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Search Results: 1 - 10 of 179 matches for " Efstratios Parikakis "
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Changing from bevacizumab to ranibizumab in age-related macular degeneration. Is it safe?
Dimitrios A Karagiannis, Ioannis D Ladas, Efstratios Parikakis, et al.
Clinical Interventions in Aging , 2009, DOI: http://dx.doi.org/10.2147/CIA.S8367
Abstract: nging from bevacizumab to ranibizumab in age-related macular degeneration. Is it safe? Original Research (4974) Total Article Views Authors: Dimitrios A Karagiannis, Ioannis D Ladas, Efstratios Parikakis, et al. Published Date November 2009 Volume 2009:4 Pages 457 - 461 DOI: http://dx.doi.org/10.2147/CIA.S8367 Dimitrios A Karagiannis1, Ioannis D Ladas2, Efstratios Parikakis1, Ilias Georgalas2, Athanasios Kotsolis2, Giorgos Amariotakis1, Vasileios Soumplis1, Panagiotis Mitropoulos1 1Ophthalmiatrio Eye Hospital of Athens, Athens, Greece; 2First Department of Ophthalmology, Medical School of Athens University, General Hospital of Athens, Athens, Greece Objective: To report our experiences in changing from intravitreal bevacizumab to ranibizumab in age-related macular degeneration (AMD). Design: Retrospective case series. Participants and methods: We retrospectively reviewed the records of 34 patients (36 eyes) who were treated with monthly injections of intravitreal bevacizumab for six months and then switched to monthly injections of ranibizumab for 12 months. Best-corrected visual acuity measurements (BCVA), contact lens biomicroscopy, optical coherence tomography (OCT), and fluorescein angiography were performed at the baseline examination and then monthly. Chi-square test was used for statistical analysis. Results: Following bevacizumab treatment, retinal thickness decreased (P = 0.033) while BCVA improved (P = 0.040). Changing from bevacizumab to ranibizumab resulted in a transient decrease in BCVA (P = 0.045) and an increase in retinal thickness (P = 0.042). In addition, three eyes presented with a large subretinal hemorrhage. However, final retinal thickness was better than the initial thickness and the value following the bevacizumab course. No major ocular or systemic side effects were noted. Conclusions: Ranibizumab was clinically effective in the long term but the change of treatment from bevacizumab to a half-size molecule with less half-life in the vitreous such as ranibizumab contributed to a transient “instability” in the eye which may have triggered the large subretinal hemorrhage. There is insufficient experience reported in the literature in switching from one agent to another. A prospective study with controls is necessary to determine whether it is safe to change from one medication to another.
Changing from bevacizumab to ranibizumab in age-related macular degeneration. Is it safe?
Dimitrios A Karagiannis,Ioannis D Ladas,Efstratios Parikakis
Clinical Interventions in Aging , 2009,
Abstract: Dimitrios A Karagiannis1, Ioannis D Ladas2, Efstratios Parikakis1, Ilias Georgalas2, Athanasios Kotsolis2, Giorgos Amariotakis1, Vasileios Soumplis1, Panagiotis Mitropoulos11Ophthalmiatrio Eye Hospital of Athens, Athens, Greece; 2First Department of Ophthalmology, Medical School of Athens University, General Hospital of Athens, Athens, GreeceObjective: To report our experiences in changing from intravitreal bevacizumab to ranibizumab in age-related macular degeneration (AMD).Design: Retrospective case series.Participants and methods: We retrospectively reviewed the records of 34 patients (36 eyes) who were treated with monthly injections of intravitreal bevacizumab for six months and then switched to monthly injections of ranibizumab for 12 months. Best-corrected visual acuity measurements (BCVA), contact lens biomicroscopy, optical coherence tomography (OCT), and fluorescein angiography were performed at the baseline examination and then monthly. Chi-square test was used for statistical analysis.Results: Following bevacizumab treatment, retinal thickness decreased (P = 0.033) while BCVA improved (P = 0.040). Changing from bevacizumab to ranibizumab resulted in a transient decrease in BCVA (P = 0.045) and an increase in retinal thickness (P = 0.042). In addition, three eyes presented with a large subretinal hemorrhage. However, final retinal thickness was better than the initial thickness and the value following the bevacizumab course. No major ocular or systemic side effects were noted.Conclusions: Ranibizumab was clinically effective in the long term but the change of treatment from bevacizumab to a half-size molecule with less half-life in the vitreous such as ranibizumab contributed to a transient “instability” in the eye which may have triggered the large subretinal hemorrhage. There is insufficient experience reported in the literature in switching from one agent to another. A prospective study with controls is necessary to determine whether it is safe to change from one medication to another.Keywords: age-related macular degeneration, bevacizumab, ranibizumab, subretinal hemorrhage
