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Mean nocturnal baseline impedance in gastro-esophageal reflux disease diagnosis:Should we strictly follow the Lyon 2 Consensus?

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World Journal of Gastroenterology 2024年第26期30卷 3253-3256页

作者： theodoros a.voulga.is Georgios P Karamanolis Department of Gastroenterology School of MedicineNational and Kapodistrian University of AthensAthens 11527Greece

Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common *** of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon *** an updated second version has been *** nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD *** a cut-off of 2292 Ohms was proposed,a value revised in the second *** updated Consensus recommended that an MNBI2500 Ohms can be used to refute *** proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic ***,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass ***,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one ***,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now ***,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.

关键词： Mean nocturnal baseline impedance Gastro-esophageal reflux disease Lyon 2 Consensus pH-impedance Diagnosis

Management of obstructed colorectal carcinoma in an emergency setting:An update

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 598-613页

作者： Efstathios T Pavlidis Ioannis N Galanis theodoros E Pavlidis 2nd Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Colorectal carcinoma is common,particularly on the left *** 20%of patients,obstruction and ileus may be the first clinical manifestations of a carcinoma that has advanced(stage II,III or even IV).Diagnosis is based on clinical presentation,plain abdominal radiogram,computed tomography(CT),CT colonography and positron emission tomography/*** best management strategy in terms of short-term operative or interventional and long-term oncological outcomes re-mains *** the most common left-sided obstruction,the first choice should be either emergency surgery or endoscopic decompression by self-expen-dable metal stents or *** operative plan should be either one-stage or two-stage ***-stage resection with on-table bowel decompression and irrigation can be accompanied or not accompanied by proximal defunctioning stoma(colostomy or ileostomy).Primary anastomosis is more convenient but has increased risks of anastomotic leakage and ***-stage resection(Hart-mann’s procedure)is safer and the most widely used despite temporally affecting quality of *** control surgery in high-risk frail patients is less frequently performed since it can be successfully substituted with endoscopic stenting or *** the less common right-sided obstruction,one-stage surgical resection is more beneficial than endoscopic *** role of minimally invasive surgery(laparoscopic or robotic)is a subject of *** laparoscopic-assisted management is advantageous to some extent but requires much expertise due to inherent difficulties in dissecting the distended colon and the risk of rup-ture and subsequent septic *** decompressing stent as a bridge to elective surgery more substantially decreases the risks of morbidity and mortality than emergency surgery for decompression and has equivalent medium-term overall survival and disease-free survival *** combination with neoadjuvant chemotherapy or radiation may have a p

关键词： Acute abdomen Obstructive ileus Colorectal carcinoma Emergency surgery Colectomy Intraluminal metal stents

New trends in diagnosis and management of gallbladder carcinoma

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 13-29页

作者： Efstathios T Pavlidis Ioannis N Galanis theodoros E Pavlidis ^(nd)Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Gallbladder(GB)carcinoma,although relatively rare,is the most common biliary tree cholangiocarcinoma with aggressiveness and poor *** is closely associated with cholelithiasis and long-standing large(>3 cm)gallstones in up to 90%of *** other main predisposing factors for GB carcinoma include molecular factors such as mutated genes,GB wall calcification(porcelain)or mainly mucosal microcalcifications,and GB polyps≥1 cm in *** is made by ultrasound,computed tomography(CT),and,more precisely,magnetic resonance imaging(MRI).Preoperative staging is of great importance in decisionmaking regarding therapeutic *** staging is based on MRI findings,the leading technique for liver metastasis imaging,enhanced three-phase CT angiography,or magnetic resonance angiography for major vessel *** is also necessary to use positron emission tomography(PET)-CT or ^(18)F-FDG PET-MRI to more accurately detect metastases and any other occult deposits with active metabolic *** laparoscopy may detect dissemination not otherwise found in 20%-28.6%of *** treatment is needed,including surgical resection,targeted therapy by biological agents according to molecular testing gene mapping,chemotherapy,radiation therapy,and *** is of great importance to understand the updated guidelines and current treatment *** extent of surgical intervention depends on the disease stage,ranging from simple cholecystectomy(T1a)to extended resections and including extended cholecystectomy(T1b),with wide lymph node resection in every case or IV-V segmentectomy(T2),hepatic trisegmentectomy or major hepatectomy accompanied by hepaticojejunostomy Roux-Y,and adjacent organ resection if necessary(T3).Laparoscopic or robotic surgery shows fewer postoperative complications and equivalent oncological outcomes when compared to open surgery,but much attention must be paid to avoiding *** addition to surgery,novel targe

