Psarras K.,Hippokration Hospital
Techniques in coloproctology | Year: 2011
Diverticular disease is a common problem in the western population and sometimes leads to serious complications such as hemorrhage, bowel stenosis, obstruction, abscesses, fistulae, bowel perforation, and peritonitis. The severity of these complications can differ, and it is not always clear which procedure is indicated in each case and what measures should be followed before bringing the patient into the operating room. Certain operations have high rates of morbidity and mortality, especially in compromised patients. Along with advancements in imaging and minimally invasive techniques, the indications for surgery have currently being adapted to "damage limitation" or "down-staging" protocols, which seem to offer improved results. There are still some questions to be solved in the following years by prospective studies, such as the usefulness of laparoscopic lavage in purulent peritonitis or of Hartmann's procedure in fecal peritonitis. These indications, based on current literature, are systematically discussed in the present review.
Anagnostis P.,Hippokration Hospital
BMJ case reports | Year: 2013
We report a case of severe eyelid oedema due to Graves' ophthalmopathy (GO). The aim was to present a case report and review of the literature about eyelid oedema due to GO. The case report includes a history of patient data and literature review. The patient was offered intravenous methylprednisolone and gave consent. A dosage of 500 mg intravenous methylprednisolone once weekly for 6 weeks, followed by 250 mg intravenous methylprednisolone once weekly for 6 weeks, with a total treatment period of 12 weeks was given. Up to day, minor improvement has been observed. Severe eyelid oedema due to GO is a rare manifestation of Graves' disease. In cases of active and moderate-to-severe disease, treatment with intravenous glucorticoids is recommended alone or with orbital radiotherapy, followed by rehabilitative surgery.
Zafeiriou D.I.,Aristotle University of Thessaloniki |
Ververi A.,Aristotle University of Thessaloniki |
Dafoulis V.,Hippokration Hospital |
Kalyva E.,University of Sheffield |
Vargiami E.,Aristotle University of Thessaloniki
American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics | Year: 2013
Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental disabilities with various etiologies, but with a heritability estimate of more than 90%. Although the strong correlation between autism and genetic factors has been long established, the exact genetic background of ASD remains unclear. A number of genetic syndromes manifest ASD at higher than expected frequencies compared to the general population. These syndromes account for more than 10% of all ASD cases and include tuberous sclerosis, fragile X, Down, neurofibromatosis, Angelman, Prader-Willi, Williams, Duchenne, etc. Clinicians are increasingly required to recognize genetic disorders in individuals with ASD, in terms of providing proper care and prognosis to the patient, as well as genetic counseling to the family. Vice versa, it is equally essential to identify ASD in patients with genetic syndromes, in order to ensure correct management and appropriate educational placement. During investigation of genetic syndromes, a number of issues emerge: impact of intellectual disability in ASD diagnoses, identification of autistic subphenotypes and differences from idiopathic autism, validity of assessment tools designed for idiopathic autism, possible mechanisms for the association with ASD, etc. Findings from the study of genetic syndromes are incorporated into the ongoing research on autism etiology and pathogenesis; different syndromes converge upon common biological backgrounds (such as disrupted molecular pathways and brain circuitries), which probably account for their comorbidity with autism. This review paper critically examines the prevalence and characteristics of the main genetic syndromes, as well as the possible mechanisms for their association with ASD. © 2013 Wiley Periodicals, Inc.
Toutouzas K.,Hippokration Hospital
The Journal of invasive cardiology | Year: 2012
We report the case of a patient presenting with unstable angina, in whom information obtained by coronary angiography was inconclusive for the existence of a culprit lesion in the ostium of the right coronary artery. The use of optical coherence tomography was required for proper lesion assessment.
Zografos G.,National and Kapodistrian University of Athens |
Koulocheri D.,Hippokration Hospital |
Liakou P.,National and Kapodistrian University of Athens |
Marmarelis V.,University of Southern California
European Radiology | Year: 2013
Objectives: To introduce a new three-dimensional (3D) diagnostic imaging technology, termed "multimodal ultrasonic tomography" (MUT), for the detection of breast cancer without ionising radiation or compression. Methods: MUT performs 3D tomography of the pendulant breast in a water-bath using transmission ultrasound in a fixed-coordinate system. Specialised electronic hardware and signal processing algorithms are used to construct multimodal images for each coronal slice, corresponding to measurements of refractivity and frequency-dependent attenuation and dispersion. In-plane pixel size is 0.25 mm × 0.25 mm and the inter-slice interval can vary from 1 to 4 mm, depending on clinical requirements. MUT imaging was performed on 25 patients ("off-label" use for research purposes only), presenting lesions with sizes >10 mm. Histopathology of biopsy samples, obtained from all patients, were used to evaluate the MUT outcomes. Results: All lesions (21 malignant and four benign) were clearly identified on the MUT images and correctly classified into benign and malignant based on their respective multimodal information. Malignant lesions generally exhibited higher values of refractivity and frequency-dependent attenuation and dispersion. Conclusion: Initial clinical results confirmed the ability of MUT to detect and differentiate all suspicious lesions with sizes >10 mm discernible in mammograms of 25 female patients. Key Points: • Technical advances in ultrasound offer new diagnostic opportunities in breast imaging • 3D ultrasound can detect breast cancer without ionising radiation or compression • Multimodal 3D ultrasound assesses acoustic refractivity, frequency-dependent attenuation and dispersion • MUT can differentiate between benign and malignant breast lesions © 2012 European Society of Radiology.