TIMOLEON GIANNAKAS

Dr. TIMOLEON GIANNAKAS

orcid

Research Focus & Metrics

Academic Career Length

7Years (2020-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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11 February 2025 in Diseases
Verified
Journal Article
Open access
PDF file
Aris KaltsasAris Kaltsas
Aris Kaltsas
TGTIMOLEON GIANNAKAS
TIMOLEON GIANNAKAS
MSMarios Stavropoulos
Marios Stavropoulos
ZKZisis Kratiras
Zisis Kratiras
MCMichael Chrisofos
Michael Chrisofos
Background/Objectives: Benign prostatic hyperplasia (BPH) is among the most common conditions affecting men as they age, resulting in lower urinary tract symptoms (LUTS) that can profoundly impact quality of life. While historically attributed primarily to androgenic imbalances, current evidence implicates additional factors—particularly oxidative stress (OS) and chronic inflammation—in BPH pathogenesis. This review aims to synthesize research on the interplay between OS, inflammation, and hormonal regulation in BPH, emphasizing their clinical relevance and potential therapeutic implications. Methods: A comprehensive review of peer-reviewed literature was conducted focusing on mechanistic studies, clinical trials, and observational reports. Searches included data on ROS generation, antioxidant capacity, inflammatory mediators, and their contribution to pathological prostatic overgrowth. Potential interventions targeting OS—such as antioxidant supplementation, anti-inflammatory drugs, vitamin D receptor agonists, and phytotherapeutics—were also evaluated for their efficacy and safety profiles. Results: Chronic inflammation and OS were consistently identified within hyperplastic prostate tissue. Excessive ROS production, diminished antioxidant defense, and sustained cytokine release create a proproliferative and antiapoptotic environment, accelerating disease progression. Metabolic comorbidities (e.g., obesity, insulin resistance) further exacerbate these imbalances. Standard therapies (α-blockers and 5-ARIs) effectively relieve symptoms but do not directly address the oxidative–inflammatory axis. Emerging evidence suggests that pharmacological and dietary approaches targeting OS and inflammation may reduce prostate volume expansion and alleviate LUTS. Conclusions: Findings indicate that OS and inflammation are key contributors to BPH progression. Incorporating antioxidant and anti-inflammatory strategies alongside conventional treatments holds promise for improving clinical outcomes and patient quality of life. Future research should focus on validating OS-specific biomarkers and optimizing personalized therapy regimens.

Verified
Journal Article
Open access
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MPMichail Papapanou
Michail Papapanou
EPEleni Papoutsi
Eleni Papoutsi
TGTIMOLEON GIANNAKAS
TIMOLEON GIANNAKAS
paraskevi katsaounouparaskevi katsaounou
paraskevi katsaounou
Current standard treatment of COVID-19 lacks in effective antiviral options. Plitidepsin, a cyclic depsipeptide authorized in Australia for patients with refractory multiple myeloma, has recently emerged as a candidate anti-SARS-CoV-2 agent. The aim of this review was to summarize current knowledge on plitidepsin’s clinical profile, anti-tumour and anti-SARS-CoV-2 mechanisms and correlate this with available or anticipated, preclinical or clinical evidence on the drug’s potential for COVID-19 treatment.PubMed, Scopus, CENTRAL, clinicaltrials.gov, medRxiv and bioRxiv databases were searched.Plitidepsinexerts its anti-tumour and antiviral properties primarily through acting on isoforms of the host cell’s eukaryotic-translation-elongation-factor-1-alpha (eEF1A). Through inhibiting eEF1A and therefore translation of necessary viral proteins, it behaves as a “host-directed” anti-SARS-CoV-2 agent. In respect to its potent anti-SARS-CoV-2 properties, the drug has demonstrated superior ex vivo efficacy compared to other host-directed agents and remdesivir, and it might retain its antiviral effect against the more transmittable B.1.1.7 variant. Its well-studied safety profile, also in combination with dexamethasone, may accelerate its repurposing chances for COVID-19 treatment. Preliminary findings in hospitalized COVID-19 patients, have suggested potential safety and efficacy of plitidepsin, in terms of viral load reduction and clinical resolution. However, the still incomplete understanding of its exact integration into host cell–SARS-CoV-2 interactions, its intravenous administration exclusively purposing it for hospital settings the and precocity of clinical data are currently considered its chief deficits. A phase III trial is being planned to compare the plitidepsin–dexamethasone regimen to the current standard of care only in moderately affected hospitalized patients. Despite plitidepsin’s preclinical efficacy, current clinical evidence is inadequate for its registration in COVID-19 patients.Therefore, multicentre trials on the drug’s efficacy, potentially also studying populations of emerging SARS-CoV-2 lineages, are warranted.

