Στην βιολογία, το περιβάλλον μπορεί να καθοριστεί σαν ενα σύνολο κλιματικών, βιοτικών, κοινωνικών και εδαφικών παραγόντων που δρουν σε έναν οργανισμό και καθορίζουν την ανάπτυξη και την επιβίωση του. Έτσι, περιλαμβάνει οτιδήποτε μπορεί να επηρεάσει άμεσα τον μεταβολισμό ή τη συμπεριφορά των ζωντανών οργανισμών ή ειδών, όπως το φως, ο αέρας, το νερό, το έδαφος και άλλοι παράγοντες. Δείτε επίσης το άρθρο για το φυσικό περιβάλλον και τη φυσική επιλογή.
Στην αρχιτεκτονική, την εργονομία και την ασφάλεια στην εργασία, περιβάλλον είναι το σύνολο των χαρακτηριστικών ενός δωματίου ή κτιρίου που επηρεάζουν την ποιότητα ζωής και την αποδοτικότητα, περιλαμβανομένων των διαστάσεων και της διαρρύθμισης των χώρων διαβίωσης και της επίπλωσης, του φωτισμού, του αερισμού, της θερμοκρασίας, του θορύβου κλπ. Επίσης μπορεί να αναφέρεται στο σύνολο των δομικών κατασκευών. Δείτε επίσης το άρθρο για το δομημένο περιβάλλον.
Στην ψυχολογία, περιβαλλοντισμός είναι η θεωρία ότι το περιβάλλον (με τη γενική και κοινωνική έννοια) παίζει μεγαλύτερο ρόλο από την κληρονομικότητα καθορίζοντας την ανάπτυξη ενός ατόμου. Συγκεκριμένα, το περιβάλλον είναι ένας σημαντικός παράγοντας πολλών ψυχολογικών θεωριών.
Στην τέχνη, το περιβάλλον αποτελεί κινητήριο μοχλό και μούσα εμπνέοντας τους ζωγράφους ή τους ποιητές. Σε όλες τις μορφές της Τέχνης αποτελεί έμπνευση και οι Καλές Τέχνες φανερώνουν την επιρροή οπού άσκησε σε όλους τους καλλιτέχνες με όποιο είδος Τέχνης κι αν ασχολούνται. Ο άνθρωπος μέσα στο περιβάλλον δημιουργεί Μουσική, Ζωγραφική, Ποίηση, Γλυπτική, χορό, τραγούδι, θέατρο, αλλά και όλες οι μορφές τέχνης έχουν άμεση έμπνευση από το περιβάλλον.

Παρασκευή 31 Μαΐου 2019

Nursing and Midwifery Sciences

Effect of cognitive behavior therapy integrated with mindfulness on perceived pain and pain self-efficacy in patients with breast cancer
Mohammad-Rasul Mozafari-Motlagh, Hamid Nejat, Hasan Tozandehjani, Ali-Akbar Samari

Journal of Nursing and Midwifery Sciences 2019 6(2):51-56

Context: Cancer pain in a complicated situation for patients with breast cancer. Researchers suggested to use complementary and alternative method in order to reduction pain and side effects in these patients. Aims: This study was aimed to investigate the effectiveness of mindfulness integrated with cognitive behavioral therapy (MiCBT) on perceived pain and pain self-efficacy in patients with breast cancer. Settings and Design: In this clinical trial study, a semi-experimental method was used. Patients with breast cancer were recurred from cancer clinic of a hospital of Mashhad University of Medical Sciences. Material and Methods: Twenty-four patients with breast cancer selected through purposive sampling method and randomly assigned with permutation blocks in two groups of intervention (n = 12) and control (n = 12). The groups were assessed by demographic questionnaire, Perceived Pain Scale, and Pain Self-efficacy Scale before, immediate, and 1 month after the intervention. Participants in the interventional group received MiCBT for 8 weeks. Statistical Analysis Used: Data were analyzed using descriptive methods and multivariate analysis of covariance. Results: The results showed that the interventional group had a significant decrease in perceived pain (P > 0.05). The pain self-efficacy of patients significantly increased in comparison to the control group in posttest and follow-up stage (P < 0.05). Conclusion: According to the results, it can be concluded that using integrated therapy with mindfulness has been effective in reducing pain and enhancing pain self-efficacy in breast cancer patients. Therefore, it can be an adequate complementary therapy for patients with breast cancer.


The lived experiences of patients with spinal muscular atrophy: A phenomenological study
Ali-Asghar Jesmi, Leila Jouybari, Akram Sanagoo

Journal of Nursing and Midwifery Sciences 2019 6(2):57-62

Context: Spinal muscular atrophy (SMA) is a neuromuscular disease which, in addition to physical disability, causes psychological and social problems for patients and their families. If physiological and mental disorders continue to persist for a long time, it leads to serious deterioration in the patient's physical condition, influences the treatment process, and prevents the outcome of the therapies. Aims: The aim of this study was to explore the lived experiences of patients with SMA. Setting and Design: In this qualitative study, a total of six participants (five patients and one patients' wife) were selected by purposive sampling method. Material and Methods: Data were collected by semi-structured interview. Eleven interviews were conducted and analyzed by Colaizzi's descriptive phenomenological approach. Statistical Analysis Used: Data were analyzed by One Note soft ware version 14.0 with Colaizzi's descriptive phenomenological approach. Results: Two main themes – “tragic life” and “vague future” – emerged from data analysis. They had four categories including “physical and psychological problems,” “limitations and lost opportunities,” “concerns,” and “uncertain future.” Conclusions: These patients experienced a lot of physical and psychological impairments in their life. They have many concerns and lost some opportunities. Therefore, policymakers and authorities should support these patients for participating as an effective members in the society, consequently their feeling improve by getting independent.


Modeling of cardiac function of patients with acute myocardial infarction based on Type-D personality: Mediating role of negative emotions
Marzieh Mohammadi Pashaki, Yarali Dousti, Bahram Mirzaian

Journal of Nursing and Midwifery Sciences 2019 6(2):63-71

Context: Cardiac function of patients with acute myocardial infarction (MI) plays a central role in their prognosis. Aims: The purpose of this study was to model the cardiac function of these patients based on Type-D personality and the mediating role of negative emotions (anger, depression, and anxiety) in this relationship. Setting and Design: This correlational study was performed using the structural equation modeling method, and specifically the regression equations (combination of path analysis and second-order factor analysis). Material and Methods: The study population was the patients with acute ST-segment elevation MI (STEMI) who were hospitalized at Mazandaran Cardiovascular Hospital and underwent under primary percutaneous coronary intervention treatment in 2017 and 2018. Using Mueller's formula modeling formula (1996) based on a sample size-to-free parameter ratio, the sample size was calculated to 220 patients were chosen by the purposive method. Data were collected using Denollet'sType-DScale-14, the Spielberger's state-trait anxiety inventory, short-form of the beck depression inventory-13, and Spielberger's state-trait anger expression inventory-2. Statistical Analysis Used: Data analysis was performed using SPSS-18 and AMOS 23. Results: Type-D personality can directly predict of the cardiac function of patients with acute STEMI. This variable also predicts the the cardiac function of these patients via the mediation of negative emotions (anger, depression, and anxiety). Conclusion: Type-D personality affects the incidence and prognosis of myocardial infarction via negative emotions. It is, therefore, recommended to screen the susceptible populations for this personality type.


The effect of teaching on team-based learning and group discussion on learning and academic motivation of operating room students in the technology of gastrointestinal surgery lesson
Zahra Aliakbarzadeh Arani, Mahsa Haji Mohammad Hoseini, Leila Ghanbari Afra, Maede Mohammadzade

Journal of Nursing and Midwifery Sciences 2019 6(2):72-77

Context: Using of varied teaching methods may be effective in motivating to learn better. Aims: The present study aimed to compare the effect of teaching based on team-based learning (TBL) and group discussion methods on academic motivation and learning of operating room students in the technology of gastrointestinal surgery lesson in Qom University of Medical Sciences. Settings and Design: This semi-experimental study was conducted among two groups of continuous and discontinuous undergraduate course students of operating room in Qom University of Medical Sciences in 2016–2017. The sampling method was the census. A combination of the TBL method and lecture was conducted randomly among group of continuous undergraduate course students (21 persons) and group discussion among discontinuous undergraduate course students (14 persons). Material and Methods: Hartler's motivation questionnaire completed by the students at the first and last semesters. The test was also carried out immediately after the end of the term and four months after that. Statistical Analysis Used: Data were analyzed using frequency, percent, and independent and paired t-test in SPSS 13 software. Results: Comparison of educational motivation score in both groups before and after the intervention was not significant (P > 0.05). Academic motivation, after the intervention, was significant in both groups (P > 0.05). Comparison of scores did not differ between the two groups immediately after training and 4 months later (P > 0.05). Conclusions: Considering the lack of significant difference between TBL and group discussion in learning and increasing the level of academic motivation of students due to the use of these two methods, it is suggested that TBL and the group discussion replace with the common teaching methods, including lectures.


