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Enhanced recovery after surgery in liver transplantation:Challenges and feasibility

World Journal of Transplantation 2022年第7期12卷 195-203页

作者： Georgios Katsanos Konstantina-Eleni Karakasi Nikolaos Antoniadis Stella Vasileiadou Athanasios Kofinas Antonios Morsi-Yeroyannis Evangelia Michailidou Ioannis Goulis Emmanouil Sinakos Olga Giouleme ilias Marios Oikonomou George Evlavis Georgios Tsakiris Eleni Massa Eleni Mouloudi Georgios Tsoulfas Department of Transplantation Medical SchoolAristotle University of ThessalonikiHippokration General HospitalThessaloniki 54642Greece Intensive Care Unit National Health SystemHippokration General HospitalThessaloniki 54642Greece Fourth Department of Internal Medicine Hippokration General HospitalMedical School of Aristotle UniversityThessaloniki 54642Greece Second Propaedeutic Department of Internal Medicine Hippokratio General HospitalAristotle University ThessalonikiThessaloniki 54642Greece Nursing Department National Health SystemDepartment of TransplantationHippokration General HospitalThessaloniki 54642Greece

BACKGROUND Enhanced recovery after surgery(ERAS)started a revolution that changed age-old surgical stereotypical practices regarding the overall management of the surgical *** the last decade,ERAS has gained significant acceptance in the community of general surgery,in addition to several other surgical specialties,as the evidence of its advantages continues to *** of the last remaining fields,given its significant complexity and intricate nature,is liver transplantation(LT).AIM To investigate the existing efforts at implementing ERAS in *** We conducted a systematic review of the existing studies that evaluate ERAS in orthotopic LT,with a multimodal approach and focusing on measurable clinical primary endpoints,namely length of hospital *** All studies demonstrated a considerable decrease in length of hospital stay,with no readmission or negative impact of the ERAS protocol applied to the postoperative *** ERAS is a well-validated multimodal approach for almost all types of surgical procedures,and its future in selected LT patients seems promising,as the preliminary results advocate for the safety and efficacy of ERAS in the field of LT.

关键词： Enhanced recovery Enhanced recovery after surgery Recovery Liver transplantation Liver

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Meta-analysis of subtotal stomach-preserving pancreaticoduodenectomy vs pylorus preserving pancreaticoduodenectomy

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World Journal of Gastroenterology 2015年第20期21卷 6361-6373页

作者： Wei Huang Jun-Jie Xiong Mei-Hua Wan Peter Szatmary Shameena Bharucha ilias Gomatos Quentin M Nunes Qing Xia Robert Sutton Xu-Bao Liu Sichuan Provincial Pancreatitis Center Department of Integrated Traditional Chinese Medicine and Western MedicineWest China HospitalSichuan University Department of Pancreatic Surgery West China HospitalSichuan University NIHR Liverpool Pancreas Biomedical Research Unit Royal Liverpool University Hospital

AIM: To investigate the differences in outcome following pylorus preserving pancreaticoduodenectomy(PPPD) and subtotal stomach-preserving pancreaticoduodenectomy(SSPPD).METHODS: Major databases including Pub Med(Medline), EMBASE and Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials(CENTRAL) in The Cochrane Library were searched for comparative studies between patients with PPPD and SSPPD published between January 1978 and July 2014. Studies were selected based on specific inclusion and exclusion criteria. The primary outcome was delayed gastric emptying(DGE). Secondary outcomes included operation time, intraoperative blood loss, pancreatic fistula, postoperative hemorrhage, intraabdominal abscess, wound infection, time to starting liquid diet, time to starting solid diet, period of nasogastric intubation, reinsertion of nasogastric tube, mortality and hospital stay. The pooled odds ratios(OR) or weighted mean difference(WMD) with 95% confidence intervals(95%CI) were calculated using either a fixed-effects or random-effects model. RESULTS: Eight comparative studies recruiting 650 patients were analyzed, which include two RCTs, one non-randomized prospective and 5 retrospective trial designs. Patients undergoing SSPPD experienced significantly lower rates of DGE(OR = 2.75; 95%CI: 1.75-4.30, P < 0.00001) and a shorter period of nasogastric intubation(OR = 2.68; 95%CI: 0.77-4.58,P < 0.00001), with a tendency towards shorter time to liquid(WMD = 2.97, 95%CI:-0.46-7.83; P = 0.09) and solid diets(WMD = 3.69, 95%CI:-0.46-7.83; P = 0.08) as well as shorter inpatient stay(WMD = 3.92, 95%CI:-0.37-8.22; P = 0.07), although these latter three did not reach statistical significance. PPPD, however, was associated with less intraoperative blood loss than SSPPD [WMD =-217.70, 95%CI:-429.77-(-5.63); P = 0.04]. There were no differences in other parameters between the two approaches, including operative time(WMD =-5.30, 95%CI:-43.44-32.84; P = 0.79

