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Biomedical subjects

F Sofras

Publications and source records attributed to F Sofras.

At least 19 recordsLinked to original sources
PubMed2006

Prevalence of urolithiasis in rural Thebes, Greece.

INTRODUCTION: Worldwide, urolithiasis is the third most common urological disease affecting both males and females. Both genetic and environmental factors contribute to stone formation. The recurrence rate is approximately 50%, rising to 70% within 10 years and this condition represents a significant healthcare cost burden. An unusually frequent history of urolithiasis has been observed among patients from the rural area of Thebes, Viotia, Greece. OBJECTIVE: To determine the prevalence of urolithiasis in Thebes. METHODS: A representative sample of persons from the rural area of Thebes was questioned about the occurrence of urinary stones during their lifetime, and acute urolithiasis in 2005. A logistic regression model was used to contrast individuals with lithiasis to those without lithiasis. RESULTS: A total of 422 subjects participated in the study. We found a 15% prevalence of urolithiasis in the rural population of Thebes. The rate was slightly higher in men than in women in almost all age groups questioned, although this was not statistically significant. No case of urolithiasis was found in subjects under the age of 17 years. The prevalence of urolithiasis appeared to increase with age in both men and women. Those drinking bottled water were less likely to have lithiasis. CONCLUSION: The life time prevalence rate of urolithiasis observed in the rural area of Thebes was higher to that reported in other studies performed among males and females in the general population of Europe.

Adult↗
PubMed2006

Incidence of impalpable carcinoma of the prostate and of non-malignant and precarcinomatous lesions in Greek male population: an autopsy study.

OBJECTIVE: The present study investigates the incidence of impalpable carcinoma of the prostate and the pathological findings of impalpable prostate carcinoma (PC) detected in autopsy material. The frequency of pre-carcinomatous and non-carcinomatous lesions as well as their relationship to the impalpable PC, were also examined. MATERIALS AND METHODS: Data were obtained from 212 autopsy specimens of the prostate gland, of men aged above 30 and under 98 years of age, born and living in Greece, who died (between 8/2002 and 8/2004), of causes other than carcinoma of the prostate. RESULTS: The age-independent frequency of histological PC in our study's population is 18.8% (ranging from 0% to 56.2% according to different age groups), whereas the age-independent frequency of histological benign prostate hyperplasia is 65.5% (ranging from 27.7% to 90.6%), of atypical adenomatous hyperplasia 15.5% (ranging from 5.5% to 25%), of prostatic intraepithelial neoplasia (PIN) 26.4% (ranging from 5.5% to 47.2%) and of prostate atrophy (PA) 10.3% (ranging from 0% to 43.7%). There was a statistically significant correlation between PIN and PC volume. Most impalpable carcinomas found within necropsy material were characterized by small volume, favorable histological type, and relatively low aggressiveness. The prevalence of PC and pre-carcinomatous lesions in our study population appears to be lower than that of most autopsy studies. CONCLUSIONS: The frequency of clinical PC in a certain population could be related to the frequency and prevalent model of impalpable carcinoma as well as to the frequency of pre-carcinomatous lesions.

Adenomatous Polyps↗
PubMed2006

Frequency of impalpable prostate adenocarcinoma and precancerous conditions in Greek male population: an autopsy study.

A series of 212 prostate specimens of men dead between August 2002-August 2004, have been sectioned in consecutive autopsies and subjected to whole mount analysis in purpose to determine the epidemiology of impalpable prostate cancer in Greece. Impalpable prostate carcinomas were found in 40 cases (18.8%) most in the peripheral region. In all, 29 of 40 impalpable cancers (70.7%) had volume less than 1 cm3. Most of impalpable carcinomas were of favorable (Gleason score 2-4) or intermediate (Gleason score 5 and 6) histological type (55 and 27.7%, respectively) while only five (12.5%) were undifferentiated (Gleason score 7 and 8). In all, 24 (60%) of the 40 impalpable carcinomas were multifocal and consisted of two or more foci, most of small size (<0.5 cm3). Most of the impalpable cancers found in this autopsy study were potentially insignificant tumors (relatively low volume, favorable or intermediate histological pattern and absence of invasiveness). Prostate intraepithelial neoplasia (PIN) coexisted with impalpable carcinomas, in almost half of the cancer-positive specimens. There was a positive correlation between PIN foci and coexistent cancer foci in most of the cases. Frequency rate and pathological features of both entities show significant variations in medical literature. Since the incidence of clinical prostate cancer in Greece is relatively low, and according to our autopsy findings, it is plausible that the frequency of clinical prostate cancer in a certain population could be related to the prevalent model of impalpable cancer as well as to the frequency and extend of the precancerous lesions.

