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Biomedical subjects

G Androulakis

Publications and source records attributed to G Androulakis.

At least 37 records · Page 2Linked to original sources
PubMed2000

Prognostic variables for patients with stage III malignant melanoma.

OBJECTIVE: To evaluate the prognostic factors for patients with stage III malignant melanoma and to identify patients at high risk of developing recurrent disease who may benefit from adjuvant therapy. DESIGN: Retrospective study. SETTING: Specialist hospital, USA. SUBJECTS: 130 patients with stage III malignant melanoma (according to the TNM classification), treated at the Roswell Park Cancer Institute between 1970 and 1992. MAIN OUTCOME MEASURES: Survival and prognostic factors on multivariate analysis. RESULTS: Four factors were independent prognostic indicators for patients with stage III malignant melanoma: age >51 years (p = 0.008), >3 involved lymph nodes, (p = 0.03), the site of the primary tumour on head or trunk, (p = 0.007), and the presence of palpable lymph nodes (p = 0.004). CONCLUSION: These prognostic factors help us to stratify patients into low and high-risk groups. High-risk patients may benefit from more aggressive adjuvant therapy in future trials of treatment of melanoma.

Adolescent↗
PubMed2000

Comparison of Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) scoring systems in a single Greek intensive care unit.

OBJECTIVE: To evaluate Acute Physiology and Chronic Health Evaluation (APACHE) II and Simplified Acute Physiology Score (SAPS) II scoring systems in a single intensive care unit (ICU), independent from the ICUs of the developmental sample; and to compare the performance of APACHE II and SAPS II by means of statistical analyses in such a clinical setting. DESIGN: Prospective, cohort study. SETTING: A single ICU in a Greek university hospital. PATIENTS: In a time interval of 5 yrs, data for 681 patients admitted to our ICU were collected. The original exclusion criteria of both systems were employed. Patients <17 yrs of age were dropped from the study to keep compatibility with both systems. Eventually, a total of 661 patients were included in the analysis. INTERVENTIONS: Demographics, clinical parameters essential for the calculation of APACHE II and SAPS II scores, and risk of hospital death were recorded. Patient vital status was followed up to hospital discharge. MEASUREMENTS AND MAIN RESULTS: Both systems showed poor calibration and underestimated mortality but had good discriminative power, with SAPS II performing better than APACHE II. The evaluation of uniformity of fit in various subgroups for both systems confirmed the pattern of underprediction of mortality from both models and the better performance of APACHE II over our data sample. CONCLUSIONS: APACHE II and SAPS II failed to predict mortality in a population sample other than the one used for their development. APACHE II performed better than SAPS II. Validation in such a population is essential. Because there is a great variation in clinical and other patient characteristics among ICUs, it is doubtful that one system can be validated in all types of populations to be used for comparisons among different ICUs.

APACHE↗
PubMed2000

Prognostic significance of circulating antibodies against carcinoembryonic antigen (anti-CEA) in patients with colon cancer.

OBJECTIVE: The discovery of antibodies against carcinoembryonic antigen (CEA) in patients with digestive cancers, in the late 1970s, initiated a number of studies on the role of these antibodies in patients with cancers of the GI tract. Our aim was to determine the prevalence and prognostic significance of the IgG and IgM anti-CEA antibodies in the serum of patients with colon cancer. METHODS: Using an enzyme-linked immunoassay, the sera of 58 colon cancer patients were examined for the presence of carcinoembryonic antigen (CEA) and for circulating antibodies against the CEA (anti-CEA). An inhibition assay was carried out for the determination of the specificity of the IgG and IgM anti-CEA antibodies. RESULTS: The CEA was elevated (> or =10 ng/ml) in only 12 patients (20.6%). Anti-CEA IgM and/or IgG antibodies were detected in 46 patients with colon cancer (79.1%). In the control group (n = 28), 10% of the individuals had detectable amounts of IgG and/or IgM anti-CEA antibodies. Patients with detectable amounts of circulating IgM anti-CEA antibodies (n = 14, 30.5%) had a statistically significantly better 2-yr survival compared to the rest of the patients (p = 0.017). The IgM anti-CEA antibodies can also be used as an independent prognostic factor in these patients (p = 0.0323). CONCLUSIONS: In this study, a high number of colon cancer patients have circulating anti-CEA antibodies in their sera. These may be used as diagnostic markers and as independent prognostic factors. In addition, the presence of these antibodies in the patients studied is associated with better prognosis and significantly increased 2-yr survival. It was also found that the anti-CEA antibodies (IgG and IgM) are more sensitive markers than CEA. These findings underline the biological importance of the anti-CEA antibodies and provide additional information on their potential use as markers of the immune status in patients with colon cancer.

