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Gkolfakis P, Chiara Petrone M, Tadic M, Tziatzios G, Karoumpalis I, Crinò SF, Facciorusso A, Hritz I, Kypraios D, Sioulas AD, Scotiniotis I, Vezakis A, Keczer B, Koukoulioti E, Muscatiello N, Triantafyllou K, Polydorou A, Grgurevic I, Arcidiacono PG, Papanikolaou IS. Efficacy and safety of endoscopic drainage of peripancreatic fluid collections: a retrospective multicenter European study. Ann Gastroenterol 2022; 35:654-662. [PMID: 36406968 PMCID: PMC9648524 DOI: 10.20524/aog.2022.0753] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/03/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Endoscopic ultrasound (EUS)-guided transmural drainage allows treatment of symptomatic peripancreatic fluid collections (PFCs), with lumen-apposing metal stents (LAMS) and double pigtail plastic stents (DPPS) being the 2 most frequently used modalities. METHODS Consecutive patients undergoing PFC drainage in 10 European centers were retrospectively retrieved. Technical success (successful deployment), clinical success (satisfactory drainage), rate and type of early adverse events, drainage duration and complications on stent removal were evaluated. RESULTS A total of 128 patients-92 men (71.9%), age 57.2±11.9 years-underwent drainage, with pancreatic pseudocyst (PC) and walled-off necrosis (WON) in 92 (71.9%) and 36 (28.1%) patients, respectively. LAMS were used in 80 (62.5%) patients and DPPS in 48 (37.5%). Technical success was achieved in 124 (96.9%) of the cases, with no difference regarding either the type of stent (P>0.99) or PFC type (P=0.07). Clinical success was achieved in 119 (93%); PC had a better response than WON (91/92 vs. 28/36, P<0.001), but the type of stent did not affect the clinical success rate (P=0.29). Twenty patients (15.6%) had at least one early complication, with bleeding being the most common (n=7/20, 35%). No difference was detected in complication rate per type of stent (P=0.61) or per PFC type (P=0.1). Drainage duration was significantly longer with DPPS compared to LAMS: 88 (70-112) vs. 35 (29-55.3) days, P<0.001. CONCLUSIONS EUS-guided drainage of PFCs achieves high percentages of technical and clinical success. Drainage using LAMS is of shorter duration, but the complication rate is similar between the 2 modalities.
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Affiliation(s)
- Paraskevas Gkolfakis
- Hepatogastroenterology Unit, Second Department of Internal Medicine- Propaedeutic, Medical School, National and Kapodistrian University of Athens, “Attikon” University General Hospital, Athens, Greece (Paraskevas Gkolfakis, Georgios Tziatzios, Eleni Koukoulioti, Konstantinos Triantafyllou, Ioannis S. Papanikolaou)
| | - Maria Chiara Petrone
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy (Maria Chiara Petrone, Paolo Giorgio Arcidiacono)
| | - Mario Tadic
- Endoscopy Unit, Department of Gastroenterology, Hepatology and Clinical Nutrition, Dubrava University Hospital Zagreb, Croatia (Mario Tadic, Ivica Grgurevic)
| | - Georgios Tziatzios
- Hepatogastroenterology Unit, Second Department of Internal Medicine- Propaedeutic, Medical School, National and Kapodistrian University of Athens, “Attikon” University General Hospital, Athens, Greece (Paraskevas Gkolfakis, Georgios Tziatzios, Eleni Koukoulioti, Konstantinos Triantafyllou, Ioannis S. Papanikolaou),
Correspondence to: Georgios Tziatzios, MD, PhD, Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutics, Medical School, National and Kapodistrian University, Attikon University General Hospital, 1, Rimini Street, 124 62 Athens, Greece, e-mail:
| | - Ioannis Karoumpalis
- Division of Gastroenterology, General Hospital of Athens “G. Gennimatas”, Athens, Greece (Ioannis Karoumpalis)
| | - Stefano Francesco Crinò
- Gastroenterology and Digestive Endoscopy Unit, University Hospital of Verona, Verona, Italy (Stefano Francesco Crinò)
| | - Antonio Facciorusso
- University of Foggia AOU, Foggia, Italy (Antonio Facciorusso, Nicola Muscatiello)
| | - Istvan Hritz
- 1 Department of Surgery, Center for Therapeutic Endoscopy Semmelweis University, Budapest, Hungary (Istvan Hritz)
