Case report: Medical cannabis-warfarin drug-drug interaction.

Aim: A case of an 85-year-old patient with concurrent use of warfarin and medical cannabis containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) is described. Warfarin continues to be a cornerstone of anticoagulation treatment despite the recent addition of FDA-approved anticoagulant agents. It is well known that warfarin has numerous drug interactions; however, much remains unknown about its interaction with THC and CBD.

A systematic review and meta-analysis for the management of Paget-Schroetter syndrome.

Objective: There is currently no general agreement on the optimal treatment of Paget-Schroetter syndrome. Most centers have advocated an interventional approach that is based on the results of small institutional series. The purpose of our meta-analysis was to focus on the safety and efficacy of thrombolysis or anticoagulation with decompression therapy.

Spirometric Values of Greek People and Comparison with ECSC and GLI Values in COPD People.

Background: During the past few years, the use of criteria introduced by Global Initiative for Chronic Obstructive Lung Disease (GOLD) is recommended for the diagnosis and classification of Chronic Obstructive Pulmonary Disease(COPD),taking into account the values of a Forced Expiratory Volume In 1 second (FEV1) and a Forced Expiratory Volume In 1 second (FEV1) to Forced Vital Capacity (FVC) ratio. In Europe, the reference values of the European Coal and Steel Community (ECSC), that were originally developed in 1993 are still used.

Aim Of The Study: The study aimed to carry out measurement of spirometric values in a healthy, non smoking Greek population, development of local equations and comparison with ECSC and Global Lung Initiative(GLI) equations, in order to see if there is a need for separate ones in everyday use.

The safety of indacaterol for the treatment of COPD.

Bronchodilators, namely long-acting inhaled β2-agonists and long-acting muscarinic antagonists, are the first-line medications for chronic obstructive pulmonary disease (COPD). The safety of these medicines is of great concern since COPD patients usually have other co-morbidities such as cardio- and cerebrovascular diseases. Areas covered: In this review we present information about the safety and the use of indacaterol in COPD.

The prognostic efficacy of beta2-microglobulin in acute pulmonary embolism.

Our aim was to prospectively assess the prognostic value of beta2-microglobulin (b2-M) in patients with acute pulmonary embolism (PE). We conducted a prospective study of 109 patients admitted in a pulmonary clinic due to acute PE. A panel of inflammatory markers including b2-M white blood cell (WBC) count and C-reactive protein (CRP) was determined for each patient.

Review of Proton Pump Inhibitor Overuse in the US Veteran Population.

A growing body of evidence provides proof that proton pump inhibitors (PPIs) are overused in the general population and that such use is associated with adverse risks and unnecessary costs. Our objective was to systematically evaluate PPI overuse in the veteran population. A literature search using MEDLINE and CINHAL databases (1946-December 2014) was performed using the search term coupled with each of the following key words: , and .

Bronchiectasis exacerbations: The role of atypical bacteria, respiratory syncytial virus and pulmonary function tests.

Background: Aside from the known role of common bacteria, there is a paucity of data regarding the possible role of atypical bacteria and viruses in exacerbations of non-cystic fibrosis bronchiectasis.

Objective: To explore the possible role of atypical bacteria (namely, Mycoplasma pneumoniae and Chlamydophila pneumoniae) and respiratory syncytial virus (RSV) as causative agents of bronchiectasis exacerbations.

Methods: A cohort of 33 patients was studied over a two-year period (one year follow-up for each patient).

Visceral leishmaniasis with endobronchial involvement in an immunocompetent adult.

Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients.

Metabolic acidosis may be as protective as hypercapnic acidosis in an ex-vivo model of severe ventilator-induced lung injury: a pilot study.

Background: There is mounting experimental evidence that hypercapnic acidosis protects against lung injury. However, it is unclear if acidosis per se rather than hypercapnia is responsible for this beneficial effect. Therefore, we sought to evaluate the effects of hypercapnic (respiratory) versus normocapnic (metabolic) acidosis in an ex vivo model of ventilator-induced lung injury (VILI).

Aerosol delivery of antimicrobial agents during mechanical ventilation: current practice and perspectives.

Critically ill patients, who develop ventilator-associated pneumonia during prolonged mechanical ventilation, often require antimicrobial agents administered through the endotracheal or the tracheotomy tube. The delivery of antibiotics via the respiratory tract has been established over the past years as an alternative route in order to deliver high concentrations of antimicrobial agents directly to the lungs and avoid systemic toxicity. Since the only formal indications for inhaled/aerosolized antimicrobial agents is for patients suffering from cystic fibrosis, consequently the majority of research and published studies concerns this group of patients.

Tuberculous pericarditis: three cases and brief review.

