236 results on '"Christos Zavos"'
Search Results
2. Letter to the editor re: Li et al. (2020), ‘The potential role of bacteria in pancreatic cancer: A systematic review’
- Author
-
Apostolis Papaefthymiou, Jannis Kountouras, Christos Zavos, Stergios A. Polyzos, and Michael Doulberis
- Subjects
Cancer Research ,Letter to the editor ,business.industry ,medicine ,Cancer research ,General Medicine ,Carcinogenesis ,medicine.disease_cause ,business - Published
- 2020
- Full Text
- View/download PDF
Catalog
3. Potential Impact of Helicobacter pylori Infection on Reflux Disease Sequence: Illuminating the Gap
- Author
-
Eleni Vagdatli, Elisabeth Vardaka, Panagiotis Katsinelos, Jannis Kountouras, Christos Zavos, Christos Liatsos, Apostolis Papaefthymiou, Michael Doulberis, Maria Tzitiridou, Stergios A. Polyzos, and George Tsikopoulos more...
- Subjects
Potential impact ,Helicobacter pylori infection ,Helicobacter pylori ,business.industry ,Gastroenterology ,Reflux ,Disease ,Virology ,Helicobacter Infections ,Ethnicity ,Gastroesophageal Reflux ,Medicine ,Humans ,business ,Esophagitis, Peptic ,Sequence (medicine) - Published
- 2019
4. Chemerin, visfatin, and vaspin serum levels in relation to bone mineral density in patients with inflammatory bowel disease
- Author
-
Ioannis E. Koutroubakis, Niki Malliaraki, Sotirios Terzoudis, Daphne A. Dimitriadou, Christos Zavos, and John Damilakis
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Bone density ,Osteoporosis ,Adipokine ,Gastroenterology ,Inflammatory bowel disease ,03 medical and health sciences ,Absorptiometry, Photon ,0302 clinical medicine ,Adipokines ,Bone Density ,Internal medicine ,medicine ,Humans ,Chemerin ,Nicotinamide Phosphoribosyltransferase ,Serpins ,Aged ,Bone mineral ,Lumbar Vertebrae ,Hepatology ,biology ,Femur Neck ,business.industry ,Case-control study ,Odds ratio ,Middle Aged ,Inflammatory Bowel Diseases ,medicine.disease ,030104 developmental biology ,Case-Control Studies ,Body Composition ,biology.protein ,Cytokines ,Intercellular Signaling Peptides and Proteins ,Female ,030211 gastroenterology & hepatology ,Chemokines ,business ,Biomarkers - Abstract
BACKGROUND There is evidence that fat mass is correlated with bone mineral density (BMD) in inflammatory bowel disease (IBD), but data on the role of adipokines on this association are limited. The aim of this study was to investigate the serum levels of chemerin, visfatin, and vaspin, hormones that act as adipokines, in relation to BMD in patients with ulcerative colitis (UC) and Crohn's disease (CD). PATIENTS AND METHODS Serum from 120 IBD patients (68 CD, 52 UC) and 98 matched healthy controls (HC) was collected. Chemerin, visfatin, and vaspin levels were assessed using an enzyme-linked immunosorbent assay. BMD was determined for the lumbar spine and the proximal femur using dual-energy X-ray absorptiometry. Full-body composition scans were analyzed using enCORE software based on the absorptiometry system. RESULTS Serum chemerin was higher in IBD patients than HC [CD 13.67.1±5.8, UC 13.9±4.3 vs. HC 7.8±2.6 ng/ml, odds ratio (OR): 0.95, 95% confidence interval (CI) 0.93-0.98, P more...
- Published
- 2016
- Full Text
- View/download PDF
5. Helicobacter pylori infection as a potential risk factor for multiple sclerosis
- Author
-
Georgia Deretzi, Michael Doulberis, Emmanuel Gavalas, Christos Liatsos, Panagiotis Katsinelos, Panagiota Kyriakou, Apostolis Papaefthymiou, Dimitri Tzivras, Elisabeth Vardaka, Maria Tzitiridou-Chatzopoulou, Marina Boziki, Stergios A. Polyzos, Jannis Kountouras, Christos Zavos, and Efthymios Dardiotis more...
- Subjects
0301 basic medicine ,Multiple Sclerosis ,Helicobacter Infections ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Risk Factors ,medicine ,Humans ,Clinically isolated syndrome ,Helicobacter pylori ,biology ,Chronic Active ,business.industry ,Multiple sclerosis ,Experimental autoimmune encephalomyelitis ,General Medicine ,medicine.disease ,biology.organism_classification ,030104 developmental biology ,Gastric Mucosa ,Gastritis ,Immunology ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Helicobacter pylori infection (Hp-I) has been associated with a wide spectrum of gastrointestinal and extra-digestive manifestations, including neurodegenerative diseases. Contradictory data have been published on Hp-I and multiple sclerosis (MS) association, with studies mainly using serology for Hp-I detection that cannot distinguish between active and past infections. We herein hypothesize that humoral and cellular immune responses induced by active Hp-I, beyond damaging locally the gastric mucosa, they may shape the character of systemic autoimmune responses, contributing to MS pathogenesis. To investigate our hypothesis, active Hp-I has been diagnosed in two small MS Greek cohorts by using primarily gastric mucosa histology. A higher prevalence of active Hp-I was documented in MS patients vs. controls (86.4 vs. 50%, P = 0.002) accompanied by exclusive existence of duodenal ulcer and autoimmune diseases with endoscopic and histological findings of chronic active gastritis for the MS group. Our preliminary data suggested that active Hp-I unlike other studies, may not protect, but contribute to MS and we proposed possible Hp-relating mechanisms involved in MS pathophysiology, that merit further evaluation. more...
- Published
- 2020
- Full Text
- View/download PDF
6. Erratum to: Letter to the editor re: Li et al. (2020), ‘The potential role of bacteria in pancreatic cancer: A systematic review’
- Author
-
Jannis Kountouras, Apostolis Papaefthymiou, Christos Zavos, Michael Doulberis, and Stergios A. Polyzos
- Subjects
Cancer Research ,Letter to the editor ,biology ,business.industry ,Pancreatic cancer ,Cancer research ,Medicine ,General Medicine ,biology.organism_classification ,business ,medicine.disease ,Bacteria - Published
- 2020
- Full Text
- View/download PDF
7. Association between Active Helicobacter pylori Infection and Glaucoma: A Systematic Review and Meta-Analysis
- Author
-
Panagiotis Katsinelos, Apostolis Papaefthymiou, Jannis Kountouras, Christos Liatsos, Christos Zavos, Michael Doulberis, David S. Srivastava, Stergios A. Polyzos, and Panagiotis Bargiotas
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,primary open-angle glaucoma ,genetic structures ,Anemia ,Glaucoma ,Microbiology ,Gastroenterology ,Helicobacter pylori infection ,pseudo-exfoliation glaucoma ,03 medical and health sciences ,0302 clinical medicine ,Virology ,Internal medicine ,Normal tension glaucoma ,medicine ,Risk factor ,lcsh:QH301-705.5 ,biology ,business.industry ,Antibody titer ,Odds ratio ,Helicobacter pylori ,medicine.disease ,biology.organism_classification ,eye diseases ,glaucoma ,lcsh:Biology (General) ,Meta-analysis ,030221 ophthalmology & optometry ,030211 gastroenterology & hepatology ,business - Abstract
Background: Glaucoma is the second most common cause of blindness worldwide affecting almost 70 million individuals. Helicobacter pylori (H. pylori) is a widespread pathogen with systematic pathogenicity. This meta-analysis aimed to estimate the contradictory data regarding a potential association between active H. pylori infection and glaucoma. Materials and Methods: A research in MEDLINE/PubMed and Google Scholar was conducted and original studies investigating the relationship between H. pylori infection and glaucoma were included. Analysis was performed with random effects model. The main outcome was the odds ratio (OR) with 95% confidence intervals (CI) of H. pylori infection as a risk factor for glaucoma. A parallel analysis studied the role of active infection as indicated by histology and the titer of anti-H. pylori antibodies. For the anti-H. pylori antibody titers, weighted mean differences (WMD) were estimated between patients and controls. Results: Fifteen studies were included, with 2664 participants (872 patients with glaucoma and 1792 controls), divided into primary open-angle glaucoma (POAG), normal tension glaucoma (NTG) and pseudo-exfoliation glaucoma (PEG). The association between H. pylori infection and overall glaucoma was significant (OR = 2.08, CI 95% 1.48–2.93) with moderate heterogeneity (I2 = 61.54%). After stratification by glaucoma subtype, heterogeneity was eliminated in the NTG subgroup. Studies with healthy controls, and controls with anemia yielded very low or no heterogeneity, respectively. Gastric biopsy to document active H. pylori infection yielded the highest OR (5.4, CI: 3.17–9.2, p < 0.001) and null heterogeneity. For anti-H. pylori antibody titers, there was a significant difference in WMD between patients and controls (WMD 15.98 IU/mL; 95% CI: 4.09–27.87; p = 0.008); values were greater in glaucoma patients, with high heterogeneity (I2: 93.8%). Meta-regression analysis showed that mean age had a significant impact on glaucoma (p = 0.037). Conclusions: Active H. pylori infection may be associated with glaucoma with null heterogeneity, as, beyond histology, quantified by anti-H. pylori titers and increases with age. more...
- Published
- 2020
- Full Text
- View/download PDF
8. A potential impact of Helicobacter pylori infection on both obstructive sleep apnea and atrial fibrillation-related stroke
- Author
-
Emmanuel Gavalas, Euthemia Daskalopoulou-Vlachogianni, Elisabeth Vardaka, Christos Stergiopoulos, Evaggelia Giartza-Taxidou, Constantinos Kountouras, Dimitri Tzivras, Jannis Kountouras, Panagiotis Katsinelos, Christos Zavos, Stergios A. Polyzos, Ioanna Tzivras, Georgia Deretzi, and Efthymia Vlachaki more...
- Subjects
medicine.medical_specialty ,Potential impact ,Helicobacter pylori infection ,Sleep Apnea, Obstructive ,Helicobacter pylori ,business.industry ,Sleep apnea ,Atrial fibrillation ,General Medicine ,medicine.disease ,Helicobacter Infections ,Obstructive sleep apnea ,Stroke ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Atrial Fibrillation ,Medicine ,Humans ,030211 gastroenterology & hepatology ,business ,030217 neurology & neurosurgery - Published
- 2017
9. The Bone and Fat Connection in Inflammatory Bowel Diseases
- Author
-
Sotirios Terzoudis, Christos Zavos, and Ioannis E. Koutroubakis
- Subjects
Bone mineral ,Adiponectin ,business.industry ,Leptin ,Osteoporosis ,Gastroenterology ,Adipokine ,Inflammatory Bowel Diseases ,Prognosis ,medicine.disease ,Bioinformatics ,Inflammatory bowel disease ,digestive system diseases ,Bone remodeling ,Osteopenia ,Bone Diseases, Metabolic ,Humans ,Immunology and Allergy ,Medicine ,business ,Adiposity - Abstract
Osteopenia and osteoporosis are common manifestations in inflammatory bowel diseases (IBD) but the pathogenetic mechanism of bone loss in IBD is only partially understood. There is evidence that fat mass is an important determinant of the bone mineral density and adipose-derived factors seem to play an important role for the association between fat mass and bone mass. The association between adiposity and low bone density is rather poorly studied in IBD, but emerging data on adipokines in IBD in relation to osteoporosis provide a novel pathophysiological concept that may shed light on the etiology of bone loss in IBD. It could be suggested that adipokines interfere in bone metabolism by altering the sensitive balance between osteoblasts and osteoclasts although further studies in this setting are needed. more...