The effect of group singing on the happiness of older people
Maryam Entezari, Manijeh Zakizadeh, Jamshid Yazdani, Zohreh Taraghi

Journal of Nursing and Midwifery Sciences 2019 6(2):78-83

Context: Happiness is important for all age groups; however, it is more highlighted in elders. Aims: The aim of the current study was to determine the effect of group singing on the happiness of older people. Setting and Design: In this quasi-experimental study, sixty participants selected among elderly referred to two Day Care Centers of Mazandaran. Materials and Methods: Samples were assigned to two groups of intervention (n = 30)and control (n = 30). The intervention group was assigned into three groups of 10. Each group selected a song from the list of songs and performed it for 10 min. This process was repeated one more time. The intervention was performed two times a week, for 3 weeks. In the control group, no intervention was performed and the elderly received the usual care. The happiness score of both groups, before and 1 month after the end of the intervention, was measured using the Oxford Happiness Inventory. Statistical Analysis Used: Data were analyzed using independent t-test, Chi-square test, and ANCOVA. Results: Before intervention, the mean scores of happiness in the intervention and control groups were 4.38 ± 0.48 and 4. 53 ± 0.26, respectively (P = 0.138). One month after intervention, the mean scores of happiness in the intervention and control groups were 4.77 ± 0.37 and 4.35 ± 0.18, respectively (P = 0.004). Conclusion: The results of this study showed that group singing was effective on the happiness of the elderly. More studies in day-care centers and other settings, especially nursing homes, are recommended. Implementation of such measures is recommended in the day-care centers.


The mediating role of emotional distress tolerance in relationship between self-discrepancy with anxiety in people suffering from special phobias
Alireza Sangani, Paria Jangi, Nahid Ramak, Aniseh Ahmadi

Journal of Nursing and Midwifery Sciences 2019 6(2):84-90

Context: The basis of anxiety disorders in cognitive and emotional fields can be effective in coping strategies to anxiety. Aims: This research aimed to investigate the mediating role of emotional distress tolerance in relationship between self-discrepancy with anxiety in people suffering from special phobias. Settings and Design: The present study was a correlational research with structural equation modeling. Materials and Methods: The statistical population of this study was all individuals suffering from specific phobia disorders in the 5th Azar Hospital in Gorgan City. The sample size selection, which was made by Loehlin method (2004), was 220 persons suffering from anxiety disorder referring to Psychiatric Clinics of 5 Azar Hospital in Gorgan City and was investigated by purposeful sampling. Data gathering tools included Distress Tolerance Scale, self-discrepancy questionnaire, and Spielberger State-Trait Anxiety Inventory. Statistical Analysis Used: The collected data were analyzed using structural regression equations using SPSS 18 and Amos 23 software. Results: The findings showed that the research model is fit and overall, 42% of the anxiety could be explained through emotional stress tolerance and self-discrepancy, and emotional distress tolerance has a mediating role in relationship self-discrepancy with anxiety. Conclusions: The results of this research emphasized the necessity of self-discrepancy as well as the role of mediator of emotional distress tolerance in anxiety in people suffering from special phobias, which can provide applied templates for improving the psychological state of anxious individuals with therapists and counselors.


Relationship between Self-efficacy and Perceived Burden among Schizophrenic Patients' Caregivers
Azar Ramzani, Mehran Zarghami, Jamshid Yazdani Charati, Maedeh Bagheri, Hamideh Azimi Lolaty

Journal of Nursing and Midwifery Sciences 2019 6(2):91-97

Context: Caregiver burden is high in schizophrenia. Self-efficacy is an emotional and behavioral response to such stressors. Aims: The aim of the study is to determine the relationship between self-efficacy and the perceived' burden among schizophrenic patients' caregivers. Setting and Design: A total of 384 schizophrenic patients' caregivers referring to a psychiatry Clinic in Sari, Iran, were selected via convenient sampling, for this descriptive correlational study. Materials and Methods: The caregivers filled the demographic questionnaire (the patient and the caregivers), the Zarit burden interview, and the general self-efficacy scale. Statistical Analysis Used: Using SPPS 20 software, the demographics of the caregivers were compared using Chi-square tests for categorical data and t- tests for continuous data. Pearson's correlation and regression method were applied after normality testing (P > 0.05). Results: Among 40.5%, 38.7%, and 7.7% of the caregivers, the burden was mild-to-average, average-to-severe, and highly severe, respectively. The mean of caregivers' self-efficacy and burden was 28.79 ± 5.60 and 40.11 ± 13.60, respectively. Furthermore, the burden had significant relationship with the patient's disease duration and income, caregiver's educational level, job, economic status, and relationship with the patient (P < 0.05). Besides, the caregivers' self-efficacy had meaningful relationship with the patient's gender, income potential, housing status, and with the caregiver's age, gender, educational level, job, housing status, economic status, and relationship with the patient (P < 0.05). The relationship between caregivers' burden and self-efficacy was significantly negative (r = −0.445, P = 0.001). Conclusion: When the self-efficacy increases, the caregiver's burden decreases. The importance of economic status of the caregivers and the patient requires special attention.


Prevention and management catheter-associated urinary tract infection in intensive care unit
Mehdi Rahimi, Khosro Farhadi, Hossein Babaei, Firouz Soleymani

Journal of Nursing and Midwifery Sciences 2019 6(2):98-103

Context: Urinary tract infection (UTI) is the most common hospital-acquired infection. Around 80% of UTIs are associated with urinary catheters. Aims: The aim of this study was to review and to describe epidemiology and approaches for the prevention and management of catheter-associated urinary tract infection (CAUTI) in intensive care unit (ICU) patients. Settings and Design: A narrative review of studies was undertaken. Materials and Methods: A review of PubMed, Google Scholar, Medline, and CINAHL databases were conducted to identify peer-reviewed, English language, and studies published between 1999 and 2018. Related papers were reviewed with using standard keywords. The research was conducted on epidemiology and management of CAUTI in the ICU. Of the 186 English publications, 36 were duplicates. Statistical Analysis Used: Quality assessments, data extractions, and analysis were completed on all included studies. Results: The prevalence of UTI in the ICU is directly related to the widespread use of urethral catheter (32.2%). Guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections for CAUTI. Conclusions: Further studies are needed due to the importance and high prevalence of these infections. We recommend the opportunity to increase any strategy able to reduce the incidence of infections related to urinary catheterization and its consequences in ICUs.


