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From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world

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World Journal of Gastroenterology 2017年第29期23卷 5282-5294页

作者： Dimitrios Dimitroulis Christos Damaskos Serena Valsami Spyridon Davakis Nikolaos Garmpis eleftherios Spartalis Antonios Athanasiou Demetrios Moris Stratigoula Sakellariou Stylianos Kykalos Gerasimos Tsourouflis Anna Garmpi Ioanna Delladetsima Konstantinos Kontzoglou Gregory Kouraklis Second Department of Propedeutic Surgery Laiko General Hospital Medical School National and Kapodistrian University of Athens Blood Transfusion Department Aretaieion Hospital Medical School National and Kapodistrian Athens University First Department of Surgery Laiko General Hospital Medical School National and Kapodistrian University of Athens N.S. Christeas Laboratory of Experimental Surgery and Surgical Research Medical School National and Kapodistrian University of Athens Department of Surgery Mercy University Hospital Lerner Research Institute Cleveland Clinic Foundation First Department of Pathology Medical School National and Kapodistrian University of Athens Internal Medicine Department Laiko General Hospital University of Athens Medical School

Hepatocellular carcinoma(HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer Staging System remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma.

关键词： Hepatocellular Cancer Epidemiology Treatment Diagnosis Staging Transplantation

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Statin escape phenomenon: Fact or fiction?

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World Journal of Experimental Medicine 2017年第1期7卷 25-30页

作者： Fotios Barkas Moses Elisaf eleftherios Klouras Theodora Dimitriou Nikolaos Tentolouris Evangelos Liberopoulos Department of Internal Medicine School of MedicineUniversity of Ioannina First Department of Propaedeutic and Internal Medicine Medical SchoolNational and Kapodistrian University of AthensLaiko General Hospital

AIM To evaluate the presence of the so called "statin escape" phenomenon among hyperlipidemic subjects attending a lipid clinic. METHODS This was a retrospective analysis of 1240 hyperlipidemic individuals followed-up for ≥ 3 years. We excluded those individuals meeting one of the following criteria: Use of statin therapy at baseline visit, discontinuation of statin treatment at most recent visit, change in statin treatment during follow-up and poor compliance to treatment. Statin escape phenomenon was defined as an increase in lowdensity lipoprotein cholesterol(LDL-C) levels at the most recent visit by > 10% compared with the value at 6 mo following initiation of statin treatment. RESULTS Of 181 eligible subjects, 31% exhibited the statin escape phenomenon. No major differences regarding baseline characteristics were found between statin escapers and non-statin escapers. Both escapes and non-escapes had similar baseline LDL-C levels [174(152-189) and 177(152-205) mg/d L, respectively]. In comparison with nonescapers, statin escapers demonstrated lower LDL-C levels at 6 mo after treatment initiation [88(78-97) mg/d L vs 109(91-129) mg/d L, P < 0.05], but higher levels at the most recent visit [103(96-118) mg/d L vs 94(79-114) mg/d L, P < 0.05]. CONCLUSION These data confirm the existence of an escape phenomenon among statin-treated individuals. The clinical significance of this phenomenon remains uncertain.

关键词： Statin Escape Cholesterol

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Comparison of cosmetic outcomes between remote-access and conventional thyroidectomy:A review of the current literature

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第1期9卷 1-8页

作者： Anna Kasouli eleftherios Spartalis Alexios Giannakodimos Gerasimos Tsourouflis Dimitrios Dimitroulis Nikolaos I.Nikiteas Hellenic Minimally Invasive and Robotic Surgery(MIRS)Study Group Medical School AthensNational and Kapodistrian University of AthensAthensGreece 2nd Department of Propaedeutic Surgery Medical SchoolNational and Kapodistrian University of AthensAthensGreece

