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Search Results: 1 - 10 of 594 matches for " Eleni Efremidou "
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Crohn’s Disease Associated Pyoderma Gangrenosum Treated with Adalimumab
Despoina Kakagia,Eleni Efremidou,Nikolaos Lyratzopoulos,Alexandros Mitrakas
Balkan Medical Journal , 2012,
Abstract: Pyoderma gangrenosum is a known, though infrequent, ulcerative skin lesion that is often associated with systemic inflammatory and immunologic diseases. Objective: To present the efficacy of Adalimumab, a fully human Tumour Necrosis Factor-α antagonist, in the treatment of pyoderma gangrenosum associated with Crohn’s disease. Methods: A young male patient with pyoderma gangrenosum of the shin as the first sign of clinically active Crohn’s disease, who was treated with Adalimumab, is herein presented. Results: Almost complete healing of the lesion was achieved after 12 weeks of treatment. Conclusions: Successful treatment outcome suggests that Adalimumab is not only a therapeutic option for Crohn’s disease but may also be a safe and effective therapy for Pyoderma gangrenosum associated with the disease. Pyoderma gangrenosum should be suspected in any cutaneous ulcerative lesion occurring in patients with Crohn’s disease.
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
Complicated Crohn's-like colitis, associated with Hermansky-Pudlak syndrome, treated with Infliximab: a case report and brief review of the literature
George Kouklakis, Eleni I Efremidou, Michael S Papageorgiou, Evdoxia Pavlidou, Konstantinos J Manolas, Nikolaos Liratzopoulos
Journal of Medical Case Reports , 2007, DOI: 10.1186/1752-1947-1-176
Abstract: We report a patient with HPS which was complicated by inflammatory bowel disease with clinical and pathologic features of Crohn's disease, refractory to antibiotics, corticosteroids and azathioprine. A trial of infliximab was attempted and repeated infusions produced a complete response.The occurrence of ileitis and perianal lesions and also the histopathological findings in our case suggest that HPS and Crohn's disease may truly be associated. Given this similarity and the failure of the standard medical therapy of corticosteroids and azathioprine, our patient received infliximab with marked clinical improvement.Hermansky-Pudlak syndrome (HPS) is a complex syndrome with a triad of manifestations of tyrosinase-positive oculocutaneous albinism (Ty-pos OCA), bleeding diathesis resulting from platelet dysfunction, and systemic complications associated with accumulation of ceroid lipofusion. Complications of the syndrome such as renal failure, cardiomyopathy, fatal pulmonary fibrosis and granulomatous colitis have been described [1,2].Specifically, the colitis is a unique type of inflammatory bowel disease which can be severe and even fatal, with clinical features suggestive of chronic ulcerative colitis and pathological features more closely similar to those of Crohn's disease [3]. It is still unclear whether the granulomatous colitis in HPS is because of ceroid deposition or reflects the coexistence of Crohn's disease and HPS.An analysis of most reported cases, since Schinella et al. first reported granulomatous colitis in association with HPS (1980), suggests that the colitis of HPS is simply a reaction to the tissue deposition of ceroid [4]. Yet, there are reported cases of HPS with gastrointestinal complications related to chronic granulomatous colitis, enterocolitis, ileitis, intestinal fistulization or granulomatous perianal disease [2-5]. These observations suggest that the colitis of HPS is due to the development of classical Crohn's disease. Therefore, it is p
Adalimumab - an effective and promising treatment for patients with fistulizing Crohn's disease: a case series
George Kouklakis, Eleni I Efremidou, Peter Zezos, Nikolaos Liratzopoulos, Vassilios D Souftas, Anthia Gatopoulou, Konstantinos Simopoulos, Konstantinos J Manolas
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-109
Abstract: We report the cases of three patients, of European Caucasian ethnicity and Greek nationality, with active luminal and fistulizing Crohn's disease. All of the cases were treated successfully with adalimumab. Patient 1 (a 44-year-old man) and patient 2 (an 18-year-old woman) developed early post-surgical enterocutaneous fistulas, while patient 3 (a 20-year-old woman) had peri-anal fistulizing Crohn's disease. Adalimumab treatment (160 mg subcutaneously at week zero, 80 mg at week two, and 40 mg every other week) was used for three different indications: (1) after the failure of other conservative medical treatments for Crohn's disease (patient 1); (2) as a monotherapy in treating a naive patient (patient 2); (3) after an intolerance to infliximab (patient 3). A remission of the active luminal and fistulizing disease was achieved soon after the initiation of adalimumab and sustained thereafter with maintenance doses. No further surgical intervention was required and no adverse effects were observed in any of the cases.Fistulizing Crohn's disease remains a challenge in clinical practice. Adalimumab seems to be an effective, well-tolerated and safe treatment option for the induction and maintenance of remission in patients with moderate to severe peri-anal fistulizing Crohn's disease. Furthermore, adalimumab seems to be a promising treatment option for patients with moderate to severe fistulizing Crohn's disease with enterocutaneous fistulas. However, this clinical observation needs to be investigated in further clinical trials.Crohn's disease (CD) is a granulomatous, segmental, transmural inflammation of unknown etiology, affecting the bowel and predisposing the formation of strictures, perforation, abscesses and fistulas. Fistulas occur in 30 to 50 percent of CD patients during the course of disease. Peri-anal fistulas are the most common type (50 percent), followed by internal enteroenteric fistulas (25 percent) [1].The treatment for fistulizing Crohn's disease (FCD)
Is Post-ERCP Pancreatitis a Genetically Predisposed Complication?
