Papers by Konstantinos Romanidis
Clinics and Practice
1) Background: Children are susceptible to home injuries. How prepared parents were to protect th... more 1) Background: Children are susceptible to home injuries. How prepared parents were to protect their children from accidents before and during the COVID-19 quarantine is uncertain. (2) Methods: We conducted a community-based, cross-sectional study in Greece between November and December 2021. We asked parents to complete an anonymous questionnaire voluntarily. Questions focused on accident-preventive measures taken at home during the COVID-19 quarantine. (3) Results: A greater proportion of parents took protective measures for a safer home before the lockdown than during the quarantine, while an interesting percentage of parents never utilized preventive measures for their children. Slightly more than half (58.6%) of parents did not seem to worry about a possible increase in domestic accidents during the quarantine. It was observed that those who had one or two children took more protective measures than those with more than two children. Older parents seemed to explain to their children how to access emergency services more often. Mothers stayed at home with the children more often, and their education affected the presence of some of the assessed measures. In our logistic regression modeling, parental concern about accidents was more related to the incidence of an accident during the pandemic and attendance at seminars. (4) Conclusions: Although the COVID-19 lockdowns disorganized family life, parents were aware of the importance of their parenting role in creating a safe environment for children, but according to the study, there is room for improvement.
Current Oncology, Jun 25, 2022
Non-alcoholic fatty liver disease (NAFLD) is now considered the main driver and leading cause of ... more Non-alcoholic fatty liver disease (NAFLD) is now considered the main driver and leading cause of chronic liver disease globally. The umbrella term NAFLD describes a range of liver conditions closely related to insulin resistance, metabolic syndrome, diabetes mellitus, obesity, and dyslipidemia. At the same time, several malignancies, including hepatocellular carcinoma and colorectal cancer, are considered to be common causes of death among patients with NAFLD. At first, our review herein aims to investigate the role of NAFLD in developing colorectal neoplasms and adenomatous polyps based on the current literature. We will also explore the connection and the missing links between NAFLD and extrahepatic cancers. Interestingly, any relationship between NAFLD and extrahepatic malignancies could be attributable to several shared metabolic risk factors. Overall, obesity, insulin resistance, metabolic syndrome, and related disorders may increase the risk of developing cancer. Therefore, early diagnosis of NAFLD is essential for preventing the progression of the disease and avoiding its severe complications. In addition, cancer screening and early detection in these patients may improve survival and reduce any delays in treatment.
PubMed, 2016
Brenner tumours of the ovary are uncommon neoplasms and mostly benign. There is general agreement... more Brenner tumours of the ovary are uncommon neoplasms and mostly benign. There is general agreement that Brenner tumors are derived from the surface epithelium of the ovary or the pelvic mesothelium through transitional cell metaplasia. It is essential to categorise these tumours as benign, borderline or malignant type as the biologic behaviour and choice of surgery differs in all of the three categories. The authors report a case of Brenner tumour that had only a single area with a beginning indistinct stroma vessel invasion. However the presence of characteristic epithelial nests, fibromatous stroma, and marked cytological metaplasia without atypia provided important clues to the correct diagnosis--proof of a benign tumour.
PubMed, 2001
Using an immunocytochemical technique, the extracellular matrix components fibronectin, vimentin,... more Using an immunocytochemical technique, the extracellular matrix components fibronectin, vimentin, laminin and collagen type IV were investigated in human chorionic villi of various stages of development. Fibronectin and laminin were consistently positive throughout embryonic development. Vimentin and collagen type IV were negative in first and second trimester chorionic villi, but became positive in term placentas. With the exception of laminin, all extracellular matrix molecules were detected in the villous stroma and, with the exception of vimentin, they were localized in the basement membranes. Our data suggest that fibronectin and laminin are essential components of the villous structure, while the presence of vimentin and collagen type IV in the chorionic villi should be regarded as an indicator of fetal maturation.