Objective:The pursuit of an esthetically pleasing scar following open thyroid surgery has led to the development of endoscopic thyroidectomy through remote incisions placed in several locations outside the *** objective of this study is to review the recent literature and compare the incision site appearance and patient satisfaction with the cosmetic outcome after extracervical and conventional ***:The English literature published since 2010 was searched through the PubMed/Medline database for studies comparing the cosmetic outcomes between remote-access endoscopic and conventional thyroidectomy using a form of scar assessment ***:A total of 9 relevant papers fulfilled the eligibility criteria including 1486 *** them,595 patients underwent endoscopic thyroidectomy through several remote-access approaches and 891 patients were assigned to the conventional *** one randomized-controlled trial was identified,whereas among the rest,four were prospective and four were retrospective nonrandomized *** the extracervical modifications performed in the endoscopic groups,the axillary approach was performed in three studies and the breast approach in four studies,while the retroauricular facelift technique and the transoral vestibular method were applied in one study,***:Evaluation of the wound appearance and patient satisfaction with the cosmetic outcome at various time points during the follow-up highlighted the superiority of the extracervical approaches over the conventional *** these findings,remote-access techniques could possibly be the ideal surgical method for patients with high esthetic requirements,providing an excellent appearance of the thoroughly exposed neck.

关键词： esthetic cosmesis cosmetic cosmetic results incision scar thyroidectomy

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Obstructive sleep apnea syndrome and cardiovascular disease: The influence of C-reactive protein

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World Journal of Experimental Medicine 2015年第2期5卷 77-83页

作者： Izolde Bouloukaki Charalampos Mermigkis eleftherios M Kallergis Violeta Moniaki Eleni Mauroudi Sophia E Schiza Sleep Disorders Center Department of Thoracic MedicineUniversity General Hospital Medical School of the University of Crete

Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein(CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS.

关键词： Sleep apnea Cardiovascular C-reactive protein

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Neuromuscular interactions around the knee in children, adults and elderly

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World Journal of Orthopedics 2014年第4期5卷 469-485页

作者： eleftherios Kellis Lida Mademli Dimitrios Patikas Nikolaos Kofotolis Laboratory of Neuromechanics School of Physical Education and Sport Sciences at Serres Aristotle University of Thessaloniki

Although injury and neuromuscular activation patterns may be common for all individuals, there are certain factors which differentiate neuromuscular activity responses between children, adults and elderly. The purpose of this study is to review recent evidence on age differences in neural activation and muscle balances around the knee when performing single joint movements. Particularly, current evidence indicates that there are some interesting similarities in the neuromuscular mechanisms by which children or the elderly differ compared with adults. Both children and elderly display a lower absolute muscle strength capacity than adults which cannot fully be explained by differences in muscle mass. Quadriceps activation failure is a common symptom ofall knee injuries, irrespective of age but it is likely that its effect is more evident in children or adults. While one might expect that antagonist co-activation would differ between age categories, it appears that this is not the case. Although hamstring: quadriceps ratio levels are altered after knee injury, it is not clear whether this is an age specific response. Finally, evidence suggests that both children and the elderly display less stiffness of the quadriceps muscle-tendon unit than adults which affects their knee joint function.

关键词： Knee stability Knee joint Stiffness Electromyography Strength imbalance Aging,Co-activation Age Injuries

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Hepatocellular carcinoma in patients co-infected with hepatitis C virus and human immunodeficiency virus

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World Journal of Hepatology 2013年第6期5卷 323-327页

作者： Dimitrios Dimitroulis Serena Valsami eleftherios Spartalis Emmanuel Pikoulis Gregory Kouraklis Second Department of Propedeutic Surgery Athens University Medical School "Laiko" Hospital Blood Transfusion Department Athens University Medical School Areteion Hospital

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) share a common route of transmission so that about one third of HIV infected individuals show HCV coinfection. Highly active antiretroviral therapy has offered a longer and better life to infected patients. While has removed AIDS-related diseases from the list of most common causes of death their place has been taken by complications of HCV infection, such as cirrhosis, end stage liver disease and hepatocellular carcinoma (HCC). HIV/HCV co-infection requires complex management, especially when HCC is present. Co-infected patients with HCC undergo the same therapeutic protocol as their mono-infected counterparts, but special issues such as interaction between regimens, withdrawal of therapy and choice of immunosuppressive agents, demand a careful approach by specialists. All these issues are analyzed in this minireview.

