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Biomedical subjects

S Pappas

Publications and source records attributed to S Pappas.

At least 19 recordsLinked to original sources
PubMed2007

Smoking habits and associated factors among Greek physicians.

OBJECTIVE: To investigate the smoking habits and associated risk factors among Greek physicians. STUDY DESIGN: Cross-sectional survey of a randomly selected sample of Greek physicians. METHODS: A national sample of 1284 physicians (718 men, 566 women) participated in the study, which was conducted between September 2003 and June 2005. Data were collected through an anonymous self-completed questionnaire. Logistic regression was used to analyse the influence of different factors on the probability of a physician being a current or former smoker. RESULTS: Overall, 38.6% of the physicians (40% of men; 37% of women) currently smoked, 13.8% were former smokers, and 47.6% had never smoked. Eighty-three per cent of smokers reported starting smoking before the age of 25 years, with half of them during medical school (aged 19-24 years). Multivariate analyses revealed that physicians who were male, unmarried, divorced or widowed, surgeons or anaesthetists, and residents were more likely to be current smokers. Former smokers were more likely to be older, male and born in a rural area. Moreover, the odds of being a current or former smoker were significantly higher among physicians with a history of parents who smoked. The proportion of physicians who reported counselling patients (often or always) to stop smoking was lower among current smokers compared with those who never smoked or those who were former smokers (74.4% vs. 85.3% vs. 84.7%, P<0.0001). CONCLUSIONS: The prevalence of smoking among Greek physicians is exceedingly high and similar to that of the general population. More effective interventions that reduce smoking in the medical community should be implemented immediately so that physicians will be better able to fulfil their function as role models for the general population.

Adult↗
PubMed2006

Topical antibiotic ear drops: are they safe?

A discharging ear is a very common condition for the general practitioner and the ENT surgeon. Oral and intravenous antibiotics have potential complications, are costly, and exhibit increasing resistance. This study explores the advantages and disadvantages of all common otic preparations and compares effectiveness, safety, cost and complication rates. In chronic otitis media (chronic discharging ears), topical antibiotics seem to be the treatment of choice by comparison with oral or intravenous antibiotics. Cultures and antibiograms do not correspond directly to clinical efficacy, as laboratory determination of resistance does not take into account the high concentration of antibiotics in local preparations. It is safer to use quinolone drops as a first-line treatment, but it is still possible to use short courses of other drops if quinolones are either unavailable or contraindicated (e.g. allergy), or when bacteria are resistant to them. However, in such a situation, a round window membrane involved in an established inflammatory process and therefore less permeable to the passage of topical preparations is the preferred setting, as ototoxicity is a potential complication, especially in the case of gentamicin, in which case patients should be warned accordingly.

Administration, Topical↗
PubMed2004

Prevalence of self-reported myocardial infarction in a Greek sample: findings from a population-based study in an urban area (medical express 2002).

During the 1970s and 1980s, Greece was known as a country with low prevalence and incidence of coronary heart disease, compared to Western populations. However, during the past decades, the Greek population has experienced marked but uneven socio-economic development, as well as change in lifestyle habits. We assessed the prevalence of self-reported myocardial infarction (MI) in a sample of the general population, aged 20-94 years. The overall prevalence of self-reported MI was 4.1% (6.3% in men and 1.9% in women). The age-adjusted prevalence was found to be 3.6%, showing a threefold increase compared to 1980s. Age, gender (male), low educational level, obesity/overweight, hypercholesterolemia, diabetes, hypertension, smoking and origin were strongly associated with prevalence of MI. Our findings indicate that the prevalence of MI increased dramatically during the past years, reflecting the change in lifestyle habits that have gradually given way to "Western"-type diets and a more sedentary lifestyle. Therefore, the need for urgent intervention is considered essential in order to prevent a further increase of disease burden.

Adult↗
PubMed2001

Voluntary self-poisoning as a cause of admission to a tertiary hospital internal medicine clinic in Piraeus, Greece within a year.

