Publications by authors named "Panagiotis Christidis"

9 Publications

  • Page 1 of 1

Transdiaphragmatic Intercostal Hernia-An Unusual Hepatic Injury After a Car Accident: A Case Report and Review of the Literature.

Discoveries (Craiova) 2021 Mar 4;9(1):e123. Epub 2021 Mar 4.

4th Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.

Transdiaphragmatic intercostal hernia, in which the abdominal contents of the hernia protrude through the diaphragm and the thoracic wall defect. is a very rare type of hernia with only a few cases having been reported in the literature. That type of hernia is usually manifested in male patients after trauma, penetrating or blunt. It is frequently presented with a palpable thoracic mass and pain. The indicated treatment is surgery. We present the case of a 60-year-old female admitted to the hospital after a car accident and suffered multiple rib fractures (6th, 7th, 8th right ribs / 7th, 8th, 9th left ribs), as well as flail thorax, hemothorax bilaterally, left subcutaneous emphysema and swelling of soft tissues of the right lateral thoracoabdominal wall. CT scan revealed herniation of hepatic parenchyma and intestinal loops into the thorax. The patient was treated surgically, and his postoperative course was uneventful. We also review the relevant literature concerning this transdiaphragmatic, intercostal hernia and identify 42 cases. Transdiaphragmatic intercostal hernia is a rare condition, usually manifested in male patients after trauma, penetrating or blunt. It is frequently presented with a palpable thoracic mass and pain. The indicated treatment is surgery.
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http://dx.doi.org/10.15190/d.2021.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8163488PMC
March 2021

Case Report: A Virilizing Adrenal Oncocytoma.

Front Surg 2021 22;8:646459. Epub 2021 Mar 22.

Fourth Academic Department of Surgery, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.

A 64-year-old female was admitted to our clinic with a 9-cm-sized adrenal mass. The patient's main symptom was hirsutism, which included thinning scalp hair and excessive hair growth over her torso and arms. Upon investigation, elevated values of testosterone, androsterone D4, and DHEA-S were found. Contrast-enhanced abdominal CT and MRI scans revealed a heterogenous large mass (diameter 9 × 8.5 cm) with focal calcifications, necrotic areas, and a clear distinction from the adjacent structures. The patient underwent a right adrenalectomy. The histological examination of the tumor revealed a borderline adrenocortical oncocytoma. The patient had an uncomplicated postoperative course and was discharged on postoperative day 8. Similar cases reported in the literature are also being reviewed in this case report.
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http://dx.doi.org/10.3389/fsurg.2021.646459DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019906PMC
March 2021

Giant Adrenocortical Carcinoma: A Case Report and Review of the Relevant Literature.

Am J Case Rep 2021 Apr 4;22:e928875. Epub 2021 Apr 4.

4th Academic Department of General Surgery, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Exochi, Thessaloniki, Greece.

BACKGROUND Adrenocortical carcinomas are rare and aggressive tumors often diagnosed as incidentalomas. The malignancy can present with abnormal hormone secretion or the tumor may be non-functioning and present as a palpable mass causing discomfort. Here, we present a case of an adrenal cortical carcinoma originally identified as an incidentaloma. CASE REPORT A 63-year-old woman presented with abdominal pain and discomfort. A large abdominal mass, occupying the left upper and lower quadrant, was palpated. Imaging revealed a mass occupying the left abdomen between the stomach and the spleen, applying pressure on the pylorus, duodenum, splenic vessels, and pancreas. The mass size was 21.2×13×14.6 cm. Hormonal investigations were normal. Surgical exploration was performed, and the tumor was excised. Pathological analysis revealed an adrenocortical carcinoma and the patient underwent adjuvant chemotherapy. Twelve months later, the carcinoma recurred. The patient underwent a second operation in which the recurrent mass was excised along with the tail of the pancreas and a small part of the left lobe of the liver. The postoperative period was uneventful, and the patient was discharged home on the 7th postoperative day. No further adjuvant therapy was applied. The patient remains disease-free 18 months after the reoperation. CONCLUSIONS Giant adrenocortical carcinomas, although rare, pose a challenge to the surgical team both diagnostically and therapeutically. Surgical excision with the appropriate oncologic support can guarantee excellent outcomes.
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http://dx.doi.org/10.12659/AJCR.928875DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033218PMC
April 2021

The effect of hepatic ischemia in the liver of rats with obstructive jaundice.

Ann Ital Chir 2020 ;91:334-344

Objective: The aim of the current study was to evaluate the effect of ischemia-reperfusion injury on the liver's function and morphology during the establishment and progress of obstructive jaundice.