关键词： Hepatocellular carcinoma Hepatitis C virus, Human immunodeficiency virus Co-infection

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获得关注是成功的一半

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科学新闻 2016年第10期 89-90页

作者： eleftherios P.Diamandis 倪伟波加拿大多伦多大学加拿大多伦多大学临床生物化学系加拿大多伦多西奈山医院临床生物化学系

招聘游戏早早就开始了。甚至在教师职位开始之前,部门成员和管理人员就开始倾向于观察合适的和他们认为候选人名单中最有前途的候选人。为了对自己有利,精明的候选人会运作这个预选过程。运作是有一些显而易见的方法的:成为一名优秀的学... 详细信息

招聘游戏早早就开始了。甚至在教师职位开始之前,部门成员和管理人员就开始倾向于观察合适的和他们认为候选人名单中最有前途的候选人。为了对自己有利,精明的候选人会运作这个预选过程。运作是有一些显而易见的方法的:成为一名优秀的学者,多发表好的作品,努力工作,与公众及你的同行进行交流。但是通过精心策划和长期的努力以确保你的"光芒"能引起那些负有招聘职责的人的注意,则是决定性的因素。以下便是我的经历。1982年,作为临床生物化学博士后学位候选人,我来到了多伦多大学。因为来自一个相当贫穷的国家——希腊,这是一个不利条件,所以我尽我所能去适应新的环境,填补我知识方面的空白,通过辛勤

关键词：系主任生物化学基础医学

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输血感染丙肝者十年存活率回顾

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国外医学（输血及血液学分册） 2004年第1期27卷 74-75页

作者： eleftherios．Vamvakas MD PhD 宋任浩不详河北省血液中心

通过人口调查获得的输血感染丙肝长期(10年以上)存活机率的数据，对于制订政策是需要的，但目前尚无1981年之后的输血感染丙肝存活的病人的资料。过去常用1981年明尼苏达Olmsted县的受血者的10年存活率的数据，但这些数字很可能不能反... 详细信息

通过人口调查获得的输血感染丙肝长期(10年以上)存活机率的数据，对于制订政策是需要的，但目前尚无1981年之后的输血感染丙肝存活的病人的资料。过去常用1981年明尼苏达Olmsted县的受血者的10年存活率的数据，但这些数字很可能不能反映上世纪90年代的输血感染者的存活率。

关键词：输血感染丙型肝炎存活率红细胞

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Clinical results of linezolid in arthroplasty and trauma related infections

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World Journal of Orthopedics 2014年第2期5卷 151-157页

作者： James Joel Simon Matthew Graham Adam Peckham-Cooper Nectarios Korres Helen Tsouchnica eleftherios Tsiridis Academic Orthopaedic and Trauma Unit Leeds Teaching Hospitals Leeds School of Medicine Leeds LS1 3EX United Kingdom Royal Liverpool University Hospital Liverpool L7 8XP United Kingdom Academic Orthopaedics and Trauma Unit Division of Surgery Aristotle University Medical School University Campus 54 124 Thessaloniki Greece

