. Other anti-obesity medications, including lorcaserin, setmelanotide, phentermine hydrochloric, phentermine/topiramate, and naltrexone/bupropion, have been minimally investigated in NAFLD. Furthermore, medications like sodium-glucose cotransporter-2 inhibitors and farnesoid X receptor have shown beneficial effects in both NAFLD and obesity, but they have not been licensed for either disease. Liraglutide, semaglutide, and orlistat may be currently used in selected patients with obesity and NAFLD. Further research is warranted, since targeting obesity may provide additional benefits on its comorbidities, including NAFLD.
MeSH term(s)	Humans ; Anti-Obesity Agents/therapeutic use ; Liraglutide/therapeutic use ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/drug therapy ; Obesity/complications ; Obesity/drug therapy ; Orlistat/therapeutic use ; Phentermine/therapeutic use ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
Chemical Substances	Anti-Obesity Agents ; Liraglutide (839I73S42A) ; Orlistat (95M8R751W8) ; Phentermine (C045TQL4WP) ; Sodium-Glucose Transporter 2 Inhibitors
Language	English
Publishing date	2022-05-02
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2162-4968
ISSN (online)	2162-4968
DOI	10.1007/s13679-022-00474-0
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Article ; Online: GLP-1 Receptor Agonists in Obese Patients with Inflammatory Bowel Disease: from Molecular Mechanisms to Clinical Considerations and Practical Recommendations for Safe and Effective Use.

Arvanitakis, Konstantinos / Koufakis, Theocharis / Popovic, Djordje / Maltese, Giuseppe / Mustafa, Omar / Doumas, Michael / Giouleme, Olga / Kotsa, Kalliopi / Germanidis, Georgios

Current obesity reports

2023 Volume 12, Issue 2, Page(s) 61–74

Abstract: Purpose of review: To discuss current literature and provide practical recommendations for the safe and effective use of glucagon-like peptide 1 receptor agonists (GLP-1 RA) in people with inflammatory bowel disease (IBD) and type 2 diabetes (T2D) and/ ... ...

Abstract	Purpose of review: To discuss current literature and provide practical recommendations for the safe and effective use of glucagon-like peptide 1 receptor agonists (GLP-1 RA) in people with inflammatory bowel disease (IBD) and type 2 diabetes (T2D) and/or obesity. The molecular mechanisms that justify the potential benefits of GLP-1 RA in IBD and the links between IBD, obesity, and cardiovascular disease are also discussed. Recent findings: Preliminary data suggest that GLP-1 RA can modulate crucial pathways in the pathogenesis of IBD, such as chronic inflammation circuits, intestinal tight junctions, and gut microbiome dysbiosis, setting the stage for human trials to investigate the role of these agents in the treatment of IBD among people with or without diabetes and obesity. However, gastrointestinal side effects related to GLP-1 RA need appropriate clinical management to mitigate risks and maximize the benefits of therapy in people with IBD. GLP-1 RA originally emerged as drugs for the treatment of hyperglycemia and are currently licensed for the management of T2D and/or overweight/obesity. However, their wealth of pleiotropic actions soon raised expectations that they might confer benefits on non-metabolic disorders. Future studies are expected to clarify whether GLP-1 RA deserve an adjunct place in the arsenal of drugs against IBD.
MeSH term(s)	Humans ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Hypoglycemic Agents/therapeutic use ; Glucagon-Like Peptide-1 Receptor/agonists ; Obesity/complications ; Obesity/drug therapy ; Glucagon-Like Peptide 1/therapeutic use ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/drug therapy ; Inflammatory Bowel Diseases/chemically induced
Chemical Substances	Hypoglycemic Agents ; Glucagon-Like Peptide-1 Receptor ; Glucagon-Like Peptide 1 (89750-14-1)
Language	English
Publishing date	2023-04-21
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2162-4968
ISSN (online)	2162-4968
DOI	10.1007/s13679-023-00506-3
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Article ; Online: Efficacy of pharmacologic interventions on magnetic resonance imaging biomarkers in patients with nonalcoholic fatty liver disease: systematic review and network meta-analysis.

Malandris, Konstantinos / Papandreou, Stylianos / Vasilakou, Despoina / Kakotrichi, Panagiota / Sarakapina, Anna / Kalopitas, Georgios / Karagiannis, Thomas / Giouleme, Olga / Bekiari, Eleni / Liakos, Aris / Iatridi, Fotini / Paschos, Paschalis / Sinakos, Emmanouil / Tsapas, Apostolos

Journal of gastroenterology and hepatology

2024

Abstract: Background and aim: Several agents are under investigation for nonalcoholic fatty liver disease (NAFLD). We assessed the comparative efficacy of pharmacologic interventions for patients with NAFLD focusing on magnetic resonance imaging (MRI) biomarkers.! ...

