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Barmpakou A, Mavrouli M, Pana A, Kourkouni E, Panagiotou I, Spanakis N, Michos A. Seroprevalence of Measles in Pairs of Mothers and Newborns in Southern Greece. Viral Immunol 2023; 36:642-648. [PMID: 38127419 DOI: 10.1089/vim.2023.0047] [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] [Indexed: 12/23/2023] Open
Abstract
Maternal immunoglobulin G (IgG) antibodies that are passively transferred to newborns through the placenta confer protection if they are exposed to measles virus. A measles outbreak occurred in several European countries including Greece, between 2016 and 2018. A prospective study was conducted in the General Hospital of Lakonia, regarding the measles seropositivity status of mother and newborn pairs. IgG antibody titer for measles was measured in serum samples acquired from pairs of mothers and newborns. The samples were analyzed through quantitative enzyme-linked immunosorbent assay, and antimeasles IgG >200 IU/mL was considered to be protective. Demographic data for mothers and neonates and data regarding immunization status of mothers were analyzed. Study population included 206 mothers and their newborns. In total, 12.6% of mothers (n = 26) and 10.7% of newborns (n = 22) did not have protective serology. A statistically significant positive linear association between maternal and neonatal antibodies was found (rho = 0.924) (p = 0.001). Neonates whose mothers were seropositive had higher antibodies [geometric mean concentration (GMC): 804.8 (728.3-889.2)] than neonates whose mothers were seronegative/borderline [GMC: 97.7 (64.2-148.8)] (p = 0.001). In the study area, a significant rate of mothers and newborns was found to have nonprotective measles serology that exceeds the limit required for herd immunity. Vaccination coverage in women of reproductive age should be increased to reduce potential for future measles epidemics.
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Affiliation(s)
- Afroditi Barmpakou
- First Department of Pediatrics, Division of Infectious Diseases, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
- Department of Pediatrics, General Hospital of Lakonia, Sparti, Greece
| | - Maria Mavrouli
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Pana
- Department of Pediatrics, General Hospital of Lakonia, Sparti, Greece
| | - Eleni Kourkouni
- First Department of Pediatrics, Division of Infectious Diseases, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | | | - Nikolaos Spanakis
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Michos
- First Department of Pediatrics, Division of Infectious Diseases, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
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Kotoulas C, Georgiou C, Chouliaras E, Theodosiadis N, Kotoulas S, Kotoulas A, Panagiotou I. Diagnostic dilemma in spontaneous innominate artery pathology: a case report. Gen Thorac Cardiovasc Surg 2020; 69:367-370. [PMID: 32862367 DOI: 10.1007/s11748-020-01472-6] [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: 05/25/2020] [Accepted: 08/20/2020] [Indexed: 11/30/2022]
Abstract
We report the case of a 71-year-old female who presented with sudden onset of right cervical pain and ipsilateral arm hypoaesthesia. The diagnostic evaluation revealed a pathology of the origin of the innominate artery (IA). The differential diagnosis was among a spontaneous acute dissection and a ruptured pseudoaneurysm. The dilemma of the proper treatment emerged. Surgical or medical treatment? Open or endovascular approach? The patient was offered an open treatment under cardiopulmonary bypass and sort circulatory arrest. As less than ten cases of isolated IA dissection have been previously reported in the literature, we discuss the differential diagnosis difficulties and the treatment options.
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Affiliation(s)
- Christophoros Kotoulas
- Cardiac Surgery Department, 401 Army General Hospital of Athens, Kifissias Ave 38, 11526, Athens, Greece.
| | - Charalampos Georgiou
- Cardiac Surgery Department, 401 Army General Hospital of Athens, Kifissias Ave 38, 11526, Athens, Greece
| | | | - Nikolaos Theodosiadis
- Cardiac Surgery Department, 401 Army General Hospital of Athens, Kifissias Ave 38, 11526, Athens, Greece
| | | | | | - Ioannis Panagiotou
- Cardiac Surgery Department, 401 Army General Hospital of Athens, Kifissias Ave 38, 11526, Athens, Greece
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Kotoulas S, Grapatsas K, Leivaditis V, Panagiotou I, Spiridakis E, Le UT, Osei-Agyemang T, Kotoulas C. Massive pulmonary embolism due to hydatid cysts: A rare postoperative complication of liver echinococcosis. Respir Med Case Rep 2020; 30:101054. [PMID: 32373452 PMCID: PMC7193314 DOI: 10.1016/j.rmcr.2020.101054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/04/2020] [Accepted: 04/04/2020] [Indexed: 11/18/2022] Open
Abstract
Pulmonary embolism due to hydatid cysts is a very rare pathology. A 55-year-old male was transferred to our hospital due to respiratory failure, as a result of left pulmonary artery obstruction by cystic lesions. His medical history included multiple operations for abdominal echinococcosis. He was urgently operated for the extraction of the proximal hydatid cysts with the use of cardiopulmonary bypass with an excellent outcome and six months later through a right thoracotomy for the distal right pulmonary artery, the cysts were extracted. Meanwhile, he followed additional medication treatment with albendazole, preoperatively as well as postoperatively. Today, 5 years later, he has no evidence of hydatidosis recurrence.
