Immunoproliferative small intestinal disease in Greece: presentation of 13 cases including two from Albania.

Objectives: Immunoproliferative small intestinal disease (IPSID) represents a spectrum of clinicopathological entities including alpha-chain disease and other types of lymphoplasmacytic proliferations of the lamina propria of the small intestine, presenting with severe malabsorption. IPSID has been described mainly in the Mediterranean, Middle East, and African countries. It occurs rarely in western countries.

Defense mechanisms in inflammatory bowel disease.

Background: Although psychiatric disturbances and personality features are possibly involved in inflammatory bowel disease, little attention has been given to the potential role of defense mechanisms in the formation, course, or prognosis of the disease. The purpose of the present study was to determine whether certain defense styles and ego mechanisms of defense are associated with inflammatory bowel disease, including both ulcerative colitis and Crohn's disease.

Methods: Seventy-six consecutive unselected outpatients participated in the study.

Validation and results of a questionnaire for functional bowel disease in out-patients.

Background: The aim was to evaluate and validate a bowel disease questionnaire in patients attending an out-patient gastroenterology clinic in Greece.

Methods: This was a prospective study. Diagnosis was based on detailed clinical and laboratory evaluation.

Increased levels of lipoprotein (a) in Crohn's disease: a relation to thrombosis?

Objective: Lipoprotein (a) is recognized as a risk factor for arterial and venous thrombosis, a property that might be related to its structural similarity to plasminogen. Since patients with inflammatory bowel disease frequently suffer from thromboembolic events, we studied the role of lipoprotein (a) in conjunction with lipids and apolipoproteins in Greek patients with ulcerative colitis and Crohn's disease.

Methods: Lipoprotein (a), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein A-1 and apolipoprotein B-100 were determined in sera from 129 consecutive fasting Greek patients with inflammatory bowel disease (66 with ulcerative colitis and 63 with Crohn's disease) and from 66 matched healthy controls.

Elevated thrombopoietin serum levels in patients with inflammatory bowel disease.

Objectives: Elevated platelet count is a well recognized marker of inflammatory bowel disease (IBD) activity. Thrombopoietin (TPO) is a critical cytokine in the physiological regulation of thrombopoiesis. The aim of this study was to investigate the serum levels of endogenous TPO in patients with IBD, the relationship between platelet counts and TPO levels, and the correlation of TPO with the clinical characteristics of the patients.

Clinical patterns of Crohn's disease in Greece: a follow-up study of 155 cases.

The aim of this prospective study was to elucidate the clinical features and natural history of Crohn's disease in Greece. One hundred and fifty-five Greek patients with definite diagnosis of Crohn's disease were followed-up for a mean period of 9.7 years and evaluated for clinical patterns and course of illness.

Carcinoma of the ampulla of Vater in Crete. A clinical and ERCP registry over eight years.

Background: Carcinoma of the ampulla of Vater is an infrequent tumor that can be diagnosed, early.

Patients And Methods: Twenty-four patients with histologically proven carcinoma of the ampulla of Vater were retrospectively studied and their data were analyzed.

Results: Most common presenting symptoms were jaundice (67%), weight loss (58%), fever and pain (54%).

Core mental state in irritable bowel syndrome.

Objective: Psychiatric illness is higher among patients with irritable bowel syndrome (IBS) who seek medical care; however, a specific psychopathology that differentiates patients with IBS from patients with other organic gastrointestinal disorders has not been found. In the study described here, we investigated the predominant psychiatric symptoms in women with IBS.

Methods: The criteria of Manning et al.

IGF-I and IGF-II in relation to colorectal cancer.

Recent data suggest that the IGF system plays an important role in the pathogenesis of several forms of human cancer, and there is evidence that IGFs acting in an autocrine and paracrine manner may also affect colorectal cancer risk. We have conducted a case-control study on the island of Crete, Greece, to examine the potential relation between circulating IGF-I and -II and their major binding protein (IGF-BP3), on the one hand, and colorectal cancer, on the other. IGF-I, IGF-II and IGF-BP3 were determined in the serum from 41 patients with colorectal cancer and 50 healthy controls; data were analyzed using unconditional multiple logistic regression, adjusting for age, gender, education, height and BMI, as well as mutually.

Appendectomy, tonsillectomy, and risk of inflammatory bowel disease: case-controlled study in Crete.

Purpose: Appendectomy has been suggested as a possible protective factor in ulcerative colitis and as a risk factor in Crohn's disease. Tonsillectomy has also been associated with Crohn's disease. We performed a case-controlled study to investigate these associations in a homogeneous Greek population.

Somatostatin for acute severe bleeding from portal hypertensive gastropathy.

Objectives: To investigate the effect of somatostatin in acute severe bleeding from portal hypertensive gastropathy in 26 cirrhotic patients.

Methods: All patients with signs of acute gastrointestinal bleeding and an upper GI endoscopy (during the first 24 h) indicating overt bleeding from portal hypertensive gastropathy were included in the study. Somatostatin (or the synthetic tetradecapeptide, octreotide) was administered in all cases.

