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Routsi E, Kanelleas A, Papaefthymiou V, Pappa G, Katoulis A. Penicillamine-Induced Localised Cutis Laxa in a Patient with Wilson Disease: A Case Report. Mediterr J Rheumatol 2024; 35:184-186. [PMID: 38736957 PMCID: PMC11082779 DOI: 10.31138/mjr.280223.pil] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/11/2023] [Accepted: 05/15/2023] [Indexed: 05/14/2024] Open
Abstract
Introduction Wilson disease is a rare genetic disorder, characterised by excessive deposition of copper in the liver, brain, and other tissues. Penicillamine, a copper-chelating agent, is used in high doses in the treatment of Wilson disease leading to a variety of cutaneous reactions, including hyper-sensitivity reactions, pseudoxanthoma elasticum, elastosis perforans serpiginosa, anetoderma, and cutis laxa (CL). We present a rare case of localised CL induced by penicillamine for Wilson disease, in the absence of elastosis perforans serpiginosa. Case Description A 41-year-old male with Wilson disease treated with long-term high-dose penicillamine was referred to us for a basal cell carcinoma on the scalp. On physical examination, diffusely flaccid and redundant skin on the right side of the neck were observed. Histopathology revealed findings consistent with CL. Conclusion Long-term treatment with penicillamine for Wilson disease may induce localized CL, possibly by direct inhibition of cross-linkage of collagen fibres.
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Affiliation(s)
- Eleni Routsi
- 2nd Department of Dermatology-Venereology, National Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Antonios Kanelleas
- 2nd Department of Dermatology-Venereology, National Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | | | - Georgia Pappa
- 2nd Department of Dermatology-Venereology, National Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Alexandros Katoulis
- 2nd Department of Dermatology-Venereology, National Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
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Sgouros D, Routsi E, Evangelodimou A, Lallas A, Apalla Z, Arvanitis DK, Pappa G, Lazaridou E, Fotiadou C, Evangelou G, Chaidemenos G, Ioannides D, Barkis I, Liopyris K, Nicolaidou E, Theotokoglou S, Syrmali A, Stratigos A, Rigopoulos D, Katoulis A. Use of Dermoscopy among Greek Dermatologists in Everyday Clinical Practice: A National Questionnaire-Based Study. J Clin Med 2024; 13:972. [PMID: 38398285 PMCID: PMC10888643 DOI: 10.3390/jcm13040972] [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: 11/09/2023] [Revised: 01/06/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Dermatoscopy has been established as an important diagnostic tool for a wide range of skin diseases. This study aims to evaluate the use of dermatoscopy in clinical practice among Greek dermatologists. Methods: A nationwide questionnaire-based survey was conducted collecting data on the frequency of dermatoscopic examinations, the types of lesions examined, training and educational resources, as well as factors influencing the choice to incorporate dermatoscopy into daily clinical routines. Results: A total of 366 Greek dermatologists participated in the survey. Most of the respondents reported the daily use of dermatoscopy in their practice. Pigmented and non-pigmented lesions, inflammatory diseases, cutaneous infectious, hair disorders, and nail lesions were the most common indications for dermatoscopy. Factors influencing the utilization of dermatoscopy included increased diagnostic accuracy, enhanced patient care, better patient communication and general compliance, and improved satisfaction among dermatologists. Conclusions: This national questionnaire-based study demonstrates that dermatoscopy has become an integral part of daily dermatological practice in Greece. The findings highlight the significance of structured training and education to promote dermoscopy's effective and routine use. Incorporating dermatoscopy into clinical practice not only improves diagnostic precision but also enhances patient care, contributing to the overall quality of dermatological services in Greece.
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Affiliation(s)
- Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (G.P.); (S.T.); (A.S.); (A.K.)
| | - Eleni Routsi
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (E.R.); (K.L.); (E.N.); (A.S.); (D.R.)
| | - Athina Evangelodimou
- Dermatology Department, General Hospital of Athens, Evangelismos, 11635 Athens, Greece;
| | - Aimilios Lallas
- First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.L.); (D.I.)
| | - Zoe Apalla
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (Z.A.); (E.L.); (C.F.)
| | - Dimitrios K. Arvanitis
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (G.P.); (S.T.); (A.S.); (A.K.)
| | - Georgia Pappa
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (G.P.); (S.T.); (A.S.); (A.K.)
| | - Elizabeth Lazaridou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (Z.A.); (E.L.); (C.F.)
| | - Christina Fotiadou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (Z.A.); (E.L.); (C.F.)
