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Papachristou E, Deftereos S, Asimakidou M, Bekiaridou K, Foutzitzi S, Defteraiou S, Oikonomou P, Gogoulis I, Nikolaou C, Aggelidou M, Sinopidis X, Romanidis K, Tsaroucha A, Kambouri K. Parental Home Safety Practices for Domestic Accident Prevention: How Prepared Were Parents for COVID-19 Confinement? A Cross-Sectional Study. Clin Pract 2023; 13:1449-1459. [PMID: 37987430 PMCID: PMC10660517 DOI: 10.3390/clinpract13060129] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023] Open
Abstract
(1) Background: Children are susceptible to home injuries. How prepared parents were to protect their children from accidents before and during the COVID-19 quarantine is uncertain. (2) Methods: We conducted a community-based, cross-sectional study in Greece between November and December 2021. We asked parents to complete an anonymous questionnaire voluntarily. Questions focused on accident-preventive measures taken at home during the COVID-19 quarantine. (3) Results: A greater proportion of parents took protective measures for a safer home before the lockdown than during the quarantine, while an interesting percentage of parents never utilized preventive measures for their children. Slightly more than half (58.6%) of parents did not seem to worry about a possible increase in domestic accidents during the quarantine. It was observed that those who had one or two children took more protective measures than those with more than two children. Older parents seemed to explain to their children how to access emergency services more often. Mothers stayed at home with the children more often, and their education affected the presence of some of the assessed measures. In our logistic regression modeling, parental concern about accidents was more related to the incidence of an accident during the pandemic and attendance at seminars. (4) Conclusions: Although the COVID-19 lockdowns disorganized family life, parents were aware of the importance of their parenting role in creating a safe environment for children, but according to the study, there is room for improvement.
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Affiliation(s)
- Eirini Papachristou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.P.); (M.A.); (K.B.); (M.A.)
| | - Savas Deftereos
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (S.D.); (S.F.)
| | - Maria Asimakidou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.P.); (M.A.); (K.B.); (M.A.)
| | - Konstantina Bekiaridou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.P.); (M.A.); (K.B.); (M.A.)
| | - Soultana Foutzitzi
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (S.D.); (S.F.)
| | | | - Panagoula Oikonomou
- Department of Experimental Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (P.O.); (A.T.)
| | - Ioannis Gogoulis
- Department of General Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (I.G.); (C.N.); (K.R.)
| | - Christina Nikolaou
- Department of General Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (I.G.); (C.N.); (K.R.)
| | - Maria Aggelidou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.P.); (M.A.); (K.B.); (M.A.)
| | - Xenophon Sinopidis
- Department of Pediatric Surgery, Rio University Hospital, University of Patras, 26504 Rio, Greece;
| | - Konstantinos Romanidis
- Department of General Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (I.G.); (C.N.); (K.R.)
| | - Alexandra Tsaroucha
- Department of Experimental Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (P.O.); (A.T.)
| | - Katerina Kambouri
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.P.); (M.A.); (K.B.); (M.A.)
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Bekiaridou K, Kambouri K, Giatromanolaki A, Foutzitzi S, Kouroupi M, Aggelidou M, Deftereos S. Predicting Complicated Appendicitis in Children: Pros and Cons of a New Score Combining Clinical Signs, Laboratory Values, and Ultrasound Images (CLU Score). Diagnostics (Basel) 2023; 13:2275. [PMID: 37443669 DOI: 10.3390/diagnostics13132275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/29/2023] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND This retrospective study aimed to combine the clinical signs, laboratory values, and ultrasound images of 199 children with acute appendicitis in order to create a new predictive score for complicated appendicitis in children. METHODS The study included children who had clinical examination of abdominal pain (description of pain, anorexia, body temperature, nausea or vomiting, duration of symptoms), laboratory findings on admission (white blood cell, platelets, neutrophils, C-reactive protein), preoperative abdominal ultrasound, and histopathological report after an operation for appendicitis in their records during the period from January 2016 to February 2022. RESULTS According to the statistical analysis of the values using multivariate logistic regression models, the patients with appendiceal diameter ≥ 8.45 mm, no target sign appearance, appendicolith, abscess, peritonitis, neutrophils ≥ 78.95%, C-reactive protein ≥ 1.99 mg/dL, body temperature ≥ 38 °C, pain migration to right lower quadrant, and duration of symptoms < 24 h were more likely to suffer from complicated appendicitis. The new score was comprised of the 10 variables that were found statistically significant in the multivariate logistic model. Each of these variables was assigned a score of 1 due to the values that were associated with complicated appendicitis. CONCLUSIONS A cutoff value of ≥4 has been a good indicator of the final score. The sensitivity with the usage of this score is 81.1%, the specificity 82.4%, the PPV 73.2%, the NPV approaches 88% and finally the accuracy is 81.9%. Also, the pros and cons of this score are discussed in this study.
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Affiliation(s)
- Konstantina Bekiaridou
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Katerina Kambouri
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | | | - Soultana Foutzitzi
- Department of Radiology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Maria Kouroupi
- Department of Pathology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Maria Aggelidou
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Savas Deftereos
- Department of Pathology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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Voulgaridou A, Paliouras D, Deftereos S, Skarentzos K, Tsergoula E, Miltsakaki I, Oikonomou P, Aggelidou M, Kambouri K. Hospitalization in neonatal intensive care unit: parental anxiety and satisfaction. Pan Afr Med J 2023; 44:55. [PMID: 37128622 PMCID: PMC10148175 DOI: 10.11604/pamj.2023.44.55.34344] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 01/04/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction the birth of an infant constitutes a challenge for all parents. Stress is intense when an infant is born prematurely or experiences health problems and enters the Neonatal Intensive Care Unit (NICU). Moreover, mothers with premature babies in the NICU would feel frustrated if they are hospitalized in the maternity clinic away from their children. The purpose of this study is to assess the stress experienced by the parents of newborns hospitalized in NICU and its correlation with their level of satisfaction from the services provided during the hospitalization. Methods the sample consisted of 102 parents whose children were hospitalized in NICU. Parental Satisfaction questionnaires of NICU and the Picker´s institute were used. Statistical analysis was performed using χ2 (chi square) and Pearson´s correlation test (bivariate). STROBE checklist was applied. Results out of the 102 parents, 66% were mothers and 33% were fathers. Parents expressed their satisfaction at a rate of 87.8% (±13.9%). In addition, there was strong evidence that the degree of parental satisfaction was significantly related to the age of the mother (p<0.05). The sudden noises from the alarms of the monitoring instruments were strongly correlated with the degree of parents´ satisfaction from the services provided by the NICU (p<0.05). Parents feel less stressful when their child is being monitored (p<0.05). Conclusion the results of this study could help the staff of NICU clinics to improve parents´ satisfaction about health services. Proper and adequate communication between parents and health professionals in NICU increases parental satisfaction.
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Affiliation(s)
| | | | - Savas Deftereos
- Radiology Department, Democritus University of Thrace, Dragana 1, Alexandroupolis, Greece
| | - Konstantinos Skarentzos
- Democritus University of Thrace, Department of Medicine, University General Hospital of Alexandroupolis, Dragana 1, Alexandroupolis, Greece
| | - Evaggelia Tsergoula
- Intensive Care Unit, Alexandroupolis University Hospital, Alexandroupolis, Greece
| | - Irini Miltsakaki
- University General Hospital of Alexandroupolis, Dragana 1, Alexandroupolis, Greece
| | - Panagoula Oikonomou
- Department of Experimental Surgery, Democritus University of Thrace, Dragana 1, Alexandroupolis, Greece
| | - Maria Aggelidou
- Department of Pediatric Surgery, Democritus University of Thrace, Dragana 1, Alexandroupolis, Greece
| | - Katerina Kambouri
- Department of Pediatric Surgery, Democritus University of Thrace, Dragana 1, Alexandroupolis, Greece
- Corresponding author: Katerina Kambouri, Department of Pediatric Surgery, Democritus University of Thrace, Dragana 1, Alexandroupolis, Greece.
