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| 1 | From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world显示文摘Hepatocellular carcinoma(HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer Staging System remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma. | Dimitrios Dimitroulis Christos Damaskos Serena Valsami Spyridon Davakis Nikolaos Garmpis Eleftherios Spartalis Antonios Athanasiou Demetrios Moris Stratigoula Sakellariou Stylianos Kykalos Gerasimos Tsourouflis Anna Garmpi Ioanna Delladetsima Konstantinos Kontzoglou Gregory Kouraklis | 2017 | World Journal of Gastroenterology2017，23，29： | 44 |
| 2 | Role of probiotics,prebiotics and synbiotics in chemoprevention for colorectal cancer显示文摘Colorectal cancer is the third most common form of cancer.Current treatments are all associated with a high risk of complications and a low success rate.Recently,synbiotics have been proposed as a new preventive and therapeutic option.There is no direct experimental evidence for cancer suppression in humans as a result of the consumption of pro-,pre-or synbiotics.However,there is a wealth of evidence emerging from laboratory studies.The mechanisms by which pro-,pre-and synbiotics may inhibit colon cancer are now beginning to be understood and will be addressed in the present review. | Constantine Iosif Fotiadis Christos Nikolaou Stoidis Basileios Georgiou Spyropoulos Eleftherios Dimitriou Zografos | 2008 | World Journal of Gastroenterology2008，14，42： | 16 |
| 3 | Overview of coronary artery variants, aberrations and anomalies显示文摘Coronary artery anomalies and variants are relatively uncommon congenital disorders of the coronary artery anatomy and constitute the second most common cause of sudden cardiac death in young competitive athletes. The rapid advancement of imaging techniques, including computed tomography, magnetic resonance imaging, intravascular ultrasound and optical coherence tomography, have provided us with a wealth of new information on the subject. Anomalous origin of a coronary artery from the contralateral sinus is the anomaly most frequently associated with sudden cardiac death, in particular if the anomalous coronary artery has a course between the aorta and the pulmonary artery. However, other coronary anomalies, like anomalous origin of the left coronary artery from the pulmonary artery, atresia of the left main stem and coronary fistulae, have also been implicated in cases of sudden cardiac death. Patients are usually asymptomatic, and in most of the cases, coronary anomalies are discovered incidentally during coronary angiography or on autopsy following sudden cardiac death. However, in some cases, symptoms like angina, syncope, heart failure and myocardial infarction may occur. The aims of this article are to present a brief overview of the diverse coronary variants and anomalies, focusing especially on anatomical features, clinical manifestations, risk of sudden cardiac death and pathophysiologic mechanism of symptoms, as well as to provide valuable information regarding diagnostic workup, follow-up, therapeutic choices and timing of surgical treatment. | Stylianos Kastellanos Konstantinos Aznaouridis Charalambos Vlachopoulos Eleftherios Tsiamis Evangelos Oikonomou Dimitris Tousoulis | 2018 | World Journal of Cardiology2018，10，10： | 12 |
| 4 | Obstructive sleep apnea syndrome and cardiovascular disease: The influence of C-reactive protein显示文摘Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein(CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS. | Izolde Bouloukaki Charalampos Mermigkis Eleftherios M Kallergis Violeta Moniaki Eleni Mauroudi Sophia E Schiza | 2015 | World Journal of Experimental Medicine2015，5，2： | 12 |
