Lemierre Syndrome with Extensive Thrombosis: A Unique Case Report and Literature Review.

Background: Lemierre syndrome (LS) is a rare complication of upper aerodigestive tract infections characterized by proximal and distal septic emboli, commonly including internal jugular vein (IJV) thrombosis. Diagnosis can be challenging, and treatment delays can result in increased patient morbidity and mortality. We present a rare case of LS with extensive thrombosis and multiple sites of distal infection and a narrative review of the literature.

Can Nondisplacement Osteoporotic Pubic Rami Fracture Be Life-Threatening Injuries? A Case Report, Overview, and Algorithm Protocol for Management.

Pubic rami fractures in the geriatric population are usually osteoporotic fractures resulting from low energy trauma and are characterized as stable injuries. Established treatment of these injuries is conservative, including rest, analgesic medication, and progressive active mobilization. These injuries are life-threatened when pubic rami fractures are accompanied by acute bleeding, either from an injury to a vessel (corona mortis) or from medication (anticoagulant or antiplatelet) for comorbidities, then.

A Rare Case Report of Thyroglossal Duct Cyst Carcinoma Coexisting with Thyroid Carcinoma in an Adolescent.

Background: Thyroglossal duct cysts (TDC) represent approximately 70% of all congenital neck masses, and up to 1% of them contain thyroid tissue malignancies. Clinical presentation of TDC carcinomas is usually indistinguishable from benign tumors preoperatively, and differential diagnosis can be challenging. We present a rare case of TDC carcinoma concurrent with thyroid cancer in an adolescent.

The application of machine learning to imaging in hematological oncology: A scoping review.

Background: Here, we conducted a scoping review to (i) establish which machine learning (ML) methods have been applied to hematological malignancy imaging; (ii) establish how ML is being applied to hematological cancer radiology; and (iii) identify addressable research gaps.

Methods: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews guidelines. The inclusion criteria were (i) pediatric and adult patients with suspected or confirmed hematological malignancy undergoing imaging (); (ii) any study using ML techniques to derive models using radiological images to apply to the clinical management of these patients (); and (iii) original research articles conducted in any setting globally ().

Clinical Controversy Surrounding the Differential Diagnosis of Branchiogenic Carcinoma.

Clinical evaluation, differential diagnosis, and management of a neck mass constitute commonly encountered problems for the head and neck surgeon. An asymptomatic neck mass in adults may be the only clinical sign of head and neck cancer. A 50-year-old female patient presented with a painless, slowly enlarging, left lateral neck lump.

Serpins in Tick Physiology and Tick-Host Interaction.

Tick saliva has been extensively studied in the context of tick-host interactions because it is involved in host homeostasis modulation and microbial pathogen transmission to the host. Accumulated knowledge about the tick saliva composition at the molecular level has revealed that serine protease inhibitors play a key role in the tick-host interaction. Serpins are one highly expressed group of protease inhibitors in tick salivary glands, their expression can be induced during tick blood-feeding, and they have many biological functions at the tick-host interface.

Validation of the International IgA Nephropathy Prediction Tool in the Greek Registry of IgA Nephropathy.

Background: Immunoglobulin A nephropathy (IgAN) is among the commonest glomerulonephritides in Greece and an important cause of end-stage kidney disease (ESKD) with an insidious chronic course. Thus, the recently published International IgAN prediction tool could potentially provide valuable risk stratification and guide the appropriate treatment module. This study aimed to externally validate this prediction tool using a patient cohort from the IgAN registry of the Greek Society of Nephrology.

Effectiveness and safety of apremilast in biologic-naïve patients with moderate psoriasis treated in routine clinical practice in Greece: the APRAISAL study.

Background: Apremilast is an oral phosphodiesterase-4 inhibitor indicated for patients with moderate-to-severe chronic plaque psoriasis and active psoriatic arthritis.

Objectives: To examine the effectiveness of apremilast on Dermatology Life Quality Index (DLQI), Psoriasis Area and Severity Index (PASI) and nail, scalp and palmoplantar involvement, when administered prior to biologics.

Methods: This 52-week real-world study included biologic-naive adults with moderate psoriasis (psoriasis-involved body surface area 10% to <20%, or PASI 10 to <20 and DLQI 10 to <20).

Irrigating Acetic Acid Solution During Colonoscopy for the Detection of Sessile Serrated Neoplasia: A Randomized Controlled Trial.

Background: Misdiagnosed sessile serrated lesions (SSLs) are important precursors for interval colorectal cancers.

