Colon cancer: An epidemiological study in Northern Greece

Colorectal or colon cancer is the third most common form of cancer with 655,000 deaths worldwide per year and the second leading cause of cancer-related death in the Western world.  variety of risk factors have been linked to colon cancer including genetic factors (age, sex and hereditary mutations of repair enzymes genes), environmental exposures, daily life habits (diet, smoking, obesity and sedentary habits) and inflam­matory conditions of the digestive tract. The present research is a retrospective epidemiological study concerning 280 patients with colon cancer who were hospitalized at Theagenion Cancer Hospital of Thessaloniki during 2006, 2007 and 2008. They were classified according to their age, sex, place of residence, occupation and tobacco consumption. The results revealed that 58.57% were males and 41,43% females, 82,49% of the patients were older than 60 years of age, 38,93% were urban and 60% rural district inhabitants. Pensioners represented 47,50%, farmers 18,93%, housekeepers 13,57%, employers or free lancers 10,71%. For the rest 9,29% no in­formation has been recorded. Regarding the consumption of tobacco, 16,79% of them were smokers, 34,64% non smokers, whereas there was no information about the smoking habits of the remaining (48,57%). The results of this research with respect to age and sex of the patients are in agreement with bibliographical data, but conclu­sions can not be drawn about the connection between occupation and colon cancer onset. The fact that among the patients the non smokers were more than smokers, which is in contrast with the international data, could be attributed to the insufficiency of respective information for 48,57% of the patients. The unexpectedly higher frequency of colorectal cancer appearance among rural district inhabitants rather than among urban district inhabitants should be researched as soon as possible. The deficiency of information about fundamental risk factors of colon cancer, as genetic and environmental factors and life­style among Greek population requires the continuation and the extension of this epidemiological study, because prevention is the best cure and epidemiological studies have offered substantial contribution to prevention

Impact of the influenza A(H1N1) 2009 pandemic to the 17-25 year age group and to the students of the Medical School, Aristotle University of Thessaloniki

Introduction: In 2009 a novel A(H1N1) influenza virus emerged and caused a pandemic. The scope of this study was to identify the impact of the pandemic to the 17-25 year age group and to normal University function.Methods: a) Epidemiological data was obtained from the National Influenza Center for northern Greece, regarding the 17-25 age group. b) Absence records from the first semester of 2008-2009 and 2009-2010 were obtained from the School of Medicine, Aristotle University of Thessaloniki and a questionnaire was given to 100 medical students.Results and discussion: a) Two pandemic waves were identified; the first was during weeks 27-35 and the second during weeks 43-52.Of the 4949 examined samples, 1632 were confirmed pandemic H1N1 2009 infections (33%), and 362 (22%) belonged to the 17-25 age group. Of the latest, 53% were male and 47% were female. Most infections belonging to this group were mild, and developed influenza like illness (ILI) symptoms. Only 19% developed pneumonia or other complications and 2 were fatal. 4% was vaccinated against influenza and 2% against S. pneumoniae. Only 7% received Tamiflu treatment. 9% noted a travel history related to their infection. b) The second wave was synchronous with the 1st University Semester. However, no statistical difference between absence levels during 2008-2009 and 2009-2010 was identified and no students had reported ILI symptoms.Conclusively, whereas the 17-25 age group was indeed of the mostly affected from the pandemic, it seems that unexpectedly there was no impact to normal University function

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Circulating Biomarkers for the Prediction of Abdominal Aortic Aneurysm Growth

Background: Abdominal aortic aneurysm represents a distinct group of vascular lesions, in terms of surveillance and treatment. Screening and follow-up of patients via duplex ultrasound has been well established and proposed by current guidelines. However, serum circulating biomarkers could earn a position in individualized patient surveillance, especially in cases of aggressive AAA growth rates. A systematic review was conducted to assess the correlation of AAA expansion rates with serum circulating biomarkers. Methods: A data search of English medical literature was conducted, using PubMed, EMBASE, and CENTRAL, until 7 March 2021, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA) guidelines. Studies reporting on humans, on abdominal aortic aneurysm growth rates and on serum circulating biomarkers were included. No statistical analysis was conducted. Results: A total of 25 studies with 4753 patients were included. Studies were divided in two broad categories: Those reporting on clinically applicable (8 studies) and those reporting on experimental (17 studies) biomarkers. Twenty-three out of 25 studies used duplex ultrasound (DUS) for following patients. Amongst clinically applicable biomarkers, D-dimers, LDL-C, HDL-C, TC, ApoB, and HbA1c were found to bear the most significant association with AAA growth rates. In terms of the experimental biomarkers, PIIINP, osteopontin, tPA, osteopontin, haptoglobin polymorphisms, insulin-like growth factor I, thioredoxin, neutrophil extracellular traps (NETs), and genetic factors, as polymorphisms and microRNAs were positively correlated with increased AAA expansion rates. Conclusion: In the presence of future robust data, specific serum biomarkers could potentially form the basis of an individualized surveillance strategy of patients presenting with increased AAA growth rates

