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Efficacy and safety of novel anticoagulants in the elderly

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Journal of Geriatric Cardiology 2016年第8期13卷 718-723页

作者： Nikolaos Karamichalakis Stamatis Georgopoulos konstantinos Vlachos Ioarmis Liatakis Michael Efremidis Antonios Sideris konstantinos P Letsas Laboratory of Cardiac Electrophysiology 'Evangelismos' General Hospital of Athens Greece

Atrial fibrillation and venous thromboembolism （VTE） are common disorders associated with maleficent thrombotic events, particularly in the elderly patients. Polypharmacy, co-morbidities, and altered pharmacokinetics, often present in these patients, render the use of antico-agulants quite challenging. Novel oral anticoagulants （NOACs） have recently emerged as alternatives to Vitamin K Antagonists （VKAs） and are gradually increasing their popularity mainly because of their fewer drug and food interactions and ease of use. Their effectiveness and safety has been weU-established in the general population but the balance between benefit and harm in the elderly is still unclear. Routine use in these patients is uncommon. Accumulating data have shown that the benefit of NOACs is consistent among all age groups, featuring equal or greater efficacy in preventing thrombotic events. Excess bleedings were lower with NOACs in comparison to VKAs, but bleeding patterns were disparate among them and head to head comparison is not available. The present review highlights on the efficacy and safety of novel anticoagulants in the elderly population.

关键词： Atrial fibrillation Efficacy Novel oral anticoagulants Safety Venous thromboembolism

Robotic-assisted microsurgery in andrology: a systematic review

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Asian Journal of Andrology 2023年第4期25卷 454-461页

作者： konstantinos Douroumis Eleftherios Spartalis konstantinos Stravodimos Panagiotis K Levis Gerasimos Tsourouflis Dimitrios Dimitroulis Nikolaos I Nikiteas Hellenic Minimally Invasive and Robotic Surgery(MIRS)Study Group National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 15bGoudiAthens 11527Greece First Department of Urology National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 17GoudiAthens 11527Greece Second Department of Propaedeutic Surgery National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 17GoudiAthens 11527Greece

Robot-assisted surgery is the gold standard of treatment in many fields of urology. In this systematic review, we aim to reportits usage in andrology and to evaluate any advantages. A systematic search of the PubMed and Cochrane Library databases wasconducted to identify articles referring to robotic-assisted microsurgery in andrology. The search strategy was in line with thePreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook. Thearticles were then reviewed by two authors. A qualitative analysis of the articles that met the inclusion criteria was ***-one articles that met the inclusion criteria were reviewed. The first results for robot-assisted vasovasostomy (RAVV) areencouraging as excellent patency rates, short operative times, and learning curves were achieved. Interestingly, patency rates weregreater in some case series for RAVV than for microsurgical vasovasostomy, with a statistically significant difference. In addition,robot has been shown to be of great use in bypassing fibrotic changes in cases of iatrogenic vasal injuries, difficulties encounteredwith traditional microsurgery. In addition, the feasibility of robot-assisted microsurgery has been proven for varicocelectomy andmicrosurgical denervation of the spermatic cord, with acceptable improvement in sperm parameters and pain, respectively. Thecurrent evidence suggests that there are potential advantages of the use of robots in andrology. However, for robotic surgery tobecome incorporated into the daily use of the andrologists, large, multicenter randomized trials are needed. As robotics systemsare becoming standard in urology practice, it is reasonable for one to believe that they will also find their place in andrology.

关键词： andrology male infertility robotic surgical procedures varicocele vasovasostomy

Is there sufficient evidence to support the use of antibiotic holiday just before the second stage of an infected total hip or knee arthroplasty revision surgery?

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World Journal of Orthopedics 2024年第5期15卷 483-485页

作者： konstantinos Tsikopoulos konstantinos Sidiropoulos Department of Orthopaedics Portsmouth Hospitals NHS University TrustPortsmouth University HospitalsPortsmouth PO63LYUnited Kingdom Emergency Department Papageorgiou General Hospital of ThessalonikiThessaloniki 54635Greece Medical School University of PatrasPatras 26504Greece

The practice of implementing an antibiotic holiday before the second stage of hip or knee arthroplasty is currently controversial due to limited evidence for this approach,as per the International Consensus Meeting 2018 on Musculoskeletal Infection.A greater understanding of this issue could augment the quality of Alrayes and Sukeik’s mini-review(2023)on diagnosing,managing,and treating periprosthetic knee ***,a significant lack of literature exists concerning the optimal duration for the antibiotic holiday,calling for more research before establishing any clinical guidelines.

