7 results on '"Michelakis, Stylianos"'
Search Results
2. KL‑6, ET‑1 and S100A9 levels in patients with idiopathic pulmonary fibrosis and obstructive sleep apnea.
- Author
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Bouloukaki, Izolde, Michelakis, Stylianos, Tsitoura, Eliza, Vasarmidi, Eirini, Koutoulaki, Chara, Tzanakis, Nikolaos, Schiza, Sophia, and Antoniou, Katerina M.
- Subjects
- *
IDIOPATHIC pulmonary fibrosis , *PULMONARY function tests , *SLEEP apnea syndromes , *CALCIUM-binding proteins , *PULMONARY fibrosis - Abstract
Obstructive sleep apnea (OSA) and idiopathic pulmonary fibrosis (IPF) frequently coexist. Elevated levels of Krebs von den Lungen-6 (KL-6), endothelin-1 (ET-1) and S100 calcium-binding protein A9 (S100A9) have been observed in patients with IPF, suggesting their potential role as biomarkers for lung fibrosis. The aim of the present study was to measure the levels of KL-6, ET-1 and S100A9 in patients with IPF-OSA and to test the potential of these biomarkers as a characteristic OSA signature with diagnostic and prognostic potential for IPF. A total of 55 subjects with newly-diagnosed IPF participated in the present cross-sectional study. In addition to performing overnight attended polysomnography and pulmonary function tests, serum and bronchoalveolar lavage (BAL) levels of KL-6, along with serum levels of ET-1 and S100A9, were also assessed. A total of 15 patients with IPF and 40 patients with IPF-OSA were included. Age, sex, comorbidities and pulmonary function tests did not differ between the groups. Although there was no significant difference between groups in the levels of KL-6, ET-1 and S100A9 (P>0.05), the serum ET-1 levels tended to be elevated in patients with OSA-IPF compared with patients with IPF (1.78 vs. 1.07 pg/ml; P=0.06). Additionally, a significant association was observed between serum KL-6 levels and the severity of IPF, and also between BAL KL-6 levels and nocturnal mean SaO2 levels, even after taking into account factors such as obesity and smoking. S100A9 levels were associated with the oxygen desaturation index, even after adjustments for obesity, smoking and the gender-age-physiology index, only in the IPF-OSA group. Conclusively, the present findings suggested significant associations between serum ET-1, S100A9 and BAL KL-6 levels and specific OSA severity parameters in the IPF-OSA group. This evidence suggested that these molecules could serve as biomarkers for the identification of patients with IPF-OSA, offering a distinct OSA signature that has diagnostic and potential treatment value. Larger studies are crucial to substantiate the present findings and reinforce this hypothesis. [ABSTRACT FROM AUTHOR] more...
- Published
- 2025
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3. Two women with unexplained dyspnoea: removing the blame game from the lungs.
- Author
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Vasarmidi E, Lambiri I, Foteinaki E, Stamatopoulou V, Mitrouska I, Pitsidianakis G, Patrianakos A, Plevritaki A, Michelakis S, Amargianitakis V, Prinianakis G, Schiza S, and Tzanakis N
- Abstract
Hypoxaemia due to right-to-left atrial shunt with normal pressures in the right heart cavities represents an underdiagnosed condition. A systematic approach to hypoxaemic respiratory failure based on pathophysiology can lead to an accurate diagnosis. https://bit.ly/4bTP8fJ., Competing Interests: Conflicts of interest: The authors have nothing to disclose., (Copyright ©ERS 2024.) more...
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- 2024
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4. Patients with idiopathic pulmonary fibrosis with and without obstructive sleep apnea: differences in clinical characteristics, clinical outcomes, and the effect of PAP treatment.
