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Cardiovascular disease: Risk factors and applicability of a risk model in a Greek cohort of renal transplant recipients

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World Journal of Transplantation 2017年第1期7卷 49-56页

作者： nikolaos-andreas anastasopoulos Evangelia Dounousi Evangelos Papachristou Charalampos Pappas Eleni Leontaridou Eirini Savvidaki Dimitrios Goumenos Michael Mitsis Department of Medicine School of Health Sciences University of Ioannina Renal Transplant Unit University Hospital of Ioannina School of Health Science University of Patras Department of Nephrology and Transplantation Patras University Hospital Department of Nephrology University Hospital of Ioannina

AIM To investigate the incidence and the determinants of cardiovascular morbidity in Greek renal transplant recipients(RTRs) expressed as major advance cardiac event(MACE) rate. METHODS Two hundred and forty-two adult patients with a functioning graft for at least three months and availabledata that were followed up on the August 31, 2015 at two transplant centers of Western Greece were included in this study. Baseline recipients' data elements included demographics, clinical characteristics, history of comorbid conditions and laboratory parameters. Follow-up data regarding MACE occurrence were collected retrospectively from the patients' records and MACE risk score was calculated for each patient. RESULTS The mean age was 53 years(63.6% males) and 47 patients(19.4%) had a pre-existing cardiovascular disease(CVD) before transplantation. The mean estimated glomerular filtration rate was 52 ± 17 mL /min per 1.73 m2. During follow-up 36 patients(14.9%) suffered a MACE with a median time to MACE 5 years(interquartile range: 2.2-10 years). Recipients with a MACE compared to recipients without a MACE had a significantly higher mean age(59 years vs 52 years, P < 0.001) and a higher prevalence of pre-existing CVD(44.4% vs 15%, P < 0.001). The 7-year predicted mean risk for MACE was 14.6% ± 12.5% overall. In RTRs who experienced a MACE, the predicted risk was 22.3% ± 17.1% and was significantly higher than in RTRs without an event 13.3% ± 11.1%(P = 0.003). The discrimination ability of the model in the Greek database of RTRs was good with an area under the receiver operating characteristics curve of 0.68(95%CI: 0.58-0.78).CONCLUSION In this Greek cohort of RTRs, MACE occurred in 14.9% of the patients, pre-existing CVD was the main risk factor, while MACE risk model was proved a dependable utility in predicting CVD post RT.

关键词： Cardiovascular disease Major advance cardiac event Risk factors Risk model Kidney Transplantation

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Transition beyond the acute phase of the COVID-19 pandemic: Need to address the long-term health impacts of COVID-19

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World Journal of Clinical Cases 2022年第27期10卷 9967-9969页

作者： Constantinos Tsioutis andreas Tofarides nikolaos Spernovasilis School of Medicine European University CyprusNicosia 2404Cyprus State Health Services Organisation Nicosia General HospitalNicosia 2029Cyprus Infectious Diseases Department German Oncology CenterLimassol 4108Cyprus

Despite gaps in knowledge,long-term sequelae of coronavirus disease 2019(COVID-19)infections are globally acknowledged and thus require special attention by public health organizations and ***,it is necessary to suppo... 详细信息

关键词： Pandemic COVID-19 Long-term Long-covid Post-covid Post-acute COVID-19 syndrome

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Effect of atrial fibrillation on cognitive function in heart failure patients

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Journal of Geriatric Cardiology 2021年第7期18卷 585-590页

作者： nikolaos Ktenopoulos Ioanna Koniari Virginia Mplani Eleni Artopoulou Grigorios Tsigkas andreas Gerakaris Nicholas Kounis Dimitrios Velissaris Department of Internal Medicine University Hospital of PatrasPatrasGreece Department of Cardiology University Hospital of South ManchesterNHS Foundation TrustManchesterUnited Kingdom Department of Cardiology University Hospital of PatrasPatrasGreece

As the population ages,conditions like heart failure(HF),atrial fibrillation(AF)and cognitive impairment(CI)demonstrate higher *** is a very common clinical syndrome affecting many people *** is estimated that in the developed countries approximately 1%-2%of the adult population suffers from HF,whereas in adults>70 years old the incidence rises to≥10%.

