Hospital hygiene,purulent wounds and viral escape attempts:an infectious history of the Comnenean Imperial Dynasty

A study published recently by Graumans and colleagues(2021)reported James Bond's exposure to infectious agents across a number of movies[1].The authors took the initiative to use cinema as a source of hygiene literacy,pointing out common flaws and risks for individual and public health.Revisiting popular sources through the lenses of public health,can become an effective tool of science communication by providing readers with an amusing and simultaneously learning experience.The latter is a dire need,taking into account the mounting health disinformation amidst the COVID-19 pandemic.

Endoscopic extraction of large common bile duct stones:A review article

Since therapeutic endoscopic retrograde cholangiopancreatography replaced surgery as the first approach in cases of choledocolithiasis,a plethora of endoscopic techniques and devices appeared in order to facilitate rapid,safe and effective bile duct stones extraction.Nowadays,endoscopic sphincterotomy combined with balloon catheters and/or baskets is the routine endoscopic technique for stone extraction in the great majority of patients.Large common bile duct stones are treated conventionally with mechanical lithotripsy,while the most serious complication of the procedure is "basket and stone impaction" that is predominately resolved surgically.In cases of difficult,impacted,multiple or intrahepatic stones,more sophisticated procedures have been used.Electrohydraulic lithotripsy and laser lithotripsy are performed using conventional mother-baby scope systems,ultra-thin cholangio-scopes,thin endoscopes and ultimately using the novel single use,single operator SpyGlass Direct Visualization System,in order to deliver intracorporeal shock wave energy to fragment the targeted stone,with very good outcomes.Recently,large balloon dilation after endoscopic sphincterotomy confirmed its effectiveness in the extraction of large stones in a plethora of trials.When compared with mechanical lithotripsy or with balloon dilation alone,it proved to be superior.Moreover,dilation is an ideal alternative in cases of altered anatomy where access to the papilla is problematic.Endoscopic sphincterotomy followed by large balloon dilation represents the onset of a new era in large bile duct stone extraction and the management of "impaction" because it seems that is an effective,inexpensive,less traumatic,safe and easy method that does not require sophisticated apparatus and can be performed widely by skillful endoscopists.When complete extraction of large stones is unsuccessful,the drainage of the common bile duct is mandatory either for bridging to the final therapy or as a curative therapy for very elderly patients with short life expectancy.Placing of more than one plastic endoprostheses is better while the administration of Ursodiol is ineffective.The great majority of patients with large stones can be treated endoscopically.In cases of unsuccessful stone extraction using balloons,baskets,mechanical lithotripsy,electrohydraulic or laser lithotripsy and large balloon dilation,the patient should be referred for extracorporeal shock wave lithotripsy or a percutaneous approach and finally surgery.

Gardner's syndrome: A case report and review of the literature

Gardner's syndrome is an autosomal dominant disease characterized by the presence of colonic polyposis,osteomas and a multitude of soft tissue tumors. The syndrome may present at any age from 2 mo to 70 years with a variety of symptoms, either colonic or extracolonic.We present a case of a 11-year-old female patient with Gardner's syndrome who presented with a lumbar area desmoid tumor and treated with resection of the desmoid,restorative proctocolectomy and ileal pouch anal anastomosis,A review of the current literature has been performed.

Coronary artery disease in women:From the yentl syndrome to contemporary treatment

In recent years attention has been raised to the fact of increased morbidity and mortality between women who suffer from coronary disease. The identification of the so called Yentl Syndrome has emerged the deeper investigation of the true incidence of coronary disease in women and its outcomes. In this review an effort has been undertaken to understand the interaction of coronary disease and female gender after the implementation of newer therapeutic interventional and pharmaceutics' approaches of the modern era.

The emerging epigenetics of PARK7 and its implication in neurodegenerative disease

PARK7/DJ-1 is a multifunctional protein that acts as a regulator in stress responsive cascades.Since its original discovery as a novel oncogene,DJ-1 was further implicated in the correspondingly dubbed PARK7 autosomal recessive early onset Parkinson’s Disease variant,expanding the spectrum of its pathophysiologyto neurodegenerative disease.

Hepatomusculoskeletal disorders:Coining a new term might improve the management of the musculoskeletal manifestations of chronic liver disease

Chronic liver disease can affect many body systems including the musculoskeletal system.The pathogenetic crosstalk between the liver and organs such as the brain and the kidneys has already been described with compound terms merging the organs affected by the pathology,such as the hepatorenal syndrome.Nevertheless,the musculoskeletal manifestations of chronic liver disease have not been coined with such a term to date.Because of this shortage,documenting the musculoskeletal implications of chronic liver disease in both research and clinical practice is challenging.To fill this gap,the authors propose the term hepatomusculoskeletal disorders,a compound term of Greek origin that encompasses all the body structures involved in the aforementioned pathologic crosstalk.

Cardiac risk stratification of the liver transplant candidate:A comprehensive review

Cardiovascular diseases(CVD)form a principal consideration in patients with end-stage liver disease(ESLD)undergoing evaluation for liver transplant(LT)with prognostic implications in the peri-and post-transplant periods.As the predominant etiology of ESLD continues to evolve,addressing CVD in these patients has become increasingly relevant.Likewise,as the number of LTs increase by the year,the proportion of older adults on the waiting list with competing comorbidities increase,and the demographics of LT candidates evolve with parallel increases in their CVD risk profiles.The primary goal of cardiac risk assessment is to preemptively reduce the risk of cardiovascular morbidity and mortality that may arise from hemodynamic stress in the peri-and post-transplant periods.The complex hemodynamics shared by ESLD patients in the pre-transplant period with adverse cardiovascular events occurring in only some of these recipients continue to challenge currently available guidelines and their uniform applicability.This review focusses on cardiac assessment of LT candidates in a stepwise manner with special emphasis on preoperative patient optimization.We hope that this will reinforce the importance of cardiovascular optimization prior to LT,prevent futile LT in those with advanced CVD beyond the stage of optimization,and thereby use the finite resources prudently.