Tuberculous pericarditis is a form of extrapulmonary tuberculosis that is considered unusual in western coun-tries. Diagnosis is often challenging, while proper treatment has a major impact on prognosis. We present three interesting cases, with complicated or unusual manifestations of tuberculous pericarditis: a patient with cardiac tamponade as the initial manifestation of tuberculosis; a patient progressing to constriction despite adequate treatment; and a patient receiving anti-TNFalpha, who developed pericarditis in the context of immune reconstitution inflammatory syndrome.

Pulmonary drug delivery systems for antimicrobial agents: facts and myths.

Inhaled antimicrobial agents are used for the treatment of respiratory tract infections due to Gram-negative bacteria, mainly Pseudomonas aeruginosa. The effectiveness of the inhaled antimicrobial therapy is believed to correlate with the delivery system used. The objective of this review was to search for data supporting differentiation in clinical effectiveness between systems used for pulmonary delivery of antibiotics, including delivery using disposable nebulisers and oxygen flow.

Tigecycline for the treatment of patients with community-acquired pneumonia requiring hospitalization.

Pneumonia, along with influenza, is the leading cause of mortality associated with infectious diseases in the USA. Tigecycline is a novel antimicrobial agent that is active against a broad spectrum of pathogens. Our objective is to review the literature about the efficacy of tigecycline in community-acquired pneumonia (CAP).

Update on the safety of linezolid.

Background: Linezolid is still the only representative of the oxazolidinones antibiotic class. Because of its novel mechanism of action and excellent tissue penetration, it is used in a variety of approved and off-label clinical conditions.

Objectives: To review the literature (including latest publications) about the adverse events of linezolid and its overall safety.

The management of acute gastric volvulus.

Acute gastric volvulus occurs when the stomach or a part of it rotates more than 180 degrees which leads to obstruction (closed loop syndrome), that finally concludes to incarceration and ischemia of the organ. It can be observed as a result of diaphragmatic hernia, a gap of the diaphragm, pancreatic or gastric cancers, traumatic injuries and fixation anomalies. Parï first described acute gastric volvulus in 1579, in a patient with diaphragmatic injury after trauma.

Therapy of the empyema thoracis. Why not thoracostoma?

Empyema toracis can be defined as a purulent pleural effusion. From 1998 to 2003 we treated 106 patients (87 men and 19 women), aged between 23 and 82 years, affected by localized empyema toracis. All of them received initially a chest tube and 73 of them (60 men and 13 women), in combination with selected antibiotics, had an uneventful recovery.

Spontaneous pneumothorax. When and how to treat.

Introduction: Spontaneous pneumothorax, whether primary or secondary, may occur in patients with or without a history of pneumonic disease.

Aim Of The Study: From 1992 to 2002, we treated 275 patients, 230 male and 45 female, in the department of Thoracic Surgery of the General Hospital of Nikaia-Piraeus. In this study the Authors report the data concerning the frequency correlated with age, sex, causes, symptoms, as well as the ways of treatment, in order to compare them and their results with those recorded in Greek and international literature.

Sternal fracture with or without associated injuries. Assessment of the difference in the diagnosis, management and complications. Eighteen years of experience.

Aim Of The Study: To determine the incidence of sternal fracture as an isolated injury as well as those which presented with concomitant injuries, and compare them in order to manage them more effectively. The Greek and International Literature related to the subject was also reviewed.

Material And Methods: From 1984 to 2002 the Authors treated 134 patients with sternal fracture in the Department of Thoracic Surgery of their hospital, 59 males and 45 females, age from 17 to 84 years.

Sternal fractures: retrospective analysis of 100 cases.

Isolated sternal fractures are seen with increasing frequency in road accidents, especially since the introduction of seatbelt legislation. The medical records of all our patients who were treated with a diagnosis of sternal fracture (SF) over the past two decades were retrospectively reviewed to determine the incidence, morbidity, and mortality of this entity. Between 1984 and 1998, 100 consecutive patients were admitted to the Department of Surge Surgery, General Hospital of Nikea-Piraeus, Greece, for SF.

Bronchobiliary fistulae due to echinococcosis.

Objective: A bronchobiliary fistula (BBF) is a rare complication of echinococcosis due to rupture of hydatid cysts located at the upper surface of the liver to the bronchial tree. We present our experience in treating this uncommon and dangerous entity.

Material: During the last 20 years, 21 patients, ten men and 11 women ranging in age from 26 to 83 years with a BBF were treated in our department.

Management of esophageal foreign bodies: a retrospective review of 400 cases.

Objective: A retrospective study was conducted in 400 patients with esophageal foreign bodies (EFB) to assess characteristics of EFB and methods of treatment.

Methods: From 1962 through 1998, 400 patients with EFB were treated in our department on an emergency basis. There were 202 men (50%) and 198 women (49.