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Critical Care Medicine

Myeloid-Derived Suppressor Cells Mediate Immunosuppression After Cardiopulmonary Bypass
Objectives: Cardiopulmonary bypass is associated with severe immune dysfunctions. Particularly, a cardiopulmonary bypass–related long-lasting immunosuppressive state predisposes patients to a higher risk of postoperative complications, such as persistent bacterial infections. This study was conducted to elucidate mechanisms of post-cardiopulmonary bypass immunosuppression. Design: In vitro studies with human peripheral blood mononuclear cells. Setting: Cardiosurgical ICU, University Research Laboratory. Patients: Seventy-one patients undergoing cardiac surgery with cardiopulmonary bypass (enrolled May 2017 to August 2018). Interventions: Peripheral blood mononuclear cells before and after cardiopulmonary bypass were analyzed for the expression of immunomodulatory cell markers by real-time quantitative reverse transcription polymerase chain reaction. T cell effector functions were determined by enzyme-linked immunosorbent assay, carboxyfluorescein succinimidyl ester staining, and cytotoxicity assays. Expression of cell surface markers was assessed by flow cytometry. CD15+ cells were depleted by microbead separation. Serum arginine was measured by mass spectrometry. Patient peripheral blood mononuclear cells were incubated in different arginine concentrations, and T cell functions were tested. Measurements and Main Results: After cardiopulmonary bypass, peripheral blood mononuclear cells exhibited significantly reduced levels of costimulatory receptors (inducible T-cell costimulator, interleukin 7 receptor), whereas inhibitory receptors (programmed cell death protein 1 and programmed cell death 1 ligand 1) were induced. T cell effector functions (interferon γ secretion, proliferation, and CD8+-specific cell lysis) were markedly repressed. In 66 of 71 patients, a not yet described cell population was found, which could be characterized as myeloid-derived suppressor cells. Myeloid-derived suppressor cells are known to impair immune cell functions by expression of the arginine-degrading enzyme arginase-1. Accordingly, we found dramatically increased arginase-1 levels in post-cardiopulmonary bypass peripheral blood mononuclear cells, whereas serum arginine levels were significantly reduced. Depletion of myeloid-derived suppressor cells from post-cardiopulmonary bypass peripheral blood mononuclear cells remarkably improved T cell effector function in vitro. Additionally, in vitro supplementation of arginine enhanced T cell immunocompetence. Conclusions: Cardiopulmonary bypass strongly impairs the adaptive immune system by triggering the accumulation of myeloid-derived suppressor cells. These myeloid-derived suppressor cells induce an immunosuppressive T cell phenotype by increasing serum arginine breakdown. Supplementation with L-arginine may be an effective measure to counteract the onset of immunoparalysis in the setting of cardiopulmonary bypass. Drs. Hübner and Tomasi contributed equally to this work. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Supported, in part, by institutional grants of the LMU Munich. The authors have disclosed that they do not have any potential conflicts of interest. Address requests for reprints to: Simone Kreth, MD, PhD, Department of Anesthesiology, University Hospital, LMU Munich, Marchioninistr 15, 81377 Munich, Germany. E-mail: simone.kreth@med.uni-muenchen.de Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Factors Associated With Quality of Death in Korean ICUs As Perceived by Medical Staff: A Multicenter Cross-Sectional Survey
Objectives: Facilitating a high quality of death is an important aspect of comfort care for patients in ICUs. The quality of death in ICUs has been rarely reported in Asian countries. Although Korea is currently in the early stage after the implementation of the "well-dying" law, this seems to have a considerable effect on practice. In this study, we aimed to understand the status of quality of death in Korean ICUs as perceived by medical staff, and to elucidate factors affecting patient quality of death. Design: A multicenter cross-sectional survey study. Setting: Medical ICUs of two tertiary-care teaching hospitals and two secondary-care hospitals. Patients: Deceased patients from June 2016 to May 2017. Interventions: Relevant medical staff were asked to complete a translated Quality of Dying and Death questionnaire within 48 hours after a patient's death. A higher Quality of Dying and Death score (ranged from 0 to 100) corresponded to a better quality of death. Measurements and Main Results: Total 416 completed questionnaires were obtained from 177 medical staff (66 doctors and 111 nurses) of 255 patients. All 20 items of the Quality of Dying and Death received low scores. Quality of death perceived by nurses was better than that perceived by doctors (33.1 ± 18.4 vs 29.7 ± 15.3; p = 0.042). Performing cardiopulmonary resuscitation and using inotropes within 24 hours before death were associated with poorer quality of death, whereas using analgesics was associated with better quality of death. Conclusions: The quality of death of patients in Korean ICUs was considerably poorer than reported in other countries. Provision of appropriate comfort care, avoidance of unnecessary life-sustaining care, and permission for more frequent visits from patients' families may correspond to better quality of death in Korean medical ICUs. It is also expected that the new legislation would positively affect the quality of death in Korean ICUs. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Dr. J. Y. Cho received funding from Seoul National University Bundang Hospital research grant. The authors have disclosed that they do not have any potential conflicts of interest. Address requests for reprints to: Yeon Joo Lee, MD, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea. E-mail: yjlee1117@snubh.org Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Neurologic Complications of Infective Endocarditis: A Joint Model for a Septic Thromboembolism and Inflammatory Small Vessel Disease
Objectives: Embolic events from vegetations are commonly accepted as the main mechanism involved in neurologic complications of infective endocarditis. The pathophysiology may imply other phenomena, including vasculitis. We aimed to define the cerebral lesion spectrum in an infective endocarditis rat model. Design: Experimental model of Staphylococcus aureus or Enterococcus faecalis infective endocarditis. Neurologic lesions observed in the infective endocarditis model were compared with three other conditions, namely bacteremia, nonbacterial thrombotic endocarditis, and healthy controls. Setting: Research laboratory of a university hospital. Subjects: Male Wistar rats. Interventions: Brain MRI, neuropathology, immunohistochemistry for astrocyte and microglia, and bacterial studies on brain tissue were used to characterize neurologic lesions. Measurements and Main Results: In the infective endocarditis group, MRI revealed at least one cerebral lesion in 12 of 23 rats (52%), including brain infarctions (n = 9/23, 39%) and cerebral microbleeds (n = 8/23, 35%). In the infective endocarditis group, neuropathology revealed brain infarctions (n = 12/23, 52%), microhemorrhages (n = 10/23, 44%), and inflammatory processes (i.e., cell infiltrates including abscesses, vasculitis, meningoencephalitis, and/or ependymitis; n = 11/23, 48%). In the bacteremia group, MRI studies were normal and neuropathology revealed only hemorrhages (n = 2/11, 18%). Neuropathologic patterns observed in the nonbacterial thrombotic endocarditis group were similar to those observed in the infective endocarditis group. Immunochemistry revealed higher microglial activation in the infective endocarditis group (n = 11/23, 48%), when compared with the bacteremia (n = 1/11, 9%; p = 0.03) and nonbacterial thrombotic endocarditis groups (n = 0/7, 0%; p = 0.02). Conclusions: This original model of infective endocarditis recapitulates the neurologic lesion spectrum observed in humans and suggests synergistic mechanisms involved, including thromboembolism and cerebral vasculitis, promoted by a systemic bacteremia-mediated inflammation. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Supported, in part, by the Société Française NeuroVasculaire. Dr. Cantier received support for article research from Société Française de Neurologie Vasculaire. Dr. Olivot received funding from consulting for Servier, Medtronic, and Astra Zeneca, and he received speaker fees from Bristol Myers Squibb and Pfizer. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: marie.cantier@aphp.fr; mikael.mazighi@aphp.fr Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Pro: Should Patients With Acute Respiratory Distress Syndrome on Veno-Venous Extracorporeal Membrane Oxygenation Have Ventilatory Support Reduced to the Lowest Tolerable Settings?
No abstract available

Why the Adjunctive Corticosteroid Treatment in Critically Ill Patients With Septic Shock (ADRENAL) Trial Did Not Show a Difference in Mortality?
No abstract available

Impact on Patient Outcomes of Pharmacist Participation in Multidisciplinary Critical Care Teams: A Systematic Review and Meta-Analysis
Objectives: The objective of this systematic review and meta-analysis was to assess the effects of including critical care pharmacists in multidisciplinary ICU teams on clinical outcomes including mortality, ICU length of stay, and adverse drug events. Data Sources: PubMed, EMBASE, and references from previous relevant systematic studies. Study Selection: We included randomized controlled trials and nonrandomized studies that reported clinical outcomes such as mortality, ICU length of stay, and adverse drug events in groups with and without critical care pharmacist interventions. Data Extraction: We extracted study details, patient characteristics, and clinical outcomes. Data Synthesis: From the 4,725 articles identified as potentially eligible, 14 were included in the analysis. Intervention of critical care pharmacists as part of the multidisciplinary ICU team care was significantly associated with the reduced likelihood of mortality (odds ratio, 0.78; 95% CI, 0.73–0.83; p < 0.00001) compared with no intervention. The mean difference in ICU length of stay was –1.33 days (95% CI, –1.75 to –0.90 d; p < 0.00001) for mixed ICUs. The reduction of adverse drug event prevalence was also significantly associated with multidisciplinary team care involving pharmacist intervention (odds ratio for preventable and nonpreventable adverse drug events, 0.26; 95% CI, 0.15–0.44; p < 0.00001 and odds ratio, 0.47; 95% CI, 0.28–0.77; p = 0.003, respectively). Conclusions: Including critical care pharmacists in the multidisciplinary ICU team improved patient outcomes including mortality, ICU length of stay in mixed ICUs, and preventable/nonpreventable adverse drug events. Drs. Lee and Ryu contributed equally to this work as co-first authors. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Supported, in part, by the Korean Hospital Pharmaceutical Education & Research Center (No. KSHPERC-18-01). The authors have disclosed that they have no potential conflicts of interest. For information regarding this article, E-mail: eykimjcb777@cau.ac.kr Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Adjusting for Disease Severity Across ICUs in Multicenter Studies
Objectives: To compare methods to adjust for confounding by disease severity during multicenter intervention studies in ICU, when different disease severity measures are collected across centers. Design: In silico simulation study using national registry data. Setting: Twenty mixed ICUs in The Netherlands. Subjects: Fifty-five–thousand six-hundred fifty-five ICU admissions between January 1, 2011, and January 1, 2016. Interventions: None. Measurements and Main Results: To mimic an intervention study with confounding, a fictitious treatment variable was simulated whose effect on the outcome was confounded by Acute Physiology and Chronic Health Evaluation IV predicted mortality (a common measure for disease severity). Diverse, realistic scenarios were investigated where the availability of disease severity measures (i.e., Acute Physiology and Chronic Health Evaluation IV, Acute Physiology and Chronic Health Evaluation II, and Simplified Acute Physiology Score II scores) varied across centers. For each scenario, eight different methods to adjust for confounding were used to obtain an estimate of the (fictitious) treatment effect. These were compared in terms of relative (%) and absolute (odds ratio) bias to a reference scenario where the treatment effect was estimated following correction for the Acute Physiology and Chronic Health Evaluation IV scores from all centers. Complete neglect of differences in disease severity measures across centers resulted in bias ranging from 10.2% to 173.6% across scenarios, and no commonly used methodology—such as two-stage modeling or score standardization—was able to effectively eliminate bias. In scenarios where some of the included centers had (only) Acute Physiology and Chronic Health Evaluation II or Simplified Acute Physiology Score II available (and not Acute Physiology and Chronic Health Evaluation IV), either restriction of the analysis to Acute Physiology and Chronic Health Evaluation IV centers alone or multiple imputation of Acute Physiology and Chronic Health Evaluation IV scores resulted in the least amount of relative bias (0.0% and 5.1% for Acute Physiology and Chronic Health Evaluation II, respectively, and 0.0% and 4.6% for Simplified Acute Physiology Score II, respectively). In scenarios where some centers used Acute Physiology and Chronic Health Evaluation II, regression calibration yielded low relative bias too (relative bias, 12.4%); this was not true if these same centers only had Simplified Acute Physiology Score II available (relative bias, 54.8%). Conclusions: When different disease severity measures are available across centers, the performance of various methods to control for confounding by disease severity may show important differences. When planning multicenter studies, researchers should make contingency plans to limit the use of or properly incorporate different disease measures across centers in the statistical analysis. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Dr. Brakenhoff and Dr. Plantinga contributed equally. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Dr. de Keizer institution received funding from National Intensive Care Evaluation foundation, during the conduct of the study (grants and advisory board member). Dr. Groenwold was supported financially by the Netherlands Organisation for Scientific Research (project 917.16.430). The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: N.L.Plantinga@umcutrecht.nl Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Recommendation of New Medical Alarms Based on Audibility, Identifiability, and Detectability in a Randomized, Simulation-Based Study
Objectives: Accurate and timely identification of existing audible medical alarms is not adequate in clinical settings. New alarms that are easily heard, quickly identifiable, and discernable from one another are indicated. The "auditory icons" (brief sounds that serve as metaphors for the events they represent) have been proposed as a replacement to the current international standard. The objective was to identify the best performing icons based on audibility and performance in a simulated clinical environment. Design: Three sets of icon alarms were designed using empirical methods. Subjects participated in a series of clinical simulation experiments that examined the audibility, identification accuracy, and response time of each of these icon alarms. A statistical model that combined the outcomes was used to rank the alarms in overall efficacy. We constructed the "best" and "worst" performing sets based on this ranking and prospectively validated these sets in a subsequent experiment with a new subject sample. Setting: Experiments were conducted in simulated ICU settings at the University of Miami. Subjects: Medical trainees were recruited from a convenience sample of nursing students and anesthesia residents at the institution. Interventions: In Experiment 1 (formative testing), subjects were exposed to one of the three sets of alarms; identical setting and instruments were used throughout. In Experiment 2 (summative testing), subjects were exposed to one of the two sets of alarms, assembled from the best and worst performing alarms from Experiment 1. Measurements and Main Results: For each alarm, we determined the minimum sound level to reach audibility threshold in the presence of background clinical noise, identification accuracy (percentage), and response time (seconds). We enrolled 123 medical trainees and professionals for participation (78 with < 6 yr of training). We identified the best performing icon alarms for each category, which matched or exceeded the other candidate alarms in identification accuracy and response time. Conclusions: We propose a set of eight auditory icon alarms that were selected through formative testing and validated through summative testing for adoption by relevant regulatory bodies and medical device manufacturers. This work was performed at the University of Miami. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http;/journals.lww.com/ccmjournal). Supported, in part, by grant from Association for the Advancement of Medical Instrumentation. Drs. Bennett's, Dudaryk's, Edworthy's, and McNeer's institution received funding from Association for the Advancement of Medical Instrumentation. Dr. Crenshaw disclosed that she does not have any potential conflicts of interest. For information regarding this article, E-mail: mcneer@miami.edu Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

