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Prognostic nutritional index in predicting survival of patients with gastric or gastroesophageal junction adenocarcinoma: A systematic review

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World Journal of Gastrointestinal Oncology 2024年第2期16卷 514-526页

作者： Stylianos Fiflis Grigorios Christodoulidis Menelaos Papakonstantinou Alexandros Giakoustidis Stergos Koukias Paraskevi Roussos Marina Nektaria Kouliou Konstantinos Eleftherios Koumarelas Dimitrios Giakoustidis First Department of Surgery General Hospital PapageorgiouThessaloniki 56429Greece Department of General Surgery University Hospital of LarissaLarissa 41110Greece

BACKGROUND Gastric cancer is the third most common cause of cancer related death *** with or without chemotherapy is the most common approach with curative intent;however,the prognosis is poor as mortality rates remain *** indexes have been proposed in the past few years in order to estimate the survival of patients undergoing *** preoperative nutritional status of gastric cancer patients has recently gained attention as a factor that could affect the postoperative course and various indexes have been *** aim of this systematic review was to assess the role of the prognostic nutritional index(PNI)in predicting the survival of patients with gastric or gastroesophageal adenocarcinoma who underwent gastrectomy with curative *** To investigate the role of PNI in predicting the survival of patients with gastric or gastroesophageal junction *** A thorough literature search of PubMed and the Cochrane library was performed for studies comparing the overall survival(OS)of patients with gastric or gastroesophageal cancer after surgical resection depending on the preoperative PNI *** PRISMA algorithm was used in the screening process and finally 16 studies were included in this systematic *** review protocol was registered in the International Prospective Register of Systematic Reviews(PRO) RESULTS Sixteen studies involving 14551 patients with gastric or esophagogastric junction adenocarcinoma undergoing open or laparoscopic or robotic gastrectomy with or without adjuvant chemotherapy were included in this systematic *** patients were divided into high-and low-PNI groups according to cut-off values that were set according to previous reports or by using receiver operating characteristic curve analysis in each individual *** 5-year OS of patients in the low-PNI groups ranged between 39%and 70.6%,while in the high-PNI groups,it ranged between 54.9%and 95.8%.In most of the included st

关键词： Prognostic nutritional index Gastric adenocarcinoma Gastroesophageal junction cancer Prognosis Overall survival

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

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

Is there sufficient evidence to support the use of antibiotic holiday just before the second stage of an infected total hip or knee arthroplasty revision surgery?

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World Journal of Orthopedics 2024年第5期15卷 483-485页

作者： Konstantinos Tsikopoulos Konstantinos Sidiropoulos Department of Orthopaedics Portsmouth Hospitals NHS University TrustPortsmouth University HospitalsPortsmouth PO63LYUnited Kingdom Emergency Department Papageorgiou General Hospital of ThessalonikiThessaloniki 54635Greece Medical School University of PatrasPatras 26504Greece

The practice of implementing an antibiotic holiday before the second stage of hip or knee arthroplasty is currently controversial due to limited evidence for this approach,as per the International Consensus Meeting 2018 on Musculoskeletal Infection.A greater understanding of this issue could augment the quality of Alrayes and Sukeik’s mini-review(2023)on diagnosing,managing,and treating periprosthetic knee ***,a significant lack of literature exists concerning the optimal duration for the antibiotic holiday,calling for more research before establishing any clinical guidelines.

关键词： Septic knee prosthesis revision Two stages Antibiotic holiday

Drawing lines in the sand: The growing threat of obesity in type 1 diabetes

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World Journal of Diabetes 2024年第5期15卷 823-827页

作者： Theocharis Koufakis Dimitrios Patoulias Ioanna Zografou Nikolaos Papanas Djordje S Popovic Second Propedeutic Department of Internal Medicine Aristotle University of ThessalonikiThessaloniki 54642Greece Diabetes Centre Second Department of Internal MedicineDemocritus University of ThraceAlexandroupolis 68100Greece Clinic for Endocrinology Diabetes and Metabolic DisordersClinical Center of VojvodinaMedical FacultyUniversity of Novi SadNovi Sad 21000Serbia

In this editorial,we comment on the article by Zeng et al published in the recent issue of the World Journal of Diabetes in *** focus on the epidemiological,pathophysiological,and clinical interplay between obesity and type 1 diabetes mellitus(T1DM).Overweight and obesity represent a growing threat for modern societies and people with T1DM could not be an exception to this *** exogenous insulin administration,genetic and epigenetic factors,and psy-chosocial and behavioral parameters,along with the modern way of life that incorporates unhealthy eating patterns and physical inactivity,set the stage for the increasing obesity rates in *** our knowledge of the underlying mechanisms that lead to the development of obesity and hyperglycemia expands,it becomes clear that there are overlap zones in the pathophysiology of the two main types of *** regarding strict dividing lines between“autoimmune”and“metabolic”phenotypes increase the risk of trapping physicians into ineffective therapeutic approaches,instead of individualized diabetes *** this context,the use of adjuncts to insulin therapy that have the potential to alleviate cardiorenal risk and decrease body weight can reduce the burden of obesity in patients with T1DM.

