PubMed Health⌕ Search

Biomedical subjects

D G Karamanolis

Publications and source records attributed to D G Karamanolis.

At least 19 recordsLinked to original sources
PubMed2005

Prevalence and impact of upper and lower gastrointestinal symptoms in the Greek urban general population.

OBJECTIVES: To study the prevalence of gastrointestinal symptoms in the Greek urban general population, their associations with patient characteristics, and their effect on patients' daily activities. MATERIAL AND METHODS: The study included 700 adults from the Athens-Piraeus area selected by a 2-stage scheme based on the official maps of the Hellenic Statistic Service. Structured questionnaires were completed through personal interviews. Dyspepsia, gastroesophageal reflux disease (GERD), and irritable bowel syndrome (IBS) were diagnosed according to widely accepted definitions. RESULTS: Of the 700 individuals, 53% reported > or = 1 gastrointestinal symptom during the past week and 55% during the past 6 months (dyspepsia: 48%, GERD: 38%, IBS: 21%). Only one disorder was diagnosed in 25% (dyspepsia: 18%, GERD: 7%), and > or = 2 disorders in 75% of symptomatic individuals. Dyspepsia or GERD was predominant in 7% and 16% and IBS in 28% and 19% of the patients with relevant symptoms during the past week and the past 6 months, respectively (p = 0.017). Substantial symptoms during the past 6 months were reported by 60% of the symptomatic individuals. Affected daily activities were reported by 22% of symptomatic and 5% of asymptomatic individuals (p < 0.001). CONCLUSIONS: Gastrointestinal symptoms are highly prevalent in the Greek urban general population and are substantial in the majority of symptomatic individuals. Dyspepsia and GERD are reported much more frequently than IBS symptoms, but there is a significant overlap between symptomatic diagnoses, while the predominant diagnosis may change over time. Gastrointestinal symptoms have a significant impact on patients' daily activities.

Activities of Daily Living↗
PubMed1999

p53 protein accumulation and colonic adenoma recurrence.

OBJECTIVES: The prognostic value of p53 protein accumulation in colonic adenomas is still controversial. The aim of the present study was to determine whether the evaluation of p53 protein accumulation in newly diagnosed colonic adenomas could predict the development of metachronous adenomas. DESIGN/METHODS: Fifty-five patients who underwent prior endoscopic polypectomy for colonic adenomas were colonoscopically re-evaluated at 24-38 months after index colonoscopy. In cases with more than one adenoma, the one with the greatest diameter and the most serious histology was taken into account. p53 protein expression was immunohistochemically examined using specific monoclonal antibody. RESULTS: p53 protein was detected in 41.8% of the 55 index adenomas. Recurrent adenomas were present in 21 patients (38.2%). Metachronous adenomas were present in 56.5% of patients with p53-positive index adenomas and in 25% of those with p53-negative index adenomas (odds ratio 3.90, P = 0.018). Among patients with 1 or 2 index adenomas, metachronous adenomas were found in 50% of those with p53-positive index adenomas and in 22.6% of those with p53-negative index adenomas (odds ratio 3.43, P= 0.042). Multivariate stepwise logistic regression analysis revealed that number of index adenomas per patient (1 or 2 versus > 2) and p53 expression (positive versus negative) in index adenomas contain independent prognostic information for adenoma recurrence (chi2 = 8.2, P= 0.004 and chi2 = 4.08, P = 0.04 respectively). Patients aged < 60 years developed recurrent adenomas relatively more frequently if they had a p53-positive index adenoma (P= 0.068). In the subgroup of patients aged < 60 years with 1 or 2 index adenomas, the recurrence of adenomas was more frequent in those with a p53-positive index adenoma but the difference did not reach statistical significance (P= 0.13). CONCLUSIONS: Our data suggest that p53 expression in index adenomas is associated with recurrent colonic adenomas.

Adult↗
PubMed1998

p53 and bcl-2 protein expression in rectosigmoid adenomas.

OBJECTIVE: The aim of this study was to evaluate whether p53 or bcl-2 protein expression in rectosigmoid adenomas is associated with histological characteristics of the adenomas and with presence of synchronous advanced proximal neoplasms. METHODS: Seventy-six average-risk patients who underwent total colonoscopy and had rectosigmoid adenoma(s) were studied. An adenoma was considered advanced if villous histology and/or severe dysplasia and/or diameter > 1 cm were present. p53 and bcl-2 protein expression was immunohistochemically examined using specific monoclonal antibodies. RESULTS: p53 protein was detected in 43% and bcl-2 in 93% of the 76 rectosigmoid adenomas. Advanced compared with nonadvanced adenomas were significantly more frequently p53-positive (28 of 44 or 63.6% vs five of 32 or 15.6%, p < 10(-4)) or had a bcl-2 score of 12 (20 of 44 or 45.5% vs five of 32 or 15.6%, p = 0.007). Proximal advanced neoplasms were mainly found in patients with rectosigmoid adenomas positive for p53 and with a bcl-2 score of 12 (six of 17 or 35.3% vs 2/59 or 3.4%, OR: 15.6, p = 0.001) and in particular in those with advanced rectosigmoid adenomas positive for p53 and with a bcl-2 score of 12 (six of 13 or 46.2% vs two of 31 or 6.5%, OR: 12.4, p = 0.007). CONCLUSION: p53 expression and bcl-2 protein overexpression in rectosigmoid adenomas are associated with advanced histology and a high risk of synchronous advanced proximal colon neoplasm.