Verified
Journal Article
Open access
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ISIoanna Sigala
Ioanna Sigala
TGTIMOLEON GIANNAKAS
TIMOLEON GIANNAKAS
VGVassilis Giannakoulis
Vassilis Giannakoulis
Efthimios ZervasEfthimios Zervas
Efthimios Zervas
ABAikaterini Brinia
Aikaterini Brinia
paraskevi katsaounouparaskevi katsaounou
paraskevi katsaounou
We conducted a retrospective observational study to assess the hospitalization rates for acute exacerbations of asthma and COPD (chronic obstructive pulmonary disease) during the first imposed lockdown in Athens, Greece. Patient characteristics and the concentration of eight air pollutants [namely, NO (nitrogen monoxide), NO2 (nitrogen dioxide), CO (carbon monoxide), PM2.5 (particulate matter 2.5), PM10 (particulate matter 10), O3 (ozone), SO2 (sulfur dioxide) and benzene] were considered. A total of 153 consecutive hospital admissions were studied. Reduced admissions occurred in the Lockdown period compared to the Pre-lockdown 2020 (p < 0.001) or the Control 2019 (p = 0.007) period. Furthermore, the concentration of 6/8 air pollutants positively correlated with weekly hospital admissions in 2020 and significantly decreased during the lockdown. Finally, admitted patients for asthma exacerbation during the lockdown were younger (p = 0.046) and less frequently presented respiratory failure (p = 0.038), whereas patients with COPD presented higher blood eosinophil percentage (p = 0.017) and count (p = 0.012). Overall, admissions for asthma and COPD exacerbations decreased during the lockdown. This might be partially explained by reduction of air pollution during this period while medical care avoidance behavior, especially among elderly patients cannot be excluded. Our findings aid in understanding the untold impact of the pandemic on diseases beyond COVID-19, focusing on patients with obstructive diseases.

7 September 2020 in European Respiratory Journal
Verified
Conference Paper
Closed access
ZBZafeiria Barmparessou
Zafeiria Barmparessou
AKAliki Korkontzelou
Aliki Korkontzelou
MIMarios Ioannou
Marios Ioannou
NVNikos Vichos
Nikos Vichos
MGMargarita Gkotsina
Margarita Gkotsina
PKParaskevi Katsaounou
Paraskevi Katsaounou
Introduction: Asthma attacks constitute a major cause of Emergency Room (ER) visits and a potential danger to patients9 life. Additionally, asthma exacerbations pose a severe economic burden for public health. Consequently, identifying the specific characteristics of this patient subgroup may lead to better patient management and subsequently less asthma attacks occurrence. Methods: Patients treated for an asthma exacerbation at the ER during four months (2019) were assessed for a definite asthma diagnosis at the outpatient clinic. The study included patients that the diagnosis of asthma was confirmed. Parameters reported at Figure 1a. Results: A total of 70 patients were enrolled, with 36,2% of them having an asthma diagnosis for the first time. Reexamination, carried out at least 3 months after the attack, revealed that the majority of patients had mild asthma. Specifically, 73,5% had stage I or II, 9,4% stage III and only 17% stage IV or V. Hospital admission occurred in 13,3% of patients (of which 50% stage I-II, 13% stage III and 37% of stage IV-V). Among patients with a previous diagnosis of asthma, prescribed medication included ICS-LABA (16,8%), ICS-LABA & LAMA (10%), SABA monotherapy (26,6%) whereas 30% did not receive any medication. 25,5% were exposed to passive smoking. Specific characteristics available at Figure 1b. Conclusion: The vast majority of patients with asthma attacks visiting ER were either not diagnosed for asthma or if they were diagnosed, they abused SABA and lacked proper medication. Most of them belong to stage II. Smoking, psychopathology, poor therapy adherence, lack of action plan and a new diagnosis where the most common characteristics.