关键词： Biliary tract neoplasms Extrahepatic cholangiocarcinoma Gallbladder carcinoma Gallbladder diseases Biliary tree diseases Gastrointestinal malignancies

Current considerations on intraductal papillary neoplasms of the bile duct and pancreatic duct

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World Journal of Gastroenterology 2024年第10期30卷 1461-1465页

作者： Efstathios T Pavlidis Ioannis N Galanis theodoros E Pavlidis 2^(nd) Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Pancreatobiliary intraductal papillary neoplasms(IPNs)represent precursors of pancreatic cancer or bile duct cholangiocarcinoma that can be detected and *** advances in diagnostic methods,identifying these premalignant lesions is still challenging for treatment *** imaging,biomarkers and molecular tests for genomic alterations can be used for diagnosis and *** intervention in combination with new chemotherapeutic agents is considered the optimal treatment for malignant *** balance between the risk of malignancy and any risk of resection guides management policy;therefore,treatment should be individualized based on a meticulous preoperative assessment of high-risk *** of the bile duct is more aggressive;thus,early diagnosis and surgery are *** conservative management of low-risk pancreatic branch-duct lesions is safe and effective.

关键词： Biliary tree diseases Pancreatic cystic neoplasms Biliary tract neoplasms Extrahepatic cholangiocarcinoma Pancreatic adenocarcinoma

Differential colour-ring loss among Dalmatian Pelican(Pelecanus crispus) colonies and its consequence on survival estimates

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Avian Research 2024年第1期15卷 66-71页

作者： Anastasios Bounas Giorgos Catsadorakis Dionyssia Hatzilacou theodoros Naziridis Jocelyn Champagnon Alain J.Crivelli Department of Biological Applications and Technology University of IoanninaIoanninaGreece Society for the Protection of Prespa Agios GermanosGreece Natural Environment and Climate Change Agency 207 Mesogeion Ave.11525AthensGreece Natural Environment and Climate Change Agency Kerkini BranchKerkiniGR-62055Kato PoroiaGreece Tour du Valat Research Institute for Conservation of Mediterranean Wetlands13200ArlesFrance

The analysis of bird ringing data often comes with some potential sources of error and bias,as ring wear and/or loss could affect mark-recapture analyses and produce erroneous estimates of ***,ring wear and loss rates may differ between and within species based on the habitat they use or the species’ life-history traits and behaviour as well as the type of the *** this study we use resighting data from a long-term double marking experiment to directly estimate the rate of colour-ring loss among different Dalmatian Pelican colonies over time,evaluate any possible factors that could contribute to differential ring loss and assess how it may bias the results of mark-resighting *** on 14,849 resightings from 1275 individuals and using multi-state continuous-time hidden Markov models(HMMs) we showed that probability of ring loss was markedly different among colonies,ranging from 0.10 to 0.42 within the first year of marking,whereas the cumulative probability of losing a ring after ten years ranged 0.64 to *** rates are among the highest estimated when compared to previous studies in *** approach assessing the intra-specific variance in ring loss provided several factors potentially involved,such as the use of glue and the fledgling age accuracy and we could further hypothesise the effect of environmental ***,our results showed that ring loss can be a significant challenge for the assessment of the species’ population dynamics using mark-recapture methods as survival was consistently underestimated when not accounting for ring loss and varied significantly among different colonies.

关键词： Bias Capture-mark-recapture Colour-ring Double-marking Hidden Markov models

Current considerations for the surgical management of gallbladder adenomas

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1507-1512页

作者： Efstathios T Pavlidis Ioannis N Galanis theodoros E Pavlidis The Second Department of Propaedeutic Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Gallbladder adenomas are rare lesions(0.5%)associated with potential malignant transformation,particularly with gallbladder adenomas that are≥1 cm in *** detection and management are crucial for preventing lethal carcinoma *** polyps can often be distinguished from the more often nonneo-plastic cholesterol pseudopolyps(5%-10%),which are *** is the first-line tool for initial diagnosis and follow-up when *** question is whether cholecystectomy is always necessary for all *** manage-ment of gallbladder adenomas is determined according to the size of the tumor,the growth rate of the tumor,the patient’s symptoms and whether risk factors for malignancy are ***≥1 cm in size,an age>50 years and a familial history of gallbladder carcinoma are indications for immediate laparoscopic ***,ultrasound follow-up is *** adenomas 6-9 mm in size,the absence of≥2 mm growth at 6 months,one year,and two years,as well as an adenoma sized<5 mm without existing risk factors indicates that no further surveillance is ***,it would be preferable to individualize the management in doubtful *** interventional modalities for preserving the gallbladder need further evaluation,especially to determine the long-term outcomes.