关键词： Obesity Overweight Type 1 diabetes Metabolic syndrome

Is there a correlation between the changes in airway inflammation and the changes in respiratory mechanics after vaping in patients with asthma?

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World Journal of Methodology 2024年第2期14卷 127-133页

作者： Serafeim-Chrysovalantis Kotoulas Kalliopi Domvri Alexandros Tsantos Ioanna Papagiouvanni Anastasia Michailidou Dionisios G Spyratos Konstantinos Porpodis Ioanna Grigoriou Despina Papakosta Athanasia Pataka Intensive Care Unit Hippokration General HospitalThessaloniki 54642Greece Pulmonary Department-Oncology Unit Aristotle University of ThessalonikiThessaloniki 57010Greece 2nd Department of Internal Medicine General Hospital of Thessaloniki‘’Ippokration’’Thessaloniki 54642Greece Fourth Department of Internal Medicine Aristotle University of ThessalonikiThessaloniki 54642ThessalonikiGreece 2nd Propaedeutic Department of Internal Medicine General Hospital of Thessaloniki“Ippokration”Thessaloniki 54642Greece Department of Pulmonary Aristotle University of ThessalonikiThessaloniki 57001Greece Respiratory Failure Clinic Papanikolaou General HospitalThessloniki 57001Greece Department of Respiratory Medicine Aristotle Univ ThessalonikiSch MedG Papanikolaou HospResp Failure UnitAristotle University of ThessalonikiThessaloniki 57001Greece

BACKGROUND Electronic cigarettes(ECs)have been promoted as alternatives to traditional *** investigate ECs’effects on respiratory system,especially in patients with respiratory *** We randomly selected 25 smokers with stable moderate asthma and matched them with 25 healthy *** were subjucted to pulmonary function tests(PFTs),impulse oscillometry(IOS),fraction exhaled Nitric Oxide(FeNO),exhaled breathe condensate(EBC)and biomarker measurements before and after vaping one nicotinecontaining *** The increase in FeNO 30 minutes after EC,reflecting airway inflammation,significantly correlated with increase of residual volume(RV),total lung capacity,respiratory impedance at 5 Hz(Z5Hz)and respiratory resistance at 5 and 20 Hz(R5Hz and R20Hz).No significant correlations were found between EBC biomarkers'changes and respiratory *** This is the first study demonstrating that the changes in airway inflammation caused by EC have direct effects in respiratory mechanics of asthmatic patients.

关键词： Asthma Electronic cigarette Airway inflammation Lung function Impulse oscillometry FeNO

Artificial kidney: Challenges and opportunities

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World Journal of Transplantation 2024年第1期14卷 42-47页

作者： Filippos F Karageorgos Stavros Neiros Konstantina-Eleni Karakasi Stella Vasileiadou Georgios Katsanos Nikolaos Antoniadis Georgios Tsoulfas Department of Transplantation Surgery Center for Research and Innovation in Solid Organ TransplantationAristotle University School of MedicineThessaloniki 54642Greece

This review aims to present the developments occurring in the field of artificial organs and particularly focuses on the presentation of developments in artificial *** challenges for biomedical engineering involved in overcoming the potential difficulties are showcased,as well as the importance of interdisciplinary collaboration in this marriage of medicine and *** this review,modern artificial kidneys and the research efforts trying to provide and promise artificial kidneys are *** what are the problems faced by each technology and to what extent is the effort enough to date?