Adult↗
PubMed2000

Prognostic factors in malignant melanoma patients with solitary or multiple brain metastases. Is there a role for surgery?

BACKGROUND: The aim of this study is to evaluate the prognostic parameters and treatment modalities of malignant melanoma patients with brain metastases. METHODS EXPERIMENTAL DESIGN: a retrospective study with a mean follow-up of 46 months. SETTING: specialized Cancer Center. PATIENTS: the charts of 136 patients, treated in Roswell Park Cancer Institute, for melanoma brain metastases, were analyzed. INTERVENTIONS: all patients were treated surgically and in the majority adjuvant therapy was applied. MEASURES: survival and time of recurrence of patients and possible prognostic factors. RESULTS: PATIENTS who were treated surgically had a better one-year survival rate (28.3%), than patients who received radiotherapy and/or chemotherapy (6.67%) or patients who refused any kind of treatment (3.45%), (p=0.006). Prolonged survival after surgical treatment was found in patients with single metastatic lesions and in patients with multiple metastatic lesions. CONCLUSIONS: Melanoma patients with single metastatic lesions to the brain seem to do better after surgical treatment. The role of surgical intervention in patients with multiple brain metastases needs re-evaluation from a big multicenter, prospective trial.

Adult↗
PubMed1999

Long term effect of splenectomy on patients operated on for cancer of the left colon: a retrospective study.

OBJECTIVE: To find out if accidental splenectomy during colonic resection influences the survival of patients with colon cancer. DESIGN: Retrospective clinical study. SETTING: University hospital, Greece. SUBJECTS: Twenty-five patients with colonic cancer (13 Dukes' B and 12 Dukes' C) who had accidental splenectomy during resection of the left colon (n = 22) or the sigmoid (n = 3) between 1973 and 1990. Each study patient was matched with control patients for age, sex, Dukes' stage, grade, site of tumour, date, type of operation and number of blood transfusions. MAIN OUTCOME MEASURES: The five year actuarial and disease free survival estimated by the Kaplan-Meier product limit method. RESULTS: There were significantly more infective postoperative complications (6/25 compared with 0/25, p = 0.02) in patients who had a splenectomy. The incidence of metastases (p = 0.07) and the five-year disease free (p = 0.08) and overall survival (p = 0.1) were lower but not significantly so in patients who had a splenectomy compared with controls. CONCLUSIONS: Splenectomy significantly increases the number of infective postoperative complications in patients with colonic cancer. Although there was a trend for shorter disease-free survival after splenectomy, it seems that splenectomy had no impact on survival.

Actuarial Analysis↗
PubMed1999

Effect of curative versus palliative surgical treatment for stage III pancreatic cancer patients.

UNLABELLED: During the last decade, significant progress has been made in pancreaticoduodenectomy for patients with pancreatic carcinoma. Pancreatic resection performed by surgeons in tertiary referral centres is therefore justified, while the indications for pancreatic resection could be extended in patients with advance stages of disease. The aim of our study is to compare the effect of curative (pancreaticoduodenectomy) versus palliative surgery in patients with stage III pancreatic cancer, during a 20-years period. We retrospectively reviewed the charts of 58 consecutive patients with stage III ductal adenocarcinoma of the head of the pancreas. 23 patients underwent pancreatoduodenectomy with curative intent while the remaining 35 patients had surgery for palliative purposes (combined biliary and gastric bypass was performed in 83%). The hospital mortality rate was similar in both groups (4% vs 6%). 43% of patients undergoing pancreaticoduodenectomy had an uncomplicated post-operative course compared with 49% of patients undergoing palliative bypass. The length of surgical procedure and post-operative hospital stay in pancreaticoduodenectomy group were significant longer compared to those patients undergoing palliative bypass (p = 0.03 and p = 0.02 respectively). The overall actuarial survival was significantly (p < 0.01) longer in the group of patients who underwent pancreaticoduodenectomy compared with the group with palliative intent surgery. CONCLUSION: Pancreaticoduodenectomy with curative intent for stage III pancreatic cancer patients, could improve prognosis with similar peri-operative morbidity and mortality when compared with palliative bypass.

