Anastasios Angelou

The TNBS-induced colitis animal model: An overview

Background Despite recent advances the pathogenesis of Crohns disease remains incompletely understood. A variety of animal models have been utilized in an effort to provide further insights and develop more therapeutic options. In order to simulate, to an extent, the pathogenesis and the clinical course of the disease, TNBS induced colitis is often used. Various approaches for inducing TNBS -colitis have been described in the literature. Methods/results In this review, we sought to present the animal model of TNBS induced colitis and outline the pathogenesis, pathophysiology, clinical course and pathological characteristics of the model. Furthermore, we describe the differences among those protocols regarding types of animals and colitis induction. Data sources The MEDLINE database was thoroughly searched using the keywords: TNBS, colitis, Crohns disease, animal model. Two investigators independently reviewed the abstracts and appropriate articles were included in this review. Additional articles were gathered and evaluated. Conclusion The aim of this study was to thoroughly present an updated review of the TNBS-induced colitis protocols that are implemented by researchers.

Statins in the chemoprevention of colorectal cancer in established animal models of sporadic and colitis-associated cancer.

Despite the availability of effective surveillance for colorectal cancer with colonoscopy, chemoprevention might be an acceptable alternative. Statins are potent inhibitors of cholesterol biosynthesis. In clinical trials, statins have been found to be beneficial in the primary and secondary prevention of coronary heart disease. However, the overall benefits observed with statins appear to be greater than what might be expected from changes in lipid levels alone, suggesting effects beyond cholesterol lowering. This systematic review aimed to gather information on the possible chemopreventive role of statins in preventing carcinogenesis and tumor promotion by a diverse array of mechanisms in both sporadic and colitis-associated cancer in animal models. The MEDLINE database was thoroughly searched using the following keywords: ‘statin, HMG-CoA reductase inhibitor, colon cancer, mice, rats, chemoprevention, colitis-associated cancer’. Additional articles were gathered and evaluated. There are a lot of clinical studies and meta-analyses, as well as a plethora of basic research studies implementing cancer cell lines and animal models, on the chemopreventive role of statins in colorectal cancer (CRC). However, data derived from clinical studies are inconclusive, yet they show a tendency toward a beneficial role of statins against CRC pathogenesis. Thus, more research on the molecular pathways of CRC tumorigenesis as related to statins is warranted to uncover new mechanisms and compare the effect of statins on both sporadic and colitis-associated cancer in animal models. Basic science results could fuel exclusive colitis-associated cancer clinical trials to study the chemopreventive effects of statins and to differentiate between their effects on the two types of CRCs in humans.

Wernicke’s encephalopathy after sleeve gastrectomy. Where do we stand today? A reappraisal

Q1 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 Dear Editor, We read with great interest the recent publication of Saab et al. [1], which reports a case of Wernicke’s encephalopathy 3 weeks after sleeve gastrectomy (SG). The authors discuss a case of rapid Wernicke’s encephalopathy due to thiamine deficiency in a 27-year-old female patient after SG. According to the authors, Wernicke’s encephalopathy was suspected due to the history of recent bariatric surgery, current presentation, and abnormal neurologic findings. This case is interesting because it describes a rare but serious complication of bariatric surgery with significant morbidity and mortality in a very short postoperative time after the procedure. According to our recent search of the literature, there are 3 additional cases of Wernicke’s encephalopathy after SG. The first case by Scarano et al. [2], describes a 37-year-old woman with a late development of Wernicke’s encephalopathy and severe polyneuropathy 3 months after SG. About 6 months after onset of neurologic picture, her symptoms partially improved with thiamine treatment. In the second case, Sharabi and Bisharat [3], describe a 43-year-old female patient who underwent SG and suffered from Wernicke’s encephalopathy and paralytic ileus. Thiamine supplementation was administered with gradual improvement in her encephalopathy; however, she was readmitted 3 months later with a profound ileus, developed multisystem organ failure, and died. The third case reported by Cerutti et al [4], described the manifestation of central and peripheral neurologic deficits and psychogenic anorexia in a 33-year-old man who presented 18 weeks after SG. Because of the patient’s history, the clinical examination, and the findings with brain magnetic resonance imaging, he

Does socio-economic status in Greece affect participation in cancer screening programmes during the period of financial crisis?

