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Acute upper gastrointestinal bleeding in patients on long-term oral anticoagulation therapy: Endoscopic findings, clinical management and outcome

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World Journal of Gastroenterology 2005年第9期11卷 1365-1368页

作者： konstantinos C Thomopoulos konstantinos P Mimidis George J Theocharis Anthie G Gatopoulou Georgios N Kartalis Vassiliki N Nikolopoulou Department of Internal Medicine the First Department of Internal Medicine

AIM: Acute gastrointestinal bleeding is a severe complication in patients receiving long-term oral anticoagulant therapy. The purpose of this study was to describe the causes and clinical outcome of these patients. METHODS: From January 1999 to October 2003, 111 patients with acute upper gastrointestinal bleeding (AUGIB) were hospitalized while on oral anticoagulants. The causes and clinical outcome of these patients were compared with those of 604 patients hospitalized during 2000-2001 with AUGIB who were not taking warfarin. RESULTS: The most common cause of bleeding was peptic ulcer in 51 patients (45%) receiving anticoagulants compared to 359/604 (59.4%) patients not receiving warfarin (P<0.05). No identifiable source of bleeding could be found in 33 patients (29.7%) compared to 31/604 (5.1%) patients not receiving anticoagulants (P=0.0001). The majority of patients with concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) (26/35, 74.3%) had a peptic ulcer as a cause of bleeding while 32/76 (40.8%) patients not taking a great dose of NSAIDs had a negative upper and lower gastrointestinal endoscopy. Endoscopic hemostasis was applied and no complication was reported. Six patients (5.4%) were operated due to continuing or recurrent hemorrhage, compared to 23/604 (3.8%) patients not receiving anticoagulants. Four patients died, the overall mortality was 3.6% in patients with AUGIB due to anticoagulants, which was not different from that in patients not receiving anticoagulant therapy. CONCLUSION: Patients with AUGIB while on long-term anticoagulant therapy had a clinical outcome, which is not different from that of patients not taking anticoagulants. Early endoscopy is important for the management of these patients and endoscopic hemostasis can be safely applied.

关键词： AUGIB Anticoagulant therapy Endoscopy

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Multipotent role of platelets in inflammatory bowel diseases:A clinical approach

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World Journal of Gastroenterology 2014年第12期20卷 3180-3190页

作者： Evangelos Voudoukis konstantinos Karmiris Ioannis E Koutroubakis Department of Gastroenterology Venizelion General Hospital Department of Gastroenterology University Hospital Heraklion

There is evidence that inflammatory bowel diseases (IBD) combine both inflammation and coagulation in their pathogenesis and clinical manifestations. Although platelets (PLT) are well known for their role in hemostasis, there are a rising number of studies supporting their considerable role as inflammatory amplifiers in chronic inflammatory conditions. IBD are associated with several alterations of PLT, including number, shape, and function, and these abnormalities are mainly attributed to the highly activated state of circulating PLT in IBD patients. When PLT activate, they increase in size, release a great variety of bio-active inflammatory and procoagulant molecules/particles, and express a variety of inflammatory receptors. These inflammatory products may represent a part of the missing link between coagulation and inflammation, and can be considered as possible IBD pathogenesis instigators. In clinical practice, thrombocytosis is associated both with disease activity and iron deficiency anemia. Controlling inflammation and iron replacement in anemic patients usually leads to a normalization of PLT count. The aim of this review is to update the role of PLT in IBD and present recent data revealing the possible therapeutic implications of anti-PLT agents in future IBD remedies.