关键词： Septic knee prosthesis revision Two stages Antibiotic holiday

Role of sodium-glucose co-transporter-2 inhibitors in the management of nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2019年第28期25卷 3664-3668页

作者： Anastasia Kontana konstantinos Tziomalos First Propedeutic Department of Internal Medicine Medical School Aristotle University of Thessaloniki AHEPA Hospital

Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. NAFLD is considerably more frequent in patients with type 2 diabetes mellitus (T2DM) than in the general population and is also more severe histologically in this group. Sodium-glucose co-transporter-2 (SGLT2) inhibitors, the newest class of antidiabetic agents, appear to represent a promising option for the management of NAFLD in patients with T2DM. In a number of studies, treatment with SGLT2 inhibitors resulted in a reduction in hepatic steatosis and in transaminase levels. However, existing studies are small, their follow-up period was short and none evaluated the effects of SGLT2 inhibitors on liver histology. Accordingly, larger studies are needed to verify these preliminary results and define the role of SGLT2 inhibitors in the treatment of NAFLD in patients with T2DM.

关键词： Nonalcoholic fatty liver disease Type 2 diabetes mellitus Sodium-glucose co-transporter-2 inhibitors Steatosis Fibrosis Transaminases

Unusual site of recurrent musculoskeletal hydatid cyst: Case report and brief review of the literature

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World Journal of Gastroenterology 2006年第34期12卷 5577-5578页

作者： Panagiotis G Drimousis konstantinos M Stamou Athanasios Koutras Dimitrios konstantinos Tsekouras George Zografos 1~(st) Department of Propeudeutic Surgery Hippocrateion Hospital Athens Medical School Athens 11527 Greece

A case of a large multiplex recurrent hydatid cyst involving the left gluteal muscle and the left iliopsoas, accompanied with degeneration of the musculature of the left upper leg is presented along with a review of the relevant literature. Very few such cases have been reported worldwide. The presented case is also distinguished by the involvement of muscles of distant anatomic areas.

关键词： Echinococcosis Hydatid disease Musculoskeletal hydatid

Comment on “Disease exacerbation is common in inflammatory bowel disease patients treated with immune checkpoint inhibitors for malignancy”

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World Journal of Clinical Cases 2022年第23期10卷 8425-8427页

作者： konstantinos Argyriou Athanasios Kotsakis Department of Gastroenterology University Hospital of LarisaLarisa GR41334Greece Department of Medical Oncology School of MedicineUniversity Hospital of LarisaLarisa GR41334Greece

We recently read with interest the original research article entitled"Disease exacerbation is common in inflammatory bowel disease patients treated with immune checkpoint inhibitors for malignancy".The abovementioned article is an observational retrospective cohort study,which could be of particular value for clinicians to understand how immunotherapy affects pre-existing enteral disease in inflammatory bowel disease *** we appreciate the endeavor of Samuel Rubin et al,based on our in-depth analysis,we detected a potential shortcoming in this article;thus,we present our comments in this *** the authors contemplate these comments on their relevant research,we believe that their contribution would be considerable for future studies.

关键词： Inflammatory bowel disease Immune-related adverse events Immune checkpoint inhibitors Immunotherapy Malignancy

Growth performance, nutrient digestibility, antioxidant capacity,blood biochemical biomarkers and cytokines expression in broiler chickens fed different phytogenic levels

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Animal Nutrition 2017年第2期3卷 114-120页

作者： Vasileios Paraskeuas konstantinos Fegeros Irida Palamidi Christine Hunger konstantinos C.Mountzouris Department of Nutritional Physiology and Feeding.Agricultural University of Athens BIOMIN Holding GmbH