- Author
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Papadogiannis G, Bouloukaki I, Mermigkis C, Michelakis S, Ermidou C, Mauroudi E, Moniaki V, Tzanakis N, Antoniou KM, and Schiza SE
- Subjects
- Continuous Positive Airway Pressure, Humans, Polysomnography, Quality of Life, Treatment Outcome, Idiopathic Pulmonary Fibrosis, Sleep Apnea, Obstructive
- Abstract
Study Objectives: Obstructive sleep apnea (OSA) in patients with idiopathic pulmonary fibrosis (IPF) is associated with worse mortality and clinical outcome. We aimed to assess differences between patients with IPF with and without OSA and the effect of positive airway pressure treatment on sleep and overall life quality, morbidity, and mortality in these patients., Methods: Forty-five patients with newly diagnosed IPF underwent polysomnography. Using an apnea-hypopnea index ≥ 15 events/h for OSA diagnosis resulted in 16 patients with IPF and 29 with IPF-OSA. The patients completed the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Functional Outcomes in Sleep Questionnaire, Fatigue Severity Scale, Short Form-36 life questionnaire, and Beck Depression Inventory before and at the end of the follow-up period., Results: Patients with IPF-OSA showed the most severe functional impairments in questionnaires, especially for General Health component of the Short Form-36 life questionnaire (37 vs 58, P = .03). At the 7-year follow-up, 16 (36%) patients had died, 6 (38%) in the IPF group and 10 (35%) in IPF-OSA group. Patients with ≥6-hour positive airway pressure use had better survival compared with patients with <6-hour use (P = .04). Significant improvement was also observed in Epworth Sleepiness Scale (3 vs 6, P = .03), Pittsburgh Sleep Quality Index (5 vs 8, P = .01), and Fatigue Severity Scale (37 vs 48, P = .008) score in patients with ≥4-hour positive airway pressure use., Conclusions: OSA plays a significant role on clinical features and quality of life in patients with IPF. Effective positive airway pressure treatment results in a significant improvement in sleepiness, fatigue, sleep quality, and mortality., Clinical Trial Registration: Registry: ClinicalTrials.gov; Name: CPAP Therapy in Patients With Idiopathic Pulmonary Fibrosis and Sleep Apnea; URL: https://clinicaltrials.gov/ct2/show/record/NCT01637831; Identifier: NCT01637831., (© 2021 American Academy of Sleep Medicine.) more...
- Published
- 2021
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5. Cardiovascular Effect and Symptom Profile of Obstructive Sleep Apnea: Does Sex Matter?
- Author
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Bouloukaki I, Mermigkis C, Markakis M, Pataka A, Alexaki I, Ermidou C, Moniaki V, Mauroudi E, Michelakis S, and Schiza SE
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- Body Mass Index, Cohort Studies, Comorbidity, Female, Humans, Male, Middle Aged, Obesity epidemiology, Polysomnography, Prevalence, Retrospective Studies, Sex Factors, Surveys and Questionnaires, Cardiovascular Diseases epidemiology, Sleep Apnea, Obstructive epidemiology
- Abstract
Study Objectives: To evaluate the influence of sex on obstructive sleep apnea (OSA)-related symptoms and prevalent cardiovascular disease (CVD) in a large clinical population of patients., Methods: A total of 6,716 patients (mean age 52 years, 24% women) had undergone diagnostic polysomnography and completed the Epworth Sleepiness Scale (ESS), Athens Insomnia Scale, and Beck Depression Inventory. We investigated the predictive value of sex on associated symptoms and prevalent cardiovascular disease, after adjustment for relevant confounding factors including age, obesity, and comorbidities., Results: Most of the patients (90%) had OSA (apnea-hypopnea index [AHI] ≥ 5 events/h), and 66% were obese. Women were older than men and had a higher body mass index; however, men had a thicker neck circumference, a higher waist-to-hip ratio, and increased OSA severity (AHI 36 versus 27 events/h, P < .001). Female sex independently predicted prevalent CVD after adjustment for confounders (odds ratio [95% CI] 1.476 [1.154-1.887], P = .002). Men independently were more likely to report driving problems (3.359 [2.470-4.569], P < .001) and excessive daytime sleepiness (ESS ≥ 16) (1.355 [1.036-1.773], P = .027). Furthermore, female sex was an independent predictive factor for depressive symptoms (2.473 [1.831-3.340], P < .001), frequent awakenings (1.703 [1.323-2.192], P < .001), nocturia (1.727 [1.340-2.226], P < .001) and morning headaches (1.855 [1.488-2.326], P < .001)., Conclusions: Females referred for sleep studies were more likely to exhibit CVD and less likely to complain of typical OSA symptoms than males in this large clinical patient cohort., (© 2019 American Academy of Sleep Medicine.) more...
- Published
- 2019
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6. The Association Between Adherence to Positive Airway Pressure Therapy and Long-Term Outcomes in Patients With Obesity Hypoventilation Syndrome: A Prospective Observational Study.
