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Necrolytic acral erythema in a human immunodeficiency virus/hepatitis C virus coinfected patient:A case report

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World Journal of Hepatology 2019年第2期11卷 226-233页

作者： katerina g oikonomou Dost Sarpel Alexandra Abrams-Downey Adnan Mubasher Douglas T Dieterich Division of Infectious Diseases Icahn School of Medicine at Mount Sinai Department of Pathology Icahn School of Medicine at Mount Sinai Division of Liver Diseases Icahn School of Medicine at Mount Sinai

BACKgROUND Necrolytic acral erythema(NAE) is a rare dermatological disorder,which is associated with hepatitis C virus(HCV) infection or zinc *** is characterized by erythematous or violaceous lesions occurring primarily in the lower *** treatment includes systemic steroids and oral zinc *** report a case of NAE in a 66-year-old human immunodeficiency virus(HIV)/HCV co-infected woman with *** is rarely reported in co-infected patients and the exact mechanisms of pathogenesis are still *** SUMMARY A 66-year-old HIV/HCV co-infected female patient presented with painless,nonpruritic rash of extremities for one week and underwent extensive work-up for possible rheumatologic disorders including vasculitis and *** skin biopsies of right and left thigh revealed thickened parakeratotic stratum corneum most consistent with *** was started on prednisone and zinc supplementation with resolution of the lesions and improvement of *** Clinicians should maintain high clinical suspicion for early recognition of NAE in patients with rash and HCV.

关键词： Necrolytic acral erythema Human immunodeficiency virus Hepatitis C virus Zinc deficiency Case report

Prevention,diagnostic evaluation,management and prognostic implications of liver disease in critically ill patients with COVID-19

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World Journal of Clinical Cases 2023年第3期11卷 514-527页

作者： Asimina Valsamaki Maria Xanthoudaki katerina g oikonomou Panagiotis J Vlachostergios AntoniosPapadogoulas Periklis Katsiafylloudis Ioanna Voulgaridi Apostolia-Lemonia Skoura Apostolos Komnos Panagiotis Papamichalis Intensive Care Unit General Hospital of LarissaLarissa 41221Greece Division of Hematology and Medical Oncology Department of MedicineWeill Cornell MedicineNew YorkNY 10065United States Department of Microbiology General Hospital of LarissaLarissa 41221Greece Transfusion Medicine Department University Hospital of LarissaLarissa 41110Greece

Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2,broke out in December 2019 in Wuhan city of China and spread rapidly ***,by March 2020,the World Health Organization declared the disease a global *** from the respiratory system,various other organs of the human body are also seriously affected by the *** injury in patients with a severe form of COVID-19 is estimated to be 14.8%-53.0%.Elevated levels of total bilirubin,aspartate aminotransferase and alanine aminotransferase and low levels of serum albumin and prealbumin are the main laboratory *** with pre-existing chronic liver disease and cirrhosis are much more prone to develop severe liver *** literature review presented the recent scientific findings regarding the pathophysiological mechanisms responsible for liver injury in critically ill patients with COVID-19,the various interactions between drugs used to treat the disease and the function of the liver and the specific tests providing the possibility of early diagnosis of severe liver injury in these ***,it highlighted the burden that COVID-19 put on health systems worldwide and its effect on transplant programs and the care provided to critically ill patients in general and particularly to those with chronic liver disease.

关键词： Coronavirus disease 2019 Severe acute respiratory syndrome coronavirus 2 Liver disease Intensive care unit Liver unit Prealbumin

gastroenterology and liver disease during COVID-19 and in anticipation of post-COVID-19 era: Current practice and future directions

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World Journal of Clinical Cases 2021年第19期9卷 4918-4938页

作者： katerina g oikonomou Panagiotis Papamichalis Tilemachos Zafeiridis Maria Xanthoudaki Evangelia Papapostolou Asimina Valsamaki Konstantinos Bouliaris Michail Papamichalis Marios Karvouniaris Panagiotis J Vlachostergios Apostolia-Lemonia Skoura Apostolos Komnos Intensive Care Unit General Hospital of LarissaLarissa 41221ThessalyGreece Surgical Department General Hospital of LarissaLarissa 41221ThessalyGreece Department of Cardiology University Hospital of LarissaLarissa 41110ThessalyGreece Intensive Care Unit University Hospital of LarissaLarissa 41110ThessalyGreece Division of Hematology and Medical Oncology Department of MedicineWeill Cornell MedicineNew YorkNY 10065United States Transfusion Medicine Department University Hospital of LarissaLarissa 41110ThessalyGreece