关键词： Artificial kidney Implantable kidney Hemodialysis Peritoneal dialysis Endstage kidney disease

Liver disease in patients with transfusion-dependentβ-thalassemia:The emerging role of metabolism dysfunction-associated steatotic liver disease

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World Journal of Hepatology 2024年第5期16卷 671-677页

作者： Nikolaos Fragkou Efthimia Vlachaki Ioannis Goulis Emmanouil Sinakos 4^(th)Department of Internal Medicine Hippokratio HospitalAristotle University of ThessalonikiThessaloniki 54642Greece 2^(nd)Department of Internal Medicine Hippokratio HospitalAristotle University of ThessalonikiThessaloniki 54642Greece

In this Editorial,we highlight the possible role that metabolism dysfunction-associated steatotic liver disease(MASLD)may play in the future,regarding liver disease in patients with transfusion-dependent β-thalassemia(TDBT).MASLD is characterized by excessive accumulation of fat in the liver(hepatic steatosis),in the presence of cardiometabolic *** is a strong correlation between the occurrence of MASLD and insulin resistance,while its increased prevalence parallels the global epidemic of diabetes mellitus(DM)and *** with TDBT need regular transfusions for life to ensure their *** these transfusions,a large amount of iron is accumulated,which causes saturation of transferrin and leads to the circulation of free iron molecules,which cause damage to vital organs(primarily the liver and myocardium).Over the past,the main mechanisms for the development of liver disease in these patients have been the toxic effect of iron on the liver and chronic hepatitis C,for which modern and effective treatments have been found,resulting in successful *** advances in the treatment and monitoring of these patients have led to a reduction in deaths,and an increase in their life *** increased survival makes them vulnerable to the onset of diseases,which until recently were mainly related to the non-thalassemic general population,such as obesity and *** is insufficient data in the literature regarding the prevalence of MASLD in this population or on the risk factors for its ***,it was recently shown by a study of 45 heavily transfused patients with beta-thalassemia(Padeniya et al,BJH),that the presence of steatosis is a factor influencing the value of liver elastography and thus liver *** findings suggest that future research in the field of liver disease in patients with TDBT should be focused on the occurrence,the risk factors,and the effect of MASLD on these patients.

关键词： Metabolism dysfunction-associated steatotic liver disease Transfusion-dependent thalassemia Metabolic syndrome Hepatic steatosis Non-invasive markers Liver fibrosis

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World Journal of Methodology 2024年第2期14卷 75-87页

作者： Maria Papaioannou Evdoxia Vagiana Serafeim-Chrysovalantis Kotoulas Maria Sileli Katerina Manika Alexandros Tsantos Nikolaos Kapravelos 1^(st)Intensive Care Unit G Papanikolaou General HospitalExohiThessaloniki 57010Greece 2^(nd)Intensive Care Unit G Papanikolaou General HospitalExohiThessaloniki 57010Greece Intensive Care Unit Hippokration General HospitalThessaloniki 54642Greece Department of Pulmonary Medical SchoolAristotle University of ThessalonikiG.Papanikolaou General HospitalExohiThessaloniki 57010Greece 2^(nd)Department of Internal Medicine General Hospital of Thessaloniki“Ippokration”Thessaloniki 54642Greece

BACKGROUND Tracheostomy is commonly used in intensive care unit(ICU)patients who are expected to be on long-term mechanical ventilation or suffer from emergency upper airway ***,some studies have conflicting findings regarding the optimal technique and its timing and *** To provide evidence of practice,characteristics,and outcome concerning tracheostomy in an ICU of a tertiary care *** This was a retrospective cohort study including adult critical care patients in a single ICU for two consecutive ***’demographic characteristics,severity of illness(APACHE II score),level of consciousness[Glasgow Coma Scale(GCS)],comorbidities,timing and type of tracheostomy procedure performed and outcome were *** defined late as tracheostomy placement after 8 days or no *** Data of 660 patients were analyzed(median age of 60 years),median APACHE II score of 19 and median GCS score of 12 at *** was performed in 115 patients,of whom 63 had early and 52 late *** tracheostomy was mainly executed in case of altered level of consciousness and severe critical illness polyneuromyopathy,however there were no significant statistical results(47.6%vs 36.5%,P=0.23)and(23.8%vs 19.2%,P=0.55)*** the method selected,early surgical tracheostomy(ST)was conducted in patients with maxillofacial injuries(50.0%vs 0.0%,P=0.033),whereas late surgical tracheostomy was selected for patients with goiter(44.4%vs 0.0%P=0.033).Patients with early tracheostomy spent significantly fewer days on mechanical ventilation(15.3±8.5 vs 22.8±9.6,P<0.001)and in ICU in general(18.8±9.1 vs 25.4±11.5,P<0.001).Percutaneous dilatation tracheostomy(PDT)vs ST was preferable in older critical care patients in the case of Central Nervous System underlying cause of admission(62.5%vs 26.3%,P=0.004).ST was the method of choice in compromised airway(31.6%,vs 7.3%P=0.008).A large proportion of patients(88/115)with t

关键词： Tracheostomy Early tracheostomy Late tracheostomy Percutaneous dilatation tracheostomy Surgical tracheostomy Weaning Survival Mechanical ventilation