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Liver replacement therapy with extracorporeal blood purification techniques current knowledge and future directions

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World Journal of Clinical Cases 2023年第17期11卷 3932-3948页

作者： Panagiotis Papamichalis Katerina G Oikonomou Asimina Valsamaki Maria Xanthoudaki Periklis Katsiafylloudis Evangelia Papapostolou Apostolia-Lemonia Skoura Michail Papamichalis Marios Karvouniaris Antonios Koutras Eleni Vaitsi Smaragdi Sarchosi Antonios Papadogoulas dimitrios papadopoulos Intensive Care Unit General Hospital of LarissaLarissa 41221ThessalyGreece Department of Transfusion Medicine University Hospital of LarissaLarissa 41110ThessalyGreece Department of Cardiology University Hospital of LarissaLarissa 41110ThessalyGreece Intensive Care Unit AHEPA University HospitalThessaloniki 54636Greece 1^(st) Department of Obstetrics and Gynecology General Hospital of Athens“ALEXANDRA”National and Kapodistrian University of AthensAthens 11528Greece Department of Anesthesiology University Hospital of LarissaLarissa 41110ThessalyGreece

Clinically,it is highly challenging to promote recovery in patients with acute liver failure(ALF)and acute-on-chronic liver failure(ACLF).Despite recent advances in understanding the underlying mechanisms of ALF and ACLF,standard medical therapy remains the primary therapeutic *** transplantation(LT)is considered the last option,and in several cases,it is the only intervention that can be ***,this intervention is limited by organ donation shortage or exclusion criteria such that not all patients in need can receive a *** option is to restore impaired liver function with artificial extracorporeal blood purification *** first such systems were developed at the end of the 20th century,providing solutions as bridging therapy,either for liver recovery or *** enhance the elimination of metabolites and substances that accumulate due to compromised liver *** addition,they aid in clearance of molecules released during acute liver decompensation,which can initiate an excessive inflammatory response in these patients causing hepatic encephalopathy,multiple-organ failure,and other complications of liver *** compared to renal replacement therapies,we have been unsuccessful in using artificial extracorporeal blood purification systems to completely replace liver function despite the outstanding technological evolution of these *** middle to high-molecular-weight and hydrophobic/protein-bound molecules remains extremely *** majority of the currently available systems include a combination of methods that cleanse different ranges and types of molecules and ***,conventional methods such as plasma exchange are being re-evaluated,and novel adsorption filters are increasingly being used for liver *** strategies are very promising for the treatment of liver ***,the best method,system,or device has not been developed yet,and its probability of

关键词： Liver failure Transplantation Blood purification Liver replacement therapy Artificial extracorporeal systems Transplant-free survival

Transjugular intrahepatic portosystemic shunt for recompensating decompensated cirrhosis?

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World Journal of Gastroenterology 2024年第20期30卷 2621-2623页

作者： dimitrios S Karagiannakis Academic Department of Gastroenterology and Hepatology Medical School of National and Kapodistrian University of AthensGeneral Hospital of Athens“Laiko”Athens 11527Greece

Transjugular intrahepatic portosystemic shunt(TIPS)is a medical procedure that has been used to manage variceal bleeding and ascites in patients with *** can prevent further decompensation and improve the survival of high-risk decompensated *** research indicates that TIPS could increase the possibility of recompensation of decompensated cirrhosis when it is combined with adequate suppression of the causative factor of liver ***,the results of the studies have been based on retrospective analysis,and further validation is required by conducting randomized controlled *** this context,we highlight the limitations of the current studies and emphasize the issues that must be addressed before TIPS can be recommended as a potential recompensating tool.

