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Biomedical subjects

S Antoniou

Publications and source records attributed to S Antoniou.

At least 19 recordsLinked to original sources
PubMed2003

The association between occupational stress and the risk of developing acute coronary syndromes: the CARDIO2000 Study.

OBJECTIVE: The aim of this study was to investigate the association between occupational stress and the risk of developing acute coronary syndromes, in a population-based sample of patients and controls. METHODOLOGY: During 2000-01, a case-control study was conducted (CARDIO2000). A random and stratified sample of 848 middle aged patients with a first of an acute coronary syndrome and 1078 cardiovascular disease free participants, matched with the patients by gender, age and region, was selected from all regions of Greece. In addition to the common cardiovascular risk factors, the effect of occupational stress on coronary risk was evaluated, after taking into account income, marital status, educational and occupational level of the participants. The levels of occupational stress were measured by administering to the individuals a self-reported questionnaire. RESULTS: After controlling for age, gender and region, by design, and the presence of smoking, hypertension, hypercholesterolaemia, diabetes mellitus, physical activity status, educational and financial status and nutritional habits, multivariate analysis showed that the levels of occupational stress are positively associated with the risk of developing acute coronary syndromes in the investigated sample (Odds Ratio = 2.2, p < 0.01). Moreover, the presence of occupational stress seems to affect more significantly males than females, smokers than non-smokers, hypertensives than normotensives and high alcohol consumers compared to low alcohol consumers. CONCLUSIONS: Although the design of the present study does not provide evidence of causality, a strong positive association between occupational stress and acute coronary syndromes seems to exist. Thus, public health policies should take into account lifestyle conditions related to work in the design of preventive strategies at the primary level.

Acute Disease↗
PubMed2002

Primary ruptured ovarian pregnancy in a spontaneous conception cycle: a case report and review of the literature.

Ovarian pregnancy is an uncommon presentation of ectopic gestation, where the gestational sac is implanted within the ovary. Usually, it ends with rupture, which occurs before the end of the first trimester. Its presentation often is difficult to distinguish from that of tubal ectopic pregnancy and hemorrhagic ovarian cyst. We describe a case of primary ovarian pregnancy in a 31-year-old patient who presented to the emergency room with symptoms and signs of peritonism and positive urine hCG test. The gestation sac was demonstrated in the right ovary by transvaginal sonography. MSD (mean sac diameter) was 15 mm corresponding to the sixth gestational week. Free fluid was found in the Douglas pouch. Culdocentesis was positive for hemoperitoneum. Henceforth, emergency laparotomy and wedge resection of the ovary was perfomed. Aetiological, clinical and therapeutical aspects of this rare extrauterine pregnancy are described. Also, the problems of its differential diagnosis are discussed.

Abdomen, Acute↗
PubMed2002

Endometriosis causing extensive intestinal obstruction simulating carcinoma of the sigmoid colon: a case report and review of the literature.

Endometriosis with intestinal serosal involvement is not uncommon in women of childbearing age, however, presentation as colon obstruction is rare. Lack of pathognomonic symptoms makes diagnosis difficult, the main problem being differential diagnosis with neoplasm, even intraoperatively. Reported here is a case of extensive bowel obstruction due to sigmoid colon endometriosis in a 43-year-old woman who presented with signs and symptoms of bowel obstruction. Barium enema showed sigmoid obstruction; subsequent exploratory laparotomy showed the sigmoid colon surrounded by fibrous tissue, leading to its angulation and extensive lumen obstruction. Left oophorectomy and radical resection of descending and sigmoid colon as for bowel carcinoma were successfully employed. Pathological examination revealed endometriosis in the bowel wall with preservation of the mucosa. Aetiology, clinical presentation, differential diagnosis and therapeutic options for intestinal obstruction due to endometriosis are discussed.

Abdominal Pain↗
PubMed2002

Intraperitoneal haemorrhage secondary to perforation of uterine fibroid after cystic degeneration. Unusual CT findings resembling malignant pelvic tumor: case report.