Adenocarcinoma↗
PubMed2004

Retrograde acucise endopyelotomy: is it worth its cost?

PURPOSE: To identify patients with ureteropelvic junction (UPJ) obstruction who will benefit from endoscopic Acucise incision of the stenosis and to compare the open Hynes-Anderson pyeloplasty with this minimally invasive technique. PATIENTS AND METHODS: In a prospective trial, 22 patients with primary and secondary UPJ obstruction were treated by Acucise endopyelotomy, and 18 patients were treated by Hynes-Anderson pyeloplasty. Preoperative and postoperative renal scans were used to determine the degree of obstruction and intravenous urography, ultrasound scanning, or both to assess the degree of dilation. RESULTS: There was a vast difference in the cure rate of the two groups: Hynes-Anderson pyeloplasty cured 94.5% of the patients, while in the Acucise group, the cure rate was only 32%. There was some improvement in another 22% of the patients, but the renal scan curve remained obstructed. The remaining 45% of patients failed to show any improvement. CONCLUSION: Acucise endopyelotomy will improve or cure only patients with good renal function and mild dilation of the pelvicaliceal system. Patients with severe dilation should be treated by Hynes-Anderson pyeloplasty.

Adolescent↗
PubMed2003

Comparison of success rates and financial cost of extracorporeal shock-wave lithotripsy in situ and after manipulation for proximal ureteral stones.

Our aim was to compare the stone free rate and the financial cost between in situ and after manipulation shock wave lithotripsy (SWL) for proximal ureteral stones. A total of 130 patients with proximal ureteral stones were prospectively randomized into two groups. Sixty-five patients (group 1) underwent SWL in situ and 65 patients (group 2) underwent SWL after an attempt was made to push back the stone into the kidney with the help of a ureteral catheter. The mean per person financial cost of both techniques was estimated after a follow up period of 3 months. The stone free rate 1 month post treatment was 83% (54/65 patients) for group 1 and 95% (62/65) for group 2. The higher success rate at 1 month for the pushback group was statistically significant ( P=0.04) but was correlated with a higher cost (euro 852 vs euro 1008.5). Fifteen additional sessions of SWL and follow up visits were needed in group 1, therefore making the final costs of the two therapeutic pathways almost equal (euro 1050.9 vs euro 1088.9), with no great difference in the overall fragmentation rates at 3 months between groups (94% and 97%, respectively). Stone manipulation offers higher stone free rates faster than in situ extracorporeal SWL, but is more expensive. This disparity in cost is diminished when costs are corrected for follow-ups and treatment of complications.

Adult↗
PubMed2001

Encrusted cystitis and pyelitis.

Encrusted cystitis (EC) and encrusted pyelitis (EP) are rare chronic inflammatory diseases of the bladder and renal pelvis, respectively, and are characterized by mucosal inflammation with deposits of ammonium magnesium phosphate on the urothelium. Corynebacterium urealyticum is the pathogen responsible in the vast majority of cases. We report 4 cases of EC and 1 case of EP. In 1 case of EC Ureaplasma urealyticum was isolated as the microorganism responsible. To the best of our knowledge, U. urealyticum-induced EC has never been reported previously.

Adult↗
PubMed1999

Multiple transrectal ultrasound guided prostatic biopsies: morbidity and tolerance.

