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Article: Predominance of Recombinant Norovirus Strains in Greece, 2016-2018.

Siafakas, Nikolaos / Anastassopoulou, Cleo / Lafazani, Maria / Chronopoulou, Genovefa / Rizos, Emmanouil / Pournaras, Spyridon / Tsakris, Athanasios

Microorganisms

2023 Volume 11, Issue 12

Abstract: GII.4 noroviruses have caused the overwhelming majority of norovirus-related gastroenteritis cases during the past two decades. However, a trend towards the emergence of new genotypes and novel GII.4 variants provided the impetus to explore further the ... ...

Abstract	GII.4 noroviruses have caused the overwhelming majority of norovirus-related gastroenteritis cases during the past two decades. However, a trend towards the emergence of new genotypes and novel GII.4 variants provided the impetus to explore further the changing patterns in norovirus epidemiology during the present study. Genotyping of 60 norovirus strains detected during a period of 33 months (January 2016-October 2018) was performed on the basis of the capsid VP1-coding ORF2 gene sequence. All norovirus strains detected were classified into seven genotypes, six of which belonged to genogroup GII. GII.2 was the dominant genotype till February 2017, whereas GII.4 prevailed thereafter. Most of the GII.4 strains were of the Sydney_2012 variant, whereas five strains could not be classified. Further recombination analysis at the ORF1/ORF2 gene junction revealed that 23 out of 24 strains were recombinant, thereby showcasing the significant role of genetic recombination in norovirus evolution and epidemiology. Continuous genomic surveillance and molecular characterization are essential for tracking norovirus evolution, which could contribute to the elucidation of new aspects of virus-host interactions that potentially affect host morbidity and epidemiology.
Language	English
Publishing date	2023-11-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms11122885
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Article ; Online: Field Evaluation of the New Rapid NG-Test

Avgoulea, Kalliopi / Beredaki, Maria-Ioanna / Vourli, Sophia / Siopi, Maria / Siafakas, Nikolaos / Pournaras, Spyros

Frontiers in public health

2022 Volume 10, Page(s) 840984

Abstract: Background: As the COVID-19 pandemic resurges affecting large numbers of patients, rapid, and accurate diagnosis using point-of-care tests is very important.: Objectives: To evaluate the NG-Test: Methods: All adult ambulatory patients presenting ... ...

Abstract	Background: As the COVID-19 pandemic resurges affecting large numbers of patients, rapid, and accurate diagnosis using point-of-care tests is very important. Objectives: To evaluate the NG-Test Methods: All adult ambulatory patients presenting to the Emergencies of "Attikon" University hospital (Athens, Greece) within three consecutive hours per day between December 2020 and March 2021 and for whom SARS-CoV-2 PCR testing was requested were included. Two NP and one OP samples obtained from each participant were analyzed to determine the diagnostic performance [sensitivity, specificity, positive/negative predictive values (PPV/NPV)] of the NG-Test (NP/OP swabs) in comparison to the reference RT-PCR (NP swab). Results: Overall, 134/263 (51%) patients tested were RT-PCR positive, whereof 108 (overall sensitivity 81%, 95% CI 73-87%) were NP NG-Test positive (PPV 99%, NPV 83%) and 68 (overall sensitivity 51%, 95% CI 42-59%) were OP NG-Test positive (PPV 100%, NPV 66%). The test's specificity (95% CI) was 99% (95-100%) and 100% (96-100%) for NP and OP swabs, respectively. The assay's sensitivity (95% CI) for high viral load (C Conclusions: NG-Test using NP swabs detected almost all patients with high viral loads, showing satisfactory performance as a point-of-care test for NP samples obtained from patients with acute infection.
MeSH term(s)	Adult ; Antigens, Viral ; COVID-19/diagnosis ; Emergencies ; Emergency Service, Hospital ; Hospitals ; Humans ; Pandemics ; Referral and Consultation ; SARS-CoV-2 ; Sensitivity and Specificity
Chemical Substances	Antigens, Viral
Language	English
Publishing date	2022-04-25
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.840984
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Article ; Online: The European Respiratory Society, 1990-2010: a 20-year anniversary story of success.

Siafakas, N M

The European respiratory journal

2010 Volume 35, Issue 1, Page(s) 1–2

MeSH term(s)	Europe ; History, 20th Century ; History, 21st Century ; Pulmonary Medicine/history ; Societies, Medical/history
Language	English
Publishing date	2010-01
Publishing country	England
Document type	Editorial ; Historical Article
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/09031936.00177809
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Article ; Online: Suicidality and COVID-19: Suicidal ideation, suicidal behaviors and completed suicides amidst the COVID-19 pandemic (Review).