Adenocarcinoma↗
PubMed1999

Does axillary dissection affect prognosis in T1 breast tumors?

BACKGROUND: The treatment of patients with breast cancer has undergone many revisions over recent decades. The current trend is toward limited resections and breast conservation. Some authors advocate the abandonment of axillary lymph node dissection (ALND) for small tumors. While it is accepted that ALND has no therapeutic effect in breast cancer patients, its prognostic significance for small tumors is debated. Eligibility criteria for surgical treatment without axillary dissection are evolving. METHODS: Considering that problem, we retrospectively reviewed the charts of 100 patients with T1 invasive carcinoma of the breast treated at Hippokration Hospital of Athens between 1986 and 1987. Patients were divided into two groups: those that underwent ALND (n=76) and those that did not (n=24). The following data were recorded: age, tumor size, grade, hormone receptor status and postoperative treatment. The ten-year overall and disease-free survival were analysed. A multivariate analysis was used to identify prognostic variables. RESULTS: There was no statistically significant difference in the ten-year overall and disease-free survival between the two groups. The univariate analysis showed that tumor size predicts both recurrence and survival. In the multivariate analysis tumor size was found to be an independent prognostic factor for overall survival. CONCLUSIONS: ALND did not influence the ten-year survival or the recurrence rate. Tumor size was the only statistically significant and independent prognostic factor for T1 breast cancer patients.

Adult↗
PubMed1999

Sweat gland carcinoma with multiple local recurrences: a case report.

We report a case of primary, high grade sweat gland carcinoma, a rare tumor, occurring in the skin of the left axilla. The patient, a 54-year-old man, was treated with wide surgical excision and lymph node dissection; he had developed metastatic deposits in one regional lymph node. The neoplasm relapsed locally thrice in a period of 10 years; however, distant metastases were not found. The differential diagnosis of sweat gland tumors is discussed in the present article.

Adenocarcinoma↗
PubMed1996

Preventable prehospital trauma deaths in a Hellenic urban health region: an audit of prehospital trauma care.

OBJECTIVE: To identify preventable prehospital deaths, caused by trauma. DESIGN: Analysis of 82 trauma victims who were dead on arrival (DOA) into our hospital. SETTING: General Hospital of Piraeus, Greece. MATERIALS AND METHODS: Evaluation of the autopsy findings of 82 DOAs. MEASUREMENTS: Demographic, autopsy, and toxicology data, ICD9 codes, Abbreviated Injury Score (AIS)-90, Injury Severity Score (ISS)-body regions, central nervous system (CNS) deaths, non-CNS deaths, p values, and opinion of a clinical assessor. MAIN RESULTS: The 29 (35.36%) DOAs had at least one AIS6 injury. Extracranial hemorrhage, airway, and breathing dysfunction were contributing factors of death of 27 "possibly preventable" CNS deaths, and the causes of death for the 20 non-CNS deaths. p value (0.5) indicated that 24 (29.26%) of the DOAs expected to survive. The clinical assessor characterized four (4.87%) as "definitely preventable" and 35 (42.65%) as "possibly preventable" deaths. CONCLUSIONS: Upgrading of the emergency medical care service is required.

Abdominal Injuries↗
PubMed1990

Glucose-based versus fat-based total parenteral nutrition (TPN): effects on hepatic function in septic patients complicated with cholestatic jaundice.

