Chrysanthakopoulos N.A.,401 General Military Hospital of Athens |
Chrysanthakopoulos N.A.,National and Kapodistrian University of Athens
Experimental Oncology | Year: 2016
Aim: The aim of the present case - control study was to examine the possible associations between periodontal disease indices and the risk of lung cancer development in a sample of Greek out-patients referred to a medical and a dental private practice. Materials and Methods: A total of 200 individuals were interviewed and underwent an oral clinical examination, and 64 of them were suffered from several histological types of lung cancer. The estimation of the possible associations between lung cancer as a dependent variable and periodontal disease indices as independent ones was carried out by using a multiple regression analysis model. Results: Probing pocket depth (odds ratio (OR) = 2.72, 95% confidence interval (CI) 1.05-7.06), clinical attachment loss (OR = 3.51, 95% CI 1.30-9.47) bleeding on probing (OR = 1.93, 95% CI 0.98-3.81) were significantly associated with the risk of developing lung cancer. Smoking (OR = 2.49, 95% CI 1.20-5.17) was significantly associated with the mentioned risk, whereas it was consisted as a confounder regarding the estimated associations between moderate/severe clinical attachment loss and presence of bleeding on probing with the risk of developing lung cancer. Conclusion: Probing pocket depth as an index for periodontal disease severity was statistically significantly associated with the risk of developing lung cancer.
Papakostidi A.,401 General Military Hospital of Athens |
Tolia M.,National and Kapodistrian University of Athens |
Tsoukalas N.,401 General Military Hospital of Athens
Journal of B.U.ON. | Year: 2014
Introduction: In radiotherapy, a team of highly specialised professionals co-operate in planning and delivery of treatment and are responsible for the effectiveness and safety of the service. The aim of this article was to present the necessity and features of a quality assurance (QA) program in radiotherapy through literature review. Methods: A search was carried out in Scirus, Medline/ PubMed databases using the keywords "clinical oncology", "radiation oncology", "radiotherapy", "oncology practice", "quality assurance" and "quality of care". Twenty-nine articles were chosen covering the period 1995-2007. Further information was obtained from the Royal College of Radiologists' UK website. Results: QA was relevant to three aspects of radiotherapy: 1) clinical, involving resources (staffing and equipment), procedures (treatment planning, follow up) and results (tumor control, toxicity); 2) medical physics, involving the measurements necessary for the safety and precision of equipment; and 3) technical, involving the accurate plan implementation and the smooth function of treatment machines. International guidelines defined best practice in diagnosis and treatment of cancer patients. Moreover, the principles of quality management provided the tools not only for a reasonable use of limited resources but also for continuous improvement of organisations towards patient-centred services. Conclusion: Quality in radiotherapy is a dynamic concept that needs to be measured and re-evaluated using scientific methods and feedback by the users. Successful implementation of a QA program in radiotherapy requires expertise, training and co-ordination in an environment of team-work.
Chatzipavlou M.,401 General Military Hospital of Athens |
Magiorkinis G.,University of Oxford |
Koutsogeorgopoulou L.,General Hospital Laiko |
Kassimos D.,401 General Military Hospital of Athens
Rheumatology International | Year: 2014
Dietary interventions have been suggested to be a safe cost-efficient way to control hyperuricemia. The aim of the study is to assess the potential of mediterranean diet as intervention to control the level of urate in patients with hyperuricemia in a small sample of patients. Patients with asymptomatic hyperuricemia were recruited from outpatient clinics and were enrolled into personal Mediterranean diet-based programs. Body mass index (BMI), serum urate, lipid profile and indirect calorimetry were measured at the beginning and then monthly for the first 3 months and then at the sixth month. At the same time, patients' compliance with the Mediterranean diet was assessed by a formal interview and standard questionnaire. Only six out of twelve patients managed to complete the diet (dropout rate 50%). Their BMI remained constant during the trial period in the level of 1st degree obesity (BMI = 31.46). The mean value of serum urate at the beginning of the study was 9.12 mg/dl. After the first month, there was a reduction in urate by 20% with mean urate at 6.92 mg/dl. The second, third and sixth month mean urate levels were 6.32, 6.1 and 6.4 mg/dl, respectively. The effect of the mediterranean diet was rapid at the first month and remained constant throughout the dietary intervention, suggesting that it might have a clinically significant effect on urate level thus providing a cost-efficient and safe alternative to pharmaceutical intervention as first-line treatment of hyperuricemia. © Springer-Verlag 2013.
