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  1. Book ; Online: Surgical Challenges in the Management of Liver Disease

    Georgios Tsoulfas

    2019  

    Abstract: Hepatic surgery represents one of the most challenging fields of surgical practice because it combines the need for surgical excellence with that for deep knowledge and understanding of liver physiology. The various hepatic diseases, whether they are ... ...

    Abstract Hepatic surgery represents one of the most challenging fields of surgical practice because it combines the need for surgical excellence with that for deep knowledge and understanding of liver physiology. The various hepatic diseases, whether they are benign or malignant, require surgical expertise in their management, especially given the complex anatomy and physiology of the liver, as well as its critical role in a variety of different biologic functions.This book is a collection of chapters offering the reader distilled knowledge of various worldwide experts in hepatic surgery and hepatic physiology. The surgical management, including complex and demanding surgical procedures, of malignancies such as hepatocellular carcinoma, cholangiocarcinoma, and metastatic disease will be addressed in an effort to present the various therapeutic choices in the surgical armamentarium.Emphasis is given to the molecular aspect of the different mechanisms involved, which offers a glimpse into the future, given the ever-increasing need for precision medicine and surgery, leading to a patient-targeted approach.
    Keywords Health Sciences ; Medicine ; Surgery ; Hepatic Surgery
    Subject code 610
    Language English
    Publisher IntechOpen
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Book ; Online: Liver Cirrhosis - Debates and Current Challenges

    Georgios Tsoulfas

    2019  

    Abstract: Liver cirrhosis and its complications affect millions of patients of all ages around the globe and present treating physicians with perplexing problems, given the variety of etiologies and the critical nature of hepatic physiology. This book is a ... ...

    Abstract Liver cirrhosis and its complications affect millions of patients of all ages around the globe and present treating physicians with perplexing problems, given the variety of etiologies and the critical nature of hepatic physiology. This book is a collection of chapters offering the distilled knowledge of various worldwide experts in hepatic surgery and hepatic physiology. The various debates that are presented regarding the diagnosis and treatment of liver cirrhosis and its significant complications, in addition to the most up-to-date information regarding molecular aspects, provide the reader with the full spectrum of knowledge in this challenging and continuously evolving field.
    Keywords Health Sciences ; Medicine ; Gastroenterology ; Hepatology
    Language English
    Publisher IntechOpen
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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  3. Book ; Online: Organ Donation and Transplantation - Current Status and Future Challenges

    Georgios Tsoulfas

    2018  

    Abstract: One of the most interesting and at the same time most challenging fields of medicine and surgery has been that of organ donation and transplantation. It is a field that has made tremendous strides during the last few decades through the combined input ... ...

    Abstract One of the most interesting and at the same time most challenging fields of medicine and surgery has been that of organ donation and transplantation. It is a field that has made tremendous strides during the last few decades through the combined input and efforts of scientists from various specialties. What started as a dream of pioneers has become a reality for the thousands of our patients whose lives can now be saved and improved. However, at the same time, the challenges remain significant and so do the expectations. This book will be a collection of chapters describing these same challenges involved including the ethical, legal, and medical issues in organ donation and the technical and immunological problems the experts are facing involved in the care of these patients.The authors of this book represent a team of true global experts on the topic. In addition to the knowledge shared, the authors provide their personal clinical experience on a variety of different aspects of organ donation and transplantation.
    Keywords Health Sciences ; Medicine ; Surgery
    Language English
    Publisher IntechOpen
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Book ; Online: Medical and Surgical Education - Past, Present and Future

    Georgios Tsoulfas

    2018  

    Abstract: The last century has witnessed tremendous changes in the education and training system of medical students, as well as medical and surgical residents, in short, our future physicians. This has been the result of the changes in the educational philosophy, ...

