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Two cameras detect more lesions in the small-bowel than one

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World Journal of Gastroenterology 2011年第11期17卷 1462-1467页

作者： Konstantinos Triantafyllou Ioannis S Papanikolaou Kostis Papaxoinis Spiros D Ladas Hepatogastroenterology Unit 2nd Department of Internal Medicine-PropaedeuticAttikon University General HospitalMedical SchoolAthens University12464 AthensGreece 1st department of internal medicine-propaedeutic Laiko General HospitalMedical SchoolAthens University11527 AthensGreece

AIM:To explore the feasibility of dual camera capsule (DCC)small-bowel(SB)imaging and to examine if two cameras complement each other to detect more SB ***:Forty-one eligible,consecutive patients underwent DCC SB *** experienced investigators examined the videos and compared the total number of detected lesions to the number of lesions detected by each camera *** tolerability was assessed using a ***:One patient was *** cameras detected 68 positive findings(POS)in 20(50%)*** of them were detected by the"yellow"camera,48 by the"green"and 28 by both cameras;44%(n=22)of the"yellow"camera’s POS were not detected by the"green"camera and 42%(n=20)of the"green" camera’s POS were not detected by the"yellow"*** two cases,only one camera detected significant *** participants had 216 findings of unknown significance(FUS).The"yellow","green"and both cameras detected 171,161,and 116 FUS,respectively;32%(n=55)of the"yellow"camera’s FUS were not detected by the"green"camera and 28%(n=45)of the"green"camera’s FUS were not detected by the "yellow"*** were no complications related to the examination,and 97.6%of the patients would repeat the examination,if ***:DCC SB examination is feasible and well *** two cameras complement each other to detect more SB lesions.

关键词： Small-bowel capsule endoscopy Dual camera capsule endoscope Feasibility Lesion detection Diagnostic yield

Pulmonary embolism after shoulder surgery:Is it a real threat?

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World Journal of Methodology 2025年第1期15卷 42-50页

作者： Charalampos Pitsilos Pericles Papadopoulos Panagiotis Givissis Byron Chalidis 2^(nd)Orthopaedic department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 54635Greece 1^(st)Orthopaedic department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 57010Greece

Pulmonary embolism(PE)is a rare but devastating complication of shoulder *** from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional *** frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 *** is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of *** usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be *** for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT *** ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 *** most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of *** with DVT may also present with swelling and pain of the respective *** treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,*** instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal *** important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital *** physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.

关键词： Pulmonary embolism Venous thromboembolism Shoulder surgery Shoulder arthroscopy Shoulder arthroplasty

Prevalence,predictors,and clinical consequences of medical adherence in IBD:How to improve it?

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World Journal of Gastroenterology 2009年第34期15卷 4234-4239页

作者： Peter Laszlo Lakatos 1st department of medicine Semmelweis University

Inflammatory bowel diseases(IBD)are chronic diseases with a relapsing-remitting disease course necessitating lifelong ***,non-adherence has been reported in over 40%of patients,especially those in remission taking maintenance therapies for IBD. The economical impact of non-adherence to medical therapy including absenteeism,hospitalization risk, and the health care costs in chronic conditions,is *** causes of medication non-adherence are complex,where the patient-doctor relationship, treatment regimen,and other disease-related factors play key ***,subjective assessment might underestimate *** adherence may result in more frequent relapses,a disabling disease course, in ulcerative colitis,and an increased risk for colorectal *** medication adherence in patients is an important challenge for *** the different patient types,the reasons given by patients for non-adherence,simpler and more convenient dosage regimens,dynamic communication within the health care team,a self-management package incorporating enhanced patient education and physician-patient interaction,and identifying the predictors of nonadherence will help devise suitable plans to optimize patient *** editorial summarizes the available literature on frequency,predictors,clinical consequences,and strategies for improving medical adherence in patients with IBD.

关键词： Inflammatory bowel disease Crohn's disease Ulcerative colitis Therapy Adherence Compliance 5-aminosalicylate Mesalazine Azathioprine

Current status of thiopurine analogues in the treatment in Crohn's disease

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World Journal of Gastroenterology 2011年第39期17卷 4372-4381页

作者： Peter Laszlo Lakatos Lajos S Kiss 1st department of medicine Semmelweis University

In the last decades,with the development of biological therapy,the treatment paradigms in patients with Crohn＇s disease have continuously *** studies focusing on the optimal use of both traditional immunosuppressants and biological therapy have been published,investigating conventional,accelerated stepup and top-down *** addition,much emphasis has been placed in recent years on the de-termination of important predictive factors that could enable early patient stratification,which would lead to a tailored management *** this review,the authors try to highlight new evidence on the optimal timing,benefits,and risks of immunosupressants alone,or in combination,in patients with Crohn＇s disease.

