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Spartalis M, Tsilimigras DI, Moris D, Spartalis E. Controversy Regarding the Beneficial Effect of Bariatric Surgery on the Incidence of Atrial Fibrillation. Obes Surg 2018; 28:2058-2059. [PMID: 29671125 DOI: 10.1007/s11695-018-3271-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Spartalis M, Tzatzaki E, Doulamis IP, Spartalis E. T1-mapping provides superior diagnostic accuracy than late gadolinium enhancement imaging in patients with acute myocarditis. Int J Cardiol 2018; 257:341. [PMID: 29506727 DOI: 10.1016/j.ijcard.2017.11.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 11/29/2017] [Indexed: 12/07/2022]
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Prodromidou A, Machairas N, Kostakis ID, Molmenti E, Spartalis E, Kakkos A, Lainas GT, Sotiropoulos GC. Outcomes after open and laparoscopic appendectomy during pregnancy: A meta-analysis. Eur J Obstet Gynecol Reprod Biol 2018; 225:40-50. [PMID: 29656140 DOI: 10.1016/j.ejogrb.2018.04.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/06/2018] [Accepted: 04/08/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Acute appendicitis is the most prevalent cause of non-obstetrical surgical disease during pregnancy. There is no consensus on the optimal surgical management of acute appendicitis in pregnancy. Our aim is to identify surgical and obstetrical outcomes of laparoscopic (LA) and open approach (OA) in pregnant patients with acute appendicitis. STUDY DESIGN Medline, Scopus, Google Scholar, Cochrane CENTRAL Register of Controlled Trials and Clinicaltrials.gov databases were searched for articles published up to May 2017, along with the references of all articles. Prospective and retrospective trials reporting outcomes among pregnant women undergoing laparoscopic and open appendectomy were included. Of the 493 records screened, 20 were eligible for meta-analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Statistical meta-analysis was performed using the RevMan 5.3 software. RESULTS A total of 6210 pregnant women from twenty studies were included in meta-analysis. Laparoscopic appendectomy was associated with significantly lower overall complication rates and shorter hospital stays (1835 patients OR 0.48 95% CI 0.29, 0.80 p = 0.005). While the open appendectomy group showed prolongation of gestational age for term deliveries, laparoscopic appendectomy patients had higher rates of fetal loss (543 patients MD -0.46 weeks 95% CI-0.87 to -0.04, p = 0.03 and 4867 patients OR 1.82 95% CI 1.30 to 2.57, p = 0.0006, respectively). CONCLUSIONS Current literature remains inconclusive on the optimal approach of appendectomy in pregnant women. Further larger-volume studies are needed in order to elucidate the critical effect of laparoscopic appendectomy on fetal loss rates.
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Spartalis M, Tzatzaki E, Spartalis E. Letter by Spartalis et al Regarding Article, "Modifiable Risk Factors and Atrial Fibrillation". Circulation 2018; 137:1528-1529. [PMID: 29610132 DOI: 10.1161/circulationaha.117.031481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
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Spartalis M, Tzatzaki E, Spartalis E, Moris D, Doulamis I, Triantafyllis AS, Livanis E, Theodorakis G. Cryoablation for atrial fibrillation and antiarrhythmic drug pretreatment: a single referral center experience. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2018. [PMID: 29687867 DOI: 10.26355/eurrev-201804-14741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
OBJECTIVE Pulmonary vein isolation (PVI) ablation has emerged as the gold standard of ablative strategies to treat medically refractory paroxysmal and persistent atrial fibrillation (AF). Regardless of the superiority of catheter ablation based on PVI over antiarrhythmic drug therapy, recurrence rates of AF remain higher than desired. PVI via cryoablation has rapidly become a mainstream treatment for AF, due to its effectiveness and fast learning curve. Our objective was to assess the safety and efficacy of cryoablation in a single referral center. PATIENTS AND METHODS This is a retrospective analysis of results after cryoablation treatment of AF over three years. 146 patients with AF underwent a cryoablation procedure in our clinical center and were followed-up for three years after the procedure. All patients received cryoablation of the pulmonary veins, although concomitant procedures were performed in 6 patients (re-ablation), including radiofrequency and cryoablation. RESULTS Cryoablation was clinically successful in 90.83% of the patients with paroxysmal AF and 60% of those with persistent AF. The clinical success of cryoablation was correlated with pretreatment with amiodarone and in the case of re-ablation. Concerning postoperative complications, major bleeding was correlated with female gender, treatment with rivaroxaban and amiodarone. CONCLUSIONS Among large trials, freedom from recurrent AF is about 65% with follow-up limited to 1 to 2 years. PVI via balloon cryoablation is a safe and efficient guideline-based treatment for AF, producing a durable event-free result in most patients out to 3 years with better outcomes than previously reported.
