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Anagnostis P.,Hippokration Hospital of Thessaloniki | Boboridis K.,Aristotle University of Thessaloniki | Adamidou F.,Hippokration Hospital of Thessaloniki | Kita M.,Hippokration Hospital of Thessaloniki
Journal of Endocrinological Investigation | Year: 2017

Background/Aims: The natural course of Graves’ orbitopathy (GO) has been poorly documented. The aim of this review is to provide current knowledge regarding the natural course of mild GO, trying to address the issue of whether and to what extent it constitutes a chronic remitting or transient disease. Methods: We systematically searched PubMed for English language publications until August 2016 under the following terms: “Graves’ orbitopathy” OR “Graves’ ophthalmopathy” OR “thyroid eye disease” AND “natural course” OR “natural history”. Results: Few studies have investigated the course of mild orbital disease in patients with GO. Large controlled trials are lacking and data can be extracted mainly from small retrospective and some prospective studies, after excluding patients who had received radioiodine for thyrotoxicosis or surgical treatment for GO. In general, more than half of GO patients may show spontaneous improvement in their clinical features, whereas no safe conclusions can be drawn with regard to complete resolution, with percentages ranging from 6 to 58 %. Conclusions: The question whether mild GO is a remitting, albeit chronic disease, or even a transient event in the course of Graves’ disease, remains currently unanswered. © 2016, Italian Society of Endocrinology (SIE).


Lappas D.,National and Kapodistrian University of Athens | Noussios G.,Aristotle University of Thessaloniki | Anagnostis P.,Hippokration Hospital of Thessaloniki | Adamidou F.,Hippokration Hospital of Thessaloniki | And 2 more authors.
Anatomical Science International | Year: 2012

Surgical management of parathyroid gland disease may sometimes be difficult, due mainly to the surgeon's failure to successfully detect parathyroids in unusual locations. The records of 942 cadavers (574 men and 368 women) who underwent autopsy in the Department of Forensic Medicine in Athens during the period 1988-2009 were reviewed. In total, 3,796 parathyroid glands were resected and histologically verified. Parathyroid glands varied in number. In 47 cases (5 %), one supernumerary (fifth) parathyroid was found, while in 19 cases (2 %) three parathyroid glands found. Superior glands were larger than inferior ones. However, there was no significant difference between the genders with respect to gland size. In 324 (8.5 %) out of 3,796, the glands were detected in an ectopic location: 7 (0.2 %) in the thyroid parenchyma, 79 (2 %) in different sites in the neck and 238 (6.3 %) in the mediastinum, 152 (4.1 %) of which were found in the upper and 86 (2.2 %) in the lower mediastinum. Significant anatomical variations of normal parathyroid glands may exist regarding number and location-knowledge that is essential for their successful identification and surgical management. © 2012 Japanese Association of Anatomists.


Noussios G.,Aristotle University of Thessaloniki | Anagnostis P.,Hippokration Hospital of Thessaloniki | Goulis D.G.,Aristotle University of Thessaloniki | Lappas D.,National and Kapodistrian University of Athens | Natsis K.,Aristotle University of Thessaloniki
European Journal of Endocrinology | Year: 2011

Ectopic thyroid tissue is a rare entity resulting from developmental defects at early stages of thyroid gland embryogenesis, during its passage from the floor of the primitive foregut to its final pre-tracheal position. It is frequently found around the course of the thyroglossal duct or laterally in the neck, as well as in distant places such as the mediastinum and the subdiaphragmatic organs. Although most cases are asymptomatic, symptoms related to tumor size and its relationship with surrounding tissues may also appear. Any disease affecting the thyroid gland may also involve the ectopic thyroid, including malignancy. The clinician must distinguish between ectopic thyroid and metastatic deposits emerging from an orthotopic gland, as well as other benign or malignant masses. Thyroid scintigraphy plays the most important role in diagnosing ectopy, but ultrasonography contributes as well. In cases of symptomatic disease, surgery is the treatment of choice, followed by radioiodine ablation and levothyroxine suppression therapy in more refractory cases. This review provides current understanding about the wide clinical spectrum of this rare condition, also referring to optimal diagnostic approach, differential diagnosis, and management strategies. © 2011 European Society of Endocrinology.


Kozeis N.,Hippokration Hospital of Thessaloniki | Tyradellis S.,Hippokration Hospital of Thessaloniki | Dragiotis E.,Hippokration Hospital of Thessaloniki | Eleftheriadis H.,Southend Hospital NHS Trusts
Clinical Ophthalmology | Year: 2010

We present an interesting case of pemphigus vulgaris with severe and rare eye manifestations. An old lady with systemic and ocular manifestations of pemphigus vulgaris was treated with systemic corticosteroids and immunosuppressants, with no effect. Subconjunctival injection of triamcinolone acetate reduced the ocular signs and led to gradual reduction of the systemic medications. © 2010 Kozeis et al.


