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Management of obstructed colorectal carcinoma in an emergency setting:An update

World Journal of Gastrointestinal Oncology 2024年第3期16卷 598-613页

作者： Efstathios T Pavlidis ioannis n Galanis Theodoros E Pavlidis 2nd Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Colorectal carcinoma is common,particularly on the left *** 20%of patients,obstruction and ileus may be the first clinical manifestations of a carcinoma that has advanced(stage II,III or even IV).Diagnosis is based on clinical presentation,plain abdominal radiogram,computed tomography(CT),CT colonography and positron emission tomography/*** best management strategy in terms of short-term operative or interventional and long-term oncological outcomes re-mains *** the most common left-sided obstruction,the first choice should be either emergency surgery or endoscopic decompression by self-expen-dable metal stents or *** operative plan should be either one-stage or two-stage ***-stage resection with on-table bowel decompression and irrigation can be accompanied or not accompanied by proximal defunctioning stoma(colostomy or ileostomy).Primary anastomosis is more convenient but has increased risks of anastomotic leakage and ***-stage resection(Hart-mann’s procedure)is safer and the most widely used despite temporally affecting quality of *** control surgery in high-risk frail patients is less frequently performed since it can be successfully substituted with endoscopic stenting or *** the less common right-sided obstruction,one-stage surgical resection is more beneficial than endoscopic *** role of minimally invasive surgery(laparoscopic or robotic)is a subject of *** laparoscopic-assisted management is advantageous to some extent but requires much expertise due to inherent difficulties in dissecting the distended colon and the risk of rup-ture and subsequent septic *** decompressing stent as a bridge to elective surgery more substantially decreases the risks of morbidity and mortality than emergency surgery for decompression and has equivalent medium-term overall survival and disease-free survival *** combination with neoadjuvant chemotherapy or radiation may have a p

关键词： Acute abdomen Obstructive ileus Colorectal carcinoma Emergency surgery Colectomy Intraluminal metal stents

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new trends in diagnosis and management of gallbladder carcinoma

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 13-29页

作者： Efstathios T Pavlidis ioannis n Galanis Theodoros E Pavlidis ^(nd)Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Gallbladder(GB)carcinoma,although relatively rare,is the most common biliary tree cholangiocarcinoma with aggressiveness and poor *** is closely associated with cholelithiasis and long-standing large(>3 cm)gallstones in up to 90%of *** other main predisposing factors for GB carcinoma include molecular factors such as mutated genes,GB wall calcification(porcelain)or mainly mucosal microcalcifications,and GB polyps≥1 cm in *** is made by ultrasound,computed tomography(CT),and,more precisely,magnetic resonance imaging(MRI).Preoperative staging is of great importance in decisionmaking regarding therapeutic *** staging is based on MRI findings,the leading technique for liver metastasis imaging,enhanced three-phase CT angiography,or magnetic resonance angiography for major vessel *** is also necessary to use positron emission tomography(PET)-CT or ^(18)F-FDG PET-MRI to more accurately detect metastases and any other occult deposits with active metabolic *** laparoscopy may detect dissemination not otherwise found in 20%-28.6%of *** treatment is needed,including surgical resection,targeted therapy by biological agents according to molecular testing gene mapping,chemotherapy,radiation therapy,and *** is of great importance to understand the updated guidelines and current treatment *** extent of surgical intervention depends on the disease stage,ranging from simple cholecystectomy(T1a)to extended resections and including extended cholecystectomy(T1b),with wide lymph node resection in every case or IV-V segmentectomy(T2),hepatic trisegmentectomy or major hepatectomy accompanied by hepaticojejunostomy Roux-Y,and adjacent organ resection if necessary(T3).Laparoscopic or robotic surgery shows fewer postoperative complications and equivalent oncological outcomes when compared to open surgery,but much attention must be paid to avoiding *** addition to surgery,novel targe

关键词： Biliary tract neoplasms Extrahepatic cholangiocarcinoma Gallbladder carcinoma Gallbladder diseases Biliary tree diseases Gastrointestinal malignancies