- Published
- 2014
- Full Text
- View/download PDF
10. Adipocytokines and cytokeratin-18 in patients with nonalcoholic fatty liver disease: Introduction of CHA index
- Author
-
Evridiki Papadopoulou, Christos Zavos, Stergios A. Polyzos, Athanasios Papatheodorou, Evangelos Terpos, Jannis Kountouras, Kalliopi Patsiaoura, Efthimia Zafeiriadou, and Evangelia Katsiki
- Subjects
Blood Glucose ,Male ,medicine.medical_treatment ,Biopsy ,Specialties of internal medicine ,Apoptosis ,Visfatin ,Severity of Illness Index ,Non-alcoholic Fatty Liver Disease ,Nonalcoholic fatty liver disease ,Insulin ,Nicotinamide Phosphoribosyltransferase ,Fatty liver ,General Medicine ,Middle Aged ,Prognosis ,RC581-951 ,Cytokines ,Female ,Adiponectin ,Adult ,medicine.medical_specialty ,Tumor necrosis factor ,Adipokine ,digestive system ,Insulin resistance ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Nonalcoholic steatohepatitis ,Hepatology ,Keratin-18 ,business.industry ,Tumor Necrosis Factor-alpha ,Quantitative insulin sensitivity check index ,nutritional and metabolic diseases ,medicine.disease ,digestive system diseases ,Fatty Liver ,Oxidative Stress ,Endocrinology ,Cross-Sectional Studies ,Case-Control Studies ,Steatosis ,business ,Reactive Oxygen Species ,Biomarkers - Abstract
Background and rationale. Insulin resistance (IR), adipocytokines, oxidative stress and hepatic apoptosis play a pathogenetic role in nonalcoholic fatty liver disease (NAFLD). Aims. The evaluation of specific adipocytokines and markers of IR, oxidative stress and apoptosis in NAFLD patients; the introduction of a combined non-invasive index for nonalcoholic steatohepatitis (NASH). Material and methods. Thirty patients with biopsy-proven NAFLD (15 with simple nonalcoholic fatty liver [NAFL], 15 with NASH) and 24 controls were recruited. Blood samples for total and high molecular weight (HMW) adiponectin, visfatin and tumor necrosis factor (TNF)-α, the apoptotic by-product cytokeratin (CK)-18, the reactive oxygen metabolites (ROMs) and standard biochemical tests were measured. Homeostatic model of assessment - insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were calculated. Main results: Total and HMW adiponectin were significantly lower and TNF-α higher in either NAFL or NASH group compared to control group; CK-18 was significantly higher in NASH compared to either NAFL or control group. CHAI (an acronym of CK-18, HOMA-IR, AST Index) was calculated as the product of parameters being significantly different between NAFL and NASH groups. CHAI was significantly higher in NASH (24.2 [15.1-214.0]) compared to either NAFL (15.7 [6.8-22.7]) or control (5.1 [2.4-7.6]) group (p < 0.001) and significantly higher as the severity of steatosis, fibrosis, ballooning, lobular and portal inflammation advanced. Conclusion. CHAI was escalating from controls to NAFL and NASH and was higher by increasing the severity of all the main histological lesions. However, a validation study is needed before introducing CHAI in clinical practice. more...
- Published
- 2013
11. Helicobacter pylori infection in patients with nonalcoholic fatty liver disease
- Author
-
Kyriaki Anastasiadou, Kalliopi Patsiaoura, Evangelos Terpos, Athanasios Papatheodorou, Jannis Kountouras, Efthimia Zafeiriadou, Christos Zavos, Stergios A. Polyzos, and Evangelia Katsiki
- Subjects
Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Urea breath test ,Aspartate transaminase ,digestive system ,Helicobacter Infections ,Endocrinology ,Non-alcoholic Fatty Liver Disease ,Internal medicine ,Nonalcoholic fatty liver disease ,medicine ,Humans ,Aspartate Aminotransferases ,Chi-Square Distribution ,Helicobacter pylori ,biology ,medicine.diagnostic_test ,Tumor Necrosis Factor-alpha ,business.industry ,Fatty liver ,nutritional and metabolic diseases ,Alanine Transaminase ,gamma-Glutamyltransferase ,biology.organism_classification ,medicine.disease ,digestive system diseases ,Fatty Liver ,C-Reactive Protein ,Cross-Sectional Studies ,Alanine transaminase ,Immunoglobulin G ,Liver biopsy ,biology.protein ,Female ,Steatosis ,business - Abstract
Objective Clinical data regarding Helicobacter pylori ( Hp) infection in nonalcoholic fatty liver disease (NAFLD) are limited. The aim was the evaluation of Hp infection in patients with NAFLD and its association with disease severity. Methods 28 patients with biopsy-proven NAFLD (15 with simple nonalcoholic fatty liver [NAFL], 13 with nonalcoholic steatohepatitis [NASH]) and 25 matched healthy controls were recruited. Blood samples for anti- Hp Immunoglobulin G (IgG) and standard biochemical tests were obtained after overnight fasting, and 13 C urea breath test was performed before liver biopsy in NAFLD group. Results Higher rates of anti- Hp IgG ( P =.038) were observed in NAFLD compared to control group. Only two NAFLD patients neither were Hp IgG seropositive nor did they have a history of eradication treatment compared to 11 control subjects ( P =.002). Both Hp infection (assessed by history of Hp eradication treatment and/or Hp IgG seropositivity) ( P =.034) and log(HOMA-IR) ( P =.007) could independently predict NAFLD in logistic regression analysis. There were similar rates of Hp IgG seropositivity or positivity in 13 C urea breath test or their combination between NAFL and NASH patients. There were no significant differences in steatosis grade, fibrosis stage, lobular or portal inflammation, or ballooning, when NAFLD patients were divided according to Hp IgG seropositivity or 13 C urea breath test positivity. Conclusions Hp infection may represent one more hit contributing to the pathogenesis of NAFL, though not to the progression from NAFL to NASH. These results warrant further validation. If confirmed, eradicating Hp infection may have certain therapeutic perspectives in NAFLD treatment. more...
- Published
- 2013
- Full Text
- View/download PDF
12. A fully covered self-expandable metal stent anchored by a 10-Fr double pigtail plastic stent: an effective anti-migration technique
- Author
-
Kiriaki Anastasiadou, Georgia Lazaraki, Grigoris Chatzimavroudis, Jannis Kountouras, Olga Giouleme, Christos Zavos, Nikos Georgakis, Panagiotis Katsinelos, and Stergios Gkagkalis
- Subjects
Pigtail ,medicine.medical_specialty ,Self expandable ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Stent ,equipment and supplies ,migration ,Surgery ,03 medical and health sciences ,Fully covered self-expandable metal stents ,0302 clinical medicine ,prevention ,030220 oncology & carcinogenesis ,medicine ,Biliary stenosis ,030211 gastroenterology & hepatology ,Plastic stent ,In patient ,Original Article ,Radiology ,Major complication ,business - Abstract
Background Fully covered self-expandable metal stents (FCSEMS) have been used successfully in the treatment of malignant and benign biliary strictures. However, stent migration is a major complication. We investigated the efficacy of anchoring FCSEMS with a 10-Fr double-pigtail plastic stent to prevent migration in patients with biliary strictures. Methods Between January 2012 and May 2013, 10 patients with malignant biliary strictures and one patient with a suprapapillary benign biliary stenosis were enrolled in the study. The primary endpoint of the study was to record the migration rate of FCSEMS. Results The placement of FCSEMSs and the anchoring with a 10-Fr double-pigtail plastic stent were successful in all patients. During a median follow-up period of eight months, proximal or distal migration of FCSEMS was not observed. No procedural complications related to the placement of FCSEMS and/or the anchoring plastic stent were recorded. Conclusions The placement of an anchoring 10-Fr double-pigtail stent is a simple and effective anti-migration technique for FCSEMS in patients with malignant biliary strictures. Keywords Fully covered self-expandable metal stents, migration, prevention Ann Gastroenterol 2017; 30 (1): 114-117 more...
- Published
- 2016
13. Comparison of Three Types of Precut Technique to Achieve Common Bile Duct Cannulation: A Retrospective Analysis of 274 Cases
- Author
-
Athanasios Beltsis, Anthi Gatopoulou, Sotiris Terzoudis, Stergios Gkagkalis, Georgia Lazaraki, Jannis Kountouras, Themistoklis Vasiliadis, Panagiotis Katsinelos, Grigoris Chatzimavroudis, and Christos Zavos more...
- Subjects
Adult ,Male ,medicine.medical_specialty ,Physiology ,MEDLINE ,digestive system ,Transplant surgery ,Internal medicine ,medicine ,Retrospective analysis ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Common Bile Duct ,Common bile duct ,business.industry ,General surgery ,Gastroenterology ,Retrospective cohort study ,Middle Aged ,Hepatology ,humanities ,Sphincterotomy, Transduodenal ,Surgery ,medicine.anatomical_structure ,Pancreatitis ,Female ,business - Abstract
The aim of this retrospective study was to evaluate the success rate and complications of three precut techniques of sphincterotomy after failure of conventional techniques of cannulation of common bile duct (CBD).Between January 2003 and October 2011, 2,903 consecutive ERCPs were performed in patients with naïve major papilla. In 283 patients in whom biliary cannulation was not achieved, precut technique was performed and these patients were included in the study.A total of 274 patients were included in the final analysis. Needle-knife papillotomy (NKP) was performed in 129 cases (47.1 %), suprapapillary fistulotomy (SPF) in 78 patients (28.5 %), and transpancreatic sphincterotomy (TPS) in 67 cases (24.5 %). No significant difference was observed in the initial and eventual success rate of biliary cannulation between the three groups. Overall, complications occurred in 54 patients (19.7 %), of which 33 (25.6 %) were with NKP, 6 (7.7 %) with SPF and 15 (22.4 %) with TPS, respectively, a difference statistically significant favoring the SPF group (p = 0.006). Post-procedure acute pancreatitis was developed in 27 cases (20.9 %) with NKP, compared to two cases (2.6 %) with SPF and 15 cases (22.4 %) with TPS, a difference statistically significant favoring the SPF group. No difference was observed between the groups with regard to the occurrence of post-procedure hemorrhage and perforation.The three types of precut sphincterotomy have no different overall CBD cannulation rates; SPF reduces post-ERCP pancreatitis risk. more...
- Published
- 2012
- Full Text
- View/download PDF
14. The Emerging Role of Endocrine Disruptors in Pathogenesis of Insulin Resistance: A Concept Implicating Nonalcoholic Fatty Liver Disease
- Author
-
Jannis Kountouras, Christos S. Mantzoros, Georgia Deretzi, Christos Zavos, and Stergios A. Polyzos
- Subjects
medicine.medical_specialty ,Population ,Phthalic Acids ,Endocrine Disruptors ,Biology ,Dioxins ,Bioinformatics ,Biochemistry ,Pathogenesis ,Insulin resistance ,Phenols ,Non-alcoholic Fatty Liver Disease ,Internal medicine ,Nonalcoholic fatty liver disease ,medicine ,Animals ,Humans ,Benzhydryl Compounds ,education ,Molecular Biology ,education.field_of_study ,Fatty liver ,nutritional and metabolic diseases ,Type 2 Diabetes Mellitus ,General Medicine ,medicine.disease ,Polycystic ovary ,Obesity ,Fatty Liver ,Endocrinology ,Molecular Medicine ,Environmental Pollutants ,Insulin Resistance ,Energy Metabolism - Abstract
Endocrine disruptors or endocrine-disrupting chemicals (EDCs) represent a highly heterogeneous group of molecules found in the environment or in consumer products. Toxicology and epidemiology studies have suggested the involvement of diverse EDCs in an increasing number of metabolic disorders, including insulin resistance (IR) and IR-related co morbidities, such as obesity, type 2 diabetes mellitus (T2DM) and polycystic ovary syndrome. Nonalcoholic fatty liver disease (NAFLD), another IR related condition, is emerging as a significant public health concern, affecting 30-45% of the general population in the Western world. To evaluate whether EDCs may also play a role in the pathogenesis of NAFLD, we reviewed the literature on well-studied EDCs, such as dioxins, bisphenol A, phthalates and other persistent organic pollutants, in relation to pathways that might contribute to the pathogenesis of fatty liver / NAFDL. Certain EDCs may be responsible for inducing alterations similar to those encountered in NAFLD either directly through a hepatotoxic effect and/or indirectly by triggering hepatic and systematic IR. Considering these effects, which act in concert with the effects of the epidemics of obesity and T2DM, EDCs may play a significant role in the pathogenesis of fatty liver, thereby increasing the prevalence of NAFLD worldwide. Translational studies and clinical trials investigating the association between EDCs and NAFLD are required to confirm and extent these studies. more...
- Published
- 2012
- Full Text
- View/download PDF
15. Letter: Helicobacter pylori in lean and obese patients with non-alcoholic fatty liver disease
- Author
-
Panagiotis Katsinelos, Georgios Kotronis, Stergios A. Polyzos, Marina Boziki, Jannis Kountouras, Evangelos Kazakos, Dimitri Tzivras, Christos Zavos, and Michael Doulberis
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Hepatology ,biology ,business.industry ,Fatty liver ,Gastroenterology ,MEDLINE ,Non alcoholic ,Disease ,Helicobacter pylori ,medicine.disease ,biology.organism_classification ,Helicobacter Infections ,Obesity ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Internal medicine ,medicine ,030211 gastroenterology & hepatology ,Pharmacology (medical) ,business - Published
- 2017
- Full Text
- View/download PDF
16. Helicobacter pylorion portal hypertension-related hepatic encephalopathy
- Author
-
Christos Zavos, Iordanis Romiopoulos, Panagiotis Katsinelos, Marina Boziki, Constantinos Kountouras, Sotiris Anastasiadis, Georgia Xiromerisiou, Elizabeth Vardaka, Stergios A. Polyzos, Elena Tsiaousi, Jannis Kountouras, Emmanuel Gavalas, Dimitri Tzivras, and Georgia Deretzi more...