| | - Dimitrios Kypraios
- Department of Gastroenterology, Saint Savvas Oncological Hospital, Athens, Greece (Dimitrios Kypraios)
| | - Athanasios D. Sioulas
- Department of Gastroenterology, Hygeia Hospital, Athens, Greece (Athanasios D. Sioulas)
| | - Ilias Scotiniotis
- Second Department of Surgery, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Ilias Scotiniotis, Bank Keczer, Andreas Polydorou, Ioannis S. Papanikolaou, Antonios Vezakis)
| | - Antonios Vezakis
- Second Department of Surgery, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Ilias Scotiniotis, Bank Keczer, Andreas Polydorou, Ioannis S. Papanikolaou, Antonios Vezakis)
| | - Bank Keczer
- 1 Department of Surgery, Center for Therapeutic Endoscopy Semmelweis University, Budapest, Hungary (Istvan Hritz)
| | - Eleni Koukoulioti
- Hepatogastroenterology Unit, Second Department of Internal Medicine- Propaedeutic, Medical School, National and Kapodistrian University of Athens, “Attikon” University General Hospital, Athens, Greece (Paraskevas Gkolfakis, Georgios Tziatzios, Eleni Koukoulioti, Konstantinos Triantafyllou, Ioannis S. Papanikolaou)
| | - Nicola Muscatiello
- University of Foggia AOU, Foggia, Italy (Antonio Facciorusso, Nicola Muscatiello)
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Internal Medicine- Propaedeutic, Medical School, National and Kapodistrian University of Athens, “Attikon” University General Hospital, Athens, Greece (Paraskevas Gkolfakis, Georgios Tziatzios, Eleni Koukoulioti, Konstantinos Triantafyllou, Ioannis S. Papanikolaou)
| | - Andreas Polydorou
- Second Department of Surgery, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Ilias Scotiniotis, Bank Keczer, Andreas Polydorou, Ioannis S. Papanikolaou, Antonios Vezakis)
| | - Ivica Grgurevic
- Endoscopy Unit, Department of Gastroenterology, Hepatology and Clinical Nutrition, Dubrava University Hospital Zagreb, Croatia (Mario Tadic, Ivica Grgurevic)
| | - Paolo Giorgio Arcidiacono
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy (Maria Chiara Petrone, Paolo Giorgio Arcidiacono)
| | - Ioannis S. Papanikolaou
- Hepatogastroenterology Unit, Second Department of Internal Medicine- Propaedeutic, Medical School, National and Kapodistrian University of Athens, “Attikon” University General Hospital, Athens, Greece (Paraskevas Gkolfakis, Georgios Tziatzios, Eleni Koukoulioti, Konstantinos Triantafyllou, Ioannis S. Papanikolaou),Second Department of Surgery, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Ilias Scotiniotis, Bank Keczer, Andreas Polydorou, Ioannis S. Papanikolaou, Antonios Vezakis)
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Tsamakis K, Gavriatopoulou M, Schizas D, Stravodimou A, Mougkou A, Tsiptsios D, Sioulas V, Spartalis E, Sioulas AD, Tsamakis C, Charalampakis N, Mueller C, Arya D, Zarogoulidis P, Spandidos DA, Dimopoulos MA, Papageorgiou C, Rizos E. Oncology during the COVID-19 pandemic: challenges, dilemmas and the psychosocial impact on cancer patients. Oncol Lett 2020; 20:441-447. [PMID: 32565968 PMCID: PMC7285823 DOI: 10.3892/ol.2020.11599] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [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: 04/13/2020] [Accepted: 05/08/2020] [Indexed: 12/16/2022] Open
Abstract
COVID-19 has caused unprecedented societal turmoil, triggering a rapid, still ongoing, transformation of healthcare provision on a global level. In this new landscape, it is highly important to acknowledge the challenges this pandemic poses on the care of the particularly vulnerable cancer patients and the subsequent psychosocial impact on them. We have outlined our clinical experience in managing patients with gastrointestinal, hematological, gynaecological, dermatological, neurological, thyroid, lung and paediatric cancers in the COVID-19 era and have reviewed the emerging literature around barriers to care of oncology patients and how this crisis affects them. Moreover, evolving treatment strategies and novel ways of addressing the needs of oncology patients in the new context of the pandemic are discussed.