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Current considerations on intraductal papillary neoplasms of the bile duct and pancreatic duct

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World Journal of Gastroenterology 2024年第10期30卷 1461-1465页

作者： Efstathios T Pavlidis ioannis n Galanis Theodoros E Pavlidis 2^(nd) Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Pancreatobiliary intraductal papillary neoplasms(IPns)represent precursors of pancreatic cancer or bile duct cholangiocarcinoma that can be detected and *** advances in diagnostic methods,identifying these premalignant lesions is still challenging for treatment *** imaging,biomarkers and molecular tests for genomic alterations can be used for diagnosis and *** intervention in combination with new chemotherapeutic agents is considered the optimal treatment for malignant *** balance between the risk of malignancy and any risk of resection guides management policy;therefore,treatment should be individualized based on a meticulous preoperative assessment of high-risk *** of the bile duct is more aggressive;thus,early diagnosis and surgery are *** conservative management of low-risk pancreatic branch-duct lesions is safe and effective.

关键词： Biliary tree diseases Pancreatic cystic neoplasms Biliary tract neoplasms Extrahepatic cholangiocarcinoma Pancreatic adenocarcinoma

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Current considerations for the surgical management of gallbladder adenomas

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1507-1512页

作者： Efstathios T Pavlidis ioannis n Galanis Theodoros E Pavlidis The Second Department of Propaedeutic Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Gallbladder adenomas are rare lesions(0.5%)associated with potential malignant transformation,particularly with gallbladder adenomas that are≥1 cm in *** detection and management are crucial for preventing lethal carcinoma *** polyps can often be distinguished from the more often nonneo-plastic cholesterol pseudopolyps(5%-10%),which are *** is the first-line tool for initial diagnosis and follow-up when *** question is whether cholecystectomy is always necessary for all *** manage-ment of gallbladder adenomas is determined according to the size of the tumor,the growth rate of the tumor,the patient’s symptoms and whether risk factors for malignancy are ***≥1 cm in size,an age>50 years and a familial history of gallbladder carcinoma are indications for immediate laparoscopic ***,ultrasound follow-up is *** adenomas 6-9 mm in size,the absence of≥2 mm growth at 6 months,one year,and two years,as well as an adenoma sizedng risk factors indicates that no further surveillance is ***,it would be preferable to individualize the management in doubtful *** interventional modalities for preserving the gallbladder need further evaluation,especially to determine the long-term outcomes.

关键词： Biliary diseases True neoplastic polyps Gallbladder adenomas Benign bi-liary tumors Gallbladder polyps Extrahepatic biliary neoplasms

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Epinephrine also acts on beta cells and insulin secretion

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World Journal of Clinical Cases 2024年第9期12卷 1712-1713页

作者： Lina Zabuliene ioannis Ilias Faculty of Medicine Vilnius UniversityVilnius LT-03101Lithuania Department of Endocrinology “Hippokration”General HospitalAthens GR-11527Greece

In a recent review examining neurotransmitter modulation of insulin secretion,the significant impact of epinephrine was not *** primary action involves inhibiting insulin release via alpha-adrenergic receptors,thereby reducing the response to insulin secretion stimulators,through the activation of K+channels and resulting in membrane hyperpolarization in beta cells.

关键词： Epinephrine Insulin Islets Glucose Human

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The Transmission,Establishment and Cross-cultural Integration of Chinese Medicine in the Mainstream Healthcare,through the Eyes of a Generation of Visionaries and Pioneers

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Chinese Medicine and Culture 2024年第1期7卷 1-4页

作者： ioannis Solos Charles Buck Saint George Clinic and Research Institute Scottsdale 85251the United States of America northern College of Acupuncture Micklegate YO16LJthe United Kingdom

