PubMed Health⌕ Search

Biomedical subjects

Panagiotis Skordilis

Publications and source records attributed to Panagiotis Skordilis.

10 recordsLinked to original sources
PubMed2005

High prevalence of Helicobacter pylori infection and monoclonal gammopathy of undetermined significance in patients with chronic idiopathic neutropenia.

The prevalence of Helicobacter pylori infection was evaluated in 120 patients with chronic idiopathic neutropenia (CIN), 8 patients with monoclonal gammopathy of undetermined significance (MGUS) associated with CIN, and 74 age- and sex-matched normal volunteers, all derived from the same geographical area. The purpose of the study was to investigate the possible causal relationships of H. pylori infection with the development of MGUS in CIN patients. We found that the prevalence of H. pylori infection was elevated to 69.2% in the group of CIN patients, 100% in the group of patients with CIN-associated MGUS, and 32.4% in the group of control subjects. No statistically significant difference, however, was found in the prevalence of H. pylori infection between CIN patients with concomitant MGUS and CIN patients without MGUS, no resolution of the gammopathy after eradication of the bacterium, no significant rise in the titers of serum anti-H. pylori antibodies, and no formation of an abnormal precipitation line in immunoelectrophoresis using a saline extract of NCTC11367 H. pylori reference strain as antigen. We concluded that there is no evidence that H. pylori infection is the cause of MGUS in CIN patients.

Aged↗
PubMed2005

Bile leakage presenting as acute abdomen due to a stone created around a migrated surgical clip.

BACKGROUND: Surgical clips may migrate into the common bile duct after surgery for cholecystolithiasis leading to usually early or middle-term complications. CASE REPORT: A 31-year-old woman, 6 years after laparoscopic cholecystectomy, developed acute abdomen and choloperitoneum after rupture of a secondary bile duct and bile leakage. This complication was due to a solitary common bile duct stone. The stone was formed around a surgical clip that had migrated from the cystic duct remnant to the common bile duct. The patient underwent investigative laparotomy and, subsequently, an ERCP with stone extraction and clearance of the common bile duct. She was perfectly well at the follow-up after 14 months. CONCLUSIONS: Rupture of a bile duct and biliary peritonitis may be a delayed complication of laparoscopic cholecystectomy due to surgical clip migration and formation of a stone. Definitive treatment of the condition may be achieved through ERCP. Surgeons, gastroenterologists and radiologists should be aware of this late complication of laparoscopic cholecystectomy in cases of acute abdomen.

Abdomen, Acute↗
PubMed2004

Natural course of inoperable esophageal cancer treated with metallic expandable stents: quality of life and cost-effectiveness analysis.

BACKGROUND AND AIM: The aim of this study was to evaluate the efficacy and safety of endoscopic therapy with self-expanding metallic endoprostheses in the management of malignant esophageal obstruction or stenosis and the cost-effectiveness of the method in patients suffering from primary esophageal carcinoma. All patients with inoperable esophageal cancers treated with either laser palliation or endoprosthesis insertion were studied retrospectively. METHOD: Between May 1997 and December 2002 obstruction of the esophagus was diagnosed in 78 patients (52 male, 26 female, age range 53-102 years, mean 72.3 years). The etiology of obstruction was squamous cell carcinoma (n = 42) and adenocarcinoma of the esophagus (n = 36). The site of obstruction was in the upper (n = 1), in the middle (n = 38) and in the lower esophagus (n = 39). In 16 cases the gastroesophageal junction was also involved. Four patients had broncho-esophageal fistulas. In all cases the tumor was considered non-resectable. A total of 89 Ultraflex metal stents were introduced endoscopically. In 46 patients dilation with Savary dilators prior to stent placement was required. RESULTS: Stents were placed successfully in all patients. After 48 h, all patients were able to tolerate solid or semisolid food. During the follow-up period eight patients developed dysphagia due to food impaction (treated successfully endoscopically). Eleven patients presented with recurrent dysphagia 4-16 weeks after stenting due to tumor overgrowth and were treated with placement of a second stent. The median survival time was 18 weeks. There was no survival difference between squamous cell and esophageal adenocarcinoma. A cost-effective analysis was performed, comparing esophageal stenting with laser therapy. The mean survival and the cost were similar. A small difference of 156 Euro was noted (3.103 Euro and 2.947 Euro for each group of patients, respectively). A significant improvement in quality of life was noted in patients that underwent stenting (96% and 75%vs 71% and 57% for the first 2 months). CONCLUSION: Placement of self-expanding metal stents is a safe and cost effective treatment modality that improve the quality of life, as compared with other palliative techniques, for patients with inoperable malignant esophageal obstructions. In cases of expansion of the mass a second stent can be used; however, the overall survival of these patients, is poor.

