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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

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 sizedexisting 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

Critical considerations for the management of acute abdomen in transplant patients

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World Journal of Transplantation 2024年第2期14卷 8-12页

作者： efstathios T Pavlidis Georgios Katsanos Athanasios Kofinas Georgios Tsoulfas ioannis N Galanis Theodoros e Pavlidis The 2^(nd)Department of Propaedeutic Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece Department of Transplantation Surgery Center for Research and Innovation in Solid Organ TransplantationAristotle University of ThessalonikiSchool of MedicineThessaloniki 54642Greece

The number of solid organ transplantations performed annually is increasing and are increasing in the following order:Kidney,liver,heart,lung,pancreas,small bowel,and uterine ***,the outcomes of transplants are impro-ving(organ survival>90%after the 1st year).Therefore,there is a high probability that a general surgeon will be faced with the management of a transplant patient with acute *** problems in immunocompromised patients may not only include graft-related problems but also nongraft-related *** perioperative regulation of immunosuppression,the treatment of accompanying problems of immunosuppression,the administration of cortisol and,above all,the realization of a rapidly deteriorating situation and the accurate evaluation and interpretation of clinical manifestations are particularly important in these *** perioperative assessment and preparation includes evaluation of the patient’s cardiovascular system and determining if the patient has hypertension or suppression of the hypothalamic-pituitary-adrenal axis,or if the patient has had any coagulation mechanism abnormalities or thromboembolic *** in transplant patients is associated with the use of calci-neurin inhibitors,corticosteroids,and antiproliferation *** times,the clinical picture is atypical,resulting in delays in diagnosis and treatment and leading to increased morbidity and *** computed tomo-graphy is of utmost importance for early diagnosis and *** recipients are prone to infections,especially specific infections caused by cytomegalovirus and Clostridium difficile,and they are predisposed to intraop-erative or postoperative complications that require great care and *** is necessary to follow evidence-based therapeutic ***,it is required that the clinician choose the correct therapeutic plan for the patient(conservative,emergency open surgery or minimally invasive s

关键词： Acute abdomen Abdominal emergency surgery Transplantation Immunocompromised patients Immuno-suppression Posttransplantation surgery

Assistive techniques and their added value for tremor classification in multiple sclerosis

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Neural Regeneration Research 2024年第5期19卷 977-978页

作者： Nabin Koirala Abdulnasir Hossen ioannis U.Isaias Jens Volkmann Muthuraman Muthuraman Child Study Center School of MedicineYale UniversityNew HavenCTUSA Department of electrical&Computer engineering Sultan Qaboos UniversityAl-KhodMuscatOman Neural engineering with Signal Analytics and Artificial Intelligence Department of NeurologyUniversity Hospital of WürzburgWürzburgGermany Centro Parkinson e Parkinsonism Azienda Socio Sanitaria Territoriale G.Pini-CTO20126 MilanItaly

Tremor occurs in about half of multiple sclerosis(MS)*** tremor has a broad frequency range of 2.5-7 Hz,with a higher prevalence of postural tremor(44%)compared to intentional tremor(6%)(Alusi et al.,2001).Tremor may affect the upper and lower extremities,head,and trunk,and may even affect the vocal cords in isolated cases of palatal *** tremor is classically attributed to lesions of the brain stem,cerebellum,or cerebellar peduncles,and tremor intensity has been shown to correlate with the number of lesions or their functional ***,recent work has demonstrated that inflammatory damage to the cerebello-thalamic and cortico-thalamic pathways might also play an important role in causing tremor,as it co-occurs with other signs and symptoms of MS such as dysarthria,dysmetria,dysdiadochokinesia,and dystonia(Alusi et al.,2001).

