1
|
Tsiachris D, Antoniou C, Doundoulakis I, Manolakou P, Kordalis A, Konstantinou D, Gatzoulis K, Tsioufis K, Stefanadis C. Three‐dimensional electroanatomically guided slow pathway elimination is associated with procedural improvements and clinical benefit in atrioventricular node reentrant tachycardia patients. J Arrhythm 2022; 38:1035-1041. [DOI: 10.1002/joa3.12778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/28/2022] [Accepted: 09/02/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Dimitrios Tsiachris
- Athens Heart Center Athens Medical Center Athens Greece
- First Department of Cardiology National and Kapodistrian University, “Hippokration” Hospital Athens Greece
| | | | - Ioannis Doundoulakis
- Athens Heart Center Athens Medical Center Athens Greece
- First Department of Cardiology National and Kapodistrian University, “Hippokration” Hospital Athens Greece
| | | | - Athanasios Kordalis
- First Department of Cardiology National and Kapodistrian University, “Hippokration” Hospital Athens Greece
| | | | - Konstantinos Gatzoulis
- First Department of Cardiology National and Kapodistrian University, “Hippokration” Hospital Athens Greece
| | - Konstantinos Tsioufis
- First Department of Cardiology National and Kapodistrian University, “Hippokration” Hospital Athens Greece
| | - Christodoulos Stefanadis
- Athens Heart Center Athens Medical Center Athens Greece
- Section of Cardiovascular Medicine Yale University School of Medicine New Haven Connecticut USA
| |
Collapse
|
2
|
Kakavas S, Karayiannis D, Bouloubasi Z, Poulia KA, Kompogiorgas S, Konstantinou D, Vougas V. Global Leadership Initiative on Malnutrition Criteria Predict Pulmonary Complications and 90-Day Mortality after Major Abdominal Surgery in Cancer Patients. Nutrients 2020; 12:nu12123726. [PMID: 33287107 PMCID: PMC7761640 DOI: 10.3390/nu12123726] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 12/11/2022] Open
Abstract
Although several studies have reported an association between malnutrition and the risk of severe complications after abdominal surgery, there have been no studies evaluating the use of Global Leadership Initiative on Malnutrition (GLIM) criteria for predicting postoperative pulmonary complications (PPCs) following major abdominal surgery in cancer patients. This study aimed to investigate the association among the diagnosis of malnutrition by GLIM criteria, PPCs risk and 90-day all-cause mortality rate following major abdominal surgery in cancer patients. We prospectively analyzed 218 patients (45% male, mean age 70.6 ± 11.2 years) with gastrointestinal cancer who underwent major abdominal surgery at our hospital between October 2018 and December 2019. Patients were assessed preoperatively using GLIM criteria of malnutrition, and 90-day all-cause mortality and PPCs were recorded. In total, 70 patients (32.1%) were identified as malnourished according to GLIM criteria, of whom 41.1% fulfilled the criteria for moderate and 12.6% for severe malnutrition. PPCs were detected in 48 of 218 patients (22%) who underwent major abdominal surgery. Univariate logistic regression analysis revealed that the diagnosis of malnutrition was significantly associated with the risk of PPCs. Furthermore, in multivariate model analysis adjusted for other clinical confounding factors, malnutrition remained an independent factor associated with the risk of PPCs (RR = 1.82; CI = 1.21–2.73) and 90-day all-cause mortality (RR = 1.97; CI = 1.28–2.63, for severely malnourished patients). In conclusion, preoperative presence of malnutrition, diagnosed by the use of GLIM criteria, is associated with the risk of PPCs and 90-day mortality rate in cancer patients undergoing major abdominal surgery.
Collapse
Affiliation(s)
- Sotirios Kakavas
- 1st Pulmonary Department, Evangelismos General Hospital of Athens, Ypsilantou 45-47, 10676 Athens, Greece; (S.K.); (S.K.)
| | - Dimitrios Karayiannis
- Department of Clinical Nutrition, Evangelismos General Hospital of Athens, Ypsilantou 45-47, 10676 Athens, Greece;
- Correspondence: ; Tel.: +3-021-320-450-35; Fax: +3-021-320-413-85
| | - Zoi Bouloubasi
- Department of Clinical Nutrition, Evangelismos General Hospital of Athens, Ypsilantou 45-47, 10676 Athens, Greece;
| | - Kalliopi Anna Poulia
- Department of Nutrition and Dietetics, Laiko General Hospital, 11527 Athens, Greece;
| | - Steven Kompogiorgas
- 1st Pulmonary Department, Evangelismos General Hospital of Athens, Ypsilantou 45-47, 10676 Athens, Greece; (S.K.); (S.K.)
| | - Dimitrios Konstantinou
- Transplant Unit, 1st Department of Surgery, Evangelismos General Hospital of Athens, 10676 Athens, Greece; (D.K.); (V.V.)
| | - Vasileios Vougas
- Transplant Unit, 1st Department of Surgery, Evangelismos General Hospital of Athens, 10676 Athens, Greece; (D.K.); (V.V.)
| |
Collapse
|
3
|
Tzikas A, Papadopoulos K, Konstantinou D, Ntaios G, Arampatzis C. Left atrial appendage occlusion through a patent foramen ovale: Should we or rather not? Hellenic J Cardiol 2020; 61:442-443. [DOI: 10.1016/j.hjc.2020.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/01/2020] [Accepted: 01/18/2020] [Indexed: 11/16/2022] Open
|
4
|
Gille N, Karila-Cohen P, Goujon G, Konstantinou D, Rekik S, Bécheur H, Pelletier AL. Low phospholipid-associated cholelithiasis syndrome: A rare cause of acute pancreatitis that should not be neglected. World J Hepatol 2020; 12:312-322. [PMID: 32742573 PMCID: PMC7364325 DOI: 10.4254/wjh.v12.i6.312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 05/10/2020] [Accepted: 05/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Low phospholipid-associated cholelithiasis (LPAC) syndrome is a very particular form of biliary lithiasis with no excess of cholesterol secretion into bile, but a decrease in phosphatidylcholine secretion, which is responsible for stones forming not only in the gallbladder, but also in the liver. LPAC syndrome may be underreported due to a lack of testing resulting from insufficient awareness among clinicians.
AIM To describe the clinical and radiological characteristics of patients with LPAC syndrome to better identify and diagnose the disease.
METHODS We prospectively evaluated all patients aged over 18 years old who were consulted or hospitalized in two hospitals in Paris, France (Bichat University Hospital and Croix-Saint-Simon Hospital) between January 1, 2017 and August 31, 2018. All patients whose profiles led to a clinical suspicion of LPAC syndrome underwent a liver ultrasound examination performed by an experienced radiologist to confirm the diagnosis of LPAC syndrome. Twenty-four patients were selected. Data about the patients’ general characteristics, their medical history, their symptoms, and their blood tests results were collected during both their initial hospitalization and follow-up. Cytolysis and cholestasis were expressed compared to the normal values (N) of serum aspartate and alanine transaminase activities, and to the normal value of alkaline phosphatase level, respectively. The subjects were systematically reevaluated and asked about their symptoms 6 mo after inclusion in the study through an in-person medical appointment or phone call. Genetic testing was not performed systematically, but according to the decision of each physician.
RESULTS Most patients were young (median age of 37 years), male (58%), and not overweight (median body mass index was 24). Many had a personal history of acute pancreatitis (54%) or cholecystectomy (42%), and a family history of gallstones in first-degree relatives (30%). LPAC syndrome was identified primarily in patients with recurring biliary pain (88%) or after a new episode of acute pancreatitis (38%). When present, cytolysis and cholestasis were not severe (2.8N and 1.7N, respectively) and disappeared quickly. Interestingly, four patients from the same family were diagnosed with LPAC syndrome. At ultrasound examination, the most frequent findings in intrahepatic bile ducts were comet-tail artifacts (96%), microlithiasis (83%), and acoustic shadows (71%). Computed tomography scans and magnetic resonance imaging were performed on 15 and three patients, respectively, but microlithiasis was not detected. Complications of LPAC syndrome required hospitalizing 18 patients (75%) in a conventional care unit for a mean duration of 6.8 d. None of them died. Treatment with ursodeoxycholic acid (UDCA) was effective and well-tolerated in almost all patients (94%) with a rapid onset of action (3.4 wk). Twelve patients’ (67%) adherence to UDCA treatment was considered “good.” Five patients (36%) underwent cholecystectomy (three of them were treated both by UDCA and cholecystectomy). Despite UDCA efficacy, biliary pain recurred in five patients (28%), three of whom adhered well to treatment guidelines.
CONCLUSION LPAC syndrome is easy to diagnose and treat; therefore, it should no longer be overlooked. To increase its detection rate, all patients who experience recurrent biliary symptoms following an episode of acute pancreatitis should undergo an ultrasound examination performed by a radiologist with knowledge of the disease.
