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Search Results: 1 - 10 of 3245 matches for " Irene Asouhidou "
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Acute aortic dissection: be aware of misdiagnosis
Irene Asouhidou, Theodora Asteri
BMC Research Notes , 2009, DOI: 10.1186/1756-0500-2-25
Abstract: From January 2000 to December 2004, 49 patients (41 men and 8 women, aged from 18–75 years old) presented to the Emergency Department of our hospital for different reasons and finally diagnosed with AAD. Fifteen of those patients suffered from arterial hypertension, one from giant cell arteritis and another patient from Marfan's syndrome. The diagnosis of AAD was made by chest X-ray, contrast enhanced computed tomography (CT), transthoracic echocardiography (TTE) and coronary angiography.Initial misdiagnosis occurred in fifteen patients (31%) later found to be suffering from AAD. The misdiagnosis was myocardial infarction in 12 patients and cerebral infarction in another three patients.Aortic dissection may present with a variety of clinical manifestations, like syncope, chest pain, anuria, pulse deficits, abdominal pain, back pain, or acute congestive heart failure. Nearly a third of the patients found to be suffering from AD, were initially otherwise diagnosed. Key in the management of acute aortic dissection is to maintain a high level of suspicion for this diagnosis.Acute aortic dissection (AAD) is a potentially fatal condition that requires rapid assessment and treatment. However, despite major advances in imaging modalities and noninvasive studies, correct diagnosis is not always the rule, with misdiagnosis occurring in less than half the cases [1,2].Classically, acute aortic dissection usually presents with an abrupt onset of severe pain in the chest, back, or abdomen. Patients often describe their pain as tearing or ripping. The severity of pain may precipitate vagal reflexes, including hypotension and bradycardia. If the aortic valve or coronary arteries are involved, congestive heart failure may acutely develop. The patient may present with paralysis of upper and/or lower extremities [3], anuria, dyspnea or pulmonary edema. Additionaly, most patients suffering from AAD often reveal insignificant medical history. The absence of suspicion rising from the pat
Early postoperative mortality in the elderly: a pilot study
Irene Asouhidou, Theodora Asteri, Petros Sountoulides, Konstantinos Natsis, George Georgiadis
BMC Research Notes , 2009, DOI: 10.1186/1756-0500-2-118
Abstract: Fifty patients aged 70 to 95 years of age were enrolled in the study. All patients had undergone major elective orthopedic procedures due to either osteoarthritis of femoral head or femoral neck fracture. Patients were followed up by telephone interview one month following their discharge. 8 out of 50 patients (16%) were reported dead at follow up. For the majority of the patients who died, the cause of death was directly related to their previous medical history.Despite the detailed preoperative evaluation, and the intensive intraoperative and early postoperative anaesthetic care, most patient's deaths were related to their previous medical history.It is estimated that by the year 2040, people over the age of 65 will constitute approximately 24% of the earth's population. Half of them will need to undergo certain surgical procedures in view of the fact that perioperative morbidity has a 3-fold increase in this subset of patients [1].It becomes quite challenging to distinguish between changes in physiology caused by aging, and the pathophysiology of certain diseases that are very common in the elderly. Functional reserve and maximal capacity of all major organ systems are significantly reduced and may not be able to meet the increased demands associated with acute illness surgery [2]. Postoperative mortality is thought to be associated with increasing age; however the severity of coexisting medical problems seems to be an equally important risk factor [3-5]. The purpose of this study is to evaluate the effect of previous medical conditions on the mortality rate of elderly patients during the early postoperative phase following major orthopedic surgery.All patients (n = 50) aged 70 to 95 years old, that were admitted to our hospital for osteoarthritis of the femoral head or femoral neck fracture between January 2004 to May 2004, were enrolled in the study. The operations performed were total hip arthroplasty for those suffering from osteoarthritis of femoral head and
Arteriovenous malformation of the spermatic cord as the cause of acute scrotal pain: a case report
Petros Sountoulides, Athanasios Bantis, Irene Asouhidou, Hellen Aggelonidou
Journal of Medical Case Reports , 2007, DOI: 10.1186/1752-1947-1-110
