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Biomedical subjects

Andreas Katsambas

Publications and source records attributed to Andreas Katsambas.

At least 19 recordsLinked to original sources
PubMed2006

Serological profile and virological evaluation of hepatitis B and hepatitis C virus infection among HIV infected patients in Greece.

In this study we evaluate the prevalence of HBV and HCV infections and the HBV and/or HCV viral load as well as HCV genotype among 737 HIV-infected patients. 89/737 (12.1%) were HBsAg(+) and the majority of them (60.7%) were HBeAg(+), in contrast to general Greek population; anti-HBc seropositivity was detected in 48.1% of the study population. Serum HBV-DNA levels were 5.75 +/- 1.66 (-log 10 copies/ml) and HBeAg(+) coinfected patients had significantly higher levels than HBeAg(-) ones (7.40 +/- 0.64 vs 4.59 +/- 1.01, respectively, p < 0.001). 8.2% of HIV-infected patients were anti-HCV(+) and the majority of them (85.7%) had HCV-RNA levels more than 700.000 IU/I. The most common HCV-genotype was genotype-1 (12/28, 42.9%), representing a difficult-to-treat special population.

Comorbidity↗
PubMed2005

Intralesional 5-fluorouracil in the treatment of keloids: an open clinical and histopathologic study.

BACKGROUND: The treatment of keloids remains unsatisfactory. Intralesional 5-fluorouracil (FU) has not been much investigated as a monotherapy in the treatment of keloids. OBJECTIVE: We sought to evaluate the use of intralesional injections of 5-FU in the treatment of keloids. METHODS: A total of 20 patients (11 male and 9 female) were treated once weekly with intralesional injections of 5-FU (50 mg/mL). Patients received an average of 7 treatments. Average injection volumes were 0.2 to 0.4 mL/cm2. All patients had full blood cell count, liver function tests, and renal function tests before and after treatment was commenced. A total of 10 patients had biopsy specimens taken before starting treatment as a baseline and after 6 sessions. Routine hematoxylin-eosin and immunohistochemical analysis detecting Ki-67 and transforming growth factor-beta were performed on paraffin sections. All patients were followed up for 12 months, or until recurrence was noted. RESULTS: Of 20 patients, 17 (85%) showed more than 50% improvement. Only one did not respond favorably. Small and previously untreated lesions improved the most. Pain (20 of 20), hyperpigmentation (20 of 20), and tissue sloughing (6 of 20) were the main adverse effects. Histopathologic and immunohistochemical evaluation were consistent with the clinical observations. Ki-67 proliferative index was significantly reduced (P = .0001) after treatment. Transforming growth factor-beta was reduced less significantly. Recurrence was noted in 47% (9 of 19) of patients who responded to treatment within 1 year. A correlation was found ( P = .028) between the duration of the lesions and recurrence. CONCLUSION: Our study demonstrates that intralesional 5-FU may be effective in the treatment of keloids, but recurrence is common and further investigation is required.

Adolescent↗
PubMed2005

Determinants of genital wart case detection rates among STD clinic attendees in Athens, Greece.

BACKGROUND AND OBJECTIVE: To report significant sociodemographic and behavioral outpatient characteristics associated with the diagnosis of genital warts. METHODS: Cross-sectional hospital-based study (1990-96). RESULTS: Genital warts (n = 2988, 51.2%) represent the leading sexually transmitted disease (STD) among 5831 consecutive symptomatic Greek and foreign immigrant STD outpatients. In Greek heterosexuals a low rate of partner change was the main patient characteristic at diagnosis (median: one partner in the past 6 months). Lower detection rate and riskier behavior characterized immigrants. Although associated with risky behavior, homo/bisexual orientation in males and injecting drug use were not significantly associated with condyloma diagnosis in the context of STDs. CONCLUSION: Broader health education and secondary prevention are needed to control this infection, whereas low-risk behavior in Greek heterosexuals with condylomata facilitates further preventive interventions.