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has emerged as a major threat to global public *** virus causes the clinical syndrome known as coronavirus disease 2019(COVID-19),in which multiple organs can get *** from manifestations of the respiratory system,which predominate,its clinical presentation is frequently accompanied by symptoms of the gastrointestinal(gI)tract and liver *** correlation of symptoms and abnormalities with disease severity is discussed,leading to ambiguous results from international ***,the disease infects patients with coexisting liver and gI disorders affecting both their health status and the availability of healthcare services provided to *** risk of transmission of the disease during aerosol-generating procedures has changed the diagnostic approach and follow-up algorithms for liver and gI *** the safety of both doctors and patients,telemedicine and distant evaluation have become everyday practice,whereas several routines and emergency visits at outpatient and emergency departments have been postponed or *** against SARS-CoV-2 is underway,providing hope to humanity and the expectation that the post-COVID-19 era is *** review aims to update knowledge about the manifestations of COVID-19 related to liver and gI diseases and the effect of the pandemic on the diagnostic and therapeutic procedures for these diseases with a special focus on how current practices have changed and what changes will possibly remain in the future.

关键词： COVID-19 SARS-CoV-2 Liver disease gastroenterology practice Endoscopy

Liver replacement therapy with extracorporeal blood purification techniques current knowledge and future directions

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World Journal of Clinical Cases 2023年第17期11卷 3932-3948页

作者： Panagiotis Papamichalis katerina g oikonomou Asimina Valsamaki Maria Xanthoudaki Periklis Katsiafylloudis Evangelia Papapostolou Apostolia-Lemonia Skoura Michail Papamichalis Marios Karvouniaris Antonios Koutras Eleni Vaitsi Smaragdi Sarchosi Antonios Papadogoulas Dimitrios Papadopoulos Intensive Care Unit General Hospital of LarissaLarissa 41221ThessalyGreece Department of Transfusion Medicine University Hospital of LarissaLarissa 41110ThessalyGreece Department of Cardiology University Hospital of LarissaLarissa 41110ThessalyGreece Intensive Care Unit AHEPA University HospitalThessaloniki 54636Greece 1^(st) Department of Obstetrics and gynecology General Hospital of Athens“ALEXANDRA”National and Kapodistrian University of AthensAthens 11528Greece Department of Anesthesiology University Hospital of LarissaLarissa 41110ThessalyGreece

Clinically,it is highly challenging to promote recovery in patients with acute liver failure(ALF)and acute-on-chronic liver failure(ACLF).Despite recent advances in understanding the underlying mechanisms of ALF and ACLF,standard medical therapy remains the primary therapeutic *** transplantation(LT)is considered the last option,and in several cases,it is the only intervention that can be ***,this intervention is limited by organ donation shortage or exclusion criteria such that not all patients in need can receive a *** option is to restore impaired liver function with artificial extracorporeal blood purification *** first such systems were developed at the end of the 20th century,providing solutions as bridging therapy,either for liver recovery or *** enhance the elimination of metabolites and substances that accumulate due to compromised liver *** addition,they aid in clearance of molecules released during acute liver decompensation,which can initiate an excessive inflammatory response in these patients causing hepatic encephalopathy,multiple-organ failure,and other complications of liver *** compared to renal replacement therapies,we have been unsuccessful in using artificial extracorporeal blood purification systems to completely replace liver function despite the outstanding technological evolution of these *** middle to high-molecular-weight and hydrophobic/protein-bound molecules remains extremely *** majority of the currently available systems include a combination of methods that cleanse different ranges and types of molecules and ***,conventional methods such as plasma exchange are being re-evaluated,and novel adsorption filters are increasingly being used for liver *** strategies are very promising for the treatment of liver ***,the best method,system,or device has not been developed yet,and its probability of

关键词： Liver failure Transplantation Blood purification Liver replacement therapy Artificial extracorporeal systems Transplant-free survival

Extracorporeal organ support for critically ill patients:Overcoming the past,achieving the maximum at present,and redefining the future

