Vasilios Papastergiou

Evangelismos Hospital

Background In patients with Crohn’s disease (CD) localized in the small intestine, endoscopic healing can be assessed by small bowel capsule endoscopy (SBCE). We aimed to investigate the rate of achieving deep remission, i.e. endoscopic healing and clinical remission in patients with CD of the small intestine, after treatment with adalimumab. Meth...

Background Prolonged biliary stenting may be considered in high-risk patients with irretrievable bile duct stones (IBDS). Distal stent migration (DSM) is a known complication, although data beyond the recommended interval of temporary stenting (3–6 months) are lacking. We compared the long-term incidence of DSM between straight and double-pigtail s...

LINKED CONTENT This article is linked to Jodal et al papers. To view these articles, visit https://doi.org/10.1111/apt.16686 and https://doi.org/10.1111/apt.16764

Objective: To compare recurrence rates among three endoscopic treatment modalities for 5-9 mm left-sided colorectal polyps. Methods: Consecutive adults referred for elective colonoscopy (1/2015-1/2018) with at least one polyp of eligible size (5-9 mm) located distally to the splenic flexure were randomly assigned (1:1:1) to one of three treatmen...

Hepatitis C virus (HCV) genotype 3 (HCV-G3) is one of the seven recognized genotypes [1]. HCV-G3 is the second most common genotype accounting for 22% of all infections globally [2, 3]. Although three-quarters of them occur in South Asia, where it is endemic, the 3a subtype is an “epidemic subtype” widely distributed geographically, probably associ...

Introduction: Eradication of Helicobacter pylori (H. pylori) becomes more challenging due to increasing antimicrobial resistance. Consequently, the performance of clarithromycin-containing triple therapies is now declining to unacceptable levels and should be abandoned unless a prior susceptibility test precludes clarithromycin resistance. Areas co...

Background: Flexible sigmoidoscopy (FS) is resource-conserving and may increase adherence to colorectal cancer (CRC) screening compared to total colonoscopy. We investigated the diagnostic performance of FS-based screening for advanced colorectal neoplasia (ACN), including advanced adenomatous neoplasms (AANs), advanced serrated lesions (ASLs) and...

Background: Adherence and persistence to long-term therapy with nucleos(t)ides analogues are crucial to the outcome of treatment in chronic hepatitis B. Our aim was to determine the persistence and adherence rates to nucleos(t)ides analogues in chronic hepatitis B patients under maintenance therapy and to identify relative to prediction of adheren...

Introduction: Endoscopic Retrograde Cholangio-Pancreatography (ERCP) is an well-established endoscopic procedure for the management of biliary diseases. The use of fluoroscopy during ERCP has often raised concerns regarding potential risks from radiation exposure, particularly in complex cases. We investigated whether a new digital single-operator...

Aims: Adenoma detection rate (ADR) is a fundamental metric in colonoscopy quality; however, it is cumbersome to obtain as it requires the linkage of endoscopy and pathology reports. The adenoma-to-polyp-detection-rate-quotient (APDRQ) has been proposed as an easy multiplier for the estimation of the individual endoscopist's ADR from polyp detection...

Aims: Flexible sigmoidoscopy (FS) is an attractive screening modality, being less invasive and costly compared to full colonoscopy. We investigated the yield of FS with respect to advanced colorectal neoplasia (ACN) detection and identified factors correlating with ACN missed by FS-based screening. Methods: Retrospective cross-sectional study of da...

Aims: Sessile serrated polyps (SSPs) are recognized as a major contributor to the epidemiologic burden of colorectal cancer, although the optimal technique for their removal remains uncertain. We aimed to prospectively evaluate the efficacy and safety of cold endoscopic mucosal resection (c-EMR) for SSPs sized 8-20 mm. Methods: Consecutive adults r...

Purpose Endoscopic Retrograde Cholangio-Pancreatography (ERCP) is a well-established endoscopic procedure for treatment or palliation of a great variety of hepatobiliary and pancreatic diseases, routinely performed using X-ray fluoroscopy. Due to extended fluoroscopy times and increased number of images, patient radiation doses can be high, especia...