- Subjects
Male ,medicine.medical_specialty ,Immunology ,Toxicology ,Gastroenterology ,Helicobacter Infections ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Hypertension, Portal ,Humans ,Immunology and Allergy ,Medicine ,Hepatic encephalopathy ,Pharmacology ,Helicobacter pylori ,biology ,business.industry ,General Medicine ,medicine.disease ,biology.organism_classification ,Hepatic Encephalopathy ,Portal hypertension ,Female ,030211 gastroenterology & hepatology ,business ,030217 neurology & neurosurgery - Abstract
In their review Licinio et al.1 concluded that, despite mostly experimental clues for an association between Helicobacter pylori (Hp) and portal hypertension (PH) have been shown, the relationship ... more...
- Published
- 2017
- Full Text
- View/download PDF
17. Combination of diclofenac plus somatostatin in the prevention of post-ERCP pancreatitis: a randomized, double-blind, placebo-controlled trial
- Author
-
Agoritsa Kaltsa, Jannis Kountouras, Sotiris Terzoudis, Kostas Fasoulas, Panagiotis Katsinelos, Eleni Dimou, Grigoris Chatzimavroudis, Christos Zavos, George Paroutoglou, Taxiarchis Katsinelos, and Athanasios Beltsis more...
- Subjects
Male ,medicine.medical_specialty ,Diclofenac ,Combination therapy ,Placebo-controlled study ,Placebo ,Gastroenterology ,law.invention ,Double-Blind Method ,Randomized controlled trial ,Risk Factors ,law ,Internal medicine ,medicine ,Humans ,Aged ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Endoscopic retrograde cholangiopancreatography ,medicine.diagnostic_test ,business.industry ,Anti-Inflammatory Agents, Non-Steroidal ,Middle Aged ,medicine.disease ,Hormones ,Pancreatitis ,Anesthesia ,Amylases ,Multivariate Analysis ,Acute pancreatitis ,Drug Therapy, Combination ,Female ,Somatostatin ,business ,medicine.drug - Abstract
Background and study aims: Pancreatitis is the most common complication of therapeutic endoscopic retrograde cholangiopancreatography (ERCP), and many pharmacoprophylactic approaches have been suggested, though not without controversy. The aim was to investigate the impact of combined therapy with diclofenac plus somatostatin on reducing the frequency and severity of post-ERCP pancreatitis (PEP). Patients and methods: A prospective, double-blind, placebo-controlled trial was conducted in two tertiary referral centers, with 540 eligible patients randomized to receive either combined therapy with diclofenac 100 mg rectally 30 to 60 minutes before ERCP plus somatostatin 0.25 mg/h for 6 hours (group A), or a placebo suppository identical in appearance to the diclofenac along with saline solution (group B). Patients were clinically evaluated and serum amylase levels were determined before ERCP and at 6 and 24 hours post-procedure. Standardized criteria were used to diagnose and grade the severity of PEP. Adverse events were recorded prospectively. Results: There were no statistical differences between the groups regarding demographic data, ERCP findings, and procedure risk factors for PEP. The overall incidence of acute pancreatitis was 7.2 %. The PEP rate was significantly lower in the patients who received the combination therapy than in controls (4.7 % vs. 10.4 %, P = 0.015). Previous history of acute pancreatitis ( P = 0.001), pancreatic opacification of first-class branches and beyond ( P = 0.008), and absence of pharmacoprophylaxis ( P = 0.023) were identified as independent risk factors for PEP in multivariate analysis. Conclusion: Although combined prophylactic therapy with diclofenac plus somatostatin was promising in reducing frequency of PEP, further comparative large-scale studies are needed to confirm our findings before definitive conclusions can be drawn. more...
- Published
- 2011
- Full Text
- View/download PDF
18. Histological Presence of Helicobacter pylori Bacteria in the Trabeculum and Iris of Patients with Primary Open-Angle Glaucoma
- Author
-
Stergios Arapoglou, Jannis Kountouras, Georgia Deretzi, Christos Zavos, Georgios Sakkias, and Ioannis Venizelos
- Subjects
Pathology ,medicine.medical_specialty ,genetic structures ,Open angle glaucoma ,biology ,medicine.diagnostic_test ,business.industry ,Coloring agents ,Glaucoma ,General Medicine ,Helicobacter pylori ,medicine.disease ,biology.organism_classification ,eye diseases ,Sensory Systems ,Pathophysiology ,Cellular and Molecular Neuroscience ,Ophthalmology ,Helicobacter pylori bacteria ,medicine.anatomical_structure ,Biopsy ,medicine ,sense organs ,Iris (anatomy) ,business - Abstract
Purpose: To investigate the role of Helicobacter pylori in primary open-angle glaucoma (POAG) pathophysiology by detecting its presence in eye biopsies of POAG patients during trabeculectomy. Patients and Methods: Fifty-one consecutive patients who underwent trabeculectomy for POAG not responsive to antiglaucoma therapy, and 35 consecutive anemic controls were examined for H. pylori presence mainly by gastric mucosa histology. In POAG patients, eye biopsies were also obtained and stained for H. pylori presence in situ. Results: Forty-three of 51 (84.3%) POAG patients and 17 of 35 (48.6%) controls were tested H. pylori positive (p = 0.0004). In 5 H. pylori-positive POAG patients, H. pylori bacteria were identified in the trabeculum and iris specimens. Conclusion: For the first time, H. pylori bacteria have been detected histologically in eye biopsies of POAG patients. more...
- Published
- 2011
- Full Text
- View/download PDF
19. Diagnostic yield and clinical impact of wireless capsule endoscopy in patients with chronic abdominal pain with or without diarrhea: A Greek multicenter study
- Author
-
Sotiris Terzoudis, Athanasios Beltsis, Agoritsa Kaltsa, Panagiotis Katsinelos, Grigoris Chatzimavroudis, Dimitris Kapetanos, Christos Zavos, Theofanis Maris, Kostas Fasoulas, George Paroutoglou, Aristea Belou, Jannis Kountouras, E. Kamperis, Stefanos Atmatzidis, Alexandros Koufokotsios, and Kostas Mimidis more...
- Subjects
Adult ,Diarrhea ,Male ,medicine.medical_specialty ,Abdominal pain ,Adolescent ,Capsule Endoscopy ,Gastroenterology ,law.invention ,Diagnosis, Differential ,Young Adult ,Capsule endoscopy ,law ,Internal medicine ,Intestine, Small ,Internal Medicine ,medicine ,Humans ,Prospective Studies ,Young adult ,Prospective cohort study ,Aged ,Aged, 80 and over ,Greece ,medicine.diagnostic_test ,business.industry ,Incidence ,Incidence (epidemiology) ,Reproducibility of Results ,Middle Aged ,Abdominal Pain ,Clinical trial ,Erythrocyte sedimentation rate ,Female ,Chronic Pain ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Background Wireless capsule endoscopy has become the gold standard for the examination of small bowel. However, its role in the evaluation of patients suffering from chronic abdominal pain is not yet clearly defined. We conducted an open-label prospective multi-center study to evaluate the yield and clinical outcome of capsule endoscopy in patients with chronic abdominal pain with/without diarrhea. Methods Seventy-two patients with chronic (> 3 months) abdominal pain with/without diarrhea in whom the underlying pathology could not be diagnosed by conventional modalities, underwent capsule endoscopy in either of the 6 participating centers. Patients were then followed up for clinical outcomes. Results The overall diagnostic yield of capsule endoscopy was 44.4%. More specifically, its diagnostic yield was 21.4% in patients with abdominal pain and negative inflammatory markers (C-reactive protein and erythrocyte sedimentation rate), 66.7% in patients with abdominal pain and positive inflammatory markers, 0% in patients with abdominal pain, diarrhea and negative inflammatory markers, and 90.1% in patients with abdominal pain, diarrhea and positive inflammatory markers. Both univariate and multivariate regression analyses showed that abnormal C-reactive protein and erythrocyte sedimentation rate were significant factors related with positive capsule endoscopy findings. Conclusions Chronic abdominal pain with/without diarrhea should be accompanied by elevated inflammatory markers to be regarded as a valid indication for capsule endoscopy. The yield of capsule endoscopy in such patients is reasonably high and clinical outcomes of patients treated with capsule endoscopy findings as a guide are significant. more...
- Published
- 2011
- Full Text
- View/download PDF
20. Large-balloon dilation of the biliary orifice for the management of basket impaction: a case series of 6 patients
- Author
-
Athanasios Beltsis, Kostas Fasoulas, Sotiris Terzoudis, Jannis Kountouras, Christos Zavos, Panagiotis Katsinelos, and Grigoris Chatzimavroudis
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Lithotripsy ,Extracorporeal ,Catheterization ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Sphincter of Oddi ,Aged ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Endoscopes ,Common bile duct ,business.industry ,Impaction ,Gastroenterology ,Balloon catheter ,Weather balloon ,Laser lithotripsy ,Surgery ,body regions ,Choledocholithiasis ,surgical procedures, operative ,medicine.anatomical_structure ,nervous system ,Balloon dilation ,Equipment Failure ,Female ,business - Abstract
ERCP with endoscopic sphincterotomy (ES) and stone extraction remains the treatment of choice for bile duct stones 1,2 ; 85% to 90% of all CBD stones can be effectively treated by ES and stone extraction by using balloon catheters or baskets. 3 Regarding the latter devices, impaction of a Dormia basket or fracture of the basket’s traction wires during endoscopic mechanical lithotripsy with an entrapped stone in the distal CBD is an uncommon but well-known complication, 4-6 presenting a challenge to most endoscopists. Reported management strategies include the use of a mechanical lithotriptor to capture the impacted basket and crush the stone, extracorporeal shock-wave lithotripsy, endoscopic laser lithotripsy, or other sophisticated methods. 7-12 This case series describes, for the first time, the safe and effective use of large-diameter balloon dilation of the biliary orifice in the management of impacted baskets in the distal CBD. more...
- Published
- 2011
- Full Text
- View/download PDF
21. The Association Between Helicobacter pylori Infection and Insulin Resistance: A Systematic Review
- Author
-
Jannis Kountouras, Christos Zavos, Stergios A. Polyzos, and Georgia Deretzi
- Subjects
Helicobacter pylori infection ,medicine.medical_specialty ,biology ,business.industry ,Gastroenterology ,MEDLINE ,Type 2 Diabetes Mellitus ,General Medicine ,Helicobacter pylori ,medicine.disease ,biology.organism_classification ,Infectious Diseases ,Insulin resistance ,Internal medicine ,Immunology ,Nonalcoholic fatty liver disease ,Medicine ,Metabolic syndrome ,Young adult ,business - Abstract
Background: Helicobacter pylori infection has been associated with diverse extradigestive morbidity, including insulin resistance (IR) syndrome. The aim of this systematic review was to summarize the epidemiologic evidence concerning the association between H. pylori infection and IR quantitative indexes. Materials and Methods: A computerized literature search in PubMed electronic databases and Cochrane Central Register of Controlled Trials was performed. Results: Nine studies reporting data on 2120 participants were finally eligible for this systematic review. Seven of them were cross-sectional studies and two were nonrandomized, open-label, controlled trials investigating the effect of H. pylori eradication on IR. Homeostatic model of assessment insulin resistance (HOMA-IR) was used in all studies to quantify IR. There seems to be a trend toward a positive association between H. pylori infection and HOMA-IR, strengthened by regression analysis in one study. However, there was significant heterogeneity between studies regarding the method(s) of H. pylori infection diagnosis based on and the study populations. The studies for the effect of H. pylori eradication on HOMA-IR revealed conflicting results. Conclusions: Although data seem to indicate a potential association between H. pylori infection and IR, further studies are needed to strengthen this association and to clarify whether there is a causative link between them. If a causal link is confirmed in the future, this may have a major impact on the pathophysiology and management of IR syndrome, including type 2 diabetes mellitus and nonalcoholic fatty liver disease. more...
- Published
- 2011
- Full Text
- View/download PDF
22. High Prevalence of Helicobacter pylori Infection in Greek Patients with Myelodysplastic Syndromes
- Author
-
Michael D. Diamantidis, Philippos Klonizakis, Eudokia Mandala, Jannis Kountouras, Christos Zavos, Efthymia Vlachaki, Ifigenia Frida-Michailidou, Elizabeth Ioannidou-Papagiannaki, Styliani Haralambidou-Vranitsa, Efthymia Parapanisiou, Ioannis Klonizakis, and Georgios Tsapournas more...
