Naval Hospital of Crete

Chaniá, Greece

Naval Hospital of Crete

Chaniá, Greece

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Mazokopakis E.E.,Naval Hospital of Crete | Starakis I.K.,University of Patras
Diabetes Research and Clinical Practice | Year: 2012

Metformin treatment is a known pharmacological cause of vitamin B12 (Cbl) deficiency with controversial responsible mechanisms. A possible diagnosis of this deficiency is based mainly on the combination of patient's medical history (usually long-term metformin use), clinical examination (possible neuropsychiatric symptoms and signs), laboratory studies which confirm a Cbl deficiency (haematological abnormalities, low serum Cbl levels, elevated serum total homocysteine and methylmalonic acid levels), and exclusion other causes of Cbl deficiency (as pernicious anaemia, food-cobalamin malabsorption syndrome, other drugs, etc.). In our review, recommendations for diagnosis and management of metformin-induced Cbl deficiency (MICD) in diabetic patients based on medical bibliography are presented and discussed. © 2012 Elsevier Ireland Ltd.


Mazokopakis E.E.,Naval Hospital of Crete | Mazokopakis E.E.,University of Crete | Karefilakis C.M.,Naval Hospital of Crete | Starakis I.K.,University of Patras
Infectious Disorders - Drug Targets | Year: 2010

Coxiella burnetii, the agent of Q fever, produces a variety of clinical syndromes. The most frequent and serious chronic presentation is endocarditis, which presents unspecifically as a blood-culture negative endocarditis. It occurs almost exclusively in patients who have pre-existing valvular disease or who are immunocompromised. Without prompt recognition and appropriate antimicrobial therapy, the course of Q fever endocarditis is severe and potentially fatal. The epidemiology, signs and symptoms, laboratory findings, diagnosis and treatment of Q fever endocarditis are presented in our review. © 2010 Bentham Science Publishers Ltd.


Mazokopakis E.E.,Naval Hospital of Crete | Karefilakis C.M.,Naval Hospital of Crete | Starakis I.K.,University of Patras
Hormones | Year: 2012

Several conditions and drugs induce subclinical hypothyroidism. We report a case of asymptomatic and reversible subclinical hypothyroidism in a 48-year old woman with minor depressive disorder receiving therapy with escitalopram 20 mg daily for six months.


Starakis I.,University of Patras | Koutras A.,University of Patras | Mazokopakis E.E.,Naval Hospital of Crete | Mazokopakis E.E.,University of Crete
Cardiovascular and Hematological Disorders - Drug Targets | Year: 2010

Patients with malignancies are often in a hypercoagulable status. The pathogenetic mechanisms of thrombotic events in malignancy are multifaceted and consist of release or expression of procoagulants by cancer cells, but also appearance of procoagulant action by normal host cells. Most importantly, current therapeutic modalities for cancer such as high dose chemotherapy and surgery represent a significant additional risk for serious or even fatal thromboembolic events. There is a wide spectrum of clinical manifestations of these events which encompass Trousseau's syndrome, deep venous thrombosis, marantic endocarditis, disseminated intravascular coagulation, thrombotic microangiopathy and arterial thrombosis. Cancer chemotherapy is most commonly associated with deep vein thrombosis but intracranial sinus vein thromboses and thrombotic microangiopathy may also occur. Our purpose is to review the relevant literature linked to the effect of chemotherapy and other cancer-related interventions on thromboembolic incidents. © 2010 Bentham Science Publishers Ltd.


Mazokopakis E.E.,Naval Hospital of Crete | Mazokopakis E.E.,University of Crete | Starakis I.K.,University of Patras | Papadomanolaki M.G.,Technical University of Crete | And 2 more authors.
Journal of the Science of Food and Agriculture | Year: 2014

BACKGROUND: Spirulina (Arthrospira platensis) is a filamentous cyanobacterium used as a food supplement. The objective of the study was to determine the lipid-lowering effects of Spirulina in Cretan Greek dyslipidaemic patients, and to document its effectiveness as a possible alternative treatment for dyslipidaemia. Fifty-two adultCretan outpatients (32 men, 20 women), median age 47 (range, 37-61) years, with recently diagnosed dyslipidaemia, consumed orally 1 g Spirulina (Greek production) per day for 12 weeks. The full lipid profile was measured in fasting blood samples at the beginning and end of the study period. Anthropometric measurements including systolic and diastolic blood pressure, height, weight and body mass index were also recorded. RESULTS: At the end of the 3-month intervention period the mean levels of triglycerides, low density lipoprotein-cholesterol, total cholesterol, non-high density lipoprotein-cholesterol levels, and the ratio of total cholesterol to high-density lipoproteincholesterol were significantly decreased: 16.3% (P < 0.0001), 10.1% (P < 0.0001), 8.9% (P < 0.0001), 10.8% (P < 0.0001) and 11.5% (P = 0.0006) respectively, whereas the mean high-density lipoprotein-cholesterol levels were not significantly increased (3.5%). Blood pressure, weight and body mass index remained almost unchanged. CONCLUSIONS: Spirulina supplementation at a dose of 1 g daily has powerful hypolipidaemic effects, especially on the triglyceride concentration in dyslipidaemic Cretan outpatients. © 2013 Society of Chemical Industry.


