Is HbA1c an ideal biomarker of well-controlled diabetes?

HbA1c is a biomarker with a central role in the diagnosis and follow-up of patients with diabetes, although not a perfect one. Common comorbidities encountered in patients with diabetes mellitus, such as renal insufficiency, high output states (iron deficiency anaemia, haemolytic anaemia, haemoglobinopathies and pregnancy) and intake of specific drugs could compromise the sensitivity and specificity of the biomarker. COVID-19 pandemic poses a pressing challenge for the diabetic population, since maintaining optimal blood glucose control is key to reduce morbidity and mortality rates.

Optical Coherence Tomography Angiography and Multifocal Electroretinogram Findings in Paracentral Acute Middle Maculopathy.

Paracentral acute middle maculopathy (PAMM) is an optical coherence tomography (OCT) finding seen in patients with retinal capillary ischemia. In this case report, we present a case of PAMM after a transient central retinal artery occlusion and the multifocal electroretinogram (mfERG) and other multimodal imaging findings. Clinical examination, OCT angiography, OCT , fluorescein angiography, and visual fields were performed at the baseline and follow-up examinations.

Patterns of 1,748 Unique Human Alloimmune Responses Seen by Simple Machine Learning Algorithms.

Allele specific antibody response against the polymorphic system of HLA is the allogeneic response marker determining the immunological risk for graft acceptance before and after organ transplantation and therefore routinely studied during the patient's workup. Experimentally, bead bound antigen- antibody reactions are detected using a special multicolor flow cytometer (Luminex). Routinely for each sample, antibody responses against 96 different HLA antigen groups are measured simultaneously and a 96-dimensional immune response vector is created.

Implantable Cardiac Monitoring in the Secondary Prevention of Cryptogenic Stroke.

Objective: In this study, we sought to evaluate the impact of implantable cardiac monitoring (ICM) in the prevention of stroke recurrence after a cryptogenic ischemic stroke or transient ischemic attack (TIA).

Methods: We evaluated consecutive patients with cryptogenic ischemic stroke or TIA admitted in a comprehensive stroke center during an 8-year period. We compared the baseline characteristics and outcomes between patients receiving conventional cardiac monitoring with repeated 24-hour Holter-monitoring during the first 5 years in the outpatient setting and those receiving continuous cardiac monitoring with ICM during the last 3 years.

Total Osseous Calcification of the Prostate Gland.

Prostatic calculi are commonly seen in older men as their incidence increases with age. They are associated with prostate hypertrophy, chronic inflammation of the gland, prostate cancer, and rarely with other pathological conditions such as granulomatous diseases. Although typical small in size, they can seldom become giant and replace the entire prostate gland with only few cases reported in literature.

Sporadic Pituitary Stalk Hemangioblastoma: A Rare Case Report and Review of the Literature.

Supratentorial hemangioblastomas have rarely been described in the literature. Pituitary stalk hemangioblastomas are extremely rare and almost always are associated with von Hippel Lindau disease. Herein, we report a sporadic case of pituitary stalk hemangioblastoma in a 36-year-old male and review the current literature regarding this pathology.

Acute mastoiditis in infants aged six months or younger.

Objective: Bibliographic data for the management of acute mastoiditis in infants aged six months or less are very limited. This study investigated the presenting symptomatology, diagnostic and treatment options, and final outcomes in this age group.

Method: A retrospective review was conducted of all infants aged six months or less suffering from acute mastoiditis, admitted to our department between 2007 and 2017.

Procalcitonin to Reduce Long-Term Infection-associated Adverse Events in Sepsis. A Randomized Trial.

Although early antimicrobial discontinuation guided by procalcitonin (PCT) has shown decreased antibiotic consumption in lower respiratory tract infections, the outcomes in long-term sepsis sequelae remain unclear. To investigate if PCT guidance may reduce the incidence of long-term infection-associated adverse events in sepsis. In this multicenter trial, 266 patients with sepsis (by Sepsis-3 definitions) with lower respiratory tract infections, acute pyelonephritis, or primary bloodstream infection were randomized (1:1) to receive either PCT-guided discontinuation of antimicrobials or standard of care.

