St Savvas Hospital

Athens, Greece

St Savvas Hospital

Athens, Greece
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Leventis M.D.,National and Kapodistrian University of Athens | Fairbairn P.,University of Detroit Mercy | Dontas I.,National and Kapodistrian University of Athens | Faratzis G.,St Savvas Hospital | And 4 more authors.
Implant Dentistry | Year: 2014

PURPOSE: The aim of this study was to evaluate the effect of a biphasic synthetic bone graft material composed of β-tricalcium phosphate (β-TCP) and calcium sulfate (CS) in 12 New Zealand rabbits. MATERIALS AND METHODS: A circular bicortical critical-size cranial defect was created in each of 12 rabbits. The defects were grafted with β-TCP/CS. Animals were euthanized at 3 and 6 weeks. Harvested tissue specimens were evaluated histologically and histomorphometrically. Parameters associated with new bone formation and graft resorption were measured and calculated. The results were statistically analyzed using the Mann-Whitney test. RESULTS: Our data demonstrated the biocompatibility of synthetic β-TCP/CS, as no inflammatory response was observed, and no fibrosis was developed between the graft particles and the newly formed bone. Moreover, β-TCP/CS acted as an osteoconductive scaffold that allowed a significant bone regeneration and graft biodegradation with time. CONCLUSION: In this animal model, synthetic β-TCP/CS proved to be a biocompatible, osteoconductive, and bioresorbable bone graft substitute. Copyright © 2013 by Lippincott Williams & Wilkins.


Loupatatzi A.,Agia Sofia Childrens Hospital | Stavrianos S.D.,St Savvas Hospital | Karantonis F.F.,Athens Naval Hospital | Machairas A.,National and Kapodistrian University of Athens | And 3 more authors.
Journal of Oral and Maxillofacial Surgery | Year: 2014

Purpose: To investigate gender and other possible factors affecting the frequency and severity of postoperative complications in head and neck cancer free flap reconstruction. Materials and Methods: A prospective longitudinal cohort study was conducted at the Greek Anticancer Institute, St. Savvas Hospital in head and neck cancer free flap reconstruction concerning postoperative complications. We documented the patients' demographic characteristics, social habits, and perioperative factors (ie, duration of general anesthesia), reconstructive techniques, neoadjuvant radiotherapy, and physical status. Initially, univariate statistical analysis was performed to confirm which predictor variables might influence the presence and severity of complications. Next, multivariate statistical analysis was performed using logistical regression and including the factors that were statistically significant on univariate analysis. Results: From 1999 to 2009, we assessed 95 patients who had undergone surgery for head and neck cancer. Of the 95 patients, 24 were women and 71 were men. The patient age range was 20 to 87 years (mean 52, median 55). A total of 55 complications occurred in 49 patients (51.57%). Of the 55 complications, 12 (12.63%) were of major severity, 21 (22.10%) of median severity, and 22 (23.15%) of low severity. The statistical analysis revealed that the factors associated with complications were preoperative radiotherapy, female gender, and operation time. The factors associated with severe complications were female gender and alcohol use. Conclusions: Multivariate analysis of the data revealed that the factor associated with an increased incidence of postoperative complications was preoperative radiotherapy. Moreover, the variable that remained statistically significant and correlated with an increased incidence and severity of free flap reconstruction complications was female gender. Identifying the etiology of these findings is an intriguing field for additional research. © 2014 Published by Elsevier Inc on behalf of the American Association of Oral and Maxillofacial Surgeons. All rights reserved.


Piperis M.,St Savvas Hospital | Provatopoulou X.,Hellenic Anticancer Institute | Sagkriotis A.,Hellenic Anticancer Institute | Kalogera E.,Hellenic Anticancer Institute | And 4 more authors.
Anticancer Research | Year: 2012

Background: The aim of this study was to investigate the effect of breast cancer adjuvant therapies on the levels of circulating surfactant protein-D (SP-D), C-Reactive protein (CRP) and soluble receptor for advanced glycation end-products (sRAGE), as potential biomarkers of subclinical pulmonary inflammation. Materials and Methods: The soluble molecules were serially determined in 38 patients, prior to the initiation of radiation therapy (RT) and during adjuvant treatment, using immunoassays. Results: Significantly higher levels of all three biomarkers were observed in patients prior to the initiation of RT compared to healthy controls (CRP: p<0.001, SP-D: p<0.05, sRAGE: p<0.05). SP-D levels exhibited a gradual increase after RT and during follow-up (p<0.005). Patients treated with a combination of RT and hormonal therapy presented a significant, but less pronounced, increase in SP-D and a significant decrease in CRP compared to those who did not receive hormonal therapy (p=0.0428 and p=0.0116, respectively). Patients treated with a combination of RT and trastuzumab presented a significant increase in SP-D levels (p=0.0310). Conclusion: The average rate of change in the levels of circulating SP-D and CRP during postoperative irradiation and adjuvant hormonal therapy suggests that the combined therapeutic regiment may potentially exert important anti-inflammatory effects on the lung. On the contrary, combined administration of RT and trastuzumab is likely to induce or provoke pulmonary inflammation.


