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

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

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COVID-19 and the heart

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World Journal of Clinical Cases 2022年第28期10卷 9970-9984页

作者： Andrew Xanthopoulos Angeliki Bourazana Grigorios Giamouzis Evangelia Skoularigki Apostolos Dimos Alexandros Zagouras michail papamichalis Ioannis Leventis Dimitrios E Magouliotis Filippos Triposkiadis John Skoularigis Department of Cardiology University Hospital of LarissaLarissa 41110Greece Department of Cardiothoracic Surgery University of ThessalyLarissa BiopolisLarissa 41110Greece

An outbreak of coronavirus disease 2019(COVID-19) occurred in December 2019 due to severe acute respiratory syndrome coronavirus 2(SARS-Co V-2),which is a strain of SARS-Co *** infected with the virus present a wide spectrum of manifestations ranging from mild flu-like symptoms,cough,fever and fatigue to severe lung injury,appearing as bilateral interstitial pneumonia or acute respiratory *** SARS-Co V-2 infection predominantly offends the respiratory system,it has been associated with several cardiovascular complications as *** example,patients with COVID-19 may either develop type 2 myocardial infarction due to myocardial oxygen demand and supply imbalance or acute coronary syndrome resulting from excessive inflammatory response to the primary *** incidence of COVID-19 related myocarditis is estimated to be accountable for an average of 7% of all COVID-19 related fatal cases,whereas heart failure(HF) may develop due to infiltration of the heart by inflammatory cells,destructive action of pro-inflammatory cytokines,micro-thrombosis and new onset or aggravated endothelial and respiratory ***,SARSCo V-2 can engender arrhythmias through direct myocardial damage causing acute myocarditis or through HF decompensation or secondary,through respiratory failure or severe res-piratory distress *** this comprehensive review we summarize the COVID-19 related cardiovascular complications(acute coronary syndromes,myocarditis,HF,arrhythmias) and discuss the main underlying pathophysiological mechanisms.

关键词： COVID-19 Virus Complications Cardiac Acute coronary syndromes Heart failure Myocarditis Arrhythmias

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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

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Patent hemostasis of radial artery:Comparison of two methods

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World Journal of Cardiology 2021年第10期13卷 574-584页

作者： Vassileios Kyriakopoulos Andrew Xanthopoulos michail papamichalis Spyridon Skoularigkis Chara Tzavara Emmanouil Papadakis Sotirios Patsilinakos Filippos Triposkiadis John Skoularigis Department of Cardiology Konstantopoulio General HospitalAthens 14233Greece Department of Cardiology University Hospital of LarissaLarissa 41110Greece Department of Health Medical SchoolUniversity of AthensAthens 11527Greece

BACKGROUND Radial artery obstruction is the most common complication of coronary angiography performed via transradial *** hemostasis can significantly reduce the risk of radial artery *** studies utilized sophisticated methods to evaluate radial artery *** and easily applicable methods for successful patent hemostasis are currently *** To determine which method(pulse oximeter vs the traditional radial artery palpation)is better to achieve patent *** This prospective,single center study included 299 consecutive patients who underwent coronary angiography or percutaneous coronary intervention between November 2017 and July *** less than 18 years old,with a history of radial artery disease,or no palpable artery pulse were excluded from the *** were randomly assigned to two *** the first group,radial artery flow was assessed by palpation of the artery during hemostasis(traditional method).In the second group,radial artery patency was estimated with the use of a pulse *** different compression devices were used for hemostasis(air chamber and pressure valve).The primary study endpoint was the achievement of successful patent *** The two groups(pulse oximeter vs artery palpation)had no significant differences in age,sex,body mass index,risk factors,or comorbidities except for supraventricular *** percentage of patients with successful patent hemostasis was significantly higher in the pulse oximeter group(82.2%vs 68.1%,P=0.005).A lower percentage of patients with spasm was recorded in the pulse oximeter group(9.9%vs 19.0%,P=0.024).The incidence of local complications,edema,bleeding,hematoma,vagotonia,or pain did not differ between the two *** the multivariate analysis,the use of a pulse oximeter(OR:2.35,95%CI:1.34-4.13,P=0.003)and advanced age(OR:1.04,95%CI:1.01-1.07,P=0.006),were independently associated with an increased probability of succe

关键词： Radial access Patent hemostasis Palpation Oximeter Coronary angiography Radial artery occlusion

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Red blood cell distribution width in elderly hospitalized patients with cardiovascular disease

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World Journal of Cardiology 2021年第9期13卷 503-513页

作者： Andrew Xanthopoulos Konstantinos Tryposkiadis Apostolos Dimos Angeliki Bourazana Alexandros Zagouras Nikolaos Iakovis michail papamichalis Grigorios Giamouzis George Vassilopoulos John Skoularigis Filippos Triposkiadis Department of Cardiology University Hospital of LarissaLarissa 41110Greece Independent Biostatistician Athens 15669Greece Department of Haematology University of Thessaly Medical SchoolLarissa 41110Greece

BACKGROUND Red blood cell distribution width(RDW)is elevated in patients with cardiovascular disease(CVD).AIM To determine RDW values and impact of CV and non-CV coexisting morbidities in elderly patients hospitalized with chronic *** This prospective study included 204 consecutive elderly patients(age 77.5[7.41]years,female 94[46%],left ventricular ejection fraction 53.00%[37.50,55.00])hospitalized with chronic CVD at the Cardiology Department of Larissa University General Hospital(Larissa,Greece)from January 2019 to April *** patients were selected due to the high prevalence of coexisting morbidities in this patient *** patients with acute CVD(acute coronary syndromes,new-onset heart failure[HF],and acute pericarditis/myocarditis),primary isolated valvular heart disease,sepsis,and those with a history of blood transfusions or cancer were *** evaluation of the patients within 24 h from admission included clinical examination,laboratory blood tests,and *** The most common cardiac morbidities were hypertension and coronary artery disease,with acutely decompensated chronic heart failure(ADCHF)and atrial fibrillation(AF)also frequently being *** most common non-cardiac morbidities were anemia and chronic kidney disease followed by diabetes mellitus,chronic obstructive pulmonary disease,and sleep *** was significantly elevated 15.48(2.15);121(59.3%)of patients had RDW>14.5%which represents the upper limit of normal in our *** associated with RDW in stepwise regression analysis were ADCHF(coefficient:1.406;95%confidence interval[CI]:0.830-1.981;P<0.001),AF(1.192;0.673 to 1.711;P<0.001),and anemia(0.806;0.256 to 1.355;P=0.004).ADCHF was the most significant factor associated with *** was on average 1.41 higher for patients with than without ADCHF,1.19 higher for patients with than without AF,and 0.81 higher for patients with than without *** patients were grouped b

关键词： Red blood cell distribution width Elderly Cardiovascular disease Coexisting morbidities

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