Tο οξύ ιδιοπαθές οίδημα του οσχέου: μια διαγνωστική πρόκληση

The acute idiopathic scrotal edema (AISE) is a self-limited disease of unknown etiology, characterized by edema and erythema of the scrotum and the dartos, without expanding to the underlying layers of scrotum’s wall or to the endoscrotal structures. About 60 to 90% of all cases involve boys younger than 10 years old. Based on the classic references, diagnosis is made after excluding the main causes of painful scrotum, especially those that require urgent intervention. Thorough clinical examination conducted by the pediatric surgeon in conjunction with the pathognomonic findings of color flow Doppler ultrasound, especially the fountain sign, eliminate significantly the need for urgent surgical intervention of the scrotum, due to diagnostic doubts. This review article aims at presenting the most recent data about the AISE, after systematic consultation of the international referencesΕίναι αυτοπεριοριζόμενη νόσος με άγνωστη αιτιολογία χαρακτηριζόμενη από οίδημα και ερύθημα του οσχέου και του δαρτού χωρίς επέκταση στα υποκείμενα τοιχωματικά στρώματα του τοιχώματος ή στις ενδοοσχεικές δομές. Στο 60-90% των περιπτώσεων αφορά αγόρια ηλικίας κάτω των 10 ετών. Με βάση την κλασσική βιβλιογραφία η διάγνωση τίθεται αποκλείοντας τα αίτια του επώδυνου οσχέου, κυρίως αυτών που απαιτούν επείγουσα επέμβαση. Η ενδελεχής κλινική εξέταση από τον ειδικό χειρουργό παίδων σε συνδυασμό με την ανάδειξη των παθογνωμονικών ευρημάτων του Doppler έγχρωμης ροής και ιδιαίτερα του σημείου πίδακα, περιορίζει σημαντικά την αναγκαιότητα της επείγουσας διερεύνησης του οσχέου λόγω διαγνωστικής αμφιβολίας.Σκοπός της παρούσας μελέτης είναι η παράθεση των πλέον πρόσφατων δεδομένων μέσα από την αναδίφηση της πρόσφατης βιβλιογραφίας

Συστροφή όρχι κατά την εμβρυϊκή ζωή και τη νεογνική ηλικία (Περιγεννητική συστροφή όρχι)

The term perinatal testicular torsion (PTT) defines the extravaginal testicular torsion that happens either during the fetal period (prenatal testicular torsion) or the neonatal period (postnatal testicular torsion). It concerns 10-22% of testicular torsions that appear during childhood. The clinical findings of PTT after birth depend on the time of the event. In every newborn male with scrotal swelling and discoloration, while the other testis is hard, PTT should be considered as the diagnosis until proven otherwise. The treatment of PTT is discussed by the authors. Disagreement is present concerning the time and method of treatment, as well as the necessity of preventing orchidopexy of the contralateral testis. In our study, we review recent literature in order to establish an evidence based conclusion over treatment.Με τον όρο περιγεννητική συστροφή όρχι (ΠΣO) αποδίδεται η εξωελυτροειδική –κατά κανόνα- συστροφή όρχι που συμβαίνει είτε κατά την εμβρυική ζωή (prenatal testicular torsion) είτε στη νεογνική ηλικία (postnatal testicular torsion). Αφορά το 10-22% των συστροφών όρχι που συμβαίνουν κατά την παιδική ηλικία. Τα κλινικά ευρήματα της ΠΣO όπως μπορούν να εκτιμηθούν μετά την γέννηση εξαρτώνται ουσιαστικά από τον χρόνο που συνέβη η συστροφή. Σε κάθε άρρεν νεογέννητο με διόγκωση οσχέου το οποίο έχει μελανόχρωμη εμφάνιση ενώ ο σύστοιχος όρχις έχει σκληρή σύσταση θα πρέπει να θεωρείται ως πιθανή η ΠΣO μέχρι απόδειξης του αντιθέτου. Σχετικά με την ενδεδειγμένη αντιμετώπιση της ΠΣO δεν υπάρχει ομοφωνία από τους συγγραφείς. Παραμένουν οι διαφωνίες αναφορικά με τον χρόνο και την μέθοδο αντιμετώπισης καθώς και για την αναγκαιότητα της προληπτικής ορχεοπηξίας του ετερόπλευρου όρχι. Στην παρούσα μελέτη, έπειτα από την διεξοδική αναδίφηση της πρόσφατης και σχετικά περιορισμένης βιβλιογραφίας, γίνεται προσπάθεια για τεκμηριωμένη αποσαφήνιση των ζητουμένων που παραμένουν