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Panagopoulou K, Gkentzi D, Fouzas S, Mentis M, Kostopoulou E, Plotas P, Papaevangelou V, Soldatou A, Karatza A, Bertzouanis A, Spyridakis I, Sfoungaris D, Zavras N, Salakos C, Blevrakis E, Sakellaris G, Kambouri K, Giapros V, Roupakias S, Jelastopulu E, Chantzi Z, Panagiotopoulos V, Varvarigou A, Dimitriou G, Sinopidis X. Child abuse experience, training, knowledge, and attitude of healthcare professionals in sixty hospitals in Greece. Eur Rev Med Pharmacol Sci 2023; 27:659-672. [PMID: 36734738 DOI: 10.26355/eurrev_202301_31068] [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: 02/04/2023]
Abstract
OBJECTIVE This study aims to record the overall perception of healthcare professionals on child abuse and identify potential affecting factors in a nationwide scale in Greece as well as to provide information that might be useful for future educational actions. MATERIALS AND METHODS A total of 1,185 healthcare professionals in 60 hospitals with pediatric departments across Greece participated in this cross-sectional study. Participants included pediatricians, pediatric surgeons, residents, nurses, psychiatrists, psychologists, and social workers. Sections under investigation involved experience and training in child abuse, knowledge of formal and judicial issues, clinical knowledge, and self-assessment. RESULTS Although more than half of the participants had confronted child abuse (n=712, 60.08%), only 273 (38.34% of them) submitted reports. One third of participants reported that they had received some training (n=440, 37.13%), mainly of postgraduate nature and based on personal initiative. Of those who reported child abuse, 175 (64.10%) had been trained. Each professional category was aware of topics regarding its own interest, without adequate knowledge of other disciplines. One third of psychiatrists, psychologists, and social workers felt confident in discussing with children and parents. Relevant scores were lower in the other categories. The lower scores were recorded among nurses and residents. The training deficit and reluctance to engage with judicial issues were the main causes of avoidance to deal with child abuse. CONCLUSIONS Focused and organized training in child abuse is crucial to create reliable professionals in the field. The internet is a considerably helpful tool. Professionalism must characterize knowledge and practice in child abuse at the same level as in other medical topics. Motivation to engage should be early inspired and developed during the graduate years.
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Affiliation(s)
- K Panagopoulou
- Department of Pediatrics, University of Patras School of Medicine, Patras, Greece.
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Kottakis G, Kambouri K, Giatromanolaki A, Valsami G, Kostomitsopoulos N, Tsaroucha A, Pitiakoudis M. Effects of the Antioxidant Quercetin in an Experimental Model of Ulcerative Colitis in Mice. Medicina (Kaunas) 2022; 59:medicina59010087. [PMID: 36676712 PMCID: PMC9861512 DOI: 10.3390/medicina59010087] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
Background and Objectives: Quercetin, a member of the flavanol family found in many fruits, vegetables, leaves and grains has been found to have a wide range of biological effects on human physiology. The aim of this study was to investigate the effects of quercetin, when administered orally in the form of the water-soluble inclusion complex with hydroxypropyl-b-cyclodextrin (Que-HP-β-CD), in an experimental model of ulcerative colitis in mice. Materials and Methods: Animals received either Dextran Sodium Sulphate (DSS), to induce colitis, + Que-HP-β-CD (Group A), DSS alone (Group B) or no intervention (control, Group C) for 7 days. All animals were weighed daily, and evaluation of colitis was performed using the Disease Activity Index (DAI). On day 7 a blood sample was taken from all animals, they were then euthanised, the large intestine was measured, and histological and immunochemical analyses were performed. Results: The DAI demonstrated an increase over time for the groups receiving DSS (Groups A and B) compared with the control group (Group C), with a significant degree of protection being observed in the group that also received quercetin (Group A): The DAI over time slope for Group B was higher than that for Group A by 0.26 points/day (95% Cl 0.20−0.33, p < 0.01). Weight calculations and immunohistochemistry results validated the DAI findings. Conclusions: In conclusion, the administration of quercetin in an ulcerative colitis model in mice presents a therapeutic/prophylactic potential that warrants further investigation.
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Affiliation(s)
- George Kottakis
- Department of Experimental Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Correspondence: ; Tel.: +30-694-529-7747
| | - Katerina Kambouri
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | | | - Georgia Valsami
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece
| | - Nikolaos Kostomitsopoulos
- Biomedical Research Foundation (BRFAA) of the Academy of Athens, Experimental Surgery and Translational Research, 11527 Athens, Greece
| | - Alexandra Tsaroucha
- Department of Experimental Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Michael Pitiakoudis
- 2nd Department of General Surgery, University of Thrace, 68100 Alexandroupolis, Greece
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Papachristou E, Deftereos S, Oikonomou P, Bekiaridou K, Foutzitzi S, Gogoulis I, Sinopidis X, Romanidis K, Tsaroucha A, Kambouri K. Is It Safe to Stay at Home? Parents’ Perceptions of Child Home Injuries during the COVID-19 Lockdown. Healthcare (Basel) 2022; 10:healthcare10102056. [PMID: 36292503 PMCID: PMC9601692 DOI: 10.3390/healthcare10102056] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/28/2022] Open
Abstract
The COVID-19 pandemic and stay-at-home regulations have increased child home injuries. This study illustrates the type and frequency of child home injuries in Greece during the COVID-19 lockdown. Moreover, the survey reports the results on parents’ proposals regarding child injuries at home during the COVID-19 quarantine. A community-based, cross-sectional, descriptive study was conducted from November to December 2021 in Greece. Parents were asked to voluntarily complete an anonymous questionnaire, designed for the needs of the research. A statistical analysis of the data was performed using the Kolmogorov–Smirnov and Shapiro–Wilk tests for a normal distribution, a chi-squared (χ2) test to compare percentages among different groups and a non-parametric Mann–Whitney U test to determine the differences in Likert scale variables between two groups. A total of 130 parents with at least one child were questioned through an online questionnaire survey. Of the parents, 39.3%, stated that the number of accidents in their home increased. The most frequent accidents were injuries (49.3%). Most of the accidents occurred inside the house (75.8%) and were observed among children aged 0–4 years. A high percentage of children’s accidents was observed in rural/island areas or in the suburbs. Children who were with either their father or mother had one accident, and a higher number of accidents occurred when the children were with their grandparents, with the nanny or alone. For those parents who had difficulty supervising their child, child accidents increased compared to parents who had the ability to supervise. It was noticed that parents who knew how to provide a safe home stated that the number of accidents remained the same. Parents must organize a safer home. Authorities should educate parents on child injury prevention and provide them with financial facilities to provide a safer house.
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Affiliation(s)
- Eirini Papachristou
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Savas Deftereos
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Panagoula Oikonomou
- Department of Experimental Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Konstantina Bekiaridou
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Soultana Foutzitzi
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Ioannis Gogoulis
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Xenophon Sinopidis
- Department of Pediatric Surgery, University of Patras, 26504 Patras, Greece
| | - Konstantinos Romanidis
- Department of Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Alexandra Tsaroucha
- Department of Experimental Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Katerina Kambouri
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Correspondence: ; Tel.: +30-6946335786
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Bekiaridou K, Kambouri K, Giatromanolaki A, Foutzitzi S, Kouroupi M, Chrysafis I, Deftereos S. The Prognostic Value of Ultrasound Findings in Preoperatively Distinguishing between Uncomplicated and Complicated Types of Pediatric Acute Appendicitis Based on Correlation with Intraoperative and Histopathological Findings. Diagnostics (Basel) 2022; 12:2315. [PMID: 36292004 PMCID: PMC9600393 DOI: 10.3390/diagnostics12102315] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/11/2022] [Accepted: 09/23/2022] [Indexed: 08/30/2023] Open
Abstract
OBJECTIVE This study compares the preoperative ultrasound findings of all children with a clinical picture of acute appendicitis on the basis of intraoperative and histopathological findings to assess the feasibility of this approach in preoperatively distinguishing between uncomplicated and complicated cases. METHODS This retrospective study includes 224 pediatric patients who underwent ultrasound prior to appendectomy at our institution between January 2016 and February 2022. Logistic regression analysis was used to investigate the association between sonographic and intraoperative histopathological findings. RESULTS Of the 224 participants, 61.1% were intraoperatively diagnosed with uncomplicated appendicitis (59.8% male). Multivariate logistic regression analysis revealed that patients with a higher appendiceal diameter, presence of appendicolith, and peritonitis were more likely to suffer from complicated appendicitis. Finally, the common anatomical position of the appendix and an appendiceal diameter greater than 6 mm had the highest sensitivity (94.6% and 94.5%, respectively) for predicting complicated appendicitis, with the most specific (99.3%) sonographic finding being the existence of an abscess. CONCLUSIONS Preoperative abdominal ultrasound in children with a clinical diagnosis of acute appendicitis can distinguish between uncomplicated and complicated appendicitis in most cases of pediatric appendicitis. A higher appendiceal diameter, the presence of appendicolith, and peritonitis are parameters noted by ultrasound that strongly predict complicated appendicitis.