Efstathiou, Vasiliki / Stefanou, Maria-Ioanna / Siafakas, Nikolaos / Makris, Michael / Tsivgoulis, Georgios / Zoumpourlis, Vassilios / Spandidos, Demetrios A / Smyrnis, Nikolaos / Rizos, Emmanouil

Experimental and therapeutic medicine

2021 Volume 23, Issue 1, Page(s) 107

Abstract: Since the outbreak of the coronavirus 2019 (COVID-19) pandemic, there has been widespread concern that social isolation, financial stress, depression, limited or variable access to health care services and other pandemic-related stressors may contribute ... ...

Abstract	Since the outbreak of the coronavirus 2019 (COVID-19) pandemic, there has been widespread concern that social isolation, financial stress, depression, limited or variable access to health care services and other pandemic-related stressors may contribute to an increase in suicidal behaviors. In patients who have recovered from COVID-19, an increased risk of developing suicidal behaviors may be noted, while post-COVID syndrome comprises another potential risk factor contributing to increased suicidal behaviors. Despite the initial alarming predictions for an increase in suicide rates due to the COVID-19 pandemic, the majority of published studies to date suggest that experienced difficulties and distress do not inevitably translate into an increased number of suicide-related deaths, at least not in the short-term. Nevertheless, the long-term mental health effects of the COVID-19 pandemic have yet to be unfolded and are likely to remain for a long period of time. Suicide prevention and measures aiming at promoting well-being and mitigating the effects of COVID-19 on mental health, particularly among vulnerable groups, should thus be a priority for healthcare professionals and policymakers amidst the evolving COVID-19 pandemic.
Language	English
Publishing date	2021-12-02
Publishing country	Greece
Document type	Journal Article ; Review
ZDB-ID	2683844-8
ISSN	1792-1015 ; 1792-0981
ISSN (online)	1792-1015
ISSN	1792-0981
DOI	10.3892/etm.2021.11030
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Article ; Online: Long COVID and neuropsychiatric manifestations (Review).

Efstathiou, Vasiliki / Stefanou, Maria-Ioanna / Demetriou, Marina / Siafakas, Nikolaos / Makris, Michael / Tsivgoulis, Georgios / Zoumpourlis, Vassilios / Kympouropoulos, Stylianos P / Tsoporis, James N / Spandidos, Demetrios A / Smyrnis, Nikolaos / Rizos, Emmanouil

Experimental and therapeutic medicine

2022 Volume 23, Issue 5, Page(s) 363

Abstract: There is accumulating evidence in the literature indicating that a number of patients with coronavirus disease 2019 (COVID-19) may experience a range of neuropsychiatric symptoms, persisting or even presenting following the resolution of acute COVID-19. ... ...

Abstract	There is accumulating evidence in the literature indicating that a number of patients with coronavirus disease 2019 (COVID-19) may experience a range of neuropsychiatric symptoms, persisting or even presenting following the resolution of acute COVID-19. Among the neuropsychiatric manifestations more frequently associated with 'long COVID' are depression, anxiety, post-traumatic stress disorder, sleep disturbances, fatigue and cognitive deficits, that can potentially be debilitating and negatively affect patients' wellbeing, albeit in the majority of cases symptoms tend to improve over time. Despite variations in results obtained from studies using different methodological approaches to define 'long COVID' syndrome, the most widely accepted factors associated with a higher risk of developing neuropsychiatric manifestations include the severity of foregoing COVID-19, the female sex, the presence of comorbidities, a history of mental health disease and an elevation in the levels of inflammatory markers, albeit further research is required to establish causal associations. To date, the pathophysiological mechanisms implicated in neuropsychiatric manifestations of 'long COVID' remain only partially elucidated, while the role of the indirect effects of the COVID-19 pandemic, such as social isolation and uncertainty concerning social, financial and health recovery post-COVID, have also been highlighted. Given the alarming effects of 'long-COVID', interdisciplinary cooperation for the early identification of patients who are at a high risk of persistent neuropsychiatric presentations, beyond COVID-19 recovery, is crucial to ensure that appropriate integrated physical and mental health support is provided, with the aim of mitigating the risks of long-term disability at a societal and individual level.
Language	English
Publishing date	2022-04-01
Publishing country	Greece
Document type	Journal Article ; Review
ZDB-ID	2683844-8
ISSN	1792-1015 ; 1792-0981
ISSN (online)	1792-1015
ISSN	1792-0981
DOI	10.3892/etm.2022.11290
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Article ; Online: New‑onset neuropsychiatric sequelae and 'long‑COVID' syndrome (Review).

