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Ymittos Athens, Greece

Zafeirakis A.G.,401 General Army Hospital of Athens | Papatheodorou G.A.,Clinical Research Unit | Limouris G.S.,National and Kapodistrian University of Athens
Nuclear Medicine Communications | Year: 2010

Objectives: To correlate serum levels of bone markers with pain levels and extent of skeletal disease (EOD), in patients suffering from prostate cancer with bone only metastases. Methods: Thirty-six males with hormone-refractory prostate carcinoma, bone only metastases and no history of therapies, drugs, or diseases that affect bone metabolism were studied. Karnofsky performance status, pain scoring, EOD, osteocalcin (OC), prostate-specific antigen, bone alkaline phosphatase amino-terminal and carboxy-terminal propeptides and telopeptides of type I collagen were analysed. Twenty-four healthy controls of the same age were also established. Results: With only the exception of OC, bone marker values of patients were significantly increased compared with the upper reference limits (P<0.0001 for bone alkaline phosphatase and amino-terminal telopeptide of type I collagen, 0.012 for amino-terminal propeptide of type I collagen, 0.0023 for carboxy-terminal propeptide of type I collagen, and 0.04 for carboxy-terminal telopeptide of type I collagen). All bone markers and prostate-specific antigen also showed significant paired correlations (P≤0.019) and linear increases with advancing EOD (P≤0.032). Finally, none of the measured markers correlated significantly with pain levels. Conclusion: Bone markers are remarkably elevated in the serum of prostate cancer patients with metastatic bone disease and correlate with EOD. Paired correlations also suggest an accelerated but proportional (coupled) bone metabolism. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source


Zafeirakis A.,401 General Army Hospital of Athens | Zissimopoulos A.,Democritus University of Thrace | Baziotis N.,St. Savvas Anticancer Hospital of Athens | Limouris G.S.,National and Kapodistrian University of Athens
Quarterly Journal of Nuclear Medicine and Molecular Imaging | Year: 2011

Aim. In this study, a new method has been used to predict pain response to 186Re-HEDP therapy in patients suffering from painful osseous metastases, on the basis of a modified bone scan index and pre-therapy pain scoring. Methods. Forty five patients received a total of 73 doses of 186Re-HEDP during a period of pain relapse without extra-osseous disease progression. All patients were under stable regimen of zoledronic acid, far off other therapeutic manipulations. Imaging studies regarding a modified estimation of bone scan index, were applied; the value of the largest bony lesion (called mBSI), provided that it also corresponded to the most prominent site of osseous pain was taken into account, and a new semi-quantitative index called Double Product Value (DPV), equal to pre-therapy pain score times mBSI was entered in the result analyses, to investigate any possible correlations with response endpoints. Results. Favourable response occurred in 35/47 evaluated therapeutic doses of 186Re-HEDP (74.5%; excellent response in 12 doses, 25.5%). Responders had significantly lower DPV (3.4±2.3 vs. 10.2±6.2, P=0.0029, for non-responders). Patients with pre-therapy DPV4, and also a longer median period of pain relief (respective mean values 5.9 versus 2.1 months, HR 2.82; P=0.0001). Conclusions. DPV, as developed and implemented in this study proved a valuable and reproducible pre-therapy tool for assessing degree and duration of pain response after 1 86Re-HEDP therapy. Source


Pothitakis C.,401 General Army Hospital of Athens | Ekmektzoglou K.A.,National and Kapodistrian University of Athens | Piagkou M.,National and Kapodistrian University of Athens | Karatzas T.,National and Kapodistrian University of Athens | Xanthos T.,National and Kapodistrian University of Athens
Heart and Lung: Journal of Acute and Critical Care | Year: 2011

Objective: The study objective was to present a comprehensive literature review on the monitoring of patients with cardiac arrest (CA) and the nursing contribution in this crucial situation. Monitoring techniques during cardiopulmonary resuscitation and in the peri-arrest period (just before or after CA) are included. Methods: Approaches used to access the research studies included a comprehensive search in relevant electronic databases (Medline, CINAHL, EMBASE, Cochrane Review, British Nursing Index) using relevant keywords (eg, cardiac arrest, resuscitation, monitoring, nurse, survival, outcome). Books and journals known to the authors were also used. Results: The nurse's role in patients with CA is extremely significant and if performed correctly adds great insight to treatment planning and correct management. Conclusion: Early recognition of CA and invasive (methods and equipment that require endarterial or intravenous access) and noninvasive monitoring should be prompt and appropriate for early return of spontaneous circulation and improved neurologic outcome in patients. © 2011 Elsevier Inc. Source


Albanopoulos K.,Hippokration Hospital | Alevizos L.,Hippokration Hospital | Linardoutsos D.,Hippokration Hospital | Menenakos E.,Hippokration Hospital | And 4 more authors.
Obesity Surgery | Year: 2011

Complications after laparoscopic sleeve gastrectomy (LSG) are usually silent and difficult to interpret. Our purpose was to evaluate the utility of routine placement of intraperitoneal drains at the end of LSG in detection and management of postoperative complications. This is a retrospective study of all patients that underwent LSG by a standard operative team in a 3-year period. Patients were enrolled in Group A when an intraperitoneal drain was placed and Group B when not. Three hundred and fifty-three patients underwent LSG with a median preoperative BMI of 46.4 k/m2. Two hundred and one patients were enrolled in group A and 152 in group B; the two groups were comparable in their characteristics. Staple line leak, bleeding, and abscess were observed in 4%, 2.9%, and 2.5% of group A and 2.6%, 1.9%, and 1.9% of group B and the differences did not reach statistical significance. In 50% of patients with drain and leak, per os blue de methylene test was negative and in another 50% leak took place after the fourth postoperative day when drain was already taken off. Abscesses were observed significantly more often in patients that had suffered postoperative bleeding (p < 0.001) or had undergone laparoscopic adjustable gastric banding (LAGB) in the past (p = 0.02). Placement of drains does not facilitate detection of leak, abscess, or bleeding. Furthermore, they don't seem to eliminate the reoperation rates for these complications. Maybe patients with previous LAGB and intraperitoneal bleeding could benefit from placement of a drain that will remain for more than 5 days. © 2010 Springer Science + Business Media, LLC. Source


Solaini L.,Thoracic Surgery Unit | Di Francesco F.,Thoracic Surgery Unit | Gourgiotis S.,Thoracic Surgery Unit | Solaini L.,401 General Army Hospital of Athens
Hernia | Year: 2010

Purpose A very simple technique to repair a superior lumbar hernia is described. The location of this type of hernia, also known as the Grynfeltt-Lesshaft hernia, is deWned by a triangle placed in the lumbar region. Method An unusual case of a 67-year-old woman with a superior lumbar hernia is reported. The diagnosis was made by physical examination. Results The defect of the posterior abdominal wall was repaired with a polypropylene dart mesh. The patient had no evidence of recurrence at 11 months follow up. Conclusions The surgical approach described in this paper is simple and easy to perform, and its result is comparable with other techniques that are much more sophisticated. No cases on the use of dart mesh to repair Grynfeltt-Lesshaft hernia have been reported by surgical journals indexed in PubMed. Source

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