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1Microproteinuria in patients with inflammatory bowel disease:Is it associated with the disease activity or the treatment with 5-aminosalicylic acid?显示文摘瞄准:调查在有煽动性的肠疾病(IBD ) 的病人的 microproteinuria 是否与 5-aminosalicylic 酸(5-ASA ) 与疾病活动或治疗被联系。方法:我们有希望地与 IBD 在 86 个连续病人学习了 microproteinuria, 61 与 ulcerative (UC ) 并且 25 与 Crohn 的疾病(CD ) ,以前象在他们在学习的包括以后的 2 和 6 个月一样。46 个病人为 28.8 个月(范围 1-168 瞬间) 的一个时期收到了 5-ASA。Microalbuminuria (妈磅) 和尿肾的管状的蛋白质 beta2-microglobulin (beta2mGLB ) 和 beta-N-acetyl-D-glucosamidase 铺平(贝它 -- 唠叨) 一夜间在 12-h 象 creatinine 一样被决定尿收集。肿瘤坏死 factor-alpha (TNF-alpha ) 浆液层次也被测量。结果:277 大小的一个总数(194 在 UC 病人并且 83 在 CD 病人) 被执行。在 UC 和 CD 病人的反常 microproteinuria 的流行为妈磅是 12.9% 和 6.0% , 22.7% 和 27.7% 为 beta2mGLB,并且 11.3% 和 8.4% 为贝它 -- 分别地唠叨。妈磅没与 IBD 活动被联系。Beta2mGLB 和贝它 -- 唠叨尿层次被相关到 UC 活动(UCAI:P<0.01;UCEI:P<0.005 ) 。在 UC 病人和贝它的妈磅 -- 在 CD 病人唠叨尿层次与 TNF-alpha 浆液层次有关。一个协会在 microproteinuria 和吸烟习惯之间被注意。有 5-ASA 的治疗没被相关到 microproteinuria 的严厉或到 creatinine 的变化。结论:Microproteinuria 主要与 UC 和它的活动被联系然而并非由 5-ASA 影响了。Androniki C Poulou Konstantinos E Goumas Dimitrios C Dandakis Ioannis Tyrmpas Maria Panagiotaki Androniki Georgouli Dimitrios C Soutos Athanasios Archimandritis 2006World Journal of Gastroenterology2006,12,5:126
2Preface显示文摘This special issue of Acta Mathematica Scientia is dedicated to the celebration of the 70th birthday of Constantine M. Dafermos. Costas is the Alumni-Alumnae University Professor of Brown University, a Fellow of the American Academy of Arts and Sciences,Chen, Gui-Qiang G. Hsiao, Ling Huang, Feimin Tzavaras, Athanasios Wang, Zhen 2012Acta Mathematica Scientia2012,32,1:72
3Efficacy of prone position in acute respiratory distress syndrome patients: A pathophysiology-based review显示文摘Acute respiratory distress syndrome(ARDS) is a syndrome with heterogeneous underlying pathological processes. It represents a common clinical problem in intensive care unit patients and it is characterized by high mortality. The mainstay of treatment for ARDS is lung protective ventilation with low tidal volumes and positive end-expiratory pressure sufficient for alveolar recruitment. Prone positioning is a supplementary strategy available in managing patients with ARDS. It was first described 40 years ago and it proves to be in alignment with two major ARDS pathophysiological lung models; the 'sponge lung'- and the 'shape matching'-model. Current evidence strongly supports that prone positioning has beneficial effects on gas exchange, respiratory mechanics, lung protection and hemodynamics as it redistributes transpulmonary pressure, stress and strain throughout the lung and unloads the right ventricle. The factors that individually influence the time course of alveolar recruitment and the improvement in oxygenation during prone positioning have not been well characterized. Although patients' response to prone positioning is quite variable and hard to predict, large randomized trials and recent meta-analyses show that prone position in conjunction with a lung-protective strategy, when performed early and in sufficient duration, may improve survival in patients with ARDS. This pathophysiology-based review and recent clinical evidence strongly support the use of prone positioning in the early management of severe ARDS systematically and not as a rescue maneuver or a last-ditch effort.Vasilios Koulouras Georgios Papathanakos Athanasios Papathanasiou Georgios Nakos 2016World Journal of Critical Care Medicine2016,5,2:39
4Intussusception of the bowel in adults:A review显示文摘Intussusception of the bowel is defined as the telescop-ing of a proximal segment of the gastrointestinal tract within the lumen of the adjacent segment.This condi-tion is frequent in children and presents with the classic triad of cramping abdominal pain,bloody diarrhea and a palpable tender mass.However,bowel intussusception in adults is considered a rare condition,accounting for 5% of all cases of intussusceptions and almost 1%-5%of bowel obstruction.Eight to twenty percent of cases are idiopathic,without a lead point lesion.Secondary intus-susception is caused by