- Subjects
medicine.medical_specialty ,Myeloid ,biology ,business.industry ,Myelodysplastic syndromes ,Case-control study ,Rapid urease test ,Hematology ,General Medicine ,Helicobacter pylori ,medicine.disease ,biology.organism_classification ,Gastroenterology ,Pathophysiology ,Serology ,Leukemia ,medicine.anatomical_structure ,hemic and lymphatic diseases ,Internal medicine ,Immunology ,medicine ,business - Abstract
Background/Aims/Methods: To determine the frequency of Helicobacter pylori infection (Hp-I) in 73 patients with myelodysplastic syndromes (MDS) and 40 controls, serologic analyses of Hp and 13C-urease breath tests (INFAI) were performed. Gastric mucosal biopsy specimens were obtained to determine the presence of Hp-I using a rapid urease test, i.e. the Campylobacter-like organism (CLO) test, and cresyl violet staining. Peripheral blood (PB) flow cytometry for CD3, CD4, CD8, CD14, CD19 and CD34 was conducted in 35 patients and in controls. Results:Hp-I was detected by: (a) serology in 75.34% of patients (p = 0.000), (b) INFAI in 57.69% of patients, (c) CLO in 60.71% of patients and (d) histological confirmation in 80.36% of patients (p = 0.001). No correlation between Hp-I and CD3, CD4, CD8, CD14, CD19 expression, leukemic transformation or death was observed. However, in 20 cases, significant variation in the PB lymphocytic proportion possibly attributable to Hp-I was ascertained, in contrast to the expected MDS ratio. Conclusion: Although there is no evidence for a causal relationship between Hp-I and MDS, the increased prevalence of Hp-I among the MDS patients is an interesting finding that deserves further investigation as it may indicate a common factor causing susceptibilities to both MDS and Hp-I or that Hp might influence the pathophysiology of MDS. more...
- Published
- 2010
- Full Text
- View/download PDF
23. From the 'little brain' gastrointestinal infection to the 'big brain' neuroinflammation: A proposed fast axonal transport pathway involved in multiple sclerosis
- Author
-
Evangelos Koutlas, Christos Zavos, Jannis Kountouras, Stavros Chatzigeorgiou, Georgia Deretzi, Nikolaos Grigoriadis, and Iakovos Tsiptsios
- Subjects
Gastrointestinal tract ,Multiple Sclerosis ,Gastrointestinal Diseases ,Multiple sclerosis ,Fast axonal transport ,Central nervous system ,Brain ,Sensory system ,General Medicine ,Biology ,medicine.disease ,Axons ,medicine.anatomical_structure ,medicine ,Axoplasmic transport ,Humans ,Enteric nervous system ,Neuroscience ,Neuroinflammation - Abstract
The human central nervous system (CNS) is targeted by different pathogens which, apart from pathogens' intranasal inoculation or trafficking into the brain through infected blood cells, may use a distinct pathway to bypass the blood-brain barrier by using the gastrointestinal tract (GIT) retrograde axonal transport through sensory or motor fibres. The recent findings regarding the enteric nervous system (often called the "little brain") similarities with CNS and GIT axonal transport of infections resulting in CNS neuroinflammation are mainly reviewed in this article. We herein propose that the GIT is the vulnerable area through which pathogens (such as Helicobacter pylori) may influence the brain and induce multiple sclerosis pathologies, mainly via the fast axonal transport by the afferent neurones connecting the GIT to brain. more...
- Published
- 2009
- Full Text
- View/download PDF
24. Migration of Plastic Biliary Stents and Endoscopic Retrieval
- Author
-
Jannis Kountouras, Konstantinos Karakousis, George Gelas, Christos Zavos, Dimitris Paikos, Panagiotis Katsinelos, Grigoris Chatzimavroudis, D Tzilves, and George Paroutoglou
- Subjects
Adult ,Male ,medicine.medical_specialty ,Referral ,medicine.medical_treatment ,Forceps ,Balloon ,Young Adult ,Foreign-Body Migration ,Cholestasis ,medicine ,Humans ,cardiovascular diseases ,Device Removal ,Duodenal Perforation ,Aged ,Retrospective Studies ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Common bile duct ,business.industry ,Stent ,Retrospective cohort study ,Middle Aged ,equipment and supplies ,medicine.disease ,Prosthesis Failure ,Surgery ,surgical procedures, operative ,medicine.anatomical_structure ,Female ,Stents ,Bile Ducts ,Radiology ,business ,Follow-Up Studies - Abstract
Background Proximal or distal migration of a plastic biliary stent is uncommon, but its management can be a technical challenge to the pancreatobiliary endoscopist. Patients and methods All cases (n=51) of proximally and distally migrated plastic biliary stents over an 8-year period at 3 referral pancreaticobiliary centers were included in this retrospective study. Indications for stenting, risk factors for migration, presentation of migration, and various techniques used for stent's retrieval are herein analyzed. Results Twenty-one proximal and 30 distal bile duct-migrated stents were identified. All patients with proximally and 17 (56.7%) with distally migrated stents were symptomatic. Choledocholithiasis, dilated common bile duct, short and large size stent were the main risk factors. The retrieval of proximally migrated stents was successful in 15 patients (71.4%) and in all symptomatic patients with distal migration. The retrieval techniques included forceps, Dormia basket, snare, Soehendra stent retriever, and balloon. One patient died of sepsis due to peritonitis from duodenal perforation from a distally migrated stent. Conclusions Retrieval of a proximally migrated stent requires experience with different endoscopic devices. Moreover, distal migration needs attention because it can cause severe complications. more...
- Published
- 2009
- Full Text
- View/download PDF
25. Eradication of Helicobacter pylori may be beneficial in the management of Alzheimer’s disease
- Author
-
Dimitrios Tzilves, Marina Boziki, Nikolaos Grigoriadis, Dimitrios Chatzopoulos, Emmanuel Gavalas, Panagiotis Katsinelos, Christos Zavos, Ioannis Venizelos, Jannis Kountouras, Georgia Deretzi, and Magda Tsolaki more...
- Subjects
Male ,medicine.medical_specialty ,Endpoint Determination ,Biopsy ,Rapid urease test ,Comorbidity ,Neuropsychological Tests ,Gastroenterology ,Helicobacter Infections ,Alzheimer Disease ,Clarithromycin ,Internal medicine ,Gastroscopy ,Prevalence ,medicine ,Clinical endpoint ,Humans ,Dementia ,Omeprazole ,Aged ,Aged, 80 and over ,Mini–Mental State Examination ,Helicobacter pylori ,medicine.diagnostic_test ,biology ,business.industry ,Amoxicillin ,Middle Aged ,Anti-Ulcer Agents ,medicine.disease ,biology.organism_classification ,Urease ,Anti-Bacterial Agents ,Regimen ,Treatment Outcome ,Neurology ,Gastric Mucosa ,Immunology ,Female ,Neurology (clinical) ,Cognition Disorders ,business ,medicine.drug - Abstract
Infectious agents have been proposed as potential causes of Alzheimer’s disease (AD). Recently, we documented a high prevalence of Helicobacter pylori (Hp) infection in patients with AD. We aim to access the effect of Hp eradication on the AD cognitive (MMSE: Mini Mental State Examination and CAMCOG: Cambridge Cognitive Examination for the Elderly) and functional (FRSSD: Functional Rating Scale for Symptoms of Dementia) status parameters. In the first part of the study, a total of 50 consecutive patients with AD and 30 age-matched anaemic controls underwent an upper gastrointestinal endoscopy, and gastric mucosal biopsies were obtained to detect the presence of Hp infection by histologic analysis and rapid urease test. Serum anti-Hp-specific IgG level was analysed by enzyme-linked immunosorbent assay. In the second part, Hp-positive AD patients received a triple eradication regimen (omeprazole, clarithromycin and amoxicillin), and all patients were followed up for 2 years, while under the same treatment with cholinesterase inhibitors. Hp was detected in 88% of AD patients and in 46.7% of controls (P < 0.001). Hp eradication was successful in 84.8% of treated patients. At the 2-year clinical endpoint, cognitive and functional status parameters improved in the subgroup of patients where Hp eradication was successful (P < 0.001 and P = 0.049 for MMSE and CAMCOG, respectively; P < 0.001 for FRSSD), but not in the other patients. Hp eradication may positively influence AD manifestations, suggesting a possible common link between Hp and AD. more...
- Published
- 2009
- Full Text
- View/download PDF
26. Prevalence, bowel habit subtypes and medical care-seeking behaviour of patients with irritable bowel syndrome in Northern Greece
- Author
-
Christos Koutras, Ioannis Pilpilidis, Konstantinos Tziomalos, Panagiotis Katsinelos, Grigoris Chatzimavroudis, Kostas Mimidis, Georgia Lazaraki, Jannis Kountouras, George Gelas, Christos Zavos, Irini Oikonomidou, and George Paroutoglou more...
- Subjects
Adult ,Diarrhea ,Male ,medicine.medical_specialty ,Constipation ,Population ,Prevalence ,Gastroenterology ,Irritable Bowel Syndrome ,Sex Factors ,Medical advice ,Internal medicine ,Epidemiology ,medicine ,Humans ,Prospective Studies ,Risk factor ,education ,Irritable bowel syndrome ,education.field_of_study ,Greece ,Hepatology ,business.industry ,Age Factors ,Urban Health ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,Quality of Life ,Female ,medicine.symptom ,business - Abstract
Although irritable bowel syndrome (IBS) prevalence ranges between 10 and 20% in the general population, it appears to be considerably undiagnosed with only 25-50% of patients with IBS seeking medical advice. The aim of this study was to determine the prevalence of IBS in Northern Greece and the prevalence by symptom subtype including diarrhoea-predominant IBS, constipation-predominant IBS (C-IBS) and mixed type IBS; to identify factors contributing to the development of this syndrome; to assess its effect on health-related quality of life and to evaluate the medical care-seeking behaviour of IBS patients.Between January 2004 and December 2007, 3112 participants were requested to fill out a questionnaire during an interview with a primary health care clinician. Data on participants' demographics, medical history, symptoms and earlier health care-seeking behaviour were also recorded. The Rome II criteria were used to establish the diagnosis of IBS. The impact of IBS on the quality of life was examined using the EuroQol with five domains (EQ-5D) measure of health status.Out of 2397 participants [704 men (29.4%), mean age 46.1+/-15.0 years] included, 373 (15.7%) reported gastrointestinal symptoms compatible with IBS of whom 136 (36.5%) suffered from diarrhoea-predominant IBS, 165 (44.2%) suffered from C-IBS and 72 (19.3%) suffered from mixed type IBS. IBS patients were more likely to be female living in an urban area compared with healthy controls (P=0.03 and 0.0001, respectively). A significant decrease in health-related quality of life (impairment in two or more of measured parameters) was noted in 246 (66%) IBS patients. Female sex, older age and housekeeping were associated with C-IBS (P=0.02, 0.001, and 0.001, respectively). Female sex and IBS-M were associated with health care-seeking behaviour.The prevalence of IBS in Northern Greece is relatively high, mainly affecting female participants living in urban areas. more...
- Published
- 2009
- Full Text
- View/download PDF
27. A comparative study of 50% dextrose and normal saline solution on their ability to create submucosal fluid cushions for endoscopic resection of sessile rectosigmoid polyps
- Author
-
Panagiotis Katsinelos, Grigoris Chatzimavroudis, Christos Zavos, Dimitris Paikos, George Paroutoglou, George Gelas, Jannis Kountouras, Konstantinos Karakousis, and Ioannis Pilpilidis
- Subjects
Adult ,Male ,medicine.medical_specialty ,Outcome measurements ,medicine.medical_treatment ,Treatment outcome ,Colonic Polyps ,Argon plasma coagulation ,Sodium Chloride ,Endoscopy, Gastrointestinal ,Double-Blind Method ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Endoscopic resection ,Prospective Studies ,Intestinal Mucosa ,Saline ,Aged ,Aged, 80 and over ,Sigmoid Diseases ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Intestinal Polyps ,Middle Aged ,Polypectomy ,Surgery ,Endoscopy ,Solutions ,Glucose ,Rectal Diseases ,Treatment Outcome ,Tonicity ,Female ,business ,Nuclear medicine - Abstract
Background EMR traditionally performed by using normal saline solution (NS) plus epinephrine (E) as a submucosal fluid cushion does not maintain the submucosal elevation for a prolonged time. It was hypothesized that 50% dextrose (D 50 ) plus E as a hypertonic, inexpensive, and easily available solution might be an ideal alternative for producing and maintaining more-prolonged mucosal elevation. Objective To evaluate D 50 +E versus NS+E during an EMR of sessile rectosigmoid polyps (>10 mm). Design A prospective, double-blind, randomized study that compared EMR by using either D 50 +E or NS+E submucosal fluid cushions. Setting Four tertiary endoscopic referral centers with 1370 polypectomies in 2006, performed by 5 experienced endoscopists. Patients Patients treated for sessile rectosigmoid polyps (>10 mm). Interventions Polypectomy with D 50 +E or NS+E submucosal fluid cushions. Main Outcome Measurements The duration of submucosal elevation, volume of solution, number of required injections to maintain the elevation, and observations for complications. Results Ninety-two sessile rectosigmoid polyps were removed. Injected solution volumes and the number of injections to maintain submucosal elevation were lower in the D 50 +E group than in the NS+E group ( P = .033 and P = .028, respectively). Submucosal elevation had a longer duration in the D 50 +E group ( P = .043). This difference mainly included large (≥20 mm) and giant (>40 mm) polyps. There were 6 and 1 cases of postpolypectomy syndrome in the D 50 +E and NS+E groups, respectively ( P = .01). Limitations May be limited by inexperienced endoscopist's lack of injection and polypectomy skills. Conclusions D 50 +E is superior to NS+E for an EMR, particularly in large and giant sessile polyps, but the risk of thermal tissue injury should be considered. more...
