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Search Results: 1 - 10 of 1306 matches for " Georgios Koukoulis "
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Risk of colorectal neoplasm in patients with acromegaly: A meta-analysis
Theodoros Rokkas, Dimitrios Pistiolas, Panos Sechopoulos, Georgios Margantinis, Georgios Koukoulis
World Journal of Gastroenterology , 2008,
Abstract: AIM: To examine the risk of colorectal neoplasm in acromegalic patients by meta-analyzing all relevant controlled studies.METHODS: Extensive English language medical literature searches for human studies, up to December 2007, were performed using suitable keywords. Pooled estimates [odds ratio (OR) with 95% confidence intervals (CI)] were obtained using either the fixed or random-effects model as appropriate. Heterogeneity between studies was evaluated with the Cochran Q test whereas the likelihood of publication bias was assessed by constructing funnel plots. Their symmetry was estimated by the adjusted rank correlation test.RESULTS: For hyperplastic polyps the pooled ORs with 95% CI were 3.557 (2.587-4.891) by fixed effects model and 3.703 (2.565-5.347) by random effects model. The Z test values for overall effect were 7.81 and 6.984, respectively (P < 0.0001). For colon adenomas the pooled ORs with 95% CI were 2.486 (1.908-3.238) (fixed effects model) and 2.537 (1.914-3.364) (random effects model). The Z test values were 6.747 and 6.472, respectively (P < 0.0001). For colon cancer the pooled OR with 95% CI was identical for both fixed and random effects model (OR, 4.351; 95% CI, 1.533-12.354; Z = 2.762, P = 0.006). There was no significant heterogeneity and no publication bias in all the above meta-analyses.CONCLUSION: Acromegaly is associated with an increased risk of colorectal neoplasm.
Impact of antiplatelet treatment on colorectal cancer staging characteristics
Dimitrios Symeonidis,Georgios Koukoulis,Grigorios Christodoulidis,Ioannis Mamaloudis
World Journal of Gastrointestinal Endoscopy , 2012, DOI: 10.4253/wjge.v4.i9.409
Abstract: AIM: To evaluate whether antiplatelet medication leads to an earlier stage colorectal cancer (CRC) diagnosis. METHODS: From January 2002 until March 2010, patients that presented to our institution with the initial diagnosis of CRC and were submitted to an open curative CRC resection or a palliative procedure were retrospectively reviewed. Exclusion criteria were the use of antithrombotic medication, i.e., coumarins, and appendiceal malignancies. Data acquired from medical files included age, gender, past medical history, antithrombotic treatment received prior to endoscopic diagnosis, preoperative imaging staging, location of the tumor, surgical and final histopathological report. Patients that did not receive any antithrombotic medication prior to the endoscopic diagnosis comprised the control group of the study, while patients that were on antiplatelet medication comprised the antiplatelet group. Primary end point was a comparison of CRC stage in the two groups of the study. CRC presenting symptoms and the incidence of each cancer stage in the two groups were also evaluated. RESULTS: A total of 387 patients with the diagnosis of CRC were submitted to our department for further surgical treatment. Ninety-eight patients (25.32%), with a median age of 71 years (range 52-91 years), were included in the antiplatelet group, while 289 (74.67%) patients, with a median age of 67 years (range 41-90 years), were not in any thrombosis prophylaxis medication (control group). Thirty-one patients were treated with some kind of palliative procedure, either endoscopic, such as endoscopic stent placement, or surgical, such as de-compressive colostomy or deviation. Coronary disease (77.55% - 76 patients), stroke recurrence prevention (14.28% - 14 patients) and peripheral arterial disease (8.16% - 8 patients) were the indications for the administration of antiplatelet treatment (aspirin, clopidogrel, ticlopidine or dipyridamole) in the antiplatelet group. All patients on aspirin treatment received a dosage of 100 mg/d, while the minimum prophylactic dosages were also used for the rest of the antiplatelet drugs. Investigation of an iron deficiency anemia (147 patients), per rectum blood loss (84 patients), bowel obstruction and/or perforation (81 patients), bowel habits alterations (32 patients), non-specific symptoms, such as weight loss, intermittent abdominal pain and fatigue, (22 patients) or population screening (21 patients) were the indications for the endoscopic investigation in both groups. Bleeding, either chronic presenting as anemia or acute was significantly
Adrenocortical Carcinoma Presenting with Signs of Acute Abdomen
Dimitrios Symeonidis,Ioannis Chatzinikolaou,Georgios Koukoulis,Ioannis Mamaloudis
Case Reports in Surgery , 2013, DOI: 10.1155/2013/132726
Abstract:
Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma
Dimitrios Symeonidis,Georgios Koukoulis,Ioannis Baloyiannis,Apostolos Rizos,Ioannis Mamaloudis,Konstantinos Tepetes
Case Reports in Gastrointestinal Medicine , 2012, DOI: 10.1155/2012/308510
Abstract: Ingestion of gastrointestinal foreign bodies represents a challenging clinical scenario. Increased morbidity is the price for the delayed diagnosis of complications and timely treatment. We present a case of 57-year-old female patient which was admitted in the emergency room department complaining of a mid-epigastric pain over the last twenty-four hours. Based on the patient's history, physical examination and elevated serum amylase levels, a false diagnosis of pancreatitis, was initially adopted. However, a CT scan confirmed the presence of a radiopaque foreign body in the pancreatic head and the presence of air bubbles outside the intestinal lumen. The patient was unaware of the ingestion of the foreign body. At laparotomy, after an oblique duodenotomy, a fish bone pinned in the pancreatic head after the penetration of the medial aspect of the second portion of the duodenal wall was identified and successfully removed. The patient had an uneventful postoperative recovery. Wide variation in clinical presentation characterizes the complicated fish bone ingestions. The strategically located site of penetration in the visceral wall is responsible for the often extraordinary gastrointestinal tract injury patterns. Increased level of suspicion is of paramount importance for the timely diagnosis and treatment.
