Background: This cross-sectional analysis investigated the impact of chronic neuropathic low back pain (CNLBP) on pain, disability, kinesiophobia, anxiety, depression, and quality of life, the level of each factor's implication, and attempted to identify key predictors of disability. Methods: Seventy individuals diagnosed with chronic neuropathic low back pain were enrolled. We assessed pain intensity using the short form McGill pain questionnaire (SF-MPQ), disability using the Roland-Morris disability questionnaire (RMDQ), kinesiophobia using the fear-avoidance belief questionnaire during physical activity/work (FABQPA/W), depression using the patient health questionnaire (PHQ-9), anxiety using the generalized anxiety disorder scale (GAD-7), and quality of life (QoL) using the World Health Organization QoL scale (WHOQOL-BREF). We analyzed relationships between the measures using Pearson's correlation coefficients and conducted multiple regression analyses to examine any confounding variables. We defined statistical significance as a p-value of less than 0.05. Results: We observed significant correlations among various clinical outcomes. SF-MPQ demonstrated a strong positive correlation with RMDQ (r =0.561, p <0.001), FABQPA (r =0.338, p =0.004), FABQW (r = 0.381, p =0.026) and PHQ9 (r =0.430, p <0.001). Conversely, SF-MPQ negatively correlated with WHOQOL-BREF Q1 (r =-0.386, p =0.001). RMDQ was significantly positively correlated with PHQ-9 (r =0.427, p <0.001), FABQPA (r =0.442, p <0.001), and GAD-7 (r =0.322, p =0.007), while it exhibited a negative correlation with WHOQOL-BREF Q1 (r =-0.482, p <0.001). Multiple regression analysis identified key predictors of RMDQ, with a statistically significant model [F(3.66) =17.975, p <0.001] and an R2 of 0.450, explaining 45 % of the variance in RMDQ scores. Higher scores on SF-MPQ (B =0.373, p =0.001) and FABQPA (B =0.245, p =0.015) were significant positive predictors of increased RMDQ scores, while higher WHOQOL-BREF Q1 scores (B =-0.275, p =0.008) were associated with lower RMDQ scores. Conclusion: The results indicate that pain, kinesiophobia, and depressive symptoms are significantly positive predictors of increased disability in chronic neuropathic low back pain, while better QoL is associated with reduced disability. HIPPOKRATIA 2025, 29 (1):25-31.
Background: Inflammation plays an important role in the pathogenesis of acute pulmonary embolism (APE), which is a cardiovascular emergency associated with high mortality. The primary determinant of the clinical course in the setting of APE is right ventricular dysfunction (RVD). In this study, we aim to investigate the usefulness of circulating immature granulocytes (IG) as an inflammatory biomarker in predicting RVD in APE. Methods: We retrospectively analyzed data of 59 patients admitted to the emergency department between January 2019 and June 2022, diagnosed with APE. A complete blood count at admission determined the IG count. According to their echocardiographic evaluation, patients were divided into two groups according to the presence of RVD. Results: We observed in APE that the mean IG count was significantly higher in patients with RVD than those without RVD (p =0.001). The multivariate logistic regression analysis detected a significant (p =0.006) and independent effect of the IG count in distinguishing cases with and without RVD. Conclusions: We found the discriminative effectiveness of the IG 0.05 cut-off value for RVD. IGs, an inflammatory precursor obtained readily and without additional cost as part of a complete blood count, may be a new and valuable biomarker for risk stratification and prognosis assessment by predicting RVD in APE patients. HIPPOKRATIA 2025, 29 (1):20-24.
Background: Fibromyalgia is a chronic condition characterized by musculoskeletal pain and gastrointestinal and neuropsychiatric symptoms that currently lacks a consistently effective symptomatic treatment. Description of the cases: We present the cases of two patients with fibromyalgia in whom the use of cannabidiol (Epidyolex) in relatively low doses was effective in significantly ameliorating their symptoms, which were previously resistant to other pharmacological interventions. Conclusion: The reported cases illustrate that cannabidiol may have a significant role in the therapeutic armamentarium of fibromyalgia.HIPPOKRATIA 2025, 29 (1):39-41.