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Affiliation(s)
- Konstantinos Tsamakis
- Second Department of Psychiatry, University of Athens, 'ATTIKON' University Hospital, 12462 Athens, Greece.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK
| | - Maria Gavriatopoulou
- Department of Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Athina Stravodimou
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
| | - Aikaterini Mougkou
- Paediatric Infectious Diseases Dept, Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Dimitrios Tsiptsios
- Department of Neurophysiology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR47TP, UK
| | - Vasileios Sioulas
- Department of Gynaecologic Oncology MITERA Hospital, 15123 Athens, Greece
| | - Eleftherios Spartalis
- 2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens School of Medicine, 11527 Athens, Greece
| | | | - Charalampos Tsamakis
- Department of Dermatology, Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton LU4 0DZ, UK
| | | | - Christoph Mueller
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Donna Arya
- Thornford Park, Elysium Healthcare, Berkshire RG19 8ET, UK
| | - Paul Zarogoulidis
- 3rd Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, 54621 Thessaloniki, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Meletios A Dimopoulos
- Hematology and Medical Oncology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, 11527 Athens, Greece
| | - Charalabos Papageorgiou
- First Department of Psychiatry, University of Athens, 'EGINITION' Hospital, 11528 Athens, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, University of Athens, 'ATTIKON' University Hospital, 12462 Athens, Greece
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Schizas D, Michalinos A, Kanavidis P, Karaolanis G, Lidoriki I, Sioulas AD, Moris D. The profile of patients receiving public and private surgical services in Greece during the economic crisis: a comparative study. Ann Transl Med 2019; 7:5. [PMID: 30788352 DOI: 10.21037/atm.2018.12.07] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background International experience has shown that deterioration of healthcare services is a common consequence of socio-economic crises. Exact mechanism of this deterioration varies with respect to particularities of each healthcare system, government and administrative policies and local epidemiological conditions. The aim of the present study was to evaluate the effect of Greek economic crisis on the profile and the satisfaction rates of patients seeking surgical services in public and private hospitals. Methods A questionnaire-based survey concerning healthcare quality and patients' satisfaction was conducted at a private and a public (university) hospital. Patient demographics alongside with patient satisfaction before and after treatment were quantified and compared. Results Significant differences between private and public sector patients were found concerning nationality, socio-economic status and medical conditions. Private sector patients are younger, of a higher socio-economic status and admitted for elective rather than urgent medical conditions. Patient expectations before treatment are lower for public sector concerning a variety of markers but patient satisfaction is similar. Conclusions Even in the years of financial crisis, Greek patients seem to be satisfied by the quality of the healthcare services in both public and private hospitals. Despite the limitations of our study regarding the selection of the population, we believe that the findings might generate more meticulous research on the field hoping that juxtaposed discussions will sensitize policy makers.
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Affiliation(s)
- Dimitrios Schizas
- The First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Adamantios Michalinos
- The First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Prodromos Kanavidis
- The First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Karaolanis
- The First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Lidoriki
- The First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Dimitrios Moris
- The First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Sioulas AD, Papadaki K, Schizas D, Scotiniotis I. Challenging Lumen-Apposing Metal Stent Removal after Successful Drainage of a Pancreatic Pseudocyst. GE Port J Gastroenterol 2018; 25:333-334. [PMID: 30480053 DOI: 10.1159/000487035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 01/09/2018] [Indexed: 11/19/2022]
Affiliation(s)
| | | | - Dimitrios Schizas
- 1st Department of Surgery, National and Kapodistrian University of Athens, Laikon Hospital, Athens, Greece
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Schizas D, Mastoraki A, Kirkilesis GI, Sioulas AD, Papanikolaou IS, Misiakos EP, Arkadopoulos N, Liakakos T. Neuroendocrine Tumors of the Esophagus: State of the Art in Diagnostic and Therapeutic Management. J Gastrointest Cancer 2018; 48:299-304. [PMID: 28656561 DOI: 10.1007/s12029-017-9978-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms composed of cells containing dense-core neuroendocrine secretory granules in their cytoplasm. NETs of the esophagus are exceedingly uncommon, with a parallel absence of data published on clinical features, prognosis, and proposed treatment strategies. METHODS As relevant classification is not well-established, knowledge acquired in NETs of lung and gastrointestinal sites usually guides esophageal NET management. Associated subtypes are divided based upon shared neuroendocrine features into small and large cell NET, typical and atypical carcinoid. RESULTS Common presenting symptoms include dysphagia, abdominal discomfort, weight loss, melena, and on occasion, signs of carcinoid syndrome. Endoscopic findings describe a polypoid, nodular elevated lesion with an overlying surface depicted as mostly smooth and glistening. Disease metastasis is assessed using anatomical imaging, including computed tomography (CT), endoscopic ultrasonography (EUS), and positron emission tomography (PET)-CT. Prognosis is influenced by the extent of lymph node metastasis and potential lymphovascular invasion. Furthermore, proliferative activity, estimated using mitotic count or Ki-67 immunostaining, has been suggested as a significant prognostic parameter. CONCLUSION Therapeutic approach depends on clinical staging. Nevertheless, currently, a specific treatment algorithm for esophageal NETs has not been elucidated. Endoscopic resection has been proposed in NETs less than 1 cm in size with absence of regional lymph node metastasis, while surgical excision combined with adjuvant chemotherapy remains the treatment of choice.
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Affiliation(s)
- Dimitrios Schizas
- 1st Department of Surgery, National and Kapodistrian University of Athens, Laikon Hospital, Athens, Greece
| | - Aikaterini Mastoraki
- 4th Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Chaidari, Athens, Greece.
