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Recent advances in the diagnostic methods and therapeutic strategies of transthyretin cardiac amyloidosis

World Journal of Cardiology 2024年第7期16卷 370-379页

作者： Christos Kourek Alexandros Briasoulis dimitrios E Magouliotis Panagiotis Georgoulias Grigorios Giamouzis Filippos Triposkiadis John Skoularigis Andrew Xanthopoulos Clinical Ergospirometry Exercise and Rehabilitation Laboratory1^(st)Critical Care Medicine DepartmentEvangelismos HospitalNational and Kapodistrian University of AthensAthens 10676Greece Department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece Department of Cardiothoracic Surgery University of ThessalyLarissa BiopolisLarissa 41110Greece Department of Nuclear Medicine University Hospital of LarissaLarissa 41110Greece Department of Cardiology School of MedicineUniversity Hospital of LarissaLarissa 41110Greece

Cardiac amyloidosis is a progressive disease characterized by the buildup of amyloid fibrils in the extracellular space of the *** is divided in 2 main types,immunoglobulin light chain amyloidosis and transthyretin amyloidosis(ATTR),and ATTR amyloidosis is further divided in 2 subtypes,non-hereditary wild type ATTR and hereditary mutant variant *** and prevalence of ATTR cardiac amyloidosis is increasing over the last years due to the improvements in diagnostic *** rates are improving due to the development of novel therapeutic *** is the only disease-modifying approved therapy in ATTR amyloidosis so ***,the most recent advances in medical therapies have added more options with the potential to become part of the therapeutic armamentarium of the *** including acoramidis,eplontersen,vutrisiran,patisiran and anti-monoclonal antibody NI006 are being investigated on cardiac function in large,multicenter controlled trials which are expected to be completed within the next 2-3 years,providing promising results in patients with ATTR cardiac ***,further and ongoing research is required in order to improve diagnostic methods that could provide an early diagnosis,as well as survival and quality of life of these patients.

关键词： Transthyretin cardiac amyloidosis Tafamidis Acoramidis Eplontersen Vutrisiran Patisiran

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Overview of the Association Between Non-Alcoholic Fatty Liver Disease and Hypertension

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Cardiology Discovery 2024年第1期4卷 30-37页

作者： Niki S.Kakouril Costas G.Thomopoulos Eirini P.Siafi Angeliki E.Valatsoul Kyriakos S.Dimitriadis Iliana P.Mani Sotirios P.Patsilinakos dimitrios M.Tousoulis Konstantinos P.Tsioufis First Department of Cardiology Medical SchoolNational and Kapodistrian University of AthensHippokration HospitalAthens 11527Greece Department of Cardiology Elena Venizelou HospitalAthens 11521Greece Department of Cardiology General Hospital Agia OlgaAthens 14233Greece

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, and its prevalence is rising. NAFLD is closely associated with metabolic syndrome, with both conditions sharing common clinical characteristics such as obesity, insulin resistance, type 2 diabetes mellitus, hypertension, and hypertriglyceridemia. Several observational studies have evaluated the relationship between NAFLD and hypertension, with the overall evidence suggesting a bidirectional relationship. It is hypothesized that activation of the sympathetic nervous and renin-angiotensin systems, observed in NAFLD with or without insulin resistance promotes the development of hypertension. In patients with hypertension, activation of these systems can lead to hepatic fibrosis and progressive inflammation through increased oxidative stress and activation of hepatic stellate cells and Kupffer cells. The present review examines the pathophysiologic and clinical evidence supporting the bidirectional association between NAFLD and hypertension.