Sfetsas K.,401 General Military Hospital of Athens |
Mitropoulos D.,Laiko Hospital of Athens
Journal of the Egyptian National Cancer Institute | Year: 2016
Background: The authors evaluated the role of photodynamic cystoscopy in the detection of additional urothelial lesions, mainly carcinoma in situ, that would not be detected solely with white light cystoscopy, leading to disease understaging. Methods: From 2009 to 2011, 70 patients underwent white light cystoscopy, followed by photodynamic cystoscopy (blue light system, Karl Storz, Tuttlingen, Germany). Preoperatively they were instilled intravesically with 50. ml of Hexvix (Hexaminolevulinate hexylester). We recorded all lesions found with white light cystoscopy and the additional lesions revealed by blue light cystoscopy. Afterward all lesions were removed and sent for pathologic evaluation. Results: Seventeen patients (24.3%) had primary tumors while 53 patients (75.7%) had recurrent disease. In 53 out of 70 patients (75.7%) white light cystoscopy revealed urothelial lesions. In the rest 17 patients who had no findings with white light cystoscopy, blue light cystoscopy revealed 7 cases of Cis (41.2%) and 8 cases of dysplasia (47%). In the group of patients with visible lesions in white light cystoscopy photodynamic cystoscopy revealed additional carcinoma in situ in 22 patients. Altogether additional carcinoma in situ cases found with the aid of photodynamic cystoscopy were 29 out of 70 cases (41.4%). Conclusions: Photodynamic cystoscopy is the most efficient diagnostic procedure for flat urothelial lesions and especially for carcinoma in situ. It is significantly more sensitive than conventional white light cystoscopy in Cis diagnosis, thus reducing understaging of the disease and consequently improving recurrence and progression rates. © 2016 National Cancer Institute, Cairo University.
Kassimos D.G.,401 General Military Hospital of Athens |
Vassilakos J.,401 General Military Hospital of Athens |
Magiorkinis G.,University of Oxford |
Garyfallos A.,Ippokratio Hospital of Thessaloniki
Clinical Rheumatology | Year: 2014
Increased awareness and sensitivity of general physicians have increased the early diagnoses of seronegative arthritis in young patients, while new agents such as anti-TNF blockers have significantly changed the treatment of the disease. To investigate the prevalence, the clinical manifestations, and the ability for military service of young Greek males (18-30 years old) with ankylosing spondylitis (AS) in the pre-anti-TNF era. We retrospectively studied the AS cases recorded from 1989 to 1995 of the rheumatology department of the largest General Military Hospital in Greece; the diagnosis was based on the modified New York criteria for AS. A total of 285 AS cases were diagnosed among 357,184 young men. The overall prevalence of AS on December 1995 was estimated at 8.2 cases per 10,000 young men (95 % C.I. 7.2-9.2). All the patients had chronic back pain. Two hundred forty (84 %, 95 % C.I. 79-88 %) patients presented sacroiliitis of whom 163 (68 %, 95 % C.I. 62-73 %) were bilateral. Two hundred five patients (72 %, 95 % C.I. 66-77 %) had peripheral joint involvement. Thirty-one patients presented with anterior uveitis (11 %, 95 % C.I. 8-15 %). One patient had IgA nephropathy. None had gut involvement. HLA-B27 antigen was found in 257 patients (90 %, 95 % C.I. 86-93 %). Ninety-one patients (32 %, 95 % C.I. 27-38 %) had permanent discharge from the military service, while 128 (45 %, 95 % C.I. 39-51 %) were able for auxiliaries attendances. The prevalence of AS for the age group 18-30 years old in this young Greek men cohort was significantly lower than in other Caucasian European populations, and the clinical manifestations were considered as mild. © 2014 Clinical Rheumatology.