| 5 | The evolution of corneal and refractive surgery with the femtosecond laser显示文摘The use of femtosecond lasers has created an evolution in modern corneal and refractive surgery.With accuracy,safety,and repeatability,eye surgeons can utilize the femtosecond laser in almost all anterior refractive procedures;laser in situ keratomileusis(LASIK),small incision lenticule extraction(SMILE),penetrating keratoplasty(PKP),insertion of intracorneal ring segments,anterior and posterior lamellar keratoplasty(Deep anterior lamellar keratoplasty(DALK)and Descemet's stripping endothelial keratoplasty(DSEK)),insertion of corneal inlays and cataract surgery.As the technology matures,it will push surgical limits and open new avenues for ophthalmic intervention in areas not yet explored.As we witness the transition from femto-LASIK to femto-cataract surgery it becomes obvious that this innovation is here to stay.This article presents some of the most relevant advances of femtosecond lasers to modern corneal and refractive surgery. | Antonis Aristeidou Elise V.Taniguchi Michael Tsatsos Rodrigo Muller Colm McAlinden Roberto Pineda Eleftherios I.Paschalis | 2015 | Eye and Vision2015，2，1： | 9 |
| 6 | Dementia and osteoporosis in a geriatric population: Is there a common link?显示文摘AIM To determine the existence of a common pathological link between dementia and osteoporosis through reviewing the current evidence base. METHODS This paper reviews the current literature on osteoporosis and dementia in order to ascertain evidence of a common predisposing aetiology. A literature search of Ovid MEDLINE(1950 to June 2016) was conducted. The keywords 'osteoporosis', 'osteoporotic fracture', 'dementia' and 'Alzheimer's disease'(AD) were used to determine the theoretical links with the most significant evidence base behind them. The key links were found to be vitamins D and K, calcium, thyroid disease, statins, alcohol and sex steroids. These subjects were then searched in combination with the previous terms and the resulting papers manually examined. Theoretical, in vitro and in vivo research were all used to inform this review which focuses on the most well developed theoretical common causes for dementia(predominantly Alzheimer's type) and osteoporosis.RESULTS Dementia and osteoporosis are multifaceted disease processes with similar epidemiology and a marked increase in prevalence in elderly populations. The existence of a common link between the two has been suggested despite a lack of clear pathological overlap in our current understanding. Research to date has tended to be fragmented and relatively weak in nature with multiple confounding factors reflecting the difficulties of in vivo experimentation in the population of interest. Despite exploration of various possible mechanisms in search for a link between the two pathologies, this paper found that it is possible that these associations are coincidental due to the nature of the evidence available. One finding in this review is that prior investigation into common aetiologies has found raised amyloid beta peptide levels in osteoporotic bone tissue, with a hypothesis that amyloid beta disorders are systemic disorders resulting in differing tissue manifestations. However, our findings were that the most compelling evidence of a common yet independent aetiology lies in the APOE4 allele, which is a well-established risk for AD but also carries an independent association with fracture risk. The mechanism behind this is thought to be the reduced plasma vitamin K levels in individuals exhibiting the APOE4 allele which may be amplified by the nutritional deficiencies associated with dementia, which are known to include vitamins K and D. The vitamin theory postulates that malnutrition and reduced exposure to sunlight in patients with AD leads to vitamin deficiencies. CONCLUSION Robust evidence remains to be produced regarding potential links and regarding the exact aetiology of these diseases and remains relevant given the burden of dementia and osteoporosis in our ageing population. Future research into amyloid beta, APOE4 and vitamins K and D as the most promising aetiological links should be welcomed. | Candice L Downey Adam Young Emily F Burton Simon M Graham Robert J Macfarlane Eva-Maria Tsapakis Eleftherios Tsiridis | 2017 | World Journal of Orthopedics2017，8，5： | 6 |
