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Cardiac risk stratification of the liver transplant candidate:A comprehensive review

World Journal of Transplantation 2022年第7期12卷 142-156页

作者： Sanjana Nagraj spyros peppas Maria Gabriela Rubianes Guerrero Damianos G Kokkinidis Felipe I Contreras-Yametti Sandhya Murthy Ulrich P Jorde Department of Medicine Jacobi Medical Center/Albert Einstein College of MedicineNew York CityNY 10461United States Department of Gastroenterology Athens Naval HospitalAthens 11521Greece Section of Cardiovascular Medicine Yale University School of MedicineYale New Haven HospitalNew HavenCT 06510United States Department of Medicine Wellstar Atlanta Medical CenterAtlantaGA 30312United States Division of Cardiology Montefiore Medical CenterAlbert Einstein College of MedicineNew York CityNY 10467United States

Cardiovascular diseases(CVD)form a principal consideration in patients with end-stage liver disease(ESLD)undergoing evaluation for liver transplant(LT)with prognostic implications in the peri-and post-transplant *** the predominant etiology of ESLD continues to evolve,addressing CVD in these patients has become increasingly ***,as the number of LTs increase by the year,the proportion of older adults on the waiting list with competing comorbidities increase,and the demographics of LT candidates evolve with parallel increases in their CVD risk *** primary goal of cardiac risk assessment is to preemptively reduce the risk of cardiovascular morbidity and mortality that may arise from hemodynamic stress in the peri-and post-transplant *** complex hemodynamics shared by ESLD patients in the pre-transplant period with adverse cardiovascular events occurring in only some of these recipients continue to challenge currently available guidelines and their uniform *** review focusses on cardiac assessment of LT candidates in a stepwise manner with special emphasis on preoperative patient *** hope that this will reinforce the importance of cardiovascular optimization prior to LT,prevent futile LT in those with advanced CVD beyond the stage of optimization,and thereby use the finite resources prudently.

关键词： Cardiovascular risk Liver transplantation End stage liver disease Liver cirrhosis Cardiovascular diseases Cardiovascular diagnostic techniques

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A CFD study on the hydrodynamic response of a small-scale ice floe induced by a passing ship

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Journal of Hydrodynamics 2024年第2期36卷 290-299页

作者： Zongyu Jiang spyros Hirdaris Sasan Tavakoli Mikko Suominen Pentti Kujala Marine and Arctic Technology Department of Mechanical EngineeringAalto UniversityEspooFinland Global Ship Systems Centre ABS Hellenic SM LLC.AthensGreece Department of Infrastructure Engineering The University of MelbourneMelbourneAustralia

A Reynolds averaged Navier-Stokes(RANS)computational fluid dynamics(CFD)model is built to investigate the hydrodynamic response of a circular ice floe under the influence of a passing ship in calm *** ship,mirroring the KRISO Container Ship’s hull design,progresses near an ice floe whose diameter is 30%of the ship’s length and its thickness is 3 *** ship advances at a constant speed,which is handled by using the overset mesh *** study focuses on the ice floe’s motions and the hydrodynamic forces induced by three speeds and three transverse distances of the passing *** reveal that ship-generated wakes notably influence the ice floe’s motions,with a greater influence on sway than ***,the ship’s speed and proximity distinctly affect the ice floe’s motions.

关键词： Hydrodynamics ship-ice interactions ice floe Reynolds averaged Navier-Stokes(RANS)computational fluid dynamics(CFD)

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The effect of high-flow oxygen via tracheostomy on respiratory pattern and diaphragmatic function in patients with prolonged mechanical ventilation:A randomized,physiological,crossover study

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Journal of Intensive Medicine 2024年第2期4卷 202-208页

作者： Elena Lytra Stelios Kokkoris Ioannis Poularas Dimitrios Filippiadis Demosthenes Cokkinos Dimitrios Exarhos spyros Zakynthinos Christina Routsi 1st Department of Intensive Care Medical SchoolNational and Kapodistrian University of AthensEvangelismos HospitalAthensGreece Radiology Department Evangelismos HospitalAthensGreece 2nd Radiology Department Medical SchoolNational and Kapodistrian University of AthensAttikon HospitalAthensGreece

