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Risk factors for gastroesophageal reflux disease and analysis of genetic contributors

World Journal of Clinical Cases 2018年第8期6卷 176-182页

作者： Alexandra Argyrou Evangelia Legaki Christos Koutserimpas Maria Gazouli ioannis Papaconstantinou George Gkiokas George Karamanolis Department of Basic Medical sciences Laboratory of BiologySchool of MedicineNational and Kapodistrian University of Athens 2nd Department of General surgery "Sismanoglion" General Hospital of Athens 2nd Department of surgery School of MedicineNational and Kapodistrian University of Athens Gastroenterology Unit 2nd Department of SurgerySchool of MedicineNational and Kapodistrian University of Athens

Gastroesophageal reflux disease(GERD) is a common gastrointestinal disorder with an increasing prevalence. GERD develops when the reflux of stomach contents causes troublesome typical and atypical symptoms and/or complications. several risk factors of GERD have been identified and evaluated over the years, including a considerable amount of genetic factors. Multiple mechanisms are involved in the pathogenesis of GERD including:(1) motor abnormalities, such as impaired lower esophageal sphincter(LEs) resting tone, transient LEs relaxations, impaired esophageal acid clearance and delayed gastric emptying; and(2) anatomical factors, such as hiatal hernia and obesity. Genetic contribution seems to play a major role in GERD and GERD-related disorders development such Barrett's esophagus and esophageal adenocarcinoma. Twin and family studies have revealed an about 31% heritability of the disease. Numerous single-nucleotide polymorphisms in various genes like FOXF1, MHC, CCND1, anti-inflammatory cytokine and DNA repair genes have been strongly associated with increased GERD risk. GERD, Barrett'sesophagus and esophageal adenocarcinoma share several genetic loci. Despite GERD polygenic basis,specific genetic loci such as rs10419226 on chromosome 19, rs2687201 on chromosome 3, rs10852151 on chromosome 15 and rs520525 on the paired related homeobox 1 gene have been mentioned as potential risk factors. Further investigation on the risk genes may elucidate their exact function and role and demonstrate new therapeutic approaches to this increasingly common disease.

关键词： single nucleotide polymorphisms Genetic risk loci Risk factors Gastroesophageal reflux disease Gastroesophageal reflux disease development

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Recent advances in the management of distal ulcerative colitis

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2010年第2期1卷 43-50页

作者： ioannis E Koutroubakis Department of Gastroenterology University Hospital Heraklion

The most frequent localization of ulcerative colitis(UC) is the distal *** treating patients with active distal UC,efficacy and targeting of the drug to the distal colon are key *** and rectal 5-aminosalicylic acid(5-AsA) preparations represent the first line therapy of mild-to-moderate distal UC for both induction and maintenance *** has been reported that many UC patients are not adherent to therapy and that noncompliant patients had a 5-fold risk of experiencing a *** findings led to the introduction of oncedaily oral regimens of 5-AsA as better therapeutic options in clinical practice due to improved *** formulations of mesalazine,including the multimatrix delivery system,and mesalazine granules,which allow once-daily administration,have been *** have been demonstrated to be efficacious in inducing and maintaining remission in mild-to-moderate distal UC in large clinical ***,existing data for distal UC are rather insufficient to make a comparison between new and classical 5-AsA *** seems that the new formulations are at least as effective as classical oral 5-AsA *** treatment options,in the case that 5-AsA therapy is not effective,include systemic corticosteroids,thiopurines(azathioprine or 6-mercaptopurine),cyclosporine,infliximab and *** combination of a prompt diagnostic work-up,a correct therapeutic approach and an appropriate follow-up schedule is important in the management of patients with distal *** approach can shorten the duration of symptoms,induce a prolonged remission,improve patient's quality of life,and optimize the use of health resources.