Abstract	Background and aim: Several agents are under investigation for nonalcoholic fatty liver disease (NAFLD). We assessed the comparative efficacy of pharmacologic interventions for patients with NAFLD focusing on magnetic resonance imaging (MRI) biomarkers. Methods: We searched Medline, Embase, and CENTRAL. We included randomized controlled trials of more than 12 weeks of intervention that recruited patients with biopsy-confirmed or MRI-confirmed NAFLD and assessed the efficacy of interventions on liver fat content (LFC) and fibrosis by means of MRI. We performed random-effects frequentist network meta-analyses and assessed confidence in our estimates using the CINeMA (Confidence in Network Meta-Analysis) approach. Results: We included 47 trials (8583 patients). Versus placebo, thiazolidinediones were the most efficacious for the absolute change in LFC, followed by vitamin E, fibroblast growth factor (FGF) analogs, and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with mean differences ranging from -7.46% (95% confidence interval [-11.0, -3.9]) to -4.36% (-7.2, -1.5). No differences between drug classes were evident. Patients receiving GLP-1 RAs or glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs were more likely to achieve ≥30% relative reduction in LFC. Among agents, efruxifermin produced the largest reduction in LFC compared to placebo [-13.5% (-18.5, -8.5)], followed by pioglitazone, while being superior to most interventions. The effect of interventions on magnetic resonance elastography assessed fibrosis was small and insignificant. The confidence in our estimates was low to very low. Conclusions: Several drug classes may reduce LFC in patients with NAFLD without a significant effect on fibrosis; nevertheless, trial duration was small, and confidence in the effect estimates was low.
Language	English
Publishing date	2024-04-16
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	632882-9
ISSN	1440-1746 ; 0815-9319
ISSN (online)	1440-1746
ISSN	0815-9319
DOI	10.1111/jgh.16559
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Zs.A 2180: 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: Tacrolimus Immunosuppression Causes Drug-Induced Hypersensitivity Reactions in Liver-Transplant Patients: A 3-Case Report.

Mavroudi, Antigoni / Imvrios, George / Xinias, Ioannis / Cassimos, Dimitrios / Vagiotas, Lampros / Giouleme, Olga

Transplantation proceedings

2021 Volume 53, Issue 5, Page(s) 1731–1735

Abstract: Background: Drug-induced hypersensitivity reactions attributed to the immunosuppressive agent tacrolimus after an organ transplant are rare in the literature. We present 3 cases of male adult patients grafted with a cadaveric liver who developed delayed ...

Abstract	Background: Drug-induced hypersensitivity reactions attributed to the immunosuppressive agent tacrolimus after an organ transplant are rare in the literature. We present 3 cases of male adult patients grafted with a cadaveric liver who developed delayed hypersensitivity reactions to tacrolimus in the form of the prolonged-release capsules (Advagraf). Furthermore, the appropriate drug concentration solutions used for allergy testing are proposed. Methods: All patients received a liver transplant (LT) because of cirrhosis of various etiologies. They were immunosuppressed with tacrolimus once daily. Several months after they had been placed on an immunosuppressive regimen with tacrolimus in the form of prolonged-release capsules (Advagraf), the patients presented with delayed hypersensitivity reactions and torturous pruritic rash that affected the whole body and was unresponsive to treatment with oral ursodeoxycholic acid, cholestyramine, or levocetirizine. Allergy testing that was performed by skin prick testing was negative. Nevertheless, intradermal testing yielded positive results in all 3 patients. Management was by interruption of the culprit agent, which was followed by symptom resolution. The immunosuppressive treatment was continued with alternative drugs. Results: Appropriate nonirritating drug concentration solutions of the drug used for intradermal testing were highly sensitive and confirmed the clinical diagnosis of tacrolimus allergy in all the affected patients. Conclusion: Immunosuppressive treatment with tacrolimus in the form of prolonged-release capsules may cause a drug hypersensitivity reaction. A suspicion of allergy warrants a referral for allergy testing. Pruritic rash refractory to treatment in liver transplanted patients should be evaluated by an allergist for possible drug allergy when bile stasis and graft disease have been excluded. Intradermal testing has proven a highly sensitive method for confirming a drug allergy diagnosis, whereas skin prick testing did not.
MeSH term(s)	Aged ; Delayed-Action Preparations ; Drug Hypersensitivity/diagnosis ; Drug Hypersensitivity/etiology ; Exanthema/diagnosis ; Exanthema/etiology ; Humans ; Immunosuppressive Agents/adverse effects ; Liver Cirrhosis/surgery ; Liver Transplantation ; Male ; Middle Aged ; Tacrolimus/adverse effects
Chemical Substances	Delayed-Action Preparations ; Immunosuppressive Agents ; Tacrolimus (WM0HAQ4WNM)
Language	English
Publishing date	2021-05-04
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.03.031
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