Efstathiou, Vasiliki / Stefanou, Maria-Ioanna / Demetriou, Marina / Siafakas, Nikolaos / Katsantoni, Eleni / Makris, Michael / Tsivgoulis, Georgios / Zoumpourlis, Vassilios / Kympouropoulos, Stylianos P / Tsoporis, James N / Spandidos, Demetrios A / Ferentinos, Panagiotis / Smyrnis, Nikolaos / Rizos, Emmanouil

Experimental and therapeutic medicine

2022 Volume 24, Issue 5, Page(s) 705

Abstract: The ongoing coronavirus disease 2019 (COVID-19) pandemic has had a widespread impact on individuals' mental health through indirect psychological and social mechanisms, related to factors such as fear of infection or death, social isolation, lack of ... ...

Abstract	The ongoing coronavirus disease 2019 (COVID-19) pandemic has had a widespread impact on individuals' mental health through indirect psychological and social mechanisms, related to factors such as fear of infection or death, social isolation, lack of social support and financial instability. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has also been associated with the development or recurrence of neuropsychiatric symptoms, both during the acute phase, as well as during the post-acute 'long-COVID' phase. In addition to the COVID-19 survivors with a mental health history that are at a high risk of experiencing a range of neuropsychiatric symptoms following resolution of acute COVID-19, there is accumulating evidence that a diagnosis of COVID-19 may also be associated with new-onset neuropsychiatric morbidity among survivors without pre-existing mental health disorders. In particular, studies investigating the incidence of post-acute neuropsychiatric sequelae, based mostly on retrospective cohort study designs and data from national health registries, have reported the development of new-onset manifestations, including depression, anxiety, psychotic symptoms, sleep disturbances and fatigue. Nevertheless, when COVID-19 survivors were compared with SARS-CoV-2-negative controls and especially survivors of other disorders (such as influenza), the findings regarding the risk of incident neuropsychiatric manifestations varied among studies. While there is evidence of an association between SARS-CoV-2 infection and the subsequent occurrence of new-onset neuropsychiatric symptoms, especially among patients with increased disease severity, further research using methodological approaches less susceptible to confounding bias is required to establish causal relationships.
Language	English
Publishing date	2022-10-04
Publishing country	Greece
Document type	Journal Article ; Review
ZDB-ID	2683844-8
ISSN	1792-1015 ; 1792-0981
ISSN (online)	1792-1015
ISSN	1792-0981
DOI	10.3892/etm.2022.11641
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Article ; Online: Evaluation of paper gradient concentration strips for antifungal combination testing of Candida spp.

Siopi, Maria / Siafakas, Nikolaos / Zerva, Loukia / Meletiadis, Joseph

Mycoses

2015 Volume 58, Issue 11, Page(s) 679–687

Abstract: In vitro combination testing with broth microdilution chequerboard (CHEQ) method is widely used although it is time-consuming, cumbersome and difficult to apply in routine setting of clinical microbiology laboratory. A new gradient concentration paper ... ...

Abstract	In vitro combination testing with broth microdilution chequerboard (CHEQ) method is widely used although it is time-consuming, cumbersome and difficult to apply in routine setting of clinical microbiology laboratory. A new gradient concentration paper strip method, the Liofilchem(®) MIC test strips (MTS), provides an alternative easy and fast method enabling the simultaneous diffusion of both drugs in combination. We therefore tested a polyene+azole and an azole+echinocandin combination against 18 Candida isolates with the CHEQ method based on EUCAST guidelines and the MTS method in research and routine settings. Fractional inhibitory concentration (FIC) indices were calculated after 24 and 48 h of incubation based on complete and prominent (FIC-2) growth inhibition endpoints. Reproducibility and agreement within 1 twofold dilution was assessed. The FICs of the two methods were correlated quantitatively with t-test and Pearson analysis and qualitatively with Chi-squared test. The reproducibility of the CHEQ and MTS method was 88-100% and their agreement was 80% with 62-77% of MTS FICs being higher than the corresponding CHEQ FICs. A statistically significant Pearson correlation (r = 0.86, P = 0.0003) and association (χ(2) = 17.05, df = 4, P = 0.002) was found between MTS FIC and CHEQ FIC-2 after 24 h. Categorical agreement was 63% with no very major or major errors. All MTS synergistic interactions were also synergistic with the CHEQ method.
MeSH term(s)	Amphotericin B/pharmacology ; Antifungal Agents/pharmacology ; Azoles/pharmacology ; Candida/drug effects ; Candida/growth & development ; Candidiasis/microbiology ; Chi-Square Distribution ; Drug Synergism ; Drug Therapy, Combination ; Echinocandins/pharmacology ; Humans ; Lipopeptides ; Microbial Sensitivity Tests/methods ; Reagent Kits, Diagnostic ; Reproducibility of Results ; Voriconazole/pharmacology
Chemical Substances	Antifungal Agents ; Azoles ; Echinocandins ; Lipopeptides ; Reagent Kits, Diagnostic ; Amphotericin B (7XU7A7DROE) ; caspofungin (F0XDI6ZL63) ; Voriconazole (JFU09I87TR)
Language	English
Publishing date	2015-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	392487-7
ISSN	1439-0507 ; 0933-7407
ISSN (online)	1439-0507
ISSN	0933-7407
DOI	10.1111/myc.12413
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Article: Effect of Levetiracetam Monotherapy on Liver Enzymes and Creatine Kinase Concentrations in Children with Epilepsy: A Prospective Study.