| 7 | Colonoscopy attachments for the detection of precancerous lesions during colonoscopy:A review of the literature显示文摘Although colonoscopy has been proven effective in reducing the incidence of colorectal cancer through the detection and removal of precancerous lesions, it remains an imperfect examination, as it can fail in detecting up to almost one fourth of existing adenomas. Among reasons accounting for such failures, is the inability to meticulously visualize the colonic mucosa located either proximal to haustral folds or anatomic curves, including the hepatic and splenic flexures. In order to overcome these limitations, various colonoscope attachments aiming to improve mucosal visualization have been developed. All of them-transparent cap, Endocuff, Endocuff Vision and Endorings-are simply mounted onto the distal tip of the scope. In this review article, we introduce the rationale of their development, present their mode of action and discuss in detail the effect of their implementation in the detection of lesions during colonoscopy. | Paraskevas Gkolfakis Georgios Tziatzios Eleftherios Spartalis Ioannis S Papanikolaou Konstantinos Triantafyllou | 2018 | World Journal of Gastroenterology2018，24，37： | 5 |
| 8 | Effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats: What we know so far?显示文摘We read with great interest the article entitled ‘‘Comparative study of the effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats’’ by Ulmer et al. [1]. The aim of this study was to analyse the impact of terlipressin versus splenectomy on postoperative liver function and liver regeneration in rats undergoing 70% partial hepatectomy. Ulmer and his colleagues concluded that neither the administration of terlipressin nor splenectomy improved liver regeneration after 70% partial hepatectomy in rats. This is a very interesting research in our understanding regarding the study of postoperative liver failure and liver regeneration after modulation of portal vein pressure. However, there are some questions which demand further consideration. | antonios athanasiou eleftherios spartalis mairead hennessy michael spartalis demetrios moris christos damaskos emmanouil pikoulis | 2018 | Hepatobiliary & Pancreatic Diseases International2018，17，1： | 5 |
| 9 | Cytokines as biomarkers of inflammatory response after open versus endovascular repair of abdominal aortic aneurysms: a systematic review显示文摘一个腹的大动脉的动脉瘤(AAA ) 的修理是与有煽动性的串联的随后的激活的神经质、新陈代谢的压力相关的反应有关的一个高风险的外科的过程。与开的修理相对照(或) , endovascular 大动脉的动脉瘤修理(EVAR ) 由为更少提供广泛的切口,解剖,和织物操作似乎是手术后的压力到减少。然而,这些有益的效果可以是由代谢物在用在 endovascular 的导管的血栓的 intra 钠操作期间修理的 cytokines 和 arachidonic 酸的版本的偏移量,导致全身的煽动性的反应(先生) ,它是临床上叫的培植以后的症候群。在我们比较了的这系统的评论或与 EVAR,以 post-interventional,从改变导致传播 cytokine 的煽动性的反应铺平。我们寻求了在 EVAR 以后关于培植以后的症候群总结所有最近的证据。我们寻找了为临床的研究作为煽动性的反应的部分在 cytokines 的版本上报导在以后的 Medline (PubMed ) , ClinicalTrials.gov 和 Cochrane 图书馆开 / 常规并且 AAA 的 endovascular 修理。我们鉴别 17 学习检验 cytokine 层次在以后或对 EVAR。或似乎特别地比 EVAR 与一位更大的先生被联系,由增加的 cytokine 层次证实了 IL-6 和 IL-8 而 IL-1, IL-10 和 TNF- 出现了,冲突在二之间的结果或没有差别组织。聚酯 endografts 看起来断然在 EVAR 以后与培植以后的症候群的发生被相关。未来大未来的研究被保证位于在 surgical 以后的 cytokine 相互作用下面描出的机制煽动性的反应背景。 | Diamantis I TSILIMIGRAS Fragiska SIGALA Georgios KARAOLANIS Ioannis NTANASIS-STATHOPOULOS Eleftherios SPARTALIS Michael SPARTALIS Nikolaos PATELIS Alexandros PAPALAMPROS Chandler LONG Demetrios MORIS | 2018 | Acta Pharmacologica Sinica2018，39，7： | 5 |
| 10 | Attainment of multifactorial treatment targets among the elderly in a lipid clinic显示文摘ObjectiveTo 检验目标成就类脂化合物阴沉, antihypertensive 和 antidiabetic 治疗在在在 Greece.MethodsThis 的一所大学医院的一个专家背景老是包括连续题目 ≥ 的回顾的研究;65 岁(n = 465 ) 与后续 ≥3 年。低密度的脂蛋白胆固醇( LDL-C ),血压( BP )和 glycated 血红素( HbA1c )目标成就根据心病学/欧洲人动脉粥样硬化社会( ESC/EAS )的欧洲社会被记录,为糖尿病( EASD ) guidelines.ResultsThe LDL-C 目标的学习的高血压( ESH ) /ESC 和欧洲协会的欧洲社会被27%很高、高、中等的风险病人,48%和62%分别地达到。更高完成的那些收到的 statin + ezetimibe 与那些收到的 statin monotherapy 相比 LDL-C 目标成就评价(48% 对 33% , P <0.05 ) 。糖尿病的题目, 71% 有 BP <140/85 mmHg,当没有糖尿病, 78% 那些有 BP < 时;140/90 mmHg。非糖尿病的个人(86%) 的一个更高的比例有 BP <150/90 mmHg。另外,有糖尿病的那些的一个更高的比例有 HbA1c <8% 而非 <7%(88% 和 47% ,分别地) 。笔记,从三个非糖尿病的个人的几乎一个和从十个糖尿病的个人的一个在一所大学医院,在非最优的 LDL-C 的老遗体的一个高比例, BP 和 HbA1c 层次的一个专家背景完成了所有三治疗 targets.ConclusionsEven。药联合的使用能改进 multifactorial 治疗目标成就,当不太严格的目标能更容易在这张人口被完成时。 | Fotios Barkas Evangelos Liberopoulos Eleftherios Klouras Angelos Liontos Moses Elisaf | 2015 | Journal of Geriatric Cardiology2015，12，3： | 5 |
