Hippokratia
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In recent years, interscalene brachial plexus block (ISB) and selective supraclavicular nerve block (SNB) have been associated with successful outcomes in the treatment of fractures of the clavicle while avoiding complications. Description of the case: A 67-year-old male sustained a fracture of his right clavicle following a fall. Regional anesthesia was favored for his treatment after obtaining informed consent as he would have been exposed to high risk if treated under general anesthesia due to his medical history of coronary artery disease and chronic obstructive pulmonary disease. Ultrasound-guided combined application of ISB and selective SNB were utilized with a low-dose local anesthetic without the occurrence of any intraoperative or postoperative complication. ⋯ Low-dose ISB and selective SNB can be effectively and safely used for clavicular fracture treatment procedures, especially in patients who have a low pulmonary reserve. HIPPOKRATIA 2019, 23(1): 25-27.
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The prevalence of childhood obesity has increased in Greece as well as worldwide. Mediterranean diet is considered the world's most popular healthy eating pattern. C-reactive protein (CRP) has been shown to play an important pathophysiological role between inflammation and cardiovascular diseases and has been linked to obesity. Our study aimed to investigate the adolescents' diet, their high-sensitivity CRP (hs-CRP) serum levels, and whether low-grade inflammation, present in obesity, is related to adolescents' diet. ⋯ Comparing the three groups (obese, overweight, and controls), we found statistically significant differences for food constituents but not for hs-CRP serum levels. In our study, inflammation was not found to be correlated with any of the dietary constituents. Further studies in a larger sample are required to consolidate these findings. HIPPOKRATIA 2019, 23(1): 3-8.
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Bowel intussusception in adults remains a rare and constant diagnostic challenge for surgeons. It has an incidence of around 2-3 new cases per million per year, and its primary cause is benign or malignant neoplasms of the small bowel and colon. This report aims to outline the importance of high clinical suspicion regarding intussusception in adults presenting with abdominal pain in the emergency department. Case report: This is a retrospective review of three cases of adult ileocecal intussusception that were treated in a single surgical department in three years (2015-2018). All patients underwent right hemicolectomy in keeping with the principles of surgical oncology. Each patient had a different clinical presentation, while, in terms of the underlining pathology, the first had an adenocarcinoma of the ascending colon, the second an adenocarcinoma of the ileocecal valve, and the third one an inflammatory fibroid polyp of the ileocecal valve, also known as Vanek's tumor. ⋯ Large bowel intussusception in adults is quite an interesting entity, not only for its rarity but for its non-specific and atypical clinical presentation as well. High suspicion from the clinician's part and availability of a computed tomography scan is the key to diagnosis. It is not unusual for imaging modalities to be unable to identify the cause of the intussusception. Thus, surgery is always the preferred method of treatment, as, more often than not, a neoplasm of the small or the large bowel is the underlining pathology. HIPPOKRATIA 2019, 23(1): 37-41.
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Signal peptide-CUB-EGF-like domain-containing protein 1 (SCUBE1) is expressed in vascular endothelium and human platelets. SCUBE1 levels are increased in acute arterial thrombosis. Multiple myeloma patients are also at increased risk of arterial thrombotic events. This study aimed to measure SCUBE1 levels in newly diagnosed multiple myeloma patients and to define whether SCUBE1 could be a useful marker determining the arterial thrombotic risk. ⋯ SCUBE1 level measuring does not help to predict the arterial thrombotic risk in multiple myeloma patients. The significantly lower levels of SCUBE1 in multiple myeloma patients are likely to be due to defective platelets and/or increased TNF-α cytokines and is another proof of platelet dysfunction seen in these patients. HIPPOKRATIA 2019, 23(1): 21-24.
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Experimental and clinical studies have shown the cardio-protective, anti-inflammatory, and anti-atherosclerotic actions of vitamin D. ⋯ Children and adolescents with T1D and normal vitamin D levels do not exhibit changes in LV dimensions or diastolic function, except for increased IVSD, compared to controls. Larger and longitudinal studies are required to confirm and consolidate this finding. HIPPOKRATIA 2019, 23(1): 9-14.