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Antoniou EA, Damaskos C, Garmpis N, Salakos C, Margonis GA, Kontzoglou K, Lahanis S, Spartalis E, Patsouras D, Kykalos S, Garmpi A, Andreatos N, Pawlik TM, Kouraklis G. Solid Pseudopapillary Tumor of the Pancreas: A Single-center Experience and Review of the Literature. ACTA ACUST UNITED AC 2018; 31:501-510. [PMID: 28652415 DOI: 10.21873/invivo.11089] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 05/19/2017] [Accepted: 05/22/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Solid pseudopapillary tumors (SPTs) of the pancreas are a rare occurrence, not exceeding 1-2% of all exocrine pancreatic tumors. SPT was first described in 1959 as "papillary tumor of the pancreas, benign or malignant" and affects mainly young women, in their second or third decade of age. These tumors are of low malignant potential, unclear pathogenesis, grow gradually and become considerably large before causing symptoms. A typical clinical presentation is often described by affected patients and, in some cases, an SPT is an incidental finding during the time the patient undergoes medical imaging studies for other health issues. SPT is frequently located at the head or tail of the pancreas. Metastases are rare but, when present, affect predominantly the liver. PATIENTS AND METHODS We report a series of five SPT cases in female patients 13-47 years old, presenting with almost identical symptoms of upper abdominal discomfort and non-tender palpable mass. Two out of five patients also reported vomiting, nausea and poor appetite as co-existing non-diagnostic symptoms. Only one patient presented without any symptoms. Tumor location and dimensions varied. One patient underwent a pancreatoduodenectomy (Whipple's procedure), while the remaining patients underwent distal pancreatectomy with concomitant splenectomy. RESULTS Perioperative morbidity and mortality was zero. All five patients are disease-free at a follow-up from 3 months to 13 years. Histopathology reports supported the diagnosis of SPT and no metastatic disease was present in any of the patients. CONCLUSION The overall prognosis of SPT of the pancreas is excellent due to its favorable biological features, even in the presence of distal metastasis. Although surgical resection is often curative, a close follow-up is advised in order to diagnose a possible local recurrence or distal metastasis and choose the proper therapeutic option for the patients.
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Spartalis E, Spartalis M, Moris D, Athanasiou A, Troupis T, Tomos P. The role of multidetector CT angiography and 3D postprocessing imaging in the diagnosis and investigation of bronchopulmonary sequestration. Clin Case Rep 2018. [PMID: 29531739 PMCID: PMC5838274 DOI: 10.1002/ccr3.1394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Congenital bronchopulmonary malformations are usually asymptomatic. Precise multimodality imaging plays an essential role in the identification of rare cardiothoracic entities, offering excellent imaging quality and the decisive diagnosis.
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Moris D, Ntanasis-Stathopoulos I, Tsilimigras DI, Vagios S, Karamitros A, Karaolanis G, Griniatsos J, Papalampros A, Papaconstantinou I, Glantzounis GK, Spartalis E, Blazer DG, Felekouras E. Update on Surgical Management of Small Bowel Neuroendocrine Tumors. Anticancer Res 2018; 38:1267-1278. [PMID: 29491050 DOI: 10.21873/anticanres.12349] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 01/24/2018] [Accepted: 01/30/2018] [Indexed: 02/07/2023]
Abstract
The widespread use of endoscopy and imaging in combination with the continuous update of the staging systems for neuroendocrine tumors has led to an increase in the incidence of small intestinal neuroendocrine tumors (si-NENs) globally. Despite high survival rates, severe complications may occur even in early stages due to the anatomic location of the primary site and the desmoplastic reaction. Surgery plays a central role in the management of patients with si-NENs. Excision of locoregional disease along with extensive lymph node dissection should be performed in fit patients, even in the presence of metastases. Multimodality treatment of liver metastases includes hepatectomy, ablative techniques and liver transplantation. Hormone therapy with somatostatine analogs is of high importance for symptomatic control; special caution should be exercised both pre- and intra-operatively. A multidisciplinary approach is essential in order to provide personalized therapeutics for patients with si-NENs. Clinical research and specialization in this field should be further encouraged.