A 360° Rotational Positioning Protocol of Organ Donors May Increase Lungs Available for Transplantation
Objectives: To evaluate the improvement in lung donation and immediate lung function after the implementation of a 360° rotational positioning protocol within an organ procurement organization in the Midwest. Design: Retrospective observational study. Setting: The Midwest Transplant Network from 2005 to 2017. Rotational positioning of donors began in 2008. Subjects: Potential deceased lung donors. Interventions: A 360° rotational protocol. Presence of immediate lung function in recipients, change in PaO2:FIO2 ratio during donor management, initial and final PaO2:FIO2 ratio, and proportion of lungs donated were measured. Outcomes were compared between rotated and nonrotated donors. Measurements and Main Results: A total of 693 donors were analyzed. The proportion of lung donations increased by 10%. The difference between initial PaO2:FIO2 ratio and final PaO2:FIO2 ratio was significantly different between rotated and nonrotated donors (36 ± 116 vs 104 ± 148; p < 0.001). Lungs transplanted from rotated donors had better immediate function than those from nonrotated donors (99.5% vs 68%; p < 0.001). Conclusions: There was a statistically significant increase in lung donations after implementing rotational positioning of deceased donors. Rotational positioning significantly increased the average difference in PaO2:FIO2 ratios. There was also superior lung function in the rotated group. The authors recommend that organ procurement organizations consider adopting a rotational positioning protocol for donors to increase the lungs available for transplantation. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). University of Missouri Kansas City and Midwest Transplant Network are sponsoring institutions. Dr. Whitt received funding from Midwest Transplant Network. Dr. Wilkins disclosed that he is the administrative Medical Director for, and is also a member of, Midwest Transplant Network. The remaining authors have disclosed that they do not have any potential conflicts of interest For information regarding this article, E-mail: mendezmar@umkc.edu Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Clinician Perception of a Machine Learning–Based Early Warning System Designed to Predict Severe Sepsis and Septic Shock
Objective: To assess clinician perceptions of a machine learning–based early warning system to predict severe sepsis and septic shock (Early Warning System 2.0). Design: Prospective observational study. Setting: Tertiary teaching hospital in Philadelphia, PA. Patients: Non-ICU admissions November–December 2016. Interventions: During a 6-week study period conducted 5 months after Early Warning System 2.0 alert implementation, nurses and providers were surveyed twice about their perceptions of the alert's helpfulness and impact on care, first within 6 hours of the alert, and again 48 hours after the alert. Measurements and Main Results: For the 362 alerts triggered, 180 nurses (50% response rate) and 107 providers (30% response rate) completed the first survey. Of these, 43 nurses (24% response rate) and 44 providers (41% response rate) completed the second survey. Few (24% nurses, 13% providers) identified new clinical findings after responding to the alert. Perceptions of the presence of sepsis at the time of alert were discrepant between nurses (13%) and providers (40%). The majority of clinicians reported no change in perception of the patient's risk for sepsis (55% nurses, 62% providers). A third of nurses (30%) but few providers (9%) reported the alert changed management. Almost half of nurses (42%) but less than a fifth of providers (16%) found the alert helpful at 6 hours. Conclusions: In general, clinical perceptions of Early Warning System 2.0 were poor. Nurses and providers differed in their perceptions of sepsis and alert benefits. These findings highlight the challenges of achieving acceptance of predictive and machine learning–based sepsis alerts. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Ginestra, Dr. Schweickert, Ms. Meadows, Mr. Lynch, and Ms. Pavan helped with data collection; Dr. Ginestra helped with analysis and interpretation of the data, and drafting of the article; and all authors helped with conception and design, and critical revision of the article for important intellectual content. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http;/journals.lww.com/ccmjournal). Dr. Umscheid's contribution to this project was supported, in part, by the National Center for Research Resources (grant no: UL1RR024134), which is now at the National Center for Advancing Translational Sciences (grant no: UL1TR000003). Presented as a poster at the 2017 Society of Hospital Medicine Annual Meeting, Las Vegas, NV. Dr. Schweickert has received funding from the American College of Physicians and Arjo. Dr. Umscheid's institution has received funding from the National Institutes of Health, Food and Drug Administration, and Agency for Healthcare Research and Quality Evidence-based Practice Center contracts, and he has received funding from the Patient-Centered Outcomes Research Institute Advisory Panel and Northwell Health (grand rounds honoraria). The remaining authors have disclosed that they do not have any potential conflicts of interest. Address requests for reprints to: Craig A. Umscheid, MD, MS, Office of Clinical Excellence, University of Chicago Medicine, American School Building, 850 E. 58th Street, Suite 123, Office 128, MC 1135, Chicago, IL 60637. E-mail: craigumscheid@medicine.bsd.uchicago.edu Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Πέμπτη 30 Μαΐου 2019

