76 results match your criteria: "417 Army Share Fund Hospital[Affiliation]"

Coronary artery aneurysms (CAAs) are rare anatomical disorders of the coronary arteries. Atherosclerosis and Kawasaki disease are the principal causes of CCAs, while other causes including genetic factors, inflammatory arterial diseases, connective tissue disorders, endothelial damage after cocaine use, iatrogenic complications after interventions and infections, are also common among patients with CAAs. Although there is a variety of noninvasive methods including echocardiography, computed tomography, and magnetic resonance imaging, coronary angiography remains the gold standard diagnostic method.

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In recent years, in the context of the increase in the life expectancy of cancer patients, special attention has been given to immunotherapy and, indeed, to immune checkpoint inhibitors. The use of immune checkpoint inhibitors has increased rapidly, and approximately 40% of cancer patients are eligible for this treatment. Although their impact is valuable on cancer treatment, immune checkpoint inhibitors come with side effects, known as immune-related adverse effects.

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Background: Aerobic exercise, either continuous or high intensity interval training (HIIT), induces important benefits in chronic heart failure (CHF) patients. Resistance training has been also shown to be beneficial in CHF. However, data regarding combined aerobic exercise and muscle strength training is still limited.

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Anticoagulation in patients with atrial fibrillation and liver cirrhosis.

Ann Gastroenterol

October 2022

1Department of Internal Medicine, 417 Army Share Fund Hospital (Eleni Karapedi, Nikolaos Papadopoulos, Eleni-Myrto Trifylli, Evangelos Koustas, Georgios Aloizos).

Atrial fibrillation (AF) is an increasingly recognized comorbidity in patients with liver cirrhosis, mainly associated with nonalcoholic fatty liver disease and alcohol-associated liver disease, affecting the quality of life and prognosis. On the other hand, cirrhosis is associated with an elevated risk of both thrombosis and bleeding, making the decision about anticoagulation therapy very challenging. Direct-acting oral anticoagulants (DOACs) are approved for patients with non-valvular AF.

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The development of cancer is a multifactorial phenomenon, while it constitutes a major global health problem. Viruses are an important factor that is involved in tumorigenesis and is associated with 12.1% of all cancer cases.

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Spontaneous coronary artery dissection (SCAD) is a rare non-atherosclerotic cause of acute coronary syndromes defined as non-iatrogenic, non-traumatic separation of the coronary artery wall. The most common profile is a middle-aged woman between 44 and 53 years with few cardiovascular risk factors. SCAD is frequently linked with predisposing factors, such as postpartum, fibromuscular dysplasia or other vasculopathies, connective tissue disease and hormonal therapy, and it is often triggered by intense physical or emotional stress, sympathomimetic drugs, childbirth and activities increasing shear stress of the coronary artery walls.

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The Emerging Role of Extracellular Vesicles and Autophagy Machinery in NASH-Future Horizons in NASH Management.

Int J Mol Sci

October 2022

2nd Department of Internal Medicine, Hippokration General Hospital of Athens, Medical School, National and Kapodistrian University of Athens, Leof. Vasilissis Sofias Avenue Str., 11527 Athens, Greece.

Non-alcoholic fatty liver disease (NAFLD) is considered the most frequent chronic hepatic disease in the general population, while it is the first cause of liver transplantation in the US. NAFLD patients will subsequently develop non-alcoholic steatohepatitis (NASH), which is characterized by aberrant hepatocellular inflammation with or without the presence of fibrosis. The lack of specific biomarkers and therapeutic strategies makes non-alcoholic steatohepatitis (NASH) management a difficult task for clinicians.

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Haemophilia is a rare, hereditary bleeding disorder. Clotting factor concentrates were a revolutionary treatment which changed the life of people with haemophilia. However, early generation of clotting factor concentrates, without viral inactivation procedures in the manufacturing process, led to an increased risk of transmission of blood-borne viral infections, mainly due to hepatitis C virus and human immunodeficiency virus.

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 Although surgical drains are widely used after lower gastrointestinal (GI) procedures, complications may occur. Specifically, sporadic cases of drain migration into a hollow viscus, most commonly regarding active drains and treated with surgical removal, have been reported. Herein, we present a case of a passive drain (penrose) migration into the colon, after segmental sigmoidectomy with primary anastomosis, presented with hematochezia.

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Colorectal cancer (CRC) constitutes the third most frequently reported malignancy in the male population and the second most common in women in the last two decades. Colon carcinogenesis is a complex, multifactorial event, resulting from genetic and epigenetic aberrations, the impact of environmental factors, as well as the disturbance of the gut microbial ecosystem. The relationship between the intestinal microbiome and carcinogenesis was relatively undervalued in the last decade.

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Background In this study, we aimed to determine the diagnostic performance of optic nerve head (ONH), macular, and circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurements of wide-field maps (12 × 9 mm) using swept-source optical coherence tomography (SS-OCT) compared to measurements of the ONH and RNFL parameters measured by Heidelberg Retina Tomograph (HRT3). Methodology This case-control study included 39 eyes of 39 glaucoma patients and 36 eyes of 36 normal subjects (control group). All participants underwent standard automated perimetry (SAP) as well as structural measurements by SS-OCT (DRI-OCT, Triton; Topcon Inc.

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Exercise Training Effects on Circulating Endothelial and Progenitor Cells in Heart Failure.

J Cardiovasc Dev Dis

July 2022

Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece.