Anagnostis P.,Hippokration Hospital of Thessaloniki | Efstathiadou Z.A.,Hippokration Hospital of Thessaloniki | Charizopoulou M.,Aristotle University of Thessaloniki | Selalmatzidou D.,Hippokration Hospital of Thessaloniki | And 3 more authors.
Endocrine | Year: 2014

Several studies have shown that acromegaly is associated with increased psychological morbidity. However, it is not known whether this is attributed to acromegaly per se or to its chronicity as a debilitating disease affecting quality of life (QoL). The aim of this study was to assess psychological profile in acromegalics compared with those suffering from other serious chronic diseases and healthy controls. Secondary end points were QoL assessment and its association with mood disturbances. Comparative, cross-sectional study conducted in Northern Greece (2011–2012). The Greek versions of the Profile of Mood States (POMS) and AcroQoL questionnaires were used to assess psychological status and QoL, respectively. Forty acromegalics, 40 age- and sex-matched people with other chronic diseases and 80 healthy controls were included. No significant differences were identified between acromegalics and those suffering from other chronic diseases, regarding tension, anger, depression, confusion, fatigue and vigor. Compared with healthy controls, acromegalics suffered more from depression and anger, which remained significant after controlling for age, gender and marital status (p = 0.003 and p = 0.048, respectively). Negative predictors were female gender, macroadenomas and radiotherapy. AcroQoL scores were negatively associated with POMS subscales. Males had better QoL than females. Other than a negative association between AcroQoL-relationships subscale and disease duration, no association with other parameters was observed. Acromegaly has a negative impact on psychological status, which is worse than that of general population, but comparable to other chronic diseases. Mood disturbances are associated with impaired QoL, mainly in females and those with longer disease duration. © 2014, Springer Science+Business Media New York.


Anagnostis P.,Hippokration Hospital of Thessaloniki | Adamidou F.,Hippokration Hospital of Thessaloniki | Polyzos S.A.,Aristotle University of Thessaloniki | Katergari S.,Hippokration Hospital of Thessaloniki | And 4 more authors.
Endocrine | Year: 2013

Antithyroid drugs (ATDs) remain the first-line therapy in patients with Graves' disease (GD), despite a high relapse rate. The purpose of this study was to identify the predictors of remission in patients with GD treated with ATDs - retrospective study at an endocrine referral service in Northern Greece. Two-hundred and eleven patients met the study's criteria. Females (p = 0.049), non-smokers (p = 0.017), patients without ophthalmopathy (p = 0.033), and those developing pharmaceutical hypothyroidism (p = 0.018) experienced longer duration of remission. Duration of remission was positively associated with therapy duration (r s = 0.151, p = 0.030), maximum TSH levels during (r s = 0.241, p = 0.001), at the end (r s = 0.280, p < 0.001) and 3 months after therapy (r s = 0.341, p = 0.003). There was a negative association with free T4 (FT4) (r s = -0.426, p < 0.001) and free triiodothyronine (FT3) (r s = -0.467, p = 0.038) levels at 6 months after ATDs discontinuation. In multiple-regression analysis, only duration of the first ATDs course for more than 24 months independently predicted duration of remission. Female gender, non-smoking, the absence of orbitopathy, treatment duration, pharmaceutical hypothyroidism, higher TSH levels during, at the end and 3 months after ATDs discontinuation, and lower FT4 and FT3 levels 6 months after therapy were associated with longer duration of remission. However, only duration of ATDs therapy for more than 24 months independently predicted predict long-term remission in GD. © 2013 Springer Science+Business Media New York.


Anagnostou V.,Aristotle University of Thessaloniki | Sdouga M.,Hippokration Hospital of Thessaloniki | Volakli H.,Hippokration Hospital of Thessaloniki | Violaki A.,Hippokration Hospital of Thessaloniki | Papa A.,Aristotle University of Thessaloniki
Vector-Borne and Zoonotic Diseases | Year: 2011

In June 2004 an 8-year-old boy was admitted to a hospital in Thessaloniki, Greece, because of high fever, tachypnea, hypotonia, diarrhea, and tonoclonic convulsions. Phlebovirus infection was diagnosed by IgG seroconversion to Toscana virus. As IgM antibodies were not detected, it is suggested that this was an acute infection caused by a phlebovirus virus distinct from Toscana virus. Complication by a hospital-acquired Pseudomonas aeruginosa pneumonia resulted in 2 months of hospitalization. Slight ataxia was still present on discharge. © Copyright 2011, Mary Ann Liebert, Inc. 2011.


