Elias E Mazokopakis

University Hospital of Heraklion, Irákleio, Attica, Greece

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Publications (67)102.35 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Spirulina (Arthrospira platensis) is a filamentous cyanobacterium used as a food supplement. OBJECTIVE: The purpose of this study was to determine the lipid-lowering effects of Spirulina in Cretan Greek dyslipidemic patients, and to document its effectiveness as a possible alternative treatment for dyslipidemia METHODS: Fifty two adult Cretan outpatients (32 males, 20 females), median age 47 (range: 37-61) years, with recently diagnosed dyslipidemia, consumed orally 1g Spirulina (Greek production) per day for 12 weeks. 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 (BMI) were also recorded RESULTS: At the end of the three-month intervention period the mean triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), total cholesterol (T-C), non-high density lipoprotein-cholesterol (non-HDL-C) levels and T-C/HDL-C (high density lipoprotein-cholesterol) ratio 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 HDL-C levels were not significantly increased: 3.5%. Blood pressure, weight and BMI remained almost unchanged. CONCLUSIONS: Spirulina supplementation at a small dose of 1g daily has powerful hypolipidemic effects, especially on the TG concentration in dyslipidemic Cretan outpatients.
    Journal of the Science of Food and Agriculture 06/2013; · 1.76 Impact Factor
  • Elias E Mazokopakis, Ioannis K Starakis
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    ABSTRACT: 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.
    Diabetes research and clinical practice 07/2012; 97(3):359-67. · 2.74 Impact Factor
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    ABSTRACT: The incorporation of targeted agents has considerably improved the management of patients with advanced non-small cell lung cancer (NSCLC) over the last years. The main targets include the epidermal growth factor receptor (EGFR) and the vascular endothelial growth factor (VEGF). Currently available agents with established role in NSCLC include the anti-EGFR tyrosine-kinase inhibitors (TKIs) erlotinib/gefitinib and the anti-VEGF monoclonal antibody bevacizumab. Moreover, several other agents targeting critical pathways in lung carcinogenesis are currently under preclinical or clinical evaluation. This review presents an update on the role of targeted agents in advanced NSCLC. In addition, we present the main clinical studies investigating the activity of these agents in NSCLC and we provide recent data with respect to future therapeutic strategies.
    Combinatorial chemistry & high throughput screening 03/2012; 15(8):641-55. · 2.46 Impact Factor
  • Ioannis Starakis, George Panos, Elias Mazokopakis
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    ABSTRACT: Although infective endocarditis (IE) is not the most frequent infection seen in intravenous (IV) drug abusers (IVDAs), health care providers should always regard it as a possible diagnosis in this population. Many researchers have tried to elucidate the clinical, epidemiologic, immunologic and pathogenetic aspects of this entity. Right-sided endocarditis accounts for almost 10% of all IE episodes and has been most commonly interrelated with IV use of illicit substances. On the other hand, recent reports have proposed that left-sided valve participation is seen more often now than in the past. While, our progress in medicine, new diagnostic criteria and especially modern imaging techniques have broadened our ability to recognize IE, there are still some gray areas regarding right-sided IE. Our aim is to comprehensively review the clinical features and complications and also the possible pathogenetic and immunologic mechanisms implicated in IE patients who are injecting illicit substances.
    Current Vascular Pharmacology 03/2012; 10(2):247-56. · 2.91 Impact Factor
  • Ioannis Starakis, George Panos, Elias Mazokopakis
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    ABSTRACT: Although infective endocarditis (IE) is not the most frequent infection seen in intravenous (IV) drug abusers (IVDAs), health care providers should always regard it as a possible diagnosis in this population. Many researchers have tried to elucidate the clinical, epidemiologic, immunologic and pathogenetic aspects of this entity. Right-sided endocarditis accounts for almost 10% of all IE episodes and has been most commonly interrelated with IV use of illicit substances. On the other hand, recent reports have proposed that left-sided valve participation is seen more often now than in the past. While, our progress in medicine, new diagnostic criteria and especially modern imaging techniques have broadened our ability to recognize IE, there are still some gray areas regarding right-sided IE. Our aim is to comprehensively review the clinical features and complications and also the possible pathogenetic and immunologic mechanisms implicated in IE patients who are injecting illicit substances.