Chrysanthakopoulos N.A.,401 General Military Hospital of Athens
Journal of investigative and clinical dentistry | Year: 2013
The aim of the present cross-sectional study was to estimate gingival recession (GR) prevalence and associated risk factors in young Greek adults. The study population consisted of 420 young adults (200 males and 220 females). All individuals were clinically examined and answered questions regarding their smoking status, educational level, and oral hygiene practices. In addition, the association between GR and the following aspects was assessed: sex, smoking status, educational level, plaque index, gingival index, calculus presence, and plaque control methods. Statistical analysis of data was accomplished using the multivariate linear regression analysis model. The average number of GR overall was 1.38 mm (standard deviation: 0.18 mm). Gingival index (P = 0.000) and smoking (P = 0.01) were the most important associated risk factors of GR, while sex, oral hygiene practices, presence of supragingival calculus, educational level, and plaque index were not significantly associated with it. Gingival inflammation, as determined by the gingival index, and smoking were the most important associated risk factors of GR. © 2013 Wiley Publishing Asia Pty Ltd.
Papakonstantinou I.,401 General Military Hospital of Athens |
Poulakidas I.,401 General Military Hospital of Athens
Hippokratia | Year: 2014
Background: Severe immune thrombocytopenia displays a rare side effect of pegylated interferon therapy for Hepatitis C infection. Our aim is to report a case of severe and late onset immune thrombocytopenia due to pegylated interferon treatment that was effectively managed with the anti-CD20 monoclonal antibody Rituximab. Description of the case: A 27-year-old male, Hepatitis C infected patient, presented with sudden, severe immune thrombocytopenia at the end of a standard 24-week antiviral treatment, as a side effect of pegylated interferon. Platelet count rapidly normalized with Rituximab infusions. Conclusion: Rituximab could be a valuable treatment option in pegylated interferon related immune thrombocytopenia, when patients are resistant to conventional treatment or when physicians are reluctant to administer corticosteroids. © Lithografia Antoniadis I - Psarras Th G.P. All rights reserved.
Koutsoumpelis A.,University of Ioannina |
Kouvelos G.,University of Ioannina |
Peroulis M.,University of Ioannina |
Tzilalis V.,401 General Military Hospital of Athens |
Matsagkas M.,University of Ioannina
International Angiology | Year: 2015
Therapeutic strategy for treating carotid artery near occlusion (CANO) has been controversial. The aim of this study was to review the literature concerning the invasive treatment of atherosclerotic CANO. A review was conducted of the English medical literature from 1980 to 2013 using Pub-Medand EMBASE database to find studies involving open or endovascular management of CANO. The search identified 20 reports describing invasive treatment of CANO encompassing 770 patients (77.7% men; mean age 66.3±5.2 years). A typical appearance of string sign was noted in nearly 60% of the patients. The vast majority (92.6%) were symptomatic. 479 (62.2%) patients underwent an open procedure, while 291 (38.8%) were treated endovascularly. The technical success rate for the endovascular procedures was 99%, while distal embolic protection devices were applied in most patients (66%). The 30 days procedural stroke rate was 2.1% and 2.4% for open and endovascular repair respectively. During a follow-up period spanning an average of approximately two years the ipsilateral cerebrovascular event rate was 5% and 1.2% for open and endovascular treatmentrespectively. Twenty five (5.2%) restenosis or occlusions were reported for the open procedures, while 13 (5.4%) were also documented for endovascular repair. The current literature concerning the invasive treatment of CANO is weak and cannot support any evidence based recommendation. The necessity to intervene as well as the best therapeutic strategy remains controversial. This review shows that the interventionon symptomatic CANO may consist a relatively safe and effective therapeutic strategy with low perioperative cerebrovascular morbidity for both treatment modalities, although durability and long-term outcomes should be further affirmed. The low incidence of this entity and the dearth of clear evidence support the need for a large multicenter registry to clarify the absolute indications for intervention and define the best therapeutic approach.