Abstract: Arteriovenous malformations (AVMs) occur mainly in the central nervous system, although they have been described in other organs as well. AVMs rarely involve the testis or the scrotal components, presenting mainly in the form of para-testicular or intra-testicular masses. This case reveals an uncommon clinical presentation of a non-palpable AVM of the spermatic cord. To our knowledge we present the first reported case of an arteriovenous malformation of the spermatic cord being the cause of recurrent acute scrotal pain.An otherwise healthy 22-year-old man presented with acute pain in his right hemiscrotum. He recalled having similar episodes of self-limited scrotal pain since his adolescence. The pain had been attributed by attending physicians to episodes of intermittent testicular torsion. He denied any history of trauma, urinary tract infection, sexually transmitted diseases, or voiding symptoms.Clinically both testes were intrascrotal, there was no swelling or signs of inflammation and the cremasteric reflex was intact. The right testis was, however, very tender in palpation. Both epidydimis were also normal and non-tender in palpation. Routine laboratory test and urinalysis were normal, and urine culture was sterile.Grey scale scrotal ultrasonography and Color Doppler Ultrasound (CDU) were performed. Sonography revealed no evidence of testicular tumor, varicocele or other pathology of the testis or epidydimis. (Figure 1)The patient underwent a diagnostic right scrotal exploration due to his persistent scrotal pain. Scrotal exploration revealed a macroscopically normal testicle, epididymis and spermatic cord. There was no evidence suggestive of intermittent testicular torsion, e.x "bell clapper" deformity of the testis, or torsion of testicular appendages.Four months later the patient presented with the same intractable right scrotal pain. Clinical examination and ultrasound investigation were insignificant. Orchiectomy was suggested this time and was performed
“Vanishing Penis” and Urinary Retention due to Locally Destructive Penile Cancer
Petros Sountoulides,Athanasios Bantis,Ioannis Zachos,Irene Asouhidou
The Scientific World Journal , 2009, DOI: 10.1100/tsw.2009.14
Aerobic exercise and intraocular pressure in normotensive and glaucoma patients
Konstantinos Natsis, Irene Asouhidou, George Nousios, Theodosios Chatzibalis, Konstantinos Vlasis, Vasilios Karabatakis
BMC Ophthalmology , 2009, DOI: 10.1186/1471-2415-9-6
Abstract: 145 individuals were subdivided into seven groups: normotensives who exercised regularly (Group A); normotensives in whose right eye (RE) timolol maleate 0.5% (Group B), latanoprost 0.005% (Group C), or brimonidine tartrate 0.2% (Group D) was instilled; and primary glaucoma patients under monotherapy with β-blockers (Group E), prostaglandin analogues (Group F) or combined antiglaucoma treatment (Group G) instilled in both eyes. The IOP of both eyes was measured before and after exercise.A statistically significant decrease was found in IOP during jogging. The aerobic exercise reduces the IOP in those eyes where a b-blocker, a prostaglandin analogue or an α-agonist was previously instilled. The IOP is also decreased in glaucoma patients who are already under antiglaucoma treatment.There is no ocular restriction for simple glaucoma patients in performing aerobic physical activity.As an increasing number of people are becoming active in aerobic physical exercise such as jogging and bicycling it would be interesting to identify any limitations or precautions, concerning the effect of exercise on intraocular pressure (IOP). Previous studies have shown a reduction in IOP following certain forms of exercise, ranging from walking to exhausting exercise, in healthy volunteers. According to Qureshi et al all forms of physical exercise (bicycling, walking and jogging) decrease IOP [1]. It is also well known that intraocular pressure decreases after severe exercise to exhaustion [2]. However, the effect of exercise on the IOP for individuals under antiglaucoma medication has not been extensively studied. The present study was designed in order to detect how IOP is affected in athletes, non athletes and glaucoma patients that perform jogging or bicycling with or without instillation of various antiglaucoma eye drugs. The study dealt with this issue using a significant number of individuals (totally 145 individuals) including normotensive individuals and glaucoma patients.One hun
Somatosensory Evoked Potentials suppression due to remifentanil during spinal operations; a prospective clinical study
Irene Asouhidou, Vasilios Katsaridis, Georgios Vaidis, Polimnia Ioannou, Panagiotis Givissis, Anastasios Christodoulou, Georgios Georgiadis
Scoliosis , 2010, DOI: 10.1186/1748-7161-5-8
