检索结果-南通市图书馆

Liver disease in patients with transfusion-dependentβ-thalassemia:The emerging role of metabolism dysfunction-associated steatotic liver disease

引用

World Journal of Hepatology 2024年第5期16卷 671-677页

作者： Nikolaos Fragkou Efthimia Vlachaki ioannis goulis Emmanouil Sinakos 4^(th)Department of Internal Medicine Hippokratio HospitalAristotle University of ThessalonikiThessaloniki 54642Greece 2^(nd)Department of Internal Medicine Hippokratio HospitalAristotle University of ThessalonikiThessaloniki 54642Greece

In this Editorial,we highlight the possible role that metabolism dysfunction-associated steatotic liver disease(MASLD)may play in the future,regarding liver disease in patients with transfusion-dependent β-thalassemia(TDBT).MASLD is characterized by excessive accumulation of fat in the liver(hepatic steatosis),in the presence of cardiometabolic *** is a strong correlation between the occurrence of MASLD and insulin resistance,while its increased prevalence parallels the global epidemic of diabetes mellitus(DM)and *** with TDBT need regular transfusions for life to ensure their *** these transfusions,a large amount of iron is accumulated,which causes saturation of transferrin and leads to the circulation of free iron molecules,which cause damage to vital organs(primarily the liver and myocardium).Over the past,the main mechanisms for the development of liver disease in these patients have been the toxic effect of iron on the liver and chronic hepatitis C,for which modern and effective treatments have been found,resulting in successful *** advances in the treatment and monitoring of these patients have led to a reduction in deaths,and an increase in their life *** increased survival makes them vulnerable to the onset of diseases,which until recently were mainly related to the non-thalassemic general population,such as obesity and *** is insufficient data in the literature regarding the prevalence of MASLD in this population or on the risk factors for its ***,it was recently shown by a study of 45 heavily transfused patients with beta-thalassemia(Padeniya et al,BJH),that the presence of steatosis is a factor influencing the value of liver elastography and thus liver *** findings suggest that future research in the field of liver disease in patients with TDBT should be focused on the occurrence,the risk factors,and the effect of MASLD on these patients.

关键词： Metabolism dysfunction-associated steatotic liver disease Transfusion-dependent thalassemia Metabolic syndrome Hepatic steatosis Non-invasive markers Liver fibrosis

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Review article: Update on current and emergent data on hepatopulmonary syndrome

引用

World Journal of Gastroenterology 2018年第12期24卷 1285-1298页

作者： Stergios Soulaidopoulos Evangelos Cholongitas George Giannakoulas Maria Vlachou ioannis goulis Fourth Department of Internal Medicine Hippokration General Hospital Medical School of Aristotle University of Thessaloniki First Department of Internal Medicine Laiko General Hospital Medical School of National and Kapodistrian University of Athens Department of Cardiology AHEPA University Hospital Medical School of Aristotle University of Thessaloniki

Hepatopulmonary syndrome(HPS) is a frequent pulmonary complication of end-stage liver disease, characterized by impaired arterial oxygenation induced by intrapulmonary vascular dilatation. Its prevalence ranges from 4% to 47% in patients with cirrhosis due to the different diagnostic criteria applied among different studies. Nitric oxide overproduction and angiogenesis seem to be the hallmarks of a complicated pathogenetic mechanism, leading to intrapulmonary shunting and ventilation-perfusion mismatch. A classification of HPS according to the severity of hypoxemia has been suggested. Contrast-enhanced echocardiography represents the gold standard method for the detection of intrapulmonary vascular dilatations which is required, in combination with an elevated alveolar arterial gradient to set the diagnosis. The only effective treatment which can modify the syndrome's natural history is liver transplantation. Although it is usually asymptomatic, HPS imparts a high risk of pretransplantation mortality, independently of the severity of liver disease, while there is variable data concerning survival rates after liver transplantation. The potential of myocardial involvement in the setting of HPS has also gained increasing interest in recent research. The aim of this review is to critically approach the existing literature of HPS and emphasizeunclear points that remain to be unraveled by future research.