PubMed | HYGEIA Hospital, National School of Management, St Savvas Hospital, University General Hospital of Heraklion and 2 more.
Type: | Journal: BMC health services research | Year: 2015

The objective of our study was to conduct a cost-effectiveness (CE) study of combined everolimus (EVE) and exemestane (EXE) versus the common clinical practice in Greece for the treatment of postmenopausal women with HR+/HER2- advanced breast cancer (BC) progressing on nonsteroidal aromatase inhibitors (NSAI). The combinations of bevacizumab (BEV) plus paclitaxel (PACL) and BEV plus capecitabine (CAPE) were selected as comparators.A Markov model, consisting of three health states, was used to describe disease progression and evaluate the CE of the comparators from a third-party payer perspective over a lifetime horizon. Efficacy and safety data as well as utility values considered in the model were extracted from the relevant randomized Phase III clinical trials and other published studies. Direct medical costs referring to the year 2014 were incorporated in the model. A probabilistic sensitivity analysis was conducted to account for uncertainty and variation in the parameters of the model. Primary outcomes were patient survival (life-years), quality-adjusted life years (QALYs), total direct costs and incremental cost-effectiveness ratios (ICER).The discounted quality-adjusted survival of patients treated with EVE plus EXE was greater by 0.035 and 0.004 QALYs, compared to BEV plus PACL and BEV plus CAPE, respectively. EVE plus EXE was the least costly treatment in terms of drug acquisition, administration, and concomitant medications. The total lifetime cost per patient was estimated at 55,022, 67,980, and 62,822 for EVE plus EXE, BEV plus PACL, and BEV plus CAPE, respectively. The probabilistic analysis confirmed the deterministic results.Our results suggest that EVE plus EXE may be a dominant alternative relative to BEV plus PACL and BEV plus CAPE for the treatment of HR+/HER2- advanced BC patients failing initial therapy with NSAIs.


Orphanos G.,St Savvas Hospital | Alexopoulos A.,St Savvas Hospital | Malliou S.,St Savvas Hospital | Ioannidis G.,St Savvas Hospital | And 4 more authors.
Journal of Cancer Research and Clinical Oncology | Year: 2010

Purpose: Survival time for metastatic breast cancer (MBC) can be substantially improved by combination chemotherapy in the adjuvant setting. Capecitabine and vinorelbine have shown considerable efficacy and favourable toxicity as single agents. The aim of this study is to evaluate the response to the combination of capecitabine and vinorelbine as second-line treatment in patients previously treated with taxanes and/or anthracyclines. Patients and methods: Thirty-nine patients with MBC, who received a combination of vinorelbine and capecitabine were included in the study. Results: Overall response rate was 53.9% and disease progression rate was 28.2% for patients who received six cycles of therapy, rates significantly higher than the three-cycle group. The treatment was generally well tolerated and toxicity was mild. Conclusions: The combination of capecitabine and vinorelbine as salvage therapy in anthracycline- and/or taxane-pre-treated patients with MBC seems to be effective and safe, even more so as the number of treatment cycles increases. © 2009 Springer-Verlag.


Fassoulaki A.,Aretaieio Hospital | Vassi E.,St Savvas Hospital | Korkolis D.,St Savvas Hospital | Zotou M.,St Savvas Hospital
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques | Year: 2016

Wound infusion with local anesthetics has been used for postoperative pain relief with variable results. This randomized, controlled, double-blind clinical trial examines the effect of ropivacaine infusion on pain after laparoscopic cholecystectomy. A total of 110 patients were randomly assigned to 2 groups. After induction of anesthesia a 75-mm catheter was inserted subcutaneously and connected to an elastomeric pump containing either 0.75% ropivacaine (ropivacaine group) or normal saline (control group) for 24 hours postoperatively. Before skin closure, each hole was infiltrated with 2mL of 0.75% ropivacaine or normal saline according to randomization. Pain at rest, pain during cough, and analgesic consumption were recorded in the postanesthesia care unit and at 2, 4, 8, 24, and 48 hours postoperatively. Analgesic requirements and pain scores were recorded 1 and 3 months after surgery. The ropivacaine group reported less pain during cough (P=0.044) in the postanesthesia care unit (P=0.017) and 4 hours postoperatively (P=0.038). Ropivacaine wound infusion had no effect on late and chronic pain. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Archontaki M.,St Savvas Hospital | Athanasiou A.,St Savvas Hospital | Stavrianos S.D.,St Savvas Hospital | Korkolis D.P.,St Savvas Hospital | And 4 more authors.
European Archives of Oto-Rhino-Laryngology | Year: 2010