Noxa upregulation and 5-gene apoptotic biomarker panel in colorectal cancer.

Background: NOXA and MCL1 are involved in the intrinsic pathway of apoptosis, where Noxa selectively binds to MCL1 and prevents it from inhibiting apoptosis. Both factors are considered as potential tumour biomarkers, while MCL1 has attracted interest as target in cancer. The purpose of this study was to investigate the expression of NOXA and MCL1 in 160 CRC tumour samples, to investigate their significance, also in combination with IAPs, DR5 expression and KRAS gene mutations in CRC.

Total gastrectomy for the treatment of Menetrier's disease persistent to medical therapy: A case report.

Background: Menetrier's disease is a rare hyperproliferative protein-losing gastropathy of the gastric foveolar epithelium. It is characterized by giant hypertrophic folds, excess mucus secretion, decreased acid secretion and hypoproteinemia due to selective loss of serum proteins across the gastric mucosa. The discovery of transforming growth factor-α overexpression opened the way of epidermal growth factor receptor blockade with cetuximab as first-line treatment modality for Menetrier's disease.

[Plasmacytoid variant of urothelial bladder cancer. A single center experience.].

Introduction: Bladder Cancer (BC) is11th most common malignancy. In terms of pathology, the vast majority of patients suffer from transitional cell carcinoma. Apart from this common type of BC, there are many morphological subtypes with different oncological characteristics.

Introducing DRGs into Greek National Healthcare System, in 27 Weeks.

Experiencing a devastating and intolerable economic crisis in Greece, the National Healthcare System (GR-NHS) needed a tool to manage expenditures and quality of healthcare services. The adoption of the Australian Disease Related Group (AU-DRG) system along with the International Statistical Classification of Diseases and Related Health Problems (ICD-10) constituted the major components of the needed tool. The tool provided the means to perform the transformation of the applying reimbursement system and at the same time to monitor and control expenditures and quality of GR-NHS.

Effect of Colchicine vs Standard Care on Cardiac and Inflammatory Biomarkers and Clinical Outcomes in Patients Hospitalized With Coronavirus Disease 2019: The GRECCO-19 Randomized Clinical Trial.

Importance: Severe acute respiratory syndrome coronavirus 2 infection has evolved into a global pandemic. Low-dose colchicine combines anti-inflammatory action with a favorable safety profile.

Objective: To evaluate the effect of treatment with colchicine on cardiac and inflammatory biomarkers and clinical outcomes in patients hospitalized with coronavirus disease 2019 (COVID-19).

Neurophysiological mechanisms of hypertonia and hypotonia in children with spastic cerebral palsy: surgical implications.

Mechanism of hypertonia in cerebral palsy children is dual: a neural component due to spasticity (velocity dependent) and a biomechanical component linked to soft tissue changes. Their differentiation-which might be clinically difficult-is however crucial, as only the first component will respond to anti-spastic treatments, the second to physiotherapy. Furthermore, spasticity is frequently associated with dystonia, which is a sustained hypertonic state induced by attempts at voluntary motion.

Effectiveness of intramuscular ergocalciferol treatment in a patient with osteomalacia and insufficiency fractures due to severe vitamin D deficiency after bariatric surgery.

Vitamin D (vitD) deficiency and bone loss may occur after bariatric surgery and hence, supplementation with high oral doses of vitD may be required. Alternatively, intramuscular depot ergocalciferol, which slowly releases vitD and bypasses the gastrointestinal tract, could be administrated. We present a case of severe vitD deficiency-osteomalacia after gastric bypass operation for morbid obesity, treated with ergocalciferol intramuscularly.

In vitro activity of ceftolozane/tazobactam alone and in combination with amikacin against MDR/XDR Pseudomonas aeruginosa isolates from Greece.

Objectives: We evaluated the in vitro activity of ceftolozane/tazobactam and comparator agents against MDR non-MBL Pseudomonas aeruginosa isolates collected from nine Greek hospitals and we assessed the potential synergistic interaction between ceftolozane/tazobactam and amikacin.

Methods: A total of 160 non-MBL P. aeruginosa isolates collected in 2016 were tested for susceptibility to ceftolozane/tazobactam and seven comparator agents including ceftazidime/avibactam.