Material And Methods: 80 Wistar rats were used for the purposes of the study and were allocated in four groups: JAUNDICE (obstructive jaundice), JAUN-ISC (obstructive jaundice and ischemia reperfusion), CONTROL (laparotomy) and ISCHEMIA (ischemia reperfusion).

Results: Obstructive jaundice, and ischemia-reperfusion injury following obstructive jaundice led to increased mortality, while no mortality was noticed in the control and ischemia groups. In the JAUN-ISC group, SGOT was significantly increased on the 10th day and SGPT was significantly increased on the 1st day compared to JAUNDICE group. Moreover, in the JAUN-ISC group, sinusoid dilation was significantly increased on the 5th and 10th days and neutrophil infiltration was significantly increased on the 10th day compared to the JAUNDICE group.

Conclusions: A mild ischemia-reperfusion injury that in the normal liver led only to slight increase of hepatic neutrophil infiltration in the presence of obstructive jaundice led to increased hepatic biochemical markers (SGOT, SGPT) and increased hepatic sinusoid dilatation and enhanced neutrophil infiltration.

Key Words: Dilatation of sinusoids, Granulocytes infiltration, Oxaloxate, Pyruvate transaminase, Transaminase reperfusion.
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January 2020

Combined pelvic and para-aortic is superior to only pelvic lymphadenectomy in intermediate and high-risk endometrial cancer: a systematic review and meta-analysis.

Arch Gynecol Obstet 2020 07 28;302(1):249-263. Epub 2020 May 28.

3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloníki, Greece.

Background: Lymph node metastasis is a principal prognostic factor for the treatment of endometrial cancer. Added value of para-aortic lymphadenectomy to only pelvic lymphadenectomy for intermediate/high-risk endometrial cancer patients remains controversial.

Objective: A systematic review and meta-analysis was performed to assess the impact of combined pelvic and para-aortic lymph node dissection (PPALND) compared to only pelvic lymph node dissection (PLND) on survival outcomes of intermediate and/or high-risk patients.

Study Design: The systematic review and meta-analysis adhered to the PRISMA guidelines for meta-analyses of interventional studies. Pubmed, Scopus, EMBASE and Cochrane were searched up to April 20, 2018. Included studies were those comparing high-risk endometrial cancer patients that had performed pelvic and para-aortic lymph node dissection (PPALND) vs. only pelvic lymph node dissection (PLND) apart from standard procedure (total hysterectomy with bilateral salpingo-oophorectomy, TAHBSO). Primary outcomes of the study were overall survival and disease-free survival rates. Methodological quality of the included studies was assessed using the ROBINS-I tool. Overall quality of the evidence for the primary and secondary outcomes was evaluated as per GRADE guideline using the GRADE pro GD tool.

Results: There were 13 studies identified with 7349 patients included. All studies were retrospective observational as no RCTs or prospective studies adhering to inclusion criteria were retrieved. Combined pelvic and para-aortic lymphadenectomy was associated with 46% decreased risk for death (HR 0.54, 95% CI 0.35-0.83, I = 62.1%) and 49% decreased risk for recurrence (HR 0.51, 95% CI 0.28-0.93). It was also associated with increased 5-year OS rate (RR 1.13, 95% CI 1.04-0.24, I = 57.3%) and increased 5-year DFS rate (RR 1.23, 95% CI 1.14-1.31, I = 85.5) compared with only pelvic lymphadenectomy.

Conclusion: Combined pelvic and para-aortic lymphadenectomy is associated with improved survival outcomes compared with only pelvic lymphadenectomy in women with intermediate/high-risk endometrial cancers. Further prospective studies should be performed.
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http://dx.doi.org/10.1007/s00404-020-05587-2DOI Listing
July 2020

Association between hemoglobin concentrations at discharge from the neonatal intensive care unit with markers of neurodevelopmental outcomes in premature neonates.

J Neonatal Perinatal Med 2019 ;12(2):221-230

Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.

Background: Premature neonates are often subjected to multiple transfusions with red blood cells during their hospitalization in the neonatal intensive care unit (NICU). The hemoglobin threshold for transfusion prior to discharge from the NICU varies significantly among different centers. The aim of the present study is to investigate the association between hemoglobin concentration at discharge with neurodevelopmental outcomes in premature neonates.

Methods: Retrospective observation study with regression analysis was performed with follow up assessment in the neuro-developmental outpatient clinic at 30 months of adjusted age.

