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Mean nocturnal baseline impedance in gastro-esophageal reflux disease diagnosis:Should we strictly follow the Lyon 2 Consensus?

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World Journal of Gastroenterology 2024年第26期30卷 3253-3256页

作者： Theodoros A Voulgaris georgios P karamanolis Department of Gastroenterology School of MedicineNational and Kapodistrian University of AthensAthens 11527Greece

Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common *** of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon *** an updated second version has been *** nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD *** a cut-off of 2292 Ohms was proposed,a value revised in the second *** updated Consensus recommended that an MNBI2500 Ohms can be used to refute *** proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic ***,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass ***,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one ***,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now ***,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.

关键词： Mean nocturnal baseline impedance Gastro-esophageal reflux disease Lyon 2 Consensus pH-impedance Diagnosis

Esophageal manifestation in patients with scleroderma

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World Journal of Clinical Cases 2021年第20期9卷 5408-5419页

作者： Theodoros A Voulgaris georgios P karamanolis Department of Gastroenterology and Hepatology Laiko General HospitalNational and Kapodistian University of AthensAthens 11527Greece

The esophagus is the most commonly affected part of the gastrointestinal system in patients with systemic sclerosis(SSc).Esophageal involvement may lead to a significant reduction in patient quality of *** exact pathophysiology is complex and not yet fully ***,esophageal smooth muscle becomes atrophied and replaced by fibrous tissue leading to severe motility disturbance of the distal *** are mainly attributed to gastroesophageal reflux disease and to esophageal *** evidence has correlated esophageal involvement to the severity of pulmonary *** formed guidelines exist about the diagnostic modalities used to assess esophageal disease in patients with SSc,though upper gastrointestinal endoscopy is the first and most important modality used as it can reveal alterations commonly observed in patients with *** exploration can be made by high resolution manometry and pH-impedance *** pump inhibitors remain the mainstay of treatment,while prokinetic agents are commonly used as add-on therapy in patients with symptoms attributed to gastroesophageal reflux disease not responding to standard therapy as well as to motility *** reflux disease symptoms in patients with SSc are frequently difficult to manage,and new therapeutic modalities are *** role of surgical treatment is restricted and should only be preserved for resistant cases.

关键词： Systemic sclerosis Esophagus Gastroesophageal reflux disease Esophageal dysmotility Proton pump inhibitors

Contribution of ghrelin to functional gastrointestinal disorders' pathogenesis

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World Journal of Gastroenterology 2019年第5期25卷 539-551页

作者： Tilemachos Koutouratsas Theodora Kalli georgios karamanolis Maria Gazouli Department of Basic Medical Science Laboratory of Biology School of Medicine University of Athens Gastroenterology Department Larnaca General Hospital Gastroenterology Unit 2nd Department of Surgery "Aretaieio"University Hospital School of Medicine University of Athens

Functional gastrointestinal disorders(FGID) are heterogeneous disorders with a variety of clinical manifestations, primarily defined by signs and symptoms rather than a definite underlying cause. Their pathophysiology remains obscure and, although it is expected to differ according to the specific FGID, disruptions in the brain-gut axis are now thought to be a common denominator in their pathogenesis. The hormone ghrelin is an important component of this axis,exerting a wide repertoire of physiological actions, including regulation of gastrointestinal motility and protection of mucosal tissue. Ghrelin's gene shows genetic polymorphism, while its protein product undergoes complex regulation and metabolism in the human body. Numerous studies have studied ghrelin's relation to the emergence of FGIDs, its potential value as an index of disease severity and as a predictive marker for symptom relief during attempted treatment. Despite the mixed results currently available in scientific literature, the plethora of statistically significant findings shows that disruptions in ghrelin genetics and expression are plausibly related to FGID pathogenesis. The aim of this paper is to review current literature studying these associations, in an effort to uncover certain patterns of alterations in both genetics and expression, which could delineate its true contribution to FGID emergence, either as a causative agent or as a pathogenetic intermediate.