关键词： Biliary diseases True neoplastic polyps Gallbladder adenomas Benign bi-liary tumors Gallbladder polyps Extrahepatic biliary neoplasms

Transcranial direct current stimulation efficacy in trigeminal neuralgia

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World Journal of Clinical Cases 2024年第5期12卷 1036-1038页

作者： theodoros Fasilis Stylianos Gatzonis Panayiotis Patrikelis Stefanos Korfias Athanasia Alexoudi 1^(st) Department of Neurosurgery National and Kapodistrian University of AthensAthens 10676Greece Department of Neurology Neurological Institute of AthensAthens 10676Greece

Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health *** direct current stimulation is a non-invasive stimulation technique which finds new utility in managing ***-fore,the introduction of alternative,non-invasive,safe,and effective methods should be considered in treating patients with trigeminal neuralgia unresponsive to conventional treatment.

关键词： Trigeminal neuralgia Patient-controlled intravenous analgesia Neuromodulation Transcranial direct current stimulation

The Demographic Problem in Greece:Consequences and Solutions

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Journal of Environmental Science and Engineering(A) 2024年第3期13卷 100-110页

作者： Adrianos Pavlopoulos theodoros Rachiotis Department of Digital Systems Faculty of Digital SystemsUniversity of PiraeusPiraeus 18534Greece Department of Physical Education and Sport Science School of Physical Education and Sport ScienceUniversity of AthensDafni 17237Greece

Globally,population dynamics are shifting towards increased life expectancy,and many countries,including Greece,face significant demographic *** is particularly impacted by one of the lowest birth rates in the world and a rapidly aging *** demographic shift places unprecedented pressure on the nation’s pension systems and economic stability,as more people retire than enter the *** study aims to explore the historical factors contributing to Greece’s demographic situation,analyze the consequences of current trends,and propose strategic *** research utilizes a literature review approach and the case study of Greece to understand the depth and breadth of the demographic *** areas of focus include the declining birth rate,the economic implications of an aging population,and the potential of migration and policy reform to rejuvenate demographic *** study evaluates various policy interventions from other countries to propose a tailored,multi-faceted strategy for *** strategies emphasize economic incentives for young families,improved childcare and parental support,healthcare investment,and inclusive migration policies to enhance workforce *** comprehensive approach seeks to provide actionable insights that can help Greece mitigate the effects of demographic decline and foster a more sustainable future,aligning policy interventions with socio-economic and cultural realities.

关键词： Demographic problem low birth rate implications policies reforms

Transurethral resection of bladder tumor: A systematic review of simulator-based training courses and curricula

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Asian Journal of Urology 2024年第1期11卷 1-9页

作者： Panagiotis Kallidonis Angelis Peteinaris Gernot Ortner Kostantinos Pagonis Costantinos Adamou Athanasios Vagionis Evangelos Liatsikos Bhaskar Somani theodoros Tokas Department of Urology University Hospital of RionPatrasGreece Department of Urology and Andrology General Hospital Hall I.T.Hall in TirolAustria Medical University of Vienna ViennaAustria Department of Urology University Hospital Southampton NHS Foundation TrustSouthamptonUK

Objective:Transurethral resection of bladder tumor is one of the most common everyday urological *** kind of surgery demands a set of skills that need training and *** this review,we aimed to investigate the current literature to find out if simulators,phantoms,and other training models could be used as a tool for teaching ***:A systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and the recommendations of the European Association of Urology guidelines for conducting systematic *** out of 932 studies met our inclusion criteria and are presented in the current ***:The UroTrainer(Karl Storz GmbH,Tuttlingen,Germany),a virtual reality training simulator,achieved positive feedback and an excellent face and construct validity by the *** inspection of bladder mucosa,blood loss,tumor resection,and procedural time was improved after the training,especially for inexperienced urologists and medical *** construct validity of UroSim®(VirtaMed,Zurich,Switzerland)was *** simulator(Samed GmbH,Dresden,Germany)was found to be a realistic and useful tool by experts and urologists with intermediate *** test objective competency model based on SIMBLA simulator could be used for evaluating *** porcine model of the Asian Urological Surgery Training and Education Group also received positive feedback by the participants that tried *** Simulation and Technology Enhanced Learning Initiative Project had an extraordinary face and content validity,and 60%of participants would like to use the simulators in the *** 5-day multimodal training curriculum“Boot Camp”in the United Kingdom achieved an increase of the level of confidence of the participants that lasted months after the ***:Simulators and courses or curricula based on a simulator training could be a valuable learning tool fo

关键词： Simulator Train Curriculum Transurethral resection Vaporesection Laser Bladder