PubMed, 2001
Most spontaneous abortions occur before 12 weeks' gestation, and most are due to chromosomal erro... more Most spontaneous abortions occur before 12 weeks' gestation, and most are due to chromosomal errors in the conceptus. Relatively few truly spontaneous abortions take place between 12 and 20 weeks' gestation. Thereafter, between 20 and 30 weeks another type of premature spontaneous termination due to ascending infection becomes prevalent. The number of cells expressing the various lymphocytic markers changes throughout pregnancy. In the present study, we investigated the immunohistochemical expression of mononuclear infiltrations in paraffin-embedded placentas, from fetuses after spontaneous abortion (8th, 10th, and 12th week of gestational age), and those after therapeutic abortion at the same time, using a panel of monoclonal antibodies for the identification of leukocytes (CD45/LCA), B-lymphocytes (CD20/L-26), T-lymphocytes (CD45RO/UCHL1) and CD5 cells. Immunologic factors in human reproductive failure are plausible mechanisms of infertility and spontaneous abortion. Approximately 25% of cases of premature ovarian failure appear to result from an autoimmune etiology. Unfortunately, current therapeutic options for these women are limited to exogenous hormone or gamete substitution. Local inflammation at the sites of endometriosis implants are postulated to mediate the pain and reduce fecundability associated with this clinical syndrome. The recruitment of immune cells, particularly monocytes and T cells, neovascularization around foci of invading peritoneal lesions, and the possible development of antiendometrial autoantibodies support an immunologic basis of this disorder. To date, treatment of pain and infertility associated with endometriosis is primarily surgical, although immune-based adjuvants are theoretical possibilities for the future. Finally, although hypotheses supporting immunologic mechanisms of recurrent pregnancy loss have been popular over the past decade, most clinical investigations in this area do not provide compelling evidence for this position. Reputable specialists in reproductive medicine use experimental immunotherapies judiciously in selected cases of repetitive abortion. For example, the use of anticoagulation therapy can be beneficial in cases with documented antiphospholipid antibodies. At present, however, efficacious immunotherapy protocols for general application have not been established. Despite these caveats, continued strides in our understanding of human reproductive immunology, should yield considerable future progress in this field. We conclude that, 1) maternal cells, probably CD45RO/UCHL1 positive cells, cross the maternofetal barrier and participate in spontaneous (involuntary) abortions, 2) a small proportion of maternal cells (approximately 30%), probably CD5 positive cells, also cross the maternal fetal barrier and cause growth delay and recurrent reproductive failure. The results were statistically significant (p < 0.0001, Student's t-test).
PubMed, Dec 3, 2020
Introduction: Gallbladder perforation (GBP) is an uncommon life-threatening and almost exclusive ... more Introduction: Gallbladder perforation (GBP) is an uncommon life-threatening and almost exclusive complication of cholecystitis. It is often associated with relatively high morbidity and mortality rates due to delay in diagnosis. GBP still continues to be a challenging issue for the surgeons. Most cases can only be diagnosed during surgery. The aim of this retrospective, case series was to present our clinical experience with gallbladder perforation and to provide an overview of promoting factors, clinical manifestations, diagnostic workup and management of GBP on the basis of recent literature review. Patients and methods: This study involved four patients with gallbladder perforation (three males and one female), who were treated in our department from May 2019 to November 2019. We made a retrospective analysis of these patients and a review of the related literature. Results: According to Niemeier's classification, all patients had type II gallbladder perforation. Mean age was 70 years (range 50-85 years). They had also significant comorbidities, of which diabetes mellitus was the most common (three patients). Ultrasonography was the initial mode of investigation in these four patients. Out of the four cases, three patients underwent immediate intervention and only one patient was initially managed conservatively with intravenous antibiotics. Conclusions: Early diagnosis of gallbladder perforation and immediate intervention are of crucial importance. Clinical examination, diagnostic imaging and high index of suspicion of this severe condition would be significant in establishing an early diagnosis of the perforation. Key words: Cholecystitis, Gallbladder perforation, Niemeier.