Objective: This study aimed to investigate the usefulness of combining lung ultrasound (LUS) score with Score for Neonatal Acute Physiology Perinatal Extension II (SNAPPE-II) in assessing the severity and prognosis of neonatal respiratory distress syndrome (NRDS). Methods: This retrospective study included 130 neonates, in total, diagnosed with NRDS between May 2020 and November 2022, and among them, 108 neonates showed improvement in their health status after treatment and were classified into the survival group, while 22 neonates did not survive, despite receiving treatment, and were classified into the non-survival group. Pearson correlation analysis evaluated the association between the SNAPPE-II and LUS scores in NRDS, and we used the receiver operating characteristic (ROC) curve to calculate the sensitivity, threshold, and specificity of NRDS. Results: The non-survival group exhibited significantly higher LUS (27 +/- 5.43) and SNAPPE-II (33.46 +/- 7.35) scores compared to the survival group (p <0.001). LUS, SNAPPE-II, and their combined diagnostic methods had statistical significance in NRDS (p <0.001). ROC analysis showed that the cutoff value of the LUS score was 22.5, with a specificity of 0.696, sensitivity of 0.926, an area under the curve (AUC) of 0.892 [95 % confidence interval (CI): 0.838-0.946], and a Youden index of 0.703. The cutoff value for the SNAPPE-II score was 20.2, with a specificity of 0.826, sensitivity of 0.676, an AUC of 0.831 (95 % CI: 0.768-0.895), and a Youden index of 0.622. Notably, the combined diagnostic method using both scoring methods showed significantly better performance than using either method alone, with an AUC of 0.934. Conclusion: The combination of LUS and SNAPPE-II scores exhibits excellent performance in diagnosing NRDS, providing better patient guidance and improving survival probability. HIPPOKRATIA 2025, 29 (1):6-12.
Background: Leishmaniasis is a rare entity in the daily practice of an otolaryngologist, and its diagnosis can be challenging, resulting in delayed treatment. A broad spectrum of clinical manifestations depends on the species involved and the host's immune response. Case report: We present an unusual case of a 90-year-old patient with progressively worsening erythematous, painful, and oedematous nose presenting a diagnostic dilemma. Conclusion: Although leishmaniasis is uncommon, clinical suspicion should be raised in the presence of a relevant patient's history and certain clinical signs such as nasal and/or oropharyngeal lesions. HIPPOKRATIA 2025, 29 (1):32-34.
Background: This study aims to explore the clinical effect of the levonorgestrel intrauterine system (LNG-IUS) on the treatment of abnormal uterine bleeding in women of childbearing age. Material and methods: We retrospectively collected clinical data of women who underwent elective hysteroscopy and concurrent curettage to treat abnormal uterine bleeding at Hefei Hospital, affiliated with Anhui Medical University, from January 2019 to January 2023. We assigned to the LNG-IUS group (n =117) those who received post-surgery LNG-IUS therapy and to the control group (n =161) patients administered dydrogesterone tablets orally instead of LNG-IUS. We recorded detailed data regarding patients' symptoms, pre-hysteroscopy hemoglobin and hematocrit levels, and transvaginal ultrasound evaluations of endometrial thickness and uterine volume. All enrolled patients had scheduled follow-up visits three and six months post-operation at the hospital's outpatient department to assess treatment efficacy and subsequently compare the two groups' efficacy. Results: In the LNG-IUS group, abnormal uterine bleeding significantly improved with a marked response rates at three and six months (83.76 and 94.87 %, respectively), compared to the control group (54.66 and 64.60 %, respectively) (p =0.031 and p =0.007, respectively). The endometrial thickness was significantly reduced post-treatment in the LNGIUS group after three months of treatment (p =0.022). Both groups significantly improved hemoglobin levels after three months of treatment compared to pre-treatment levels (p =0.031 and p=0.025, respectively). Only the LNG-IUS group showed a statistically significant decrease in uterine volume at six compared to three months post-treatment (p =0.009). Conclusions: In women of childbearing age, LNG-IUS shows significant clinical efficacy in treating abnormal uterine bleeding and can be considered an appropriate therapy for women not wishing to have children. HIPPOKRATIA 2025, 29 (1):1-5.