organic lesions,such as inflam-matory bowel disease,postoperative adhesions,Meckel's diverticulum,benign and malignant lesions,metastatic neoplasms or even iatrogenically,due to the presence of intestinal tubes,jejunostomy feeding tubes or after gas-tric surgery.Computed tomography is the most sensitive diagnostic modality and can distinguish between intus-susceptions with and without a lead point.Surgery is the definitive treatment of adult intussusceptions.Formal bowel resection with oncological principles is followed for every case where a malignancy is suspected.Reduction of the intussuscepted bowel is considered safe for benign lesions in order to limit the extent of resection or to avoid the short bowel syndrome in certain circumstances.Athanasios Marinis Anneza Yiallourou Lazaros Samanides Nikolaos Dafnios Georgios Anastasopoulos Ioannis Vassiliou Theodosios Theodosopoulos 2009World Journal of Gastroenterology2009,15,4:31
5MELD vs Child-Pugh and creatinine-modified Child-Pugh score for Dredicting survival in patients with decompensated cirrhosis显示文摘AIM: Model of End-stage Liver Disease (MELD) score has recently gained wide acceptance over the old Child-Pugh score in predicting survival in patients with decompensated cirrhosis, although it is more sophisticated. We compared the predictive values of MELD, Child-Pugh and creatinine modified Child-Pugh scores in decompensated cirrhosis. METHODS: A cohort of 102 patients with decompensated cirrhosis followed-up for a median of 6 mo was studied.Two types of modified Child-Pugh scores estimated by adding 0-4 points to the original score using creatinine levels as a sixth categorical variable were evaluated.RESULTS: The areas under the receiver operating characteristic curves did not differ significantly among the four scores, but none had excellent diagnostic accuracy (areas:0.71-0.79). Child-Pugh score appeared to be the worst, while the accuracy of MELD was almost identical with that of modified Child-Pugh in predicting short-term and slightly better in predicting medium-term survival. In Cox regression analysis, all four scores were significantly associated with survival, while MELD and creatinine-modified Child-Pugh scores had better predictive values (c-statistics: 0.73 and 0.69-0.70) than Child-Pugh score (c-statistics: 0.65). Adjustment for gamma-glutamate transpeptidase levels increased the predictive values of all systems (c-statistics: 0.77-0.81). Analysis of the expected and observed survival curves in patients subgroups according to their prognosis showed that all models fit the data reasonably well with MELD probably discriminating better the subgroups with worse prognosis. CONCLUSION: MELD compared to the old Child-Pugh and particularly to creatinine-modified Child-Pugh scores does not appear to offer a clear advantage in predicting survival in patients with decompensated cirrhosis in daily clinical practice.George V. Papatheodoridis Evangelos Cholongitas Eleni Dimitriadou Giota Touloumi Vassilios Sevastianos Athanasios J. Archimandritis 2005World Journal of Gastroenterology2005,11,20:30
6Advances in prognostic factors in acute pancreatitis:a mini-review显示文摘BACKGROUND:Early assessment of the severity of acute pancreatitis is essential to the proper management of the disease.It is dependent on the criteria of the Atlanta classification system.DATA SOURCES:PubMed search of recent relevant articles was performed to identify information about the severity and prognosis of acute pancreatitis.RESULTS:The scoring systems included the Ranson's or Glasgow's criteria ≥3,the APACHE II classification system ≥8,and the Balthazar's criteria ≥4 according to the computed tomography enhanced scanning findings.The single factors on admission included age >65 years,obesity,hemoconcentration(>44%),abnormal chest X-ray,creatinine >2 mg/dl,C-reactive protein>150 mg/dl,procalcitonin >1.8 ng/ml,albumin <2.5 mg/dl,calcium <8.5 mg/dl,early hyperglycemia,increased intra-abdominal pressure,macrophage migration inhibitory factor,or a combination of IL-10 >50 pg/ml with calcium <6.6 mg/dl.CONCLUSION:The prediction of the severity of acute pancreatitis is largely based on well defined multiple factor scoring systems as well as several single risk factors.Theodoros E Pavlidis Efstathios T Pavlidis Athanasios K Sakantamis 2010Hepatobiliary & Pancreatic Diseases International2010,9,5:25
