Stefanos Flindris

Aristotle University of Thessaloniki

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Stamatios Petousis

Aristotle University of Thessaloniki

Aristarchos Almperis

Aristotle University of Thessaloniki

Chrysoula Margioula‐Siarkou

Aristotle University of Thessaloniki

Konstantinos Dinas

Aristotle University of Thessaloniki

Georgia Margioula‐Siarkou

Aristotle University of Thessaloniki

Minas Paschopoulos

University Hospital of Ioannina

Pavlos Papakotoulas

Theageneio General Hospital

Stefanos K Stefanou

Henry Dunant Hospital

Frédéric Guyon

Institut Bergonié

Konstantina Mponiou

Theageneio General Hospital

Cooperative Institutions

University of Ioannina

University Hospital of Ioannina

Aristotle University of Thessaloniki

National and Kapodistrian University of Athens

General Hospital of Ioannina G. Hatzikosta

Ippokrateio General Hospital of Thessaloniki

Hospital Universitario Insular de Gran Canaria

General Hospital of Filiates

Institut Bergonié

Laiko General Hospital of Athens

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PsycTESTS Dataset (2023)

Vassiliki Siafaka Orestis Tsonis Christos Christogiannis Katerina‐Maria Kontouli Kalypso Margariti

10.1037/t88604-000

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Colovesical Fistula due to Sigmoid Diverticulitis

Case Reports in Surgery (2023)

Christos K Stefanou S Gkogkos Stefanos Flindris Apostolis K. Paxinos Thomas Tsiantis

Introduction. The incidence of colonic diverticulosis has risen significantly. Diverticular disease is the most frequent cause of colovesical fistulas, which are uncommon complications of diverticulitis. Clinical signs, such as fecaluria and pneumaturia, are typically required to confirm its presence. Finding the cause of the disease so that the proper therapy can be started is the primary goal of a diagnostic workup rather than observing the fistula tract itself. Case Presentation. We present a 43-year-old man complaining of frequent urinary tract infections for six months. On CT abdomen and pelvis, a colovesical fistula was diagnosed. Surgery was performed, and after the division between the sigmoid colon and the bladder, a sigmoidectomy and an end-to-end colorectal anastomosis were performed. During the surgery, the fistula tract was not detected. The patient was discharged in excellent condition on day six, and the catheter was removed on day 10. Conclusion. In conclusion, as in our case, any patient with a urinary tract infection should be suspected of having this condition, especially if he has persistent symptoms that have not responded to standard medical care. Patients who present with fecaluria, pneumaturia, and other specific symptoms of a colovesicular fistula do not necessarily need a barium enema or cystography to confirm the presence of the fistula.

Diverticulitis

Barium enema

Diverticulosis

Diverticular disease

Cystography

10.1155/2023/8835222

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Plasmablastic Lymphoma with Coexistence of Chronic Lymphocytic Leukemia in an Immunocompetent Patient: A Case Report and Mini-Review

Case Reports in Hematology (2017)

Eleftheria Hatzimichael Konstantina Papathanasiou Ioannis Zerdes Stefanos Flindris Alexandra Papoudou‐Bai

Background . Plasmablastic lymphoma (PBL) is a rare, aggressive B-cell lymphoma with poor prognosis usually found in the oral cavity of HIV-positive patients. Chronic lymphocytic leukemia (CLL) is an indolent B-cell lymphoma with a variable clinical course. Transformation of CLL to PBL as Richter’s syndrome is rare while coexistence of CLL and PBL at diagnosis is even rarer. Case Report . We describe a case of a male immunocompetent patient with an ileum-cecum valve mass and a soft tissue mass at the left humerus with histologic evidence of PBL with coexistence of CLL in the bone marrow and peripheral blood. Amputation of the patient’s left arm was inevitable, and the patient was started on bortezomib and dexamethasone. However, prolonged hospitalization was complicated by aspiration pneumonia, and the patient passed away. Conclusions . No standard of care exists for patients with PBL, and prognosis remains dismal. Concomitant presentation of hematological malignancies becomes increasingly recognized, and further insight is needed in order to delineate whether they originate from the same clone or from different ones.

Plasmablastic lymphoma

10.1155/2017/2861596

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Citations (14)

1185 Sentinel lymph node staging in early-stage cervical cancer: a systematic review

Chrysoula Margioula‐Siarkou Aristarchos Almperis Emmanouela-Aliki Almperi Georgia Margioula‐Siarkou Stefanos Flindris

Introduction/Background

Current guidelines suggest full pelvic lymphadenectomy (PLND) for lymph node staging in early-stage cervical cancer (CC) patients. Main objective of this review is to consolidate existing evidence on the diagnostic precision and survival results of sentinel lymph node biopsy (SLNB) compared to radiographic nodal assessment and systematic lymphadenectomy.

