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Viazis N, Drygiannakis I, Karmiris K, Theodoropoulou A, Zampeli E, Tzouvala M, Bamias G, Liatsos C, Theocharis G, Vrakas S, Tsironi E, Mathou N, Mantaka A, Christidou A, Koustenis K, Veretanos C, Papathanasiou E, Zacharopoulou E, Tribonias G, Kitsou V, Kartsoli S, Theodoulou A, Michopoulos S, Thomopoulos K, Koutroubakis IE, Mantzaris GJ. The natural history of COVID-19 in vaccinated inflammatory bowel disease patients. Dig Liver Dis 2023; 55:305-309. [PMID: 36658043 PMCID: PMC9843500 DOI: 10.1016/j.dld.2022.12.012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/07/2022] [Accepted: 12/15/2022] [Indexed: 01/18/2023]
Abstract
AIM Assess the characteristics of break through COVID-19 in Inflammatory Bowel Disease (IBD) patients, despite complete vaccination. METHODS Patients who reported a COVID-19 at least 3 weeks after complete vaccination were asked to answer an on-line anonymous questionnaire which included patient and disease characteristics, vaccination history, and the evolution of COVID-19. RESULTS Among 3240 IBD patients who reported complete vaccination between 1st May 2021 and 30thJune 2022, 402 (12.4%) were infected by SARS Cov-2 [223 male, 216 Crohn's disease (CD), 186 Ulcerative Colitis (UC), mean (SD) age 42.3 (14.9) years, mean (SD) IBD duration 10.1 (9.7) years]. Three hundred and sixty-nine patients (91.8%) were infected once and 33 (8.2%) twice. The mean (SD) time between last vaccination and infection was 4.1 (1.6) months. Overall, 351 (87.3%) patients reported mild constitutional and/or respiratory symptoms, 34 (8.4%) were asymptomatic and only 17 patients (4.2%) required hospitalization. Of hospitalized patients, 2 UC patients died of COVID-19 pneumonia. The remaining hospitalized patients did not need high flow oxygen supply or ICU admission. CONCLUSIONS A minority of completely vaccinated IBD patients developed COVID-19 which evolved with mild symptoms and a favorable outcome. These results reinforce the importance of vaccination especially in vulnerable populations.
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Affiliation(s)
- N Viazis
- Gastroenterology Department, Evangelismos-Polykliniki General Hospital, Athens, Greece.
| | - I Drygiannakis
- Gastroenterology Department, University Hospital of Heraklion, Crete, Greece
| | - K Karmiris
- Gastroenterology Department, Venizeleio General Hospital Heraklion, Crete, Greece
| | - A Theodoropoulou
- Gastroenterology Department, Venizeleio General Hospital Heraklion, Crete, Greece
| | - E Zampeli
- Gastroenterology Department, Alexandra General Hospital, Greece
| | - M Tzouvala
- Gastroenterology Department, General Hospital Nikaia Piraeus Agios Panteleimon-General Hospital Dytikis Attikis Agia Varvara, Greece
| | - G Bamias
- Gastroenterology Unit, 3rd Academic Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Greece
| | - C Liatsos
- Gastroenterology Department, 401 General Military Hospital of Athens, Greece
| | - G Theocharis
- Gastroenterology Department, University Hospital of Patras, Greece
| | - S Vrakas
- Gastroenterology Department, Tzaneio Hospital, Piraeus, Greece
| | - E Tsironi
- Gastroenterology Department, Metaxa Hospital, Piraeus, Greece
| | - N Mathou
- Gastroenterology Department, "Konstantopoulio-Patision" General District Hospital, Nea Ionia, Athens, Greece
| | - A Mantaka
- Gastroenterology Department, General Hospital of Chania, Crete, Greece
| | - A Christidou
- Gastroenterology Department, Evangelismos-Polykliniki General Hospital, Athens, Greece
| | - K Koustenis
- Gastroenterology Department, Evangelismos-Polykliniki General Hospital, Athens, Greece
| | - Ch Veretanos
- Gastroenterology Department, Evangelismos-Polykliniki General Hospital, Athens, Greece
| | - E Papathanasiou
- Gastroenterology Department, Alexandra General Hospital, Greece
| | - E Zacharopoulou
