Patient and treatment characteristics and safety outcomes of patients with relapsing-remitting multiple sclerosis treated with natalizumab in Greece: Results from the multicenter, 5-year prospective observational study 'TOPICS greece'.

Background: Natalizumab is a highly efficacious treatment for relapsing-remitting multiple sclerosis (RRMS).

Objective: To assess the real-world long-term safety of natalizumab in RRMS.

Methods: This multicenter, 5-year prospective observational study, included adults with RRMS newly initiated on natalizumab as per the approved product label in the routine care in Greece.

The onset of multiple sclerosis in Greece: a single-center study of 1,034 consecutive patients.

Background/aims: The onset of multiple sclerosis (MS) in Greece has not been systematically studied. We sought to provide data on the onset of MS in Greece with detailed information regarding initial symptoms, and to confirm the prognostic significance of demographic and clinical factors at onset.

Methods: We studied 1,034 consecutive patients with MS and independently assessed 265 patients 'seen at onset'.

Subacute thyroiditis presenting as fever of unknown origin.

Subacute thyroiditis is a painful, inflammatory disease of the thyroid gland, probably of viral origin. It is an uncommon but important cause of fever of unknown origin (FUO). We report a case of a 72-year-old man who presented with a 1 month history of fever, headache and weakness, and in whom extensive evaluation only revealed subacute thyroiditis.

Superficial siderosis due to a lumbar ependymoma mimicking adult-onset spinocerebellar ataxia.

Superficial siderosis (SS), as a result of chronic subarachnoid haemorrhage and haemosiderin deposition on the leptomeninges and subpial layers of the brain, cerebellum and spinal cord, can cause ataxia, pyramidal tract lesions and hearing deficits. In cases with not pronounced hearing impairment adult-onset spinocerebellar ataxia can be considered as a differential diagnostic alternative. We report a similar case where the diagnosis of SS was established by means of gradient echo MRI sequences 5 years after symptom onset.

Alterations in arterial blood parameters in patients with liver cirrhosis and ascites.

In cirrhotic patients, in addition to hepatocytes and Kuppfer cells dysfunction circulatory anatomic shunt and ventilation/perfusion (V(A)/ Q) ratio abnormalities can induce decrease in partial pressure of oxygen in arterial blood (PaO(2)), in oxygen saturation of hemoglobin (SaO(2)) as well as various acid-base disturbances. We studied 49 cases of liver cirrhosis (LC) with ascites compared to 50 normal controls. Causes were: posthepatic 37 (75.

Fever of unknown origin due to dental infections: cases report and review.

Persistent undiagnosed fever remains a common problem in clinical practice. In a variable number of cases, no definitive diagnosis is made. This lack of a clear etiology indicates that certain disorders are not being detected despite the recently developed technology usually applied in this situation.

Pericardial involvement as an atypical manifestation of giant cell arteritis: report of a clinical case and literature review.

Purpose: Pericardial effusion has been known to be a rare manifestation of giant cell arteritis. During the last six decades, only 24 cases have been cited in the literature. In this report, we describe the case of a patient presenting with nonspecific symptoms and development of pericardial effusion.

Autoimmune cholangitis presented as fever of unknown origin.

Autoimmune cholangitis is a rare chronic cholestatic liver disease. Fever of unknown origin is defined as a temperature higher than 38.3 degrees C that lasts for more than 3 weeks with no obvious source despite appropriate investigation.

Splenic abscess due to Staphylococcus lentus: a rare entity.

Splenic abscess is an unusual condition, most often seen in immunocompromised patients. Splenic abscesses are due to aerobic and anaerobic bacteria, fungi and parasites, Staphylococcus aureus being the most common aetiological agent. We describe a case of splenic abscess in an alcoholic patient due to Staphylococcus lentus, a rare aetiology included in the microbiology of this disease.

[Reversible pathological gambling under treatment with pramipexole].

In the recent past, pathological gambling has been increasingly reported to be related with dopamine agonist application in patients with Parkinson's disease. We present the case of a female patient whose gambling behavior occurred shortly after reaching the final dose of a combined levodopa and pramipexole therapy and resolved completely after stopping pramipexole. Pathological gambling seems to be a rare and serious but reversible adverse reaction to treatment with dopamine agonists of which clinicians should be aware in patients with Parkinson's disease.

Parotid mass due to cat scratch disease.

Cat scratch disease (CSD), due to Bartonella henselae, is a self-limited chronic lymphadenopathy. A previously healthy 22-year-old woman presented with a palpable painful swelling in the right submandibular region accompanied by enlarged cervical lymph nodes. A diagnosis of B.

Consequences of the discontinuation of antihypertensive treatment in successfully treated patients.

