Adult vaccination. A priority of the late 90ties

Hippokratia 1998, 2(1):7-15

F. Kanakoudi-Tsakalidou

Abstract

Vaccination of susceptible adults is mainly targeting: 1. To protect them from a vaccine preventable disease which may have an adverse outcome. 2. To prevent a spread of the disease either to specific population groups who may suffer serious consequences or to the general population with the risk of disease outbreaks. Nowadays, vaccination of adolescents and adults is a necessity for two more reasons: First, because of the failure of various Organizations, Committees etc to eradicate all the vaccine preventable diseases even from the developed countries and second, because of the change of the epidemiologic scenery in the 90ties that affected many countries, Greece among them. Adults have to be vaccinated with almost all vaccines recommended for children unless they have acquired natural immunity after exposure. However, there are certain adult high risk population groups which must be immunized at least against certain vaccine preventable diseases because of their job or living conditions or style of life or age etc. The recommended schedule for vaccinating adults depends on their immunization status (vaccines given during childhood). The strategy of vaccination in a country is determined by the epidemiological conditions of this country, its Health Care System, financial factors and the targets that have been put as far as the future of the disease is concerned (eradication, reduction of morbidity, control of an epidemic).

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Allergic reactions after Hymenoptera sting

Hippokratia 1998, 2(1):16-21

I. Sidiropoulos

Abstract

Allergic reactions after Hymenoptera Sting are a serious problem for a part of the population, although in our country the frequency of the severe reactions is relatively low (3-4%). Therapeutic confrontation of such reactions involves: a) Avoidance, b) Drug therapy and c) specific immunotherapy. Especially the allergen specific venom immunotherapy appears to be an effective treatment.

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Operation of cardiological outpatient clinic during 24 hour emergency service in Northern Greece

Hippokratia 1998, 2(1):22-27

A. Efthimiadis, N. Lefkos, I. Papadopoulos, G. Kazinakis, M. Hatzihasan

Abstract

The purpose of our study is the retrospective assessment of the cardiological outpatient clinic movement during a 24 hour emergency service in Northern Greece, according to the number of the patients who were examined, the urgent management applied; the way of the selection and the types of the admitted patient?s diseases. The cardiological outpatient clinic records were retrospectively studied the period from 8-6-1995 to 30-8-1996. The total number of the cardiological patients examined was 3321 (M = 1842, F = 1479, aged 14-99 years). A detailed medical history and a 12 lead ECG recording were obtained from all patients. The treatment of the severely ill patients (acute pulmonary oedema, shock etc) was started with their presentation at the outpatient clinic and continued at the coronary care unit. The main symptom was chest pain in the majority of the examined patients (2360) dyspnoea in 473, palpitation in 442 and syncope in 47. The diagnosis in the 1044 patients who were admitted (M = 578, F = 466, mean age 64.7?12.6 years) was ischaemic heart disease in 525, acute pulmonary oedema in 69, paroxysmal atrial fibrillation in 105, paroxysmal atrial tachycardia in 85, congestive heart failure in 75, valvulopathy in 40, atypical chest pain in 90, syncope in 20, acute or chronic pericarditis in 30, while in 5 pts dissection of the aorta was diagnosed. During the 24 hour emergency service the main tool contributing to the correct diagnosis and so the safe treatment and the proper choice of the patients needing hospitalization is the detailed medical history in combination with the proper use of the other diagnostic methods. Ischaemic heart disease is the most often reason for patients meeting the outpatient clinic during emergency service and the greater percentage of them are males. Women presenting acute myocardial infarction were 10 years older than men. Supraventricular tachycardias, particularly atrial fibrillation was the more frequent type of arrhythmias, while valvulopathies and pericarditis were less common reason for hospitalization.