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,


Adjuvant therapies in venous leg ulcer management: A scoping review Victoria Team DrPH  Peter G. Chandler...
Adjuvant therapies in venous leg ulcer management: A scoping reviewVictoria Team DrPH  Peter G. Chandler BCom, BSc(Hons)  Carolina D. Weller PhDFirst published: 26 April 2019 https://doi.org/10.1111/wrr.12724This work should be attributed to Monash Nursing and Midwifery.Read the full textePDFPDFTOOLS SHAREAbstractCompression therapy is the current evidence‐based approach to manage venous leg ulcers (VLU); however, adherence is a major barrier to successful treatment. Combination approaches may relieve...
Αλέξανδρος Γ. Σφακιανάκης
now
Pressure Ulcer Summit 2018: An Interdisciplinary Approach to Improve Our Understanding of the Risk of...
Pressure Ulcer Summit 2018: An Interdisciplinary Approach to Improve Our Understanding of the Risk of Pressure‐Induced Tissue DamageLisa J. Gould MD, PhD, FACS  Gregory Bohn MD, UHM/ABPM, MAPWCA, FACHM  Ruth Bryant PhD, MS, RN, CWOCN  Tim Paine PT  Kara Couch MS, CRNP, CWS, CWCN‐AP … See all authorsFirst published: 23 May 2019 https://doi.org/10.1111/wrr.12730This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination...
Αλέξανδρος Γ. Σφακιανάκης
1m
Leukemia inhibitory factor promotes the regeneration of rat uterine horns with full thickness injury...
Leukemia inhibitory factor promotes the regeneration of rat uterine horns with full thickness injuryBai Xue MD  Dan Liu PhD  Minmin Song MD  Guangfeng Zhao PhD  Yun Cao PhD  Guijun Yan PhD  Jianwu Dai PhD  Yali Hu PhDFirst published: 20 May 2019 https://doi.org/10.1111/wrr.12729This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and...
Αλέξανδρος Γ. Σφακιανάκης
1m
Toll like receptors (TLRs) in response to human gut microbiota of Indian obese and lean individuals...
Toll like receptors (TLRs) in response to human gut microbiota of Indian obese and lean individualsTej Bahadur, Rama Chaudhry, Vishwa Deepak Bamola, Sonu K Agrawal, Pawan Malhotra, Alka M Chutani, Bijay R Mirdha, Bimal K Das, Rahul K Sharma, Chandan K ThakurJournal of Family Medicine and Primary Care 2019 8(5):1567-1570Background: The rising incidence of obesity is one of the most serious public health issues in the developed as well as in developing countries like India. Obesity and overweight are...
Αλέξανδρος Γ. Σφακιανάκης
1m
Evaluation of hypercalciuria in patients receiving intravenous Cefotaxime Zahra Kalantari, Parsa Yousefichaijan,...
Evaluation of hypercalciuria in patients receiving intravenous CefotaximeZahra Kalantari, Parsa Yousefichaijan, Manijeh Kahbazi, Ali Arjmand ShabestariJournal of Family Medicine and Primary Care 2019 8(5):1558-1561Introduction: Cefotaxime is one of the third generation cephalosporins, which is used against many infections. This drug has a urinary excretion and potentially may have nephrotoxic effects. Hypercalciuria can cause important complications, including the formation of kidney stones. In the...
Αλέξανδρος Γ. Σφακιανάκης
2m
Family Medicine and Primary Care
A primary care–based patient centric palliative care modelSunil Kumar Raina, Raman Kumar, Rajiv Kumar GuptaJournal of Family Medicine and Primary Care 2019 8(5):1519-1522The World Health Organization defined palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other...
Αλέξανδρος Γ. Σφακιανάκης
2m
Cytochemical tests to investigate sperm DNA damage: Assessment and review Soheila Pourmasumi, Alireza...
Cytochemical tests to investigate sperm DNA damage: Assessment and reviewSoheila Pourmasumi, Alireza Nazari, Niloofar Fagheirelahee, Parvin SabetiJournal of Family Medicine and Primary Care 2019 8(5):1533-1539Male factor infertility has been diagnosed as the cause of infertility in about 20% of infertile couples. Sperm analysis is the most common method for diagnosing infertility in a laboratory. However, approximately 15% of infertile men have a normal sperm analysis. Therefore, the result of a...
Αλέξανδρος Γ. Σφακιανάκης
2m
IL‐17A is not a treatment target in progressive vitiligo Reinhart Speeckaert   Sofie Mylle   Nanja...
IL‐17A is not a treatment target in progressive vitiligoReinhart Speeckaert  Sofie Mylle  Nanja van GeelFirst published: 07 May 2019 https://doi.org/10.1111/pcmr.12789EU Clinical Trials Register (EudraCT number: 2015‐003552‐48).Funding information: Novartis Pharmaceuticals provided funding for this study. The research activities of R. Speeckaert and N. van Geel are supported by the Scientific Research Foundation‐Flanders (Krediet aan Navorsers: 1504718N and FWO Senior Clinical Investigator: 1831512N,...
Αλέξανδρος Γ. Σφακιανάκης
7m
The next‐generation BET inhibitor, PLX51107, delays melanoma growth in a CD8‐mediated manner Dan...
The next‐generation BET inhibitor, PLX51107, delays melanoma growth in a CD8‐mediated mannerDan A. Erkes  Conroy O. Field  Claudia Capparelli  Manoela Tiago  Timothy J. Purwin  Inna Chervoneva Adam C. Berger  Edward J. Hartsough  Jessie Villanueva  Andrew E. AplinFirst published: 07 May 2019 https://doi.org/10.1111/pcmr.12788SECTIONSPDFTOOLS SHAREAbstractEpigenetic agents such as bromodomain and extra‐terminal region inhibitors (BETi) slow tumor growth via tumor intrinsic alterations; however, their...
Αλέξανδρος Γ. Σφακιανάκης
8m
Otolaryngology & Head and Neck Surgery
Current approaches to cleft lip revisionPurpose of review Cleft lip repair requires multidisciplinary follow-up throughout a child's life and often requires lip revision surgery in adolescence to restore function and symmetry of the lip. There is significant variability in the approaches taken for lip repair and therefore a review of current techniques and subsequent guidance to secondary cleft lip repair is warranted. Recent findings New methods of secondary reconstruction can be divided into superficial...
Αλέξανδρος Γ. Σφακιανάκης
8m
Tropical Medicine
Antimalarial activity of a novel series of artemisinin-derived 1, 2, 3-triazole dimersKabita Gogoi, Gokul Baishya, Biswajit Saikia, Nabin Chandra Barua, Chandrajit Dohutia, Akalesh Kumar Verma, Anil PrakashAsian Pacific Journal of Tropical Medicine 2019 12(5):195-203Objective: To obtain suitable artimisinin-based drug candidates with high antimalarial activity. Methods: Three different reaction schemes were used to synthesize a total of 15 artemisinin-based compounds. The first synthetic scheme involved...
Αλέξανδρος Γ. Σφακιανάκης
9m
Treating the primary in metastatic prostate cancer: where do we stand? Purpose of review Traditionally,...
Treating the primary in metastatic prostate cancer: where do we stand?Purpose of review Traditionally, local treatment was reserved for palliative control of symptoms in men with metastatic prostate cancer. In the past few years there have been many advances in the systemic options available. The aim of this review is to explore the evidence in support of treating the primary tumor despite the presence of metastatic disease. Recent findings There is a wealth of retrospective studies demonstrating...
Αλέξανδρος Γ. Σφακιανάκης
11m
Cytoreductive nephrectomy in metastatic kidney cancer: what do we do now? Purpose of review Metastatic...
Cytoreductive nephrectomy in metastatic kidney cancer: what do we do now?Purpose of review Metastatic renal cell carcinoma (mRCC) has traditionally been treated with a combination of targeted systemic therapy and cytoreductive nephrectomy. This approach has recently become a topic of debate, because of new randomized data suggesting a lack of survival benefit for cytoreductive nephrectomy. We review the literature relevant to cytoreductive nephrectomy in the modern era of targeted and immune systemic...
Αλέξανδρος Γ. Σφακιανάκης
12m
Treating advanced penile cancer: where do we stand in 2019? Purpose of review Penile squamous cell...
Treating advanced penile cancer: where do we stand in 2019?Purpose of review Penile squamous cell carcinoma (PSCC) remains a challenging malignancy to treat and there is an urgent need of significant improvements at all levels of medical care. In the current review, we summarized the significant obstacles encountered during management of PSCC and discussed the clinical relevance of novel findings and their potential to address these obstacles. Recent findings The recent genetic and immunological...
Αλέξανδρος Γ. Σφακιανάκης
12m
Supplemental oxygen for the management of dyspnea in interstitial lung disease Purpose of review This...
Supplemental oxygen for the management of dyspnea in interstitial lung diseasePurpose of review This article presents a summary of the evidence relating to supplemental oxygen use for the management of dyspnea in patients with interstitial lung disease (ILD). Recent findings In contrast to the majority of the available literature, recent findings suggest that supplemental oxygen can significantly reduce exertional dyspnea in ILD. ILD patients' need for supplemental oxygen often surpasses the levels...
Αλέξανδρος Γ. Σφακιανάκης
12m
Multidimensional measurement of breathlessness: recent advances Purpose of review Breathlessness is...
Multidimensional measurement of breathlessness: recent advancesPurpose of review Breathlessness is a multidimensional sensation for which a range of instruments exists for children, youth and adults, capable or unable to self-report distress with breathing. This review presents developments and applications of multidimensional assessments of breathlessness. Recent findings Excluding unidimensional measures and instruments assessing the impact of breathlessness, at least eight psychometrically robust...
Αλέξανδρος Γ. Σφακιανάκης
13m
Interdisciplinary management of chronic breathlessness Purpose of review Breathlessness is a common...
Interdisciplinary management of chronic breathlessnessPurpose of review Breathlessness is a common yet complex symptom of advanced disease. Effective management will most likely draw upon the skills of multiple disciplines and professions. This review considers recent advances in the management of chronic breathlessness with regards to interdisciplinary working. Recent findings There are growing data on interventions for chronic breathlessness that incorporate psychosocial mechanisms of action, for...