Axial eye length measurements pre- and post- laser-assisted in situ keratomileusis using the IOL Master: a pilot study
Spyridon E Chalkiadakis, Georgios A Amariotakis, Efstratios A Parikakis, et al
Clinical Ophthalmology , 2010, DOI: http://dx.doi.org/10.2147/OPTH.S14332
Abstract: xial eye length measurements pre- and post- laser-assisted in situ keratomileusis using the IOL Master: a pilot study Original Research (3188) Total Article Views Authors: Spyridon E Chalkiadakis, Georgios A Amariotakis, Efstratios A Parikakis, et al Published Date November 2010 Volume 2010:4 Pages 1267 - 1269 DOI: http://dx.doi.org/10.2147/OPTH.S14332 Spyridon E Chalkiadakis, Georgios A Amariotakis, Efstratios A Parikakis, Vasileios G Peponis Athens Eye Hospital, 2nd Eye Clinic, Athens, Greece Purpose: A preliminary study in order to test the accuracy of the IOL Master in detecting axial eye length changes after laser-assisted in situ keratomileusis and to correlate the findings with the theoretical ablation depth. Methods: Pre- and postoperative axial eye length measurements were performed in 10 consecutive eyes that underwent laser-assisted in situ keratomileusis with the Alcon Ladar Vision excimer laser to treat myopic refractive errors ranging from -2.50 to -8.00 diopters of spherical equivalent (mean: -5.23 ± 1.30 D). Results: The preoperative axial eye length measurements ranged from 24.53 mm to 27.78 mm (mean: 25.80 ± 1.01 mm) and from 24.57 mm to 27.57 mm (mean: 25.68 ± 0.93 mm) 1 month after the operation. Preoperative and 1-month postoperative data showed a statistically significant difference (P <0.05). Conclusions: The IOL Master showed a decrease in the axial eye length measurements that was bigger than the theoretical ablation depth and did not correlate well with it. Such data need to be confirmed by a larger cohort of patients.
Axial eye length measurements pre- and post- laser-assisted in situ keratomileusis using the IOL Master: a pilot study
Spyridon E Chalkiadakis,Georgios A Amariotakis,Efstratios A Parikakis,et al
Clinical Ophthalmology , 2010,
Abstract: Spyridon E Chalkiadakis, Georgios A Amariotakis, Efstratios A Parikakis, Vasileios G PeponisAthens Eye Hospital, 2nd Eye Clinic, Athens, GreecePurpose: A preliminary study in order to test the accuracy of the IOL Master in detecting axial eye length changes after laser-assisted in situ keratomileusis and to correlate the findings with the theoretical ablation depth.Methods: Pre- and postoperative axial eye length measurements were performed in 10 consecutive eyes that underwent laser-assisted in situ keratomileusis with the Alcon Ladar Vision excimer laser to treat myopic refractive errors ranging from -2.50 to -8.00 diopters of spherical equivalent (mean: -5.23 ± 1.30 D).Results: The preoperative axial eye length measurements ranged from 24.53 mm to 27.78 mm (mean: 25.80 ± 1.01 mm) and from 24.57 mm to 27.57 mm (mean: 25.68 ± 0.93 mm) 1 month after the operation. Preoperative and 1-month postoperative data showed a statistically significant difference (P <0.05).Conclusions: The IOL Master showed a decrease in the axial eye length measurements that was bigger than the theoretical ablation depth and did not correlate well with it. Such data need to be confirmed by a larger cohort of patients.Keywords: ablation, biometry, coherence, excimer, interferometry, keratomileusis, laser
Photodynamic Therapy for Juxtapapillary Retinal Capillary Hemangioma
Panagiotis G. Mitropoulos,Irini P. Chatziralli,Vasileios G. Peponis,Vasileia A. Tsiotra,Efstratios A. Parikakis
Case Reports in Ophthalmological Medicine , 2014, DOI: 10.1155/2014/756840
Abstract: Various treatment modalities have been described for retinal capillary hemangioma. Our purpose is to present a case of juxtapapillary retinal capillary hemangioma treated with photodynamic therapy. A 69-year-old woman with no previous ocular history presented with blurred vision and photopsias in the right eye three months ago. At presentation, her best corrected visual acuity was 6/9 in the right eye and 6/6 in the left eye. The anterior segment was totally normal and IOP was normal in both eyes as well. Dilated fundoscopy revealed a yellowish, well-circumscribed, elevated area with blood vessels, on the inferior margin of the right optic disc, as optic disc edema. Fluorescein angiography and angiogram with indocyanine green confirmed the diagnosis of juxtapapillary retinal capillary hemangioma. The patient was treated with photodynamic therapy with verteporfin and three months later her visual acuity was 6/7.5 in the right eye, while the lesion was slightly smaller. These findings remained stable at the one-year follow-up. In conclusion, photodynamic therapy offers promising anatomical and functional results for juxtapapillary retinal capillary hemangioma, providing visual acuity improvement or even stabilization and restriction of enlargement of the lesion. 