    Current Vascular Pharmacology 02/2012; 10(2):247-256. · 2.91 Impact Factor
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    ABSTRACT: 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.
    Hormones (Athens, Greece) 01/2012; 11(1):101-3. · 2.01 Impact Factor
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    ABSTRACT: Infections of the central nervous system may provoke glial and autoimmune responses but a definitive linkage between these infections and the pathogenesis of chronic neurologic disorders is still elusive. There are controversial reports implicating infectious agents in the pathogenetic mechanisms of chronic or long-term neurologic disorders, such as multiple sclerosis, amyotrophic lateral sclerosis, Parkinson's disease, Alzheimer's disease and autistic spectrum disorders, but the specific role of bacterial or viral infections in the pathogenesis of these medical entities has not been fully elucidated. Up till now, the evidence is distant from definite, but certain cases may be attributed to infections in the millieu of multiple toxic events such as trauma, nutritional deficits, immune dysregulation and excitotoxicity in genetically vulnerable indiniduals. There is an ongoing debate concering the direct involvement of various infectious agents in the neurodegenerative and neurobehavioral diseases pathogenesis and/or their contribution to the deterioration of the disease or co-morbidity in these patients. These patients are exceptionally difficult to be treated by using single therapeutic modalities, because their disese is multifocal and treatment is aimed to control signs and symptoms rather than the true causes of the disease and its progressive course. Furthermore, even if these causative links were indetifiable, our therapeutic interventions would come too late due to the irreversible damages at the time of the initiation of treatment. Our aim is to comprehensively review all available data suggesting that infections could be common antecedent events of progressive neurologic degenerative or behavioural diseases.
    Cardiovascular & hematological disorders drug targets. 03/2011; 11(1):40-52.
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    ABSTRACT: Epstein-Barr Virus (EBV) infection has the potential to establish life-long, benign infections in their hosts. Although biochemical evidence of hepatocellular damage is common, jaundice is uncommon and complete recovery is the rule. The present study describes clinical characteristics and changes of liver function tests during the course of infectious mononucleosis. All immunocompetent patients with hepatic dysfunction associated with acute EBV infection, cared for at the University Hospital of Heraklion, over a 6-year period, were identified and retrospectively studied. The study included 41 patients with a median age of 18.5 (15-51) years. Aspartate-aminotransferase (AST) and alanine-aminotransferase (ALT) were increased in an average maximum of 5-fold. Both transaminase levels started to rise 2 days after the clinical onset of the disease, and returned to normal after a period of 20 days. Alkaline-phosphatase (ALP), γ-glutamyltransferase (γ-GT) and bilirubin levels also increased above the normal values during the course of the disease and returned to normal after a period of 20, 30 and 22 days respectively. The changes of mean AST and ALT levels over time were statistically significant, while those of mean ALP, γ-GT and bilirubin levels over time were not. Anicteric cholestatic liver disease was observed in 24 patients (59%), while icteric only in 2 (6%). Liver involvement in acute EBV infection represents mild and self-limited hepatitis with predominantly cholestatic features.
    European Journal of Internal Medicine 02/2011; 22(1):73-6. · 2.05 Impact Factor
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    ABSTRACT: 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.
    Dermatologic Therapy 01/2011; 24(1):134-6. · 1.96 Impact Factor
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    Elias E Mazokopakis, Ioannis K Starakis
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    ABSTRACT: Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for osteoporosis and fractures because of lifestyle factors, systemic effects of the disease, side effects of treatment, and comorbidities. The initial evaluation of COPD men for osteoporosis must include a detailed medical history and physical examination, assessment of COPD severity, and additional tests, as suggested by results of clinical evaluation. Osteoporosis is diagnosed on the basis of bone mineral density (BMD) measurement with DEXA of the lumbar spine and hip, but fracture risk assessments tools, as FRAX, could be used as useful supplements to BMD assessments for therapeutics interventions. The prevention and treatment of osteoporosis in COPD involves nonpharmacologic and pharmacologic measures, as lifestyle measures and nutritional recommendations, management of COPD treatment (based on the use of limited corticosteroids doses), and drug therapy (bisphosphonates, teriparatide). In this paper, the current recommendations for diagnosis and management of osteoporosis in COPD men, based on recent medical bibliography, are presented and discussed.