Adenoma↗
PubMed1998

Proliferative patterns of rectal mucosa as predictors of advanced colonic neoplasms in routinely processed rectal biopsies.

OBJECTIVES: We sought to determine whether the evaluation of rectal cell proliferation in routinely processed rectal biopsies of apparently normal mucosa can predict the presence of advanced colonic neoplasms. METHODS: Fifty consecutive patients, who did not meet any of the following exclusion criteria, underwent total colonoscopy. Patients with nonadvanced adenomas, inflammatory bowel disease, hereditary predisposition to colonic cancer, or a history of colonic neoplasms were excluded. Patients with neoplasms in the distal 40 cm of the large bowel were also excluded. An adenoma was considered advanced if it had a diameter > 1 cm, or villous or severe dysplasia histology were present. In 26 of the 50 patients (Group A: 16 men, 10 women; mean age, 65 yr) advanced colonic neoplasms (advanced adenomas or cancer) were detected; in the remaining 24 (Group B: 13 men, 11 women; mean age, 66 yr) the large bowel was free of neoplasms. In all patients the proliferative patterns of apparently normal rectal mucosa were evaluated using the monoclonal antibody MIB-1 to assess the expression of Ki-67 antigen in routinely processed tissues. Proliferation index for the entire crypt, as well as proliferation indices for each of the five equal compartments, into which the crypt had been divided longitudinally, were calculated for each patient. RESULTS: The mean proliferation indices were similar between the two groups compared. The mean proliferation index for the upper crypt compartments (4 + 5) in the Group A patients was significantly higher than for those of the Group B patients (p < 0.01). Multivariate stepwise logistic regression analysis revealed that among gender, age, and proliferative parameters, the pattern of cell proliferation in the upper rectal crypt (4 + 5) compartment was the only predictor of advanced colonic neoplasms (beta = 11.01, p < 0.001). CONCLUSIONS: Our data suggest that the evaluation of the upward expansion of the rectal crypt proliferative zone in routinely processed rectal biopsies of apparently normal mucosa appears to predict the presence of advanced colonic neoplasms. These preliminary results should be confirmed in larger studies.

Adenoma↗
PubMed1996

Systemic absorption of 5-aminosalicylic acid in patients with inactive ulcerative colitis treated with olsalazine and mesalazine.

OBJECTIVE: To compare the systemic load of 5-aminosalicylic acid (5-ASA) as a basis for potential long-term toxicity during treatment in usual dosage with olsalazine (Dipentum) and one controlled-release mesalazine preparation (Salofalk) in patients with inactive ulcerative colitis. DESIGN: Open, randomized, crossover study. TREATMENT SCHEDULE: Olsalazine 500 mg twice daily for 7 days and mesalazine 500 mg thrice daily for 7 days consecutively. PATIENTS: Fifteen patients (12 males/3 females) aged between 18-70 years with ulcerative colitis in endoscopically confirmed remission for at least one month. METHODS: A morning predose plasma sample and a 24-h urine collection on days 6 and 7 of each course were obtained from all patients for quantitative determination of 5-ASA and acetyl-5-ASA (Ac-5-ASA) concentrations. High performance liquid chromatography was used and all analyses were performed blindly on coded samples. RESULTS: Treatment with mesalazine compared with olsalazine gave significantly higher levels of 5-ASA and Ac-5-ASA in plasma and urine. Maximum values and ranges of all variables were higher in the mesalazine group than in the olsalazine group. It is noteworthy that there was clear discriminance in the range of urine 5-ASA and Ac-5-ASA concentrations after mesalazine and olsalazine treatment. CONCLUSION: 1. The mesalazine preparation used, in comparison with olsalazine given in usual dosages, causes significantly higher levels of 5-ASA and Ac-5-ASA in plasma and urine in patients with inactive ulcerative colitis. 2. The lower systemic load of 5-ASA may reduce the potential risk of adverse events and in particular of nephrotoxicity.

Administration, Oral↗
PubMed1996

Characteristics of rectosigmoid adenomas as predictors of synchronous advanced proximal colon neoplasms.

