Hippokratia
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Brucella spp. isolation is one of the mainstays of brucellosis diagnosis. Simultaneously, the true brucellosis disease rate may be underrepresented in notification systems. This study aims at assessing the nosocomial capacity for Brucella spp. isolation and the underreporting rate of brucellosis cases in Greece. ⋯ Interventions for improving diagnosis and reporting of the disease are recommended. Assessment of brucellosis underreporting by comparing raw numerical data of survey-captured isolations and officially notified cases lacks the case by case specificity, however, keeping required data to a minimum achieves high feedback rate from hospitals and provides a tentative estimation of the notification deficit. HIPPOKRATIA 2019, 23(3): 106-110.
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Case Reports
Posterior reversible encephalopathy syndrome as a complication of bacterial meningitis.
Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome, which is presented with headache, seizures, altered mental consciousness, and visual disturbances, and is characterized by white matter vasogenic edema, predominantly affecting the posterior occipital and parietal lobes of the brain. This clinical syndrome is increasingly recognized due to the improvement and availability of brain imaging and, more specifically, magnetic resonance imaging. ⋯ PRES is a neurotoxic state characterized by a unique brain imaging pattern typically associated with a number of complex clinical conditions including infection, sepsis, and shock. The syndrome should be promptly recognized since it is reversible and treatable. HIPPOKRATIA 2019, 23(2): 131-134.
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In advanced cirrhotic patients, extensive mesenteric vein thrombosis extends the operative time, causes peri- and postoperative complications, and increases the mortality and morbidity in liver transplantation (LT). The anastomosis between the left renal vein and graft portal vein is one of the crucial options in such patients. However, especially in living donor liver transplantation (LDLT) practice, limited cases are published in the literature. ⋯ In LT, for providing efficient portal flow to the graft, the RPAs should be considered as an option in case of extensive splanchnic vein thrombosis and large splenorenal shunt. Ensuring that graft volume is close to the recipient standard liver volume, RPA can be performed safely and effectively in LDLT as an acceptable and life-saving procedure. HIPPOKRATIA 2019, 23(3): 140-142.