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Search Results: 1 - 10 of 504 matches for " Petros Zezos "
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Esophageal Crohn's Disease Treated “Topically” with Swallowed Aerosolized Budesonide
Petros Zezos,Georgios Kouklakis,Anastasia Oikonomou,Michail Pitiakoudis,Constantinos Simopoulos
Case Reports in Medicine , 2010, DOI: 10.1155/2010/418769
Abstract: Proximal Crohn's disease, involving the esophagus, the stomach, the duodenum, and the proximal jejunum, is uncommon. Treatment for proximal Crohn's disease is based on data derived from case series than from controlled trials. We present a case of Crohn's colitis with concomitant proximal esophagogastroduodenal involvement treated with conventional treatment plus swallowed aerosolized budesonide as a novel adjuvant topical treatment for the esophageal disease, and we review the treatment options for proximal Crohn's disease.
Total Splenectomy due to an Unexpected “Complication” after Successful Extended Laparoscopic Partial Decapsulation of a Giant Epidermoid Splenic Cyst: A Case Report
Michail Pitiakoudis,Petros Zezos,Anastasia Oikonomou,Prodromos Laftsidis,Georgios Kouklakis,Constantinos Simopoulos
Case Reports in Medicine , 2011, DOI: 10.1155/2011/318208
Abstract: Splenic cysts are rare entities and are classified as true cysts or pseudocysts based on the presence of an epithelial lining. Congenital nonparasitic true cysts can be epidermoid, dermoid, or endodermoid, present at a young age, and are commonly located in the upper pole of the spleen. Surgical treatment is recommended for symptomatic, large (more than 5 cm), or complicated cysts. Depending on cyst number, location, relation to hilus, and the major splenic vessels, the surgical options include aspiration, marsupialization, cystectomy, partial cystectomy (decapsulation), and partial or complete splenectomy. Laparoscopic techniques have now become the standard approach for many conditions, including the splenic cysts, with emphasis on the spleen-preserving minimally invasive operations. We present the successful extended partial laparoscopic decapsulation of a giant epidermoid splenic cyst in a young female patient that, although asymptomatic, was unfortunately followed by complete splenectomy five days later due to a misinterpreted abdominal CT suggesting splenic postoperative ischemia.
Endoscopic Treatment of a Gastrocutaneous Fistula Using the Over-The-Scope-Clip System: A Case Report
Georgios Kouklakis,Petros Zezos,Nikolaos Liratzopoulos,Anthia Gatopoulou,Anastasia Oikonomou,Michail Pitiakoudis,Eleni Efremidou,Constantinos Simopoulos
Diagnostic and Therapeutic Endoscopy , 2011, DOI: 10.1155/2011/384143
Abstract: The over-the-scope-clip (OTSC; Ovesco Endoscopy GmbH, Tuebingen, Germany) system is a newly designed method for the mechanical compression of large areas in the gastrointestinal tract. So far, indications for OTSC application are hemostasis of primary or postinterventional bleeding, closure of iatrogenic full-thickness or covered perforations. Recently closure of gastrointestinal tract fistulas using this device has been described. A 44-year-old man developed a gastrocutaneous fistula after surgical treatment for a perforated gastric ulcer. We describe the successful endoscopic closure of the fistula using the OTSC system. The patient's clinical followup was uneventful. Fistula closure was successfully implemented as it was documented by imaging and endoscopic examinations performed on the 2nd day and 6th week after the application of the clip. Endoscopic application of the OTSC device was safe and effective for the treatment of a gastrocutaneous fistula. 1. Introduction The over-the-scope-clip (OTSC) system (Ovesco Endoscopy GmbH, Tuebingen, Germany) is a newly designed method for the mechanical compression of large areas in the gastrointestinal tract. So far, indications for OTSC application are hemostasis primary or postinterventional bleeding and closure of iatrogenic full-thickness or covered perforations during endoscopic mucosal resection or after natural orifice transluminal endoscopic surgery procedures (NOTES) [1]. We report the successful treatment of a gastrocutaneous fistula with closure of the gastric orifice using the OTSC system without postprocedure complications. 2. Case Presentation A 44-year-old man, who had been having a history of recurrent abdominal pain, attended the emergency services with peritonitis. Upright chest X-ray demonstrated free subdiaphragmatic air bilaterally (Figure 1). An emergent laparotomy was performed and a perforated pyloric ulcer was found which was treated with simple surgical sutures and omental patches. Figure 1: Upright posteroanterior chest radiograph: there is free subdiaphragmatic air bilaterally that is more clearly noted on the left side (white arrows). A few days later the patient displayed a septic course with persistent fever and leukocytosis. An abdominal CT scanning revealed an abscess in the left subphrenic space and in the space of Douglas. A new surgical intervention was undertaken and peritoneal drainage was reestablished in the areas with the abscesses. The immediate postoperative period was uneventful with the exception of a persistent draining of gastric contents by the abdominal drains
Spontaneous idiopathic pneumoperitoneum presenting as an acute abdomen: a case report
Michail Pitiakoudis, Petros Zezos, Anastasia Oikonomou, Michail Kirmanidis, Georgios Kouklakis, Constantinos Simopoulos
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-86