Collapse
Affiliation(s)
- Nicolas Gille
- Department of Hepato-Gastroenterology and Digestive Oncology, AP-HP Bichat University Hospital, Paris 75018, France
| | | | - Gaël Goujon
- Department of Hepato-Gastroenterology and Digestive Oncology, AP-HP Bichat University Hospital, Paris 75018, France
| | - Dimitrios Konstantinou
- Department of Hepato-Gastroenterology and Digestive Oncology, AP-HP Bichat University Hospital, Paris 75018, France
| | - Samia Rekik
- Department of Hepato-Gastroenterology and Digestive Oncology, AP-HP Bichat University Hospital, Paris 75018, France
| | - Hakim Bécheur
- Department of Hepato-Gastroenterology and Digestive Oncology, AP-HP Bichat University Hospital, Paris 75018, France
| | - Anne-Laure Pelletier
- Department of Hepato-Gastroenterology and Digestive Oncology, AP-HP Bichat University Hospital, Paris 75018, France
| |
Collapse
|
5
|
Apalla Z, Kirtsios T, Katodritou E, Lallas A, Konstantinou D, Karamitsos T. Pinch purpura unmasking systemic amyloidosis. Int J Dermatol 2019; 58:e195-e196. [DOI: 10.1111/ijd.14552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/20/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Zoe Apalla
- State Dermatology Department Hippokratio General Hospital of Thessaloniki Thessaloniki Greece
| | | | - Eirini Katodritou
- Haematology Department Theagenio Cancer Hospital Thessaloniki Greece
| | - Aimilios Lallas
- First Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | | | - Theodoros Karamitsos
- First Cardiology Department Aristotle University of Thessaloniki Thessaloniki Greece
| |
Collapse
|
6
|
Valainathan S, Boukris A, Arapis K, Schoch N, Goujon G, Konstantinou D, Bécheur H, Pelletier AL. Energy expenditure in acute pancreatitis evaluated by the Harris-Benedict equation compared with indirect calorimetry. Clin Nutr ESPEN 2019; 33:57-59. [PMID: 31451277 DOI: 10.1016/j.clnesp.2019.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Enteral nutrition (EN) is recommended for severe acute pancreatitis (AP) and for biliary AP if cholecystectomy is delayed. Energy expenditure (EE) is calculated using the Harris-Benedict equation (HBE), but indirect calorimetry (IC) can also be employed. We wished to compare EE evaluated by the HBE equation, modified HBE (mHBE) and IC at study inclusion and 1 month after AP resolution. METHODS We undertook a single-center prospective study in Paris, France. RESULTS Among 35 patients, 19 had biliary AP and 11 alcoholic-related AP. Eleven cases had severe AP. There was no significant difference between EE calculated by the HBE and that using IC at study inclusion. However, the EE calculated by the mHBE was significantly higher than that calculated using IC. For severe AP, the HBE underestimated EE whereas the mHBE overestimated it. No difference was found based on the cause of AP. There was no difference between methods for EE at 30 days. CONCLUSIONS The HBE underestimated EE for severe AP, whereas the mHBE overestimated it. IC seems to be the best means of EE evaluation for AP.
Collapse
Affiliation(s)
- S Valainathan
- Service d'Hépatogastroentérologie, Hôpital Bichat-Claude Bernard, 75018, Paris, France
| | - A Boukris
- Service d'Hépatogastroentérologie, Hôpital Bichat-Claude Bernard, 75018, Paris, France
| | - K Arapis
- Service de Chirurgie Digestive, Hôpital Bichat-Claude Bernard, 75018, Paris, France
| | - N Schoch
- Service d'Hépatogastroentérologie, Hôpital Bichat-Claude Bernard, 75018, Paris, France
| | - G Goujon
- Service d'Hépatogastroentérologie, Hôpital Bichat-Claude Bernard, 75018, Paris, France
| | - D Konstantinou
- Service d'Hépatogastroentérologie, Hôpital Bichat-Claude Bernard, 75018, Paris, France
| | - H Bécheur
- Service d'Hépatogastroentérologie, Hôpital Bichat-Claude Bernard, 75018, Paris, France
| | - A L Pelletier
- Service d'Hépatogastroentérologie, Hôpital Bichat-Claude Bernard, 75018, Paris, France.
| |
Collapse
|
7
|
Kyriakides A, Poulikakos D, Galata A, Konstantinou D, Panagiotopoulos E, Chroni E. The effect of level of injury and physical activity on heart rate variability following spinal cord injury. J Spinal Cord Med 2019; 42:212-219. [PMID: 29052467 PMCID: PMC6419680 DOI: 10.1080/10790268.2017.1383709] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE/BACKGROUND To assess frequency domain heart rate variability (HRV) parameters at rest and in response to postural autonomic provocations in individuals with spinal cord injury (SCI) and investigate the autonomic influences on the heart of different physical activities. DESIGN Cross-sectional study. METHODS Ten subjects with complete cervical SCI and fourteen subjects with complete low thoracic SCI were prospectively recruited from the community and further divided in sedentary and physically active groups, the latter defined as regular weekly 4 hour physical activity for the preceding 3 months. Sixteen healthy individuals matched for sex and age were recruited to participate in the control group. The Low Frequency (LF), High Frequency (HF) powers and the LF/HF ratio of HRV were measured from continuous electrocardiogram (ECG) recordings at rest and after sitting using a fast Fourier transformation. OUTCOME MEASURES The LF,HF, and the LF/HF ratio at rest and after sitting. RESULTS A significant decrease in all HRV parameters in patients with SCI was found compared to controls. The change in HF, LF and LF/HF following sitting maneuver was significantly greater in controls as compared with the SCI group and greater in subjects with paraplegia as compared to subjects with tetraplegia. Better HRV values and enhanced vagal activity appears to be related to the type of physical activity in active subjects with paraplegia. CONCLUSION In this cohort of subjects spectral parameters of HRV were associated with the level of the injury. Passive standing was associated with higher HRV values in subjects with paraplegia.
Collapse
Affiliation(s)
- Athanasios Kyriakides
- Spinal Cord Unit, University Hospital of Patras, Rion, Greece,Correspondence to: Athanasios Kyriakides, Spinal Cord Unit, University Hospital of Patras, Rion, Greece. ;
| | | | - Angeliki Galata
- Spinal Cord Unit, University Hospital of Patras, Rion, Greece
| | | | | | | |
Collapse
|
8
|
Tzatzaki E, Spartalis M, Kamperidis V, Spartalis E, Konstantinou D, Kapoukranidou D, Karvounis H. Association of brain natriuretic peptide and adrenomedullin plasma levels with left ventricular filling pressures in end-stage renal disease patients on hemodialysis. Eur Rev Med Pharmacol Sci 2018; 22:7945-7951. [PMID: 30536342 DOI: 10.26355/eurrev_201811_16422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Adrenomedullin (ADM) and brain natriuretic peptide (BNP) are known to be associated with elevated left ventricular filling pressures. However, little is known about this association in hemodialysis (HD) patients with preserved left ventricular ejection fraction (LVEF). Our objective was to evaluate the potential association between E/e' ratio and plasma levels of BNP and ADM in end-stage renal disease (ESRD) patients with preserved LVEF undergoing chronic hemodialysis. PATIENTS AND METHODS The study group enrolled 62 ESRD patients treated with hemodialysis three times weekly. BNP and ADM plasma concentration measurements and echocardiographic examination were performed 30 minutes after hemodialysis. E/e' ratio, evaluated by Tissue Doppler imaging and measured at the basal septum, was used as a surrogate marker for assessing left ventricular filling pressures. RESULTS The mean age of patients was 62 ± 25 years. The mean BNP and ADM values after hemodialysis were 0.40 ± 6.73 ng/ml and 0.06 ± 2.12 ng/ml, respectively. Elderly patients with hypertrophied left ventricles and larger left atria displayed higher E/e' values. BNP (r = 0.324. p = 0.018) and ADM (r = 0.319, p = 0.042) plasma levels were positively and significantly associated with E/e΄. Multivariate regression analysis including BNP, ADM, age, hemodialysis duration, left ventricular end-systolic volume index, LVEF, left ventricular mass index and left atrium volume index, revealed that ADM (p-value 0.025) but not BNP levels, were independently associated with the E/e' ratio. CONCLUSIONS ADM, but not BNP, was independently associated with septal E/e' in HD patients with preserved LVEF. ADM plasma levels can be used as a surrogate index to assess left ventricular filling pressures in HD patients.