Purpose To study speech and swallowing in patients who underwent microvascular free Xap reconstruction after major surgery of the oral cavity. Patients and methods Twenty patients, 17 men and 3 women, with a mean age of 58.5 years (range 27-79 years) were included in the study. Squamous cell carcinoma was the most common malignancy. Swallowing assessment was performed through videoXuoroscopy, using three consistencies of barium meal. The recorded swallows were assessed for the ability to hold the bolus during the oral phase, lip seal, tongue movement, residue in the Xoor of the mouth, laryngeal penetration and aspiration. Speech function regarding intelligibility and articulation was objectively assessed. Results Fifteen out of 20 patients (75%) had a good lip seal. Fourteen patients (73.6%) had adequate control of bolus, while in 89.4% the neotongue motility was satisfactory. Vallecular residue was noted in 25% of patients, laryngeal penetration in two (10%), while three patients (15%) continued to have signiWcant aspiration, which necessitated continuous feeding through a gastrostomy. Postoperative speech intelligibility and articulation was satisfactory in 75 and 62.5% of the patients, respectively. Conclusions Microvascular free Xap reconstruction of major defects after oral resections rehabilitates the functions of swallowing and speech in acceptable levels, improving quality of life in these patients. © 2010 Springer-Verlag.


PubMed | St Savvas Hospital
Type: Clinical Trial, Phase II | Journal: Journal of cancer research and clinical oncology | Year: 2011

Survival time for metastatic breast cancer (MBC) can be substantially improved by combination chemotherapy in the adjuvant setting. Capecitabine and vinorelbine have shown considerable efficacy and favourable toxicity as single agents. The aim of this study is to evaluate the response to the combination of capecitabine and vinorelbine as second-line treatment in patients previously treated with taxanes and/or anthracyclines.Thirty-nine patients with MBC, who received a combination of vinorelbine and capecitabine were included in the study.Overall response rate was 53.9% and disease progression rate was 28.2% for patients who received six cycles of therapy, rates significantly higher than the three-cycle group. The treatment was generally well tolerated and toxicity was mild.The combination of capecitabine and vinorelbine as salvage therapy in anthracycline- and/or taxane-pre-treated patients with MBC seems to be effective and safe, even more so as the number of treatment cycles increases.


PubMed | St Savvas Hospital
Type: Comparative Study | Journal: Journal of B.U.ON. : official journal of the Balkan Union of Oncology | Year: 2012

The purpose of the current experimental research was to investigate whether hydroxyzine can reduce the necrotic area in ischemia-reperfusion injury in epigastric rat skin flaps and to compare its role with cimetidine and vitamin C.From a total of 77 ischemic rat skin flaps, 18 were treated with normal saline, 18 with vitamin C, 18 with cimetidine and 18 with hydroxyzine before reperfusion. Flap necrotic area, neutrophils and mast cells were measured on the 7th day. Analysis of variance for multiple comparisons and post hoc Dunnetts test were used for statistical analyses.The sham group of animals (n=5) showed 0% flap necrosis. The saline-treated group demonstrated 7515.3% of necrosis. The vitamin C, cimetidine and hydroxyzine groups had 56.2 24.4%, 25.8 19.3%, and 33.6 27.8% of flap necrosis, respectively. In addition, the number of neutrophils and mast cells were decreased in the pharmacologically treated groups compared with flaps perfused with normal saline (p<0.05).Our data suggest that administering hydroxyzine in rat epigastric skin flaps before reperfusion may attenuate necrosis, neutrophils and mast cell counts. The beneficial effect of cimetidine was the same as hydroxyzines but the use of vitamin C was less effective.


PubMed | St Savvas Hospital
Type: Journal Article | Journal: Anticancer research | Year: 2012

The aim of this study was to investigate the effect of breast cancer adjuvant therapies on the levels of circulating surfactant protein-D (SP-D), C-Reactive protein (CRP) and soluble receptor for advanced glycation end-products (sRAGE), as potential biomarkers of subclinical pulmonary inflammation.The soluble molecules were serially determined in 38 patients, prior to the initiation of radiation therapy (RT) and during adjuvant treatment, using immunoassays.Significantly higher levels of all three biomarkers were observed in patients prior to the initiation of RT compared to healthy controls (CRP: p<0.001, SP-D: p<0.05, sRAGE: p<0.05). SP-D levels exhibited a gradual increase after RT and during follow-up (p<0.005). Patients treated with a combination of RT and hormonal therapy presented a significant, but less pronounced, increase in SP-D and a significant decrease in CRP compared to those who did not receive hormonal therapy (p=0.0428 and p=0.0116, respectively). Patients treated with a combination of RT and trastuzumab presented a significant increase in SP-D levels (p=0.0310).The average rate of change in the levels of circulating SP-D and CRP during postoperative irradiation and adjuvant hormonal therapy suggests that the combined therapeutic regiment may potentially exert important anti-inflammatory effects on the lung. On the contrary, combined administration of RT and trastuzumab is likely to induce or provoke pulmonary inflammation.

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