Methodology

A systematic review through PubMed, Scopus and EMBASE was carried out up to July 2023 scrutinizing the application of SLNB in women with early-stage CC focusing on the comparison with PET/CT and PLND. Eligible studies included prospective and retrospective randomized control trials (RCTs), cohort studies, case-control and case series studies, as well as systematic review articles and meta-analyses, having as primary objective to compare survival outcomes and diagnostic accuracy in terms of false-positive, false negative rates (FPR, FNR), sensitivity and specificity. Additionally, studies investigating low-volume disease in sentinel nodes and its impact on survival outcomes or recurrence risk were also considered eligible.

Results

There were finally 10 articles meeting the inclusion criteria, among which, 4 studies highlighted SLNB's superior accuracy in determining lymph node status for primary CC compared to advanced imaging methods, with PET being regarded as the optimal choice. In 1 systematic review and one meta-analysis, SLNB shows comparable oncologic efficacy to PLND, exhibiting higher positive node detection and pre-dominance of no lymph node recurrences. However, due to the lack of robust prospective evidence, especially regarding long-term oncological safety, SLNB hasn't attained gold standard status. Regarding low-volume disease impact, 4 cohort studies presented conflicting findings: micrometastases (MIC) were linked to both increased and decreased survival rates or acted as an independent recurrence risk factor.

Conclusion

This critical review strongly supports the safety and efficacy of SLNB over imaging staging in early-stage CC. Abandoning PLND in early-stage CC isn't justified per major guidelines. Further multicenter RCTs are needed for conclusive evidence.

Disclosures

Authors have nothing to disclose.

Lymphadenectomy

10.1136/ijgc-2024-esgo.242

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The Expression of NRIP1 and LCOR in Endometrioid Endometrial Cancer

In Vivo (2021)

Stefanos Flindris Nikolaos Katsoulas Anna Goussia Andreas C. Lazaris Iordanis Navrozoglou

The aim of the study was to analyze the expression of nuclear receptor interacting protein 1 (NRIP1) and its partner ligand-dependent nuclear receptor co-repressor (LCOR) in endometrioid endometrial cancer and to investigate their association with estrogen receptor (ER), progesterone receptor (PR), Ki-67, clinicopathological parameters and patient survival.Immunohistochemical evaluation was carried out to investigate the subcellular expression of NRIP1 and LCOR in endometrioid endometrial cancer samples. Statistical analysis was used to identify the correlations of NRIP1 and LCOR expression with clinicopathological variables and to estimate the survival rates.Endometrial cancer tissues exhibited higher expression of NRIP1 and LCOR in comparison with the normal tissues. Cytoplasmic LCOR expression was positively associated with ER and PR expression, while cytoplasmic NRIP1 expression was positively associated with ER expression. Moreover, cytoplasmic expression of NRIP1 was positively associated with Ki-67.Our study demonstrated that high cytoplasmic expression of LCOR may predict a longer overall survival of patients with endometrioid endometrial cancer. Patients with tumors expressing low levels of LCOR showed a worse survival compared to those expressing high levels.

Progesterone receptor

10.21873/invivo.12545

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Citations (4)

1236 Successful total pelvic exenteration in a 38-year old patient with relapsed vaginal cancer

Chrysoula Margioula‐Siarkou Emmanouela-Aliki Almperi Georgia Margioula‐Siarkou Aristarchos Almperis Stefanos Flindris

Introduction/Background

To present the clinical image and clinical video of a total pelvic exenteration for relapsed

Methodology

The patient's medical history and laboratory, imaging and histopathological reports were reviewed in order to comprehensively present the diagnostic approach and course of treatment.

Results

A 38 year old woman with locally advanced vaginal cancer initially treated with combined chemo-radiation therapy (25 cycles of radiation with concurrent cisplatin), one month later was presented vaginal bleeding. As further treatment cauterization of vaginal lesions was performed followed by brachytherapy. Six months later, during her follow-up period, the patient performed imaging tests where a suspicious lesion in upper vagina was found in Magnetic Resonance Imaging (MRI). The patient sought consultation from the gynecologic oncology team of our ESGO certified Department, where a biopsy was perfomed which confirmed the presence of residual disease. The case was discussed in our Multidisciplinary Tumour Board as per protocol and a treatment with 6 cycles of chemotherapy (carboplatin/paclitaxel) was decided. 3 months later she presented again to our Department with an ulceration in vulva and vagina, and a new biopsy confirmed the presence of residual disease. As a result, after thorough consideration and detailed consultation to the patient, a pelvic exenteration with an appendectomy, vaginal excision, end-colostomy and ureterostomy was performed.

Conclusion

Total pelvic exenteration is an ultraradical demanding surgical procedure, which may in certain cases be the only remaining therapeutic solution. Relapsed vaginal cancer may consist a relative indication.