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Affiliation(s)
- Konstantina Bekiaridou
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Katerina Kambouri
- Department of Pediatric Surgery, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | | | - Soultana Foutzitzi
- Department of Radiology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Maria Kouroupi
- Department of Pathology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Ioannis Chrysafis
- Department of Radiology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Savas Deftereos
- Department of Radiology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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8
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Deftereos SP, Foutzitzi S, Skarentzos K, Aggelidou M, Oikonomou P, Kambouri K. Role of Contrast Enhanced Ultrasound (CEUS) in the Paediatric Population with Blunt Abdominal Trauma: A Prospective Study from a Single Center Experience for Paediatric Blunt Abdominal Trauma. Maedica (Bucur) 2022; 17:44-51. [PMID: 35733753 PMCID: PMC9168570 DOI: 10.26574/maedica.2022.17.1.44] [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: 06/15/2023]
Abstract
Aim:The aim of our study is to evaluate the diagnostic ability of contrast-enhanced ultrasonography (CEUS) in pediatric population with history of blunt abdominal trauma (BAT). Materials and methods: In an eight-year period (1/2012-1/2020), fifty-nine children (4-14 years old) were transferred to the Emergency Department with referred BAT. The initial imaging method was ultrasound scan (US). Thirty-two children were discharged in good condition 24 hours after their admission. The remaining 27, who had moderate to severe injuries and according to their laboratory tests and US results, were evaluated with CEUS and contrast-enhanced computed tomography (CECT). Results:Five children were confirmed with splenic injury, two with liver lacerations, one with liver lacerations and right kidney contusion, while in nineteen, no visceral pathology was found by US, CEUS and CECT. The CEUS and CECT were in complete agreement. On the contrary, unenhanced-US showed free peritoneal fluid in eleven children and possible parenchymal lesions in two children. In two of the patients with negative US-study, splenic contusions in CECT and CEUS were revealed. The CEUS study was also used as a follow-up method. Among the 27 patients, there were no adverse reactions from the CEUS contrast agent either at one-week and six-month follow-up, or after one-year period. Conclusion:Contrast-enhanced ultrasonography is an effective, easily performed, low cost and radiation free imaging method. It is ideal for both initial and follow up evaluation of trauma and thus, we encourage its usage in paediatric BAT cases.
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Affiliation(s)
| | - S Foutzitzi
- Radiology Department, University Hospital of Alexandroupolis, Greece, ORCID ID: 0000-0001-5090-6917
| | - K Skarentzos
- Department of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, 68100, Greece, ORCID ID: 0000-0003-0994-4959
| | - M Aggelidou
- Department of Pediatric Surgery, University Hospital of Alexandroupolis, Greece, ORCID ID: 0000-0002-3907-0407
| | - P Oikonomou
- Department of Experimental Surgery, Democritus University of Thrace, Dragana, Alexandroupolis, 68100, Greece, ORCID ID: 0000-0001-5059-8010
| | - K Kambouri
- Department of Pediatric Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100, Greece, ORCID ID: 0000-0003-0817-6513
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9
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Deftereos S, Vasilopoulos A, Kambouri K. Large Congenital Juvenile Xanthogranuloma in a Two-Month-Old Girl, a Case of Non-Langerhans Cell Histiocytosis. Acta Med Acad 2021; 50:304-305. [PMID: 34847683 DOI: 10.5644/ama2006-124.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/11/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Savas Deftereos
- Department of Radiology, University General Hospital of Alexandroupolis, School of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
| | - Anastasios Vasilopoulos
- Department of Radiology, University General Hospital of Alexandroupolis, School of Medicine, Democritus University of Thrace, Alexandroupoli, Greece.
| | - Katerina Kambouri
- Department of Pediatric Surgery, University General Hospital of Alexandroupoli, School of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
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10
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Skarentzos K, Papadopulos N, Deftereos SP, Thomaidis S, Kambouri K. Serious Rodent Bites to an 8-Month-Old Infant Due to Child Neglect. Cureus 2021; 13:e18493. [PMID: 34754654 PMCID: PMC8569684 DOI: 10.7759/cureus.18493] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 01/16/2023] Open
Abstract
Animal bites are among the top causes of preventable traumatic injuries. We describe the case of an 8-month-old female infant who was brought to the emergency department by her grandfather with serious rodent bites on her eyes, nose, right cheek, upper right extremity, and other smaller bites all over her body. This case is another proof of child neglect, or a possible infanticide attempt, as the motives of leaving the child in a hut without proper care, are not cleared up to this date. Rodent bites could be associated with Streptobacillus moniliformis infection and rat-bite fever. If the bites are left untreated for hours, the infant may suffer from hypovolemic shock due to bleeding, a possible fatal situation. The emergency surgical treatment of wounds is of vital importance.
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Affiliation(s)
- Konstantinos Skarentzos
- Medicine, Democritus University of Thrace/General University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Nikolaos Papadopulos
- Plastic Surgery, Democritus University of Thrace/General University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Savvas P Deftereos
- Radiology, Democritus University of Thrace/University General Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Stavros Thomaidis
- Pediatrics, Democritus University of Thrace/University General Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Katerina Kambouri
- Pediatric Surgery, Democritus University of Thrace/University General Hospital of Alexandroupolis, Alexandroupolis, GRC
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Kambouri K, Skarentzos K, Oikonomou P, Papachristou E, Aggelidou M. Reduction in Pediatric Surgery's Emergency Department Visits During COVID-19 Pandemic in a Tertiary University General Hospital in Greece. Cureus 2021; 13:e17543. [PMID: 34646600 PMCID: PMC8478439 DOI: 10.7759/cureus.17543] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 11/25/2022] Open
Abstract
Background From January 2020, coronavirus has caused more than three million deaths. Lockdown has been enforced in many countries worldwide, affecting the emergency department visits of many surgical specialties. Methods The purpose of this study was to present the difference in trends in pediatric emergency department visits from March 1 to May 30, 2020, compared to the same 3-month period in 2019 in a tertiary university hospital in Greece, which was one of the referral centers for COVID-19 patients. Results A 42.5% reduction in emergency department visits was observed. In 2020, only 196 patients visited the pediatric surgery emergency department, versus 341 patients in 2019 (p<0.05). The reasons for visiting the emergency department did not change in most categories. Even though visits to the emergency department were reduced, the rates of the distance of the patient’s residency from the hospital remained roughly the same. Hospital admission rates remained roughly the same. Conclusion Even though there was a huge decrease in numbers, the reasons for visiting the ED remained roughly the same. The only exception was indoor accidents, which increased in 2020.
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Affiliation(s)
- Katerina Kambouri
- Pediatric Surgery, Democritus University of Thrace/ General University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Konstantinos Skarentzos
- Medicine, Democritus University of Thrace/ General University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Panagoula Oikonomou
- Experimental Surgery, Democritus University of Thrace/ General University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Eirini Papachristou
- Medicine, Democritus University of Thrace/ General University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Maria Aggelidou
- Pediatric Surgery, General University Hospital of Alexandroupolis, Alexandroupolis, GRC
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12
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Nistikoulis G, Christodoulou E, Kambouri K, Deftereos SP. An Unexpected Location of Enostosis, a Pediatric "Never Mind" Bone Lesion. Maedica (Bucur) 2021; 16:318-319. [PMID: 34621359 DOI: 10.26574/maedica.2020.16.2.318] [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: 11/03/2022]
Abstract
Enostoses, also known as bone islands, are common benign sclerotic bone lesion that usually represent incidental findings. They constitute a small focus of compact bone within cancellous bone. Enostoses can be seen on radiographs, CT, and MRI, and are considered one of the skeletal do not touch lesions.
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Affiliation(s)
- Georgios Nistikoulis
- Department of Radiology, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Katerina Kambouri
- Departement of Paediatric Surgery, Democritus University of Thrace, Alexandroupolis, Greece
| | - Savas P Deftereos
- Department of Radiology, Democritus University of Thrace, Alexandroupolis, Greece
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13
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Skarentzos K, Aggelidou M, Savas D, Bekiaridou K, Kambouri K. Hypertrophic pyloric stenosis case series in twins and first cousins: genes, feeding patterns or both? (a case report). Pan Afr Med J 2021; 39:210. [PMID: 34603591 PMCID: PMC8464213 DOI: 10.11604/pamj.2021.39.210.29180] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/06/2021] [Indexed: 12/04/2022] Open
Abstract
We present two cases of dizygotic male twins and two cases of male first cousins with infantile hypertrophic pyloric stenosis (IHPS). All patients were treated with open pyloromyotomy. No complications were reported. The patients had the same risk factors for IHPS. First, all patients were first-born white males. Second, the twins were preterm (35 weeks). Third, the twins and the first cousins were exclusively bottle feeding. Thus, a combination of genetic and environmental factors may have contributed to the appearance of IHPS.
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Affiliation(s)
- Konstantinos Skarentzos
- Democritus University of Thrace, Department of Medicine, General University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Maria Aggelidou
- Democritus University of Thrace, Department of Paediatric Surgery, General University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Deftereos Savas
- Democritus University of Thrace, Department of Radiology, General University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Konstantina Bekiaridou
- Democritus University of Thrace, Department of Paediatric Surgery, General University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Katerina Kambouri
- Democritus University of Thrace, Department of Paediatric Surgery, General University Hospital of Alexandroupolis, Alexandroupolis, Greece
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14
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Aggelidou M, Deftereos SP, Cassimos DC, Skarentzos K, Oikonomou P, Angelidou A, Nikolaou C, Koufopoulos G, Kambouri K. Influence of education and residence on the parental search for pediatric surgical information on the internet. World J Clin Pediatr 2021; 10:93-105. [PMID: 34616651 PMCID: PMC8465516 DOI: 10.5409/wjcp.v10.i5.93] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/20/2021] [Accepted: 08/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The internet is a valuable tool for access to health-related information. There is limited literature regarding its use by parents of children with surgical conditions.
