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E Merikas

Publications and source records attributed to E Merikas.

6 recordsLinked to original sources
PubMed2001

Ulcerative colitis in the elderly: clinical patterns and outcome in 51 Greek patients.

PURPOSE: In this study, the clinical characteristics and course of all patients with ulcerative colitis in whom diagnosis of the disease was made at or after the age of 60 (older group), were analyzed and compared with those of patients with ulcerative colitis in whom diagnosis of the disease was made before the age of 60 (younger group). METHODS: The older group consisted of 51 patients (28 men and 23 women; aged 64+/-3.1 years) and the younger group consisted of 362 patients (192 men and 170 women; aged 38.4+/-14.9 years). The mean follow-up times in the two groups were 9.3 and 12.6 years, respectively. RESULTS: No significant differences between the two groups were found as far as the extent of the disease, the severity of the initial episode, and the outcome of the first episode of ulcerative colitis were concerned. However, significantly fewer elderly patients were operated on for their disease compared with younger patients (6.25% vs 22.3%; P = 0.0268). Although some differences in the course of the disease between elderly and younger patients were observed, such as the number of exacerbations and recurrences and the number of patients who developed colorectal cancer, these differences did not reach statistical significance. CONCLUSION: It is concluded that ulcerative colitis in elderly Greek patients runs a rather similar course to that in younger patients. However, some unique characteristics observed in the elderly patients (lower rate of colectomy, absence of patients with colorectal cancer, and increased death rate) could be attributed either to truly different disease behavior in the elderly people or to factors directly related to their advanced age.

Adult↗
PubMedDate not supplied

Surgery for Crohn's disease in Greece: a follow-up study of 79 cases.

BACKGROUND/AIMS: The aim of this prospective study was to elucidate the clinical features, indications for surgery and long-term outcome of a series of 79 Greek patients operated on for Crohn's disease. METHODOLOGY: The clinical features and follow-up of 79 out of 155 patients with definite diagnosis of Crohn's disease (51%), who were operated on at least once during the course of their disease, are analyzed. Three main locations of the disease were identified (small bowel, large bowel and small and large bowel). The need for surgery, indications for surgery and outcome of patients were analyzed and compared separately for these three main locations. The mean follow-up period after the first operation was 8.8 +/- 6.5 years. RESULTS: The proportion of men to women was 1.55:1 (P = 0.068). The main indication for surgery was poor response to conservative treatment, followed by obstructive ileus, erroneous diagnosis of acute appendicitis and development of fistulae or abscesses. Statistically significant differences between the three main locations of the disease were found for obstructive ileus (P < 0.01), and bowel perforation (P < 0.0297). Enterectomy and end-to-end anastomosis was the most frequently performed operation. Minor surgical procedures were performed mainly for drainage of perianal abscess. Differences in the number of operations required (one, two and three or more) according to the three main locations of the disease were statistically significant (P < 0.044). Emergency operation was required in 17.3%. Most of the urgently operated patients had only small bowel involvement. Twenty-six percent of patients required a surgical procedure for perianal disease. One or more, major or minor, perioperative complications occurred in 13 out of 79 operated patients (16.4%). No perioperative deaths were noticed. Evolution to cancer was observed in 2% (3 patients). The outcome of patients after the operation was characterized by exacerbations and remissions. A mortality rate of 11.6% was noticed in the follow-up period. However, most deaths were unrelated to the underlying Crohn's disease. CONCLUSIONS: The clinicoepidemiological characteristics of patients with Crohn's disease of Greek origin operated-on for their disease do not differ significantly from those reported from other Western or neighboring Mediterranean countries. However, other parameters such as the relatively low incidence of overall surgical need, the low incidence of colorectal cancer and the low incidence of surgery for perianal disease, all underline the importance of various genetic and environmental factors on the evolution and behavior of the disease in different parts of the world.

Aged↗
PubMedDate not supplied

Endocrine function in abetalipoproteinemia: a study of a female patient of Greek origin.

AIM: To investigate the pituary, genitalia, adrenal, thyroid, parathyroid and pancreatic endocrine function of a female patient aged 37 with abetalipoproteinemia at the time of diagnosis and 5 years thereafter (after application of a modified diet). SUBJECT-METHODS: Serum concentrations of cortisol, A4, ACTH, aldosteron, renin, dehydroepiandrosterone sulfate (DHEA-5), progesterone, 17-OH progesterone, testosterone, SH13G, estradiol, luteinizing hormone, follicle stimulating hormone, T3, T4, TSH, FT3, FT4, parathormone, osteocalcin, prolactin, proinsuline, insulin, glucagon, somatomedin-C (Insulin-like Growth Factor-1, IGF-1), IG171-13P3, 25 (OH) Vitamin D3 and 1-25 (OH) 2 Vitamin D3, were measured by radioimmunoassay. Synactlien test, and 24-hour urine cortisol, were also estimated. Serum leptin estimation was carried-out using a sensitive enzymatic technique. Ionized part of serum calcium was measured by the use of a special machine (CORNING), while bone alkaline phosphatase was measured by radioimmunoassay. RESULTS: Serum progesterone and 17-OH-progesterone were reduced in both examinations. Estimation of serum progesterone performed on the 21th day of the menstrual cycle revealed again values below the lowest normal limit. Serum prolactin was increased both in rest and during movement. The levels of both, somatomedin-C (IGF-1) and leptin were below the lowest normal limit. Despite normal serum parathormone, serum-ionized calcium and 25-OH vitamin D were low, while serum bone alkaline phosphatase was increased. Serum proinsulin was increased, and serum insulin was low. Serum thyroid hormone, glucagon, parathormone, FSH, LH, ACTH, testosterone, estradiol and SH13G were normal. The hormonal profile of the patient estimated 5 years later did not differ substantially suggesting that the metabolic improvement due to the adoption of the modified diet had not any significant impact on it. CONCLUSION: Female patients with abetalipoproteinernia have reduced production of progesterone by the corpus luteum and slightly abnormal bone metabolism. The reduced production of progesterone is probably due to the low levels of serum LDL and cholesterol, while reduced serum levels of Leptin and IG17-1 are probably due to the impairment nutritional status. The adoption of a modified diet does not alter the hormonal profile significantly.

Abetalipoproteinemia↗
PubMedDate not supplied

Cutaneous delayed hypersensitivity in patients with colorectal cancer: application of multi-test.

A prospective study of delayed hypersensitivity was carried out in 63 colorectal cancer (CRC) patients of good nutritional status and 63 healthy controls over a period of 3 years. Delayed hypersensitivity was assessed by application of Multi-test which involves synchronous multiple puncture testing with seven antigens. Subjects were classified in three groups: Immunocompetent, Relatively anergic and Anergic. Logistic regression analysis was applied. The patients had lower mean scores for skin reactions to all tested antigens with the widest differences observed for Trichophyton. The average number of positive reactions was lower for patients than controls; there were no anergic subjects among the controls and the differences between patients and controls were statistically significant. Patients with early disease (Dukes' A and B), had lower scores for all seven antigen reactions than controls, but higher than those with advanced disease. Differences between early stage cases and controls were not statistically significant for any antigen, nor for the total number of positive reactions or the total score. In the late stages of their disease patients with CRC and without malnutrition, or any other kind of acquired immunodeficiency, have impaired cellular immunity in comparison with normal controls.

Adult↗