关键词： Anemia, Crohn’ s disease, Platelets, Thrombocytosis, Ulcerative colitis

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Efficacy and safety of anti-hepatic fibrosis drugs

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World Journal of Gastroenterology 2020年第41期26卷 6304-6321页

作者： konstantinos Damiris Zaid H Tafesh Nikolaos Pyrsopoulos Department of Medicine Rutgers-New Jersey Medical SchoolNewarkNJ 07103United States Medicine-Gastroenterology and Hepatology Rutgers-New Jersey Medical SchoolNewarkNJ 07103United States

Recent progress in our understanding of the pathways linked to progression from hepatic insult to cirrhosis has led to numerous novel therapies being investigated as potential cures and inhibitors of hepatic fibrogenesis. Liver cirrhosis is the final result of prolonged fibrosis, which is an intimate balance between fibrogenesis and fibrinolysis. A number of these complex mechanisms are shared across the various etiologies of liver disease. Thankfully, investigation has yielded some promising results in regard to reversal of fibrosis, particularly the indirect benefits associated with antiviral therapy for the treatment of hepatitis B and C and the farnesoid receptor agonist for the treatment of primary biliary cholangitis and metabolic associated fatty liver disease. A majority of current clinical research is focused on targeting metabolic associated fatty liver disease and its progression to metabolic steatohepatitis and ultimately cirrhosis, with some hope of potential standardized therapeutics in the near future. With our ever-evolving understanding of the underlying pathophysiology, these therapeutics focus on either controlling the primary disease(the initial trigger of fibrogenesis), interrupting receptor ligand interactions and other intracellular communications, inhibiting fibrogenesis, or even promoting resolution of fibrosis. It is imperative to thoroughly test these potential therapies with the rigorous standards of clinical therapeutic trials in order to ensure the highest standards of patient safety. In this article we will briefly review the key pathophysiological pathways that lead to liver fibrosis and present current clinical and experimental evidence that has shown reversibility of liver fibrosis and cirrhosis, while commenting on therapeutic safety.

关键词： Liver Fibrosis Cirrhosis Antifibrotic Pharmacotherapy Clinical trial Safety

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Patterns of morphometric variation in the alpine newt (Mesotriton alpestris) at the southern limit of its distribution: environmental correlates

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Integrative Zoology 2008年第2期3卷 123-133页

作者： konstantinos SOTIROPOULOS Anastasios LEGAKIS Rosa Maria POLYMENI Section of Zoology-Marine Biology Zoological Museum Department of BiologyUniversity of AthensAthensGreece

We applied multivariate analyses to an array of body measures of alpine newt specimens derived from 11 localpopulations in Greece to describe, analyse and detect patterns and putative causes of within-population andamong-population morphometric variation. The observed morphometric variation was partitioned into several independentlyvarying aspects of the external phenotype, frequently following variation patterns in different environmentalfactors. The size and features of the aquatic habitat were found to affect body size, while altitude was foundto affect head-shape variation in both sexes. At the intra-population level, variation in generalized body size andshape was found to be significantly lower when competitive newt species were present in the habitat, indicatingstabilizing selection towards a decrease in inter-specific competition. No clear discrimination on body size andshape proportions was detected between the two genetic lineages examined, implying ecogenetic or environmentallyinduced variation rather than phylogeny.

关键词： body size/shape environment Greece Mesotriton alpestris morphometrics

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Catheter ablation of atrial fibrillation in the elderly

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Journal of Geriatric Cardiology 2014年第4期11卷 291-295页

作者： Louiza Lioni konstantinos P. Letsas Michael Efremidis konstantinos Vlachos Georgios Giannopoulos Vasileios Kareliotis Spyridon Deftereos Antonios Sideris Second Department of Cardiology Laboratory of Cardiac Electrophysiology Evangelismos General Hospital of Athens Athens 10676 Greece Department of Cardiology 'G. Gennimatas ' General Hospital of Athens Greece

