First postoperative day review after uneventful phacoemulsification cataract surgery: Is it necessary?

BACKGROUND: Our purpose was to examine the value of the first postoperative day review after uneventful phacoemulsification cataract surgery. METHODS: 291 patients who underwent uneventful phacoemulsification were randomized into two groups (ClinicalTrials.gov Identifier: NCT01247155): i) Next day review (NDR group, n = 146) and ii) No next day review (NNDR group, n = 145). The rate of complications, percentage of patients seeking non-scheduled medical consultation up to postoperative day 14, presence of any inflammation-related sign and best corrected visual acuity (BCVA) on postoperative day 28 were analyzed. RESULTS: In the NDR group, 5.5% of patients developed a postoperative complication, whereas the respective rate was 6.2% in the NNDR group. The difference was not statistically significant (p = 0.791). The most frequent complications were: elevated intraocular pressure, allergy to postoperative treatment, corneal abrasion, punctuate epitheliopathy, iris prolapse and postoperative hyphema, whose rates did not differ between the two groups. The rate of patients seeking non-scheduled medical consultation up to postoperative day 14, presence of any inflammation-related sign, as well as BCVA on day 28 did not exhibit any significant differences between the study groups. CONCLUSIONS: First postoperative day review could be omitted in cases of uneventful cataract surgery

Health-related Quality of Life in Vacuum-Assisted Breast Biopsy: short-term effects, long-term effects and predictors

<p>Abstract</p> <p>Background</p> <p>The impact of Vacuum-assisted breast biopsy (VABB, 11-Gauge) upon Health-related Quality of Life (HRQoL) remains an open field. This study aims to: i) assess short-term (4 days after VABB) responses in terms of HRQoL after VABB, ii) evaluate long-term (18 months after VABB) responses, if any, and iii) examine whether these responses are modified by a variety of possible predictors (anthropometric, sociodemographic, lifestyle habits, breast-related parameters, reproductive history, VABB-related features and complications, seasonality).</p> <p>Methods</p> <p>This study included 102 eligible patients undergoing VABB and having benign lesions. A variable number of cores (24-96 cores) has been excised. HRQoL was assessed by EQ-5D and SF-36^®questionnaires: i) in the morning of the VABB procedure day (baseline measurement), ii) four days after VABB (early post-biopsy measurement) and iii) 18 months after VABB (late post-biopsy measurement). Statistical analysis comprised two steps: i. evaluation of differences in EQ-5D/SF-36 dimensions and calculated scores (baseline versus early post-biopsy measurement and baseline versus late post-biopsy measurement) and ii. assessment of predictors through multivariate linear, logistic, ordinal logistic regression, as appropriate.</p> <p>Results</p> <p>At baseline patients presented with considerable anxiety (EQ-5D anxiety/depression dimension, EQ-5D TTO/VAS indices, SF-36 Mental Health dimension). At the early post-biopsy measurement women exhibited deterioration in Usual Activities (EQ-5D) and Role Functioning-Physical dimensions. At the late measurement women exhibited pain (EQ-5D pain/discomfort and SF-36 Bodily Pain), deterioration in Physical Functioning (SF-36 PF) and overall SF-36 Physical Component Scale (PCS). Mastalgia, older age and lower income emerged as significant predictors for baseline anxiety, whereas seasonality modified early activities-related responses. Pain seemed idiosyncratic.</p> <p>Conclusions</p> <p>The HRQoL profile of patients suggests that VABB exerts effects prior to its performance at a psychological level, immediately after its performance at a functioning-physical level and entails long-term effects associated with pain.</p

GRČKA BOLNICA I LJEKARNE U SMIRNI (1723. – 1922.)

From the mid-18th century to the mid-20th century, Greek doctors in Smyrna collaborated with pharmacists, churches, and the city’s Greek Orthodox community to create a state of-the-art health network and charitable foundation to serve physical and mental health needs of the local community. At Graekikon Nosokomion o Agios Haralampos (Greek Saint Charalampos Hospital), or the Greek Hospital, every citizen, regardless of origin, language, religion, or economic status, had access to the most appropriate medical and pharmaceutical care. Neighborhood pharmacists complemented this care by administering vaccinations and preparing medicines. Smyrna’s pivotal influence on the Greek medical community ended in August 1922, when the Greek Hospital was destroyed during the Catastrophe of Smyrna.Od sredine 18. do sredine 20. stoljeća grčki liječnici u Smirni surađivali su s farmaceuti-ma, crkvama i gradskom grčkom pravoslavnom zajednicom kako bi stvorili najsuvremeniju zdravstvenu mrežu i dobrotvornu zakladu koja će služiti fizičkim i mentalnim zdravstvenim potrebama lokalne zajednice. U Graekikon Nosokomion o Agios Haralampos (grčka bol-nica Saint Charalampos), ili Grčkoj bolnici, svaki je građanin imao pristup najprikladnijoj medicinskoj i farmaceutskoj skrbi bez obzira na podrijetlo, jezik, vjeru ili ekonomski status. Farmaceuti u kvartovima nadopunili su tu skrb cijepljenjem i pripremanjem lijekova. Ključ-ni utjecaj Smirne na grčku medicinsku zajednicu završio je u kolovozu 1922. kada je grčka bolnica uništena tijekom katastrofe u Smirni