Collapse
Affiliation(s)
- E Tzatzaki
- 1st Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | | | | | | | | | | | | |
Collapse
|
9
|
Tzatzaki E, Spartalis M, Kamperidis V, Spartalis E, Konstantinou D, Kapoukranidou D, Karvounis H. Association of brain natriuretic peptide and adrenomedullin plasma levels with left ventricular filling pressures in end-stage renal disease patients on hemodialysis. Eur Rev Med Pharmacol Sci 2018. [PMID: 30536342 DOI: 10.26355/eurrev-201811-16422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
OBJECTIVE Adrenomedullin (ADM) and brain natriuretic peptide (BNP) are known to be associated with elevated left ventricular filling pressures. However, little is known about this association in hemodialysis (HD) patients with preserved left ventricular ejection fraction (LVEF). Our objective was to evaluate the potential association between E/e' ratio and plasma levels of BNP and ADM in end-stage renal disease (ESRD) patients with preserved LVEF undergoing chronic hemodialysis. PATIENTS AND METHODS The study group enrolled 62 ESRD patients treated with hemodialysis three times weekly. BNP and ADM plasma concentration measurements and echocardiographic examination were performed 30 minutes after hemodialysis. E/e' ratio, evaluated by Tissue Doppler imaging and measured at the basal septum, was used as a surrogate marker for assessing left ventricular filling pressures. RESULTS The mean age of patients was 62 ± 25 years. The mean BNP and ADM values after hemodialysis were 0.40 ± 6.73 ng/ml and 0.06 ± 2.12 ng/ml, respectively. Elderly patients with hypertrophied left ventricles and larger left atria displayed higher E/e' values. BNP (r = 0.324. p = 0.018) and ADM (r = 0.319, p = 0.042) plasma levels were positively and significantly associated with E/e΄. Multivariate regression analysis including BNP, ADM, age, hemodialysis duration, left ventricular end-systolic volume index, LVEF, left ventricular mass index and left atrium volume index, revealed that ADM (p-value 0.025) but not BNP levels, were independently associated with the E/e' ratio. CONCLUSIONS ADM, but not BNP, was independently associated with septal E/e' in HD patients with preserved LVEF. ADM plasma levels can be used as a surrogate index to assess left ventricular filling pressures in HD patients.
Collapse
Affiliation(s)
- E Tzatzaki
- 1st Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | | | | | | | | | | | | |
Collapse
|
10
|
Xanthopoulos A, Tryposkiadis K, Giamouzis G, Konstantinou D, Giannakoulas G, Karvounis H, Kattan MW, Skoularigis J, Parissis J, Starling RC, Triposkiadis F. Larissa Heart Failure Risk Score: a proposed simple score for risk stratification in chronic heart failure. Eur J Heart Fail 2017; 20:614-616. [PMID: 29271552 DOI: 10.1002/ejhf.1132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 12/16/2022] Open
Affiliation(s)
- Andrew Xanthopoulos
- Department of Cardiology, University General Hospital of Larissa, Larissa, Greece.,Department of Cardiovascular Medicine, Heart and Vascular Institute, Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, OH, USA
| | | | - Gregory Giamouzis
- Department of Cardiology, University General Hospital of Larissa, Larissa, Greece
| | | | - George Giannakoulas
- First Cardiology Department, University General Hospital AHEPA, Thessaloniki, Greece
| | - Haralambos Karvounis
- First Cardiology Department, University General Hospital AHEPA, Thessaloniki, Greece
| | - Michael W Kattan
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - John Skoularigis
- Department of Cardiology, University General Hospital of Larissa, Larissa, Greece
| | - John Parissis
- Department of Cardiology, Athens University Hospital Attikon, Athens, Greece
| | - Randall C Starling
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, OH, USA
| | | |
Collapse
|
11
|
Wobb J, Evangelista M, Chao A, Konstantinou D, Bazan J, Young R, Skoracki R, White J. Toxicity Outcomes for Immediate and Delayed Autologous Reconstruction in Patients Receiving Post-mastectomy Radiation Therapy: Is It Time to Reconsider Sequencing? Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
12
|
Skalidis T, Papaparaskevas J, Konstantinou D, Kapolou E, Falagas ME, Legakis N. Aerococcus urinae, a cause of cystitis with malodorous urine in a child: clinical and microbiological challenges. JMM Case Rep 2017; 4:e005083. [PMID: 28348806 PMCID: PMC5361636 DOI: 10.1099/jmmcr.0.005083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/08/2017] [Indexed: 11/28/2022] Open
Abstract
Introduction. An infection of the lower urinary tract associated with an extremely unpleasant odour due to Aerococcus urinae in an otherwise healthy 5-year-old boy is described herein. Case presentation. Interestingly, imaging examination revealed the presence of a bladder diverticulum. Routine microbiological examination based on Gram staining, colony morphology and catalase reactivity suggested that the responsible pathogen could belong either to staphylococci, α-haemolytic streptococci or enterococci, which are more common urine isolates. Of note is that the VITEK 2 automated system could not identify the micro-organism. Susceptibility testing showed full sensitivity to β-lactam antibiotics and resistance to trimethoprim/sulfamethoxazole. The isolate was subjected to 16S rRNA gene sequence analysis because of its unusual characteristics. It was identified as A. urinae and the sequence was deposited in GenBank under the accession number KU207150. Conclusion.A. urinae should be considered as a causative agent of urinary-tract infection associated with malodorous urine.
Collapse
Affiliation(s)
- Tilemachos Skalidis
- Central Laboratories, IASO Gynecology, Maternity and Pediatric Hospital, Iaso Group Hospitals , Athens , Greece
| | - Josef Papaparaskevas
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Goudi , Athens , Greece
| | | | - Eleni Kapolou
- Central Laboratories, IASO Gynecology, Maternity and Pediatric Hospital, Iaso Group Hospitals , Athens , Greece
| | - Mathhew E Falagas
- Department of Medicine - Infectious Diseases, IASO Group Hospitals , Athens , Greece
| | - Nicholas Legakis
- Central Laboratories, IASO Gynecology, Maternity and Pediatric Hospital, Iaso Group Hospitals , Athens , Greece
| |
Collapse
|
13
|
Paraskevaidis S, Konstantinou D, Kolettas V, Stavropoulos G, Koutsakis A, Nikolaidou C, Ziakas A, Karvounis H. The role of catheter ablation in the management of patients with implantable cardioverter defibrillators presenting with electrical storm. Hellenic J Cardiol 2017; 58:51-56. [PMID: 28189736 DOI: 10.1016/j.hjc.2017.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 09/01/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Electrical storm (ES) is not uncommon among patients with an implantable cardioverter defibrillator (ICD) in situ. Catheter ablation (CA) may suppress the arrhythmia in the acute setting and prevent ES recurrence. METHODS Nineteen consecutive patients with an ICD in situ presenting with ES underwent electrophysiologic studies followed by CA. CA outcome was classified as a complete success if both clinical and non-clinical tachycardia were successfully ablated, partial success if ≥1 non-clinical tachycardia episodes were still inducible post-CA, and failure if clinical tachycardia could not be abolished. Patients were followed for a median period (IQR) of 5.6 (1.8-13.7) months. The primary endpoint was event-free survival from ES recurrence. The secondary endpoint was event-free survival from a composite of ES and/or sustained ventricular tachycardia (VT) recurrence. RESULTS Clinical arrhythmia was successfully ablated in 14 out of 19 (73.7%) cases after a single CA procedure. A completely successful CA outcome was associated with significantly increased ES-free survival compared with a partially successful or failed procedure (Log rank P=0.039). Nevertheless, patients with acute suppression of all tachycardia episodes (n=11), relative to those with a partially successful or a failed CA procedure (n=8), did not differ in incidence of the composite endpoint of sustained VT or ES (Log rank P=0.278). CONCLUSION A single CA procedure can acutely suppress clinical arrhythmia in three-quarters of cases. A completely successful CA outcome can prolong ES-free survival; however, sporadic ICD therapies cannot be abrogated.
Collapse
Affiliation(s)
- Stelios Paraskevaidis
- First Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Dimitrios Konstantinou
- First Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece.
| | - Vassilios Kolettas
- First Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - George Stavropoulos
- First Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Athanasios Koutsakis
- First Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Chrysovalantou Nikolaidou
- First Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Antonios Ziakas
- First Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Haralambos Karvounis
- First Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| |
Collapse
|
14
|
Panagiotopoulos V, Papathanasopoulos P, Bonanos G, Messinis L, Fotakopoulos G, Klironomos G, Geropoulou E, Partheni M, Konstantinou D. Ataxic gait due to posterior thoracic spinal cord compression by a Tarlov cyst. J Neurosurg Sci 2016; 60:408-410. [PMID: 27402409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
|
15
|
Dakos G, Konstantinou D, Chatzizisis YS, Chouvarda I, Filos D, Paraskevaidis S, Mantziari L, Maglaveras N, Karvounis H, Vassilikos V. P wave analysis with wavelets identifies hypertensive patients at risk of recurrence of atrial fibrillation: A case–control study and 1year follow-up. J Electrocardiol 2015. [DOI: 10.1016/j.jelectrocard.2015.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
16
|
Faropoulos K, Panagiotopoulos V, Partheni M, Tzortzidis F, Konstantinou D. Therapeutic management of intraventricular cavernoma: case series and review of the literature. J Neurol Surg A Cent Eur Neurosurg 2015; 76:233-9. [PMID: 25798802 DOI: 10.1055/s-0034-1389093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Intraventricular cavernoma (IVC) is a rare intracranial vascular malformation and only 100 cases of IVC have been described in the literature. Although IVCs share some common characteristics with intraparenchymal cavernomas, they also have some distinct features involving structure, clinical symptoms, radiologic appearance, and onset of symptoms. This review presents our experience, consisting of five IVC cases over a period of 11 years. We describe the symptoms leading to hospital admission, the main radiologic findings, the management of each ICV case, and the patients' clinical status after surgery. We also reviewed the international literature on IVC, presenting the main demographic characteristics, their most common location in the ventricular system, and the main signs and symptoms. Finally, we present the management options according to the current literature, the advantages and disadvantages of every management option, accompanied by a brief follow-up of most IVC cases, whether the cavernoma was treated surgically or conservatively.
