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Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery:A systematic review

World Journal of Cardiology 2024年第1期16卷 27-39页

作者： Christos Kourek Marios Kanellopoulos Vasiliki Raidou Michalis Antonopoulos Eleftherios Karatzanos irini Patsaki Stavros Dimopoulos Medical School of Athens National and Kapodistrian University of AthensAthens 15772Greece Clinical Ergospirometry Exercise and Rehabilitation LaboratoryEvangelismos HospitalAthens 10676Greece Intensive Care Unit Onassis Cardiac Surgery CenterKallithea 17674Greece Department of Physiotherapy University of West AtticaAthens 12243Greece

BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher mortality.Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay.Neuromuscular electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these patients.AIM To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery.METHODS We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac surgery.RCTs were assessed for methodological rigor and risk of bias via the PEDro.The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function.RESULTS Ten studies were included in our systematic review,resulting in 703 participants.Almost half of them performed NMES and the other half were included in the control group,treated with usual care.Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery.Functional capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac surgery.Nine studies explored the effects of NMES on muscle strength

关键词： Neuromuscular electrical stimulation Cardiac surgery coronary artery bypass grafting Heart valve replacement Peak VO2 Safety

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Enhanced direct gaseous CO_(2) fixation into higher bio-succinic acid production and selectivity

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Journal of Environmental Sciences 2024年第9期143卷 164-175页

作者： Ziyi Yang Wanling Wu Qing Zhao irini ang.lidaki Samuel Gyebi Arhin Dongliang Hua Yuxiao Zhao Hangyu Sun Guangqing Liu Wen Wang Biomass Energy and Environmental Engineering Research Center Beijing University of Chemical TechnologyBeijing 100029China College of Chemical Engineering Beijing University of Chemical TechnologyBeijing 100029China Department of Chemical and Biochemical Environmental Engineering Technical University of DenmarkDK-2800Kgs LyngbyDenmark Energy Research Institute Qilu University of Technology(Shandong Academy of Sciences)Shandong Provincial Key Laboratory of Biomass Gasification TechnologyJinan 250014China

Utilizing CO_(2)for bio-succinic acid production is an attractive approach to achieve carbon capture and recycling(CCR)with simultaneous production of a useful platform chemical.Actinobacillus succinogenes and Basfia succiniciproducens were selected and investigated as microbial catalysts.Firstly,the type and concentration of inorganic carbon concentration and glucose concentration were evaluated.6 g C/L MgCO_(3)and 24 g C/L glucose were found to be the optimal basic operational conditions,with succinic acid production and carbon yield of over 30 g/L and over 40%,respectively.Then,for maximum gaseous CO_(2)fixation,carbonate was replaced with CO_(2)at different ratios.The“less carbonate more CO_(2)”condition of the inorganic carbon source was set as carbonate:CO_(2)=1:9(based on the mass of carbon).This condition presented the highest availability of CO_(2)by well-balanced chemical reaction equilibrium and phase equilibrium,showing the best performance with regarding CO_(2)fixation(about 15 mg C/(L·hr)),with suppressed lactic acid accumulation.According to key enzymes analysis,the ratio of phosphoenolpyruvate carboxykinase to lactic dehydrogenase was enhanced at high ratios of gaseous CO_(2),which could promote glucose conversion through the succinic acid path.To further increase gaseous CO_(2)fixation and succinic acid production and selectivity,stepwise CO_(2)addition was evaluated.50%-65%increase in inorganic carbon utilization was obtained coupled with 20%-30%increase in succinic acid selectivity.This was due to the promotion of the succinic acid branch of the glucose metabolism,while suppressing the pyruvate branch,along with the inhibition on the conversion from glucose to lactic acid.