Mazokopakis E.E.,Naval Hospital of Crete | Mazokopakis E.E.,University of Crete | Syros P.K.,Naval Hospital of Crete | Starakis I.K.,University of Patras
Cardiovascular and Hematological Disorders - Drug Targets | Year: 2010

The term nonbacterial thrombotic endocarditis (NBTE), or marantic endocarditis, refers to a spectrum of lesions ranging from microscopic aggregates of platelets to large vegetations on previously undamaged heart valves (most often aortic and mitral) in the absence of a bloodstream bacterial infection. NBTE is a rare condition often associated with hypercoagulable states or advanced malignancy such as adenocarcinomas. In this article, the pathogenesis, incidence, clinical manifestations, diagnosis, and management of NBTE in cancer patients are reviewed. © 2010 Bentham Science Publishers Ltd.


Bourolias C.,Naval Hospital of Crete | Gkotsis A.,Naval Hospital of Crete | Kontaxakis A.,Naval Hospital of Crete | Tsoukarelis P.,Naval Hospital of Crete
American Journal of Otolaryngology - Head and Neck Medicine and Surgery | Year: 2010

Statement of problem: The aim of this study was to evaluate the efficacy of lidocaine spray 10%, compared with tetracaine 2% solution, as a local anesthetic for patients undergoing transnasal fiber-optic laryngoscopy. Method of study: A prospective study was conducted on patients undergoing transnasal fiber-optic laryngoscopy. Microsurgical sponges were applied in each side of the nose for 10 minutes before laryngoscopy. Patients were randomly classified into group A and group B, in which tetracaine 2% solution and lidocaine spray 10% were used, respectively. Patients were asked to evaluate the severity of pain during the procedure by a visual analog scale. Patients data, pain score, and potential complications were placed in a database and statistically assessed. Main results: Our series consisted of 48 patients. Statistical analysis showed significant lower mean nasal discomfort score in favor of the tetracaine group (2.29 vs 3.04 [P < .001]). No tetracaine complications or side effects occurred. Principal conclusion: Neurosurgical sponge application of tetracaine 2% solution is an easy, safe, inexpensive, and effective analgesia for transnasal fiber-optic laryngoscopy. © 2010 Elsevier Inc. All rights reserved.


Mazokopakis E.E.,Naval Hospital of Crete | Kotsiris D.A.,Naval Hospital of Crete
Hellenic Journal of Nuclear Medicine | Year: 2014

Hashimoto's thyroiditis (HT) is a chronic autoimmune thyroid disease caused by an interaction between genetic factors and environmental conditions, both of which are not yet completely understood. The significant association between vitamin D deficiency and HT has been investigated regarding the immune role of this hormone. In HT, an immunologic reaction is triggered when thyrocytes express major histocompatibility complex (MHC) class II surface HLA-DR antigens, a process induced by the production from T helper (Th)1 type lymphocytes, of inflammatory cytokines (especially IFN-γ), which may be inhibited by 1,25[OH]2D. Genetic polymorphism of vitamin D receptor (VDR), binding protein (DBP) and of a 1α-hydroxylase (CYP1α) may also predispose to the development of HT. Considering current evidence, presented in this review, screening for vitamin D deficiency and careful vitamin D supplementation, when required, may be recommended for patients with HT. Further research is needed in patients with HT in order to investigate the mechanisms by which vitamin D affects autoimmunity and also to evaluate the cost-effectiveness of vitamin D supplementation and to suggest the possible optimal dose treatment.


Bourolias C.,Naval Hospital of Crete | Gkotsis A.,Naval Hospital of Crete
American Journal of Otolaryngology - Head and Neck Medicine and Surgery | Year: 2011

We report 2 cases of a 29- and a 37-year-old male patient both having sphenoid sinus barotrauma associated with free diving at about 12-m depth. A unilateral occupation of the sphenoid sinus was revealed in both cases by computed tomography and magnetic resonance imaging examination of the paranasal sinuses. © 2011 Elsevier Inc. All rights reserved.


Mazokopakis E.E.,Naval Hospital of Crete | Kofteridis D.P.,University of Crete | Pateromihelaki A.T.,Naval Hospital of Crete | Vytiniotis S.D.,Naval Hospital of Crete | Karastergiou P.G.,Naval Hospital of Crete
Dermatologic Therapy | Year: 2011

Pyoderma gangrenosum (PG) is a rare noninfectious destructive neutrophilic dermatosis of unknown origin affecting the skin and occasionally the subcutaneous fat. In this report, we present the results of intensive hyperbaric oxygen (HBO) therapy in a 62-year-old Greek woman who had been diagnosed with ulcerative PG two years ago, but had been resistant to other therapies. © 2011 Wiley Periodicals, Inc.

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