- Gastroenterology Department, General Hospital Nikaia Piraeus Agios Panteleimon-General Hospital Dytikis Attikis Agia Varvara, Greece
| | - G Tribonias
- Gastroenterology Department, General Hospital Nikaia Piraeus Agios Panteleimon-General Hospital Dytikis Attikis Agia Varvara, Greece
| | - V Kitsou
- Gastroenterology Unit, 3rd Academic Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Greece
| | - S Kartsoli
- Gastroenterology Department, Tzaneio Hospital, Piraeus, Greece
| | - A Theodoulou
- Gastroenterology Department, Metaxa Hospital, Piraeus, Greece
| | - S Michopoulos
- Gastroenterology Department, Alexandra General Hospital, Greece
| | - K Thomopoulos
- Gastroenterology Department, University Hospital of Patras, Greece
| | - I E Koutroubakis
- Gastroenterology Department, University Hospital of Heraklion, Crete, Greece
| | - G J Mantzaris
- Gastroenterology Department, Evangelismos-Polykliniki General Hospital, Athens, Greece
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Foteinogiannopoulou K, Karmiris K, Axiaris G, Velegraki M, Gklavas A, Kapizioni C, Karageorgos C, Kateri C, Katsoula A, Kokkotis G, Koureta E, Lamouri C, Markopoulos P, Palatianou M, Pastras P, Fasoulas K, Giouleme O, Zampeli E, Theodoropoulou A, Theocharis G, Thomopoulos K, Karatzas P, Katsanos KH, Kapsoritakis A, Kourikou A, Mathou N, Manolakopoulos S, Michalopoulos G, Michopoulos S, Boubonaris A, Bamias G, Papadopoulos V, Papatheodoridis G, Papaconstantinou I, Pachiadakis I, Soufleris K, Tzouvala M, Triantos C, Tsironi E, Christodoulou DK, Koutroubakis IE. Correction to: The burden and management of anemia in Greek patients with inflammatory bowel disease: a retrospective, multicenter, observational study. BMC Gastroenterol 2021; 21:301. [PMID: 34325662 PMCID: PMC8323283 DOI: 10.1186/s12876-021-01872-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Kalliopi Foteinogiannopoulou
- Gastroenterology Department, University Hospital of Heraklion, Medical School University of Crete, P.O. BOX 1352, 71110, Heraklion, Crete, Greece.
| | | | - Georgios Axiaris
- Department of Gastroenterology, General Hospital of Athens "Alexandra", Athens, Greece
| | - Magdalini Velegraki
- Department of Gastroenterology, Venizelio General Hospital, Heraklion, Greece
| | - Antonios Gklavas
- 2nd Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Kapizioni
- Department of Gastroenterology, General Hospital of Piraeus "Tzaneio", Athens, Greece
| | - Charalabos Karageorgos
- Hepato-Gastroenterology/Endoscopy Unit, 2nd Department of Internal Medicine, National and Kapodistrian University of Athens, Athens General Hospital "Heppocratio", Athens, Greece
| | - Christina Kateri
- Department of Gastroenterology, University General Hospital of Larissa, Larissa, Greece
| | - Anastasia Katsoula
- 2nd Internal Medicine Department, General Hospital of Thessaloniki "Ippokratio", Thessaloniki, Greece
| | - Georgios Kokkotis
- Gastroenterology Unit, 3rd Academic Department of Internal Medicine, National and Kapodistrian Univeristy of Athens, "Sotiria" General Hospital, Athens, Greece
| | - Evgenia Koureta
- Department of Gastroenterology, National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece
| | - Charikleia Lamouri
- Department of Gastroenterology, University General Hospital of Ioannina, Ioannina, Greece
| | - Panagiotis Markopoulos
- Department of Gastroenterology, "Metaxa" General Anticancer Hospital of Piraeus, Piraeus, Greece
| | - Maria Palatianou
- Department of Gastroenterology, General Hospital of Nikaia Piraeus "Ag. Panteleimon"-General Hospital Dytikis Attikis "Agia Varvara", Athens, Greece
| | - Ploutarchos Pastras
- Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece
| | - Konstantinos Fasoulas
- Department of Gastroenterology-Oncology, Theageneio Cancer Hospital of Thessaloniki, Thessaloniki, Greece
| | - Olga Giouleme
- 2nd Internal Medicine Department, General Hospital of Thessaloniki "Ippokratio", Thessaloniki, Greece
