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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

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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

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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

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Hidden army within:Harnessing the microbiome to improve cancer treatment outcomes

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World Journal of Clinical Cases 2024年第28期12卷 6159-6164页

作者： Ippokratis Messaritakis georgios Vougiouklakis Asimina Koulouridi Aris p Agouridis Nikolaos Spernovasilis Department of Microbiology German Oncology Center&Yiannoukas Labs LTDBioiatriki GroupLimassol 4108Cyprus Department of Internal Medicine German Oncology CenterLimassol 4108Cyprus Department of Oncology German Oncology CenterLimassol 4108Cyprus School of Medicine European University CyprusNicosia 2404Cyprus Department of Infectious Diseases German Oncology CenterLimassol 4108Cyprus

The gut microbiome has emerged as a critical player in cancer pathogenesis and treatment ***,an imbalance in the gut microbial community,impacts tumor initiation,progression,and therapy *** bacterial species have been associated with either promoting or inhibiting tumor growth,offering potential targets for therapeutic *** gut microbiome in-fluences the efficacy and toxicity of conventional treatments and cutting-edge immunotherapies,highlighting its potential as a therapeutic target in cancer ***,translating microbiome research into clinical practice requires addres-sing challenges such as standardizing methodologies,validating microbial bio-markers,and ensuring ethical ***,we provide a comprehensive overview of the gut microbiome's role in cancer highlighting the need for on-going research,collaboration,and innovation to harness its full potential for im-proving patient outcomes in *** current editorial aims to explore these insights and emphasizes the need for standardized methodologies,validation of microbial biomarkers,and interdisciplinary collaboration to translate microbiome research into clinical ***,it underscores ethical consider-ations and regulatory challenges surrounding the use of microbiome-based ***,this article advocates for ongoing research,collaboration,and innovation to realize the full potential of microbiome-guided oncology in impro-ving patient care and outcomes.

关键词： Gut microbiome Cancer treatment Immunotherapy Microbiome-based interventions Dysbiosis precision oncology

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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

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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

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Effect of growth hormone on colonic anastomosis after intraperitoneal administration of 5-fluorouracil, bleomycin and cisplatin: An experimental study

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2679-2688页

作者： Ioannis Lambrou Ioannis Mantzoros Orestis Ioannidis Dimitrios Tatsis Elissavet Anestiadou Vasiliki Bisbinas Manousos-georgios pramateftakis Efstathios Kotidis Barbara Driagka Ourania Kerasidou Savvas Symeonidis Stefanos Bitsianis Freideriki Sifaki Konstantinos Angelopoulos Haralabos Demetriades Stamatios Angelopoulos Fourth Department of Surgery Medical SchoolAristotle University of ThessalonikiThessaloniki 57010Greece Department of ENT Royal Cornwall Hospitals NHS TrustCornwall TR13LJUnited Kingdom

BACKGROUND Growth hormone(GH)plays a crucial role in wound healing and tissue repair in postoperative *** particular,colonic anastomosis healing following colorectal surgery is impaired by numerous chemotherapy *** To investigate whether GH can improve the healing of a colonic anastomosis following the adverse effects of intraperitoneal administration of 5-fluorouracil(5-FU),bleomycin and *** Eighty Wistar rats underwent laparotomy and a 1 cm-resection of the transverse colon,followed by an end-to-end anastomosis under general *** rats were blindly allocated into four equal groups and administered a different daily intraperitoneal therapeutic regimen for 6 *** control group(A)received normal *** B received chemotherapy with 5-FU(20 mg/kg),bleomycin(4 mg/kg)and cisplatin(0.7 mg/kg).Group C received GH(2 mg/kg),and group D received the aforementioned combination chemotherapy and GH,as *** rats were sacrificed on the 7th postoperative day and the anastomoses were macroscopically and microscop-ically *** weight,bursting pressure,hydroxyproline levels and inflammation markers were *** All rats survived until the day of sacrifice,with no infections or other complications.A decrease in the body weight of group D rats was observed,not statistically significant compared to group A(p=1),but significantly different to groups C(p=0.001)and B(ppressure was not significantly different between groups A and D(p=1.0),whereas group B had a significantly lower bursting pressure compared to group D(pps had significantly more adhesions than group ***,as a measurement of collagen deposition,was significantly higher in group D compared to group B(ppared to group *** changes in group D were recorded,compared to group A

关键词： Growth hormone Colonic anastomosis Adhesion Bursting pressure Collagen Hydroxyproline Inflammation Neoangiogenesis Chemotherapy

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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

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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

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Acute coronary syndrome after infliximab therapy in a patient with Crohn’s disease

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World Journal of Gastroenterology 2006年第38期12卷 6235-6238页

作者： Vasilios panteris Anna perdiou Vasilios Tsirimpis Demetrios georgios karamanolis Department of Gastroenterology "Tzaneio" General Hospital Piraeus Greece Hematology and Laboratory Medicine "Tzaneio" General Hospital Piraeus Greece Department of Cardiology "Tzaneio" General Hospital Piraeus Greece

Infliximab is a potent anti-TNF antibody, which is used with great success in Crohn’s disease patients. Since its release in clinical practice, several adverse reactions have been observed. The interest in possible consequences of its administration is still high because of the recent introduction of the drug for the long-term maintenance therapy of refractory luminal and fistulizing Crohn’s disease. We present a case of acute coronary syndrome (non-STEMI) in a patient with corticoid resistant Crohn’s disease after his first dose of infliximab. By reviewing the scant articles that exist in the literature on this topic we made an effort to delineate the possible mechanisms of this phenomenon.

关键词： Infliximab Adverse reactions Crohn's disease Myocardial infarction Ischemic heart disease TNF-α

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