AIM To investigate internet usage by parents seeking information about the surgical conditions of their offspring in relation to epidemiological factors such as family residential area and parental educational level and to subsequently review the literature regarding this topic.
METHODS An anonymous questionnaire about internet usage was completed by eligible parents of children who were admitted to our clinic for minor surgical procedures during a six-month period.
RESULTS Our results demonstrated that the internet has been mostly used by mothers for children’s health information. Google was the most commonly used search engine, while pediatricians were the first parental choice for ‘live’ information. Only one-quarter of the parents informed their doctor about the information found online. Nine of ten parents had a positive opinion of an official website managed by the doctors of our clinic. Our results mostly agreed with the international literature.
CONCLUSION In conclusion, the establishment of official websites (designed and managed by specialists) that parents can access to receive appropriate health information is mandatory in the internet era.
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Affiliation(s)
- Maria Aggelidou
- Department of Pediatric Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece
| | - Savas P Deftereos
- Department of Radiology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Dimitrios C Cassimos
- Department of Pediatrics, Alexandroupolis University Hospital, Alexandroupolis 68100, Greece
| | | | - Panagoula Oikonomou
- Department of Surgery, Alexandroupolis University Hospital, Alexandroupolis 68100, Greece
| | - Artemis Angelidou
- Student of Molecular Biology, Alexandroupolis University Hospital, Alexandroupolis 68100, Greece
| | - Christina Nikolaou
- Department of Surgery, Alexandroupolis University Hospital, Alexandroupolis 68100, Greece
| | | | - Katerina Kambouri
- Department of Pediatric Surgery, Alexandroupoli University Hospital, Democritus University of Thrace, Alexandroupoli 68132, Greece
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15
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Kambouri K, Sotiropoulou R, Nistikoulis GP, Foutzitzi S, Aggelidou M, Deftereos S. Can the ultrasound suggest the emergency operation of a sliding ovary in a hernia sac? SAGE Open Med Case Rep 2021; 9:2050313X211020079. [PMID: 34104449 PMCID: PMC8170337 DOI: 10.1177/2050313x211020079] [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] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/05/2021] [Indexed: 11/16/2022] Open
Abstract
In this case, it is described the importance of ultrasound in children with sliding
ovaries in inguinal hernias. If the child has no symptoms, an emergency ultrasound could
suggest the manner of the operation, scheduled or emergency.
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Affiliation(s)
- Katerina Kambouri
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, Komotini, Greece
| | - Rodoula Sotiropoulou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, Komotini, Greece
| | - George Petros Nistikoulis
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, Komotini, Greece
| | - Soultana Foutzitzi
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, Komotini, Greece
| | - Maria Aggelidou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, Komotini, Greece
| | - Savas Deftereos
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, Komotini, Greece
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16
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Kambouri K, Chatzipantelis P, Foutzitzi S, Dimitriadou C, Aggelidou M, Giatromanolaki A, Deftereos S. Dermatofibrosarcoma protuberans in a child, that's why soft tissue lesions are not always innocent in children. Clin Case Rep 2021; 9:e04080. [PMID: 34084498 PMCID: PMC8142409 DOI: 10.1002/ccr3.4080] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/14/2021] [Indexed: 11/18/2022] Open
Abstract
Pediatric soft tissue tumors should be always operated and sent for a biopsy.
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Affiliation(s)
- Katerina Kambouri
- Department of Pediatric Surgery Alexandroupolis University Hospital Democritus University of Thrace Komotini Greece
| | - Paschalis Chatzipantelis
- Department of Pathology Alexandroupolis University Hospital Democritus University of Thrace Komotini Greece
| | - Soultana Foutzitzi
- Department of Radiology Alexandroupolis University Hospital Democritus University of Thrace Alexandroupolis Greece
| | - Chrysavgi Dimitriadou
- Department of Pediatric Surgery Alexandroupolis University Hospital Democritus University of Thrace Komotini Greece
| | - Maria Aggelidou
- Department of Pediatric Surgery Alexandroupolis University Hospital Democritus University of Thrace Komotini Greece
| | - Alexandra Giatromanolaki
- Department of Pathology Alexandroupolis University Hospital Democritus University of Thrace Komotini Greece
| | - Savas Deftereos
- Department of Radiology Alexandroupolis University Hospital Democritus University of Thrace Alexandroupolis Greece
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17
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Deftereos SP, Foutzitzi S, Karagiannakis G, Aggelidou M, Cassimos DC, Kambouri K. Constipation and dilated bowel: Hirschsprung's disease is not always the case. Clin Pract 2020; 10:1270. [PMID: 33123335 PMCID: PMC7586137 DOI: 10.4081/cp.2020.1270] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 09/25/2020] [Indexed: 12/01/2022] Open
Abstract
A case of a 2-month-old boy with constipation and a localized abdominal distension in the right abdomen and hypogastrium is presented. Plain radiograph, ultrasound exam as well as a barium enema were suggestive of Hirschsprung’s disease (HD) (ultrashort segment disease). Nevertheless, rectal suction biopsy was negative for neuronal abnormalities and unexpectedly on plain radiograph vertebral abnormalities were noticed. Subsequently magnetic resonance imaging of the spine and abdomen was performed, to evaluate possible spinal cord lesions and potential abnormalities of the perineal region musculature. A syringe throughout medullary cone was noted. The well-known issue, that the diagnosis of HD does not depend on the imaging (radiological) findings, was confirmed. The step-bystep diagnostic approach from the initial thought of ultrashort segment HD to the later imaging-based diagnosis of syringomyelia is discussed in this present paper.
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Affiliation(s)
- Savas P Deftereos
- Department of Radiology, Democritus University of Thrace (D.U.Th.) University Hospital of Alexandroupolis
| | | | | | - Maria Aggelidou
- Consultant Paediatric Surgeon, University Hospital of Alexandroupolis
| | - Dimitrios C Cassimos
- Department of Paediatrics, Democritus University of Thrace (D.U.Th.), University Hospital of Alexandroupolis
| | - Katerina Kambouri
- Department of Paediatric Surgery, Democritus University of Thrace (D.U.Th.), University Hospital of Alexandroupolis, Greece
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18
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Kambouri K, Aggelidou M, Deftereos S, Tsalikidis C, Chloropoulou P, Botaitis S, Giannakopoulos S, Pitiakoudis M. Comparison of Two Tubularized Incised Plate Urethroplasty Techniques in Hypospadias Reconstructive Surgery. World J Plast Surg 2020; 9:254-258. [PMID: 33330000 PMCID: PMC7734945 DOI: 10.29252/wjps.9.3.254] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Hypospadias repair is a challenging type of urogenital reconstructive surgery for which different techniques are currently used. The purpose of this study is to determine the outcomes of distal, mid-shaft and proximal hypospadias repair using two new variations of tubularized incised plate (TIP) urethroplasty (TIP-δ and TIP-ελ) and to compare their complication rates with other already known operative techniques made from the same surgical team. METHODS This study included 269 boys with hypospadias. The preoperative meatal site was distal in 179 patients, mid-shaft in 44 and proximal in 46. The average age at the operation was 17 months. The technique applied in distal hypospadias was Mathieu in 77 patients, Snodgrass in 28 and (TIP)-δ in 74. The technique applied in mid-shaft hypospadias was a tubularized island flap (TIF) in 12 patients, onlay island flap (OIF) in 5 and TIP-ελ in 27. The operative technique for proximal hypospadias was TIF in 15 patients, OIF in 10 and TIP-ελ in 21. TIP-δ and TIP-ελ are two new variants of TIP operation that we have used in our clinic since 2010. Postoperative complications were recorded, and we compared the outcomes obtained by applying the techniques. RESULTS The use of TIP-δ in the distal hypospadias and long TIP-ελ in the mid-shaft and proximal hypospadias resulted in significantly fewer complications than the other surgical methods across all cases of hypospadias (p<0.05). CONCLUSION The type of tissue used for neourethral coverage seems to play an important role in the outcome of hypospadias surgery.
