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C Politis

Publications and source records attributed to C Politis.

At least 37 records · Page 2Linked to original sources

Left ventricular filling pattern in beta-thalassaemia major--a Doppler echocardiographic study.

The pattern of left ventricular filling was assessed by Doppler echocardiography in 38 adult beta-thalassaemia major patients; 28 with normal (age 25.2 +/- 5.3 years) and 10 with abnormal (age 24.5 +/- 8.8 years) left ventricular systolic function. The findings were compared with those obtained from 38 age and sex matched normal individuals. In patients with normal left ventricular systolic function, peak flow velocity in early diastole was higher than in the controls (94 +/- 16 vs 79 +/- 12 cm.s-1, P < 0.001). The peak flow velocity in late diastole was also greater (60 +/- 18 vs 46 +/- 9 cm.s-1, P < 0.001), but the ratio between the early and late (atrial) peaks was approximately the same in both groups (1.74 +/- 0.72 vs 1.70 +/- 0.30). There was no difference in deceleration time and rate between the two groups (152 +/- 32 vs 151 +/- 21 ms and 504 +/- 93 vs 508 +/- 115 cm.s-2 respectively). None of the patients had atrial predominant left ventricular inflow pattern. In patients with congestive heart failure the peak flow velocity in early diastole was greater than in the controls (96 +/- 10 vs 79 +/- 2 cm.s-1 P < 0.001) while in late diastole it was smaller (39 +/- 6 vs 44 +/- 2 cm.s-1, P < 0.05). The ratio between the early and late peaks was greater in the patients than in the controls (2.5 +/- 0.35 vs 1.8 +/- 0.08, P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Public knowledge of thalassemia in Greece and current concepts of the social status of the thalassemic patients.

Current concepts with regard to the social integration of the thalassemia patient worldwide require further evaluation. In this work we have investigated the concepts of the average citizen of continental Greece and Crete about the problem of thalassemia, his awareness of the basic characteristics of the disease and his attitudes towards some 'life-style' parameters of the thalassemic sufferer. We used the method of stratified random sampling and interviewed 3500 people aged 15-65 years. We carried out multivariate statistical analysis of responses to the items on thalassemia in relation to sex, age, educational level, place of residence and marital status. The results of this survey show that education was the factor with the greatest influence on the likelihood of being aware of thalassemia and of having accurate knowledge of the basic features of the disease. There was also a general effect of age with the highest awareness and the best knowledge being found in those aged 21-44 years, while place of residence was a significant factor for two items. The features known best were that thalassemia is non-infectious, that it calls for blood transfusion, and is inherited. Education had the strongest influence on the probability that a person holds the attitude that the sufferer from thalassemia can play a normal role in society as regards working and having a family, as well as generally living a normal life and, in the case of thalassemic children, playing and going to school. The attitude that thalassemics should work instead of receiving a state benefit depended on education, age and place of residence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Social integration of the older thalassaemic patient.

Because social policy favours the fullest possible social integration of chronically ill patients, we have evaluated the facilities that are needed to achieve this for patients with beta thalassaemia major in the light of the therapeutic advances that now permit them to survive into adulthood. We have investigated the social integration of adolescent and young adult thalassaemic patients, 171 from Greece and 112 from Ferrara in Italy. Patients in both areas show a good level of social integration and favourable self image, indicating what may be achieved by providing psychosocial support as part of a comprehensive approach to treatment.

Adolescent↗

Long-term results of surgical intervention on the temporomandibular joint.

Between 1973-1987, 40 patients (51 joints) underwent 71 surgical procedures on the temporomandibular joint (TMJ). Indications for surgery included painful TM dysfunction, not alleviated by conservative treatment of at least 12 months' duration, or complete anterior disk dislocation not responding to conservative treatment for three to six months. The incidence of surgical treatment in the period 1983-1987 was 4.1% in a group of 679 patients. The mean follow-up is 5.8 years (range 1-15 years). At the follow-up examination (37/51) 72.5% of the treated joints appeared to have an excellent or good result; however, 14/51 joints had one or more reoperations (= 14/40 patients: 35%). The first surgical procedure on the TMJ resulted in an excellent or good result in 29/51 (57%) joints: 6/14 (= 42.9%) high condylectomies; 5/8 (= 62.5%) high condylectomies with a plication procedure; 15/24 (= 62.5%) plication procedure only; 2/2 silastic implants. After one or more reoperations, these figures improved to 10/14 (71%) high condylectomies, 7/8 (87.5%) high condylectomies with a plication procedure, 17/24 (70.8%) plication procedures. Radiographic changes, including flattening of the condyle, lack of condylar contour, erosion, sclerosis, subcondral cysts, and osteophytes were seen in all (16/16) patients in which a high condylectomy was performed. Out of 22 joints in which only a disk repositioning and plication procedure was performed, only 4/22 showed radiographic changes. The radiographic status was not correlated to the clinical picture at the time of the follow-up examination.

Adolescent↗

Thalassemic patients are at high risk for transfusion-transmitted cytomegalovirus infections.

