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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

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

Simple hematological predictors of AF recurrence in patients undergoing atrial fibrillation ablation

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Journal of Geriatric Cardiology 2019年第9期16卷 671-675页

作者： George Bazoukis konstantinos P Letsas konstantinos vlachos Athanasios Saplaouras Dimitrios Asvestas konstantinos Tyrovolas Aikaterini Rokiza Eirini Pagkalidou Gary Tse Stavros Stavrakis Antonios Sideris Michael Efremidis Department of Cardiology Electrophysiology Laboratory Evangelismos General Hospital of Athens Athens Greece Department of Hygiene and Epidemiology School of Medicine Aristotle University of Thessaloniki Thessaloniki Greece Department of Medicine and Therapeutics Faculty of Medicine Chinese University of Hong Kong Hong Kong China Li Ka Shing Institute of Health Sciences Faculty of Medicine Chinese University of Hong Kong Hong Kong SAR China Department of Medicine Cardiovascular Section Heart Rhythm Institute University of Oklahoma Health Sciences Center Oklahoma City Oklahoma USA

Backgound Red cell distribution width(RDW) and neutrophil-to-lymphocyte ratio(NLR) are simple hematologic indices that have been used to predict adverse outcomes in different clinical settings. The aim of our study is to determine whether RDW and NLR can predict atrial fibrillation(AF) recurrence in patients undergoing AF ablation. Methods Consecutive patients, without known hematological disorders, who underwent AF catheter ablation between January 2014 and April 2017 were enrolled into this study. Blood samples were taken one day before and five hours after the ablation procedure. Results A total of 346 patients(224 males(65%), mean age: 59 ± 11 years old) were included. After a mean follow up of 26.2 ± 12.1 months, 80(23.1%) patients experienced late AF recurrence(defined as any recurrence after the blanking period of three months), while 97(28%) patients experienced early AF recurrence during the blanking period. Univariate analysis showed that early arrhythmia recurrence, type of AF and NLR after the procedure were significantly associated with late AF recurrence, while early arrhythmia recurrence and NLR remained significant in multivariate analysis. RDW was not associated with late AF recurrence. None of the parameters above predicted early arrhythmia recurrence. Conclusions Simple and inexpensive hematological indices such as NLR should be evaluated for their ability to predict AF recurrence in patients undergoing catheter ablation in larger prospective studies.

关键词： Atrial fibrillation Neutrophils Radiofrequency ablation

Headache:An unusual presentation of acute myocardial infraction

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World Journal of Cardiology 2014年第6期6卷 514-516页

作者： Dimitrios Asvestas konstantinos vlachos Anastasios Salachas konstantinos P Letsas Antonios Sideris Second Department of Cardiology Evangelismos General Hospital10676 AthensGreece

Acute myocardial infarction should be diagnosed as early as possible for the appropriate management to salvage ischemic myocardium. Accurate diagnosis is typically based on the typical symptoms of angina. Headache is an unusual symptom in patients with acute myocardial infraction. We report a patient with ST-segment elevation acute myocardial infarction who presented to the emergency department complaining of severe occipital headache without chest discomfort.

关键词： Headache Angina Myocardial infarction

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

Modeling and optimization of non-isothermal convective drying process of Lavandula×allardii

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Information Processing in Agriculture 2024年第1期11卷 1-13页

作者： Vasileios Chasiotis konstantinos-Stefanos Nikas Andronikos Filios Laboratory of Thermo Fluid Systems(LTFS) Department of Mechanical EngineeringUniversity of West AtticaAncient Olive Grove CampusThivon Str.250GR12244 EgaleoGreece

Non-isothermal convective drying schemes were examined for Lavandula×allardii leaves and *** process parameters were optimized using response surface methodology(RSM)to ensure the peak operational *** effects of temperature increase rate(2–4°C/h)and the airflow velocity(1–3 m/s)on the essential oil yield,drying duration and consumption,were investigated.A face-centered central composite design was deployed and the experimental data was adapted to the most suitable polynomial models,as determined by the regression *** of variance was applied to assess the effects of the process variables,their interactions and the statistical significance of the examined *** factors of temperature increase rate and airflow velocity had a significant impact on the drying *** velocity had a greater effect on leaves’essential oil yield and inflorescences’process energy consumption,whereas the rates of temperature increase had a greater influence on the inflorescences’essential oil yield and leaves’energy *** minimum drying duration and energy consumption were obtained for the maximum temperature increasing rate at 3 and 1 m/s airflow velocities respectively;and the highest essential oil yield was obtained for the least rate of temperature increase and airflow velocity for both leaves and *** optimization was performed for minimizing drying duration and energy consumption by maximizing the essential oil *** rate of temperature increases of 4°C/h and the airflow velocity of 1 m/s,were proposed as the optimum non-isothermal drying conditions for both leaves and inflorescences of Lavandula×*** values of essential oil content have been 1.387/3.05 mL/g,4.21/4.18 h drying time and 0.809/0.732 kWh energy consumption at the optimum operation point for leaves and inflorescences,*** resulted optimized non-stationary temperature scheme considerably improved the drying