Konstantinos Mystakidis,George Kouklakis,Androniki Papoutsi,Vasilios D. Souftas,Eleni Efremidou,Dimitrios Kapetanos,Michail Pitiakoudis,Nikolaos Lyratzopoulos,Anastasios Karagiannakis,Alexandros Pantelios
Gastroenterology Research and Practice , 2012, DOI: 10.1155/2012/473960
Abstract: Background/Objectives. Pancreatitis remains the most common complication of ERCP. History of post-ERCP pancreatitis is an independent risk factor for a new episode, suggesting a genetic background. The N34S mutation in serine protease inhibitor Kazal type 1 (SPINK 1) gene may downregulate the threshold for the development of pancreatitis. The aim of the present study is to evaluate the presence of this mutation among patients with post-ERCP pancreatitis. Methods. During a period of four years, thirty patients with post-ERCP pancreatitis entered the study. Patients and procedural data were collected, focusing on risk factors for pancreatitis. Blood samples were taken for genetic testing for the presence of N34S mutation in SPINK 1 gene. After DNA extraction, we used an allele-specific polymerase chain reaction as an initial screening method for the N34S mutation, and in order to confirm the results and to determine the hetero- and homozygosity genotype status, we used a restriction fragment length polymorphism (RFLP) method. Results. None of the thirty patients was found to carry the N34S mutation, with both of the applied methods. Patients had an average of two of the known risk factors. Conclusion. SPINK1 N34S mutation does not seem to play a role in post-ERCP pancreatitis, but larger studies needed to confirm our results. 1. Introduction Pancreatitis remains the most common complication of ERCP, with the reported incidence ranging from 2% to 9% [1]. Although 80% of cases are mild, a significant number of patients may develop severe pancreatitis, that means additional morbidity and risk for death. ERCP, despite the development of new diagnostic tools, remains a widely used procedure, so post-ERCP pancreatitis is a problem with significant impact. So far only the use of pancreatic stents in high risk patients has become a widely accepted practice to minimize the risk for post-ERCP pancreatitis [2]. However, this technique is costly and not widely available, so the question who are high risk patients remains vivid. Several studies and meta-analyses helped us to recognize special factors that put an individual in high risk for the development of post-ERCP pancreatitis [3–10]. Among these factors special interest presents the history of post-ERCP pancreatitis as an independent risk factor for a new episode of post-ERCP pancreatitis. It seems that some individuals have a genetically predisposed susceptibility in this particular complication. Genetic factors, such mutations in genes of cationic trypsinogen and CFTR, are known to play a causal role in the
Effect of Storage Conditions on the Sensory Quality, Colour and Texture of Fresh-Cut Minimally Processed Cabbage with the Addition of Ascorbic Acid, Citric Acid and Calcium Chloride  [PDF]
Eleni Manolopoulou, Theodoros Varzakas
Food and Nutrition Sciences (FNS) , 2011, DOI: 10.4236/fns.2011.29130
Abstract: The aim of this study was to investigate the effect of storage conditions on the sensory quality, colour and texture of fresh-cut cabbage during the addition of ascorbic acid, citric acid and calcium chloride. Ascorbic acid maintained the overall quality for 14 days at 0℃ and 7 days at 5℃; no difference, however, was observed regarding browning of cut surface compared to the control sample at both storage temperatures. Calcium chloride maintained the overall quality and cut surface browning for 14 days at both storage temperatures. It was also found that citric acid 1% can be used for minimally processed cabbage. Soaking with citric acid helped retain the color and increased the overall acceptance and organoleptic quality of fresh cut cabbage; it reduced browning of the cut surface and protected against formation of black specks. Citric acid treatment combined with low temperature storage (0℃) prolonged the shelf life of minimally processed cabbage for 22 days, time sufficient for acceptable marketing of the product. The lightness of minimally processed cabbage decreased linearly from 70.94 ± 6 to 63.8 ± 8.5 - 61.3 ± 8 units for the chemical treatments during 22 days of storage at 0℃. Hue angle values during storage time were also significantly influenced by chemical treatments mainly at 0℃.
