Factors Associated With Retinal Vessel Diameters in an Elderly Population: the Thessaloniki Eye Study

Purpose: To identify the factors associated with retinal vessel diameters in the population of the Thessaloniki Eye Study. Methods: Cross-sectional population-based study (age ≥ 60 years). Subjects with glaucoma, late age-related macular degeneration, and diabetic retinopathy were excluded from the analyses. Retinal vessel diameters were measured using the IVAN software, and measurements were summarized to central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole to venule ratio (AVR). Results: The analysis included 1614 subjects. The hypertensive group showed lower values of CRAE (P = 0.033) and AVR (P = 0.0351) compared to the normal blood pressure (BP) group. On the contrary, the group having normal BP under antihypertensive treatment did not have different values compared to the normal BP group. Diastolic BP (per mm Hg) was negatively associated with CRAE (P < 0.0001) and AVR (P < 0.0001), while systolic BP (per mm Hg) was positively associated with CRAE (P = 0.001) and AVR (P = 0.0096). Other factors significantly associated included age, sex, alcohol, smoking, cardiovascular disease history, ophthalmic medication, weight, and IOP; differences were observed in a stratified analysis based on BP medication use. Conclusions: Our study confirms previous reports about the association of age and BP with vessel diameters. The negative correlation between BP and CRAE seems to be guided by the effect of diastolic BP as higher systolic BP is independently associated with higher values of CRAE. The association of BP status with retinal vessel diameters is determined by diastolic BP status in our population. Multiple other factors are also independently associated with retinal vessel diameters

Pleurobiliary fistula, a rare complication of hepatocellular carcinoma after locoregional chemotherapy: a case report

A rare complication of the compilation of high intrahepatic biliary pressure and the formation of a subdiaphragmatic abscess is that of pleurobiliary fistula. We present a case of 67-year-old male who presented with pleurobiliary fistula following transarterial chemoembolization in a patient with a large hepatocellular carcinoma, as well as the course of the diagnostic procedures and the therapeutics interventions which took place

Primary hepatic carcinoid; a diagnostic dilemma: a case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Solid Pseudopapillary Tumor of the Pancreas: An Enigmatic Tumor

Solid pseudopapillary tumor of the pancreas is a rare pancreatic tumor that predominantly occurs in young non-Caucasian women. Although most tumors show benign behavior, malignant degeneration may occur. A case of solid pseudopapillary pancreatic tumor in a Caucasian woman is presented that was investigated by endoscopic ultrasonography (EUS), computed tomography, magnetic resonance imaging and EUS-guided fine needle aspiration. The patient underwent surgery and radiological findings are correlated with histopathology. The preoperative diagnosis of solid pseudopapillary tumor of the pancreas is challenging, frequently leading to imaging by multiple different modalities