| | - George I Kirkilesis
- 1st Department of Surgery, National and Kapodistrian University of Athens, Laikon Hospital, Athens, Greece
| | - Athanasios D Sioulas
- 3rd Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Chaidari, Athens, Greece
| | - Ioannis S Papanikolaou
- 4th Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Chaidari, Athens, Greece
| | - Evangelos P Misiakos
- 3rd Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Chaidari, Athens, Greece
| | - Nikolaos Arkadopoulos
- 4th Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Chaidari, Athens, Greece
| | - Theodore Liakakos
- 1st Department of Surgery, National and Kapodistrian University of Athens, Laikon Hospital, Athens, Greece
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Papanikolaou IS, Apostolopoulos P, Tziatzios G, Vlachou E, Sioulas AD, Polymeros D, Karameris A, Panayiotides I, Alexandrakis G, Dimitriadis GD, Triantafyllou K. Lower adenoma miss rate with FUSE vs. conventional colonoscopy with proximal retroflexion: a randomized back-to-back trial. Endoscopy 2017; 49:468-475. [PMID: 28107765 DOI: 10.1055/s-0042-124415] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 01/04/2023]
Abstract
Background and study aims Full-spectrum colonoscopy (FSC) promises to increase adenoma detection by providing a wider field of view. The aim of this study was to compare adenoma miss rates of FSC with those of conventional colonoscopy complemented by right-colon re-examination using scope retroflexion (CC/R). Patients and methods At two tertiary endoscopy facilities, patients who were scheduled for colonoscopy for the assessment of symptoms or for colorectal cancer screening/surveillance were randomized (1:1) to undergo same-day, back-to-back colonoscopies (FSC or CC/R first), performed by one of five endoscopists who had documented adenoma detection rates > 35 %. Per-protocol data were analyzed. Results We randomized 220 patients. There were five FSC technical failures (three air pump and two left screen); therefore, 107 and 108 cases were analyzed in the FSC and CC/R index procedure arms, respectively. Withdrawal times were similar for FSC and CC/R (7.7 minutes vs. 7.6 minutes). Overall, we detected 3 cancers and 153 adenomas (FSC = 92; CC/R = 61); 81 were detected in the proximal colon, 3 of which were detected by retroflexed examination. By per-lesion analysis, FSC showed a significantly lower adenoma miss rate compared with CC/R overall (10.9 % [95 % confidence interval (CI) 3.8 to 18.1] vs. 33.7 % [95 %CI 23.4 to 44.1]) and in the proximal colon (13.9 % [95 %CI 2.6 to 25.2] vs. 42.2 % [95 %CI 27.8 to 56.7]). The advanced adenoma miss rate was lower with FSC overall (4.3 % [95 %CI - 4.0 to 12.7] vs. 25.9 % [95 %CI 9.4 to 42.5]). There were no adverse events. Conclusions FSC outperformed conventional colonoscopy with right-colon scope retroflexion in the detection of missed adenomas, both overall and in the proximal colon, even when performed by experienced endoscopists.Trial registered at ClinicalTrials.gov (NCT02117674).
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Affiliation(s)
- Ioannis S Papanikolaou
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | | | - Georgios Tziatzios
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | - Erasmia Vlachou
- Department of Gastroenterology, 417 Army Veterans Hospital, Athens, Greece
| | - Athanasios D Sioulas
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | - Dimitrios Polymeros
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | | | - Ioannis Panayiotides
- Second Department of Pathology, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | | | - George D Dimitriadis
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, Athens, Greece
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Sterlacci W, Sioulas AD, Veits L, Gönüllü P, Schachschal G, Groth S, Anders M, Kontos CK, Topalidis T, Hinsch A, Vieth M, Rösch T, Denzer UW. 22-gauge core vs 22-gauge aspiration needle for endoscopic ultrasound-guided sampling of abdominal masses. World J Gastroenterol 2016; 22:8820-8830. [PMID: 27818598 PMCID: PMC5075557 DOI: 10.3748/wjg.v22.i39.8820] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 08/21/2016] [Accepted: 09/14/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To compare the aspiration needle (AN) and core biopsy needle (PC) in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of abdominal masses.
METHODS Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge (G) AN (Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22G PC (EchoTip ProCore; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and complications.
RESULTS Fifty six consecutive patients (29 men; mean age 68 years) with pancreatic lesions (n = 38), lymphadenopathy (n = 13), submucosal tumors (n = 4), or others lesions (n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy (AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy (AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes (AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score (AN: 1.7 vs PC: 1.1, P = 0.058), and complications (none). A diagnosis on the basis of histology was achieved in the PC group in 36 (64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN (AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical significance.
CONCLUSION Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.
