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Biomedical subjects

E Pavlakis

Publications and source records attributed to E Pavlakis.

9 recordsLinked to original sources
PubMed2004

The treatment of chronic anal fissure with botulinum toxin.

BACKGROUND/AIMS: The aim of this study was to evaluate the effectiveness of botulinum toxin for the treatment of uncomplicated dorsal chronic idiopathic anal fissure. MATERIAL AND METHODS: Forty-five patients who reported post defecatory anal pain since two months or more were given a total of 20U botulinum toxin in the anal sphincter apparatus on both sides as well as below the anal fissure. RESULTS: Thirty-seven patients received a second session of 25U botulinum toxin injection. Thirty-five patients (78%) presented completely healed anal fissure, while ten needed lateral internal sphincterotomy. All patients were followed up for 8-36 months. Two patients relapsed. CONCLUSION: Local injection of botulinum toxin is a new and safe treatment; however, two sessions of injections are necessary to be effective and long-term follow-up to assess the recurrence rate of fissure is needed to evaluate further this method of treatment. Partial internal lateral sphincterotomy is no more the treatment of choice for chronic anal fissure.

Adult↗
PubMed2001

Aortic transsection after blunt chest trauma.

We report a case of an 18-year-old female who developed an extensive hemothorax after blunt chest trauma. Transesophageal echocardiography (TEE) showed transsection of the aorta at the level of the isthmus and turbulent flows in several places around the aorta. We discuss the contribution of TEE for detecting traumatic injuries to the thoracic aorta.

Adolescent↗
PubMed2000

Presentation of blunt small intestinal and mesenteric injuries.

During the 10 year period from 1988 to 1997, 64 patients with blunt small bowel and mesenteric injuries were treated at two trauma centres. The majority (52 cases) were victims of motor vehicle accidents, and 54% of them wore seat belts at the time of the accident. There were 22 small bowel injuries (17 full-thickness and 5 seromuscular) and 42 mesenteric injuries (7 with and 35 without a devascularised bowel segment). Shock on admission was present in 34% of the patients and generalised abdominal tenderness in 75%. Diagnostic peritoneal lavage was positive for blood in 25 out of 36 cases in which it was performed (69%), and positive for bowel content in 4/6 patients (67%) with full-thickness bowel perforations or transactions. Emergency room ultrasound was positive for blood in 13/25 cases (52%), and CT scan in 7/17 (41%). It is concluded that blunt small bowel and mesenteric injuries including patients with perforated or ischaemic bowel are difficult to diagnose using currently available diagnostic tools, and require a low threshold for exploration based on clinical suspicion in order to reduce the complications following delayed treatment of these injuries.

Accidents, Traffic↗
PubMed1988

Correlation of histoenzymological studies with the response to chemotherapy and survival in breast cancer patients.

The enzyme activity of cancerous tissue and the adjacent normal epithelium of 40 patients with breast cancer was determined. This enzymatic activity was correlated with the responsiveness of those tumors to the chemotherapy. It was found that the presence of cytochrome oxidase and alkaline phosphatase and the absence of leucine aminopeptidase, beta-glucuronidase and dehydrogenases in cancerous tissues was related to good response. On the contrary, the absence of alkaline phosphatase and cytochrome oxidase and the presence of leucine aminopeptidase, beta-glucuronidase and dehydrogenases in the cancerous tissues was related to poor response and therefore to poor survival.

Alkaline Phosphatase↗
PubMed1983

Immunological characterization of an ocular adnexal lymphoid T tumor by monoclonal antibodies.

The phenotype of a lymphoid orbital tumor is described, using monoclonal antibodies of the OKT series. The majority of tumor cells lacked surface immunoglobulins and bound OKT3, hence they arose from the T lineage. These cells belonged to the mature helper T cell subpopulation since a great proportion was recognized by OKT4 antibody. In contrast, a decrease in the peripheral blood OKT4+ pool was observed. The results demonstrate the importance of using a panel of markers, such as monoclonal antibodies, for the identification of cell derivation of lymphomas.

Aged↗
PubMedDate not supplied

Spiral computerized tomography : a diagnostic aid in patients with atypical acute appendicitis.

This retrospective study aimed to estimate the value of spiral Computerized Tomography (sCT) in patients with suspected appendicitis who remained undiagnosed after 48 hours of expectant management. We assessed a cohort of 150 patients by focused unenhanced sCT. According to the clinical scenario we occasionally employed contrast media and extended the scanned area. The major radiological signs were appendiceal enlargement and inflammatory changes of periappendiceal tissue and mesenteric fat. Regarding acute appendicitis the examination was 95.8% sensitive, 97.4% specific, had a positive predictive value of 97.18%, a negative predictive value of 96.2% and an accuracy of 96.7%. It also provided alternative diagnoses in 55 patients leading correctly 31 of them to the theatre for a variety of abdominal surgical diseases. For abdominal surgical pathology in general, sCT was 97.1% sensitive, 95.7% specific, had a positive predictive value of 98% and a negative predictive value of 93.8%. The importance of good communication between the clinicians and radiologists was pointed out by the correct alternative diagnoses set by imaging in the 55 patients after modifying the sCT protocol and was highlighted by the unnecessary appendectomy of three patients with negative imaging. Our results verify the accuracy and value of unenhanced sCT in patients with a clinical picture which remains inconclusive after an initial period of expectant management.

Adult↗