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Affiliation(s)
- Sotirios Kotoulas
- Cardiothoracic Surgery Department, "Iaso" General Hospital, Athens, Greece
| | - Konstantinos Grapatsas
- Cardiothoracic Surgery Department, "Iaso" General Hospital, Athens, Greece.,Cardiac Surgery Department, 401 General Military Hospital of Athens, Athens, Greece.,Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, Germany
| | - Vasileios Leivaditis
- Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - Ioannis Panagiotou
- Cardiothoracic Surgery Department, "Iaso" General Hospital, Athens, Greece.,Cardiac Surgery Department, 401 General Military Hospital of Athens, Athens, Greece
| | | | - Uyen-Thao Le
- Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, Germany
| | - Thomas Osei-Agyemang
- Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, Germany
| | - Christophoros Kotoulas
- Cardiothoracic Surgery Department, "Iaso" General Hospital, Athens, Greece.,Cardiac Surgery Department, 401 General Military Hospital of Athens, Athens, Greece
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Kotoulas C, Georgiou C, Grapatsas K, Kotoulas S, Theodosiadis N, Panagiotou I. Cavernous hemangioma of the left atrium: A rare tumor. J Card Surg 2019; 35:202-203. [PMID: 31765014 DOI: 10.1111/jocs.14373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Konstantinos Grapatsas
- Department of Thoracic Surgery, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
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Kotoulas C, Georgiou C, Grapatsas K, Kotoulas S, Kagialaris G, Panagiotou I. “Atrial fibrillation as initial symptom of an intrapericardial bronchogenic cyst”. J Card Surg 2019; 34:1649-1650. [DOI: 10.1111/jocs.14356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Konstantinos Grapatsas
- Department of Thoracic Surgery, Faculty of Medicine Medical Center‐University of Freiburg Freiburg Germany
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Moraitis SD, Agrafiotis AC, Marinos L, Panagiotou I, Sakellaridis T, Tsakalakis C, Poulakidas E. Mediastinal debulking for a T-cell leukaemia/lymphoma presenting with cardiac tamponade. Monaldi Arch Chest Dis 2019; 89. [PMID: 31107038 DOI: 10.4081/monaldi.2019.1072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/09/2019] [Indexed: 11/23/2022] Open
Abstract
Anterior mediastinal masses are relatively uncommon and include a wide variety of lesions. Lymphomas account for 25% of anterior mediastinal masses. Lymphomas and other haematological malignancies are associated with pericardial effusion. There are also cases where a cardiac tamponade occurred. The aim of the case reported herein is to discuss the surgical approach and particularly the mediastinal debulking as an adjunct to systematic treatment for haematological diseases presenting as an anterior mediastinal mass responsible for a cardiac tamponade.
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Affiliation(s)
- Sotirios D Moraitis
- Joint Corps Armed Forces Cardiac Surgery Department, 401 Hellenic Army Hospital, Athens.
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Tsiambas E, Stamatelopoulos A, Karameris A, Panagiotou I, Rigopoulos D, Chatzimichalis A, Bouros D, Patsouris E. Simultaneous EGFR and VEGF Alterations in Non-Small Cell Lung Carcinoma Based on Tissue Microarrays. Cancer Inform 2017. [DOI: 10.1177/117693510700300026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Epidermal growth factor receptor (EGFR) overexpression is observed in significant proportions of non-small cell lung carcinomas (NSCLC). Furthermore, overactivation of vascular endothelial growth factor (VEGF) leads to increased angiogenesis implicated as an important factor in vascularization of those tumors. Patients and Methods Using tissue microarray technology, forty-paraffin ( n = 40) embedded, histologically confirmed primary NSCLCs were cored and re-embedded into a recipient block. Immunohistochemistry was performed for the determination of EGFR and VEGF protein levels which were evaluated by the performance of computerized image analysis. EGFR gene amplification was studied by chromogenic in situ hybridization based on the use of EGFR gene and chromosome 7 centromeric probes. Results EGFR overexpression was observed in 23/40 (57.5%) cases and was correlated to the stage of the tumors ( p = 0.001), whereas VEGF was overexpressed in 35/40 (87.5%) cases and was correlated to the stage of the tumors ( p = 0.005) and to the smoking history of the patients ( p = 0.016). Statistical significance was assessed comparing the protein levels of EGFR and VEGF ( p = 0.043, k = 0.846). EGFR gene amplification was identified in 2/40 (5%) cases demonstrating no association to its overall protein levels ( p = 0.241), whereas chromosome 7 aneuploidy was detected in 7/40 (17.5%) cases correlating to smoking history of the patients ( p = 0.013). Conclusions A significant subset of NSCLC is characterized by EGFR and VEGF simultaneous overexpression and maybe this is the eligible target group for the application of combined anti-EGFR/VEGF targeted therapies at the basis of genetic deregulation (especially gene amplification for EGFR).
