Hippokratia
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Severe or massive bleeding in cardiac surgery is an uncommon but important clinical scenario. Its existing definitions are diverse. Its characteristics constantly change during an active hemorrhage and, thus is difficult to define appropriately. ⋯ Severe perioperative hemorrhage in cardiac surgery carries significant morbidity and mortality. Currently, prediction and identification of massive bleeding is a feasible but incomplete clinical task despite the availability of effective treatment regimens. A still missing, compact definition of massive perioperative bleeding in cardiac surgery that incorporates all phases of treatment could augment clinical preparedness, allow for the development of accurate prediction tools and permit the application of well-validated protocols of management. Hippokratia 2016, 20(3): 179-186.
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Although effective treatment in terms of inducing virological and biochemical response for chronic hepatitis B (CHB) is available, its effect on the clinical course of the disease has not yet been accurately estimated. Objective of this study was to evaluate the effect of antiviral therapy and its type [interferon +/- nucleos(t)ide analogs (NAs) vs. NAs] on the occurrence of a clinical event (liver decompensation, liver transplant, hepatocellular carcinoma and death from a liver-related cause) in CHB patients. ⋯ Data from observational studies can provide useful inference, provided they are analyzed appropriately. The current study has shown that the available treatment options for CHB offer a significant clinical benefit to CHB infected individuals. Hippokratia 2016, 20(3): 214-221.
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Patent foramen ovale (PFO) is an anatomic variant that may lead to several pathological conditions, notably right to left shunt, paradoxical embolism, hypoxemia, and cerebral fat embolism. Mechanical positive pressure ventilation may increase the prevalence of PFO opening in Intensive Care Unit (ICU) patients; however, the respiratory and hemodynamic determinants of PFO opening have been poorly investigated. Contrast-enhanced transesophageal echocardiogram (ce-TEE) is considered the gold standard for PFO detection. We prospectively performed a multicenter study using ce-TEE in order to determine the respiratory and hemodynamic factors that may lead to PFO opening. ⋯ In this group of mechanically ventilated, critically ill adult patients, right ventricular dilatation and plateau pressure above 26 mmHg were significantly associated with foramen ovale opening. Hippokratia 2016, 20(3): 209-213.
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The most common histological types of invasive breast carcinomas are the invasive ductal carcinoma (IDC) and the invasive lobular carcinoma (ILC). The purpose of our study was to evaluate the role of the diffusion-weighted imaging (DWI) and the in vivo proton magnetic resonance spectroscopy (1H-MRS ) at 3 Tesla magnet in invasive breast cancer and correlate them with the dynamic contrast enhancement (DCE) and pathologic findings. ⋯ Our results are consistent with previous findings that both ADC values and choline detection in the spectrum play a significant role in establishing the final diagnosis of malignancy, especially when the kinetic pattern of enhancement is misleading. Hippokratia 2016, 20(3): 192-197.
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This study aims at demonstrating the ability of BLADE sequences to reduce or even eliminate all the image artifacts as well as verifying the significance of using this technique in certain pathological conditions. ⋯ BLADE sequence was found to decrease both flow artifacts in the temporal lobes and motion artifacts from the orbits. Additionally, it was shown to improve flow artifacts and image quality in cystic pathologies such as arachnoid cysts. Hippokratia 2016, 20(3): 244-248.