General Hospital of Chalkida

Chalkída, Greece

General Hospital of Chalkida

Chalkída, Greece
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Gavriatopoulou M.,National and Kapodistrian University of Athens | Garcia-Sanz R.,Hospital Of Universitario Of Salamanca | Kastritis E.,National and Kapodistrian University of Athens | Morel P.,Center Hospitalier Schaffner | And 9 more authors.
Blood | Year: 2017

In this phase 2 multicenter trial, we evaluated the efficacy of the combination of bortezomib, dexamethasone, and rituximab (BDR) in 59 previously untreated symptomatic patients with Waldenström macroglobulinemia (WM), most of which were of advanced age and with adverse prognostic factors. BDR consisted of a single 21-day cycle of bortezomib alone (1.3 mg/m2 IV on days 1, 4, 8, and 11), followed by weekly IV bortezomib (1.6 mg/m2 on days 1, 8, 15, and 22) for 4 additional 35-day cycles, with IV dexamethasone (40 mg) and IV rituximab (375 mg/m2) on cycles 2 and 5, for a total treatment duration of 23 weeks. On intent to treat, 85% responded (3% complete response, 7% very good partial response, 58% partial response). After a minimum follow-up of 6 years, median progression-free survival was 43 months and median duration of response for patients with at least partial response was 64.5 months. Overall survival at 7 years was 66%. No patient had developed secondary myelodysplasia, whereas transformation to high-grade lymphoma occurred in 3 patients who had received chemoimmunotherapy after BDR. Thus, BDR is a very active, fixed-duration, chemotherapy-free regimen, inducing durable responses and with a favorable long-term toxicity profile (www.ClinicalTrials.gov #NCT00981708). © 2017 by The American Society of Hematology.


Kallinikas G.,Kent and Canterbury Hospital | Tsimiliotis D.,General Hospital of Chalkida | Koutsokostas E.,Konstantopouleion Patision Hospital | Bokor B.,Kent and Canterbury Hospital
International Urology and Nephrology | Year: 2017

The prevalence of RCC in Europe is 2–3% and increasing every year. Hereditary predisposition is found in 5–8% of all RCC cases. Hereditary syndromes associated with RCC include: Von Hippel–Lindau, hereditary papillary renal cell carcinoma, Birt–Hogg–Dube’, hereditary leiomyomatosis, succinate dehydrogenase’s deficiency, tuberous sclerosis complex and Cowden’s syndrome. These syndromes are related to specific genetic mutations. So far the European Association of Urology and American Urological Association have not established guidelines for referral of patients with RCC for germline mutation screening. The scope of this article is to review which clinical manifestations should direct clinicians’ thinking towards hereditary kidney carcinomas and therefore suggest which patients could benefit from genetic testing. © 2017 Springer Science+Business Media Dordrecht


Dimopoulos M.A.,National and Kapodistrian University of Athens | Garcia-Sanz R.,Hospital Universitario Of Salamanca | Gavriatopoulou M.,National and Kapodistrian University of Athens | Morel P.,Hopital Schaffner | And 10 more authors.
Blood | Year: 2013

In this phase 2 multicenter trial, we evaluated the activity of bortezomib, dexamethasone, and rituximab (BDR) combination in previously untreated symptomatic patients with Waldenström macroglobulinemia (WM). To prevent immunoglobulin M (IgM) "flare," single agent bortezomib (1.3 mg/m 2 IV days 1, 4, 8, and 11;21-day cycle), was followed by weekly IV bortezomib (1.6 mg/m2 days 1, 8, 15, and 22) every 35 days for 4 additional cycles, followed by IV dexamethasone (40 mg) and IV rituximab (375 mg/m2) in cycles 2 and 5. Fifty-nine patients were treated; 45.5% and 40% were high and intermediate risk per the International Prognostic Scoring System for WM. On intent to treat, 85% responded (3% complete response, 7% very good partial response, 58% partial response [PR]).In 11% of patients, an increase of IgM ≥25% was observed after rituximab; no patient required plasmapheresis. After a minimum follow-up of 32 months, median progression-free survival was42months, 3-year durationof response for patients with≥PR was 70%, and 3-year survival was 81%. Peripheral neuropathy occurred in 46% (grade ≥3 in 7%); only 8% discontinued bortezomib due to neuropathy. BDR is rapidly acting, well tolerated, and nonmyelotoxic, inducing durable responses in previously untreated WM. © 2013 by The American Society of Hematology.


