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Biomedical subjects

Georgios Pappas

Publications and source records attributed to Georgios Pappas.

26 records · Page 2Linked to original sources

Treatment of brucella spondylitis: lessons from an impossible meta-analysis and initial report of efficacy of a fluoroquinolone-containing regimen.

Although spondylitis is the most common of the complications of brucellosis, and is often debilitating and difficult to treat, there is no consensus on the preferred combination of antibiotics used. We attempted to perform a meta-analysis based on series on brucellar spondylitis published in the last 22 years. Meta-analysis was aborted largely due to insufficient data recorded in most series. However, useful conclusions could be drawn, such as the importance of prolonged treatment, usually more than 12 weeks. No antibiotic combination was proven to be superior, but 14 different regimens were used in the series studied. The authors propose the use of a combination of doxycycline and ciprofloxacin for a period of 3 months, and report the successful use of such a combination in five patients with brucellosis and spondylitis.

Anti-Bacterial Agents↗

Brucellosis and the respiratory system.

Brucellosis is a zoonotic disease that remains endemic worldwide. Its clinical manifestations and focal complications are often troublesome in making a diagnosis. Involvement of the respiratory system in brucellosis is an acknowledged but rare event that is only occasionally described in literature. We describe 37 cases of respiratory involvement during the course of brucellosis that presented as pneumonia, bronchopneumonia, pleural effusion with a predominance of monocytic or lymphocytic infiltrates, and paroxysmal dry cough. We also discuss aspects of the respiratory pathology, radiological characteristics, coexisting complications, and aspects of treatment of respiratory brucellosis.

Adolescent↗

Infectious diseases in cinema: virus hunters and killer microbes.

The world of infectious diseases has been rarely presented in the cinema with accuracy. Apart from random biographies of scientists and retellings of stories about great epidemics from the past, most films focus on the dangers presented by outbreaks of unknown agents that originate from acts of bioterrorism, from laboratory accidents, or even from space. We review these films and underline the possible effect that they have on the public's perception of infection--a perception that, when misguided, could prove to be problematic in times of epidemics.

Bioterrorism↗

STING Millennium: A web-based suite of programs for comprehensive and simultaneous analysis of protein structure and sequence.

STING Millennium Suite (SMS) is a new web-based suite of programs and databases providing visualization and a complex analysis of molecular sequence and structure for the data deposited at the Protein Data Bank (PDB). SMS operates with a collection of both publicly available data (PDB, HSSP, Prosite) and its own data (contacts, interface contacts, surface accessibility). Biologists find SMS useful because it provides a variety of algorithms and validated data, wrapped-up in a user friendly web interface. Using SMS it is now possible to analyze sequence to structure relationships, the quality of the structure, nature and volume of atomic contacts of intra and inter chain type, relative conservation of amino acids at the specific sequence position based on multiple sequence alignment, indications of folding essential residue (FER) based on the relationship of the residue conservation to the intra-chain contacts and Calpha-Calpha and Cbeta-Cbeta distance geometry. Specific emphasis in SMS is given to interface forming residues (IFR)-amino acids that define the interactive portion of the protein surfaces. SMS may simultaneously display and analyze previously superimposed structures. PDB updates trigger SMS updates in a synchronized fashion. SMS is freely accessible for public data at http://www.cbi.cnptia.embrapa.br, http://mirrors.rcsb.org/SMS and http://trantor.bioc.columbia.edu/SMS.

Chymotrypsin↗

Smooth muscle antibodies and type 1 autoimmune hepatitis.

BACKGROUND/AIM: Smooth muscle antibodies (SMA) characterize type 1 autoimmune hepatitis. Our aim was to evaluate sensitivity and specificity of different immunofluorescence substrates for the detection of SMA. METHODS: Sera from 55 patients with type 1 AIH 20 with primary biliary cirrhosis, 20 with HCV-related chronic hepatitis and 25 blood donors were studied for SMA and anti-microfilaments reactivity by immunofluorescence on rat tissue sections, cultured fibroblasts and commercially available HEp-2 cells (collectively revealing the so called anti-actin pattern), and for the XR1 system by counterimmunoelectrophoresis. SMA was classified on the basis of its immunofluorescence pattern (V--vessels, G--glomerular, T--tubular). As further control group, we studied 26 patients with a diagnosis other than AIH, selected on the basis of a SMA-non-T/XR1 positivity. RESULTS: In patients with AIH the SMA-T pattern on rodent tissue, and anti-MF on fibroblasts and on HEp-2 cells were present in 80, 82 and 80%, respectively. Five out of 11 SMA-non T positive AIH patients were anti-MF positive. None of the pathological and healthy controls was positive for SMA-T or anti-MF reactivity. XR1 system was present in 84% of AIH patients and in 5% of pathological controls (p = 0.01). Two out of 26 SMA-non-T/XR1 positive sera were positive for anti-MF by fibroblasts and HEp-2 cells. A significant correlation was found between SMA-T pattern and anti-MF reactivity; no correlation was found between XR1 system and SMA-T pattern or anti-MF reactivity. CONCLUSIONS: SMA-T pattern is highly sensitive and specific first diagnostic test for type 1 AIH; anti-MF can be used as additional tool for the diagnosis, particularly when, despite the absence of the SMA-T pattern, AIH is strongly suspected.

Animals↗

The hepatitic/cholestatic "overlap" syndrome: an Italian experience.

BACKGROUND: Patients with hepatitic and cholestatic autoimmune liver disease ("overlap syndrome") represent a diagnostic and therapeutic challenge. AIM: To evaluate the prevalence of the "hepatitic/cholestatic overlap" in a large series of consecutive patients with cholestatic autoimmune liver disease. METHODS: We re-evaluated the diagnosis of 235 patients with autoimmune liver disease, including 70 with type 1 autoimmune hepatitis (AIH), 142 with primary biliary cirrhosis (PBC), and 23 with primary sclerosing cholangitis (PSC), using the revised International Autoimmune Hepatitis Group (IAIHG) scoring system. Anti-mitochondrial, anti-nuclear, anti-smooth muscle, anti-liver kidney microsomal type 1, anti-liver cytosol type 1, perinuclear anti-neutrophil nuclear and anti-soluble liver antigen antibodies were evaluated in each patient. RESULTS: Ten patients (3 with a previous diagnosis of PBC and 7 of PSC) scored as "probable" or "definite" AIH. These patients did not have a specific autoantibody profile. CONCLUSIONS: Among patients with PBC, the occurrence of a PBC/AIH overlapping syndrome is rare (2.1%), whereas among patients with PSC an overlap between PSC and AIH is frequent (30.4%). Whether patients with the hepatitic/cholestatic overlap syndrome would benefit from a combination therapy with immunosuppression and ursodeoxycholic acid remains to be established.

Autoantibodies↗

Coxiella burnetii: an unusual ENT pathogen.

Coxiella burnetii, the causative agent of Q fever, is a prevalent zoonotic disease manifestating usually as atypical pneumonia or hepatitis. We describe 2 cases of serologically proven infection by Coxiella burnetii whose primary manifestations arose from the upper respiratory tract and were initially referred to the ear, nose, and throat (ENT) department. This is the first related report in medical literature. A 20-year-old woman with fever, bilateral tonsillitis, lymphadenopathy, and mild aminotransferase elevation, and a 30-year old man with spiking fever and laryngitis are presented. Diagnosis in both cases was achieved through evolving serological response to Coxiella burnetii. The importance of including the pathogen in the differential diagnosis of ENT patients, in assorted epidemiological settings, and the significance of the proper antibiotic selection are further discussed.

Adult↗