PubMed, 2001
Quality assessment schemes are widespread in most branches of pathology but are uncommon in the m... more Quality assessment schemes are widespread in most branches of pathology but are uncommon in the more subjective areas of histopathology and cytology. Researchers in many fields have become increasingly aware of the observer as an important source of measurement error. The validity of any method of reporting evidence of an abnormal process in cellular material is based on the degree of correlation with the actual disease process as it exists in the tissue and its reproducibility. Correlations can be tested in retrospective studies in which diagnoses based on cellular evidence are matched against the disease process present in biopsy specimens. Correlations can also be tested by examination of a set of unknown cellular preparations obtained in the presence of proven disease. While reproducibility is indirectly related to correlation, it is meant to imply satisfactory utilization of the method by other groups of cytotechnologists and cytopathologists. While cytopathology will continue to play an important role as a screening technique for the detection of cancer of the uterine cervix, its usefulness in the study of the early manifestations of the disease process is yet to be realized on a universal basis.
PubMed, 2001
Basement membrane zones are specialized sheets--like arrangements of extracellular matrix protein... more Basement membrane zones are specialized sheets--like arrangements of extracellular matrix proteins and glycosaminoglycans, and act as an interface between parenchymal cells and support tissue. They separate epithelium, endothelium, muscle cells and Schwann cells from adjacent connective tissue stroma, and also from a limiting membrane in the central nervous system. They are involved in several cellular and biological processes, including adhesion, migration and cellular differentiation. Basement membranes have five major components: collagen type IV, laminin, heparan sulfate, entactin, and fibronectin. In addition, there are numerous minor and poorly characterized protein and glycosaminoglycan components. The various components of the basement membranes of the skin (collagen type IV, proteoglycans--heparan sulfate, laminin, entactin and fibronectin) are products of the epithelial (epidermal) cells. We studied immunohistochemically the origin, the first appearance and distribution of the adhesive extracellular glycoprotein laminin and the fibrillar proteins of the extracellular matrix collagen type IV and fibronectin in the basement membranes of fetal human skin between 12 to 21 weeks of gestational age. Additionally, we studied the expression of vimentin in the extracellular matrix of the epithelial/mesenchyme junction of the skin. This study demonstrates clearly that the expression of the antigens laminin, collagen type IV and fibronectin starts in the germinative epithelial cells of the skin at the bulbs of the hair follicles (12th week for fibronectin and 19th week for laminin and collagen type IV), and migrating progressively involves the epithelial epidermal cells of the covering skin, as well as, the basement membrane at the dermal-epidermal junction in that region (between 20 to 21 weeks of gestational age).
Gynecologic Oncology, Sep 1, 2002
The goal of this work was to evaluate the use of intraoperative cytology in the improvement of ov... more The goal of this work was to evaluate the use of intraoperative cytology in the improvement of ovarian cancer staging. Fifty-two patients with clinical stage IA-IIB ovarian cancer underwent peritoneal washing (PW) cytology and imprint cytology performed on retroperitoneal lymph node samples, during primary surgical treatment. Cytologic specimens were stained by the May-Grünwald-Giemsa (MGG) and hematoxylin-eosin (HE) techniques. Pertinent histologic sections of the ovarian lesions, cell blocks prepared from PW sediments, and lymph node samples were studied and compared with the cytologic findings. Our study reveals that, when malignant cells are present in the peritoneal cavity, PW cytology has 84.6% sensitivity and 94.7% specificity in detecting them. Imprint cytology performed on lymph node samples presented 94.1% sensitivity and 94.1% specificity in the diagnosis of retroperitoneal metastasis of ovarian cancer. Only 7 patients (13.4%) were upstaged with either cytologic method. PW cytology alone upstaged 6 more patients, while imprint cytology alone upstaged 11 more patients. This corresponds to a total of 17 patients (32.6%) who benefit from the combined performance of both cytologic methods. HE stain presents lower values of sensitivity and specificity compared with MGG. Cytologic evaluation of intraperitoneal and retroperitoneal spread of ovarian cancer by use of PW cytology and imprint cytology performed on lymph node samples contributes to the improvement of ovarian cancer staging.
