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  1. Article ; Online: Artificial intelligence (AI) in medicine as a strategic valuable tool.

    Larentzakis, Andreas / Lygeros, Nik

    The Pan African medical journal

    2021  Volume 38, Page(s) 184

    Abstract: Humans' creativity led to machines that outperform human capabilities in terms of workload, effectiveness, precision, endurance, strength, and repetitiveness. It has always been a vision and a way to transcend the existence and to give more sense to life, ...

    Abstract Humans' creativity led to machines that outperform human capabilities in terms of workload, effectiveness, precision, endurance, strength, and repetitiveness. It has always been a vision and a way to transcend the existence and to give more sense to life, which is precious. The common denominator of all these creations was that they were meant to replace, enhance or go beyond the mechanical capabilities of the human body. The story takes another bifurcation when Alan Turing introduced the concept of a machine that could think, in 1950. Artificial intelligence, presented as a term in 1956, describes the use of computers to imitate intelligence and critical thinking comparable to humans. However, the revolution began in 1943, when artificial neural networks was an attempt to exploit the architecture of the human brain to perform tasks that conventional algorithms had little success with. Artificial intelligence is becoming a research focus and a tool of strategic value. The same observations apply in the field of healthcare, too. In this manuscript, we try to address key questions regarding artificial intelligence in medicine, such as what artificial intelligence is and how it works, what is its value in terms of application in medicine, and what are the prospects?
    MeSH term(s) Algorithms ; Artificial Intelligence ; Delivery of Health Care/methods ; Humans ; Machine Learning ; Neural Networks, Computer
    Language English
    Publishing date 2021-02-17
    Publishing country Uganda
    Document type Journal Article
    ZDB-ID 2514347-5
    ISSN 1937-8688 ; 1937-8688
    ISSN (online) 1937-8688
    ISSN 1937-8688
    DOI 10.11604/pamj.2021.38.184.28197
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Trauma system in Greece: Quo Vadis?

    Anagnostou, Evangelos / Larentzakis, Andreas / Vassiliu, Pantelis

    Injury

    2018  Volume 49, Issue 7, Page(s) 1243–1250

    Abstract: Introduction: Implementation of trauma systems has markedly assisted in improving outcomes of the injured patient. However, differences exist internationally as diverse social factors, economic conditions and national particularities are placing ... ...

    Abstract Introduction: Implementation of trauma systems has markedly assisted in improving outcomes of the injured patient. However, differences exist internationally as diverse social factors, economic conditions and national particularities are placing obstacles. The purpose of this paper is to critically evaluate the current Greek trauma system, provide a comprehensive review and suggest key actions.
    Methods: An exhaustive search of the - scarce on this subject - English and Greek literature was carried out to analyze all the main components of the Greek trauma system, according to American College of Surgeons' criteria, as well as the WHO Trauma Systems Maturity Index.
    Results: Regarding prevention, efforts are in the right direction lowering the road traffic incidents-related death rate, however rural and insular regions remain behind. Hellenic Emergency Medical Service (EKAB) has well-defined communications and emergency phone line but faces problems with educating people on how to use it properly. In addition, equal and systematic training of ambulance personnel is a challenge, with the lack of pre-hospital registry and EMS quality assessment posing a question on where the related services are currently standing. Redistribution of facilities' roles with the establishment of the first formal trauma centre in the existing infrastructure would facilitate the development of a national registry and introduction of the trauma surgeon subspecialty with proper training potential. Definite rehabilitation institutional protocols that include both inpatient and outpatient care are needed. Disaster preparedness entails an extensive national plan and regular drills, mainly at the pre-hospital level. The lack, however, of any accompanying quality assurance programs hampers the effort to yield the desirable results.
    Conclusion: Despite recent economic crisis in Greece, actions solving logistics and organising issues may offer a well-defined, integrated trauma system without uncontrollably raising the costs. Political will is needed for reforms that use pre-existing infrastructure and working power in a more efficient way, with a first line priority being the establishment of the first major trauma centre that could function as the cornerstone for the building of the Greek trauma system.
    MeSH term(s) Ambulances ; Delivery of Health Care/organization & administration ; Delivery of Health Care/standards ; Disaster Planning ; Emergency Medical Services/organization & administration ; Emergency Medical Services/standards ; Greece ; Health Services Research ; Humans ; National Health Programs ; Public Health Practice ; Quality Assurance, Health Care ; Trauma Centers/organization & administration ; Trauma Centers/standards ; Traumatology/education
    Language English
    Publishing date 2018-05-23
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 218778-4
    ISSN 1879-0267 ; 0020-1383
    ISSN (online) 1879-0267
    ISSN 0020-1383
    DOI 10.1016/j.injury.2018.05.022
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  3. Article ; Online: Mega-megacolon: a case report.