BACKGROUND: Out of 1705 patients hospitalised for various reasons in the 3rd Internal Medicine Department of the Regional General Hospital of Nikaea, in Piraeus, 146(8,5%) persons were admitted for drug intoxication between November 1999 and November 2000. METHODS: On average, these persons [male 50(34,2%)--female 96(65,8%)] were admitted to the hospital within 3.7 hours after taking the drug. RESULTS: The drugs that were more frequently taken, alone or in combination with other drugs, were sedatives (67.1%), aspirins and analgesics (mainly paracetamol) (43.5%). 38.3% of patients had a mental illness history, 31.5% were in need of psychiatric help and 45.2% had made a previous suicide attempt. No death occurred during the above period and the outcome of the patients' health was normal. After mental state examination, the mental illnesses diagnosed were depression (20.96%), psychosis (15.32%), dysthymic disorder (16,2%), anxiety disorder (22.58%) and personality disorder (8.87%). CONCLUSIONS: Self-poisoning remains a crucial problem. The use of paracetamol and sedatives are particularly important in the population studied. Interpersonal psychiatric therapy may be a valuable treatment after people tried to poison themselves.

Adolescent↗
PubMed2000

Search for CP violation in B+/- --> J/psiK+/- and B+/- --> psi(2S)K+/- decays.

We present a search for direct CP violation in B+/--->J/psiK+/- and B+/--->psi(2S)K+/- decays. In a sample of 9.7x10(6) B&Bmacr; meson pairs collected with the CLEO detector, we have fully reconstructed 534 B+/--->J/psiK+/- and 120 B+/--->psi(2S)K+/- decays with very low background. We have measured the CP-violating charge asymmetry to be [+1.8+/-4.3(stat)+/-0.4(syst)]% for B+/--->J/psiK+/- and [+2.0+/-9. 1(stat)+/-1.0(syst)]% for B+/--->psi(2S)K+/-.

Journal Article↗
PubMed2000

Submucosa of canine small intestine as an alternative medium-diameter autogenous arterial graft.

BACKGROUND: Small intestinal canine submucosa has been used in previous studies as a large diameter arterial graft and has shown acceptable patency rates. The aim of our experimental study was to assess its effectiveness when it is used as an autogenous medium-sized diameter arterial graft (5-7 mm). METHODS: Fifteen mongrel dogs were included and underwent laparotomy under general anaesthesia. The mucosa, tunica muscularis and serosa were removed from a resected intestinal segment. The remaining tube, which consisted of the submucosa and the basilar tunica mucosa, represented the experimental graft which was used to replace a proportional gap of the canine infrarenal aorta. Ascertainment of peripheral pulses, measurement of the intra-aortic pressures, aortography and in vivo/in situ observation before the sacrifice of the animals, were the procedures used for verification of the graft's patency. RESULTS: The resistance to thrombogenicity of the graft was considered satisfactory: nine out of 10 grafts remained patent for postoperative intervals ranging from one day to one year; one graft showed partial obstruction due to a technical perioperative error. The grafts showed also excellent physical characteristics (ease of handling and suturing, blood impermeability and durability), resistance to infection and showed no tendency to develop myointimal hyperplasia. CONCLUSIONS: Small intestinal canine submucosa showed satisfactory haemodynamic properties, long-term patency and resistance to infection, when used as a medium-diameter arterial substitute.

Animals↗
PubMed1998

Segmental wall motion abnormalities alter vulnerability to ventricular ectopic beats associated with acute increases in aortic pressure in patients with underlying coronary artery disease.

OBJECTIVE: To evaluate whether patients with coronary artery disease are susceptible to pressure related ventricular arrhythmias, and if so to identify possible risk factors. DESIGN: Interventional study. METHODS: Metaraminol was given to 43 patients undergoing coronary arteriography for ischaemic heart disease to increase their aortic pressure, provided their systolic blood pressure was < 160 mm Hg and they were in sinus rhythm, without any ventricular ectopic activity (or with fewer than six ventricular ectopic beats a minute) during a five minute control period. RESULTS: During the metaraminol infusion, systolic aortic pressure rose from 131 (15) to 199 (12) mm Hg (mean (SD)). Ventricular ectopy appeared (or ventricular ectopic beats increased by > 100%) in 13/43 patients. Ventricular ectopy was not related to age, sex, presence of hypertension, history of myocardial infarction, use of beta blockers, positive exercise test, number of vessels diseased, or heart rate change during metaraminol infusion. There was a strong relation between the appearance of ventricular arrhythmia and segmental wall motion abnormalities: 1/19 (5.3%, 95% confidence interval 0.1% to 26.0%) without abnormality; 2/12 (16.7%, 2.1% to 48.4%) with hypokinesia; and 10/12 (83.3%, 51.6% to 97.1%) with akinesia or dyskinesia, chi 2 = 22.7, p < 0.001). Ejection fraction was also a significant but not independent risk factor. CONCLUSIONS: Patients with segmental wall motion abnormalities are predisposed to ventricular ectopic beats during an increase in systolic aortic pressure. This could be explained by associated electrophysiological inhomogeneity. The presence of mechanical inhomogeneity, as may occur in postinfarction akinesia or dyskinesia, may affect the aortic pressure above which ventricular arrhythmias appear.