| | - Georgios Evangelou
- Department of Dermatology, University General Hospital of Heraklion, 71500 Heraklion, Greece;
| | | | - Dimitrios Ioannides
- First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.L.); (D.I.)
| | | | - Konstantinos Liopyris
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (E.R.); (K.L.); (E.N.); (A.S.); (D.R.)
| | - Electra Nicolaidou
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (E.R.); (K.L.); (E.N.); (A.S.); (D.R.)
| | - Sofia Theotokoglou
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (G.P.); (S.T.); (A.S.); (A.K.)
| | - Anna Syrmali
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (G.P.); (S.T.); (A.S.); (A.K.)
| | - Alexander Stratigos
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (E.R.); (K.L.); (E.N.); (A.S.); (D.R.)
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (E.R.); (K.L.); (E.N.); (A.S.); (D.R.)
| | - Alexander Katoulis
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (G.P.); (S.T.); (A.S.); (A.K.)
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Kanelleas A, Pappa G, Routsi E, Milionis V, Bozi E, Katoulis A. Penile Granulomas Induced by Isotretinoin. Dermatol Pract Concept 2024; 14:dpc.1401a12. [PMID: 38364411 PMCID: PMC10869026 DOI: 10.5826/dpc.1401a12] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 02/18/2024] Open
Affiliation(s)
- Antonios Kanelleas
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, “Attikon” General University Hospital, Athens, Greece
- Dermathens Private Practice, Athens, Greece
| | - Georgia Pappa
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, “Attikon” General University Hospital, Athens, Greece
| | - Eleni Routsi
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, “Attikon” General University Hospital, Athens, Greece
| | - Vassilis Milionis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, “Attikon” General University Hospital, Athens, Greece
- Istomedica Private Anatomic Pathology Lab, Athens, Greece
| | - Evangelia Bozi
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, “Attikon” General University Hospital, Athens, Greece
| | - Alexandros Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, “Attikon” General University Hospital, Athens, Greece
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Alexandrou M, Driva TS, Makri S, Nikolakea M, Routsi E, Spyrou N, Msaouel P, Esagian SM. Gender disparity trends in genitourinary oncology academic publishing over the past 3 decades: A bibliometric analysis. Urol Oncol 2023; 41:432.e21-432.e27. [PMID: 37573196 DOI: 10.1016/j.urolonc.2023.06.009] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/28/2023] [Accepted: 06/18/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVES To examine gender disparities in genitourinary (GU) oncology academic publishing over the past three decades. MATERIALS AND METHODS We performed a bibliometric analysis of eight academic journals featuring GU oncology research articles: Journal of Clinical Oncology, Cancer, European Journal of Cancer, European Urology, Journal of Urology, BJU International, Prostate Cancer and Prostatic Diseases, and Urologic Oncology: Seminars and Original Investigations. After selecting four time points (1990, 2000, 2010, 2020), we recorded the gender of the first and senior authors and investigated their association with independent variables including publication year, research field, and geographic continent. Results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A total of 14,786 articles were included in our analyses. Females comprised 25.7% of first and 18.1% of senior authors. Compared to 1990, there was a trend of progressively higher female first author (OR 1.47 [95% CI 1.27-1.69] in 2000; 2.28 [95% CI 2.00-2.59] in 2010; 3.10 [95% CI 2.71-3.55] in 2020) and senior author positions (OR 1.23 [95% CI 1.05-1.45] in 2000; 1.67 [95% CI 1.45-1.93] in 2010; 2.55 [95% CI 2.20-2.96] in 2020). Compared to GU oncology, non-GU oncology articles were more likely to have female first (OR 2.61, 95% CI 2.38-2.86) or senior authors (OR 2.61, 95% CI 2.35-2.91). Articles from Asia (OR 0.45, 95% CI 0.38-0.51), Africa (OR 0.45, 95% CI 0.22-0.91), and international collaborations (OR 0.62, 95% CI 0.50-0.76) had a lower proportion of female first authors compared to North America. First authors were significantly more likely to be female when senior authors were also female (OR 2.45, 95% CI 2.23-2.69). CONCLUSIONS Despite the bridging trend demonstrated, GU oncology remains a male-predominant discipline. Female leadership and mentorship are pivotal in achieving gender parity in the academic medicine community.