Background Atrial fibrillation （AF） catheter ablation has emerged as a promising treatment strategy for AF, but has not been widely adopted in the elderly population. The present study aimed to determine the safety and efficacy of AF catheter ablation in the elderly popula-tion. Methods and Results The study population consisted of 316 patients with paroxysmal AF who underwent left atrial ablation. Ninety-five patients were≥65 years （48 males, mean age 68.9 ± 3.0 years old） and 221 patients were〈65 years old （130 males, mean age 52.5 ± 10.4 years old）. After a mean follow-up period of 34.0 ± 15.1 months, 55 （57.9%） patients in the elderly group were free from ar-rhythmia recurrence compared with 149 （67.4%） patients in the younger group （P=0.169）. Procedural complications were uncommon in both study groups. In logistic regression analysis, left atrial diameter （P=0.003）, hypertension （P=0.001）, dyslipidemia （P=0.039）, and coronary artery disease （P=0.018） were independent predictors of AF recurrence in the elderly population. Conclusions Catheter ablation of AF is safe and effective in older patients. Invasive strategies should be considered as an alternative choice in symptomatic elderly patients with AF.

关键词： Ablation Atrial fibrillation The elderly

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Role of genetics in the diagnosis and prognosis of Crohn's disease

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World Journal of Gastroenterology 2012年第2期18卷 105-118页

作者： Epameinondas V Tsianos konstantinos H Katsanos Vasileios E Tsianos 1st Division of Internal Medicine and Hepato-Gastroenterology Unit Department of MedicineMedical SchoolUniversity of IoanninaLeoforos Stavrou NiarxouPO Box 118645110 IoanninaGreece

Considering epidemiological,genetic and immunological data,we can conclude that the inflammatory bowel diseases are heterogeneous disorders of multifactorial etiology in which hereditability and environment interact to produce the *** is probable that patients have a genetic predisposition for the development of the disease coupled with disturbances in *** genes have been so far related to the diagnosis of Crohn's *** genes are related to innate pattern recognition receptors,to epithelial barrier homeostasis and maintenance of epithelial barrier integrity,to autophagy and to lymphocyte *** far,the most strong and replicated associations with Crohn's disease have been done with NOD2,IL23R and ATG16L1 *** genes have so far been implicated in prognosis of Crohn's disease and many attempts have been made to classify genetic profiles in Crohn's ***15 seems not only a susceptibility gene,but also a disease-modifier gene for Crohn's *** our understanding on Crohn's disease genetics is important but when combining genetic data with functional data the outcome could be of major importance to clinicians.

关键词： Crohn's Genetics Polymorphism Diagnosis Prognosis Genome wide scan Genetic consortium

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Can periprosthetic hip joint infections be successfully managed by debridement and prosthesis retention?

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World Journal of Orthopedics 2014年第3期5卷 218-224页

作者： konstantinos Anagnostakos Cornelia Schmitt Klinik für Orthop?die und orthop?dische Chirurgie Universit?tsklinikum des SaarlandesD-66421 Homburg/SaarGermany

To evaluate the current literature about how successfully periprosthetic hip joint infections can be managed by debridement and prosthesis retention.A literature search was performed through Pub Med until September *** terms were"DAIR(debridement,antibiotics,irrigation,and retention)"alone and in combination with"hip"as well as"hip infection+prosthesis retention".A total of 11 studies reporting on 292 cases could be *** different treatment modalities have been described with varying success rates(debridement-21%infection eradication rate;debridement+lavage-75%infection eradication rate;debridement,lavage,with change of modular prosthesis components-70.4%infection eradication rate;debridement,lavage,change of modular prosthesis components+vacuum-assisted closure-92.8%infection eradication rate;acetabular cup removal+spacer head onto retained stem-89.6%infection eradication rate).With regard to the postoperative antibiotic therapy,no general consensus could be drawn from the available ***,antibiotic therapy,irrigation,and prosthesis retention is an acceptable solution in the management of early and acute hematogenous periprosthetic hip joint *** current literature does not allow for generalization of conclusions with regard to thebest treatment modality.A large,multi-center study is required for identification of the optimal treatment of these infections.