Diaphragmatic rupture causing repeated vomiting in a combined abdominal and head injury patient: a case report and review of the literature
Dimitrios Symeonidis, Michail Spyridakis, Georgios Koukoulis, Grigorios Christodoulidis, Ioannis Mamaloudis, Konstantinos Tepetes
World Journal of Emergency Surgery , 2012, DOI: 10.1186/1749-7922-7-20
Abstract: We present a challenging case of a young male with combined abdominal and head trauma. Repeated episodes of vomiting dominated on clinical presentation that in the presence of a deep scalp laceration and facial bruising shifted differential diagnosis towards a traumatic brain injury. However, a computed tomography scan of the brain ruled out any intracranial pathology. Finally, a more meticulous investigation with additional imaging studies confirmed the presence of diaphragmatic rupture that justified the clinical symptoms.The combination of diaphragmatic rupture with head injury creates a challenging trauma scenario. Increased level of suspicion is essential in order to diagnose timely diaphragmatic rupture in multiple trauma patients.
Spontaneous expulsion from rectum: a rare presentation of intestinal lipomas
Vasileios K Kouritas, Ioannis Baloyiannis, Georgios Koukoulis, Ioannis Mamaloudis, Dimitris Zacharoulis, Matheos Efthimiou
World Journal of Emergency Surgery , 2011, DOI: 10.1186/1749-7922-6-19
Abstract: Intestinal lipomas were firstly described by Bauer in 1757 [1] with 275 cases reported in the literature till 2001 [2]. They comprise a 5% of all gastrointestinal tract tumors [3,4]. Lipomas are considered to be the second most frequent benign lesions of the intestine appearing relatively rarely in clinical practice after adenomatous polyps [3-5]. Their malignant potential is considered to be minimal [3,4].They are non-epithelial, mostly solitary, sessile or pedunculated lesions originating from mature lipocyte cells [6]. They can also appear in multiple locations in a 10-20% of cases especially if the lipoma is located in the ceacum [7,8]. They usually are small lesions, with a diameter less than 2 cm, but can reach a diameter of 30 cm [9,10] with most lesions being 4 cm at the time of detection [11]. They grow in the submucosal plane although occasionally they may extend into the muscularis propria, whereas in a 10% of cases they are subserosal [12]. They are covered either by an atrophic mucosa with congestion and inflammatory foci or are ulcerated with erosion of the overlying mucosa at the dome of the lipoma [13].Their site of appearance starts from the hypopharynx till the rectum, with the ascending colon and the distal ileum alongside with the ileo-cecal valve being the most common sites of appearance [3,4,6,14-16]. The transverse, descending, sigmoid colon and rectum are other sites in order of greater appearance [17].Lipomas present mainly on the right side of the abdomen with females in their 5th decade of age being favored [11,18]. In males, the left abdomen is more often manifested [19].Lipomas are long standing and usually run asymptomatic and unnoticed whatsoever for many years [6]. They become symptomatic in less than 30% of cases [4-6] and this usually occurs when they increase more than 2 or 3 cm in diameter [7,11]. It is reported that a 75% of patients with intestinal lipomas larger than 4 cm had symptoms [20]. In another study, 46% of the patients
Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma
Dimitrios Symeonidis,Georgios Koukoulis,Ioannis Baloyiannis,Apostolos Rizos,Ioannis Mamaloudis,Konstantinos Tepetes
Case Reports in Gastrointestinal Medicine , 2012, DOI: 10.1155/2012/308510
Abstract: Ingestion of gastrointestinal foreign bodies represents a challenging clinical scenario. Increased morbidity is the price for the delayed diagnosis of complications and timely treatment. We present a case of 57-year-old female patient which was admitted in the emergency room department complaining of a mid-epigastric pain over the last twenty-four hours. Based on the patient's history, physical examination and elevated serum amylase levels, a false diagnosis of pancreatitis, was initially adopted. However, a CT scan confirmed the presence of a radiopaque foreign body in the pancreatic head and the presence of air bubbles outside the intestinal lumen. The patient was unaware of the ingestion of the foreign body. At laparotomy, after an oblique duodenotomy, a fish bone pinned in the pancreatic head after the penetration of the medial aspect of the second portion of the duodenal wall was identified and successfully removed. The patient had an uneventful postoperative recovery. Wide variation in clinical presentation characterizes the complicated fish bone ingestions. The strategically located site of penetration in the visceral wall is responsible for the often extraordinary gastrointestinal tract injury patterns. Increased level of suspicion is of paramount importance for the timely diagnosis and treatment. 