BACKGROUND/AIM: Colonoscopy is recommended to every patient with adenoma in rectosigmoid to disclose synchronous proximal neoplasms. The aim of this study was to determine whether characteristics of rectosigmoid adenomas are associated with proximal advanced neoplasms. PATIENTS/METHODS: One hundred consecutive symptomatic patients who underwent total colonoscopy and had rectosigmoid adenomas were included in the study. Patients with iron-deficiency anemia were excluded. All polyps were removed endoscopically. An adenoma was considered advanced if it had a diameter > 1 cm and/or villous and/or severe dysplasia histology were present. RESULTS: Advanced rectosigmoid adenomas were found in 55 of the 100 patients. Proximal neoplasms were found in 26 (26%) patients. In particular, nonadvanced adenomas were found in 15 (15%), advanced adenomas in eight (8%), and cancer in three (3%) patients. The presence of proximal neoplasms was related to neither sex, age, or presenting symptoms nor to any of the characteristics of rectosigmoid adenomas. On the contrary, the presence of advanced proximal neoplasms (advanced adenoma or cancer) was significantly correlated with the presence of advanced rectosigmoid adenomas, which were detected in 11 (20%) of the 55 patients with advanced and in none of the 45 patients with nonadvanced, rectosigmoid adenomas (odds ratio: 23.5, p = 0.001). Logistic regression analysis revealed that the presence of advanced rectosigmoid adenoma was the main predictor of advanced proximal neoplasms (beta: 1.34, p < 10(-6)). CONCLUSIONS: Among patients with rectosigmoid adenomas, 1) proximal advanced neoplasms appear to exist only in those with advanced adenomas and 2) baseline colonoscopy does not seem necessary in those without advanced adenomas.

Adenoma↗
PubMed1995

Folate status and adenomatous colonic polyps. A colonoscopically controlled study.

PURPOSE: The aim of our study was to assess any association of folate with development of colonic adenomas. METHODS: Serum and red blood cell folate levels were measured in 62 colonoscopically and histologically evaluated patients with colon adenomas (Group A) and in 50 selected colonoscopically negative controls (Group B). Patients with colon polyps underwent colonoscopy for alterations of bowel habits or abdominal pain, and detected polyps were found coincidentally. Controls underwent colonoscopy for alterations of bowel habits or abdominal pain. There was no difference in hematocrit between the two groups. RESULTS: The mean serum folate level in patients with colonic adenomas was 4.57 ng/ml +/- 2.8 standard deviations (SD), and the mean red blood cells folate levels were 536 ng/ml +/- 273.3 (SD). In controls the mean folate levels in serum and red blood cells were 5.09 ng/ml +/- 2.7 (SD) and 743.8 ng/ml +/- 297.1 (SD), respectively. The red blood cell folate level of colon adenoma patients was statistically lower than the respective level of controls at a highly significant level (P < 0.01). CONCLUSIONS: We suggest that depressed red blood cell folate levels are associated with development of colonic adenomas.

Adenoma↗
PubMed1995

Proliferative activity in colonic adenomas as a predictor of metachronous adenomas as assessed by proliferating cell nuclear antigen immunohistochemistry.

OBJECTIVES: The aim of this study was to determine whether cell proliferation in colonic adenomas, as estimated by proliferating cell nuclear antigen (PCNA), predicts the development of metachronous colonic adenomas. METHODS: Forty patients who underwent prior endoscopic polypectomy for colonic adenomas were reevaluated by colonoscopy 2 yr later. The expression of PCNA was studied in all adenomas that were removed. A five-point semiquantitative scale of 1-5 was used to estimate the PCNA score by the percentage of positively stained cells. RESULTS: Among the 40 patients studied, 16 developed recurrent adenomas (group A) and 24 were free of adenomas (group B). At initial colonoscopy, a total number of 51 adenomas (25 in group A and 26 in group B), were found. The median PCNA score in group A and group B index adenomas was 4 (interquartile range, 3-5) and 2 (interquartile range, 1-3), respectively (p < 0.01, Mann-Whitney U-test). A stepwise logistic regression analysis showed that PCNA score is a significant risk factor (p = 0.007, odds ratio 15.8, 95% confidence interval 2.2-112.4) in predicting adenoma recurrence. The median PCNA score in metachronous adenomas was 2 (interquartile range, 1-3). The difference in the PCNA score between group A index and metachronous adenomas was again statistically significant (p < 0.01, Mann-Whitney U-test). CONCLUSIONS: We conclude that the increased expression of PCNA in colonic adenomas may be a predictor for metachronous adenomas.

Adenoma↗
PubMed1994

A family of five first degree relatives affected by Lynch II syndrome.