A prospective study of two types of total parenteral nutrition (TPN) was carried out in 34 patients suffering from sepsis and complicated liver dysfunction. Group 1 (18 patients) received non-protein energy as glucose plus fat emulsion in a caloric ratio of 19:1, while group 2 (16 patients) received the same energy intake but with a ratio of 1:1. Group 1 exhibited higher levels of bilirubin and alkaline phosphatase with values of 93.5 +/- 25.5 mumol/l and 160 +/- 30 IU/l respectively compared to Group 2, in which the corresponding values were 81.6 +/- 32.3 mumol/l and 120 +/- 10 IU/l (p < 0.05). On the other hand, group 1 had lower levels of serum albumin and serum transferrin with values 25 +/- 1.3 g/l and 40 +/- 20% of normal, compared to group 2 in whom the corresponding values were 28 +/- 8 g/l and 48 +/- 30% of normal (p < 0.05). There were no differences between the two groups, in the absolute number of T-lymphocytes and in transaminase levels. In sepsis complicated by liver dysfunction a 50:50 glucose: fat regimen caused less disturbance of liver function than one consisting almost entirely of glucose.

Journal Article↗
PubMed1989

Plethysmographic confirmation of the beneficial effect of calcium dobesilate in primary varicose veins.

Sixty patients with varicose veins, in the age range 25 to 52 years, entered the trial and were divided by random allocation into 2 equal groups. The first group received calcium dobesilate orally in dosage of 750 mg daily while the second remained untreated. Out of 25 patients who completed the 3-month treatment course, clinical improvement occurred in 19 (76%). Mercury strain gauge plethysmography in those 19 patients showed a statistically significant mean fall in the venous distensibility index, in maximum venous outflow and in the capillary filtration coefficient after the course of calcium dobesilate. The mean erythrocyte sedimentation rate in the 25 patients fell from 40 mm in 1 hour (Westergren) before treatment to 10 mm at the end of the course. In 42% of the patients there was a fall in serum globulin concentration and correction of the albumin/globulin ratio and in 35% there was a slight fall in serum fibrinogen concentration. Possibly calcium dobesilate's known action in lowering blood viscosity contributes to its beneficial effect in varicose veins.

Adult↗
PubMed1988

Fundic, antral and pancreatic D-cell population changes following oophorectomy and sex hormone administration in guinea pigs. Experimental immunocytochemical study.

Twelve female guinea pigs were given estradiol and another 12 testosterone for 18 days. A third group of 15 animals underwent oophorectomy and a group of 8 animals served as controls. Gastric and pancreatic D-cells were quantitated in all four groups. Oophorectomy and androgens significantly increased and estrogens significantly decreased gastric D-cell populations. Additionally, estrogens significantly decreased D-cell population in pancreatic islets. It is concluded that the alterations in gastric and pancreatic D-cell populations, which are induced by sex hormone administration and oophorectomy, possibly reflect a hormonal adaptive attempt to restore gastric secretory functions within the normal range.

Animals↗
PubMed1978

[Selective catheterization of peripheral arteries for the monitoring of patients in intensive care units].

In critical ill patients, determination of blood gases is a crucial part of patient evaluation and management. In intensive care situations many blood-gas determinations are required in a single day. The introduction of an arterial catheter into a small peripheral artery is an invaluable technique that allows continuous blood-sampling. During the past three years we had catheterized either the radial, ulnar or the pedal artery in 450 instances. The arterial catheter was left in place from 1 to 15 days. There were no serious complication. Haemorrhage due to accidental opening of the catheter occurred in three occasions. No case of ischaemia was encountered after a single artery catheterization. Temporary ischaemia of the upper limb appeared in three patients after simultaneous catheterization of both ulnar and radial arteries. The infection rate was nil. Arterial catheterization and maintenance of indwelling catheter for repeated blood-samples is a simple and safe procedure with minimal complications, invaluable in the management of critical ill patients.

Acid-Base Equilibrium↗
PubMed1976

[Valve of plastic repair of the deep femoral artery in chronic circulatory disease of the lower extremities].

It is reported about indication, surgical technique, early and late postoperative results of the plastic of the profunda femoris artery. On 17, mainly old patients with chronic circulatory disease of the lower limbs was this operation carried out, because a longer angioplastic operative procedure would have been a great risk. The statement, that 47% of our patients were practically without symptoms after four years is promising for the plastic of the profunda femoris artery with chronic ischemia syndrome of the lower limbs.

Aged↗