关键词： Functional gastrointestinal disorders Functional colonic diseases Irritable bowel syndrome Cyclic vomiting syndrome Infantile colic Gastrointestinal disease Ghrelin Genetics Epigenetic processes

Molecular basis of the irritable bowel syndrome

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World Journal of Gastroenterology 2014年第2期20卷 376-383页

作者： Anna Vaiopoulou georgios karamanolis Theodora Psaltopoulou George Karatzias Maria Gazouli Department of Basic Medical Science Laboratory of BiologySchool of MedicineUniversity of Athens11527 AthensGreece 2~(nd) Department of Surgery "Aretaieio" University HospitalSchool of MedicineUniversity of Athens11527 AthensGreece Department of Hygiene Epidemiology and Medical StatisticsSchool of MedicineUniversity of Athens11527 AthensGreece

Irritable bowel syndrome(IBS)is a functional disorder characterized by abdominal pain,discomfort and *** pathophysiology of IBS is poorly understood,but the presence of psychosocial basis is now *** is an increasing number of publications supporting the role of genetics in *** of the variations are found in genes associated with the brain-gut axis,revealing the strong correlation of brain-gut axis and ***,which play critical roles in physiological processes,are not well studied in ***,so far there is found an involvement of alterations in miRNA expression or sequence,in IBS *** phenotype is affected by epigenetic alteration and *** in DNA and histone methylation are observed in patients who suffered childhood trauma or abuse,resulting in altered gene expression,such as the glucocorticoid receptor ***,diet is another factor associated with IBS,which may contribute to symptom *** foods may affect on bacterial metabolism and epigenetic modifications,predisposing to IBS.

关键词： Irritable bowel syndrome Gastrointestinal diseases Genetics Epigenetics Diet

Solitary colonic neurofibroma in a patient with transient segmental colitis: Case report

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World Journal of Gastroenterology 2005年第35期11卷 5573-5576页

作者： Vasilios Panteris Thivi Vassilakaki Nikos Vaitsis Ioannis Elemenoglou Irini Mylonakou Dimitrios georgios karamanolis Department of Gastroenterology "Tzaneion" General Hospital Zanni and Afentouli 1 Piraeus 18536 Greece Department of Pathology "Tzaneion" General Hospital Zanni and Afentouli 1 Piraeus 18536 Greece Department of Pathology"Tzaneion" General Hospital Zanni and Afentouli 1 Piraeus 18536 Greece

Neurofibromas of the large bowel are very rare and usually are part of the colonic involvement in neurofibromatosis type 1 （Nf1, yon Recklinghausen＇s disease）. Solitary neurofibromas of the colon are extremely rare. We describe a case of an isolated neurofibroma that was found in the large bowel of a patient who suffered from segmental colitis and presented with bloody diarrhea. A review of the literature is also included, concerning the disclosure of isolated neurofibromas in the gut and other body parts and the type of gastrointestinal involvement in von Recklinghausen＇s disease.

关键词： Solitary neurofibroma Isolated neurofibroma,Neurofibromatosis Intestinal neurofibromatosis von Recklinghausen's disease

A prospective cross-over study using a sphincterotome and a guidewire to increase the success rate of common bile duct cannulation

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World Journal of Gastroenterology 2005年第11期11卷 1649-1652页

作者： georgios karamanolis Aikaterini Katsikani Nikos Viazis Gerasimos Stefanidis Spilios Manolakopoulos Spiros Sgouros Efthimia Papadopoulou Apostolos Mantides Department of Gastroenterology Department of Radiology Second Department of Gastroenterology Gastroenterology Department

AIM: During endoscopic retrograde cholangiopancreatography (ERCP), selective cannulation of the common bile duct (CBD) is required in most of the ***: From June 2001 till December 2002, all patients referred to our unit for ERCP were considered for entry into the study. Selective CBD cannulation was first attempted with a standard catheter with or without the use of a guidewire. In cases, where CBD cannulation was considered unsuccessful, patients were crossed over to a double-lumen sphincterotome and a guidewire. All patients were hospitalized for 24 h after the procedure in order to assess the incidence of post-ERCP ***: The study sample consisted of 158 *** CBD cannulation using a standard ERCP catheter with or without the assistance of a guidewire, was accomplished in 129 patients (success rate: 81.65%).From the 29 patients who were crossed over to a sphincterotome and a guidewire, selective CBD cannulation was achieved in 24; the overall success rate rising to 96.8%. Meanwhile, the use of this technique did not increase the incidence of post-ERCP ***: The use of a sphincterotome and a guidewire increases the success rate of selective bile duct cannulation in cases that this has not been accomplished with a standard catheter.

