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New trends in diagnosis and management of gallbladder carcinoma

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

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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

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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

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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

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Experimental models of high-risk bowel anastomosis in rats:A systematic review

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World Journal of Experimental medicine 2024年第2期14卷 114-131页

作者： Georgios Ntampakis Manousos-Georgios Pramateftakis Elissavet Anestiadou Stefanos Bitsianis Orestis Ioannidis Chryssa Bekiari George Koliakos Maria Karakota Anastasia Tsakona Angeliki Cheva Stamatios Angelopoulos Fourth Department of Surgery Medical SchoolAristotle University of ThessalonikiThessaloniki 57010Greece Laboratory of Anatomy and Histology School of Veterinary MedicineFaculty of Health SciencesAristotle University of ThessalonikiThessaloniki 54124Greece Experimental and Research Center Papageorgiou General Hospital of ThessalonikiThessaloniki 56403Greece Laboratory of Biochemistry Faculty of MedicineAristotle University of ThessalonikiThessaloniki 54124Greece Department of Pathology Faculty of MedicineAristotle University of ThessalonikiThessaloniki 54124Greece

BACKGROUND Anastomotic leaks remain one of the most dreaded complications in gastrointestinal surgery causing significant morbidity,that negatively affect the patients’quality of *** studies play an important role in understanding the pathophysiological background of anastomotic healing and there are still many fields that require further *** drawn from these studies can lead to interventions or techniques that can reduce the risk of anastomotic leak in patients with high-risk *** the advances in experimental protocols and techniques,designing a high-quality study is still challenging for the investigators as there is a plethora of different models *** To review current state of the art for experimental protocols in high-risk anastomosis in *** This systematic review was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses *** identify eligible studies,a comprehensive literature search was performed in the electronic databases PubMed(MEDLINE)and Scopus,covering the period from conception until 18 October *** From our search strategy 102 studies were included and were categorized based on the mechanism used to create a high-risk *** of assessing anastomotic healing were extracted and were individually *** Anastomotic healing studies have evolved over the last decades,but the findings are yet to be translated into human *** is a need for high-quality,well-designed studies that will help to the better understanding of the pathophysiology of anastomotic healing and the effects of various interventions.

关键词： High-risk anastomosis Rats Experimental models Bowel Colon Anastomotic leak Colon resection Inflammatory bowel disease Intra-abdominal sepsis Bursting pressure

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New perspectives in the management of diabetic nephropathy

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World Journal of Diabetes 2024年第6期15卷 1086-1090页

作者： Anna Psyllaki Konstantinos Tziomalos The First Propedeutic Department of Internal medicine Medical SchoolAristotle University of ThessalonikiAHEPA HospitalThessaloniki 54636Greece

Diabetic nephropathy(DN)is the leading cause of end-stage renal disease and is also associated with increased risk for cardiovascular *** recently,strict glycemic control and blockade of the renin-angiotensin system(RAS)constituted the mainstay of treatment of ***,randomized controlled trials showed that sodium-glucose cotransporter 2 inhibitors further reduce the progression of ***,these agents are recommended in all patients with DN regardless of DN stage and HbA1c ***,additional blockade of the RAS with finerenone,a selective non-steroidal mineralocorticoid receptor antagonist,was also shown to prevent both the decline of renal function and cardiovascular events in this ***,promising preliminary findings suggest that glucagon-like peptide 1 receptor agonists might also exert reno-and cardioprotective effects in patients with ***,this knowledge will improve the outcomes of this high-risk group of patients.

关键词： Diabetes mellitus Diabetic nephropathy Sodium-glucose cotransporter 2 inhibitors Finerenone Glucagon-like peptide 1 receptor agonists Finerenone

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Electrocardiographic characteristics of pediatric and adolescent football players

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Sports medicine and Health Science 2024年第2期6卷 179-184页

作者： Maria Doumparatzi Panagiota Sotiriou Asterios Deligiannis Evangelia Kouidi Sports medicine Laboratory School of Physical Education and Sports ScienceAristotle University of ThessalonikiThermiGR57001Greece

Electrocardiographic characteristics of children and adolescents present differences compared to *** aim of our work was to study electrocardiograms(ECGs)of football male players from childhood to late adolescence and examine if the ECG parameters are influenced by systematic *** thousand fifty-four football players participated and formed four *** A included 89 players aged 5–7 years,group B 353 players aged 8–11 years,group C consisted of 355 football players 12-15 yearsold and group D of 257 players with 16–18 years of *** participants underwent preparticipation screening,including 12-lead surface *** rate(HR),PR,RR,QRS,QT,QTc intervals,QT dispersion(QTdisp)and QRS axis were *** ECGs were evaluated according to the current preparticipation cardiac screening guidelines,that refer to athletes aged 12–35 years and do not include pediatric *** percent of the participants presented an ECG *** D obtained the lowest values of HR,QTc and the highest of PR,RR,QRS,QT intervals and QTdisp,whereas no differences in QRS axis were *** Right Bandle Branch Block(RBBB)was the most frequent ECG peculiarity,detected in 7.3%of the *** of training were statistically significantly correlated to HR,PR,RR,QRS and QT *** conclusion,guidelines for ECG interpretation of athletes in childhood,early and late adolescence are needed.

