PubMed Health⌕ Search

Biomedical subjects

Dimitrios K Filippou

Publications and source records attributed to Dimitrios K Filippou.

14 recordsLinked to original sources
PubMed2006

Comparison of stroke among Christians and Muslims in Thrace, Greece.

INTRODUCTION BACKGROUND AND PURPOSE: Previous studies have demonstrated significant racial differences in incidence, age of onset, outcome and subsequent risk factors of stroke. However, there is scarce evidence available for Muslim populations worldwide. Xanthi region, a mainly rural and remote area in northern Greece, which is characterized by a mixed Christian/Muslim population, is considered appropriate for further studies in this area. METHODS: A prospective clinical study, based on a cohort of 530 consecutive unselected patients, 366 Christians and 164 Muslims, who had their first documented episode of stroke between 1998 and 2002. Chi-square and Fisher's exact test for comparison between discrete parameters, Student's t-test for comparison between quantitative parameters and Pearson's r for correlations (along with Bonferroni's adjustment) were used. A multiple logistic regression model was performed for evaluation of religion and gender as independent predictors of type of stroke. RESULTS: Muslims, when compared with Christians: (1) present with ischemic stroke less often (p = 0.049); (2) suffer from stroke at a younger age (67.26 +/- 9.77 vs 71.43 +/- 10.88 years; p < 0.001); (3) show a significantly lower incidence rate (87.2 vs 173.9 cases/100,000 person*years; RR 1.994; p < 0.001); (4) have lower rates of diabetes (p = 0.019) and atrial fibrillation (p < 0.001) and (5) present similar mortality (p = 0.347). CONCLUSIONS: Lower diabetes and atrial fibrillation rates among the Muslims of Thrace, Greece, might account for their low incidence of stroke. The contribution of culture-related habits (diet, occupation) remains to be investigated in further studies.

Aged↗
PubMed2004

Rupture of totally implantable central venous access devices (Intraports) in patients with cancer: report of four cases.

BACKGROUND: Totally implantable central venous access devices (intraports) are commonly used in cancer patients to administer chemotherapy or parenteral nutrition. Rupture of intraport is a rare complication. PATIENTS AND METHODS: During 3 years period, a total of 245 intraports were placed in cancer patients for chemotherapy. Four of these cases (two colon cancer and one each of pancreas and breast cancer) had rupture of the intraport catheter, these forms the basis of present report. RESULTS: Mean time insitu for intraports was 164 (35) days. Median follow-up time was 290 days and total port time in situ was 40180 days. The incidence of port rupture was 1 per 10,000 port days. Three of the 4 cases were managed by successful removal of catheters. In two of these the catheter was removed under fluoroscopic control using femoral route, while in the third patient the catheter (partial rupture) was removed surgically. One of the catheters could not be removed and migrated to right ventricle on manipulations. CONCLUSION: Port catheter rupture is a rare but dreaded complication associated with subcutaneous port catheter device placement for chemotherapy. In case of such an event the patient should be managed by an experienced vascular surgeon and interventional radiologist, as in most cases the ruptured catheter can be retrieved by non operative interventional measures.

Journal Article↗
PubMed2004

Modified capitonage in partial cystectomy performed for liver hydatid disease: report of 2 cases.

BACKGROUND: Several techniques have been described in liver hydatid disease surgery, with most well known partial cystectomy, capitonage and introflexion. METHODS: We present a technical modification on open partial cystectomy for liver hydatid disease. We performed this operation in 2 patients with liver echinococcosis. The cyst is being unroofed and evacuated from the daughter cysts. The identified bile vessels ligated. The remnants of the anterior wall (capsule of the cyst) are anchored with sutures in the posterior wall in a manner that the cavity of the cyst disappears. RESULTS: In both patients the disease eradicated. No postoperative complications were observed including bile leaking and/or abscess formation. CONCLUSIONS: Our technique helps in the fast, and effective mobilization of the patient, as well as in the minimization of postoperative bile leaking.

Albendazole↗
PubMed2004

Impact of the European Union enlargement on health professionals and health care systems.

As the European family enlarges, the admission of new human resources in the health services will have an impact on the European market and health care system. Under the umbrella of the European Union (EU) equality, the educational quality barriers (e.g. PLAB test in UK, DIKATSA test in Greece) will be abolished. The overproduction of health professionals and their heterogeneous regional and per specialty distribution will lead to medical unemployment and demotion of the medical profession. Medical and political authorities and decision makers of the EU need to reform the European Health System, supervise, and assess the quality of medical education, harmonize the individual National Health System policies, and follow the World Health Organization (regional office for Europe) guidelines on health policy. An agreed, structured European Health Policy might moderate the vibrations of the forthcoming EU enlargement.

