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Vertebral fracture assessment:Current research status and application in patients with kyphoplasty

World Journal of Orthopedics 2015年第9期6卷 680-687页

作者： Efstathios Drampalos Konstantinos Nikolopoulos Christos Baltas Alexia Balanika Antonis Galanos nikolaos papaioannou Spyros Pneumaticos Laboratory for the Research of the Musculoskeletal System (LRMS) Faculty of MedicineUniversity of Athens Center for Hip Surgery Wrightington Hospital C’ Orthopedic Department University of Athens"K.A.T" Hospital

Imaging of the spine is of paramount importance for the recognition of osteoporotic vertebral fractures(VFs), and standard radiography(SR) of the spine is the suggested diagnostic method but is not routinely used because of the cost and radiation exposure considerations. VF assessment(VFA) is an efficient, low radiation method for identifying VFs at the time of bone mineral density(BMD) measurement. Prediction models used to indicate the need for VFA may have little predictive power in subspecialty referral populations such as rheumatologic patients or patients who underwent kyphoplasty. Rheumatologic patients are frequently at increased risk for VFs, and VFA should be performed on an individual basis, also taking in account the guidelines for the general population. Kyphoplasty is a new minimal invasive procedure for the treatment of VFs and is being performed with increasing frequency. Following kyphoplasty, there may be a risk of new VFs in adjacent vertebrae. The assessment and follow-up of patients who underwent kyphoplasty requires repetitive X-ray imaging with the known limitations of SR. Thus, VFA may facilitate the evaluation of VFs in these patients because most of the kyphoplasty patients would fulfill the criteria. In a pilot study, we measured the BMD and performed VFA in 28 patients treated with kyphoplasty. Ratios of anterior to posterior(A/P) and middle to posterior(M/P) height were measured, and Genant's method was used to classify vertebrae accordingly. Intraobserver and interobserver reliability for A/P, M/P and the Genant's method were determined. Only 1 patient did not meet the criteria for VFA. Of the 364 available vertebrae, 295 could be analyzed. Most missing data(concerning 69 vertebrae) occurred in the upper thoracic region. Three of the 69 non-eligible vertebrae were lumbar vertebrae with cement leakage from the kyphoplasty procedure. In our hands, VFA was highly reproducible, demonstrating very good agreement in terms of intraobserver and

关键词： Vertebral fracture assessment Current research Kyphoplasty Guideline

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World Journal of Methodology 2024年第2期14卷 75-87页

作者： Maria papaioannou Evdoxia Vagiana Serafeim-Chrysovalantis Kotoulas Maria Sileli Katerina Manika Alexandros Tsantos nikolaos Kapravelos 1^(st)Intensive Care Unit G Papanikolaou General HospitalExohiThessaloniki 57010Greece 2^(nd)Intensive Care Unit G Papanikolaou General HospitalExohiThessaloniki 57010Greece Intensive Care Unit Hippokration General HospitalThessaloniki 54642Greece Department of Pulmonary Medical SchoolAristotle University of ThessalonikiG.Papanikolaou General HospitalExohiThessaloniki 57010Greece 2^(nd)Department of Internal Medicine General Hospital of Thessaloniki“Ippokration”Thessaloniki 54642Greece