Aims: Pulmonary embolism is the most severe complication of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this study, we aimed to evaluate the prognostic value of PE in patients admitted to the intensive care unit (ICU) and identify factors associated with an increased risk of thromboembolic disease in this population. Methods: We conducted a retrospective case-control study collecting data regarding patients with severe coronavirus disease who were hospitalized in the ICU between September 2020 and January 2022, using the online platform of "Sotiria" Hospital. The diagnosis of thromboembolic disease was based either on a computed tomography pulmonary angiogram or on a positive triplex of the lower extremities. Results: The study included 297 patients, of whom 33 had pulmonary embolism (PE). Patients with PE required a longer hospital stay, both overall and in the intensive care unit (ICU), higher oxygen concentrations, and had elevated levels of C-reactive protein, D-dimers, and lactate dehydrogenase (LDH) compared to patients without PE. Specifically, the p-values for hospital stay duration, oxygen concentrations, C-reactive protein, D-dimers, and LDH were 0.031, 0.023, 0.02, 0.03, and 0.04, respectively. Patients with cardiovascular comorbidities did not exhibit a significantly higher incidence of pulmonary embolism. Finally, the survival of patients with and without pulmonary embolism hospitalized in the ICU due to SARS-Cov-2 infection did not differ significantly. Conclusion: In patients with severe SARS-Cov 2 infection admitted to the ICU, pulmonary embolism presence was associated with elevated D-dimer and lactate dehydrogenase levels, greater need for mechanical ventilation, more frequent occurrence of sepsis, barotrauma, and fungal infections, and prolonged ICU stay. A better understanding of the pathophysiological mechanisms of thrombosis and its correlation with laboratory data is useful for the early recognition of PE in these patients.
Background: Polycythemia vera (PV) is a chronic myeloproliferative disease. Kidney involvement in PV is not a clinical manifestation. However, rarely, especially untreated, uncontrolled forms of PV may complicate ischemic and proliferative glomerular diseases with fibrosis. Description of the case: This paper reports a 53-year-old male patient treated for PV for two years. A gradual decrease in kidney function with proteinuria was observed. This is the first report of a controlled PV patient with a newly diagnosed advanced immunoglobulin A nephropathy (IgAN) entity from T & uuml;rkiye. Conclusion: In conclusion, repeat urinalysis in every patient should be performed for hematuria and proteinuria in order not to delay the diagnosis of kidney involvement. IgAN and PV's togetherness is rare, but the underlying mechanisms must be elucidated. HIPPOKRATIA 2025, 29 (1):35-38.
Introduction:Experiential learning activities (ELAs) constitute a novel teaching method. This study aims to investigate the impressions and experiences of final-year medical students regarding an ELA during their clinical placement in the general practice (GP) course at the Medical School of the Aristotle University of Thessaloniki. The impact of this ELA on the students is examined based on their experiences. Sixth-year medical students participated in blood pressure (BP) measurements in primary healthcare units. Methods:Students reported their experiences in a web-based Qualitative Survey. The reports were analyzed utilizing Braun and Clarke's qualitative analysis method. Forty-four medical students participated in the ELA. Results: The analysis resulted in five themes: benefits for students, patients, and the health care system, facilitators, and obstacles for the action. Students gained theoretical and experiential knowledge and refined their communicational skills. Detection of patients with high BP and increase of their awareness towards hypertension are some of the benefits for the patients. Conclusions: Considering the increased numbers of undiagnosed and uncontrolled hypertensive patients worldwide, along with the workload of physicians in everyday clinical practice, the subsequent challenge would be to investigate if the involvement of medical students such as ELAs could potentially contribute to the diagnosis and better control of hypertensive individuals in the community. HIPPOKRATIA 2024, 28 (1):72-78.