关键词： Hypertension Non-alcoholic fatty liver disease Insulin resistance Sympathetic nervous system Metabolic syndrome

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今日中国（英文版） 2024年第2期

作者： FOUKIS dimitrios

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Smoothing Non-Stationary Time Series Using the Discrete Cosine Transform

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Journal of Systems Science & Complexity 2016年第2期29卷 382-404页

作者： THOMAKOS dimitrios Department of Economics University of PeloponneseGreece22100 & Rimini Center for Economic Analysis

This paper considers the problem of smoothing a non-stationary time series(having either deterministic and/or stochastic trends) using the discrete cosine transform(DCT).The DCT is a powerful tool which has found fruitful applications in filtering and smoothing as it can closely approximate the optimal Karhunen-Loeve transform(KLT).In fact,it is known that it almost corresponds to the KLT for first-order autoregressive processes with a root close to unity:This is the case with most economic and financial time series.A number of new results are derived in the paper:(a) The explicit form of the linear smoother based on the DCT,which is found to have time-varying weights and that uses all observations;(b) the extrapolation of the DCT-smoothed series;(c) the form of the average frequency response function,which is shown to approximate the frequency response of the ideal low pass filter;(d) the asymptotic distribution of the DCT coefficients under the assumptions of deterministic or stochastic trends;(e) two news method for selecting an appropriate degree of smoothing,in general and under the assumptions in(d).These findings are applied and illustrated using several real world economic and financial time *** results indicate that the DCT-based smoother that is proposed can find many useful applications in economic and financial time series.

关键词： Discrete cosine transform non-stationary time series order selection singular spectrumanalysis smoothing trend extraction unit root.

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Next-generation surgicalmeshes for drug delivery and tissue engineering applications:materials,design and emerging manufacturing technologies

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Bio-Design and Manufacturing 2021年第2期4卷 278-310页

作者： Francesca Corduas dimitrios A.Lamprou Elena Mancuso Nanotechnology and Integrated Bio-Engineering Centre(NIBEC) Ulster UniversityJordanstown CampusNewtownabbey BT370QBUK School of Pharmacy Queen’s University BelfastBelfast BT97BLUK

Surgical meshes have been employed in the management of a variety of pathological conditions including hernia,pelvic floor dysfunctions,periodontal guided bone regeneration,wound healing and more recently for breast plastic surgery after *** common pathologies affect a wide portion of the worldwide population;therefore,an effective and enhanced treatment is crucial to ameliorate patients’living conditions both from medical and aesthetic points of *** present,non-absorbable synthetic polymers are the most widely used class of biomaterials for the manufacturing of mesh implants for hernia,pelvic floor dysfunctions and guided bone regeneration,with polypropylene and poly tetrafluoroethylene being the most *** prostheses,such as surgical grafts,have been employed mainly for breast plastic surgery and wound healing *** the advantages of mesh implants to the treatment of these conditions,there are still many drawbacks,mainly related to the arising of a huge number of post-operative complications,among which infections are the most *** a mesh that could appropriately integrate with the native tissue,promote its healing and constructive remodelling,is the key aim of ongoing research in the area of surgical mesh *** this end,the adoption of new biomaterials including absorbable and natural polymers,the use of drugs and advanced manufacturing technologies,such as 3D printing and electrospinning,are under investigation to address the previously mentioned challenges and improve the outcomes of future clinical *** aim of this work is to review the key advantages and disadvantages related to the use of surgical meshes,the main issues characterizing each clinical procedure and the future directions in terms of both novel manufacturing technologies and latest regulatory considerations.

关键词： 3D printing Electrospinning Manufacturing technologies Biomaterials Drug delivery Surgical mesh implants

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Special Column on Multiscale Stochastic Finite Element Method

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Frontiers of Structural and Civil Engineering 2015年第2期9卷 105-106页

作者： Xu, Xi F. stefanou, George Proppe, Carsten Wu, Yu Ching Beijing Jiaotong University Beijing China Aristotle University of Thessaloniki Thessaloniki Greece Karlsruhe Institute of Technology Karlsruhe Germany Tongji University Shanghai China

