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Near-infrared cholangiography with intragallbladder indocyanine green injection in minimally invasive cholecystectomy

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1017-1029页

作者： Savvas Symeonidis ioannis Mantzoros Elissavet Anestiadou Orestis Ioannidis Panagiotis Christidis Stefanos Bitsianis Vasiliki Bisbinas Konstantinos Zapsalis Trigona Karastergiou Dimitra Athanasiou Stylianos Apostolidis Stamatios Angelopoulos Fourth Department of Surgery Medical SchoolAristotle University of ThessalonikiThessaloniki 57010Greece ENT Department Royal Cornwall Hospitals NHS TrustCornwall TR13LJUnited Kingdom 1^(st)Propedeutic Surgical Department University Hospital of ThessalonikiAristotle University of ThessalonikiThessaloniki 54636Greece

Laparoscopic cholecystectomy(LC)remains one of the most commonly performed procedures in adult and paediatric *** the advances made in intraoperative biliary anatomy recognition,iatrogenic bile duct injuries during LC represent a fatal complication and consist an economic burden for healthcare systems.A series of methods have been proposed to prevent bile duct injury,among them the use of indocyanine green(ICG)*** most commonly reported method of ICG injection is the intravenous administration,while literature is lacking studies investigating the direct intragallbladder ICG *** narrative mini-review aims to assess the potential applications,usefulness,and limitations of intragallbladder ICG fluorescence in *** screened the available international literature to identify the reports of intragallbladder ICG fluorescence imaging in minimally invasive cholecystectomy,as well as special issues regarding its *** search retrieved four prospective cohort studies,three case-control studies,and one case *** the three case-control studies selected,intragallbladder near-infrared cholangiography(NIRC)was compared with standard LC under white light,with intravenous administration of ICG for NIRC and with standard intraoperative cholangiography(IOC).In total,133 patients reported in the literature have been administered intragallbladder ICG administration for biliary mapping during *** includes several reports of intragallbladder ICG administration,but a standardized technique has not been established *** data suggest that NIRC with intragallbladder ICG injection is a promising method to achieve biliary mapping,overwhelming limitations of IOC including intervention and radiation exposure,as well as the high hepatic parenchyma signal and time interval needed in intravenous ICG ***-based guidelines on the role of intragallbladder ICG fluorescence in LC require the assessment of furth

关键词： Minimally invasive cholecystectomy Laparoscopic cholecystectomy Biliary tract mapping Indocyanine green Near-infrared fluorescent cholangiography Intracystic indocyanine green Intragallbladder indocyanine green Bile duct injury

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Traumatic lumbar hernia: A systematic review of the literature

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Chinese Journal of Traumatology 2024年第1期27卷 53-57页

作者： ioannis Tsouknidas Nikolaos Tasis Maria Ioanna Antonopoulou Vasileios Acheimastos Dimitrios KManatakis Department of Surgery Stony Brook University HospitalStony BrookNew YorkUSA Department of Surgical Oncology St Savvas Cancer HospitalAthensGreece nd Department of Surgery Athens Naval and Veterans HospitalAthensGreece Department of Surgery Naval Hospital of CreteChaniaGreece

Purpose:Traumatic lumbar hernia(TLH)constitutes a protrusion of content through a defect in the posterior abdominal wall,as a result of *** rare entity has been described in limited number of ***:A systematic review of the literature was performed according to the meta-analysis of observational studies in epidemiology *** English literature from 1990 until 2021 was reviewed,using PubMed,EMBASE and Google Scholar bibliographic databases,to identify case reports and case series with patients that were diagnosed with *** each eligible study,demographics,clinical presentation,hernia characteristics,preoperative imaging investigations,operation details,and postoperative data were extracted for *** analysis was performed on SPSS,version ***:A total of 62 studies were included for review,with 164 patients with *** age was(42.6±14.3)years(47.6%males,31.1%females,gender not specified in 35 cases).Mean diameter of hernia neck was(6.3±3.1)cm,while the triangles of Petit and Grynfeltt were affected in 74.5%and 14.6%,*** diagnosed in the emergency setting account for 54.2%,with CT scan establishing diagnosis in all but one case(97.7%).A delayed diagnosis was made in 45.8%,at a mean 1 year following *** bulging(82.8%)and chronic back pain(34.3%)were the most frequent *** both delayed and acute group,open surgery(63.6%and 92.3%,respectively)was the preferred surgical *** complications were reported in 11.4%of acute and 15.0%of delayed *** recurrence was 7%.Conclusions:TLH is uncommon with 164 cases described since *** scan is the gold standard in *** surgery is generally the preferred approach,particularly in the emergency *** TLH can be treated either by primary suture repair or mesh,depending on the local conditions,whereas delayed cases usually require a mesh.