OBJECTIVE: Early detection of prostate cancer has become a matter of vital importance in modern societies. Ultrasound guided transrectal biopsy is the current standard urological procedure to detect prostate cancer. In this study our intention was to confirm the high tolerance and low complication rate of this procedure, facts already established in urologists' minds. MATERIAL AND METHODS: In order to evaluate the morbidity as well as the acceptance of the procedure, we investigated 120 patients who underwent ultrasound guided transrectal biopsies of the prostate, in our department from September 1995 to January 1996. All patients at each biopsy underwent 6 needle passes and took periprocedural antibiotic therapy. Alongside with recording the periprocedural side effects of this method patients answered a questionnaire in order to evaluate the pain they experienced by this procedure. RESULTS: Twenty patients were found to have prostate cancer at various stages. All patients tolerated well the whole procedure. Pain was the most common complaint among patients. Several complications were recorded; the most common of all was haematuria. Only two patients required admission to hospital because they developed fever after the procedure. CONCLUSION: Ultrasound guided transrectal biopsy of the prostate is a well-tolerated and effective method for obtaining multiple biopsy specimens from the prostate with low incidence of serious complications. Its is also accurate enough, allowing its use in everyday urology, as a diagnostic procedure.

Aged↗
PubMed1998

The effect of ESWL of renal calculi on pancreatic function.

Fifteen patients were treated by ESWL for renal calculi. The sagittal size of the head, neck and tail of the pancreas, and serum amylase, insulin, c-peptide and 24-hour urine amylase levels were estimated pre and post-treatment. Serum glucose, serum amylase and urinary levels remained within normal limits. Serum levels of insulin, c-peptide and the size of the gland increased but this was not statistically significant. There may be some danger to the pancreas during ESWL as there are some morphological changes even though there are no evident peptide changes. Caution should be taken if patients have a history of pancreatitis.

Adult↗
PubMed1998

Efficacy of escalating doses of intravesical interferon alpha-2b in reducing recurrence rate and progression in superficial transitional cell carcinoma.

OBJECTIVE: To compare the efficacy of three different doses of intravesical interferon alpha-2b (IFN alpha-2b) in reducing recurrence and progression rates in superficial grade II, transitional cell carcinoma (TCC). PATIENTS AND METHODS: Eighty-nine patients with primary or recurrent TCC stage Ta/T1, grade II, were randomly allocated into four groups after transurethral resection (TUR) of the tumour. Group A (20 patients) received no further treatment, serving as the control group; group B (22 patients) received 40 MU of IFN alpha-2b, group C (24 patients) 60 MU and group D (23 patients) 80 MU. The instillations started within 48-72 h after TUR and were performed weekly for 2 months, bimonthly for the next 4 months and thereafter monthly for 6 months. The patients were followed for 36 months. The four groups were compared for the number of recurrences (simple recurrence rate), progression in stage, disease-free interval and recurrence rate per 100 patient-months. RESULTS: During the follow-up, 33 patients had recurrence (13, eight, seven and five in groups A to D, respectively). The simple recurrence rate was 65% for group A, compared with 36% (P = 0.06), 29% (P < 0.05) and 22% (P < 0.01) for groups B, C and D, respectively. The differences in simple recurrence rates between the groups treated with IFN alpha-2b were not statistically significant. Eleven patients experienced progression in stage, with six, there, one and one in groups A to D, respectively. The differences were statistically significant only between groups A and C (P < 0.05) and groups A and D (P < 0.05). The disease-free interval was 15 months for group A, compared with 21.4 (P < 0.05), 26.1 (P < 0.001) and 30 months (P < 0.001) for groups C to D, respectively. The disease-free intervals of the groups treated with IFN alpha-2b were significantly different between all patients in groups B and D (P < 0.01) and only for those with stage T1 between groups C and D (P < 0.01). Finally the recurrence rate per 100 patient-months was 2.91, 1.19, 0.88 and 0.63 for groups A to D, respectively (all P < 0.001). The results were always in favour of the patients treated with the high dose, the only exception being the difference between groups C and D (P = 0.026). No side-effects of the drug were noted, nor was any adverse reaction reported from any patient. CONCLUSION: These results show a significant advantage for adjuvant intravesical IFN alpha-2b treatment over TUR alone for the 36 months of follow up and indicate that IFN alpha-2b can modify the clinical course of superficial TCC at least in the short term. The appropriate dose was apparently 80 MU, for although 40 MU was better than TUR alone, it was less effective than 60 MU and 80 MU; the 80 MU dose was slightly better than 60 MU and thus this regimen is recommended.