AbstractᅟPrimary health care reflects a country’s health level in relation to the current social and economic conditions according to the Declaration of Alma Ata (1978). Secondary prevention activities (Pap smear test, mammogram) promote public health through the early diagnosis of a disease. Since 2011 in Greece, due to the financial crisis, a significant reduction of national public health funding has occurred, along with substantial annual family income suppression and an increasing use of public health services.AimTo investigate the socio-economic features of women participating in secondary prevention of breast and cervical cancer in an austerity setting.MethodCross-sectional study in 225 women through an anonymous self-administered questionnaire in the outpatient clinic of a large anti-cancer hospital in Athens.ResultsThe majority of participants (56.9%) are unemployed and 24.1% declare no income. The main reason for choosing a state hospital is purely financial (55.1%). Women with higher educational level are 1.85 times more likely to get regular Pap smear tests (p = 0.026) compared to less educated women, and they also have the highest percentage (85.1%) of getting regular mammograms.ConclusionThe financial crisis is complex and several factors affect all levels of the health system. Greece has no organised population-based screening programme. Mean annual income and education level determine participation in cancer screening in women visiting a major state anticancer hospital. Moreover, reduced public health spending in a prolonged austerity setting will hinder the participation of unemployed and less educated women in regular preventive activities, thus breaching the human right to access to health prevention.

Incidence and Risk Factors for Organ/Space Infection after Radiofrequency-Assisted Hepatectomy or Ablation of Liver Tumors in a Single Center: More than Meets the Eye

Introduction Surgical site infections (SSIs) and especially organ/space infection (O/SI) after resection or ablation of liver tumors are associated with increased morbidity and mortality. A secondary blood stream infection (BSI) is considered an O/SI but the exact prevalence is unknown. We aimed to investigate the incidence of O/SI and BSIs in a cohort of consecutive patients after liver resection or ablation, to seek for a possible connection between them and to search for potential risk factors. Materials and methods We reviewed all patients who underwent hepatic resection or intraoperative liver ablation between January 2012 and December 2016 in our department. We focused on age, gender, Child–Pugh score, preoperative biliary drainage, indication for surgery, type of resection, resection or ablation of tumor, need for bilioenteric reconstruction, additional procedure to hepatectomy, blood transfusion, operative time, postoperative admission to ICU, and antibiotic chemoprophylaxis. All positive cultures from intra-abdominal fluids and blood were recorded. O/SI and BSIs were diagnosed by the criteria set by Centers for Disease Control. All variables were compared between the group with O/SI and the group without infection. BSIs were associated with these infections also. Results Eighty-one consecutive patients with a mean age of 64 years were enrolled. Fifteen patients presented a positive culture postoperatively: intra-abdominal fluid in eight, blood cultures in six, and both blood and intra-abdominal fluid in one patient. The directly estimated incidence of O/SI amounted to 11.1%. Four blood cultures were secondary to O/SI, and the remaining two secondary to central line catheter. O/SI was diagnosed indirectly, through the BSI in an additional 4.9% of the patients, raising the incidence of SSI to 16%. Among the factors studied, only admission to the ICU was found to be statistically significant as a risk factor for the development of O/SI (p = 0.026). Conclusion O/SI should be actively seeked for after liver surgery including blood cultures. Patients with affected physical status, comorbidities are in greater risk of developing O/SI.

Damage Control for Vascular Trauma from the Prehospital to the Operating Room Setting

Early management of vascular injury, starting at the field, is imperative for survival no less than any operative maneuver. Contemporary prehospital management of vascular trauma, including appropriate fluid and volume infusion, tourniquets, and hemostatic agents, has reversed the historically known limb hemorrhage as a leading cause of death. In this context, damage control (DC) surgery has evolved to DC resuscitation (DCR) as an overarching concept that draws together preoperative and operative interventions aiming at rapidly reducing bleeding from vascular disruption, optimizing oxygenation, and clinical outcomes. This review addresses contemporary DCR techniques from the prehospital to the surgical setting, focusing on civilian vascular injuries.

A Novel Modification of the AOM/DSS Model for Inducing Intestinal Adenomas in Mice

Background/Aim: Our aim was to develop an animal model of the precancerous stages of colitis-associated carcinogenesis by modifying the established azoxymethane/dextran sulfate sodium (AOM/DSS) protocol. Materials and Methods: Six mice were treated with varying cycles of DSS following AOM administration as above (group 1: three mice received three 5-day cycles of 3.0% DSS and group 2: three mice received three 7-day cycles of 2.5% DSS; every cycle was followed by a 2-week rest period) and were sacrificed on day 84 of the experiment. By contrast, three female C57BL6 mice (group 3) were treated with a single intraperitoneal dose (10 mg/kg of body weight) of AOM followed by three 5-day cycles of oral 2.5% DSS, with each cycle interrupted by a 2-week rest period. The mice of this group were sacrificed at 60 days. Results: In groups 1 and 2, cancer was noted in five out of the six mice. In group 3, adenomas with dysplastic lesions were noted in all of the mice, but none had developed adenocarcinoma. Conclusion: Our results suggest that the administration of three 5-day cycles of 2.5% DSS following an initial dose of AOM may successfully induce adenoma formation without the concurrent presence of carcinoma in female C57BL6 mice that are sacrificed on experimental day 60. In turn, this modification of the widely used AOM/DSS protocol may constitute a novel approach for investigating colitis-related colonic adenomas.