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Biomedical subjects

E Frangoulis

Publications and source records attributed to E Frangoulis.

12 recordsLinked to original sources

Superficial mycoses due to Trichophyton violaceum in Athens, Greece: a 15-year retrospective study.

This is a retrospective study on the superficial mycoses due to Trichophyton violaceum in the greater Athens area for the last 15 years - 1989-2003. During this period 104 patients were found to have an infection due to T. violaceum- an incidence rate of 0.75% of all dermatophytosis. Of the patients 59 were Greeks, 15 Greek Gypsies and 30 immigrants mostly from Albania (50%). Of them 58 were children, 46 adults (mainly women, 34 cases). Trichophyton violaceum infection was presented with a variety of manifestations (127 cases). The prevailing was tinea capitis present in 85 patients - 57 children, 24 women and four men (women : men 6 : 1). Tinea capitis together with other forms of the infection was found in 14 patients. Tinea facie, corporis, manuum, barbae and unguium were seen in nineteen patients. The isolation rate of T. violaceum infection in the Greek population remained at a low level for three decades after the mid-1960s. However, a substantial increase in the isolation rate is observed in the mid-1990s attributed mainly to the influx of economic immigrants from countries where the infection is endemic.

Adolescent↗

Is itraconazole the treatment of choice in Microsporum canis tinea capitis?

Mycotic scalp infection caused by Microsporum canis is the most dominant cause of tinea capitis in Greece. Griseofulvin has been the gold standard for the treatment of tinea capitis, but it is unavailable in our country. In this study, we evaluated 111 children with M. canis tinea capitis that were treated with itraconazole. Eighty-one of them were treated with itraconazole capsule pulse therapy (group A) and 30 (group B) were treated with oral suspension administered in continuous regimen. Twenty-one patients, all from group A, were lost to follow-up, probably due to the length of this regimen. In all patients that made up the study protocol, complete cure was achieved within seven pulses for group A and 12 weeks for group B. No significant side effects to lead to the cessation of therapy were recorded. Laboratory investigations were performed in 32 randomly chosen patients and were within normal ranges. The response to therapy did not appear to depend upon the formulation administered (capsules versus suspension). Using the pulse regimen, we also believe that it is necessary to individualize the number of pulses administered according to the clinical response. In conclusion, itraconazole proved safe and effective in our study, providing an ideal alternative to griseofulvin.

Adolescent↗

Etiology of tinea capitis in Athens, Greece -- a 6-year (1996-2001) retrospective study.

A total of 577 patients with tinea capitis have been diagnosed at the Mycology laboratory of 'A. Sygros' Hospital of Skin and Venereal Diseases, Athens, Greece between 1996 and 2001. From these patients, 100 were immigrants from Balkan, Near East and African countries. The vast majority of the patients (95%) were children, mainly at preschool and school age and only 5% were adults. Zoophilic dermatophytes accounted for 86.5% followed by anthropophilic (12.4%) and geophilic (1.2%) dermatophytes. The majority of anthropophilic infections (59.5%) were recorded in the sub-population of immigrants. Microsporum canis (84.5%) was the main etiologic agent.

Adolescent↗

Identification of Malassezia species from patient skin scales by PCR-RFLP.

OBJECTIVE: This study was aimed at the development of a DNA-based procedure directly applicable to pathological skin scales and at the assessment of its value in rapid laboratory confirmation and identification of each of the seven Malassezia species. These lipophilic basidiomycetous yeasts in predisposed individuals are involved in pityriasis versicolor, seborrheic dermatitis, blepharitis, folliculitis, atopic dermatitis and fungemia. Standard identification procedures to species level are available, but so far no system for direct detection and characterization of Malassezia species in clinical specimens is available. METHODS: Malassezia DNA was extracted from pathological skin scales by a modified hexadecyltrimethylammonium bromide (CTAB) method and amplified by single and nested polymerase chain reaction (PCR), assays using the general fungal ITS 1/4 and 3/4 primers for amplification of sequences from the Malassezia major ribosomal DNA complex. Restriction fragment length polymorphism (RFLP) analysis of PCR products was used in subsequent species identification. DNA extracted from culture-positive skin scales was also tested by PCR and the RFLP patterns obtained were analyzed. RESULTS: A total of 36 isolates were tested. Distinct pure culture and skin-scale ITS 3/4 HinfI and AluI restriction patterns differentially identified M. furfur, M. globosa, M. restricta, M. sympodialis, M. pachydermatis, M. obtusa and M. slooffiae. Malassezia DNA was extracted from pathological skin scales and RFLP identified solitary and multiple Malassezia species in the same specimen. Molecular identification was confirmed by cultures and biochemical tests. Concurrent detection and identification of Candida and Yarrowia species was also feasible from skin scales. CONCLUSION: The proposed method, described for the first time, could provide a sensitive and rapid detection and identification system for Malassezia species, which may be applied to epidemiological surveys and routine practice.

Animals↗

Rhodotorula rubra fungaemia in an immunosuppressed patient.