关键词： Aminosalicylates Azathioprine Infliximab mesalazine Ulcerative colitis

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Extent of lymphadenectomy has no impact on postoperative complications after gastric cancer surgery in sweden

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Chinese Journal of Cancer Research 2017年第4期29卷 313-322页

作者： chih-han kung huan song weimin ye magnus nilsson jan johansson ioannis rouvelas tomoyuki irino lars lundell jon a tsai mats lindblad Department of surgery Skane University Hospital and Lund University Faculty of Medicine Department of Clinical Sciences 221 00 Lund Sweden

Objective： Curative gastric cancer surgery entails removal of the primary tumor with adequate margins including regional lymph nodes. European randomized controlled trials with recruitment in the 1990＇s reported increased morbidity and mortality for D2 compared to D 1. Here, we examined the extent of lymphadenectomy during gastric cancer surgery and the associated risk for postoperative complications and mortality using the strengths of a population-based study. Methods： A prospective nationwide study conducted within the National Register of Esophageal and Gastric Cancer. All patients in sweden from 2006 to 2013 who underwent gastric cancer resections with curative intent were included. Patients were categorized into DO, D I, or D I ＋/D2, and analyzed regarding postoperative morbidity and mortality using multivariable logistic regression. Results： In total, 349 （31.7%） patients had a DO, 494 （44.9%） DI, and 258 （23.4%） DI＋/D2 lymphadenectomy. The 30-d postoperative complication rates were 25.5%, 25.1% and 32.2 % （DO, D I and D1 ＋/D2, respectively）, and 90-d mortality rates were 8.3%, 4.3 % and 5.8%. After adjustment for confounders, in mukivariable analysis, there were no significant differences in risk for postoperative complications between the lymphadenectomy groups. For 90-d mortality, there was a lower risk for D1 vs. DO. Conclusions： The majority of gastric cancer resections in sweden have included only a limited lymphadenectomy （DO and DI）. More extensive lymphadenectomy （DI＋/D2） seemed to have no impact on postoperative morbidity or mortality.

关键词： Gastric cancer lymphadenectomy national database mortality complications

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Array Comparative Genomic Hybridization as a Diagnostic Tool in Cancer

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Journal of Cancer Therapy 2019年第7期10卷 518-524页

作者： Panagiotis Apostolou ioannis Papasotiriou Research & Development Department Research Genetic Cancer Centre S.A. Florina Greece

The knowledge of the primary origin of tumor is essential in designing an efficient cancer treatment algorithm. Useful diagnostic tools enable determination of primary origin of the tumor;however the majority of them require tissue examination. Recent years, exploration of circulating tumor cells enabled scientists to study different parameters using the painless liquid biopsy. The present study aimed to identify whether aCGH might be used as a diagnostic tool in cancer detecting the primary origin of the tumor. Blood was extracted from healthy individuals and cancer samples and CTCs isolated. DNA extracted from the above samples and aCGH experiments followed. The samples were blinded analyzed and then unmasked to calculate specificity and sensitivity of the method. The sensitivity was 94%, the specificity 88%, while the positive prediction rate of the primary tumor was 72%. aCGH is a powerful tool in cancer diagnosis and treatment plan with high sensitivity and specificity rates. It can be performed from blood sample, which makes it an appropriate method for every patient, mainly for patients with unknown origin of the primary tumor.

关键词： Cancer of Unknown Primary Origin Array Comparative Genomic Hybridization Cytogenetic Cancer

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Third-Order Corrections and Mass-shedding Limit of Rotating Neutron stars Computed By a Complex-Plane strategy

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International Journal of Astronomy and Astrophysics 2012年第4期2卷 210-217页

作者： ioannis sfaelos Vassilis Geroyannis Department of Physics University of Patras Patras Greece

We implement the so-called “complex-plane strategy” for computing general-relativistic polytropic models of uniformly rotating neutron stars. This method manages the problem by performing all numerical integrations, required within the framework of Hartle’s perturbation method, in the complex plane. We give emphasis on computing corrections up to third order in the angular velocity, and the mass-shedding limit. We also compute the angular momentum, moment of inertia, rotational kinetic energy, and gravitational potential energy of the models considered.