关键词： Succinic acid CO_(2) fixation Actinobacillus succinogenes Basfia succiniciproducens Lactic acid

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Increasing role of post-intensive care syndrome in quality of life of intensive care unit survivors

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World Journal of Critical Care Medicine 2024年第2期13卷 7-10页

作者： irini Patsaki Stavros Dimopoulos Department of Physiotherapy University of West AttikaAthens 12243Greece Cardiac Surgery Intensive Care Unit Onassis Cardiac Surgery CentreAthens 17674Greece

In this editorial we comment on the detrimental consequences that post-intensive care syndrome(PICS)has in the quality of life of intensive care unit(ICU)survivors,highlighting the importance of early onset of multidisciplinary rehabilitation from within the ICU.Although,the syndrome was identified and well described early in 2012,more awareness has been raised on the long-term PICS related health problems by the increased number of coronavirus disease 2019 ICU survivors.It is well outlined that the syndrome affects both the patient and the family and is described as the appearance or worsening of impairment in physical,cognitive,or mental health as consequence of critical illness.PICS was described in order:(1)To raise awareness among clinicians,researchers,even the society;(2)to highlight the need for a multilevel screening of these patients that starts from within the ICU and continues after discharge;(3)to present preventive strategies;and(4)to offer guidelines in terms of rehabilitation.An early multidisci-plinary approach is the key element form minimizing the incidence of PICS and its consequences in health related quality of life of both survivors and their families.

关键词： Intensive care unit acquired weakness Physical impairment Quality of life Mental Cognitive function

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Biogas and its opportunities——A review

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Frontiers of Environmental Science & Engineering 2018年第3期12卷 1-12页

作者： Panagiotis G. Kougias irini ang.lidaki Department of Environmental Engineering Technical University of Denmark Kgs. Lyngby DK-2800 Denmark

Biogas production is a well-established technology primarily for the generation of renewable energy and also for the valorization of organic residues. Biogas is the end product of a biological mediated process, the so called anaerobic digestion, in which different microorganisms, follow diverse metabolic pathways to decompose the organic matter. The process has been known since ancient times and was widely applied at domestic households providing heat and power for hundreds of years. Nowadays, the biogas sector is rapidly growing and novel achievements create the foundation for constituting biogas plants as advanced bioenergy factories. In this context, the biogas plants are the basis of a circular economy concept targeting nutrients recycling, reduction of greenhouse gas emissions and biorefinery purposes. This review summarizes the current state-of-the-art and presents future perspectives related to the anaerobic digestion process for biogas production. Moreover, a historical retrospective of biogas sector from the early years of its development till its recent advancements gives an outlook of the opportunities that are opening up for process optimisation.

关键词： Anaerobic digestion Biogas Biowastes Solid waste Manure Industrial waste

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Serum leptin and ghrelin in chronic hepatitis C patients with steatosis

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World Journal of Gastroenterology 2011年第46期17卷 5097-5104页

作者： Christos Pavlidis Georgios I Panoutsopoulos Dina Tiniakos Sotirios Koutsounas John Vlachogiannakos irini Zouboulis-Vafiadis First Department of Propaedeutic Medicine"LAIKO"General Hospital Department of Nursing University of PeloponneseOrthias Artemidos and PlateonSparta Laboratory of Histology and Embryology Medical SchoolNational and Kapodistrian University of Athens Reference Center for Viral Hepatitis

AIM:To determine the associations between leptin and ghrelin concentrations and sustained virological response(SVR)in chronic hepatitis C patients with ste-atosis.METHODS:We retrospectively assessed 56 patients infected with hepatitis C virus(HCV)genotype-1 and 40 with HCV genotype-3.Patients with decompensated cirrhosis,and those with other causes of chronic liver disease,were excluded.Serum HCV-RNA concentra-tions were measured before the initiation of treatment;at weeks 12(for genotype 1 patients),24 and 48 during treatment;and 24 wk after the end of treatment.Genotype was determined using INNO-LIPA HCV as-says,and serum leptin and ghrelin concentrations were measured using enzyme-linked immunosorbent assay.Biopsy specimens were scored according to the Ishak system and steatosis was graded as mild,moderate,or severe,according to the Brunt classif ication.RESULTS:Overall,SVR was positively related to the presence of genotype-3,to biopsy-determined lower histological stage of liver disease,and lower grade of steatosis.Patients ≥ 40 years old tended to be less responsive to therapy.In genotype-1 infected pa-tients,SVR was associated with a lower grade of liver steatosis,milder fibrosis,and an absence of insulin resistance.Genotype-1 infected patients who did not achieve SVR had significantly higher leptin concen-trations at baseline,with significant increases as the severity of steatosis worsened,whereas those who achieved SVR had higher ghrelin concentrations.In genotype-3 infected patients,SVR was associated only with fibrosis stage and lower homeostasis model as-sessment insulin resistance at baseline,but not with the degree of steatosis or leptin concentrations.Geno-type-3 infected patients who achieved SVR showed signif icant decreases in ghrelin concentration at end of treatment.Baseline ghrelin concentrations were elevat-ed in responders of both genotypes who had moderate and severe steatosis.CONCLUSION:Increased serum leptin before treat-ment may predict non-SVR,especially in HCV geno-type-1 infected pati