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World Journal of Critical Care Medicine 2024年第2期13卷 19-28页

作者： Panagiotis Papamichalis katerina g oikonomou Maria Xanthoudaki Asimina Valsamaki Apostolia-Lemonia Skoura Sophia K Papathanasiou Achilleas Chovas Intensive Care Unit General Hospital of LarissaLarissa 41221Greece Department of Transfusion Medicine University Hospital of LarissaLarissa 41110Greece Department of Internal Medicine General Hospital of LarissaLarissa 41221Greece

Extracorporeal organ support(ECOS)has made remarkable progress over the last few *** replacement therapy,introduced a few decades ago,was the first available application of *** subsequent evolution of ECOS enabled the enhanced support to many other organs,including the heart[veno-arterial extracorporeal membrane oxygenation(ECMO),slow continuous ultrafiltration],the lungs(veno-venous ECMO,extracorporeal carbon dioxide removal),and the liver(blood purification techniques for the detoxification of liver toxins).Moreover,additional indications of these methods,including the suppression of excessive inflammatory response occurring in severe disorders such as sepsis,coronavirus disease 2019,pancreatitis,and trauma(blood purification techniques for the removal of exotoxins,endotoxins,or cytokines),have *** organ support therapy is crucial since a vast majority of critically ill patients present not with a single but with multiple organ failure(MOF),whereas,traditional therapeutic approaches(mechanical ventilation for acute respiratory failure,antibiotics for sepsis,and inotropes for cardiac dysfunction)have reached the maximum efficacy and cannot be improved ***,several issues remain to be clarified,such as the complexity and cost of ECOS systems,standardization of indications,therapeutic protocols and initiation time,choice of the patients who will benefit most from these interventions,while evidence from randomized controlled trials supporting their use is still ***,these methods are currently a part of routine clinical practice in intensive care *** editorial presents the past,present,and future considerations,as well as perspectives regarding these *** better understanding of these methods,the pathophysiology of MOF,the crosstalk between native organs resulting in MOF,and the crosstalk between native organs and artificial organ support systems when applied sequentially or simultaneously,will lead t

关键词： Kidney-liver replacement therapy Heart-lung support Blood purification Native–artificial organ crosstalk Multiple organ support therapy Extracorporeal organ support

Influence of education and residence on the parental search for pediatric surgical information on the internet

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World Journal of Clinical Pediatrics 2021年第5期10卷 93-105页

作者： Maria Aggelidou Savas P Deftereos Dimitrios C Cassimos Konstantinos Skarentzos Panagoula oikonomou Artemis Angelidou Christina Nikolaou george Koufopoulos katerina Kambouri Department of Pediatric Surgery Democritus University of ThraceUniversity Hospital of AlexandroupolisAlexandroupolis 68100Greece Department of Radiology University Hospital of AlexandroupolisDemocritus University of ThraceAlexandroupolis 68100Greece Department of Pediatrics Alexandroupolis University HospitalAlexandroupolis 68100Greece Student of Medicine Alexandroupolis University HospitalAlexandroupolis 68100Greece Department of Surgery Alexandroupolis University HospitalAlexandroupolis 68100Greece Student of Molecular Biology Alexandroupolis University HospitalAlexandroupolis 68100Greece Department of Surgery Laiko General HospitalAthens 11527Greece Department of Pediatric Surgery Alexandroupoli University HospitalDemocritus University of ThraceAlexandroupoli 68132Greece

BACKgROUND The internet is a valuable tool for access to health-related *** is limited literature regarding its use by parents of children with surgical *** To investigate internet usage by parents seeking information about the surgical conditions of their offspring in relation to epidemiological factors such as family residential area and parental educational level and to subsequently review the literature regarding this *** An anonymous questionnaire about internet usage was completed by eligible parents of children who were admitted to our clinic for minor surgical procedures during a six-month *** Our results demonstrated that the internet has been mostly used by mothers for children’s health *** was the most commonly used search engine,while pediatricians were the first parental choice for‘live’*** one-quarter of the parents informed their doctor about the information found *** of ten parents had a positive opinion of an official website managed by the doctors of our *** results mostly agreed with the international *** In conclusion,the establishment of official websites(designed and managed by specialists)that parents can access to receive appropriate health information is mandatory in the internet era.

关键词： Internet Child Health Mothers Fathers