    Abstract The last century has witnessed tremendous changes in the education and training system of medical students, as well as medical and surgical residents, in short, our future physicians. This has been the result of the changes in the educational philosophy, the technology, and the needs of our patients, just to name a few. The challenge is to learn more about the various systems in medical education throughout the world and identify advantages and disadvantages, a process from which we can all (and most importantly our patients) benefit from. This book is a compilation of the experiences, thoughts, and ""best-practice"" advice of a panel of international experts on medical and surgical education.
    Keywords Health Sciences ; Medicine ; Surgery
    Language English
    Publisher IntechOpen
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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  5. Book ; Online: Liver Cirrhosis - Update and Current Challenges

    Georgios Tsoulfas

    2017  

    Abstract: Liver cirrhosis represents one of the major challenges for most physicians and surgeons on a global scale. This book provides practicing hepatologists, gastroenterologists and liver surgeons with a valuable tool in their efforts to understand the ( ... ...

    Abstract Liver cirrhosis represents one of the major challenges for most physicians and surgeons on a global scale. This book provides practicing hepatologists, gastroenterologists and liver surgeons with a valuable tool in their efforts to understand the (molecular) mechanisms involved, be updated regarding the newest and less invasive diagnostic methods, and educate themselves about the challenges involved in the management of liver cirrhosis and its complications. The authors of this book represent a team of true global experts on the topic. In addition to the knowledge shared, the authors provide their personal clinical experience on a variety of different aspects of liver cirrhosis, giving us a well-rounded overview.
    Keywords Health Sciences ; Medicine ; Gastroenterology ; Hepatology
    Language English
    Publisher IntechOpen
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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  6. Article ; Online: Liver Transplantation and dd-cfDNA

    Eleni Avramidou / Stella Vasileiadou / Nikolaos Antoniadis / Georgios Katsanos / Athanasios Kofinas / Konstantina-Eleni Karakasi / Georgios Tsoulfas

    Livers, Vol 3, Iss 7, Pp 76-

    A Small Solution for a Big Problem

    2023  Volume 81

    Abstract: Dd-cfDNA is a novel biomarker with many diagnostic applications in various areas of medicine. In this review of the literature, we investigate its role in the diagnosis of many complications that occur in liver transplantations. In our review, we ... ...

    Abstract Dd-cfDNA is a novel biomarker with many diagnostic applications in various areas of medicine. In this review of the literature, we investigate its role in the diagnosis of many complications that occur in liver transplantations. In our review, we retrieved data from the medical databases PubMed and Scopus. In our bibliography, many areas concerning the contributions of dd-cfDNA to the field of liver transplantation, such as in the diagnosis of complications that include signsof rejection or graft injury, are mentioned. Dd-cfDNA, which are correlated with other biomarkers such as liver enzymes, can have a high diagnostic value. Measurements of Dd-cfDNA also depend on the graft’s size and origin; therefore, these data should be taken into account for the estimation and explanation of dd-cfDNA values. Despite the utility of this novel diagnostic technique, it comes with some limitations and applicational exclusions, such as cases where there is a blood relation between the donor and recipient.
    Keywords dd-cfDNA ; liver transplantation ; graft injury ; rejection ; biomarker ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: THE EVOLUTION OF CRITERIA FOR LIVER TRANSPLANTATION FOR HEPATOCELLULAR CARCINOMA

    Ioannis A. Ziogas / Georgios Tsoulfas

    Revista de la Facultad de Medicina Humana, Vol 17, Iss 3, Pp 56-

    FROM MILAN TO SAN FRANCISCO AND ALL AROUND THE WORLD!

    2017  Volume 69

    Abstract: Introduction: Hepatocellular carcinoma (HCC) is the fifth most common malignancy and the third most common cancerrelated cause of death in the world. According to the stage of the disease, each patient is allocated to a different treatment option. Liver ... ...