Annals of The Royal College of Surgeons of England, Mar 1, 2022
Acute appendicitis is common in patients with right lower quadrant pain and affects all gender an... more Acute appendicitis is common in patients with right lower quadrant pain and affects all gender and age groups. Because clinical diagnosis of patients with right lower quadrant pain remains a challenge to emergency physicians and surgeons, imaging is of major importance. Ultrasound has well-established direct and indirect signs for diagnosing acute appendicitis and revealing the presence of an appendicolith. Appendectomy, which can be either open or laparoscopic, constitutes the basic treatment. However, the need for an appendectomy is debatable, particularly in high-risk patients. We report the case of a 42-year-old woman with no relevant medical history who was sent to the emergency department by her family physician with right lower quadrant pain of 18 hours’ duration. Using ultrasound, the emergency physicians identified, inside the appendix, a 0.6cm appendiceal faecolith, migration of which was eventuated by manipulation of the ultrasound probe. The patient was then successfully treated non-operatively without any antibiotic prescription. Despite its rarity, migration of an appendiceal faecolith is possible. When migration of an appendicolith is perhaps actualised spontaneously or by ultrasound probe manipulation, the likelihood of an appendectomy decreases dramatically. This hypothesis provides patients who present an appendiceal faecolith with an alternative treatment approach that will lead to the avoidance of surgery, minimise morbidity and reduce hospitalisation costs.
Journal of B.U.ON. : official journal of the Balkan Union of Oncology, Mar 1, 2015
Malignant pleural mesothelioma (MPM) is an asbestos-related disease with a dismal prognosis. Ethi... more Malignant pleural mesothelioma (MPM) is an asbestos-related disease with a dismal prognosis. Ethic, social, legal and economic parameters are implicated in its management. It is quite clear that multimodality therapy is necessary to improve long-term results but precise treatment schemes have not yet been equivocally accepted. The extent of surgery is questioned and radical operations are highly debatable. On the other hand, debulking or cyto-reductive surgery have been also proposed within a multimodality approach. However, the role and order of adjuvant or neoadjuvant use of chemotherapy, radiotherapy and surgery has not been established. The aim of this study was to analyze contemporary studies on the impact of different surgical approaches on outcome of patients with MPM.
Journal of Medical Case Reports, Jun 2, 2015
Introduction: In this case report, we describe the successful treatment of a small-bowel intussus... more Introduction: In this case report, we describe the successful treatment of a small-bowel intussusception, which was caused by a 3cm solitary hamartomatous polyp, with single-incision laparoscopic surgery. Single-incision laparoscopic surgery is a minimally invasive surgical procedure with important advantages that allows the reduction of the intussusception and the resection of the polyp. This case report contributes to the medical literature by describing the advantages of this surgical technique that warrant its consideration as a treatment of choice in similar cases. Case presentation: We report a case of a 19-year-old Greek woman who complained about intermittent, non-specific abdominal pain in her left lateral abdomen. She had been admitted to the hospital because of incomplete obstructive ileus. Ultrasound and computed tomography were carried out, which revealed an intussusception of the small bowel. This pathogenic situation was treated by single-incision laparoscopic surgery. Her pathology report revealed a benign, hamartomatous excised polyp of the Peutz-Jeghers type. The patient had a quick recovery without any post-operative complications. We recommend single-incision laparoscopic surgery for the safe excision of solitary hamartomatous polyps and the management of their complications, as it represents a potential advance in minimally invasive approaches.
Healthcare, Oct 17, 2022
The COVID-19 pandemic and stay-at-home regulations have increased child home injuries. This study... more The COVID-19 pandemic and stay-at-home regulations have increased child home injuries. This study illustrates the type and frequency of child home injuries in Greece during the COVID-19 lockdown. Moreover, the survey reports the results on parents' proposals regarding child injuries at home during the COVID-19 quarantine. A community-based, cross-sectional, descriptive study was conducted from November to December 2021 in Greece. Parents were asked to voluntarily complete an anonymous questionnaire, designed for the needs of the research. A statistical analysis of the data was performed using the Kolmogorov-Smirnov and Shapiro-Wilk tests for a normal distribution, a chi-squared (χ 2 ) test to compare percentages among different groups and a non-parametric Mann-Whitney U test to determine the differences in Likert scale variables between two groups. A total of 130 parents with at least one child were questioned through an online questionnaire survey. Of the parents, 39.3%, stated that the number of accidents in their home increased. The most frequent accidents were injuries (49.3%). Most of the accidents occurred inside the house (75.8%) and were observed among children aged 0-4 years. A high percentage of children's accidents was observed in rural/island areas or in the suburbs. Children who were with either their father or mother had one accident, and a higher number of accidents occurred when the children were with their grandparents, with the nanny or alone. For those parents who had difficulty supervising their child, child accidents increased compared to parents who had the ability to supervise. It was noticed that parents who knew how to provide a safe home stated that the number of accidents remained the same. Parents must organize a safer home. Authorities should educate parents on child injury prevention and provide them with financial facilities to provide a safer house.