Disclosures

Authors have nothing to disclose.

Pelvic exenteration

10.1136/ijgc-2024-esgo.1067

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Citations (0)

PsycTESTS Dataset (2023)

Vassiliki Siafaka Orestis Tsonis Christos Christogiannis Katerina‐Maria Kontouli Kalypso Margariti

Pandemic

10.1037/t88603-000

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Sentinel Node Procedure For Apparent Early-Stage Endometrial Cancer: A Prospective Cohort Study

International Journal of Gynecological Cancer (2025)

Chrysoula Margioula‐Siarkou Stamatios Petousis Georgia Margioula‐Siarkou Stefanos Flindris Emmanouela-Aliki Almperi

10.1016/j.ijgc.2024.100866

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Systemic Thrombolysis for Treatment of Acute Life-threatening Pulmonary Embolism During Cesarean Section Followed by Post-partum Rescue Hysterectomy: A Case Report and Review of the Literature

In Vivo (2023)

Agathi Karakosta Theocharis Evangelou Stefanos Flindris Ιωάννα Σαμαρά Effrosyni Styliara

Abstract

Background/Aim: Acute pulmonary embolism during cesarean section is extremely rare and only a limited number of cases have been reported in literature. The aim of this study was to report a case of acute high risk pulmonary embolism during elective cesarean section treated with systemic thrombolysis and discuss the multidisciplinary management in both early recognition and prompt treatment. Case Report: A 39-year-old, G5P2, ASA II parturient presented for repeat cesarean section under general anesthesia. A sudden drop in end-tidal CO₂ after placenta delivery combined with significant hemodynamic instability after an uneventful intraoperative course was strongly indicative of pulmonary embolism. Urgent transthoracic ultrasound revealed a sizable thrombus in the inferior vena cava and the right atrium. Thrombolysis was carried out intraoperatively using recombinant tissue plasminogen activator, which was administered under continuous US monitoring until thrombus resolution. This resulted in significant bleeding that was treated in a stepwise manner beginning with implementation of massive transfusion protocol, Bakri balloon placement, and rescue hysterectomy several hours after the event. Follow-up was uneventful and she was discharged on the 12^th postoperative day. Conclusion: Though pregnancy is one of the major risk factors of the development of venous thromboembolism, acute intraoperative pulmonary embolism is extremely rare. Specific guidelines for the management of such cases are difficult to issue due to the paucity of relevant data. Thus, an individualized approach by a multidisciplinary team for diagnosis and intervention is mandated.

10.21873/invivo.13106

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Citations (5)

Psychometric properties of the Greek versions of the Pandemic-Related Pregnancy Stress Scale and the Pandemic-Related Postpartum Stress Scale and associated risk factors during the second year of the COVID-19 pandemic

BJPsych Open (2023)

Vassiliki Siafaka Orestis Tsonis Christos Christogiannis Katerina‐Maria Kontouli Kalypso Margariti

Background The COVID-19 pandemic has affected perinatal mental health. Reliable tools are needed to assess perinatal stress during pandemic situations. Aims To assess the psychometric properties of the Greek versions of the Pandemic-Related Pregnancy Stress Scale (PREPS) and the Pandemic-Related Postpartum Stress Scale (PREPS-PP) and to explore the associations between women's characteristics and perinatal stress during the second pandemic wave. Methods The PREPS and PREPS-PP were completed by 264 pregnant and 188 postpartum women, respectively, who also completed the State-Trait Anxiety Inventory (STAI) and the Edinburgh Perinatal Depression Scale (EPDS). Results The internal consistency was similar for PREPS and PREPS-PP. It was good for preparedness stress (a = 0.77 and α = 0.71, respectively) and infection stress (α = 0.83 for both scales) but low for positive appraisal (α = 0.46 and α = 0.41, respectively). Of the pregnant women, 55.33% and 55.27%, respectively, reported scores of ≥40 on STAI-S and STAI-T, and the respective percentages for the postpartum women were 47.34% and 46.80%. In addition, 14.39% of the pregnant women and 20.74% of the postpartum women scored ≥13 on the EPDS. Higher preparedness stress on PREPS and PREPS-PP was associated with primiparity ( P = 0.022 and P = 0.021, respectively) and disrupted perinatal care ( P = 0.069 and P = 0.007, respectively). In postpartum women, higher infection stress was associated with chronic disease ( P = 0.037), primiparity ( P = 0.02) and perceived risk of infection ( P = 0.065). Higher score on infection stress was associated with disrupted perinatal care in both groups ( P = 0.107 and P = 0.010, respectively). Conclusions The Greek versions of PREPS and PREPS-PP are valid tools for the assessment of women at risk of perinatal stress during a health crisis.

Pandemic

Perceived Stress Scale

Preparedness

Stressor

10.1192/bjo.2022.635

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Citations (2)