Syncope in the elderly from cardiological point of view

Hippokratia 2005; 9(4):147-153

DZ Psirropoulos
Cardiology Division, 2nd Dpt Internal Medicine, Hippokratio Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Abstract

Syncope is attributed to neurogenic reflexes , orthostatic hypotension, arrythmias, heart diseases or cerebrovascular diseases . The usual syncope causes in elderly are orthostatic hypotension (20-30%) ,hypersensitivity of carotid sinus (>20%) , vasovagal reflexes (>20%) and arhythmias (>20%) .The existence of heart disease and the advanced age are the strongest predictors for acute death in the elderly patients with syncope history.The syncope management is easier achieved when it is directed towards the responsible causes.The management of otherwise healthy elderly patients with at least one syncopic episode is similar to that of younger patients.In contrary , the management of weak or very old patients is modified in respect to their prognosis.

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Management of cancer pain

Hippokratia 2005; 9(4):154-160

R Gbandi, Z Kanonidou
3rd Anesthesiology Dpt, Hippokratio General Hospital, Thessaloniki, Greece

Abstract
Cancer pain is one of the most frequent common syptoms in all patients with advanced cancer disease. However ,cancer-related pain is often poorly treated ,resulting in unnecessary suffering of these patients. Recent advances of research in the field of pathophysiology of cancer pain,have contributed to discovering of new knowledge and to increasing understanding of the possible pathophysiological mechanisms that are involved in the generation and treatment of cancer pain.AS a result systematic approach of pain treatment based on specialized knowledge is being increasingly adopted, leading to the creation of pain clinic where pain is treated more like any other chronic disease.Applying specific approach in the treatment of cancer pain has shown that such pain can be managed effectively in almost all cases. The suggested approach includes the following four steps: 1) Identification of the cause and the possible mechanism of the cancer pain, 2) Assesment of pain and other clinical syptoms of patients on the bases of clinical history , examination and investigation, 3) Selection and appliance different modalities of available treatment for cancer pain, 4)Regular review and reassesment of the treatment.

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Spiral CT angiography in the evaluation of the renal arteries in patients with renal hypertension

Hippokratia 2005; 9(4):161-166

I Tsitouridis, Z Chrondromatidou, P Papapostolou, F Goutsaridou, M Emmanouilidou, Ch Tsadiridis, Ch Papastergiou

Abstract

The purpose of our study is to present our experience in the diagnostic value of CTA in the evaluation and management of patients with suspected renovascular disease.We describe the technique of CTA and the advantages of 3D-reconstructions of renal arteries.From our study ,the conclusion is that CTA is the method of choice in the evaluation of renal arteries in patients with suspected renovascular disease ,and also we must aware of a small percentage of stenosis overestimation.

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The role of spiral computed tomography in complications of abdominal aortic aneurysms treated with stent grafts

Hippokratia 2005; 9(4):167-172

G Grollios, D Daravingas, E Chartampilas, K Tsinoglou, M Kalovoulos, G Anastasiou
1st Radilogy Dpt, Hippokratio General Hospital, Thessaloniki, Greece

Abstract

The objective of our retrospective study of 212 patients, is to reveal , with the assistance of computed tomography, the complications of abdominal aortic aneurysms treated with stent-grafts.
As a result we had 31 patients who presented endoleak,1 patient with trombosis of one limb a bifid stent-graft, 1 patient with partial occlusion of the right renal artey and 5 patients who exhibited cruro-inguinal hematoma.
Conclusively, spiral computed tomography is the modality of choice in the detailed examination of stent-graft complications in abdominal aortic aneurysms.

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The contribution of three dimensional computed tomography imaging in the diagnosis of craniosynostosis

Hippokratia 2005; 9(4):173-179

G Grollios, Ir Kazantzidou, G Anastasiou, D Daravingas, M Siopi, K Tsinoglou, Gr Terzis, K Tsarouchas
1st Radiology Dpt, Hippojkratio General Hospital, Thessaloniki, Greece

Abstract

The purpose of this study is to demonstrate the role of three-dimentional computed tomography(3D-CT) in the diagnosis and study of the various types of craniostenosis and to help the correct management of the disease .32 children ,with a clinical indication of craniostenosis or suspicion of the disease after a CT-scan ,were examined with a three-dimensional reconstruction of the acquired axial CT images. The age of the examined children ranged from 12 days to 5 years. In every case, the diagnosis of craniostenosis was clear .Moreover the possible coexistence of other intracranial lesions or congential disease was investigated.The surgical repair was planned based on the results of the three -dimensional CT reconstruction .Our study also included the Siamese sisters who exhibited craniosynostosis at the six-month follow-up follow-up after their succesful separation.
In conclusion , we can claim that three-dimentional computed tomography ,combined with classic axial CT imaging contributes to the diagnosis of the type of craniosynostosis , providing detailed information about the extent of the disease and revealing also possible coexisting intracranial disease; Finally, 3D-CT can be used as a base for the surgical planning of patients with craniosynostosis.

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Treatment of Diabetes Melitus

Hippokratia 2005; 9(4):180-183

An. Chamalidou-Alexiadou
Dpt Internal Medicine, "St. Pavlos" General Hospital, Thessaloniki, Greece

Abstract

The treatment of diabetes melitus consists of psysical exercise, diet, oral, hypoglycemic agents , insulin, and whole pancreas or islet cell transplantation.Diet and physical exercise are of high importance in both type I and type II diabetes. Insulin treatment is absolutely necessary in type I diabetic patients and in many type II diabetic patients.Pancreatic transplantation.Finally islet transplatation is actually experimental.

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