- Published
- 2008
- Full Text
- View/download PDF
28. Combination of endoprostheses and oral ursodeoxycholic acid or placebo in the treatment of difficult to extract common bile duct stones
- Author
-
Panagiotis Katsinelos, Grigoris Chatzimavroudis, George Paroutoglou, Christos Zavos, and Jannis Kountouras
- Subjects
Male ,Cholagogues and Choleretics ,medicine.medical_specialty ,medicine.medical_treatment ,Biliary Stenting ,Lithotripsy ,Placebo ,Gastroenterology ,Group B ,law.invention ,Sphincterotomy, Endoscopic ,Randomized controlled trial ,law ,Internal medicine ,Humans ,Medicine ,Aged ,Cholangiopancreatography, Endoscopic Retrograde ,Hepatology ,Common bile duct ,business.industry ,Ursodeoxycholic Acid ,Significant difference ,Ursodeoxycholic acid ,Choledocholithiasis ,Treatment Outcome ,medicine.anatomical_structure ,Female ,Stents ,business ,medicine.drug - Abstract
Background When common bile duct (CBD) stones cannot be removed after conventional endoscopic techniques or mechanical lithotripsy, biliary stenting serves for further planned endoscopic attempt of stone removal or operation. The aim of our study was to investigate the effect of ursodeoxycholic acid (UDCA) or placebo plus endoprostheses on stones’ fragmentation or size. Methods Forty-one patients with difficult to extract CBD stones were prospectively studied. They were randomised to receive either a 10 Fr straight plastic stent and oral 750 mg UDCA (group A, 21 patients) or placebo (group B, 20 patients) daily for 6 months. Results A total clearance of CBD was achieved in 16 patients (76.9%) of group A and 15 patients (75%) of group B. The stones remained unchanged in size in five patients (23.8%) of group A and five patients (25%) of group B. In seven patients (33%) of group A and five patients (25%) of group B a repeated ERCP demonstrated fragmentation of CBD stones that were easily extracted. A reduction in stones’ size was observed in 8 patients (38%) of group A (1.61 ± 0.32 cm before treatment vs. 1.21 ± 0.24 cm after treatment, p = 0.002) and 10 patients (50%) of group B (1.61 ± 0.35 cm before vs. 1.24 ± 0.22 cm after treatment, p = 0.001). There was no statistically significant difference on stone size reduction ( p = 0.602) and fragmentation ( p = 0.558) between the two groups. Conclusion The results of this study suggest that UDCA does not seem to contribute to the reduction in stones’ size or stones’ fragmentation during the endoprosthetic procedure. more...
- Published
- 2008
- Full Text
- View/download PDF
29. New Aspects of Helicobacter pylori Infection Involvement in Gastric Oncogenesis
- Author
-
Dimitrios Chatzopoulos, Christos Zavos, Panagiotis Katsinelos, and Jannis Kountouras
- Subjects
Helicobacter pylori ,biology ,Tumor suppressor gene ,Adenomatous polyposis coli ,Stem Cells ,Cancer ,Adenocarcinoma ,biology.organism_classification ,medicine.disease_cause ,medicine.disease ,Helicobacter Infections ,CDH1 ,Gene Expression Regulation, Neoplastic ,Loss of heterozygosity ,Cell Transformation, Neoplastic ,Stomach Neoplasms ,Immunology ,biology.protein ,medicine ,Humans ,Surgery ,Carcinogenesis ,Stomach cancer ,Germ-Line Mutation - Abstract
Gastric adenocarcinoma not located in the cardia still remains second only to lung cancer as the leading cause of cancer-related mortality worldwide, whereas adenocarcinoma of the cardia and gastroesophageal junction has been rapidly rising over the past two decades. Gastric malignancy can be subdivided into diffuse and intestinal pathologic entities that have different epidemiological and prognostic features. Various genetic and environmental factors lead to either abnormal gene overexpression or inappropriate expression of normal genes, whose products confer the malignant phenotype. Advances have been made in genetic changes mostly of the intestinal type; its development is probably a multistep process, as has been well described in colon carcinogenesis. Oncogene overexpression, tumor suppressor loss, and defective DNA mismatch repair is associated with gastric cancer. The most common genetic abnormalities tend to be loss of heterozygosity of particularly tumor suppressor p53 gene or "adenomatous polyposis coli" gene. The latter leads to gastric carcinogenesis through changes related to E-cadherin-catenin complex, which plays a critical role in normal tissue architecture maintenance. Mutation of any of its components results in loss of cell-cell adhesion, thereby contributing to malignancy. Putative trophic factors have also been involved in gastric oncogenesis. E-cadherin/CDH1 gene germline mutations have been recognized in families with an inherited predisposition to diffuse-type malignancy. This review focuses mainly on Helicobacter pylori infection involved in gastric carcinogenesis through various mechanisms, including repopulation of the stomach with bone marrow-derived stem cells that may facilitate gastric cancer progression, thereby necessitating eradication of this bacterium. more...
- Published
- 2008
- Full Text
- View/download PDF
30. Uncovered Hanaro Versus Luminex Metal Stents for Palliation of Malignant Biliary Strictures
- Author
-
Christos Zavos, Dimitris Paikos, Panagiotis Katsinelos, Grigoris Chatzimavroudis, George Paroutoglou, John Moschos, Evangelos Makrigiannis, and Jannis Kountouras
- Subjects
Male ,medicine.medical_specialty ,Cost effectiveness ,Biopsy ,medicine.medical_treatment ,Perforation (oil well) ,Prosthesis Design ,Stent patency ,Diagnosis, Differential ,Prosthesis Implantation ,Duodenal Neoplasms ,Occlusion ,Humans ,Medicine ,Prospective Studies ,cardiovascular diseases ,Prospective cohort study ,Digestive System Surgical Procedures ,Aged ,Cholangiopancreatography, Endoscopic Retrograde ,business.industry ,Palliative Care ,Gastroenterology ,Stent ,Patient survival ,Cholestasis, Extrahepatic ,equipment and supplies ,Surgery ,Pancreatic Neoplasms ,Treatment Outcome ,surgical procedures, operative ,Metals ,Female ,Gallbladder Neoplasms ,Stents ,Radiology ,Tomography, X-Ray Computed ,business ,Median survival ,Follow-Up Studies - Abstract
Background: Endoscopic stent insertion is the optimum method of palliation for malignant biliary obstruction. Various types of self-expanding metal stents have been introduced in the market. Whether one type of stents is superior to the others in terms of stent patency remains undefined. Goals: This randomized trial compared 2 uncovered metal stents with similar technical characteristics, but significant cost difference, in the palliation of inoperable malignant biliary strictures. Study: Ninety-two patients with inoperable biliary obstruction were randomized to receive either a 10-mm diameter Hanaro or Luminex uncovered metal stent. The duration of stent patency, the overall patient survival, the mechanism of stent occlusion, and the adverse events were analyzed. Results: Eighty-nine patients were included in the analysis; 44 received Hanaro stents and 45 Luminex stents. The overall median patency rates between the 2 stents did not differ (328 d for the Hanaro vs. 289d for the Luminex stent; P = 0.815). Similarly, no difference was found between the overall median survival rates by the 2 stents (347 d for the Hanaro vs. 307 d for the Luminex stent; P = 0.654). Two major procedure-related complications occurred, perforation (Hanaro stent) and proximal stent migration (Luminex stent). Stent occlusion requiring reintervention occurred in 25 patients (11 with the Hanaro vs. 14 with the Luminex stent; P = 0.521). Conclusions: The 2 uncovered metal stents are comparable in terms of placement, occlusion rates, overall stent patency, and patient survival; Hanaro stent insertion, however, seems to be a cost-saving strategy at least in Greece. more...
- Published
- 2008
- Full Text
- View/download PDF
31. Endoclipping-assisted Resection of Large Colorectal Polyps
- Author
-
Basilis Papaziogas, Panagiotis Katsinelos, Grigoris Chatzimavroudis, Ioannis Pilpilidis, Jannis Kountouras, Christos Zavos, Themistoklis Vasiliadis, and George Paroutoglou
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Perforation (oil well) ,Colonic Polyps ,Colonoscopy ,Carcinoma ,Humans ,Medicine ,CLIPS ,Aged ,Retrospective Studies ,computer.programming_language ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Middle Aged ,medicine.disease ,digestive system diseases ,Polypectomy ,Surgery ,Colon polyps ,Clinical trial ,surgical procedures, operative ,Female ,Colorectal Neoplasms ,business ,computer - Abstract
Background The use of endoclipping may minimize the risk of bleeding after endoscopic polypectomy of large pedunculated polyps. The aim of this study was to assess the safety and efficacy of endoclipping of the stalk before resection of large pedunculated colorectal polyps, drawing particular attention to the cases in which the use of this method could be very useful. Patients and methods This retrospective study included 17 patients [10 men, 7 women; median age: 62 y (range 38 to 79)] with 18 large pedunculated colorectal polyps, who underwent endoclipping-assisted endoscopic polypectomy between March 2003 and May 2006. The outcome of the technique and the technique-related complications were evaluated. Results Application of the clips was possible in all patients. In 4 patients (23.5%), the endoclipping was performed via the more flexible gastroscope. En bloc resection of colon polyps was achieved in all patients. No immediate or late bleeding or perforation occurred. One patient (5.9%) developed postcoagulation syndrome and was successfully treated conservatively. Histologic examination showed in situ carcinoma in 6 polyps (33.3%). Follow-up colonoscopy demonstrated no recurrence of polyps or cancer development. Conclusions Endoclipping, followed by snare transection, may be safer than conventional polypectomy in large pedunculated colorectal polyps. Special attention is needed not to cut very close to clips to avoid thermal injury of colonic wall. more...
- Published
- 2008
- Full Text
- View/download PDF
32. Association between Helicobacter pylori infection and mild cognitive impairment
- Author
-
Marina Boziki, Nikolaos Kapetanakis, Emmanuel Gavalas, Ioannis Venizelos, Christos Stergiopoulos, Dimitrios Chatzopoulos, Christos Zavos, Magda Tsolaki, and Jannis Kountouras
- Subjects
Male ,medicine.medical_specialty ,Atrophic gastritis ,Chronic gastritis ,Gastroenterology ,Helicobacter Infections ,Serology ,Internal medicine ,mental disorders ,Biopsy ,Confidence Intervals ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,Homocysteine ,Aged ,Aged, 80 and over ,Chi-Square Distribution ,Helicobacter pylori ,medicine.diagnostic_test ,biology ,business.industry ,Odds ratio ,Middle Aged ,medicine.disease ,biology.organism_classification ,Neurology ,Gastritis ,Immunoglobulin G ,Immunology ,Female ,Neurology (clinical) ,medicine.symptom ,Cognition Disorders ,business - Abstract
The association of Helicobacter pylori infection and Alzheimer's disease (AD) has recently been addressed, but no relative data exist regarding mild cognitive impairment (MCI), a prodromal phase of AD. The aim of this prospective study was to evaluate H. pylori infection, by histology in a Greek MCI cohort. Sixty-three consecutive patients with amnestic MCI and 35 normal controls underwent upper gastrointestinal endoscopy, histologic and serological examinations. The prevalence of H. pylori infection was 88.9% (56/63) in MCI patients and 48.6% (17/35) in anaemic controls, as confirmed by biopsy (P < 0.001, odds ratio: 8.47, 95% CI: 3.03-23.67). Mean serum anti-H. pylori IgG concentration and plasma total homocysteine (Hcy) titre were higher in MCI patients than controls (74.86 +/- 57.22 vs. 17.37 +/- 9.30 U/ml; and 16.03 +/- 4.28 vs. 13.5 +/- 1.20 micromol/l; P < 0.001 and P = 0.015, respectively). When compared with the anaemic participants, MCI patients exhibited more often multifocal (body and antral) gastritis (92.1% vs. 68.6%; P = 0.03); in H. pylori positive MCI patients cognitive state correlated with serum anti-H. pylori IgG concentration. In conclusion, H. pylori prevalence was significantly higher in MCI patients than controls. This infection might contribute, at least in part, to the pathophysiology of MCI, possibly through induction of chronic atrophic gastritis and elevated Hcy consequences. more...
