Publications by authors named "Konstantinos Krithinakis"

5 Publications

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Abdominal and perineal scar endometriosis: Retrospective study on 40 cases.

Eur J Obstet Gynecol Reprod Biol 2020 Sep 26;252:225-227. Epub 2020 Jun 26.

Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece.

Objective(s): Abdominal and perineal scar endometriosis usually develop in association with a prior surgical scar. The purpose of the study was to detect and review patients' characteristics of these women over a long period.

Study Design: We retrospectively review the clinical records of 860 women with endometriosis between 1989 and 2019. Data were collected and analyzed from medical and pathological reports of 40 patients with abdominal and perineal scar endometriosis.

Results: 26 patients (3,0 %) were detected in the abdominal wall endometriosis group (AWE) (mean age 36,5 ± 3,4 years) and 14(1,6 %) cases in the perineal endometriosis (PE) group (32,5 ± 2,4 years), respectively. We observed that 92,3 % of women with AWE had undergone at least 1 cesarean section. Moreover, the majority of patients presented with abdominal pain (77, 0 %) and sensation of a mass (96,2 %). 15,4 % of cases had concurrent pelvic endometriosis and the recurrent rate of the disease was 15,4 %. All cases with perineal scar endometriosis were multiparous and delivered vaginally with episiotomy. 92,8 % of patients presented with cyclical pain and swelling. 3 cases suffered from perineal endometriosis combined with pelvic endometriosis. There was a recurrence of perineal endometriosis in 2 women (14,2 %). Surgical excision was the standard treatment of this condition and tissue biopsy confirmed the diagnosis.

Conclusions: Abdominal wall and perineal scar endometriosis are rare, multifactorial entities which are associated mainly with cesarean section and vaginal episiotomy. Clinicians should be aware of these conditions among all women of reproductive age presenting with cyclic or non-cyclic pain and swelling at the incision sites.
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http://dx.doi.org/10.1016/j.ejogrb.2020.06.054DOI Listing
September 2020

Retrospective evaluation of pathological results among women with ovarian endometriomas versus teratomas.

Mol Clin Oncol 2019 Jun 15;10(6):592-596. Epub 2019 Apr 15.

Department of Obstetrics and Gynecology, Venizeleio and Pananio General Hospital of Heraklion, Heraklion 71409, Greece.

The coexistence of endometrioma with dermoid cyst of the ovaries is an unusual entity, although they are both common and benign gynecological tumors. The present study aimed to investigate the association between ovarian dermoid cyst (teratoma) and endometrioma. We retrospectively, included 315 women with endometrioma and 172 with ovarian teratoma. Data were collected from medical and pathological reports from two different areas between 1995 and 2018. The mean age of cases with endometrioma was similar (35.8±7.2 years) to patients with ovarian teratoma (34.2±6.8 years). Considering the types of dermoid cysts, the observed proportion of mature type was 168/172 (98%), the immature type was 4/172 (2%) and struma ovarii was14/172 (8.1%) respectively. Endometrioma was significantly more frequent in the left ovary [174/266 (65.4%)] than in the right ovary [92/266 (34.6%)], P<0.001. By contrast, ovarian teratoma were predominant in the right ovary, 98/172 (60.6%), compared to the left side, 56/172 (32.5%), P<0.001. Regarding the size of the masses, we detected an inverse distribution between the two groups. Thirteen women were detected with ovarian teratoma and endometriosis, with 6 cases being in the same ovary. Our results indicate a left lateral predispostion of endometrioma and a right of ovarian teratoma and suggest that the pathogenesis between these conditions is different. The coexistence of endometriosis with dermoid cyst of the ovary, presents a challenge to the physicians and the investigators. Further research is required to establish the relationship between endometriosis and ovarian teratoma.
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http://dx.doi.org/10.3892/mco.2019.1844DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488942PMC
June 2019

Defining the genetic profile of endometriosis.

Exp Ther Med 2019 May 6;17(5):3267-3281. Epub 2019 Mar 6.

Section of Molecular Pathology and Human Genetics, Department of Internal Medicine, School of Medicine, University of Crete, Heraklion 71003, Greece.