关键词： Hip joint infection Prosthesis retention Debridement Hip revision Antibiotic therapy Irrigation

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The explosion in cryptocurrencies:a black hole analogy

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Financial Innovation 2021年第1期7卷 185-192页

作者： Antonis Ballis konstantinos Drakos Department of Accounting and Finance School of BusinessAthens University of Economics and Business76 Patission Street10434 AthensGreece

Using an analogy between finance and astrophysics,this study aims to investigate whether there exists a mechanism that can describe the explosive increase in the number of traded cryptocurrencies and the cryptocurrency market in *** physics,the Schwarzschild radius indicates that black holes are constantly expanding because of their mass *** this analogy,we consider the cryptocurrency market as a self-gravitational body whose mass is denoted by(1)the number of traded cryptocurrencies and(2)in terms of increasing market capitalization for a given number of traded *** analyzing weekly snapshot data of all traded cryptocurrencies from January 4,2009,to June 14,2020,we find evidence that the above-mentioned mechanism *** results clearly indicate the self-gravitational property of the cryptocurrency market,which is direct evidence toward the hypothesis that the changes in the traded cryptocurrencies are a positive function of the previous period’s number of traded cryptocurrencies.

关键词： Bitcoin Cryptocurrencies Econophysics Negative specific heat Thermodynamic disequilibrium

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Successful lifestyle modifications may underlie umbilical cordmesenchymal stromal cell effects in type 2 diabetes mellitus

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World Journal of Diabetes 2023年第3期14卷 347-351页

作者： Alexandra Papadopoulou konstantinos I Papadopoulos Occupational and Environmental Health Services Feelgood LundLund 22363SkåneSweden Department of Research and Development THAI StemLife Co.Ltd.Bangkok 10310BangkokThailand

Type 2 diabetes mellitus(T2DM)is a lifelong condition and a grave threat to human *** efforts to relieve its detrimental effects are acutely *** sine qua non in T2DM management is consistent adherence to a prudent lifestyle and nutrition,combined with aerobic and resistance exercise regimens,together repeatedly shown to lead to complete reversal and even longterm ***-adherence to the above lifestyle adjustments condemns any treatment effort and ultimately the patient to a grim *** is thus imperative that every study evaluating the effects of innovative interventions in T2DM objectively compares the novel treatment modality to lifestyle modifications,preferably through double-blind controlled randomization,before claiming efficacy.

关键词： Type 1 diabetes mellitus Type 2 diabetes mellitus Human umbilical cord mesenchymal stem cells Diabetes remission Diabetes reversal Lifestyle modifications

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Comparing traveler preferences for BRT and LRT systems in developing countries:Evidence from Multan,Pakistan

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Journal of Traffic and Transportation Engineering(English Edition) 2020年第3期7卷 384-393页

作者： konstantinos Kepaptsoglou Christina Milioti Dimitra Spyropoulou Farhan Haider Aristeidis GKarlaftis School of Rural &Surveying Engineering National Technical University of AthensZografou 15780Greece Department of Transportation Engineering and Management University of Engineering and TechnologyLahorePakistan Senior Transportation Engineering Expert AthensGreece

Rapid transit(RT)systems are becoming increasingly attractive in the developing world as they improve transportation and mobility conditions in urban areas,reduce motorization impacts and offer high quality,yet cost effective services to *** rail transit(LRT)and bus rapid transit(BRT)are RT systems that combine high capacity with relatively low investment costs,and as such,they are preferred in developing countries over regular metro *** paper investigates traveler preferences over alternative,planned rapid transit options for the city of Multan,*** analysis is based on a household information survey with over 2300 questionnaires completed via personal *** to pay for improved PT services and choice between LRT and BRT systems are investigated,using appropriate econometric *** of this study can assist in better understanding the factors and their effect on choice between BRT and LRT in developing *** show that potential travelers,who prefer LRT are willing to pay more for better public transport *** the other hand,commuters and elders express a taste towards BRT *** on model outputs policy makers can develop targeted marketing policies in order to promote BRT/LRT implementation andattract candidate travelers from different groups,improving the possibility that users would support a BRT or LRT project.

关键词： Transportation engineering LRT BRT Binary logit model Traveler preferences

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