Collapse
|
17
|
Konstantinou D, Lei M, Xia Z, Kanamarlapudi V. Growth factors mediated differentiation of mesenchymal stem cells to cardiac polymicrotissue using hanging drop and bioreactor. Cell Biol Int 2015; 39:502-7. [PMID: 25492631 DOI: 10.1002/cbin.10409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 10/30/2014] [Indexed: 11/09/2022]
Abstract
Heart disease is the major leading cause of death worldwide and the use of stem cells promises new ways for its treatment. The relatively easy and quick acquisition of human umbilical cord matrix mesenchymal stem cells (HUMSCs) and their properties make them useful for the treatment of cardiac diseases. Therefore, the main aim of this investigation was to create cardiac polymicrotissue from HUMSCs using a combination of growth factors [sphingosine-1-phosphate (S1P) and suramin] and techniques (hanging drop and bioreactor). Using designated culture conditions of the growth factors (100 nM S1P and 500 µM suramin), cardiomyocyte differentiation medium (CDM), hanging drop, bioreactor and differentiation for 7 days, a potential specific cardiac polymicrotissue was derived from HUMSCs. The effectiveness of growth factors alone or in combination in differentiation of HUMSCs to cardiac polymicrotissue was analysed by assessing the presence of cardiac markers by immunocytochemistry. This analysis demonstrated the importance of those growth factors for the differentiation. This study for the first time demonstrated the formation of a cardiac polymicrotissue under specific culture conditions. The polymicrotissue thus obtained may be used in future as a 'patch' to cover the injured cardiac region and would thereby be useful for the treatment of heart diseases.
Collapse
Affiliation(s)
- Dimitrios Konstantinou
- School of Biomedicine, University of Manchester, Manchester, UK; Institute of Life Science, College of Medicine, Swansea University, Swansea, UK
| | | | | | | |
Collapse
|
18
|
Karayiannis D, Bouloubasi Z, Konstantinou D, Chourdakis M, Magganas D, Drakopoulos S. PP162-MON: Preoperative Nutritional Assessment for Predicting Complications Risk in Patients Undergoing Abdominal Surgery. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50496-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
19
|
Syrengelas D, Kalampoki V, Kleisiouni P, Konstantinou D, Siahanidou T. Gross motor development in full-term Greek infants assessed by the Alberta Infant Motor Scale: reference values and socioeconomic impact. Early Hum Dev 2014; 90:353-7. [PMID: 24796209 DOI: 10.1016/j.earlhumdev.2014.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/08/2014] [Accepted: 04/12/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aims of this study were to investigate gross motor development in Greek infants and establish AIMS percentile curves and to examine possible association of AIMS scores with socioeconomic parameters. METHODS Mean AIMS scores of 1068 healthy Greek full-term infants were compared at monthly age level with the respective mean scores of the Canadian normative sample. In a subgroup of 345 study participants, parents provided, via interview, information about family socioeconomic status. Multiple linear regression analysis was performed to evaluate the relationship of infant motor development with socioeconomic parameters. RESULTS Mean AIMS scores did not differ significantly between Greek and Canadian infants in any of the 19 monthly levels of age. In multiple linear regression analysis, the educational level of the mother and also whether the infant was being raised by grandparents/babysitter were significantly associated with gross motor development (p=0.02 and p<0.001, respectively), whereas there was no significant correlation of mean AIMS scores with gender, birth order, maternal age, paternal educational level and family monthly income. CONCLUSIONS Gross motor development of healthy Greek full-term infants, assessed by AIMS during the first 19months of age, follows a similar course to that of the original Canadian sample. Specific socioeconomic factors are associated with the infants' motor development.
Collapse
Affiliation(s)
- Dimitrios Syrengelas
- Department of Pediatric Physical Therapy, "Aghia Sophia" Children's Hospital, Athens, Greece.
| | - Vassiliki Kalampoki
- First Department of Pediatrics, Athens University Medical School, Athens, Greece
| | - Paraskevi Kleisiouni
- Department of Pediatric Physical Therapy, "Aghia Sophia" Children's Hospital, Athens, Greece
| | | | - Tania Siahanidou
- First Department of Pediatrics, Athens University Medical School, Athens, Greece
| |
Collapse
|
20
|
Dakos G, Chatzizisis YS, Konstantinou D, Chouvarda I, Filos D, Paraskevaidis S, Mantziari L, Maglaveras N, Karvounis H, Styliadis I, Vassilikos V. Wavelet-based analysis of P waves identifies patients with lone atrial fibrillation: A cross-sectional pilot study. Int J Cardiol 2014; 174:389-92. [PMID: 24767760 DOI: 10.1016/j.ijcard.2014.03.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 03/31/2014] [Indexed: 11/17/2022]
Affiliation(s)
- George Dakos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece.
| | - Yiannis S Chatzizisis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Dimitrios Konstantinou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Ioanna Chouvarda
- Laboratory of Medical Informatics, Aristotle University Medical School, Thessaloniki, Greece
| | - Dimitrios Filos
- Laboratory of Medical Informatics, Aristotle University Medical School, Thessaloniki, Greece
| | - Stylianos Paraskevaidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Lilian Mantziari
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece; Department of Cardiology, Electrophysiology Unit, Royal Brompton Hospital, London, UK
| | - Nicos Maglaveras
- Laboratory of Medical Informatics, Aristotle University Medical School, Thessaloniki, Greece
| | - Haralambos Karvounis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Ioannis Styliadis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Vassilios Vassilikos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece; Third Department of Cardiology, Hippokrateion University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| |
Collapse
|
21
|
Konstantinou D, Margariti E, Hadziyannis E, Pectasides D, Papatheodoridis GV. Significance of the 13C-caffeine breath test for patients with cirrhosis. Ann Gastroenterol 2014; 27:53-59. [PMID: 24714782 PMCID: PMC3959537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 09/05/2013] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND The 13C-caffeine breath test (CBT) is a non-invasive, quantitative test of liver function which has been shown to correlate inversely to the Child-Pugh score. The aim of the study was to determine the utility of CBT in the assessment of cirrhosis and its correlation to the model for end-stage liver disease (MELD) score. METHODS Thirty-nine patients, 29 with cirrhosis and 10 with chronic liver disease without cirrhosis, and 8 healthy volunteers were included. Cirrhotic patients were graded according to Child-Pugh and MELD scores. All participants underwent CBT and laboratory tests on the same day. The results of the CBT were expressed as percentages of changes over baseline values (Δ‰) per 100 mg caffeine. RESULTS The mean single 15-min, 30-min, 45-min and 1-h CBT results, as well as cumulative CBT values differed significantly between healthy controls or chronic liver disease patients and cirrhotics (1-h CBT: 3.22±1.06 or 3.56±2.80 vs. 1.69±2.52, P≤0.01). In contrast, the CBT results at any time point or cumulative values did not correlate with MELD or Child-Pugh scores. Receiver operating characteristics (ROC) analysis showed that the 30-min CBT values were more accurate in differentiating cirrhotics from chronic liver disease patients (area under ROC curve: 0.871). CONCLUSIONS CBT can reliably differentiate the patients with decompensated cirrhosis from non-cirrhotic patients with chronic liver diseases. However, in patients with decompensated cirrhosis, CBT results do not seem to be associated with the Child-Pugh and MELD scores.
