Karalis V.,Thriassio General Hospital |
Magklara E.,KLEVA Pharmaceuticals SA |
Shah V.P.,International Pharmaceutical Federation |
MacHeras P.,National and Kapodistrian University of Athens
Pharmaceutical Research | Year: 2010
This is a summary report of the conference on drug absorption and bioequivalence issues held in Titania Hotel in Athens (Greece) from the 28 th to the 30th of May 2009. The conference included presentations which were mainly divided into three sections. The first section focused on modern drug delivery systems such as polymer nanotechnology, cell immobilization techniques to deliver drugs into the brain, nanosized liposomes used in drug eluting stents, encapsulation of drug implants in biocompatible polymers, and application of differential scanning calorimetry as a tool to study liposomal stability. The importance of drug release and dissolution were also discussed by placing special emphasis on camptothecins and oral prolonged release formulations. The complexity of the luminal environment and the value of dissolution in lyophilized products were also highlighted. The second session of the conference included presentations on the Biopharmaceutics Classification Scheme (BCS), the Biopharmaceutics Drug Disposition Classification System (BDDCS), and the role of transporters in the classification of drugs. The current status of biowaivers and a modern view on non-linear in vitro-in vivo (IVIVC) correlations were also addressed. Finally, this section ended with a special topic on biorelevant dissolution media and methods. The third day of the conference was dedicated to bioequivalence. Emphasis was placed on high within-subject variability and its impact on study design. Two unresolved issues of bioequivalence were also discussed: the use of generic antiepileptic drugs and the role of metabolites in bioequivalence assessment. Finally, the conference closed with a presentation of the current regulatory status of WHO and EMEA. © 2010 Springer Science+Business Media, LLC.
Bafa M.,Thriassio General Hospital |
Georgopoulos G.,National and Kapodistrian University of Athens |
Mihas C.,Thriassio General Hospital |
Stavrakas P.,Thriassio General Hospital |
And 2 more authors.
Acta Ophthalmologica | Year: 2011
Purpose: To evaluate the effect of prostaglandin analogues on the central corneal thickness (CCT) of patients with chronic open-angle glaucoma (COAG). Methods: One hundred and twenty-nine eyes were included in this study. Of these, 108 were treated with prostaglandin analogues (latanoprost, travoprost and bimatoprost), while 21 eyes treated with β-blockers were used as controls. CCT was measured before treatment and at 3-month intervals. Results: A slight but significant increase in CCT was recorded in the bimatoprost and latanoprost groups. Treatment with bimatoprost produced a constant increase (1.85-8.83 μm) in CCT at all time-points of the study. The CCT rise found in the latanoprost group was significant for the first year. Treatment with travoprost did not affect CCT. Conclusion: The possibility of corneal thickening under prolonged, local prostaglandin treatment should be investigated further. However, in clinical practice, CCT changes may sometimes influence intraocular pressure measurements significantly. © 2009 Acta Ophthalmol.
Koupetori M.,Thriassio General Hospital |
Retsas T.,National and Kapodistrian University of Athens |
Antonakos N.,Rimini Street |
Vlachogiannis G.,Aghios Dimitrios General Hospital |
And 10 more authors.
BMC Infectious Diseases | Year: 2014
Background: Choice of empirically prescribed antimicrobials for sepsis management depends on epidemiological factors. The epidemiology of sepsis in Greece was studied in two large-periods.Methods: Sepsis due to bloodstream infections (BSI) from July 2006 until March 2013 was recorded in a multicenter study in 46 departments. Patients were divided into sepsis admitted in the emergencies and hospitalized in the general ward (GW) and sepsis developing after admission in the Intensive Care Unit (ICU). The primary endpoints were the changes of epidemiology and the factors related with BSIs by multidrug-resistant (MDR) pathogens; the secondary endpoint was the impact of de-escalation on antimicrobial therapy.Results: 754 patients were studied; 378 from 2006-2009 and 376 from 2010-2013. Major differences were recorded between periods in the GW. They involved increase of: sepsis severity; the incidence of underlying diseases; the incidence of polymicrobial infections; the emergence of Klebsiella pneumoniae as a pathogen; and mortality. Factors independently related with BSI by MDR pathogens were chronic hemofiltration, intake of antibiotics the last three months and residence into long-term care facilities. De-escalation in BSIs by fully susceptible Gram-negatives did not affect final outcome. Similar epidemiological differences were not found in the ICU; MDR Gram-negatives predominated in both periods.Conclusions: The epidemiology of sepsis in Greece differs in the GW and in the ICU. De-escalation in the GW is a safe strategy. © 2014 Koupetori et al.; licensee BioMed Central Ltd.