关键词：丙型肝炎病毒生长素低脂肪患者瘦素血清慢性 ghrelin

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What Is the Difference between Post- and Pre-Dilution in On-Line Haemodiafiltration in the Removing of Median-Molecular-Weight Toxins?

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Journal of Biosciences and Medicines 2023年第3期11卷 105-119页

作者： Konstantinos S. Mavromatidis irini M. Kalogiannidou Ploumis S. Passadakis Renal Unit “Dimokrition” Komotini Greece

Introduction: β2-microglobulin and prolactin are medium-molecular-weight toxins. We believe that the rate of removal of these molecules, using filters with two different surfaces, in post- and pre-dilution haemodiafiltration, will be of interest to the literature. Methods: We studied, in 12 haemodialyzed patients, the removal of those, with filter with surface of 2.5 m2 (Group A) or 2.1 m2 (Group B) with post-dilution haemodiafiltration, and with a filter with surface 2.5 m2 with pre-dilution (Group C). Results: Satisfactory removal of β2-microglobulin (best with post-dilution) was found, and a good rate of removal of prolactin without the filter surface played a role in both cases. Conclusion: The elimination of β2-microglobulin in post-dilution is not affected by the filter surface area. Pre-dilution achieves removal of β2-microglobulin, less than that of post-dilution. Prolactin was removed satisfactorily regardless of the filter surface in post-dilution, and its removal appears to be less than that of β2-microglobulin.

关键词： Haemodiafiltration Pre-Dilution Post-Dilution β2-Microglobulin Prolactin

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Eros and Thanatos in Theo angelopoulos＇ Trilogy： The Weeping Meadow （2004） and Dust of Time （2008）

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Journal of Literature and Art Studies 2012年第5期2卷 526-537页

作者： irini Stathi University of the Aegean Mytilene Greece

Eros and Thanatos are the forces of life and death. The Ancient Greek Philosophers never showed the two gods together. Nevertheless, in the main myths related to the netherworld such as those of Orpheus or Persephone, the two gods are in a continuous fight which has determined the human condition until nowadays. The author wishes in this paper to examine how the Orpheus" myth related to the duality Eros and Thanatos is treated in Theo angelopoulos" world and especially how it appears in Ulysses" Gaze (1995) and Trilogy: The Weeping Meadow (2004) and Dust of Time (2008). In this last angelopoulos" Trilogy, we will search the unfolds of the love story of two young people started in Odessa in 1918 and finished by the death of the woman at the end of the century, under the lens of the duality Eros and Thanatos as literal and metaphorical qualities. The historical and personal adventures of the two characters represent a daedal itinerary from East to West, which offers multiple levels of reading of the filmic texts. A comparative approach with myth, literature, and historical research will demonstrate the richness of artistic expression and a profound relationship of angelopoulos" thought with the formulaic myths he introduces in his filmic work.

关键词：时间草原粉尘艺术表现力爱情故事神话哲学家古希腊

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Solitary colonic neurofibroma in a patient with transient segmental colitis: Case report

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World Journal of Gastroenterology 2005年第35期11卷 5573-5576页

作者： Vasilios Panteris Thivi Vassilakaki Nikos Vaitsis Ioannis Elemenoglou irini Mylonakou Dimitrios Georgios Karamanolis Department of Gastroenterology "Tzaneion" General Hospital Zanni and Afentouli 1 Piraeus 18536 Greece Department of Pathology "Tzaneion" General Hospital Zanni and Afentouli 1 Piraeus 18536 Greece Department of Pathology"Tzaneion" General Hospital Zanni and Afentouli 1 Piraeus 18536 Greece

