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Receptor activator of nuclear factorκB ligand/osteoprotegerin axis and vascular calcifications in patients with chronic kidney disease

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World Journal of Nephrology 2016年第1期5卷 1-5页

作者： Michalis spartalis Aikaterini Papagianni Department of Nephrology Aristotle University of Thessaloniki"Hippokration"General Hospital54642 ThessalonikiGreece

Vascular calcifications are commonly observed in patients with chronic kidney disease （CKD） and contri-bute to the excessive cardiovascular morbidity and mortality rates observed in these patients populations. Although the pathogenetic mechanisms are not yet fully elucidated, recent evidence suggests a link between bone metabolism and the development and progression of vascular calcifications. Moreover, accumulating data indicate that receptor activator of nuclear factor κB ligand/osteoprotegerin axis which plays essential roles in the regulation of bone metabolism is also involved in extra-osseous bone formation. Further studies are required to establish the prognostic significance of the above biomarkers as predictors of the presence and severity of vascular calcifications in CKD patients and of cardiovascular morbidity and mortality. Moreover, randomized clinical trials are needed to clarify whether inhibition of osteoclast activity will protect from vascular calcifcations.

关键词： Arterial stiffness Bone turnover Chronic kidney disease Osteoprotegerin RANK ligand Receptor activator nuclear factor κB Vascular calcifcations

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Acute esophageal necrosis: A systematic review and pooled analysis

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World Journal of Gastrointestinal Surgery 2020年第3期12卷 104-115页

作者： Dimitrios Schizas Nikoletta A Theochari Konstantinos S Mylonas Prodromos Kanavidis Eleftherios spartalis Stamatina Triantafyllou Konstantinos P Economopoulos Dimitrios Theodorou Theodore Liakakos First Department of Surgery National and Kapodistrian University of AthensLaikon General HospitalAthens 11527Greece Department of Medicine Surgery Working GroupSociety of Junior DoctorsAthens 15122Greece Laboratory of Experimental Surgery and Surgical Research N.S.Christeas National and Kapodistrian University of AthensAthens 11527Greece First Propedeutic Department of Surgery National and Kapodistrian University of AthensHippocration General HospitalAthens 11527Greece Department of Surgery Duke University Medical CenterDurhamNC 27708United States

BACKGROUND Acute esophageal necrosis(AEN)is a rare entity with multifactorial etiology,usually presenting with signs of upper gastrointestinal *** To systematically review all available data on demographics,clinical features,outcomes and management of this medical *** A systematic literature search was performed with respect to the PRISMA statement(end-of-search date:October 24,2018).Data on the study design,interventions,participants and outcomes were extracted by two independent *** Seventy-nine studies were included in this ***,114 patients with AEN were identified,of whom 83 were males and 31 *** patient age was 62.1±*** most common presenting symptoms were melena,hematemesis or other manifestations of gastric bleeding(85%).The lower esophagus was most commonly involved(92.9%).The most widely implemented treatment modality was conservative treatment(75.4%),while surgical or endoscopic intervention was required in 24.6%of the *** overall followup was 66.2±101.8 *** 29.9%of patients died either during the initial hospital stay or during the follow-up *** symptoms on presentation[Odds ratio 3.50(1.09-11.30),P=0.03]and need for surgical or endoscopic treatment[surgical:Odds ratio 1.25(1.03-1.51),P=0.02;endoscopic:Odds ratio 1.4(1.17-1.66),P<0.01]were associated with increased odds of complications.A sub-analysis separating early versus late cases(after 2006)revealed a significantly increased frequency of surgical or endoscopic intervention(9.7%vs 30.1%respectively,P=0.04)CONCLUSION AEN is a rare condition with controversial pathogenesis and unclear optimal *** the frequency of surgical and endoscopic intervention has increased in recent years,outcomes have remained the ***,further research work is needed to better understand how to best treat this potentially lethal disease.

关键词： Acute esophageal necrosis Black esophagus Acute necrotizing esophagitis

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From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world

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World Journal of Gastroenterology 2017年第29期23卷 5282-5294页

作者： Dimitrios Dimitroulis Christos Damaskos Serena Valsami Spyridon Davakis Nikolaos Garmpis Eleftherios spartalis Antonios Athanasiou Demetrios Moris Stratigoula Sakellariou Stylianos Kykalos Gerasimos Tsourouflis Anna Garmpi Ioanna Delladetsima Konstantinos Kontzoglou Gregory Kouraklis Second Department of Propedeutic Surgery Laiko General Hospital Medical School National and Kapodistrian University of Athens Blood Transfusion Department Aretaieion Hospital Medical School National and Kapodistrian Athens University First Department of Surgery Laiko General Hospital Medical School National and Kapodistrian University of Athens N.S. Christeas Laboratory of Experimental Surgery and Surgical Research Medical School National and Kapodistrian University of Athens Department of Surgery Mercy University Hospital Lerner Research Institute Cleveland Clinic Foundation First Department of Pathology Medical School National and Kapodistrian University of Athens Internal Medicine Department Laiko General Hospital University of Athens Medical School

Hepatocellular carcinoma(HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer Staging System remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma.

关键词： Hepatocellular Cancer Epidemiology Treatment Diagnosis Staging Transplantation

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Comparison of cosmetic outcomes between remote-access and conventional thyroidectomy:A review of the current literature

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第1期9卷 1-8页

作者： Anna Kasouli Eleftherios spartalis Alexios Giannakodimos Gerasimos Tsourouflis Dimitrios Dimitroulis Nikolaos I.Nikiteas Hellenic Minimally Invasive and Robotic Surgery(MIRS)Study Group Medical School AthensNational and Kapodistrian University of AthensAthensGreece 2nd Department of Propaedeutic Surgery Medical SchoolNational and Kapodistrian University of AthensAthensGreece

Objective:The pursuit of an esthetically pleasing scar following open thyroid surgery has led to the development of endoscopic thyroidectomy through remote incisions placed in several locations outside the *** objective of this study is to review the recent literature and compare the incision site appearance and patient satisfaction with the cosmetic outcome after extracervical and conventional ***:The English literature published since 2010 was searched through the PubMed/Medline database for studies comparing the cosmetic outcomes between remote-access endoscopic and conventional thyroidectomy using a form of scar assessment ***:A total of 9 relevant papers fulfilled the eligibility criteria including 1486 *** them,595 patients underwent endoscopic thyroidectomy through several remote-access approaches and 891 patients were assigned to the conventional *** one randomized-controlled trial was identified,whereas among the rest,four were prospective and four were retrospective nonrandomized *** the extracervical modifications performed in the endoscopic groups,the axillary approach was performed in three studies and the breast approach in four studies,while the retroauricular facelift technique and the transoral vestibular method were applied in one study,***:Evaluation of the wound appearance and patient satisfaction with the cosmetic outcome at various time points during the follow-up highlighted the superiority of the extracervical approaches over the conventional *** these findings,remote-access techniques could possibly be the ideal surgical method for patients with high esthetic requirements,providing an excellent appearance of the thoroughly exposed neck.

关键词： esthetic cosmesis cosmetic cosmetic results incision scar thyroidectomy

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