Introduction Trans-Anal Submucosal Endoscopic Resection (TASER) is a novel instrumental platform for resection of large (≥5 cm) and/or complex rectal polyps (CRPs). It involves a multi-port trans-anal access, enabling dynamic tissue retraction to assist endoscopic submucosal dissection (ESD), used alone or in conjunction with supplementary techniqu...

Introduction There is limited experience of endoscopic submucosal dissection (ESD) for resection of colorectal lesions in the West and outcome data tends to be worse than that reported from Japanese centres. We report the outcomes of ESD in a single, tertiary UK referral centre. Methods A prospective database was analysed including 165 consecutive...

Colonoscopy is generally safe, although expansion of colorectal cancer prevention programs is likely to increase the number of post-colonoscopy complications. We report the case of a 42-year old woman with a prior history of 2 cesarean section deliveries who developed abdominal pain after an otherwise uneventful screening colonoscopy. Urgent explor...

Background and study aims Cold snare polypectomy is an established method for the resection of small colorectal polyps; however, significant incomplete resection rates still leave room for improvement. We aimed to assess the efficacy of cold snare endoscopic mucosal resection (CS-EMR), compared with hot snare endoscopic mucosal resection (HS-EMR),...

Background Endoscopic papillary large balloon dilation with biliary sphincterotomy (EPLBD + EBS) is safe and effective in patients with large common bile duct (CBD) stones. However, data on long-term outcomes after EPLBD + EBS remain limited. We sought to prospectively evaluate the long-term recurrence of CBD stones after EPLBD + EBS and to identif...

Background: The efficacy and applicability of molecular testing to guide the selection of antibiotics in triple Helicobacter pylori (H. pylori) eradication regimens have not been reported. We tested a 7-day, genotypic resistance-guided triple H. pylori eradication therapy in a high-resistance setting. Methods: Consecutive dyspeptic patients with H...

Background Hybrid therapy is a promising first-line regimen for Helicobacter pylori (H. pylori) eradication. We evaluated a hybrid therapy, assessing the impact of antibiotic resistance on eradication outcome. Methods This was a prospective study that included 155 treatment-naïve patients diagnosed with H. pylori infection by positive CLO-test, co...

Introduction People who inject drugs (PWID) account for a large burden of hepatitis C virus (HCV) infection. However, they often face several barriers to accessing antiviral treatment. In the era of highly-efficacious direct-acting antivirals (DAAs), knowledge of factors that prevent treatment among PWID is very crucial. Aims & Methods We retrospe...

Appendix S2: Cost‐effectiveness frontier (CEAF) for HBeAg(‐) and (+) patients.

Appendix S1: Data extraction and analysis, search strategy, utility data, quality assessment of included studies, unit costs for NILTs and liver biopsy, stage 1 incremental analysis for HBeAg(‐) and (+) patients.

Ever since Helicobacter pylori (H. pylori ) was recognized as an infectious cause of gastric cancer, there has been increasing interest in examining its potential role in colorectal carcinogenesis. Data from casecontrol and cross-sectional studies, mostly relying on hospital-based samples, and several meta-analyses have shown a positive statistical...

We compared the cost-effectiveness of various noninvasive tests (NITs) in patients with chronic hepatitis B and elevated transaminases and/or viral load who would normally undergo liver biopsy to inform treatment decisions. We searched various databases until April 2012. We conducted a systematic review and meta-analysis to calculate the diagnostic...

Background: Evaluation of factors correlating with the quality of bowel preparation (QBP) is critical to ensure high-quality colonoscopy. Objectives: We sought to determine whether the time interval between the start of conventional polyethylene glycol (PEG) ingestion and the onset of bowel activity is predictive of QBP. Methods: Consecutive a...