关键词： Hepatopulmonary syndrome Liver cirrhosis Liver transplantation Portal hypertension Contrast echocardiography

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Clinical impact of microbiome in patients with decompensated cirrhosis

引用

World Journal of Gastroenterology 2018年第34期24卷 3813-3820页

作者： Theodora Oikonomou George V Papatheodoridis Michael Samarkos ioannis goulis Evangelos Cholongitas Fourth Department of Internal Medicine Hippokration General Hospital Medical School of Aristotle University of Thessaloniki Academic Department of Gastroenterology Laiko General Hospital Medical School of National and Kapodistrian University of Athens First Department of Internal Medicine Laiko General Hospital Medical School of National and Kapodistrian University of Athens

Cirrhosis is an increasing cause of morbidity and mortality. Recent studies are trying to clarify the role of microbiome in clinical exacerbation of patients with decompensated cirrhosis. Nowadays, it is accepted that patients with cirrhosis have altered salivary and enteric microbiome, characterized by the presence of dysbiosis. This altered microbiome along with small bowel bacterial overgrowth, through translocation across the gut, is associated with the development of decompensating complications. Studies have analyzed the correlation of certain bacterial families with the development of hepatic encephalopathy in cirrhotics. In general, stool and saliva dysbiosis with reduction of autochthonous bacteria in patients with cirrhosis incites changes in bacterial defenses and higher risk for bacterial infections, such as spontaneous bacterial peritonitis, and sepsis. Gut microbiome has even been associated with oncogenic pathways and under circumstances might promote the development of hepatocarcinogenesis. Lately, the existence of the oral-gutliver axis has been related with the development of decompensating events. This link between the liver and the oral cavity could be via the gut through impaired intestinal permeability that allows direct translocation of bacteria from the oral cavity to the systemic circulation. Overall, the contribution of the microbiome to pathogenesis becomes more pronounced with progressive disease and therefore may represent an important therapeutic target in the management of cirrhosis.

关键词： Microbiome Dysbiosis Oral-gut-liver axis Hepatic encephalopathy Decompensated cirrhosis Liver carcinoma

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Role of immunotherapy in downsizing hepatocellular carcinoma prior to liver transplantation

引用

World Journal of Transplantation 2022年第11期12卷 331-346页

作者： Konstantinos Ouranos Anthi Chatziioannou ioannis goulis Emmanouil Sinakos 4th Medical Department Hippokratio HospitalAristotle University of ThessalonikiThessaloniki 54642Greece

Hepatocellular carcinoma(HCC)is an aggressive primary liver neoplasm that,according to tumor stage,can be treated with resection,transplantation,locoregional treatment options,or systemic *** interventions only in early-stage disease can offer complete tumor regression,systemic therapy in advanced disease can significantly prolong overall survival,according to published clinical *** emergence of immunotherapy in the field of cancer therapy has had a positive impact on patients with HCC,resulting in atezolizumab–bevacizumab currently being the first-line option for treatment of advanced *** light of this,application of immunotherapy in the preoperative process could increase the number of patients fulfilling the criteria for liver transplantation(LT).Implementation of this approach is faced with challenges regarding the safety of immunotherapy and the possibly increased risk of rejection in the perioperative *** reports and clinical trials assessing the safety profile and effectiveness of neoadjuvant immunotherapy,highlight important aspects regarding this newly evolving approach to HCC *** studies need to be conducted in order to reach a consensus regarding the optimal way to administer immunotherapy prior to *** this review,we summarize the role,safety profile and future considerations regarding the use of neoadjuvant immunotherapy prior to LT in patients with HCC.