Background: Dengue fever is a mosquito-borne viral disease occurring mainly in countries outside of Europe. It manifests with non-specific signs and symptoms. Greece has been largely untouched by dengue fever since the early 20(th) century. Case description: We present the case of a 28-year-old woman with imported dengue fever after a trip to North and Latin America. The patient presented with fever, headache, fatigue, and sore throat. Clinical and laboratory examination revealed a maculopapular rash, enlarged lymph nodes, leukocytopenia, thrombopenia, and high levels of liver enzymes. An infectious disease panel showed that the cause of the patient's symptoms was dengue fever. Conclusion: The reported case was unusual. Dengue fever is a rare disease in Europe, with cases being predominantly imported, which, combined with the non-specific manifestations of the disease, can lead to diagnostic problems. This is especially important due to the risk of dengue fever becoming autochthonous again.
Objective: This study aims to assess the feasibility and short-term efficacy of employing laparoscopic surgery for the treatment of right-sided colon cancer complicated by acute intestinal obstruction following intestinal decompression. Methods: We undertook a retrospective analysis of a cohort of 22 patients (designated as the study group) hospitalized between January 2017 and December 2022 who presented with right-sided colon cancer complicated by acute intestinal obstruction and underwent laparoscopic-assisted right hemicolectomy subsequently to intestinal decompression. The control group consisted of 36 patients who underwent laparoscopic right hemicolectomy for right-sided colon cancer without intestinal obstruction during the same period. We compared the study group and a control group regarding operative time, surgical blood loss, number of lymph nodes harvested, time to first flatus, postoperative hospital stay, and postoperative complications between the two groups. Results: The operative time for the study group and control group was (181.82 f 14.84) minutes and (155.75 f 17.86) minutes, respectively, and the difference was statistically significant (p <0.001). However, we found no significant differences between the two groups in terms of surgical blood loss (89.32 f 47.62 vs 94.58 f 42.65) ml), the number of lymph nodes (23.05 f 5.08 vs 23.50 f 5.57), time to first flatus (4.36 f 1.01 vs 3.93 f 1.09 days), postoperative hospital stay(16.36 f 3.26 vs 16.17 f 2.54 days), and incidence of short-term postoperative complications (13.64 % vs 7.69 %). Conclusion: In individuals diagnosed with right-sided colon cancer and acute intestinal obstruction, the implementation of laparoscopic-assisted right hemicolectomy subsequent to intestinal decompression proves to be a minimally invasive, safe, feasible, and effective intervention. HIPPOKRATIA 2024, 28 (2):50-55.
Aim: This study aimed to evaluate the quality of life, anxiety, and depression levels in gastric cancer patients receiving radiotherapy. We also investigated the impact of demographic, clinical, pathological, and laboratory data on the quality of life, anxiety, and depression levels. Methods: We designed this prospective observational study that enrolled gastric cancer patients treated in the Radiation Oncology Department of Kayseri City Education and Research Hospital. Patients were requested to complete questionnaires on the first day of their adjuvant radiotherapy and six months after treatment completion. We utilized the clinical data collection form, the European Cancer Treatment and Organization Committee Quality of Life Questionnaire (EORTC QLQ-C30), and the Hospital Anxiety and Depression Scale (HADS) scale forms, and we analyzed statistically the data obtained. Results: Fifty-one gastric cancer patients with a mean age of 67.1 years and 64 % males were included in the study. We found no statistically significant difference when comparing HADS scores with demographic, clinical, and pathological data. When we compared the mean scores of the EORTC QLQ-C30 with the clinicopathological characteristics of the patients, the difference was significant between gender, radiotherapy, and chemotherapy. When we performed subgroup analysis for the scales examined on the first day of radiotherapy and six months later, we found the results to be significant for fatigue, pain, financial difficulty, global health, and dyspnea for chemotherapy; role function, dyspnea, constipation, and financial situation for radiotherapy; and role function, pain, dyspnea, and insomnia for gender. Conclusion: We demonstrated that gender, radiotherapy, and chemotherapy affected the quality of life in patients with gastric cancer, but we found no relationship between depression, anxiety, and quality of life. HIPPOKRATIA 2024, 28 (2):56-64.