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Denzer UW, Sioulas AD, Abdulkarim M, Groth S, Rösch T, Busch P, Izbicki J, Ittrich H, Adam G, Schachschal G. Endoscopic ultrasound-guided drainage of abdominal fluid collections after pancreatic surgery: Efficacy and long-term follow-up. Z Gastroenterol 2016; 54:1047-53. [PMID: 27612217 DOI: 10.1055/s-0042-112032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND/PURPOSE Endoscopic ultrasound-guided drainage (EUS-GD) of postoperative abdominal fluid collections (POFC) following pancreatic surgery is used as an alternative or complement to percutaneous drainage (PD) procedure. The present single-center retrospective study evaluates its efficacy and safety. METHOD We included consecutive cases with POFC treated by EUS-GD between September 2009 and November 2014 in our department. Technical success, long-term clinical success, recurrence rate and need for surgery were analyzed. RESULTS 24 procedures in 20 patients (95 % after pancreatic resection) were assessed. Indications for surgery included tumors/lesions located in the pancreas (15/20), chronic pancreatitis (3/20) and duodenal adenoma not completely resectable endoscopically (2/20). EUS-GD was performed within a median of 30 days (IQR: 8.25) for a median fluid collection size of 72.5 mm (IQR: 46.25), requiring a mean of 1.2 sessions with placement of a mean of 2.1 plastic stents (7 Fr/10 Fr) per patient for a mean of 89 days (IQR: 127). Microbiology of aspirated fluid revealed positive cultures in 13 patients, mostly polymicrobial, isolated positive for fungal and 3 multidrug-resistant gram negative (MRGN) in 4 cases. An additional transpapillary drainage was inserted in 1/20 patients. 4/20 patients received PD, mostly before EUS-GD. Technical and clinical success was achieved in 20/20 (100 %) and 18/20 (90 %) patients, respectively, while 2 patients required re-operation. During follow-up (median 630 days after stent removal, range: 45 - 2160), recurrence occurred in 1/18 (5.5 %) patient that was referred for surgery. No death or severe adverse events were noted. CONCLUSION EUS-GD is an effective, minimally invasive and safe method for therapy of POFC after pancreatic surgery offering long-term remission in about 95 % of cases.
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Affiliation(s)
- U W Denzer
- Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A D Sioulas
- Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Abdulkarim
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Groth
- Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Rösch
- Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Busch
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Izbicki
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Ittrich
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Schachschal
- Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Sioulas AD, Papanikolaou IS. Is optical diagnosis sufficiently established to safely discard diminutive polyps? Endoscopy 2016; 48:792-3. [PMID: 27571587 DOI: 10.1055/s-0042-112576] [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: 12/10/2022]
Affiliation(s)
- Athanasios D Sioulas
- Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ioannis S Papanikolaou
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, "Attikon" University General Hospital, University of Athens, Greece
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Vlachonikolou G, Gkolfakis P, Sioulas AD, Papanikolaou IS, Melissaratou A, Moustafa GA, Xanthopoulou E, Tsilimidos G, Tsironi I, Filippidis P, Malli C, Dimitriadis GD, Triantafyllou K. Academic hospital staff compliance with a fecal immunochemical test-based colorectal cancer screening program. World J Gastrointest Oncol 2016; 8:629-634. [PMID: 27574556 PMCID: PMC4980654 DOI: 10.4251/wjgo.v8.i8.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/26/2016] [Accepted: 06/02/2016] [Indexed: 02/05/2023] Open
Abstract
AIM: To measure the compliance of an Academic Hospital staff with a colorectal cancer (CRC) screening program using fecal immunochemical test (FIT).
METHODS: All employees of “Attikon” University General Hospital aged over 50 years were thoroughly informed by a team of physicians and medical students about the study aims and they were invited to undergo CRC screening using two rounds of FIT (DyoniFOB® Combo H, DyonMed SA, Athens, Greece). The tests were provided for free and subjects tested positive were subsequently referred for colonoscopy. One year after completing the two rounds, participants were asked to be re-screened by means of the same test.
RESULTS: Among our target population consisted of 211 employees, 59 (27.9%) consented to participate, but only 41 (19.4%) and 24 (11.4%) completed the first and the second FIT round, respectively. Female gender was significantly associated with higher initial participation (P = 0.005) and test completion - first and second round - (P = 0.004 and P = 0.05) rates, respectively. Phy
sician’s (13.5% vs 70.2%, P < 0.0001) participation and test completion rates (7.5% vs 57.6%, P < 0.0001 for the first and 2.3% vs 34%, P < 0.0001 for the second round) were significantly lower compared to those of the administrative/technical staff. Similarly, nurses participated (25.8% vs 70.2%, P = 0.0002) and completed the first test round (19.3% vs 57.6%, P = 0.004) in a significant lower rate than the administrative/technical staff. One test proved false positive. No participant repeated the test one year later.
CONCLUSION: Despite the well-organized, guided and supervised provision of the service, the compliance of the Academic Hospital personnel with a FIT-based CRC screening program was suboptimal, especially among physicians.
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Abstract
Obesity is a global epidemic with significant morbidity and mortality. Weight loss results in reduction of health risks and improvement in quality of life, thus representing a goal of paramount importance. Bariatric surgery is the most efficacious choice compared to conservative alternatives including diet, exercise, drugs and behavioral modification to treat obese patients. Following bariatric operations, patients may present with upper gastrointestinal tract complaints that warrant endoscopic evaluation and the various bariatric surgery types are often linked to complications. A subset of these complications necessitates endoscopic interventions for accurate diagnosis and effective, minimal invasive treatment. This review aims to highlight the role of upper gastrointestinal endoscopy in patients who have undergone bariatric surgery to evaluate and potentially treat surgery-related complications and upper gastrointestinal symptoms.