It has historically been very difficult to trace the history of the westward transmission of Chinese medicine through the accounts of its protagonists. Many of the early scholars such as Jack Worsley, Dick Van Buren, and Joe Goodman were reluctant to divulge information about the source of their knowledge, or their professional qualifications. Others, such as John Shen and Hong Yuan-bain were early 20th century immigrants who transmitted highly personalized versions of acupuncture and Chinese medicine to select disciples. Eventually, a new class of scholars appeared, including names such as Ted Kaptchuk, Peter Deadman, nigel Wiseman, William Morris, Peter Eckman, John Mc Donald, Charles Buck, and the late Giovanni Maciocia who looked for answers back in China, developed translation methodologies and terminology, compiled the main textbooks currently in use at TCM colleges, overcame enormous scholastic adversity, developed courses and pursued the regulation and accreditation of TCM in various countries. This special issue synopsizes the path towards the global acculturation of TCM over the last 50 years, the main protagonists, the enormous accomplishments they have achieved for the profession, their philosophy, their clinical perspectives and visions for the future.

关键词： Chinese medicine Cross-cultural integration Westward transmission James Reston Acupuncture History

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Retinal capillary plexus in Parkinson’s disease using optical coherence tomography angiography

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International Journal of Ophthalmology(English edition) 2024年第1期17卷 131-136页

作者： ioannis Giachos Spyridon Doumazos Anastasia Tsiogka Konstantina Manoli George Tagaris Tryfon Rotsos Vassilios Kozobolis ioannis Iliopoulos Marilita Moschos First Department of Ophthalmology National and Kapodistrian University of Athens Medical SchoolAthens 11527Greece Department of neurology General Hospital of Athens“Georgios Gennimatas”Athens 11527Greece Department of Ophthalmology Faculty of MedicineSchool of Health SciencesUniversity of PatrasPatras 26504Greece neurology Department Democritus University of ThraceAlexandroupolis 68100Greece

AIM:To evaluate the alterations of the retinal microvasculature and foveal avascular zone in patients with Parkinson’s disease(PD)using optical coherence tomography angiography(OCT-A).METHODS:A retrospective study of PD patients examined in the Ophthalmology Department of the General Hospital of Athens,“Georgios Gennimatas”from March 2021 to March 2022 was *** 44 patients with PD were included and 18 healthy controls were examined,hence a total of 124 eyes were enrolled in the *** foveal and parafoveal superficial and deep capillary plexus vascular density(fSCP-VD,fDCP-VD,pSCP-VD,pDCP-CD)and foveal avascular zone(FAZ)were quantified with *** coherence tomography(OCT)was used to measure macular *** statistical analysis was conducted by using a mixed effect linear regression ***:After adjustment for age and gender,the mean parafoveal superficial capillary plexus vascular density(pSCP-VD)and mean parafoveal deep capillary plexus vascular density(pDCP-VD)were significantly decreased in individuals with PD(Pn both)by-2.35(95%CI-3.3,-1.45)and-7.5(95%CI-10.4,-4.6)***-VD and fDCP-VD didn’t approach statistical *** FAZ area and perimeter were significantly decreased(Pn both)by-0.1 mm^(2)(95%CI-0.13,-0.07)and-0.49 mm^(2)(95%CI-0.66,-0.32)*** didn’t approach statistical *** retinal thickness(CRT)was significantly decreased in individuals with PD(Pnd temporal retinal thickness(TRT)was decreased(P=0.025)by-11μm(95%CI-22,-1.5)while nasal retinal thickness(nRT)only approached statistical significance(P=0.066).COnCLUSIOn:The mean pSCP-VD,pDCP-VD,CRT and TRT are significantly decreased and FAZ is altered in individuals with *** findings can be potentially used as biomarkers for the diagnosis and evaluation of early PD.

关键词： Parkinson’s disease optical coherence tomography angiography retinal vascular density foveal avascular zone

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Extending the decision-making process during yellow phase from human drivers to autonomous vehicles:A microsimulation study with safety considerations

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Journal of Traffic and Transportation Engineering(English Edition) 2024年第2期11卷 362-379页

作者： Efthymis Papadopoulos Anastasia nikolaidou Emmanouil Lilis ioannis Politis Panagiotis Papaioannou Transport Engineering Laboratory School of Civil EngineeringFaculty of EngineeringAristotle University of ThessalonikiThessaloniki 54124Greece

