Human Sexual and reproductive rights

Hippokratia 2005, 9 (2): 51-53

V Karagiannis, A Mamopoulos, P Petropoulos, N. Ververidou, Th Karagiannis

Abstract
Human sexual and reproductive rights.In 1995, the International Planned Parenthood Federation, bearing in wind the goals of family planning, has created a charter of protection of the human sexual and reproductive rights. The aim of that charter is to delineate the moral limits within which men and women, equally, claim their sexual and reproductive rights, which are fundamental elements of the normal development both of a human being but, also, of the society as a whole.This charter gives the right to national Family planning Federations, to intervene whenever and wherever there is a violation of these rights, according to internationally accepted rates of behavior. Sexual and reproductive rights are summarized in 12 ?articles? that concern individuals and couples of all nations, races, religions, political beliefs and sexual orientation.

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Acidosis of cardiac arrest. The use of bicarbonates

Hippokratia 2005; 9(2):54-59

G Efstratiadis, E Damvopoulou, G Tsiaousis
Nephrology Dpt, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Abstract

Cardiac arrest and the subsequent acidosis consist a major clinical challenge in the Intensive Care Unit, and anywhere Medicine is practiced. The effort to optimize its treatment led to the reconsideration of the axiom of administering bicarbonate, through experimental (in animal models and in humans) and clinical research, which contributed to a better understanding of the acidosis that accompanies cardiac arrest. The sort of acid-base disturbance that characterizes cardiac arrest is described, as well as its exact biochemical basis and the methods used to monitor its course. Finally, the arguments in favour of and against the use of bicarbonate are discussed, and the guidelines concerning this issue presented.

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Churg-Strauss syndrome

Hippokratia 2005; 9(2):65- 72

A Papadopoulou, P Boura
2nd Dpt Internal Medicine, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Abstract

Churg- Strauss syndrome (CSS) is a form of primary systemic vasculitis, which mainly affects the lower respiratory tract, the nervous system, the gastrointestinal system , heart, skin and kidneys. The incidence of CSS in asthma populations is high. Its exact pathogenesis remains unknown; hyperresponsivness to an antigenic stimulus seems to initiate disease process. In asthmatics, cysteinyl leykotriene receptor type antagonists are reported to trigger the disease. Its pathophysiology is not clearly understood. Stydies concerning the cytokine profile of lymphocytes involved in CSS, suggests that it may be a Th2 mediated disease, although it seems that all types of hypersensitivity reactions take part. Leading laboratory findings are eosinophilia and normochromic normocytic anemia together with elevated IgE, while ANCA are found in approximately 50% of all patients with CSS, but their clinical significance is under researh. Therapeutic protocols include corticosteroids, immunosuppressive regimens and interferon-a, while future alternative treatment protocols target to cytokine inhibition, such as IL-5 and TNF- a.

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Diabetes mellitus type 2 and coronary heart disease

Hippokratia 2005; 9(2):73-79

Boudonas G.E.
2nd Dpt Internal Medicine, Hippokratio General Hospital, Thessaloiki, Greece

Abstract

It is well known that type 2 diabetes is a major risk factor for atherosclerosis and coronary artery disease. Recently, a large amount of evidence, suggests that this relation possibly is deeper and the metabolic disorders initiating both diseases may be common. This article is a review of the pathogenetic mechanisms by which the metabolic disorders leading to or caused by type 2 diabetes are leading to atherogenesis and coronary artery disease. The pathogenesis of type 2 diabetes and the epidemiological evidence confirming the correlation between diabetes and atherogenesis are also briefly discussed. Particularly, the relationship between insulin resistance with the concomitant hyperinsulinaemia and the atherogenesis is reviewed; the effect of fasting plasma glucose, postprandial hyperglycaemia, good glycaemic control (measured by means of HbA1c) as well as the oxidation and glycosylation of plasma and cell membrane proteins on the mechanisms of atherogenesis is discussed. Finally, the possible relation between gene polymorphisms and pathogenesis of atherosclerosis in type 2 diabetic patients is reviewed. It seems that insulin resistance, the initial perturbation of type 2 diabetes mellitus and metabolic syndrome, and the impaired endothelial function, central component of atherogenesis, are often silent partners that present many years before the onset of type 2 diabetes mellitus. Therefore, strategies of early diagnosis and management of both diseases is of increased importance.