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Affiliation(s)
- Evangelos Tsiambas
- Department of Pathology, Tissue Microarrays and Computerized Image Analysis Laboratory, 417 VA Hospital (NIMTS), Athens, Greece
- Departmentt of Pathology, Medical School, University of Athens, Greece
| | | | - Andreas Karameris
- Department of Pathology, Tissue Microarrays and Computerized Image Analysis Laboratory, 417 VA Hospital (NIMTS), Athens, Greece
- Departmentt of Pathology, Medical School, University of Athens, Greece
| | | | | | | | - Demosthenes Bouros
- Department of Respiratory Diseases, “Demokrition” University of Thrace, Alexandropole, Greece
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Affiliation(s)
- Christophoros Kotoulas
- 1 Department of Cardiothoracic Surgery, Bioclinic General Hospital of Athens, Athens, Greece
| | - Ioannis Panagiotou
- 1 Department of Cardiothoracic Surgery, Bioclinic General Hospital of Athens, Athens, Greece
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Kotoulas C, Panagiotou I, Tsipas P, Melachrinou M, Alexopoulos D, Dougenis D. Experimental studies in the bronchial circulation. Which is the ideal animal model? J Thorac Dis 2014; 6:1506-12. [PMID: 25364530 DOI: 10.3978/j.issn.2072-1439.2014.09.32] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/09/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND The importance of the role of bronchial arteries is notable in modern days thoracic surgery. The significance of their anastomoses with adjusted structures has not yet been sufficiently rated, especially in cases of haemoptysis, heart-lung transplantations and treatment of aneurysms of the thoracic aorta. The need of a thorough study is more relevant than ever and appropriate laboratory animals are required. METHODS We review the literature in order to highlight the ideal experimental animal for the implementation of pilot programs relative to the bronchial circulation. A comparative analysis of the anatomy of the bronchial arterial system in humans along with these of pigs, dogs, rats, and birds, as being the most commonly used laboratory animals, is presented in details. RESULTS The pig has the advantage that the broncho-oesophageal artery usually originates from the aorta as a single vessel, which makes the recognition and dissection of the artery easy to perform. In dogs, there is significant anatomical variation of the origin of the bronchial arteries. In rats, bronchial artery coming from the aorta is a rare event while in birds the pattern of the bronchial artery tree is clearly different from the human analog. CONCLUSIONS The pig is anatomically and physiologically suited for experimental studies on the bronchial circulation. The suitable bronchial anatomy and physiology along with the undeniable usefulness of the pig in experimental research and the low maintenance cost make the pig the ideal model for experiments in bronchial circulation.
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Affiliation(s)
- Christophoros Kotoulas
- 1 Department of Cardiothoracic Surgery, Army General Hospital of Athens, Athens, Greece ; 2 School of Medicine, University of Patras, Patras, Greece
| | - Ioannis Panagiotou
- 1 Department of Cardiothoracic Surgery, Army General Hospital of Athens, Athens, Greece ; 2 School of Medicine, University of Patras, Patras, Greece
| | - Panteleimon Tsipas
- 1 Department of Cardiothoracic Surgery, Army General Hospital of Athens, Athens, Greece ; 2 School of Medicine, University of Patras, Patras, Greece
| | - Maria Melachrinou
- 1 Department of Cardiothoracic Surgery, Army General Hospital of Athens, Athens, Greece ; 2 School of Medicine, University of Patras, Patras, Greece
| | - Dimitrios Alexopoulos
- 1 Department of Cardiothoracic Surgery, Army General Hospital of Athens, Athens, Greece ; 2 School of Medicine, University of Patras, Patras, Greece
| | - Dimitrios Dougenis
- 1 Department of Cardiothoracic Surgery, Army General Hospital of Athens, Athens, Greece ; 2 School of Medicine, University of Patras, Patras, Greece
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Kotoulas C, Panagiotou I, Tsipas P, Koutoulakis E. Inappropriate antidiuretic hormone secretion due to squamous cell lung cancer. Asian Cardiovasc Thorac Ann 2014; 23:579-81. [PMID: 25037146 DOI: 10.1177/0218492314544128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The syndrome of inappropriate secretion of antidiuretic hormone is a disorder of impaired water excretion caused by the inability to suppress secretion of antidiuretic hormone. It has been commonly associated with small cell carcinoma. The association of this syndrome with squamous cell lung carcinoma has rarely been reported, with only 4 cases over the past two decades in the English literature. We describe the case of a 75-year-old Caucasian male who developed the syndrome after a right pneumonectomy for down-staged squamous cell lung cancer previously treated with neoadjuvant platinum-based chemotherapy and radiotherapy.
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Affiliation(s)
- Christophoros Kotoulas
- Cardiothoracic Surgery and Cardiology Departments, Iaso General Hospital, Athens, Greece
| | - Ioannis Panagiotou
- Cardiothoracic Surgery and Cardiology Departments, Iaso General Hospital, Athens, Greece
| | - Panteleimon Tsipas
- Cardiothoracic Surgery and Cardiology Departments, Iaso General Hospital, Athens, Greece
| | - Emmanouil Koutoulakis
- Cardiothoracic Surgery and Cardiology Departments, Iaso General Hospital, Athens, Greece
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Panagiotou I, Tsilika E, Parpa E, Patiraki E, Zygogianni A, Kouloulias V, Mystakidou K. Locus of control and distressing symptoms in young cancer patients when assessing depression. J BUON 2014; 19:792-798. [PMID: 25261669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The aim of the current study was to evaluate the correlation between depression, sense of control (internal and external) and cancer-related distressing symptoms in younger patients (<65 years) with locally advanced or metastatic cancer, and to investigate their potential predictive role when screening for depression. METHODS 70 patients completed the Beck Depression Inventory (BDI), the Cancer Locus of Control Scale, the Linear Analogue System Assessment (LASA) (for Quality of Life/ QoL) and the M.D. Anderson Symptom Inventory (MDASI). Distressing symptoms, QoL, and locus of control (LOC) were correlated with the presence of depression. RESULTS The total BDI score was suggestive of depression. In univariate analysis significant correlations were found between the presence of depression and poor QoL, low Eastern Cooperative Oncology Group performance status and 'sense of control over the course of cancer' (p<0.0005). Depression was significantly correlated with pain, distress and poor general activity, overall enjoyment of life and relationships (p=0.004), as well as anxiety, fatigue, anorexia, dyspnoea and sleep disturbances (p=0.001). Multivariate analysis demonstrated that poor QoL and 'sense of control over the course of cancer', as well as anxiety, fatigue, anorexia, dyspnoea and sleep disturbances were significantly correlated with depression (p<0.0005). CONCLUSIONS We suggest that younger cancer patients' poor QoL, 'sense of control over the course of cancer', as well as anxiety, fatigue, anorexia, dyspnoea and sleep disturbances are significantly correlated with the presence of depression and can eventually represent potential screening predictors.