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Affiliation(s)
- Katerina Kambouri
- Department of Anesthesiology, Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
| | - Maria Aggelidou
- Department of Anesthesiology, Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
| | - Savvas Deftereos
- Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
| | - Christos Tsalikidis
- Department of Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
| | - Pelagia Chloropoulou
- Anesthesiology, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
| | - Sotirios Botaitis
- Department of Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
| | - Stelios Giannakopoulos
- Department of Urology, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
| | - Michail Pitiakoudis
- Department of Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
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19
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Kambouri K, Aggelidou M, Foutzitzi S, Deftereos S. Magnetic balls ingestion as a cause of intestinal volvulus in a 6-year-old boy. Gazz Med Ital - Arch Sci Med 2019. [DOI: 10.23736/s0393-3660.18.03935-9] [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: 11/08/2022]
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20
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Kambouri K, Aggelidou M, Deftereos S, Tsalkidis A, Vaos G, Pitiakoudis M. What are the Risk Factors Responsible for the Delay in Diagnosis of Acute Appendicitis in Children? Eleven-year Research from a Single Institution. Folia Med (Plovdiv) 2019; 61:389-396. [PMID: 32337925 DOI: 10.3897/folmed.61.e39355] [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: 08/22/2019] [Accepted: 03/19/2019] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION We conducted a retrospective analysis of 602 children operated on for acute appendicitis (AA) in our department between 1/2007 and 12/2017. AIM The aim of this study was to identify factors that are related to a delay in diagnosing AA in children. Furthermore, we’d like to strengthen our previous preliminary results by a) adding gender as a new factor and b) studying a much larger population. MATERIALS AND METHODS The time that elapsed from the onset of symptoms to the surgical intervention was associated with gender, age, obesity, use of antibiotics prior to diagnosis, and the initial examination by a paediatric surgeon or another physician. Univariate and multivariate logistic regression method (backward method) was applied. RESULTS The diagnosis of AA was delayed by at least 48 hours in 287 patients (group A, 47.7%) and was made within 48 hours in 315 patients (group B, 52.3%). In multivariate model we noticed that boys who were examined by a paediatric surgeon and didn’t take antibiotics had decreased odds of having length of diagnostic period >48 hours, girls who received antibiotics compared to girls who do not use antibiotics are almost 12 times more likely to have length of diagnostic period >48 hours, the very young age has а main effect оn the diagnostic delay and girls who have been examined by other physician compared to females who have been examined by paediatric surgeon have decreased odds of having length of diagnostic period >48 hours. CONCLUSIONS Therefore, physicians examining children with abdominal pain must keep in mind the multiple causes of diagnostic delay that may exist alone or in combination, and which can lead to serious complications and lengthen the hospital stay. Performing repeated examinations and asking for advice from a specialist specifically for children who are a special category of patients, in areas where it is rather impossible to use imaging techniques, could be the key to correctly diagnosing and treating AA.
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Affiliation(s)
- Katerina Kambouri
- Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupolis, Greece
| | - Maria Aggelidou
- Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupolis, Greece
| | - Savvas Deftereos
- Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupolis, Greece
| | - Aggelos Tsalkidis
- Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupolis, Greece
| | - George Vaos
- Attikon University Hospital, Athens University, Athens, Greece
| | - Michail Pitiakoudis
- Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupolis, Greece
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Aggelidou M, Kambouri K, Kouroupi M, Cassimos D, Foutzitzi S, Deftereos S. Acute eosinophilic appendicitis after generalized skin reaction due to unknown cause in a child: Case report and literature review. Clin Pract 2019; 9:1177. [PMID: 31579497 PMCID: PMC6763710 DOI: 10.4081/cp.2019.1177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 06/03/2019] [Accepted: 08/30/2019] [Indexed: 12/25/2022] Open
Abstract
Acute eosinophilic appendicitis (AEA) is a rare variant of appendix inflammation possibly linked to allergy. Histopathological evidence of eosinophilic infiltration of the muscularis propria and edema separating the muscle fibers is the gold standard for the diagnosis. Here, we report a case of a young boy with AEA following a skin reaction of possible allergic origin. A 6-year-old male was presented to the emergency department with a two-day diffuse abdominal pain and tenderness in the right lower quadrant. A possible allergic reaction had occurred five days before as a pruritic rash. There was no history of allergy and the stool examination was negative for parasites. The initial diagnosis was acute appendicitis, and appendectomy was performed. The histopathological diagnosis was AEA. Further studies on the proper diagnostic and treatment approach of AEA before surgery are required.
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Affiliation(s)
- Maria Aggelidou
- Department of Pediatric Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis
| | - Katerina Kambouri
- Department of Pediatric Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis
| | - Maria Kouroupi
- Department of Pathology, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis
| | - Dimitrios Cassimos
- Department of Pediatrics, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis
| | - Soultana Foutzitzi
- Department of Radiology, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
| | - Savas Deftereos
- Department of Radiology, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
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22
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Sinopidis X, Fouzas S, Kambouri K, Panagidis A, Alexopoulos V, Karatza A, Athanasopoulou M, Georgiou G. Predictive model of heterotopy in Meckel's diverticulum in children. ANZ J Surg 2019; 89:E241-E245. [PMID: 31067605 DOI: 10.1111/ans.15226] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/11/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND The presence of heterotopic tissue in Meckel's diverticulum (MD) increases the incidence of future complications. Based on this concept, this study aimed to detect clinical and morphological parameters able to predict the probability of heterotopy in incidentally discovered uncomplicated MD and to develop a risk-based classification tool. METHODS The clinical records of 146 patients who underwent MD resection were reviewed. MD complications (bleeding, inflammation, perforation or involvement in pathological processes such as intussusception) and MD dimensions (width, length and the product width × length) were evaluated in association with heterotopy. Regression analysis was used to explore the discrete effect of clinically relevant parameters, which were subsequently combined in a Classification and Regression Tree. RESULTS The probability of heterotopy was higher in complicated MDs. The width of the base of the MD and the product width × length were also significant predictors of heterotopy. A stepwise combination (Classification and Regression Tree model) of (i) uncomplicated macroscopic presentation, (ii) width <2.5 cm, (iii) age <10 years and (iv) product width × length <4 cm2 resulted in a null probability of heterotopy in our study group. CONCLUSION The combination of MD-related clinical and morphological parameters using advanced statistical tools may assist in estimating the probability of heterotopy. This may be applied in incidentally discovered uncomplicated MDs during abdominal surgery for other morbidities. Prospective studies are required to confirm our findings and test the practical usefulness of the classification tool developed here.
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Affiliation(s)
- Xenophon Sinopidis
- Department of Paediatric Surgery, University of Patras School of Medicine, University General Hospital, Patras, Greece
| | - Sotirios Fouzas
- Department of Paediatrics, University of Patras School of Medicine, University General Hospital, Patras, Greece
| | - Katerina Kambouri
- Department of Paediatric Surgery, Democritus University of Thrace School of Medicine, University General Hospital, Alexandroupolis, Greece
| | | | | | - Ageliki Karatza
- Department of Paediatrics, University of Patras School of Medicine, University General Hospital, Patras, Greece
| | | | - George Georgiou
- Department of Paediatric Surgery, Children's Hospital, Patras, Greece
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Aggelidou M, Deftereos S, Foutzitzi S, Oikonomou P, Kambouri K. Handlebar hernia in children: a conservative approach. Case report and literature review. J Surg Case Rep 2018; 2018:rjy075. [PMID: 29692885 PMCID: PMC5909425 DOI: 10.1093/jscr/rjy075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/27/2018] [Accepted: 04/12/2018] [Indexed: 11/14/2022] Open
Abstract
Handlebar hernias are very rare and occur after a blunt abdominal trauma by a bicycle handlebar or a handlebar-shape object. As a result the abdominal wall musculature and fascia are disrupted while the skin is still intact. A good history of the injury and physical examination are usually enough to pose a diagnosis. We report the case of bicycle-handlebar hernia in a 6-year-old boy who presented to our emergency department because of a reducible swelling above the left iliac crest after falling from his bicycle 3 days ago. The patient was treated conservatively with a weekly follow-up. Four weeks later the muscle disruption was healed. In pediatric patient in the absence of internal organ injuries, a handlebar hernia can successfully be managed conservatively.