In the past decade, multi-scale modelling in mathematical physics and engineering has been growing with vast advancement based on deterministic assumption. Because all information across scales contains a certain level of uncertainty due to incomplete knowledge and inherent chaos with respect to physical laws and parameters, a combination of multi-scale and stochastic techniques becomes a new approach. Incorporation of stochastic process into multi-scale modelling with accurate assessment of uncertainty propagation across scales is highly challenging but essential for a rising number of applications, and in certain areas such models can provide critical insights that deterministic approaches could never predict. In computational mechanics, research topics on discrete-to-continuum, stochastic-to-deterministic, and scale coupling are prioritized as the most significant directions. In the past half century, the finite element method has been a mature and widely-used numerical technique. When both multi-scale and stochastic phenomena are considered, cross-cutting multi-scale stochastic finite element modelling forms a novel research frontier. In this special issue,there are five original research papers relevant to multi-scale stochastic finite element methods or their applications.

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Role of surgery in colorectal liver metastases:Too early or too late?

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World Journal of Gastroenterology 2010年第28期16卷 3484-3490页

作者： dimitrios Dimitroulis Nikolaos Nikiteas Theodore Troupis dimitrios Patsouras Panayiotis Skandalakis Gregory Kouraklis Second Department of Propaedeutic Surgery School of MedicineUniversity of Athens"LAIKON" University Hospital14 Ag.Thoma Street11527 AthensGreece Department of Surgery and Transplantation 4 Sakelariou Street17455 AlimosAthensGreece Department of Anatomy School of MedicineUniversity of Athens75 Mikras Asias Street11527 AthensGreece

As colorectal cancer and colorectal liver metastases become a serious public health problem,new treatment modalities are needed in order to achieve better results. In the last decade there has been very important progress in oncology,with new and more effective chemotherapeutic agents administered alone or in combination improving the resectability rate in up to 40%of patients with colorectal liver *** in interventional radiology,in particular,with the use of portal vein embolization and radiofrequency thermal ablation are new strategies allowing major liver resections and treatment of small liver metastases or early ***,however,remains the gold standard strategy with intention to *** this review article we will describe the advanced role of surgery in the multidisciplinary approach to colorectal liver metastases,and the clinical problems the liver surgeon has to deal with,such as theresectability of the metastases,the presence of bilobar liver lesions and extrahepatic disease,the impact of chemotherapy in already resectable liver metastases,the problem of vanishing metastases after chemotherapy and the dilemma of staged or combined liver and colon operations and which organ first in the clinical scenario of synchronous colorectal liver metastases.

关键词： Metastases Liver metastases Colorectal cancer Surgery

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Gastrointestinal stromal tumor causing small bowel intussusception in a patient with Crohn’s disease

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World Journal of Gastroenterology 2009年第41期15卷 5224-5227页

作者： George E Theodoropoulos dimitrios Linardoutsos dimitrios Tsamis Paraskevas Stamopoulos dimitrios Giannopoulos Flora Zagouri Nikolaos V Michalopoulos First Department of Propaedeutic Surgery Hippocration University Hospital Department of Pathology Hippocration University Hospital Department of Clinical Therapeutics Alexandra Hospital

We report a case of jejunoileal intussusception in a 42-year-old patient with Crohn's disease caused by a gastrointestinal stromal tumor. The patient complained of vague diffuse abdominal pain for a period of 4 mo. Intussusception was suspected at computer tomography and magnetic resonance imaging scans. Segmental resection of the small intestine was performed. Pathological examination of the surgical specimen revealed a gastrointestinal stromal tumor as well as aphthous ulcerations and areas of inflammation, which were characteristic of Crohn's disease. This is the f irst report of small bowel intussusception due to a gastrointestinal stromal tumor coexisting with Crohn's disease.