    Abstract Introduction: Hepatocellular carcinoma (HCC) is the fifth most common malignancy and the third most common cancerrelated cause of death in the world. According to the stage of the disease, each patient is allocated to a different treatment option. Liver transplantation, along with surgical resection, is the only totally therapeutic option and is primarily indicated in HCC patients with underlying cirrhosis. However, the restricted number of liver grafts imposes difficulties in selecting the most suitable patients to receive those limited grafts and therefore certain criteria have been proposed. The Milan criteria are currently the most widely accepted and utilized criteria around the world, despite their restrictiveness. In an attempt to assist HCC patients exceeding them, but with a potential to display acceptable survival outcomes, undergo liver transplantation, research teams worldwide suggest expanded criteria based on their findings. Some of the most broadly known are the University of California, San Francisco (UCSF), Kyoto, Tokyo, Hangzhou and up-to-7 criteria. On the other hand, in order to expand the liver donor pool, grafts may be accepted from living, non-heart beating, elderly, steatotic, or even HCV-infected donors, in addition to the use of split livers with both advantages and disadvantages. The aim of this review is to thoroughly present the current situation of liver transplantation for HCC patients, with a focus on the criteria used and emerging challenges presented. Core tip: Hepatocellular carcinoma (HCC) is the third most common malignancy worldwide and liver transplantation represents the treatment of choice, particularly in the setting of cirrhosis. Lack of grafts led to the utilization of certain criteria in order to determine the eligibility of an HCC patient to access the waiting list. The most widely accepted are the Milan criteria, even though they are thought off as too restrictive. Consequently, transplant research groups all over the world published their own criteria, which showed ...
    Keywords Medicine ; R ; Medicine (General) ; R5-920
    Subject code 610
    Language Spanish
    Publishing date 2017-09-01T00:00:00Z
    Publisher Universidad Ricardo Palma
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Exploring Perturbations in Peripheral B Cell Memory Subpopulations Early after Kidney Transplantation Using Unsupervised Machine Learning

    Ariadni Fouza / Anneta Tagkouta / Maria Daoudaki / Maria Stangou / Asimina Fylaktou / Konstantinos Bougioukas / Aliki Xochelli / Lampros Vagiotas / Efstratios Kasimatis / Vasiliki Nikolaidou / Lemonia Skoura / Aikaterini Papagianni / Nikolaos Antoniadis / Georgios Tsoulfas

    Journal of Clinical Medicine, Vol 12, Iss 6331, p

    2023  Volume 6331

    Abstract: Background: B cells have a significant role in transplantation. We examined the distribution of memory subpopulations (MBCs) and naïve B cell (NBCs) phenotypes in patients soon after kidney transplantation. Unsupervised machine learning cluster analysis ... ...

    Abstract Background: B cells have a significant role in transplantation. We examined the distribution of memory subpopulations (MBCs) and naïve B cell (NBCs) phenotypes in patients soon after kidney transplantation. Unsupervised machine learning cluster analysis is used to determine the association between the cellular phenotypes and renal function. Methods: MBC subpopulations and NBCs from 47 stable renal transplant recipients were characterized by flow cytometry just before (T0) and 6 months after (T6) transplantation. T0 and T6 measurements were compared, and clusters of patients with similar cellular phenotypic profiles at T6 were identified. Two clusters, clusters 1 and 2, were formed, and the glomerular filtration rate was estimated (eGFR) for these clusters. Results: A significant increase in NBC frequency was observed between T0 and T6, with no statistically significant differences in the MBC subpopulations. Cluster 1 was characterized by a predominance of the NBC phenotype with a lower frequency of MBCs, whereas cluster 2 was characterized by a high frequency of MBCs and a lower frequency of NBCs. With regard to eGFR, cluster 1 showed a higher value compared to cluster 2. Conclusions: Transplanted kidney patients can be stratified into clusters based on the combination of heterogeneity of MBC phenotype, NBCs and eGFR using unsupervised machine learning.
    Keywords B lymphocytes ; B cell subsets ; kidney transplantation ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-10-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Challenges in Abdominal Organ Transplantation During the COVID-19 Pandemic

    Stepan M. Esagian / Ioannis A. Ziogas / Dimitrios Giannis / Muhammad H. Hayat / Nahel Elias / Georgios Tsoulfas

    Frontiers in Medicine, Vol

    2020  Volume 7

    Abstract: As the coronavirus disease 2019 (COVID-19) outbreak has rapidly evolved into a global pandemic, abdominal organ transplantation programs are currently facing multiple challenges. Transplant candidates and recipients are considered high-risk populations ... ...