Chrysanthakopoulos N.A.,401 General Military Hospital of Athens
Journal of Clinical and Experimental Dentistry | Year: 2012
Objectives: The aim of this study was to estimate the prevalence of dental erosion and to investigate possible associations among dental erosion and medical history, dietary and lifestyle habits in a sample of adolescents in Greece. Study design: The study sample consisted of 770 adolescents, 374 boys and 396 girls aged 13 to 16 years. All individuals were clinically examined and answered questions regarding their medical history, rate and frequency of drinks and food consumption and lifestyle habits. Statistical analysis of the questionnaire items was performed by using the multiple logistic regression analysis model. Results: Two hundreds and sixty adolescents were diagnosed as having dental erosion, giving a prevalence rate 33.8%. The habit of holding drinks in the mouth before swallowing [OR=2.85, 95% CI=1.45-5.58] (p=0.002), the ingestion of acidic drinks at bedtime [OR=0.24, 95% CI=0.11-0.53] (p=0.000), the consumption of carbonated drinks [OR=3.99, 95% CI=1.37-11.59] (p=0.011) and fruit juices [OR=0.12, 95% CI=0.04-0.38] (p=0.000) were the most important associated factors of dental erosion. Conclusions: The prevalence of dental erosion in the study sample was 33.8% while dental erosion experience was associated with frequency and habits of consumption of some dietary components. © Medicina Oral S.L.
Kouvelos G.N.,University of Ioannina |
Vourliotakis G.,401 General Military Hospital of Athens |
Arnaoutoglou E.,University of Ioannina |
Papa N.,University of Ioannina |
And 4 more authors.
Journal of Vascular Surgery | Year: 2013
Background: Isolated acute abdominal aortic dissection (IAAAD) is considered an unusual clinical entity and is traditionally treated by open surgical repair. We report our single-center experience during the last 9 years, evaluating the outcomes after endovascular repair in this patient population. Methods: All patients with a diagnosis of IAAAD treated in our institute were included in this retrospective review. Between January 2004 and December 2012, 38 patients suffering from an acute aortic dissection were referred regionally for intervention to our department: 24 (63.2%) with a thoracic aortic dissection type B and 14 patients (36.8%, all male; median age, 65 years) with an IAAAD. Demographics, perioperative, procedure-specific, and follow-up data were prospectively aggregated in an electronic database. Results: Patients suffering from IAAAD presented with acute abdominal pain (n = 13) and acute lumbar pain (n = 1). Insufferable pain and enlargement of the aorta were the main indications for treatment. Mean (± standard deviation) maximal abdominal aortic diameter at presentation was 3.5 ± 0.94 cm (range, 2.6-5.1 cm). None of these patients had a concomitant thoracic aortic dissection. All patients were treated by endovascular means, with a primary technical success rate of 100%. Two patients (14%) died perioperatively from cardiac causes. Median hospital stay was 4.5 days (range, 3-16 days). During a mean follow-up period of 37.41 ± 23.56 months (range, 8-82 months; median, 32.5 months), two patients experienced primary treatment failure needing reintervention that led to a successful outcome. The cumulative free-from-reintervention rate was estimated 90.9% at 58 months (standard error, 8.7%). A full aortic remodeling without any events was noted in all other patients during the follow-up period. Conclusions: Based on our series, IAAAD may represent a not so rare clinical entity as generally thought, suggesting that it may be underdiagnosed. Endovascular treatment of IAAAD appears to be a feasible and efficient therapeutic approach and might be considered as the first-line treatment in all patients with suitable anatomy. Copyright © 2013 by the Society for Vascular Surgery.