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Affiliation(s)
- I Panagiotou
- Pain Relief and Palliative Care Unit, Department of Radiology, "Areteion" Hospital, School of Medicine, Kapodistrian University of Athens, Athens, Greece
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Kotoulas C, Panagiotou I, Koutoulakis E. Acute type A intramural hematoma mimicking saccular aneurysm in aortography. Asian Cardiovasc Thorac Ann 2014; 22:232-3. [PMID: 24585806 DOI: 10.1177/0218492312468120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Sakellaridis T, Koukis I, Marouflidou T, Panagiotou I, Piyis A, Tsolakis K. Intrapulmonary solitary fibrous tumor masquerade sigmoid adenocarcinoma metastasis. Korean J Thorac Cardiovasc Surg 2013; 46:295-8. [PMID: 24003413 PMCID: PMC3756163 DOI: 10.5090/kjtcs.2013.46.4.295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 01/25/2013] [Accepted: 03/07/2013] [Indexed: 12/01/2022]
Abstract
Solitary fibrous tumor is a rare spindle cell mesenchymal tumor entity, with either benign or malignant behavior that cannot be accurately predicted by histological findings. An intrapulmonary site of origin is even rarer. We report a case of a 51-year-old woman in whom an abnormal nodule in the lower right lung was detected during staging for sigmoid adenocarcinoma. The nodule was excised and pathological examination revealed an intrapulmonary solitary fibrous tumor.
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Mystakidou K, Parpa E, Tsilika E, Panagiotou I, Galanos A, Gouliamos A. The influence of distressing symptoms to levels of depression in cancer patients. J BUON 2013; 18:751-759. [PMID: 24065495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Our objectives were to identify the depression and the distressing symptoms in younger and elderly advanced cancer patients. METHODS : The instruments that have been used were the Beck Depression Inventory (BDI) for younger patients, the Geriatric Depression Scale (GDS) for geriatric patients and the M. D. Anderson Symptom Inventory (MDASI) for the severity and impact of cancer-related symptoms. RESULTS A trend for significant correlation was found between the GDS and MDASI symptoms for nausea (p=0.058), while a significant correlation was observed for increased sadness (p=0.011), increased constipation (p=0.021), interference of symptoms in mood (p=0.012) and in relations with people (p=0.007); interference of symptoms in mood was the most important risk factor. For younger patients, many statistically significant associations were found between distressing symptoms and depression; however, interference of symptoms in mood (p=0.045) was the only important risk factor. CONCLUSION Health-care professionals should take into consideration the risk factors for depressive symptoms suggesting a holistic care in advanced cancer patients.
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Affiliation(s)
- K Mystakidou
- Pain Relief and Palliative Care Unit, Department of Radiology, Aretaieion Hospital, School of Medicine, University of Athens, Athens, Greece
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Sakellaridis T, Panagiotou I, Gaitanakis S, Katsenos S. Subpleural lipoma: Management of a rare intrathoracic tumor. Int J Surg Case Rep 2013; 4:463-5. [PMID: 23562893 DOI: 10.1016/j.ijscr.2013.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 02/24/2013] [Accepted: 02/25/2013] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Subpleural lipomas are rare intrathoracic benign tumors. They are often discovered incidentally on plain chest radiographs and the diagnosis is usually established by computed tomography. PRESENTATION OF CASE We report a case of subpleural lipoma, with enlargement during a period of two years. Pathology examination of the specimen confirmed the diagnosis of lipoma. DISCUSSION For non-invasive diagnostic investigation, computed tomography enables the identification and quantification of subpleural lipoma due to their characteristic fat attenuation. Surgical resection with thoracotomy or VATS provides more accurate and firm diagnosis, and complete excision. CONCLUSION This clinical entity needs attention due to difficult preoperative differentiation. Complete surgical excision of these lesions with the appropriate surgical approach is mandatory, for both diagnosis and treatment.
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Affiliation(s)
- Timothy Sakellaridis
- Thoracic Surgery Department, 401 Military Hospital, Katehaki Ave & Mesogion Ave, 11525 Athens, Greece.
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Mystakidou K, Tsilika E, Parpa E, Panagiotou I, Galanos A, Gouliamos A. Differences in levels of self-efficacy and anxiety between cancer and chronically-ill patients attending a Palliative Care Unit. J BUON 2012; 17:785-790. [PMID: 23335542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE To investigate the differences in anxiety and self-efficacy beliefs as well as the sociodemographic and clinical characteristics, between cancer and chronically-ill patients. METHODS A total of 175 patients from a pain relief and palliative care unit participated in this study. Patient sociode-mographic and clinical characteristics were recorded. Patients completed the Greek version of the Spielberger State-Trait Anxiety Inventory (STAI) and the Greek version of the General Perceived Self-Efficacy Scale (GSE). RESULTS No statistically significant differences were found between the two patient populations regarding self-efficacy. Statistically significant differences were found between chronically-ill and cancer patients in the scales of "emotionality" (p<0.0005), and "self-deprecation" (p<0.0005). Statistically significant negative correlations were found between all STAI scales and self-efficacy for both cancer and chronically-ill patients (r ranged from -0.231 to -0.503). CONCLUSION Chronically-ill patients experienced increased anxiety compared to cancer patients. Self-efficacy had a significant negative correlation with anxiety between the two groups of patients.
