Alexandros Charisis

University Hospital of Ioannina, Yannina, Epirus, Greece

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Publications (4)7.5 Total impact

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    ABSTRACT: SETTING: Ioannina University Hospital, Ioannina, Greece.OBJECTIVE: To evaluate the value of adding an interferon-gamma release assay (IGRA) to the tuberculin skin test (TST) for detecting latent tuberculous infection (LTBI) in a Greek university hospital among health care workers (HCWs) predominantly vaccinated with bacille Calmette-Guérin (BCG).DESIGN: Of 788 HCWs enrolled, 68.1% were BCG-vaccinated. A TST  10 mm was considered positive and was followed by the QuantiFERON-TB® Gold In-Tube assay (QFT-GIT) in a two-step strategy.RESULTS: Of the enrolled HCWs, 36.4% were TST-positive, of whom only 14.4% were IGRA-positive. Agreement between the tests was poor (κ = 0.019; 95%CI −0.014–0.05, P = 0.355). Both TST and IGRA positivity increased with TST diameter, from 5.7% in TST 10–14 mm to 48.8% in TST 20 mm. TST-positive, IGRA-negative results were most likely in younger, recently BCG-vaccinated HCWs (84.6% in those aged 20–29 years) and less likely in older HCWs (45% in those aged 50–59 years). The two-step strategy would have been more cost saving compared to the TST-only approach if adherence to LTBI treatment in our cohort had been 24%.CONCLUSIONS: Poor overall agreement between TST and QFT-GIT was found. Use of IGRA as a second step in TST-positive cases offers an appropriate tool for LTBI detection among BCG-vaccinated HCWs in low-TB-incidence settings.
    No preview · Article · Sep 2014 · The International Journal of Tuberculosis and Lung Disease
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    ABSTRACT: Results: Questionnaires were completed by 789 employees including 192 physicians, 436 nurses, 67 technicians, 72 assistants, and 22 administrators. Most employees recognized respiratory droplets as transmission route (86.1%), and pulmonary TB as infectious (88.6%); however, only 25% acknowledged that TB is an airborne disease. Additionally, few (18.6%) recognized laryngeal TB as infectious. Among 491 who had managed a suspected case, 75.8% used regular masks, 8.8% high protection masks, while 15.4% did not wear masks. For newly diagnosed patients, 63.6% of employees supported care in special infectious disease units, while 31.7% supported care in a regular hospital ward, in isolation.
    No preview · Article · Jan 2014 · Pneumon
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    ABSTRACT: Long-term oxygen therapy (LTOT) is the cornerstone mode of treatment in patients with chronic obstructive pulmonary disease (COPD). The present study aims to investigate the effect of two oxygen sources (concentrator and liquid oxygen) on quality of life, exercise tolerance and compliance to LTOT in patients with COPD. The survey included 104 patients with COPD (31 on concentrator treatment and 73 on liquid oxygen). Patients were subjected to pulse oximetry, basic spirometry, measurement of health-related quality of life by the St. George's Hospital respiratory questionnaire instrument and assessment of dyspnoea severity by the modified Borg category scale. Exercise tolerance was evaluated by the S(a)O(2) value after 3 min of walking. S(a)O(2) was measured before and after treatment with each device. Compliance with therapy was defined by the daily duration of oxygen use. The two LTOT groups did not differ significantly concerning pulmonary function tests (p = 0.49 for FEV(1), 0.98 for FVC, 0.15 for FEV(1)/FVC% and 0.38 for FEF(50%)), S(a)O(2) before (p = 0.28) and after (p = 0.80) O(2) treatment and after the 3-min walking trial (p = 0.47), and St. George's Hospital respiratory questionnaire score (p = 0.45). The liquid oxygen group was less dyspnoeic before treatment (p = 0.02), but this difference disappeared after treatment (p = 0.95). A highly significant difference (p < 0.001) was noted concerning the daily oxygen use. Complete compliance to LTOT (> or =15 h/day) was observed in 12.9 and 42.5%, respectively (p < 0.005). Noise disturbance was noted only in the concentrator group (80%). We conclude that stationary liquid oxygen seems to be a satisfactory alternative mode for LTOT treatment in COPD patients, with higher patient compliance to therapy in comparison with concentrators.
    No preview · Article · Feb 2006 · Respiration
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    ABSTRACT: Long-term oxygen treatment (LTOT) is very important, especially in patients with severe chronic obstructive pulmonary disease (COPD), but its efficacy is closely related to patient compliance. The aim of the present study was to investigate the compliance of patients under LTOT in the Prefecture of Ioannina (north-western Greece) and to identify factors that might be involved. The study included 249 patients treated with LTOT during a 1-year period. They were visited at home by the investigating staff (a chest specialist and a primary care nurse). Compliance to therapy was defined by the daily use of the O2 concentrator (in hours). Patients underwent pulse oximetry, basic spirometry, and trial inhalation of bronchodilators. Only 67 patients (26.9%) complied with therapy, while the daily concentrator use lasted 9.7 +/- 6.09 h. SaO2, FEV1 and FVC were negatively correlated to patient compliance. No significant differences concerning LTOT compliance were noted between men and women, urban and rural population, and between smokers, ex-smokers and non-smokers. A chest physician recommended LTOT for the majority of patients (86.3%), while COPD was the main reason for LTOT prescription (74.7%). Nevertheless, compliance to LTOT was not significantly higher when prescribed by a respiratory physician. No specific medical instructions and information was recorded for the majority of the study patients treated with LTOT. Our results suggest that an organized home care program establishing the relative guidelines is necessary for substantial improvement in patient compliance to LTOT in Greece.
    Full-text · Article · Dec 2004 · Respiration