Collapse
Affiliation(s)
- Dimitrios Konstantinou
- 2nd Department of Internal Medicine, Athens University Medical School, Hippokration General Hospital (Dimitrios Konstantinou, Ekaterini Margariti, Emilia Hadziyannis, Dimitrios Pectasides, George V. Papatheodoridis)
| | - Ekaterini Margariti
- 2nd Department of Internal Medicine, Athens University Medical School, Hippokration General Hospital (Dimitrios Konstantinou, Ekaterini Margariti, Emilia Hadziyannis, Dimitrios Pectasides, George V. Papatheodoridis)
| | - Emilia Hadziyannis
- 2nd Department of Internal Medicine, Athens University Medical School, Hippokration General Hospital (Dimitrios Konstantinou, Ekaterini Margariti, Emilia Hadziyannis, Dimitrios Pectasides, George V. Papatheodoridis)
| | - Dimitrios Pectasides
- 2nd Department of Internal Medicine, Athens University Medical School, Hippokration General Hospital (Dimitrios Konstantinou, Ekaterini Margariti, Emilia Hadziyannis, Dimitrios Pectasides, George V. Papatheodoridis)
| | - George V. Papatheodoridis
- 2nd Department of Internal Medicine, Athens University Medical School, Hippokration General Hospital (Dimitrios Konstantinou, Ekaterini Margariti, Emilia Hadziyannis, Dimitrios Pectasides, George V. Papatheodoridis),Gastroenterology Department, Athens University Medical School, Laikon General Hospital (George V. Papatheodoridis), Athens, Greece,
Correspondence to: George V. Papatheodoridis, MD, PhD, Head of Gastroenterology Department, Athens University Medical School, Laikon General Hospital of Athens, Agiou Thoma 17, 115 27 Athens, Greece, Tel.: +30 210 7456504, Fax: +30 210 7462601, e-mail:
| |
Collapse
|
22
|
Vamvakidou A, Konstantinou D, Salam S, Mahmoud M. A patient with pleuritic chest pain and abnormal blood clotting tests. Acute Med 2014; 13:174-177. [PMID: 25521088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We present the case of a 58 year old man who developed pleuritic chest while an in-patient; investigations revealed pulmonary embolism, despite a significantly raised Activated Partial Thromboplastin Time (APTT), which was subsequently attributed to Antiphospholipid syndrome (APS). The diagnosis and initial management of APS in the acute setting is discussed.
Collapse
Affiliation(s)
| | | | - S Salam
- Consultant Rehabilitation Medicine, Bishop Auckland Hospital
| | - M Mahmoud
- Consultant Haematologist, Darlington Memorial Hospital
| |
Collapse
|
23
|
Anastasiadis K, Asteriou C, Antonitsis P, Argiriadou H, Grosomanidis V, Kyparissa M, Deliopoulos A, Konstantinou D, Tossios P. Enhanced Recovery After Elective Coronary Revascularization Surgery With Minimal Versus Conventional Extracorporeal Circulation: A Prospective Randomized Study. J Cardiothorac Vasc Anesth 2013; 27:859-64. [DOI: 10.1053/j.jvca.2013.01.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Indexed: 11/11/2022]
|
24
|
Konstantinou D, Guha K, Cook C, Sharma R. QRS duration and clinical outcomes in heart failure patients receiving cardiac resynchronization therapy. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
25
|
Asteriou C, Antonitsis P, Argiriadou H, Deliopoulos A, Konstantinou D, Foroulis C, Papakonstantinou C, Anastasiadis K. Minimal extracorporeal circulation reduces the incidence of postoperative major adverse events after elective coronary artery bypass grafting in high-risk patients. A single-institutional prospective randomized study. Perfusion 2013; 28:350-6. [DOI: 10.1177/0267659113479135] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Coronary artery bypass grafting (CABG) using minimal extracorporeal circulation (MECC) has been associated with an improved short-term clinical outcome compared to conventional extracorporeal circulation (CECC). The aim of this study was to evaluate the impact of MECC compared to CECC on postoperative major adverse events in high-risk patients undergoing elective coronary revascularization procedures. Two hundred patients undergoing elective CABG were randomized into two groups. In Group A (n=100), MECC was used while Group B (n=100) included patients who were operated on CECC. The incidence of postoperative major adverse events (myocardial infarction, renal failure, stroke, death) was the primary end-point of the study. MECC was associated with a 77% relative risk reduction in the incidence of major adverse events compared to CECC (p=0.004). The rate of major adverse events occurring in the high-risk patient subgroup (preoperative left ventricular ejection fraction ≤40%, age >65 years, EuroSCORE II >5) operated on with MECC was significantly lower in comparison to their CECC counterparts. Based on our results, cardiac centres should be encouraged to use MECC as the standard circuit when performing elective coronary procedures, even in a high-risk population.
Collapse
Affiliation(s)
- C Asteriou
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | - P Antonitsis
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | - H Argiriadou
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | - A Deliopoulos
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | - D Konstantinou
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | - C Foroulis
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | - C Papakonstantinou
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| | - K Anastasiadis
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
| |
Collapse
|
26
|
Argyriou AA, Panagiotopoulos V, Masmanidis A, Tzortzidis F, Konstantinou D. Destructive Cervical Spine Osteoblastoma at C5 in a Young Patient Initially Presenting with Quadriparesis: Case Report and Review of the Literature. J Emerg Med 2013; 44:e1-4. [DOI: 10.1016/j.jemermed.2011.05.089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 11/22/2010] [Accepted: 05/25/2011] [Indexed: 10/14/2022]
|
27
|
Rossolymos NA, Papatheodoridis G, Tsakoniatis M, Konstantinou D, Lazaris A. Expression of cyclooxygenase-2 in gastritis and gastric premalignant lesions. Ann Gastroenterol 2013; 26:275. [PMID: 24714295 PMCID: PMC3959445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 02/17/2013] [Indexed: 11/26/2022] Open
Affiliation(s)
- Nikolaos A. Rossolymos
- Department of Gastroenterology (Nikolaos A. Rossolymos, Michalis Tsakoniatis, Dimitrios Konstantinou), Hippokration Hospital of Athens, Athens, Greece,
Correspondence to: Nikolaos A. Rossolymos, GI Department, Hippokration Hospital of Athens, Vas. Sophias 114, Athens, Greece, Tel.: + 213 2088 337, e-mail:
| | - George Papatheodoridis
- Department of Internal Medicine (George Papatheodoridis), Hippokration Hospital of Athens, Athens, Greece
| | - Michalis Tsakoniatis
- Department of Gastroenterology (Nikolaos A. Rossolymos, Michalis Tsakoniatis, Dimitrios Konstantinou), Hippokration Hospital of Athens, Athens, Greece
| | - Dimitrios Konstantinou
- Department of Gastroenterology (Nikolaos A. Rossolymos, Michalis Tsakoniatis, Dimitrios Konstantinou), Hippokration Hospital of Athens, Athens, Greece
| | - Andreas Lazaris
- 1st Department of Pathology, Medical school, The Athens National University (Andreas Lazaris), Athens, Greece
| |
Collapse
|
28
|
Lallas A, Apalla Z, Lefaki I, Sotiriou E, Lazaridou E, Ioannides D, Tiodorovic-Zivkovic D, Sidiropoulos T, Konstantinou D, Di Lernia V, Argenziano G, Zalaudek I. Dermoscopy of discoid lupus erythematosus. Br J Dermatol 2012; 168:284-8. [DOI: 10.1111/bjd.12044] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
29
|
Karagiozoglou-Lampoudi T, Skouroliakou M, Konstantinou D, Agakidis C, Delikou N, Koutri K, Antoniadi M. Omega-3-polyunsaturated fatty acid – enriched parenteral lipid emulsion and prevention of cholestasis in preterm infants. Comparison with soybean-based lipid emulsion. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
30
|
Michaelides M, Nikolaidou A, Konstantinou D, Balis GC, Tsitouridis I. Posterior mediastinal Castleman's disease presented as hypervascular lipomatous tumor. Hippokratia 2011; 15:361-362. [PMID: 24391422 PMCID: PMC3876856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Castleman's disease (CD) is a rare lymphoproliferative disorder most often found in the chest. Herein we describe the imaging findings of a histologically proven case of CD involving the posterior mediastinum in a 41-year-old asymptomatic man presented as a well-defined hypervascular lipomatous tumor. To our knowledge less than 10 cases of posterior mediastinal CD have been reported so far and this is the first case of CD mimicking mediastinal lipomatous tumor.
Collapse
Affiliation(s)
- M Michaelides
- Department of Diagnostic and Interventional Radiology, Papageorgiou General Hospital, Thessaloniki, Greece
| | - A Nikolaidou
- Department of Pathology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - D Konstantinou
- Department of Diagnostic and Interventional Radiology, Papageorgiou General Hospital, Thessaloniki, Greece
| | - GC Balis
- Department of Pathology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - I Tsitouridis
- Department of Diagnostic and Interventional Radiology, Papageorgiou General Hospital, Thessaloniki, Greece
| |
Collapse
|
31
|
Kollatos C, Konstantinou D, Raftopoulos S, Klironomos G, Messinis L, Zampakis P, Papathanasopoulos P, Panagiotopoulos V. Cerebellar hemorrhage after supratentorial burr hole drainage of a chronic subdural hematoma. Hippokratia 2011; 15:370-372. [PMID: 24391425 PMCID: PMC3876859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Cerebellar hemorrhage is an unusual, but increasingly recognized complication after supratentorial surgery. Even rarer are the cases of cerebellar hemorrhage after supratentorial burr-hole drainage of a chronic subdural hematoma (CSDH). The pathophysiology of this rare complication still remains unclear. Hypertension and overdrainage of cerebrospinal fluid seem to be causative factors of postoperative cerebellar hemorrhage. The most important key to minimize this hazardous sequel is to be aware of this potential complication and its pathogenetic mechanisms. We report our case of a 43-year old man who developed cerebellar hemorrhage after burr hole trephination for supratentorial CSDH.