| | - Evanthia Zampeli
- Department of Gastroenterology, General Hospital of Athens "Alexandra", Athens, Greece
| | | | - Georgios Theocharis
- Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece
| | - Konstantinos Thomopoulos
- Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece
| | - Pantelis Karatzas
- Department of Gastroenterology, National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece
| | | | - Andreas Kapsoritakis
- Department of Gastroenterology, University General Hospital of Larissa, Larissa, Greece
| | - Anastasia Kourikou
- Hepato-Gastroenterology/Endoscopy Unit, 2nd Department of Internal Medicine, National and Kapodistrian University of Athens, Athens General Hospital "Heppocratio", Athens, Greece
| | - Nikoleta Mathou
- Department of Gastroenterology, General Hospital of Nea Ionia "Konstantopoulio - Patision", Athens, Greece
| | - Spilios Manolakopoulos
- Hepato-Gastroenterology/Endoscopy Unit, 2nd Department of Internal Medicine, National and Kapodistrian University of Athens, Athens General Hospital "Heppocratio", Athens, Greece
| | | | - Spyridon Michopoulos
- Department of Gastroenterology, General Hospital of Athens "Alexandra", Athens, Greece
| | | | - Giorgos Bamias
- Gastroenterology Unit, 3rd Academic Department of Internal Medicine, National and Kapodistrian Univeristy of Athens, "Sotiria" General Hospital, Athens, Greece
| | | | - George Papatheodoridis
- Department of Gastroenterology, National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece
| | - Ioannis Papaconstantinou
- 2nd Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Pachiadakis
- Department of Gastroenterology, 424 General Military Hospital, Thessaloniki, Greece
| | - Konstantinos Soufleris
- Department of Gastroenterology-Oncology, Theageneio Cancer Hospital of Thessaloniki, Thessaloniki, Greece
| | - Maria Tzouvala
- Department of Gastroenterology, General Hospital of Nikaia Piraeus "Ag. Panteleimon"-General Hospital Dytikis Attikis "Agia Varvara", Athens, Greece
| | - Christos Triantos
- Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece
| | - Eftychia Tsironi
- Department of Gastroenterology, "Metaxa" General Anticancer Hospital of Piraeus, Piraeus, Greece
| | | | - Ioannis E Koutroubakis
- Gastroenterology Department, University Hospital of Heraklion, Medical School University of Crete, P.O. BOX 1352, 71110, Heraklion, Crete, Greece
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Papastergiou V, Mathou N, Manes K, Maniatis P, Paraskeva K, Evgenidi A, Giannakopoulos A, Karagiannis JA. When perforation is not the culprit : case report and systematic review of mechanical small-bowel obstruction complicating colonoscopy. Acta Gastroenterol Belg 2018; 81:89-92. [PMID: 29562381] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Colonoscopy is generally safe, although expansion of colorectal cancer prevention programs is likely to increase the number of post-colonoscopy complications. We report the case of a 42-year old woman with a prior history of 2 cesarean section deliveries who developed abdominal pain after an otherwise uneventful screening colonoscopy. Urgent exploration revealed closed-loop obstruction involving the terminal ileum, caused by an adhesive band close to the site of her previous Pfannenstiel incision. A systematic review of the literature revealed 11 reports (1985-2008) describing a total of 13 cases of mechanical small bowel obstruction (MSBO) after colonoscopy, 9 of which were confirmed by laparotomy. Colonoscopy-induced MSBO is practically impossible to anticipate, and only a prior history of abdominal/pelvic surgery may be deemed as a predisposing factor. However, it is related to significant morbidity, as it often leads to an ischemic bowel with need for surgical resection. Thus, endoscopists should be aware and maintain a low operative threshold to this rare, but hazardous, complication of colonoscopy.
