Hippokratia
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The diagnosis of acute abdomen in the emergency setting, still remains a challenging problem. In these cases timely diagnosis and management is of great importance, while the anesthetic risk is high. The combination of the risk of an open laparotomy and the relative high likelihood of negative findings when performed, creates the need for a better approach. The alternative actually exists since 1911 when Eruheim made the first gasless laparoscopy. The aim of this study is to put back into the spotlight, gasless laparoscopy in the differential diagnosis of acute abdomen and to underline the advantages of this simple, cheap and very useful technique, especially in patients that require prompt diagnosis and have relative or absolute contraindications to general anesthesia or pneumoperitoneum. ⋯ The gasless technique for laparoscopy is an extremely useful mean of diagnosis in emergency conditions, or for patients with contraindications to undergo laparoscopy by pneumoperitoneum. Requiring only local or regional anesthesia, this technique could easily find application in diagnosis and treatment, while avoiding unnecessary laparotomies. Hippokratia 2015, 19 (1): 69-72.
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Anaplastic thyroid carcinoma (ATC) has the most aggressive progression among thyroid malignancies. Most of the patients have metastasis, especially to the lungs, liver and regional lymph nodes, at the time of diagnosis. Gastrointestinal tract metastasis of ATC has been rarely reported. We report a case who presented with gastrointestinal bleeding and was diagnosed with ATC accompanied with gastric, skin, lung and adrenal gland metastases. ⋯ We reported a case of ATC with gastric, skin, lung and adrenal gland metastases, initially presenting with gastrointestinal bleeding due to the gastric metastasis. Hippokratia 2015, 19 (1): 85-87.
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Progressive lung disease is the main cause of clinical deterioration and mortality in cystic fibrosis (CF) patients. Being able to assess the effectiveness of interventions is very significant. ⋯ LCI is more sensitive marker than FEV1 to assess the effect of IV antibiotic treatment among CF children. IV antibiotics are more effective on lung function parameters, when they are administered for an acute exacerbation, than when they are given on a regular basis. Hippokratia 2015, 19 (1): 47-52.
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The aim of this study was to investigate the disease characteristics of children with juvenile idiopathic arthritis (JIA) in southeast Turkey. ⋯ In the present study, polyarticular JIA was the predominant subtype and there were fewer patients with positive ANA or uveitis compared to previous studies. Hippokratia 2015, 19 (1): 63-68.
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Gastrointestinal stromal tumors (GISTs) represent 85% of all mesenchymal neoplasms that affect the gastrointestinal track. Aim of this study is to report a case series of 18 GISTs treated surgically in a single centre and to discuss the diagnostic and therapeutic issues regarding these tumors. ⋯ Due to non-specific presentation of GISTs, initial diagnosis of these tumors may be delayed. High clinical suspicion and knowledge of their characteristics are essentials in order to achieve an early diagnosis and lead patients to surgery as soon as possible. Hippokratia 2015, 19 (1): 73-75.