Review of Studies Concerning the prevelance of dislipidaemia in Greece

Hippokratia 2003; 7(3):99-107

D Psirropoulos
2nd Dpt Internal Medicine, Hippokratio general Hospital, Thessaloniki, Greece

Abstract

The determination of coronary artery decease (CAD) as a multi factorial in 50's preceded the determination of its "classic" risk factors in 60's, such as dyslipidaemia, diabetes mellitus, blood pressure, smoking, obesity, heredity and of course preceded the determination of the newer risk factors, such as coagulation-fibrinolysis factors, endothelium dysfunction, inflammation factors, metabolic syndrome e.t.c. CAD is the first reason for mortality in global scale and this further contributes to the extended effort for understanding its nature and to the certification of its risk factors through epidemiological studies. The lipids disorders and the risk coming from them constitute, in global stage, still the most important aim for these studies. The present study is an effort to write down the studies done in Greece from 1950 and after, having as a main objective the status of lipids disorders. Concerning the Greek reality the most of the studies done either extensive or restricted, were about special sub-groups of the general population, f.e. habitants of specific cities or persons of specific age groups or only males while the most data for the classic risk factors come from the Seven Countries Study which lasted more than 30 years. In spite of some exceptions, periodic repeated tests according the international experiences and demands and especially the corresponding introductions of W.H.O., were not achieved. The gap in the scientific knowledge, concerning the incidence of the CAD risk factors in Greece, still remains wide.

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Protruding ears - Surgical reconstruction. A 12 year retrospective study in Otoplasty

Hippokratia 2003; 7(3): 108-112

St Triaridis, Iord Konstantinidis, Ath Triaridis, I Petropoulos, N Benis, K Karagiannidis, G Kontzoglou
ENT Clinic, Hippokratio General Hospital, Thessaloniki, Greece

Abstract

The auricle has a significant role in facial symmetry. Protruding ears may be a source of psychological distress in either sex and at any age. For this reason surgical reconstruction becomes often necessary, having as a rule a truly gratifying psychological response to a well performed otoplasty. In a period of 12 years (1990-2002) 112 patients underwent an otoplasty with the use of several techniques in ENT Department of Hippokratio General Hospital of Thessaloniki. More specifically 46 patients underwent an otoplasty with converse technique, 23 patients with Mustarde technique, 14 patients with Stark-Saunders technique, 8 patients with Stenstrom-Bergstrom technique, 11 patients with Furnas technique and 10 patients with Epstein-Kabaker technique. The vast majority of patients had an excellent outcome in a follow up appointment 6 months to 1 year postoperatively. In cases of weak cartilage, techniques using sutures were preferable. When the cartilage was strong, then a cartilage-weakening procedure was chosen. Complication rate was extremely low. Early complication was seen in only 1 patient who developed perichondritis and treated successfully with antibiotics and ointment. Late complications included 5 cases of residual deformity and 2 cases of granulomas as a reaction in nonresorbable sutures. We present our results and analyze the advantages and disadvantages of each technique and the complication rate, with a revue of the current literature.

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Primary hyperaldosteronism due to a rennin-responsive adenoma. A case report

Hippokratia 2003; 7(3):119-124

B Batakoias, M Kita, D.G Goulis, D Gakis, M Leontsini, A Avramides
Endocrinology Dpt, Hippokratio General Hospital, Thessaloniki, Greece

Abstract

A case of primary hyperaldosteronism in a 57-year-old female patient with unilateral adrenal adenoma (aldosterinoma) is presented. Serum aldosterone was very high at supine position (22.0 ng/dl, normal range 1.0-10.5) in spite of the low levels of plasma renin (0.23 ng/ml/h, normal range 0.20-2.70) and was notably increased after standing at upright position (131.0 ng/dl, normal range 3.4 Œ27.3), suggesting a renin-responsive lesion. Computed tomography revealed an adenoma of the left adrenal gland. Adrenal scintigraphy during dexamethasone suppression showed unilateral radiotracer uptake at the left side. The left adrenal gland was removed and an aldosterone-producing adenoma was confirmed by histologic examination. Four months after surgery, serum potassium and plasma aldosterone levels were normal and a marked decrease of blood pressure to normal levels was observed.

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Auricular emergenicies. Three years experience in a District General Hospital

Hippokratia 2003; 7(3): 113-118

St Triaridis, Iord Konstantinidis, Ath Triaridis, N Benis, K Karagiannidis, G Kontzogloy
ENT Clinic, Hippokratio General Hospital, Thessaloniki, Greece