关键词： Crohn's disease Immunosuppressives Azathioprine Thiopurine methyltrans ferase Biologicals

Early ileocolonoscopy with biopsy for the evaluation of persistent post-transplantation diarrhea

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World Journal of Gastroenterology 2010年第30期16卷 3834-3840页

作者： Giorgos Bamias John Boletis Theodoros Argyropoulos Chrysanthi Skalioti Spyros I Siakavellas Ioanna Delladetsima Irene Zouboulis-Vafiadis George L Daikos Spiros D Ladas Gastroenterology Division 1st Department of Internal MedicinePropaedeuticMedical SchoolUniversity of Athens"Laikon" Hospital11527AthensGreece department of Nephrology and Renal Transplantation Unit "Laikon" Hospital11527AthensGreece 1st department of Pathology University of Athens"Laikon"Hospital11527AthensGreece

AIM: To investigate the signifi cance of ileocolonoscopy with histology in the evaluation of post-transplantation persistent diarrhea (PD). METHODS: We retrospectively reviewed all records of renal transplant patients with PD, over a 3-year period. All patients were referred for ileocolonoscopy with biopsy, following a negative initial diagnostic work up. Clinical and epidemiological data were compared between cases with infectious or drug-induced diarrhea. RESULTS: We identif ied 30 episodes of PD in 23 renaltransplant patients (1-3 cases per patient). There were 16 male patients and the mean age at the time of PD was 51.4 years. The average time from transplantation to a PD episode was 62.3 ± 53.2 mo (range 1-199 mo). Ileocolonoscopy detected mucosal abnormalities in 19 cases, whereas the intestinal mucosa appeared normal in 11 cases. Histological examination achieved a specific diagnosis in 19/30 cases (63.3%). In nine out of 11 cases (82%) with normal endoscopic appearance of the mucosa, histological examination of blinded biopsies provided a specif ic diagnosis. The etiology of PD was infectious in 11 cases (36.6%), drug-related in 10 (33.3%), of other causes in three (10%), and of unknown origin in six cases (20%). Infectious diarrhea occurred in significantly longer intervals from transplantation compared to drug-related PD (85.5 ± 47.6 mo vs 40.5 ± 44.8 mo, P st year post-transplantation. Clinical improvement followed therapeutic intervention in 90% of cases. Modif ication of immunosuppressive regimen was avoided in 57% of patients. CONCLUSION: Early ileocolonoscopy with biopsies from both affected and normal mucosa is an important adjunctive tool for the etiological diagnosis of PD in renal transplant patients.

关键词： Endoscopy Post-transplantation diarrhea Histology Enteric infections Mycophenolate mofetilcolitis

Patients admitted in the intensive care unit after solid organ or bone marrow transplantation:Retrospective cohort study

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World Journal of Transplantation 2025年第1期15卷 95-104页

作者： Ana Vujaklija Brajkovic Iva Kosuta Lucija Batur Sara Sundalic Marijana Medic Andro Vujevic Luka Bielen Jaksa Babel department of internal medicine University Hospital Centre ZagrebZagreb 10000Croatia School of medicine University of ZagrebZagreb 10000Croatia

BACKGROUND Solid organ transplantation(SOT)and hematopoietic stem cell transplantation(HSCT)revolutionized the survival and quality of life of patients with malignant diseases,various immunologic,and metabolic disorders or those associated with a significant impairment in a patient's quality of *** To investigate admission causes and treatment outcomes of patients after SOT or HSCT treated in a medical intensive care unit(ICU).METHODS We conducted a single-center,retrospective epidemiological study in the medical ICU at the University Hospital Centre Zagreb,Croatia covering the period from January 1,2018 to December 31,*** The study included 91 patients with either SOT[28 patients(30.8%)]or HSCT[63 patients(69.2%)].The median age was 56(43.2-64.7)years,and 60.4%of the patients were *** with SOT had more comorbidities than patients after HSCT[χ^(2)(5,n=141)=18.513,P1].Sepsis and septic shock were the most frequent reasons for admission,followed by acute respiratory insufficiency in patients following *** rate significantly differed between SOT and HSCT[χ^(2)(1,n=91)=21.767,P1].ICU survival was 57%in the SOT and 12.7%in the HSCT *** need for mechanical ventilation[χ^(2)(1,n=91)=17.081,P1]and vasopressor therapy[χ^(2)(1,n=91)=36.803,P1]was associated with *** necessity for acute renal replacement therapy did not influence patients'survival[χ^(2)(1,n=91)=0.376,P=0.54].In the subgroup of patients with infection,90%had septic shock,and the majority had positive microbiological samples,mostly Gram-negative *** ICU survival of patients with sepsis/septic shock cumulatively was 15%.The survival of SOT patients with sepsis/shock was 45%.CONCLUSION Patients with SOT or HSCT are frequently admitted to the ICU due to sepsis and septic *** advancements in critical care,the mortality rate of patients with refractory septic shock and multiorgan failure in this patient population is extremely hig