1. Introduction Retinal capillary hemangioma (RCH) or hemangioblastoma is an uncommon benign vascular tumor and may occur sporadically (54%) or as a manifestation of von Hippel-Lindau (VHL) disease (46%) [1–4]. Although it is usually considered as a solitary unilateral tumor, when associated with VHL disease, up to 50% of the cases present multifocal or bilateral involvement [1–8]. The clinical course of the disease is usually progressive and difficult to predict [7, 8]. As the RCH enlarges, it can cause complications, such as exudation, subretinal fluid accumulation, macular edema, and exudative retinal detachment, resulting in visual deterioration. Furthermore, glial proliferation can lead to epiretinal membrane development or tractional retinal detachment [1–8]. RCH can be located at the disc (papillary), juxtapapillary, or at the peripheral retina, occurring most commonly at the temporal side of the disc [1–8]. Treatment depends on the location and size of the RCH and varies from observation to radiotherapy, cryotherapy, transpupillary thermotherapy, laser photocoagulation, photodynamic treatment (PDT), antivascular endothelial growth factor (anti-VEGF) agents, intravitreal triamcinolone, vitreoretinal surgery, or combination of treatment modalities [5, 6, 9–28]. There are few case reports and
Sutureless prepuceplasty with wound healing by second intention: An alternative surgical approach in children's phimosis treatment
Efstratios Christianakis
BMC Urology , 2008, DOI: 10.1186/1471-2490-8-6
Abstract: Eightyseven children with phimosis were treated with this new developed technique, between 2003 and 2005. Sutureless prepuceplasty creates a permanent surgical extension of the close prepuce. Stretching and retraction of phimotic foreskin reveals a tight prepuce ring that is cutting in its dorsal surface longitudinally. Rarely triple symmetric incisions in the preputial outlet are necessary. The foreskin is loose and moves absolutely free in bilateral courses. The wounds are healing by second intention. Antisepsis, steroids and Elicina cream, (which contains allantoin, collagen, elastin, glycolic acid and vitamins A, D, and E) should apply daily, for twenty to thirty days.The foreskin is moving in centripetal or efferent courses absolutely loosely, painlessly and bloodlessly. The mean time of follow-up was 27 months (one to four years). No complications were observed.Sutureless prepuceplasty may present an acceptable alternative in children's phimosis reconstruction.Circumcision is probably the oldest and one of the most common elective procedures all over the world. It was initially performed for ritual, religious or family traditional reasons [1]. Simultaneously, circumcision was probably performed for phimosis treatment. Another ancient surgical method for phimosis treatment was the dorsal slit operation, which is a super incision, with no tissue removed [2]. The value of foreskin properties as well as aesthetic reasons determined to other operations preserving the foreskin. The most interesting was the report of prepuceplasty suggested by Homlund DE in 1973. It is a limited dorsal incision of the phimotic prepuce with transverse skin closure with absorbable sutures [3]. Although it is a good operation, it is not without complications or re-operations [4-6]. Sutureless prepuceplasty (SLP) is a faster, easier, painless and without complications technique, which has excellent cosmetic results.Between 2003 and 2005, eightyseven boys (87) with tight phimotic rings, m
Mathematical knowledge and drug dosage calculation: Necessary clinical skills for the nurse
Athanasakis Efstratios
To Vima tou Asklipiou , 2013,
Abstract: When nurses perform their tasks, they manage situations where maths knowledge is required. Such a situation is the calculation of medication dosage. Aim: The literature review of papers relevant with the mathematical knowledge and drug calculation skills of nurses and nursing students. Material-Method: A search of published research and review articles from January 1989 until March 2012, has been conducted in Pubmed database. The search terms used were: nurses, mathematics skills, numeracy skills and medication dosology calculation skills. Results: Literature review showed that many studies focus in the mathematical knowledge and drug dosage calculation competency of nursing students. Results from these studies revealed that nursing students had poor mathematical knowledge and drug dosage calculation skills. In contrast with students, professional nurses are more likely to have sufficient skills in drug calculations. Apart from the papers analyzing calculation skills' assessment, several studies examined educational interventions in the context of calculation skills enhancement. Accuracy and proficiency in the dosage calculation of medications is a preventive factor of errors made at medication preparation and administration. Conclusion: Mathematical knowledge and drug dosage calculation abilities are interrelated concepts and essential clinical skills for the nurse. The fact that nursing students do not have adequate skills for calculating medications' dosage, might be an issue that schools of nursing education should focus in. Further research of the drug dosage calculation skills is considered essential.