Abstract: Ten patients underwent spinal surgery. Anesthesia was induced with propofol (2 mg/Kg), fentanyl (2 mcg/Kg) and a single dose of cis-atracurium (0.15 mg/Kg), followed by infusion of 0.8 mcg/kg/min of remifentanil and propofol (30-50 mcg/kg/min). The depth of anesthesia was monitored by Bispectral Index (BIS) and an adequate level (40-50) of anesthesia was maintained. Somatosensory evoked potentials (SSEPs) were recorded intraoperatively from the tibial nerve (P37) 15 min before initiation of remifentanil infusion. Data were analysed over that period.Remifentanil induced prolongation of the tibial SSEP latency which however was not significant (p > 0.05). The suppression of the amplitude was significant (p < 0.001), varying from 20-80% with this decrease being time related.Remifentanil in high doses induces significant changes in SSEP components that should be taken under consideration during intraoperative neuromonitoring.Electrophysiological monitoring is applied during spinal surgery in order to assess the nervous tissue at risk for injury in a patient who is unable to respond due to anesthesia. There are several tests that can be performed intraoperatively to indicate a probable spinal injury; the so-called "wake up" test is time consuming and can not be performed at any time or in the emergency setting while motor evoked potentials (MEPs) are extremely sensitive to anesthetic agents. Somatosensory evoked potentials (SSEP) measure the integrity of the sensory pathways in the dorsal columns of the spinal cord, by stimulating a peripheral sensory nerve and measuring the electrical response in the brain. The introduction of SSEP monitoring to spinal surgery has significantly reduced the rate of intraoperative injury. A survey of the Scoliosis Research Society and the European Spinal Deformities Society documented a reduction in injury rate from 0.7-4.0% in the pre-SSEP monitoring days to less than 0.55% with SSEP monitoring [1].SSEP are less affected by anesthetic ag
Oxidative and pre-inflammatory stress in wedge resection of pulmonary parenchyma using the radiofrequency ablation technique in a swine model
Theodoros Karaiskos, Periklis Tomos, Irene Asouhidou, Nikolaos Nikiteas, Theodoros Kontakiotis, Apostolos Papalois
Journal of Cardiothoracic Surgery , 2012, DOI: 10.1186/1749-8090-7-7
Abstract: Fourteen white male swines, divided in two groups, the RFA-group and the control group (C-group) underwent a small left thoracotomy and wedge lung resection of the lingula. The wedge resection in the RFA-group was performed using the RFA technique whereas in C-group the simple "cut and sew" method was performed. We measured the malondialdehyde (MDA) and TNF-α concentration in the resected lung tissue of both groups.In C-group the MDA mean deviation rate was 113 ± 42.6 whereas in RFA-group the MDA mean deviation rate was significantly higher 353 ± 184 (p = 0.006). A statistically significant increase in TNF-α levels was also observed in the RFA-group (5.25 ± 1.36) compared to C-group (mean ± SD = 8.48 ± 2.82) (p = 0.006).Our data indicate that RFA-assisted wedge lung resection in a swine model increases regional MDA and TNF-a factors affecting by this oxidative and pre-inflammatory stress of the procedure. Although RFA-assisted liver resection can be well tolerated in humans, the possible use of this method to the lung has to be further investigated in terms of regional and systemic reactions and the feasibility of performing larger lung resections.Radiofrequency ablation (RFA) is performed by the delivery of electrical energy through a needle electrode to the area of interest, using high frequency alternating electrical current in order to cause a heat-based tissue damage. After hitting the target tissue, the current returns back to the generator through grounding skin pads. As the electrical energy increases the tissue temperature to 60-100°C there is denaturation of cellular proteins, melting of lipids, and instantaneous coagulative necrosis, resulting in irreversible cell damage.and destruction of tissue. Tissue destruction is enhanced by the creation of a secondary, wedge-shaped zone of damage due to vascular thrombosis. The RFA-created lesion heals with fibrosis and scarring [1].This technique has been widely used for the in situ destruction of small, usually m
Early postoperative cognitive dysfunction and postoperative delirium after anaesthesia with various hypnotics: study protocol for a randomised controlled trial - The PINOCCHIO trial
Federico Bilotta, Andrea Doronzio, Elisabetta Stazi, Luca Titi, Ivan Zeppa, Antonella Cianchi, Giovanni Rosa, Francesca Paoloni, Sergio Bergese, Irene Asouhidou, Polimnia Ioannou, Apolonia Abramowicz, Allison Spinelli, Ellise Delphin, Eugenia Ayrian, Vladimir Zelman, Philip Lumb
Trials , 2011, DOI: 10.1186/1745-6215-12-170