| 11 | Hepatocellular carcinoma in patients co-infected with hepatitis C virus and human immunodeficiency virus显示文摘Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) share a common route of transmission so that about one third of HIV infected individuals show HCV coinfection. Highly active antiretroviral therapy has offered a longer and better life to infected patients. While has removed AIDS-related diseases from the list of most common causes of death their place has been taken by complications of HCV infection, such as cirrhosis, end stage liver disease and hepatocellular carcinoma (HCC). HIV/HCV co-infection requires complex management, especially when HCC is present. Co-infected patients with HCC undergo the same therapeutic protocol as their mono-infected counterparts, but special issues such as interaction between regimens, withdrawal of therapy and choice of immunosuppressive agents, demand a careful approach by specialists. All these issues are analyzed in this minireview. | Dimitrios Dimitroulis Serena Valsami Eleftherios Spartalis Emmanuel Pikoulis Gregory Kouraklis | 2013 | World Journal of Hepatology2013，5，6： | 4 |
| 12 | Indications,limitations and maneuvers to enable extended hepatectomy:Current trends显示文摘The liver is a solid organ with a wide variety of primary benign or malignant tumors as well as metastatic lesions.Surgical resection of these tumors remains the only curative modality.Several limitations,however,do not allow the performance of these operations.This review evaluates the indications and limitations regarding these extended hepatic resections,as well as describing all the manipulations that increase the candidates for such operations.A thorough review of the literature was performed in order to define indications for extended hepatectomy,as well as to present all methods that contribute to increasing the volume of the future remnant liver.The role of portal vein ligation,portal vein embolization,two-stage hepatectomy,and in situ liver transection are evaluated in the setting of indications and results.Extended hepatectomies are a necessity due to oncological reasons.All methods developed in order to increase the volume of the remnant liver are safe and efficient.in situ liver transection is a novel and revolutionary two-step procedure for extended hepatic resections.Further clinical studies are required to estimate long-term results and the oncological basis of this technique. | Dimitrios Dimitroulis Petros Tsaparas Serena Valsami Dimitrios Mantas Eleftherios Spartalis Charalampos Markakis Gregory Kouraklis | 2014 | World Journal of Gastroenterology2014，20，24： | 4 |
| 13 | Kallikrein-related peptidases 6 and 10 are elevated in cerebrospinal fluid of patients with Alzheimer’s disease and associated with CSF-TAU and FDG-PET显示文摘Background:Alterations in the expression of human kallikrein-related peptidases(KLKs)have been described in patients with Alzheimer’s disease(AD).We elucidated the suitability of KLK6,KLK8 and KLK10 to distinguish AD from NC and explored associations with established AD biomarkers.Methods:KLK levels in cerebrospinal fluid(CSF),as determined by ELISA,were compared between 32 AD patients stratified to A/T/(N)system with evidence for amyloid pathology and of 23 normal controls with normal AD biomarkers.Associations between KLK levels and clinical severity,CSF and positron emission tomography(PET)based AD biomarkers were tested for.Results:Levels of KLK6 and KLK10 were significantly increased in AD.KLK6 differed significantly between AD A+/T+/N+and AD A+/T−/N+or NC with an AUC of 0.922.CSF pTau and tTau levels were significantly associated with KLK6 in AD.Conclusions:KLK6 deserves further investigations as a potential biomarker of Tau pathology in AD. | Oliver Goldhardt Inanna Warnhoff Igor Yakushev Ilijana Begcevic Hans Förstl Viktor Magdolen Antoninus Soosaipillai Eleftherios Diamandis Panagiotis Alexopoulos Timo Grimmer | 2019 | Translational Neurodegeneration2019，8，1： | 3 |