Background Compared to conventional oxygen devices,high-flow oxygen treatment(HFOT)through the nasal cannulae has demonstrated clinical *** data exist on whether such effects are also present in HFOT through ***,we aimed to examine the short-term effects of HFOT through tracheostomy on diaphragmatic function and respiratory parameters in tracheostomized patients on prolonged mechanical *** A randomized,crossover,physiological study was conducted in our ICU between December 2020 and April 2021,in patients with tracheostomy and prolonged mechanical *** patients underwent a 30-min spontaneous breathing trial(SBT)and received oxygen either via T-piece or by HFOT through tracheostomy,followed by a washout period of 15-min breathing through the T-piece and receipt of 30-min oxygen with the other modality in a randomized crossover *** the start and end of each session,blood gasses,breathing frequency(f),and tidal volume(VT)via a Wright's spirometer were measured,along with diaphragm ultrasonography including diaphragm excursion and diaphragmatic thickening fraction,which expressed the inspiratory muscle *** Eleven patients were enrolled in whom 19 sessions were uneventfully completed;eight patients were studied twice on two different days with alternate sessions;and three patients were studied *** were randomly assigned to start the SBT with a T-piece(n=10 sessions)or with HFOT(n=9 sessions).With HFOT,VT and minute ventilation(VE)significantly increased during SBT(from[465±119]mL to[549±134]mL,P<0.001 and from[12.4±4.3]L/min to[13.1±4.2]L/min,P<0.05,respectively),but they did not change significantly during SBT with T-piece(from[495±132]mL to[461±123]mL and from[12.8±4.4]mL to[12.0±4.4]mL,respectively);f/VT decreased during HFOT(from[64±31]breaths/(min∙L)to[49±24]breaths/(min∙L),P<0.001),but it did not change significantly during SBT with T-piece(from[59±28]breaths/(min∙L)to[64±33]breaths/(m

关键词： Diaphragm Diaphragm ultrasonography High-flow oxygen Prolonged mechanical ventilation Tracheostomy

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Bacterial community in response to packaging conditions in farmed gilthead seabream

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Aquaculture and Fisheries 2023年第4期8卷 410-421页

作者： Apollon Thomas spyros J.Konteles Sotiris Ouzounis spyros Papatheodorou Aliki Tsakni Dimitra Houhoula Theofania Tsironi Department of Food Science and Technology Faculty of Food SciencesUniversity of West AtticaAthens11521Greece Medical Image and Signal Processing Laboratory Department of Biomedical EngineeringUniversity of West AtticaAthens11521Greece Laboratory of Food Process Engineering Department of Food Science and Human NutritionAgricultural University of AthensAthens11855Greece

The objective of this study was to evaluate the effect of modified atmosphere packaging(MAP)on fish skin,gills and intestines bacterial *** gilthead seabream was packed aerobically or under modified atmospheres(60%CO_(2),30%N_(2),10%O_(2))and stored isothermally at 0℃.Next Generation Sequencing(NGS)analysis was applied for the characterization of fish microbiome on fish skin,gills,and intestines initially(time of packaging,1 day after harvesting)and after 10 days of isothermal storage at 0℃.NGS results indicated statistically significant differences in families’richness and diversity in the tested fish tissues between aerobic and MAP packaging during storage at 0℃.The most persistent bacteria were Proteobacteria for both packaging *** fish skin microbiota,the initially prevailing families were Comamonadaceae,Enterobacteriaceae and Moraxellaceae while in the intestines Comamonadaceae,Anaplasmataceae,Bacillaceae and Enterobacteriaceae were the dominant *** the end of storage period,the fish microbiota was dominated by psychotropic and psychrophilic families(Pseudoalteromonadaceae,Psychromonadaceae,and Shewanellaceae),while families such as Comamonadaceae were persistent under MAP *** 8 days of fish storage at 0℃,МАРsamples exhibited higher sensory scorings than the respective aerobically stored fish,indicating better retention of fish freshness and fish quality attributes under *** on the results of the study,MAP modified significantly the microbiological status and extended the shelf life of *** was a powerful tool that provided a more complete assessment compared to a culture-based analysis.