Attilakos, Achilleas / Dinopoulos, Argirios / Paschalidou, Maria / Tsirouda, Maria / Prasouli, Alexia / Siafakas, Nikos / Garoufi, Anastasia

Journal of clinical neurology (Seoul, Korea)

2018 Volume 14, Issue 4, Page(s) 594–595

Language	English
Publishing date	2018-10-04
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2500489-X
ISSN	2005-5013 ; 1738-6586
ISSN (online)	2005-5013
ISSN	1738-6586
DOI	10.3988/jcn.2018.14.4.594
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Article ; Online: Serum sodium, potassium, and magnesium in children with epilepsy treated with levetiracetam monotherapy: A prospective study.

Attilakos, Achilleas / Garoufi, Anastasia / Paschalidou, Maria / Tsirouda, Maria / Siafakas, Nikos / Dinopoulos, Argiris

CNS neuroscience & therapeutics

2018 Volume 24, Issue 9, Page(s) 846–847

MeSH term(s)	Adolescent ; Anticonvulsants/therapeutic use ; Biomarkers/blood ; Child ; Child, Preschool ; Epilepsy/blood ; Epilepsy/drug therapy ; Female ; Humans ; Infant ; Levetiracetam/therapeutic use ; Magnesium/blood ; Male ; Potassium/blood ; Prospective Studies ; Sodium/blood ; Treatment Outcome
Chemical Substances	Anticonvulsants ; Biomarkers ; Levetiracetam (44YRR34555) ; Sodium (9NEZ333N27) ; Magnesium (I38ZP9992A) ; Potassium (RWP5GA015D)
Language	English
Publishing date	2018-04-23
Publishing country	England
Document type	Letter
ZDB-ID	2423467-9
ISSN	1755-5949 ; 1755-5930
ISSN (online)	1755-5949
ISSN	1755-5930
DOI	10.1111/cns.12868
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Article ; Online: A hypothesis for the initiation of COPD.

Tzortzaki, E G / Siafakas, N M

The European respiratory journal

2009 Volume 34, Issue 2, Page(s) 310–315

Abstract: Chronic obstructive pulmonary disease (COPD) is generally thought to depend on an aberrant immune response to a noxious or infectious agent, which may cause chronic inflammation. However, the initiation of this abnormal response is not fully understood. ... ...

Abstract	Chronic obstructive pulmonary disease (COPD) is generally thought to depend on an aberrant immune response to a noxious or infectious agent, which may cause chronic inflammation. However, the initiation of this abnormal response is not fully understood. Here, we propose a new hypothesis for the beginning of COPD, that the immune response to inhaled agents, mainly cigarette smoke, is directed toward the airway epithelium, due to oxidative DNA damage of the lung epithelial barrier cells (LEBCs). The steps of this model are as follows. 1) Cigarette smoke induces oxidative DNA damage of LEBCs. 2) The acquired mutations are expressed at the microsatellite DNA level of LEBCs. 3) The altered LEBCs are recognised by dendritic cells (DCs) as "nonself". DCs travel, with the new information, to the lymph nodes, presenting it to the naïve T-lymphocytes. 4) A predominant CD8+ cytotoxic T-lymphocyte proliferation occurs. The CD8+ cells, by releasing perforin and granzymes, attack the altered LEBCs activating cell death cascades. Obviously, the above scenario needs further experimental exploration. However, it is an attractive model for the initiation of the abnormal inflammation in COPD, comprising oxidative DNA damage of LEBCs and host immune response.
MeSH term(s)	CD8-Positive T-Lymphocytes/metabolism ; Cell Death ; DNA Damage ; Dendritic Cells/cytology ; Epithelium/pathology ; Female ; Humans ; Inflammation ; Lung/pathology ; Male ; Microsatellite Repeats/genetics ; Mutation ; Oxygen/chemistry ; Oxygen/metabolism ; Pulmonary Disease, Chronic Obstructive/etiology ; Pulmonary Disease, Chronic Obstructive/therapy ; Smoking ; T-Lymphocytes, Cytotoxic/cytology
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2009-08
Publishing country	England
Document type	Journal Article
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/09031936.00067008
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