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Affiliation(s)
- Michaella Alexandrou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Oncology Working Group, Society of Junior Doctors, Athens, Greece
| | - Tatiana S Driva
- Oncology Working Group, Society of Junior Doctors, Athens, Greece; First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavriani Makri
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Oncology Working Group, Society of Junior Doctors, Athens, Greece
| | - Melina Nikolakea
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Oncology Working Group, Society of Junior Doctors, Athens, Greece
| | - Eleni Routsi
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Oncology Working Group, Society of Junior Doctors, Athens, Greece
| | - Nikolaos Spyrou
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Pavlos Msaouel
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Stepan M Esagian
- Oncology Working Group, Society of Junior Doctors, Athens, Greece; Department of Medicine, NYC Health + Hospitals / Jacobi, Albert Einstein College of Medicine, Bronx, NY.
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Kanelleas A, Efthymiou O, Routsi E, Sgouros D, Pappa G, Tsoureli Nikita E, Bozi E, Katoulis A. Clinical and Epidemiological Characteristics of Hidradenitis Suppurativa Patients with Paradoxical Psoriasiform Reactions following Treatment with Adalimumab. Skin Appendage Disord 2022; 8:415-418. [PMID: 36161088 PMCID: PMC9485989 DOI: 10.1159/000524174] [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: 01/06/2022] [Accepted: 03/12/2022] [Indexed: 07/25/2023] Open
Abstract
Introduction Immunomodulation using TNF-α inhibitors (anti-TNF-a), especially adalimumab, is highly effective in the treatment of hidradenitis suppurativa (HS) in cases that are poorly controlled by conventional treatments. However, paradoxical psoriasis represents a peculiar type of psoriasis that may occur de novo or as the worsening of pre-existent psoriatic lesions during treatment with adalimumab. Case Presentation We reported 4 cases of patients suffering from HS, who developed paradoxical psoriasis after treatment with adalimumab for their HS, analyzing their clinical and epidemiological characteristics. All 4 cases were middle aged, smokers, overweight or obese. Half of the patients were males (50%). All of them were classified as Hurley stage III, with a mean duration of HS of 20 years. Two patients had a family history of psoriasis. All 4 patients had been on at least 5 months of successful treatment with adalimumab before the onset of the lesions. Conclusions Paradoxical psoriasis emerged in 4 patients who received at least 5-month regimen of adalimumab for long-lasting HS. Although different mechanisms have been hypothesized for such events, the exact underlying pathogenetic pathway remains unclear. Consistent reporting of such rare cases, and on a larger scale, is encouraged in order to enrich the available literature.
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Affiliation(s)
| | | | - Eleni Routsi
- 2nd Department of Dermatology − Venereology, National Kapodistrian University of Athens, ATTIKON University Hospital, Athens, Greece
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Sgouros D, Routsi E, Almpanis Z, Korogiannos A, Katoulis A. Dermatoscopic features of a metastatic eccrine porocarcinoma arising on lymphedema. Dermatol Pract Concept 2022; 12:e2022079. [PMID: 35646434 PMCID: PMC9116565 DOI: 10.5826/dpc.1202a79] [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] [Accepted: 09/15/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Dimitrios Sgouros
- Second Department of Dermatology-Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Eleni Routsi
- Second Department of Dermatology-Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Zannis Almpanis
- Department of Pathology, 251 Hellenic Air Force General Hospital of Athens, Athens, Greece
| | | | - Alexander Katoulis
- Second Department of Dermatology-Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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Schizas D, Papapanou M, Routsi E, Mastoraki A, Lidoriki I, Zavras N, Avgerinos DV, Lazaris AM, Tsaroucha A. Career barriers for women in surgery. Surgeon 2022; 20:275-283. [PMID: 34996719 DOI: 10.1016/j.surge.2021.11.008] [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: 04/21/2020] [Revised: 11/09/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Despite the increasing numbers of female medical students, surgery remains male-dominated. PURPOSE To highlight the principal career obstacles experienced by aspiring female surgeons. METHODS A narrative review of literature on the position and career barriers of female surgeons has been conducted, using the MEDLINE and EMBASE databases. MAIN FINDINGS Implicit and even explicit biases against female surgeons remain prevalent, negatively impacting their training performance and overall professional trajectory. Female surgeons are globally underrepresented in leadership positions and senior academic rankings, especially that of a full professor. They feel hampered by lack of effective mentorship, whose value for a successful career has been acknowledged by all medical students, surgeons and surgical leaders. Their work-life imbalance is sometimes expressed as lower likelihood than their male contemporaries of getting married or having children and may be attributed to their conventional association with the role of caretaker, their personal desire to accommodate occupational and family duties and the inadequate implementation of parental leave and childcare policies. Female surgeons' "infertility" may be further explained by direct and indirect pregnancy-related difficulties. Female surgeons are also financially undercompensated compared to their male contemporaries. Finally, specialty-specific challenges should not be overlooked. CONCLUSIONS While encouraging steps have been made, women in surgery feel still hindered by various obstacles. The qualitative, interview-based nature of current literature requires more meticulous studies on these barriers with a more quantitative and objective approach. Attenuation of gender imbalance in surgical specialties requires further changes in mentality and more targeted modifications in relevant policies.