Hereditary non-polyposis colorectal cancer (Lynch syndromes) has been reported in the international literature over the last decade. We now present a case of a family with Lynch II syndrome, in which five first-degree relatives were affected by colorectal cancer; in addition, the two female patients had ovarian or breast cancer.

Adult↗
PubMed1985

Diverticula, neoplasia, or both? Early detection of carcinoma in sigmoid diverticular disease.

In 105 patients with symptomatic sigmoid diverticular disease, colonoscopy revealed an associated frequency of carcinoma of seven (6.6%) (Dukes A in 4, B in 2, and C in 1) and adenomas in 29 (27.6%), with a peak incidence of 60 to 79 years and an equal sex distribution. In 45 (43%) examinations, the barium enema was inaccurate. The presenting complaints of abdominal pain and/or alteration in bowel habit in 36 patients with neoplasms and 69 without were similar, but significantly more patients with neoplasms complained of rectal bleeding (p less than 0.05). Endoscopic examination is therefore recommended in patients with sigmoid diverticular disease, particularly in those aged over 60 years and with rectal bleeding.

Aged↗
PubMed1985

Post-gastrectomy nutrition: methods of outpatient screening for early osteomalacia.

A cohort of 227 patients treated by partial gastrectomy between 1955-1960 has been followed up regularly for evidence of osteomalacia. Of these, 10 developed clinical or subclinical osteomalacia as proven by bone biopsy. The diagnosis of early asymptomatic osteomalacia in bone biopsies presented many difficulties. As an alternative, patients with a rising serum alkaline phosphatase (SAP) were screened for liver disease, Paget's disease, osteoporotic crush fractures and bony secondaries. In the absence of these a therapeutic trial of eight Calcium and Vitamin D tablets BPC daily was given. In 5 out of 11 patients the SAP fell to normal and these were given a maintenance daily dose of six tablets. These patients were presumed to have had subclinical osteomalacia. This approach, involving regular monitoring of the SAP, is recommended as the most applicable for routine screening of a gastrectomy population, particularly in District Hospitals.

Alkaline Phosphatase↗
PubMed1984

Is colonoscopy necessary in diverticular disease?

Colonoscopy was carried out in 65 patients in whom double-contrast barium enemas for bowel symptoms had shown sigmoid diverticular disease. In 19 of these, barium enemas had shown neoplastic lesions--polyps in 17 and carcinoma in 2; but colonoscopy showed no polyps in 9 of the 17. In 1 a carcinoma not a polyp was found, and of the 2 carcinomas only 1 was confirmed. In 46 patients the barium enemas showed diverticular disease only, but colonoscopy revealed polyps in 8 and carcinoma in 3. Thus in 23 patients (35%) the barium enema was inaccurate. 13 of 20 patients with neoplasia but only 11 of 45 without had rectal bleeding, but the numbers in the two groups who had abdominal pain or change in bowel habit were similar in the two groups. Colonoscopy revealed neoplastic lesions in 20 of the 65 patients (31%), an incidence great enough to recommend routine colonoscopy in patients with symptomatic diverticular disease, especially those with rectal bleeding.

Aged↗
PubMedDate not supplied

Genes and gastric cancer.

Gastric cancer remains quite a common malignancy and counts among the most important causes of cancer-related death worldwide. Although the pathogenesis is multifactorial, familial aggregation in a significant proportion of cases suggests the importance of genetic predisposition. The association between the E-cadherin/CDH1 gene germline mutations and the development of diffuse gastric cancer was the first evidence for a molecular basis of gastric cancer in predisposed families and led many authorities in the world to produce guidelines regarding the management of such families members. The recent advances in genetics resulted in the discovery of numerous genetic events occurring during the course of gastric carcinogenesis (activation of oncogenes, silencing of tumor suppressor genes, mutations in DNA-repairing genes) and contributed to a better understanding in pathogenesis. Many genetic changes described have been found to affect tumor's biological behavior. In this article the authors attempt a review of all the molecular alterations in gastric cancer described in the literature and their impact on the management of patients with an inherited predisposition to gastric cancer. The promising role of gene therapy in the treatment of gastric cancer in the near future is also commented on.

Cadherins↗
PubMedDate not supplied

The puzzle of somatostatin: action, receptors, analogues and therapy.

The scientific search for the revelation of the multiple physiological aspects of somatostatin has already begun. Investigators have managed to clarify many pathophysiological processes that have been influenced or regulated by somatostatin. The focus of future research seems to be the therapeutic application of this accumulated knowledge. The aim of this study is to collect the available information on the action, receptors and use of somatostatin analogues in human tissues. For this reason findings were based on Internet search and complete studies with abstracts written in English. A special mention on the influence of somatostatin on the immune system and inflammatory bowel disease is also included.

Autoimmunity↗