Adult↗
PubMed1998

Clinical characteristics and follow-up of patients with chest pain and normal coronary arteries.

The authors identified 160 men and women from all 3,700 patients with anginal pain between 1990 and 1994 who were subsequently found to have normal coronary arteries at diagnostic cardiac catheterization with follow-up to the present (mean follow-up 2.5 years). The group comprised 50 women and 110 men. Mean age was significantly greater in women (53.1 +/- 7.7 vs 47.2 +/- 9.2 years, p<0.001). Forty percent of the women but only 10% of the men had a positive exercise test. At follow-up, a larger proportion of patients continue to experience chest pain (95 patients, 59%) of whom 65 patients (41%) continue antianginal therapy. Furthermore one patient suffered a sudden cardiac death and two patients had a nonfatal myocardial infarction. Of patients referred with chest pain, women were more likely to have normal coronary arteries, compared with men. All patients have an excellent prognosis. A large proportion of women had a positive exercise test in the absence of coronary artery disease. On the other hand, morbidity remains high in these patients, despite the reassurance of a normal-appearing coronary arteriogram.

Activities of Daily Living↗
PubMed1996

Glucose intolerance in thalassemia major is related to insulin resistance and hepatic dysfunction.

Glucose intolerance is a common consequence of transfusion therapy in patients with thalassemia major (TM), but the relative contribution of pancreatic damage and insulin resistance to glucose intolerance is unclear. We have investigated oral (OGTT) and intravenous (IVGTT) glucose tolerance, insulin sensitivity, and fasting concentrations of insulin, proinsulin, and des 31,32 proinsulin in 12 patients with TM (seven hepatitis C virus [HCV] antibody-negative and five-positive), eight patients with hepatic cirrhosis, and nine healthy controls. Two-hour plasma glucose concentrations were marginally higher in anti-HCV-negative (median, 7.4 mmol/ L; range, 4.0 to 8.2) and significantly so in anti-HCV-positive thalassemics (median, 8.5 mmol/L; range, 6.4 to to 23.0) and cirrhotics (median, 8.0 mmol/L; range, 4.7 to 17.6) than in controls (median, 5.5 mmol/L; range, 3.0 to 6.3). Insulin sensitivity was also reduced in the three patient groups (P < .05). Insulin resistance was the main determinant of oral glucose intolerance in all patient groups (partial r2 = .49, P < .0001, n = 28). In turn, the main determinants of insulin insensitivity in TM patients were liver damage (albumin, r = .67, P = .02) and serum ferritin concentration (r = -.62, P = .03). There was no relationship of either 2-hour or incremental insulin concentrations with ferritin levels or with HCV status in TM subjects. Moreover, these patients showed no elevation of concentrations of proinsulin and des 31,32 proinsulin, markers of pancreatic beta-cell damage, in excess of those observed in cirrhotic patients. In conclusion, the glucose intolerance of TM, like that of cirrhosis, is associated with insulin resistance, not insulin deficiency, and may be a direct or indirect consequence of hepatic damage.

Adolescent↗
PubMed1996

Usefulness of Renal Arteriography Following Coronary Angiography.

PURPOSE: To determine the usefulness of renal angiography in patients that underwent coronary angiography because of clinically suspected coronary artery disease. METHODS: Selective arteriography of the renal arteries was performed in 205 patients (mean age 60 +/- 8 years; 80% males) at the time after coronary angiography with the use of right coronary Judkins catheter. RESULTS: Two-hundred renal angiographies were judged technically adequate. Average additional fluoroscopy time was 3 +/- 2 min and 30 +/- 8 ml of additional contrast medium was used. Coronary artery disease (³ 50% narrowing) was found in 158 (79%). Renal arterial disease was found in 17 (8.5%) patients. Reduction in lumen diameter was < 50% in 11 patients (5.5%) including 3 patients with bilateral stenosis, and ³ 50% in 6 patients (3%). The only clinical variable associated with renal artery stenosis was peripheral vascular disease. CONCLUSION: There is no justification for doing routine renal angiography for patients undergoing coronary arteriography because the prevalence of severe renal artery stenosis is low.

