Hippokratia
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Acute appendicitis and cholecystitis during pregnancy are the most common non-obstetrical surgical emergencies and can create severe clinical issues. Surgical treatment tends to be the method physicians recommend due to its tolerability and safety. During pregnancy, surgical intervention should minimize fetal risk without compromising the mother's health, although a favorable outcome for pregnant women is heavily dependent on accurate, early diagnosis and prompt intervention. Furthermore, the physicians should remain informed on the differences in current techniques to optimize the outcome of the operation. ⋯ Our meta-analysis and data suggest that laparoscopic appendectomy is a safer option for treatment. There is a reduced risk of fetal demise and preterm delivery for pregnant women. HIPPOKRATIA 2022, 26 (1):1-6.
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Case Reports
Giant malignant phyllodes tumor with distant metastases: a case report and review of the literature.
Phyllodes tumors (PTs) represent a rare type of breast tumor and are classified into benign, borderline, and malignant. Giant PTs, meaning those sized more than ten cm, are even rarer, most commonly malignant, and usually have a dismal prognosis due to the high metastatic potential. ⋯ Although giant PTs are uncommon, clinical suspicion should be high in rapidly growing breast mass patients. A comprehensive review of all metastatic giant MPT cases reported in the English literature emphasizes the lack of consensus regarding appropriate treatment. In the case of metastatic foci, pathologists need to be aware of the previous history to make a definitive diagnosis. Also, a comparative histopathologic study of the primary and metastatic tumors is sometimes necessary. HIPPOKRATIA 2022, 26 (1):41-45.
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The relationship between stasis dermatitis (SD), clinical factors, and heart failure (HF) outcomes in outpatients has not been previously assessed. ⋯ SD was found, for the first time, to be independently associated with DM, COPD, and increased SPAP values and determined as an independent predictor for HF-related hospitalization.HIPPOKRATIA 2022, 26 (1):13-18.
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Pregnancy poses a risk factor for respiratory infections due to hormonal changes, reduced tolerance to hypoxia, immunodeficiency, and increased susceptibility towards viral infections. Pregnant women might develop a broad spectrum of clinical conditions associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, from asymptomatic to potentially life-threatening complications. Critical respiratory failure associated with the progression of viral pneumonia is the most severe complication of the coronavirus disease (COVID-19). In some cases, it may require intubation and invasive mechanical ventilation. ⋯ Obesity, maternal age, and diagnosis of ARDS were most commonly observed in our group of patients with lethal outcomes. Preventive measurements, counseling, and enlightenment of potential risk factors, such as obesity, advanced maternal age, and pregnancy-related comorbidities, should be the cornerstones in crises such as COVID-19 when medical care and resources are limited or restricted. HIPPOKRATIA 2022, 26 (1):32-37.
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Patients with end-stage renal disease are prone to develop heart failure (HF). The N-terminal pro-brain natriuretic peptide (NT-proBNP, BNP) is regarded as the gold standard for diagnosing HF. However, its prognostic sensitivity in patients with end-stage renal disease is sub-optimal. Soluble suppression of tumorigenesis-2 (sST2) has been well studied in HF but rarely in patients with maintenance hemodialysis (MHD). This study aimed to evaluate the value of sST2 in predicting HF in MHD patients. ⋯ sST2 can predict HF in MHD patients and facilitate early diagnosis and prevention of HF in MHD patients. HIPPOKRATIA 2022, 26 (1):19-24.