关键词： Pancreaticoduodenectomy Pylorus preservingSubtotal stomach preserving pancreaticoduodenectomy Delayed gastric emptying Pancreatic surgery Metaanalysis

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Circadian rhythm disruption and endocrine-related tumors

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World Journal of Clinical Oncology 2024年第7期15卷 818-834页

作者： Christos Savvidis Efthymia Kallistrou Eleni Kouroglou Sofia Dionysopoulou Georgios Gavriiloglou Dimitra Ragia Vasiliki Tsiama Stella Proikaki Konstantinos Belis Ioannis ilias Department of Endocrinology Hippocration General HospitalAthens GR-11527Greece

This review delved into the intricate relationship between circadian clocks and physiological processes,emphasizing their critical role in maintaining *** by interlocked clock genes,the circadian timekeeping system regulates fundamental processes like the sleep-wake cycle,energy metabolism,immune function,and cell *** central oscillator in the hypothalamic suprachiasmatic nucleus synchronizes with light-dark cycles,while peripheral tissue clocks are influenced by cues such as feeding *** disruption,linked to modern lifestyle factors like night shift work,correlates with adverse health outcomes,including metabolic syndrome,cardiovascular diseases,infec-tions,and *** explored the molecular mechanisms of circadian clock genes and their impact on metabolic disorders and cancer *** associ-ations between circadian disruption and endocrine tumors,spanning breast,ovarian,testicular,prostate,thyroid,pituitary,and adrenal gland cancers,are *** work is associated with increased breast cancer risk,with PER genes influencing tumor progression and drug *** gene expression correlates with cisplatin resistance in ovarian cancer,while factors like aging and intermittent fasting affect prostate *** review underscored the intricate interplay between circadian rhythms and cancer,involving the regulation of the cell cycle,DNA repair,metabolism,immune function,and the tumor *** advocated for integrating biological timing into clinical consider-ations for personalized healthcare,proposing that understanding these connec-tions could lead to novel therapeutic *** supports circadian rhythm-focused therapies,particularly chronotherapy,for treating endocrine *** review called for further research to uncover detailed connections between circadian clocks and cancer,providing essential insights for targeted *** emphasized the importance of pub

关键词： Circadian rhythm Circadian disruption Shift work CLOCK gene Cancer Endocrine tumors Chronotherapy

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Epidemio-Clinical and Uretrocystographic Profile of Pathologies of the Lower Urinary Tract at the Chu Pr Bss of Kati

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Open Journal of Medical Imaging 2023年第1期13卷 40-48页

作者： ilias Guindo Souleymane Sanogo Alassane Kouma Dramane Bagayoko Issa Diarra Mamadou N’diaye Ouncoumba Diarra Amadou Kassogue Salia Coulibaly Adama Diaman Keita Medical Imaging Department Kati University Hospital Kati Mali Department of Radiology Luxembourg Mother-Child Hospital Bamako Mali Radiology Department Bamako Infirmary Bamako Mali Medical Imaging Service CS Ref of Commune III Bamako Mali Department of Urology University Hospital of Kati Kati Mali Department of Radiology and Nuclear Medicine Point “G” University Hospital Bamako Mali

Introduction: Pathologies of the lower urinary tract are common in urology composed of various conditions, responsible for urinary disorders. Despite the new methods, exploration in Africa is mainly based on retrograde urethrocystography (UCR). The main objective was to determine the importance of UCR in the diagnosis of pathologies of the lower urinary tract. Materials and Methods: This was a retrospective and descriptive study covering a period of 5 years (July 2016-June 2021). It involved all patients admitted to the ward for retrograde urethrocystography during the period. A remote-controlled table of the GE PRESTILIX 1600× type was used for the examinations. Results: At the end of our study we collected 100 cases of pathologies of the lower urinary tract out of a total of 112 RCUs performed or 89.28%. Pathologies of the lower urinary tract accounted for 78% of the UCRs in the department. The age group of (61 - 70) was the most affected with extremes from 1 year to 101 years. Non-specific urination disorders were the most common indications (43%), followed by acute urine retention (18%). Acquired urethral pathology was the most common (89%), followed by bladder neck disease 5% and posterior urethral valve with 4%, Bladder struggle was the most common associated sign (54%) with post-urination residue in 97% of patients. Conclusion: Pathologies of the lower urinary tract are relatively common in our region, dominated by urethral narrowings. Retrograde urethrocystography remains the reference examination in our control for the diagnosis of obstructive pathologies of the lower urinary tract while specifying the seat of the obstacle.