关键词： Lumbar hernia Petit Grynfeltt Traumatic lumbar hernia Trauma

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High PSMA expression is associated with immunosuppressive tumor microenvironment in clear cellrenal cell carcinoma

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Precision Clinical Medicine 2024年第2期7卷 190-193页

作者： Panagiotis J.Vlachostergios Athanasios Karathanasis Konstantinos Dimitropoulos ioannis Zachos Vassilios Tzortzis Department of Medical Oncology IASO Thessalias HospitalLarissa 41110Greece Department of Urology University of ThessalySchool of Health SciencesFaculty of MedicineUniversity Hospital of LarissaLarissa 41110Greece Division of Hematology and Medical Oncology Department of MedicineWeill Cornell MedicineNew YorkNY 10065USA Department of Urology Aberdeen Royal InfirmaryAberdeen AB252ZNUK

Dear Editor,Clear cell renal cell carcinoma(ccRCC)is a highly vascular *** surrogate markers that may reflect the neovasculature burden of ccRCC,prostate specific membrane antigen(PSMA)has emerged as a promising one,by virtue of its ability to be measured either immunohistochemically and transcriptionally or on positron emission tomography(PET)imaging[1,2].While the relationship between PSMA and neoangiogenesis in ccRCC is well established,the potential association between PSMA and the immune landscape of ccRCC is much less understood.

关键词： PSMA carcinoma cell

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Evaluation of Technical Education by Using a Modern Structured MOODLE Laboratory Course, in Relation to Recent Data

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Journal of Intelligent Learning Systems and Applications 2024年第3期16卷 316-339页

作者： Gerasimos Vlassopoulos George Albert Karikas Efstathia Papageorgiou ioannis Psaromiligkos Niki Giannouli Pigi Vlassopoulou Petros Karkalousos Department of Biomedical Sciences University of West Attica Athens Greece

E-learning platforms support education systems worldwide, transferring theoretical knowledge as well as soft skills. In the present study high-school pupils’, and adult students’ opinions were evaluated through a modern structured MOODLE interactive course, designed for the needs of the laboratory course “Automotive Systems”. The study concerns Greek secondary vocational education pupils aged 18 and vocational training adult students aged 20 to 50 years. The multistage, equal size simple random cluster sample was used as a sampling method. Pupils and adult students of each cluster completed structured 10-question questionnaires both before and after attending the course. A total of 120 questionnaires were collected. In general, our findings disclosed that the majority of pupils and adult students had significantly improved their knowledge and skills from using MOODLE. They reported strengthening conventional teaching, using the new MOODLE technology. The satisfaction indices improved quite, with the differences in their mean values being statistically significant.

关键词： Information and Communication Technologies (ICT) Distance Learning E-Learning Students’ Opinions Education in Greece I.C.T. in Greece Students Pupils Adults Adult Students MOODLE MOOC (V.H.S.) Vocational High Schools (S.H.V.T.) Schools of Higher Vocational Training Vocational Profession Interactive Lessons Courses Training Laboratory Course Secondary Education Automotive Systems Car Systems

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The effect of high-flow oxygen via tracheostomy on respiratory pattern and diaphragmatic function in patients with prolonged mechanical ventilation:A randomized,physiological,crossover study

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Journal of Intensive Medicine 2024年第2期4卷 202-208页

作者： Elena Lytra Stelios Kokkoris ioannis Poularas Dimitrios Filippiadis Demosthenes Cokkinos Dimitrios Exarhos Spyros Zakynthinos Christina Routsi 1st Department of Intensive Care Medical SchoolNational and Kapodistrian University of AthensEvangelismos HospitalAthensGreece Radiology Department Evangelismos HospitalAthensGreece 2nd Radiology Department Medical SchoolNational and Kapodistrian University of AthensAttikon HospitalAthensGreece

Background Compared to conventional oxygen devices,high-flow oxygen treatment(HFOT)through the nasal cannulae has demonstrated clinical *** data exist on whether such effects are also present in HFOT through ***,we aimed to examine the short-term effects of HFOT through tracheostomy on diaphragmatic function and respiratory parameters in tracheostomized patients on prolonged mechanical *** A randomized,crossover,physiological study was conducted in our ICU between December 2020 and April 2021,in patients with tracheostomy and prolonged mechanical *** patients underwent a 30-min spontaneous breathing trial(SBT)and received oxygen either via T-piece or by HFOT through tracheostomy,followed by a washout period of 15-min breathing through the T-piece and receipt of 30-min oxygen with the other modality in a randomized crossover *** the start and end of each session,blood gasses,breathing frequency(f),and tidal volume(VT)via a Wright's spirometer were measured,along with diaphragm ultrasonography including diaphragm excursion and diaphragmatic thickening fraction,which expressed the inspiratory muscle *** Eleven patients were enrolled in whom 19 sessions were uneventfully completed;eight patients were studied twice on two different days with alternate sessions;and three patients were studied *** were randomly assigned to start the SBT with a T-piece(n=10 sessions)or with HFOT(n=9 sessions).With HFOT,VT and minute ventilation(VE)significantly increased during SBT(from[465±119]mL to[549±134]mL,P<0.001 and from[12.4±4.3]L/min to[13.1±4.2]L/min,P<0.05,respectively),but they did not change significantly during SBT with T-piece(from[495±132]mL to[461±123]mL and from[12.8±4.4]mL to[12.0±4.4]mL,respectively);f/VT decreased during HFOT(from[64±31]breaths/(min∙L)to[49±24]breaths/(min∙L),P<0.001),but it did not change significantly during SBT with T-piece(from[59±28]breaths/(min∙L)to[64±33]breaths/(m