关键词： tremor sclerosis

Multifunctional HDPe/Cu biocidal nanocomposites for MeX additive manufactured parts: Perspectives for the defense industry

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Defence Technology（防务技术） 2024年第8期38卷 16-32页

作者： Nectarios Vidakis Nikolaos Michailidis Markos Petousis Nektarios K.Nasikas Vassilios Saltas Vassilis Papadakis Nikolaos Mountakis Apostolos Argyros Mariza Spiridaki ioannis Valsamos Department of Mechanical engineering Hellenic Mediterranean UniversityHeraklion 71410Greece Physical Metallurgy Laboratory Mechanical Engineering DepartmentSchool of EngineeringAristotle University of ThessalonikiThessaloniki 54124Greece Centre for Research&Development of Advanced Materials(CeRDAM) Center for Interdisciplinary Research and InnovationBalkan CentreThessaloniki 57001Greece Division of Mathematics and engineering Sciences Department of Military SciencesHellenic Army AcademyVari GR16673AtticaGreece Department of electronic engineering Hellenic Mediterranean UniversityChania 73133Greece Department of Industrial Design and Production engineering University of West AtticaAthens 12244Greece Institute of electronic Structure and Laser Foundation for Research and Technology-HellasHeraklion 70013Greece

In this study, we investigated the performance improvement caused by the addition of copper(Cu)nanoparticles to high-density polyethylene(HDPe) matrix material. Composite materials, with filler percentages of 0.0, 2.0, 4.0, 6.0, 8.0, and 10.0 wt% were synthesized through the material extrusion(MeX)3D printing technique. The synthesized nanocomposite filaments were utilized for the manufacturing of specimens suitable for the experimental procedure that followed. Hence, we were able to systematically investigate their tensile, flexural, impact, and microhardness properties through various mechanical tests that were conducted according to the corresponding standards. Broadband Dielectric Spectroscopy was used to investigate the electrical/dielectric properties of the composites. Moreover, by employing means of Raman spectroscopy and thermogravimetric analysis(TGA) we were also able to further investigate their vibrational, structural, and thermal properties. Concomitantly, means of scanning electron microscopy(SeM), as well as atomic force microscopy(AFM), were used for the examination of the morphological and structural characteristics of the synthesized specimens, while energy-dispersive Xray spectroscopy(eDS) was also performed in order to receive a more detailed picture on the structural characteristics of the various synthesized composites. The corresponding nanomaterials were also assessed for their antibacterial properties regarding Staphylococcus aureus(S. aureus) and escherichia coli(e. coli) with the assistance of a method named screening agar well diffusion. The results showed that the mechanical properties of HDPe benefited from the utilization of Cu as a filler, as they showed a notable improvement. The specimen of HDPe/Cu 4.0 wt% was the one that presented the highest levels of reinforcement in four out of the seven tested mechanical properties(for example, it exhibited a 36.7%improvement in the flexural strength, compared to the pure matrix). At the same

关键词： High-density polyethylene(HDPe) Copper(Cu) Material extrusion(MeX) Mechanical performance electrical properties Antibacterial Defense and security

Fetal lung growth predicts the risk for early-life respiratory infections and childhood asthma

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World Journal of Pediatrics 2024年第5期20卷 481-495页

作者： Dimitra e.Zazara Olympia Giannou Steven Schepanski Mirja Pagenkemper Anastasios D.Giannou Maike Pincus ioannis Belios Stefan Bonn Ania C.Muntau Kurt Hecher Anke Diemert Petra Clara Arck Division for experimental Feto-Maternal Medicine Department of Obstetrics and Fetal MedicineUniversity Medical Center Hamburg-Eppendorf(UKE)Martinistraße 5220251HamburgGermany University Children’s Hospital UKEHamburgGermany Computer engineering and Informatics Department Polytechnic SchoolUniversity of PatrasPatrasGreece Institute of Developmental Neurophysiology Center for Molecular Neurobiology Hamburg(ZMNH)UKEHamburgGermany Department of Obstetrics and Fetal Medicine UKEHamburgGermany Department of General Visceral and Thoracic SurgeryUKEHamburgGermany Section of Molecular Immunology and Gastroenterology Ⅰ.Department of MedicineUKEHamburgGermany Pediatrics and Pediatric Pneumology Practice BerlinGermany Institute of Medical Systems Biology ZMNHUKEHamburgGermany Hamburg Center for Translational Immunology UKEHamburgGermany

