The AHEPA University General Hospital (Greek: Πανεπιστημιακό Νοσοκομείο ΑΧΕΠΑ), also known as AHEPA Hospital, is considered one of the biggest hospitals in Greece, based in Thessaloniki. Covers 680 beds and all the spectrum of medical and surgical specialities of medicine as well as the psychiatric sector. Is associated with the 4th Health District of Health Services of Macedonia and Thrace as an independent service, with administrative and economic autonomy. The central service of AHEPA hospital is located in the territory of Aristotle University of Thessaloniki, within the administrative region of the municipality of Thessaloniki. It is a major teaching hospital and part of the ESY (Greek: ΕΣΥ - Εθνικό Σύστημα Υγείας), the National Healthcare System of Greece. The structured areas of the hospital cover 50,000 sqm, built in several time points, to cope with the emerging needs..
In patients with Graves’ disease, the 2016 American Thyroid Association guidelines and 2018 European Thyroid Association guidelines recommend the administration of Lugol’s solution prior to surgery. The objective of this study was to evaluate whether preoperative administration of this solution in patients undergoing thyroidectomy for Graves’ disease really improves surgical outcomes. Patients who underwent total thyroidectomy for Graves’ disease, performed by high-volume surgeons, in six European centers, between 2019 and 2023, were retrospectively evaluated. Based on preoperative administration of Lugol’s solution, two groups were identified: LS Group, including patients who received this solution, and NoLS Group, including those who did not receive it. Surgical outcomes were assessed after performing propensity score matching (1:1). According to the inclusion criteria, 1380 patients were enrolled: 622 in LS Group and 758 in NoLS Group. After propensity score matching, the study population consisted of 494 patients: 247 in LS Group and 247 in NoLS Group. Regarding complications, neck hematomas managed conservatively were significantly greater in NoLS Group (P = 0.016); while unilateral recurrent laryngeal nerve injury, overall postoperative hypoparathyroidism, and temporary hypoparathyroidism were significantly greater in LS Group (P = 0.026, P < 0.001, P < 0.001; respectively). The duration of surgery and postoperative hospital stay were significantly longer in LS Group (P < 0.001, P < 0.001; respectively). Based on our findings and those of other authors, we believe that the recommendations of existing guidelines should be revised.
Background: There is increasing interest in cosmeceuticals-cosmetic regimes incorporating a specific probiotic or postbiotic strain, fully characterized genetically and phenotypically-which, when topically applied, have the ability to modulate the skin microbiome, exhibit anti-inflammatory properties and improve the overall skin appearance by reducing signs of aging. In addition, claims have been made that emotional and psychological well-being can be improved by neuroactive substances released by the probiotics in cosmeceuticals, acting via the skin-brain axis. However, claims are somewhat generalized and imprecise, and we deemed it important to look more precisely at published research relating to cosmeceuticals. There have been very few research publications on these products, identified as neurocosmetics, and they immediately provoked strong reactions from dermatologists and psychiatrists, mainly with regard to the ethical and safety aspects of their use. Objectives/Method: The present strain-centered literature evaluation aimed to select from peer-reviewed publications referring to cosmeceuticals only those dealing with fully characterized, specific probiotic strains with documented beneficial skin properties. Eligible strains found were subsequently subjected to a secondary search to ascertain whether they also demonstrated clinical, or even experimental, evidence of strain-specific psychobiotic properties. Results: From 33 strain-specific cosmeceuticals identified, only three strains-Lactococcus lactis subsp. cremoris H61, Limosilactobacillus reuteri DSM 17938, and Weizmannia coagulans MTCC 5856-demonstrated reproducible evidence of psychobiotic potential. Conclusions: Current evidence does not support the notion that cosmeceuticals are likely to directly modulate emotional states through topical application, since the coexistence of cosmeceutical and psychobiotic properties within the same probiotic strain seems to be both uncommon and highly strain-specific and therefore of little practical, generalized use.
Predicting disease progression at the individual level is essential for personalized medicine. We previously developed machine-learning tools to estimate 5-year progression risk in people with multiple sclerosis (PwMS). Such models should account for disease-modifying therapy (DMT) and objective outcome definitions. In a retrospective multicenter case–control study, we evaluated adults with relapsing–remitting multiple sclerosis (RRMS) at baseline. Using machine-learning, we developed two complementary tools for individualized 5-year risk estimation: DAAE-M, optimized for transparency, software-neutral use, and mitigation of indication bias, and ELIE, optimized for dynamic landmark-based modeling, complex treatment histories, and mitigation of immortal-time bias. Disease progression was defined using both a clinical outcome (RRMS-to-progressive MS) and an objective outcome (late-stage confirmed progression independent of relapse activity). Among 34,510 people with RRMS (72.6
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a continuum of hepatic pathological manifestations of the metabolic syndrome. Pathogenesis is not clearly understood despite recent progress, but Kupffer cells and bone marrow-derived macrophages (BMDMs) have a fundamental role. In this review, the multiple pathophysiological aspects of MASLD are presented, including genetics, insulin resistance, lipotoxicity, and inflammation. The participation of innate and adaptive immunity, as well as the implications of the recently described trained immunity, is presented. The interplay of the liver with the gut microbiota is also analyzed. A recent adipocentric theory and the various mechanisms of hepatocyte death are also described. The fundamental role of Kupffer cells and other liver macrophages is discussed in detail, including their extreme phenotypic plasticity in both the normal and the MASLD liver. The functional differentiation between pro-inflammatory and anti-inflammatory subpopulations and their protective or detrimental involvement is further described, including the participation of Kupffer cells and BMDMs in all aspects of MASLD pathogenesis. The role of macrophages in the development of advanced MASLD, including fibrosis and hepatocellular carcinoma, is analyzed and the lack of explanation for the transition from MASLD to MASH is recognized. Finally, current modalities of drug treatment are briefly presented and the effects of different drugs on macrophage polarization and functions are discussed.
Diffusion-weighted imaging (DWI) has been increasingly utilized in the emergent evaluation of acute ischemic stroke (AIS) patients. DWI enhances sensitivity and specificity and enables the use of delayed reperfusion treatments in selected cases. However, DWI is not devoid of limitations. DWI-negative AIS is not uncommon in clinical practice and is reported in up to 1 of 4 AIS patients. We reviewed the relevant literature and searched the PubMed and Google Scholar databases for studies reporting on DWI-negative AIS prevalence during the 2021-2025 time period. Additionally, we included cases from our practice to highlight key points. DWI-negative AIS prevalence was 16% in one meta-analysis and ranged from 6.9% to 23.2% in identified studies that met our inclusion criteria. The biological, pathophysiological, technical, epidemiological and clinical factors that contribute to DWI-negative stroke are presented in detail. Overall, the application of diffusion imaging modalities for stroke is not bereft of blind spots despite enhanced sensitivity. Over-reliance on advanced neuroimaging and unfamiliarity with its limitations predispose DWI to errors in AIS assessment. Awareness of the predisposing factors, treatment effect, and prognosis guides appropriate decision-making, promoting good outcomes. Prospective appropriately designed trials should address the lingering questions identified, such as the association between time of imaging and DWI negativity.
