Electroencephalographic abnormalities in sepsis patients in correlation to the calculated prognostic scores: A case series

OBJECTIVE: To evaluate the electroencephalographic (EEG) findings and correlate EEG findings with inflammatory biomarkers and the sepsis prognostic scores SOFA, SAPS II and APACHE II in patients who present in the Emergency Department with sepsis without clinical central nervous system involvement. METHODS: The study included seventeen patients (\u3c 70 years old) with sepsis without central nervous system involvement presenting in the Emergency Department of the University Hospital of Patras, Greece. All patients underwent neurologic examination and EEG analysis on admission to the hospital and were treated according to the international guideline protocols for sepsis. RESULTS: Six of seventeen sepsis patients had mild or moderate EEG abnormalities. We did not find any significant correlation between EEG abnormalities and inflammatory biomarkers (CRP, WBC) or commonly used prognostic sepsis scores. CONCLUSIONS: EEG could serve as a useful tool to identify brain alterations at an early stage in sepsis, before clinical sings of encephalopathy can be detected. However, the presence of EEG abnormalities does not correlate with sepsis severity as measured by the commonly used prognostic sepsis scores SOFA, APACHE II or SAPS II. Because this was a small single center observational study, large multi-center studies are warranted to confirm these findings

Continuous positive airway pressure in the treatment of COVID-19 patients with respiratory failure. A report of six cases with excellent outcome

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently considered a significant threat to global health and global economy. This new rapidly spreading virus causes enormous stress to healthcare systems as large number of patients present with respiratory failure, needing intubation and mechanical ventilation. While the industry is racing to meet the rising demand for ventilators, all the alternative respiratory support modalities are employed to save lives in hospitals around the globe. We hereby report 6 patients who were diagnosed with SARS-CoV-2 and treated with continuous positive airway pressure in a negative pressure isolated room in a tertiary center in western Greece. The rapid progression of mild flu-like symptoms to respiratory failure in all patients was controlled with the use of continuous positive airway pressure making this strategy a reasonable alternative to respiratory failure due to SARS-CoV-2 as it may avert intubation and mechanical ventilation

Perspective Chapter: Moderate Aortic Stenosis and Heart Failure With Reduced Ejection Fraction; Early Replacement or Conservative Treatment?

Aortic stenosis (AS) is the most common valve lesion among the continuously aging population with serious effect on the left ventricular ejection fraction (LVEF). If left untreated, it is associated with serious complications such as heart failure (HF), pulmonary hypertension, thromboembolic events, and even sudden death. Early diagnosis and treatment is of outmost importance to avoid the above complications but also to maintain the patient’s normal heart function. Echocardiography is the key examination that assesses the severity of the stenosis, valve calcification, left ventricular (LV) function, and wall thickness. Also new imaging methods such as cardiac computed tomography (CT) and cardiac magnetic resonance imaging (MRI) help in assessing the severity of aortic valve stenosis when echocardiography has limitations. Based on the categorization of the severity of the stenosis, its treatment is determined. Although things are clear in cases of asymptomatic disease and severe stenosis, this is not the case in moderate disease. Experts and clinical trials do not define clearly which cases can be treated conservatively and which need surgical or transcatheter intervention. The purpose of this article is to gather all the latest data on the treatment of moderate aortic stenosis, especially in patients with heart failure and low ejection fraction

Primary biliary cirrhosis and autoimmune cholangitis are not associated with coeliac disease in Crete

BACKGROUND: An increased prevalence of coeliac disease in patients with primary biliary cirrhosis has been recently reported. However, in other studies the association has not been confirmed. There have been no formal attempts to systematically evaluate patients with autoimmune cholangitis for coeliac disease. METHODS: Sera from 62 patients with primary biliary cirrhosis, 17 with autoimmune cholangitis and 100 blood donors were screened for anti-gliadin, anti-endomysial, anti-reticulin, and IgA class antibodies to guinea pig liver-derived tissue transglutaminase. Eighteen untreated coeliacs served as methodological controls. Analyses were performed by using the χ(2) and Fischer's exact tests. RESULTS: Anti-gliadin antibodies were detected in 21% of patients with primary biliary cirrhosis, 35% of patients with autoimmune cholangitis, and 3% of controls (p < 0.001). IgA class gliadin antibodies positivity was more pronounced in patients with Scheuer's stage III-IV disease (p < 0.05). Anti-transglutaminase antibodies were detected in 10% and in 18% of patients with primary biliary cirrhosis and autoimmune cholangitis respectively (p < 0.001). Anti-reticulin and anti-endomysial antibodies were negative in all patients. Duodenal biopsies were performed in 59% and 71% of patients with primary biliary cirrhosis and autoimmune cholangitis respectively, tested positive for at least one antibody class. No histological features of coeliac disease were found. CONCLUSIONS: We were unable to demonstrate an increased risk of coeliac disease in patients with primary biliary cirrhosis and autoimmune cholangitis. Our results confirm the previously reported high prevalence of false-positive anti-gliadin and guinea pig liver-derived anti-tissue transglutaminase antibodies in patients with chronic liver disease