关键词： Convective drying Non-isothermal drying Lavender Essential oil Process optimization

New perspectives in the management of diabetic nephropathy

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World Journal of Diabetes 2024年第6期15卷 1086-1090页

作者： Anna Psyllaki konstantinos Tziomalos The First Propedeutic Department of Internal Medicine Medical SchoolAristotle University of ThessalonikiAHEPA HospitalThessaloniki 54636Greece

Diabetic nephropathy(DN)is the leading cause of end-stage renal disease and is also associated with increased risk for cardiovascular *** recently,strict glycemic control and blockade of the renin-angiotensin system(RAS)constituted the mainstay of treatment of ***,randomized controlled trials showed that sodium-glucose cotransporter 2 inhibitors further reduce the progression of ***,these agents are recommended in all patients with DN regardless of DN stage and HbA1c ***,additional blockade of the RAS with finerenone,a selective non-steroidal mineralocorticoid receptor antagonist,was also shown to prevent both the decline of renal function and cardiovascular events in this ***,promising preliminary findings suggest that glucagon-like peptide 1 receptor agonists might also exert reno-and cardioprotective effects in patients with ***,this knowledge will improve the outcomes of this high-risk group of patients.

关键词： Diabetes mellitus Diabetic nephropathy Sodium-glucose cotransporter 2 inhibitors Finerenone Glucagon-like peptide 1 receptor agonists Finerenone

Understanding autoimmune pancreatitis: Clinical features, management challenges, and association with malignancies

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World Journal of Gastroenterology 2024年第15期30卷 2091-2095页

作者： Grigorios Christodoulidis Marina Nektaria Kouliou konstantinos Eleftherios Koumarelas Department of General Surgery University Hospital of LarissaUniversity of ThessalyLarissa 41110Greece

In this editorial we comment on the article by Jaber et *** pancreatitis(AIP)represents a distinct form of pancreatitis,categorized into AIP-1 and AIP-2,characterized by obstructive jaundice,lymphoplasmacytic infiltrate,and ***-1,associated with elevated immunoglobulin G4(IgG4)levels,exhibits higher relapse rates,affecting older males,while AIP-2 is less common and linked to inflammatory bowel *** is considered a manifestation of IgG4-related systemic disease,sharing characteristic histological *** are the primary treatment,with emerging biomarkers like interferon alpha and *** poses an increased risk of various malignancies,and the assoc-iation with pancreatic cancer is *** is reserved for severe cases,necessitating careful evaluation due to diagnostic *** patients may have concurrent PanINs but display favorable long-term outcomes compared to pancreatic cancer *** diagnostic assessment,including biopsy and steroid response,is crucial for informed surgical decisions in AIP.

关键词： Autoimmune pancreatitis Immunoglobulin G4-related disease Pancreatic cancer Surgery

Revolutionizing gastric cancer treatment:The potential of immunotherapy

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World Journal of Gastroenterology 2024年第4期30卷 286-289页

作者： Grigorios Christodoulidis konstantinos Eleftherios Koumarelas Marina Nektaria Kouliou Department of General Surgery University Hospital of LarissaLarissa 41110Greece

Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual *** in Eastern Europe and Eastern Asia,risk factors include family medical history,dietary habits,tobacco use,Helicobacter pylori,and Epstein-Barr virus ***,gastric cancer is often diagnosed at an advanced stage,leading to a grim prognosis,with a 5-year overall survival rate below 5%.Surgical intervention,particularly with D2 Lymphadenectomy,is the mainstay for early-stage cases but offers limited *** advanced cases,the National Comprehensive Cancer Network recommends chemotherapy,radiation,and targeted *** immunotherapy presents promise,especially for unresectable or metastatic cases,with strategies like immune checkpoint inhibitors,tumor vaccines,adoptive immunotherapy,and nonspecific *** this Editorial,with regards to the article“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review”,we address the advances in the field of immunotherapy in gastric cancer and its future prospects.

关键词： Immunotherapy Adaptive immunotherapy Tumor vaccines Chimeric antigen receptor therapy Tumor-infiltrating lymphocytes therapy Natural killer therapy Cytokine-induced killer therapy Engineered T cell receptor therapy Immune checkpoint inhibitors