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Affiliation(s)
- Maria Aggelidou
- Department of Pediatric Surgery, Faculty of Medicine, Alexandroupoli University Hospital, Democritus University of Thrace, Dragana 68100, Alexandroupoli, Greece
| | - Savas Deftereos
- Department of Radiology, Faculty of Medicine, Alexandroupoli University Hospital, Democritus University of Thrace, Dragana 68100, Alexandroupoli, Greece
| | - Soultana Foutzitzi
- Department of Radiology, Faculty of Medicine, Alexandroupoli University Hospital, Democritus University of Thrace, Dragana 68100, Alexandroupoli, Greece
| | - Panagoula Oikonomou
- Second Department of Surgery, Faculty of Medicine, Alexandroupoli University Hospital, Democritus University of Thrace, Dragana 68100, Alexandroupoli, Greece
| | - Katerina Kambouri
- Department of Pediatric Surgery, Faculty of Medicine, Alexandroupoli University Hospital, Democritus University of Thrace, Dragana 68100, Alexandroupoli, Greece
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24
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Cassimos D, Kambouri K, Mavroudi A, Xinias I, Thomaidis S, Aggelidou M, Gardikis S, Chatzimichael A. Night Sweats, Stress Activation and Coeliac Disease. Glob Pediatr Health 2017; 4:2333794X17744138. [PMID: 29226189 PMCID: PMC5714074 DOI: 10.1177/2333794x17744138] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 09/25/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Dimitrios Cassimos
- Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupoli, Greece
| | - Katerina Kambouri
- Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupoli, Greece
| | | | - Ioannis Xinias
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Thomaidis
- Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupoli, Greece
| | - Maria Aggelidou
- Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupoli, Greece
| | - Stefanos Gardikis
- Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupoli, Greece
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Kambouri K, Aggelidou M, Tsalkidis A, Vaos G, Gardikis S. Risk Factors for Delay in Diagnosing Acute Appendicitis. Indian J Pediatr 2017; 84:491. [PMID: 28281213 DOI: 10.1007/s12098-017-2322-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/28/2016] [Accepted: 02/14/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Katerina Kambouri
- Department of Pediatric Surgery, Faculty of Medicine, Alexandroupoli University Hospital, Democritus University of Thrace, Dragana, 68100, Alexandroupoli, Greece.
| | - Maria Aggelidou
- Department of Pediatric Surgery, Faculty of Medicine, Alexandroupoli University Hospital, Democritus University of Thrace, Dragana, 68100, Alexandroupoli, Greece
| | - Aggelos Tsalkidis
- Department of Pediatrics, Faculty of Medicine, Alexandroupolis University Hospital, Democritus University of Thrace, Alexandroupolis, Greece
| | - George Vaos
- Department of Pediatric Surgery, "Attikon" University Hospital, Athens University, Athens, Greece
| | - Stefanos Gardikis
- Department of Pediatric Surgery, Faculty of Medicine, Alexandroupoli University Hospital, Democritus University of Thrace, Dragana, 68100, Alexandroupoli, Greece
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Gardikis S, Kambouri K, Giatromanolaki A, Agelidou M, Kalaitzis C, Giannakopoulos S, Touloupidis S, Vaos G. The use of a perimeatal-based penile skin flap to cover the repair of a tubularized incised plate urethroplasty: from experimental surgery to clinical practice. J Pediatr Urol 2014; 10:469-73. [PMID: 24444860 DOI: 10.1016/j.jpurol.2013.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 05/14/2013] [Accepted: 12/07/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To prospectively evaluate the efficacy and safety of a perimeatal-based penile skin flap for neourethral coverage after repair of distal hypospadias with tubularized incised plate urethroplasty (TIPU). METHODS In 12 New Zealand white rabbits a ventral urethral defect was created and reconstruction was accomplished with continuous suture. An epithelialized defect-based flap was harvested from the penile skin to cover the repaired defect. The animals were euthanized on the 28th postoperative day and their penises were processed for microscopic examination. In 32 children with distal hypospadias a TIPU was performed. A penile skin flap was created immediately below the distal end of the neourethra and used to cover the urethroplasty. RESULTS Histological examinations revealed complete restoration of continuity of the stratified squamous epithelium without evidence of inflammation or fistula formation with full consistency with the underlying papillary reticular and corium. There were no cases of fistula formation. One patient developed meatal stenosis. All patients had a satisfactory cosmetic appearance and excellent functional results. CONCLUSION The formation of a perimeatal-based skin flap is a simple and safe method of providing additional cover for the constructed neourethra after TIPU, minimizing the fistula rate.
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Affiliation(s)
- Stefanos Gardikis
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, 68100 Alexandroupolis, Greece.
| | - Katerina Kambouri
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, 68100 Alexandroupolis, Greece
| | - Alexandra Giatromanolaki
- Department of Pathology, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, 68100 Alexandroupolis, Greece
| | - Maria Agelidou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, 68100 Alexandroupolis, Greece
| | - Christos Kalaitzis
- Department of Urology, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, 68100 Alexandroupolis, Greece
| | - Stilianos Giannakopoulos
- Department of Urology, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, 68100 Alexandroupolis, Greece
| | - Stavros Touloupidis
- Department of Urology, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, 68100 Alexandroupolis, Greece
| | - George Vaos
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, 68100 Alexandroupolis, Greece
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Abstract
Crohn's disease (CD) can occur anywhere in the gastrointestinal tract from the mouth to the anus and sometimes it presents in a nonspecific manner. Herein we describe a case of local peritonitis as the first manifestation of CD in an 11-year-old girl, and the subsequent method of treatment.
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Affiliation(s)
- Katerina Kambouri
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
| | - Stefanos Gardikis
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
| | - Maria Agelidou
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
| | - George Vaos
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
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Efstathiou E, Gardikis S, Giatromanolaki A, Kambouri K, Sivridis E, Simopoulos C, Vaos G. Effect of VEGF on angiogenesis in pedicle penile skin flaps: an experimental study of urethral reconstruction in rabbits. Eur J Pediatr Surg 2012; 22:460-4. [PMID: 22782324 DOI: 10.1055/s-0032-1315808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 10/28/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the expression of vascular endothelial growth factor (VEGF) in pedicle penile skin flaps (PPSFs) used for urethral reconstruction in rabbits and the effect of exogenous VEGF on the angiogenesis process in the PPSFs. METHODS We randomly divided 28 male New Zealand rabbits into two sets of animals. A ventral urethral defect was created in all animals. In the first set of animals (first experiment, n = 10), a PPSF was used for the repair and VEGF expression in the flap was estimated on days 1, 2, 3, 5, and 7 postoperatively. The second set of animals (second experiment, n = 18) included three groups: control, untreated, and VEGF groups. In control group (n = 6), the defect was repaired by simple closure. In untreated (n = 6) and VEGF (n = 6) groups, a PPSF was used for the reconstruction. In VEGF group, exogenous VEGF was injected subdermally on the postoperative day corresponding to the peak endogenous VEGF expression (first experiment results). The animals were sacrificed on the 21st postoperative day and the angiogenic activity was assessed. A p < 0.05 was considered statistically significant. RESULTS The highest expression of endogenous VEGF in PPSFs was noted on postoperative day 3. Angiogenesis in control, untreated, and VEGF groups was 23.06 ± 4.1, 30.00 ± 6.9, and 34.7 ± 6.9 (mean values ± standard deviation) vessels per optical field, respectively. There were statistically significant differences between control-untreated groups (p = 0.04) and untreated-VEGF groups (p < 0.0001), and indicative difference between untreated and VEGF groups (p = 0.064). CONCLUSIONS VEGF is expressed in PPSFs, used for urethral reconstruction in rabbits. Flap angiogenesis is much higher than angiogenesis in simple wound closure. VEGF injection on postoperative day 3 seems to enhance angiogenesis in flaps.
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Affiliation(s)
- Elefteria Efstathiou
- Alexandroupolis University Hospital, Laboratory of Experimental Surgery and Surgical Research, Alexandroupolis, Greece
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Tsalkidis A, Gardikis S, Kambouri K, Zissimopoulos A, Boussios N, Deftereos S, Vaos G, Chatzimichael A. (99m)Tc-DMSA scintigraphy diagnosing crossed renal ectopia with fusion in a three years old boy. Hell J Nucl Med 2011; 14:300-303. [PMID: 22087453] [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] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 10/17/2011] [Indexed: 05/31/2023]
Abstract
A 3 years old boy with a history of surgery for orchidopexy was admitted to our hospital with fever and abdominal pain. Clinical examination and laboratory investigations revealed urinary tract infection with renal involvement. Ultrasonography demonstrated a solitary left kidney and raised the suspicion of a fusion anomaly. Voiding cystography disclosed grade III vesicoureteral reflux and technetium-99m dimercaptosuccinic acid scintigraphy revealed right to left crossed renal ectopia with fusion (L-shaped kidney). The patient is undergoing standard follow-up for the early detection of possible renal complications. In conclusion, L-shaped kidney is a rare entity and the (99m)Tc-DMSA scintigraphy played an important role on timely diagnosis.
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Affiliation(s)
- Aggelos Tsalkidis
- Department of Pediatric Surgery, Alexandroupolis University Hospital, Dragana, 68100 Alexandroupolis, Greece.