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Affiliation(s)
- K Mystakidou
- Pain Relief and Palliative Care Unit, Department of Radiology, Aretaieion Hospital, School of Medicine, University of Athens, Athens, Greece.
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Panagiotou I, Tsiambas E, Lazaris AC, Kavantzas N, Konstantinou M, Kalkandi P, Ragkos V, Metaxas GE, Roukas DK, Vilaras G, Patsouris E. PTEN expression in non small cell lung carcinoma based on digitized image analysis. J BUON 2012; 17:719-723. [PMID: 23335531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE HER2 depended signalling pathway is dereg-ulated in a subset of non small cell lung carcinoma (NSCLC). The tumor suppressor gene PTEN (10q21) regulates the HER2/PI3K/Akt signalling pathway. Our aim was to evaluate PTEN protein expression in NSCLC based on a quantitative analysis method correlating also the results with clinicopathological parameters. METHODS Protein expression was determined by immunohistochemistry (IHC) in 61 paraffin-embedded cases of patients with NSCLC. Digital image analysis (staining intensity levels) was performed in the corresponding immunostained slides. RESULTS Loss of PTEN expression was observed in 24 (39.34%) cases, low expression in 29 (47.54%) and overexpression in 8 (13.12%) cases. Multivariate analysis determined that PTEN overexpression was associated with lower risk to develop metastases (p=0.05). CONCLUSION PTEN deregulation is a relatively frequent genetic event in NSCLC, associated with progressive metastatic process in those patients. Because of binding to the ErbB2 receptor, trastuzumab stabilizes and activates PTEN gene, and loss of its expression negatively affects the response rates in such patients.
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Affiliation(s)
- I Panagiotou
- Department of Thoracic Surgery, 401 GA Hospital of Athens, Athens, Greece
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Mystakidou K, Parpa E, Panagiotou I, Tsilika E, Galanos A, Gouliamos A. Caregivers' anxiety and self-efficacy in palliative care. Eur J Cancer Care (Engl) 2012; 22:188-95. [DOI: 10.1111/ecc.12012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sakellaridis T, Panagiotou I, Arsenoglou A, Kaselouris K, Piyis A. Re-expansion pulmonary edema in a patient with total pneumothorax: a hazardous outcome. Gen Thorac Cardiovasc Surg 2012; 60:614-7. [PMID: 22627959 DOI: 10.1007/s11748-012-0067-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 12/13/2011] [Indexed: 10/28/2022]
Abstract
Re-expansion pulmonary edema (REPE) is a rare complication of treatment of spontaneous pneumothorax or large pleural effusions. As a complication of spontaneous pneumothorax treatment, only few cases are documented, and even fewer document the role of non-invasive continuous positive airway pressure mechanical ventilation for treatment of this rare entity. We present a case of 23-year-old man who presented with left-sided pneumothorax, developed unilateral REPE and was treated with non-invasive continuous positive airway pressure.
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Affiliation(s)
- Timothy Sakellaridis
- Department of Thoracic Surgery, 401 Military Hospital of Athens, Ave Kanellopoulou & Ave Mesogion, 11525 Athens, Greece.
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Panagiotou I, Georgiannos SN, Tsiambas E, Karameris A, Konstantinou M, Lazaris AC, Kavantzas N, Vilaras G, Patsouris E. Impact of HER2 and PTEN simultaneous deregulation in non-small cell lung carcinoma: correlation with biological behavior. Asian Pac J Cancer Prev 2012; 13:6311-8. [PMID: 23464451 DOI: 10.7314/apjcp.2012.13.12.6311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HER2/neu overexpression due to gene amplification is an important factor in breast cancer, modifying the sensitivity to anti-HER2 monoclonal antibody therapy. The clinical significance of HER2 expression in non small cell lung carcinoma (NSCLC) is currently under evaluation. The tumor suppressor gene PTEN negatively regulates the HER2/PI3K/Akt signalling pathway. The purpose of this study was to evaluate the role of simultaneous alteration in HER2 and PTEN protein expression in relation to biological behaviour of NSCLCs. MATERIALS AND METHOD Protein expression was determined by immunohistochemistry in sixty-one (n=61) NSCLC cases along with CISH for HER2 gene analysis and detection of chromosome 17 aneuploidy. Patients were followed-up for a period of 34 to 41 months after surgery. RESULTS HER2 overexpression (2+/3+ score) was detected in 17 (27.9%) patients while loss of PTEN expression was observed in 24 (39.3%) cases, low expression in 29 (47.6%) and overexpression in 8 (13.1%). Simultaneous HER2 overexpression and PTEN low/loss of expression were correlated with metastasis (71.4% vs 36.2% p=0.03) . Analysis in the subgroup of 22 patients of pTNM stage III with lymph node status N1 or N2 revealed that there was a relationship between the number of positive regional lymph node groups and simultaneous deregulation of the two genes (p=0.04). Multivariate analysis determined that HER2 overexpression was associated with an increasing risk of developing metastases (OR: 4.3; 95%CI: 1.2-15.9; p: 0.03) while PTEN overexpression was associated with lower risk (OR: 0.1; 95%CI: 0.1, 1.0; p: 0.05). CONCLUSIONS Simultaneous HER2/PTEN deregulation is a significant genetic event that leads to a more aggressive phenotype of NSCLC.