Anti-cardiolipin and anti-beta2-glycoprotein I antibodies in patients with inflammatory bowel disease.

Patients with inflammatory bowel disease (IBD) frequently suffer from thromboembolic events. Anti-cardiolipin (aCL) antibodies have been shown to be associated with thrombosis. Recently, the antibodies against the anti-cardiolipin cofactor beta2-glycoprotein I (a(beta2)GPI) have been found with higher specificity for thrombosis.

Ulcerative colitis in Greece: clinicoepidemiological data, course, and prognostic factors in 413 consecutive patients.

The clinical course and prognosis of ulcerative colitis was studied in a group of 413 Greek patients. The study lasted for 16 years and follow-up was achieved in 95% of the patients. Both sexes were almost equally affected, mainly between the ages of 40-49.

Lung function in patients with inflammatory bowel disease.

Previous studies on baseline pulmonary function testing (PFT) abnormalities in patients with inflammatory bowel disease (IBD) are conflicting because most of them have incorporated patients suffering from both ulcerative colitis (UC) and Crohn's disease (CD). The aim of the study is to investigate whether any PFT abnormalities could be detected in a large group of IBD patients and whether there are differences between the two IBD entities. A total of 132 patients, 47 with CD (mean age 35 years) and 85 with UC (mean age 40 years) were studied.

Association between ulcerative colitis and systemic lupus erythematosus: report of two cases.

Background: Common aetiopathogenic factors may explain the association of ulcerative colitis with autoimmune disorders such as systemic lupus erythematosus.

Patients: We report two cases of ulcerative colitis associated with idiopathic systemic lupus erythematosus: one patient who developed ulcerative colitis 11 years after having been diagnosed as a case of systemic lupus erythematosus and one case of simultaneous appearance of the two diseases. The lupus clinical manifestations were in neither case correlated with the treatment of ulcerative colitis.

Treatment of hepatocellular carcinoma with octreotide: a randomised controlled study.

Background: Standard treatment of inoperable hepatocellular carcinoma has not been established. Somatostatin has been shown to possess antimitotic activity against a variety of non-endocrine tumours.

Aims: To assess the presence of somatostatin receptors in human liver and to treat advanced hepatocellular carcinoma with the somatostatin analogue, octreotide.

Natural history of advanced hepatocellular carcinoma in Crete. Association with hepatitis C virus.

Objective: To investigate the clinical characteristics of advanced hepatocellular carcinoma (HCC) in Crete and to analyse the natural course of the untreated disease.

Participants: Seventy-three patients (62 men) were enrolled in a prospective 4-year study. Clinical and virological parameters were recorded.

Autoimmune hemolytic anemia and positive Coombs test associated with ulcerative colitis.

Objectives: To estimate the frequency of autoimmune hemolytic anemia and Coombs positivity without overt hemolysis in ulcerative colitis, to determine possible subsets of patients with ulcerative colitis susceptible to this complication, and to assess the efficacy of the applied therapeutic modalities.

Methods: Three hundred and two patients with ulcerative colitis treated at the University Hospital of Heraklion, Crete, over a 6-yr period were included. Within this group, a subgroup of 152 patients were studied prospectively for the presence of a positive direct Coombs test.

Management of varicella infection during the course of inflammatory bowel disease.

Objective: To study the natural history and outcome of varicella infection developing in steroid treated inflammatory bowel disease.

Background: Varicella infection occurring in immunosuppressed or immunocompromised patients is a common problem with a significant mortality. Varicella infection during the course of inflammatory bowel disease has been reported in a small number of patients with at least one fatality.

Roux-Y choledochojejunostomy and duodenojejunostomy for the complicated duodenal diverticulum.

Background: Exclusion of the duodenum by means of transection and Roux-Y duodenojejunostomy has been practiced for the treatment of complicated duodenal diverticulum. However, this method does not divert bile away from the diverticulum, hence the possibility of pancreaticobiliary complications is not eliminated.

Methods: Roux-Y choledochojejunostomy and duodenojejunostomy, for the diversion of bile and food, has been applied for the treatment of pancreaticobiliary complications of duodenal diverticulum in 4 patients.

Ulcerative colitis is as common in Crete as in northern Europe: a 5-year prospective study.

Objective: To study the incidence of ulcerative colitis and to analyse the pattern of the disease in the prefecture of Heraklion, Crete.

Participants: The population at risk comprised 263,670 inhabitants in the prefecture of Heraklion (2641 km2). The two regional hospitals, five health centres, 109 private family doctors and 145 specialists participated in the study.

A prospective epidemiologic study of Crohn's disease in Heraklion, Crete. Incidence over a 5-year period.

Background: There has been an impression from published work that Crohn's disease is less common in southern than in northern Europe. A low incidence of Crohn's disease has been observed in Greece, but conclusive data are still lacking.

Method: A 5-year prospective and population-based epidemiologic study of Crohn's disease was carried out in a well-defined area of Crete.