Spyropoulou G.-A.,Thriassio General Hospital |
Karamatsoukis S.,Thriassio General Hospital |
Foroglou P.,Aristotle University of Thessaloniki
Aesthetic Plastic Surgery | Year: 2011
Background: Five cases of unilateral occupation-related pseudogynecomastia are presented. All the patients in these cases worked in the same metal-pressing factory. Methods: One patient with grade 4 unilateral gynecomastia in the right breast presented to the authors' outpatient department asking persistently for surgery. He also reported that all his male colleagues working in the same business (a total of 5) had different degrees of unilateral gynecomastia. Their line of work involved holding a long round rod under the axilla and then pressing the distal end of it firmly against a spinning metal plate. The patient underwent a superior pedicle breast reduction, with 1,800 ml of tissue removed from his right breast. Unfortunately, the patient experienced partial nipple loss. However, he was satisfied with the final result, and good symmetry was achieved. Results: All five patients who worked in the same metalpressing factory presented with unilateral gynecomastia and were examined in our department. Their average age was 51.4 years. All the patients had normal hormonal and biochemical status, and the results of screening for toxins and heavy metal exposure were negative. All the patients were heavy smokers. At examination, none of the patients had nipple discharge or retraction, skin changes, galactorrhea, or lymphadenopathy. Examination showed one patient with grade 4, three patients had grade 2, and one patient with grade 1 unilateral gynecomastia. Conclusions: The authors believe that gynecomastia may be considered an occupational risk in analogous metal-pressing factories because all the workers in this factory presented with some degree of unilateral gynecomastia. However, they emphasize that this may simply be an observational phenomenon without a true cause and effect relationship. © Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2010.
Simopoulos V.,University of Thessaly |
Tagarakis G.I.,University of Thessaly |
Daskalopoulou S.S.,McGill University |
Daskalopoulos M.E.,Thriassio General Hospital |
And 6 more authors.
Angiology | Year: 2014
Ranolazine is a relatively novel antiischemic/antianginal compound with antiarrhythmic properties. We investigated its ability to shorten the time to conversion of postoperative atrial fibrillation (POAF) when added to amiodarone after coronary artery bypass graft (CABG) surgery. In this prospective, randomized, allocation-concealed, single-blind, single-site clinical trial, we enrolled consecutive eligible patients who developed POAF after elective on-pump CABG surgery. Participants were randomized to receive either ranolazine 375 mg twice daily orally plus intravenous amiodarone (active group) or intravenous amiodarone alone (control group). We enrolled 41 patients; 20 in the active and 21 in the control group. There were no significant differences between the groups in terms of age, procedural duration, extracorporeal circulation time, and aortic cross-clamp time. Mean time of conversion was significantly shorter in the active group (19.9 ± 3.2 vs 37.2 ± 3.9 hours, P <.001), suggesting that compared to amiodarone alone, the ranolazine-amiodarone combination had a superior antiarrhythmic effect against POAF. © The Author(s) 2013.
Eleni K.,Thriassio General Hospital
Journal of the European Academy of Dermatology and Venereology | Year: 2015
Background: The tremendous increase in the use of drugs has considerably increased their side effects. Objectives: The aim of this work is to demonstrate Dress syndrome induced by levetiracetam an anti-epileptic drug. Methods: We describe a skin eruption observed in an-hospitalized in an intensive care unit patient who received levetiracetam. Results: According to morphology of the rash and the laboratory findings the rash fulfills the criteria for Dress syndrome. Conclusion: Levetiracetam may induce Dress syndrome. © 2014 European Academy of Dermatology and Venereology.
Karadima V.,Thriassio General Hospital
Archives of Hellenic Medicine | Year: 2015
Fractures of the scaphoid bone present relatively frequently in the primary health care (PHC) setting. The diagnosis is not always obvious, and delay worsens the prognosis. Scaphoid fractures constitute 2-7% of all recorded fractures in humans, but the true incidence is estimated to be greater because of misdiagnosis. The majority of patients are young men. The diagnosis is usually confirmed by radiography, and only in a few cases advanced imaging procedures are needed. Treatment may be conservative or surgical, depending on the type of fracture. A cast should be applied even on suspicion of fracture, as many fractures are occult on the preliminary X-rays. Patients with early immobilization have an excellent prognosis. Late diagnosis of scaphoid fracture is an important cause of dysfunction of the wrist joint, and therefore fractures should be identified and treated without delay. © Athens Medical Society.