7Role of soluble triggering receptor expressed on myeloid cells in inflammatory bowel disease显示文摘瞄准:为了调查可溶的被触发的可能的角色,受体在煽动性的肠疾病(IBD ) 的致病在骨髓的上表示了 cells-1 (sTREM-1 ) 。方法:58 个病人被注册;十九个健康志愿者用作控制;8 个病人与 Crohn 的疾病被诊断,并且 31 与 ulcerative。有 Crohn 的疾病和 ulcerative 的病人的临床、内视镜的活动索引分别地被估计。在承认之上,血被取样;sTREM-1 和 TNFalpha 被 thiobarbitourate 试金被免疫分析和 malondialdehyde (MDA ) 测量,在通过一个 HPLC 系统的经过以后。结果:控制,有 Crohn 的疾病的病人和有 ulcerative 的病人的 TNFalpha 的中部的 +/- SE 是 6.02 +/- 3.94, 7.98 +/- 5.08 (P = NS 对控制) ,并且 8.45 +/- 4.15 ng/L (P = 0.018 对控制) 分别地。sTREM-1 的各自的价值是 53.31 +/- 32.93, 735.10 +/- 197.17 (P = 0.008 对控制) 并且 435.82 +/- 279.71 ng/L (P = 0.049 对控制) 。sTREM-1 断然与 Crohn 的疾病活动索引和 ulcerative 的临床、内视镜的活动索引被相关(P = 0.002, 0.001 和 0.009,分别地) 。有 ulcerative 的病人的 sTREM-1 断然与 TNFalpha 被相关(P = 0.001 ) 。结论:sTREM-1 似乎在与肠粘膜的炎性反应的度的关联在 IBD 作为一个新奇调停人表现。Michalis Tzivras Vassilios Koussoulas Evangelos J Giamarellos-Bourboulis Dimitrios Tzivras Thomas Tsaganos Pantelis Koutoukas Helen Giamarellou Athanasios Archimandritis 2006World Journal of Gastroenterology2006,12,21:17
8Prediction of atrial fibrillation development and progression:current perspectives显示文摘Atrial fibrillation(AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression(from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and heart failure and the congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category scores as well as biomarkers related to inflammation may also add important information on this topic. There is now increasing evidence that even in patients with so-called lone or idiopathic AF, the arrhythmia is the manifestation of a structural atrial disease which has recently been defined and described as fibrotic atrial cardiomyopathy. Fibrosis results from a broad range of factors related to AF inducing pathologies such as cell stretch, neurohumoral activation, and oxidative stress. The extent of fibrosis as detected either by late gadolinium enhancement-magnetic resonance imaging or electroanatomic voltage mapping may guide the therapeutic approach based on the arrhythmia substrate. The knowledge of these risk factors may not only delay arrhythmia progression, but also reduce the arrhythmia burden in patients with first detected AF. The present review highlights on the conventional and novel risk factors of development and progression of AF.Konstantinos Vlachos Konstantinos P Letsas Panagiotis Korantzopoulos Tong Liu Stamatis Georgopoulos Athanasios Bakalakos Nikolaos Karamichalakis Sotirios Xydonas Michael Efremidis Antonios Sideris 2016World Journal of Cardiology2016,8,3:16
9Simultaneous development of diabetic ketoacidosis and Hashitoxicosis in a patient treated with pegylated interferon-alpha for chronic hepatitis C显示文摘Classical interferon-alpha has been shown to be correlated with the development of a variety of autoimmune disorders. A 38 year-old female patient developed simultaneously diabetic ketoacidosis and hyperthyroidism 5 mo following initiation of treatment with pegylated interferon-α and ribavirin for chronic hepatitis C. High titers of glutamic acid decarboxylase, antinuclear and thyroid (thyroid peroxidase and thyroglobulin) antibodies were detected. Antiviral treatment was withdrawn and the patient was treated with insulin for insulin-dependent diabetes mellitus and propranolol for hyperthyroidism. Twelve months after cessation of pegylated interferon-α therapy the patient was euthyroid without any medication but remained insulin-dependent.Aspasia S Soultati Spyridon P Dourakis Alexandra Alexopoulou Melanie Deutsch Athanasios J Archimandritis 2007World Journal of Gastroenterology2007,13,8:15