Βilocular cystic ileal duplication

The aim of this study is to present two rare entities: a) a bilocular cystic intestinal duplication and b) the oc­currence of bleeding from the duplication due to lesions associated with chronic hemorrhagic enteritis rather than ectopic gastric mucosa. A 13-year-old male was hospitalized in the Department of Pediatrics for severe lower GI hemorrhage. During neonatal life, the boy had been hospitalized in the Intensive Care Neonatal Unit for necrotizing enterocolitis treated by peritoneal drainage (drains entered into iliac fossae bilaterally). Imaging and scintigraphic exams failed to identify the cause of the current GI hemorrhage. After a second episode of bleeding, pediatricians asked for a pediatric surgical consult and we decided to proceed to an urgent exploratory laparotomy. A diverticular lesion of considerable size and with a wide base was identified 30 cm proximal to the ileocecal valve at the antimesenteric intestinal surface. The lateral wall of the lesion was adhered to the sigmoid colon while its upper surface was adhered to the lateral abdominal wall. Our attempt to mobilize the small bowel from the sigmoid colon revealed the absence of muscular layers in both the small and large bowel walls for a length of 1.5 cm. Segmental intestinal resection including the duplication was performed followed by an end to end anastomosis in two layers. The histopathologic examination showed a bilocular cystic duplication with lesions of active chronic hemorrhagic enteritis; no ectopic gastric mucosa was identified

Epididymal Adenomatoid Tumor: A Very Rare Paratesticular Tumor of Childhood

Adenomatoid tumor is an uncommon benign mesothelial neoplasm, usually localized in the epididymis. It is the most common paratesticular tumor of middle-aged patients (average age of clinical presentation: 36 years). However, these tumors in pediatric and pubertal patients are extremely rare. Due to their rarity, we present a case of adenomatoid tumor of the tail of the epididymis in a 16-year-old patient. After systematic research of the current literature, we did not find another case report of epididymal adenomatoid tumor in a male patient aged 16 years old or less. This notice and our concern, as well, about the patient’s surveillance protocol during the postoperative period were the motive for this case study

Early data about the use of roflumilast in patients with COPD

Η ροφλουμιλάστη αποτελεί έναν νεότερο αντιφλεγμονώδη παράγοντα 2ης γραμμής για τη θεραπεία ασθενών με συγκεκριμένο φαινότυπο Χρόνιας Αποφρακτικής Πνευμονοπάθειας. Στο παρόν άρθρο μετά από αναδίφηση της πλέον πρόσφατης διεθνούς βιβλιογραφίας, επιχειρείται η παρουσίαση των έως τώρα πειραματικών αλλά και κλινικών αποτελεσμάτων, όσον αφορά στα οφέλη που προκύπτουν από τη χρήση της, τους περιορισμούς της χορήγησης της, αλλά και τις μελλοντικές προοπτικές για τη βελτιστοποίηση της δράσης της.Roflumilast is a new second line anti-inflammatory drug, approved by the FDA in March 2011, for the treatment of patients with a specific phenotype of Chronic Obstructive Pulmonary Disease (COPD). In this review article, after systematically reviewing the latest published references on roflumilast, we aim at presenting the experimental and clinical results that have emerged so far, concerning the benefits and the limitations of its use and the future prospects for the optimization of its effects

The Therapeutic Role of SGLT-2 Inhibitors in Acute Heart Failure: From Pathophysiologic Mechanisms to Clinical Evidence with Pooled Analysis of Relevant Studies across Safety and Efficacy Endpoints of Interest

(1) Background: Sodium-glucose co-transporter-2 (SGLT-2) inhibitors constitute a novel drug class with remarkable cardiovascular benefits for patients with chronic heart failure (HF). Recently, this class has been utilized in acute HF as an additional treatment option to classic diuretics, which remain the cornerstone of treatment. (2) Methods: We attempted to identify those pathophysiologic mechanisms targeted by SGLT-2 inhibitors, which could be of benefit to patients with acute HF. We then conducted a comprehensive review of the literature within the PubMed database in order to identify relevant studies, both randomized controlled trials (RCTs) and observational studies, assessing the safety and efficacy of SGLT-2 inhibitors in acute HF. (3) Results: SGLT-2 inhibitors induce significant osmotic diuresis and natriuresis, decrease interstitial fluid volume and blood pressure, improve left ventricular (LV) function, ameliorate LV remodeling and prevent atrial arrhythmia occurrence, mechanisms that seem to be beneficial in acute HF. However, currently available studies, including six RCTs and two real-world studies, provide conflicting results concerning the true efficacy of SGLT-2 inhibitors, including "hard" surrogate endpoints. (4) Conclusions: Current evidence appears insufficient to substantiate the use of SGLT-2 inhibitors in acute HF. Further trials are required to shed more light on this issue

Multimarker Approach as More Reliable Method Than Single Vitamin D in Relationship with Type 2 Diabetes Mellitus in Montenegrin Postmenopausal Women