Background: Daratumumab, an anti-cancer monoclonal antibody available in a subcutaneous and intravenous formulation for use in the day hospital setting, is indicated for patients with relapsed or refractory multiple myeloma. This study evaluated the impact of using subcutaneous instead of intravenous formulation in the Greek National Health System. Methods: We developed a resource optimization tool to calculate the time for each patient and the impact on hospital capacity when using the subcutaneous versus the intravenous formulation of daratumumab. The free time for each patient and the potential additional number of infusions that could be performed in the hospital are estimated by this tool, assuming all freed time is allocated to treating more oncological patients. Sequential calculations were performed, followed by a sensitivity analysis on a range of hospital capacity for oncology infusions (50-250 /day) and intravenous daratumumab patient numbers (10-160) to reflect the reality in Greece. Results: Subcutaneous use of daratumumab resulted, across all cases, in 60.86-85.94 hours saved per year per intravenous patient and a 7-178 % increase in the hospital's capacity to provide additional oncology-related infusions. Results were consistent regardless of hospital size and daratumumab patient populations. Conclusions: Using daratumumab subcutaneously rather than intravenously in eligible patients in the Greek National Health System may reduce patient treatment burden and increase efficiencies, regardless of hospital size.
Purpose: To present the case of a 23-year-old woman with an optic disc pit coexistent with an optic nerve cyst in her left eye and to highlight the importance of optic nerve imaging in this cavitary optic disc disorder. Case Presentation: The patient was referred with the diagnosis of an optic disc pit in her left eye and a left-sided feeling of tension at the head and neck without any visual deterioration. The best-corrected visual acuity was logMAR 0.0 bilaterally, and intraocular pressure was within normal limits. On fundoscopy, a dark-colored optic pit was present in the temporal segment of the optic disc with respective neuroretinal rim thinning in the left eye. B-mode ultrasonography revealed a cystic lesion behind the globe, while magnetic resonance imaging confirmed the diagnosis of an optic nerve cyst. Since there was no visual deterioration, a decision for regular follow-up was made. Conclusion: An optic disc pit can be associated with an optic nerve cyst. Our report underscores the importance of optic nerve imaging in comprehensively assessing this cavitary optic disc disorder. HIPPOKRATIA 2024, 28 (4):176-179.
Background: Rudimentary horn (RH) uterine anomalies are rare m & uuml;llerian duct development anomalies. RH pregnancies often result in rupture and may endanger the life of the mother; therefore, when RH is detected, excision of the RH is recommended. First case: A 28-year-old G4P3 (one vaginal delivery and two cesarean sections) pregnant woman at 14 weeks gestation was admitted to the emergency department with complaints of widespread abdominal pain and fainting. The ultrasound revealed that the fetus was in the abdomen with an intact amniotic membrane, widespread free fluid, and hematoma in the abdomen, and we performed an urgent laparotomy. As a result of the rupture of the RH, massive intra-abdominal bleeding and the fetus was found to be in the abdominal cavity. We excised the ruptured RH with a right salpingectomy, and her life was saved. Second case: A 26-year-old, G1P0, 36 weeks pregnant, underwent emergency cesarean section due to 5 cm cervical dilation and breech presentation. The left RH was detected intraoperatively and left tubal ligation was performed due to the proximity of RH to the unicornuate uterus. Conclusion: Appropriate clinical management is crucial for patients who have RH anomalies. Excision of RH is recommended to prevent future RH pregnancy because of its high risk of rupture. Even if excision is not feasible, at least ligating the fallopian tube on the rudimentary side is an option to prevent future RH pregnancy.