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Spartalis M, Tzatzaki E, Spartalis E. Letter by Spartalis et al Regarding Article, "Cardiomyocyte Regeneration: A Consensus Statement". Circulation 2018; 137:1094-1095. [PMID: 29507004 DOI: 10.1161/circulationaha.117.030436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
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Spartalis M, Voudris V, Iliopoulos DC, Spartalis E, Siasos G. Acute transient myocardial ischemia: A common pathophysiological mechanism in takotsubo syndrome. Is it still a cardiomyopathy? J Cardiol 2018; 72:176. [PMID: 29458995 DOI: 10.1016/j.jjcc.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 01/12/2018] [Indexed: 12/07/2022]
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Karagkiouzis G, Spartalis E, Moris D, Patsouras D, Athanasiou A, Karathanasis I, Verveniotis A, Konstantinou F, Kouerinis IA, Potaris K, Dimitroulis D, Tomos P. Surgical Management of Non-small Cell Lung Cancer with Solitary Hematogenous Metastases. ACTA ACUST UNITED AC 2018; 31:451-454. [PMID: 28438878 DOI: 10.21873/invivo.11082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/24/2017] [Accepted: 03/01/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The treatment of patients with solitary hematogenous metastases from non-small cell lung cancer (NSCLC) remains controversial, although numerous retrospective studies have reported favorable results for patients offered combined surgical therapy. Our aim was to determine the role of surgical resection in the management of NSCLC with solitary extrapulmonary metastases and to investigate for possible prognostic factors. PATIENTS AND METHODS Between January 2004 and December 2012, 12 patients with NSCLC, from two Institutions, underwent metastasectomy for their solitary metastatic lesion. Sites of metastases included brain (n=3), adrenal gland (n=6), thoracic wall (n=2) and diaphragm (n=1). All patients had undergone pulmonary resections for their primary NSCLC. RESULTS Median survival for the entire cohort was 24.1 months, whereas 1- and 5-year survival rates were 73% and 39%, respectively. Patients with stage III intrathoracic disease had significantly worse survival than those with lower tumor stage. A tendency for adenocarcinomatous histology to positively affect survival was recognized, although it was proven not to be statistically significant. CONCLUSION Despite the retrospective nature of our study and the small cohort size, it is emerging that combined surgical resection might offer patients with NSCLC with solitary hematogenous metastases a survival benefit. Limited intrathoracic disease and adenocarcinomatous histology might be associated with better outcomes.
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Spartalis M, Voudris V, Iliopoulos DC, Spartalis E, Siasos G. The paradox of increased risk of atrial fibrillation following bariatric surgery. J Cardiol 2018; 72:87. [PMID: 29452764 DOI: 10.1016/j.jjcc.2018.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 01/16/2018] [Indexed: 01/29/2023]
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138
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Athanasiou A, Spartalis E, Hennessy M, Spartalis M, Moris D, Damaskos C, Pikoulis E. Effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats: What we know so far? Hepatobiliary Pancreat Dis Int 2018; 17:91-92. [PMID: 29428114 DOI: 10.1016/j.hbpd.2018.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/10/2017] [Indexed: 02/05/2023]
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Spartalis M, Tzatzaki E, Tsilimigras DI, Spartalis E. Re: Trends in the Prevalence of Severe Obesity and Bariatric Surgery Access: A State-Level Analysis from 2011 to 2014 (J Laparoendosc Adv Surg Tech A 2017;27:669-675). J Laparoendosc Adv Surg Tech A 2018; 28:1115-1116. [PMID: 29369746 DOI: 10.1089/lap.2017.0718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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140
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Moris D, Theocharis S, Davakis S, Patelis N, Agrogiannis G, Vlachos IS, Spartalis E, Athanasiou A, Bakoyiannis C, Perrea DN, Georgopoulos S. Serum Calprotectin as a Novel Biomarker in Abdominal Aortic Aneurysm Pathogenesis and Progression: Preliminary Data from Experimental Model in Rats. Curr Vasc Pharmacol 2018; 16:168-178. [DOI: 10.2174/1570161115666170202155724] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/02/2017] [Accepted: 01/02/2017] [Indexed: 11/22/2022]
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Spartalis M, Tzatzaki E, Nikiteas NI, Spartalis E. Cost-effectiveness of prasugrel versus clopidogrel in acute coronary syndrome patients undergoing percutaneous coronary intervention. Int J Cardiol 2018; 251:32. [PMID: 29197452 DOI: 10.1016/j.ijcard.2017.09.155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 09/15/2017] [Indexed: 12/07/2022]