关键词： Liver transplantation Kidney transplantation Hematopoietic stem cell transplantation Critical care Sepsis Septic shock Mortality

Lipoma induced jejunojejunal intussusception

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World Journal of Gastroenterology 2007年第26期13卷 3641-3644页

作者： Andreas Manouras Emmanuel E Lagoudianakis Dimitrios Dardamanis Dimitrios K Tsekouras Haridimos Markogiannakis Michael Genetzakis Nikolaos Pararas Artemisia Papadima Christos Triantafillou Vagelogiannis Katergiannakis 1st department of propaedeutic Surgery Hippocrateion HospitalAthens Medical SchoolUniversity of Athens AthensGreece

Intussusception in adults is rare. The clinical picture of intussusception in adults is subtle and the diagnosis is,therefore,elusive. The presence of a structural abnor- mality in the great majority of the adult cases mandates high clinical suspicion. Gastrointestinal lipomas are rare benign tumors and intussusception due to a gastrointes- tinal lipoma constitutes an infrequent clinical entity. The present report describes a case of jejunojejunal intus- susception in an adult with a history of severe episodes of hematochezia and colicky upper abdominal pain. The diagnosis was suspected preoperatively but computed tomography scan could not rule out malignancy. Explor- atory laparotomy revealed jejunojejunal intussusception secondary to a lipoma which was successfully treated with segmental intestinal resection.

关键词： Intussusception Small bowel Gastro-intestinal lipoma Jejunal tumor

Gender disparities and woman-specific trends in Barrett’s esophagus in the United states:An 11-year nationwide populationbased study

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World Journal of Methodology 2025年第1期15卷 60-71页

作者： Karina Fatakhova Faisal Inayat Hassam Ali Pratik Patel Attiq Ur Rehman Arslan Afzal Muhammad Sarfraz Shiza Sarfraz Gul Nawaz Ahtshamullah Chaudhry Rubaid Dhillon Arthur Dilibe Benjamin Glazebnik Lindsey Jones Emily Glazer Division of Gastroenterology and Hepatology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States department of internal medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Division of Gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Division of Gastroenterology and Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States department of internal medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States department of internal medicine St.Dominic's HospitalJacksonMS 39216United States department of Gastroenterology Hepatologyand NutritionCleveland Clinic FoundationClevelandOH 44195United States department of internal medicine Mather Hospital and Hofstra University ZuckerSchool of MedicinePort JeffersonNY 11777United States

BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United states,but many patients who are at risk of EAC are not *** practice guidelines include male gender as a predisposing factor for BE and *** population-based clinical evidence regarding female gender remains *** To study comparative trends of gender disparities in patients with BE in the United *** A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)*** with a primary or secondary diagnosis code of BE were *** major outcome of interest was determining the gender disparities in patients with *** analysis for respective outcomes for females was also reported to ascertain any time-based *** We identified 1204190 patients with BE for the study *** the included patients,717439(59.6%)were men and 486751(40.4%)were *** mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P1).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P1).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P1).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P1).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P1).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P1).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P1).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(***),and diabetes mellitus among females than males(P1).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of *** and diabetes mellitus among women(P1).CONCLUSION The prevalence of BE among

关键词： Barrett’s esophagus Gender disparity Epidemiological trends Esophageal adenocarcinoma Screening endoscopy Female gender Risk factors

Risk for colorectal cancer in ulcerative colitis:Changes,causes and management strategies

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World Journal of Gastroenterology 2008年第25期14卷 3937-3947页

作者： Peter Laszlo Lakatos Laszlo Lakatos 1st department of medicine Semmelweis University 1st department of medicine Csolnoky F. County Hospital

The risk of colorectal cancer for any patient with ulcer-ative colitis is known to be elevated, and is estimated to be 2% after 10 years, 8% after 20 years and 18% after 30 years of disease. Risk factors for cancer in-clude extent and duration of ulcerative colitis, primary sclerosing cholangitis, a family history of sporadic colorectal cancer, severity of histologic bowel inflam-mation, and in some studies, young age at onset of colitis. In this review, the authors discuss recent epide-miological trends and causes for the observed chang-es. Population-based studies published within the past 5 years suggest that this risk has decreased over time, despite the low frequency of colectomies. The crude annual incidence rate of colorectal cancer in ulcerative colitis ranges from approximately 0.06% to 0.16% with a relative risk of 1.0-2.75. The exact mechanism for this change is unknown; it may partly be explained by the more widespread use of maintenance therapy and surveillance colonoscopy.

关键词： Ulcerative colitis Colorectal cancer Riskfactors Surveillance Chemprevention