General Hospital of Corinth

Kórinthos, Greece

General Hospital of Corinth

Kórinthos, Greece

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Vlastarakos P.V.,Lister Hospital | Nikolopoulos T.P.,National and Kapodistrian University of Athens | Pappas S.,General Hospital of Corinth | Buchanan M.A.,Lister Hospital | And 2 more authors.
Expert Review of Medical Devices | Year: 2010

The selection of cochlear implant (CI) candidates requires consideration of a variety of clinical and radiographic factors. The present article reviews the current knowledge regarding the preoperative imaging of CI candidates and explores emerging developments in different imaging modalities. Preoperative radiologic assessment should evaluate the status of the middle/inner ear, auditory nerve and central acoustic pathways. Preoperative computed tomography displays anatomic middle ear variations of surgical importance. MRI can demonstrate fluid/obliteration in the inner ear and depict the retrocochlear auditory pathways. Dual modality imaging with high-resolution computed tomography and MRI of the petrous bone and brain can provide the maximum information regarding surgical landmarks and detect deafness-related abnormalities. Cost-effectiveness issues also justify its use. New systems are now becoming available, offering improved soft-tissue delineation, sophisticated segmentation techniques, volumetric measurements, semitransparent views and superior surface resolution, thus significantly advancing our diagnostic acumen and making the preoperative evaluation of CI candidates more accurate and reliable. © 2010 Expert Reviews Ltd.


Koukourakis G.,Saint Sawas Anticancer Institute | Kouloulias V.,National and Kapodistrian University of Athens | Zacharias G.,General Hospital of Corinth | Koukourakis M.,Democritus University of Thrace
Journal of B.U.ON. | Year: 2010

Purpose: Capecitabine is an oral fluoropyrimidine which had been developed as a pro-drug of fluorouracil (FU), and had shown improved tolerability and intratumor drug concentrations through its tumor-specific conversion to the active drug. Our purpose was to make a comprehensive literature review regarding capecitabine 's efficacy in metastatic colorectal cancer. Methods: We searched the Pubmed and Cochrane databases regarding all available information on capecitabine, focusing on its clinical effectiveness against metastatic colorectal cancer. Special attention was paid on trials that compared capecitabine with standard folinic acid (leucovorin/LV)-modulated intravenous 5-fluorouracil (5-FU) bolus regimens inpatients with metastatic colorectal cancer. Moreover, the efficacy of capecitabine alone or in several combinations with other active drugs such as irinotecan and oxaliplatin on metastatic colorectal cancer were also assessed. Results: Comparative trials showed that capecitabine is at least equivalent to standard 5-FU/LV combination regarding progression-free and overall survival, expressing at the same time a better tolerability profile with a much lower incidence of stomatitis. Conclusion: Nowadays it is known that capecitabine can be combined with other active drugs such as irinotecan and oxaliplatin and the combination of oxaliplatin with capecitabine represents a new standard of care for metastatic colorectal cancer. © 2010 Zerbinis Medical Publications.


Vlastarakos P.V.,Lister Hospital | Kiprouli C.,National and Kapodistrian University of Athens | Pappas S.,General Hospital of Corinth | Xenelis J.,Hippokrateion General Hospital of Athens | And 3 more authors.
European Archives of Oto-Rhino-Laryngology | Year: 2012

The objective of the study was to evaluate the accuracy of the preoperative radiological assessment regarding 10 different middle ear structures in patients with chronic otitis media (COM). The setting of the prospective study was in a Tertiary university hospital. Fifty patients scheduled for a primary operation for COM. All patients underwent preoperative temporal bone high-resolution CT-scan (HRCT). AC1-statistics between the radiological report and the intra-operative findings were calculated. There was no correlation between the radiological assessment and the surgical findings in the scutum, attic area, and oval window. There was a poor or fair agreement on the condition of the malleus-incus complex, the status of the tympanic cavity, and the round window. There was a moderately strong agreement regarding the status of the lateral semicircular canal (LSCC) and tegmen tympani. This agreement was primarily observed, when no erosion/exposure was present in the LSCC or the dura. There was a very strong agreement in the mastoid air-cell complex and the sigmoid sinus, especially when the former was abnormal and the latter had no pathology. There are significant difficulties in radiological imaging for reliably assessing the middle ear in patients with chronic otitis media, using HRCT. The preoperative CT scan generally underestimates the actual pathology found by the surgeon in certain middle ear areas. The decision for surgical intervention should not be based on the radiological interpretation of certain middle ear structures, and ENT surgeons should be prepared to encounter conditions which are not reported by the radiologist preoperatively, and modify the operating strategy accordingly. EBM level: 2c. © 2011 Springer-Verlag.