关键词： Gastrointestinal stromal tumor Crohn's disease Intussusception

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New generation of breast cancer clinical trials implementing molecular profiling

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Cancer Biology & Medicine 2016年第2期13卷 226-235页

作者： dimitrios Zardavas Martine Piccart-Gebhart Breast International Group(BIG) Brussels 100Belgium Medicine Department Institue Jules BordetUniversite Libre de BruxellesBrussels 100Belgium

The implementation of molecular profiling technologies in oncology deepens our knowledge for the molecular landscapes of cancer diagnoses, identifying aberrations that could be linked with specific therapeutic vulnerabilities. In particular, there is an increasing list of molecularly targeted anticancer agents undergoing clinical development that aim to block specific molecular aberrations. This leads to a paradigm shift, with an increasing list of specific aberrations dictating the treatment of patients with cancer. This paradigm shift impacts the field of clinical trials, since the classical approach of having clinico-pathological disease characteristics dictating the patients' enrolment in oncology trials shifts towards the implementation of molecular profiling as prescreening step. In order to facilitate the successful clinical development of these new anticancer drugs within specific molecular niches of cancer diagnoses, there have been developed new, innovative trial designs that could be classified as follows: i)longitudinal cohort studies that implement(or not) "nested" downstream trials, 2) studies that assess the clinical utility of molecular profiling, 3) "master" protocol trials, iv) "basket" trials, v) trials following an adaptive design. In the present article, we review these innovative study designs, providing representative examples from each category and we discuss the challenges that still need to be addressed in this era of new generation oncology trials implementing molecular profiling. Emphasis is put on the field of breast cancer clinical trials.

关键词： Clinical trial molecular profiling breast cancer study design

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Synchronous resection of esophageal cancer and other organ malignancies: A systematic review

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World Journal of Gastroenterology 2019年第26期25卷 3438-3449页

作者： dimitrios Papaconstantinou Diamantis I Tsilimigras dimitrios Moris Adamantios Michalinos Aikaterini Mastoraki Efstratia Mpaili Natasha Hasemaki Anargyros Bakopoulos dimitrios Filippou dimitrios Schizas Third Department of Surgery National and Kapodistrian University of AthensAttikon University HospitalAthens 12462Greece Department of Surgery Division of Surgical OncologyThe Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research InstituteColumbusOH 43210United States Department of Surgery Duke University Medical CenterDurhamNC 27710United States Department of Anatomy European University of CyprusNicosia 2404Cyprus First Department of Surgery National and Kapodistrian University of AthensLaikon General HospitalAthens 11527Greece Department of Anatomy and Surgical Anatomy National and Kapodistrian University of AthensMedical SchoolAthens 11527Greece

BACKGROUND Neoplasms arising in the esophagus may coexist with other solid organ or gastrointestinal tract neoplasms in 6%to 15%of *** of both tumors synchronously or in a staged procedure provides the best chances for long-term *** resection of both esophageal and second primary malignancy may be feasible in a subset of patients;however,literature on this topic remains rather *** To analyze the operative techniques employed in esophageal resections combined with gastric,pancreatic,lung,colorectal,kidney and liver resections and define postoperative outcomes in each *** We conducted a systematic review according to PRISMA *** searched the Medline database for cases of patients with esophageal tumors coexisting with a second primary tumor located in another organ that underwent synchronous resection of both *** English language articles deemed eligible for inclusion were accessed in full *** criteria included:(1)Hematological malignancies;(2)Head/neck/pharyngeal neoplasms;(3)Second primary neoplasms in the esophagus or the gastroesophageal junction;(4)Second primary neoplasms not surgically excised;and(5)Preclinical *** regarding the operative strategy employed,perioperative outcomes and longterm outcomes were extracted and analyzed using descriptive *** The systematic literature search yielded 23 eligible studies incorporating a total of 117 *** these patients,71%had a second primary neoplasm in the *** who underwent total gastrectomy had a reconstruction using either a colonic(n=23)or a jejunal(n=3)conduit while for those who underwent gastric preserving resections(i.e.,non-anatomic/wedge/distal gastrectomies)a conventional gastric pull-up was ***,in cases of patients who underwent esophagectomy combined with pancreaticoduodenectomy(15%of the cohort),the decision to preserve part of the stomach or not dictated the reconstruction met

关键词： Esophagectomy Esophageal neoplasm Second primary Multiple primary Concurrent neoplasms Management

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