- Published
- 2007
- Full Text
- View/download PDF
33. A comparative study of 10-Fr vs. 7-Fr straight plastic stents in the treatment of postcholecystectomy bile leak
- Author
-
Christos Zavos, Basilis Papaziogas, Panagiotis Katsinelos, Grigoris Chatzimavroudis, Jannis Kountouras, Dimitris Paikos, Ioannis Pilpilidis, George Germanidis, and George Paroutoglou
- Subjects
Male ,Leak ,medicine.medical_specialty ,Biliary Fistula ,medicine.medical_treatment ,Prosthesis Design ,Risk Assessment ,Postoperative Complications ,Humans ,Minimally Invasive Surgical Procedures ,Medicine ,Prospective Studies ,Aged ,Probability ,Cholangiopancreatography, Endoscopic Retrograde ,Chi-Square Distribution ,Endoscopic retrograde cholangiopancreatography ,medicine.diagnostic_test ,business.industry ,Bile duct ,Gallbladder ,Stent ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Cholecystectomy, Laparoscopic ,Biliary tract ,Pancreatitis ,Female ,Stents ,Cholecystectomy ,Bile Ducts ,business ,Plastics ,Follow-Up Studies - Abstract
Biliary decompression is a key factor in the treatment of postcholecystectomy bile leak. However, the optimal size of the stent introduced by therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is yet to be determined. The aim of the study was to compare the effectiveness of two straight plastic stents with different sizes (10-Fr and 7-Fr) in the treatment of postcholecystectomy bile leak. Between January 2003 and August 2006, 63 patients underwent therapeutic ERCP for postcholecystectomy bile leak. After visualization of the bile duct injury, endoscopic sphincterotomy was performed and the patients were randomized to receive either a 7-Fr (31 subjects, group A) or a 10-Fr (32 subjects, group B) straight plastic stent for four weeks. The success of the endoscopic treatment was determined by the elimination of the symptoms and the removal of the drain without any adverse outcomes. The endoscopic intervention was successful in 29 patients of group A (93.54%) and in 31 patients of group B (96.87%). In the remaining two patients of group A, the 7-Fr stent was substituted by a 10-Fr stent after 7 days because the leak remained unaffected, resulting in healing of the leaks. Surgery was required in the remaining one patient of group B. Eight patients developed post-ERCP pancreatitis (5 mild, 2 moderate, 1 severe), which was treated conservatively. This trial suggests that the stent size does not affect the outcome of the endoscopic intervention in postcholecystectomy bile leaks due to minor biliary tract injury; however, larger cohorts are required to confirm the optimal stent size in bile leaks due to major bile duct injury. more...
- Published
- 2007
- Full Text
- View/download PDF
34. Bone Marrow-Derived Stem Cells in Pathogenesis of Helicobacter pylori-Associated Gastrointestinal Cancer
- Author
-
Constantinos Kountouras, Christos Zeglinas, Jannis Kountouras, Ioannis Pilpilidis, Elizabeth Vardaka, Stergios A. Polyzos, Georgia Deretzi, Michael Vrettos, Nikolaos Kapetanakis, Panagiotis Katsinelos, and Christos Zavos more...
- Subjects
biology ,business.industry ,Gastroenterology ,Helicobacter pylori ,Ligand (biochemistry) ,biology.organism_classification ,medicine.disease ,Malignant transformation ,Pathogenesis ,medicine.anatomical_structure ,Immunology ,medicine ,Bone marrow ,Gastrointestinal cancer ,CXC chemokine receptors ,Stem cell ,business ,Letter to the Editor - Abstract
To the Editor: Yaghoobi1 discussed selected findings on how bone marrow-derived stem cells (BMDSCs) compromise local immunity and skip local defense mechanisms to undergo malignant transformation, and the role of CXC chemokine receptor type 4 (CXCR-4) through binding to its ligand stromal-derived factor in migration of BMDSCs involved in Helicobacter pylori (Hp)-related gastric cancer pathogenesis. more...
- Published
- 2015
35. Impact of Helicobacter pylori on multiple sclerosis-related clinically isolated syndrome
- Author
-
Panagiotis Katsinelos, Jannis Kountouras, Dimitrios Tsiptsios, Christos Zavos, Marina Boziki, Stergios A. Polyzos, Evangelos Koutlas, Ioannis Venizelos, Emmanuel Gavalas, Iakovos Tsiptsios, and Georgia Deretzi more...
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Gastroenterology ,Helicobacter Infections ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Clinical endpoint ,Prevalence ,Humans ,Expanded Disability Status Scale ,Clinically isolated syndrome ,biology ,Greece ,HLA-A Antigens ,Helicobacter pylori ,business.industry ,Multiple sclerosis ,General Medicine ,Middle Aged ,biology.organism_classification ,medicine.disease ,Regimen ,Titer ,030104 developmental biology ,Neurology ,HLA-B Antigens ,Case-Control Studies ,Cohort ,Immunology ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Demyelinating Diseases - Abstract
Objectives There are no data regarding the relationship between Helicobacter pylori infection (Hp-I) and clinically isolated syndrome (CIS) suggestive of multiple sclerosis. The purpose of this pilot study was to investigate the association between active Hp-I, confirmed by histology, and CIS and to evaluate the impact of Hp eradication on the CIS clinical course. Material and Methods We conducted a study on 48 patients with CIS and 20 matched controls. At baseline, apart from histology, serum anti-Hp-specific IgG titer, inflammatory mediators, and HLA-A, HLA-B, HLA-DR genetic polymorphisms were estimated. Hp-positive patients received standard triple eradication regimen, and all patients were followed up for 2 years. Results The prevalence of Hp-I was significantly higher in patients with CIS (43/48, 89.6%) than in control (10/20, 50%) (P more...
- Published
- 2015
36. Helicobacter pylori-related ApoE 4 polymorphism may be associated with dysphagic symptoms in older adults
- Author
-
Constantinos Kountouras, Christos Zavos, Fani Tsolaki, Jannis Kountouras, Emmanuel Gavalas, Marina Boziki, Panagiotis Katsinelos, Georgios I Tagarakis, Elizabeth Vardaka, Stergios A. Polyzos, Georgia Deretzi, and Magda Tsolaki more...
- Subjects
Apolipoprotein E ,Polymorphism, Genetic ,biology ,Helicobacter pylori ,business.industry ,Apolipoprotein E4 ,Gastroenterology ,General Medicine ,biology.organism_classification ,Helicobacter Infections ,03 medical and health sciences ,0302 clinical medicine ,Immunology ,Medicine ,Humans ,030211 gastroenterology & hepatology ,Apolipoprotein e4 ,business ,Deglutition Disorders ,030217 neurology & neurosurgery ,Aged - Published
- 2015
37. Tannenbaum and metal stents in the palliative treatment of malignant distal bile duct obstruction: a comparative study of patency and cost effectiveness
- Author
-
Athanasios Beltsis, G. Chatzimavroudis, Jannis Kountouras, Panagiotis Katsinelos, A Gatopoulou, Christos Zavos, George Paroutoglou, I Moschos, Dimitris Paikos, and Basilios Papaziogas
- Subjects
Male ,medicine.medical_specialty ,Palliative care ,Cost effectiveness ,Common Bile Duct Diseases ,Cost-Benefit Analysis ,medicine.medical_treatment ,Bile Duct Neoplasm ,Distal Common Bile Duct ,Cholestasis ,medicine ,Humans ,cardiovascular diseases ,Aged ,Aged, 80 and over ,Bile duct ,business.industry ,Palliative Care ,Stent ,Cholestasis, Extrahepatic ,Middle Aged ,equipment and supplies ,medicine.disease ,Surgery ,Pancreatic Neoplasms ,Survival Rate ,surgical procedures, operative ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Metals ,Biliary tract ,Female ,Stents ,Radiology ,business - Abstract
Stent clogging is the major limitation of palliative treatment for malignant biliary obstruction. Metal stents have much better patency than plastic stents, but are more expensive. Preliminary data suggest that the recently designed plastic (Tannenbaum) stent has better duration of patency than the polyethylene stent. This study aimed to compare the efficacy and cost effectiveness between the Tannenbaum stent without side holes and the uncovered metal stent for patients with malignant distal common bile duct obstruction.In this study, 47 patients (median age, 73 years, range, 56-86 years) with inoperable malignant distal common bile duct strictures were prospectively randomized to receive either a Tannenbaum stent (n = 24) or an uncovered self-expandable metal stent (n = 23). The patients were clinically evaluated, and biochemical tests were analyzed if necessary until their death or surgery for gastric outlet obstruction. Cumulative first stent patency and patient survival were compared between the two groups. Cost-effectiveness analysis also was performed for the two study groups.The two groups were comparable in terms of age, gender, and diagnosis. The median first stent patency was longer in the metal group than in the Tannenbaum stent group (255 vs 123.5 days; p = 0.002). There was no significant difference in survival between the two groups. The total cost associated with the Tannenbaum stents was lower than for the metal stents (17,700 vs 30,100 euros; p = 0.001), especially for patients with liver metastases (3,000 vs 6,900 euros; p0.001).Metal stent placement is an effective treatment for inoperable malignant distal common bile duct obstruction, but Tannenbaum stent placement is a cost-saving strategy, as compared with metal stent placement, especially for patients with liver metastases and expected short survival time. more...
- Published
- 2006
- Full Text
- View/download PDF
38. Prometheus’ Challenge: Molecular, Cellular and Systemic Aspects of Liver Regeneration
- Author
-
Jannis Kountouras, Payam S. Pahlavan, Christos Zavos, and Robert E. Feldmann
- Subjects
Liver cytology ,medicine.medical_treatment ,Liver transplantation ,Biology ,Liver disease ,medicine ,Animals ,Hepatectomy ,Humans ,Growth Substances ,Liver Diseases ,Growth factor ,medicine.disease ,Liver regeneration ,Liver Regeneration ,Liver Transplantation ,Cell biology ,Liver ,Immunology ,Cytokines ,Surgery ,Hepatocyte growth factor ,GDF15 ,Signal Transduction ,Transcription Factors ,medicine.drug - Abstract
The fascinating aspect of the liver is the capacity to regenerate after injury or resection. A variety of genes, cytokines, growth factors, and cells are involved in liver regeneration. The exact mechanism of regeneration and the interaction between cells and cytokines are not fully understood. There seems to exist a sequence of stages that result in liver regeneration, while at the same time inhibitors control the size of the regenerated liver. It has been proven that hepatocyte growth factor, transforming growth factor, epidermal growth factor, tumor necrosis factor-alpha, interleukins -1 and -6 are the main growth and promoter factors secreted after hepatic injury, partial hepatectomy and after a sequence of different and complex reactions to activate transcription factors, mainly nuclear factor kappaB and signal transduction and activator of transcription-3, affects specific genes to promote liver regeneration. Unraveling the complex processes of liver regeneration may provide novel strategies in the management of patients with end-stage liver disease. In particular, inducing liver regeneration should reduce morbidity for the donor and increase faster recovery for the liver transplantation recipient. more...