Administration, Intravesical↗
PubMed1997

Cisplatin, ifosfamide, methotrexate and vinblastine combination chemotherapy for metastatic urothelial cancer.

PURPOSE: We investigated the activity of combination chemotherapy consisting of cisplatin, ifosfamide, methotrexate and vinblastine in patients with metastatic urothelial cancer. MATERIALS AND METHODS: A total of 32 consecutive patients was treated with 30 mg./m.2 cisplatin on days 1 through 3, 1.5 gm./m.2 ifosfamide with mesna on days 1 through 3, 30 mg./m.2 methotrexate and 3 mg./m.2 vinblastine on day 1 plus 5 micrograms./kg. granulocyte colonystimulating factor on days 7 through 11. Courses were repeated every 21 days for a maximum of 6 cycles. RESULTS: Major toxicity was granulocytopenia in 56% of patients, including 11 episodes of granulocytopenic fever. Anemia and thrombocytopenia developed in a third of the cases. No other significant toxicity or treatment related death was noted. An objective response was achieved in 20 patients (62.5%, 95% confidence interval 44 to 79). Median time to progression was 7 months and median survival was 13 months. CONCLUSIONS: The cisplatin, ifosfamide, methotrexate and vinblastine regimen appeared active in patients with metastatic urothelial carcinoma. This regimen was associated with significant but manageable hematological toxicity and the incidence of mucositis or renal impairment was low. Prospective randomized studies are needed to assess whether the addition of ifosfamide to other active agents will improve the survival of patients with this disease.

Adenocarcinoma↗
PubMed1996

Transurethral thermotherapy in the management of benign prostatic hyperplasia.

Transurethral radiofrequency thermotherapy for symptomatic benign prostatic hyperplasia was performed in 50 selected patients, using the THERMEX II device. High surgical risk patients were included, among them 13 previously catheterized ones, because of unresolved retention for more than 6 months. The treatment consisted of a three-hour single session at 47 degrees C. Follow-up studies were carried out at 1, 3, 6 and 12 months using Madsen score, maximum flow rate, residual urine volume determinations and prostate bulk measurement by transrectal ultrasound. Subjective and objective improvement (of more than two parameters) was noticed in 62% of the patients. Prostatic volume did not change. In the retention group 54% of the patients remained free of catheter. Postoperative histology in 8 cases that failed to respond, revealed focal haemorrhagic and necrotic changes in periurethral glandular tissue. This is a promising method for selected high risk patients that achieves reasonable but not comparable results to TURP and requires further investigation in larger patient groups with BPH.

Aged↗
PubMed1996

Management of lithiasis in medullary sponge kidneys.

Twenty-four patients with medullary sponge kidneys (MSKs), diagnosed on a recent IVU, and renal lithiasis were treated by extracorporeal shock wave lithotripsy (ESWL). A detailed history regarding frequency of renal colic and urinary tract infection (UTI) was recorded and compared to the post-ESWL frequency of the symptoms. Our results show that the stone clearance rate is similar to that of non-MSK patients but there is a great reduction in the frequency of renal colic and UTI.

Adult↗
PubMed1995

A "novel" surgical approach to ureteroileal anastomosis in patients with bricker urinary diversion.

We present a technique used in two patients with Bricker urinary diversion for the approach of ureteroileal anastomosis. The right lateral extraperitoneal approach provides fast access to the site, is virtually bloodless and appears to have no major complications. Although this method is extensively used by urologists, it does not appear in the literature on repairs of ureteroileal strictures.

Aged↗