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Spartalis M, Tzatzaki E, Spartalis E, Doulamis IP, Tsilimigras DI, Moris D, Dimitroulis D, Voudris V. Intrinsic Atrioventricular Node Conduction Recovery After Transcatheter Aortic Valve Implantation and the Permanent Pacemaker Implantation Enigma. Cardiol Res 2018; 8:269-270. [PMID: 29317967 PMCID: PMC5755656 DOI: 10.14740/cr633w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 11/28/2017] [Indexed: 11/26/2022] Open
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Kontogiannis CD, Kosmopoulos M, Tsilimigras DI, Spartalis E, Tselegkidi ME, Hamodraka E, Chatzidou S. A Novel "Trouserslike" Technique for the Extraction of 22-Year-Old Pacemaker Leads. Ann Thorac Surg 2018; 105:e203-e205. [PMID: 29305146 DOI: 10.1016/j.athoracsur.2017.11.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
Cardiac management devices have become an integral part of our armament for treatment of heart diseases. However, complications may arise that mandate extraction of either the device or the lead. The noninterventional lead extraction has become a topic of avid debate as simple traction is associated with low success rates whereas laser-assisted extraction carries a high economic cost. Herein we present a case of 22-year-old pacemaker leads extracted with a novel "trouserslike technique" that could present an attractive alternative for leads implanted for more than 10 years when laser sheaths are not accessible.
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Tsilimigras DI, Ntanasis-Stathopoulos I, Spartalis E, Kontos M, Moris D. Endocrine therapy in early-stage breast cancer care: defining the appropriate regimen and time frame. JOURNAL OF B.U.ON. : OFFICIAL JOURNAL OF THE BALKAN UNION OF ONCOLOGY 2018; 23:276-277. [PMID: 29552801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Damaskos C, Tomos I, Garmpis N, Karakatsani A, Dimitroulis D, Garmpi A, Spartalis E, Kampolis CF, Tsagkari E, Loukeri AA, Margonis GA, Spartalis M, Andreatos N, Schizas D, Kokkineli S, Antoniou EA, Nonni A, Tsourouflis G, Markatos K, Kontzoglou K, Kostakis A, Tomos P. Histone Deacetylase Inhibitors as a Novel Targeted Therapy Against Non-small Cell Lung Cancer: Where Are We Now and What Should We Expect? Anticancer Res 2018; 38:37-43. [PMID: 29277754 DOI: 10.21873/anticanres.12189] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 10/23/2017] [Accepted: 10/25/2017] [Indexed: 12/07/2022]
Abstract
Non-small cell lung cancer constitutes the most common type of lung cancer, accounting for 85-90% of lung cancer, and is a leading cause of cancer-related death. Despite the progress during the past years, poor prognosis remains a challenge and requires further research and development of novel antitumor treatment. Recently, the role of histone deacetylases in gene expression has emerged showing their regulation of the acetylation of histone proteins and other non-histone protein targets and their role in chromatin organization, while their inhibitors, the histone deacetylase inhibitors, have been proposed to have a potential therapeutic role in diverse malignancies, including non-small cell lung cancer. This review article focuses on the role of histone deacetylase inhibitors in the treatment of non-small cell lung cancer and the major molecular mechanisms underlying their antitumor activity recognized so far.
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Spartalis E, Garmpis N, Spartalis M, Damaskos C, Moris D, Athanasiou A, Gkolfakis P, Korkolopoulou P, Dimitroulis D, Mantas D. Rare Coexistance of Ileal Diverticulosis, Crohn's Disease and Small Bowel Adenocarcinoma: Report of a Case. ACTA ACUST UNITED AC 2017; 32:191-195. [PMID: 29275319 DOI: 10.21873/invivo.11224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/08/2017] [Accepted: 11/09/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND/AIM Adenocarcinoma is one of the most common malignant tumors of the small intestine complicating Crohn's disease. However, the coexistence of both conditions with diverticulosis of small bowel in young age makes this coincidence rare and clinical diagnosis very difficult. CASE REPORT We report a case of a woman admitted to our Department with acute abdominal pain and fever. The surgical and histological investigation, revealed a rare coexistence that has never been mentioned in the published medical literature. CONCLUSION Ileal diverticulosis is not frequent and often asymptomatic as well as adenocarcinoma of the small bowel. In this case, those diseases along with Crohn's disease led the patient to acute symptoms.