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Gardikis S, Giatromanolaki A, Kambouri K, Tripsianis G, Sivridis E, Vaos G. Acute appendicitis in preschoolers: a study of two different populations of children. Ital J Pediatr 2011; 37:35. [PMID: 21787396 PMCID: PMC3151210 DOI: 10.1186/1824-7288-37-35] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 07/25/2011] [Indexed: 01/07/2023] Open
Abstract
Objective To assess the incidence and the risk factors implicated in acute appendicitis in preschoolers in our region. Methods Over a 7-year period, 352 children underwent appendectomy for suspected acute appendicitis. Of these, data for 23 children were excluded because no inflammation of the appendix was found on subsequent histology. Of the remaining 329, 82 were ≤ 5 years old (i.e., preschool children) and 247 were 5-14 years old. These two groups of children were further divided according to their religion into Muslims and Christian Orthodox: 43 of the children aged ≤ 5 years were Muslims and 39 were Christian Orthodox. A household questionnaire was designed to collect data concerning age, gender, type of residence area, living conditions, vegetable consumption, and family history of surgery for acute appendicitis as preschool children. The removed appendices were also assessed histologically for the amount of lymphoid tissue. Results Acute appendicitis of preschoolers developed more frequently in Muslims (39.4%) than in Christians (17.7%; p < 0.001). The lack of inside toilet facilities at home, overcrowded living conditions, living in rural areas, and the amount of appendix lymphoid tissue were significantly more frequent among the Muslim preschool children (p < 0.05), while there were no statistically significant differences between Muslim and Christian children with regard to gender, the family history of acute appendicitis, or the vegetable consumption (p > 0.05). Conclusions In our region, the percentage of preschool-aged Muslim children with acute appendicitis was remarkably high. One possible explanation for this finding could be the higher amount of lymphoid tissue in the wall of the appendix in Muslim preschool children together with their low standard of hygiene.
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Affiliation(s)
- Stefanos Gardikis
- Department of Pediatric Surgery, Alexandoupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis 68100, Greece.
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Abstract
Primary omental infarction (POI) has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US) examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intra-operative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.
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Tsalkidis A, Vaos G, Gardikis S, Kambouri K, Tripsianis G, Mantadakis E, Paraskakis E, Chatzimicael A. Acute poisoning among children admitted to a regional university hospital in Northern Greece. Cent Eur J Public Health 2011; 18:219-23. [PMID: 21361107 DOI: 10.21101/cejph.a3617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of our study was to elucidate the current pattern of acute poisoning among children admitted to a regional University Hospital in the prefecture of Evros in Northern Greece. We also compared the obtained findings with those of two previous studies performed in the same region. METHODS Demographic and clinical data, management, and outcome of children with acute poisoning were recorded in our region, during the past 5-years (2005-2009, period C) and compared to similar studies carried out in the periods 1985-1989 (period A) and 1995-1999 (period B). RESULTS Comparison between the three periods showed that in period Athe lower incidence of children's acute poisoning (CAP) was observed. Also this revealed a 20%-reduction in the frequency of poisoning over the past 5-years (period C) compared to period B (p = 0.219), a significant increase in tobacco intoxication over the years (in the order A-C; p < 0.001 for comparisons of periods A and B, and periods B and C), while poisoning from insecticides-pesticides decreased (p < 0.001). The incidence of poisoning via salicylates significantly reduced from 9.7% in period A to 6.2% in period B, and further to 4.7% in period C (p = 0.016), whereas during the same periods poisoning via paracetamol increased from 2.3% to 5.1% and then to 10.4%, respectively (p < 0.001). Atrend toward a higher incidence of suicide attempt via poisoning was found during the three periods (from 3.0% in period A to 4.7% and 6.6%, in periods B and C, respectively; p = 0.049). CONCLUSIONS The frequency of acute poisoning among children has decreased over the past 5 years. The incidences of poisoning via paracetamol and tobacco, and attempted suicide have increased in recent years. Targeted and continuous educational preventive programs are mandatory.
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Affiliation(s)
- Aggelos Tsalkidis
- Department of Paediatrics, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece
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Vaos G, Kambouri K, Gardikis S, Cassimos D, Chatzimichael A. Acute abdomen: always a puzzle (Case presentation). Acta Paediatr 2009; 98:1391, 1538-40. [PMID: 19673727 DOI: 10.1111/j.1651-2227.2009.01395.x] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- G Vaos
- Department of Paediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, School of Medicine, Alexandroupolis, Greece.
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Cassimos D, Tsalkidis A, Gardikis S, Lazopoulou N, Oikonomou A, Vaos G, Kambouri K, Verettas D, Theodoridou M, Chatzimichael A. Pott's disease in a two-year-old girl. Minerva Pediatr 2009; 61:451-454. [PMID: 19752854] [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: 05/28/2023]
Abstract
Fractures in children require a specific treatment depending on age. While obstetric fractures usually heal well even in case of significant dislocations and conservative therapy, the proportion of operative interventions among all pediatric fractures is increasing with age. Though the vast majority of fractures in childhood are still treated non-operatively, a trend towards early operative interventions and cast-free mobilization has been noticeable in the recent years. The methods of operative stabilization differ between the respective age groups: While K-wire osteosynthesis and a minimal invasive approach using elastic stable intramedullary nailing (ESIN) are common in the group of school aged children, the use of external fixation and plate osteosynthesis has been accepted for the treatment of fractures in adolescents. Bioresorbable implants do not yet play a decisive role in the management of pediatric fractures. This review is focusing on the current indications and concepts for stabilization of frequent pediatric fractures.
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Affiliation(s)
- D Cassimos
- Department of Pediatrics, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
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Gardikis S, Kambouri K, Tsalkidis A, Chatzimicael A, Vaos G. Lipoblastoma on the posterior side of the neck. Turk J Pediatr 2009; 51:287-289. [PMID: 19817275] [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: 05/28/2023]
Abstract
Lipoblastoma is a rare benign pediatric tumor derived from embryonic fat, and only two cases of lipoblastoma located on the posterior side of the neck have been reported in the literature. Here, we present the third case of posterior neck lipoblastoma in a 13-month-old healthy girl, who presented with a firm, posterior cervical mass. The tumor was completely resected following ultrasonography, computerized tomography, and magnetic resonance imaging evaluations. Histological examination of the resected tissue showed the typical characteristics of lipoblastoma. The child's postoperative progress was uneventful and no recurrence was observed 27 months after the operation. The clinical manifestations, radiologic and histopathologic findings, and treatment of this lesion are discussed.
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Affiliation(s)
- Stefanos Gardikis
- Department of Pediatric Surgery, Democritus University of Thrace, Alexandroupolis University Hospital, Alexandroupolis, Greece
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Kotoula A, Gardikis S, Tsalkidis A, Mantadakis E, Zissimopoulos A, Kambouri K, Deftereos S, Tripsianis G, Manolas K, Chatzimichael A, Vaos G. Procalcitonin for the early prediction of renal parenchymal involvement in children with UTI: preliminary results. Int Urol Nephrol 2008; 41:393-9. [PMID: 18836845 DOI: 10.1007/s11255-008-9472-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [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: 02/13/2008] [Accepted: 08/27/2008] [Indexed: 11/25/2022]
Abstract
In order to establish the most reliable marker for distinguishing urinary tract infections (UTI) with and without renal parenchymal involvement (RPI), we recorded the clinical features and admission leukocyte count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum procalcitonin (PCT) in 57 children (including 43 girls) aged 2-108 months admitted with a first episode of UTI. RPI was evaluated by Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy within 7 days of admission. To establish cut-off points for ESR, CRP, and PCT, we used receiver operating characteristics curves and compared the area under the curve for ESR, CRP, and PCT. Twenty-seven children were diagnosed as having RPI based on positive renal scintigraphy. A body temperature of >38 degrees C, a history of diarrhea, and poor oral intake were more common in patients with RPI. ESR, CRP, and PCT, but not leukocyte count, were significantly higher in patients with RPI (P < 0.001). PCT was more sensitive and specific for the diagnosis of upper versus lower UTI than ESR and CRP. Using a cut-off value of 0.85 ng/ml, PCT had the best performance, with sensitivity, specificity, and positive and negative predictive values of 89%, 97%, 96%, and 91% respectively. Serum PCT is a better marker than ESR, CRP, and leukocyte count for the early prediction of RPI in children with a first episode of UTI.
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Affiliation(s)
- Aggeliki Kotoula
- Department of Pediatrics, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, 68100 Alexandroupolis, Greece
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Abstract
BACKGROUND Acute abdominal pain in children is a common cause for referral to the emergency room and for subsequent hospitalization to pediatric medical or surgical departments. There are rare occasions when the abdominal pain is derived from extra-abdominal organs or systems. The aim of the present study was to establish the most common extra-abdominal causes of acute abdominal pain. METHODS The notes of all children (1 month-14 years of age) examined for acute abdominal pain in the Accident and Emergency (A&E) Department of Alexandroupolis District University Hospital in January 2001-December 2005 were analyzed retrospectively. Demographic data, clinical signs and symptoms, and laboratory findings were recorded, as well as the final diagnosis and outcome. RESULTS Of a total number of 28 124 children who were brought to the A&E department, in 1731 the main complaint was acute abdominal pain. In 51 children their symptoms had an extra-abdominal cause, the most frequent being pneumonia (n = 15), tonsillitis (n = 10), otitis media (n = 9), and acute leukemia (n = 5). CONCLUSION Both abdominal and extra-abdominal causes should be considered by a pediatrician who is confronted with a child with acute abdominal pain.
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Affiliation(s)
- Aggelos Tsalkidis
- Department of Pediatrics, University Hospital of Alexandroupolis, Democritus University of Thrace-Medical School, Alexandroupolis, Greece.