Collapse
Affiliation(s)
- C Kollatos
- 1Department of Neurosurgery, University of Patras, Greece
| | - D Konstantinou
- 1Department of Neurosurgery, University of Patras, Greece
| | - S Raftopoulos
- 1Department of Neurosurgery, University of Patras, Greece
| | - G Klironomos
- 1Department of Neurosurgery, University of Patras, Greece
| | - L Messinis
- Department of Neurology, Neuropsychology Section, University of Patras, Greece
| | - P Zampakis
- Department of Radiology, University Hospital of Patras
| | | | | |
Collapse
|
32
|
Hao X, Zhang Y, Zhang X, Nirmalan M, Davies L, Konstantinou D, Yin F, Dobrzynski H, Wang X, Grace A, Zhang H, Boyett M, Huang CLH, Lei M. TGF-β1-mediated fibrosis and ion channel remodeling are key mechanisms in producing the sinus node dysfunction associated with SCN5A deficiency and aging. Circ Arrhythm Electrophysiol 2011; 4:397-406. [PMID: 21493874 DOI: 10.1161/circep.110.960807] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mutations in the cardiac Na(+) channel gene (SCN5A) can adversely affect electric function in the heart, but effects can be age dependent. We explored the interacting effects of Scn5a disruption and aging on the pathogenesis of sinus node dysfunction in a heterozygous Scn5a knockout (Scn5a(+/-)) mouse model. METHODS AND RESULTS We compared functional, histological, and molecular features in young (3 to 4 month) and old (1 year) wild type and Scn5a(+/-) mice. Both Scn5a disruption and aging were associated with decreased heart rate variability, reduced sinoatrial node automaticity, and slowed sinoatrial conduction. They also led to increased collagen and fibroblast levels and upregulated transforming growth factor-β(1) (TGF-β(1)) and vimentin transcripts, providing measures of fibrosis and reduced Nav1.5 expression. All these effects were most noticeable in old Scn5a(+/-) mice. Na(+) channel inhibition by Nav1.5-E3 antibody directly increased TGF-β(1) production in both cultured human cardiac myocytes and fibroblasts. Finally, aging was associated with downregulation of a wide range of ion channel and related transcripts and, again, was greatest in old Scn5a(+/-) mice. The quantitative results from these studies permitted computer simulations that successfully replicated the observed sinoatrial node phenotypes shown by the different experimental groups. CONCLUSIONS These results implicate a tissue degeneration triggered by Nav1.5 deficiency manifesting as a TGF-β(1)-mediated fibrosis accompanied by electric remodeling in the sinus node dysfunction associated with Scn5a disruption or aging. The latter effects interact to produce the most severe phenotype in old Scn5a(+/-) mice. In demonstrating this, our findings suggest a novel regulatory role for Nav1.5 in cellular biological processes in addition to its electrophysiologic function.
Collapse
Affiliation(s)
- Xiaojin Hao
- School of Biomedicine, University of Manchester, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Asteriou C, Barbetakis N, Kleontas A, Konstantinou D. Giant mediastinal teratoma presenting with paroxysmal atrial fibrillation. Interact Cardiovasc Thorac Surg 2010; 12:308-10. [PMID: 21075832 DOI: 10.1510/icvts.2010.253039] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Mediastinum is a common site where benign tumors, like teratomas, can develop. Usually, these lesions do not cause any symptoms and the diagnosis is reached accidentally. As they enlarge they may cause symptoms by compressing the nearby structures of the thorax, mostly the trachea and the bronchi. Extrinsic compression of the heart or the great vessels appears to be a very rare occurrence. Atrial fibrillation as the first clinical presentation of left atrial compression by a giant mediastinal teratoma is extremely uncommon and very few cases have been described in the English literature.
Collapse
Affiliation(s)
- Christos Asteriou
- Department of CardioThoracic Surgery, Theagenio Cancer Hospital, Al. Symeonidi 2, 54007 Thessaloniki, Greece.
| | | | | | | |
Collapse
|
34
|
Michaelides M, Sotiriadis C, Konstantinou D, Pervana S, Tsitouridis I. Tuberculous orchitis US and MRI findings. Correlation with histopathological findings. Hippokratia 2010; 14:297-299. [PMID: 21311645 PMCID: PMC3031331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Tuberculosis of the testis is a rare disease. Although Ultrasound (US) findings of tuberculous epididymo-orchitis have been well described, there are only few reported cases describing the Magnetic Resonance Imaging (MR) findings of this disease. Herein, we describe the US and MR findings in a patient with tuberculous orchitis of the left testis and correlate them with the histopathological findings. In our case, the MR findings differ from previous studies because granulomatous areas in the testis had intermediate to high signal intensity on T2WI, while in all studies granulomatous areas in tuberculous epididymo-orchitis demonstrated invariably low signal intensity.
Collapse
|
35
|
Skouroliakou M, Konstantinou D, Koutri K, Kakavelaki C, Stathopoulou M, Antoniadi M, Xemelidis N, Kona V, Markantonis S. A double-blind, randomized clinical trial of the effect of omega-3 fatty acids on the oxidative stress of preterm neonates fed through parenteral nutrition. Eur J Clin Nutr 2010; 64:940-7. [PMID: 20551967 DOI: 10.1038/ejcn.2010.98] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVES The aim of this study was to research and draw conclusions about the effect of a parenteral nutrition (PN) fat emulsion, rich in omega-3 fatty acids, on the antioxidant markers of preterm infants, when compared with a standard fat emulsion. This was a double-blind, parallel-group study conducted in Athens, Greece, using an equal randomization method. SUBJECTS/METHODS Thirty-eight infants were selected using a double-blind method and a computer-generated randomization list. Both groups received PN, based on the same protocols. Group A received SMOFlipid fat emulsion, while group B received the standard fat emulsion (Intralipid). Serum levels of vitamin A, E and total antioxidant potential (TAP) were measured on days 0, 7 and 14 of PN support. Clinical and biochemical data were collected on days 0, 14 and on the day of discharge. RESULTS Serum levels of vitamin E and A were significantly increased in group A, while only vitamin A serum level was increased in group B on the fourteenth day (group A: vitamin E: P-value=0.002, vitamin A: P-value=0.000, group B: vitamin E: P-value=0.065, vitamin A: P-value=0.000). TAP was increased only in the intervention group (group A: P-value=0.000, group B: P-value=0.287). Mild anemia was developed in both groups, while no differences were detected in the infection rate, days of hospitalization, days of ventilator support and days of phototherapy. CONCLUSIONS Oxidative stress was significantly reduced in those neonates fed with omega-3 fatty acids, whereas no effect was observed in the neonates fed with standard lipids. Intervention had no effect on infants' growth and clinical outcome.
Collapse
Affiliation(s)
- M Skouroliakou
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
| | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Damianidis C, Konstantinou D, Kyriakou V, Arvaniti M, Kotziamani N, Rodokalakis G, Agriou A, Emmanouilidou M, Tsitouridis I. Magnetic Resonance Imaging and Ultrasonographic Evaluation of Retinal Detachment in Orbital Uveal Melanomas. Neuroradiol J 2010; 23:329-38. [DOI: 10.1177/197140091002300313] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 05/11/2010] [Indexed: 11/16/2022] Open
Abstract
We assess the role of ultrasonography (US) in the evaluation of retinal detachment in patients with uveal melanomas, in correlation with magnetic resonance imaging (MRI) findings. Twenty-six patients (13♂ and 13♀) with uveal melanomas underwent MRI and US examination. The signal intensity of the tumors and retinal detachments were depicted using MRI. The position of retinal detachment in correlation with the position of intraocular tumor was also evaluated performing ultrasound examination. MRI and US identified uveal melanoma in all 26 patients. In 11 of the 26 patients (42.3%) uveal melanoma was accompanied by retinal detachment. MRI demonstrated retinal detachment in nine patients. US disclosed retinal detachment in two more cases. US has an important role in the depiction of uveal melanomas and associated retinal detachment. It also appears to be more sensitive than MRI in detecting retinal detachment in patients with orbital uveal melanomas.
