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Biomedical subjects

Nikolaos Akritidis

Publications and source records attributed to Nikolaos Akritidis.

At least 19 recordsLinked to original sources
PubMed2006

Use of ceftriaxone in patients with severe leptospirosis.

The optimal treatment of severe and late leptospirosis, and even the need for antibiotic treatment in such clinical settings, remains a subject of debate. Twenty-two patients with severe late leptospirosis were treated with intravenous ceftriaxone 2g daily. Twenty-one patients recovered and one patient passed away due to respiratory complications of the disease. The adverse effect profile and the convenience of the regimen were superior to penicillin regimens reported in other clinical trials. Ceftriaxone may be a reasonable alternative in severe leptospirosis as an efficient, convenient and safe regimen. Large multicentre studies may further define the optimal interventions in severe leptospirosis as well as possible variations in the pathogenic and clinical parameters of respiratory leptospirosis.

Adult↗
PubMed2006

Health literacy in the field of infectious diseases: the paradigm of brucellosis.

OBJECTIVES: Treatment outcome for infectious diseases, including brucellosis, may be influenced by patient awareness of the disease itself, as well as by compounding socioeconomic factors. We attempted to evaluate parameters of patient awareness and disease perception in brucellosis and the ways they influence outcome. METHODS: We used a specifically developed questionnaire assessing various parameters of patient literacy on brucellosis in 70 patients with a new diagnosis of brucellosis. Patients were assessed by interviewing at the time of diagnosis and during follow-up. Awareness and perception of the disease, willingness for epidemiologic surveillance, mode of referral, treatment preferences, and adherence were evaluated. RESULTS: Although basic disease awareness is high, willingness to collaborate in epidemiologic surveillance is limited. Patient education may improve adherence to treatment and willingness to undergo surveillance, but may also result in many false referrals for relapse. Level of academic education does not influence the results. Convenience is the major factor when determining treatment preferences. CONCLUSION: Improving health literacy may result in improved treatment outcome and improved control of disease incidence. There is a need for constant evaluation of the quality and quantity of information distributed in order to reduce transmission of misinformation and occurrences of public anxiety.

Brucellosis↗
PubMed2006

Acute pancreatitis associated with brucellosis.

CONTEXT: Acute pancreatitis can be caused by a variety of infectious agents but it is regarded as an extremely rare complication of brucellosis. CASE REPORT: We briefly describe a 56-year-old man who presented with acute pancreatitis, fever, myalgia, and other clinical symptoms. Brucella melitensis was cultured from his blood. All clinical manifestations gradually resolved with the institution of intramuscular streptomycin and oral doxycycline therapy. CONCLUSION: Acute pancreatitis may rarely be a complication of infection with B. melitensis. In areas where brucellosis is endemic, it should be kept in mind that acute pancreatitis may result from infection with brucella organisms.

Acute Disease↗
PubMed2006

CT evaluation of renal artery embolism with ectopic artery.

We present an 80-year-old woman, with a history of well-controlled hypertension and atrial fibrillation, who suffered from back pain and elevated blood pressure for 2 weeks prior to admission. At physical examination, a low-pitched systolic heart murmur was heard in the tricuspid area and there was mild tenderness in the left lower quadrant. Laboratory studies revealed an elevated hematocrit, lactate dehydrogenase, and liver aminotransferase. Macroscopic hematuria was present in urine and 20% eosinophils were detected with Hansel's stain method. Assuming a possible vascular embolic episode, angiography of the renal arteries was performed, which revealed an obstructive pattern in the presence of a left duplicate system.

Journal Article↗
PubMed2006

The new global map of human brucellosis.

The epidemiology of human brucellosis, the commonest zoonotic infection worldwide, has drastically changed over the past decade because of various sanitary, socioeconomic, and political reasons, together with the evolution of international travel. Several areas traditionally considered to be endemic--eg, France, Israel, and most of Latin America--have achieved control of the disease. On the other hand, new foci of human brucellosis have emerged, particularly in central Asia, while the situation in certain countries of the Near East (eg, Syria) is rapidly worsening. Furthermore, the disease is still present, in varying trends, both in European countries and in the USA. Awareness of this new global map of human brucellosis will allow for proper interventions from international public-health organisations.