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Tsalkidis A, Gardikis S, Cassimos D, Kambouri K, Vaos G, Chatzimichael A. Case 2: painful red plagues in a 6-year-old child (case presentation). Acta Paediatr 2008; 97:525-6; discussion 685-6. [PMID: 18394092 DOI: 10.1111/j.1651-2227.2008.00710.x] [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] [Indexed: 11/30/2022]
Affiliation(s)
- A Tsalkidis
- Department of Paediatric, University Hospital of Alexandroupolis, Democritus, University of Thrace, School of Medicine, Alexandroupolis, Greece
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Chatzimicael A, Tsalkidis A, Cassimos D, Gardikis S, Spathopoulos D, Tripsianis GA, Kambouri K, Aivazis V, Vaos G, Bouros D. Effect of passive smoking on lung function and respiratory infection. Indian J Pediatr 2008; 75:335-40. [PMID: 18536886 DOI: 10.1007/s12098-008-0034-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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] [Received: 11/02/2006] [Accepted: 01/17/2008] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To study the effect of environmental tobacco smoke to children's health and more specifically to the development of respiratory tract infections and also its influence to their respiratory function. METHODS We studied 586 children from the district of west Thrace in Greece aged 5-14 years, randomly selected from 20 primary and 10 secondary schools in regards their exposure to tobacco smoke, and its possible relation with respiratory tract infections. We assessed respiratory function by spirometry. Epidemiological data were also analysed. RESULTS Children who were exposed to environmental tobacco smoke had higher risk for upper and lower respiratory tract infections in comparison to children who lived in a smoke free environment (3 fold and 2 fold, respectively. Their lung function was also reduced with decreased values of FEV1, FEF50, PFR (values p<0.001). CONCLUSION Passive smoking has an unfavorable effect in respiratory function of children and predisposes them to respiratory tract infections. Every effort should be undertaken in order to avoid exposure of children to environmental tobacco smoke.
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Affiliation(s)
- Athanassios Chatzimicael
- Department of Pediatrics, University Hospital, Democritus, University of Thrace, Medical School, 68100, Alexandroupolis, Greece
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Kambouri K, Gardikis S, Giatromanolaki A, Efstathiou E, Pitiakoudis M, Ipsilantis P, Botaitis S, Perente S, Antypas S, Polychronidis A, Sivridis E, Simopoulos C. Comparison of angiogenic activity after urethral reconstruction using free grafts and pedicle flap: an experimental study. Eur J Pediatr Surg 2006; 16:323-8. [PMID: 17160776 DOI: 10.1055/s-2006-924601] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE An experimental study was undertaken in order to estimate the angiogenic activity in different free grafts and pedicle flap in urethral reconstruction in an animal model. METHODS Twenty-eight white New Zealand rabbits were randomly divided into five groups (O, A, B, C and D). A ventral urethral defect was created in all groups. In the group O, (n = 4), a simple closure of the defect was performed. Free penile skin graft (group A, n = 6), buccal mucosal graft (group B, n = 6), bladder mucosal graft (group C, n = 6), and pedicle penile skin graft (group D, n = 6) were used to bridge the urethral defect as an onlay patch. The animals were euthanized on the 21st postoperative day. The angiogenic activity was assessed with immunohistochemistry, using the anti-CD31 MoAb and the alkaline phosphatase antialkaline phosphatase procedure. The native vascularity of penile skin as well as buccal and bladder mucosa was assessed in rabbits from group O (n = 3). Statistical analysis was performed using one-way ANOVA. RESULTS The angiogenesis seen with a magnification of x 200 in groups O, A, B, C, and D was 34.1 +/- 4.1 (mean +/- SD), 61.7 +/- 6.4, 94.3 +/- 6.4, 91.5 +/- 7.2, and 30.8 +/- 5.2 vessels per optical field, respectively. There were statistically significant differences (p < 0.001) between group O and groups A, B, C and between group A and groups B, C, D, but not (p > 0.5) between groups B and C and groups O and D. The native vascularity of penile skin, buccal mucosa and bladder mucosa was 23.3 +/- 3.0, 24.6 +/- 3.7 and 17.0 +/- 2.6 vessels per optical field, respectively. CONCLUSION Buccal and bladder mucosal grafts exhibit a higher angiogenic activity than free and pedicle penile skin flap when transplanted in urethral defects. As the buccal mucosal graft showed the higher angiogenic activity and its harvesting is easier than bladder mucosa, we propose that in urethral reconstruction surgery the use of this graft might offer more reliable results.
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Affiliation(s)
- K Kambouri
- Department of Paediatric Surgery, University Hospital of Alexandroupolis, Democritus University of Thrace-Medical School, 43 G. Papandreou Street, 68100 Alexandroupolis, Greece
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Abstract
Annular pancreas is the rare congenital anomaly where the pancreas forms a full or incomplete ring around the second segment of the duodenum, causing various degrees of stenosis or atresia. It is estimated that it appears in 1 out of 12 000-15 000 births of living neonates and until now, in the literature, only 6 cases have been reported among individuals of the same family. We present the case of two siblings, a boy and a girl, with annular pancreas from consecutive pregnancies of the same couple. Both neonates had a prenatal diagnosis of duodenal obstruction and they underwent duodenoduodenal, proximal transverse to distal longitudinal anastomosis. Furthermore, the girl had a mobile ascending colon. Their postoperative condition was perfect. The case we are reporting is an addition to the other 6 cases of familial presentation of annular pancreas and is similar to one of them. In these families, a total of 16 persons present this congenital anomaly while 14 are seemingly healthy. Twelve of the affected persons are female and 4 male. In conclusion, it can be stated that female individuals seem to have a greater propensity to transmit the disease to their descendants, compared to males, suggesting the possible action of an autosomal recessive sex-influenced gene. The recording of such rare family cases should be encouraged, in order to fully recognize a possible type of inherited transmission.
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Affiliation(s)
- N Lainakis
- 1st Pediatric Surgery Department, Aghia Sophia Children's Hospital, Athens, Greece
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Gardikis S, Antypas S, Kambouri K, Lainakis N, Panagidis A, Deftereos S, Polychronidis A, Dolatzas T, Simopoulos C. The Roux-en-Y procedure in congenital hepato-biliary disorders. Rom J Gastroenterol 2005; 14:135-40. [PMID: 15990932] [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] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND The use of the Roux-en-Y procedure is limited in paediatric surgery practice, and is performed mainly in congenital hepatobiliary disorders either as an initial or permanent treatment. In this 18-year retrospective study, we present our experience of the Roux-en-Y procedure in childhood cases of biliary atresia (BA) and congenital choledochal cyst (CCC). METHODS Twenty-eight children (18 females and 10 males; age 25 days-12 years) with hepatobiliary disorders were treated in our clinics between 1986-2004. Twenty patients suffered from BA (11 females, 9 males) and eight from CCC (seven females, one male). The surgical approach in the patients with BA (mean age 2.1 months) was Roux-en-Y hepatic portoenterostomy (Kasai procedure) and in the patients with CCC (mean age 7.2 years) was cyst excision with Roux-en-Y hepaticojejunostomy. The mean follow up period was 9.3 years. RESULTS The children with BA developed the follow postoperative complications: 12 cholangitis, 6 portal hypertension and 5 hepatic cirrhosis. Among the children with CCC, two presented post-operative cholangitis, which was treated conservatively, and one developed anastomotic stricture and underwent reoperative reconstruction. At the end of the follow-up period among the children with BA 6 had died, 3 had undergone liver transplantation, and 5 were on a waiting list for transplantation. All children with CCC were alive without sequelae. CONCLUSIONS Roux-en-Y in BA, with timely diagnosis, is preferred as an initial procedure, followed by liver transplantation in cases with no bile drainage and is the only possible reconstruction in cases of CCC after excision of the biliary cyst.
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Affiliation(s)
- Stefanos Gardikis
- University Hospital of Alexandroupolis, Democritus University of Thrace, Department of Pediatric Surgery, 43 G. Papandreou Str., 68100 Alexandroupolis, Greece.
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Gardikis S, Soultanidis C, Deftereos S, Kambouri K, Limas C, Vaos G, Vaos CG, Touloupidis S, Polychronidis A, Simopoulos C. Suprapubic catheter knotting: An unusual complication. Int Urol Nephrol 2004; 36:537-9. [PMID: 15787332 DOI: 10.1007/s11255-004-0862-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We describe a case of true knotting of a suprapubic catheter in a 25-month-old boy who underwent surgery for urethrocutaneous fistula as a complication of a distal penile hypospadias repair. This unusual complication was probably attributable to an excessive length of catheter being inserted into the bladder, thereby allowing it to bend onto itself.
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Affiliation(s)
- Stefanos Gardikis
- Department of Pediatric Surgery, University Hospital of Alexandroupolis, Democritus University of Thrace, Medical School, Alexandroupolis, Greece.
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