Aged↗
PubMed2002

Validation and results of a questionnaire for functional bowel disease in out-patients.

BACKGROUND: The aim was to evaluate and validate a bowel disease questionnaire in patients attending an out-patient gastroenterology clinic in Greece. METHODS: This was a prospective study. Diagnosis was based on detailed clinical and laboratory evaluation. The questionnaire was tested on a pilot group of patients. Interviewer-administration technique was used. One-hundred-and-forty consecutive patients attending the out-patient clinic for the first time and fifty healthy controls selected randomly participated in the study. Reliability (kappa statistics) and validity of the questionnaire were tested. We used logistic regression models and binary recursive partitioning for assessing distinguishing ability among irritable bowel syndrome (IBS), functional dyspepsia and organic disease patients. RESULTS: Mean time for questionnaire completion was 18 min. In test-retest procedure a good agreement was obtained (kappa statistics 0.82). There were 55 patients diagnosed as having IBS, 18 with functional dyspepsia (Rome I criteria), 38 with organic disease. Location of pain was a significant distinguishing factor, patients with functional dyspepsia having no lower abdominal pain (p < 0.001). Significant factors distinguishing between IBS and functional dyspepsia were relief of pain by either antacids or defecation (19% vs 71% and 66% vs 0% respectively). Awakening from pain at night was also a factor distinguishing between IBS and organic disease groups (26% vs 61%, p < 0.01). CONCLUSIONS: This questionnaire for functional bowel disease is a valid and reliable instrument that can distinguish satisfactorily between organic and functional disease in an out-patient setting.

Abdominal Pain↗
PubMed2002

Is endosonography an effective method for detection and local staging of the ampullary carcinoma? A prospective study.

BACKGROUND: The relatively rare carcinoma of the ampulla of Vater is a neoplasia with a good prognosis compared to pancreatic cancer. Preoperative staging is important in planning the most suitable surgical intervention. AIM: To prospectively evaluate the diagnostic accuracy of Endoscopic Ultrasonography (EUS) in comparison with conventional US and CT scan, in staging of patients with ampullary carcinoma. PATIENTS AND METHODS: 20 patients (7 women and 13 men) with histologically proven carcinoma of the ampulla of Vater were assessed by EUS, CT scan and US. Results were compared to surgical findings. RESULTS: Endoscopic biopsies were diagnostic in 76% of the patients. Detection of ampullary cancer with US and CT scan was 15% and 20% respectively. Only indirect signs of the disease were identified in the majority of cases using these methods. Overall accuracy of EUS in detection of ampullary tumours was 100%. The EUS was significantly (p < 0.001) superior than US and CT scan in ampullary carcinoma detection. Tumour size, tumour extension and the existence of metastatic lymph nodes were also identified and EUS proved to be very useful for the preoperative classification both for the T and the N components of the TNM staging of this neoplasia. The diagnostic accuracy for tumour extension (T) was 82% and for detection of metastatic lymph nodes (N) was 71%. CONCLUSION: EUS is more accurate in detecting ampullary cancer than US and CT scan. Tumor extension and locally metastatic lymph nodes are more accurately assessed by means of EUS than with other imaging methods.