关键词： Fish Preservation Next generation sequencing Modified atmosphere packaging Microbiome

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Provision of Ramp-rate Limitation as Ancillary Service from Distribution to Transmission System:Definitions and Methodologies for Control and Sizing of Central Battery Energy Storage System

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Journal of Modern Power Systems and Clean Energy 2023年第5期11卷 1507-1518页

作者： spyros I.Gkavanoudis Kyriaki-Nefeli D.Malamaki Eleftherios O.Kontis Aditya Shekhar Umer Mushtaq Sagar Bandi Venu Charis S.Demoulias Department of Electrical&Computer Engineering Aristotle University of ThessalonikiThessalonikiGreece Electrical Engineering Mathematics&Computer Science DepartmentDelft University of TechnologyDelftNetherlands FENECON Gmbh DeggendorfGermany

The variability of the output power of distributed renewable energy sources(DRESs)that originate from the fastchanging climatic conditions can negatively affect the grid ***,grid operators have incorporated ramp-rate limitations(RRLs)for the injected DRES power in the grid *** the DRES penetration levels increase,the mitigation of high-power ramps is no longer considered as a system support function but rather an ancillary service(AS).Energy storage systems(ESSs)coordinated by RR control algorithms are often applied to mitigate these power ***,no unified definition of active power ramps,which is essential to treat the RRL as AS,currently *** paper assesses the various definitions for ramp-rate RR and proposes RRL method control for a central battery ESS(BESS)in distribution systems(DSs).The ultimate objective is to restrain high-power ramps at the distribution transformer level so that RRL can be traded as AS to the upstream transmission system(TS).The proposed control is based on the direct control of theΔP/Δt,which means that the control parameters are directly correlated with the RR requirements included in the grid *** addition,a novel method for restoring the state of charge(So C)within a specific range following a high ramp-up/down event is ***,a parametric method for estimating the sizing of central BESSs(BESS sizing for short)is *** BESS sizing is determined by considering the RR requirements,the DRES units,and the load mix of the examined *** BESS sizing is directly related to the constant RR achieved using the proposed ***,the proposed methodologies are validated through simulations in MATLAB/Simulink and laboratory tests in a commercially available BESS.

关键词： Battery energy storage system distributed renewable energy resource sizing distribution system transmission system ramp-rate limitation state of charge

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Application of hurdle technology for the shelf life extension of European eel(Anguilla anguilla)fillets

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Aquaculture and Fisheries 2023年第4期8卷 393-402页

作者： Maria C.Giannakourou Natalia Stavropoulou Theofania Tsironi Vladimiros Lougovois Vassiliki Kyrana spyros J.Konteles Vassilia J.Sinanoglou Analysis&Design of Food Processes Laboratory of ChemistrySchool of Food SciencesDepartment of Food Science and TechnologyUniversity of West AtticaAgiouSpyridonos12243AigaleoAthensGreece Laboratory of Food Process Engineering Department of Food Science and Human NutritionAgricultural University of AthensIera Odos 75Athens11855Greece

Fresh fish,and especially fatty species,are highly perishable due to oxidative deterioration of fish flesh and the elevated microbial load on fish *** implementation of a variety of“mild hurdles”may significantly decrease the rates of fish chemical degradation and microbiological spoilage,by better retaining the initial quality,compared to more intense preservation *** aim of this work is the comparative study of different,single or combined,treatments at 15℃on the quality and shelf life of chilled eel *** fillets were treated using osmotic solutions consisting of glycerol(30%–40%–45%)and 5%NaCl with and without former antioxidant impregnation by using Rosemary *** all cases,water activity decreased to approximately 0.90 after 420 min of osmotic *** and osmotically treated fish fillets were subsequently stored at 4℃and their stability under chill conditions was assessed based on microbial growth and oxidative *** growth of treated samples was significantly delayed,especially due to the osmotic step(OS)and the derived water activity *** oxidation,a major cause of rejection for fatty fish such as eel,was greatly inhibited in treated fillets,owing to both‘hurdles’,aw lowering(OS)and antioxidant impregnation with rosemary serum(RS/OS),showing the synergistic effect of these successive *** life of treated eel fillets exhibited a more than 10-fold increase,as compared to the untreated samples,based on chemical composition and a 2 to 3-fold shelf life improvement,in terms of microbial growth.