Abstract: We present the case of an idiopathic spontaneous pneumoperitoneum. A 69-year-old Greek woman presented with acute abdominal pain, fever and vomiting. Diffuse abdominal tenderness on deep palpation without any other signs of peritonitis was found during physical examination, and laboratory investigations revealed leukocytosis and intraperitoneal air below the diaphragm bilaterally. Her medical history was unremarkable except for previous cholecystectomy and appendectomy. The patient did not take any medication, and she was not a smoker or an alcohol consumer. Emergency laparotomy was performed, but no identifiable cause was found. A remarkable improvement was noticed, and the patient was discharged on the seventh postoperative day, although the cause of pneumoperitoneum remained obscure.A thorough history and physical examination combined with the appropriate laboratory tests and radiologic techniques are useful tools in identifying patients with non-surgical pneumoperitoneum and avoiding unnecessary operations.Pneumoperitoneum is the result of a gastrointestinal (GI) tract perforation in more than 90% of cases [1]. Perforation of the stomach or duodenum caused by peptic ulcer is considered the most common cause of pneumoperitoneum. Pneumoperitoneum can also be the result of a diverticular rupture or of an abdominal trauma [1]. It commonly presents with signs and symptoms of peritonitis, and subphrenic free gas in an upright chest radiograph is the most common radiologic finding. In most cases, pneumoperitoneum requires urgent surgical exploration and intervention [1].However, sometimes pneumoperitoneum not associated with a perforated viscus can occur; this is called spontaneous pneumoperitoneum (SP) or "non-surgical" pneumoperitoneum. SP is associated with intrathoracic, intraabdominal, gynecologic, iatrogenic or other miscellaneous causes [1]. Although it is not usually complicated with peritonitis, SP is characterized by a benign course and can be managed conserv
The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease
Andreas Nakos,Georgios Kouklakis,Michail Pitiakoudis,Petros Zezos,Eleni Efraimidou,Alexandra Giatromanolaki,Alexandros Polychronidis,Nikolaos Liratzopoulos,Efthimios Sivridis,Konstantinos Simopoulos
Gastroenterology Research and Practice , 2011, DOI: 10.1155/2011/905872
Abstract: Introduction. The pathogenesis of GERD is strongly related with mixed acid and bile reflux. Benign and malignant esophageal and gastric lesions have been associated with synergetic activity between those parameters. Bile reflux causes reactive gastropathy evaluated with Bile Reflux Index (BRI). The aim was to investigate if the sequence: bile reflux-intestinal metaplasia-GERD-esophagitis, is associated with apoptotic/oncogenetic disturbances. Materials/Methods. Fifteen asymptomatic subjects and 53?GERD patients underwent gastroscopy with biopsies. The specimens examined histologically and immunohistochemically for p53, Ki-67, Bax, and Bcl-2. Results. Elevated BRI score detected in 47% (25/53) of patients with GERD and in 13% (2/15) of controls ( ). Severe esophageal lesions were significantly more common in BRI (+) patients (14/25) compared to BRI (?) ones ( ). Immunohistochemical analysis did not show associations between BRI score and biomarker expression. Conclusions. Bile reflux gastropathy is associated with GERD severity, but not with oncogene expression or apoptotic discrepancies of the upper GI mucosa. 1. Introduction The gastroesophageal reflux disease (GERD) represents one of the most common gastrointestinal disorders, especially in the western countries [1, 2]. It is the result of the exposure of the esophageal mucosa to acidic gastric juice and/or bile-containing duodenal refluxates via an incompetent lower esophageal sphincter. The acid and bile exposure times, as demonstrated by 24?h monitoring methodologies, greatly overlap among the cases of GERD with diverse endoscopic findings ranging from normal mucosa (nonerosive reflux disease (NERD)) to severe reflux oesophagitis, Barrett’s esophagus, and complications such as strictures or ulcers [3–6]. Although in the past the pathogenesis of GERD was strongly associated with the gastric acid, during the last two decades the role of mixed reflux has been increasingly investigated. The synergetic activity between acid and bile has largely been implicated in the clinical spectrum of GERD and methods such as Bilitec 2000 and the multichannel intraluminal impedance are nowadays widely used towards the thorough evaluation of the disorder [7]. The highest esophageal exposure to bile has been observed in patients with Barrett’s dysplasia and esophageal adenocarcinoma. However, it has also been associated with erosive oesophagitis, Barrett’s esophagus without dysplasia, and intestinal metaplasia of the gastric antrum [8–15]. The passage of duodenal contents through the stomach produces consistent
Existence and Uniqueness of Global Smooth Solutions for Vlasov Maxwell Equations  [PDF]
Lukas Degu Petros
Advances in Pure Mathematics (APM) , 2018, DOI: 10.4236/apm.2018.81005
Abstract: Global existence of classical solutions to the relativistic Vlasov-Maxwell system, given sufficiently regular initial data, is a long-standing open problem. The aim of this project is to present in details the results of a paper published in 1986 by Robert Glassey and Walter Strauss. In that paper, a sufficient condition for the global existence of a smooth solution to the relativistic Vlasov-Maxwell system is derived. In the following, the resulting theorem is proved by taking initial data \"\", \"\". A small data global existence result is presented as well.