10Impact of periampullary diverticula on the outcome and fluoroscopy time in endoscopic retrograde cholangiopancreatography显示文摘BACKGROUND: It is unclear whether the presence of periampullary diverticula (PAD) affects technical success and complication rates during endoscopic retrograde cholangio- pancreatography (ERCP). Moreover, the impact of PAD on fluoroscopy duration is still unknown. The present study aimed to investigate the success rate and difficulty of common bile duct (CBD) cannulation, post-procedure complications and fluoroscopy duration in patients with and without PAD. METHODS: Patients from January 2008 to December 2010 with PAD (group A) and without PAD (group B) and similar indications for therapeutic ERCP were prospectively compared. The comparison included patient characteristics, findings of ERCP, and details of procedure and fluoroscopy time. The influence of papilla's location with respect to the diverticulum on procedure was also investigated. RESULTS: A total of 428 consecutive patients who had undergone therapeutic ERCP for similar indications were divided in two groups according to the presence (group A, 107 patients) or absence (group B, 321 patients) of PAD. The mean age and ASA score of the patients with PAD were significantly higher than those patients without PAD. The main indication was choledocholithiasis. Successful final CBD cannulation was achieved in 97.20% of the patients in group A vs 99.69% in group B (P=0.05). CBD diameter, number of stones and the largest stone size were significantly higher in group A thangroup B (P<0.001). Complete clearance of the CBD after the first attempt was achieved in 85.86% and 94.75% of the patients in groups A and B, respectively (P=0.03). In both groups, the time needed to complete the procedure and fluoroscopy time was significantly longer in patients with PAD (22.87 vs 18.99 minutes, P<0.001; 76.51 vs 47.42 seconds, P<0.001). There was no significant difference between the two groups in the complication rate. The type of papilla's location with respect to the diverticulum did not influence the total cannulation rate and post-procedure complications. CONCLUSION: The presence of a PAD does not affect the success rate and complications of therapeutic ERCP in expert hands; however, the fluoroscopy time is significantly longer in patients with PAD.Panagiotis Katsinelos Grigoris Chatzimavroudis Kostas Tziomalos Christos Zavos Athanasios Beltsis Georgia Lazaraki Sotiris Terzoudis Jannis Kountouras 2013Hepatobiliary & Pancreatic Diseases International2013,12,4:15
11Cholangiocarcinoma:principles and current trends显示文摘BACKGROUND:Cholangiocarcinoma(CCA)is a lethal cancer of the biliary epithelium,originating from the liver(intrahepatic),at the confluence of the right and left hepatic ducts(hilar)or in the extrahepatic bile ducts.It is a rare malignancy associated with poor prognosis.DATA SOURCES:We searched the PubMed/MEDLINE database for relevant articles published from 1989 to 2008.The search terms used were related to 'cholangiocarcinoma' and its ' treatment'.Although no language restrictions were imposed initially,for the full-text review and final analysis,our resources only permitted the review of articles published in English.This review deals with the treatment of cholangiocarcinoma,the principles and the current trends.RESULTS:The risks and prognostic factors,symptoms and differential diagnosis are thoroughly discussed.In addition,the tools of preoperative diagnosis such as endoscopic retrograde cholangiopancreatography,digital image analysis,fluorescence in situ hybridization and magnetic resonance cholangiopancreatography are reviewed.Moreover,the treatment of CCA is discussed.CONCLUSIONS:The only curative treatment available is surgical management.Unfortunately,many patients present with unresectable tumors,the majority of whom die within a year of diagnosis.Surgical treatment involves major resections of the liver,pancreas and bile duct,with considerable mortality and morbidity.However,in selected cases and where indicated,appropriate management with aggressive surgery may achieve a good outcome with a prolonged survival expectancy.George N Zografos Athanasios Farfaras Flora Zagouri Dimosthenis Chrysikos Kostas Karaliotas 2011Hepatobiliary & Pancreatic Diseases International2011,10,1:14