Respiratory medicine case reports, 2020
Catamenial pneumothorax (CP) is considered to be the most common form of thoracic endometriosis s... more Catamenial pneumothorax (CP) is considered to be the most common form of thoracic endometriosis syndrome, which also includes catamenial hemothorax, catamenial hemopneumothorax, catamenial hemoptysis, and endometriosis lung nodules. Diagnosis can be hinted by high recurrence rates of lung collapse in a woman of reproductive age with endometriosis. In our case we present a 41 year old woman at the time of the second incidence with a left pneumothorax and holes in the pericardium in the diaphragm location. Laparoscopic evaluation was performed along with video-assisted thoracoscopy and treatment was performed with both techniques.
Surgical laparoscopy, endoscopy & percutaneous techniques, Apr 1, 2013
Small-intestinal nonmeckelian diverticula are very uncommon and are considered to be acquired pul... more Small-intestinal nonmeckelian diverticula are very uncommon and are considered to be acquired pulsion diverticula. Most of these diverticula are asymptomatic and are simply incidental findings. Complicated-acquired diverticular disease of the jejunum and ileum is a diagnostic dilemma. Small-bowel diverticulum is diagnosed with the aid of radiography techniques, such as small-bowel contrast series or enteroclysis. Laparotomy remains the gold standard for a definite diagnosis of asymptomatic and complicated diverticula, but laparoscopy is also very useful in the diagnosis and treatment of this condition. A surgical approach is the best form of treatment for complicated jejunoileal diverticula. The current report is about a patient who presented with iron deficiency anemia caused by a complicated jejunal diverticulum and managed with single-trocar transumbilical laparoscopy.
Journal of Gynecologic Surgery, Apr 1, 2013
Background: Serous cystadenomas are common benign ovarian tumors that range in diameter from 3 cm... more Background: Serous cystadenomas are common benign ovarian tumors that range in diameter from 3 cm to 40 cm. The main purpose of this case report is to present the successful treatment of a huge serous cystadenoma using a special laparoscopic technique, without any postoperative complications. Case: A case of a serous cystadenoma in a 67-year-old woman who presented with abdominal distension and nonspecific abdominal pain is presented. Computerized tomography and ultrasound revealed a huge ovarian serous cystadenoma on the right ovary with dimensions of 13.5 cm • 11.4 cm • 19.5 cm. The cyst was completely excised by laparoscopic surgery, and the histopathologic findings confirmed the diagnosis. Results: Postoperatively, the patient had a quick recovery, and she was discharged on postoperative day 3 without any complications. She showed no signs of recurrence during a follow-up period of 6 months. Conclusions: The current contradictory opinions about the laparoscopic treatment of huge serous cystadenomas have made laparotomy the standard approach. However, laparoscopic surgery should be a safe treatment of choice even in patients with large serous cystadenomas because, with proper handling, this technique can ensure complete tumor excision and reduce the probability of the intraperitoneal diffusion of cancerous cells. Furthermore, this procedure allows a quick recovery and discharge without any postoperative complications. ( J GYNECOL SURG 29:105)
BMC Research Notes, Jun 4, 2014
Background: Tc-sestamibi is the most frequently used radionuclide agent for the detection of para... more Background: Tc-sestamibi is the most frequently used radionuclide agent for the detection of parathyroid adenomas in the clinical setting. However, Tc-tetrofosmin is another such agent that may be used for this purpose. This case report presents the significance and practicality of 99m Tc-tetrofosmin for the diagnosis of parathyroid adenomas with probable high p-glycoprotein levels. Case presentation: A 45-year-old woman was referred to our Nuclear Department with a palpable neck nodule suspicious for parathyroid adenoma. She had no significant medical history or other accompanying symptoms. Blood examination results were normal with the exception of the parathormone level which was high at 167.2 pg/ml. Neck ultrasonography revealed a hypoechoic mass near the lower pole of the thyroid gland. 99m Tc-tetrofosmin dual-phase scintigraphy with early and delayed images was performed and the results supported the presupposition of parathyroid adenoma as shown by increased radiopharmaceutical levels near the lower left thyroid gland on the early image that disappeared on the delayed image. Moreover, TcO 4 -thyroid scintigraphy results excluded thyroid pathology. Two months after the diagnosis, parathyroidectomy was successfully performed without postoperative complications. The pathology report and clinical response to a gradual decrease of parathormone confirmed the initial diagnosis. We strongly recommend the use of reverse 99m Tc-tetrofosmin scintigraphy as a useful and safe examination technique for the diagnosis of parathyroid adenomas.
