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Journal of Environmental Science and Engineering 2011年第4期5卷 475-482页

作者： A.S. Christodoulou N. Theodoridis k. papastergiou Laboratory of Forest Economics Faculty of Forestry and Natural Environment Thessalonik 54124i Greece Forest Inspection of South Aegean Region Rhodes 85100 Greece Technical and Environmental Services of the Municipality of k.meiros Rhodes 85106 Greece

Rhodes is one of the most forested islands of Greece, in the Prefecture of Dodecanese, in southeast of Aegean Sea. The island in recent times has been struck.by big and devastating fires. After 1993, the local Forest Service and the local political authority have adopted a new prevention and suppression system relied on the fast fire detection and suppression at its initial stages. By the present research, comparing the results of 1993-2006 （a time span when the above method was applied） with the results of the immediately precedent equal time of 1978-1992, was made certain that the firefighting system applied after 1993 had very good results irrespective from the primary agency in charge of extinguishing the forest fires. Among others, it was made clear that, during the period that this method was applied, a much less area was burnt per year than the period before the application in spite of the fact that in the same period （1993-2006） there has been a significant increase of forest fires. It is also estimated that the economic damage occurred in the first period （1978-1992） on average was 12.4 times per year higher compared to the second period （1993-2006）.

关键词： Forest fires fire detection economic impacts Rhodes island-Greece.

Treatment of Helicobacter pylori infection:Meeting the challenge of antimicrobial resistance

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World Journal of Gastroenterology 2014年第29期20卷 9898-9911页

作者： Vasilios papastergiou Sotirios D Georgopoulos Stylianos k.ratapanis Department of Internal Medicine General Hospital of Rhodes Department of Gastroenterology Athens MedicalP Faliron Hospital

Treatment of Helicobacter pylori (H. pylori) infection is paramount for the management of prevalent gastrointestinal disorders including peptic ulcer disease and gastric cancer. Due to the wide increase in prevalence of H. pylori resistance to antibiotics, clarithromycin-based triple therapies are not any more suitable for unconditional empiric use, and should not be recommended, unless local resistance to this antibiotic is low (< 20%). Alternative strategies have been proposed to overcome the issue of increasing clarithromycin resistance, and some of them are already implemented in clinical practice. These comprise: (1) adoption of novel, more effective, empirical treatments: bismuth quadruple, sequential, non-bismuth quadruple (concomitant), dual-concomitant (hybrid), and levofloxacin-based regimens, the latter mainly designated as second-line/rescue options; (2) perspectives for a susceptibility-guided (tailored) therapeutic approach based on culture-free molecular testing methods; and (3) adjunct use of probiotics to improve eradication rates. The present article is aimed to provide a comprehensive overview of current and emerging strategies in the treatment of H. pylori infection, focusing on the challenge of antimicrobial resistance.

关键词： Helicobacter pylori Antibiotic resistance Bismuth-quadruple Concomitant Sequential

Helicobacter pylori and colorectal neoplasia:Is there acausal link.

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World Journal of Gastroenterology 2016年第2期22卷 649-658页

作者： Vasilios papastergiou Stylianos k.ratapanis Sotirios D Georgopoulos Department of Internal Medicine General Hospital of Rhodes85100 RhodesGreece Department of Gastroenterology Athens MedicalPaleo Faliron General Hospital17562 AthensGreece

Ever since Helicobacter pylori(H. pylori) was recognized as an infectious cause of gastric cancer, there has been increasing interest in examining its potential role in colorectal carcinogenesis. Data from casecontrol and cross-sectional studies, mostly relying on hospital-based samples, and several meta-analyses have shown a positive statistical relationship between H. pylori infection and colorectal neoplasia. However, the possibility exists that the results have been influenced by bias, including the improper selection of patients and disparities with respect to potential confounders. While the evidence falls short of a definitive causal link. it appears that infection with H. pylori /H. pylori-related gastritis is associated with an increased, although modest, risk.of colorectal adenoma and cancer. The pathogenic mechanisms responsible for this association remain uncertain. H. pylori has been detected in colorectal malignant tissues; however, the possibility that H. pylori is a direct activator of colonic carcinogenesis remains purely hypothetical. On the other hand, experimental data have indicated a series of potential oncogenic interactions between these bacteria and colorectal mucosa, including induction and perpetuation of inflammatory responses, alteration of gut microflora and release of toxins and/or hormonal mediators, such as gastrin, which may contribute to tumor formation.

关键词： Helicobacter pylori Colorectal cancer Polyp Adenoma Gastrin

Current status and emerging challenges in the treatment of hepatitis C virus genotypes 4 to 6

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World Journal of Clinical Cases 2015年第3期3卷 210-220页

作者： Vasilios papastergiou Stylianos k.ratapanis Department of Internal Medicine General Hospital of Rhodes

Hepatitis C virus(HCV) genotypes 4, 5 and 6 are mainly present in Africa, the Middle East and Asia and they have been less extensively studied with respect to epidemiology, natural disease history and therapeutic endpoints. Response rates to a 48-wk.combined peginterferon/ribavirin treatment range to 40%-69% for HCV 4, 55%-60% for HCV 5 and 60%-90% for HCV 6. Response-guided schedules are recommended to optimize the outcomes of peginterferon/ribavirin treatment in HCV 4 and, in form of preliminarydata, for HCV 6, but no data are yet available to support such an individualization of therapy for HCV 5. Recently, the direct-acting antivirals(DAAs) with pan-genotypic activities simeprevir, sofosbuvir and daclatasvir have been recommended in triple regimens with peginterferon/ribavirin for the treatment of HCV genotypes 4 to 6 infections. In the future, DAA-based interferon-free therapies are awaited to drastically improve treatment outcomes in HCV. However, efforts to improve treatment outcomes with peginterferon/ribavirin should continue, as the HCV 4-6 infected population is mainly based in resource-limited settings with restricted access to the costly DAAs.

关键词： Hepatitis C virus Genotype 4 Genotype 5 Genotype 6 Pegylated interferon Ribavirin Directacting antivirals

Treatment of Helicobacter pylori infection: Past, present and future

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World Journal of Gastrointestinal Pathophysiology 2014年第4期5卷 392-399页

Helicobacter pylori(H. pylori) is a major human patho-gen associated with significant morbidity and mortal-ity. However, after decades of efforts, treatment of H. pylori remains a challenge for physicians, as there is no universally effective regimen. Due to the rising prevalence of antimicrobial resistance, mainly to clar-ithromycin, efficacy of standard triple therapies has declined to unacceptably low levels in most parts of the world. Novel regimens, specifically experimented to improve the therapeutic outcome against antibiotic-resistant H. pylori strains, are now recommended as first-line empirical treatment options providing high ef-ficacy(reportedly > 90% in intention to treat analysis) even in high clarithromycin resistance settings. These include the bismuth quadruple, concomitant, sequential and hybrid therapies. Due to the rapid development of quinolone resistance, levofloxacin-based regimens should be reserved as second-line/rescue options. Adjunct use of probiotics has been proposed in order to boost eradication rates and decrease occurrence of treatment-related side effects. Molecular testing meth-ods are currently available for the characterization of H. pylori therapeutic susceptibility, including genotypic detection of macrolide resistance and evaluation of the cytochrome P450 2C19 status k.own to affect the me-tabolism of proton pump inhibitors. In the future, use of these techniques may allow for culture-free, non-invasive tailoring of therapy for H. pylori infection.

关键词： Helicobacter pylori Antibiotic resistance Bismuth-quadruple Concomitant Sequential Probiotics