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Spartalis M, Tzatzaki E, Nikiteas NI, Spartalis E. Uninterrupted dabigatran is safer than warfarin in patients undergoing ablation for atrial fibrillation. J Arrhythm 2017; 33:655-656. [PMID: 29255521 PMCID: PMC5728998 DOI: 10.1016/j.joa.2017.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 07/27/2017] [Accepted: 07/30/2017] [Indexed: 12/07/2022] Open
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Spartalis M, Tzatzaki E, Spartalis E, Damaskos C, Athanasiou A, Livanis E, Voudris V. The Role of Echocardiography in the Optimization of Cardiac Resynchronization Therapy: Current Evidence and Future Perspectives. Open Cardiovasc Med J 2017; 11:133-145. [PMID: 29387277 PMCID: PMC5748829 DOI: 10.2174/1874192401711010133] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/28/2017] [Accepted: 11/28/2017] [Indexed: 01/24/2023] Open
Abstract
Background: Cardiac resynchronization therapy (CRT) has become a mainstay in the management of heart failure. Up to one-third of patients who received resynchronization devices do not experience the full benefits of CRT. The clinical factors influencing the likelihood to respond to the therapy are wide QRS complex, left bundle branch block, female gender, non-ischaemic cardiomyopathy (highest responders), male gender, ischaemic cardiomyopathy (moderate responders) and narrow QRS complex, non-left bundle branch block (lowest, non-responders). Objective: This review provides a conceptual description of the role of echocardiography in the optimization of CRT. Method: A literature survey was performed using PubMed database search to gather information regarding CRT and echocardiography. Results: A total of 70 studies met selection criteria for inclusion in the review. Echocardiography helps in the initial selection of the patients with dyssynchrony, which will benefit the most from optimal biventricular pacing and provides a guide to left ventricular (LV) lead placement during implantation. Different echocardiographic parameters have shown promise and can offer the possibility of patient selection, response prediction, lead placement optimization strategies and optimization of device configurations. Conclusion: LV ejection fraction along with specific electrocardiographic criteria remains the cornerstone of CRT patient selection. Echocardiography is a non-invasive, cost-effective, highly reproducible method with certain limitations and accuracy that is affected by measurement errors. Echocardiography can assist with the identification of the appropriate electromechanical substrate of CRT response and LV lead placement. The targeted approach can improve the haemodynamic response, as also the patient-specific parameters estimation.
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Spartalis M, Tzatzaki E, Athanasiou A, Spartalis E. eComment. Platelet-rich plasma and cardiac tissue regeneration. Interact Cardiovasc Thorac Surg 2017; 26:154. [PMID: 29272455 DOI: 10.1093/icvts/ivx321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Spartalis E, Tsilimigras DI, Charalampoudis P, Karachaliou GS, Moris D, Athanasiou A, Spartalis M, Bolkas V, Dimitroulis D, Nikiteas N. The "Yin and Yang" of Platelet-rich Plasma in Breast Reconstruction After Mastectomy or Lumpectomy for Breast Cancer. Anticancer Res 2017; 37:6557-6562. [PMID: 29187430 DOI: 10.21873/anticanres.12112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/03/2017] [Accepted: 10/11/2017] [Indexed: 12/07/2022]
Abstract
Surgery remains the mainstay of treatment for breast cancer, including complete or partial mastectomy and lumpectomy. Breast reconstruction has gained popularity mainly due to its tremendous impact on the psychological status of the patients. Autologous fat grafting is a well-established method used in cosmetic surgery; however, fat re-absoprtion, fat necrosis, calcifications and oil-cyst formation are some usually encountered complications limiting the efficacy of this approach. Platelet-rich plasma (PRP) has recently been postulated as a promising method for tissue regeneration since it contains high levels of diverse human growth factors. To date, preliminary results from clinical studies regarding the combination of PRP and fat grafting in breast reconstruction have shown ambiguous results, whereas preclinical studies are more favorable. However, concerns have been raised regarding the extent of cellular promotion induced by PRP application and the corresponding potential malignant transformation. The aim of our study was to present, analyze and critically evaluate the role of PRP in breast reconstruction after breast cancer surgery in terms of efficacy and oncological safety highlighting the caution that needs to be taken in order to eliminate any chance of recurrence in patients who have theoretically undergone complete excision of the tumor burden.
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