Risk factors analysis concerning infections in general surgery

Σκοπός:Oι λοιμώξεις που ακολουθούν τις χειρουργικές επεμβάσεις αποτελούν σημαντική πηγή νοσηρότητας και θνητότητας στους ασθενείς. Με σειρά συχνότητας καταγράφονται η λοίμωξη του χειρουργικού πεδίου, η πνευμονία, η βακτηριαιμία που σχετίζεται με τον φλεβικό καθετήρα και οι ουρολοιμώξεις. Σε δύο τμήματα γενικής χειρουργικής τριτοβάθμιου νοσοκομείου διεξήχθη μελέτη ασθενών-μαρτύρων προκειμένου να εκτμηθούν οι παράγοντες κινδύνου για τις μετεγχειρητικές λοιμώξεις.Υλικά-Μέθοδοι: Ως παράγοντες κινδύνου καθορίσθηκαν: το γένος, η ηλικία, η συννοσηρότητα (σακχαρώδης διαβήτης, ηπατική ανεπάρκεια, καρδιακή ανεπάρκεια, αναπνευστική ανεπάρκεια, νόσος κολλαγόνου, νεοπλασία), η χρήση κορτικοστεροειδών, η χρήση αντινεοπλασματικών, η παχυσαρκία (>30 kg/m2), η υποθρεψία, ο χρόνος της επέμβασης (επείγουσα ή προγραμματισμένη), η ταξινόμηση της επέμβασης (καθαρή, καθαρή-μολυσμένη, μολυσμένη, ρυπαρή), η διάρκεια της επέμβασης, η φυσική κατάσταση του ασθενούς όπως καθορίζεται από το ASA score, το είδος της αναισθησίας (γενική, ραχιαία, επισκληρίδιος), η χρήση καπνού ή/και αλκοόλ.Αποτελέσματα:Η λοίμωξη του χειρουργικού πεδίου ήταν η συχνότερη μετεγχειρητική λοίμωξη στη μελέτη. Χρησιμοποιώντας μοντέλο μονοπαραγοντικής λογιστικής παλινδρόμησης οι ακόλουθοι παράγοντες βρέθηκαν στατιστικά σημαντικοί για την πρόκληση λοίμωξης (p3, και το άρρεν φύλο.Συμπεράσματα: Η λοίμωξη του χειρουργικού πεδίου είναι η συχνότερη μετεγχειρητική λοίμωξη. Παράγοντες κινδύνου στατιστικά σημαντικοί για λοίμωξη είναι ο σακχαρώδης διαβήτης, ο χρόνος της επέμβασης, ASA score >3, και το άρρεν φύλο.Background: Postoperative infectious complications are important source of morbidity and mortality in surgical patients. Surgical Site Infection (SSI), is the most common followed by pneumonia, Central Venous Catheter (CVC) bloodstream infection and Urinary Tract Infection (UTI).Methods: A case-control study was conducted in two general surgery departments trying to assess the risk factors for postsurgical infections. Gender, age, co-morbidities (diabetes mellitus, liver failure, heart failure, respiratory failure, connective tissue disease, neoplasia), use of corticosteroids, use of chemotherapeutic agents, obesity (>30 kg/m2), malnutrition, time of operation (elective or scheduled), wound classification (clean, clean-contaminated, contaminated, dirty), duration of surgical procedure, ASA score, type of anesthesia (general, epidural, spinal), smoke abuse and alcohol abuse were defined as risk factors.Results: SSI was the most common postsurgical infection in our study. The univariable logistic regression model revealed the following significant predictors (p3 and male sex, retained statistical significance (p3 and emergency procedure, are considered statistically significant

Management of Pancreatic Cystic Lesions

Background: The prevalence of undefined pancreatic cystic neoplasms (PCNs) is high in the general population, increasing with patient age. PCNs account for different biological entities with different potential for malignant transformation. The clinician must balance his or her practice between the risk of surgical overtreatment and the error of keeping a malignant lesion under surveillance. Methods: We review and discuss the clinical management of PCNs. Specifically, we analyze the main features of PCNs from the surgeon's point of view, as they present in the outpatient clinic. We also review the different consensus guidelines, address recent controversies in the literature, and present the current clinical practice at 4 different European Centers for pancreatic surgery. Results: The main features of PCNs were analyzed from the surgeon's point of view as they present in the outpatient clinic. All aspects of surgical management were discussed, from indications for surgery to intraoperative management and surveillance strategies. Conclusions: Management of PCNs requires a selective approach with the aim of minimizing clinically relevant diagnostic mistakes. Through the evaluation of clinical and radiological features of a PCN, the surgeon can elaborate on a diagnostic hypothesis and assess malignancy risk, but the final decision should be tailored to the individual patient's need

Giant hepatic hydatid cyst with sub-fascial extension treated by open minimally invasive surgery: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hepatic hydatid disease can be successfully treated by a variety of modalities.</p> <p>Case Presentation</p> <p>We report a case of a 60 year old male with giant hepatic hydatid disease who presented with a huge cystic mass in the upper abdomen. Diagnosis was confirmed by serology, ultrasonography and CT scan. The patient was treated successfully by open minimally invasive surgery with minimum breaching of the peritoneal cavity using a laparoscopic trocar to evacuate the cyst.</p> <p>Conclusion</p> <p>The use of a laparoscopic trocar through a small abdominal incision in selected patients with hepatic hydatid disease with subfascial extension can be a safe, minimally-invasive option of treatment</p