| 14 | Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial显示文摘 | David N Krag Stewart J Anderson Thomas B Julian Ann M Brown Seth P Harlow Joseph P Costantino Takamaru Ashikaga Donald L Weaver Eleftherios P Mamounas Lynne M Jalovec Thomas G Frazier R Dirk Noyes André Robidoux Hugh MC Scarth Norman Wolmark | 2010 | Lancet Oncology2010，，10： | 3 |
| 15 | Posterior shoulder fracture-dislocation:A systematic review of the literature and current aspects of management显示文摘Purpose Posterior fracture-dislocation of shoulder is an infrequent traumatic event;however,most orthopaedic surgeons may face the challenge of treating it.The aim of this study is to review and summarise systematically the current principles of the management of this complex injury,and create a treatment algorithm.Methods Both PubMed and Scopus Databases were systematically searched for the terms“posterior shoulder fracture-dislocation”or“posterior glenohumeral fracture-dislocation”or“posterior glenoid fracture-dislocation”for articles written in English and published in the last decade.Results A total of 900 articles were identified,of which 13 were retained for analysis.A total of 153 patients(161 shoulders)were identified.These patients were treated either with open reduction and internal fixation,modified McLaughlin procedure,allograft/autograft humeral head reconstruction or shoulder arthroplasty.The mean age was 40.15 years.The mean postoperative Constant score in cases treated by open reduction and internal fixation was 86.45,whereas by bone graft was 84.18.Further,the mean postoperative Constant score was between 79.6 and 67.1 in those that were managed by modified McLaughlin and arthroplasty procedure,respectively.Conclusion The management of posterior shoulder fracture-dislocation may be challenging,and the best surgical option depends on many variables such as the chronicity of the injury,the presence of a fracture at the level of the surgical neck or tuberosities and the extend of the Hill-Sachs lesion if any.A treatment algorithm is proposed,based on the current literature in an effort to create a consensus for these injuries.For the acute shoulder fracture-dislocations,an open reduction should be performed.For the chronic fracture/dislocations in the elderly low-demand patients,conservative treatment should be performed.For the rest of the patients,depending on the severity of the Hill-Sachs lesion different surgical options are available such as the McLaughlin technique,the use of an allograft,osteotomy or arthroplasty. | Georgios Paparoidamis Efthymios Iliopoulos AAli Narvani Ofer Levy Eleftherios Tsiridis loannis Polyzois | 2021 | Chinese Journal of Traumatology2021，24，1： | 3 |
| 16 | Concept of histone deacetylases in cancer:Reflections on esophageal carcinogenesis and treatment显示文摘Esophageal cancer (EC) presents a high mortality rate, mainly due to its aggressive nature. Squamous cell carcinoma is the most common histological type world-wide, though, a continuous increase in esophageal adenocarcinomas has been noted in the past decades. Common risk factors associated with EC include smoking, alcohol consumption, gastroesophageal reflux disease, Barrett's esophagus and obesity. In an effort to overcome chemotherapy resistance in oncology, it was discovered that histone acetylation/deacetylation equilibrium is altered in carcinogenesis, leading to changes in chromatin structure and altering expression of genes important in the cell cycle, differentiation and apoptosis. Based on this knowledge, histone acetylation was addressed as a potential novel chemotherapy drug target to repress cancer cell proliferation. There are four classes of histone deacetylases (HDACs) inhibitors with a variety of different mechanisms of actions that render them possible anticancer drugs. They arrest the cell cycle, inhibit differentiation and angiogenesis