One of the main factors affecting the safety of signalised intersections is the stop/go behaviour during the yellow *** previous research has exhaustively examined drivers’stop/go decision-making,the expected autonomous vehicles’(AVs’)stop/go behaviour has not yet been thoroughly *** a series of simulation experiments developed for conventional and autonomous vehicles using different carfollowing,lane-changing,lateral placement and stop/go model parameter values,we examine here whether the default VISSIM stop/go parameter values can adequately replicate the observed drivers’behaviour at the considered intersection and assess the suitability of using the currently available options,albeit referring to human drivers,to simulate the expected stop/go behaviour of *** also propose a policy framework for determining the desired behaviour of AVs in yellow interval,which is integrated into an AVs logic and achieved in the last simulation to explore the effect of automation on the stop/go outcome and,hence,on the safety level of signalised *** data analysis and modeling techniques were used for the formulation of certain scenarios,including binary choice *** default stop/go parameter values were found unfit to replicate the observed stop/go behaviour and subjected to *** to the currently available options,the proposed AVs logic proved to produce the most accurate results,in terms of the stop/go simulation *** the impact of automation on the stop/go outcome,the simulation experiments showed that AVs preferred a more conservative behaviour in favor of road safety,as indicated by the significant reduction(≈15%)in the number of vehicles crossing the stop line during the yellow light and zero instances of red light ***,compared to the conservative drivers represented by the default stop/go parameter values,AVs preferred a more rational behaviour in favor of intersection capacit

关键词： Driver behaviour AVs behaviour Signalised intersection Choice model Micro-simulation Policy framework

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William Morris,Establishing the Foundation for the Advancement of TCM in the US

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Chinese Medicine and Culture 2024年第1期7卷 29-40页

作者： ioannis Solos Charles Buck William Morris Saint George Clinic and Research Institute Scottsdale 85251the United States of America northern College of Acupuncture Micklegate YO16LJthe United Kingdom AOMA Graduate School of Integrative Medicine Austin 78745the United States of America

The interview was conducted on March 2nd, 2023 by ioannis Solos and Charles Buck. William Morris has sustained practice since 1980. He has served on the California, Texas and Massachusetts Professional Associations, as well as the national Association. He has tendered 20 years of service to the field through academic medicine, earning a master’s degree in medical education to assist in developing Chinese medical doctoral programs and institutional review boards. He earned an OM.D. in 1988, a DAOM in 2002, and a Ph.D. focused on pulse diagnosis as clinical epistemology in 2009. He has published five books, including TCM Case Studies Dermatology, Li Shi-zhen Pulse Studies: An Illustrated Guide, neoclassical Pulse Diagnosis, Cycles in Medical Astrology, and Transformation: Treating Trauma with Acupuncture and Herbs.

关键词： Acupuncture sustained diagnosis

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First case of fungal keratitis secondary to Yamadazyma mexicana

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International Journal of Ophthalmology(English edition) 2024年第6期17卷 1164-1167页

作者： ioannis Giachos Aristea Velegraki Sotiria Palioura First Department of Ophthalmology National and Kapodistrian University of Athens Medical SchoolAthens 11527Greece Mycology Research Laboratory Microbiology DepartmentMedical SchoolNational and Kapodistrian University of AthensAthen 11527Greece BIOIATRIKI S.A Healthcare Group Athens 11526Greece Department of Ophthalmology University of Cyprus Medical SchoolNicosia 2109Cyprus

Dear Editor,Fungal keratitis is a serious and potentially sightthreatening infection that poses a global health concern,with higher incidence rates reported in low-income countries and regions with tropical climates[1-3].Risk factors for fungal keratitis include trauma with vegetative matter,contact lens wear,history of ocular surgery,chronic topical steroid use,low socioeconomic status and tropical climate[1-2].Fungi have the propensity to penetrate deep into the corneal stroma,making the infection difficult to treat with topical antifungal agents *** such as corneal perforation and endophthalmitis can arise in severe cases,making early identification of the causative fungal pathogen of utmost importance[4-5].Moreover,obtaining susceptibilities to the available antifungal agents can be sight and eye saving[5].

关键词： arise steroid income

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