    ISRN rheumatology. 01/2011; 2011:901416.
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    ABSTRACT: The association between Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) remains controversial in medical bibliography. The main objective of our study was to determine the prevalence of PTC and HT coexistence in histopathologic material of thyroidectomized patients. In a retrospective study, the clinicohistopathologic data of 140 patients (19 males/121 females), who underwent a total or near total thyroidectomy for any thyroid pathology from January 2005 to December 2009 at the Naval Hospital of Crete, were analysed. The mean age of the patients was 52 years (range 16-74). HT was detected in 42 (30%) and PTC in 32 (22.9%) specimens. Coexistence of HT with PTC was present in 12 (8.6%) specimens. Among 32 specimens with PTC, the prevalence of HT was 37.5%. Among 42 specimens with HT, the prevalence of PTC was 28.6%. There was no statistically significant difference between the presence of PTC and HT in histopathologic material. The prevalence of PTC and HT coexistence in histopathologic material of 140 thyroidectomized patients was 8.6%, whereas the difference between PTC and HT was not statistically significant.
    Hormones (Athens, Greece) 10/2010; 9(4):312-7. · 2.01 Impact Factor
  • Ioannis Starakis, Angelos Koutras, Elias E Mazokopakis
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    ABSTRACT: 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.
    Cardiovascular & hematological disorders drug targets. 06/2010; 10(2):94-102.
  • Elias E Mazokopakis, Periklis K Syros, Ioannis K Starakis
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    ABSTRACT: 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.
    Cardiovascular & hematological disorders drug targets. 06/2010; 10(2):84-6.
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    ABSTRACT: All bacteraemic cases, from August 2006 to September 2007 were identified by reviewing all positive blood culture results from the microbiology department of our hospital. One thousand three hundred and sixty six cases were detected in 1336 patients. The rate of true bacteremia which was 13.1 and 10.7% of cultures were contaminated. Of the 1366 episodes of bloodstream infection, 55.3% were community-acquired and 44.7% were health-care associated. Gram-positive bacteria prevailed (58.5%), followed by gram negative bacilli (38.5%). Polymicrobial bacteremia was detected in 2.2% of cases. Coagulase-negative staphylococci (CoNS) were the leading cause (550/1366 = 40.3%), whilst enterococci, Staphylococcus aureus and Streptococci represented 8, 6.4 and 3.8% respectively. Pseudomonas aeruginosa was the commonest gram-negative isolate (155/1366 = 11.3%), followed by Escherichia coli (8.2%) and Acinetobacter sp. (7.3%). Fungi were isolated in the 3% of the isolates and Candida albicans accounted for the 70.7% of them. Fatal outcome due to bloodstream infections was 15.3% and 5.7% in hospital (HA) and community-acquired (CA) episodes, respectively (P < 0.0005).The highest mortality occurred in patients with bacteremia due to Acinetobacter (41%) in HA episodes, and in patients with bacteremia due to S. aureus (34.0%) in CA incidents.
    Medical Practice and Review. 05/2010; 1:1-8.
  • I Starakis, E E Mazokopakis, H Bassaris
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    ABSTRACT: Brucellosis remains a diagnostic puzzle. We retrospectively studied the case notes of 105 patients with brucellosis who were admitted in the Department of Internal Medicine of the University of Patras Hospital, a tertiary care institution serving an extended rural area in western Greece, from 2003 to 2006. Five unusual causes of brucellosis were identified: hepatic, epidural and thyroid abscesses, intrahepatic cholestatic liver disease and pancytopenia. Virtually every human organ and system can be involved in brucellosis, which highlights the need to include brucellosis in the differential diagnosis, especially in endemic areas.
    Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ 04/2010; 16(4):365-70.
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    ABSTRACT: 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.
    Infectious disorders drug targets. 02/2010; 10(1):27-31.
  • Ioannis Starakis, Elias E Mazokopakis
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    ABSTRACT: Infective endocarditis (IE) is not the most frequent infection acquainted in intravenous drug abusers (IVDAs). On the other hand, all physicians should keep a high index of suspicion and always consider this possibility when they are dealing with an infectious process in this special population group. Since Sir William Osler, at the turn of the previous century, first described IE, there have been tremendous alterations in the very nature of this serious and possibly fatal disease. Right-sided endocarditis accounts for almost 10% of all IE episodes and has been correlated most commonly with injection of illicit drugs. However, recent reports have proposed that left-sided valves' participation is seen more often now than in the past. Although, the advances in medicine and especially modern imaging techniques have expanded our capacity to identify IE, there are still some gray areas in our ability to fully comprehend right-sided IE. Hussey et al. [1] were the first to distinguish IE as a distinct impediment of IV narcotics abuse in 1950. Although, many reports have been published since then arguing about the aspects of this medical entity, we will try here to comprehensively review the epidemiology and predisposing factors, clinical features and complications, diagnosis, treatment and prognosis of this disease, emphasizing on those distinctive or exclusive features seen in IE patients who are injecting illicit substances.
    Infectious disorders drug targets. 02/2010; 10(1):22-6.
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    ABSTRACT: Thrombophilia, either congenital or acquired, has foremost consequences in the abdominal vessels. We review here the cases of patients admitted with abdominal vessel thrombosis over a five-year period. Our data focused on gender and age at diagnosis, site of thrombosis, previous thromboembolic events, underlying conditions, and family history. Investigations included measurement of protein C, protein S, activated PC resistance, and antithrombin, and screening for factor V Leiden, prothrombin G20210A, the C677T variant of the methylenetetrahydrofolate reductase gene, and V617F JAK2 mutation, r lupus anticoagulant, antiphospholipid antibodies and paroxysmal nocturnal hemospherinouria, and also serum folate, vitamin 12, and total homocysteine concentrations. Twenty-nine patients were admitted and 18 of their family members also underwent the same thrombophilia investigations. Eighteen patients (62.1%) presented with portal vein thrombosis (PVT), five patients (17.2%) with mesenteric vein thrombosis (MVT), four patients (13.8%) with splenic vein thrombosis (SVT), and two (6.9%) patients with hepatic vein thrombosis (HVT). There was a high incidence of congenital thrombophilia (37.9%), acquired thrombophilic conditions (27.6%), or both (20.7%). Sixteen of 18 patients with PVT, four of five patients with MVT, all four patients with SVT, and one of two patients with HVT had one or more thrombophilic risk factors. In 13.8% of the patients no underlying condition was identified. We concluded that thrombophilia may have major implications in the pathogenesis of abdominal vessel thrombosis in adult life, and a thorough thrombophilia investigation should be performed in all these patients.
    Gastroenterology Insights. 01/2010;
  • Journal of alternative and complementary medicine (New York, N.Y.) 12/2009; 15(12):1273-4. · 1.69 Impact Factor
  • Journal of alternative and complementary medicine (New York, N.Y.) 11/2009; 15(11):1155. · 1.69 Impact Factor

Publication Stats

237 Citations
102.35 Total Impact Points

Institutions

  • 2003–2013
    • University Hospital of Heraklion
      • Department of Gastroenterology
      Irákleio, Attica, Greece
  • 2009–2012
    • Πανεπιστημιακό Γενικό Νοσοκομείο Πατρών
      Pátra, West Greece, Greece
  • 2002–2005
    • University of Crete
      • • Department of Internal Medicine
      • • Clinic of Social and Family Medicine (CSFM)
      • • School of Medicine
      Retimo, Crete, Greece
  • 2000
    • ΝΑΥΤΙΚΟ ΝΟΣΟΚΟΜΕΙΟ ΑΘΗΝΩΝ
      Athínai, Attica, Greece