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Natural anticoagulants and lipid profile in hemodialysis patients

Hippokratia 1998, 2(1):28-31

R. Tsitamidou, K. Kynigopoulou, Gr. Dimitriadis, M. Tsardaki, K. Sombolos

Abstract

Patients undergoing hemodialysis (HD) are subject to risk of thrombotic events. Lipid disorders and abnormalities in hemostatic variables have been implicated in thrombotic events. Study's aim was to measure the plasma levels of natural anticoagulants and lipid profile in uremic patients treated with HD.In 41 non-diabetic uremic patients and in 20 healthy volunteers protein C(PC), protein S(PS) antithrombin III (ATIIII), TC, Tr, LDL-C, HDLC, Apo-A, Apo-B were measured. Results showed that HD patients had higher levels TC, Tr, LDL-C and lower values of protein C than controls. In conclusion, the lower plasma activity of PC and uremic dyslipidemia may lead to increased risk of thrombosis.

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The influence of the CHD risk factors in the long lasting progress of the patients with bypass surgery

Hippokratia 1998, 2(1):32-37

AP. Efthmiadis, N. Lefkos, F. Sugiultzoglou, I. Papadopoulos, G. Kazinakis, Ag. Mertzemekis, G. Tsapas

Abstract

Aim of the study is to stress the role of the effect of the CUD risk factors on the long-term prognosis of patients with experience on bypass surgery. Methods: 117 persons, middle aged, both sexes (M = 72, F = 45, mean age 48,5 ? 6,7), have been studied and divided in 4 groups. Group I: 20 healthy adults (M = 11, F = 9, mean age 33,1?6,8 years) who consist the control group. Group II: 21 patients (M = 15, F = 6, mean age 48,7?5,8 years) who were subjected to bypass surgery because of three vessel disease and they did not exhibit any complication two years after surgery (normal progress). Group III: 37 patients (M = 21, F = 16, mean age 55,6?5,8 years) who were hospitalized in our cardiology department for AMI during the first or the second year after the by pass operation. Group IV: 39 patients (M = 25, F = 19, mean age 56,9?11,5) who were hospitalized in our clinic for AMI, without by pass surgery. In all these patients the CHD risk factors blood glucose, serum lipids, and lipoprotein-a were defined. Also the haemostatic-fibrinolytic factors (fibrinogen, AT-III, PAI-1 and t-PA) were defined in all patients. Results: 1. Patients with bypass surgery consisted the 48% of the total number of patients who were hospitalized for AMI in our department during one year time. Significant increase of Lp(a), fibrinogen, LDL-x, PAI-1, t-PA and decrease of HDL-x and AT-III have been ascertained in patients of group III compared to those of control group and to those of group II (by pass surgery with normal progress). 2. Significant differences in the above parameters were not found out in patients with AMI regardless of by pass surgery. Conclusions: The accumulation of CHD risk factors and the disorders of heamostatic-fibrinolytric mechanisms define significantly the postoperative progress of the patients who experience the bypass surgery regardless of drug treatment for CHD.

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Silently evolving acute myocardial infarction

Hippokratia 1998, 2(1):38-41

I. Kanonidis, N. Nikolaidis, B. Pavlidis, Th. Benis, A. Platis, M. Haldoupi, C. Papadopoulos

Abstract

The cases of seven patients with silently evolving acute myocardial infarction are described. These patients were hospitalized in various departments of the Hospital for reasons unrelated to the cardiovascular system. The acute myocardial infarction was diagnosed on the basis of the electrocardiographic findings (ST elevation) which were performed in the context of the standard evaluation of the patients. The initial diagnosis was confirmed with enzyme elevation and the patients were treated in the Coronary Care Unit of the Department. In six out of the seven patients the evolution of the acute myocardial infarction was uneventful and the patients were discharged from the Hospital alive. A brief discussion of the cases with review of the literature is attempted.

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Churg-Strauss Syndrome. A case report

Hippokratia 1998, 2(1):42-45

J. Xanthopoulos, P. Papadopoulos, Ch. Preponis

Abstract
A woman aged 47, came to the outpatient clinic of ENT, with difficulty of nose breathing. With anterior rhinoscopy we found polyps in the nose. One year ago she appeared to have bronchial asthma and two months ago petechiaes on the legs. Biopsy of the skin showed allergic angiitis and granulomatosis. After she received steroids, skin lesions and bronchial asthma disappeared. In this paper, we present this case of Churg-Strauss syndrome because of its very rare appearance in Otorhinolaryngology. A discussion follows which includes the relative informational bibliography.

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