Techniques in Coloproctology, Nov 1, 2004
In 21 (72.5%) there was a complete obstruction located in 17 (81%) at the sigmoid, in 2 (9.5%) in... more In 21 (72.5%) there was a complete obstruction located in 17 (81%) at the sigmoid, in 2 (9.5%) in right flexure and in 2 (9.5%) in left flexure. Five patients (17%) had developed peritonitis due to perforation proximal to the tumour and three patients (10.5%) had developed necrotic colitis and haemorrhage due to the obstruction. In 23 patients (79.5%) a radical curative operation was feasible [11 (38%) subtotal colectomies with ileo-rectal anastomosis, seven (24%) Hartman's, three (10%) right hemicolectomy and two (7%) on table bowel lavage plus colectomy with ileo-rectal anastomosis] and in six (11%) only palliative operations could be done (transverse loop colostomy). In all cases the postoperative period was uneventful. Three patients with palliative operation were submitted to a radical curative operation 2 months later and the other three patients died 6 months later from causes irrelevant to the primary disease. It is concluded that in this series of patients radical curative operations for carcinoma of the large bowel even under urgent conditions were feasible in the cases without additional complications, eliminating the necessity for reoperations later on.
Current Oncology
Anastomotic leakage (AL) remains one of the most severe complications following colorectal cancer... more Anastomotic leakage (AL) remains one of the most severe complications following colorectal cancer (CRC) surgery. Indeed, leaks that may occur after any type of intestinal anastomosis are commonly associated with a higher reoperation rate and an increased risk of postoperative morbidity and mortality. At first, our review aims to identify specific preoperative, intraoperative and perioperative factors that eventually lead to the development of anastomotic dehiscence based on the current literature. We will also investigate the role of several biomarkers in predicting the presence of ALs following colorectal surgery. Despite significant improvements in perioperative care, advances in surgical techniques, and a high index of suspicion of this complication, the incidence of AL remained stable during the last decades. Thus, gaining a better knowledge of the risk factors that influence the AL rates may help identify high-risk surgical patients requiring more intensive perioperative survei...
Current Health Sciences Journal, 2021
Background: The first wave of the COVID-19 pandemic initiated officially in October 2020. Since t... more Background: The first wave of the COVID-19 pandemic initiated officially in October 2020. Since then several observations have been made regarding the disease and its symptoms. Patients and Methods: We included eighty seven in our observational study. Our main aim was to investigate their long term respiratory follow-up in correlation with their initial radiological and laboratory findings and values. The nose swab PCR test for COVID-19 was used for diagnosis. Patients were monitored at 3 and 6 months after their hospital reception whereas basic parameters of health condition (smoking, PO2, SPO2, WBC, CXR, CRP, intercurrent findings, days of nursing, colchicine administration) in joint with gender and age were recorded. Results: Males seem more susceptible to the viral disease than females in a ratio 1,8:1. The parameters FEV1 and FVC (as % relative changes) were not affected, apart from the DLCO to which CRP (in loge+1 transformation) and SPO2 showed a statistically significant eff...
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Papers by Konstantinos Romanidis