Hippokratia
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Hemoglobin Adana is a non-deletional alpha chain mutation, particularly rare, and to date, it is mostly described in coinheritance to other a-thalassemia mutations. Such interactions result in various phenotypes depending on the underlying genotype. Since routine hematological tests do not detect the aforementioned unstable variant, it is quite likely a diagnosis to be missed or delayed, with any complications this may have for a patient. Description of the case: A case report of late mutation identification in a 64-year-old woman of Greek origin is described. The importance of conducting not only molecular studies to confirm common mutations, such as the -a3.7 kb deletion, but also DNA studies in patients whose phenotype and results of standard tests are not consistent or who present with severe, late complications is highlighted. ⋯ The awareness of the necessity for accurate diagnosis is raised, especially in populations that thalassemia prevails and is attributed to numerous mutations. HIPPOKRATIA 2020, 24(1): 38-42.
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The postoperative supplementary motor area (SMA) syndrome may complicate unilateral surgery involving the SMA cortex and manifests as contralateral or global akinesia, mutism, or speech deficit, with complete or major recovery in weeks to months. ⋯ Prevention of SMA syndrome is not always possible in resective surgery. Given its favorable prognosis, it should be well known to the health professionals of different specialties engaged in such patients' postoperative care. The possibility of SMA should be preoperatively discussed with the patients and caregivers. HIPPOKRATIA 2020, 24(1): 38-42.
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Complicated cholecystitis (CC) is the severe form of acute cholecystitis (AC). Clinical, radiological, inflammatory, or biochemical parameters are used to predict presence of CC. We aimed to evaluate the Glasgow prognostic (GPS) and modified systemic inflammation scores (mSIS) that are used to predict presence of CC. ⋯ CRP, WBC, and NEU could be used to predict presence of CC. The combination of CRP or LMR with albumin could be a positive but weak predictor of CC, and it is quick, easy to use, and reliable. HIPPOKRATIA 2020, 24(1): 15-20.