George Vaiopoulos

Publications (8)22.92 Total impact

• Article: Evaluation of current therapeutic strategies in Behçet’s disease

  Iliana Alexoudi, Violetta Kapsimali, Aristides Vaiopoulos, Meletios Kanakis, George Vaiopoulos
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  ABSTRACT: Behçet’s disease (BD) is a chronic relapsing vasculitis with multifunctional pathogenesis. The mucocutaneous and ocular lesions are the commonest manifestations, but BD also affects the musculoskeletal, intestinal, cardiac, and central nervous system. BD therapy is based on the suppression of the inflammatory process, using immunomodulating and immunosuppressive agents. In selected cases, invasive procedures may be required. KeywordsBehcet’s disease–Biologic agents–Management–Organs–Therapy–Treatment
  Clinical Rheumatology 04/2012; 30(2):157-163. · 2.00 Impact Factor
• Article: Adalimumab or cyclosporine as monotherapy and in combination in severe psoriatic arthritis: results from a prospective 12-month nonrandomized unblinded clinical trial.

  George N Karanikolas, Eftyhia-Maria Koukli, Aikaterini Katsalira, Aikaterini Arida, Dimitrios Petrou, Eleni Komninou, Kalliopi Fragiadaki, Anna Zacharioudaki, Ioannis Lasithiotakis, Eirini Giavri, George Vaiopoulos, Petros P Sfikakis
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  ABSTRACT: To assess the efficacy and safety of adalimumab or cyclosporine (CYC) as monotherapy or combination therapy for patients with active psoriatic arthritis (PsA), despite methotrexate (MTX) therapy. A prospective 12-month, nonrandomized, unblinded clinical trial of 57, 58, and 55 patients who received CYC (2.5-3.75 mg/kg/day), adalimumab (40 mg every other week), or combination, respectively. Lowering of concomitant nonsteroidal antiinflammatory drugs (NSAID) and corticosteroids and reductions of adalimumab and/or CYC doses in responding patients were not restricted. Mean numbers of tender/swollen joints at baseline were 9.7/6.7 in CYC-treated, 13.0/7.8 in adalimumab-treated, and 14.5/9.4 in combination-treated patients, indicating lesser disease severity of patients assigned to the first group. The Psoriatic Arthritis Response Criteria at 12 months were met by 65% of CYC-treated (p = 0.0003 in favor of combination treatment), 85% of adalimumab-treated (p = 0.15 vs combination treatment), and 95% of combination-treated patients, while the American College of Rheumatology-50 response rates were 36%, 69%, and 87%, respectively (p < 0.0001 and p = 0.03 in favor of combination treatment). A significantly greater mean improvement in Health Assessment Questionnaire Disability Index was achieved by combination treatment (-1.11) vs CYC (-0.41) or adalimumab alone (-0.85). Combination therapy significantly improved Psoriasis Area and Severity Index-50 response rates beyond adalimumab, but not beyond the effect of CYC monotherapy. Doses of NSAID and corticosteroids were reduced in combination-treated patients; CYC doses and frequency of adalimumab injections were also reduced in 51% and 10% of them, respectively. No new safety signals were observed. The combination of adalimumab and CYC is safe and seemed to produce major improvement in both clinical and serological variables in patients with severely active PsA and inadequate response to MTX.
  The Journal of Rheumatology 09/2011; 38(11):2466-74. · 3.69 Impact Factor
• Article: Kawasaki disease: current aspects on aetiopathogenesis and therapeutic management.

  Iliana Alexoudi, Meletios Kanakis, Violetta Kapsimali, George Vaiopoulos
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  ABSTRACT: Kawasaki disease (KD) is a vasculitis that affects mainly children of 6 months to 4 years old. It is important to be early recognised so as to limit the inflammatory cascade that may lead to aneurysmatic dilatations of coronary arteries. The causative agent of KD has not been still indentified and the aetiopathogenetic theories are based on epidemiologic, laboratory and histological data. The management of the disease is divided according to the clinical stage and patients' follow up should be continued for years after the disease onset. The exact period is determined by the risk level of the KD.
  Autoimmunity reviews 07/2011; 10(9):544-7. · 6.37 Impact Factor
• Source

  Available from: PubMed Central

  Article: Serum anti-Saccharomyces cerevisiae antibodies in Greek patients with Behcet's disease.

  George Vaiopoulos, Peter Laszlo Lakatos, Maria Papp, Faedon Kaklamanis, Efrosyni Economou, Vassilis Zevgolis, John Sourdis, Kostas Konstantopoulos
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  ABSTRACT: We tested 59 Greek patients with Behcet's Disease (BD) for serum anti-Saccharomyces cerevisiae antibodies. No increase of these antibodies was detected in the cases compared to 55 healthy unrelated blood donors from the same population. This finding is in contrast with the correlation between Saccharomyces cerevisiae antibodies and BD as reported in other populations. It seems that environmental factors may contribute to disease expression in different populations, producing different effects according to the individual's genetic predisposition. Saccharomyces cerevisiae antibodies do not seem to be of any significance in the Greek population.
  Yonsei medical journal 03/2011; 52(2):347-50. · 0.77 Impact Factor
• Article: Evaluation of current therapeutic strategies in Behçet's disease.