Beltsios M.,Thriassio General Hospital
Journal of surgical orthopaedic advances | Year: 2010
The management of scaphoid nonunion in heavy manual workers is challenging. Symptoms appear earlier and manual labor-related stress at the operated nonunion site may worsen the postoperative outcome. This study involved 16 heavy manual workers with scaphoid nonunion (11 cases involving the dominant hand) treated by internal fixation and autologous bone grafting. The nonunion was in 12 patients in the waist, in 3 patients in the proximal, and in 1 patient in the distal pole of the scaphoid. Clinical and radiographic evaluation of union was done according to the criteria of Bynum et al. and Fernandez and Eggli. Pain, wrist motion, and grip strength were evaluated and compared to the contralateral side. At a mean follow-up of 24 months (range, 10 months to 6 years), the mean range of motion and the grip strength compared to the contralateral hand were 95% and 91%, respectively. Overall hand function was excellent in 13 patients, good in 2 patients, and fair in 1 patient. All except one patient were pain free and returned to their work without or with minimal complaints at an average of 3.4 months (range, 2-6 months), postoperatively. In 15 patients, scaphoid nonunions healed at a mean time of 64 days. One patient had a reoperation, and union was observed at 90 days after the second operation. In all patients, the radiolunate angle was restored to normal. One patient developed complex regional pain syndrome that resolved completely after 2 months with adequate intensive physical therapy. Clinical symptoms of scaphoid nonunions are more severe and appear earlier in heavy manual workers; in this group of patients, surgical treatment is necessary. The double-threaded screw provides adequate stabilization for union. Autologous cancellous bone graft, because of its plasticity and malleability to exactly fill the scaphoid defect, is recommended.
Ninos A.P.,Thriassio General Hospital |
Pierrakakis S.K.,Thriassio General Hospital
World Journal of Gastroenterology | Year: 2011
A pancreatic pleural effusion may result from a pan-creatopleural fistula. We herein discuss two interesting issues in a similar case report of a pleural effusion caused after splenectomy, which was recently published in the World Journal of Gastroenterology. Pancreatic exudate passes directly through a natural hiatus in the diaphragm or by direct penetration through the dome of the diaphragm from a neighboring sub-diaphragmatic collection. The diaphragmatic lymphatic "stomata" does not contribute to the formation of such a pleural effusion, as it is inaccurately mentioned in that report. A strictly conservative approach is recommended in that article as the management of choice. Although this may be an option in selected frail patients, there has been enough accumulative evidence that a pancreaticopleural fistula may be best managed by early endoscopy in order to avoid complications causing prolonged hospitalization. © 2011 Baishideng. All rights reserved.
McNicol E.D.,Tufts Medical Center |
Tzortzopoulou A.,Thriassio General Hospital |
Cepeda M.S.,Tufts Medical Center |
Francia M.B.D.,Rush University Medical Center |
And 2 more authors.
British Journal of Anaesthesia | Year: 2011
Paracetamol is the most commonly prescribed analgesic for the treatment of acute pain. The efficacy and safety of i.v. formulations of paracetamol is unclear. We performed a systematic search (multiple databases, bibliographies, any language, to May 2010) for single-dose, randomized, controlled clinical trials of propacetamol or i.v. paracetamol for acute postoperative pain in adults or children. Thirty-six studies involving 3896 patients were included. For the primary outcome, 37 of patients (240/367) receiving propacetamol or i.v. paracetamol experienced at least 50 pain relief over 4 h compared with 16 (68/527) receiving placebo (number needed to treat4.0; 95 confidence interval, 3.54.8). The proportion of patients in propacetamol or i.v. paracetamol groups experiencing at least 50 pain relief diminished over 6 h. Patients receiving propacetamol or paracetamol required 30 less opioid over 4 h and 16 less opioid over 6 h than those receiving placebo. However, this did not translate to a reduction in opioid-induced adverse events (AEs). Similar comparisons between propacetamol or i.v. paracetamol and active comparators were either not statistically significant, not clinically significant, or both. AEs occurred at similar rates with propacetamol or i.v. paracetamol and placebo. However, pain on infusion occurred more frequently in those receiving propacetamol compared with placebo (23 vs 1). A single dose of either propacetamol or i.v. paracetamol provides around 4 h of effective analgesia for about 37 of patients with acute postoperative pain. Both formulations are associated with few AEs, although patients receiving propacetamol have a higher incidence of pain on infusion. © The Author .