    Larentzakis, Andreas / Kalyva, Adamantia / Kantas, Theodosios / Michalopoulos, Nikolaos V / Zografos, Constantinos G / Zografos, Georgios C

    International journal of colorectal disease

    2020  Volume 35, Issue 8, Page(s) 1615–1617

    Abstract: Purpose: Large bowel obstruction and megacolon formation secondary to complicated diverticulitis is rare.: Methods: We present a case of an 84-year-old woman surviving large bowel obstruction and mega-megacolon formation secondary to complicated ... ...

    Abstract Purpose: Large bowel obstruction and megacolon formation secondary to complicated diverticulitis is rare.
    Methods: We present a case of an 84-year-old woman surviving large bowel obstruction and mega-megacolon formation secondary to complicated diverticulitis, with an impressive presentation of abdominal distention.
    Results: The patient's symptoms, laboratory test results, and imaging were consistent with large bowel obstruction. The patient underwent urgent exploratory laparotomy. Upon entry in the abdomen, it was unexpected that the extreme colonic wall thickening had prevented perforation, indicating the longtime course of illness. The biopsy of the specimen from the site of the obstruction demonstrated an inflammatory obstructing mass.
    Conclusion: This report aims to point out the atypical and in-extremes presentation of an otherwise common disease.
    MeSH term(s) Aged, 80 and over ; Diverticulitis/surgery ; Female ; Humans ; Intestinal Obstruction/diagnostic imaging ; Intestinal Obstruction/surgery ; Laparotomy ; Megacolon
    Language English
    Publishing date 2020-05-24
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-020-03642-7
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  4. Article ; Online: Validation of a Novel Needle Holder to Train Advanced Laparoscopy Skills to Novices in a Simulator Environment.

    Oussi, Ninos / Georgiou, Konstantinos / Larentzakis, Andreas / Thanasas, Dimitrios / Castegren, Markus / Georgiou, Evangelos / Enochsson, Lars

    Surgical innovation

    2020  Volume 27, Issue 2, Page(s) 211–219

    Abstract: Background. ...

    Abstract Background.
    MeSH term(s) Adolescent ; Adult ; Female ; Humans ; Laparoscopy/education ; Laparoscopy/instrumentation ; Learning Curve ; Male ; Needles ; Simulation Training/methods ; Students, Medical ; Surgical Equipment ; Suture Techniques/adverse effects ; Suture Techniques/instrumentation ; Young Adult
    Language English
    Publishing date 2020-02-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2182571-3
    ISSN 1553-3514 ; 1553-3506
    ISSN (online) 1553-3514
    ISSN 1553-3506
    DOI 10.1177/1553350619901222
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  5. Article: Surgeons' and surgical trainees' acute stress in real operations or simulation: A systematic review.

    Georgiou, Konstantinos / Larentzakis, Andreas / Papavassiliou, Athanasios G

    The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

    2017  Volume 15, Issue 6, Page(s) 355–365

    Abstract: Background and purpose: Acute stress in surgery is ubiquitous and has an immediate impact on surgical performance and patient safety. Surgeons react with several coping strategies; however, they recognise the necessity of formal stress management ... ...

    Abstract Background and purpose: Acute stress in surgery is ubiquitous and has an immediate impact on surgical performance and patient safety. Surgeons react with several coping strategies; however, they recognise the necessity of formal stress management training. Thus, stress assessment is a direct need. Surgical simulation is a validated standardised training milieu designed to replicate real-life situations. It replicates stress, prevents biases, and provides objective metrics. The complexity of stress mechanisms makes stress measurement difficult to quantify and interpret. This systematic review aims to identify studies that have used acute stress estimation measurements in surgeons or surgical trainees during real operations or surgical simulation, and to collectively present the rationale of these tools, with special emphasis in salivary markers.
    Methods: A search strategy was implemented to retrieve relevant articles from MEDLINE and SCOPUS databases. The 738 articles retrieved were reviewed for further evaluation according to the predetermined inclusion/exclusion criteria.
    Results: Thirty-three studies were included in this systematic review. The methods for acute stress assessment varied greatly among studies with the non-invasive techniques being the most commonly used. Subjective and objective tests for surgeons' acute stress assessment are being presented.
    Conclusion: There is a broad spectrum of acute mental stress assessment tools in the surgical field and simulation and salivary biomarkers have recently gained popularity. There is a need to maintain a consistent methodology in future research, towards a deeper understanding of acute stress in the surgical field.
    MeSH term(s) Acute Disease ; Clinical Competence ; Education, Medical, Graduate ; General Surgery/manpower ; Humans ; Simulation Training ; Stress, Psychological/physiopathology ; Stress, Psychological/psychology ; Surgeons/psychology ; Surgical Procedures, Operative/psychology ; Training Support
    Language English
    Publishing date 2017-07-14
    Publishing country Scotland
    Document type Journal Article ; Review
    ZDB-ID 2102927-1
    ISSN 1479-666X
    ISSN 1479-666X
    DOI 10.1016/j.surge.2017.06.003
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  6. Article: Place of hyperthermic intraperitoneal chemotherapy in the armament against pancreatic adenocarcinoma: A survival, mortality and morbidity systematic review.