BACKGROUND Tracheostomy is commonly used in intensive care unit(ICU)patients who are expected to be on long-term mechanical ventilation or suffer from emergency upper airway ***,some studies have conflicting findings regarding the optimal technique and its timing and *** To provide evidence of practice,characteristics,and outcome concerning tracheostomy in an ICU of a tertiary care *** This was a retrospective cohort study including adult critical care patients in a single ICU for two consecutive ***’demographic characteristics,severity of illness(APACHE II score),level of consciousness[Glasgow Coma Scale(GCS)],comorbidities,timing and type of tracheostomy procedure performed and outcome were *** defined late as tracheostomy placement after 8 days or no *** Data of 660 patients were analyzed(median age of 60 years),median APACHE II score of 19 and median GCS score of 12 at *** was performed in 115 patients,of whom 63 had early and 52 late *** tracheostomy was mainly executed in case of altered level of consciousness and severe critical illness polyneuromyopathy,however there were no significant statistical results(47.6%vs 36.5%,P=0.23)and(23.8%vs 19.2%,P=0.55)*** the method selected,early surgical tracheostomy(ST)was conducted in patients with maxillofacial injuries(50.0%vs 0.0%,P=0.033),whereas late surgical tracheostomy was selected for patients with goiter(44.4%vs 0.0%P=0.033).Patients with early tracheostomy spent significantly fewer days on mechanical ventilation(15.3±8.5 vs 22.8±9.6,P<0.001)and in ICU in general(18.8±9.1 vs 25.4±11.5,P<0.001).Percutaneous dilatation tracheostomy(PDT)vs ST was preferable in older critical care patients in the case of Central Nervous System underlying cause of admission(62.5%vs 26.3%,P=0.004).ST was the method of choice in compromised airway(31.6%,vs 7.3%P=0.008).A large proportion of patients(88/115)with t

关键词： Tracheostomy Early tracheostomy Late tracheostomy Percutaneous dilatation tracheostomy Surgical tracheostomy Weaning Survival Mechanical ventilation

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Elevated plasma von Willebrand factor levels in patients with active ulcerative colitis reflect endothelial perturbation due to systemic inflammation

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World Journal of Gastroenterology 2005年第48期11卷 7639-7645页

作者： Petros Zezos Georgia papaioannou nikolaos Nikolaidis Themistoclis Vasiliadis Olga Giouleme nikolaos Evgenidis Division of Gastroenterology Department of Haematology

AIM: To evaluate the plasma von Willebrand factor (vWF) levels in patients with ulcerative colitis (UC) and to investigate their relationship with disease activity,systemic inflammation and coagulation ***: In 46 patients with ulcerative colitis (active in 34 patients), clinical data were gathered and plasma vWF levels, markers of inflammation (ESR, CRP, and fibrinogen) and thrombin generation (TAT, F1+2, and D-dimers) were measured at baseline and after 12 wk of treatment. Plasma vWF levels were also determined in 52 healthy controls (HC). The relationship of plasma vWF levels with disease activity, disease extent, response to therapy, acute-phase reactants (APRs) and coagulation markers (COAGs) was ***: The mean plasma vWF concentrations were significantly higher in active UC patients (143.38±63.73%) than in HC (100.75±29.65%, P = 0.001)and inactive UC patients (98.92±43.6%, P = 0.031).ESR, CRP and fibrinogen mean levels were significantly higher in active UC patients than in inactive UC patients,whereas there were no significant differences in plasma levels of D-dimers, F1+2, and TAT. UC patients with raised APRs had significantly higher mean plasma vWF levels than those with normal APRs (144.3% vs 96.2%,P = 0.019), regardless of disease activity. Although the mean plasma vWF levels were higher in UC patients with raised COAGs than in those with normal COAGs,irrespective of disease activity, the difference was not significant (141.3% vs 118.2%, P = 0.216). No correlation was noted between plasma vWF levels and disease extent. After 12 wk of treatment, significant decreases of fibrinogen, ESR, F1+2, D-dimers and vWF levels were noted only in UC patients with clinical and endoscopic ***: Our data indicate that increased plasma vWF levels correlate with active ulcerative colitis and increased acute-phase proteins. Elevated plasma vWF levels in ulcerative colitis possibly reflect an acutephase response of the perturbed e

关键词： Coagulation Endothelial injury Inflammation Inflammatory bowel disease Ulcerative colitis von Willebrand factor

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Hyperhomocysteinemia in ulcerative colitis is related to folate levels

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World Journal of Gastroenterology 2005年第38期11卷 6038-6042页

作者： Petros Zezos Georgia papaioannou nikolaos Nikolaidis Themistoclis Vasiliadis Olga Giouleme nikolaos Evgenidis Division of Gastroenterology Department of Haematology