关键词： Hepatocellular carcinoma Immunotherapy Tumor downsizing Liver transplantation Neoadjuvant Rejection

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

COVID-19 and liver injury: An ongoing challenge

引用

World Journal of Gastroenterology 2023年第2期29卷 257-271页

作者： Ioanna Papagiouvanni Serafeim-Chrysovalantis Kotoulas Athanasia Pataka Dionisios G Spyratos Konstantinos Porpodis Afroditi K Boutou Georgios Papagiouvannis Ioanna Grigoriou Christos Vettas ioannis goulis Fourth Department of Internal Medicine Aristotle University of ThessalonikiThessaloniki 54642ThessalonikiGreece Intensive Care Unit Hippokration General HospitalThessaloniki 54642Greece Department of Respiratory Medicine G Papanikolaou HospitalResp Failure UnitAristotle University of ThessalonikiThessaloniki 57001Greece Pulmonary Department Aristotle University of ThessalonikiThessaloniki 57001Greece Pulmonary Department G Papanikolaou HospitalResp Failure UnitAristotle University of ThessalonikiThessaloniki 54642Greece Department of Pharmacy School of Health SciencesFrederick UniversityNicosia 1036Cyprus Respiratory Failure Clinic Papanikolaou General HospitalThessloniki 57001Greece Fourth Department of Internal Medicine Hippokration General HospitalThessaloniki 54642Greece

The new coronavirus severe acute respiratory syndrome coronavirus 2(SARSCoV-2)was identified in December 2019,in Wuhan,*** virus was rapidly spread worldwide,causing coronavirus disease 2019(COVID-19)*** COVID-19 is presented,usually,with typical respiratory symptoms(i.e.,dyspnea,cough)and fever,extrapulmonary manifestations are also *** injury is a common feature in patients with COVID-19 and ranges from mild and temporary elevation of liver enzymes to severe liver injury and,even,acute liver *** pathogenesis of liver damage is not clearly defined;multiple mechanisms contribute to liver disorder,including direct cytopathic viral effect,cytokine storm and immune-mediated hepatitis,hypoxic injury,and druginduced liver *** with underlying chronic liver disease(i.e.,cirrhosis,non-alcoholic fatty liver disease,alcohol-related liver disease,hepatocellular carcinoma,etc.)may have greater risk to develop both severe COVID-19 and further liver deterioration,and,as a consequence,certain issues should be considered during disease *** aim of this review is to present the prevalence,clinical manifestation and pathophysiological mechanisms of liver injury in patients with SARS-CoV-2 ***,we overview the association between chronic liver disease and SARS-CoV-2 infection and we briefly discuss the management of liver injury during COVID-19.

关键词： COVID-19 Liver injury Cytokine storm Hypoxic hepatitis Drug-induced liver injury Chronic liver disease

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Effects of an active lifestyle on the physical frailty of liver transplant candidates

引用

World Journal of Transplantation 2022年第11期12卷 365-377页

作者： Ilias Marios Oikonomou Emmanouil Sinakos Nikolaos Antoniadis ioannis goulis Olga Giouleme Maria Anifanti Georgios Katsanos Konstantina-Eleni Karakasi Georgios Tsoulfas Evangelia Kouidi Department of Transplant Surgery Aristotle University of ThessalonikiThessaloniki 54642Greece The Fourth Department of Internal Medicine Aristotle University of ThessalonikiThessaloniki 54642Greece The Second Propaedeutic Department of Internal Medicine Aristotle University of ThessalonikiThessaloniki 54642Greece Laboratory of Sports Medicine Aristotle University of ThessalonikiThessaloniki 57001Greece