Intraperitoneal haemorrhage is a rare complication of myomatous uterus. We present a case of a 37-year-old white nullipara who presented in the emergency room with acute, lower-abdominal pain which reportedly started after riding over a bump on a motorcycle. On examination, the abdomen was diffusely tender, with moderate spasm and rebound tenderness in both iliac fossae. Pregnancy test was negative. Computed tomography revealed a soft-tissue mass with cystic components and inhomogeneous appearance. Free fluid in the peritoneal cavity suggested ascites. The patient underwent an exploratory laparotomy. A ruptured, actively bleeding, subserosal, nonpedunculated, cystic degenerated uterine fibroid was found, as well as approximately two liters of free, bloodstained peritoneal fluid and clots. Subtotal hysterectomy without salpingo-oophorectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, definitive, preoperative diagnosis of a perforated, haemorrhaging, uterine fibroid is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening condition.

Abdominal Pain↗
PubMed2002

Ultrasonographic and computed tomography manifestations of intussusception secondary to primary non-Hodgkin's lymphoma diagnosed in puerperium: report of a case and review of the literature.

Non-Hodgkin's lymphoma is infrequently diagnosed during pregnancy and puerperium. A 21-year-old woman, para II, gravida II, on the seventh postpartum day arrived at the Emergency Gynaecologic Clinic complaining of colicky abdominal pain associated with bilious vomiting. A large tender mass of firm consistency was palpated in the midline towards the left hypochondrium. A CT scan of the upper abdomen showed thickened small bowel with halo, specifically at the junction of the jejunum with the ileum, resembling imaging of intussusception. Also, blocks of mesenteric and paraortic lymph nodes and multiple lymph nodes inducing enlargement of the anterior mediastinum were found. These findings rendered a picture of lymphoma in Stage at least III. Subsequent exploratory laparotomy confirmed our preoperative diagnosis. Histopathological examination of the lymph node biopsies established the diagnosis of a primary non-Hodgkin's lymphoma. Judging from the extent of the non-Hodgkin's lymphoma in our patient seven days after delivery the disease probably already existed during the last trimester of pregnancy. This study demonstrates a remarkable delay in diagnosis of non-Hodgkin's lymphoma in pregnancy. The diagnostic dilemmas of non-Hodgkin's lymphoma during pregnancy are emphasized and the literature is reviewed.

Abdominal Pain↗
PubMed1999

Incidence of vein thrombosis in peripheral intravenous nutrition: effect of fat emulsions.

The relative risk of thrombophlebitis induced by either Long-chain Triglycerides (LCTs) or Medium-chain Triglycerides (MCTs) during peripheral i.v. nutrition (PIN) was evaluated. A total of 76 patients were randomly assigned into group A (n=40) and group B (n=36). The nutritional requirements in both groups were covered by a standardized regime of osmolality 1130 mOsm and pH 5.2, which provided 14 kg/day(-1) nitrogen, 600 kcal/day(-1) of carbohydrates and 1000 kcal/day(-1) of lipids. Group A received the lipids as pure LCTs while group B received a mixture of LCTs/MCTs at a ratio 1:1. The infused nutritional volume was 2000 ml and was delivered via a suitable vein in a proximal forearm, using a fine bore polyurethane 22G catheter. The two standardized regimes were evaluated over a 10 day period regarding the incidence of thrombophlebitis. The cumulative risk of thrombophlebitis was documented to be significantly lower in group A compared to group B (17.5% versus 44.4%, P < 0.05). LCTs appear to prolong peripheral vein feeding by lessening the reaction of venous endothelium to the irritating nutritional infusate.

Double-Blind Method↗
PubMed1996

Fractional urea clearance in continuous ambulatory peritoneal dialysis: effects of volume disturbances.