AIM: To study the prevalence and clinical significance of hyperhomocysteinemia (hHcys), an independent factor for arterial and venous thrombosis, in a group of patients with ulcerative colitis (UC).METHODS: Fasting homocysteine (Hcys), folate, and vitamin B12 serum levels were measured in 40 UC patients and 50 healthy controls. Clinical data regarding UC were ***: Median serum Hcys levels in UC patients were similar to those in controls (12.26 μmol/L vs 12.32 μmol/L), but the prevalence of hHcys was higher in UC patients than in controls (30% vs 10%, P= 0.028). UC significantly increased the risk of hHcys (adjusted odds ratio: 4.125;95% CI: 1.26-13.44). Multivariate regression analysis showed that male sex, folate and vitamin B12 deficiency or lower serum values were significant independent predictors of higher Hcys levels in UC patients (r2 = 0.4; P＜0.001).CONCLUSION: hHcys is common in UC patients and it is related to folate and vitamin B12 deficiency or lower serum values. It would be reasonable for patients with UC to receive folate and vitamin B complex supplements as a prophylactic measure.

关键词： Folate Homocysteine Hyperhomocysteinemia Thrombosis Ulcerative colitis Vitamin B12

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Antithrombotic therapy in TAVI

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Journal of Geriatric Cardiology 2018年第1期15卷 66-75页

作者： Manolis Vavuranakis Konstantinos Kalogeras Angelos Michail Kolokathis Dimitrios Vrachatis nikolaos Magkoutis Gerasimos Siasos Euaggelos Oikonomou Maria Kariori Theodoros papaioannou Maria Lavda Carmen Moldovan Ourania Katsarou Dimitrios Tousoulis The First Department of Cardiology Hippokration Hospital Medical School National & Kapodistrian University of Athens Ilioupoli Greece

Transcatheter aortic valve implantation （TAVI） carries a significant thromboembolic and concomitant bleeding risk, not only during the procedure but also during the periprocedural period. Many issues concerning optimal antithrombotic therapy after TAVI are still under debate. In the present review, we aimed to identify all relevant studies evaluating antithrombotic therapeutic strategies in relation to clinical outcomes after the procedure. Four randomized control trials （RCT） were identified analyzing the post-TAVI antithrombotic strategy with all of them utilizing aspirin lifelong plus clopidogrel for 3-6 months. Seventeen registries have been identified, with a wide variance among them regarding baseline characteristics, while concerning antiplatelet therapy, clopidogrel duration was ranging from 3-12 months. Four non-randomized trials were identified, comparing single vs. dual antiplatelet therapy after TAVI, in respect of investigating thromboembolic outcome events over bleeding complications. Finally, limited data from a single RCT and a retrospective study exist with regards to anticoagulant treatment during the procedure and the optimal antithrombotic therapy when concomitant atrial fibrillation. In conclusion, due to the high risk and frailty of the treated population, antithrombotic therapy after TAVI should be carefully evaluated. Diminishing ischaemic and bleeding complications remains the main challenge in these patients with further studies to be needed in this field.

关键词： Antiplatelets Antithrombotic Bleeding Stroke Transcatheter aortic valve implantation

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Platelet rich plasma effectiveness in bowel anastomoses:A systematic review

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World Journal of Gastrointestinal Surgery 2021年第12期13卷 1736-1753页

作者： Georgios Geropoulos Kyriakos Psarras Dimitrios Giannis Eirini Chrysovalantou Martzivanou Maria papaioannou Christos Dimitrios Kakos Efstathios Theodoros Pavlidis nikolaos Symeonidis Georgios Koliakos Theodoros Efstathios Pavlidis Department of General Surgery University College London HospitalsLondon NW12BUUnited Kingdom Laboratory of Scientific Research and Experimental Surgery 2nd Propedeutic Department of SurgerySchool of MedicineAristotle UniversityThessaloniki 54642Greece Surgery Working Group Society of Junior DoctorsAthens 15123Greece Institute of Health Innovations and Outcomes Research Feinstein Institutes for Medical ResearchManhassetNY 11030United States Laboratory of Biological Chemistry School of MedicineFaculty of Health SciencesAristotle University of ThessalonikiThessaloniki 54124Greece