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Affiliation(s)
- Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Michail Papapanou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
| | - Eleni Routsi
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Aikaterini Mastoraki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Irene Lidoriki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Nikolaos Zavras
- Department of Pediatric Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Dimitrios V Avgerinos
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, NewYork Presbyterian, New York, NY, United States
| | - Andreas M Lazaris
- Department of Vascular Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Alexandra Tsaroucha
- Second Department of Surgery and Laboratory of Experimental Surgery, Democritus University of Thrace, Alexandroupolis, Greece
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Siristatidis H, Papapanou M, Papaioannou M, Petta A, Routsi E, Farmaki M, Nikolaos V. O-197 Maternal and neonatal characteristics and outcomes of COVID-19 from early pregnancy until labor: an overview of systematic reviews. Hum Reprod 2021. [PMCID: PMC8385926 DOI: 10.1093/humrep/deab128.008] [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] [Indexed: 11/15/2022] Open
Abstract
Abstract
Study question
What is the current obstetric-perinatal and neonatal outcome of infected pregnant women and their newborns during the COVID-19 pandemic?
Summary answer
Miscarriage rates were <2.5%, even when only studies of moderate/high-quality were included. Increased rates of CS and preterm birth were found, with uncertain vertical transmission.
What is known already
A considerable number of systematic reviews, with substantial heterogeneity regarding their methods and included populations, on the impact of COVID-19 on infected pregnant women and their neonates, has emerged.
Study design, size, duration
Three bibliographical databases were searched (last search: September 10, 2020). Quality assessment was performed using the AMSTAR-2 tool. Primary outcomes included mode of delivery, preterm delivery/labor, premature rupture of membranes (PROM/pPROM) and abortions/miscarriages. Outcomes were mainly presented as ranges. A separate analysis, including only moderate and high-quality systematic reviews, was also conducted. The protocol was registered with PROSPERO (CRD42020214447);
Participants/materials, setting, methods
The search strategy followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guideline. Keywords employed were (COVID-19 OR SARS-CoV-2 OR “Coronavirus disease 2019”) AND (“Neonatal outcom*” OR “Neonatal characteristic*” OR “Maternal outcom*” OR “maternal characteristic*” OR “pregnancy outcom*” OR “vertical transmission”). All retrieved studies were imported into the Rayyan QCRI and duplicated articles were removed. A snow-ball procedure was also implemented by hand-searching the reference lists of included systematic reviews for additional sources.
Main results and the role of chance
Thirty-nine reviews were analyzed. Twelve reviews (30.8%) were found to be of “very low quality”, 11 of “low quality”, 13 (33.3%) of “moderate”, and three (7.7%) of “high quality”.
Ten articles dealt with miscarriages. One review integrated them into pregnancy terminations (1.4% (4/295)), one into intrauterine fetal deaths (1(3%)), while another one described them as “spontaneous abortions” (0.8% (3/385)). Taking into account reviews, which calculated these rates for their entire included population, miscarriage rates were <2.5%. The reported rates by moderate and high-quality studies were ≤ 2%. Reported rates,regarding both preterm and term gestations, varied between 52.3%-95.8% for caesarean sections; 4.2%-44.7% for vaginal deliveries; 14.3%-63.8% specifically for preterm deliveries and 22.7%-32.2% for preterm labor; 5.3%-12.7% for PROM and 6.4%-16.1% for pPROM. Maternal anxiety for potential fetal infection contributed to abortion decisions, while SARS-CoV-2-related miscarriages could not be excluded. Maternal ICU admission and mechanical ventilation rates were 3%-28.5% and 1.4%-12%, respectively. Maternal mortality rate was <2%, while stillbirth, neonatal ICU admission and mortality rates were <2.5%, 3.1%-76.9% and <3%, respectively. Neonatal PCR positivity rates ranged between 1.6% and 10%. After accounting for quality of studies, ranges of our primary outcomes remained unchanged.
Limitations, reasons for caution
Results are presented in a narrative way using ranges as the primary mean of quantification. We also included studies with both RT-PCR positive women and women with suspected infection based on their clinical and imaging manifestations, whereas, if excluding them, we might have missed a considerable source of information.