Curriculum↗
PubMed2004

Popliteal artery entrapment syndrome: anatomic or functional syndrome?

PURPOSE: The purpose of this retrospective study is to present our clinical experience in the diagnosis and treatment of young athletes with popliteal artery entrapment syndrome. DESIGN: Retrospective Case Series. METHODS: We report our experience with 5 patients with lower leg pain in a population of 2000 athletes in whom popliteal artery entrapment diagnosed with the use of duplex ultrasonography, computed tomography, digital subtraction angiography or conventional arteriography. Posterior surgical approach performed to offer better view of the anatomic structures compressing the popliteal artery. RESULTS: In 4 patients in whom compression had not yet damaged the arterial wall, no anatomical abnormalities found within the popliteal fossa during surgical exploration. Hypertrophy of gastrocnemius muscle was the only finding. In the fifth patient an anatomical abnormality found in which the artery following the classic aberrant course, looped medially to and then beneath the medial head of gastrocnemius. All patients recovered completely. CONCLUSIONS: We conclude that physicians who encounter athletes with progressive lower leg pain should consider functional popliteal artery entrapment surgery, which can prevent the disease's progression. We discuss clinical symptoms of the syndrome, radiological and ultrasonographical findings, and diagnostic criteria. Early diagnosis is of great importance in order to avoid vascular complications, and aid in athletes' early rehabilitation.

Adult↗
PubMed2004

Low back pain in physical education teachers.

The purpose of this study was to investigate the factors related to occupational low back pain (LBP) occurring in male physical education teachers (PET). The location was set in Athens and we used questionnaires to collect information. Analysis revealed that the prevalence of LBP during the survey was 63%. The correlation of personal factors and LBP showed that the prevalence of LBP was significantly higher in those PET (odds ratio, 2.5) who answered yes to the item "no personal training" than in the PET who did not. Moreover, many occupational factors are related to LBP. These were the items "lifting gym instruments" (odds ratio, 2.6) and "helping students into flexing posture" (odds ratio, 3.0). From the working conditions it was confirmed that the PET (odds ratio, 2.5) who "spent more than 35 hours per week in teaching physical education" were correlated with LBP. Our results suggest that PET, under the current working condition, are vulnerable to low back pain. An improvement of these conditions must be taken into account in order to prevent LBP.

Adult↗
PubMed2004

Sport related plantar fasciitis. Current diagnostic and therapeutic advances.

UNLABELLED: Plantar fasciitis is the most common diagnosis for pain in the inferior aspect of the heel among runners, accounting for 10% of injuries that occur in connection with running. The etiology of pain is multifactorial. The aim of the present study is to report our experience in the treatment of plantar fasciitis in athletes and compare our diagnostic strategy and treatment modalities with the current practice. MATERIAL AND METHODS: We treated 32 athletes with plantar fasciitis from 1997-2002. The diagnostic procedure included detailed history, clinical examination and imaging techniques. Conservative treatment consisted of anti-inflammatory drugs, stretching exercises, suitable training routines and special orthotic insoles, which offer a good chance of complete resolution of symptoms. Surgical fasciotomy should be reserved for use in patients in whom conservative measures have failed. RESULTS: Conservative treatment consisting of rest, anti-inflammatory medications, stretching exercises and special orthotic insoles was efficient in 26 patients (81%), while only 6 (19%) had to be treated surgically. CONCLUSION: Plantar fasciitis is a common disorder among athletes. Patient's history, clinical examination and common imaging techniques help to make the correct diagnosis. The patient should be treated conservatively at first and only in severe cases surgically.

Adult↗
PubMed2004

Electrocardiographic changes after laparoscopic cholecystectomy.

AIM: To determine whether ECG changes observed after laparoscopic cholecystectomy could be correlated with procedure characteristics. MATERIAL AND METHODS. We studied prospectively 500 patients who underwent laparoscopic cholecystectomy for documented gallstones and prior history of cardiovascular disease, volume of carbon dioxide insufflated in the peritoneal cavity, duration of the procedure and intra-abdominal pressure created. RESULTS: We found that 9 (1.8%) patients developed LV strain, 2 (0.4%) patients--atrial fibrillation, 2 (0.4%) patients--tachyarrhythmia in the presence of AF, 1 (0.2%) patient--RBBB and 1 (0.2%) patient--myocardial ischemia with ST depression regarding these ECG leads. Statistical analysis of the data was performed using multifactorial logistic regression analysis. These changes were not correlated to the above referred procedure characteristics. CONCLUSION: We conclude that ECG changes are frequent events after laparoscopic cholecystectomy (3%) but are not correlated to prior history of cardiovascular disease, the duration of the procedure, the volume of carbon dioxide insufflated and the intra-abdominal pressure.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Fournier's gangrene. Immediate diagnosis and multimodality treatment is the comerstone for successful outcome.

