Hippokratia
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Greece is one of the few countries in the European Union/European Economic Area, which do not report tuberculosis (TB) treatment outcome. This study aimed to assess treatment outcomes and identify possible intervening factors in patients with TB in Thessaloniki, Greece, over the period 2012-2017. ⋯ TB treatment success rate in Greece is below the World Health Organization standards. Interventions such as appropriate multidisciplinary staffing of TB centers may prove valuable in improving TB care in Greece. HIPPOKRATIA 2019, 23(4): 154-159.
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Slipped capital femoral epiphysis (SCFE) is a condition commonly affecting adolescents. It is scarcely reported in children under ten years of age, but it can be debilitating when misdiagnosed. Our purpose was to report the incidence and treatment methods of SCFE that were applied in our institution in children under the age of ten. ⋯ The diagnosis of SCFE should be considered in overweight children under the age of ten, with hip-related clinical manifestations. Treatment in this young group of patients can be demanding. K-wire and partially threaded CS fixation both provide stability and accommodate the femoral head's future growth. The use of K-wire fixation is recommended at a very young age (6-8 years of age). Orthopedic surgeons have to be aware of the increased risk of hardware-related complications when using K-wires that may have to be addressed surgically. HIPPOKRATIA 2019, 23(4): 165-168.
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Neutrophil-to-lymphocyte ratio (NLR) has been reported to be a valuable diagnostic tool in the decision-making process for surgical procedures in cases requiring urgent intervention. It was also reported that NLR could be used as an independent predictor of septic shock, hospitalization in the intensive care unit, and death in patients with a liver abscess. This study aimed to investigate the contribution of the NLR, which is a cheap and easily calculable marker, to decisions regarding surgical therapy in patients with intestinal obstruction (IO). ⋯ Similar to previous studies investigating other inflammation criteria, we found that high NLR values were statistically significant in favor of the surgical therapy group in determining the need for surgery in ileus cases. The data obtained in our study demonstrate that the NLR measurement contributes to early decision-making concerning surgical therapy in patients with IO at the time of their initial admission to the emergency department. HIPPOKRATIA 2019, 23(4): 160-164.
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Case Reports
Upper extremity pleomorphic dermal sarcoma in a patient with chronic myelomonocytic leukemia.
Pleomorphic dermal sarcoma is a potentially high-grade cutaneous spindle cell tumor that closely resembles atypical fibroxanthoma in the superficial, dermal aspects but with adverse pathological features. Chronic inflammation, as several autoimmune disorders are co-associated with chronic myelomonocytic leukemia. ⋯ Differentiating between atypical fibroxanthoma and pleomorphic dermal sarcoma is pivotal. A partial sampling of the skin lesion poses a significant pitfall, as important diagnostic features cannot be assessed. Immunosuppression seems to be involved in the pathogenesis of chronic myelomonocytic leukemia and pleomorphic dermal sarcomas, because of the advanced patient age. HIPPOKRATIA 2019, 23(4): 181-185.