Hypertension is probably the most important public health problem in developed countries. Over the last 40 years, an increasing number of hypertensive patients have been treated with various antihypertensive drugs. If the blood pressure (BP) is controlled, the discontinuation of the antihypertensive drug may result either in a relapse of the disease or in the maintenance of normal BP for a long time.

Meningitis associated with familial Mediterranean fever.

Neurologic involvement in patients with familial Mediterranean fever is relatively uncommon, and rarely described in the literature. Although headache occurs frequently, meningitis and convulsions are rare. We describe the case of a 30-year-old man with attacks of meningitis.

An increase in creatine kinase secondary to acute pancreatitis: a case report.

Creatine kinase (CK) activity is found in high concentrations in skeletal muscle, cardiac muscle and brain. Here, we describe a 64-year-old woman with acute pancreatitis and elevated serum CK activity. This association is extraordinarily rare.

The 20-year outcome of the charnley arthroplasty in younger and older patients.

The purpose of this study is to present the 20-year outcome of 206 Charnley low-friction arthroplasties done by the same surgeon on 181 patients who were separated into two age groups (younger and older). In Group A (76 patients, 92 hips) the mean age at surgery was 44 years (range, 24-55 years), and in Group B (105 patients, 114 hips) the mean age at surgery was 65 years (range, 56-82 years). All patients were evaluated clinically and radiographically.

Withdrawal syndrome following cessation of antihypertensive drug therapy.

In this study, a review of the available information concerning abrupt withdrawal of antihypertensive drug therapy is presented. Abrupt withdrawal of these drugs can produce a syndrome of sympathetic overactivity that includes nervousness, tachycardia, headache, agitation and nausea 36-72 h after cessation of the drug. A withdrawal syndrome may occur after discontinuation of almost all types of antihypertensive drugs, but mostly occurs with clonidine, beta-blockers, methyldopa and guanabenz.

Left atrial myxoma prolapsing into the left ventricle. Case report and review of the literature.

Cardiac myxomas are rare tumors which may present differently. Left atrial myxoma is an entity from anatomopathological and clinical aspects. To the best of our knowledge, only 2 cases of infected left atrial myxomas treated surgically have been reported in the last 6 years.

Fever of unknown origin in carcinoma of the colon.

Objective: To report a case of fever of unknown origin in a patient with carcinoma of the colon but without gastrointestinal symptoms.

Clinical Presentation And Intervention: A 65-year-old man presented with a long-standing fever (of 38 degrees C, about two months' duration), night sweats, fatigue, malaise and anxiety. General physical examination including rectum, radiographic examinations of the chest, abdomen and bones (including ultrasonography and CT scanning) was normal.

Infectious mononucleosis, diffuse pneumonia and acute respiratory failure in an elderly woman.

Infectious mononucleosis (IM) is a benign disease and is frequently associated with mild respiratory symptoms. The pulmonary manifestations rarely dominate the clinical picture. We report a case of an older adult patient with IM who developed diffuse pneumonia and acute respiratory failure.

Penetration of antimicrobial agents into the prostate.

In the present review article, the penetration of antimicrobial agents into prostatic fluid and tissue was examined. Three major factors determining the diffusion and concentration of antimicrobial agents in prostatic fluid and tissue are the lipid solubility, dissociation constant (pKa) and protein binding. The normal pH of human prostatic fluid is 6.

Pleural effusion in temporal arteritis.

A 73-year-old woman was admitted to hospital with a one-month history of temporal headache, low-grade fever, fatigue, nocturnal sweats and pleural pain. On the fifth day after admission she developed chest pain at the left site of the thorax, productive cough and progressive dyspnea. A pleural effusion was revealed on physical examination, as well as a bilateral temporal artery thickening.

Biliary excretion of antimicrobial drugs.

The development of drugs able to prevent and cure bacterial infections is one of the 20th century's major contributions to human longevity and quality of life. Antibacterial agents are among the most commonly prescribed drugs of any kind worldwide. Used appropriately, these drugs are lifesaving.

Infectious endocarditis due to Yersinia enterocolitica.

Yersinia enterocolitica is a gram-negative coccobacillus. Y. enterocolitica infection is acquired by humans via the oral route.

Trimalleolar fracture with a double fragment of the posterior malleolus: a case report and modified operative approach to internal fixation.

Fractures of the medial and lateral malleoli are frequently associated with fractures of the posterior malleolus, comprising trimalleolar fractures. The posterior fragment may be posteromedial or posterolateral and its size determines the necessity for surgical or non-surgical treatment. The authors describe a case of trimalleolar fracture with double involvement of the posterior malleolus, both a posteromedial and posterolateral fragment.