Αλέξανδρος Γ. Σφακιανάκης
13m
Supportive and Palliative Care
Interdisciplinary management of chronic breathlessnessPurpose of review Breathlessness is a common yet complex symptom of advanced disease. Effective management will most likely draw upon the skills of multiple disciplines and professions. This review considers recent advances in the management of chronic breathlessness with regards to interdisciplinary working. Recent findings There are growing data on interventions for chronic breathlessness that incorporate psychosocial mechanisms of action, for...
Αλέξανδρος Γ. Σφακιανάκης
13m
Organ Transplantation
Nontuberculous mycobacteria in solid organ transplantPurpose of review Nontuberculous mycobacteria (NTM) are emerging pathogens of concern especially in solid organ transplant candidates and recipients. This review aims to address diagnostic challenges, new and emerging treatment options, and infection prevention. Recent findings The incidence of NTM infections in transplant candidates and recipients is rising. The infection prevalence of these environmental pathogens varies geographically by species...
Αλέξανδρος Γ. Σφακιανάκης
14m
Serum carcinoembryonic antigen to predict recurrence in the follow-up of patients with colorectal cancer...
Serum carcinoembryonic antigen to predict recurrence in the follow-up of patients with colorectal cancerShow all authorsWinesh Ramphal, Jeske R.E. Boeding, Maartje van Iwaarden, ...First Published March 11, 2019 Research Article https://doi.org/10.1177/1724600818820679Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractIntroduction:Serum carcinoembryonic (CEA) antigen is used as a diagnostic screening tool during follow-up in colorectal cancer patients....
Αλέξανδρος Γ. Σφακιανάκης
15m
Precision medicine in the ageing world: The role of biospecimen sciences Show all authors Silvia Riondino,...
Precision medicine in the ageing world: The role of biospecimen sciencesShow all authorsSilvia Riondino, Patrizia Ferroni, Mario Roselli, ...First Published March 11, 2019 Editorial https://doi.org/10.1177/1724600818816995Article information Article has an altmetric score of 1   Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseKeywords Elderly, precision medicine, risk assessment model, biomarker discovery, methodsThe trends in population growth and aging worldwide see the population...
Αλέξανδρος Γ. Σφακιανάκης
16m
Prognostic roles of microRNA 143 and microRNA 145 in colorectal cancer: A meta-analysis Show all authors...
Prognostic roles of microRNA 143 and microRNA 145 in colorectal cancer: A meta-analysisShow all authorsChenyao Li, Guoqiang Yan, Libin Yin, ...First Published March 10, 2019 Review Article https://doi.org/10.1177/1724600818807492Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractBackground:A systematic analysis was conducted to clarify the relationship between miR-143/145 and the prognosis of colorectal cancer.Materials and methods:We searched four databases:...
Αλέξανδρος Γ. Σφακιανάκης
17m
Elevated neutrophil to lymphocyte and platelet to lymphocyte ratios predict high grade and advanced...
Elevated neutrophil to lymphocyte and platelet to lymphocyte ratios predict high grade and advanced stage renal cell carcinomaSelahattin Çalışkan First Published March 11, 2019 Research Article https://doi.org/10.1177/1724600818817557Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractIntroduction:Renal cell carcinoma is the most common malignancy of the kidney, which accounts 85% of all renal tumors. In recent years, the incidence of renal cell carcinoma...
Αλέξανδρος Γ. Σφακιανάκης
17m
Associated measurement of fucosylated levels of AFP, DCP, and GPC3 for early diagnosis in hepatocellular...
Associated measurement of fucosylated levels of AFP, DCP, and GPC3 for early diagnosis in hepatocellular carcinomaShow all authorsMin Wu, Zhaobo Liu, Aiying Zhang, ...First Published March 10, 2019 Research Article https://doi.org/10.1177/1724600818812472Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractBackground:Hepatocellular carcinoma is a serious health problem worldwide, especially in Asian countries, such as China. However, there are difficulties...
Αλέξανδρος Γ. Σφακιανάκης
18m
Clinicopathological and prognostic significance of metastasis-associated in colon cancer-1 in gastric...
Clinicopathological and prognostic significance of metastasis-associated in colon cancer-1 in gastric cancer: A meta-analysisShow all authorsYan Jin, Kun Zhou, Wenjing Zhao, ...First Published March 10, 2019 Research Article https://doi.org/10.1177/1724600818813634Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractBackground:The gene metastasis-associated in colon cancer-1 (MACC1) has been reported to be overexpressed in diverse human malignancies, and...
Αλέξανδρος Γ. Σφακιανάκης
18m
β-Arrestin-1 expression and epithelial-to-mesenchymal transition in laryngeal carcinoma Show all authors...
β-Arrestin-1 expression and epithelial-to-mesenchymal transition in laryngeal carcinomaShow all authorsGino Marioni, Lorenzo Nicolè, Rocco Cappellesso, ...First Published March 10, 2019 Research Article https://doi.org/10.1177/1724600818813621Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractAim:The novel primary end-point of the present study was to ascertain β-arrestin-1 expression in a cohort of consecutive patients with laryngeal squamous cell carcinoma...
Αλέξανδρος Γ. Σφακιανάκης
19m
Prognostic nomogram for patients with non-metastatic HER2 positive breast cancer in a prospective cohort...
Prognostic nomogram for patients with non-metastatic HER2 positive breast cancer in a prospective cohortShow all authorsChuanxu Luo, Xiaorong Zhong, Zhu Wang, ...First Published March 11, 2019 Research Article https://doi.org/10.1177/1724600818824786Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractPurpose:A nomogram is a reliable tool to generate individualized risk prediction by combining prognostic factors. We aimed to construct a nomogram for predicting...
Αλέξανδρος Γ. Σφακιανάκης
19m
Clinicopathological and molecular differences in colorectal cancer according to location Show all authors...
Clinicopathological and molecular differences in colorectal cancer according to locationShow all authorsYu-Lun Hsu, Chun-Chi Lin, Jeng-Kai Jiang, ...First Published March 10, 2019 Research Article https://doi.org/10.1177/1724600818807164Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractPurpose:The incidence, pathogenesis, molecular pathways, and outcomes of colorectal cancer vary depending on the location of the tumor. This study aimed to compare the...
Αλέξανδρος Γ. Σφακιανάκης
19m
Performance of a MethyLight assay for methylated SFRP2 DNA detection in colorectal cancer tissue and...
Performance of a MethyLight assay for methylated SFRP2 DNA detection in colorectal cancer tissue and serumShow all authorsHui Li*, Zhenzhen Wang*, Guodong Zhao*, ...First Published March 11, 2019 Research Article https://doi.org/10.1177/1724600818820536Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractBackground:Colorectal cancer is one of the five most common cancers in China, and its incidence is steadily increasing. An accurate and non-invasive screening...
Αλέξανδρος Γ. Σφακιανάκης
20m
Cell-free microRNAs as non-invasive biomarkers in glioma: a diagnostic meta-analysis Jinfeng Wang, Fengyuan...
Cell-free microRNAs as non-invasive biomarkers in glioma: a diagnostic meta-analysisJinfeng Wang, Fengyuan Che, Jinling Zhang First Published April 10, 2019 Research Article https://doi.org/10.1177/1724600819840033Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractObjective:Since the diagnostic value of microRNAs for detecting glioma is contentious, we aimed to carry out a meta-analysis to synthetically evaluate the diagnostic significance of cell-free...
Αλέξανδρος Γ. Σφακιανάκης
21m
Urinary markers in treatment monitoring of lung cancer patients with bone metastasis Pei Cheng Jin,...
Urinary markers in treatment monitoring of lung cancer patients with bone metastasisPei Cheng Jin, Bo Gou, Wei QianFirst Published May 21, 2019 Research Article https://doi.org/10.1177/1724600819848762Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractBackground:Bone metastasis remains critical for advanced stage non-small cell lung cancer (NSCLC)—a disease that is challenging to manage. Urinary markers present opportunities for non-invasive testing.Methods:Urine...
Αλέξανδρος Γ. Σφακιανάκης
22m
Circular RNA ABCB10 promotes tumor progression and correlates with pejorative prognosis in clear cell...
Circular RNA ABCB10 promotes tumor progression and correlates with pejorative prognosis in clear cell renal cell carcinomaShow all authorsYunfang Huang, Yun Zhang, Lin Jia, ...First Published May 20, 2019 Research Article https://doi.org/10.1177/1724600819842279Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractObjective:Our study aimed to evaluate the effect of circular RNA ABCB10 (circ-ABCB10) on proliferation and apoptosis of clear cell renal cell...
Αλέξανδρος Γ. Σφακιανάκης
22m
Predictive significance of CYFRA21-1, squamous cell carcinoma antigen and carcinoembryonic antigen for...
Predictive significance of CYFRA21-1, squamous cell carcinoma antigen and carcinoembryonic antigen for lymph node metastasis in patients with esophageal squamous cancerShow all authorsXinyu Mei, Xiaodong Zhu, Lei Zuo, ...First Published May 15, 2019 Research Article https://doi.org/10.1177/1724600819847999Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractFrom January 2018 to May 2018, 108 patients with thoracic esophageal cancer underwent esophagectomy...
Αλέξανδρος Γ. Σφακιανάκης
23m
Clinical significance of tumor miR-21, miR-221, miR-143, and miR-106a as biomarkers in patients with...