Nurses’ Research Behavior and Barriers to Research Utilization Into Clinical Nursing Practice: a Closer Look
Efstratios Athanasakis
International Journal of Caring Sciences , 2013,
Abstract: Background: It is widely accepted that utilization of the best-known research evidence in nursing practice entails improvement of nursing care received by patients and strengthening of nursing profession.Aim: The aim of this paper was the review of nurses’ research behavior and the barriers that nurses meet in order to utilize research evidence into clinical nursing practice.Methodology: There has been conducted a literature search in Pubmed and Science Direct libraries, using specific search terms. An important inclusion criterion for the studies was the use of barriers to research utilization scale (BRUS), along or combined with another instrument.Results: A total of 37 original papers included in the present article. A table of the top five barriers to research utilization scale has been conducted. Data from the table indicate that the existence of barriers to incorporation of evidence into practice comes mainly from clinical settings characteristics. In addition, issues about nursing education, nurses’ research and reading habits, facilitators of research utilization and their relevance for nursing staff and clinical practice are also discussed.Conclusions: Since the barriers to research utilization are well identified in the nursing literature and there is a wealth of information on this subject, the next step is to find ways to overcome them and value the impact of the relevant interventions towards research utilization behavior.
Photovoltaic effect for narrow-gap Mott insulators
Efstratios Manousakis
Physics , 2009, DOI: 10.1103/PhysRevB.82.125109
Abstract: We discuss the photovoltaic effect at a p-n heterojunction, in which the illuminated side is a doped Mott insulator, using the simplest description of a Mott insulator within the Hubbard model. We find that the internal quantum efficiency of such a device, if we choose an appropriate narrow-gap Mott insulator, can be significantly enhanced due to impact ionization caused by the photoexcited ``hot'' electron/hole pairs. Namely, the photoexcited electron and/or hole can convert its excess energy beyond the Mott-Hubbard gap to additional electrical energy by creating multiple electron/hole pairs in a time scale which can be shorter than the time characterizing other relaxation processes.
String excitations of a hole in a quantum antiferromagnet and photoelectron spectrospopy
Efstratios Manousakis
Physics , 2007, DOI: 10.1103/PhysRevB.75.035106
Abstract: The aim of the present paper is twofold. The first goal is to show that high resolution angle-resolved photoelectron spectra from cuprates indicate the presence of string-like excitations of the quasihole excitation in a quantum antiferromagnet. In order to compare with the experimental intensity plots, we calculate the spectral function of the t-J and the t-t'-t"-J models within the self-consistent Born approximation for widely accepted values of the parameters of these models. The main features of the high resolution photoelectron spectra are in general agreement with the results based on the above models and can be understood by considering not only the lowest energy quasiparticle peak but, also, the higher energy string-like excitations of the hole. The second goal of the present paper is to make the case that a proper analysis of both the numerical results obtained from these models and of the experimental results, suggests a theoretical picture for the internal structure of the hole-quasiparticle and a string-exchange pairing mechanism due to strong antiferromagnetic correlations among the background spins. We find that, using a simple model in which the Hilbert space is restricted to states of only unbroken strings attached to the holes and in which the holes are connected with unbroken strings, we can provide a good quantitative description of the most accurate numerical results. We find that the holes experience an effective interaction due to a string-exchange mechanism which is characterized by a rather large string tension and this can provide pairing energy scales much larger that those suggested by spin-fluctuation mediated pairing models. In addition, it is argued that such string-exchange interaction tends to bind holes in a bound state with the $d_{x^2-y^2}$ symmetry.
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