We report the case of a patient who, following surgical removal of an extensive tumour of the bowel, developed fungaemia. The yeast was isolated from repeated blood and urine cultures and identified as Rhodotorula rubra on the basis of macroscopic and microscopic features. Following treatment with amphotericin B, the patient's condition improved and the cultures became sterile.

Amphotericin B↗

Prevalence of hepatitis A, B, and C markers in school children of a rural area of Crete, Greece.

OBJECTIVE: To determine the prevalence of hepatitis A, B, and C markers in children who were attending junior and senior high schools in a high risk area in rural Crete, Greece. METHODS: Three-hundred and thirty-four children who attended the three junior schools and one senior high school in the Agios Vassilios province of Southern Crete were invited to participate in the study. Three hundred and four of them were tested for hepatitis A, B, and C markers. Hepatitis B (HBV) markers (HBsAg and anti-HBc) as well as hepatitis A (anti-HAV) and hepatitis (anti-HCV) antibodies were tested with commercial enzyme-linked immunosorbent assay kits. RESULTS: Six of the 304 children (1.97%) were found to be positive for anti-HAV, 1 (0.33%) to HBsAg, 7 (2.30%) to anti-HBc and none were found positive for anti-HCV. No significant differences were seen between the prevalence of anti-HAV antibodies in males (2%) and females (1.95%), and of anti-HBc antibodies in males (3.33%) and females (1.30%). CONCLUSIONS: The very low prevalence of anti-HAV is obviously due to the improved conditions of hygiene and it raises the question of the possible emergence of this disease at an older age and therefore appropriate preventative strategies should be considered. The low endemicity of hepatitis B in Crete in contrast to other areas of Greece also calls for a vaccination policy probably during adolescence. The absence of hepatitis C markers in the children in contrast to the observed higher prevalence of HCV-infected people in the adult population in the same rural area raises questions regarding possible sources of transmission of hepatitis C during the preceding years.

Adolescent↗

Survival, growth and quality of life in children after orthotopic liver transplantation: a 5 year experience.

The aims of this study were to investigate outcome and to evaluate areas of potential ongoing concern after orthotopic liver transplantation (OLT) in children. Actuarial survival in relation to age and degree of undernutrition at the time of OLT was evaluated in 53 children (age 0.58-14.2 years) undergoing OLT for endstage liver disease. Follow-up studies of growth and quality of life were undertaken in those with a minimum follow-up period of 12 months (n = 26). The overall 3 year actuarial survival was 70%. Survival rates did not differ between age groups (actuarial 2 year survival for ages less than 1, 1-5 and greater than 5 years were 70, 70 and 69% respectively) but did differ according to nutritional status at OLT (actuarial 2 year survival for children with Z scores for weight less than -1 was 57%, greater than -1 was 95%; P = 0.004). Significant catch-up weight gain was observed by 18 months post-transplant, while height improved less rapidly. Quality of life (assessed by Vineland Adaptive Behaviour Scales incorporating socialization, daily living skills, communication and motor skills) was good (mean composite score 91 +/- 19). All school-aged children except one were attending normal school. Two children had mild to moderate intellectual handicap related to post-operative intracerebral complications. Satisfactory long-term survival can be achieved after OLT in children regardless of age but the importance of pre-operative nutrition is emphasized. Survivors have an excellent chance of a good quality of life and of satisfactory catch-up weight gain and growth.

Activities of Daily Living↗

Early induction of secretory immunity in infancy: specific antibody in neonatal breast milk.

Neonatal breast milk from 50 babies aged between 2 and 39 days was studied for the presence of antibody to the cows' milk protein beta lactoglobulin. Specific IgA antibody and specific secretory antibody to beta lactoglobulin were detectable towards the end of the second week of life in milk secreted by neonates fed cows' milk formula. Specific antibody concentrations were independent of total IgA concentrations. Babies receiving little or no cows' milk protein did not produce antibody in neonatal breast milk. Antigen specific mucosal immune responses develop in tissues distant from the site of primary mucosal exposure by the end of the second week of life in term human neonates, suggesting that prophylactic immunisation against enteric or other mucosal pathogens within a few days of birth may provide antibody responses in secretions, which may protect against mucosal infection.

Aging↗

Kidney damage in recurrent renal lithiasis. A survey of 175 cases with clinicopathological observations.

We evaluated the degree of kidney damage in 175 patients treated by nephrectomy for recurrent renal stones. Renal histopathological lesions of the removed kidneys were graded and correlated to clinical and operative findings. Nonexcreting kidneys on intravenous pyelography or small atrophic kidneys with poor contrast excretion showing advanced hydronephrosis and pyelonephritic scarring intraoperatively corresponding to kidneys with advanced parenchymatous destruction histopathologically. In 91% of the cases severe renal damage was correctly predicted, and a decision to remove the affected kidney was justified.

Adolescent↗

[Endometrial chondroma].

A case of ectopic cartilage formation is reported in the endometrium of woman suffering from tuberculosis of the internal genitalia. The possibilities as far as the theories relating to the explanation of cartilage formation are analysed.

Aged↗