The effects of inclusion levels of a phytogenic feed additive(PFA), characterized by menthol anethol and eugenol, on broiler growth performance, nutrient digestibility, biochemical biomarkers and total antioxidant capacity(TAC) of plasma and meat, as well as on the relative expression of selected cytokines,were studied in a 42-d experiment. A total of 225 one-day-old male Cobb broiler chickens were assigned into 3 treatments, with 5 replicates of 15 chickens each. Chickens were fed maize-soybean meal basal diets following a 3 phase(i.e., starter, grower and finisher) feeding program. Depending on PFA inclusion level, treatments were: no PFA(PFA-0), PFA at 100 mg/kg(PFA-100) and PFA at 150 mg/kg(PFA-150).Feed and water were available ad libitum. Feed conversion ratio(FCR) during finisher phase was improved quadratically(P < 0.05) with increasing PFA level. Overall, increasing PFA level increased body weight gain(BWG) in a linear(P < 0.05) and quadratic(P < 0.05) manner with treatments PFA-100 and PFA-150 being greater(P < 0.05) compared with PFA-0. Total tract apparent digestibility of dry matter increased linearly(P < 0.05) and quadratically(P < 0.05) with increasing PFA level. The apparent metabolizable energy corrected for nitrogen(AMEn) also increased linearly(P < 0.05). Increasing PFA level resulted in a linear(P < 0.05) increase in blood plasma TAC. Expression of pro-inflammatory cytokine interleukin-18(IL-18) was reduced linearly(P < 0.05) in spleen with increasing PFA level. In conclusion, PFA inclusion at 100 mg/kg diet positively influenced performance, whereas PFA inclusion at150 mg/kg resulted in a stronger improvement in AMEn and plasma TAC. Finally, PFA inclusion resulted in a pattern of reduced pro-inflammatory biomarker IL-18 at spleen. Overall, this study provides evidence for the beneficial role of PFA as a natural growth and health promoter in broiler chickens that needs to be further confirmed in field studies.

关键词： Chicken Phytogenic Antioxidant Menthol Anethol Eugenol

Role of cenicriviroc in the management of nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2018年第48期24卷 5415-5417页

作者： Georgios Neokosmidis konstantinos Tziomalos First Propedeutic Department of Internal Medicine Medical SchoolAristotle University of ThessalonikiAHEPA Hospital

Nonalcoholic fatty liver disease(NAFLD) is the commonest chronic liver disease in high-income countries and is associated with increased morbidity and mortality. Macrophages appear to play an important role in the development and progression of hepatic fibrosis in patients with NAFLD. Accordingly, modulation of macrophage trafficking might represent an attractive therapeutic strategy in this population. Cenicriviroc is an oral inhibitor of the chemokine ligand 2/C-C chemokine receptor 2 pathway, which plays an important role in the hepatic recruitment of the macrophages. Preclinical studies and a phase 2b study in humans suggest that this agent might hold promise in the management of NAFLD.

关键词： Cenicriviroc Macrophages Nonalcoholic fatty liver disease Fibrosis Nonalcoholic steatohepatitis

Sequence-discrete species for prokaryotes and other microbes:A historical perspective and pending issues

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mLife 2023年第4期2卷 341-349页

作者： konstantinos T.Konstantinidis School of Civil and Environmental Engineering and School of Biological SciencesGeorgia Institute of TechnologyAtlantaGeorgiaUSA

Whether prokaryotes,and other microorganisms,form distinct clusters that can be recognized as species remains an issue of paramount theoretical as well as practical consequence in identifying,regulating,and communicating about these *** the past decade,comparisons of thousands of genomes of isolates and hundreds of metagenomes have shown that prokaryotic diversity may be predominantly organized in such sequence-discrete clusters,albeit organisms of intermediate relatedness between the identified clusters are also frequently *** evidence suggests,however,that the latter“intermediate”organisms show enough ecological and/or functional distinctiveness to be considered different ***,the area of discontinuity between clusters often—but not always—appears to be around 85%–95%genome-average nucleotide identity,consistently among different *** recent studies have revealed remarkably similar diversity patterns for viruses and microbial eukaryotes as *** high consistency across taxa implies a specific mechanistic process that underlies the maintenance of the *** underlying mechanism may be a substantial reduction in the efficiency of homologous recombination,which mediates(successful)horizontal gene transfer,around 95%nucleotide *** from the 95%threshold(e.g.,species showing lower intraspecies diversity)may be caused by ecological differentiation that imposes barriers to otherwise frequent gene *** this hypothesis that clusters are driven by ecological differentiation coupled to recombination frequency(i.e.,higher recombination within *** groups)is appealing,the supporting evidence remains *** data needed to rigorously test the hypothesis toward advancing the species concept are also outlined.

关键词： average nucleotide identity(ANI) genomovar homologous recombination metagenomics strain