Wider implications of the findings
In conclusion, a rapid increase of CS was observed, especially at the beginning of the pandemic, most likely due to lack of knowledge and robust recommendations. Preterm birth rates were elevated, with iatrogenic reasons potentially involved. Even though neonatal infections were rare, the probability of vertical transmission cannot be eliminated.
Trial registration number
not applicable’
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Affiliation(s)
- H Siristatidis
- National and Kapodistrian University of Athens, Second Department of Obstetrics and Gynecology- “Aretaieion Hospital”, Athens, Greece
| | - M Papapanou
- National and Kapodistrian University of Athens, Second Department of Obstetrics and Gynecology- “Aretaieion Hospital”, Athens, Greece
| | - M Papaioannou
- National and Kapodistrian University of Athens, Second Department of Obstetrics and Gynecology- “Aretaieion Hospital”, Athens, Greece
| | - A Petta
- National and Kapodistrian University of Athens, Second Department of Obstetrics and Gynecology- “Aretaieion Hospital”, Athens, Greece
| | - E Routsi
- National and Kapodistrian University of Athens, Second Department of Obstetrics and Gynecology- “Aretaieion Hospital”, Athens, Greece
| | - M Farmaki
- National and Kapodistrian University of Athens, Second Department of Obstetrics and Gynecology- “Aretaieion Hospital”, Athens, Greece
| | - V Nikolaos
- National and Kapodistrian University of Athens, Second Department of Obstetrics and Gynecology- “Aretaieion Hospital”, Athens, Greece
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Lidoriki I, Jager-Wittenaar H, Papapanou M, Routsi E, Frountzas M, Mylonas KS, Ottery FD, Schizas D. Greek translation and cultural adaptation of the scored patient-generated subjective global assessment: A nutritional assessment tool suitable for cancer patients. Clin Nutr ESPEN 2021; 43:322-328. [PMID: 34024535 DOI: 10.1016/j.clnesp.2021.03.032] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND AIMS Patients with cancer frequently present with disease-related malnutrition and functional decline. The scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a malnutrition screening and assessment tool commonly used in patients with cancer. The aim of the current study was to translate and culturally adapt the original English PG-SGA for the Greek setting, including assessment of comprehensibility, difficulty and content validity in patients and healthcare professionals. METHODS Our study was conducted according to the ten steps of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Principles of Good Practice for Translation and Cultural Adaptation. Comprehensibility and difficulty of the Greek translation were assessed in 100 patients and 100 healthcare professionals (HCPs) from Greece. Content validity of the translation was assessed among HCPs. Item and scale indices were calculated for comprehensibility (I-CI; S-CI), difficulty (I-DI; S-DI), and content validity (I-CVI; S-CVI). RESULTS Patient perceived comprehensibility and difficulty of the PG-SGA were considered to be excellent (S-CI = 0.97, S-DI = 0.97). HCPs perceived content validity for the patient component was also excellent (S-CVI = 0.95). The perceived content validity, comprehensibility and difficulty for the professional component of the PG-SGA, as perceived by the HCPs, was excellent (S-CVI = 0.94, S-CI = 0.94, S-DI = 0.90), with the physical exam being perceived as most difficult (I-DI = 0.78-0.92). CONCLUSIONS Our study resulted in the successful translation and cross-cultural adaptation of the original English PG-SGA for the Greek setting. The Greek language version of the PG-SGA is characterized by high comprehensibility, low difficulty, and is considered relevant for use in Greece.
