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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 Voulgaris 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

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Bloodstream infections in the era of the COVID-19 pandemic: Changing epidemiology of antimicrobial resistance in the intensive care unit

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Journal of Intensive medicine 2024年第3期4卷 269-280页

作者： Fotinie Ntziora Efthymia Giannitsioti 1st Department of Propaedeutic Internal medicine Medical SchoolNational and Kapodistrian University of AthensLaiko General HospitalAthensGreece

The Coronavirus disease 2019(COVID-19)pandemic increased the burden of critically ill patients who required hospitalization in the intensive care unit(ICU).Bacterial and fungal co-infections,including bloodstream infections(BSIs),increased significantly in ICU patients with COVID-19;this had a significant negative impact on patient *** data pertaining to BSI episodes from the ICU setting during the COVID-19 pandemic were collected and analyzed for this narrative *** searched the PubMed database for articles published between March 2020 and October 2023;the terms“COVID-19”AND“bloodstream infections”AND“ICU”were used for the search.A total of 778 articles were retrieved;however,only 27 were exclusively related to BSIs in ICU patients with *** pertaining to the epidemiological characteristics,risk factors,characteristics of bacterial and fungal BSIs,patterns of antimicrobial resistance,and comparisons between ICU and non-ICU patients during and before the COVID-19 pandemic were *** on antimicrobial stewardship and infection-control policies were also *** rates of BSI were found to have increased among ICU patients with COVID-19 than in non-COVID-19 patients and those admitted during the pre-pandemic *** gender,60–70 years of age,increased body mass index,high Sequential Organ Failure Assessment scores at admission,prolonged hospital and ICU stay,use of central lines,invasive ventilation,and receipt of extracorporeal membrane oxygenation were all defined as risk factors for *** use of immune modulators for COVID-19 appeared to increase the risk of BSI;however,the available data are ***,Enterococci,Acinetobacter baumannii,and Candida *** as prominent infecting organisms during the pandemic;along with Enterobacterales and Pseudomonas aeruginosa they had a significant impact on ***-resistant organisms prevailed in the ICU,especially if antimicrobial resistance was establish

关键词： COVID-19 Bloodstream infection ICU Antimicr obial resistance Stewardship

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Latest updates on structure and recommendations of cardiac rehabilitation programs in chronic heart failure

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World Journal of Clinical Cases 2024年第8期12卷 1382-1387页

作者： Christos Kourek Alexandros Briasoulis Dimitrios E Magouliotis John Skoularigis Andrew Xanthopoulos Medical school of athens National and Kapodistrian University of AthensAthens 15772Greece Department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece Department of Surgery University Hospital of LarissaLarissa 41110Greece of Cardiology University Hospital of LarissaLarissa 41110Greece

Chronic heart failure(HF)is a clinical syndrome with high morbidity and mor-tality *** rehabilitation(CR)is a medically supervised program designed to maintain or improve cardiovascular health of people living with HF,recommended by both American and European guidelines.A CR program con-sists of a multispecialty group including physicians,nurses,physiotherapists,trainers,nutritionists,and psychologists with the common purpose of improving functional capacity and quality of life of chronic HF *** activity,lifestyle,and psychological support are core components of a successful CR *** has been shown to be beneficial in all ejection fraction categories in HF and most patients,who are stable under medication,are capable of *** individualized exercise prescription should be developed on the basis of a baseline evaluation in all *** main modalities of exercise training are aerobic exercise and muscle strength training of different intensity and *** is important to set the appropriate clinical outcomes from the beginning,in order to assess the effectiveness of a CR *** are still significant limitations that prevent patients from participating in these programs and need to be solved.A significant limitation is the generally low quality of research in CR and the presence of negative trials,such as the rehabilitation after myocardial infarction trial,where comprehensive rehabilitation following myocardial infraction had no important effect on mortality,morbidity,risk factors,or health-related quality of life or *** the present editorial,we present all the updated knowledge and recommendations in CR programs.