关键词： General-Relativistic Polytropic Models Hartle’s Perturbation Method Neutron stars Numerical Methods Mass-shedding Limit

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Microproteinuria in patients with inflammatory bowel disease:Is it associated with the disease activity or the treatment with 5-aminosalicylic acid?

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World Journal of Gastroenterology 2006年第5期12卷 739-746页

作者： Androniki C Poulou Konstantinos E Goumas Dimitrios C Dandakis ioannis Tyrmpas Maria Panagiotaki Androniki Georgouli Dimitrios C soutos Athanasios Archimandritis Gastroenterology Department of Red Cross Hospital of Athens Athanasaki 111521 AthensGreece 2~(nd) Department of Internal Medicine University of Athens Medical School"Hippokratio"General Hospital11521 AthensGreece

AIM： To investigate whether microproteinuria in patients with inflammatory bowel disease （IBD） is associated with the disease activity or the treatment with 5-aminosalicylic acid （5-AsA）. METHODs： We prospectively studied microproteinuria in 86 consecutive patients with IBD, 61 with ulcerative colitis （UC） and 25 with Crohn＇s disease （CD）, before as well as 2 and 6 months after their inclusion in the study. Forty-six patients received 5-AsA for a period of 28.8 months （range 1-168 too）. Microalbuminuria （mALB） and urine levels of the renal tubular proteins β2-microglobulin （β2mGLB） and β-N-acetyI-D-glucosamidase （β-NAG） as well as the creatinine clearance were determined in a 12-h overnight urine collection. Tumor necrosis factor-α （TNF-α） serum levels were also measured. REsULTs： A total of 277 measurements （194 in UC patients and 83 in CD patients） were performed. The prevalence of abnormal microoproteinuria in UC and CD patients was 12.9% and 6.0% for mALB, 22.7% and 27.7% for B2mGLB, and 11.3% and 8.4% for β-NAG, respectively, mALB was not associated with IBD activity. β2mGLB and B-NAG urine levels were correlated to UC activity （UCAI： P〈0.01; UCEI： P〈0.005）. mALB in UC patients and β-NAG urine levels in CD patients were related to TNF-α serum levels. An association was noticed between microproteinuria and smoking habit. Treatment with 5-AsA was not correlated to the severity of microproteinuria or to the changes of creatinine clearance.CONCLUsION： Microproteinuria is mainly associated with UC and its activity but not affected by 5-AsA.

关键词： Inflammatory bowel disease Microproteinuria 5-aminosalicylic acid

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Cardiovascular magnetic resonance: stressing the future

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World Journal of Cardiology 2019年第8期11卷 195-199页

作者： ioannis Merinopoulos Tharusha Gunawardena simon C Eccleshall Vassilios s Vassiliou Norwich Medical school University of East AngliaNorfolk and Norwich University HospitalNorwich NR4 7UYUnited Kingdom Department of Cardiology Norfolk and Norwich University HospitalNorwich NR4 7UQUnited Kingdom

Non-invasive cardiac stress imaging plays a central role in the assessment of patients with known or suspected coronary artery *** current guidelines suggest estimation of the myocardial ischaemic burden as a criterion for revascularisation on prognostic grounds despite the lack of standardised reporting of the magnitude of ischaemia on various non-invasive imaging *** studies should aim to accurately describe the relationship between myocardial ischaemic burden as assessed by cardiovascular magnetic resonance imaging and mortality.

关键词： Coronary artery disease Myocardial ischaemic burden Non-invasive imaging Cardiac stress Magnetic resonance imaging

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A survey among Texas Pain society Physicians Regarding the Types and Dosages of steroids Utilized Clinically in Epidural steroid Injectates

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Open Journal of Anesthesiology 2014年第11期4卷 291-299页

作者： Thuan Dao ioannis skaribas Department of Anesthesiology University of Texas Medical School at Houston Houston USA