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Affiliation(s)
- V Papastergiou
- Gastroenterology Department, "Konstantopoulio" General Hospital, Athens, Greece
| | - N Mathou
- Gastroenterology Department, "Konstantopoulio" General Hospital, Athens, Greece
| | - K Manes
- Surgical Department, "Konstantopoulio" General Hospital, Athens, Greece
| | - P Maniatis
- Radiology Department, "Konstantopoulio" General Hospital, Athens, Greece
| | - K Paraskeva
- Gastroenterology Department, "Konstantopoulio" General Hospital, Athens, Greece
| | - A Evgenidi
- Gastroenterology Department, "Konstantopoulio" General Hospital, Athens, Greece
| | - A Giannakopoulos
- Gastroenterology Department, "Konstantopoulio" General Hospital, Athens, Greece
| | - J A Karagiannis
- Gastroenterology Department, "Konstantopoulio" General Hospital, Athens, Greece
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Anagnostopoulos GK, Stefanou D, Arkoumani E, Chalkley L, Karagiannis J, Paraskeva K, Mathou N, Dellaporta E, Tsianos E, Agnantis NJ. Expression of Bax protein in gastric carcinomas. A clinicopathological and immunohistochemical study. Acta Gastroenterol Belg 2007; 70:285-289. [PMID: 18074738] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND AND STUDY AIMS Reduced Bax protein expression has been shown to be a negative prognostic factor in patients with breast, ovarian, colorectal, esophageal and pancreatic cancer. Our aim was to immunohistochemically study Bax protein expression in gastric carcinomas and correlate its expression with clinicopathological parameters and prognosis. PATIENTS AND METHODS Immunohistochemistry was performed, using a monoclonal antibody against bax, in paraffin-embedded tumor specimens from 47 cases of gastric cancer. RESULTS Positive staining for the Bax protein was found in 20/47 (42.4%) adenocarcinomas examined. Negative Bax protein expression in tumour cells was correlated with lymph node metastasis (P < 0.05), and degree of differentiation (p < 0.05). Univariate analysis showed that the variables with a significant negative impact on survival were: high TNM tumour stage, depth of penetration in the gastric wall, lymph node involvement, and Bax protein expression. Multivariate analysis showed that the only variable with an impact on survival was Bax protein expression (p < 0.05, Relative Risk: 3.34). Kaplan-Meier curves showed that the 5-year survival was 36.8% in cases with positive compared with 16% in cases with negative Bax protein expression (p = 0.0427). CONCLUSION Negative Bax expression in gastric cancer is associated with de-differentiation, lymph node metastases, and poor clinical prognosis. Bax protein expression might play an important role in the development and phenotypic differentiation of gastric carcinomas and tumor progression.
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Avgerinos A, Armonis A, Stefanidis G, Mathou N, Vlachogiannakos J, Kougioumtzian A, Triantos C, Papaxoinis C, Manolakopoulos S, Panani A, Raptis SA. Sustained rise of portal pressure after sclerotherapy, but not band ligation, in acute variceal bleeding in cirrhosis. Hepatology 2004; 39:1623-30. [PMID: 15185303 DOI: 10.1002/hep.20236] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.3] [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: 01/03/2023]
Abstract
During variceal bleeding, several factors may increase portal pressure, which in turn may precipitate further bleeding. This study investigates the early effects of endoscopic injection sclerotherapy (EIS) and endoscopic band ligation (EBL) on hepatic venous pressure gradient (HVPG) during acute bleeding and the possible influence in outcome. In 50 cirrhotic patients with bleeding esophageal varices treated with EIS (n = 25) or EBL (n = 25), we performed repeated HVPG measurements before and immediately after endoscopic treatment (time 0) and every 24 hours for a 5-day period. Endotherapy was continued until the varices were too small for further treatment. Both groups were comparable with regard to age, gender, Child-Turcotte-Pugh grade, and HVPG. In the EBL and EIS groups, a significant (P <.0001) increase was observed in mean portal pressure (20.7 mm Hg +/- 4.4 SD and 21.5 mm Hg +/- 4.5 SD, respectively) immediately after treatment (time 0) as compared with pretreatment (18.1 +/- 4.5 and 18.1 +/- 4.0). However, HVPG in the EBL group returned to baseline values within 48 hours after treatment, while in the EIS group it remained high during the 120-hour study period (P <.0001). Bleeding stopped in all patients after endotherapy. During the 42-day follow-up period, the rebleeding rate over time was lower in the EBL group compared with the EIS group (P =.024). Patients with an initial HVPG greater than 16 mm Hg had, despite endoscopic treatment, a significantly higher likelihood of death (P =.024) and overall failure (P =.037) [correction]. In conclusion, during acute variceal bleeding EIS, but not EBL, causes a sustained increase in HVPG, which is followed by a higher rebleeding rate.
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Affiliation(s)
- Alec Avgerinos
- 2nd Department of Gastroenterology, Athens University, Evangelismos Hospital, Athens, Greece.
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