关键词： Pathologies of the Lower Urinary Tract UCR CHU Kati

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Rare Antenatal Fetal Malformations of the Anterior Abdominal Wall in Mali: About a Case

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Open Journal of Medical Imaging 2022年第4期12卷 208-214页

作者： Ousmane Traore Ouncoumba Diarra Mamadou N’Diaye Souleymane Sanogo ilias Guindo Abdoulaye Kone Hamady Sissoko Mahamadou Diallo Siaka Sidibe Adama Diaman Keita Radiology Department of the Medical Clinic “Marie Curie” Bamako Mali Department of Radiology Center Hospital-University “Le Point G” Bamako Mali Radiology Department Commune III Reference Health Center of Bamako Bamako Mali Radiology Department of the Military Camp of Bamako Bamako Mali Department of Radiology Center Hospital-University “Le Luxembourg” Bamako Mali Radiology Department Center Hospital-University de Kati Bamako Mali Radiology Department of the Medical Clinic “Pasteur” Bamako Mali Department of Radiology Center Hospital-University “Gabriel Toure” Bamako Mali

Abdominal wall malformations correspond to a wide spectrum of congenital anomalies that are due to a defect in the closure of the anterior abdominal wall and can be fatal. We report the case of laparoschisis associated with a poly malformation syndrome in the same fetus at the reference health center of commune III of the district of Bamako. The objective is to clarify the interest of antenatal ultrasound in the diagnosis and prognosis of these malformations. It was a 19-year-old prim gravid woman received as part of the prenatal check-up. Antenatal ultrasound had allowed the diagnosis of malformation of the anterior abdominal wall of the gastroschisis type associated with abnormalities of the neural tube, the urogenital system and the bone skeleton. The antenatal diagnosis of the malformations had motivated the realization of a therapeutic termination of pregnancy at 19 weeks of amenorrhea and 3 days by triggering and vaginal delivery, allowing the confirmation of the diagnosis of gastroschisis and the poly malformation syndrome which is extremely rare. Antenatal ultrasound remains an ideal means of imaging for monitoring pregnancy and had made it possible to make the prognosis and antenatal diagnosis of multiple malformations in association, and to indicate better therapeutic decision-making.

关键词： Malformation Fetus Antenatal Ultrasound Laparoschisis

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The Epidemiological, Clinical and Radiological (Echography, Mammography) Characteristics of Breast Pathologies at the Diagnostic Imaging Center (C.I.D) “Teriya” in Bamako

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Open Journal of Medical Imaging 2023年第1期13卷 30-39页

作者： ilias Guindo Souleymane Sanogo Mamadou N’diaye Mody Abdoulaye Camara Adama Dao Youssouf Goita Amadou Sow Mohamed Malinke Salia Coulibaly Mahamadou Diallo Medical Imaging Department CHU Pr BSS of Kati Kati Mali Medical Imaging Department CHU Gabriel Touré Bamako Mali Medical Imaging Department Luxembourg Mother-Child Hospital Bamako Mali Imaging Service Bamako Infirmary Central Directorate of Armed Forces Health Services (DCSSA) Bamako Mali Medical Imaging Department Mali Hospital Bamako Mali TERIYA Diagnostic Imaging Center Bamako Mali

Breast pathology is varied, bringing together tumor and non-tumor lesions. Objective: To study the contribution of the ultrasound-mammography pair in the diagnosis of breast pathologies. Materials and Method: This was a retrospective descriptive study, carried out over a period of 3 years (from January 2018 to December 2020) at the Diagnostic Imaging Center (C.I.D) “TERIYA” in BAMAKO. It concerned all patients who came for a mammogram/ultrasound examination of the breast. All women admitted for mammogram or breast ultrasound who were diagnosed with a breast injury during the study period were included. Incomplete records and radiological checks were not included. The variables analyzed were age, sex, clinical data, and ultrasound and mammography aspects. The devices used are: a Voluson 730 PRO ultrasound machine and a G 600T type mammography machine. Results: At the end of our study, we collected 254 breast pathologies on a number of 382 women, i.e. a frequency of 66.49%. The average age of our patients was 41 years old. The dominant clinical data were mastodynia (41.88%) and mammary nodule (21.70%). On imaging (mammo-ultrasound) the lesions predominated on the left in 36% of cases, bilateral in 28% of cases and in the upper-outer quadrants in 31.5% of cases. Tumor pathologies represented 66.54% of which 45.27% were benign mainly composed of fibro-adenoma (20.88%) and cyst (18.50%), 11.8% of suspected cases and 9.45% of cancers. Non-tumor pathologies represented 33.46%, mainly mastitis (16.14%), galactophoric dilations (11.02%) and abscesses (5.51%). These pathologies were classified in 50.3% in ACR2, 17.75% in ACR3 and 4, and in 14.20% in ACR5. Lymphadenopathy was present in 73.21% of cases.