and induce apoptosis. They do not necessarily act on histone proteins, since they can also exert indirect anti-cancer effects, by modifying various cellular proteins.In addition,HDACs have also been associated with increased chemotherapy resistance.Based on the literature,HDACs have been associated with EC,with surveys revealing that increased expression of certain HDACs correlates with advanced TNM stages,tumor grade,metastatic potential and decreased 5-year overall and disease-free survival.The aim of this survey is to elucidate the molecular identity and mechanism of action of HDAC inhibitors as well as verify their potential utility as anti-cancer agents in esophageal cancer. | Dimitrios Schizas Aikaterini Mastoraki Leon Naar Eleftherios Spartalis Diamantis I Tsilimigras Georgia-Sofia Karachaliou George Bagias Dimitrios Moris | 2018 | World Journal of Gastroenterology2018，24，41： | 3 |
| 17 | Exercise training in heart transplantation显示文摘Heart transplantation remains the gold standard in the treatment of end-stage heart failure(HF).Heart transplantation patients present lower exercise capacity due to cardiovascular and musculoskeletal alterations leading thus to poor quality of life and reduction in the ability of daily self-service.Impaired vascular function and diastolic dysfunction cause lower cardiac output while decreased skeletal muscle oxidative fibers,enzymes and capillarity cause arteriovenous oxygen difference,leading thus to decreased peak oxygen uptake in heart transplant recipients.Exercise training improves exercise capacity,cardiac and vascular endothelial function in heart transplant recipients.Pre-rehabilitation regular aerobic or combined exercise is beneficial for patients with end-stage HF awaiting heart transplantation in order to maintain a higher fitness level and reduce complications afterwards like intensive care unit acquired weakness or cardiac cachexia.All hospitalized patients after heart transplantation should be referred to early mobilization of skeletal muscles through kinesiotherapy of the upper and lower limbs and respiratory physiotherapy in order to prevent infections of the respiratory system prior to hospital discharge.Moreover,all heart transplant recipients after hospital discharge who have not already participated in an early cardiac rehabilitation program should be referred to a rehabilitation center by their health care provider.Although high intensity interval training seems to have more benefits than moderate intensity continuous training,especially in stable transplant patients,individualized training based on the abilities and needs of each patient still remains the most appropriate approach.Cardiac rehabilitation appears to be safe in heart transplant patients.However,long-term follow-up data is incomplete and,therefore,further high quality and adequately-powered studies are needed to demonstrate the long-term benefits of exercise training in this population. | Christos Kourek Eleftherios Karatzanos Serafim Nanas Andreas Karabinis Stavros Dimopoulos | 2021 | World Journal of Transplantation2021，11，11： | 3 |
| 18 | Conduit necrosis following esophagectomy: An up-to-date literature review显示文摘Esophageal conduit ischaemia and necrosis is an uncommon but devastating complication of esophagectomy and remains one of the most challenging issues in surgical practice. The incidence, time interval to develop symptoms, and clinical presentation are highly variable with no predictable pattern. Evidence comes from case reports and case series rather than randomized controlled trials.We describe the issues surrounding conduit necrosis affecting the stomach,jejunum and colon as an esophageal replacement and the advantages,disadvantages and challenges of each type of reconstruction. Diagnosis is challenging for the most experienced surgeon. Upper gastrointestinal endoscopy and computed tomography thorax with both oral and intravenous contrast is the gold standard. Management, either conservative or interventional is also a difficult decision. Management options include