Aims: We investigated the usage of acetic acid (AA) solution for improving the detection of SSLs in the right colon in a randomized controlled trial.

Methods: A tandem observation of the right colon was performed in 412 consecutive patients.

Cutaneous thyroid carcinoma sixteen years after benign total thyroidectomy: a unique case.

Background: Cutaneous metastasis of papillary thyroid carcinoma is rare and is a hallmark of a locally aggressive tumor.

Case Report: We present a unique case of cutaneous thyroid carcinoma sixteen years after total thyroidectomy for multi-nodular goiter. The tumor originated from the upper anterior thoracic wall's skin and was found to invade the rostral half of the sternum's external periosteum and the caudal part of the right sternocleidomastoid muscle.

Treatment options for K. pneumoniae, P. aeruginosa and A. baumannii co-resistant to carbapenems, aminoglycosides, polymyxins and tigecycline: an approach based on the mechanisms of resistance to carbapenems.

The management of carbapenem-resistant infections is often based on polymyxins, tigecycline, aminoglycosides and their combinations. However, in a recent systematic review, we found that Gram-negative bacteria (GNB) co-resistant to carbapanems, aminoglycosides, polymyxins and tigecycline (CAPT-resistant) are increasingly being reported worldwide. Clinical data to guide the treatment of CAPT-resistant GNB are scarce and based exclusively on few case reports and small case series, but seem to indicate that appropriate (in vitro active) antimicrobial regimens, including newer antibiotics and synergistic combinations, may be associated with lower mortality.

COVID-19 and diabetes: What does the clinician need to know?

COVID-19 and diabetes are currently two global pandemics. Epidemiological studies indicate that diabetes is the second most common comorbidity in COVID-19. This review aims to summarize currently available data about prevalence, possible pathophysiological mechanisms and management of patients with diabetes and COVID-19.

Canagliflozin and Amputation Risk: Evidence So Far.

The CANVAS program detected a 2-fold increased risk of lower limb amputation in patients treated with canagliflozin compared with those with placebo. This adverse effect was not confirmed in the CREDENCE trial. Moreover, randomized controlled trials with other agents in this class, dapagliflozin and empagliflozin, did not detect increased risk of amputation.

In-hospital screening for diabetes mellitus with HbA1c in an internal medicine department was not useful; a prospective pilot study.

Background: Screening inpatients for diabetes mellitus may be a good opportunity to detect undiagnosed cases and several studies have demonstrated the feasibility and usefulness of this practice. HbA1c has been suggested as the method of choice due to the effects of acute illness on glucose. The aim of this study was to evaluate a screening protocol based on HbA1c to identify inpatients with undiagnosed diabetes mellitus in an internal medicine department.

Euglycemic Diabetic Ketoacidosis Secondary to Dapagliflozin in a Patient with Colon Malignancy.

The use of sodium-glucose cotransporter 2 (SGLT2) inhibitors for the treatment of type 2 diabetes is steadily increasing. SGLT2 inhibitors are associated with weight loss, lowering of blood pressure, and low hypoglycemia risk along with beneficial cardiovascular and renoprotective effects. In view of the increasing use of SGLT2i, physicians must be aware of their adverse effects.

Antimicrobial overuse and misuse in the community in Greece and link to antimicrobial resistance using methicillin-resistant S. aureus as an example.

Both antimicrobial consumption and antimicrobial resistance are very high in Greece, ranking among the highest of Europe. The link between antimicrobial consumption and resistance is well-known. Here, we discuss the reasons of antimicrobial overuse in Greece in the community (such as self-medication, dispersion of antibiotics by pharmacies without prescription, over-prescription by physicians, patient expectations and liability pressure) and we explore the misuse of antibiotics for common community infections.

Central nervous system tuberculosis reactivation following intravenous iron supplementation.

Patients with inflammatory bowel disease (IBD) are often treated with tumor necrosis factor (TNF)-alpha inhibitors and are therefore at higher risk for tuberculosis (TB) reactivation. IBD patients also frequently have iron deficiency which is often treated with intravenous iron supplementation. Iron plays an important role in mycobacterial infections, and reactivation of TB has been rarely reported after iron repletion.

Eosinophil count (EC) as a diagnostic and prognostic marker for infection in the internal medicine department setting.

Introduction: Eosinopenia has been previously investigated as a marker to differentiate infectious from non-infectious diagnoses and as a prognostic marker. Most previous studies were conducted in intensive care unit patients. Our study focuses on the value of eosinopenia in patients admitted to the Internal Medicine department.