Clinical significance of tumor miR-21, miR-221, miR-143, and miR-106a as biomarkers in patients with osteosarcomaShow all authorsHui Zhao, Peng Yan, Jian Wang, ...First Published May 14, 2019 Research Article https://doi.org/10.1177/1724600819843537Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractObjective:To investigate the expression of miR-21, miR-221, miR-143, and miR-106a in patients' osteosarcoma samples, and to explore the correlation between...
Αλέξανδρος Γ. Σφακιανάκης
23m
The serum level of CC chemokine ligand 18 correlates with the prognosis of non-small cell lung cancer...
The serum level of CC chemokine ligand 18 correlates with the prognosis of non-small cell lung cancerShow all authorsHui Huang, Jing Li, Wen-jia Hu, ...First Published May 3, 2019 Research Article https://doi.org/10.1177/1724600819829758Article information Article has an altmetric score of 1   Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractBackground:CC chemokine ligand 18 (CCL18) is a chemotactic cytokine involved in the pathogenesis and progression of various cancers....
Αλέξανδρος Γ. Σφακιανάκης
24m
iTRAQ-based proteomics reveals SOD2 as a potential salivary biomarker in liver cancer Show all authors...
iTRAQ-based proteomics reveals SOD2 as a potential salivary biomarker in liver cancerShow all authorsFeng Ding, Kehuan Sun, Ningning Sun, ...First Published May 1, 2019 Research Article https://doi.org/10.1177/1724600819841619Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractBackground:Salivary proteomic analysis has been extensively used in a wide range of cancer, but not in hepatocellular carcinoma. The aim of this study was to identify potential salivary...
Αλέξανδρος Γ. Σφακιανάκης
24m
New and old biomarkers in the differential diagnosis of lung cancer: Pro-gastrin-releasing peptide in...
New and old biomarkers in the differential diagnosis of lung cancer: Pro-gastrin-releasing peptide in comparison with neuron-specific enolase, carcinoembryonic antigen, and CYFRA 21-1Show all authorsCristian Mauro, Rita Passerini, Lorenzo Spaggiari, ...First Published April 17, 2019 Research Article https://doi.org/10.1177/1724600819834235Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractBackground:Testing for circulating biomarkers in lung cancer is...
Αλέξανδρος Γ. Σφακιανάκης
25m
New and old biomarkers in the differential diagnosis of lung cancer: Pro-gastrin-releasing peptide in...
New and old biomarkers in the differential diagnosis of lung cancer: Pro-gastrin-releasing peptide in comparison with neuron-specific enolase, carcinoembryonic antigen, and CYFRA 21-1Show all authorsCristian Mauro, Rita Passerini, Lorenzo Spaggiari, ...First Published April 17, 2019 Research Article https://doi.org/10.1177/1724600819834235Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractBackground:Testing for circulating biomarkers in lung cancer is...
Αλέξανδρος Γ. Σφακιανάκης
26m
Prognostic markers affecting the early recurrence of hepatocellular carcinoma with liver cirrhosis after...
Prognostic markers affecting the early recurrence of hepatocellular carcinoma with liver cirrhosis after curative resectionShow all authorsWan-Joon Kim, Tae-Wan Lim, Pyoung-Jae Park, ...First Published April 12, 2019 Research Article https://doi.org/10.1177/1724600819834306Article information  Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractBackground:Early recurrence is associated with poor prognosis after curative resection for hepatocellular carcinoma. Thus, we studied...
Αλέξανδρος Γ. Σφακιανάκης
26m
Cancer registries - guardians of breast cancer biomarker information: A systematic review Show all authors...
Cancer registries - guardians of breast cancer biomarker information: A systematic reviewShow all authorsLena Voith von Voithenberg, Emanuele Crocetti, Carmen Martos, ...First Published April 10, 2019 Research Article https://doi.org/10.1177/1724600819836097Article information Article has an altmetric score of 1   Open Access Creative Commons Attribution 4.0 LicenseArticle InformationArticle first published online: April 10, 2019Received: July 16, 2018; Revisions received: January 24, 2019; Accepted:...
Αλέξανδρος Γ. Σφακιανάκης
27m
Automated Pupillometry Devices in Critically Ill PatientsBackground: Automated pupillometry may help...
Automated Pupillometry Devices in Critically Ill PatientsBackground: Automated pupillometry may help detect early cerebral disturbances in critically ill patients. It remains unclear whether different automated pupillometry devices can detect pupillary abnormalities with similar accuracy. The aim of this study was to compare the performance of 2 commercially available automated pupillometry devices—Neurolight Algiscan (NL) and NPi-200 (NP) versus standard pupillary light reflex (PLR) examination...
Αλέξανδρος Γ. Σφακιανάκης
30m
Language Monitoring in Brain Surgery Under General Anesthesia Background: Awake surgeries for cerebral...
Language Monitoring in Brain Surgery Under General AnesthesiaBackground: Awake surgeries for cerebral lesion resection have several limitations including patient fear, discomfort, or pain. This study aimed to determine whether components of language function could be measured under general anesthesia. In this study, the occurrence of mismatch negativity (MMN) was searched in evoked potentials for phonological sounds. Materials and Methods: Five normal hearing, French native speaker, awake volunteers...
Αλέξανδρος Γ. Σφακιανάκης
30m
Subanesthetic Dose of Ketamine Improved CFA-induced Inflammatory Pain and Depression-like Behaviors...
Subanesthetic Dose of Ketamine Improved CFA-induced Inflammatory Pain and Depression-like Behaviors Via Caveolin-1 in MiceBackground: Ketamine, a commonly used nonbarbiturate anesthetic drug, possesses antidepressant properties at subanesthetic doses; however, the underlying mechanisms remain unclear. Materials and Methods: The analgesic and antidepressant effects of ketamine were explored using a complete Freund adjuvant (CFA)-induced peripheral inflammatory pain model in vivo. Mice were first divided...
Αλέξανδρος Γ. Σφακιανάκης
30m
Defining a Taxonomy of Intracranial Hypertension: Is ICP More Than Just a Number? Intracranial pressure...
Defining a Taxonomy of Intracranial Hypertension: Is ICP More Than Just a Number?Intracranial pressure (ICP) monitoring and control is a cornerstone of neuroanesthesia and neurocritical care. However, because elevated ICP can be due to multiple pathophysiological processes, its interpretation is not straightforward. We propose a formal taxonomy of intracranial hypertension, which defines ICP elevations into 3 major pathophysiological subsets: increased cerebral blood volume, masses and edema, and...
Αλέξανδρος Γ. Σφακιανάκης
31m
Pain Anxiety as a Mechanism Linking Pain Severity and Opioid Misuse and Disability Among Individuals...
Pain Anxiety as a Mechanism Linking Pain Severity and Opioid Misuse and Disability Among Individuals With Chronic PainObjective: Chronic pain affects a significant number of individuals in the United States and is associated with several negative health-related outcomes, including possibility of opioid misuse and disability. The identification of factors associated with both opioid misuse and disability is of critical public health importance, and significant research suggests that pain severity...
Αλέξανδρος Γ. Σφακιανάκης
31m
The Association Between Antenatal Maternal Self-reported Substance Use, Maternal Characteristics, and...
The Association Between Antenatal Maternal Self-reported Substance Use, Maternal Characteristics, and Obstetrical VariablesBackground: Substance use disorders during pregnancy are a concern both to the public and medical community, because the negative consequences can be detrimental to both mother and the fetus. The accurate identification of prenatal drug exposure is necessary to determine appropriate medical and psychosocial intervention, and to identify risk factors that may affect outcomes for...
Αλέξανδρος Γ. Σφακιανάκης
32m
Prenatal Practice Staff Perceptions of Three Substance Use Screening Tools for Pregnant Women Objective:...
Prenatal Practice Staff Perceptions of Three Substance Use Screening Tools for Pregnant WomenObjective: There is a need to identify an acceptable and comprehensive substance use screening tool for pregnant women in the United States. This qualitative study sought to better understand prenatal practice staff perceptions of three existing substance use screening tools for use among pregnant women in an outpatient practice setting. Methods: Eight focus groups with 40 total participants were conducted...
Αλέξανδρος Γ. Σφακιανάκης
32m
Exploring the Effects of Vitamin D Supplementation on Cognitive Functions and Mental Health Status...
Exploring the Effects of Vitamin D Supplementation on Cognitive Functions and Mental Health Status in Subjects Under Methadone Maintenance TreatmentObjectives: Vitamin D deficiency may be linked to several mental complications including cognitive deficits, depression, and anxiety in patients under methadone maintenance treatment (MMT). This study was designed to explore the effect of vitamin D supplementation on cognitive functions and mental health parameters in subjects under MMT. Methods: This...
Αλέξανδρος Γ. Σφακιανάκης
32m
How Might Maternal Poverty Impact the Course of Neonatal Opioid Withdrawal Syndrome? Neonatal Opioid...
How Might Maternal Poverty Impact the Course of Neonatal Opioid Withdrawal Syndrome?Neonatal Opioid Withdrawal Syndrome (NOWS) is an increasing problem in the midst of the current opioid epidemic, frequently associated with pharmacologic treatment and prolonged hospitalizations. NOWS is a highly variable condition with many clinical and genetic variables contributing to the clinical course. Social variables such as maternal poverty remain understudied. In this commentary, we review one of the first...
Αλέξανδρος Γ. Σφακιανάκης
33m
Poverty and Excess Length of Hospital Stay in Neonatal Opioid Withdrawal SyndromeObjectives: To study...