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Affiliation(s)
- Chrysoula P Malli
- Hepatogastroenterology Unit, Second Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | - Athanasios D Sioulas
- Hepatogastroenterology Unit, Second Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | - Theodoros Emmanouil
- Hepatogastroenterology Unit, Second Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | - George D Dimitriadis
- Hepatogastroenterology Unit, Second Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University, Athens, Greece
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Vasilatou D, Sioulas AD, Pappa V, Papanikolaou IS, Triantafyllou K, Dimitriadis GD, Papageorgiou SG. The role of miRNAs and epigenetic mechanisms in primary gastric mucosa-associated lymphoid tissue lymphoma. Future Oncol 2016; 12:1587-93. [PMID: 27079806 DOI: 10.2217/fon-2016-0038] [Citation(s) in RCA: 4] [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] [Indexed: 12/28/2022] Open
Abstract
Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a rare low-grade B-cell non-Hodgkin lymphoma associated with Helicobacter pylori infection and the subsequent chronic inflammation. Significant progress in understanding the pathogenesis of the disease has already been made. However, the exact molecular pathways of lymphomagenesis remain unclear. Furthermore, difficulties regarding accurate diagnosis of gastric MALT lymphoma and its discrimination from gastritis or other lymphoma subtypes arise. Recent studies evaluate the role of miRNAs and epigenetic alterations on MALT lymphoma pathogenesis and prognosis. This review critically summarizes the most important data on the role of miRNAs and epigenetics in MALT lymphomas pathogenesis, prognosis and treatment.
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Affiliation(s)
- Diamantina Vasilatou
- Second Department of Internal Medicine & Research Institute, 'Attikon' University General Hospital, Medical School, University of Athens, Haidari, Greece
| | - Athanasios D Sioulas
- Second Department of Internal Medicine & Research Institute, 'Attikon' University General Hospital, Medical School, University of Athens, Haidari, Greece
| | - Vasiliki Pappa
- Second Department of Internal Medicine & Research Institute, 'Attikon' University General Hospital, Medical School, University of Athens, Haidari, Greece
| | - Ioannis S Papanikolaou
- Second Department of Internal Medicine & Research Institute, 'Attikon' University General Hospital, Medical School, University of Athens, Haidari, Greece
| | - Konstantinos Triantafyllou
- Second Department of Internal Medicine & Research Institute, 'Attikon' University General Hospital, Medical School, University of Athens, Haidari, Greece
| | - George D Dimitriadis
- Second Department of Internal Medicine & Research Institute, 'Attikon' University General Hospital, Medical School, University of Athens, Haidari, Greece
| | - Sotirios G Papageorgiou
- Second Department of Internal Medicine & Research Institute, 'Attikon' University General Hospital, Medical School, University of Athens, Haidari, Greece
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Affiliation(s)
- Athanasios D Sioulas
- Hepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, 1 Rimini street, 12462 Haidari, Greece
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, 1 Rimini street, 12462 Haidari, Greece.
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Triantafyllou K, D. Sioulas A, J. Giamarellos-Bourboulis E. Rifaximin: The Revolutionary Antibiotic Approach for Irritable Bowel Syndrome. Mini Rev Med Chem 2015. [DOI: 10.2174/1389557515666150722105340] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Papanikolaou IS, Sioulas AD, Magdalinos N, Beintaris I, Lazaridis LD, Polymeros D, Malli C, Dimitriadis GD, Triantafyllou K. Improved bowel preparation increases polyp detection and unmasks significant polyp miss rate. World J Clin Cases 2015; 3:880-886. [PMID: 26488024 PMCID: PMC4607806 DOI: 10.12998/wjcc.v3.i10.880] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 07/26/2015] [Accepted: 09/18/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To retrospectively compare previous-day vs split-dose preparation in terms of bowel cleanliness and polyp detection in patients referred for polypectomy.
METHODS: Fifty patients underwent two colonoscopies: one diagnostic in a private clinic and a second for polypectomy in a University Hospital. The latter procedures were performed within 12 wk of the index ones. Examinations were accomplished by two experienced endoscopists, different in each facility. Twenty-seven patients underwent screening/surveillance colonoscopy, while the rest were symptomatic. Previous day bowel preparation was utilized initially and split-dose for polypectomy. Colon cleansing was evaluated using the Aronchick scale. We measured the number of detected polyps, and the polyp miss rates per-polyp.
RESULTS: Excellent/good preparation was reported in 38 cases with previous-day preparation (76%) vs 46 with split-dose (92%), respectively (P = 0.03). One hundred and twenty-six polyps were detected initially and 169 subsequently (P < 0.0001); 88 vs 126 polyps were diminutive (P < 0.0001), 25 vs 29 small (P = 0.048) and 13 vs 14 equal or larger than 10 mm. The miss rates for total, diminutive, small and large polyps were 25.4%, 30.1%, 13.7% and 6.6%, respectively. Multivariate analysis revealed that split-dose preparation was significantly associated (OR, P) with increased number of polyps detected overall (0.869, P < 0.001), in the right (0.418, P = 0.008) and in the left colon (0.452, P = 0.02).
CONCLUSION: Split-dose preparation improved colon cleansing, enhanced polyp detection and unmasked significant polyp miss rates.
