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Zavras N.,National and Kapodistrian University of Athens | Kostakis I.D.,National and Kapodistrian University of Athens | Sakellariou S.,National and Kapodistrian University of Athens | Damaskos C.,National and Kapodistrian University of Athens | And 6 more authors.
International Urology and Nephrology | Year: 2014

Purpose: Tissue damage in testicular torsion/detorsion is caused not only by the ischemia, but also by the ischemia/reperfusion injury after detorsion. Erythropoietin and sildenafil are considered to protect against ischemia/reperfusion injury. Here, we studied and compared their actions in testicular torsion/detorsion in adult rats. Methods: Twenty-two adult male Wistar Albino rats were divided into four groups. Rats in group A (n = 5) were sham operated. Rats in group B (n = 5), group C (n = 6) and group D (n = 6) underwent torsion of the right testis and detorsion after 90 min. No pharmaceutical intervention was performed in group B. Erythropoietin (1,000 IU/kg) and sildenafil (0.7 mg/kg) were injected intraperitoneally in groups C and D, respectively, after 60 min of torsion. All animals were killed 24 h after detorsion, and their right testis was extracted, placed into 10 % formalin solution and sent for histopathological examination. The histological changes in the testes were scored according to the four-point grading system proposed by Cosentino et al. Results: All rats in group A had normal testicular architecture (grade 1). The untreated group B had a mean grade of 3.81 (range 3.65-4). The treated groups C (mean grade 3.24; range 3.05-3.45) and D (2.69, range 2.4-2.9) presented statistically significant better results (lower grades) compared with the untreated group B. Group D had significantly better results (lower grades) than group C. Conclusions: The intraperitoneal injection of erythropoietin and sildenafil protects against ischemia/reperfusion injury after testicular torsion and detorsion. Sildenafil may have a stronger action than erythropoietin at the doses used in this study. © 2013 Springer Science+Business Media Dordrecht. Source

Theodoros D.,Penteli General Childrens Hospital | Nikolaides P.,P and A Kuriakou | Petousis G.,P and A Kuriakou
African Journal of Paediatric Surgery | Year: 2010

Despite of a number of techniques in the armentarium of the paediatric surgeon, the management of pancreatic pseudocysts remains a challenge. We report on a case of a 5-year-old child with a post-traumatic pancreatic pseudocyst who was successfully treated with endoscopic ultrasound-guided transgastric approach. Endoscopic ultrasound-guided transgastric drainage of a pancreatic pseudocyst is effective and safe in children. Source

Vaos G.,Democritus University of Thrace | Zavras N.,Penteli General Childrens Hospital | Zavras N.,National and Kapodistrian University of Athens | Eirekat K.,Penteli General Childrens Hospital
International Urology and Nephrology | Year: 2014

Testicular dysmorphism (TD) associated with infantile abdominoscrotal hydrocele (ASH) may be due to the pressure effect of hydrocele on the testis or may be a developmental abnormality. Only a few reports are referred to the etiology of testicular changes in infantile ASH. We present an additional case of infantile ASH together with a review of the literature, focusing on insights into etiology of TD and its appropriate management. © 2014 Springer Science+Business Media. Source

Zavras N.,National and Kapodistrian University of Athens | Tsamoudaki S.,Penteli General Childrens Hospital | Ntomi V.,National and Kapodistrian University of Athens | Yiannopoulos I.,General Hospital of Lamia | And 2 more authors.
Korean Journal of Pain | Year: 2015

Background: Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. Methods: We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial plasty technique (PP), and conventional circumcision (CC). Demographics and base-line clinical characteristics were collected, and assessment of the level of preoperative anxiety was performed. Subsequently, a statistical model was designed in order to examine predictive factors of postoperative pain and postoperative anxiety. Assessment of postoperative pain was performed using the Faces Pain Scale (FPS). The Post Hospitalization Behavior Questionnaire study was used to assess negative behavioral manifestations. Results: A total of 301 children with a mean age of 7.56 ± 2.61 years were included in the study. Predictive factors of postoperative pain measured with the FPS included a) the type of surgical technique, b) the absence of siblings, and c) the presence of postoperative complications. Predictive factors of postoperative anxiety included a) the type of surgical technique, b) the level of education of mothers, c) the presence of preoperative anxiety, and d) a history of previous surgery. Conclusions: Although our study was not without its limitations, it expands current knowledge by adding new predictive factors of postoperative pain and postoperative anxiety. Clearly, further randomized controlled studies are needed to confirm its results. © The Korean Pain Society, 2015. Source

Zavras N.,Penteli General Childrens Hospital | Christianakis E.,Penteli General Childrens Hospital | Tsamoudaki S.,Penteli General Childrens Hospital | Velaoras K.,Penteli General Childrens Hospital
Case Reports in Dermatology | Year: 2012

Infantile perianal pyramidal protrusion (IPPP) is characterized by a protrusion located most often anterior to the anus. Three types of IPPPs are recognized: (a) constitutional, (b) acquired (mainly due to constipation), and (c) IPPPs due to lichen sclerosus et atrophicus. The aim of this study was to make a brief review on IPPPs from articles retrieved from PubMed, and to present our experience in this field. We conclude that awareness of pediatric surgeons and pediatricians of the condition is essential for the correct diagnosis of IPPP, and could help to avoid erroneous investigation of other lesions in this area. © 2012 S. Karger AG, Basel. Source

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