Journal Article↗
PubMed1995

Effect of preload and afterload on ventricular arrhythmogenesis.

To examine whether it is an increase in preload or afterload that may cause ventricular arrhythmias, the ventricles of 13 anesthetized open-chest dogs were bandaged. Next, metaraminol, an almost pure alpha stimulator, was given, followed by removal of the bandage. The ventricles were then sucked in a plastic cup, which was finally removed. The systolic and diastolic ventricular pressures were measured, and the presence of arrhythmias (ventricular ectopic beats or ventricular tachycardia) was observed. Banding the ventricles caused a significant diminution of systolic pressure (-42 +/- 38.0 mmHg; mean +/- SD) and a rise in diastolic pressure (+3.5 +/- 3.7), starting from control values of 126 +/- 36/6.5 +/- 3.0, but no arrhythmia. Metaraminol raised both pressures (+122 +/- 58 and +9.0 +/- 10.3) and caused ventricular arrhythmias in 6 of 13 experiments. Removing the bandage further increased the systolic pressure (+45 +/- 42) and reduced the diastolic pressure (-7.2 +/- 10.3), but made the arrhythmia worse in 10 of 13 experiments. Suction reduced both pressures (-166 +/- 96 and -5.4 +/- 14) and stopped all arrhythmias. Removing the cup increased both pressures (+133 +/- 68 and +15.5 +/- 15.3, respectively) and worsened the arrhythmia in seven of eight experiments. In general, deterioration of ventricular arrhythmias was observed in 23 of 25 maneuvers with either an increase or no change in systolic pressure, but in none of the maneuvers was there a decrease (P < .0001) in systolic pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Emphysematous pyelonephritis: a case report and review of the literature.

Emphysematous pyelonephritis is a rare and life-threatening suppurative infection of renal parenchymal and perirenal tissues, characterized by spontaneous gas production. Although uncommon (76 cases in the literature), it occurs almost exclusively in diabetic patients (87% of the cases). We describe a recent case of a diabetic woman with emphysematous pyelonephritis due to E. coli, successfully managed with unilateral nephrectomy. Symptoms, diagnostic approach and management are discussed and related to the previously reported series.

Aged↗
PubMed1988

Analysis of ppb levels of organics in water by means of purge-and-trap, capillary gas chromatography and selective detectors.

The Environmental Protection Agency (EPA) has issued a series of methods (500 and 600 series) for the analysis of organics in drinking water and industrial discharges. Methods 601 and 602 employ packed-column gas chromatography (GC) with electrolytic conductivity (E1CD) and photoionization detection (PID), respectively. A purge-and-trap system is used for concentration of volatiles. The EPA is in the process of converting methods 601 and 602 and certain 500-series methods to capillary column analysis. We have also initiated the conversion of a number of these methods, using E1CD and PID and have described them in detail in this paper. We have evaluated both 0.32- and 0.53-mm diameter capillary columns, using helium and nitrogen as carrier gases with each detector. We found that with nitrogen optimum results are obtained at a flow-rate of 15 ml/min, and with helium at 6-8 ml/min. As a result of system optimization, including operation of the two detectors in series, and converting from packed to capillary columns, we found that analysis time could be reduced from 80 min (for two methods separately) to ca. 30 min. In addition, the elution of more than five components in one peak, observed when the packed column specified in method 601 are used, was eliminated.

Chromatography, Gas↗
PubMed1988

A model of the differing change in motor and sensory action potentials over distance.

Clinically recorded motor and sensory nerve responses show different degrees of change in response size over distance along a nerve. We describe a computer model to investigate possible causes of this phenomenon. Effects of the range of conduction velocity in a nerve and the size of the constituent action potentials forming the recorded response are evaluated. We conclude that the broader duration of the motor unit potential is the predominant factor in accounting for motor nerve responses showing less change over distance than sensory responses. The contributions of temporal dispersion and phase cancellation are also discussed.

Action Potentials↗