School Effects on Adolescent Substance Use: Prevention through Interactive and Social Learning Strategies  [PDF]
Eleni Stefanidi, George Tsitsas
Creative Education (CE) , 2015, DOI: 10.4236/ce.2015.65050
Abstract: This study aimed to examine: a) the factors in Greek schools that are related to the school course of the adolescent drug abusers; b) the effectiveness of new interactive and social learning strategies in preventing drug use. Data were drawn from a face-to-face survey carried out on population of ex-drug abusers that were attending therapeutic programs of STROFI-KETHEA and in other places such as private with psychiatrists. The sample was 22 boys and 8 girls aged 16 to 21 years. All participants had a drug use experience and high rates of school drop out. The results suggest that factors related to the Greek school environment-meaning its culture, sense of community, education strategies–have negatively affected the school course of the participants. The poor school connectedness and dropping out effect negatively on young people’s behavior and drug use problems. Prevention should be considered through a new approach of the education system.
Ethical Climate and Sports Personship
MILTIADIS PROIOS,EVGENIA GIANITSOPOULOU,BASILIKI EFREMIDOU
Choregia , 2010,
Abstract: Moral behavior in sports is one of the most important issues that concern sportspersons. The aim of the present study was to examine whether the ethical work climate that prevails in non profit sport teams is related to moral behaviours (sports personship). Two hundred and fourteen students of three sport schools (n=126males, n=88females), aged between 12-18 years, from ten different sports (both individual and team) have been used in this study. The students filled in the Ethical Climate Questionnaire (ECQ; Victor &Cullen, 1987, 1988) and the Multidimensional Sportsperson-ship Orientation Scale (Vallerand, Briere, Blanchard, & Provencher, 1997). The results revealed the presence of a caring climate in non profit sport teams. Moreover, it was found that the individual climate is positively related to the four dimensions of sportsperson ship, while the machiavelianism climate is negatively related to the dimension respect for rules and officials.
New Agents Targeting Angiogenesis in Glioblastoma
Eleni Timotheadou
Chemotherapy Research and Practice , 2011, DOI: 10.1155/2011/878912
Abstract: Glioblastoma is the most common malignant glioma in adults, and despite recent advances in standard treatment, the prognosis still remains dismal, with a median survival of 15 months. The incorporation of bevacizumab in the standard treatment of relapsed glioblastoma has been a significant step towards combining targeted agents with chemotherapy, and there is an increasing number of new antiangiogenic agents in various stages of development, that are being tested both in relapsed and newly diagnosed disease, alone or in combination with standard treatment. The relatively favorable toxicity profile for most of them presents an advantage, but several concerns arise regarding their actual efficacy on the clinical level and the most efficient schedule of administration for each of them, as their molecular targets and patterns of action may vary significantly. This may lead to future modifications of the current rational of administering these agents concomitantly with initial chemotherapy or maintenance treatment.
Os refugos do mundo: figuras do pária
Varikas, Eleni;
Estudos Avan?ados , 2010, DOI: 10.1590/S0103-40142010000200003
Abstract: from the 16th to the 18th centuries, the term pariah, coined by western travelers, imperial officials or missionaries to designate the abjection of the outcasts in india, circulated in portuguese, english, french, german and dutch literati circles. in the discourse of enlightenment - and throughout the 19th century - it acquires a new meaning, related to the increasingly pejorative connotation of "caste". the metaphor of the "pariah" provides thus an idiom of the critique of arbitrary authority and the persisting social and political exclusion. thanks to the literature, theater, and opera, it enters the european literary and plebeian public spaces, giving a name to the modern invisible hierarchies, and denouncing the dehumanizing construction of the other in a world claiming as its grounding principle the universality of human rights.
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