The prevalence of total as well as IgM antibodies against cytomegalovirus (CMV) was determined by enzyme immunoassay in a group of 287 multitransfused thalassemia major patients aged 5-39 years and in another group of 1,220 healthy controls. A significantly higher prevalence of CMV antibodies was observed in thalassemic patients of all age-groups compared with controls. The prevalence among splenectomized thalassemia patients was higher than among nonsplenectomized thalassemics. It is concluded concluded that patients with thalassemia, especially if splenectomized, are at high risk for transfusion-transmitted CMV infections. The high prevalence of CMV infections might be responsible, at least in part, for the immunological disturbances and the susceptibility to other infections observed in thalassemic patients. On the basis of these results, it is suggested that safe blood should be provided for anti-CMV-negative thalassemics, with priority to anti-HIV-positives and those who are to receive bone marrow transplantation.

Adolescent↗

Frameshift codon 5 [Fsc-5 (-CT)] thalassemia; a novel mutation detected in a Greek patient.

Sequence analysis and dot-blot hybridization of DNA from a Greek patient with a transfusion dependent thalassemia revealed the combination of a beta IVS-I-1 G----A mutation (beta(0) -thalassemia) and a hitherto undescribed frameshift mutation; the latter concerns the absence of a CT dinucleotide from codon 5 and results in a termination signal at the new codon 21 (also a beta (0)-thalassemia).

Adolescent↗

Skeletal stability following sagittal split osteotomy using monocortical miniplate internal fixation.

Skeletal stability was evaluated in 20 patients with mandibular hypoplasia, treated with bilateral sagittal split osteotomies to advance the mandible. Stable internal fixation was obtained using osseous miniplates and monocortical screws. Intermaxillary fixation was released after 5.15 days (range 1 to 11 days). The average B-point advancement was 6.07 mm (range 2.25 to 17.5 mm) and the average Pogonion-point advancement was 5.39 mm (range 1.75 to 14 mm). Mandibular range of motion, TMJ dysfunction and neurosensory deficits were also evaluated. The follow-up period averaged 8.85 months (range 6 to 14 months) and final evaluations were made after completion of orthodontics. Relapse measured at B-point was 10.7% and at Pogonion was 18.7%. Maximal opening decreased an average of 0.47 mm. Symptoms in 8 patients with TMJ dysfunction resolved, while 3 others developed TMJ dysfunction following surgery. Neurosensory deficits were subjectively identified in 9 patients (10 sides) and were objectively measured in 5 patients (5 sides).

Bone Plates↗

Assessment of splenic and RES function of patients with thalassemia major long after partial splenic embolization: in vivo clearance study.

The activity of the remaining reticuloendothelial system (RES) and the function of the splenic remnants was estimated in 5 thalassemic patients who had undergone successful partial splenic embolization (PSE) 6 yr previously. The kinetics of 125I-heat-denatured human albumin as well as that of 51Cr-heat-damaged homologous red blood cells were applied for this purpose and the parameters derived were compared to those of nonsplenectomized as well as splenectomized thalassemics with the following results: (a) The parameters of splenic function in embolized thalassemics were found to be within the limits observed in nonsplenectomized patients. (b) Their maximum phagocytic capacity was significantly lower, not only than that found in nonsplenectomized, but also than in thalassemic patients splenectomized at about the same time. It is concluded that, 6 yr after PSE has been performed, a reorientation of the altered circulatory dynamics has taken place in the splenic remnants allowing previously blockaded areas to gain normal function. It therefore seems that, despite the continuing hemolytic stimulus, RES hyperplasia is prevented, resulting in the stable, low-level transfusion requirements that have been observed in embolized thalassemics.

Adolescent↗

Partial splenic embolisation for hypersplenism of thalassaemia major: five year follow up.

Six patients with thalassaemia major were treated by partial splenic embolisation as an alternative to splenectomy and followed up for five years. Results were compared with those in a matched control group of seven patients treated by splenectomy. All patients treated by partial splenic embolisation showed a reduction in blood transfusion requirements comparable with those in the controls and which remained unchanged over the five years. Serious infections that commonly occur in patients splenectomised for thalassaemia did not occur after embolisation, presumably owing to preservation of some immune function by the splenic remnant. By contrast with the change in platelet counts seen after splenectomy, platelet counts remained normal after partial splenic embolisation, so reducing the risk of thromboses. On the other hand, pre-existing leucopenia and thrombocytopenia were corrected after embolisation. It is concluded that partial splenic embolisation provides an alternative to splenectomy for thalassaemia major and is equally effective and much safer.

Adolescent↗

Arthroplasty for temporomandibular joint ankylosis secondary to ankylosing spondylitis.

Although temporomandibular joint involvement is frequent in ankylosing spondylitis, ankylosis seldom ensues. A patient with a temporomandibular joint ankylosis secondary to ankylosing spondylitis is presented. Treatment consisted of an osteoarthrectomy, followed by a costochondral ribgraft. A follow-up period of 39 months showed a satisfactory result.

Adult↗

The use of costochondral grafts in arthroplasty of the temporomandibular joint.

Replacement of the condyle with a costochondral graft restores the altered biomechanics after condylectomy or gap-arthroplasty procedures. It avoids the recurrence of ankylosis. In the child, this graft allows harmonious growth of the mandible due to the characteristics of the costochondral cartilage. A case of uncontrolled multidirectional and excessive growth of the graft during pregnancy supports the view that the costochondral junction also carries intrinsic growth properties. Long-term follow-up evaluation shows very satisfactory cosmetic and functional results. In patients neglecting postoperative jaw mobilisation, maximal interincisal opening is acceptable but remains low. If no posterior dental support is provided after restoring the vertical dimension with the graft, some degree of graft resorption is possible.

Adult↗