Hepatitis C in patients with renal transplantation

Hippokratia 2001; 5 (1): 3-12

Gr Miserlis

Abstract

HCV infection is a usual and significant problem either in the patient with end-stage renal disease or in the renal transplant recipient. Nosocomial transmission of HCV in the dialysis unit is a risk factor for HCV infection. HCV positive patients should be tested for HCV RNA to document active infection. Management of HCV RNA positive patients on the waiting list, includes liver biopsy before renal transplantation to provide interferon ? treatment if chronic active hepatitis is present. After transplantation, liver disease is more frequent in HCV positive patients than in HCV negative patients. In the long term, this leads to significant liver and renal graft complications. The patients have a higher risk of developing proteinuria and infections. Long terrn patient and renal graft survival rates are lower in HCV positive than in HCV negative renal graft recipients. Mortality because of liver disease and infections is higher in these patients. Nevertheless, renal transplantation is the best option for the HCV positive patient with end-stage renal disease. Transplantation of HCV positive kidneys should be offered to HCV positive recipients. Adjustment of immunosuppression and careful follow-up for early detection of proteinuria, infection, and worsening of liver disease is mandatory.

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Enzyme alterations during the period of acute ischemia and reperfusion of muscle tissue (experimental study)

Hippokratia 2001; 5 (1): 13-22

AP Kambaroudis, Th Gerassimidis, D Karamanos, Ch Passinis, Ath Sakadamis

Abstract

The purpose of this study was: a) the evaluation of the changes of the values of GOT (glutamine-transaminase), GPT (glutamine-pyruvate transaminase) and CPK (creatine - phosphokinase), during a 12-hour - period of acute muscle tissue ischemia and corresponding time of reperfusion, and b) the investigation of utilizing these changes and the evaluation of the degree of ischemic lesions and the restoration of them after reperfusion.
Methods - Material: In the right posterior limb of 15 non thorough - canines we provoked acute ischemia lasting 12 hours that was followed by reperfusion of the corresponding time by removing the cause of obstruction. Before the introduction of ischemia, 6 hours after it, 12 hours after it, 6 hours after reperfusion and 12 hours after reperfusion we obtained blood samples from systemic circulation (healthy limb was used as reference values) and from the venous circulation of the suffering limb and samples from muscle tissue from the healthy limb that was used as reference value and from the suffering limb for the evaluation of GOT, GPT and CPK.
Results: GOT and GPT in systemic circulation and in the intracellular space of the healthy muscle tissue did not show consideIable changes. In venous blood and in the intracellular space of the suffering limb during the period of acute ischemia we observed a statistically non-important increase of GOT and GPT which was observed during reperfusion as well. CPK in systemic circulation in venous blood of the suffering limb and in suffering muscle tissue was increased considerably during ischemia and remained increased during reperfusion.
Conclusion: The changes of GOT and GPT in systemic circulation and in the intracellular space of healthy muscle tissue and in the suffering limb did not correlate to the degree of ischemic changes ?or to the changes after reperfusion. The changes of CPK in systemic circulation and in venous blood of the suffering limb can be used selectively for the evaluation of the ischemic lesion. The change in CPK in the intracellular space of the muscle tissue of the suffering limb cannot be used for the evaluation of the degree of the ischemic lesion.

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The incidence of hepatitis C in students of Medical School

Hippokratia 2001; 5 (1): 26-29

J Vesiropoulos, P Mentzelopoulou, C Tsiouri, J Mauroudi, I Raptopoulou-Gigi

Abstract

The prevalence of HCV infection among srudents attending the 4th, 5th a?d 6th year of education in medica! school, consisting mainly of clinical courses, was studied in ninety (90) srudents of medical school in Aristotelion University of Thessaloniki. Forty four were men (48.8 %) and forty six were women (51.2 %) with an age ra?nge from 21 to 27 years. Fourteen of them (5.6%) were in the 4th year, thirty nine (43.3 %) in the 5th year and thirty seve? (41.1 %) in the 6th year of medical school. Our results showed that a?ti-HCV were negative in all the students participating in the present study. The students came from various places of Greece and Cyprus. Other paramerers that have been taken under consideration included a history of blood transfusion and intravenous drug abuse. Among the ninety students, one mentioned a blood transfusion in the past and ??ly one had used intravenous drugs. Conclusion: Our results showed that the incidence of HCV infection among medical students ?n our university is zero and this is possibly due to the way of life and habits of ??r students and the fact that i?travenous drug use is almost absent among medical students.

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The contribution of real-time ultrasonography and infusion cholecystography in the diagnosis of acute colecystitis

Hippokratia 2001, 5 (1): 23-25

V Papanicolaou, D Koutarelos, I Aidonidis, G Mitis, J Vardoulis

Abstract

The aim of this comparative study was to evaluate the reliability of infusion cholecystography (IC) and ultrasonography (US) in the diagnosis of acute cholecystitis. Sixty-three patients with possible clinical diagnosis of acute cholecystitis were investigated and the preoperative interpretations were correlated to operative findings in 38 of them. The diagnosis by IC was correct in 36 patients (sensitivity 95%) whereas the US sensitivity was 82% (31/38). The specificity of each one method was 100%. These findings suggest that IC can make a significant contribution in reducing the incidence of misdiagnosis in acute cholecystitis and this is of special importance when early surgery is to be the standard treatment.

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Retroperitoneal spontaneous rupture of common bile duct

Hippokratia 2001, 5 (1): 30-34

V Papanicolaou, D Koutarelos, Chr Garyfallou, D Moraitidis, D Maintas, J Vardoulis

Abstract

Spontaneous rupture of the common bile duct is an extremely rare condition. ?n unusual case of this complication with the formation of a !arge retroperitoneal abscess presenting with c!inical findings of strangulated femoral hernia is described. Hepatic iminodiacetic acid scan (Tc 99m-HIDA) was the most reliable test to show the extravasation of the bile and to confirm the perforation site. The possible etiology and the goals of operative treatment are discussed.

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Co-inheritance of hemoglobin S and hemoglobin D-Punjab: case report

Hippokratia 2001, 5 (1): 35-36

M Economou, M Athanasiou-Metaxa, Ch Tsantali, P Pratsidou, I Tsatra

Abstract

Although sickle cell disease is very common in certain Greek populations, the association of hemoglobin S with hemoglobin D, another beta chain variant, is considered extremely rare. We report a case of Hb S and Hb D co-inheritance, diagnosed ?n a 2 year old twin boy born after oocyte donation.

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Schatzki's ring: Report of two cases

Hippokratia 2001, 5 (1): 37-41

I Vougiouklis, I Arvanitakis, A Spanos, I Siopi, S Bantios, A Akriviadis, E Arvanitakis

Abstract

Schatzki's ring constitutes a rare pathologic entity of controversial rate with the characteristic clinical presentation of acute dysphagia. Diagnosis is established with barium meal or endoscopy. This is a report of two cases of acute dysphagia due to Schatzki's ring diagnosed with the aid of endoscopy and barium meal. A review is included of the features of Schatzki's ring, its rate and the different forms of rings in the lower esophagus with description of their radiological characteristics. The purpose of this study is to emphasize the existence of this pathological entity and the need for careful radiological investigation as diagnosis with barium meal depends an meticulous technique and good knowledge of the anatomy and functional physiology of the lower esophagus.

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