关键词： Breast Pathologies Ultrasound-Mammography Pair Diagnostic Imaging Center Bamako

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Giant Aneurysmal Bone Cyst of the Right Femur about a Case

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Open Journal of Radiology 2023年第3期13卷 139-145页

作者： Cheick Oumar Keïta Aboudramane Konaté Yacouba Drissa Traoré Youssouf Koné Abdoulaye Koné Issa Diarra ilias Guindo Salia Coulibaly Mahamadou Diallo Siaka Sidibé Radiology Department Mohammed VI Perinatal Clinic Bamako Mali Radiology Department County Hospital of Sikasso Sikasso Mali Radiology Department CNAM Bamako Mali Radiology Department Jacques Boutard Hospital Center Saint Yrieix La Perche France Medical Imaging Department University Hospital of Point G Bamako Mali Medical Imaging Department University Hospital of Kati Kati Mali Medical Imaging Department Gabriel Touré University Hospital Bamako Mali

Aneurysmal bone cyst (ABC) is a rare bone tumor accounting for 1% - 4% of benign bone tumors. Its etiopathogenesis remains unknown. The main site is the metaphysis of the long bones. ABC occurs almost exclusively in young people, with a slight female predominance. We report an exceptional case of ABC of the femur with involvement of the right hip in a 16-year-old girl in the Medical Imaging Department of Pr Bocar Sidy Sall Hospital of Kati (Mali). We will discuss the clinical and radiological aspects of this pathology. Observation: Mrs N C., aged 16, was referred to the orthopaedic-traumatology department for an X-ray of the right thigh, indicated as having a large, disabling thigh. Clinical examination revealed a large thigh measuring 890 mm in circumference, compared with 300 mm on the contralateral side. Radiographically, the femur showed a blown appearance, with the cortex thinned and broken in places. Exceptionally, the lesion affected the entire femur. On CT scan, we found a voluminous fluid collection occupying the entire right femur, including the right femoral head and homolateral ischium. The cortex was interrupted in places, and the adjacent soft tissues were thinned or laminated, but not infiltrated. Histology revealed haemorrhagic and inflammatory elements compatible with the diagnosis of ABC. Conclusion: ABC is a tumor entity that is often difficult to diagnose. Medical imaging, topographical distribution and histology form an indissociable whole to establish a diagnosis of certainty.

关键词： Aneurysmal Bone Cyst Medical Imaging Femur

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图尔奈旧城更新——对话:过去与现状

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城市环境设计 2015年第8期 142-151页

作者： Michel Delplace Cyril Trétout ilias Rasmouni Benjamin Schlit Agence Nicolas Michelin & Associés-ANMA Nicolas Michelin

项目名称:图尔奈旧城更新项目地点:比利时图尔内总规划面积:16hm2建筑面积:21 000m2竞赛时间:2008.06设计时间:2008.09-2014建造时间:2009-2015建成时间:2015盐田大道景观设计位于比利时图尔奈(Tournai,Belgique)市的盐田大道改造项目... 详细信息

项目名称:图尔奈旧城更新项目地点:比利时图尔内总规划面积:16hm2建筑面积:21 000m2竞赛时间:2008.06设计时间:2008.09-2014建造时间:2009-2015建成时间:2015盐田大道景观设计位于比利时图尔奈(Tournai,Belgique)市的盐田大道改造项目是城市历史中心改造计划中的标志性项目,盐田大道的完工为已经没落的城市公共空间注入了新的活力。穿越市区的埃斯考河(l'Escaut)塑造了图尔奈市的整体形态。项目所在的盐田大道原来只是狭窄的沿河小道,我们的设

关键词：旧城更新盐田大道滩田主入口图尔

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Computed Tomography Findings and Clinico-Epidemiological Aspects of COVID-19 Pneumonia at CHME Luxembourg in Bamako (Mali)

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Open Journal of Medical Imaging 2022年第1期12卷 1-8页