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Affiliation(s)
- Ioannis Panagiotou
- Department of Thoracic Surgery, 401 General Military Hospital, Athens, Greece.
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21
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Mystakidou K, Parpa E, Tsilika E, Panagiotou I, Galanos A, Sakkas P, Gouliamos A. Posttraumatic stress disorder and preparatory grief in advanced cancer. J BUON 2012; 17:155-159. [PMID: 22517711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE The purpose of the current study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and its association with sociodemographic variables and preparatory grief in patients with advanced cancer. METHODS 195 advanced cancer patients participated in the study. Out of them, 170 had PTSD and 25 had other anxiety disorders. The diagnoses were made in strict accordance with Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I)-Clinician version. Patients completed also the Preparatory Grief in Advanced Cancer Patients (PGAC) scale. RESULTS Patients with PTSD were younger (63.54 ± 12.07 years) than those without PTSD (70.36 ± 13.03 years, p=0.010). Patients with PTSD revealed more preparatory grief (37.69 ± 12.11) than those without PTSD (29.58 ± 14.04, p= 0.003). Multiple logistic regression analysis showed that preparatory grief (p=0.012), and metastatic disease (p=0.009) remained in the model whereas age showed a trend for independent significance (p=0.067). CONCLUSION In advanced cancer stages, younger patients, those with metastatic disease or patients with elevated scores on preparatory grief seemed to have a greater likelihood to develop PTSD. Thus, given the prevalence of PTSD in advanced cancer patients, health care professionals should be able to better recognize those who are at risk for or exhibit symptoms of this disorder so that appropriate treatment referrals can be made.
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Affiliation(s)
- K Mystakidou
- Pain Relief & Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, Greece.
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Panagiotou I, Kostikas K, Sampaziotis D, Kotoulas C. Alveolar adenoma: an extremely rare innocent coin lesion. Interact Cardiovasc Thorac Surg 2011; 14:335-7. [PMID: 22159242 DOI: 10.1093/icvts/ivr040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Alveolar adenoma is an extremely rare benign tumour of the lung. Less than 30 cases have been reported in the English literature. A 42-year-old asymptomatic female who presented with a solitary peripheral pulmonary nodule on chest roentgenogram underwent thoracoscopic wedge resection and was diagnosed with this rare tumour. The indolent clinical progression and the absence of recurrence and metastasis after complete resection are the most important characteristics of this tumour. The classical solitary pulmonary nodule is a common and vexing problem. Nodules are extremely common in clinical practice and challenging to manage. Solitary pulmonary nodules can represent different specific lung diseases, focal non-specific inflammations, and primary and secondary malignant tumours. Identification of malignant nodules is important because they represent a potentially curable form of lung cancer.
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Affiliation(s)
- Ioannis Panagiotou
- Department of Thoracic Surgery, 401 General Military Hospital, Athens, Greece
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Syrigou E, Panagiotou I, Chouliaras G, Pitsios K, Kanariou M, Roma E. Food Allergy Related Pediatric Constipation: Appropriate Time Of Tolerance. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Panagiotou I, Patris K, Kotileas P, Kotoulas C. Dissection of the aortic root presenting as a double aortic valve. Hellenic J Cardiol 2010; 51:275-277. [PMID: 20515863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
We report a case of aortic root dissection in a middle-aged male without history of recent trauma, presenting as a critical aortic regurgitation due to right cusp dislodgement. The intraoperative transesophageal echocardiogram revealed the "double aortic valve" sign suggestive of low dissection, which proved to extend to both coronary arteries.
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Affiliation(s)
- Ioannis Panagiotou
- Cardiothoracic Surgery Department, Iaso General Hospital of Athens, 38 Kifissias Avenue, Athens, Greece
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Affiliation(s)
- M Konstantinou
- Second Department of General Thoracic Surgery, Sotiria General Hospital of Chest Diseases, Athens, Greece
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Syrigou E, Panagiotou I, Pachoula I, Salavoura M, Kanariou M, Chroussos G, Roma-Giannikou E. Atopy Patch Test for The Diagnosis of Food Allergy in Children with Chronic Constipation. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sakellaridis T, Koulaxouzidis G, Panagiotou I, Kigka C, Papamichalis G, Antypas G. Aspiration of fixed dental prosthesis following maxillofacial trauma. Emerg Med J 2008; 25:143. [PMID: 18299360 DOI: 10.1136/emj.2007.050807] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- T Sakellaridis
- 2nd Department of Thoracic Surgery, Sotiria General Hospital of Chest Diseases, Athens, Greece.