Results: Data from 357 neonates born at less than 37 weeks' gestation were analyzed. Sensory and motor neurodevelopment at 30 months of adjusted age, were not associated with the hemoglobin concentration at discharge (p=0.5891 and p=0.4575, respectively). There was no association between the hemoglobin concentration at discharge with fine or gross motor development (p=0.1582 and p=0.3805, respectively). Hemoglobin concentration at discharge was not associated with poor neurodevelopmental outcomes up until 30 months of adjusted age.

Conclusions: The data of the present study indicate that the hemoglobin concentration of premature neonates at the time of discharge is not associated with poorer markers of neurodevelopmental outcomes at 30 months of adjusted age. Comorbidities such as BPD and IVH that are present to premature neonates were identified as potential risk factors for certain aspects of the neurodevelopment.
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http://dx.doi.org/10.3233/NPM-1822DOI Listing
January 2020

Specialty education and Greek financial crisis: should I stay or should I go?

Postgrad Med J 2019 02 23;95(1120):113-114. Epub 2019 Jan 23.

3rd Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle Unversity of Thessaloniki, Thessaloniki, Greece.

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http://dx.doi.org/10.1136/postgradmedj-2018-136368DOI Listing
February 2019

Detection of structural abnormalities in fetuses with normal karyotype at 11-13 weeks using the anatomic examination protocol of the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG).

J Matern Fetal Neonatal Med 2020 Aug 7;33(15):2581-2587. Epub 2019 Jan 7.

3rd University Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece.

To assess the performance of sonography in the detection of fetal nonchromosomal abnormalities using a standard anatomic examination protocol proposed by International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) at 11-13 weeks. A prospective observational study was conducted between June 2013-May 2017 in singleton pregnancies attending for a routine scan at 11-13 weeks. All examinations were performed by maternal-fetal medicine specialists certified by the Fetal Medicine Foundation according to the anatomic examination protocol described in the ISUOG guidelines. First-trimester findings were compared to those of the anomaly scan at 20-23 weeks and the postnatal examination. The primary outcome was the detection rate of major structural abnormalities in fetuses with normal karyotype at 11-13 weeks. After excluding 17 chromosomal abnormalities, major fetal structural defects were detected in 57 (1.7%) of the remaining 3361 cases. Of these, 27 (47.3%) were detected at 11-13 weeks, including all cases of acrania (4), exomphalos (4), megacystis (2) and body stalk anomaly (2). Furthermore, there was a first-trimester diagnosis in 36.4% (4/11) of major cardiac defects, 38% (6/16) of limb defects, and 100% (2/2) of facial clefts. Targeted ultrasound examination may identify all the so called "always" detectable major abnormalities and a significant proportion of the "sometimes", detectable at 11-13 weeks.
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http://dx.doi.org/10.1080/14767058.2018.1555807DOI Listing
August 2020

Discrepancy between colposcopy, punch biopsy and final histology of cone specimen: a prospective study.

Arch Gynecol Obstet 2018 05 13;297(5):1271-1275. Epub 2018 Feb 13.

3rd Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Falireos 16, 56224, Thessaloniki, Greece.

Purpose: Τo estimate the discrepancy rate between colposcopy, punch biopsy histology and surgical specimen histology as well as the positive (PPV) and negative predictive value (NPV) of colposcopic diagnosis for high-grade squamous intraepithelial lesions (HGSIL).

Methods: A prospective study was conducted during the period of 2012-2016. Αll cases in which surgical treatment had been applied and histopathological diagnosis of those surgical specimens was available were included. Cases in which ablation was performed and cases with incomplete data or conservative approach were excluded. Primary outcome was the agreement rate between histologic diagnosis of surgical specimen, histologic diagnosis of punch biopsy and colposcopic diagnosis according to REID Colposcopic Index. PPV and NPV of colposcopy and biopsy to diagnose HGSIL were also assessed.

Results: Τhere were 120 cases meeting our inclusion criteria, while biopsy was obtained in 104 cases. Mean age of women was 32.7 ± 9.0. Colposcopic diagnosis was CIN2 in 65 cases, CIN3 in 11 cases, CIN1 or less in 44 cases. Τhe level of agreement was fair between colposcopy-surgical specimen histology (κ value 0.443), fair between colposcopy-punch biopsy (κ value 0.34) and moderate between punch biopsy-cone specimen histology (κ value 0.443). PPV of colposcopy to detect HGSIL was 72.3%, while NPV was only 47.7%.

Conclusion: Punch biopsy and surgical specimen histology present the highest agreement between the different diagnostic procedures. Colposcopy presented satisfying PPV for HGSIL cases, but its NPV was poor. In contrary, punch biopsy was characterized by both satisfying PPV and NPV for HGSIL cases.
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http://dx.doi.org/10.1007/s00404-018-4714-8DOI Listing
May 2018
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