15 September 2025 in Reports
Verified
Journal Article
Open access
PDF file
TGTIMOLEON GIANNAKAS
TIMOLEON GIANNAKAS
Aris KaltsasAris Kaltsas
Aris Kaltsas
OMOrnella Moschovaki-Zeiger
Ornella Moschovaki-Zeiger
SGStavros Grigoriadis
Stavros Grigoriadis
MCMichael Chrisofos
Michael Chrisofos
Background and Clinical Significance: Retained intrarenal foreign bodies are rare adverse events after endourological stone surgery. Guidewire fracture or detachment is uncommon and can trigger infection, obstruction, or encrustation if unrecognized. We report antegrade percutaneous snare retrieval of a retained hydrophilic guidewire tip and provide a concise literature review (seven PubMed-indexed intrarenal cases identified by a structured search) to inform diagnosis, management, and prevention. We also clarify the clinical rationale for an antegrade versus retrograde approach and the sequencing of decompression, definitive stone management, and stenting in the context of sepsis. Case Presentation: A 75-year-old woman with diabetes presented with obstructive left pyelonephritis from ureteral and renal calculi. After urgent percutaneous nephrostomy, she underwent semirigid and flexible ureteroscopic lithotripsy with double-J stenting; the nephrostomy remained. During routine tube removal, the stent was inadvertently extracted. Seven days later she re-presented with fever and flank pain. KUB and non-contrast CT showed a linear 4 cm radiopaque foreign body in the left renal pelvis with dilatation. Under local anesthesia and fluoroscopy, a percutaneous tract was used to deploy a 35 mm gooseneck snare and retrieve the distal tip of a hydrophilic guidewire (Sensor/ZIP-type). Inflammatory markers were normalized; the nephrostomy was removed on day 5; six-week imaging confirmed complete clearance without complications. Conclusions: Retained guidewire fragments should be suspected in postoperative patients with unexplained urinary symptoms or infection. Cross-sectional imaging confirms the diagnosis, while minimally invasive extraction—preferably an antegrade percutaneous approach for rigid or coiled fragments—achieves prompt resolution. This case adds to the seven prior PubMed-indexed intrarenal reports identified in our review, bringing the total to eight, underscoring prevention through pre-/post-use instrument checks, immediate fluoroscopy when withdrawal resistance occurs, and structured device accounting to avoid “never events.”

12 June 2026 in Reports
Verified
Journal Article
Open access
PDF file
TGTIMOLEON GIANNAKAS
TIMOLEON GIANNAKAS
DDDimitrios Deligiannis
Dimitrios Deligiannis
PMPanagiotis Mitsos
Panagiotis Mitsos
APAnna Papakonstantinou
Anna Papakonstantinou
MSMarios Stavropoulos
Marios Stavropoulos
Aris KaltsasAris Kaltsas
Aris Kaltsas
Background and Clinical Significance: Spontaneous renal forniceal rupture is an uncommon complication of obstructive uropathy and is classically associated with ureteric calculi rather than distal urinary retention. Bilateral retention-related rupture appears to be exceptionally rare and may be diagnostically challenging when renal function begins to improve after bladder decompression; Case Presentation: An 82-year-old man with a history of prostate cancer treated five years earlier with external beam radiotherapy and androgen deprivation therapy presented with acute abdominal pain radiating to both flanks and inability to void. Bedside ultrasonography showed urinary retention and bilateral hydronephrosis, and a 16-Fr Foley catheter drained 900 mL of urine. Admission evaluation showed severe acute kidney injury, microscopic hematuria, minimal leukocyturia, and elevated inflammatory markers. Post-obstructive diuresis developed after bladder decompression. CT urography with excretory-phase imaging on hospital day 3 demonstrated severe bilateral hydroureteronephrosis with bilateral renal forniceal rupture and associated urinomas, including a larger left-sided collection extending toward the psoas compartment. Bilateral percutaneous nephrostomies were placed on hospital day 4 for upper-tract diversion. Immediate nephrostography showed no active contrast extravasation. At one-month follow-up, combined CT and nephrostographic assessment confirmed complete resolution of the bilateral urinomas without persistent leak, and the nephrostomy tubes were removed; Conclusions: This case suggests that urinary retention in an older man with prior prostate radiotherapy may reflect radiation-associated outlet pathology and/or impaired detrusor function rather than simple prostate enlargement. Delayed-phase CT urography was essential for diagnosis, and active bilateral diversion was justified by bilateral rupture, acute kidney injury, and the extent of urinary extravasation. The report expands the limited PubMed-indexed literature on retention-related upper urinary tract rupture and supports cautious follow-up aimed at defining the underlying mechanism of retention.