- Published
- 2006
- Full Text
- View/download PDF
39. Endoloop-assisted polypectomy for large pedunculated colorectal polyps
- Author
-
Athanasios Beltsis, I. Vasiliadis, Jannis Kountouras, G. Chatzimavroudis, Christos Zavos, George Paroutoglou, Basilios Papaziogas, Taxiarchis Katsinelos, and Panagiotis Katsinelos
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Colonic Polyps ,Lumen (anatomy) ,Rectum ,Hemorrhage ,Endoscopic polypectomy ,Left colon ,medicine ,Humans ,Colonoscopic Polypectomy ,Intraoperative Complications ,Ligation ,Digestive System Surgical Procedures ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,General surgery ,Intestinal Polyps ,Colonoscopy ,Equipment Design ,Middle Aged ,Surgical Instruments ,Polypectomy ,Surgery ,Endoscopy ,Rectal Diseases ,medicine.anatomical_structure ,Female ,business ,Abdominal surgery - Abstract
The use of an endoloop may minimize the risk for bleeding after endoscopic polypectomy of large colorectal polyps. This study aimed to assess the safety and efficacy of colonoscopic ligation of the stalk of large pedunculated polyps by means of an endoloop technique, and to focus particular attention on the instances in which the use of this device was unsuccessful.This study retrospectively evaluated attempted endoloop endoscopic polypectomy in 33 patients (19 men and 14 women; mean age, 62.5 years) with large pedunculated polyps.Application of the endoloop was impossible in four patients, and the snare became entangled with the loop in one patient. The remaining 28 patients underwent endoloop-assisted polypectomy. Bleeding occurred in four patients, either because the loop slipped of the stalk after polypectomy (2 patients) or because a thin stalk (or = 4 mm) was transected by the loop before polypectomy (2 patients).Colonoscopic polypectomy with an endoloop may be safer than conventional polypectomy. The reasons for technical failure of this technique include a narrow left colon lumen, a thin stalk (or = 4 mm), and close cutting in relation to the site of encirclement by the loop. more...
- Published
- 2006
- Full Text
- View/download PDF
40. Severe acute haemorrhagic gastritis controlled by hydrogen peroxide
- Author
-
Kostas Mimidis, Panagiotis Katsinelos, Athanasios Beltsis, Jannis Kountouras, Ioannis Pilpilidis, Christos Zavos, and George Paroutoglou
- Subjects
medicine.medical_specialty ,Haemorrhagic gastritis ,Controlled studies ,Gastroenterology ,Hemostatics ,chemistry.chemical_compound ,Internal medicine ,Humans ,Medicine ,Stomach Ulcer ,Hydrogen peroxide ,Aged, 80 and over ,Hepatology ,Hemostatic Techniques ,business.industry ,Acute haemorrhagic gastritis ,Anti-Inflammatory Agents, Non-Steroidal ,Hydrogen Peroxide ,Hemostatic technique ,Peptic Ulcer Hemorrhage ,chemistry ,Gastritis ,Female ,medicine.symptom ,business - Abstract
A 92-year-old woman presented with severe acute haemorrhagic gastritis due to abuse of non-steroidal anti-inflammatory drugs (NSAIDs). She was treated with instillation of 150 ml 3% hydrogen peroxide (H2O2) every 2 h via a nasogastric tube. The copious amount of bright red blood through the nasogastric tube started to decline substantially after the first administration of H2O2 and continued to reveal clear material during the second and third instillation of H2O2. The total amount of H2O2 administered was 600 ml. No rebleeding and only a few flame-shaped intramucosal haemorrhages were observed on the following four consecutive daily endoscopic evaluations. These are promising observations which will have to be confirmed with respect to the safety and efficacy of H2O2 treatment by further controlled studies. more...
- Published
- 2006
- Full Text
- View/download PDF
41. Non-invasive cardiologic findings in patients with malignant melanoma*
- Author
-
Fotini Christidou, Leora Moldovan, Charalampos Andreadis, Christos Zavos, Despina Mouratidou, Dimitrios Platogiannis, and Theodoros Bischiniotis
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Heart disease ,Autopsy ,Dermatology ,Pericardial effusion ,QT interval ,Heart Neoplasms ,Electrocardiography ,QRS complex ,Internal medicine ,medicine ,Humans ,PR interval ,Melanoma ,business.industry ,Middle Aged ,medicine.disease ,Confidence interval ,Oncology ,Effusion ,Echocardiography ,Cardiology ,Female ,business - Abstract
Although malignant melanoma has a great propensity (38-50%) for cardiac involvement, as indicated by autopsy findings, cardiac metastases are rarely identified ante-mortem. The aim of this study was to record abnormal electrocardiographic and echocardiographic findings in patients with malignant melanoma. One hundred and eighty-five consecutive patients (male/female, 99/86; mean age, 59.6 years) with histologically proven malignant melanoma (American Joint Committee on Cancer stages II-IV), and with no known history of heart disease, were evaluated prospectively over a period of 11 years. The cardiologic findings considered were an unexpected delayed conduction of an electrical stimulus, recorded by high-resolution signal-averaged electrocardiogram (presence of ventricular late potentials), prolongation of the PR, QRS and QTc segments in a surface electrocardiogram, and abnormal Q waves. Echocardiographic findings comprised pericardial implantation/effusion or presence of intracavitary/intramyocardial metastases. Forty-one abnormal findings were recorded, pertaining to 38 of the 185 patients (19.5%). In particular, PR interval prolongation was found in eight patients (4.3%) and QTc interval prolongation in 11 (6%). Abnormal Q waves were recorded in five patients (2.7%). The filtered QRS interval was prolonged in seven patients (3.8%). Finally, echocardiographic examination showed discrete pericardial implantations and small to moderate pericardial effusion in six patients (3.2%) and intracavitary/intramyocardial metastases in four (2.1%). The median survival of these patients was 33 months (95% confidence interval, 19.9-46.1 months). It can be concluded that abnormal electrocardiographic and echocardiographic findings are recorded at the time of diagnosis of the disease in a significant percentage of patients with malignant melanoma. more...
- Published
- 2005
- Full Text
- View/download PDF
42. Intravenous N-acetylcysteine does not prevent post-ERCP pancreatitis
- Author
-
Athanasios Beltsis, Christos Zavos, Jannis Kountouras, Panagiotis Katsinelos, Kostas Mimidis, and George Paroutoglou
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pancreatic disease ,medicine.medical_treatment ,Placebo ,Severity of Illness Index ,Gastroenterology ,Loading dose ,Antioxidants ,Drug Administration Schedule ,Double-Blind Method ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Saline ,Aged ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Pancreatitis, Acute Necrotizing ,business.industry ,Incidence (epidemiology) ,Middle Aged ,medicine.disease ,Treatment Outcome ,Amylases ,Injections, Intravenous ,Cystine ,Acute pancreatitis ,Pancreatitis ,Female ,Complication ,business ,Follow-Up Studies - Abstract
Background Acute pancreatitis remains the most common complication of ERCP. Prophylactic administration of N-acetylcysteine (NAC) probably decreases the incidence and the severity of experimental pancreatitis. The aim of the present study was to assess the efficacy of intravenous NAC for prevention of post-ERCP pancreatitis in humans, who represent an appropriate model to study the potential role of NAC in this setting. Methods A prospective, double-blind, placebo-controlled trial was conducted in 256 patients who underwent ERCP. Patients were randomized to receive intravenous NAC at a loading dose of 70 mg/kg 2 hours before and 35 mg/kg at 4-hour intervals for a total of 24 hours after the procedure, or to receive normal saline solution as placebo. Patients were clinically evaluated, and serum amylase levels were measured before and 6 hours and 24 hours after the procedure. Standardized criteria were used to diagnose and to grade the severity of post-ERCP pancreatitis. Results A total of 249 patients were included in the analysis. The two groups were matched for age, gender, underlying disease and indication for treatment, ERCP findings, and type of treatment. The overall incidence of post-ERCP acute pancreatitis was 10.8%, with 12.1% in the NAC group and 9.6% in the placebo group. There were no statistical differences in the incidence or severity grades between the groups. The mean duration of hospitalization for pancreatitis also was similar in the NAC group and the placebo group (3.6 ± 0.9 and 3 ± 1.5 days, respectively). Conclusions The results of this trial show the absence of any beneficial effect of NAC on the incidence and the severity of ERCP-induced pancreatitis. more...
- Published
- 2005
- Full Text
- View/download PDF
43. New Molecular Concepts of Barrett’s Esophagus: Clinical Implications and Biomarkers
- Author
-
Jannis Kountouras, Christos Zavos, Dimitrios Chatzopoulos, and Athanassios Kyrgidis
- Subjects
medicine.medical_specialty ,Esophageal Neoplasms ,Receptor, ErbB-2 ,Adenomatous Polyposis Coli Protein ,Adenocarcinoma ,Gastroenterology ,Endoscopy, Gastrointestinal ,Barrett Esophagus ,Risk Factors ,Internal medicine ,Metaplasia ,Biomarkers, Tumor ,medicine ,Humans ,Cyclin D1 ,Esophagus ,Risk factor ,Clinical Trials as Topic ,business.industry ,Esophageal disease ,NF-kappa B ,Membrane Proteins ,Cadherins ,medicine.disease ,Up-Regulation ,Gene Expression Regulation, Neoplastic ,Survival Rate ,medicine.anatomical_structure ,Cyclooxygenase 2 ,Prostaglandin-Endoperoxide Synthases ,Barrett's esophagus ,Gastroesophageal Reflux ,GERD ,Surgery ,Tumor Suppressor Protein p53 ,medicine.symptom ,Colorectal Neoplasms ,business ,Biomarkers ,Chemoradiotherapy - Abstract
Barrett's esophagus (BE) represents the most serious histological consequence of gastroesophageal reflux disease (GERD) that develops in 5-10% of patients with GERD. Given that BE is the only known precursor to esophageal adenocarcinoma (EA), a systematic endoscopic biopsy protocol can detect EAs at an early stage. However, endoscopic and histopathological evaluation of BE are not adequate for effective screening of high risk patients. Therefore, molecular abnormalities associated with BE have been considered as surrogate markers and their use as such is proposed. Flow cytometry is the most useful adjunct to histology, and ploidy status of BE is an independent risk factor. Cyclin D1 overexpression is inversely correlated with survival in EA. C-erbB2 (+) patients have poorer prognosis. High plasma adenomatous polyposis coli levels correlate with reduced patient survival. p53 expression allows patient risk for EA stratification. Nuclear factor-kappaB overexpression inversely correlates with good response to adjuvant chemotherapy and radiotherapy in EA. Patients with cyclooxygenase-2 overexpression have reduced survival rates. Increased E-cadherin staining is associated with shorter survival in EA patients who received chemoradiotherapy. Finally, existing data cannot rule out a correlation between EA and colorectal tumors. Seventeen BE molecular alterations yielded noteworthy clinical implications. Apart from endoscopy and histology, these data allow for better risk stratification for patients with BE and for more efficient and timely therapeutic approaches. more...
- Published
- 2005
- Full Text
- View/download PDF
44. High-dose allopurinol for prevention of post-ERCP pancreatitis: a prospective randomized double-blind controlled trial
- Author
-
Athanasios Beltsis, Josef Chatzis, George Paroutoglou, K. Christodoulou, Christos Zavos, Jannis Kountouras, Panagiotis Katsinelos, and Kostas Mimidis
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pancreatic disease ,medicine.drug_class ,Allopurinol ,Placebo ,Gastroenterology ,law.invention ,Double-Blind Method ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,Xanthine oxidase inhibitor ,Aged ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,business.industry ,Free Radical Scavengers ,Middle Aged ,medicine.disease ,digestive system diseases ,Surgery ,Clinical trial ,surgical procedures, operative ,Pancreatitis ,Female ,business ,medicine.drug - Abstract
Pancreatitis is the most common major complication of diagnostic and therapeutic ERCP. Allopurinol, a xanthine oxidase inhibitor that blocks generation of oxygen-derived free radicals, potentially may prevent post-ERCP pancreatitis. This study assessed the efficacy of high-dose oral allopurinol for prevention of post-ERCP pancreatitis.A prospective, double-blind, placebo-controlled trial was conducted in 250 patients undergoing ERCP. Patients were randomized to receive allopurinol (600 mg) or placebo orally at 15 and 3 hours before the procedure. Patients were clinically evaluated, and serum amylase levels were determined before ERCP and at 6 and 24 hours thereafter. Standardized criteria were used to diagnose and to grade the severity of post-ERCP pancreatitis.A total of 243 patients were included in the analysis. The two groups were similar with regard to age; gender; underlying disease; indication for treatment; ERCP findings; and type of treatment, except for biliary sphincterotomy. Only 43 patients in the allopurinol group underwent biliary sphincterotomy vs. 87 in the placebo group ( p0.001). The frequency of acute pancreatitis was significantly lower in the allopurinol vs. the placebo group in the final multinomial regression analysis: allopurinol group, 4/125 (3.2%), with all 4 cases graded as mild, vs. placebo group, 21/118 (17.8%), of which 8/118 (6.8%) were graded as mild, 11/118 (9.3%) as moderate, and 2/118 (1.6%) as severe with fatal outcome ( p0.001). The protective effect of allopurinol was also apparent in the diagnostic ERCP and the biliary sphincterotomy subgroups when the frequency of post-ERCP pancreatitis was analyzed after stratification by procedure. The mean duration of hospitalization for pancreatitis was significantly shorter in the allopurinol compared with the placebo group (2.5 vs. 5.67 days; p0.001).Pretreatment with high-dose, orally administered allopurinol decreases the frequency of post-ERCP pancreatitis. Despite the promising results of this prospective, randomized trial, further studies are needed to verify these observations before allopurinol can be recommended for routine clinical use. more...