Adult↗
PubMed2005

Treatment of cutaneous leishmaniasis with cryosurgery.

BACKGROUND: The management of cutaneous leishmaniasis with topical methods, if effective, can spare patients from long and costly inpatient treatments. METHODS: Seventeen patients with cutaneous leishmaniasis were treated with cryosurgery using liquid nitrogen as the cryogen. Two cycles of 10-30 s freezing time were used and repeated at 3-week intervals. RESULTS: All patients responded well to therapy with excellent cosmetic results and no relapse in any case. Side-effects were rare. CONCLUSIONS: Cutaneous leishmaniasis can be successfully treated with a simple protocol of cryosurgery with minor side-effects.

Adult↗
PubMed2005

Topical retinoids in the treatment of photoaging.

A large number of different substances comprise the family of retinoids, which are traditionally described as vitamin A derivatives. By exerting their action through nuclear and cytoplasmic receptors they may improve photoaging. Tretinoin is the best studied retinoid in the treatment of photoaging. Others such as isotretinoin, retinaldehyde, and tazarotene, although less well studied, have given promising results.

Journal Article↗
PubMed2003

Incidence determinants of gonorrhea, chlamydial genital infection, syphilis and chancroid in attendees at a sexually transmitted disease clinic in Athens, Greece.

OBJECTIVE: To determine the specific impact on the incidence rate of some demographic and behavioral characteristics in outpatients with four bacterial sexually transmitted diseases (STDs). STUDY DESIGN: A cross-sectional hospital outpatient-based study was conducted from 1990 to 1996 on 1064 consecutive symptomatic STD cases (Chlamydia trachomatis, n = 375; gonorrhea, n = 369; early symptomatic syphilis, n = 288, and chancroid, n = 32) using a standardized questionnaire. RESULTS: In a reference STD population of 5831 symptomatic outpatients, the relative incidence of gonorrhea, syphilis and chancroid was found to be increased among immigrants. Low educational/socioeconomic level was also a significant incidence predictor. Older age characterized homo/bisexuals. The chlamydial infection detection rate was not affected by nationality, injecting drug use history or sexual orientation in males. CONCLUSION: Innovative preventive and control strategies are needed among immigrants, older men having sex with men and injecting drug users, apart from those targeting the general population.

Adolescent↗
PubMed2003

Lasers for facial rejuvenation: a review.

BACKGROUND: Different types of laser are used for resurfacing and collagen remodeling in cutaneous laser surgery. METHODS: A systematic review was performed of the different types of laser currently employed for skin rejuvenation. These systems are either ablative [high-energy pulsed or scanned carbon dioxide (CO2) laser emitting at a wavelength of 10,600 nm, single- or variable-pulse or dual ablative/coagulative mode erbium:yttrium aluminum garnet (Er:YAG) laser emitting at a wavelength of 2940 nm, or systems combining both 10,600 nm and 2940 nm wavelengths] or nonablative [Q-switched neodymium:yttrium aluminum garnet (Nd:YAG) laser emitting at a wavelength of 1064 nm, Nd:YAG laser emitting at a wavelength of 1320 nm, or diode laser emitting at a wavelength of 1450 nm]. Different protocols, patient selection, treatment techniques, and complications are discussed for each system. RESULTS: New-generation CO2 resurfacing lasers have been successful in the treatment of photodamaged skin and scarring, with a postoperative morbidity dependent on the depth of thermal damage. Because of its minimal penetration, the pulsed Er:YAG laser, usually used in the treatment of more superficial rhytides, produces less postoperative morbidity. Novel ablative systems have been developed and a further understanding of laser-tissue interaction has led to the design of nonablative systems for the treatment of rhytides, scarring, and photodamaged skin, the efficacy and profile of which remain to be evaluated in the long term. CONCLUSIONS: There are several effective techniques for scar revision and the treatment of aged skin, but all have their drawbacks due to a lack of precise depth control and unwanted damage to the lower layers of the dermis. The Er:YAG laser is the treatment of choice for fine lines and superficial scars, whereas the CO2 laser is better for deeper rhytides and scars. In the future, a combination of lasers may be used for facial rejuvenation.