    Abstract As the coronavirus disease 2019 (COVID-19) outbreak has rapidly evolved into a global pandemic, abdominal organ transplantation programs are currently facing multiple challenges. Transplant candidates and recipients are considered high-risk populations for severe disease and death due to COVID-19 as a result of their numerous underlying comorbidities, advanced age and impaired immune function. Emerging reports of atypical and delayed clinical presentations in these patients generate further concerns for widespread disease transmission to medical personnel and the community. The striking similarities between COVID-19 and other outbreaks that took place over the past two decades, like Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome, highlight the severity of the situation and dictate that extra measures should be taken by the transplant programs to avoid adverse outcomes. Transplant organizations are currently calling for strict screening and isolation protocols to be established in all transplant programs, for both organ donors and recipients. As the situation escalates, more radical measures might be necessary, including a temporary hold on non-urgent transplantations, resulting in serious ethical dilemmas between the survival of these patients and the safety of the community. Further data about these special populations could result in more individualized guidelines for abdominal organ transplantation in the era of COVID-19.
    Keywords coronavirus ; liver transplantation ; kidney transplantation ; immunosuppression ; super-spreading events ; Medicine (General) ; R5-920 ; covid19
    Subject code 610
    Language English
    Publishing date 2020-06-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: DermAI 1.0

    Prabhav Sanga / Jaskaran Singh / Arun Kumar Dubey / Narendra N. Khanna / John R. Laird / Gavino Faa / Inder M. Singh / Georgios Tsoulfas / Mannudeep K. Kalra / Jagjit S. Teji / Mustafa Al-Maini / Vijay Rathore / Vikas Agarwal / Puneet Ahluwalia / Mostafa M. Fouda / Luca Saba / Jasjit S. Suri

    Diagnostics, Vol 13, Iss 3159, p

    A Robust, Generalized, and Novel Attention-Enabled Ensemble-Based Transfer Learning Paradigm for Multiclass Classification of Skin Lesion Images

    2023  Volume 3159

    Abstract: Skin lesion classification plays a crucial role in dermatology, aiding in the early detection, diagnosis, and management of life-threatening malignant lesions. However, standalone transfer learning (TL) models failed to deliver optimal performance. In ... ...

    Abstract Skin lesion classification plays a crucial role in dermatology, aiding in the early detection, diagnosis, and management of life-threatening malignant lesions. However, standalone transfer learning (TL) models failed to deliver optimal performance. In this study, we present an attention-enabled ensemble-based deep learning technique, a powerful, novel, and generalized method for extracting features for the classification of skin lesions. This technique holds significant promise in enhancing diagnostic accuracy by using seven pre-trained TL models for classification. Six ensemble-based DL (EBDL) models were created using stacking, softmax voting, and weighted average techniques. Furthermore, we investigated the attention mechanism as an effective paradigm and created seven attention-enabled transfer learning (aeTL) models before branching out to construct three attention-enabled ensemble-based DL (aeEBDL) models to create a reliable, adaptive, and generalized paradigm. The mean accuracy of the TL models is 95.30%, and the use of an ensemble-based paradigm increased it by 4.22%, to 99.52%. The aeTL models’ performance was superior to the TL models in accuracy by 3.01%, and aeEBDL models outperformed aeTL models by 1.29%. Statistical tests show significant p-value and Kappa coefficient along with a 99.6% reliability index for the aeEBDL models. The approach is highly effective and generalized for the classification of skin lesions.
    Keywords skin lesions ; attention ; ensemble-based deep learning ; reliability ; validation ; Medicine (General) ; R5-920
    Subject code 006
    Language English
    Publishing date 2023-10-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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