- Published
- 2005
- Full Text
- View/download PDF
45. Association between Helicobacter pylori infection and acute inflammatory demyelinating polyradiculoneuropathy
- Author
-
Dimitrios Chatzopoulos, T. Nicolaides, Ioannis Venizelos, Jannis Kountouras, Christos Zavos, Georgia Deretzi, L. Touloumis, and P. Karatzoglou
- Subjects
Adult ,Male ,Adolescent ,Neural Conduction ,Enzyme-Linked Immunosorbent Assay ,Guillain-Barre Syndrome ,Asymptomatic ,Helicobacter Infections ,medicine ,Animals ,Humans ,Aged ,Aged, 80 and over ,Helicobacter pylori ,biology ,Guillain-Barre syndrome ,business.industry ,Autoantibody ,Polyradiculoneuropathy ,Iron deficiency ,Middle Aged ,medicine.disease ,biology.organism_classification ,Titer ,Neurology ,Immunoglobulin G ,Immunology ,biology.protein ,Female ,Neurology (clinical) ,medicine.symptom ,Antibody ,business - Abstract
The aim of this study was to investigate a possible association between Helicobacter pylori infection and acute inflammatory demyelinating polyradiculoneuropathy (AIDP). Of 17 consecutive patients with Guillain-Barre syndrome (GBS), 13 patients (six females; mean age 50 +/- 24 years) with AIDP were investigated. Clinical status was evaluated according to Hughes' score, and electrophysiological tests were performed within 2 weeks from disease onset. Helicobacter pylori infection was detected histologically and serum H. pylori-specific IgG antibodies were analysed by ELISA. Twenty asymptomatic patients (12 females; mean age 63 +/- 8 years), undergoing upper gastrointestinal endoscopy for investigation of mild iron deficiency anaemia, served as controls. Helicobacter pylori was found in 12 of 13 AIDP patients (92%), and in 10 of 20 controls (50%), (P = 0.02). Electrophysiological studies showed demyelination in all AIDP patients. High levels of anti-H. pylori IgG antibodies correlated with advanced clinical status. Five of seven AIDP patients with high levels of anti-H. pylori IgG antibodies had delayed F-wave latencies, indicating affection of proximal segments of peripheral nerves. Helicobacter pylori infection seems to be more frequent in AIDP patients. Anti-H. pylori titre might reflect advanced clinical status. Anti-H. pylori IgG antibodies are also associated with involvement of the proximal parts of peripheral nerves in AIDP. more...
- Published
- 2005
- Full Text
- View/download PDF
46. A concept on the role of Helicobacter pylori infection in autoimmune pancreatitis
- Author
-
Dimitrios Chatzopoulos, Christos Zavos, and Jannis Kountouras
- Subjects
Male ,Pathology ,medicine.medical_specialty ,T-Lymphocytes ,Apoptosis ,Autoimmune hepatitis ,medicine.disease_cause ,Models, Biological ,Autoimmune Diseases ,Helicobacter Infections ,Autoimmunity ,Sex Factors ,Primary biliary cirrhosis ,medicine ,Humans ,Pancreas ,Autoimmune pancreatitis ,Pancreatic duct ,Helicobacter pylori ,business.industry ,Molecular Mimicry ,Autoantibody ,Cell Biology ,Medical Hypothesis ,medicine.disease ,Molecular mimicry ,medicine.anatomical_structure ,Pancreatitis ,Molecular Medicine ,Female ,business - Abstract
Autoimmune pancreatitis, an inflammatory process of the pancreas due to an autoimmune mechanism establishing etiology of chronic pancreatitis, is characterized by the presence of autoantibodies, hypergammaglobulinemia, pancreatic enlargement, pancreatic duct strictures, and pathologic features of fibrotic changes with intense, mainly lymphocytic infiltrations, which may contribute to tissue destruction probably by apoptosis. In almost 60% of the cases, this type of pancreatitis coexists with other autoimmune diseases such as Sjogren's syndrome, sclerosing extrahepatic cholangitis, primary biliary cirrhosis, autoimmune hepatitis, or other extrapancreatic disorders, and recently with gastric peptic ulceration. The diversity of extrapancreatic lesions with similar histopathologic findings suggests general involvement of the digestive system in this disease, although the presence of such involvement has not been fully elucidated. Similarly, Helicobacter pylori (H. pylori) infection, a well known cause of gastric ulcer, has been associated, via molecular mimicry of host structures by its constituents with the same autoimmune conditions, also characterized by fibrotic changes and/or lymphoplasmacytic inflammations, accompanied by aberrations of T cell apoptosis that contribute to hepatobiliary- or extrahepatic-tissue destruction. Considering that H. pylori is involved in the pathogenesis and pathophysiology of these autoimmune disorders, we propose that this organism might trigger autoimmune pancreatitis through induction of autoimmunity and apoptosis. more...
- Published
- 2005
- Full Text
- View/download PDF
47. A hypothesis on the role of insulin-like growth factor I in testicular germ cell tumours
- Author
-
Despina Mouratidou, Christos Zavos, Charalampos Andreadis, and Nikolaos Diamantopoulos
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Biology ,Models, Biological ,Neovascularization ,Pathogenesis ,Insulin-like growth factor ,Testicular Neoplasms ,Prostate ,Internal medicine ,Acromegaly ,Biomarkers, Tumor ,medicine ,Animals ,Humans ,Insulin-Like Growth Factor I ,Lung cancer ,Clinical Trials as Topic ,Evidence-Based Medicine ,Growth factor ,Cancer ,General Medicine ,medicine.disease ,Germ Cells ,medicine.anatomical_structure ,Endocrinology ,Cancer research ,Germinoma ,medicine.symptom - Abstract
It has already been established that the growth effects of growth hormone (GH) are mediated through insulin-like growth factor I (IGF-I). Recent studies demonstrated a relationship between IGF-I levels and various types of cancer, namely colon, prostate, breast, brain and lung cancer. In addition, many experimental observations documented a participation of the IGF-I system in tumourigenesis through enhanced cell proliferation rate, anti-apoptotic functions and stimulation of neovascularization. With the present known biological mechanisms, implicated in the pathogenesis of testicular germ cell tumours (GCT), it is difficult to interpret the consistently increasing incidence of this tumour over the last decades. On the other hand, unpublished data of our department are in accordance with previous published studies, suggesting that GCT may be positively associated with body height. Scattered publications report development of GCT secondary to acromegaly or long-term GH replacement therapy. Thus, it is possible that the IGF-I system may be implicated in this pathogenesis, thereby predisposing to an increased risk of testicular GCTs. If IGF-I and IGFBP-3 are found to correlate with a high incidence of testicular GCT, they might be useful surrogate markers for diagnosis and surveillance of tumour growth, and an early screening method to identify an increased risk of this type of cancer in the first degree young male relatives of these patients. more...
- Published
- 2004
- Full Text
- View/download PDF
48. Increased levels of Helicobacter pylori IgG antibodies in aqueous humor of patients with primary open-angle and exfoliation glaucoma
- Author
-
Anna Boukla, Anastasios G. P. Konstas, Jannis Kountouras, Christos Zavos, Nikolaos Mylopoulos, and Dimitrios Chatzopoulos
- Subjects
Adult ,medicine.medical_specialty ,genetic structures ,Open angle glaucoma ,Spirillaceae ,Eye disease ,Glaucoma ,Exfoliation Syndrome ,Cataract ,Immunoglobulin G ,Aqueous Humor ,Cellular and Molecular Neuroscience ,Ophthalmology ,Odds Ratio ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Aged, 80 and over ,Helicobacter pylori ,biology ,business.industry ,Osmolar Concentration ,Case-control study ,Middle Aged ,biology.organism_classification ,medicine.disease ,Antibodies, Bacterial ,eye diseases ,Sensory Systems ,Surgery ,Case-Control Studies ,biology.protein ,sense organs ,business ,Glaucoma, Open-Angle - Abstract
A prospective, nonrandomized, comparative study was carried out to investigate the levels of anti- H. pylori-specific IgG antibodies in the aqueous humor and serum of patients with primary open-angle glaucoma (POAG) and patients with exfoliation glaucoma (XFG), and to compare them with those in age-matched cataract patients.Aqueous humor was aspirated at the beginning of glaucoma surgery from 26 eyes of 26 patients with POAG, 27 eyes of 27 patients with XFG, and at the beginning of phakoemulsification cataract surgery from 31 eyes of 31 age-matched normotensive cataract patients. Serum samples were obtained the day before surgery from all patients. Anti- H. pylori IgG concentration in the aqueous humor and serum was measured by means of an enzyme-linked immunosorbent assay.The mean concentration (+/- SE) of anti- H. pylori-specific IgG was significantly greater in the aqueous humor samples from patients with POAG (14.27+/-3.86 U/ml) and XFG (14.25+/-3.39 U/ml) than in those from age-matched control cataract patients (4.67+/-1.07 U/ml); ( P=0.006 and P=0.003, respectively). No difference was observed in the levels of H. pylori-specific IgG antibodies between POAG and XFG aqueous humor samples ( P=0.5). Similarly, the serum concentration of anti- H. pylori antibodies was significantly greater in patients with POAG (69.96+/-9.69 U/ml; P=0.013) and XFG (81.37+/-10.62 U/ml; P=0.002) than in the cataract controls (44.16+/-6.48 U/ml). The mean vertical cupping correlated significantly with the titer of anti- H. pylori-specific IgG in the aqueous humor in the POAG patients.H. pylori-specific IgG antibody levels are significantly increased in the aqueous humor and serum of patients with POAG and XFG. Moreover, the titer of anti- H. pylori antibody in the aqueous humor might reflect the severity of glaucomatous damage in POAG patients. These findings support a role for H. pylori infection in the pathobiology of these two common glaucomas. more...
- Published
- 2003
- Full Text
- View/download PDF
49. Apoptosis, Inflammatory Bowel Disease and Carcinogenesis: Overview of International and Greek Experience
- Author
-
Nikolaos Zavos, Dimitrios Chatzopoulos, Christos Zavos, Georgios Kouklakis, Jannis Kountouras, John Moschos, and Epaminodas Molyvas
- Subjects
Necrosis ,T-Lymphocytes ,Apoptosis ,Disease ,Global Health ,medicine.disease_cause ,Inflammatory bowel disease ,Antibodies ,Animals ,Humans ,Medicine ,Intestinal Mucosa ,lcsh:RC799-869 ,Tissue homeostasis ,Caspase ,Greece ,biology ,Interleukin-6 ,Tumor Necrosis Factor-alpha ,business.industry ,Interleukins ,Gastroenterology ,Cancer ,General Medicine ,Inflammatory Bowel Diseases ,medicine.disease ,Interleukin-12 ,Cell Transformation, Neoplastic ,Drug Design ,Colonic Neoplasms ,Immunology ,biology.protein ,lcsh:Diseases of the digestive system. Gastroenterology ,medicine.symptom ,business ,Carcinogenesis - Abstract
Apoptosis is critical for organ development, tissue homeostasis, the elimination of abnormal cells and the maintenance of immune homeostasis by variable regulatory mechanisms. The death of T lymphocytes following their activation involves a series of proteases (caspases), which comprise the central executioners of apoptosis. Abnormal regulation of apoptosis results in disease. T-cell resistance against apoptosis contributes to inappropriate T-cell accumulation and the perpetuation of the chronic inflammatory process in inflammatory bowel disease with potential tumourigenic effect. The use of antitumour necrosis factor-alpha, anti-interleukin-6R and anti-interleukin-12 antibodies suppresses colitis activity by induction of T-cell apoptosis, thereby having important implications for the design of effective therapeutic strategies in inflammatory bowel diseases. Contrary to international data, the incidence of cancer in Greek patients with inflammatory bowel disease appears to be low. A balance between cell proliferation (Ki-67 overexpression) and apoptosis (Bax protein overexpression) may partly explain the low incidence of cancer development in Greek inflammatory bowel disease patients. more...
- Published
- 2003
50. Spondylodiscitis complicating cholangitis caused by stent occlusion
- Author
-
Panagiotis Katsinelos, Grigoris Chatzimavroudis, Jannis Kountouras, Sotiris Terzoudis, Christos Zavos, and Kostas Fasoulas
- Subjects
Spondylodiscitis ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Stent ,medicine.disease ,Stent occlusion ,Surgery ,Occlusion ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,Complication ,business ,Spondylitis ,Biliary tract disease - Published
- 2011
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.