Abstract: We designed this study to evaluate postoperative delirium rate after general anaesthesia with various hypnotics in patients undergoing surgical procedures other than cardiac or brain surgery. We also aimed to test whether delayed postoperative cognitive recovery increases the risk of postoperative delirium.After local ethics committee approval, enrolled patients will be randomly assigned to one of three treatment groups. In all patients anaesthesia will be induced with propofol and fentanyl, and maintained with the anaesthetics desflurane, or sevoflurane, or propofol and the analgesic opioid fentanyl.The onset of postoperative delirium will be monitored with the Nursing Delirium Scale every three hours up to 72 hours post anaesthesia. Cognitive function will be evaluated with two cognitive test batteries (the Short Memory Orientation Memory Concentration Test and the Rancho Los Amigos Scale) preoperatively, at baseline, and postoperatively at 20, 40 and 60 min after extubation.Statistical analysis will investigate differences in the hypnotics used to maintain anaesthesia and the odds ratios for postoperative delirium, the relation of early postoperative cognitive recovery and postoperative delirium rate. A subgroup analysis will be used to categorize patients according to demographic variables relevant to the risk of postoperative delirium (age, sex, body weight) and to the preoperative score index for delirium.The results of this comparative anaesthesiological trial should whether each the three hypnotics tested is related to a significantly different postoperative delirium rate. This information could ultimately allow us to select the most appropriate hypnotic to maintain anaesthesia for specific subgroups of patients and especially for those at high risk of postoperative delirium.ClinicalTrials.gov: NCT00507195Postoperative delirium (PD), defined as altered perception with hallucinations, acute decline in cognition and attention and inappropriate behaviour, is a
The role that oilseeds, including new hi-oleic varieties can play in improving the profile of fat intake by the UK population  [PDF]
Janice Irene Harland
Agricultural Sciences (AS) , 2014, DOI: 10.4236/as.2014.53024

The production in the EU of the oilseeds, rapeseed and sunflower, has increased dramatically over the last 20 years. Much of the oil produced after crushing is used for culinary purposes; this enhanced intake of vegetable oil has led to a substantial change of fatty acid (FA) supply. This has been conclusively demonstrated by taking the UK oil supply data and by use of the FA profile of the key oils converting the supply data into a FA profile of the UK market place for 2008-2012. The most marked changes are a reduction in saturated fat (SFA) and an increase in monounsaturated fatty acids (MUFA) available for consumption. Furthermore the introduction of varieties of hi-oleic sunflower oil can further affect the market FA profile. The fat profiles of rapeseed and sunflower oils are considered healthy and they can have a positive impact when included in the diet, particularly as a replacement for oils or fats rich in SFA. In the UK and much of Europe, adult SFA intake continues to exceed recommendations. While reductions in the UK population’s SFA intake have occurred over the last 20 years, these are modest and it may be timely to identify ways in which SFA intake can be further reduced. To do this, the UK market FA supply data has been analysed alongside the profile of FA intake from adults recording their intake in national dietary surveys in order to identify if the market supply affects overall FA consumption. There is an indication that market oil supply is reflected in adults dietary intake of the main groups of FA. Consequently changes made to the oil profile of oilseeds by plant breeders and use of the resulting healthier oils by food manufacturers could have important roles to play in helping adults to achieve the recommended intake of SFA and also improve the overall fat quality in their diet leading to enhanced long-term health and well-being. Thus changes made in pri

The Relationship between Access to Mass Media and HIV/AIDS Related Knowledge, Beliefs and Behaviours in Kenya  [PDF]
Irene Muli, Stephen Lawoko
Psychology (PSYCH) , 2014, DOI: 10.4236/psych.2014.57084

Aim: We scrutinized the association between access to mass media and HIV/AIDS related knowledge, beliefs and behaviours in Kenya. Methods: Data on a representative sample of Kenyan women between 15 - 30 years of age (n = 3909) was retrieved from the Kenyan demographic and health survey (DHS 2008) and analyzed using Chi-square tests and binary logistic regression. Results: Media use was common with over 70% of participants using radio at least once a week. Between 3% - 30% of participants had poor to inadequate knowledge/beliefs about HIV/AIDS, with variations depending on demographic and social factors such as age, education, literacy, wealth and residential area. HIV/AIDS knowledge, beliefs and behaviours were associated with exposure to media, even after control for possible co-variation with social and demographic factor. Conclusion: Despite wide exposure to media among young Kenyan women, substantial proportions have poor to inadequate knowledge of the aetiology, risk/protective factors and control measures of HIV/AIDS. Yet, such knowledge was positively associated with media use. Media thus could ideally be used to implement a comprehensive awareness campaign in the general population about the aetiology, risk/protective factors and control measures in HIV/AIDS.

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