  Iliana Alexoudi, Violetta Kapsimali, Aristides Vaiopoulos, Meletios Kanakis, George Vaiopoulos
  [show abstract] [hide abstract]
  ABSTRACT: Behçet's disease (BD) is a chronic relapsing vasculitis with multifunctional pathogenesis. The mucocutaneous and ocular lesions are the commonest manifestations, but BD also affects the musculoskeletal, intestinal, cardiac, and central nervous system. BD therapy is based on the suppression of the inflammatory process, using immunomodulating and immunosuppressive agents. In selected cases, invasive procedures may be required.
  Clinical Rheumatology 02/2011; 30(2):157-63. · 2.00 Impact Factor
• Article: Soft tissue gas gangrene: a severe complication of emphysematous cholecystitis.

  Michael Safioleas, Michael Stamatakos, Meletios Kanakis, Constantina Sargedi, Constantinos Safioleas, Anastasios Smirnis, George Vaiopoulos
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  ABSTRACT: Soft tissue gas gangrene with myonecrosis is a severe complication of traumatic and non-traumatic conditions with a potentially lethal outcome. Emphysematous cholecystitis is a complication of acute cholecystitis, which is characterized by air accumulation in the gallbladder wall and is reported in the literature as a rare causative factor of soft tissue gas gangrene. Here we report 4 patients who developed soft tissue gas gangrene as a complication of emphysematous cholecystitis. Two patients were female octogenarians (one with a history of diabetes mellitus), and underwent percutaneous trans-gallbladder drainage and fascia incisions of the affected soft tissue with prompt administration of antibiotics. Finally, both of them died. The other two patients were male (32 years old diabetic and 47 years old with a history of chronic alcoholism). They underwent open cholecystectomy. Fascia incisions of the gangrenous areas and antibiotic therapy administration were also performed. Both of them were discharged from the hospital and are currently in excellent clinical status. We also present the ultrasonographic and/or radiologic images of these four patients. Soft tissue gas gangrene may complicate emphysematous cholecystitis, and clinicians should be aware of the coexistence of these two clinical conditions, since immediate management is needed in order to prevent fatal outcome.
  The Tohoku Journal of Experimental Medicine 01/2008; 213(4):323-8. · 1.24 Impact Factor
• Source

  Available from: Meletios A Kanakis

  Article: Colour duplex sonography of temporal arteries before decision for biopsy: a prospective study in 55 patients with suspected giant cell arteritis.

  Maria Karahaliou, George Vaiopoulos, Spiros Papaspyrou, Meletios A Kanakis, Konstantinos Revenas, Petros P Sfikakis
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  ABSTRACT: Although a temporal artery biopsy is the gold standard for the diagnosis of giant cell arteritis (GCA), there is considerable evidence that characteristic signs demonstrated by colour duplex sonography (CDS) of the temporal arteries may be of diagnostic importance. We aimed to test the hypothesis that CDS can replace biopsy in the algorithm for the approach to diagnose GCA. Bilateral CDS was performed in consecutive patients older than 50 years with clinically suspected GCA, as well as in 15 age- and gender-matched control subjects with diabetes mellitus and/or stroke and 15 healthy subjects, to assess flow parameters and the possible presence of a dark halo around the arterial lumen. Unilateral temporal artery biopsy was then performed in patients with suspected GCA, which was directed to a particular arterial segment in case a halo was detected in CDS. Final diagnoses, after completion of a 3-month follow-up in 55 patients, included GCA (n = 22), polymyalgia rheumatica (n = 12), polyarteritis nodosa, Wegener's, and Adamantiades-Behçet's diseases (n = 3), and neoplastic (n = 8) and infectious diseases (n = 10). A dark halo of variable size (0.7-2.0 mm) around the vessel lumen was evident at baseline CDS in 21 patients (in 12 and 9 uni- or bilaterally, respectively) but in none of the controls. The presence of unilateral halo alone yielded 82% sensitivity and 91% specificity for GCA, whereas the specificity reached 100% when halos were found bilaterally. Blood-flow abnormal parameters (temporal artery diameter, peak systolic blood-flow velocities, stenoses, occlusions) were common in GCA and non-GCA patients, as well as in healthy and atherosclerotic disease-control, elderly subjects. At follow-up CDS examinations performed at 2 and 4 weeks after initiation of corticosteroid treatment for GCA, halos disappeared in all 18 patients (9 and 9, respectively). We conclude that CDS, an inexpensive, non-invasive, and easy-to-perform method, allows a directional biopsy that has an increased probability to confirm the clinical diagnosis. Biopsy is not necessary in a substantial proportion of patients in whom bilateral halo signs can be found by CDS.
  Arthritis research & therapy 02/2006; 8(4):R116. · 4.27 Impact Factor
• Article: Multiple myeloma associated with systemic lupus erythematosus.

  George Vaiopoulos, Kostas Konstantopoulos, Marina Mantzourani, Phaedon Kaklamanis
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  ABSTRACT: A case of systemic lupus erythematosus (SLE) complicated by multiple myeloma is presented; the lupus diagnosis was put together with the diagnosis of myeloma but the symptoms had commenced a few years before. The putative mechanisms underlying this unusual combination are discussed.
  Leukemia and Lymphoma 06/2003; 44(5):893-4. · 2.58 Impact Factor