Article Synopsis
  • - Heart failure (HF) is a significant global health issue, particularly affecting patients with reduced or mildly reduced ejection fractions, leading to vascular endothelial dysfunction and decreased levels of endothelial progenitor cells (EPCs), which are crucial for blood vessel repair and regeneration.
  • - The identification of EPCs is challenging, with the common method involving monoclonal antibodies and flow cytometry, using various cell surface markers such as CD34 and VEGFR-2.
  • - Exercise training can enhance the number and functionality of EPCs in individuals with heart failure, potentially due to increased blood flow and hypoxic signals, highlighting the need for tailored exercise programs in rehabilitation settings.
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Gastrointestinal (GI) cancer constitutes a highly lethal entity among malignancies in the last decades and is still a major challenge for cancer therapeutic options. Despite the current combinational treatment strategies, including chemotherapy, surgery, radiotherapy, and targeted therapies, the survival rates remain notably low for patients with advanced disease. A better knowledge of the molecular mechanisms that influence tumor progression and the development of optimal therapeutic strategies for GI malignancies are urgently needed.

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Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) constitute highly malignant forms of primary liver cancers. Hepatocellular and bile duct carcinogenesis is a multiplex process, caused by various genetic and epigenetic alterations, the influence of environmental factors, as well as the implication of the gut microbiome, which was undervalued in the previous years. The molecular and immunological analysis of the above malignancies, as well as the identification of the crucial role of intestinal microbiota for hepatic and biliary pathogenesis, opened the horizon for novel therapeutic strategies, such as immunotherapy, and enhanced the overall survival of cancer patients.

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Cerebrotendinous xanthomatosis (CTX) is a rare inherited disorder of the alternative pathway of bile acid biosynthesis, due to mutation(s) of the gene CYP27A1, leading to sterol 27-hydroxylase deficiency. The latter results in a systematic deposition of cholestanol and cholesterol to the central nervous system and tendons, premature cataract, as well as the manifestation of systematic symptoms, such as chronic diarrhea, osteoporosis, and premature atherosclerosis. Due to its marked clinical heterogeneity, prompt diagnosis of this disorder is challenging.

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Cranial giant cell arteritis mimickers: A masquerade to unveil.

Autoimmun Rev

May 2022

Rheumatology Unit, First Department of Propaedeutic Internal Medicine, School of Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Giant cell arteritis (GCA) is a large-vessel vasculitis that affects cranial and extra-cranial arteries. Extra-cranial GCA presents mainly with non-specific symptoms and the differential diagnosis is very broad, while the cranial form has more typical clinical picture and physicians have a lower threshold for diagnosis and treatment. Although temporal artery biopsy (TAB) has an established role, ultrasound (US) is being increasingly used as the first-line imaging modality in suspected GCA.

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Article Synopsis
  • A 55-year-old woman diagnosed with migratory osteoporosis (MO) experienced pain and bone marrow edema in her left ankle, initially treated with non-weight-bearing methods and risedronate.
  • Despite some initial improvement, the condition worsened, affecting her foot and left hip, indicating that the initial treatment was ineffective.
  • Ultimately, a single infusion of zoledronic acid led to complete pain relief and resolution of bone marrow edema, allowing her to return to daily activities, highlighting the need for more robust treatment for MO.
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Article Synopsis
  • - A 63-year-old man initially presented with symptoms resembling giant cell arteritis (GCA) but was later diagnosed with microscopic polyangiitis (MPA) after further evaluation.
  • - His treatment began with corticosteroids for what was thought to be GCA, but after complications arose, tests revealed positive p-ANCA antibodies.
  • - The patient underwent successful treatment with cyclophosphamide, achieving remission from MPA, and has remained symptom-free for two years.
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 Central pancreatectomy (CP), a partial resection of the pancreas, is indicated for the excision of neuroendocrine tumors (NETs) of the pancreas, when located at the neck or the proximal body. Specifically, CP is preferable in functional NET and in nonfunctional sized 1 to 2 cm or/with proliferation marker Ki67 < 20% (Grade I/II). Postoperative leakage from the remaining pancreas constitutes the most frequent complication of CP (up to 63%).

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Article Synopsis
  • Rituximab (RTX) treatment for rheumatoid arthritis (RA) can lead to hypogammaglobulinemia (HGG), a decrease in immunoglobulin levels (IgG, IgM, IgA), affecting patient outcomes and infection rates.
  • In a study of 83 RA patients treated with RTX, nearly 43% experienced HGG, with lower baseline immunoglobulin levels predicting the occurrence of low IgG and low IgM.
  • Interestingly, patients who developed low IgM showed better disease activity outcomes, while the development of HGG did not result in a higher rate of serious infections.*
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COVID-19 and liver injury: where do we stand?

Ann Gastroenterol

June 2020

2nd Department of Internal Medicine, Hippokration General Hospital of Athens, Medical School of National & Kapodistrian University of Athens (Sofia Vasileiadi, Melanie Deutsch), Greece.

The coronavirus SARS-CoV-2 was identified as the cause of COVID-19, a severe acute respiratory syndrome. Several clinical studies refer to liver injury as the most frequent clinical extrapulmonary manifestation. In this review, we summarize the available clinical data concerning liver injury during COVID-19.

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Tuberculosis and targeted synthetic or biologic DMARDs, beyond tumor necrosis factor inhibitors.

Ther Adv Musculoskelet Dis

June 2020

Rheumatology Unit, First Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Article Synopsis
  • - Patients with autoimmune rheumatic diseases (ARD) have a heightened risk of developing tuberculosis (TB), especially when treated with tumor necrosis factor inhibitors (TNFi) and glucocorticoids, which can lead to latent TB reactivation.
  • - Recent biologic and targeted synthetic DMARDs (like rituximab and JAK inhibitors) seem to show a lower TB risk compared to TNFi, although more real-life data is needed for a clearer understanding.
  • - It's crucial to screen for latent TB before starting any DMARD treatment, and further studies are necessary to compare TB risks among different ARD treatment options.
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