Introduction: Treatment of Helicobacter pylori (H. pylori) infection is paramount for the management of prevalent gastrointestinal disorders and in the prevention of gastric cancer. Due to increasing antimicrobial resistance, performance of standard triple therapies has now declined to unacceptably low levels. Areas covered: In this article: i) we...

Infection with hepatitis B virus (HBV) remains a top health priority worldwide and a devastating cause of morbidity and mortality accounting for more than 600,000 deaths in 2013. It is mainly transmitted through percutaneous or mucosal contact with infected blood or other body fluids. In high-endemic settings, the commonest route of transmission is...

Hepatitis C virus (HCV) genotypes 4, 5 and 6 are mainly present in Africa, the Middle East and Asia and they have been less extensively studied with respect to epidemiology, natural disease history and therapeutic endpoints. Response rates to a 48-wk combined peginterferon/ribavirin treatment range to 40%-69% for HCV 4, 55%-60% for HCV 5 and 60%-90...

Background: Liver biopsy is the reference standard for diagnosing the extent of fibrosis in chronic liver disease; however, it is invasive, with the potential for serious complications. Alternatives to biopsy include non-invasive liver tests (NILTs); however, the cost-effectiveness of these needs to be established. Objective: To assess the diagn...

Helicobacter pylori (H. pylori) is a major human pathogen associated with significant morbidity and mortality. However, after decades of efforts, treatment of H. pylori remains a challenge for physicians, as there is no universally effective regimen. Due to the rising prevalence of antimicrobial resistance, mainly to clarithromycin, efficacy of sta...

Background: Increased preoperative inflammation scores, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and inflammation-based index (IBI) have been related to post-transplant HCC recurrence. We evaluated the association between inflammation-based scores (NLR, PLR, IBI) and post-LT HCC recurrence as well as tumour n...

Unlabelled: The cost-effectiveness of noninvasive tests (NITs) as alternatives to liver biopsy is unknown. We compared the cost-effectiveness of using NITs to inform treatment decisions in adult patients with chronic hepatitis C (CHC). We conducted a systematic review and meta-analysis to calculate the diagnostic accuracy of various NITs using a b...

Treatment of Helicobacter pylori (H. pylori) infection is paramount for the management of prevalent gastrointestinal disorders including peptic ulcer disease and gastric cancer. Due to the wide increase in prevalence of H. pylori resistance to antibiotics, clarithromycin-based triple therapies are not any more suitable for unconditional empiric use...

Supplementary Information

Introduction: Schistosomal cholecystitis is remarkably uncommon. Almost all of the reported cases in literature, less than eleven universally, are associated with concomitant gallstone disease. It is unclear whether the extensive fibrocalcific reaction of the bladder`s wall and the cystic duct, seen in all cases, predisposes to cholelithiasis, or g...

Despite alcoholic hepatitis (AH) is the most acute manifestation of alcohol-related liver disease, its treatment remains controversial. Corticosteroids, given either as monotherapy or together with N-acetylecysteine, have been associated with a moderate short-term survival benefit in patients with severe disease. The Maddrey's Discriminant Function...

Scatter plots of admission score values for prognostic scores in alcoholic hepatitis correlated with 30- (a) and 90-day (b) mortality.

Background Several prognostic models have emerged in alcoholic hepatitis (AH), but lack of external validation precludes their universal use. AimTo validate the Maddrey Discriminant Function (DF); Glasgow Alcoholic Hepatitis Score (GAHS); Mayo End-stage Liver Disease (MELD); Age, Bilirubin, INR, Creatinine (ABIC); MELD-Na, UK End-stage Liver Diseas...

Treatment of Helicobacter pylori (H. pylori) infection is crucial for the management of prevalent digestive and more recently also extra-digestive disorders. Rising prevalence of clarithromycin resistance worldwide has accounted for a dramatic decline in the efficacy of standard triple therapies, which should not be prescribed, unless local clarith...

In primary biliary cirrhosis (PBC), biochemical criteria at 1 year are considered surrogates of response to ursodeoxycholic acid (UDCA). However, due to the slow natural history of PBC, evaluation at 1 year may be suboptimal to assess the therapeutic response, particularly in early disease. To determine whether evaluation of biochemical criteria at...