Adult↗
PubMedDate not supplied

Binge drinking and nitric oxide metabolites in chronic liver disease.

AIMS: The effect of binge drinking in the production of nitric oxide metabolites has not been studied in patients with chronic viral liver disease. METHODS: We therefore studied serum levels of nitrites and nitrates (NOx) in 13 patients with chronic viral hepatitis and nine patients with compensated viral cirrhosis, after administration of 80 g alcohol. 15 patients with compensated alcoholic cirrhosis and seven healthy individuals were used as controls. Serum NOx levels were measured by a modification of the Griess reaction before and at 2, 12 and 24 h after alcohol consumption. RESULTS: An increase of serum NOx levels, that was statistically significant at 12 h, was found in healthy controls (P < 0.05). A similar pattern of NOx levels was observed in patients with chronic hepatitis. By contrast, in patients with cirrhosis, either viral or alcoholic, no significant increase was found after alcohol administration. However, basal levels in cirrhotics were significantly elevated (82.2 +/- 13.8 vs. 43.1 +/- 7.2 micro mol/l, P < 0.01) compared to healthy controls. CONCLUSIONS: Binge drinking causes a significant increase of serum NOx evident after 12 h with a return after 24 h at pre-drinking levels in healthy controls and patients with chronic viral hepatitis. In cirrhosis, such an increase is not observed serum levels being constantly elevated throughout the study period.

Adult↗
PubMedDate not supplied

Treatment of hepatocellular carcinoma with long acting somatostatin analogues.

An earlier report has shown that subcutaneous short acting octreotide significantly improves survival of patients with inoperable hepatocellular carcinoma (HCC). The aim of this study was to compare survival of the patients with inoperable HCC treated with long acting somatostatin analogues (LASA) to a historical control group of untreated patients. The survival of 32 patients with inoperable HCC who received LASA treatment was compared to those of 27 untreated patients. The Karnofsky scale was used for assessing quality of life. An improved overall survival was found in the treated group (median survival 15 months, 95% CI 6-24 months for the treated group and 8 months, 95% CI 5-11 months for the controls). The survival benefit remains even after removal of the most advanced cases from the control group. The relative risk of death of the untreated patients is 2.7 (95% CI 1.4-5.3) compared to the treated patients. The tumor remained stable or regressed in 40% of the treated patients. A superior quality of life was found in the treated group. In conclusion long acting somatostatin analogues appear to be beneficial, improving survival and performance status in inoperable HCC cases. Further studies are required to define a subgroup of patients that may benefit to a greater extent than others.

Aged↗
PubMedDate not supplied

Increasing incidence of cholangiocarcinoma in Crete 1992-2000.

BACKGROUND: There have been recent reports of an increased incidence of cholangiocarcinoma. PATIENTS AND METHODS: Patients with cholangiocarcinoma, resident on the island of Crete, diagnosed between 1992 and 2000, were studied. Case ascertainment was enhanced by collaboration of the pathology departments and all gastroenterologists of Crete in providing relevant data. A specially designed patient protocol was used. Crude incidence rates are presented. RESULTS: During the 9-year period 7 patients were diagnosed with cholangiocarcinoma of the intrahepatic ducts, 17 with Klatskin and 16 patients with extrahepatic ducts carcinoma. A steady incidence increase of cholangiocarcinoma, irrespective of location, was shown. The estimated incidence rate per three-year period progressively increased from 0.998 to 2.329 and 3.327 per 100,000 for the periods 92-94, 95-97 and 98-2000, respectively. Median survival time was 8.5 months. No significant difference was seen between survival according to the location of cholangiocarcinoma. CONCLUSION: A steady incidence increase of cholangiocarcinoma cases in Crete during the time-period 1992-2000 was shown.

Bile Duct Neoplasms↗