1. Introduction Foreign body ingestion is a common phenomenon especially in the pediatric population. The vast majority of these pediatric ingestions are accidental. Intentional ingestion of foreign bodies especially occurs in individuals beyond the age of adolescence [1, 2]. While coins, toy’s parts and batteries are the most commonly encountered objects in children, meat and fish bones represent the most often accidentally ingested foreign bodies in adults [2]. The size, shape, and the material of the foreign body as well as the patient’s age determine the natural history of this condition. Sharp foreign bodies increase the risk for complications and the possibility of successful observational management declines. The incidence of foreign bodies requiring operative removal varies greatly in the literature. Figures ranging from 1% to 14% have been reported [3]. A conservative approach to foreign body ingestions is generally justified, although early endoscopic removal of objects within the stomach is recommended. The success of nonoperative management depends on the absence of symptoms in a patient with a clear history [4]. On the other hand, sharp object ingestions warrant a higher index of suspicion as they are associated with a significantly higher
Evidence of Increased Muscle Atrophy and Impaired Quality of Life Parameters in Patients with Uremic Restless Legs Syndrome
Christoforos D. Giannaki,Giorgos K. Sakkas,Christina Karatzaferi,Georgios M. Hadjigeorgiou,Eleftherios Lavdas,Vassilios Liakopoulos,Nikolaos Tsianas,Georgios N. Koukoulis,Yiannis Koutedakis,Ioannis Stefanidis
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0025180
Abstract: Restless Legs Syndrome is a very common disorder in hemodialysis patients. Restless Legs Syndrome negatively affects quality of life; however it is not clear whether this is due to mental or physical parameters and whether an association exists between the syndrome and parameters affecting survival.
ErbB Receptors and ErbB Targeted Therapies in Endometrial Cancer  [PDF]
Georgios Androutsopoulos, Georgios Michail, Georgios Adonakis, Georgios Decavalas
Journal of Cancer Therapy (JCT) , 2014, DOI: 10.4236/jct.2014.56055
Abstract:

The Epidermal Growth Factor system is present in human organs and plays an important role in cell proliferation, differentiation and apoptosis during embryogenesis and postnatal development. It has four receptors (EGFR, ErbB-2, ErbB-3 and ErbB-4) and numerous ligands. Dysregulation of the Epidermal Growth Factor signaling network is implicated in the pathogenesis of various disorders. Especially in cancer, the Epidermal Growth Factor system becomes hyperactivated with various mechanisms (ligand overproduction, receptor overproduction, constitutive receptor activation). EGFR overexpression may have a dual role in endometrial cancer. It seems that in type I endometrial cancer, EGFR overexpression did not affect disease progression. However in type II endometrial cancer, EGFR overexpression associated with high grade disease and adverse clinical outcome. Moreover ΕrbB-2 overexpression especially in type II endometrial cancer, is an indicator of a highly aggressive disease with poor overall survival. The potential role of ErbB receptors (especially EGFR and ErbB-2) as targets for cancer therapy has been investigated for over 20 years. There are 2 major classes of ErbB targeted therapies: anti-ErbB monoclonal antibodies (MoAbs) and ErbB-specific tyrosine kinase inhibitors (TKIs). ErbB targeted therapies have still shown modest effect in unselected endometrial cancer patients. However, they may be clinically active as adjuvant therapy in well-defined subgroups of type II endometrial cancer patients with EGFR and ErbB-2 overexpression.

Liquid Column Deformation and Particle Size Distribution in Gas Atomization  [PDF]
Georgios S. E. Antipas
Materials Sciences and Applications (MSA) , 2011, DOI: 10.4236/msa.2011.22012
Abstract: A water-gas flow injected by a close coupled atomizer was studied via High Speed Photography and Phase Doppler Anemometry. The formation of a wave disturbance on the surface of the water column was confirmed. The flow converged within an area approximately 3 mm in diameter, independent of atomization conditions. The particle size distribution across the spray suggested a trend of decreasing particle sizes and particle velocities with increasing distance from the spray axis of symmetry.
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