12Colorectal cancer,screening and primary care: A mini literature review显示文摘Colorectal cancer(CRC) is a common health problem,representing the third most commonly diagnosed cancer worldwide and causing a significant burden in terms of morbidity and mortality,with annual deaths estimated at 700000. The western way of life,that is being rapidly adopted in many regions of the world,is a well discussed risk factor for CRC and could be targeted in terms of primary prevention. Furthermore,the relatively slow development of this cancer permits drastic reduction of incidence and mortality through secondary prevention. These facts underlie primary care physicians(PCPs) being assigned a key role in health strategies that enhance prevention and prompt diagnosis. Herein,we review the main topics of CRC in the current literature,in order to better understand its pathogenesis,risk and protective factors,as well as screening techniques. Furthermore,we discuss preventive and screening policies to combat CRC and the crucial role served by PCPs in their successful implementation. Relevant articles were identified through electronic searches of MEDLINE and through manual searches of reference lists.Athanasios Hadjipetrou Dimitrios Anyfantakis Christos G Galanakis Miltiades Kastanakis Serafim Kastanakis 2017World Journal of Gastroenterology2017,23,33:13
13Current opinion on lymphadenectomy in pancreatic cancer surgery显示文摘BACKGROUND:Adenocarcinoma of the pancreas exhibits aggressive behavior in growth,inducing an extremely poor prognosis with an overall median 5-year survival rate of only 1%-4%.Curative resection is the only potential therapeutic opportunity. DATA SOURCES:A PubMed search of relevant articles published up to 2009 was performed to identify information about the value of lymphadenectomy and its extent in curative resection of pancreatic adenocarcinoma. RESULTS:Despite recent advances in chemotherapy,radio-therapy or even immunotherapy,surgery still remains the major factor that affects the outcome.The initial promising performance in Japan gave conflicting results in Western countries for the extended and more radical pancreatectomy; it has failed to prove beneficial.Four prospective,randomized trials on extended versus standard lymphadenectomy during pancreatic cancer surgery have shown no improvement in long-term survival by the extended resection.The exact lymph node status,including malignant spread and the total number retrieved as well as the lymph node ratio,is the most important prognostic factor.Positive lymph nodes after pancreatectomy are present in 70%.Paraaortic lymph node spread indicates poor prognosis. CONCLUSIONS:Undoubtedly,a standard lymphadenectomy including>15 lymph nodes must be no longer preferred in patients with the usual head location.The extended lymphadenectomy does not have any place,unless in randomized trials.In cases with body or tail location,the radical antegrade modular pancreatosplenectomy gives promising results.Nevertheless,accurate localization and detailed examination of the resected specimen are required for better staging.Theodoros E Pavlidis Efstathios T Pavlidis Athanasios K Sakantamis 2011Hepatobiliary & Pancreatic Diseases International2011,10,1:12
14Foregut duplication cysts of the stomach with respiratory epithelium显示文摘Gastrointestinal duplication is a congenital rare disease entity. Gastric duplication cysts seem to appear even more rarely. Herein, two duplications cysts of the stomach in a 46 year-old female patient are presented. Abdominal computed tomography demonstrated a cystic lesion attached to the posterior aspect of the gastric fundus, while upper gastrointestinal endoscopy was negative. An exploratory laparotomy revealed a non-communicating cyst and a smaller similar cyst embedded in the gastrosplenic ligament. Excision of both cysts along with the spleen was performed and pathology reported two smooth muscle coated cysts with a pseudostratified ciliated epithelial lining (respiratory type).Theodosios Theodosopoulos Athanasios Marinis Konstantinos Karapanos Georgios Vassilikostas Nikolaos Dafnios Lazaros Samanides Εleni Carνounis 2007World Journal of Gastroenterology2007,13,8:12