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Affiliation(s)
- Irene Lidoriki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands; Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Michail Papapanou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Eleni Routsi
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Maximos Frountzas
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Athens, Greece
| | - Konstantinos S Mylonas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Faith D Ottery
- Ottery & Associates, LLC. Deerfield (Greater Chicago Area), IL, USA
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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10
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Pountoukidou A, Potamiti-Komi M, Sarri V, Papapanou M, Routsi E, Tsiatsiani AM, Vlahos N, Siristatidis C. Management and Prevention of COVID-19 in Pregnancy and Pandemic Obstetric Care: A Review of Current Practices. Healthcare (Basel) 2021; 9:467. [PMID: 33920781 PMCID: PMC8071177 DOI: 10.3390/healthcare9040467] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 03/09/2021] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 02/06/2023] Open
Abstract
Constant accumulation of data results in continuous updates of guidelines and recommendations on the proper management of pregnant women with COVID-19. This study aims to summarize the up-to-date information about the prevention and management of suspected/confirmed SARS-CoV-2 infection in obstetric patients and obstetric care during prenatal, intrapartum, and postpartum periods. We conducted a comprehensive literature search in PubMed for relevant English-written full-text reviews. We also included relevant guidelines and recommendations. In women with a low risk for infection and uncomplicated pregnancy, elective and non-urgent appointments should be postponed or completed through telehealth. Vaccination should be discussed and distance and personal hygiene preventive measures should be recommended. Routine ultrasound examinations should be adjusted in order to minimize exposure to the virus. Standardized criteria should evaluate the need for admission. Women with moderate/high-risk for infection should be isolated and tested with RT-PCR. The mode and timing of delivery should follow routine obstetric indications. In case of infection, glucocorticoids are recommended in critically ill pregnant women, after individualized evaluation. During labor and concomitant infection, the duration of the first two stages should be reduced as possible to decrease aerosolization, while minimization of hemorrhage is essential during the third stage. Close maternal monitoring and adequate oxygenation when necessary always remain a prerequisite. Discharge should be considered on the first or second day postpartum, also depending on delivery mode. Breastfeeding with protective equipment is recommended, as its benefits outweigh the risks of neonatal infection. Recommendations are currently based on limited available data. More original studies on infected pregnant women are needed to establish totally evidence-based protocols of care for these patients.
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Affiliation(s)
- Argyro Pountoukidou
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Maria Potamiti-Komi
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Vrisiis Sarri
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Michail Papapanou
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Eleni Routsi
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Anna Maria Tsiatsiani
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Nikolaos Vlahos
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece
| | - Charalampos Siristatidis
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece
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11
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Papapanou M, Routsi E, Tsamakis K, Fotis L, Marinos G, Lidoriki I, Karamanou M, Papaioannou TG, Tsiptsios D, Smyrnis N, Rizos E, Schizas D. Medical education challenges and innovations during COVID-19 pandemic. Postgrad Med J 2021; 98:321-327. [PMID: 33782202 DOI: 10.1136/postgradmedj-2021-140032] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/12/2021] [Indexed: 12/13/2022]
Abstract
COVID-19 pandemic has undoubtedly disrupted the well-established, traditional structure of medical education. Τhe new limitations of physical presence have accelerated the development of an online learning environment, comprising both of asynchronous and synchronous distance education, and the introduction of novel ways of student assessment. At the same time, this prolonged crisis had serious implications on the lives of medical students including their psychological well-being and the impact on their academic trajectories. The new reality has, on many occasions, triggered the 'acting up' of medical students as frontline healthcare staff, which has been perceived by many of them as a positive learning and contributing experience, and has led to a variety of responses from the educational institutions. All things considered, the urgency for rapid and novel adaptations to the new circumstances has functioned as a springboard for remarkable innovations in medical education,including the promotion of a more "evidence-based" approach.
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Affiliation(s)
- Michail Papapanou
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Routsi
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Tsamakis
- Second Department of Psychiatry, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lampros Fotis
- Third Department of Paediatrics, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Marinos
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Lidoriki
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Marianna Karamanou
- Department of History of Medicine and Medical Ethics, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore G Papaioannou