关键词： Decompensated cirrhosis Liver recompensation Baveno VII Transjugular intrahepatic portosystemic shunt

Optimal Offering of Energy Storage in UK Day-Ahead Energy and Frequency Response Markets

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Journal of Modern Power Systems and Clean Energy 2024年第2期12卷 415-426页

作者： Makedon Karasavvidis Andreas Stratis dimitrios Papadaskalopoulos Goran Strbac Department of Electrical and Electronic Engineering Imperial College LondonLondonUK Statkraft UK Ltd. LondonUK Department of Electrical and Computer Engineering University of PatrasPatrasGreece IEEE

The offering strategy of energy storage in energy and frequency response(FR) markets needs to account for country-specific market regulations around FR products as well as FR utilization factors, which are highly uncertain. To this end, a novel optimal offering model is proposed for stand-alone price-taking storage participants, which accounts for recent FR market design developments in the UK, namely the trade of FR products in time blocks, and the mutual exclusivity among the multiple FR products. The model consists of a day-ahead stage, devising optimal offers under uncertainty, and a real-time stage, representing the storage operation after uncertainty is materialized. Furthermore, a concrete methodological framework is developed for comparing different approaches around the anticipation of uncertain FR utilization factors(deterministic one based on expected values, deterministic one based on worst-case values, stochastic one, and robust one), by providing four alternative formulations for the real-time stage of the proposed offering model, and carrying out an out-of-sample validation of the four model instances. Finally, case studies employing real data from UK energy and FR markets compare these four instances against achieved profits, FR delivery violations, and computational scalability.

关键词： Energy markets energy storage frequency response optimal offering robust optimization stochastic programming

Role of exosomal circular RNAs as microRNA sponges and potential targeting for suppressing hepatocellular carcinoma growth and progression

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World Journal of Gastroenterology 2024年第9期30卷 994-998页

作者： Nikolaos papadopoulos Eleni-Myrto Trifylli The Second Department of Internal Medicine 401 General Army Hospital of AthensAthens 11525Greece The First Department of Internal Medicine 417 Share Army Fund HospitalAthens 11521Greece

In this editorial,we comment on the article by Lyu et al published in the recent issue of the World Journal of Gastroenterology(2023;2219-2840).Hepatocellular carcinoma(HCC)is a frequently encountered and highly aggressive primary liver cancer,which remains the third-commonest cause of cancer-related death despite the current therapeutic *** is urgency in developing novel thera-peutic approaches,such as by manipulating extracellular vesicles,which con-stitute a highly heterogeneous nanoparticle population that contains various *** cargoes have a pivotal role in cell-to-cell communication and can modify the functional level of the recipient cells via their uptake by other recipient *** non-coding RNAs have particular evolving significance in HCC,such as circular RNAs,which have been found differentially expressed in normal hepatic and HCC *** aberrations in their expression levels have a key role in the HCC development and progression and the overall *** this editorial,we will shed light on the emerging role of exosomal circular RNAs in HCC development and progression,focusing on the oncogenic or potentially tumor suppressive effect of mesenchymal stem cells-derived exosomal non-coding RNAs.

关键词： circular sponge progression

Extending the decision-making process during yellow phase from human drivers to autonomous vehicles:A microsimulation study with safety considerations

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Journal of Traffic and Transportation Engineering(English Edition) 2024年第2期11卷 362-379页

作者： Efthymis papadopoulos Anastasia Nikolaidou Emmanouil Lilis Ioannis Politis Panagiotis Papaioannou Transport Engineering Laboratory School of Civil EngineeringFaculty of EngineeringAristotle University of ThessalonikiThessaloniki 54124Greece