    Larentzakis, Andreas / Anagnostou, Evangelos / Georgiou, Konstantinos / Vrakopoulou, Gavriella-Zoi / Zografos, Constantinos G / Zografos, Georgios C / Toutouzas, Konstantinos G

    Oncology letters

    2021  Volume 21, Issue 4, Page(s) 246

    Abstract: Pancreatic adenocarcinoma is one of the deadliest types of cancer worldwide, with a 5-year survival rate of 8% despite recent treatment advancements. The present systematic review aimed to investigate the role of hyperthermic intraperitoneal chemotherapy ...

    Abstract Pancreatic adenocarcinoma is one of the deadliest types of cancer worldwide, with a 5-year survival rate of 8% despite recent treatment advancements. The present systematic review aimed to investigate the role of hyperthermic intraperitoneal chemotherapy (HIPEC) following surgical resection for pancreatic adenocarcinoma, with or without peritoneal carcinomatosis. A systematic search of the MEDLINE and SCOPUS electronic databases was performed according to PRISMA guidelines. All possible relevant articles published between January 1980 and May 2019 were retrieved using multiple search terms associated with HIPEC and pancreatic adenocarcinoma. The initial search resulted in 1,244 reports, which condensed to 41 reports following screening of titles and abstracts, and subsequently to four reports following full-text thorough examination. The four reports included involved a prospective cohort study of HIPEC use in resectable pancreatic adenocarcinoma, and three retrospective studies of HIPEC use following cytoreductive surgery for peritoneal carcinomatosis due to pancreatic adenocarcinoma, resulting in a total of 47 patients. The overall survival ranged between 2 and 62 months, and the hospital mortality rate was 8.5%. Morbidity (34%) was mainly attributed to anastomotic leak or respiratory failure. Due to the small sample size and low quality of evidence of the included studies, no valid conclusions could be drawn. Therefore, further studies are required to justify the use of HIPEC as an adjuvant therapy in resectable pancreatic adenocarcinoma, while cytoreductive surgery and HIPEC in peritoneal carcinomatosis of pancreatic origin seems not only not useful but also unsafe at this level of evidence.
    Language English
    Publishing date 2021-02-03
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 2573196-8
    ISSN 1792-1082 ; 1792-1074
    ISSN (online) 1792-1082
    ISSN 1792-1074
    DOI 10.3892/ol.2021.12507
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  7. Article: Severe anaphylactic reaction after blue dye injection for sentinel lymph node biopsy in breast surgery: Report of two cases and literature review.

    Frountzas, Maximos / Theodoropoulos, Charalampos / Karathanasis, Panagiotis / Nikolaou, Christina / Zografos, Constantinos G / Larentzakis, Andreas / Zografos, George C / Michalopoulos, Nikolaos V

    Clinical case reports

    2021  Volume 9, Issue 7

    Abstract: Anaphylactic reactions, and especially the severe ones (types III and IV), should be kept in mind as considerable adverse effects while using blue dyes for SLNB. ...

    Abstract Anaphylactic reactions, and especially the severe ones (types III and IV), should be kept in mind as considerable adverse effects while using blue dyes for SLNB.
    Language English
    Publishing date 2021-05-07
    Publishing country England
    Document type Case Reports
    ZDB-ID 2740234-4
    ISSN 2050-0904
    ISSN 2050-0904
    DOI 10.1002/ccr3.3904
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  8. Article ; Online: Tourniquet use at the Boston Marathon bombing: Lost in translation.

    King, David Richard / Larentzakis, Andreas / Ramly, Elie P

    The journal of trauma and acute care surgery

    2015  Volume 78, Issue 3, Page(s) 594–599

    Abstract: Background: The Boston Marathon bombing was the first major, modern US terrorist event with multiple, severe lower extremity injuries. First responders, including trained professionals and civilian bystanders, rushed to aid the injured. The purpose of ... ...