Correlation between neutrophil-to-lymphocyte ratio and severity scores in septic patients upon hospital admission. A series of 50 patients

Introduction. The neutrophil-to-lymphocyte ratio (NLR) as calculated from the white cell differential blood count is a marker that has been used as a prognostic index when assessing patients suffering from several clinical syndromes, including sepsis. The aim of this study was to evaluate the relationship between NLR and the commonly used severity scores of sepsis SOFA, APACHE II and SAPS II in a population of emergency admitted adult patients with sepsis in a tertiary center

Κατασκευή και μελέτη δέκτη αρχιτεκτονικής software defined radio για υψηλές συχνότητες

σ.Σκοπός της παρούσας διπλωματικής είναι η παρουσίαση της μελέτης και κατασκευής ενός δέκτη Software Defined Radio, ο οποίος λειτουργεί στις υψηλές συχνότητες (HF). Η τεχνολογία των Software Defined Radio αποτελεί αντικείμενο έρευνας για πάνω από μια δεκαετία. Σκοπός της είναι οι λειτουργίες που επιτελούνται στα αναλογικά μέρη των ραδιοσυστημάτων να γίνονται πλέον ψηφιακά. Με τον τρόπο αυτό, τα ραδιοσυστήματα αποκτούν μεγάλη ευελιξία και μπορούν εύκολα να επαναπρογραμματιστούν μέσω αναβαθμίσεων λογισμικού. Η τεχνολογία των SDR βρίσκεται ακόμα σε πρώιμο επίπεδο, ωστόσο αναπτύσσεται ραγδαία. Λόγω των πλεονεκτημάτων που προσφέρει, υιοθετείται με γρήγορους ρυθμούς από τις διάφορες αγορές, όπως στρατιωτικές εφαρμογές, κινητή τηλεφωνία, δορυφορικές επικοινωνίες κ.α. Η καθιέρωση των SDR στις εμπορικές εφαρμογές θα ανοίξει τον δρόμο της δημιουργίας νέων τύπων υπηρεσιών για τον χρήστη και θα εξασφαλίσει απρόσκοπτη λειτουργία ανάμεσα σε δίκτυα που υλοποιούν διαφορετικά πρωτόκολλα και πρότυπα. Στην παρούσα διπλωματική εργασία , αρχικά γίνεται εισαγωγή στις διάφορες αρχιτεκτονικές δεκτών και στα βασικά στοιχεία από τα οποία αποτελούνται. Στην συνέχεια, παρουσιάζεται η τεχνολογία των Software defined Radio και εκτίθεται η αρχιτεκτονική των δεκτών της, τα χαρακτηριστικά τους και οι εφαρμογές τους. Τέλος, παρουσιάζονται τα χαρακτηριστικά του δέκτη που επιλέχθηκε καθώς και η διαδικασία κατασκευής και λειτουργίας του.The purpose of this thesis is to present the study and construction of a Software Defined Radio receiver who operates at High Frequencies (HF). Software defined radio is an emerging technology that has been an active research topic for over a decade. Its purpose is: All of the functions performed by analog components in radios to be software defined. This brings flexibility to radios and provides reconfigurability through simple software updates. Software defined radio technology is rapidly advancing, at least on most fronts. Due to its many advantages, it has a large rate of adoption in different markets such as defense markets, mobile communications, satellite communications etc. The wide commercial use of SDR systems will create possibilities for new kind of services for users and will allow seamless operation across networks of different protocols and standards. The thesis begins with an introduction into the different radio receiver architectures and the different analog RF components that implement them. Afterwards, Software Defined Radio receiver architecture is presented as well as its characteristics and applications. Finally, in the last chapter, we present the characteristics of the chosen SDR kit and we describe the construction process and the overall function of the receiver.Δημήτριος Κ. Γώγο

Procalcitonin as a diagnostic and prognostic marker in diabetic foot infection. A current literature review

Diabetic foot ulcers (DFUs) are a very common cause of mortality and morbidity. The distinction between infected and non-infected DFU remains a very challenging task for clinicians in everyday practice. Even when infection is documented, the spectrum of diabetic foot infection is wide, ranging from cellulitis and soft tissue infection to osteomyelitis. Procalcitonin (PCT), a well-established sepsis biomarker, has been used in the diagnosis of several infections including osteomyelitis in patients with diabetes mellitus. This review gathers and presents all the relevant data, up until now, regarding the use of PCT as an assessment tool in diabetic patients with foot infection. Current evidence suggests that PCT levels could aid clinicians in distinguishing infected from non-infected DFUs as well as in the distinction between soft tissue infection and bone involvement, but further and larger studies are warranted to confirm these findings