PubMed | Hospital Of Universitario Of Salamanca, General Hospital of Chalkida, Netherlands Cancer Institute, University of Pavia and 4 more.
Type: Journal Article | Journal: Blood | Year: 2016

In this phase 2 multicenter trial, we evaluated the efficacy of the combination of bortezomib, dexamethasone, and rituximab (BDR) in 59 previously untreated symptomatic patients with Waldenstrm macroglobulinemia (WM), most of which were of advanced age and with adverse prognostic factors. BDR consisted of a single 21-day cycle of bortezomib alone (1.3 mg/m


Vrachnis N.,National and Kapodistrian University of Athens | Belitsos P.,General Hospital of Chalkida | Sifakis S.,University of Crete | Dafopoulos K.,University of Thessaly | And 3 more authors.
International Journal of Endocrinology | Year: 2012

Previous Gestational Diabetes Mellitus (pGDM) is a common condition and has been associated with future development of Type 2 Diabetes Mellitus (T2DM) and Metabolic Syndrome (MS) in women affected. The pathogenesis and risk factors implicated in the development of these conditions later in the lives of women with pGDM are not as yet fully understood. Research has recently focused on a group of substances produced mainly by adipose tissue called adipokines, this group including, among others, adiponectin, leptin, Retinol-Binding Protein-4 (RBP-4), and resistin. These substances as well as other inflammatory mediators (CRP, IL-6, PAI-1, TNF-) seem to play an important role in glucose tolerance and insulin sensitivity dysregulation in women with pGDM. We summarize the data available on the role of these molecules. Copyright © 2012 Nikolaos Vrachnis et al.


PubMed | General Hospital of Kalamata, General Hospital of Chalkida, Technological Educational Institute of Athens, National and Kapodistrian University of Athens and 4 more.
Type: | Journal: Preventive medicine | Year: 2016

The association between depression status and 10-year cardiovascular disease (CVD) incidence among acute coronary syndrome (ACS) patients, in relation to nutritional and financial status, was evaluated.From October 2003 to September 2004, a sample of 2172 consecutive ACS patients from 6 Greek hospitals was enrolled. In 2013-14, the 10-year follow-up was performed. Depressive symptoms were evaluated using the validated CES-D score (range 0-60). Adherence to Mediterranean diet was assessed through MedDietScore (range 0-55) and financial status was determined by the annual income.Ranking from the 1st to 3rd CES-D tertile, recurrent fatal/non fatal ACS rates were 33%, 37% and 42%, respectively (p=0.006). Multiple logistic regression models revealed an adverse association of severe depression status (i.e. 3rd tertile) compared to no depression (i.e. 1st tertile) [odds ratio (OR)=1.31, 95% confidence interval (95% CI) 1.01, 1.69]. When controlling for financial status, the relationship between depression and ACS prognosis remained marginally significant; while subgroup analysis revealed that only patients with low/moderate income were negatively affected [OR=1.36, 95% CI 0.98, 1.88]. Further stratified analysis, by MedDietScore group, was applied; the above association remained significant only in patients with low compliance to this dietary pattern [OR=1.68, 95% CI 1.10, 2.18].ACS coexisting with severe depression status seems to result in adverse disease outcomes while financial status and Mediterranean diet are proposed as potential moderators. Public health programs should focus on vulnerable groups and minimize depressive symptoms through appropriate medical treatment and lifestyle interventions, so as to ameliorate the disease prognosis in clinical and community levels.


PubMed | General Hospital of Kalamata, General Hospital of Chalkida, National and Kapodistrian University of Athens, General Hospital of Karditsa and 3 more.
Type: Journal Article | Journal: Journal of human nutrition and dietetics : the official journal of the British Dietetic Association | Year: 2016

The present study evaluated the association between long-term, exclusive olive oil consumption, in cooking preparation or as a dressing, and the 10-year (2004-2014) incidence of acute coronary syndrome (ACS) among cardiac patients.From October 2003 to September 2004, a sample of 2172 ACS consecutive patients from six major Greek hospitals were enrolled. During 2013-2014, the 10-year follow-up was performed in 1918 patients (88% participation rate). The development of fatal or nonfatal ACS was recorded through medical records or hospital registries. Among other dietary components, added fats (i.e. olive oil, butter, margarine and seed oils) consumption at baseline examination was assessed using a semi-quantitative food frequency questionnaire.Non-exclusive olive oil consumption on a daily basis was associated with an adverse effect on the ACS incidence after taking into account various potential confounders [odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.05-1.86, P = 0.024]. However, significant interactions between olive oil consumption and body mass index (BMI) (P = 0.082) and educational level (P = 0.054) led to further stratified analysis. Using BMI as strata (i.e. 29.9 versus >29.9 kg m(-2)), the above association remained significant only in obese patients (OR = 1.80, 95% CI = 1.03-3.12, P = 0.038), whereas, on examining the education status (i.e. 9 versus >9 years of school), a significant association was observed only among the higher educated patients (OR = 1.83, 95% CI = 1.01-3.32, P = 0.047).Exclusive use of olive oil, either as a salad dressing or in cooking, should be promoted through the dietary management of ACS patients, with the aim of reducing the likelihood of recurrent cardiac episodes.