关键词： Cardiac rehabilitation Heart failure Outcomes Exercise protocols Prescription Future perspectives Limitations

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Transjugular intrahepatic portosystemic shunt for recompensating decompensated cirrhosis?

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World Journal of Gastroenterology 2024年第20期30卷 2621-2623页

作者： Dimitrios S Karagiannakis Academic Department of Gastroenterology and Hepatology Medical School of National and Kapodistrian University of AthensGeneral Hospital of Athens“Laiko”Athens 11527Greece

Transjugular intrahepatic portosystemic shunt(TIPS)is a medical procedure that has been used to manage variceal bleeding and ascites in patients with *** can prevent further decompensation and improve the survival of high-risk decompensated *** research indicates that TIPS could increase the possibility of recompensation of decompensated cirrhosis when it is combined with adequate suppression of the causative factor of liver ***,the results of the studies have been based on retrospective analysis,and further validation is required by conducting randomized controlled *** this context,we highlight the limitations of the current studies and emphasize the issues that must be addressed before TIPS can be recommended as a potential recompensating tool.

关键词： Decompensated cirrhosis Liver recompensation Baveno VII Transjugular intrahepatic portosystemic shunt

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Targeted nanopore sequencing for the identification of novel PRMT1 circRNAs unveils a diverse transcriptional profile of this gene in breast cancer cells

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Genes & Diseases 2024年第2期11卷 589-592页

作者： Maria Papatsirou Andreas Scorilas Diamantis C.Sideris Christos K.Kontos Department of Biochemistry and Molecular Biology National and Kapodistrian University of AthensPanepistimiopolisAthens GR 15701Greece

Long-read sequencing with nanopore technology has been widely utilized for the identification of the full-length sequence of RNA molecules."It is especially suitable for the identification of circular RNAs(circRNAs),which are regulatory molecules that are regarded as promising non-invasive biomarkers for various human malignancies,including breast cancer.2 The impact of circRNAs derived from the protein arginine methyltransferase 1(PRMT1)gene has not been clarified yet,even though the effect of PRMT1-mediated methylation on breast cancer cell characteristics has been well established.

关键词： PRMT1 breast cancer

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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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Current remarks and future directions on the interactions between metabolic dysfunction-associated fatty liver disease and COVID-19

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World Journal of Gastroenterology 2024年第11期30卷 1480-1487页

作者： Leonidas Brilakis Eirini Theofilogiannakou Panagis M Lykoudis school of medicine National&Kapodistrian University of AthensAthens 11527Greece Division of Surgery&Interventional Science University College LondonLondon WC1E 6BTUnited Kingdom

During the outbreak of the coronavirus disease 2019(COVID-19)pandemic,particular interest rose regarding the interaction between metabolic dysfunctionassociated fatty liver disease(MAFLD)and the COVID-19 *** studies highlighted the fact that individuals with MAFLD had higher probability of severe acute respiratory syndrome coronavirus 2 infection and more severe adverse clinical *** of the proposed mechanisms is the inflammatory response pathway,especially the one involving cytokines,such as interleukin 6,which appeared particularly elevated in those patients and was deemed responsible for additional insult to the already damaged *** should increase our vigilance in terms of early detection,close follow up and early treatment for individuals with MAFLD and COVID-19 *** the direction of early diagnosis,biomarkers such as cytokeratin-18 and scoring systems such as Fibrosis-4 index score are ***-19 is a newly described entity,expected to be of concern for the years to come,and MAFLD is a condition with an ever-increasing *** the interaction between these two entities should be brought into the focus of *** morbidity and mortality of patients with COVID-19 and MAFLD should be the ultimate objective,and the optimal way to achieve this is by designing evidence-based prevention and treatment policies.