One of the main factors affecting the safety of signalised intersections is the stop/go behaviour during the yellow *** previous research has exhaustively examined drivers’stop/go decision-making,the expected autonomous vehicles’(AVs’)stop/go behaviour has not yet been thoroughly *** a series of simulation experiments developed for conventional and autonomous vehicles using different carfollowing,lane-changing,lateral placement and stop/go model parameter values,we examine here whether the default VISSIM stop/go parameter values can adequately replicate the observed drivers’behaviour at the considered intersection and assess the suitability of using the currently available options,albeit referring to human drivers,to simulate the expected stop/go behaviour of *** also propose a policy framework for determining the desired behaviour of AVs in yellow interval,which is integrated into an AVs logic and achieved in the last simulation to explore the effect of automation on the stop/go outcome and,hence,on the safety level of signalised *** data analysis and modeling techniques were used for the formulation of certain scenarios,including binary choice *** default stop/go parameter values were found unfit to replicate the observed stop/go behaviour and subjected to *** to the currently available options,the proposed AVs logic proved to produce the most accurate results,in terms of the stop/go simulation *** the impact of automation on the stop/go outcome,the simulation experiments showed that AVs preferred a more conservative behaviour in favor of road safety,as indicated by the significant reduction(≈15%)in the number of vehicles crossing the stop line during the yellow light and zero instances of red light ***,compared to the conservative drivers represented by the default stop/go parameter values,AVs preferred a more rational behaviour in favor of intersection capacit

关键词： Driver behaviour AVs behaviour Signalised intersection Choice model Micro-simulation Policy framework

Subtalar dislocation without associated fractures: Case report and review of literature

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World Journal of Orthopedics 2015年第3期6卷 374-379页

作者： Dionisios Giannoulis dimitrios V papadopoulos Marios G Lykissas Panagiotis Koulouvaris Ioannis Gkiatas Alexandros Mavrodontidis Department of Orthopedics University Hospital of Ioannina Department of Orthopedics University Hospital "Attikon"

Isolated subtalar dislocations are unusual injuries due to the inherent instability of the talus. Subtalar dislocations are frequently associated with fractures of the malleoli, the talus, the calcaneus or the fifth metatarsal. Four types of subtalar dislocation have been described according to the direction of the foot in relation to the talus: medial, lateral posterior and anterior. It has been shown that some of these dislocations may spontaneously reduce. A rare case of a 36-year-old male patient who sustained a closed medial subtalar dislocation without any associated fractures of the ankle is reported. The patient suffered a pure closed medial subtalar dislocation that is hardly reported in the literature. Six months after injury the patient did not report any pain, had a satisfactory range of motion, and no signs of residual instability or early posttraumatic osteoarthritis. The traumatic mechanism, the treatment options, and the importance of a stable and prompt closed reduction and early mobilization are discussed.

关键词： Subtalar Dislocation Talus Calcaneus Isolated Medial

Minimally invasive pelvic exenteration for primary or recurrent locally advanced rectal cancer:A glimpse into the future

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 1960-1964页

作者： dimitrios Kehagias Charalampos Lampropoulos Ioannis Kehagias Department of General Surgery General University Hospital of PatrasPatras 26504Greece Intensive Care Unit Saint Andrew’s General HospitalPatras 26335Greece Division of Bariatric and Metabolic Surgery Department of SurgeryUniversity of PatrasPatras 26504Greece

Surgeons have grappled with the treatment of recurrent and T4b locally advanced rectal cancer(LARC)for many *** main objectives are to increase the overall survival and quality of life of the patients and to mitigate postoperative ***,pelvic exenteration(PE)with or without neoadjuvant treatment is a curative treatment when negative resection margins are *** traditional open approach has been favored by many ***,the technological advancements in minimally invasive surgery have radically changed the surgical *** studies have demonstrated promising results in postoperative complications and oncological outcomes after robotic or laparoscopic PE.A recent retrospective study entitled“Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review”was published in the World Journal of Gastrointestinal *** we read this article with great interest,we decided to delve into the latest data regarding the benefits and risks of minimally invasive PE for ***,the small number of suitable patients,limited surgeon experience,and steep learning curve are hindering the establishment of minimally invasive PE.