Carotid Plaque Vulnerability Diagnosis by CTA versus MRA: A Systematic Review

Stenosis grade of the carotid arteries has been the primary indicator for risk stratification and surgical treatment of carotid artery disease. Certain characteristics of the carotid plaque render it vulnerable and have been associated with increased plaque rupture rates. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) have been shown to detect these characteristics to a different degree. The aim of the current study was to report on the detection of vulnerable carotid plaque characteristics by CTA and MRA and their possible association. A systematic review of the medical literature was executed, utilizing PubMed, SCOPUS and CENTRAL databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. The study protocol has been registered to PROSPERO (CRD42022381801). Comparative studies reporting on both CTA and MRA carotid artery studies were included in the analysis. The QUADAS tools were used for risk of bias diagnostic imaging studies. Outcomes included carotid plaque vulnerability characteristics described in CTA and MRA and their association. Five studies, incorporating 377 patients and 695 carotid plaques, were included. Four studies reported on symptomatic status (326 patients, 92.9%). MRA characteristics included intraplaque hemorrhage, plaque ulceration, type VI AHA plaque hallmarks and intra-plaque high-intensity signal. Intraplaque hemorrhage detected in MRA was the most described characteristic and was associated with increased plaque density, increased lumen stenosis, plaque ulceration and increased soft-plaque and hard-plaque thickness. Certain characteristics of vulnerable carotid plaques can be detected in carotid artery CTA imaging studies. Nevertheless, MRA continues to provide more detailed and thorough imaging. Both imaging modalities can be applied for comprehensive carotid artery work-up, each one complementing the other

Carotid Plaque Vulnerability Diagnosis by CTA versus MRA: A Systematic Review

Stenosis grade of the carotid arteries has been the primary indicator for risk stratification and surgical treatment of carotid artery disease. Certain characteristics of the carotid plaque render it vulnerable and have been associated with increased plaque rupture rates. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) have been shown to detect these characteristics to a different degree. The aim of the current study was to report on the detection of vulnerable carotid plaque characteristics by CTA and MRA and their possible association. A systematic review of the medical literature was executed, utilizing PubMed, SCOPUS and CENTRAL databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. The study protocol has been registered to PROSPERO (CRD42022381801). Comparative studies reporting on both CTA and MRA carotid artery studies were included in the analysis. The QUADAS tools were used for risk of bias diagnostic imaging studies. Outcomes included carotid plaque vulnerability characteristics described in CTA and MRA and their association. Five studies, incorporating 377 patients and 695 carotid plaques, were included. Four studies reported on symptomatic status (326 patients, 92.9%). MRA characteristics included intraplaque hemorrhage, plaque ulceration, type VI AHA plaque hallmarks and intra-plaque high-intensity signal. Intraplaque hemorrhage detected in MRA was the most described characteristic and was associated with increased plaque density, increased lumen stenosis, plaque ulceration and increased soft-plaque and hard-plaque thickness. Certain characteristics of vulnerable carotid plaques can be detected in carotid artery CTA imaging studies. Nevertheless, MRA continues to provide more detailed and thorough imaging. Both imaging modalities can be applied for comprehensive carotid artery work-up, each one complementing the other

sj-docx-2-jet-10.1177_15266028221133701 – Supplemental material for Systematic Review on Customized and Non-customized Device Techniques for the Endovascular Repair of the Aortic Arch

Supplemental material, sj-docx-2-jet-10.1177_15266028221133701 for Systematic Review on Customized and Non-customized Device Techniques for the Endovascular Repair of the Aortic Arch by Petroula Nana, Konstantinos Spanos, Konstantinos Dakis, Athanasios Giannoukas, Tilo Kölbel and Stephan Haulon in Journal of Endovascular Therapy</p

sj-docx-3-jet-10.1177_15266028221133701 – Supplemental material for Systematic Review on Customized and Non-customized Device Techniques for the Endovascular Repair of the Aortic Arch

Supplemental material, sj-docx-3-jet-10.1177_15266028221133701 for Systematic Review on Customized and Non-customized Device Techniques for the Endovascular Repair of the Aortic Arch by Petroula Nana, Konstantinos Spanos, Konstantinos Dakis, Athanasios Giannoukas, Tilo Kölbel and Stephan Haulon in Journal of Endovascular Therapy</p

sj-docx-1-jet-10.1177_15266028221133701 – Supplemental material for Systematic Review on Customized and Non-customized Device Techniques for the Endovascular Repair of the Aortic Arch

Supplemental material, sj-docx-1-jet-10.1177_15266028221133701 for Systematic Review on Customized and Non-customized Device Techniques for the Endovascular Repair of the Aortic Arch by Petroula Nana, Konstantinos Spanos, Konstantinos Dakis, Athanasios Giannoukas, Tilo Kölbel and Stephan Haulon in Journal of Endovascular Therapy</p