Stability Analysis and Stochastic SI Modelling of Endemic Diseases  [PDF]
Desalegn Petros Kelkile
Advances in Pure Mathematics (APM) , 2018, DOI: 10.4236/apm.2018.85030
Abstract: In this paper, we study a stochastic epidemic model in Meta-population setting. The stochastic model is obtained from the deterministic model by set up random perturbations about the endemic equilibrium state. The outcome of random perturbations on the stability actions of endemic equilibrium is discussed. Stability of the two equilibriums is studied using the Lyapunov function.
Characterization of Rational Numbers Using Kronecker’s Orbit: A Didactic Approach  [PDF]
Petros-Stylianos Marsellos
Creative Education (CE) , 2018, DOI: 10.4236/ce.2018.915193
Abstract: For every real number x, we define as integer part the biggest integer k so that kx and is expressed [x]. The difference of the number from its integral part is defined as decimal part of x and expressed with \"\". Consequently, for every x, the Kronecker’s orbit is defined, namely the set \"\". Through Kronecker’s orbit, rational numbers are characterized as the numbers whose orbit is a bounded set, while irrational numbers are characterized as the numbers whose orbit is a dense set. Using this fundamental theoretical result and utilizing a computer, a didactic approach was established, initially referring to the definition of rational numbers as fraction equivalence classes and basically to the segregation of rational and irrational numbers. This didactic approach also incorporates elements of ancient Greek mathematics history. The proposition was applied to students and was evaluated.
Planning of Recreation Parks in the University Campus  [PDF]
Anthopoulos K. Petros, George Costa
Journal of Environmental Protection (JEP) , 2011, DOI: 10.4236/jep.2011.24040
Abstract: The benefits of parks and recreation are very serious. The purpose of this study was to investigate the attitudes of the people that use the campus area of Democritus university of Thrace, in Komotini. There are series of factors that should be taken under consideration when campus is under planned. In this research took part 742 people and more specific, they were: under graduate students, post graduate students, tutors as well as teaching and administrative staff. An analysis of Principle components has been accomplished and 8 factors have been accrued with eigenvalue more than 1. These factors explain the 55.32% of the whole variation. The conclusion of this study was that a model for campus planning must consists of these 8 parameters: land, climate, vegetation, physical activity, environmental consciousness, daily users of territory and inhabitants of an area.
Right Lower Quadrant Abdominal Pain in a Patient with Prior Ventriculoperitoneal Shunting: Consider the Tip!
Petros Charalampoudis
Case Reports in Medicine , 2012, DOI: 10.1155/2012/253027
Abstract: Introduction. Ventriculoperitoneal (VP) shunting is the treatment of choice for nonobstructive hydrocephalus. In patients with such a device, right lower quadrant abdominal pain can puzzle the surgeon, posing a differential diagnostic problem among appendicitis, nonsurgical colicky pain, and primary shunt catheter tip infection. Treatment is different in either case. Presentation of Case. We hereby present a case of a young woman with prior ventriculoperitoneal shunt positioning who presented to our department with right lower quadrant abdominal pain. The patient underwent a 24-hour observation including a neurosurgery consult in order to exclude acute appendicitis and VP shunt tip infection. Twenty four hours later, the patient’s symptomatology improved, and she was discharged with the diagnosis of atypical colicky abdominal pain seeking a gastroenterologist consult. Discussion. This case supports that when a patient with prior VP shunting presents with right lower quadrant abdominal pain, differential diagnosis can be tricky for the surgeon. Conclusion. Apart from acute appendicitis, primary or secondary VP catheter tip infection must be considered because the latter can be disastrous.
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