Farmaki K.,General Hospital of Corinth | Tzoumari I.,General Hospital of Corinth | Pappa C.,General Hospital of Corinth | Chouliaras G.,National and Kapodistrian University of Athens | Berdoukas V.,National and Kapodistrian University of Athens
British Journal of Haematology | Year: 2010

Cardiac and endocrine disorders are common sequelae of iron overload in transfused thalassaemia patients. Combined chelation with desferrioxamine (DFO) and deferiprone (DFP) is well tolerated and produces an additive/synergistic effect superior to either drug alone. 52 thalassaemia major patients were transitioned from DFO to combined chelation with DFO and DFP. Serum ferritin, cardiac and hepatic iron levels were monitored regularly for up to 7 years, as were cardiac and endocrine function. Patients' iron load normalized, as judged by ferritin and cardiac and hepatic magnetic resonance imaging findings. In all 12 patients receiving treatment for cardiac dysfunction, symptoms reversed following combined chelation, enabling nine patients to discontinue heart medications. In the 39 patients with abnormal glucose metabolism, 44% normalized. In 18 requiring thyroxine supplementation for hypothyroidism, 10 were able to discontinue, and four reduced their thyroxine dose. In 14 hypogonadal males on testosterone therapy, seven stopped treatment. Of the 19 females, who were hypogonadal on DFO monotherapy, six were able to conceive. Moreover, no patients developed de novo cardiac or endocrine complications. These results suggest that intensive combined chelation normalized patients' iron load and thereby prevented and reversed cardiac and multiple endocrine complications associated with transfusion iron overload. © 2009 Blackwell Publishing Ltd.


Farmaki K.,General Hospital of Corinth | Tzoumari I.,General Hospital of Corinth | Pappa C.,General Hospital of Corinth
Blood Cells, Molecules, and Diseases | Year: 2011

Combined chelation treatment may be a better approach for transfusion-dependent thalassemia major patients with iron overload complications because of increased efficacy. Combination therapy with desferrioxamine and deferiprone has already been reported to improve survival dramatically by reversing cardiac dysfunction and other endocrine complications. Some patients have intolerance or inconvenience to parenteral desferrioxamine. The hypothesis of this study was that combining two oral chelators, deferiprone and deferasirox, might lead to similar results. Following approval by the hospital ethical committee and a written informed consent from each patient, 16 patients who fulfilled the criteria participated in a study protocol for a period of up to 2 years. Efficacy measures analysis demonstrated a statistically significant decrease of total body iron load as estimated by serum ferritin, LIC and MRI T2* indices. Regarding the safety assessment, the incidence of adverse events was minor compared to the associated toxicity of monotherapy of each drug. No new onset of iron overload-related complications was demonstrated. A reversal of cardiac dysfunction was observed in 2/4 patients, while the mean LVEF increased significantly. Regarding endocrine assessment, in 2/8 patients with impaired glucose tolerance, we noted a significant decrease in the mean 2. h glucose in OGTT. Additionally an improvement in gonadal function was observed and one male and one female gave birth to two healthy children without hormonal stimulation. Combined oral chelation in thalassemia offers the promise of easier administration, better compliance and may lead to an improvement of patient quality of life by preventing or even reversing iron overload complications. © 2011 Elsevier Inc.


Farmaki K.,General Hospital of Corinth | Berdoukas V.,Childrens Hospital of Los Angeles
European journal of Clinical and Medical Oncology | Year: 2010

Advances in the management of transfusion-dependent thalassemia major have resulted in increased survival, principally through reduction in iron-related cardiac disease. The newer challenges include the reduction and reversal of the endocrinopathies. Some early progress has been reported and has been associated with improved ability to identify organ-specific iron load and increasing the intensity of the chelation regimes. In particular, the combination of desferrioxamine and deferiprone has shown to be particularly valuable. By reducing total body iron to normal levels, some endocrinopathies have been reversed and the incidence of new morbidities has been reduced. Larger trials that will use different approaches to chelation and most likely different combinations promise to demonstrate further improvements and reductions in morbidity. They will also clarify the relative toxicities that may present with the achievements of very low total iron body stores. Irrespective of the regimes prescribed, it will be essential for these to be acceptable to patients so that the overall survival can be improved even further and for the approaches to be effective in achieving the required aims.