关键词： Diaphragm Diaphragm ultrasonography High-flow oxygen Prolonged mechanical ventilation Tracheostomy

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Percutaneous decannulation of extracorporeal membrane oxygenation using MANTA device:A real-world single-center experience

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World Journal of Cardiology 2024年第10期16卷 574-579页

作者： ioannis Milioglou Alice Qian Pedro Rafael Vieira de Oliveira Salerno Gabriel Tensol Rodrigues Pereira Luis Augusto Palma Dallan Kelsey E Gray Michael Morrison Yasir Abu-Omar Mohammad Eldiasty Cristian Baeza Department of Cardiology University Hospitals Cleveland Medical CenterClevelandOH 44106United States Department of Surgery University Hospitals Cleveland Medical Center and Case Western Reserve University School of MedicineClevelandOH 44106United States

BACKGROUND The MANTA vascular closure device(VCD)represents a novel approach to achieving hemostasis after large-bore femoral access *** clinical studies have evaluated the efficacy of the MANTA device across a range of patient populations undergoing different ***,there is still a paucity of data available concerning the use of MANTA devices in aiding the decannulation of venoarterial extracorporeal membrane oxygenation(VAECMO).AIM To present our single-center experience of utilizing the MANTA VCD in patients undergoing this *** This single-center study included all patients undergoing percutaneous decannulation of femoral VA-ECMO using the MANTA plug-based VCD between January 2021 and October 2023 at University Hospitals Cleveland Medical *** criteria were adult patients who required prolonged(>24 hours)hemodynamic support with *** included all-cause mortality,hemostasis,bleeding,limb ischemia,and site *** This is a retrospective cohort study of 19 patients with a mean age of 56.8 *** of them were males with a mean body mass index of *** most common extracorporeal membrane oxygenation indication was acute coronary syndrome complicated by cardiogenic shock at 36.8%.The mean length of intensive care unit stay for these patients was 18.8±8.42 *** out of 19 patients survived to *** MANTA device was successfully deployed in 19 patients,with 10 procedures conducted at the bedside and 9 in an operating room *** hemostasis was achieved within 5 minutes of MANTA deployment in 17 out of 19 *** 2 patients manual compression after Manta deployment was required to achieve adequate ***,acute lower extremity ischemia was noted in two patients,necessitating endovascular *** infections were reported at the site of MANTA *** Overall,based on our experience and that of other centers,the MANTA VCD

关键词： Extracorporeal membrane oxygenation MANTA Decannulation Hemostasis Ischemia

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Future clinical prospects of C-peptide testing in the early diagnosis of gestational diabetes

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World Journal of Experimental Medicine 2024年第1期14卷 13-21页

作者： Charalampos Milionis ioannis Ilias Anastasia Lekkou Evangelia Venaki Eftychia Koukkou Department of Endocrinology Diabetesand Metabolism‘Elena Venizelou’General HospitalAthens 11521Greece

Gestational diabetes is typically diagnosed in the late second or third trimester of *** is one of the most common metabolic disorders among expectant mothers,with potential serious short-and long-term complications for both maternal and offspring health.C-peptide is secreted from pancreatic beta-cells into circulation in equimolar amounts with *** is a useful biomarker to estimate the beta-cell function because it undergoes negligible hepatic clearance and consequently it has a longer half-life compared to *** induces increased insulin resistance due to physiological changes in hormonal and metabolic *** compensation by islet beta-cells results in *** standard oral glucose tolerance test at 24-28 wk of gestation sets the *** evidence from prospective studies indicates a link between early pregnancy C-peptide levels and the risk of subsequent gestational *** C-peptide levels and surrogate glycemic indices at the beginning of pregnancy could prompt appropriate strategies for secondary prevention.