Collapse
Affiliation(s)
- C.H. Damianidis
- Radiology Department, Papageorgiou General Hospital; Thessaloniki, Greece
| | - D. Konstantinou
- Radiology Department, Papageorgiou General Hospital; Thessaloniki, Greece
| | - V. Kyriakou
- Radiology Department, Papageorgiou General Hospital; Thessaloniki, Greece
| | - M. Arvaniti
- Radiology Department, Papageorgiou General Hospital; Thessaloniki, Greece
| | - N. Kotziamani
- Radiology Department, Papageorgiou General Hospital; Thessaloniki, Greece
| | - G. Rodokalakis
- Radiology Department, Papageorgiou General Hospital; Thessaloniki, Greece
| | - A. Agriou
- Radiology Department, Papageorgiou General Hospital; Thessaloniki, Greece
| | - M. Emmanouilidou
- Radiology Department, Papageorgiou General Hospital; Thessaloniki, Greece
| | - I. Tsitouridis
- Radiology Department, Papageorgiou General Hospital; Thessaloniki, Greece
| |
Collapse
|
37
|
Barbetakis N, Asteriou C, Konstantinou D, Giannoglou D, Tsilikas C, Giannoglou G. Spontaneous chylous cardiac tamponade: a case report. J Cardiothorac Surg 2010; 5:11. [PMID: 20236535 PMCID: PMC2848034 DOI: 10.1186/1749-8090-5-11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2009] [Accepted: 03/17/2010] [Indexed: 11/17/2022] Open
Abstract
Background Chylous cardiac tamponade is a rare condition with little known cause. Case presentation A case of an otherwise healthy woman who admitted with dyspnea and palpitations is presented. She had a history of a painful flexion-hyperextension of the spine. Diagnostic evaluation proved a chylous pericardial effusion with a disruption of the anterior longitudinal spinal ligament. Video-assisted thoracic surgery with mass supradiaphragmatic ligation of the thoracic duct and pericardial window formation was carried out successfully and resulted in the complete cure of the patient's condition. Conclusion Chylous pericardial effusion and subsequent tamponade is a rare entity. Endoscopic surgery is offering a safe and effective treatment.
Collapse
Affiliation(s)
- Nikolaos Barbetakis
- Cardiothoracic Surgery Department, Theagenio Cancer Hospital, Al, Symeonidi 2, Thessaloniki, Greece, 54007.
| | | | | | | | | | | |
Collapse
|
38
|
Spinos P, Matzaroglou C, Partheni M, Deli A, Karanikolas M, Konstantinou D. Surgical management of cervical spondyloarthropathy in hemodialysis patients. Open Orthop J 2010; 4:39-43. [PMID: 20148095 PMCID: PMC2817893 DOI: 10.2174/1874325001004010039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Revised: 12/21/2009] [Accepted: 12/22/2009] [Indexed: 11/22/2022] Open
Abstract
Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy. Optimal management of cervical spine spondyloarthropathy often requires circumferential reconstructive surgery, because affected patients typically have both the anterior column and the facet joints compromised. The occasional presence of noncontiguous or "skip lesions" adds an additional level of complexity to surgical management, because decompression and fusion in an isolated segment of neural compression can worsen spine deformity by applying increased stress to adjacent cervical spine segments. We report two cases of hemodialysis patients who presented with cervical myelopathy and initially had anterior cervical discectomy or corpectomy. Because symptoms recurred due to hardware failure, both patients required posterior spine fusion as well. In retrospect, because of the hardware failure, both of these patients might have benefited from a circumferential (combined anterior and posterior) cervical spine reconstruction as their initial treatment.
Collapse
Affiliation(s)
- Panayiotis Spinos
- Department of Neurosurgery, Patras University Hospital, Rion, Greece
| | | | | | | | | | | |
Collapse
|
39
|
Asteriou C, Konstantinou D, Kleontas A, Paliouras D, Samanidis G, Papadopoulou F, Barbetakis N. Blurred vision due to choroidal metastasis as the first manifestation of lung cancer: a case report. World J Surg Oncol 2010; 8:2. [PMID: 20064203 PMCID: PMC2817644 DOI: 10.1186/1477-7819-8-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 01/08/2010] [Indexed: 11/17/2022] Open
Abstract
Background Reduction in visual acuity combined with blurred vision is rarely the first sign of lung cancer and very few cases have been announced globally. Case presentation A case of a 46-year-old man who admitted with blurred vision is presented. His medical history, apart from a mild gastritis under treatment was negative. Ocular examination revealed a decrease in visual acuity due to a choroidal tumor. Further image body scans demonstrated a right lung lesion with dissemination to other organs. Diagnosis of a non-small cell lung cancer established after a VATS biopsy carried out. Conclusion Blurred vision due to choroidal metastasis as the primary symptom of lung cancer is very uncommon. A great index of suspicion is essential when a choroidal lesion appears.
Collapse
Affiliation(s)
- Christos Asteriou
- Cardiothoracic Surgery Department, Theagenio Cancer Hospital, Al Symeonidi 2, Thessaloniki, Greece.
| | | | | | | | | | | | | |
Collapse
|
40
|
Asteriou C, Konstantinou D, Lalountas M, Kleontas A, Setzis K, Zafiriou G, Barbetakis N. Nine years experience in surgical approach of leiomyomatosis of esophagus. World J Surg Oncol 2009; 7:102. [PMID: 20030817 PMCID: PMC2804581 DOI: 10.1186/1477-7819-7-102] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2009] [Accepted: 12/23/2009] [Indexed: 12/25/2022] Open
Abstract
Background Leiomyomas of esophagus, although rare, are the most frequent benign tumors of esophagus. Aim of this study is the presentation of 7 patients with esophageal leiomyomas who underwent surgical treatment during a 9-year period. Methods Epidemiological data (sex, age), the presenting symptoms, diagnostic examinations, tumor location, histopathological findings and the safety and efficacy of surgical resection are analyzed and assessed. Results 5 men and 2 women with mean age of 56.9 years were operated. In 3 cases the tumor was located at the lower esophagus, while in the other 4 cases, the leiomyoma was found at the median third of esophagus. 4 patients had severe symptoms related to the leiomyoma, such as dysphagia and epigastric pain. All patients underwent a right postolateral thoracotomy with enucleation of the lesion. None of them received resection of part of the esophagus. The mean diameter of the resected tumors was 4.3 cm. The dimensions of leiomyomas were immediately associated with the symptoms. In no case was detected malignancy or recurrence. All patients were relieved from their symptoms, while postoperative morbidity and mortality did not occur. Conclusions Esophageal leiomyoma is a benign tumor, which causes symptoms only if its size becomes large. Surgical enucleation is considered to be safe and effective, without complications.
Collapse
Affiliation(s)
- Christos Asteriou
- CardioThoracic Surgery Department, Theagenio Cancer Hospital, Al, Symeonidi 2, Thessaloniki, 54007, Greece.
| | | | | | | | | | | | | |
Collapse
|
41
|
Damianidis C, Kyriakou V, Vachtsevanos N, Tzikos F, Konstantinou D, Tsitouridis I. Craniosynostosis : correlation with cranial vault shape and osseous defects. Neuroradiol J 2009; 22:426-34. [PMID: 24207149 DOI: 10.1177/197140090902200411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Accepted: 06/29/2009] [Indexed: 11/17/2022] Open
Abstract
This study assessed the value of three-dimensional CT (3D CT) in the diagnosis of craniosynostosis, and correlated the cranial deformity with the presence of osseous defects in cranial vault's bones. One hundred and two children (55♀ and 47♂) with a clinical suspicion of craniosynostosis, underwent spiral computed tomography with 3D reconstruction using the shaded surface display (SSD) and volume rendering (VR) algorithms. We evaluated the presence of osseous defects in cranial bones in correlation with the type of craniosynostosis and the shape of the cranial vault. 3D CT allowed the evaluation of craniosynostosis in all patients. All patients had combined forms of craniosynostosis. Osseous defects in the bones of cranial vault were found in 56 patients of whom nine had scaphocephaly, eight plagiocephaly and one trigonocephaly. CT of the skull with three-dimensional reconstruction can safely and reliably identify craniosynostoses in children and could be used for the identification of osseous defects in the cranial vault.
Collapse
Affiliation(s)
- Ch Damianidis
- Department of Neuroradiology, Papageorgiou General Hospital; Thessalonki, Greece -
| | | | | | | | | | | |
Collapse
|
42
|
|
43
|
Argyriou AA, Polychronopoulos P, Partheni M, Konstantinou D, Papapetropoulos S, Chroni E. Co-occurrence of brain tumours and demyelination of the central nervous system: coincidence or interrelation? Eur J Cancer Care (Engl) 2008; 17:616-8. [PMID: 18771535 DOI: 10.1111/j.1365-2354.2008.00930.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The co-occurrence of a brain tumour and demyelinating disease of the central nervous system (CNS) constitutes a rare clinical entity. We herein report the incidence of meningioma and CNS non-specific demyelination in a patient with a 6-year history of operated brain tumour (meningioma). Our case bolsters the argument that in at least some cases, the occurrence of a brain tumour could predispose to CNS non-specific demyelination.
Collapse
Affiliation(s)
- A A Argyriou
- Department of Neurology, University Hospital of Patras, Patras, Greece.
| | | | | | | | | | | |
Collapse
|
44
|
Voulgaris S, Partheni M, Gousias K, Polyzoidis K, Konstantinou D. Solitary plasmacytoma of the upper cervical spine: therapeutic considerations. J Neurosurg Sci 2008; 52:55-59. [PMID: 18500219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Solitary plasmacytomas are localized plasma cell malignancies involving bone marrow (solitary bone plasmacytoma, SBP) or extramedullary tissues (solitary extramedullary plasmacytoma, SEP). The upper cervical spine involvement by SBP is a rare and more challenging condition. The authors describe a patient with solitary plasmacytoma involving all the elements of C2 vertebra. Severe neck pain was the only manifestation of disease. The patient underwent an occipito-cervical stabilization with a partial decompression through a single posterior approach. The authors stress the importance of early diagnosis followed by appropriate multidisciplinary treatment strategies, including surgery and discuss the management dilemmas concerning the timing and management consequence, in scope to prevent a major neurological damage and allow the patient to be ambulatory.