15Mirizzi syndrome type Ⅴa:A rare coexistence of double cholecysto-biliary and cholecysto-enteric fistulae显示文摘Mirizzi syndrome is a rare cause of intermittent obstructive jaundice,where an impacted stone in the cystic duct or Hartmann's pouch mechanically obstructs the common bile duct(CBD) .We report a rare case of double cholecysto-biliary and cholecysto-enteric fistulae,in a 75-year-old female patient,presenting with a right upper quadrant abdominal pain and intermittent obstructive jaundice.Endoscopic retrograde cholangiopancreatography suggested Mirizzi syndrome.Operative findings included erosions of the lateral wall of the CBD and the second portion of the duodenum due to impacted gallstones.The defects were reconstructed primarily and a Kehr tube was inserted.The patient had an uneventful postoperative course and was discharged on the 14th postoperative day.Pavlos Lampropoulos Nikolaos Paschalidis Athanasios Marinis Spiros Rizos 2010World Journal of Radiology2010,2,10:10
16E2F transcription factors and digestive system malignancies: How much do we know?显示文摘E2F family of transcription factors regulates various cellular functions related to cell cycle and apoptosis. Its individual members have traditionally been classified into activators and repressors, based on in vitro studies. However their contribution in human cancer is more complicated and difficult to predict. We review current knowledge on the expression of E2Fs in digestive system malignancies and its clinical implications for patient prognosis and treatment. E2F1, the most extensively studied member and the only one with prognostic value, exhibits a tumor-suppressing activity in esophageal, gastric and colorectal adenocarcinoma, and in hepatocellular carcinoma (HCC), whereas in pancreatic ductal adenocarcinoma and esophageal squamous cell carcinoma may function as a tumorpromoter. In the latter malignancies, E2F1 immunohistochemical expression has been correlated with higher tumor grade and worse patient survival, whereas in esophageal, gastric and colorectal adenocarcinomas is a marker of increased patient survival. E2F2 has only been studied in colorectal cancer, where its role is not considered significant. E2F4's role in colorectal, gastric and hepatic carcinogenesis is tumor-promoting. E2F8 is strongly upregulated in human HCC, thus possibly contributing to hepatocarcinogenesis. Adenoviral transfer of E2F as gene therapy to sensitize pancreatic cancer cells for chemotherapeutic agents has been used in experimental studies. Other therapeutic strategies are yet to be developed, but it appears that targeted approaches using E2F-agonists or antagonists should take into account the tissue-dependent function of each E2F member. Further understanding of E2Fs' contribution in cellular functions in vivo would help clarify their role in carcinogenesis.Athanasios Xanthoulis Dina G Tiniakos 2013World Journal of Gastroenterology2013,19,21:10
17A case of hepatocellular carcinoma arising within large focal nodular hyperplasia with review of the literature显示文摘Focal nodular hyperplasia (FNH) is a relatively rare benign hepatic tumor, usually presenting as a solitary lesion; however, multiple localizations have also been described. The association of FNH with other hepatic lesions, such as adenomas and haemangiomas has been reported by various authors. We herein report a case of a hepatocellular carcinoma arising within a large focal nodular hyperplasia, in a young female patient.Theodoros Petsas Athanasios Tsamandas Irene Tsota Dionisios Karavias Chrysoula Karatza Vassilios Vassiliou Dimitrios Kardamakis 2006World Journal of Gastroenterology2006,12,40:10