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Panagiotou I, Kelekis DA, Karatza C, Nikolaou V, Mouyia V, Brountzos EN. Treatment of Budd-Chiari syndrome by transjugular intrahepatic portosystemic shunt. Hepatogastroenterology 2007; 54:1813-1816. [PMID: 18019724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Patients with Budd-Chiari syndrome may require therapy with portal decompressive surgery. Transjugular intrahepatic portosystemic shunt has recently emerged as a new treatment alternative to surgical shunting, but reported literature is scarce and its long-term outcome is to be evaluated. The aim of our study was to present two patients with Budd-Chiari syndrome treated with transjugular intrahepatic portosystemic shunt. Two female patients with acute and subacute Budd-Chiari syndrome respectively, uncontrolled by medical therapy, were referred for transjugular intrahepatic portosystemic shunting. Both patients had refractory ascites, while one had hepatic insufficiency. Hepatic vein thrombosis was without definitive etiology in one patient and due to essential thrombocytosis in the other. Transjugular intrahepatic portosystemic shunt was successfully created in both patients; in one a transcaval approach was performed. Bare stents were used in one, while in the other a polytetrafluoroethylene-covered stent-graft. Technical success was 100% with no complications. Ascites resolved in both patients and liver function improved. The first patient remains asymptomatic with good shunt patency 6 months after intervention. The second patient is symptom-free two years after the shunt creation, despite stent occlusion. She remains asymptomatic due to hepatic vein collateral development. In patients with acute or subacute Budd-Chiari syndrome uncontrolled by medical therapy, transjugular intrahepatic portosystemic shunt is highly effective with no complications and an associated mid-term clinical success.
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Affiliation(s)
- I Panagiotou
- 2nd Department of Radiology, Athens University School of Medicine, Attikon University Hospital Athens, Greece
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Tsiambas E, Stamatelopoulos A, Karameris A, Panagiotou I, Rigopoulos D, Chatzimichalis A, Bouros D, Patsouris E. Simultaneous EGFR and VEGF alterations in non-small cell lung carcinoma based on tissue microarrays. Cancer Inform 2007; 3:275-84. [PMID: 19455247 PMCID: PMC2675836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) overexpression is observed in significant proportions of non-small cell lung carcinomas (NSCLC). Furthermore, overactivation of vascular endothelial growth factor (VEGF) leads to increased angiogenesis implicated as an important factor in vascularization of those tumors. PATIENTS AND METHODS Using tissue microarray technology, forty-paraffin (n = 40) embedded, histologically confirmed primary NSCLCs were cored and re-embedded into a recipient block. Immunohistochemistry was performed for the determination of EGFR and VEGF protein levels which were evaluated by the performance of computerized image analysis. EGFR gene amplification was studied by chromogenic in situ hybridization based on the use of EGFR gene and chromosome 7 centromeric probes. RESULTS EGFR overexpression was observed in 23/40 (57.5%) cases and was correlated to the stage of the tumors (p = 0.001), whereas VEGF was overexpressed in 35/40 (87.5%) cases and was correlated to the stage of the tumors (p = 0.005) and to the smoking history of the patients (p = 0.016). Statistical significance was assessed comparing the protein levels of EGFR and VEGF (p = 0.043, k = 0.846). EGFR gene amplification was identified in 2/40 (5%) cases demonstrating no association to its overall protein levels (p = 0.241), whereas chromosome 7 aneuploidy was detected in 7/40 (17.5%) cases correlating to smoking history of the patients (p = 0.013). CONCLUSIONS A significant subset of NSCLC is characterized by EGFR and VEGF simultaneous overexpression and maybe this is the eligible target group for the application of combined anti-EGFR/VEGF targeted therapies at the basis of genetic deregulation (especially gene amplification for EGFR).
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Affiliation(s)
- Evangelos Tsiambas
- Department of Pathology, Tissue Microarrays and Computerized Image Analysis Laboratory, 417 VA Hospital (NIMTS), Athens, Greece,Departmentt of Pathology, Medical School, University of Athens, Greece,Correspondence: Capt Evangelos Tsiambas, MD, Ph.D., MC., Department of Pathology, Tissue Microarrays and Computerized Image Analysis Laboratory, 417 VA Hospital (NIMTS), 17 Patriarchou Grigoriou Street, 153 41 Ag Paraskevi, Athens, Greece. Tel/Fax: +30 210 7297977;
| | | | - Andreas Karameris
- Department of Pathology, Tissue Microarrays and Computerized Image Analysis Laboratory, 417 VA Hospital (NIMTS), Athens, Greece,Departmentt of Pathology, Medical School, University of Athens, Greece
| | | | | | | | - Demosthenes Bouros
- Department of Respiratory Diseases, “Demokrition” University of Thrace, Alexandropole, Greece
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Sakellaridis T, Panagiotou I, Georgantas T, Micros G, Rontogianni D, Antiochos C. Undifferentiated embryonal sarcoma of the liver mimicking acute appendicitis. Case report and review of the literature. World J Surg Oncol 2006; 4:9. [PMID: 16504010 PMCID: PMC1403776 DOI: 10.1186/1477-7819-4-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2005] [Accepted: 02/20/2006] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Undifferentiated embryonal sarcoma (UES) of liver is a rare malignant neoplasm, which affects mostly the pediatric population accounting for 13% of pediatric hepatic malignancies, a few cases has been reported in adults. CASE PRESENTATION We report a case of undifferentiated embryonal sarcoma of the liver in a 20-year-old Caucasian male. The patient was referred to us for further investigation after a laparotomy in a district hospital for spontaneous abdominal hemorrhage, which was due to a liver mass. After a through evaluation with computed tomography scan and magnetic resonance imaging of the liver and taking into consideration the previous history of the patient, it was decided to surgically explore the patient. Resection of I-IV and VIII hepatic lobe. Patient developed disseminated intravascular coagulation one day after the surgery and died the next day. CONCLUSION It is a rare, highly malignant hepatic neoplasm, affecting almost exclusively the pediatric population. The prognosis is poor but recent evidence has shown that long-term survival is possible after complete surgical resection with or without postoperative chemotherapy.