BACKGROUND Liver transplantation is the most important therapeutic intervention for end-stage liver disease(ELD).The prioritization of these patients is based on the model for end-stage liver disease(MELD),which can successfully predict short-term ***,despite its great validity and value,it cannot fully incorporate several comorbidities of liver disease,such as sarcopenia and physical frailty,variables that can sufficiently influence the survival of such ***,there is growing interest in the importance of physical frailty in regard to mortality in liver transplant candidates and recipients,as well as its role in improving their survival *** To evaluate the effects of an active lifestyle on physical frailty on liver transplant *** An observational study was performed within the facilities of the Department of Transplant Surgery of Aristotle University of *** liver transplant candidate patients from the waiting list of the department were included in the *** that were bedridden,had recent cardiovascular incidents,or had required inpatient treatment for more than 5 d in the last 6 mo were excluded from the *** following variables were evaluated:Activity level via the International Physical Activity Questionnaire(IPAQ);functional capacity via the 6-min walking test(6MWT)and cardiopulmonary exercise testing;and physical frailty via the Liver Frailty Index(LFI).RESULTS According to their responses in the IPAQ,patients were divided into the following two groups based on their activity level:Active group(A,10 patients);and sedentary group(S,10 patients).Comparing mean values of the recorded variables showed the following results:MELD(A:12.05±5.63 vs S:13.99±3.60;P>0.05);peak oxygen uptake(A:29.78±6.07 mL/kg/min vs S:18.11±3.39 mL/kg/min;P<0.001);anaerobic threshold(A:16.71±2.17 mL/kg/min vs S:13.96±1.45 mL/kg/min;P<0.01);6MWT(A:458.2±57.5 m vs S:324.7±55.8 m;P<0.001);and LFI(A:3.75±0.31 vs

关键词： Liver transplantation Frailty Six-minute walk test Cardiopulmonary exercise testing Exercise therapy Observational study

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Managing Hepatitis C Patients in Greece: A Budget Impact Analysis of Simeprevir plus Pegylated Interferon/Ribavirin Regimen at Early Stages of the Disease

引用

Health 2017年第11期9卷 1482-1493页

作者： Mary Geitona Hara Kousoulakou ioannis goulis Spilios Manolakopoulos Themistoclis Vasiliadis Dimitrios Christodoulou Charalabos Gogos Spyridon Dourakis ioannis George Koskinas Alexandra Papadokostopoulou Aris Lathouris George Papatheodoridis University of Peloponnese Corinth Greece Aristotle University of Thessaloniki Thessaloniki Greece National and Kapodistrian University of Athens Athens Greece University of Ioannina Ioannina Greece University of Patras Patra Greece Janssen-Cilag Pharmaceutical SACI Athens Greece

Objectives: To identify local resource use such as pharmaceutical treatment, medical follow-up, and patient hospitalization and estimate the budget impact of simeprevir (SMV) plus pegylated interferon (P)/ribavirin (R) as a treatment option in the early stages of the disease in Greece. Methods: A budget impact tool was developed with a two-year time horizon, which estimated the impact on the Social Insurance Funds (SIFs) of introducing SMV + PR in the management of the early disease stages. Total direct and indirect costs were estimated for each of the following health states: non-cirrhotic chronic Hepatitis C (and within that by fibrosis stage), compensated cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma. Data gaps on treatment algorithms, resource use and productivity losses were covered via an expert panel of eight leading hepatologists. Epidemiology data were taken from the published literature. Unit costs were obtained from the Ministry of Health and SIFs. The perspective was that of the SIF and the cost base year was 2015. Results: The total (direct and indirect) cost per patient per year (excluding cost of antiviral treatment) was estimated at €647, €703, €5,753, €16,313 and €37,237 for non-cirrhotic CHC, compensated cirrhosis, decompensated cirrhosis, HCC and liver transplantation, respectively. The budget impact analysis showed that adding SMV to PR in the early stages of the disease would lead to an increase in the cost of antiviral treatment by €2.03 million. Conclusions: Costs of managing CHC increase dramatically with disease severity. SMV + PR for naive patients at early disease stages has a significant but manageable budget impact, and could prevent high costs in advanced stages.

关键词： Hepatitis C Budget Impact Analysis Simeprevir Greece

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Enhanced recovery after surgery in liver transplantation:Challenges and feasibility

引用

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

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：