    Abstract Background: The Boston Marathon bombing was the first major, modern US terrorist event with multiple, severe lower extremity injuries. First responders, including trained professionals and civilian bystanders, rushed to aid the injured. The purpose of this review was to determine how severely bleeding extremity injuries were treated in the prehospital setting in the aftermath of the Boston Marathon bombing.
    Methods: A database was created and populated by all the Boston Level I trauma centers following the Boston Marathon bombing. Data regarding specific injuries, extremities affected, demographics, prehospital interventions (including tourniquet types), and outcomes were extracted.
    Results: Of 243 injured, 152 patients presented to the emergency department within 24 hours. Of these 152 patients, there were 66 (63.6% female) experiencing at least one extremity injury, with age ranging from younger than 15 years to 71 years, and with a median Injury Severity Score (ISS) of 10 (range, 1-38). Of the 66 injured patients, 4 had upper limbs affected, 56 had injuries on the lower limbs only, and 6 had combined upper and lower limbs affected. The extremity Abbreviated Injury Scale (AIS) scores had a median of 3 (range, 1-4). There were 17 lower extremity traumatic amputations in 15 patients. In addition, there were 10 patients with 12 lower extremities experiencing major vascular injuries. Of 66 injured patients, 29 patients had recognized extremity exsanguination at the scene. In total, 27 tourniquets were applied: 16 of 17 traumatic amputations, 5 of 12 lower extremities with major vascular injuries, and 6 additional limbs with major soft tissue injury. All tourniquets were improvised, and no commercial, purpose-designed tourniquets were identified. Among all 243 patients, mortality was 0%.
    Conclusion: After the Boston Marathon bombings, extremity exsanguination at the point of injury was either left untreated or treated with an improvised tourniquet in the prehospital environment. An effective, prehospital extremity hemorrhage control posture should be translated to all civilian first responders in the United States and should mirror the military's posture toward extremity bleeding control. The prehospital response to extremity exsanguination after the Boston Marathon bombing demonstrates that our current practice is an approach, lost in translation, from the battlefield to the homeland.
    Level of evidence: Epidemiologic study, level V.
    MeSH term(s) Adolescent ; Adult ; Aged ; Arm Injuries/therapy ; Blast Injuries/therapy ; Boston ; Female ; Hemorrhage/therapy ; Humans ; Injury Severity Score ; Leg Injuries/therapy ; Male ; Middle Aged ; Terrorism ; Tourniquets/utilization ; Trauma Centers ; Treatment Outcome
    Language English
    Publishing date 2015-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000000561
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    Zs.A 127: Show issues Location:
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  9. Article ; Online: Cyclops' eye-like large ulcerated umbilical mass: a rare presentation of urachal cancer.

    Larentzakis, Andreas / Eleftheriou, Malvina M / Zografos, Constantinos G / Manolis, Ioannis T / Zografos, George C / Toutouzas, Konstantinos G

    ANZ journal of surgery

    2020  Volume 91, Issue 1-2, Page(s) E77–E79

    MeSH term(s) Holoprosencephaly ; Humans ; Minocycline ; Umbilicus ; Urinary Bladder Neoplasms
    Chemical Substances Minocycline (FYY3R43WGO)
    Language English
    Publishing date 2020-07-17
    Publishing country Australia
    Document type Case Reports ; Journal Article
    ZDB-ID 2050749-5
    ISSN 1445-2197 ; 1445-1433 ; 0004-8682
    ISSN (online) 1445-2197
    ISSN 1445-1433 ; 0004-8682
    DOI 10.1111/ans.16143
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  10. Article: Treatment of sea urchin injuries.

    King, David R / Larentzakis, Andreas

    Journal of special operations medicine : a peer reviewed journal for SOF medical professionals

    2011  Volume 14, Issue 2, Page(s) 56–59

    Abstract: Sea urchin injuries can be sustained in a variety of environments in which U.S. Forces are operating, and familiarity with this uncommon injury can be useful. Injuries by sea urchin spines can occur during military activities close to rocky salt aquatic ... ...

    Abstract Sea urchin injuries can be sustained in a variety of environments in which U.S. Forces are operating, and familiarity with this uncommon injury can be useful. Injuries by sea urchin spines can occur during military activities close to rocky salt aquatic ecosystems via three mechanisms. The author describes these mechanisms and discusses the diagnosis, management, and treatment of sea urchin injuries.
    MeSH term(s) Animals ; Anti-Bacterial Agents/therapeutic use ; Back Injuries/diagnosis ; Back Injuries/therapy ; Bites and Stings/diagnosis ; Bites and Stings/therapy ; Female ; Foreign Bodies/diagnosis ; Foreign Bodies/therapy ; Humans ; Marine Toxins ; Military Personnel ; Sea Urchins ; Therapeutic Irrigation ; Tomography, X-Ray Computed ; Wound Infection/drug therapy ; Wounds, Penetrating/diagnosis ; Wounds, Penetrating/therapy ; Young Adult
    Chemical Substances Anti-Bacterial Agents ; Marine Toxins
    Language English
    Publishing date 2011-12-29
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 3006517-3
    ISSN 1553-9768
    ISSN 1553-9768
    DOI 10.55460/M5U1-2Y40
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