AIM: To analyse the management of patients treated with linezolid for orthopaedic ***: Twenty-two patients with orthopaedic related infections receiving a course of linezolid were reviewed retrospectively. Patients were classified into either post trauma, post arthroplasty and non trauma related infections. A diagnosis of infection was based on clinical findings, positive microbiological specimens, and positive signs of infection on radiological imaging and raised inflammatory markers. Pathogens isolated, inflammatory markers both at presentation and at final follow up, length of linezolid treatment, adverse drug reactions, concomitant anti-microbial therapy, length of hospital stay and any surgical interventions were ***: Infections were classified as post arthroplasty(n = 10), post trauma surgery(n = 8) or nontrauma related infections(n = 4). Twenty patients(91%) underwent surgical intervention as part of their treatment. The number of required surgical procedures ranged from 1 to 6(mean = 2.56). Mean total length of stay per admission was 28.5 d(range 1-160 d). Furthermore, the mean duration of treatment with linezolid of patients who had resolution of symptoms was 31 d(range 10-84 d). All patients within this group were discharged on oral linezolid. Pathogens isolated included methicillin resistant Staphylococcus aureus, coagulase negative staphylococci, coliforms, enterococcus, Staphylococcus epidermidis, streptococcus viridans, Escherichia coli, group B streptococcus and pseudomonas. An overall 77% of patients demonstrated resolution of infections at follow-up, with mean C-reactive protein reducing from 123 mg/L to 13.2 mg/***: This study demonstrates that the use of linezolid offers excellent efficacy in orthopaedic related infections when used alongside appropriate surgical management.

关键词： Antibiotic resistance Linezolid Orthopaedic infections Osteomyelitis Periprosthetic joint infection

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Biomechanical characteristics of bone in streptozotocin-induced diabetic rats:An in-vivo randomized controlled experimental study

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World Journal of Orthopedics 2013年第3期4卷 124-129页

作者： Nektarios Korres eleftherios Tsiridis George Pavlou Athanasios Mitsoudis Despina N Perrea Aristedes B Zoumbos KAT First Department of Orthopaedics and Trauma 14561 AthensGreece Academic Orthopaedics and Trauma Unit Division of SurgeryAristotle University Medical School54124 ThessalonikiGreece Department of Orthopaedics Robert Jones and Agnes Hunt Orthopaedic HospitalOswestry SY10 7AGUnited Kingdom Department of Biomechanics School of Applied Mathematical and Physical SciencesNational Technical University of Athens14561 AthensGreece Department of Experimental Surgical Research "N.S.Christeas" Athens University Medical School14561 AthensGreece Department of Orthopaedics Academic Orthopaedic Department "Attikon" HospitalAthens University Medical School14561 AthensGreece

AIM: To investigate the in vivo effects of type Ⅰdiabetes on the mechanical strength of tibial bone in a rodent ***: The biomechanical effect of diabetes on the structural integrity of the tibia in streptozotocin induced diabetic Wistar rats was analysed. Induction of diabetes was achieved by an intra-peritoneal injection and confirmed by measuring serial blood glucose levels(> 150 mg/d L). After 8 wk the tibiae were harvested and compared to a control group. Biomechanical analysis of harvested tibiae was performed using a threepoint bending technique on a servo hydraulic MTS 858 MiniB ionix frame. Maximum force applied to failure(N), stiffness(N × mm) and energy absorbed(N/mm) were recorded and plotted on load displacement curves. A displacement control loading mode of 1 mm/min was selected to simulate quasi-static loading conditions. Measurements from load-displacement curves were directly compared between ***: Fourteen streptozotocin induced diabetic Wistar rats were compared against nineteen non-diabetic controls. An average increase of 155.2 g in body weight was observed in the control group compared with only 5 g in the diabetic group during the experimental study period. Levels of blood glucose increased to 440.25 mg/d L in the diabetic group compared to 116.62 mg/d L in the control *** biomechanical results demonstrate a highly significant reduction in the maximum load to failure from 69.5 N to 58 N in diabetic group compared to control(P = 0.011). Energy absorption to fracture was reduced from 28.2 N in the control group to 23.5 N in the diabetic group(P = 0.082). No significant differences were observed between the groups for bending ***: Streptozotocin-induced diabetes in rodents reduces the maximum force and energy absorption to failure of bone, suggesting a predisposition for fracture risk.

关键词： Streptozotocin Rodent Bone Biomechanics

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