Animals↗
PubMed2006

Future trends in human brucellosis treatment.

The global burden of human brucellosis remains enormous. Existing treatment options, largely based on experience gained > 30 years ago, are adequate but not optimal. The evolving understanding of the pathophysiology of the disease may augment in designing and evaluating alternative approaches that may prove to be superior. Current alternative approaches such as co-trimoxazole-containing regimens, should be widely evaluated as being more cost-effective. New methods of delivery such as gentamicin-loaded microparticles, neutralisation of the environment where Brucella resides and use of novel antibiotics such as tigecycline may be of importance in the future. The role of immunomodulation, widely but inconsistently applied in 'chronic' brucellosis, should be further evaluated in all disease stages to define if it is of any use. The development of a subcellular vaccine would be an important step forward although one has to take into account the multiple interactions between Brucella and the immune system, various technical problems and the lack of funds. Reviewing existing attempts at the development of such a vaccine, the authors conclude that a trivalent subcellular vaccine may be needed for adequate efficacy.

Anti-Bacterial Agents↗
PubMed2005

Brucellosis.

Explore the source record for details and available documents.

Antibodies, Bacterial↗
PubMed2005

New approaches to the antibiotic treatment of brucellosis.

The global burden of human brucellosis remains enormous, yet its optimal treatment remains based on traditional combinations of doxycycline with either rifampicin or streptomycin. Of the currently existing alternative regimens, only the combination of doxycycline with gentamicin can be considered therapeutically adequate and cost effective, the latter factor being a major obstacle in the utilisation of quinolones for brucellosis. Newer antibiotics, most notably tigecycline, may help in achieving monotherapy or shorter treatment duration. Alternatively, modification of the acidic intracellular environment where Brucellae reside may allow for enhanced effectiveness of existing antibiotics.

Anti-Bacterial Agents↗
PubMed2005

Brain tuberculomas due to miliary tuberculosis.

Brain tuberculomas are a rare complication of tuberculosis arising through hematogenous spread from an extracranial source, most often of pulmonary origin. The clinical course is usually subacute or chronic, lasting weeks or months, and they typically occur in immunocompromised patients. Recognition and prompt diagnosis of this disorder is important because early treatment can prevent patient worsening and lead to clinical improvement. The authors report a 68-year-old diabetic man with headache and cognitive/behavioral changes in whom investigation revealed disseminated brain tuberculomas resulting from miliary tuberculosis. He received antituberculous treatment and had an excellent recovery.

Aged↗
PubMed2005

Effective treatments in the management of brucellosis.

Treatment of uncomplicated brucellosis in humans utilises a variety of anti-biotic combinations, applied to a series of important pathogenetic and clinical parameters. The currently recommended treatment regimens have not been surpassed by newer compounds, and various therapeutic strategies utilising these compounds cannot be adequately evaluated due to the absence of large, multi-centre, multinational trials. The review focuses on the basic principles of brucellosis treatment, the properties of the various regimens used, the results of trials involving them, and the questions raised about the efficacy of these regimens in certain clinical situations.

Anti-Bacterial Agents↗
PubMed2004

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↗
PubMed2004

Sarcoidosis associated with interferon-alpha therapy for chronic hepatitis C.

BACKGROUND: Recombinant interferon-alpha (IFN-alpha ) is widely used for the treatment of chronic hepatitis C. Pulmonary side effects of IFN-alpha therapy seem to be rare. So far, only a few cases of sarcoidosis in association with IFN-alpha treatment of chronic hepatitis C have been CASE REPORT: A 52-year-old woman with chronic hepatitis C developed sarcoidosis during treatment with IFN-alpha. Diagnosis of sarcoidosis was based on chest imaging studies, the increased serum angiotensin converting enzyme levels, and the histology of a biopsied cervical lymph node. Spontaneous remission was observed following IFN-alpha withdrawal. CONCLUSIONS: Use of recombinant IFN-alpha in patients with chronic hepatitis C may trigger or contribute to the development of sarcoidosis in susceptible individuals. Patients should be monitored during and following IFN-alpha therapy for the occurrence of manifestations suggesting sarcoidosis.

Antiviral Agents↗
PubMed2003

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↗
PubMed2003

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↗