Baseline characteristics of consecutive patients with early primary biliary cirrhosis (normal baseline bilirubin and albumin): (a) considering the whole cohort and (b) after excluding patients (n = 30) with late (Scheuer's III and IV) baseline histology.

To examine the treatment efficacy of a combination of pegylated interferon α (PegIFNa) plus ribavirin in patients chronically infected with hepatitis C virus genotype 5 (HCV-5) and to assess the on-treatment virological responses as predictors of sustained virological response (SVR). HCV-5 is uncommonly reported, and little therapeutic data is avai...

Background & aims: Neo-adjuvant transarterial therapies are commonly used for patients with HCC in the waiting list for liver transplantation (LT) to delay tumour progression, however, their effectiveness is not well-established. We studied the effect of pre-LT transarterial therapies on post-LT HCC recurrence, using the explanted liver histology...

Objectives: Previous studies, mostly retrospective using conventional interferon, have suggested a favorable prognosis for patients with chronic hepatitis C and a sustained virological response (SVR). However, long-term outcome, including changes in the degree of hepatic fibrosis, of SVR patients in the era of pegylated interferon (PegIFN) remains...

Introduction: Treatment of Helicobacter pylori (H. pylori) infection is crucial for prevalent disease's management, including gastritis, peptic ulcer and gastric cancer, whereas novel extradigestive causal associations are increasingly being recognized. Despite long-standing efforts, there is not as yet an optimal empirical therapy to eradicate H....

Introduction Assessment of mortality is paramount in alcoholic hepatitis (AH). Although several prognostic scores have been proposed, external validation and model comparisons are required as no one score is used universally. Method We aimed to validate seven prognostic models for short-term mortality in biopsy-proven AH: Maddrey discriminant funct...

Background & aims: Liver transplant (LT) patients might be overimmunosuppressed as recommendations for tacrolimus trough concentrations (TC) within 4-6 weeks after liver transplantation are set too high (10-15 ng/ml). Early tacrolimus exposure was evaluated in relation to acute rejection and long-term outcomes. Methods: Four hundred and ninety-t...

Hepatitis C virus genotype 4 (HCV-4) is spreading beyond Africa and the Middle East but data regarding treatment with pegylated interferon alpha and ribavirin of European populations infected with HCV-4 remains limited. Interestingly, European (vs. Egyptian) origin has been associated with lower sustained virological response rates. Hence the aim o...

Goals: To compare the efficacy, compliance, and tolerability of a quadruple, nonbismuth-containing concomitant therapy with standard triple therapy, both of the duration of 10 days, for Helicobacter pylori eradication. Background: Eradication rates obtained with standard therapies are declining as antibiotic resistance becomes more prevalent wor...

HCV-related cirrhosis represents the leading indication for liver transplantation in the Western countries. HCV reinfection after liver transplantation occurs in virtually all patients transplanted for HCV-related liver disease Histological evidence of chronic HCV infection develops in 50 to 90 % of patients by 12 months after liver transplantation...

Presence of cardiac dysfunction has been associated with an unfavorable prognosis in patients with liver cirrhosis. In the present study, 92 consecutive, newly-diagnosed patients with liver cirrhosis were prospectively evaluated. Liver disease was graded according to the modified Child-Turcotte-Pugh (CTP) score whereas left ventricular diastolic fu...

With the rising prevalence of antimicrobial resistance, the eradication rates of Helicobacter pylori (H. pylori) with standard treatments are decreasing to unacceptable levels (i.e., ≤80%) in most countries. After these disappointing results, several authorities have proposed that infection with H. pylori should be approached and treated as any oth...

Universal screening for the identification of hepatitis B surface antigen [HBsAg(+)] mothers is essential to prevent perinatal hepatitis B virus (HBV) infection. In Greece, although adherence to HBV prenatal testing has improved significantly, there are still pregnant women who do not receive testing, and there is concern that this group may includ...