- Department of History of Medicine and Medical Ethics, National and Kapodistrian University of Athens, Athens, Greece.,First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Tsiptsios
- Department of Clinical Neurophysiology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Nikolaos Smyrnis
- Second Department of Psychiatry, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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12
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Papapanou M, Papaioannou M, Petta A, Routsi E, Farmaki M, Vlahos N, Siristatidis C. Maternal and Neonatal Characteristics and Outcomes of COVID-19 in Pregnancy: An Overview of Systematic Reviews. Int J Environ Res Public Health 2021; 18:E596. [PMID: 33445657 PMCID: PMC7828126 DOI: 10.3390/ijerph18020596] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 12/19/2022]
Abstract
(1) Background: A considerable number of systematic reviews, with substantial heterogeneity regarding their methods and included populations, on the impact of COVID-19 on infected pregnant women and their neonates, has emerged. The aim was to describe the obstetric-perinatal and neonatal outcome of infected pregnant women and their newborns during the COVID-19 pandemic; (2) Methods: Three bibliographical databases were searched (last search: September 10, 2020). Quality assessment was performed using the AMSTAR-2 tool. Primary outcomes included mode of delivery, preterm delivery/labor, premature rupture of membranes (PROM/pPROM) and abortions/miscarriages. Outcomes were mainly presented as ranges. A separate analysis, including only moderate and high-quality systematic reviews, was also conducted. The protocol was registered with PROSPERO (CRD42020214447); (3) Results: Thirty-nine reviews were analyzed. Reported rates, regarding both preterm and term gestations, varied between 52.3 and 95.8% for cesarean sections; 4.2-44.7% for vaginal deliveries; 14.3-63.8% specifically for preterm deliveries and 22.7-32.2% for preterm labor; 5.3-12.7% for PROM and 6.4-16.1% for pPROM. Maternal anxiety for potential fetal infection contributed to abortion decisions, while SARS-CoV-2-related miscarriages could not be excluded. Maternal ICU admission and mechanical ventilation rates were 3-28.5% and 1.4-12%, respectively. Maternal mortality rate was <2%, while stillbirth, neonatal ICU admission and mortality rates were <2.5%, 3.1-76.9% and <3%, respectively. Neonatal PCR positivity rates ranged between 1.6% and 10%. After accounting for quality of studies, ranges of our primary outcomes remained almost unchanged, while among our secondary outcomes, maternal ICU admission (3-10%) and mechanical ventilation rates (1.4-5.5%) were found to be relatively lower; (4) Conclusions: Increased rates of cesarean sections and preterm birth rates were found, with iatrogenic reasons potentially involved. In cases of symptomatic women with confirmed infection, high maternal and neonatal ICU admission rates should raise some concerns. The probability of vertical transmission cannot be excluded. Further original studies on women from all trimesters are warranted.
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Affiliation(s)
- Michail Papapanou
- Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (M.P.); (M.P.); (A.P.); (E.R.); (M.F.); (N.V.)
| | - Maria Papaioannou
- Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (M.P.); (M.P.); (A.P.); (E.R.); (M.F.); (N.V.)
| | - Aikaterini Petta
- Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (M.P.); (M.P.); (A.P.); (E.R.); (M.F.); (N.V.)
| | - Eleni Routsi
- Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (M.P.); (M.P.); (A.P.); (E.R.); (M.F.); (N.V.)
| | - Maria Farmaki
- Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (M.P.); (M.P.); (A.P.); (E.R.); (M.F.); (N.V.)
| | - Nikolaos Vlahos
- Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (M.P.); (M.P.); (A.P.); (E.R.); (M.F.); (N.V.)
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece
| | - Charalampos Siristatidis
- Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (M.P.); (M.P.); (A.P.); (E.R.); (M.F.); (N.V.)
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece
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13
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Halvatsiotis P, Siatelis A, Koulouvaris P, Batrinou A, Vougiouklaki D, Routsi E, Papapanou M, Trapali M, Houhoula D. Comparison of Q223R leptin receptor polymorphism to the leptin gene expression in Greek young volunteers. AIMSMEDS 2021. [DOI: 10.3934/medsci.2021025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
<abstract><sec>
<title>Objective</title>
<p>The objective of the present study was to identify the leptin gene expression and the leptin receptor polymorphisms in blood samples and to correlate gene expression values with anthropometric characteristics.</p>
</sec><sec>
<title>Methods</title>
<p>Blood from 140 Greek young volunteers was subjected to polymerase chain reaction–restricted fragment length polymorphism (PCR–RFLP), for the genomic region of Q223R polymorphism at codon 223 in the leptin receptor gene (<italic>LEPR</italic>) coding region. RNA extraction, cDNA synthesis and Quantitative Real-Time PCR was performed for assessing the expression of the leptin gene (<italic>LEP</italic>).</p>
</sec><sec>
<title>Results</title>
<p>Leptin gene was identified in all tested specimens and the gene was expressed in 88.9% of all volunteers with BMI < 25. In addition, it was observed that gene expression is affected by various external factors, such as Body Mass Index (BMI), eating behavior, gender and age. It was also shown that as for the Q223R polymorphism (A to G) allele G occurs with a frequency of 100% in men with BMI > 30 and 75.9% in men and 88.9% in women with BMI 25–30. Volunteers with BMI 25–30 who were homozygous on the G allele were 50% and 77.8% in men and women respectively. All subjects with a BMI > 30 were homozygous on the G allele at 100%.</p>
</sec><sec>
<title>Conclusions</title>