- Author
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Bouloukaki I, Mermigkis C, Michelakis S, Moniaki V, Mauroudi E, Tzanakis N, and Schiza SE
- Subjects
- Aged, Blood Gas Analysis statistics & numerical data, Continuous Positive Airway Pressure statistics & numerical data, Depressive Disorder complications, Depressive Disorder psychology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity Hypoventilation Syndrome complications, Obesity Hypoventilation Syndrome physiopathology, Polysomnography, Prospective Studies, Quality of Life psychology, Treatment Outcome, Continuous Positive Airway Pressure methods, Obesity Hypoventilation Syndrome therapy, Patient Compliance statistics & numerical data
- Abstract
Study Objectives: To assess the role of different levels of adherence and long-term effects of positive airway pressure (PAP) therapy on gas exchange, sleepiness, quality of life, depressive symptoms, and all-cause mortality in patients with obesity hypoventilation syndrome (OHS)., Methods: A total of 252 patients with newly diagnosed OHS were followed up for a minimum of 2 years after PAP initiation. PAP adherence (h/night) was monitored. Arterial blood gas samples were taken with patients being alert for more than 4 hours after morning awakening. Subjective daytime sleepiness (Epworth Sleepiness Scale [ESS]), quality of life (Short Form 36 [SF-36]) and patient's depressive symptoms (Beck Depression Inventory [BDI]) were assessed before and at the end of the follow-up period, along with all-cause mortality., Results: At the end of the follow-up period (median duration [25th-75th percentile], 30 [24-52] months), PaO
2 increased from baseline (72.7 ± 10.3 versus 63.2 ± 10.6, P < .001) and both PaCO2 and HCO3 - decreased (43.0 [39.2-45.0] versus 50.0 [46.7-55.4] and 27.5 ± 3.2 versus 31.4 ± 4.2, respectively, P < .001). In addition, PAP therapy significantly improved ESS (7 [4-9] versus 14 [11-16], P < .001), BDI (8.8 ± 4.9 versus 15.5 ± 7.3, P < .001) and SF-36 (82 [78-87] versus 74 [67-79], P < .001) scores. Over the follow-up period 11 patients died. Patients who used PAP for > 6 h/night had significant improvements ( P < .05) in blood gases and SF-36 scores than less adherent patients., Conclusions: Increased hours of use and long-term therapy with PAP are effective in the treatment of patients with OHS. Clinicians should encourage adherence to PAP therapy in order to provide a significant improvement in clinical status and gas exchange in these patients., Commentary: A commenary on this article appears in this issue on page 1455., Clinical Trial Registration: Title: PAP Therapy in Patients With Obesity Hypoventilation Syndrome, Registry: ClinicalTrials.gov, Identifier: NCT03449641, URL: https://clinicaltrials.gov/ct2/show/NCT03449641., (© 2018 American Academy of Sleep Medicine.) more...- Published
- 2018
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7. Intensive versus standard follow-up to improve continuous positive airway pressure compliance.
- Author
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Bouloukaki I, Giannadaki K, Mermigkis C, Tzanakis N, Mauroudi E, Moniaki V, Michelakis S, Siafakas NM, and Schiza SE
- Subjects
- Adult, Aged, Continuous Positive Airway Pressure economics, Female, Follow-Up Studies, Health Care Costs, Hospitalization, Humans, Male, Middle Aged, Patient Compliance, Polysomnography, Prospective Studies, Quality of Life, Sleep Apnea, Obstructive economics, Sleep Apnea, Obstructive psychology, Surveys and Questionnaires, Continuous Positive Airway Pressure methods, Sleep Apnea, Obstructive therapy
- Abstract
We aimed to compare the effect of intensive versus standard interventions on continuous positive airway pressure (CPAP) adherence 2 years after CPAP initiation, as well as on sleepiness, quality of life, depression, hospitalisation and death rate due to cardiovascular disease (CVD). 3100 patients with newly diagnosed sleep apnoea were randomised into the standard group, with usual follow-up care, or the intensive group, with additional visits, telephone calls and education. Subjective daytime sleepiness (Epworth Sleepiness Scale; ESS), quality of life (36-item Short Form Health Survey; SF-36) and the patient's level of depression (Beck Depression Inventory; BDI) were recorded before and 2 years after CPAP initiation, together with CVD hospitalisations and death rate. 2 years after CPAP initiation, the intensive group used CPAP significantly more than the standard group (6.9 versus 5.2 h per night; p<0.001). ESS, SF-36 and BDI scores were also significantly better in the intensive group. Furthermore, the standard group had significantly more deaths and hospitalisations due to CVD. CPAP usage can be improved by both intensive and standard patient support. However, the patients who received intensive CPAP support had significantly better ESS, BDI and SF-36 scores, and lower cardiovascular morbidity and mortality, suggesting that an intensive programme could be worthwhile., (©ERS 2014.) more...
- Published
- 2014
- Full Text
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