关键词： atrial fibrillation clinical

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Facing the challenge of venous thromboembolism prevention in patients undergoing major abdominal surgical procedures for gastrointestinal cancer

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World Journal of Gastrointestinal Oncology 2018年第10期10卷 328-335页

作者： Aikaterini Mastoraki Sotiria Mastoraki Dimitrios Schizas Raphael Patras nikolaos Krinos Ioannis S Papanikolaou andreas Lazaris Theodore Liakakos nikolaos Arkadopoulos 4th Department of Surgery National and Kapodistrian University of AthensAttikon University HospitalAthens 12462Greece Department of Vascular Surgery National and Kapodistrian University of AthensAttikon University HospitalAthens 12462Greece 1st Department of Surgery National and Kapodistrian University of AthensLaikon HospitalAthens 11527Greece

Venous thromboembolism(VTE)refers to a hypercoa-gulable state that remains an important and preven-table factor in the surgical treatment of *** includes two identical entities with regards to deep vein thrombosis and pulmonary *** incidence of VTE after major abdominal interventions for gastro-intestinal,hepato-biliary and pancreatic neoplastic disor-ders is as high as 25%without *** use of classic or low-molecular-weight heparin,anti-Xa factors,antithrombotic stocking,intermittent pneumatic compression devices and early mobilization have been ***,thromboprophylaxis is often dis-continued after discharge,although a serious risk may persist long after the initial triggering event,as the coagu-lation system remains active for at least 14 d *** aim of this review is to evaluate the results of the current practice of VTE prevention in cancer patients undergoing major abdominal surgical operations,with special attention to adequately elucidated guidelinesand widely accepted *** addition,the recent literature is presented in order to provide an update on the current concepts concerning the surgical manage-ment of the disease.

关键词： Deep vein thrombosis Pulmonary embolism Gastro-intestinal cancer Thromboprophylaxis Venous thromboembolism

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Intussusception of the bowel in adults:A review

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World Journal of Gastroenterology 2009年第4期15卷 407-411页

作者： Athanasios Marinis Anneza Yiallourou Lazaros Samanides nikolaos Dafnios Georgios anastasopoulos Ioannis Vassiliou Theodosios Theodosopoulos Second Department of Surgery Areteion University HospitalAthens Medical SchoolUniversity of Athens

Intussusception of the bowel is defined as the telescop-ing of a proximal segment of the gastrointestinal tract within the lumen of the adjacent *** condi-tion is frequent in children and presents with the classic triad of cramping abdominal pain,bloody diarrhea and a palpable tender ***,bowel intussusception in adults is considered a rare condition,accounting for 5% of all cases of intussusceptions and almost 1%-5%of bowel *** to twenty percent of cases are idiopathic,without a lead point *** intus-susception is caused by organic lesions,such as inflam-matory bowel disease,postoperative adhesions,Meckel's diverticulum,benign and malignant lesions,metastatic neoplasms or even iatrogenically,due to the presence of intestinal tubes,jejunostomy feeding tubes or after gas-tric *** tomography is the most sensitive diagnostic modality and can distinguish between intus-susceptions with and without a lead *** is the definitive treatment of adult *** bowel resection with oncological principles is followed for every case where a malignancy is *** of the intussuscepted bowel is considered safe for benign lesions in order to limit the extent of resection or to avoid the short bowel syndrome in certain circumstances.

