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Biomedical subjects

Panagiotis Kostopoulos

Publications and source records attributed to Panagiotis Kostopoulos.

13 recordsLinked to original sources
PubMed2007

Biomarkers of folate and vitamin B12 are related in blood and cerebrospinal fluid.

BACKGROUND: B-vitamins (folate, B(12)) are important micronutrients for brain function and essential cofactors for homocysteine (HCY) metabolism. Increased HCY has been related to neurological and psychiatric disorders. We studied the role of the B-vitamins in HCY metabolism in the brain. METHODS: We studied blood and cerebrospinal fluid (CSF) samples from 72 patients who underwent lumbar puncture. We measured HCY, methylmalonic acid (MMA), and cystathionine by gas chromatography-mass spectrometry; S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) by liquid chromatography-tandem mass spectrometry; and the B-vitamins by HPLC or immunoassays. RESULTS: Concentrations were lower in CSF than serum or plasma for HCY (0.09 vs 9.4 micromol/L), SAH (13.2 vs 16.8 nmol/L), cystathionine (54 vs 329 nmol/L), and holotranscobalamin (16 vs 63 pmol/L), whereas concentrations in CSF were higher for MMA (359 vs 186 nmol/L) and SAM (270 vs 113 nmol/L; all P <0.05). CSF concentrations of HCY correlated significantly with CSF folate (r = -0.46), CSF SAH (r = 0.48), CSF-albumin (r = 0.31), and age (r = 0.32). Aging was also associated with lower concentrations of CSF-folate and higher CSF-SAH. The relationship between serum and CSF folate depended on serum folate: the correlation (r) of serum and CSF-folate was 0.69 at serum folate <15.7 nmol/L. CSF concentrations of MMA and holotranscobalamin were not significantly correlated. CONCLUSIONS: CSF and serum/plasma concentrations of vitamin biomarkers are significantly correlated. Older age is associated with higher CSF-HCY and CSF-SAH and lower CSF-folate. These metabolic alterations may be important indicators of low folate status, hyperhomocysteinemia, and neurodegenerative diseases.

Adult↗
PubMed2006

Development and validation of a prognostic model to predict recovery following intracerebral hemorrhage.

CONTEXT: While several models have been developed to predict mortality following intracerebral hemorrhage (ICH), the functional outcome and its predictors in surviving patients have been poorly investigated so far. OBJECTIVES: To identify predictors and validate a prognostic model for independent functional outcome in patients with acute ICH. DESIGN: An inception cohort was assessed on the National Institutes of Health Stroke Scale (NIH-SS) at admission and followed-up after 100 days. SETTING: 11 neurological departments with an acute stroke unit. PATIENTS: 207 consecutive patients who were neither comatose nor intubated at admission within 6 hours after ICH and with complete follow-up. RESULTS: After 100 days, 40 patients (19.3 %) had died, 78 (37.7%) had regained functional independence (Barthel Index > or = 95) and 89 (43%) had survived but not recovered. In these patients, age and the NIH-SS total score were identified as independent predictors for functional independence after 100 days. With the predefined cut-off value, the prognosis of 79.8% of all patients could be predicted accurately upon validation in an independent data set of 173 non-comatose patients with acute ICH. CONCLUSION: Our study provides a validated prognostic model for prediction of complete recovery following ICH which could be very useful for the design of clinical studies.

Age Factors↗
PubMed2006

Postinfantile giant-cell hepatitis associated with ulcerative colitis and autoimmune hepatitis.

Postinfantile giant cell hepatitis (PGCH) is rare. It is characterized by the presence of multinucleated giant cells in liver biopsy, and although it has been associated with several etiological agents, in many cases its etiology remains unclear. The case is presented herein of an adult woman with PGCH in the setting of ulcerative colitis and autoimmune hepatitis. The presence of autoimmune hepatitis in the patient is consistent and supports the autoimmune pathogenesis of PGCH in a subgroup of patients. Furthermore, this finding, along with others, suggests that PGCH may be included in the list of hepatic complications of inflammatory bowel disease.

Adult↗
PubMed2005

Malignant fibrous histiocytoma of the liver: a case report and review of the literature.

Malignant fibrous histiocytoma (MFH) is a common soft tissue sarcoma, usually occurring in the extremities. MFH of the liver is an extremely rare neoplasm, with only 28 cases reported in the international literature since 1985. We present a case of MFH of the liver in an 87-year-old woman. The tumor was located in the right lobe of the liver and measured 12 ' 8 cm. It consisted of spindle-shaped, pleomorphic, malignant cells in a storiform pattern associated with histiocyte-like cells and giant cells. Most of the tumor cells and giant cells were vimentin and a 1-antichymotrypsin positive. Histopathological findings were consistent with an MFH of the storiform / pleomorphic subtype. The literature is briefly reviewed.