Neurofibromas of the large bowel are very rare and usually are part of the colonic involvement in neurofibromatosis type 1 (Nf1, von Recklinghausen's disease). Solitary neurofibromas of the colon are extremely rare. We describe a case of an isolated neurofibroma that was found in the large bowel of a patient who suffered from segmental colitis and presented with bloody diarrhea. A review of the literature is also included, concerning the disclosure of isolated neurofibromas in the gut and other body parts and the type of gastrointestinal involvement in von Recklinghausen's disease.

关键词：结肠纤维神经瘤大肠炎病例报告临床表现腹泻

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Improving <i>in Silico</i>Prediction of Epitope Vaccine Candidates by Union and Intersection of Single Predictors

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World Journal of Vaccines 2011年第2期1卷 15-22页

作者： Ivan Dimitrov Darren R. Flower irini Doytchinova Life and Health Sciences Aston University United Kingdom School of Pharmacy Medical University of Sofia Bulgaria

The in silico prediction of peptide binding affinities to MHC proteins is a very important first step in the process of epi-tope-based vaccine design and development. Five MHC class II binding prediction servers were combined in different ways and the resulting performance of these combinations was evaluated using a test set, which consisted of 4540 known HLA-DRB1 binders. The five servers were: NetMHCIIpan, NetMHCII, ProPred, RANKPEP, and EpiTOP. The top 5% of the ranked predictions from each server were combined using union and intersection operators. The outputs were evaluated in terms of sensitivity and positive predictive value (PPV). The union operator showed high sensitivity (65-79%) and low PPVs (6-8%), while intersection outputs had low sensitivities (4-41%) yet significantly higher PPVs (14-31%). Thus there is a defining trade-off between sensitivity and PPV for each combination. The union of outputs from different servers brings more “noise” than “signal” to the resulting set of predicted binders. Conversely, selecting only commonly predicted binders increases the probability that an identified binder is a true binder.

关键词： MHC Class II Binders T-cell Epitopes HLA-DRB1 Alelles

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Acute upper gastrointestinal bleeding in octοgenarians:Clinical outcome and factors related to mortality

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World Journal of Gastroenterology 2008年第25期14卷 4047-4053页

作者： George J Theocharis Vassiliki Arvaniti Stelios F Assimakopoulos Konstantinos C Thomopoulos Vassilis Xourgias irini Mylonakou Vassiliki N Nikolopoulou Division of Gastroenterology Department of Internal Medicine University Hospital of Patras Department of Gastroenterology "Tzaneio" General Hospital Department of Internal MedicineUniversity Hospital of Patras

AIM: To evaluate the aetiology, clinical outcome and factors related to mortality of acute upper gastrointestinal bleeding (AUGIB) in octogenarians. METHODS: We reviewed the records of all patients over 65 years old who were hospitalised with AUGIB in two hospitals from January 2006 to December of 2006. Patients were divided into two groups: Group A (65-80 years old) and Group B (> 80 years old). RESULTS: Four hundred and sixteen patients over 65 years of age were hospitalized because of AUGIB. Group A included 269 patients and Group B 147 patients. Co-morbidity was more common in octogenarians (P = 0.04). The main cause of bleeding was peptic ulcer in both groups. Rebleeding and emergency surgery were uncommon in octogenarians and not different from those in younger patients. In-hospital complications were more common in octogenarians (P = 0.05) and more patients died in the group of octogenarians compared to the younger age group (P = 0.02). Inability to perform endoscopic examination (P = 0.002), presence of high risk for rebleeding stigmata (P = 0.004), urea on admission (P = 0.036), rebleeding (P = 0.004) and presenceof severe co-morbidity (P < 0.0001) were related to mortality. In multivariate analysis, only the presence of severe co-morbidity was independently related to mortality (P = 0.032). CONCLUSION: While rebleeding and emergency surgery rates are relatively low in octogenarians with AUGIB, the presence of severe co-morbidity is the main factor of adverse outcome.

关键词：急性胃肠出血中年死亡率病理机制

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