18Autoimmune pancreatitis versus pancreaticcancer: a comprehensive review withemphasis on differential diagnosis显示文摘BACKGROUND: Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis with a discrete pathophysiology occasional diagnostic radiological findings, and characteristic histological features. Its etiology and pathogenesis are still under investigation, especially during the last decade Another aspect of interest is the attempt to establish specific criteria for the differential diagnosis between autoimmune pancreatitis and pancreatic cancer, entities that are frequently indistinguishable. DATA SOURCES: An extensive search of the PubMed database was performed with emphasis on articles about the differential diagnosis between autoimmune pancreatitis and pancreatic cancer up to the present. RESULTS: The most interesting outcome of recent research is the theory that autoimmune pancreatitis and its various extra-pancreatic manifestations represent a systemic fibro inflammatory process called IgG4-related systemic disease The diagnostic criteria proposed by the Japanese Pancreatic Society, the more expanded HISORt criteria, the new definitions of histological types, and the new guidelines of the International Association of Pancreatology help to establish the diagnosis of the disease types. CONCLUSION: The valuable help of the proposed criteria for the differential diagnosis between autoimmune pancreatitis and pancreatic cancer may lead to avoidance of pointless surgical treatments and increased patient morbidity.Kyriakos Psarras Minas E Baltatzis Efstathios T Pavlidis Miltiadis A Lalountas Theodoros E Pavlidis Athanasios K Sakantamis 2011Hepatobiliary & Pancreatic Diseases International2011,10,5:9
19Premalignant lesions and gastric cancer: Current understanding显示文摘Over the last two decades there has been a broad paradigm shift in our understanding of gastric cancer(GC)and its premalignant states from gross histological models to increasingly precise molecular descriptions.In this review we reflect upon the historic approaches to describing premalignant lesions and GC,highlight the current molecular landscape and how this could inform future risk assessment prevention strategies.Athanasios Koulis Andrew Buckle Alex Boussioutas 2019World Journal of Gastrointestinal Oncology2019,11,9:9
20Endoscopic treatment and follow-up of gastrointestinal Dieulafoy's lesions显示文摘AIM: To investigate retrospectively the clinical and endoscopic features of bleeding Dieulafoy's lesions and to assess the short- and long-term effectiveness of endoscopic treatment.METHODS: Twenty-three patients who had gastrointestinal bleeding from Dieulafoy's lesions underwent endoscopic therapy. Demographic data, mode of presentation, riskfactors for gastrointestinal bleeding, blood transfusion requirements, endoscopic findings, details of endoscopic therapy, recurrence of bleeding, and mortality rates were collected and analyzed retrospectively.RESULTS: Hemostasis was attempted by dextrose 50% plus epinephrine in 10 patients, hemoclipping in 8 patients,heater probe in 2 patients and ethanolamine oleate in 2 patients. Comorbid conditions were present in 17 patients (74%). Overall permanent hemostasis was achieved in 18 patients (78%). Initial hemostasis was successful with no recurrent bleeding in patients treated with hemoclipping, heater probe or ethanolamine injection. In the group of patients who received dextrose 50% plus epinephrine injection treatment, four (40%) had recurrent bleeding and one (10%) had unsuccessful initial hemostasis.Of the four patients who had rebleeding, three had unsuccessful hemostasis with similar treatment. Surgical treatment was required in five patients (22%) owing to uncontrolled bleeding, recurrent bleeding with unsuccessful retreatment and inability to approach the lesion. One patient (4.3%) died of sepsis after operation during hospitalization. There were no side-effects related to endoscopic therapy. None of the patients in whom permanent hemostasis was achieved presented with rebleeding from Dieulafoy's lesion over a mean long-term follow-up of 29.8 mo.CONCLUSION: Bleeding from Dieulafoy's lesions can be managed successfully by endoscopic methods, which should be regarded as the first choice. Endoscopic hemoclipping therapy is recommended for bleeding Dieulafoy's lesions.Panagiotis Katsinelos George Paroutoglou Kostas Mimidis Athanasios Beltsis Basilios Papaziogas George Gelas Yiannis Kountouras 2005World Journal of Gastroenterology2005,11,38:8
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