Background early-life respiratory infections and asthma are major health burdens during *** predicting an increased risk for early-life respiratory diseases are ***,we identified the predictive value of ultrasound-monitored fetal lung growth for the risk of early-life respiratory infections and *** Fetal lung size was serially assessed at standardized time points by transabdominal ultrasound in pregnant women participating in a pregnancy *** between fetal lung growth and respiratory infections in infancy or early-onset asthma at five years were ***-learning models relying on extreme gradient boosting regressor or classifier algorithms were developed to predict respiratory infection or asthma risk based on fetal lung *** model development and validation,study participants were randomly divided into a training and a testing group,respectively,by the employed *** enhanced fetal lung growth throughout pregnancy predicted a lower early-life respiratory infection *** sex was associated with a higher risk for respiratory infections in *** lung growth could also predict the risk of asthma at five years of *** designed three machine-learning models to predict the risk and number of infections in infancy as well as the risk of early-onset *** models’R2 values were 0.92,0.90 and 0.93,respectively,underscoring a high accuracy and agreement between the actual and predicted *** variables included known risk factors and novel predictors,such as ultrasound-monitored fetal lung *** Sonographic monitoring of fetal lung growth allows to predict the risk for early-life respiratory infections and asthma.

关键词： Asthma Child risk early-life respiratory infections Prenatal lung development Sexual dimorphism

Percutaneous decannulation of extracorporeal membrane oxygenation using MANTA device:A real-world single-center experience

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World Journal of Cardiology 2024年第10期16卷 574-579页

作者： ioannis Milioglou Alice Qian Pedro Rafael Vieira de Oliveira Salerno Gabriel Tensol Rodrigues Pereira Luis Augusto Palma Dallan Kelsey e Gray Michael Morrison Yasir Abu-Omar Mohammad eldiasty Cristian Baeza Department of Cardiology University Hospitals Cleveland Medical CenterClevelandOH 44106United States Department of Surgery University Hospitals Cleveland Medical Center and Case Western Reserve University School of MedicineClevelandOH 44106United States

BACKGROUND The MANTA vascular closure device(VCD)represents a novel approach to achieving hemostasis after large-bore femoral access *** clinical studies have evaluated the efficacy of the MANTA device across a range of patient populations undergoing different ***,there is still a paucity of data available concerning the use of MANTA devices in aiding the decannulation of venoarterial extracorporeal membrane oxygenation(VAeCMO).AIM To present our single-center experience of utilizing the MANTA VCD in patients undergoing this *** This single-center study included all patients undergoing percutaneous decannulation of femoral VA-eCMO using the MANTA plug-based VCD between January 2021 and October 2023 at University Hospitals Cleveland Medical *** criteria were adult patients who required prolonged(>24 hours)hemodynamic support with *** included all-cause mortality,hemostasis,bleeding,limb ischemia,and site *** This is a retrospective cohort study of 19 patients with a mean age of 56.8 *** of them were males with a mean body mass index of *** most common extracorporeal membrane oxygenation indication was acute coronary syndrome complicated by cardiogenic shock at 36.8%.The mean length of intensive care unit stay for these patients was 18.8±8.42 *** out of 19 patients survived to *** MANTA device was successfully deployed in 19 patients,with 10 procedures conducted at the bedside and 9 in an operating room *** hemostasis was achieved within 5 minutes of MANTA deployment in 17 out of 19 *** 2 patients manual compression after Manta deployment was required to achieve adequate ***,acute lower extremity ischemia was noted in two patients,necessitating endovascular *** infections were reported at the site of MANTA *** Overall,based on our experience and that of other centers,the MANTA VCD

关键词： extracorporeal membrane oxygenation MANTA Decannulation Hemostasis Ischemia