关键词： Common bile duct Cannulation Sphincterotome Guidewire

Incidence of ulcerative colitis in Central Greece: A prospective study

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World Journal of Gastroenterology 2005年第12期11卷 1785-1787页

作者： Spiros D.Ladas Elias Mallas Konstantinos Giorgiotis georgios karamanolis Dimitrios Trigonis Apostolos Markadas Vana Sipsa Sotirios A.Raptis Gastroenterology Unit The Trikala Cooperative IBD Group Biostatistic Laboratory

AIM: To study the incidence of ulcerative colitis UC in the prefecture of Trikala, Central Greece. METHODS: A prospective and population based epidemiological study of UC from 1990 to the end of 1994 was conducted. Trikala is a semirural prefecture of Central Greece with a population of 138 946 (census 1991). Three gastroenterologists (one hospital based, two private doctors) of the prefecture participated in this study. RESULTS: During the study period, 66 new historically verified cases of UC were recorded. The mean annual incidence of the disease in 1990-1994 was 11.2 per 105 inhabitants (95%CI: 8.7-14.3). There was no difference between men and women (annual incidence: 10.5 and 12.0 per 105 inhabitants respectively), either among urban, semirural or rural populations (annual incidence: 11.7, 17.1 and 9,9 per 105 inhabitants respectively). The majority (56%) of the patients never smoked and a quarter were ex-smokers. About a half of all cases had proctitis. CONCLUSION: UC is common in Central Greece and its incidence is similar to that in North-Western European countries.

关键词： Ulcerative colitis Histology

Association of rs1568885, rs1813443 and rs4411591 polymorphisms with anti-TNF medication response in Greek patients with Crohn's disease

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World Journal of Gastroenterology 2014年第13期20卷 3609-3614页

作者： Diamantis Thomas Maria Gazouli Theodoros Karantanos Stella Rigoglou georgios karamanolis Konstantinos Bramis George Zografos George E Theodoropoulos Colorectal Unit 1st Department of Propaedeutic Surgery"Hippokrateio" HospitalSchool of MedicineUniversity of Athens11527 AthensGreece Department of Basic Medical Science Laboratory of BiologySchool of MedicineUniversity of Athens11527 AthensGreece Gastroenterology Unit 2nd Department of Surgery"Aretaieio" HospitalUniversity of AthensAthens 11527Greece

AIM: To investigate the correlation between rs1568885, rs1813443 and rs4411591 polymorphisms and response to infliximab in a cohort of Greek patients with Crohn’s disease (CD).

关键词： Crohn’ s disease, Treatment response, Infliximab, Polymorphisms

Serum zonulin levels in patients with liver cirrhosis:Prognostic implications

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World Journal of Hepatology 2021年第10期13卷 1394-1404页

作者： Theodoros A Voulgaris Dimitrios Karagiannakis E Hadziyannis Spilios Manolakopoulos georgios P karamanolis George Papatheodoridis John Vlachogiannakos Academic Department of Gastroenterology and Hepatology Medical School of National and Kapodistrian University of AthensGeneral Hospital of Athens“Laiko”Athens 11527Greece Academic Department of Medicine Hippokrat General HospitalNational and Kapodistrian University of AthensAthens 11527Greece

BACKGROUND Increased gut permeability and bacterial translocation play an important role in liver *** is a recently recognized protein involved in the disintegration of the intestinal *** To investigate possible differences in serum zonulin levels among patients with different cirrhosis stages and their potential prognostic *** Consecutive cirrhotic patients who attended our liver clinic were included in the *** zonulin levels,clinical,radiological and biochemical data were collected at *** who accepted participation in a regular surveillance program were followed-up for at least 12 *** We enrolled 116 cirrhotics[mean Child-Turcotte-Pugh(CTP)score:6.2±1.6;model for end-stage liver disease score:11±3.9].The causes of cirrhosis were viral hepatitis(39%),alcohol(30%),non-alcoholic fatty liver disease(17%),and other(14%).At baseline,53% had decompensated cirrhosis,48% had ascites,and 32% had history of hepatic *** zonulin levels were significantly higher in patients with CTP-B class than CTP-A class(4.2±2.4 ng/dL vs 3.5±0.9 ng/dL,P=0.038),with than without ascites(P=0.006),and with than without history of encephalopathy(P=0.011).Baseline serum zonulin levels were independently associated with the probability of decompensation at 1 year(P=0.039),with an area under the receiving operating characteristic of 0.723 for predicting hepatic *** CTP score(P=0.021)and portal vein diameter(P=0.022)were independent predictors of *** Serum zonulin levels are higher in patients with more advanced chronic liver disease and have significant prognostic value in identifying patients who will develop decompensation.

关键词： Zonulin Cirrhosis Intestinal barrier Bacterial translocation Decompensation Permeability