Aged↗
PubMed2004

Budd-Chiari syndrome and portal vein thrombosis due to right atrial myxoma.

Budd-Chiari syndrome is a rare disorder characterized by hepatic venous outflow obstruction. Atrial myxomas account for 35% to 50% of primary cardiac tumors and are usually located in the left atrium. We describe a patient who presented with hepatic inferior vena cava and portal vein thrombosis due to a large myxoma of the right atrium. After the successful removal of the tumor, ascites resolved completely. We conclude that right atrial myxoma is a rare but potentially curable cause of Budd-Chiari syndrome.

Anticoagulants↗
PubMed2004

Esomeprazole versus omeprazole for the eradication of Helicobacter pylori infection: results of a randomized controlled study.

BACKGROUND: Esomeprazole has higher oral bioavailability and increased antimicrobial activity against Helicobacter pylori than omeprazole. GOALS: To compare 7 days esomeprazole with 7 days of omeprazole based triple therapies for the eradication of H. pylori, and to assess whether the administration of higher dose of esomeprazole leads to improved eradication rates. STUDY: One hundred and fifty-six dyspeptic patients with H. pylori received either: (1) 1-week treatment including esomeprazole 40 mg once daily, amoxicillin 1 g, and clarithromycin 500 mg, both twice daily (EAC1 group, n = 52); (2) 1-week treatment of omeprazole 20 mg, amoxicillin 1 g, and clarithromycin 500 mg, all administered twice daily (OAC group, n = 52); or (3) 1-week treatment with esomeprazole 40 mg, amoxicillin 1 g, and clarithromycin 500 mg, all given twice daily (EAC2 group, n = 52). RESULTS: H. pylori was eradicated in 37 of 52 patients in the OAC group (Intension to treat [ITT] 71%), and in 42 patients in the EAC1 group (ITT 81%). High eradication rate was achieved by the EAC2 regimen (ITT; 96%), but more patients reported unwanted effects. CONCLUSION: Seven days of esomeprazole based triple therapy is a satisfactory eradication regimen for H. pylori infection. Higher doses of esomeprazole have excellent eradication rates, but they may lead to increased side effects.

Dose-Response Relationship, Drug↗
PubMed2004

Can somatostatin prevent post-ERCP pancreatitis? Results of a randomized controlled trial.

BACKGROUND: Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), occurring in 1-10% of patients. Several substances have been used, with negative results, in an attempt to prevent this complication. METHODS: We performed a double-blind randomized trial in 372 consecutive patients undergoing diagnostic or therapeutic ERCP to evaluate the role of somatostatin in preventing post-ERCP pancreatitis. The first group received continuous somatostatin infusion for 12 h starting 30 min before ERCP, the second group received a bolus intravenous injection of somatostatin at the time of cannulation of the papilla, and the third group received a placebo. RESULTS: Two patients in each of the somatostatin groups (1.7%) and 12 patients in the placebo group (9.8%) developed pancreatitis (P<0.05). Serum amylase levels 5 and 24 h after the procedure were lower in both groups that received somatostatin than in the placebo group (P<0.05). CONCLUSION: Somatostatin is useful in preventing post-ERCP pancreatitis. Further studies must be designed to investigate the cost-effectiveness of the drug and to determine the ideal administration route and dosage.

Aged↗
PubMed2003

Acute pancreatitis due to pravastatin therapy.

CONTEXT: Few data exist about the incidence of drug-induced pancreatitis in the general population. Drugs are related to the etiology of pancreatitis in about 1.4-2% of cases. Statins are generally well tolerated. Acute pancreatitis has been reported in a few cases treated with atorvastatin, fluvastatin, lovastatin and simvastatin. CASE REPORT: We report the case of a 56-year-old patient who, after 6 months of treatment with pravastatin 20 mg once daily for hypercholesterolemia, presented with acute pancreatitis. Other causes of the disease were ruled out. Five months later, the patient, on his own initiative, reintroduced pravastatin and acute pancreatitis recurred after 3 days. CONCLUSION: To our knowledge this is the first report of pravastatin-induced pancreatitis and further strengthens the fact that statins may cause acute pancreatitis.

Acute Disease↗