Sexually Transmitted Infections in a Cohort of 15,921 Refugees (1926-1940) in the Region of Imathia, Northern Greece

This historical epidemiological study evaluates sexually transmitted infections (STIs) among Greek refugees during the Interwar period in the region of Imathia, Central Macedonia, Greece, as a part of the effort against sexually transmitted infections in Greece (1910-1940). We examined the archives of the Refugee Hospital of Veroia – the capital of the regional unit of Imathia (March 5, 1926 to October 27, 1940). This is a report of previously unpublished primary material comprising a cohort of 15,921 cases, among whom 41 patients were hospitalized on account of syphilis and 19 on account of gonococcal infection. Descriptive statistics were estimated. Primary (n=4), secondary (n=2), tertiary (n=13), congenital (n=7), and not further specified (n=15) cases of syphilis were identified, whereas a variety of differential diagnosis problems arose. Syphilis and gonococcal infection/gonorrhea seemed to affect various social groups, as evidenced by the variety of professions involved. Refugee patients originated from various areas such as Caucasus, Thrace, Constantinople, Bithynia, and Pontus. Lack of information and poor healthcare led to spreading of STIs in Greece. Law 3032/1922 was crucial for the Greek effort against sexually transmitted infection

Sexually Transmitted Infections in a Cohort of 15,921 Refugees (1926-1940) in the Region of Imathia, Northern Greece

This historical epidemiological study evaluates sexually transmitted infections (STIs) among Greek refugees during the Interwar period in the region of Imathia, Central Macedonia, Greece, as a part of the effort against sexually transmitted infections in Greece (1910-1940). We examined the archives of the Refugee Hospital of Veroia – the capital of the regional unit of Imathia (March 5, 1926 to October 27, 1940). This is a report of previously unpublished primary material comprising a cohort of 15,921 cases, among whom 41 patients were hospitalized on account of syphilis and 19 on account of gonococcal infection. Descriptive statistics were estimated. Primary (n=4), secondary (n=2), tertiary (n=13), congenital (n=7), and not further specified (n=15) cases of syphilis were identified, whereas a variety of differential diagnosis problems arose. Syphilis and gonococcal infection/gonorrhea seemed to affect various social groups, as evidenced by the variety of professions involved. Refugee patients originated from various areas such as Caucasus, Thrace, Constantinople, Bithynia, and Pontus. Lack of information and poor healthcare led to spreading of STIs in Greece. Law 3032/1922 was crucial for the Greek effort against sexually transmitted infection

Neutrophil gelatinase-associated lipocalin in dehydrated patients: a preliminary report

<p>Abstract</p> <p>Background</p> <p>Acute kidney injury has been recognized as a major contributor to end stage renal disease. Although neutrophil gelatinase-associated lipocalin (Ngal) has been reported as a promising biomarker for early detection of acute kidney injury, no study has yet examined its potential clinical impact in patients with normal renal function. The purpose of current study is to investigate possible difference in serum Ngal levels between dehydrated and control patients.</p> <p>Findings</p> <p>A total of twelve patients presented with symptoms of mild dehydration defined by history of diarrheas or vomiting and orthostatic (postural) hypotension and an age and sex matched group of twelve control patients were included. The two groups of patients did not seem to differ in basic clinical and laboratory parameters. Serum Ngal was higher in dehydrated patients when compared to control group (Ngal = 129.4 ± 25.7 ng/mL vs 60.6 ± 0.4 ng/mL, p = 0.02). Ngal was not correlated with age, hemoglobin, white blood cell count, red blood cell count, urea or creatinine.</p> <p>Conclusions</p> <p>The presence of elevated Ngal levels in dehydrated patients may suggest its role as a very sensitive biomarker in even minimal and "silent" prerenal kidney dysfunction</p

Volume of blood suctioned during vacuum-assisted breast biopsy predicts later hematoma formation

<p>Abstract</p> <p>Background</p> <p>To evaluate whether the volume of blood suctioned during vacuum-assisted breast biopsy (VABB) is associated with hematoma formation and progression, patient's age and histology of the lesion.</p> <p>Findings</p> <p>177 women underwent VABB according to standardized protocol. The volume of blood suctioned and hematoma formation were noted at the end of the procedure, as did the subsequent development and progression of hematoma. First- and second-order logistic regression was performed, where appropriate. Cases with hematoma presented with greater volume of blood suctioned (63.8 ± 44.7 cc vs. 17.2 ± 32.9 cc; p < 0.001, Mann-Whitney-Wilcoxon test for independent samples, MWW); the likelihood of hematoma formation was increasing till a volume equal to 82.6 cc, at which the second-order approach predicts a maximum. The volume of blood suctioned was positively associated with the duration of the procedure (Spearman's rho = 0.417, p < 0.001); accordingly, hematoma formation was also positively associated with the latter (p = 0.004, MWW). The volume of blood suctioned was not associated with patients' age, menopausal status and histopathological diagnosis.</p> <p>Conclusion</p> <p>The likelihood of hematoma is increasing along with increasing amount of blood suctioned, reaching a plateau approximately at 80 cc of blood lost.</p