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Dráma, Greece

The predominant pathophysiological feature of homozygous sickle cell anemia (SCA) is the vaso-occlusion. Vaso-occlusion can be associated with painful crises, which are the primary reason for those patients to seek medical care. Vaso-occlusion is responsible for the acute chest syndrome (ACS) with large morbidity and mortality or more rarely (and especially in adults) for priapism and acute neurological events (strokes). A 10-year-old boy with homozygous SCA was admitted to the Pediatric Emergencies with painful vaso-occlusive crisis and fever. Initially he had normal chest X-ray but, after 24-hour-hospitalization, he developed ACS with new chest X-ray findings. He was treated with broad spectrum antibiotics, blood transfusions and bronchodilators and after a six-day treatment, he was significantly improved. The patient was discharged 13 days later with no other therapy at home. The possibility of ACS development should be still considered, even when a known patient with SCA presents a painful vaso-occlusive crisis with an initial normal chest X-ray. Therefore, repeated clinical examination is required and possible changes in the clinical status could indicate the necessity of a new radiographic examination. In this way, early ACS could be recognized and the catastrophic consequences due to this syndrome could be avoided. Source

Neocleous C.,General Hospital of Drama
Scottish medical journal | Year: 2012

Benign acute childhood myositis (BACM) is a rare, acute, self-limiting muscle disorder, mainly affecting school-aged boys, with an excellent prognosis, requiring no therapeutic intervention. We report a series of seven previously healthy school-aged children with clinical and laboratory findings suggesting BACM where no specific diagnostic investigations were performed. All of the children were hospitalized without any specific therapeutic intervention and were discharged after two or three days free of symptoms, residual impairment or other complication. This report emphasizes that the correct diagnosis of BACM, by considering the characteristic clinical and laboratory findings of this syndrome and by recognizing more severe pathological conditions, which must be excluded from the diagnosis, can prevent unnecessary diagnostic investigations and reassure both parents and patients of the excellent prognosis. Source

Blouhos K.,General Hospital of Drama | Boulas K.A.,General Hospital of Drama | Charalampidis C.,Democritus University of Thrace | Hatzigeorgiadis A.,General Hospital of Drama
Surgical Chronicles | Year: 2013

Introduction. Parietal endometrioma is an uncommon pathology. It can occur on all scars, most often after surgical procedure with hysterotomy. Surgical scar endometriosis following cesarean section has an incidence of 0.03% to 1.5%. The correct diagnosis is frequently overlooked due to the rarity of this entity. Case presentation. A 32-year-old female patient referred to our surgical department owing to continuous right lower quadrant pain associated with a palpable mass 25 days after the onset of symptoms. The location of the tender mass was 2 cm under the right pole of a Pfannenstiel incision performed 2.5 years before for a cesarean section. Sonography showed a 25×8 mm subcutaneous roundish hypoechoic nodule with fibrotic changes, irregularly margins and a single vascular pedicle. Wide local excision performed. Cut section demonstrated a grey white nodular tissue with areas of reddish discoloration representing hemorrhage. Histopathology revealed endometrial glands and stroma embedded in fibrous tissue. Conclusion. The clinical scenario (palpable mass near cesarean section scar and pain, especially if cyclic with menses) along with a careful sonographic examination are sufficient for a confident preoperative diagnosis of abdominal wall endometrioma. Definitive diagnosis is established only after excision and histopathology of the lesion. Source

Blouhos K.,General Hospital of Drama | Boulas K.A.,General Hospital of Drama | Hatzigeorgiadis A.,General Hospital of Drama
Updates in Surgery | Year: 2013

Although there is little evidence that bursectomy has clinical benefit, its continuing practice imposes evaluation of bursectomy-related adverse effects, especially pancreatic fistula and intestinal obstruction. The aims of this study were to provide a detailed description of the technique of bursectomy as standardized by the authors and determine if extended surgery for gastric cancer with additional bursectomy can be performed safely in Western population. A total of 72 consecutive patients of median age 76.4 years and mean ASA score grade 2.1, who submitted to D2 or D2+ gastrectomy with additional bursectomy for gastric adenocarcinoma, were prospectively studied. Bursectomy was associated with a median additional operative time of 41 min and a median additional blood loss of 65 ml. The post-operative morbidity rate was 19.4 %. Among various adverse events, pancreatic fistula was observed in three patients (4.2 %) and intestinal obstruction was observed in eight patients (11.1 %) including two cases of delayed gastric emptying, one case of afferent loop syndrome, one case of early postoperative adhesions and four cases of prolonged postoperative ileus. The in-hospital mortality rate was 1.4 %. D2 or D2+ gastrectomy with additional bursectomy can be safely performed in Western patients. Although the incidence of pancreatic fistula that we reported was low, the incidence of bursectomy-related intestinal obstruction was high and should always be kept in mind when performing extended surgery for gastric cancer. © 2013 Springer-Verlag Italia. Source

Adramerina A.,General Hospital of Drama | Xatzigeorgiou S.,General Hospital of Drama | Spanou C.,General Hospital of Drama | Tzanetis F.,General Hospital of Drama | Neocleous C.,General Hospital of Drama
Pediatric Emergency Care | Year: 2016

Foreign body aspiration (FBA) in preschool children is a worldwide challenging clinical problem that can result in life-threatening complications. Three cases of FBA in preschool children are presented. All the children were admitted to the hospital with asthma-like symptoms, without any aspiration history. Although FBAwas considered in differential diagnosis, there was no strong evidence to support this diagnosis. The persistence of symptoms despite the appropriate treatment for the asthma symptoms was the main reason for the reconsideration of FBA. All of the children underwent bronchoscopy, with the successful removal of small organic food items from the main bronchi. The main cause of FBAwas the parents' lack of awareness concerning the risk of FBA when small organic food items are provided to preschool children. These cases demonstrate that some parents are unfamiliar with the risk of FBA when small organic food items are provided to their children. It is crucial to make it understood that consideration of FBA should be maintained throughout the clinical course of patients with an acute onset of respiratory symptoms, despite the initial lack of evidence to support this diagnosis, and that parental education about the causes and hazards of this conditionmay be the best preventive measure to decrease its incidence. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Source

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