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Sioulas AD, Malli C, Dimitriadis GD, Triantafyllou K. Self-expandable metal stents for achalasia: Thinking out of the box! World J Gastrointest Endosc 2015; 7:45-52. [PMID: 25610533 PMCID: PMC4295180 DOI: 10.4253/wjge.v7.i1.45] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/04/2014] [Accepted: 11/10/2014] [Indexed: 02/05/2023] Open
Abstract
Achalasia is a primary motor disorder of the esophagus diagnosed manometrically in the clinical setting of dysphagia to both solids and liquids. Currently established treatment options include pneumatic dilation, laparoscopic Heller myotomy, botulinum toxin injection performed endoscopically, oral agents that relax the lower esophageal sphincter and esophagectomy for refractory, end-stage disease. Despite their effectiveness, a significant proportion of patients eventually relapses and needs retreatment. In this setting, several new techniques are under investigation promising future enrichment of our therapeutic armamentarium for achalasic patients. Among them, peroral endoscopic myotomy and self-expandable metal stents placed across the gastro-esophageal junction represent the most encouraging modalities, as initial studies assessing their efficacy and safety indicate. This review highlights the role of self-expandable metal stents in the management of patients with achalasia. Their possible position in the therapeutic algorithm of achalasia along with established and novel techniques is also assessed. Finally, the need for large prospective randomized trials is underlined in order to elucidate the numerous relevant issues.
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Malli C, Sioulas AD, Dimitriadis GD, Triantafyllou K. Unexpected drainage of pancreatic pseudocyst through the common bile duct. Ann Gastroenterol 2015; 28:156. [PMID: 25609243 PMCID: PMC4289998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 07/23/2014] [Indexed: 11/02/2022] Open
Affiliation(s)
- Chrysoula Malli
- Hepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, Greece
| | - Athanasios D. Sioulas
- Hepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, Greece,
Correspondence to: Athanasios D. Sioulas, Hepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, 1 Rimini street, 12462 Haidari, Greece, Tel.: +30 210 5832087, Fax: +30 210 5326454, e-mail:
| | - George D. Dimitriadis
- Hepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, Greece
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, Greece
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Sioulas AD, Beintaris I, Triantafyllou K. A rosebud-like retrograde view of the duodenal bulb. Clin Gastroenterol Hepatol 2014; 12:A17. [PMID: 24951846 DOI: 10.1016/j.cgh.2014.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 06/07/2014] [Accepted: 06/09/2014] [Indexed: 02/07/2023]
Affiliation(s)
- Athanasios D Sioulas
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, Athens, Greece
| | - Iosif Beintaris
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, Athens, Greece
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, Athens, Greece
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Sioulas AD, Vasilatou D, Pappa V, Dimitriadis G, Triantafyllou K. Epigenetics in gastrointestinal stromal tumors: clinical implications and potential therapeutic perspectives. Dig Dis Sci 2013; 58:3094-102. [PMID: 23873383 DOI: 10.1007/s10620-013-2785-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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] [Received: 04/28/2013] [Accepted: 06/28/2013] [Indexed: 12/18/2022]
Abstract
Gastrointestinal stromal tumors (GIST) represent the most common mesenchymal neoplasms affecting the gastrointestinal tract. Activating mutations in either the KIT or PDGFRa gene are the principal oncogenic triggers with the former accounting for more than 80 % of cases. In the small subset of GIST that are wild type for both the aforementioned changes, other germline or somatic mutations have been identified. GIST exhibit a highly variable clinical behavior and the main prognostic determinants are tumor size, mitotic rate, and location. It is, however, strongly believed that, beyond classic genetics, additional epigenetic phenomena such as DNA hypomethylation and hypermethylation, microRNA alterations, and chromatin modifications underlie GIST tumorigenesis and influence the clinical course and response to standard treatment. This review aims to illuminate current advances in terms of epigenetics in GIST, as well as possible implications in prognosis and therapeutics.