关键词： Exercise Children Adolescents Electrocardiogram Soccer

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Regenerative medicine strategies for chronic complete spinal cord injury

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Neural Regeneration Research 2024年第4期19卷 818-824页

作者： Shogo Hashimoto Narihito Nagoshi Masaya Nakamura Hideyuki Okano Department of Orthopedic Surgery Keio University School of Medicine Department of Physiology Keio University School of Medicine

Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various *** rapid progress has been made in regenerative medicine for spinal cord injury that was previously untreatable,most research in this field has focused on the early phase of incomplete ***,the majority of patients have chronic severe injuries;therefore,treatments for these situations are of fundamental *** reason why the treatment of complete spinal cord injury has not been studied is that,unlike in the early stage of incomplete spinal cord injury,there are various inhibitors of neural ***,we assumed that it is difficult to address all conditions with a single treatment in chronic complete spinal cord injury and that a combination of several treatments is essential to target severe ***,we established a combination therapy of cell transplantation and drug-releasing scaffolds,which contributes to functional recovery after chronic complete transection spinal cord injury,but we found that functional recovery was limited and still needs further ***,for the further development of the treatment of chronic complete spinal cord injury,we review the necessary approaches to the different pathologies based on our findings and the many studies that have been accumulated to date and discuss,with reference to the literature,which combination of treatments is most effective in achieving functional recovery.

关键词： cell transplantation chronic phase complete transection regenerative medicine spinal cord injury

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Extending the decision-making process during yellow phase from human drivers to autonomous vehicles:A microsimulation study with safety considerations

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Journal of Traffic and Transportation Engineering(English Edition) 2024年第2期11卷 362-379页

作者： Efthymis Papadopoulos Anastasia Nikolaidou Emmanouil Lilis Ioannis Politis Panagiotis Papaioannou Transport Engineering Laboratory School of Civil EngineeringFaculty of EngineeringAristotle University of ThessalonikiThessaloniki 54124Greece

One of the main factors affecting the safety of signalised intersections is the stop/go behaviour during the yellow *** previous research has exhaustively examined drivers’stop/go decision-making,the expected autonomous vehicles’(AVs’)stop/go behaviour has not yet been thoroughly *** a series of simulation experiments developed for conventional and autonomous vehicles using different carfollowing,lane-changing,lateral placement and stop/go model parameter values,we examine here whether the default VISSIM stop/go parameter values can adequately replicate the observed drivers’behaviour at the considered intersection and assess the suitability of using the currently available options,albeit referring to human drivers,to simulate the expected stop/go behaviour of *** also propose a policy framework for determining the desired behaviour of AVs in yellow interval,which is integrated into an AVs logic and achieved in the last simulation to explore the effect of automation on the stop/go outcome and,hence,on the safety level of signalised *** data analysis and modeling techniques were used for the formulation of certain scenarios,including binary choice *** default stop/go parameter values were found unfit to replicate the observed stop/go behaviour and subjected to *** to the currently available options,the proposed AVs logic proved to produce the most accurate results,in terms of the stop/go simulation *** the impact of automation on the stop/go outcome,the simulation experiments showed that AVs preferred a more conservative behaviour in favor of road safety,as indicated by the significant reduction(≈15%)in the number of vehicles crossing the stop line during the yellow light and zero instances of red light ***,compared to the conservative drivers represented by the default stop/go parameter values,AVs preferred a more rational behaviour in favor of intersection capacit

关键词： Driver behaviour AVs behaviour Signalised intersection Choice model Micro-simulation Policy framework

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Cannabinoids and endocannabinoids as therapeutics for nervous system disorders:preclinical models and clinical studies

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Neural Regeneration Research 2024年第4期19卷 788-799页

作者： R.Scott Duncan Sean M.Riordan Matthew C.Gernon Peter Koulen Department of Ophthalmology School of MedicineUniversity of Missouri Department of Biomedical Sciences School of MedicineUniversity of Missouri

Cannabinoids are lipophilic substances derived from Cannabis sativa that can exert a variety of effects in the human *** have been studied in cellular and animal models as well as in human clinical trials for their therapeutic benefits in several human *** of these include central nervous system(CNS)diseases and dysfunctions such as forms of epilepsy,multiple sclerosis,Parkinson’s disease,pain and neuropsychiatric *** addition,the endogenously produced cannabinoid lipids,endocannabinoids,are critical for normal CNS function,and if controlled or modified,may represent an additional therapeutic avenue for CNS *** review discusses in vitro cellular,ex vivo tissue and in vivo animal model studies on cannabinoids and their utility as therapeutics in multiple CNS *** addition,the review provides an overview on the use of cannabinoids in human clinical trials for a variety of CNS *** and endocannabinoids hold promise for use as disease modifiers and therapeutic agents for the prevention or treatment of neurodegenerative diseases and neurological disorders.

关键词： anandamide cannabidiol cannabinoid endocannabinoid epilepsy multiple sclerosis neurodegeneration neuroprotection tetrahydrocannabinol

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