BACKGROUND Anastomotic leak constitutes a major problem in abdominal *** insufficiency,topical or systemic factors contribute to disrupted healing of the performed bowel anastomosis and result in anastomosis leakage,with detrimental effects on patient postoperative *** the investigation of several factors and the invention of protective materials,the ideal agent to prevent anastomotic leaks is yet to be *** To study the effect of platelet rich plasma(PRP)on the healing of bowel *** A systematic literature search was performed in PubMed,EMBASE,and Scopus databases to identify studies investigating the effect of PRP application on bowel *** Eighteen studies were eligible with a total population of 712 animals including rats(14 studies),rabbits(2 studies)and pigs(2 studies).No postoperative complications were reported following PRP *** out of 18 studies reported a statistically significant higher anastomosis bursting pressure in PRP groups compared to control either in healthy animals or animal models with underlying condition or intervention,such as intraperitoneal chemotherapy or *** results were reported by ten studies in terms of tissue hydroxyproline *** study reported significant increase in collagen deposition in PRP *** application resulted in significantly decreased inflammatory cell infiltration in the presence of peritonitis or intraperitoneal chemotherapy(6 studies).CONCLUSION The application of PRP is associated with improved bowel anastomosis outcomes,especially in animal models having an underlying condition affecting the normal healing *** application seems to augment the normal healing process under these ***,further studies are needed to investigate the potential role of PRP on bowel anastomosis healing,especially in clinical settings.

关键词： Platelet rich plasma Colonic anastomosis Small bowel anastomosis Large bowel anastomosis Bowel anastomosis Surgery

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P Wave Analysis in Patients with Sarcoidosis

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International Journal of Clinical Medicine 2013年第9期4卷 388-394页

作者： Elias Gialafos Elias Perros Aggeliki Rapti Theodore G. papaioannou Vassilios Kouranos Ioannis Moyssakis Konstantina Aggeli Georgios Dimopoulos Charalambos Kostopoulos Eleftherios Stamboulis John Gialafos Christodoulos Stefanadis nikolaos Koulouris Myron Mavrikakis Department of Cardiology University of Athens Athens Greece Department of Clinical Therapeutics University of Athens Athens Greece Department of Clinical Therapeutics University of Athens Athens Greece Department of Criti- cal Care Medicine University of Athens Athens Greece. Department of Neurology University of Athens Athens Greece Department of Neurology University of Athens Athens Greece Department of Pulmonology University of Athens Athens Greece Department of Pulmonology University of Athens Athens Greece Outpatient Department of Sarcoidosis Chest Disease Hospital “Sotiria” Athens Greece

Introduction: Atrial arrhythmias in patients with sarcoidosis (Sar) are not unusual and can occur due to either atrial myocardial fibrosis and/or due to autonomic nervous system imbalance. Electrocardiographic markers (ECG), like maximum and minimum P wave duration and P wave dispersion {Pdis = Pmax?﹣Pmin} reflect atrial depolarization inhomogeneity and can indicate patients prone to develop atrial arrhythmias while standard deviation of RR interval (SDNN) is an index of heart rate variability, reflecting autonomic nervous system (ANS) activity. Methods: 90 patients with sarcoidosis (41 males/49 females) enrolled in this multicenter prospective study underwent digital electrocardiography, echocardiography and pulmonary function tests (PFTs). Diastolic and systolic indices of right and left ventricle were measured echocardiographically including Doppler parameters while Pmax, Pmin, Pdis and SDNN were measured in a 5-minute duration digital electrocardiogram. All consecutive patients were compared to 65 healthy volunteers (30 males/35 females). Results: Although heart rate and the echocardiographic indices were similar among the two groups, the electrocardiographic indices were significantly prolonged in the patient group compared to controls. Maximum P wave duration was correlated with SDNN (p dis was correlated with SDNN (p max and Pdis were independently correlated with SDNN. Conclusion: P wave dispersion is significantly increased in patients with systemic sarcoidosis compared to healthy persons while maximum P wave duration and P wave dispersion are negatively correlated with the standard deviation of RR, an index of heart rate variability implying imbalance of ANS function. Further studies are needed for the clarification of the significance of this correlation.

关键词： P Wave Analysis Systemic Sarcoidosis Autonomic Nervous System

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