Objective: Epidural steroid injections (EsI) are used extensively to treat radicular back pain. This study is designed to evaluate the types and dosages of steroids commonly used and understand prescribing habits of the Texas Pain society pain management physicians. Method: From April to May 2014, we sent all 270 Texas Pain society members a questionnaire to complete online. We collected 45 responses. Result: Type of steroid commonly used in injectate: Eighteen (41.9%) phy-sicians reported using methylprednisolone most. Fifteen (34.9%) physicians use triamcinolone, 9 (20.9%) physicians use dexamethasone, 1 (2.3%) uses betamethasone, and 2 skipped this question. Important factors influencing the type of steroid use in injectate: Half of the physicians reported that the location of the EsI was most important (19 responses, 48.7%). Ten (25.6%) reported that the approach of the EsI was most important. Another ten (25.6%) agreed that the potency of the steroid was most important. Dosage of steroid used in injectate: About half of the physicians use a fixed dose of steroid (22, 51.2%) while 21 (48.8%) use a variable dose of steroid. Of those who use a fixed dose of steroid, many use methylprednisolone 80 mg (9, 39.1%). Of those who use a variable dosage of steroid, the most important factor in their determination of the dosage is the patient’s comorbidities (20 responses, 58.8%). The use of depo-steroid in injectate: Thirty-two out of 43 (74.4%) use depo-steroid while 11 out of 43 (25.6%) wouldn’t use depo-steroid. Of those who use depo-steroid, the duration and availability in the epidural space is the most common reason for its use (23, 76.7%). Conclusion: By using a simple questionnaire detailing what types and dosages of steroids are used, compiling a list of best practices can help Texas Pain society physicians tremendously in the treatment of radicular back pain.

关键词： Epidural steroid Injection Radicular Back Pain Type of steroid Dosage of steroid Injectate Methylprednisolone Triamcinolone Dexamethasone Betamethasone

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The emergence of digital storytelling and multimedia technology in improving Greek language teaching and learning： Challenges versus limitations

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sino-Us English Teaching 2010年第4期7卷 1-14页

作者： smaragda Papadopoulou spantidakis ioannis Department of Primary Education University of loannina loannina 54640 Greece Department of Elementary Education University of Creta Rethymno 74100 Greece

Greek schools are witnessing widening gaps between traditional definitions and applications of literacy, which include reading, writing and speaking in terms of exercises from school textbooks and contemporary literacy practices like digital storytelling, interactive multimedia use and online communications. Language and literacy teachers of primary education are called upon daily to bridge these contradictions through pedagogical and textual choices they make in classroom teaching. This paper reports an experimental study with children of the fifth grade at public Greek schools to apply modernist literacy approaches involving digital storytelling and online communication in improving language skills. The paper analytically presents the didactic examples of a thematic union within the framework of the Greek curriculum and the alternative assessment for the experimental teaching on digital technologies among mother tongue learners. The findings have implications for teacher＇s and student＇s education and also for the integration of a pedagogical-technological content of curriculum within the continuing debate of being culturally and equally literate in today＇s education.

关键词： storytelling multimedia technology language teaching language acquisition

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Transbronchial Lung Cryobiopsy in the Diagnosis of Interstitial Lung Diseases. Looking at the Holy Grail or Another Misleading Diagnostic Approach?

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Open Journal of Respiratory Diseases 2018年第4期8卷 69-74页

作者： ioannis sotiriou Alaxandra Konstantinidou University Hospital of Larissa Larissa Greece

Interstitial lung diseases (ILD’s) are a group of heterogenous chronic, ferociously progressive lung diseases. The aetiology of the aforementioned diseases is not always recognisable. The diagnosis of these dismal diseases is a vivid challenge for the physicians. Through the intervening years different diagnostic algorithms have been implemented towards more accurate outcome. Different types of ILD’s demand diverse diagnostic approaches. In the latest years a novel diagnostic mini invasive approach seems to gain continuously terrain towards the diagnosis of ILD’s. Transbronchial cryobiopsy may be the Holy Grail in the diagnosis of these diseases or a misleading diagnostic tool in this challenging field.

关键词： Transbronchial Lung Biopsy Transbronchial Lung Cryobiopsy surgical Lung Biopsy Interstitial Lung Diseases

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