Objective: Previous studies suggested that ethnic differences, sex and obesity could modify the relationship between 25-hydroxyvitamin D [25(OH)D], glycometabolic markers and/or type 2 di- abetes mellitus (T2D). We aimed to examine the potential relationship between [25(OH)D] and T2D in postmenopausal women in Montenegro. In addition, we aimed to explore if a set of biomarkers, rather than [25(OH)D] as a single biomarker, could better explain its potential association with T2D. Patients and Methods: A total of 116 postmenopausal, otherwise healthy women and 48 postmenopausal women with T2D were included. Univariable and multivariable binary logistic regression analy- sis, along with principal component analysis (PCA), were applied to test the associations between examined biomarkers/set of biomarkers with T2D. Results: Women with T2D had lower serum [25(OH)D] levels than healthy controls (p = 0.024). No independent relationship between [25(OH)D] and T2D was found. PCA extracted three significant factors that were associated with T2D, i.e., age-glycometabolic-related factor (i.e., with positive loadings of age, glucose and insulin; OR = 11.321, p < 0.001), obesity-inflammation- related factor (i.e., with positive loadings of hsCRP and WC, and negative loading of [25(OH)D]; (OR = 2.079, p < 0.001)) and lipid-related factor (i.e., with positive loadings of TG and LDL-c, and negative loading of HDL-c; OR = 1.423, p = 0.044). Conclusions: The relationship between [25(OH)D] and T2D is modulated by central obesity (as measured by WC) and inflammation (as measured with hsCRP) in postmenopausal women. Their joint measurement, rather than [25(OH)D] itself, could provide better information for the risk assessment for T2D in postmenopausal women

Editorial: Oxidative stress and inflammation in cardiometabolic disorders

Editorial on the Research Topic: Oxidative stress and inflammation in cardiometabolic disorder

Σύγχρονες τεχνικές σχεδιασμού και κατασκευής ιστοσελίδων

Η παρούσα μελέτη που διεξήχθη μέσα στα πλαίσια πτυχιακής εργασίας με θέμα &quot;Σύγχρονες τεχνικές σχεδιασμού και κατασκευής ιστοσελίδων&quot; περιλαμβάνει αρχικά τον θεωρητικό σχεδιασμό μιας ιστοσελίδας και κατόπιν τον πρακτική υλοποίησή της. Πιο συγκεκριμένα, δημιουργείται πλάνο αρχιτεκτονικής ιστοχώρου, πάνω στο οποίο εφαρμόζονται όλες οι γενικές αρχές σχεδιασμού ιστοσελίδων και ευχρηστίας, ώστε μετά να λάβει την τελική μορφή του στον φυλλομετρητή του χρήστη. Μέσα στην μελέτη συμπεριλαμβάνονται, επίσης, διάφορες τεχνολογίες του διαδικτύου και λογισμικά κατασκευής ιστοσελιδών. Ορισμένα από αυτά είναι το Wordpress το οποίο χρησιμοποιήθηκε ως σύστημα διαχείρισης περιεχομένου της ιστοσελίδας, διάφορα πρόσθετα εργαλεία του Wordpress και η γλώσσα προγραμματισμού PHP με την οποία κατασκευάστηκε ένας ανιχνευτής ιστού (web crawler). Σκοπός, λοιπόν, αυτής της μελέτης είναι η έρευνα και εφαρμογή των τεχνολογιών του διαδικτύου και των τεχνικών κατασκευής ιστοσελίδων, μέσα από τον επανασχεδιασμό της ιστοσελίδας της ερευνητικής ομάδας Green Adaptive and Intelligent Networking group (GAIN) του Τμήματος Πληροφορικής και Τηλεπικοινωνιών του Εθνικού και Καποδιστριακού Πανεπιστημίου Αθηνών.The present study conducted within the framework of a thesis on &quot;Modern Techniques of Web Design and Development&quot; first involves the theoretical design of a website and then its practical implementation. Specifically, a site architecture plan is created, on which all the general principles of web design and usability are applied, so that it then gets its final form on the user&apos;s browser. The study also includes various Internet technologies and web design software. Some of them are Wordpress which was used as a web content management system, various Wordpress plugin tools, and the PHP programming language with which a web crawler was built. The purpose of this study, therefore, is to research and implement web technologies and web design techniques through the redesign of the website of the Green Adaptive and Intelligent Networking group (GAIN) research group of the Department of Informatics and Telecommunications of the National and Kapodistrian University of Athens

Case Report Multiple Gastric Erosion Early after a 3 V Lithium Battery (CR2025) Ingestion in an 18-Month-Old Male Patient: Consideration about the Proper Time of Intervention

Introduction. Button battery ingestion is considered an emergency situation in pediatric patients that needs to be managed promptly; otherwise, it may lead to serious and potentially lethal complications, especially when it is impacted in the esophagus. Less attention has been given in cases where the battery passes into the stomach, with guidelines for emergency intervention being based on the presence of symptoms. Case Report. We present a case of an 18-month-old male patient who presented to our emergency department after button battery ingestion. He did not have any symptoms and no pathological findings were encountered during clinical examination. X-ray investigation revealed the presence of the battery in the stomach. The patient was admitted for observation and two hours later he had two episodes of vomiting. He underwent urgent endoscopic removal of the battery where multiple acute gastric mucosal erosion in place of direct contact of the battery&apos;s negative pole with the mucosa of the gastric antrum was found. Conclusion. In specific cases the urgent endoscopic intervention for removal of an ingested button battery that is located in the stomach even in asymptomatic patients should be suggested