关键词： Hurdle Eel fillets Osmotic treatment Rosemary extract Shelf life

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Modern diagnostic approaches to cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2012年第4期11卷 349-359页

作者： Larisa E Vasilieva Stefanos I Papadhimitriou spyros P Dourakis Second Department of Internal Medicine University of Athens Medical SchoolHippokration General Hospital114 Vas Sofias AvenueAthens 11527Greece Molecular Cytogenetics Unit Haematology Laboratory"G.Genimatas" Regional General HospitalAthensGreece

BACKGROUND:Cholangiocarcinoma is a very aggressive tumor with poor ***,early diagnosis and surgical resection are of paramount *** diagnosis is difficult because access to the tumor is not *** is possible only for intrahepatic cholangiocarcinoma,which accounts for 10% of *** brush cytology from endoscopic retrograde cholangiopancreatography(ERCP) has a high specificity of 100% but unfortunately a low sensitivity of 30%.In this review we briefly describe new diagnostic techniques applicable to ERCP brush cytology specimens and targeting the genetic background of the disease,in particular fluorescence in situ hybridization(FISH) and digital image analysis(DIA).DATE SOURCES:The PubMed database up to 2011 was used for the retrieval of relevant *** search terms FISH,fluorescence in situ hybridization,DIA,digital image analysis and cholangiocarcinoma were *** original and review articles were ***:FISH identifies cells with chromosomal abnormalities,mainly numerical aberrations,using a mixture of fluorescencelabeled *** offers a higher sensitivity than routine cytology,retaining a high level of *** DIA criterion for malignancy is demonstration of *** technique increases the sensitivity to 40%,but the specificity remains *** data from application to other tumors suggest that combination of FISH and DIA may be of further ***:The new techniques offer a significantly enhanced diagnostic efficacy in the evaluation of ERCP brush *** from contributing to a more timely diagnosis,their wider application to cholangiocarcinoma may also facilitate the genetic study of the disease and add to our understanding of oncogenesis at the molecular level,with the prospect of identifying targets for novel therapeutic interventions.

关键词： cholangiocarcinoma fluorescence in situ hybridization digital image analysis

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Walled-off pancreatic necrosis

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World Journal of Gastroenterology 2010年第14期16卷 1707-1712页

作者： Michael Stamatakos Charikleia Stefanaki Konstantinos Kontzoglou spyros Stergiopoulos Georgios Giannopoulos Michael Safioleas 4th Department of Surgery Medical School University of Athens Attikon Hospital Athens 12462 Greece 2nd Department of Propaedeutic Surgery Medical School University of Athens Laikon Hospital Athens 11527 Greece

Walled-off pancreatic necrosis (WOPN), formerly known as pancreatic abscess is a late complication of acute pancreatitis. It can be lethal, even though it is rare. This critical review provides an overview of the continually expanding knowledge about WOPN, by review of current data from references identified in Medline and PubMed, to September 2009, using key words, such as WOPN, infected pseudocyst, severe pancreatitis, pancreatic abscess, acute necrotizing pancreatitis (ANP), pancreas, inflammation and alcoholism. WOPN comprises a later and local complication of ANP, occurring more than 4 wk after the initial attack, usually following development of pseudocysts and other pancreatic fluid collections. The mortality rate associated with WOPN is generally less than that of infected pancreatic necrosis. Surgical intervention had been the mainstay of treatment for infected peripancreatic fluid collection and abscesses for decades. Increasingly, percutaneous catheter drainage and endoscopic retrograde cholangiopancreatography have been used, and encourag-ing results have recently been reported in the medical literature, rendering these techniques invaluable in the treatment of WOPN. Applying the recommended therapeutic strategy, which comprises early treatment with antibiotics combined with restricted surgical intervention, fewer patients with ANP undergo surgery and interventions are ideally performed later in the course of the disease, when necrosis has become well demarcated.

关键词： Walled-off pancreatic necrosis Infected pseudocyst Severe pancreatitis Acute necrotizing pancreatitis Pancreas Inflammation Alcoholism

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Effects of endoscopic sphincterotomy on biliary epithelium:A case-control study

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World Journal of Gastroenterology 2012年第8期18卷 794-799页

作者： John Kalaitzis Antonios Vezakis George Fragulidis Irene Anagnostopoulou spyros Rizos Efstathios Papalambros Andreas Polydorou First Department of Surgery Tzaneio General Hospital of Piraeus Second Department of Surgery and Endoscopic Unit National and Kapodistrian University of Athens Medical School Aretaieion Hospital Department of Cytology Tzaneio General Hospital of Piraeus First Department of Surgery National and Kapodistrian University of Athens Medical School Laiko General Hospital