Abstract

The auricle has a significant contribution in the symmetry and aesthetic appearance of the face. Traumatic disfiguring injuries of the auricle often have a significant post-traumatic psychologic distress. Treatment of traumatic and infectious conditions of the auricle concerning the exact reconstruction of the anatomical details is challenging for the surgeon. Different locations and extent of auricular injuries and infections demand different therapeutic strategies. The insufficient treatment results in mostly difficult secondary conditions. During a 3 years period (1998-2001) 202 patients with external ear injuries, 17 patients with auricular haematomas and 195 patients with auricular inflammations were treated by the ENT department of Hippokratio General Hospital concerning the 1,1% of all ENT emergencies. In the group of patients with auricular injuries the aesthetic result after surgical reconstruction was very good in 195 patients with complete preservation of all anatomical structures of the auricle. Only 7 patients had disfiguring result because of large missing parts or necrotic areas of the auricle. In the management of 27 auricular haematomas, 18 patients were treated with drainage and tied bandage and 9 patients with drainage, suturing with splints from a folley catheter and bandage. The group of patients with suturing of the auricle, had significantly decreased need in days for tied bandage, a fact which significantly improves patient's quality of life. Inflammatory conditions of the auricle were treated with iv antibiotics and drainage in cases of abscesses. All patients had complete recovery without secondary auricular deformity. Surgeons have to preserve all anatomical structures of the auricle in order to avoid the development of significant post-traumatic psychologic distress.

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Diagnosis and Treatment of visceral leischmaniasis: A retrospective analysis of six patients

Hippokratia 2003; 7(3): 125-131

K Tziomalos, V Perifanis, A Karagiannis, N Krikis, P Semertzidis, A Diakou, V Garypidou, N Harsoulis
2nd Dpt Internal Medicine, Hippokratio General Hospital, Thessaloniki, Greece

Abstract

The clinical manifestations and treatment of six male adult patients from North Greece who were diagnosed with visceral leishmaniasis during 2001-2002 are being presented. The mean age of the patients was 36 years (range 18-60 years), only one reported contact with animals and none was HIV positive. The mean interval from the onset of symptoms to hospital admission was 3.2 months. Splenomegaly was observed in all the patients, hepatomegaly in five, while fever was present in four of them. Thrombocytopenia was observed in all patients, leukopenia in five, while anaemia was present in one of them. A bone marrow myelogram was obtained in all cases and Leishmania amastigotes were found in three of the patients. Three patients were treated with meglumine antimonate and the rest with liposomal amphotericin B. One patient who received meglumine antimonate relapsed and subsequently was treated successfully with liposomal amphotericin B. Our findings demonstrate the diverse clinical image of visceral leishmaniasis and suggest that liposomal amphotericin B should be considered as treatment of choice, since it is both safe and effective.

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Angioplasty and stenting of left internal carotid artery in cases of abnormal origin of left common carotid (bovine arch)

Hippokratia 2003; 7(3):132-137

Th Gerasimidis, K Konstantinidis, A Kambaroudis, K Papazoglou, D Karamanos, G Sphiroeras, E Zaphiriadou, A Phileli
5th Surgical Dpt, Hippokratio General Hospital, Aristitle University of Thessaloniki, Thessaloniki, Greece

Abstract

Left common artery arisen from the innominate artery ("Bovine arch" variation) is an anatomical variation which is considered to increase the difficulty of endovascular treatment of carotid occlusive disease. The aim of this study is to present our results and experience in patients with this anatomical variation. It refers to 6 (5.2%) (out of a total 115 cases) male patients with symptomatic carotid occlusive disease, (m.v. 71 years old), all of which had stenosis > 75%, 4 of them with residual neurological sign as well as different concomitant diseases and deteriorating factors (hypertension, hyperlipidaimia, diabetes mellitus). All patients underwent successful endovascular treatment with angioplasty and stenting of internal carotid artery. None of the patients developed any complication involving deterioration of neurological signs. On the contrary, postoperative control came up with improvement of blood flow in carotid arterial system. This study proves that ihbovine archli is not a contradiction for the choice of CAS in carotid stenosis even without the use of distal cerebral protection devices.

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Severe interstitial pneumonia due to Coxiella Burnetti infection. A case report

Hippokratia 2003; 7(3):138-142

E Mendrinou, P Georgakopoulos, G Liaros, A Notoropoulos, I Ravani, K Dragotis, G Siempos, V Ntontou, A Regli
Microbiology Dpt of "St Andreas" General Hospital of Patras,
Intensive Care Unit, "St Andreas" General Hospita; of Patras
Nuclear Dpt, "AHEPA" University Hospital of Thessaloniki, Thessaloniki, Greece

Abstract

We present a case of a 41-years old male with severe interstitial pneumonia due to Coxiella Burnetii infection. The infection evolved on ARDS and the patient was supported with mechanical ventilation under sedation in the Critical Care Unit. The diagnosis was based on seropositive tests (an ImmunoFluorescence Assay - IFA). The severe general situation and the insisting respiratory failure with refractory hypoxemia, obliged us to use prone position ventilation twice, for 24h each time, although the patient was non responding. After the 9 th day of hospitalization, the patient was getting better. A difficult weaning started on day 13 but he was tracheostomised on day 15 and was eliberated from ventilator on day 23. We used the antibiotics Erythromycine, Rifampicine and Vancomycin although Tetracycline is reffered as the antibiotic of choice in Coxiella Burnetti Pneumonia. The patient had a good outcome with few sequelae as pulmonary fibrosis in middle lobe and lingula, detected with CT scan, but without functional respiratory disturbances on spirometry.

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