关键词： Intussusception Intestinal invagination Adult Bowel obstruction Computed tomography Ultra-sonography Surgery

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Internet Regulation, a New Approach： Outline of a System Formed to Be Controlled by the Internet Users

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Computer Technology and Application 2012年第1期3卷 16-23页

作者： nikolaos Koumartzis andreas Veglis Media Informatics Lab Dept. Journalism ＆ Mass Communication Aristotle University of Thessaloniki Thessaloniki 54 625 Greece

This paper describes an outline for the proper design of a Fair Internet Regulation System （FIRS）, i.e., a system that will be implemented in a national level and encourage the participation of Internet users in enriching and correcting its ＂behavior＂. Authors aim to design a system that will be operated in some extent by the Internet users, and so it will be easier to be accepted by Western democracies willing to implement a fair Internet regulation policy. Last, the authors state the importance of using well-designed surveys prior to the implementation of FIRS, announce the launch of an online tool （***） and invite researchers to be part of this international effort.

关键词： Content filtering content blocking internet regulation blacklist.

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Foreign Language Web-Based Learning by Means of Audiovisual Interactive Activities

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Journal of Software Engineering and Applications 2021年第6期14卷 207-232页

作者： Catherine Kanellopoulou Minas Pergantis nikolaos Konstantinou nikolaos Grigorios Kanellopoulos andreas Giannakoulopoulos Department of Audio and Visual Arts Ionian University Corfu Greece

Online learning has been on an upward trend for many years and is becoming more and more prevalent every day, consistently presenting the less privileged parts of our society with an equal opportunity at education. Unfortunately, though, it seldom takes advantage of the new technologies and capabilities offered by the modern World Wide Web. In this article, we present an interactive online platform that provides users with learning activities for students of English as a foreign language. The platform focuses on using audiovisual multimedia content and a user experience (UX) centered approach to provide learners with an enhanced learning experience that aims at improving their knowledge level while at the same time increasing their engagement and motivation to participate in learning. To achieve this, the platform uses advanced techniques, such as interactive vocabulary and pronunciation assistance, mini-games, embedded media, voice recording, and more. In addition, the platform provides educators with analytics about user engagement and performance. In this study, more than 100 young students participated in a preliminary use of the aforementioned platform and provided feedback concerning their experience. Both the platform’s metrics and the user-provided feedback indicated increased engagement and a preference of the participants for interactive audiovisual multimedia-based learning activities.

关键词： Online Learning Multimedia Interactivity World Wide Web Education English Language Teaching Learning Platform Audiovisual

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Bochdaleck's hernia complicating pregnancy: Case report

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World Journal of Gastroenterology 2006年第15期12卷 2469-2471页

作者： nikolaos Barbetakis andreas Efstathiou Michalis Vassiliadis Theocharis Xenikakis Ioannis Fessatidis Department of Cardiothoracic Surgery Geniki Kliniki-Euromedica Paraliaki Ave and Gravias 2ThessalonikiGreece

Diaphragmatic hernia complicating pregnancy is rare and results in a high mortality rate, particularly if early surgical intervention is not undertaken. We report a case in which a woman presenting at 23 wk＇s gestation was admitted with symptoms of respiratory failure and bowel obstruction due to incarceration of viscera through a left posterolateral defect of the diaphragm （Bochdalek＇s hernia）. Surgery （left thoracoabdominal incision） demonstrated compression atelectasis, mediastinal shift, strangulation and gangrene of the herniated viscera which led to segmental resection of the involved portion of large intestine with re-establishment of bowel continuity by end to end anastomosis. The greater omentum was partly necrotic necessitating resection. The diaphragmatic defect was closed with interrupted sutures. Postoperative period was uncomplicated. Pregnancy was allowed to continue until 39 wk＇s gestation at which time elective cesarean delivery was performed. It is concluded that symptomatic maternal diaphragmatic hernia during pregnancy is a surgical emergency and requires a high index of suspicion.