Kourbeti I.S.,General Hospital of Chalkida | Vakis A.F.,University Hospital of Heraklion | Ziakas P.,Brown University | Karabetsos D.,University Hospital of Heraklion | And 3 more authors.
Journal of Neurosurgery | Year: 2015

Object The authors performed a prospective study to define the prevalence and microbiological characteristics of infections in patients undergoing craniotomy and to clarify the risk factors for post-craniotomy meningitis. Methods Patients older than 18 years who underwent nonstereotactic craniotomies between January 2006 and December 2008 were included. Demographic, clinical, laboratory, and microbiological data were systemically recorded. Patient characteristics, craniotomy type, and pre- and postoperative variables were evaluated as risk factors for meningitis Results Three hundred thirty-four procedures were analyzed (65.6% involving male patients). Traumatic brain injury was the most common reason for craniotomy. Almost 40% of the patients developed at least 1 infection. Ventilatorassociated pneumonia (VAP) was the most common infection recorded (22.5%) and Acinetobacter spp. were isolated in 44% of the cases. Meningitis was encountered in 16 procedures (4.8%), and CSF cultures were positive for microbial growth in 100% of these cases. Gram-negative pathogens (Acinetobacter spp., Klebsiella spp., Pseudomonas aeruginosa, Enterobacter cloaceae, Proteus mirabilis) represented 88% of the pathogens. Acinetobacter and Klebsiella spp. demonstrated a high percentage of resistance in several antibiotic classes. In multivariate analysis, the risk for meningitis was independently associated with perioperative steroid use (OR 11.55, p = 0.005), CSF leak (OR 48.03, p < 0.001), and ventricular drainage (OR 70.52, p < 0.001). Con clusion s Device-related postoperative communication between the CSF and the environment, CSF leak, and perioperative steroid use were defined as risk factors for meningitis in this study. Ventilator-associated pneumonia was the most common infection overall. The offending pathogens presented a high level of resistance to several antibiotics. © AANS, 2015.


Karatapanis S.,General Hospital of Rhodes | Tsoplou P.,Bioiatriki S.A. | Papastergiou V.,General Hospital of Rhodes | Vasiageorgi A.,Bioiatriki S.A. | And 7 more authors.
Journal of Medical Virology | Year: 2012

Hepatitis C virus (HCV) genotype 5 (G5) is a rare genotype reported mainly in South Africa. However, increasing data suggest the sporadic presence of this genotype in different European countries. To assess the epidemiology of HCV-G5 in Greece, genotyping was performed in 973 consecutive patients infected with HCV, referred to 7 hepatology centers throughout Greece, from January 2005 to December 2009. Genotype 5a (19 patients, 1.9%) was the fifth most prevalent genotype after genotype 1 (408 patients, 41.9%), genotype 3 (318 patients, 32.7%), genotype 4 (158 patients, 16.2%), and genotype 2 (70 patients, 7.2%). The majority of patients infected with G5 (16/19,84.2%) were referred to the General Hospital of Rhodes, an island in south-east Greece. The HCV genotype distribution in that particular island, indicates a particularly high G5 prevalence of 12.8%, after genotype 1 (40%), genotype 3 (28%), and genotype 4 (15%). Among the patients from Rhodes infected with G5 (n=16), 13 (81.2%) were females. The mean age was 62.3±6.5 years, significantly older than the patients infected with other HCV genotypes (mean age 40.6±7.2, P<0.0001). Nine out of the 16 cases (56.2%) presented features of high pre-treatment viral loads. Advanced liver fibrosis (Metavir F3-F4) was found in four out of five performed liver biopsies. Ten patients received treatment with pegylated interferon plus ribavirin and a sustained viral response were achieved in six cases. The source of infection is unknown but parenteral iatrogenic routes of transmission seem to have contributed significantly to the spread of genotype 5a in this region. © 2011 Wiley Periodicals, Inc.


Chaliotis G.,General Hospital of Chalkida | Kritsotakis E.I.,University of Crete | Psaroulaki A.,University of Crete | Tselentis Y.,University of Crete | Gikas A.,University of Crete
International Journal of Infectious Diseases | Year: 2012

Objectives: To document and evaluate the clinico-epidemiological profile of murine typhus during the re-emergence of the disease in a previously endemic focus in central Greece. Methods: This was a 5-year, hospital-based, observational study, in which 90 adult patients with murine typhus were prospectively identified and studied. Results: Most cases of the disease occurred in rural (52%) and semi-urban (34%) settings, with a seasonal frequency peak during the late summer. The triad of fever, headache, and rash was present in 64% of the patients within 2 days of hospital admission. Normal white blood cell counts (63%), thrombocytopenia (81%), and a high erythrocyte sedimentation rate (93%) were the main hematological findings upon presentation. Elevated aminotransferases (>84%), hypoalbuminemia (81%), and hyponatremia (36%) were prominent biochemical abnormalities. Pulmonary, neurological, and renal complications were noted in 26% of the patients and subsided after specific treatment. The duration of fever was shorter in patients treated with doxycycline (median 3 days) compared to ofloxacin (p=0.001) or doxycycline plus ofloxacin (p=0.009). Conclusions: Murine typhus has the potential to cause significant morbidity. Awareness of the disease in endemic areas, early recognition of its clinical and laboratory features, and prompt administration of effective treatment are key factors to prevent potentially severe complications. © 2012 International Society for Infectious Diseases.

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