<p>In this small-scale study, results have shown that the leptin gene expression correlates with BMI and that the allele G in Q223R polymorphism is linked to overweight individuals.</p>
</sec></abstract>
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14
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Schizas D, Mastoraki A, Routsi E, Papapanou M, Tsapralis D, Vassiliu P, Toutouzas K, Felekouras E. Combined hepatocellular-cholangiocarcinoma: An update on epidemiology, classification, diagnosis and management. Hepatobiliary Pancreat Dis Int 2020; 19:515-523. [PMID: 32753331 DOI: 10.1016/j.hbpd.2020.07.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 01/31/2020] [Accepted: 07/17/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Combined hepatocellular-cholangiocarcinoma (CHC) is a rare subtype of primary hepatic malignancies, with variably reported incidence between 0.4%-14.2% of primary liver cancer cases. This study aimed to systematically review the epidemiological, clinicopathological, diagnostic and therapeutic data for this rare entity. DATA SOURCES We reviewed the literature of diagnostic approach of CHC with special reference to its clinical, molecular and histopathological characteristics. Additional analysis of the recent literature in order to evaluate the results of surgical and systemic treatment of this entity has been accomplished. RESULTS The median age at CHC's diagnosis appears to be between 50 and 75 years. Evaluation of tumor markers [alpha fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA)] along with imaging patterns provides better opportunities for CHC's preoperative diagnosis. Reported clinicopathologic prognostic parameters possibly correlated with increased tumor recurrence and grimmer survival odds include advanced age, tumor size, nodal and distal metastases, vascular and regional organ invasion, multifocality, decreased capsule formation, stem-cell features verification and increased GGT as well as CA19-9 and CEA levels. In case of inoperable or recurrent disease, combinations of cholangiocarcinoma-directed systemic agents display superior results over sorafenib. Liver-directed methods, such as transarterial chemoembolization (TACE), percutaneous ethanol injection (PEI), hepatic arterial infusion chemotherapy (HAIC), radioembolization and ablative therapies, demonstrate inferior efficacy than in cases of hepatocellular carcinoma (HCC) due to CHC's common hypovascularity. CONCLUSIONS CHC demonstrates an overlapping clinical and biological pattern between its malignant ingredients. Natural history of the disease seems to be determined by the predominant tumor element. Gold standard for diagnosis is histology of surgical specimens. Regarding therapeutic interventions, major hepatectomy is acknowledged as the cornerstone of treatment whereas minor hepatectomy and liver transplantation may be applied in patients with advanced cirrhosis. Despite all therapeutic attempts, prognosis of CHC remains dismal.
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Affiliation(s)
- Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Aikaterini Mastoraki
- Fourth Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
| | - Eleni Routsi
- Fourth Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Michail Papapanou
- Fourth Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | | | - Pantelis Vassiliu
- Fourth Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Konstantinos Toutouzas
- First Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Evangelos Felekouras
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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15
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Katsaros I, Routsi E, Papapanou M, Mastoraki A, Kontogeorgi E, Tsapralis D, Vlachos K, Schizas D. Supravesical hernias: a systematic review of the literature. ANZ J Surg 2020; 90:2187-2192. [PMID: 32808417 DOI: 10.1111/ans.16252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND A supravesical hernia (SH) is a rare abdominal wall hernia that is defined by the protrusion of abdominal viscera through the supravesical fossa. The objective of this study was to review current literature on SHs and elucidate their clinical manifestations and preferred therapeutic approach. METHODS PubMed, Embase and Cochrane bibliographical databases were searched (last search: 30 March 2020) for articles reporting on SHs. RESULTS Thirty-four studies met our inclusion criteria and involved collectively 38 patients (94.7% males) with an age of 59.57 ± 14.84 (mean ± standard deviation) years. Abdominal pain (81.6%) and nausea and vomit (71.1%) were the most frequently encountered symptoms. The majority of patients (78.1%) had signs of bowel obstruction. Twenty-nine patients (76.3%) suffered from an internal SH, while nine (23.7%) had an external one. An open hernia repair was conducted at 29 patients (76.3%), while eight (21.1%) had a laparoscopic approach and in one case (2.6%) the laparoscopic operation was converted to an open one. A mesh was applied at 14.3% of included cases. Eight patients (21.1%) underwent a bowel resection and hernia sac was resected at six (15.8%) cases. Four patients (11.8%) experienced postoperative complications and one patient (2.9%) died on first postoperative day. CONCLUSION SH is an extremely rare type of hernia occurring through the supravesical fossa between the remnants of urachus and foetal umbilical arteries. All clinicians should be aware of this entity and further studies are necessary in order to clarify their aetiology, true incidence and optimal therapeutic approach.
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Affiliation(s)
- Ioannis Katsaros
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Eleni Routsi
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Michail Papapanou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Aikaterini Mastoraki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Evangelia Kontogeorgi
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | | | | | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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