关键词： Pregnancy Diaphragmatic hernia Incarceration

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Managing injuries of hepatic duct confluence variants after major hepatobiliary surgery:An algorithmic approach

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World Journal of Gastroenterology 2008年第19期14卷 3049-3053页

作者： Georgios Fragulidis Athanasios Marinis andreas Polydorou Christos Konstantinidis Georgios anastasopoulos John Contis Dionysios Voros Vassilios Smyrniotis Second Department of Surgery Areteion University HospitalAthens Medical SchoolUniversity of Athens

AIM:To investigate injuries of anatomy variants of hepatic duct confluence during hepatobiliary surgery and their impact on morbidity and mortality of these procedures. An algorithmic approach for the management of these injuries is proposed. METHODS:During a 6-year period 234 patients who had undergone major hepatobiliary surgery were retrospectively reviewed in order to study postoperative bile leakage. Diagnostic workup included endoscopic and magnetic retrograde cholangiopancreatography (E/MRCP), scintigraphy and fistulography. RESULTS:Thirty (12.8%) patients who developed postoperative bile leaks were identified. Endoscopic stenting and percutaneous drainage were successful in 23 patients with bile leaks from the liver cut surface. In the rest seven patients with injuries of hepatic duct confluence, biliary variations were recognized and a stepwise therapeutic approach was considered. Conservative management was successful only in 2 patients. Volume of the liver remnant and functional liver reserve as well as local sepsis were used as criteria for either resection of the corresponding liver segment or construction of a biliary-enteric anastomosis. Two deaths occurred in this group of patients with hepatic duct confluence variants (mortality rate 28.5%). CONCLUSION:Management of major biliary fistulaethat are disconnected from the mainstream of the biliary tree and related to injury of variants of the hepatic duct confluence is extremely challenging. These patients have a grave prognosis and an early surgical procedure has to be considered.

关键词： Biliary aberrations Bile duct injury Postope-rative bile leakage Hepatic duct confluence Hepatectomy

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Mesenteric ischemia:Pathogenesis and challengingdiagnostic and therapeutic modalities

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World Journal of Gastrointestinal Pathophysiology 2016年第1期7卷 125-130页

作者： Aikaterini Mastoraki Sotiria Mastoraki Evgenia Tziava Stavroula Touloumi nikolaos Krinos nikolaos Danias andreas Lazaris nikolaos Arkadopoulos 4th Department of Surgery Athens UniversityMedical SchoolATTIKON University Hospital12462 ChaidariAthensGreece Department of Vascular Surgery Athens UniversityMedical SchoolATTIKON University Hospital12462 ChaidariAthensGreece

Mesenteric ischemia(MI) is an uncommon medical condition with high mortality rates. ΜΙ includes inadequate blood supply, inflammatory injury and eventually necrosis of the bowel wall. The disease can be divided into acute and chronic MI(CMI), with the first being subdivided into four categories. Therefore, acute MI(AMI) can occur as a result of arterial embolism, arterial thrombosis, mesenteric venous thrombosis and nonocclusive causes. Bowel damage is in proportion to the mesenteric blood flow decrease and may vary from minimum lesions, due to reversible ischemia, to transmural injury, with subsequent necrosis and perforation. CMI is associated to diffuse atherosclerotic disease in more than 95% of cases, with all major mesenteric arteries presenting stenosis or occlusion. Because of a lack of specific signs or due to its sometime quiet presentation, this condition is frequently diagnosed only at an advanced stage. Computed tomography(CT) imaging and CT angiography contribute to differential diagnosis and management of AMI. Angiography is also the criterion standard for CMI, with mesenteric duplex ultrasonography and magnetic resonance angiography also being of great importance. Therapeutic approach of MI includes both medical and surgical treatment. Surgical procedures include restoration of the blood flow with arteriotomy, endarterectomy or anterograde bypass, while resection of necrotic bowel is always implemented. The aim of this review was to evaluate the results of surgical treatment for MI and to present the recent literature in order to provide an update on the current concepts of surgical management of the disease. Mesh words selected include MI, diagnostic approach and therapeutic management.

关键词： Acute mesenteric ischemia Mesentericischemia Chronic diagnostic approach Therapeuticmanagement Surgical strategy

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