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The TIMI risk score and its prognostic implication to acute coronary syndromes

Hippokratia 2005; 9(2): 80- 86

I Vogiatzis, T Karamitsos, E Kambitsi, M Kachrimanidou, D Samanidis, P Prodromidis
Cardilogy Dpt, General Hospital of Veria, Veria, Greece

Abstract

Background: Patients with Unstable Angina / Non ST segment elevation myocardial infarction (UA / NSTEMI) present a wide spectrum of risk for death and new cardiac ischemic events. It is useful to develop a simple risk score, easily calculated at patient presentation, with broad applicability, to identify patients at risk and with different responses to treatments for UA / NSTEMI. The aim of the study is to examine the clinical application of TIMI Risk Score and its prognostic significance to risk stratification of patients with acute coronary syndromes (UA / NSTEMI).
Methods. 380 patients (295 patients with UA and 85 patients with NSTEMI) were studied (mean age 65.7+18.73 years). Timi Risk Score was achieved for each patient using the summation of seven variables (value of 1 when the variable was present at patient admission) : age > 65 years, at least 3 factors for coronary artery disease, prior history of coronary artery disease, at least 2 anginal events in prior 24 hours, ST segment deviation on electrocardiogram at presentation, elevated cardiac markers and use of aspirin in prior 7 days. End points were all cause mortality and complications (new or recurrent MI, ischemia, urgent revascularization) through 30 days and the relationship with TIMI Risk score.
Results. Event rates increased significantly as the TIMI Risk Score increased : 0.64 % for Score 0 / 1, 8.4 % for Score 2, 8.48 for Score 3, 10.9 % for Score 4, 21.2 % for Score 5, 23.64 % for Score 6 and 32.72% for TIMI risk score 7 (p=0.04 by x2). There was a significant interaction between TIMI Risk Score with female gender (p=0.05) and no interaction with biochemical factors as lipids, fibrinogen, CRP.
Conclusion. In patients with UA / NSTEMI the TIMI Risk Score is a simple prognostic scheme that categorizes a patients' risk of death and cardiac events and provides a basis for therapeutic decision making.

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Heart failure after thiazolidinedione therapy

Hippokratia 2005; 9(2):87-91

Ch Sambanis, K Tziomalos, E Kehagia, E Nakou, E Randou, E Kountana, T Didangelos, D Karamitsos
2nd Propedeutic Dpt Internal Medicine, Hippokratio General Hospital, Thessaloniki, Greece

Abstract

Background. Thiazolidinediones are a group of hypoglycemic agents that enhance insulin sensitivity and improve glycemic control in patients with type 2 diabetes. Their main side effect is fluid retention, which might lead to congestive heart failure. The aim of this study was to report the clinical characteristics of nine patients with type 2 diabetes who developed heart failure after the administration of thiazolidinediones.
Methods. Nine patients with type 2 diabetes (six females), with a mean age of 71.7 years (range 63-82 years), who were receiving thiazolidinediones (6 of them rosiglitazone and 3 pioglitazone), were included in this study.
Results. All patients were admitted in our Department because of symptoms and signs of heart failure (3 manifested acute pulmonary edema and six worsening heart failure). All patients had experienced weight gain (range 2.5-7 kg), peripheral edema, exertional dyspnea and one of them unstable angina. These signs and symptoms developed at a median time of 1,9 months (range 1-3 months) after the initiation of thiazolidinedione treatment. Eight patients had coronary heart disease (documented by their history and ECG), three had a history of pulmonary edema, eight were hypertensive, five were receiving loop diuretics and two were receiving insulin. Therapy for heart failure was provided and thiazolidinediones were discontinued. All patients showed a decrease in body weight, and edema and dyspnea resolved rapidly.
Conclusions. Administration of. thiazolidinediones is associated with an increased risk of development of heart failure in patients with type 2 diabetes who often have multiple risk factors for heart failure. Heart function should be carefully evaluated prior to the initiation of thiazolidinedione treatment and patients should be closely monitored, particularly during the first three months of treatment.

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Family planning in the 3rd Obstetric and Gynecologic Clinic of Aristotelian University of Thessaloniki

Hippokratia 2005; 9(2):92-94

M Karagiannis, D Rousso, A Mamopoulos, J Tsimbanakos, Th Karagiannis
3rd Dpt Obstetrics & Gynaecology, Hippokratio General Hospital, Thessaloniki, Greece

Abstract

Family planning is defined as the right of the parents to decide, with their willingness, about the number of children they wish to have; this should always be in accordance to the rules of health that guarantee the safe process of pregnancy and the health of mother and child. The aim of family planning is the prevention of undesired pregnancies using several methods of contraception, the preclusion of illnesses that obstract the reproductive ability and the prenatal control that leads to a healthy newborn. The Family Planning Outpatient Department of the 3rd Dept of Obstetrics & Gynecology accepts people that proceed for contraception councelling. It also accepts pregnant women who ask for prenatal control or for artificial abortion. In this clinic, about 200 artificial abortions are conducted every year. Only 10% of these abortions are done for medical reasons, with the rest 90% for several social- economic reasons.

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Lead in building paints as a risk factor of human health

Hippokratia 2005; 9(2):60-64

SN Kamenopoulos

Abstract

Lead is a metallic element that has long been recognized as a health hazard especially to small children. Chronic exposure to lead causes damage to blood forming organs, kidneys and reproductive organs. The exposure to lead-based paint residential environments can be directly from painted surfaces or, more commonly, from dusts and soils that have been contaminated by lead-based paint. This article is an effort to describe current conditions in Greece concerning lead-based paints.

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