Cicatrix↗
PubMedDate not supplied

Acne: systemic treatment.

Acne vulgaris is a disease affecting mostly adolescents and young adults that, when severe, has the potential to result in scarring and permanent disfigurement. Systemic treatment is necessary to prevent significant psychological and social impairment in these patients.(1) Significant inflammatory and nodulocystic acne is usually recalcitrant to topical treatment, whereas uncommon acne variants, such as acne fulminans, pyoderma faciale, and acne conglobata, need to be promptly and effectively controlled. In all of these circumstances, systemic agents are indispensable. The choices include oral antibiotics, isotretinoin, and hormonal treatment (Table 1).

Acne Vulgaris↗
PubMedDate not supplied

Life-threatening purpura and vasculitis.

Palpable purpura, the inflammation of blood vessels is the hallmark of vasculitis. It can be observed in a variety of settings, where vessels can be affected primarily or as a secondary event. Every patient with vasculitis should be considered to have a systemic disease unless proven otherwise. One or more systemic symptoms occur in at least 50% of patients and there is no way to predict systemic involvement. Patients may demonstrate mild systemic involvement like arthralgia and arthritis, fever and malaise or more severe symptoms such as massive proteinuria and raised creatinine leading to chronic renal failure, severe intestinal bleeding or perforation with a fatal outcome. In this article we will review the life-threatening aspects of purpura and vasculitis.

Critical Illness↗
PubMedDate not supplied

Life-threatening dermatoses due to connective tissue disorders.

Connective tissue disorders such as scleroderma, dermatomyositis and lupus erythematosus are autoimmune, multi-system disorders whose clinical manifestations can be restricted to the skin or may involve many organs. The degree and rate of organ system involvement defer, as does the prognosis and rapidity of disease progression. In this article, scleroderma, dermatomyositis and lupus erythematosus will be reviewed in respect to their life-threatening potential.

Autoimmune Diseases↗
PubMedDate not supplied

Cutaneous markers of HIV infection.

Despite the development of laboratory methods, dermatological symptoms are a basic index of the presence and physical course of HIV infection. HIV infection usually undergoes a long latent period, proceeds to a period of immunodeficiency-related symptoms, and ends in an advanced immunodeficiency state characterized by opportunistic infections and neoplasms. Occasionally, dermatological manifestations can be the first signs of asymptomatic disease, indices of advanced immunodeficiency, or symptoms of opportunistic infections or neoplasms. The variety of symptoms and signs for the skin during the course of HIV infection is a consequence of the progressing immunodeficiency and therefore indicates the underlying disorder. The use of these manifestations is a challenge for clinical praxis.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

AIDS in pregnancy, part I: epidemiology, testing, effect on disease progression, opportunistic infections, and risk of vertical transmission.

Contribution of acquired immunodeficiency syndrome/human immunodeficiency virus (HIV) infection to pregnancy mortality rates is difficult to estimate; however, it appears to be one of the leading causes of death, at least in developing countries. Prenatal HIV testing affords the best opportunity for the prevention of perinatal HIV transmission. Rapid HIV testing substantially increases the proportion of women who obtain HIV results compared with conventional enzyme-linked immunosorbent assay testing, thus maximizing perinatal HIV interventions. Pregnancy appears to have no effect on the course of HIV disease. Infections due to a variety of pathogens influence the clinical course of the HIV infection and may complicate pregnancy and increase maternal mortality. The main risk factors for mother-to-child HIV transmission are high maternal viral load and CD4 cell count <700 cells/mm3. The main protective factor is antiretroviral therapy.

AIDS-Related Opportunistic Infections↗