Papakonstantinou G.,General Hospital of Corinth
Memo - Magazine of European Medical Oncology | Year: 2013

The promise of all targeted therapies is the specific induction of cytotoxicity in malignant cells without adversely affecting normal tissues. Antibody-drug conjugates (ADCs) consist of a monoclonal antibody chemically linked to an anticancer agent, and are a niche class of drugs that raise great expectations, particularly as oncology drugs. Brentuximab vedotin and trastuzumab emtansine, both recently US Food and Drug Administration approved, open a promising new area in the therapy of hematologic malignancies and solid tumors. Further improvement of bioengineering and development of preclinical and clinical data are the challenges for the next generation of ADCs. © 2013 Springer-Verlag Wien.


Berdoukas V.,Childrens Hospital of Los Angeles | Farmaki K.,General Hospital of Corinth | Wood J.C.,Childrens Hospital of Los Angeles | Coates T.,Childrens Hospital of Los Angeles
Expert Review of Hematology | Year: 2011

Over the last 20 years, the management of thalassemia major has improved to the point where we predict that the patients life expectancy will approach that of the normal population. These outcomes result from safer blood transfusions, the availability of three iron chelators, new imaging techniques that allow organ-specific assessment of the degree of iron overload and improvement in the treatment of hepatitis. The ability to prescribe any of the three chelators, as well as their combinations, has led to a more effective reduction of the total body iron. The ability to determine the amount of iron in the liver and heart by MRI has allowed the prescription of the most appropriate chelation regime for the patient and has allowed the reconsideration of the comfort zones. Thus, normalizing iron stores not only prevents new morbidities but also reverses many complications, such as cardiac failure, hypothyroidism, hypogonadism, impaired glucose tolerance and Type 2 diabetes, therefore improving survival and patients quality of life. Furthermore, outcomes should continue to improve in the future. Starting relatively intensive chelation in younger children may prevent short stature and abnormal pubertal maturation, as well as other iron-related morbidities. In addition, further information should become available on the use of other combinations in chelation treatment, some of which have only been used in a very limited fashion so far. New safe oral chelators may also become available that may offer additional ease of use. All these advances in management do require absolute cooperation and understanding on behalf of childrens parents and subsequently the adult themself. Only with such cooperation can normal long-term survival be achieved as it is likely that adherence to treatment is the primary barrier to longevity. © 2011 Expert Reviews Ltd.


Koukourakis G.,Saint Savvas Anticancer Institute | Zacharias G.,General Hospital of Corinth
Journal of B.U.ON. | Year: 2011

In man, nicotine is commonly consumed via smoking cigarettes, cigars or pipes. The addictive liability and pharmacological effects of smoking are primarily mediated by the major tobacco alkaloid nicotine. There are elevated serum cadmium and lead levels in smokers resulting in glomerular dysfunction. There is a constant and direct attack of various cigarette smoke reagents on the oral epithelial cells, which gradually accumulate and may cause a stepwise malignant transformation. The association between cigarettes and lung cancer has been proven by large cohort studies. Tobacco use has been reported to be the main cause of 90% of male and 79% of female lung cancers. Ninety percent of deaths from lung cancer are estimated to be due to smoking. This review describes the implication of nicotine, smoking, smoke extracts and other tobacco constituents on oral cancers, lung cancer and cancers of the urinary tract. © 2011 Zerbinis Medical Publications.


PubMed | General Hospital of Corinth
Type: | Journal: Southern medical journal | Year: 2011

: The aims of this study were to estimate the hepatitis B vaccination coverage levels among nurses and understand the reasons for receiving or not receiving the preventive vaccination.: This cross-sectional study was based on a self-reported questionnaire, which was administered to 788 nurses working in 17 hospitals in Greece.: Overall, 606 out of 784 participants (77.3%) completed the survey. Of these, 63.2% nurses reported that they were fully vaccinated. The majority of immunized nurses (66%) were female (P = 0.008), and 72.6% of the fully-vaccinated nurses were working in Intensive Care Units (ICUs).: This study showed that almost 40% of nurses are not protected against hepatitis B infection. There is a need for a more aggressive approach to increase the vaccination coverage among nurses.

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