AIM: To study the long-term effects of endoscopic sphincterotomy on biliary epithelium. METHODS: This is a prospective case-control study. A total of 25 patients with a median age of 71 years (range 49-89 years) and prior endoscopic sphincterotomy (ES) for benign disease formed the fi rst group. The median time from ES was 42 mo (range 8-144 mo). Another 25 patients with a median age of 76 years (range 44-94 mo) and similar characteristics who underwent current endoscopic retrograde cholangio-pancreatography (ERCP) and ES for benign disease formed the second group (control group). Brush cytology of the biliary tree with p53 immunocytology was performed in all patients of both groups. ERCPs and recruitment were conducted at the Endoscopic Unit of Aretaieion University Hospital and Tzaneio Hospital, Athens, from October 2006 to June 2010. RESULTS: No cases were positive or suspicious for malignancy. Epithelial atypia was higher in the first group (32% vs 8% in the second group, P = 0.034). Acute cholangitis and previous biliary operation rates were also higher in the fi rst group (acute cholangitis, 60% vs 24% in the second group, P = 0.01; previous biliary operation, 76% vs 24% in the second group, P = 0.001). Subgroup analysis showed that previous ES was the main causal factor for atypia, which was not related to the time interval from the ES (P = 0.407). Two patients (8%) with atypia in the fi rst group were p53-positive. CONCLUSION: ES causes biliary epithelial atypia that represents mostly reactive/proliferative rather than premalignant changes. The role of p53 immunoreactivity in biliary atypia needs to be further studied.

关键词：上皮细胞括约肌胆管内镜病例大学医院 p53 致病因素

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Apalutamide for patients with metastatic castrationsensitive prostate cancer in East Asia:a subgroup analysis of the TITAN trial

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Asian Journal of Andrology 2022年第2期24卷 161-166页

作者： Byung Ha Chung Jian Huang Zhang-Qun Ye Da-Lin He Hirotsugu Uemura Gaku Arai Choung Soo Kim Yuan-Yuan Zhang Yusoke Koroki SuYeon Jeong Suneel Mundle spyros Triantos Sharon McCarthy Kim N Chi Ding-Wei Ye Department of Urology Gangnam Severance HospitalYonsei University College of Medicine211 Eonju-roGangnam-guSeoul 135-271Korea Sun Yat-Sen Memorial Hospital Sun Yat-sen UniversityGuangzhou 510120China Wuhan Tongji Hospital Tongji Medical CollegeWuhan 430030China First Affiliated Hospital of Xi’an Jiaotong University Xi’an 719054China Kindai University Hospital Ōsakasayama 589-8511Japan Dokkyo Medical University Saitama Medical Center Saitama 2-1-50Japan Asian Medical Center University of UlsanSeoul 138-040Korea Janssen Medical Affairs Department Beijing 100025China Janssen Medical Affairs Department Tokyo 101-0065Japan Janssen Medical Affairs Department Seoul 140-012Korea Janssen Global Medical Affairs Department HorshamPA 08869USA Janssen Research and Development Spring HousePA 19477USA Janssen Research and Development RaritanNJ 08869USA BC Cancer and Vancouver Prostate Centre VancouverBC V5Z 1G1Canada Fudan University Shanghai Cancer Center Shanghai 200032China

Ethnicity might be associated with treatment outcomes in advanced prostate *** study aimed to evaluate the efficacy and safety of androgen deprivation therapy(ADT)combined with apalutamide in East Asians with metastatic castration-sensitive prostate cancer(mCSPC).The original phase 3 Targeted Investigational Treatment Analysis of Novel Anti-androgen(TITAN)trial was conducted at 260 sites in 23 *** subgroup analysis included patients enrolled in 62 participating centers in China,Japan,and *** progression-free survival(PFS),time to prostate-specific antigen(PSA)progression,and PSA changes from baseline were compared between groups in the East Asian *** intent-to-treat East Asian population included 111 and 110 participants in the apalutamide and placebo groups,*** 24-month radiographic PFS rates were 76.1%and 52.3%in the apalutamide and placebo groups,respectively(apalutamide vs placebo:hazard ratio[HR]=0.506;95%confidence interval[CI],0.302–0.849;P=0.009).Median time to PSA progression was more favorable with apalutamide than placebo(HR=0.210;95%CI,0.124–0.357;P<0.001).Median maximum percentages of PSA decline from baseline were 99.0%and 73.9%in the apalutamide and placebo groups,*** most common adverse event(AE)was rash in the apalutamide group,with a higher rate than that in the placebo group(37.3%vs 9.1%).The most common grade 3 or 4 AEs were rash(12[10.9%])and hypertension(12[10.9%])for *** efficacy and safety of apalutamide in the East Asian subgroup of the TITAN trial are consistent with the global results.

关键词： apalutamide East Asia metastasis prostatic neoplasm survival

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