The effects of volume disturbances on the KT/V were investigated prospectively in 133 consecutive urea clearance studies on patients on continuous ambulatory peritoneal dialysis (CAPD). Four subjects (group A) had fluid loss (actual weight < dry weight), 57 (group B) were studied on the basis of their dry weight, 58 (group C) had moderate fluid excess (0.5% of dry weight), and 14 patients (group D) had severe fluid excess (> 5% of dry weight). The KT/V was calculated on the basis of dry weight and actual weight with V obtained from the Watson anthropometric formulae which were applied either uncorrected or with a correction for changes in body water from dry weight conditions. The groups compared by variance analysis. The following weekly KT/V estimates were obtained: (1) using dry weight V: group A 1.81 +/- 0.17, group B 2.0 +/- 0.59, group C 1.79 +/- 0.46, group D 1.85 +/- 0.37 (no difference between groups); (2) using uncorrected actual weight V: group A 1.85 +/- 0.15, group B 2.05 +/- 0.59, group C 1.77 +/- 0.45, group D 1.78 +/- 0.37 (group B had a higher KT/V than group C, p < 0.05), and (3) using corrected actual weight V: group A 1.93 +/- 0.14, group B 2.05 +/- 0.59, group C 1.70 +/- 0.43, group D 1.63 +/- 0.36, (group B had a higher KT/V than either group C or group D, both at p < 0.01). In CAPD, fluid deficit is rare and causes a small increase in KT/V, whereas fluid retention is frequent and causes a decrease in KT/V. This decrease is pronounced in patients with severe fluid excess. The uncorrected Watson formulae underestimate V and, consequently, overestimate KT/V in CAPD patients with fluid excess.

Aged↗
PubMed1995

Cross-sectional analysis of erythropoietin use in CPD: its relation to azotemic index clearances.

The association between the use of erythropoietin and urea or creatinine clearance was studied in two populations on continuous peritoneal dialysis (CPD) residing either at an altitude of 1600 m (n = 194) or at sea level (n = 108). Among peritoneal and total KT/V urea and creatinine clearance (CCr) indices, only total CCr was lower in the high altitude group receiving erythropoietin than in the corresponding group not receiving erythropoietin (68.0 +/- 34.9 vs 82.9 +/- 40.9 L/1.73 m2 weekly, p < 0.01). However, 24-hour urine volume and urinary KT/V urea and CCr were consistently lower in the groups receiving erythropoietin than in those not receiving erythropoietin. Total weekly KT/V urea < or = 1.70 and CCr < or = 52 L/1.73 m2 were considered indicators of inadequate CPD. Although the percent of patients receiving erythropoietin did not differ overall between groups with adequate and those with inadequate CPD, a trend towards more frequent use of erythropoietin was found in the sea level group with inadequate CCr versus the group with adequate CCr (28.2% vs 16.9%, p = 0.084). In CPD decreased renal function is associated with more frequent use of erythropoietin. Whether inadequate total urea or creatinine clearance is also associated with more frequent erythropoietin use requires further study.

Altitude↗
PubMed1993

Role of early and extensive surgery in the treatment of severe necrotizing soft tissue infection.

Forty-two patients with necrotizing soft tissue infection are reviewed. Bacterial culture revealed between two and seven types of micro-organism in each patient. All patients were treated with radical surgical debridement and a combination of antibiotics. In 30 patients, early diagnosis and treatment resulted in only two deaths. Delayed surgical intervention in 12 patients transferred from outside hospitals was followed by nine deaths. Predisposing factors and site of infection did not affect outcome. Of 26 patients with systemic manifestations of sepsis, 16 survivors responded well to initial surgical debridement.

Connective Tissue Diseases↗
PubMed1993

The effect of simvastatin on dyslipemia in continuous ambulatory peritoneal dialysis patients.

The efficacy of simvastatin, an inhibitor of HMG-CoA reductase, was evaluated in 14 nondiabetic hypercholesterolemic continuous ambulatory peritoneal dialysis (CAPD) patients with or without hypertriglyceridemia. Following a hypolipemic diet for 6 weeks, simvastatin was administered at a dose of 10 mg/day for 6 months. After 6 weeks on simvastatin, cholesterol was reduced by 22% (p < 0.001), triglycerides by 24% (p < 0.001), low-density lipoprotein (LDL) by 27% (p < 0.001), while high-density lipoprotein (HDL) increased by 18% (p < 0.005). These changes remained steady for 6 months. Apolipoprotein-B (Apo-B) was reduced by 17.8% (p < 0.0001), while Apo-A was stable. There were no liver function abnormalities observed. In 3 patients serum creatinine kinase (CK) was increased, and in 2 treatment was stopped. No new lens opacities or other side effects were detected. Simvastatin seems to be an effective and relatively well-tolerated drug for dyslipemias in CAPD.