Collapse
Affiliation(s)
- S Voulgaris
- Department of Neurosurgery, School of Medicine, University of Ioannina, Ioannina, Greece
| | | | | | | | | |
Collapse
|
45
|
Efstratiadis G, Konstantinou D, Chytas I, Vergoulas G. Cardio-renal anemia syndrome. Hippokratia 2008; 12:11-16. [PMID: 18923761 PMCID: PMC2532969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The interaction between chronic heart failure, chronic kidney insufficiency and anemia, form a vicious cycle, termed as the cardio-renal anemia syndrome. The interaction between these three conditions causes deterioration of the cardiac and renal function and increases anemia. Each of the three can cause or be caused by the others.We herein analyze and speculate the mechanisms involved in the pathophysiology of this new syndrome highlighting the main points of interest that seem to expand upon more than one specialty. The cardio-renal anemia syndrome is emerging in the area of clinical investigation with progressively elevated significance. Additionaly we report the data related to anemia treatment as part of therapeutic perspective concerning the management of patients manifesting the profile of this syndrome.
Collapse
Affiliation(s)
- G Efstratiadis
- Nephrology Department, Aristotle University of Thessaloniki Hippokratio Hospital, Thessaloniki.
| | | | | | | |
Collapse
|
46
|
Abstract
Dorsal epidural migration of an extruded disc fragment is an infrequent event, especially in the thoracic spine. An uncommon case involving a 55-year-old man is presented, with a 1-month history of paraparesis and thoracolumbar pain. Magnetic resonance imaging demonstrated a dorsally located, extramedullary mass at the T10-T11 intervertebral level. The lesion was suspected to be a tumor. The patient underwent a T10-T11 laminectomy. Intraoperatively, an encapsulated mass of soft tissue adherent to the dural sac was found. The pathologic diagnosis was inflammatory tissue and disc material. Six months after the operation, the patient remained asymptomatic, and radiologic control showed no residual mass. Although rare, a sequestered disc fragment should be included in the differential diagnosis of an enhancing posterior extramedullary thoracic mass. Preoperative diagnosis of such pathology is difficult because the clinical signs and radiologic images may not entirely exclude other more common thoracic spinal lesions, especially tumors.
Collapse
Affiliation(s)
- M Partheni
- Department of Neurosurgery, University of Patras, Patra, Greece
| | | | | | | | | | | |
Collapse
|
47
|
Tzortzidis F, Partheni M, Voulgaris S, Gousias K, Konstantinou D. Resection of giant meningiomas of the anterior cranial fossa using orbital osteotomies. J Neurosurg Sci 2005; 49:77-84. [PMID: 16288190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
AIM The challenge in large cranial base meningiomas is total resection of the tumor with the least possible mortality and morbidity. During the last two decades the technical approaches for anterior skull base tumors have shown a considerable progress, providing a wide exposure with minimal brain retraction. The purpose of this study is to present our experience with these approaches for treatment of giant anterior cranial fossa meningiomas. METHODS A retrospective analysis was performed in 20 patients with giant meningiomas (diameter >4.5 cm) of the anterior cranial fossa, which were treated surgically in our department, between January 1992 and January 2002. There were 5 men and 15 women with an average age of 48,3 years. Mental and visual disturbances were the most common presenting symptoms. We used the extended subfrontal approach for 16 patients and the fronto-orbito-zygomatic approach for 4 patients. The follow-up period ranged from 3 to 10 years. RESULTS In all patients, total resection of the tumor (Simpson grade I, 12 patients, Simpson grade II, 8 patients) was accomplished. Significant improvement occurred by the time of follow-up examination in all but three patients. No evidence of recurrence was observed in 19 of the 20 patients. CONCLUSIONS The extended anterior skull base approaches, using orbital osteotomies, for giant meningiomas of the anterior cranial fossa have improved the extent of radical tumor removal with minimal neurological morbidity. Furthermore a long term prevention of recurrence was achieved.
Collapse
Affiliation(s)
- F Tzortzidis
- Department of Neurosurgery, School of Medicine, University of Patras, Patras, Greece
| | | | | | | | | |
Collapse
|
48
|
Panagiotopoulos V, Konstantinou D, Kalogeropoulos A, Maraziotis T. The predictive value of external continuous lumbar drainage, with cerebrospinal fluid outflow controlled by medium pressure valve, in normal pressure hydrocephalus. Acta Neurochir (Wien) 2005; 147:953-8; discussion 958. [PMID: 16041469 DOI: 10.1007/s00701-005-0580-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Accepted: 06/03/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although sporadic studies have described temporary external cerebrospinal fluid (CSF) lumbar drainage as a highly accurate test for predicting the outcome after ventricular shunting in normal pressure hydrocephalus (NPH) patients, a more recent study reports that the positive predictive value of external lumbar drainage (ELD) is high but the negative predictive value is deceptively low. Therefore, we conducted a prospective study in order to evaluate the predictive value of a continuous ELD, with CSF outflow controlled by medium pressure valve, in NPH patients. METHOD Twenty-seven patients with presumed NPH were admitted to our department and CSF drainage was carried out by a temporary (ELD) with CSF outflow controlled by a medium pressure valve for five days. All patients received a ventriculoperitoneal shunt using a medium pressure valve based upon preoperative clinical and radiographic criteria of NPH, regardless of ELD outcome. Clinical evaluation of gait disturbances, urinary incontinence and mental status, and radiological evaluation with brain CT was performed prior to and after ELD test, as well as three months after shunting. FINDINGS Twenty-two patients were finally shunted and included in this study. In a three-month follow-up, using a previously validated score system, overall improvement after permanent shunting correlated well to improvement after ELD test (Spearman's rho = 0.462, p = 0.03). When considering any degree of improvement as a positive response, ELD test yielded high positive predictive values for all individual parameters (gait disturbances 94%, 95% CI 71%-100%, urinary incontinence 100%, 95% CI 66%-100%, and mental status 100%, 95% CI 66%-100%) but negative predictive values were low (< 50%) except for cognitive impairment (85%, 95% CI 55%-98%). CONCLUSION This study suggests that a positive ELD-valve system test should be considered a reliable criterion for preoperative selection of shunt-responsive NPH patients. In case of a negative ELD-valve system test, further investigation of the presumed NPH patients with additional tests should be performed.
Collapse
Affiliation(s)
- V Panagiotopoulos
- Department of Neurosurgery, University Hospital of Patras, Rion of Patras, Greece.
| | | | | | | |
Collapse
|
49
|
Siablis D, Kagadis GC, Karamessini MT, Konstantinou D, Karnabatidis D, Petsas T, Nikiforidis GC. Intracranial aneurysms: reproduction of the surgical view using 3D-CT angiography. Eur J Radiol 2005; 55:92-5. [PMID: 15950104 DOI: 10.1016/j.ejrad.2004.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2004] [Revised: 10/09/2004] [Accepted: 10/13/2004] [Indexed: 10/26/2022]
Abstract
Our purpose was to describe a technique for simulating the surgical view of ruptured intracranial aneurysms, using volume-rendering techniques in spiral computed tomography (CT) angiography data. The 3D (three-dimensional) rendered images were assessed by a team consisted of four radiologists, one neurosurgeon and one medical physicist. The resultant 'surgical view' image was standardized in space using a three-dimensional coordinate system, which allowed for its reproduction in the operating theatre. The surgical views are a potentially useful tool for the surgical planning of intracranial aneurysms.
Collapse
Affiliation(s)
- Dimitrios Siablis
- Department of Radiology, School of Medicine, University of Patras, Rion GR 26500, Greece.
| | | | | | | | | | | | | |
Collapse
|
50
|
Solomou E, Maragkos M, Kotsarini C, Konstantinou D, Maraziotis T. Multiple spinal epidural abscesses extending to the whole spinal canal. Magn Reson Imaging 2004; 22:747-50. [PMID: 15172071 DOI: 10.1016/j.mri.2004.01.072] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2003] [Accepted: 01/30/2004] [Indexed: 11/24/2022]
Abstract
Spinal epidural abscess (SEA) is a rare life-threatening disease mostly affecting patients with an altered immune system. It presents as a sequela of adjacent infection or hematogenous spread. MRI is the method of choice in evaluating patients with suspected SEAs and should always include the whole spinal canal, excluding the exceedingly rare possibility of multiple epidural collections. We present a rare case of a patient with no predisposing factors suffering from multiple SEAs, extending to the whole spinal canal.
Collapse
Affiliation(s)
- E Solomou
- Department of Radiology, Medical School, University of Patras, Patras, Greece.
| | | | | | | | | |
Collapse
|