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Affiliation(s)
- Athanasios D Sioulas
- 2nd Department of Internal Medicine and Research Unit, Attikon University General Hospital, Medical School, Athens University, Rimini 1, 12462, Haidari, Greece,
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Sioulas AD, Panayiotides IG, Kavatha D, Foukas PG, Antonakos N, Triantafyllou K. A rare case of dysphagia in a severely immunocompromised patient. Arch Med Sci 2013; 9:381-3. [PMID: 23671454 PMCID: PMC3648814 DOI: 10.5114/aoms.2012.31254] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 02/15/2012] [Accepted: 02/19/2012] [Indexed: 11/17/2022] Open
Affiliation(s)
- Athanasios D Sioulas
- Hepatogastroenterology Unit, 2 Department of Internal Medicine and Research Unit, University of Athens Medical School, Attikon University General Hospital, Haidari, Greece
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Beintaris I, Polymeros D, Papanikolaou IS, Kontopoulou C, Kourikou A, Sioulas AD, Danias N, Dimitriadis G, Triantafyllou K. Fatal perforation with subcutaneous emphysema complicating ERCP. Endoscopy 2013; 44 Suppl 2 UCTN:E313-4. [PMID: 23011997 DOI: 10.1055/s-0032-1309758] [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] [Indexed: 12/10/2022]
Affiliation(s)
- I Beintaris
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, University of Athens, Greece
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Sioulas AD, Polymeros D, Beis D, Triantafyllou K. Jejunal diverticulosis. Ann Gastroenterol 2013; 26:354. [PMID: 24714703 PMCID: PMC3959493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 04/29/2013] [Indexed: 11/08/2022] Open
Affiliation(s)
- Athanasios D. Sioulas
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, Attikon University General Hospital,
Correspondence to: Athanasios D. Sioulas, Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, Attikon University General Hospital, 1 Rimini str., 124 62 Athens, Greece, e-mail:
| | - Dimitrios Polymeros
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, Attikon University General Hospital
| | - Dimitrios Beis
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, Attikon University General Hospital
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, Attikon University General Hospital
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Polymeros D, Sioulas AD, Tsiamoulos Z, Kontopoulou C, Giannitsioti E, Triantafyllou K. Endoscopically drained abdominal abscess compressing the sigmoid. Indian J Gastroenterol 2012; 31:346-8. [PMID: 22843307 DOI: 10.1007/s12664-012-0196-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Accepted: 05/22/2012] [Indexed: 02/04/2023]
Abstract
Intra-abdominal abscesses (IAA) complicate numerous medical and surgical pathologic conditions. Accurate radiological diagnosis combined with percutaneous or surgical drainage and antibiotics is the current standard of care for IAA. We herein report a case of a 52-year-old woman with a 10-day history of fever and abdominal pain. An intra-abdominal abscess externally compressing the sigmoid was revealed and successfully drained during colonoscopy.
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Affiliation(s)
- Dimitrios Polymeros
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, University of Athens Medical School, Attikon University General Hospital, 1 Rimini Street, 12462 Haidari, Greece
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Papanikolaou IS, Sioulas AD, Kalimeris S, Papatheodosiou P, Karabinis I, Agelopoulou O, Beintaris I, Polymeros D, Dimitriadis G, Triantafyllou K. Awareness and attitudes of Greek medical students on colorectal cancer screening. World J Gastrointest Endosc 2012; 4:513-517. [PMID: 23189223 PMCID: PMC3506969 DOI: 10.4253/wjge.v4.i11.513] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
AIM: To prospectively assess the knowledge and attitudes of medical students (MS), as tomorrow’s physicians, about colorectal cancer (CRC) and its screening modalities.
METHODS: Three hundred fourth year MS of the University of Athens were enrolled in this survey. Their selection was random, based on student identification card number. All participants completed an anonymous written questionnaire over a 4 month period. The questionnaire was divided into 4 sections and included queries about CRC-related symptoms, screening with colonoscopy and MS awareness and attitudes in this field. Following collection and analysis of the data, the results are presented as percentages of answers for each separate question.
RESULTS: Two hundred and sixty-five students answered the questionnaire over a 4 mo period. Interestingly, only 69% of the study population considered CRC to be a high-risk condition for public health. However, the vast majority of participants identified CRC-related symptoms and acknowledged its screening to be of great value in reducing CRC incidence and mortality. A very small proportion (38%) had received information material regarding CRC screening (either during their medical training or as a part of information provided to the general public) and only 60% of the participants declared willingness to receive further information. Regarding colonoscopy, 85% would prefer an alternative to colonoscopy methods for CRC screening. Moreover, 53% considered it to be a painful method and 68% would appreciate more information about the examination.
CONCLUSION: MS in Greece need to be better informed about CRC screening and screening colonoscopy.
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Affiliation(s)
- Ioannis S Papanikolaou
- Ioannis S Papanikolaou, Athanasios D Sioulas, Stylianos Kalimeris, Persephone Papatheodosiou, Ioannis Karabinis, Olga Agelopoulou, Iosif Beintaris, Dimitrios Polymeros, George Dimitriadis, Konstantinos Triantafyllou, Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, Attikon University General Hospital, Medical School, Athens University, 12462 Haidari, Greece
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Sioulas AD, Polymeros D, Kourikou A, Papanikolaou IS, Triantafyllou K. Intragastric balloon left in the stomach for more than a year: two case reports. Obes Facts 2012; 5:436-9. [PMID: 22797371 DOI: 10.1159/000341134] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 11/26/2011] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Intragastric balloon (IGB) is often used to achieve short-term weight reduction in morbidly obese patients. It is placed endoscopically for a 6-month-period either in the pre-bariatric surgery setting and also in cases where no bariatric surgery is planned. Prolonged implantation may be accompanied by serious complications. CASE REPORTS We herein report two cases of extraction of intact IGBs long time after their placement. CONCLUSION Although no adverse events were observed, adherence to manufacturers' recommendations is definitely suggested.
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Affiliation(s)
- Athanasios D Sioulas
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, University of Athens, Haidari, Greece.
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