关键词： Metabolic dysfunction-associated fatty liver disease COVID-19 Liver fibrosis Cytokine storm Drug induced liver injury

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Recognizing and preventing complications regarding bioresorbable scaffolds during coronary interventions

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World Journal of Cardiology 2024年第9期16卷 508-511页

作者： George Latsios Leonidas Koliastasis Konstantinos Toutouzas Kostas Tsioufis Department of Cardiology Hippokration General HospitalAthens Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece

The evolution of coronary intervention techniques and equipment has led to more sophisticated procedures for the treatment of highly complex ***,as a result,the risk of complications has increased,which are mostly iatrogenic and often include equipment *** dislodgement warrants vigilance for the early diagnosis and a stepwise management approach is required to either expand or retrieve the lost *** the era of bioresorbable scaffolds that are not radiopaque,increased caution is *** imaging may assist in detecting the lost scaffold in cases of no visibility *** lesion preparation is the key to minimizing the possibility of equipment loss;however,in the case that it occurs,commercially available and improvised devices and techniques may be applied.

关键词： Bioresorbable scaffolds Stent dislodgement Complication prevention Coronary complications Equipment failure

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First case of fungal keratitis secondary to Yamadazyma mexicana

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International Journal of Ophthalmology(English edition) 2024年第6期17卷 1164-1167页

作者： Ioannis Giachos Aristea Velegraki Sotiria Palioura First Department of Ophthalmology National and Kapodistrian University of Athens Medical SchoolAthens 11527Greece Mycology Research Laboratory Microbiology DepartmentMedical SchoolNational and Kapodistrian University of AthensAthen 11527Greece BIOIATRIKI S.A Healthcare Group Athens 11526Greece Department of Ophthalmology University of Cyprus Medical SchoolNicosia 2109Cyprus

Dear Editor,Fungal keratitis is a serious and potentially sightthreatening infection that poses a global health concern,with higher incidence rates reported in low-income countries and regions with tropical climates[1-3].Risk factors for fungal keratitis include trauma with vegetative matter,contact lens wear,history of ocular surgery,chronic topical steroid use,low socioeconomic status and tropical climate[1-2].Fungi have the propensity to penetrate deep into the corneal stroma,making the infection difficult to treat with topical antifungal agents *** such as corneal perforation and endophthalmitis can arise in severe cases,making early identification of the causative fungal pathogen of utmost importance[4-5].Moreover,obtaining susceptibilities to the available antifungal agents can be sight and eye saving[5].

关键词： arise steroid income

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Overcoming geographical and socioeconomic limitations in colorectal cancer screening

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1683-1689页

作者： Sofia Rozani Panagis M Lykoudis school of medicine National and Kapodistrian University of AthensAthens 11527Greece Division of Surgery and Interventional Science University College LondonLondon WC1E 6BTUnited Kingdom

Despite colorectal cancer’s(CRC)high global incidence,residents of low-and middle-income countries,as well as low-income minorities in advanced economies have low screening *** studies demonstrate that in these groups higher incidence of CRC is observed,yet screening rates remain low for consistent *** income,low educational background,and lack of awareness in combination with inadequate social security of certain population groups impede access and compliance rates to CRC *** the other hand,despite the global availability of multiple screening approaches(colonoscopy,sigmoidoscopy,faecal occult blood test,faecal immunochemical test,computed tomography-colonography,etc.)with proven diagnostic validity,many low-income countries still lack established screening *** absence of screening guidelines in these countries along with the heterogeneity of guidelines in the rest of the world,demonstrate the need for global measures to tackle this issue *** essential step forward is to develop a global approach that will link specific elements of screening with the incidence and available resources in each country,to ensure the achievement of at least a minimum screening program in low-income *** cheaper,cost-effective techniques,which can be carried out by less specialized healthcare providers,might not be equivalent to endoscopy for CRC screening but seems more realistic for areas with fewer *** has been highlighted as the most pivotal element for the effective implementation of any screening program concerning ***,multiple studies have demonstrated that outreach strategies and community-based educational programs are associated with encouraging outcomes,yet a centrally coordinated expansion of these programs could provide more consistent ***,patient navigator programs,wherever implemented,have increased CRC screening and improved ***,global coordin

关键词： Colorectal cancer Screening Low-and middle-income countries Socioeconomic disparities Cancer

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