BACKGROUND: Fournier's gangrene is a synergistic necrotic fasciitis or myositis of genitalia, perineum and abdominal wall. Several etiologic factors have been reported, microorganisms isolated and co-morbidity factors identified. Immediate and accurate diagnosis decreases mortality rate, which ranges from 3-67%. Aggressive resuscitation and surgical debridement consist the appropriate treatment. MATERIAL AND METHODS: Six cases of Fournier's gangrene treated the last ten years were reviewed. Three of them presented with mild infection while the other three with severe. The mean time interval between first symptoms and initial treatment was 2.1 days. The diagnosis was set immediately and the treatment included fluid-electrolyte resuscitation, aggressive surgical debridement, and broad-spectrum antibiotics administration. RESULTS: All patients survived. The defects healed by second intention in four patients and only in two patients specific plastic reconstructive techniques were required. Hyperbaric oxygenation administrated in one patient induced surprisingly the healing of the lesion. CONCLUSIONS: The Authors confirm that Fournier's gangrene is a rare and potentially fatal disease. Early suspicion, accurate diagnosis and multimodality treatment including aggressive surgical intervention are essential for successful outcome.

Adult↗
PubMedDate not supplied

Malignant gastrointestinal stromal tumor of the ampulla of Vater presenting with obstructive jaundice.

Malignant gastrointestinal stromal tumor (GIST) consists a rare neoplasm, developing in small intestine and stomach. The presenting manifastations include weakness, weight loss, nausea, melena and anaemia. The present case refers to a 65 years old female patient with a GIST of the ampulla of Vater presenting with obstructive jaundice. Diagnosis was achieved pre-operatively by biopsies collected through diagnostic ERCP. The tumour was locally excised, with preservation of the ampulla. The histological analysis suggested low grade GIST positive for both CD 117 (c-kit) and CD34. Two years after the surgery the patient remains free of disease. Malignant GIST of the ampulla of the Vater is extremely rare as only few similar cases have been described in the literature. This is the first time a GIST being presented as obstructive jaundice ever reported. Despite the unavailability of EUS-FNA, the diagnosis was set preoperatively and the tumor was resected.

Aged↗
PubMedDate not supplied

Blunt trauma to the extrahepatic biliary tract. A multicenter study.

BACKGROUND/AIMS: Blunt trauma to the extrahepatic biliary tract is a rare and challenging injury The purpose of this paper is to review our experience of these injuries, with special reference to their clinical presentation. PATIENTS AND METHODS: In a retrospective multicenter study of the records of a trauma-admitting in three hospitals, seven patients with blunt extrahepatic biliary tract trauma were identified, one with combined gallbladder and common bile duct injuries and six with a ruptured gallbladder. RESULTS: Except for the patient with the common bile duct injury developing peritoneal signs during observation and being operated 24 hours post-admission, all other patients underwent early laparotomy for shock, peritonitis or positive diagnostic peritoneal lavage (DPL) caused by associated injuries. The common bile duct injury was treated with suture repair over a T tube and the gallbladder injuries with cholecystectomy, except for two cases in which a cholecystostomy was performed. CONCLUSIONS: In patients with blunt trauma, especially to the right upper quadrant, a high index of suspicion and liberal use of diagnostic studies to exclude an isolated extrahepatic biliary tract injury is recommended.

Adult↗
PubMedDate not supplied

Malignant proliferating trichilemmal tumour of the scalp. Report of a case and a short review of the literature.

BACKGROUND: Malignant proliferating trichilemmal tumour is a rare skin tumour that originates from the root sheath of the hair and usually arises in the sun-exposed areas of elderly women. It mimicks poorly differential squamous cell carcinoma ant its biological behaviour is unpredictable, because rarely can produce distant metastases. CASE REPORT: The Authors report on a case of a 54-year-old female patients who proceeded with a cystic lesion in the scalp. The lesion was removed with wide excision. The histological examination of the lesion revealed a malignant proliferating trichilemmal tumour. Two years after the excison the patients is free of disease. DISCUSSION: Only few cases (about seventy) of malignant proliferating trichilemmal tumours have been reported in the Bibliography, in some of the patients with malignancy, the tumour produces distant metastases. In the reported case, although the high risk of distant metastasis, two years after the tumour resection the patient is free of disease, It is also reported a short review of the literature. CONCLUSIONS: Malignant proliferating trichilemmal tumours are rare malignant lesions that affect mainly older women. The appropriate treatment includes wide resection and dose postoperative follow-up of the patient to facilitate the early diagnosis of distant metastases.

Female↗