conservative treatment and more aggressive treatments such as stent insertion, surgical debridement and repair of the esophagus using jejunum, colon or a musculocutaneous flap. In spite of recent advances in surgical techniques, there is no reliable strategy to manage esophageal conduit necrosis. Our review covers the pathophysiology and clinical significance of esophageal necrosis while highlighting current techniques of prevention, diagnosis and treatment of this life-threatening condition. | Antonios Athanasiou Mairead Hennessy Eleftherios Spartalis Benjamin H L Tan Ewen A Griffiths | 2019 | World Journal of Gastrointestinal Surgery2019，11，3： | 2 |
| 19 | Meta-analysis on the effectiveness of powered toothbrushes for orthodontic patients显示文摘 | Eleftherios G. Kaklamanos Sotos Kalfas | 2008 | American Journal of Orthodontics & Dentofacial Orthopedics2008，，2： | 2 |
| 20 | Cardiovascular efficacy and safety of dipeptidyl peptidase-4 inhibitors:A meta-analysis of cardiovascular outcome trials显示文摘BACKGROUND Dipeptidyl peptidase-4(DPP-4)inhibitors are a generally safe and well tolerated antidiabetic drug class with proven efficacy in type 2 diabetes mellitus(T2DM).Recently,a series of large,randomized controlled trials(RCTs)addressing cardiovascular outcomes with DPP-4 inhibitors have been published.AIM To pool data from the aforementioned trials concerning the impact of DPP-4 inhibitors on surrogate cardiovascular efficacy outcomes and on major cardiac arrhythmias.METHODS We searched PubMed and grey literature sources for all published RCTs assessing cardiovascular outcomes with DPP-4 inhibitors compared to placebo until October 2020.We extracted data concerning the following“hard”efficacy outcomes:fatal and non-fatal myocardial infarction,fatal and non-fatal stroke,hospitalization for heart failure,hospitalization for unstable angina,hospitalization for coronary revascularization and cardiovascular death.We also extracted data regarding the risk for major cardiac arrhythmias,such as atrial fibrillation,atrial flutter,ventricular fibrillation and ventricular tachycardia.RESULTS We pooled data from 6 trials in a total of 52520 patients with T2DM assigned either to DPP-4 inhibitor or placebo.DPP-4 inhibitors compared to placebo led to a non-significant increase in the risk for fatal and non-fatal myocardial infarction[risk ratio(RR)=1.02,95%CI:0.94-1.11,I2=0%],hospitalization for heart failure(RR=1.09,95%CI:0.92-1.29,I2=65%)and cardiovascular death(RR=1.02,95%CI:0.93-1.11,I2=0%).DPP-4 inhibitors resulted in a non-significant decrease in the risk for fatal and non-fatal stroke(RR=0.96,95%CI:0.85-1.08,I2=0%)and coronary revascularization(RR=0.99,95%CI:0.90-1.09,I2=0%),Finally,DPP-4 inhibitors demonstrated a neutral effect on the risk for hospitalization due to unstable angina(RR=1.00,95%CI:0.85-1.18,I2=0%).As far as cardiac arrhythmias are concerned,DPP-4 inhibitors did not significantly affect the risk for atrial fibrillation(RR=0.95,95%CI:0.78-1.17,I2=0%),while they were associated with a significant increase in the risk for atrial flutter,equal to 52%(RR=1.52,95%CI:1.03-2.24,I2=0%).DPP-4 inhibitors did not have a significant impact on the risk for any of the rest assessed cardiac arrhythmias.CONCLUSION DPP-4 inhibitors do not seem to confer any significant cardiovascular benefit for patients with T2DM,while they do not seem to be associated with a significant risk for any major cardiac arrhythmias,except for atrial flutter.Therefore,this drug class should not be the treatment of choice for patients with established cardiovascular disease or multiple risk factors,except for those cases when newer antidiabetics(glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors)are not tolerated,contraindicated or not affordable for the patient. | Dimitrios Ioannis Patoulias Aristi Boulmpou Eleftherios Teperikidis Alexandra Katsimardou Fotios Siskos Michael Doumas Christodoulos E Papadopoulos Vassilios Vassilikos | 2021 | World Journal of Cardiology2021，13，10： | 2 |
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