Poverty and Excess Length of Hospital Stay in Neonatal Opioid Withdrawal SyndromeObjectives: To study the impact of sociodemographic factors on length of stay (LOS) for infants with neonatal opioid withdrawal syndrome (NOWS) secondary to fetal opioid exposure. Methods: In this retrospective cohort study, we included term infants with NOWS, excluding those with other significant medical issues. Comprehensive clinical and sociodemographic data were collected. Multivariate regression modeling was used...
Αλέξανδρος Γ. Σφακιανάκης
33m
Neurosurgical Anesthesiology
The Effect of Depth of Anesthesia on Hemodynamic Changes Induced by Therapeutic Compression of the Trigeminal GanglionBackground: Percutaneous compression of the trigeminal ganglion (PCTG) has been used to treat trigeminal neuralgia since 1983. A PCTG-related trigeminocardiac reflex (TCR) can induce dramatic hemodynamic disturbances. This study investigates the effects of depth of propofol anesthesia on hemodynamic changes during PCTG. Materials and Methods: A total of 120 patients who underwent...
Αλέξανδρος Γ. Σφακιανάκης
33m
The Effect of Depth of Anesthesia on Hemodynamic Changes Induced by Therapeutic Compression of the...
The Effect of Depth of Anesthesia on Hemodynamic Changes Induced by Therapeutic Compression of the Trigeminal GanglionBackground: Percutaneous compression of the trigeminal ganglion (PCTG) has been used to treat trigeminal neuralgia since 1983. A PCTG-related trigeminocardiac reflex (TCR) can induce dramatic hemodynamic disturbances. This study investigates the effects of depth of propofol anesthesia on hemodynamic changes during PCTG. Materials and Methods: A total of 120 patients who underwent...
Αλέξανδρος Γ. Σφακιανάκης
33m
Addiction Medicine
Poverty and Excess Length of Hospital Stay in Neonatal Opioid Withdrawal SyndromeObjectives: To study the impact of sociodemographic factors on length of stay (LOS) for infants with neonatal opioid withdrawal syndrome (NOWS) secondary to fetal opioid exposure. Methods: In this retrospective cohort study, we included term infants with NOWS, excluding those with other significant medical issues. Comprehensive clinical and sociodemographic data were collected. Multivariate regression modeling was used...
Αλέξανδρος Γ. Σφακιανάκης
34m
Vehicle Collision : Blunt rupture of the myocardium,Blunt Cardiac Injury,Atrial and pericardial rupture from blunt cardiac trauma
Blunt rupture of the myocardium - The Annals of Thoracic Surgeryhttps://www.annalsthoracicsurgery.org/article/0003-4975(89)90203-8/pdfby WC Pevec - ‎1989 - ‎Cited by 83 - ‎Related articlesblunt rupture of the heart, prompted this review. History. The first ... cardiac rupture, in a male victim of a motor vehicle accident who sustained a tear of the right atrial-superior vena caval ... chamber: right atrium, 36; left atrium, 30; right ventricle,.Case reports of atrial and pericardial rupture from...
Αλέξανδρος Γ. Σφακιανάκης
36m
Variability in international normalized ratio and activated partial thromboplastin time after injury...
Variability in international normalized ratio and activated partial thromboplastin time after injury are not explained by coagulation factor deficitsIntroduction Conventional coagulation assays (CCAs), PT/INR (prothrombin time/international normalized ratio) and aPTT (activated partial thromboplastin time), detect clotting factor (CF) deficiencies in hematologic disorders. However, there is controversy about how these CCAs should be used to diagnose, treat and monitor trauma-induced coagulopathy....
Αλέξανδρος Γ. Σφακιανάκης
45m
Promotility Agents For The Treatment Of Ileus In Adult Surgical Patients: A Practice Management Guideline...
Promotility Agents For The Treatment Of Ileus In Adult Surgical Patients: A Practice Management Guideline From The Eastern Association For The Surgery Of TraumaBackground Ileus is a common challenge in adult surgical patients with estimated incidence to be 17%-80%. The main mechanisms of the postoperative ileus pathophysiology are fluid overload, exogenous opioids, neurohormonal dysfunction, gastrointestinal stretch and inflammation. Management includes addressing the underlying cause and supportive...
Αλέξανδρος Γ. Σφακιανάκης
45m
Ketamine Infusion for Pain Control in Adult Patients with Multiple Rib Fractures Kugler, Nathan W.,...
Ketamine Infusion for Pain Control in Adult Patients with Multiple Rib FracturesKugler, Nathan W., MD; Juul, Janelle, PharmD; Peppard, William J., PharmD; Carver, Thomas W., MD, FACSJournal of Trauma and Acute Care Surgery: May 24, 2019 - Volume Publish Ahead of Print - Issue - pdoi: 10.1097/TA.0000000000002377
Αλέξανδρος Γ. Σφακιανάκης
45m
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Induced Myocardial Injury is Mitigated...
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Induced Myocardial Injury is Mitigated by Endovascular Variable Aortic Control (EVAC)Background The cardiac effects of resuscitative endovascular balloon occlusion of the aorta (REBOA) are largely unknown. We hypothesized that increased afterload from REBOA would lead to cardiac injury, and that partial flow using endovascular variable aortic control (EVAC) would mitigate this injury. Methods Eighteen anesthetized swine underwent controlled...
Αλέξανδρος Γ. Σφακιανάκης
46m
Trauma and Acute Care Surgery
Unfractionated heparin attenuates histone-mediated cytotoxicity in vitro and prevents intestinal microcirculatory dysfunction in histone-infused ratsAbstract: Background Extracellular histones are major mediators of organ dysfunction and death in sepsis, and they may cause microcirculatory dysfunction. Heparins have beneficial effects in sepsis and have been reported to bind to histones and neutralize their cytotoxicity. The aim of this study was to investigate the impact of histones on intestinal...
Αλέξανδρος Γ. Σφακιανάκης
46m
Unfractionated heparin attenuates histone-mediated cytotoxicity in vitro and prevents intestinal microcirculatory...
Unfractionated heparin attenuates histone-mediated cytotoxicity in vitro and prevents intestinal microcirculatory dysfunction in histone-infused ratsAbstract: Background Extracellular histones are major mediators of organ dysfunction and death in sepsis, and they may cause microcirculatory dysfunction. Heparins have beneficial effects in sepsis and have been reported to bind to histones and neutralize their cytotoxicity. The aim of this study was to investigate the impact of histones on intestinal...
Αλέξανδρος Γ. Σφακιανάκης
47m
Wall Contrast Enhancement of Thrombosed Intracranial Aneurysms at 7T MRI T. Sato, T. Matsushige, B....
Wall Contrast Enhancement of Thrombosed Intracranial Aneurysms at 7T MRIT. Sato, T. Matsushige, B. Chen, O. Gembruch, P. Dammann, R. Jabbarli, M. Forsting, A. Junker, S. Maderwald, H.H. Quick, M.E. Ladd, U. Sure and K.H. WredeAmerican Journal of Neuroradiology May 2019, DOI: https://doi.org/10.3174/ajnr.A6084ArticleFigures & DataInfo & MetricsReferences PDFThis article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article....
Αλέξανδρος Γ. Σφακιανάκης
50m
Assessment of Explicitly Stated Interval Change on Noncontrast Head CT Radiology Reports M. Braileanu,...
Assessment of Explicitly Stated Interval Change on Noncontrast Head CT Radiology ReportsM. Braileanu, K. Crawford, S.R. Key and M.E. MullinsAmerican Journal of Neuroradiology May 2019, DOI: https://doi.org/10.3174/ajnr.A6081ArticleFigures & DataInfo & MetricsReferences PDFThis article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.AbstractBACKGROUND AND PURPOSE: Consistent...
Αλέξανδρος Γ. Σφακιανάκης
50m
Deep Learning–Based Automatic Segmentation of Lumbosacral Nerves on CT for Spinal Intervention: A Translational...
Deep Learning–Based Automatic Segmentation of Lumbosacral Nerves on CT for Spinal Intervention: A Translational StudyG. Fan, H. Liu, Z. Wu, Y. Li, C. Feng, D. Wang, J. Luo, W.M. Wells and S. HeAmerican Journal of Neuroradiology May 2019, DOI: https://doi.org/10.3174/ajnr.A6070ArticleFigures & DataSupplementalInfo & MetricsReferences PDFAbstractBACKGROUND AND PURPOSE: 3D reconstruction of a targeted area ("safe" triangle and Kambin triangle) may benefit the viability assessment of transforaminal...
Αλέξανδρος Γ. Σφακιανάκης
51m
Hazardous Materials
Reduction of phoxim pesticide residues from grapes by atmospheric pressure non-thermal air plasma activated waterPublication date: 5 September 2019Source: Journal of Hazardous Materials, Volume 377Author(s): Yongping Zheng, Songjie Wu, Jie Dang, Shifang Wang, Zhengxin Liu, Jing Fang, Ping Han, Jue ZhangAbstractIn this study, we propose a novel strategy, plasma activated water (PAW) to reduce pesticide residues on agricultural products. To validate its feasibility and effectiveness, we employee high-performance...
Αλέξανδρος Γ. Σφακιανάκης
52m
Sugar Alternatives : Molasses,Raw Honey,Stevia,Xylitol
XylitolXylitol is a sugar alcohol derived from xylose - a crystalline sugar found in birch bark[8]. Sweet like sugar but with only 40% of the calories, xylitol is fast becoming the preferred sweetener of health-conscious consumers.Low-carb dieters will find xylitol appealing, with less than a quarter of the carbohydrates found in cane sugar. It also stands apart from synthetic sweeteners thanks to its natural origins. Besides birch trees, xylitol is found in the cellular structure of fruits like...
Αλέξανδρος Γ. Σφακιανάκης
55m
The Hearing Journal
 The Hearing JournalVol. 72, No. 6, June 2019 pp: 28-48View Contributor IndexThe Power of Partnerships: Audiologist-Physician Collaboration Improves Patient CareBy Kelly WolfgangStrong relationships between audiologists and physicians can lead to better patient care and other opportunities for collaboration. Building and maintaining these relationships could be a challenge to many busy clinicians, but these creative and long-term strategies will help make network-building effective, collaborative,...
Αλέξανδρος Γ. Σφακιανάκης
59m

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480