Stavrakaki S.,Aristotle University of Thessaloniki | Alexiadou A.,University of Stuttgart | Kambanaros M.,University of Cyprus | Bostantjopoulou S.,Aristotle University of Thessaloniki | Katsarou Z.,Hippokration Hospital of Thessaloniki
Aphasiology | Year: 2011

Background: Recent studies revealed that aphasic speakers have difficulties with the production of the intransitive (unaccusative) variant of verbs entering transitivity alternations. A key point of the current interpretations of these difficulties concerns the movement operations taking place at surface syntax, namely, the A-movement operation (Bastiaanse & van Zonneveld, 2005; Bastiaanse, 2008; Thompson, 2003). Aim: The present study revisits the issue of processing verbs with alternating transitivity in non-fluent aphasia in Greek, a language with rich morphology and relatively free word order, which lacks A-movement. In addition, in Greek, unaccusative verbs appear with different voice morphology: One class of intransitive variants of alternating verbs bears active morphology, another one non-active morphology and a third one can surface with both. The presence of non-active voice has been argued to correspond to the presence of a voice projection in syntax of these variants, while the variants that bear active morphology are not associated with a voice projection at the level of syntax. This study investigates the ability of non-fluent aphasic speakers to produce and comprehend verbs entering transitivity alterations and explores the role of active vs. non-active morphology and word order in the performance of aphasic speakers. Methods & Procedures: We tested five non-fluent patients and fifteen control participants. We used two tasks supported by pictures: an elicited production task and a comprehension task. The experimental material consisted of fifteen transitive and fifteen unaccusative verbs (marked for active, and/or non-active voice morphology) in sentence contexts. Outcomes & Results: The results indicated that (i) the aphasic speakers performed better on the production and comprehension of transitives than of unaccusatives, (ii) they showed significantly lower performance on the comprehension of unaccusatives with active morphology than on unaccusatives with non-active morphology, and finally (iii) they produced transitive (S)VO structures instead of the unaccusative ones. Conclusion: We suggest, in agreement with other researchers (for example, Schwartz, Linebarger, Saffran, & Pate, 1987) that aphasic individuals overuse a mapping strategy that associates the theta roles of agent and theme with syntactic subject and object respectively, as they produce transitive (S)VO structures, to a large extent, instead of unaccusatives. In addition, as they had difficulties with unaccusative verbs marked for active voice, we suggest that they could not successfully interpret unaccusative verbs with active voice morphology as non-agentive structures. © 2011 Psychology Press.


Kozeis N.,Hippokration Hospital of Thessaloniki | Trachana M.,Hippokration Hospital of Thessaloniki | Tyradellis S.,Hippokration Hospital of Thessaloniki
Cornea | Year: 2011

Purpose: To present a rare ocular manifestation of reactive arthritis (Reiter syndrome) in a child. Methods: A 10-year-old girl who was admitted to our hospital with low-grade fever, arthritis, and aching left eye with blurred vision was diagnosed with Reiter reactive arthritis. At the time of admittance, the ophthalmologic examination revealed keratitis; this mildly affected the vision. Results: Keratitis resolved under treatment with topical steroids and antibiotic drops after 1 month, without scarring. Although 75% of the patients with reactive arthritis present ophthalmic manifestations, keratitis is a very rare finding in reactive arthritis and even rarer in children. Conclusions: It should be kept in mind that keratitis could be an ocular manifestation of reactive arthritis in young patients. Copyright © 2011 by Lippincott Williams & Wilkins.


Anagnostis P.,Hippokration Hospital of Thessaloniki | Efstathiadou Z.A.,Hippokration Hospital of Thessaloniki | Slavakis A.,Hippokration Hospital of Thessaloniki | Selalmatzidou D.,Hippokration Hospital of Thessaloniki | And 5 more authors.
International Journal of Clinical Practice | Year: 2014

Aims Subclinical hypothyroidism (SH) is associated with increased risk for atherosclerosis, mainly attributable to dyslipidaemia and hypercoagulability. However, conflicting data exist regarding the effect of L-thyroxine substitution on these parameters. The purpose of this study was to assess the effect of L-thyroxine therapy on lipidaemic profile, coagulation markers, high-sensitivity C-reactive protein (hsCRP) and glucose homoeostasis in SH patients. Methods It was a prospective open-label study. The following parameters were measured before and 6 months after intervention: anthropometric data, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), apolipoproteins B (apoB) and A1 (apoA1), lipoprotein (a) [Lp(a)], fasting plasma glucose and insulin, homoeostasis model assessment-insulin resistance (HOMA-IR), hsCRP, antithrombin III (AT-III), protein C (PC), protein S (PS), fibrinogen and homocysteine. Results Thirty-two patients (30 women) aged 52.1 ± 13.9 years with SH completed the study. Baseline mean TSH levels were 6.79 ± 2.58 mIU/ml. Achievement of euthyroidism significantly reduced systolic blood pressure (BP) in patients with SH (from 135.2 ± 18.5 to 129.7 ± 15.8 mmHg, p = 0.03) and diastolic BP only in those with baseline TSH levels > 7 mIU/ml (from 79.5 ± 9.8 to 72.1 ± 7.3 mmHg, p = 0.03). No significant changes in body weight, TC, LDL-C, HDL-C, TG, apoB, glucose, insulin, HOMA-IR, hsCRP, AT-III, PC, PS, fibrinogen or homocysteine levels were noticed after restoration of euthyroidism, except for a decrease in apoA1 (p = 0.04) and an increase in Lp(a) levels (p = 0.02). Conclusions Except for a reduction in systolic and diastolic BP, thyroid substitution therapy does not affect lipidaemic profile, systematic inflammation, glucose homoeostasis or coagulation in patients with SH. © 2014 John Wiley & Sons Ltd.

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