关键词： Locally advanced rectal cancer Pelvic exenteration Multivisceral resection Minimally invasive surgical procedures Robotic surgical procedures

Incidence, risk factors and clinical outcome of multidrug-resistant organisms after heart transplantation

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World Journal of Transplantation 2024年第2期14卷 107-118页

作者： Sophia Hatzianastasiou Paraskevas Vlachos Georgios Stravopodis dimitrios Elaiopoulos Afentra Koukousli Josef Papaparaskevas Themistoklis Chamogeorgakis Kyrillos papadopoulos Theodora Soulele Despoina Chilidou Kyriaki Kolovou Aggeliki Gkouziouta Michail Bonios Stamatios Adamopoulos Stavros Dimopoulos Microbiology Department and Infection Control Office Onassis Cardiac Surgery CenterAthens 17674Greece Heart Transplantation Unit Onassis Cardiac Surgery CenterAthens 17674Greece Cardiac Surgery Intensive Care Unit Onassis Cardiac Surgery CenterAthens 17674Greece

BACKGROUND Transplant recipients commonly harbor multidrug-resistant organisms(MDROs),as a result of frequent hospital admissions and increased exposure to antimi-crobials and invasive *** To investigate the impact of patient demographic and clinical characteristics on MDRO acquisition,as well as the impact of MDRO acquisition on intensive care unit(ICU)and hospital length of stay,and on ICU mortality and 1-year mortality post heart *** This retrospective cohort study analyzed 98 consecutive heart transplant patients over a ten-year period(2013-2022)in a single transplantation *** was collected regarding MDROs commonly encountered in critical *** Among the 98 transplanted patients(70%male),about a third(32%)acquired or already harbored MDROs upon transplantation(MDRO group),while two thirds did not(MDRO-free group).The prevalent MDROs were Acinetobacter baumannii(14%),Pseudomonas aeruginosa(12%)and Klebsiella pneumoniae(11%).Compared to MDRO-free patients,the MDRO group was characterized by higher body mass index(P=0.002),higher rates of renal failure(P=0.017),primary graft dysfunction(10%vs 4.5%,P=0.001),surgical re-exploration(34%vs 14%,P=0.017),mechanical circulatory support(47%vs 26%P=0.037)and renal replacement therapy(28%vs 9%,P=0.014),as well as longer extracorporeal circulation time(median 210 vs 161 min,P=0.003).The median length of stay was longer in the MDRO group,namely ICU stay was 16 vs 9 d in the MDRO-free group(P=0.001),and hospital stay was 38 vs 28 d(P=0.006),while 1-year mortality was higher(28%vs 7.6%,log-rank-χ2:7.34).CONCLUSION Following heart transplantation,a predominance of Gram-negative MDROs was *** acquisition was associated with higher complication rates,prolonged ICU and total hospital stay,and higher post-transplantation mortality.

关键词： Heart transplantation Multi drug resistant organisms Transplantation complications Transplantation outcome

Downstaging strategies for unresectable hepatocellular carcinoma

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World Journal of Gastroenterology 2024年第20期30卷 2731-2733页

作者： Georgia Sofia Karachaliou Nikolaos Dimitrokallis dimitrios P Moris Division of Gastroenterology Department of MedicineDuke University Medical CenterDurhamNC 27710United States First Department of Surgery&Organ Transplant Unit Evangelismos General HospitalAthens 10676Greece Department of Surgery Duke University Medical CenterDurhamNC 27710United States

A significant number of patients with hepatocellular carcinoma(HCC)are usually diagnosed in advanced stages,that leads to inability to achieve *** options are focusing on downstaging a locally advanced *** is wellsupported in the literature that patients with HCC who undergo successful conversion therapy followed by curative-intent surgery may achieve a significant survival benefit compared to those who receive chemotherapy alone or those who are successfully downstaged with conversion therapy but not treated with *** artery infusion chemotherapy can be a potential downstaging strategy,since recent studies have demonstrated excellent outcomes in patients with colorectal liver metastatic disease as well as primary liver malignancies.

关键词： Unresectable hepatocellular carcinoma Hepatic arterial infusion chemotherapy Downstaging Hepatocellular carcinoma