Endometriosis is a pathological condition which has been extensively studied, since its pathophysiology stems from a broad spectrum of environmental influences and genetic factors. Familial studies aim at defining inheritance trends, while linkage analysis studies focus on the identification of genetic sites related to endometriosis susceptibility. Genetic association studies take into account candidate genes and single nucleotide polymorphisms, and hence target at unraveling the association between disease severity and genetic variation. The common goal of various types of studies is, through genetic mapping methods, the timely identification of therapeutic strategies for disease symptoms, including pelvic pain and infertility, as well as efficient counselling. While genome-wide association studies (GWAS) play a primary role in depicting genetic contributions to disease development, they entail a certain bias as regards the case-control nature of their design and the reproducibility of the results. Nevertheless, genetic-oriented studies and the implementation of the results through clinical tests, hold a considerable advantage in proper disease management. In this review article, we present information about gene-gene and gene-environment interactions involved in endometriosis and discuss the effectiveness of GWAS in identitying novel potential therapeutic targets in an attempt to develop novel therapeutic strategies for a better management and treatment of patients with endometriosis.
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http://dx.doi.org/10.3892/etm.2019.7346DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447774PMC
May 2019

First trimester screening for gestational diabetes mellitus by maternal factors and markers of inflammation.

Metabolism 2016 Mar 31;65(3):131-7. Epub 2015 Oct 31.

Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK. Electronic address:

Objective: To examine the potential role of maternal serum levels of tumor necrosis factor-α (TNF-α) and high sensitivity C-reactive protein (Hs-CRP) in the first trimester of pregnancy in the prediction of gestational diabetes mellitus (GDM).

Methods: Maternal serum TNF-α and Hs-CRP concentrations were measured in a case-control study of singleton pregnancies at 11-13 weeks' gestation, which included 200 cases that subsequently developed GDM and 800 unaffected controls. Measured levels of TNF-α and Hs-CRP were expressed as multiples of the median (MoM) after adjustment for maternal characteristics and history. The performance of screening for GDM by maternal factors and MoM values of TNF-α and Hs-CRP was evaluated by the area under the receiver operating characteristic curves (AUROC).

Results: In the GDM group, compared to the normal group, the median TNF-α was significantly increased (1.303 MoM, interquartile range [IQR] 1.151-1.475 vs. 1.0 MoM, IQR 0.940-1.064; p=0.031) and the median Hs-CRP was not significantly different (1.113 MoM, IQR 0.990-1.250 vs. 1.0 MoM, IQR 0.943-1.060; p=0.084). In the prediction of GDM, the AUROC for maternal characteristics with TNF-α or Hs-CRP was not significantly different than the AUROC for maternal characteristics alone (p=0.5055 and p=0.2197, respectively).

Conclusions: In pregnancies that develop GDM there is no evidence of an inflammatory response at 11-13 weeks' gestation and the levels of serum TNF-α and Hs-CRP are not useful in first-trimester screening for GDM.
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http://dx.doi.org/10.1016/j.metabol.2015.10.029DOI Listing
March 2016

Solitary cecal diverticulitis: an unusual cause of acute right iliac fossa pain-a case report and review of the literature.

Case Rep Surg 2014 23;2014:131452. Epub 2014 Nov 23.

Department of Surgery, General Hospital of Agios Nikolaos, Lasithi, 72100 Crete, Greece.

Solitary cecal diverticulitis is a rare cause of acute abdominal pain in the Western world. Its clinical presentation, in most cases, mimics acute appendicitis. A 38-year-old Caucasian man presented with acute abdomen and clinical signs of acute appendicitis. Laparotomy was performed and revealed an inflammatory, solitary diverticulum of the cecum. A typical appendectomy was performed and a catheter was inserted for draining percutaneously the inflamed diverticulum of the cecum. The patient had an uneventful recovery and was discharged on the 4th postoperative day. This frequently misdiagnosed condition, in most cases, is being suspected and identified intraoperatively as acute appendicitis. The aim of this study is to review the available different surgical management options and to present an alternative therapeutic approach that may be valuable under specific circumstances.
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http://dx.doi.org/10.1155/2014/131452DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258334PMC
December 2014