Adult↗
PubMed1990

Serotonin in the control of blood pressure and ultrafiltration in CAPD.

Urinary 5-OH-Indoloacetic acid (5-HIAA) indicates the turnover of almost all circulating serotonin (5-HT), a potent vasoactive agent. We tried to investigate the possible excretion of 5-HIAA in the dialysate of CAPD patients and its possible effects on blood pressure control (BP) and/or ultrafiltration (UF). The 24 h excretion of 5-HIAA in the urine of 10 patients with chronic renal failure (CRF) and 8 healthy persons (CONTROL), and in the dialysate of 15 patients on CAPD was measured by FPIA. In CRF 5-HIAA excretion was less than that in control (p less than 0.01). In CAPD patients two distinct patterns of 5-HIAA excretion were found. Patients with high excretion (greater than 6 mg) had high BP and low UF, while those with low excretion (less than 3.14) had low BP, high UF and frequent hypotensive episodes. Excretion of 5-HIAA in the dialysate had a negative correlation with UF (r = -0.779, p less than 0.001) and a positive correlation with B.P. (r = 0.487, n.s.). A highly significant (p less than 0.01) correlation between BP and UF was also found. As no differences between the two groups in factors that could affect UF or BP were found, the implication that 5-HT affects ultrafiltration and/or BP regulation is suggested.

Blood Pressure↗
PubMed1990

Tissue reaction to deep cuff of Tenckhoff's catheter and peritonitis.

To define the type of reaction around the deep cuff of Tenckhoff catheters and possible implications in peritonitis development, a histological evaluation of the tissue reaction around and into the deep cuff was done. Eight catheters, functioning for 2 to 40 months and removed for various reasons were studied. In all cases foreign body granulomata and fibrosis were found, with prominent giant cell formation. An inert birefrigent material, probably dacron particles, was found surrounded by giant cells in fibrotic regions and in some cases appearing as cytoplasmic inclusions. In 6 cases an inflammatory infiltration was observed, while in 4 with relapsing peritonitis, polymorphonuclears and microabscesses were also found. It can be suggested that the tissue reaction to deep cuff predisposes to local infections and might be a factor for relapsing peritonitis.

Adult↗
PubMedDate not supplied

The relationship between urine volume and drain volume as determinants of fractional urea clearance in continuous peritoneal dialysis.

A logistic regression model developed and validated in Albuquerque identified 24 hr urine volume (UV) and 24 hr drain volume/(body water) (DV/V) as predictors of fractional urea clearance (KT/V) in continuous peritoneal dialysis (CPD). Solution of this model provided DV/V values consistent with KT/V at least equal to a target KT/V for a given UV. The predictive accuracy of these unique DV/V values was tested in urea kinetic studies performed in 108 CPD patients in Thessaloniki and Athens with UV varying between 0 and 2 L/24 h. Two target weekly KT/V values, 1.70 and 1.90, were investigated. The equation DV/V = (5.2811-3.6996 UV)/ 17.554, derived by solving the logistic regression model, detected weekly KT/V > 1.70 (69/108, or 63.9% of the studies) with a sensitivity of 87.3% and a specificity of 60.4%. According to the same equation, the maximal UV consistent with weekly KT/V < or = 1.70 is 1.427 L/24 hr. The equation DV/V = (5.4994-2.6007 UV)/17.007 detected weekly KT/V > 1.90 (44/108, or 40.7% of the studies) with a sensitivity of 90.3% and a specificity of 79.2%. According to this equation, the maximal UV consistent with weekly KT/V < or = 1.90 is 2.115 L/24 hr. Determination of the lowest daily DV consistent with a target KT/V at any daily UV (within a wide range) is feasible in CPD.

Feasibility Studies↗
PubMedDate not supplied

Metastatic mixed mullerian tumour of the esophagus.

Involvement of the esophagus by metastatic disease from malignancies of other distant organs is uncommon. A case of malignant mixed mullerian tumour metastatic to the esophagus is reported. Though a variety of malignancies is known to metastasize to the esophagus, metastasis from malignant mixed mullerian tumour has not been reported, as yet.

Aged↗