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Affiliation(s)
| | | | | | - George Micros
- 1Surgical Department, 401 Army Force General Hospital of Athens, Greece
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31
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Brountzos EN, Petersen B, Binkert C, Panagiotou I, Kaufman JA. Primary Stenting of Subclavian and Innominate Artery Occlusive Disease: A Single Center?s Experience. Cardiovasc Intervent Radiol 2004; 27:616-23. [PMID: 15578138 DOI: 10.1007/s00270-004-0218-y] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To review immediate and midterm results of primary stenting for innominate and subclavian artery occlusive lesions. METHODS Retrospective data were collected from 48 consecutive symptomatic patients (27 men and 21 women, median age 64 years) having 49 subclavian and innominate artery lesions treated with stenting. Of the patients 52% had concomitant ischemic heart disease, and 30% had carotid and/or vertebral artery disease. Indication for treatment was vertebrobasilar insufficiency (VBI) in 16.6% of the patients; upper limb ischemia (ULI) in 31.3%; VBI and ULI in 12.5%; transient ischemic attack in 16.7%; angina in 12.5% before or after left internal mammary artery-to-coronary artery bypass grafting; and leg claudication in 10.4% before or after axillofemoral bypass grafting. Balloon-expandable stents were used in 44 lesions and self-expandable stents in 5 lesions. In total, 53 stents were placed in 48 patients. RESULTS Technical success was 96%, and clinical success 94%. We encountered four complications (two puncture site hematomas, one distal hand embolization and one transient cerebral ischemia). Two patients died within 30 days from other causes, and seven patients were lost to follow-up. Mean follow-up time was 16.7 months (range 0.3 to 68.2). Five patients had recurrent lesions treated by surgical (n = 2) or endovascular (n = 3) means. Cumulative primary patency rate was 91.7% and 77% at 12 and 24 months, respectively. Cumulative secondary patency rate was 96.5% and 91.7% at 12 and 24 months, respectively. CONCLUSION Stenting of subclavian and innominate artery lesions resulted in immediate resolution of patients' symptoms with durable midterm effect and few complications in a larger patient group with serious comorbid conditions.
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Affiliation(s)
- E N Brountzos
- Dotter Interventional Institute, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Rd., L342, Portland, Oregon 97201-3098, USA.
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el-Geneidy M, Garzotto M, Panagiotou I, Hsieh YC, Mori M, Peters L, Klein T, Beer TM. Delayed therapy with curative intent in a contemporary prostate cancer watchful-waiting cohort. BJU Int 2004; 93:510-5. [PMID: 15008720 DOI: 10.1111/j.1464-410x.2003.04669.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To identify predictors of delayed therapy with curative intent, an increasingly common option in contemporary patients with prostate cancer who initially choose watchful waiting. PATIENTS AND METHODS The characteristics of all patients at one institution and diagnosed with T1-4NXM0 prostate cancer between 1993 and 2000 were prospectively recorded. Factors recorded included: age, tumour stage, histological type, Gleason score, serum prostate specific antigen (PSA) level, prostate volume, PSA density (PSAD), percentage of positive biopsy cores, and the initial treatment selection. Outcomes, including all cancer-directed interventions, all serum PSA values, and initial outcomes of all interventions with curative intent, were determined by review of all medical records and cancer registry data. RESULTS Of 187 patients on watchful waiting, 175 had stage T1 or T2 cancer and were analysed primarily. Thirty-eight (22%) of these patients received delayed intervention with curative intent (15 radical prostatectomy, 17 external beam radiotherapy, six brachytherapy). Age (P < 0.001) and percentage of positive biopsy cores (P = 0.042) were significant independent predictors of intervention with curative intent. When the PSA doubling time was added to the model it became a significant predictor (P = 0.018), with percentage positive biopsy cores (P = 0.022) and age (P < 0.001). CONCLUSIONS Therapy with curative intent is common in contemporary patients with prostate cancer who initially choose watchful waiting. Age and percentage positive biopsy cores are independent predictors of such intervention, with PSA doubling time also an independent predictor.
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Affiliation(s)
- M el-Geneidy
- Oregon Health & Science University, Department of Medicine, Division of Hematology & Medical Oncology, Oregon, USA
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Abstract
A retrospective study of 385 melanoma patients was performed, with the goal of evaluating the clinical characteristics, the role of imaging and the impact of treatment on patients with gastrointestinal (GI) metastases. Eighteen patients (4.7%) had GI tract metastases. In 50% the primary lesion was on the lower extremities (P< 0.01), while 61.1% had nodular melanomas (P < 0.01). Imaging and/or endoscopy were undertaken in 72.2% of the patients, yielding positive results in all. Eight patients underwent curative surgery, two received no treatment, while the remaining eight patients had chemotherapy or immunochemotherapy. Long-term palliation was offered to 87.5% of the surgical patients compared with 50% of the patients treated medically. Median survival in the patients treated with surgery was 47.5 months compared with 5.8 months in the medical group (P < 0.01). GI tract metastases were more common in patients with nodular melanoma of the lower extremities. To our knowledge, this is the first study correlating the primary lesion's characteristics with the development of GI tract metastases. Imaging is effective in the diagnosis of GI tract involvement. Melanoma patients with GI tract metastases can benefit from palliation by surgical resection. Survival is improved when such patients are treated with curative surgery.
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Affiliation(s)
- I Panagiotou
- Second Department of Medical Oncology, Metaxa Cancer Hospital, Piraeus, Greece
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