关键词： C-peptide Gestational diabetes Secondary prevention Pregnancy Clinical laboratory techniques

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Fetal lung growth predicts the risk for early-life respiratory infections and childhood asthma

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World Journal of Pediatrics 2024年第5期20卷 481-495页

作者： Dimitra E.Zazara Olympia Giannou Steven Schepanski Mirja Pagenkemper Anastasios D.Giannou Maike Pincus ioannis Belios Stefan Bonn Ania C.Muntau Kurt Hecher Anke Diemert Petra Clara Arck Division for Experimental Feto-Maternal Medicine Department of Obstetrics and Fetal MedicineUniversity Medical Center Hamburg-Eppendorf(UKE)Martinistraße 5220251HamburgGermany University Children’s Hospital UKEHamburgGermany Computer Engineering and Informatics Department Polytechnic SchoolUniversity of PatrasPatrasGreece Institute of Developmental Neurophysiology Center for Molecular Neurobiology Hamburg(ZMNH)UKEHamburgGermany Department of Obstetrics and Fetal Medicine UKEHamburgGermany Department of General Visceral and Thoracic SurgeryUKEHamburgGermany Section of Molecular Immunology and Gastroenterology Ⅰ.Department of MedicineUKEHamburgGermany Pediatrics and Pediatric Pneumology Practice BerlinGermany Institute of Medical Systems Biology ZMNHUKEHamburgGermany Hamburg Center for Translational Immunology UKEHamburgGermany

Background Early-life respiratory infections and asthma are major health burdens during *** predicting an increased risk for early-life respiratory diseases are ***,we identified the predictive value of ultrasound-monitored fetal lung growth for the risk of early-life respiratory infections and *** Fetal lung size was serially assessed at standardized time points by transabdominal ultrasound in pregnant women participating in a pregnancy *** between fetal lung growth and respiratory infections in infancy or early-onset asthma at five years were ***-learning models relying on extreme gradient boosting regressor or classifier algorithms were developed to predict respiratory infection or asthma risk based on fetal lung *** model development and validation,study participants were randomly divided into a training and a testing group,respectively,by the employed *** Enhanced fetal lung growth throughout pregnancy predicted a lower early-life respiratory infection *** sex was associated with a higher risk for respiratory infections in *** lung growth could also predict the risk of asthma at five years of *** designed three machine-learning models to predict the risk and number of infections in infancy as well as the risk of early-onset *** models’R2 values were 0.92,0.90 and 0.93,respectively,underscoring a high accuracy and agreement between the actual and predicted *** variables included known risk factors and novel predictors,such as ultrasound-monitored fetal lung *** Sonographic monitoring of fetal lung growth allows to predict the risk for early-life respiratory infections and asthma.

关键词： Asthma Child risk Early-life respiratory infections Prenatal lung development Sexual dimorphism

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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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PD-1 inhibitors monotherapy in hepatocellular carcinoma: Meta-analysis and systematic review

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Hepatobiliary & Pancreatic Diseases International 2019年第6期18卷 505-510页

作者： ioannis A.Voutsadakis Algoma District Cancer Program Sault Area Hospital Section of Internal Medicine Division of Clinical Sciences Northern Ontario School of Medicine

Background:Immunity plays a major role in carcinogenesis and this is the case also for hepatocellular carcinomas(HCC).Checkpoint inhibitors,novel drugs that enhance the immune system’s ability to attack cancers,have been successfully introduced for the therapy of various malignancies including *** important target of these drugs is the PD-L1/PD-1 ligand/receptor pair and several clinically available inhibitors of this pair *** sources:A search of the literature until April 20,2019 was performed in the MEDLINE/PubMed database,the Embase database and the Cochrane Central Register of Controlled *** clinical studies describing treatment with PD-L1/PD-1 inhibitors as monotherapy in HCC patients were *** characteristics with relevance for treatment efficacy,such as liver function,disease extend and previous treatment,were extracted from identified *** and survival outcomes were the primary focus of the *** estimates of response rates and survival were calculated using a random or fixed effect model,depending on *** common adverse effects were also recorded and ***:Three studies(two on nivolumab and one on pembrolizumab)with a total of 400 patients were included in the *** summary response rate(RR)was 17.3%[95%confidence interval(CI):13.2%–21.4%].The summary disease control rate(DCR)was 56.6%(95%CI:44.7%–68.5%).Summary progression free survival(PFS)was 3.5 months(95%CI:2.8–4.2 months).Summary overall survival(OS)was 10.4 months(95%CI:3.5–17.2 months).Adverse effect rate was low and also consistent with the adverse effect profile of PD-L1/PD-1 inhibitors in other disease ***:Pembrolizumab and nivolumab are the only checkpoint inhibitors with data in *** of their effectiveness discloses rates not dissimilar to other systemic therapies available for this *** interest also are the observed long responses in a sub-set of ***

关键词： Hepatocellular carcinoma Immune checkpoint inhibitors Nivolumab Pembrolizumab Meta-analysis

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