作者： Alassane Kouma Souleymane Sanogo Issa Cissé Ousmane Traoré ilias Guindo Ouncoumba Diarra Mamadou Dembélé Seydou Ly Mahamane Mariko Mamoudou Camara Siaka Sidibé Medical Imaging Department of CHME Luxembourg Bamako Mali Marie Curie Clinic Bamako Mali Department of Medical Imaging of the CHU of Kati Bamako Mali Department of Medical Imaging of CSREF CIII Bamako Mali Medical clinic Fertilia Bamako Mali Medical Imaging Department of the CHU Point G Bamako Mali

Objective: To describe the CT findings and clinico-epidemiological aspects of coronavirus pulmonary lesions at the Radiology Department of Mother-Child Luxembourg’s Hospital in Bamako, West Africa. Materials and Method: This was a cross-sectional descriptive study over a period of three months (November 2020-January 2021). The study involved all patients with a clinical suspicion of COVID-19 or confirmed cases with suggestive CT scan lesions during this period. No patients without suggestive CT lesions were not included. The variables were age, sex, clinical data, lungs lesions on CT scan and their severity. Results: Out of 202 patients enlisted, the age group 52 - 63 years was more frequent (30.2%), i.e. an average age of 60.43 years (range 23 and 95 years). Men represented 56.4% or a sex ratio of 1.3. Cough was the most common clinical manifestations (26.7%). Major findings were mixed appearance of the lung lesions (45.5%). The peripheral distribution was 57.4% and the bilateral topography was 98%. These lesions were extensive in the majority of our patients with 28.2%. Conclusion: Older people dominated the socio-demographic profile of our series with a predominance of men. Cough was the most observed clinical information. Mixed lesions with peripheral and bilateral distribution dominated the semiological tomodensitometric aspects. By severity, extensive lung lesions were the most commonly observed.

关键词： COVID-19 CT Scan Mixed Lesion Cough

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Study on Compliance with Radiation Protection Rules in the Medical Imaging Department of Pr Bocar Sidy Sall Hospital of Kati (Mali)

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Open Journal of Radiology 2022年第4期12卷 239-257页

作者： Issa Diarra Salia Coulibaly ilias Guindo Cheick Oumar Keita Soumaïla Diallo Souleymane Sanogo Hawa Diarra Boubacar Sonfo Aboubacar Sidiky N’diaye Youssouf Kone Bourama Diarra Medical Imaging Department The CHU Pr Bocar Sidy Sall Kati Mali Medical Imaging Department Perinatal Clinic Mohamed VI Bamako Mali Medical Imaging Department The Mother-Child Hospital Luxembourg Bamako Mali Medical Imaging Department The Hospital of Mali Bamako Mali Pasteur Polyclinic Bamako Mali Centre Hospitalier Jacques Boutard Saint Yrieix La Perche France Centre de Radiologie Diagnostique et Interventionnelle CRDI Bamako Mali

Objective: Evaluate the level of compliance with radiation protection rules in the medical imaging department of the University Hospital Center (CHU) of Kati. Methodology: This was a cross-sectional and descriptive study carried out in the medical imaging department of Pr Bocar Sidy Sall (BSS) Hospital of Kati. A questionnaire was developed and sent to the staff of the medical imaging department. The assessment focused on the radiation protection of personnel, radiation protection measures for patients, the delimitation and signage of zoning as well as the application of radiation protection principles. Results: Twenty-one people participated in the study, 90% of whom were men. The 30 - 39 age group was predominant with 61.90%. 33.33% of the staff knew the principles of radiation protection;86% of our sample knew the basic rules of radiation protection. The majority of the staff in the imaging department (61.90%) had a perfect knowledge of protective equipment. For 76% of our workforce, the limits of the radiation doses received are regulated in Mali. 76% of those surveyed have not taken any additional training in radiation protection. The doors are closed during the X-ray examination for 76.19% of the respondents and 95% of the staff put themselves behind the sealed screen during the examination. For 81% of the respondents, the design of the premises met radiation protection standards. 62% of practitioners have a dosimeter and 80% of them wear it during their shift. For 62% of our sample, the change of the dosimeter is quarterly. The systematic request for DDR (date of last menstrual period) in women and the adaptation of the delivered dose to the patient’s morphology was only carried out by 65% of practitioners. The majority of staff (81%) did not benefit from medical surveillance, while for 55% of respondents the level of radiation protection in the establishment was average. Conclusion: This study enabled us to highlight the shortcomings in terms of radiation pr

关键词： Radiation Protection Compliance X-Rays Dosimetry

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