Background: This study aims to elucidate the beneficial effects of Interleukin-10 (IL-10) on ameliorating endotoxemiainduced cellular immune suppression and inflammation in obstructive jaundice (OJ), a condition associated with high mortality. Material and Methods: This study employed a rat model of OJ, characterized by significant morbidity and mortality due to septic complications and disease pathophysiology. The experimental design involved two primary groups of rats, each subdivided into three subgroups. The first primary group comprised rats undergoing sham surgery, sham surgery with endotoxin and physiological serum solution, and sham surgery with endotoxin and interleukin 10 (IL-10). The second primary group included rats with ligated common bile ducts, ligated common bile ducts with endotoxin and physiological serum solution, and ligated common bile ducts with endotoxin and IL-10. We collected blood samples to assess tumor necrosis factor-alpha (TNF-alpha), alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total/direct bilirubin levels. Additionally, liver tissues were examined for cellular changes. We performed statistical analyses utilizing Kruskal-Wallis and Mann-Whitney U tests. Results: A statistically significant elevation in serum TNF-alpha levels was observed in the subgroups with OJ and endotoxin toxicity. Conversely, a significant reduction in TNF-alpha levels was noted in subgroups treated with IL-10. Furthermore, IL-10 administration markedly attenuated the adverse hepatic effects of OJ and endotoxemia. Conclusions: IL-10 effectively modulates the proinflammatory state induced by endotoxemia in OJ, as evidenced by reduced TNF-alpha levels and improved biochemical and cellular markers. The potential clinical application of IL-10 in OJ could contribute to lowering mortality rates.
Background: In the etiology of coronary artery spasm (CAS), elevated thyroid hormone levels have been implicated, disrupting cardiac homeostasis and precipitating acute myocardial infarction (AMI). We report a case of AMI secondary to CAS in a male with hyperthyroidism without other classical cardiovascular risk factors. Case Description: A 48-year-old male with a known history of hyperthyroidism but no other known classical cardiovascular risk factor urgently attended the hospital with suggestive symptoms of an AMI. The diagnostic process revealed CAS; he was managed successfully with intracoronary nitrates. We noted his elevated thyroid hormone levels, thus linking the hyperthyroid state to the CAS and subsequent AMI. Conclusion: The reported case highlights the diagnostic complexities in patients suffering from hyperthyroidism and presenting with atypical AMI and emphasizes the importance of thyroid function evaluation in such cases. The management includes treatment of the AMI and long-term normalization of the thyroid function, and this case emphasizes the critical interaction between these conditions, advocating for a multidisciplinary approach to managing atypical coronary events in the context of underlying endocrine disorders. HIPPOKRATIA 2024, 28 (3):126-128.
Background: Obstructive sleep apnea (OSA) can lead to left atrial (LA) dysfunction, which increases the risk of severe heart problems such as atrial fibrillation and heart failure. Early detection of LA dysfunction is essential to prevent these complications. We investigated whether the new morphology-voltage-P wave duration electrocardiography (MVP ECG) level could effectively identify early-stage LA functional abnormality in OSA individuals, as current diagnostic techniques have limitations. Methods: We studied a sample of 120 OSA patients using speckle-tracking echocardiography to assess LA function. After the echocardiography exam, we divided these individuals into two groups: those with regular LA and those with impaired LA functions. Our main measure of LA function was peak atrial longitudinal strain (PALS). Results: We found significant differences in PALS values between groups (p <0.001) despite having an equivalent LA size, suggesting occult LA dysfunction in OSA patients. The MVP ECG score proved effective in identifying LA dysfunction caused by changes in atrial structure (sensitivity: 89 %, specificity: 63 %, AUC: 0.862). Conclusions: The MVP ECG score is a promising non-invasive method to detect early atrial changes in OSA patients. Using this score in regular medical care could help physicians intervene earlier, potentially reducing the risk of heart problems in these high-risk individuals.
Background: Topical anesthesia is an invaluable tool in ophthalmic practice with vast diagnostic and therapeutic utilization - from Goldman tonometry to intraocular surgery. Topical anesthetic abuse (TAA) is a rare form of severe selfinduced ocular disease, which can lead to life-long disability. Methods: We conducted a prospective observational case series of fourteen eyes of eleven patients. Inclusion criteria were patients with self-prescribed topical anesthetic use, corneal infiltrates, epithelial defects, and ulcers. We obtained a detailed history and investigated with visual acuity, slit lamp examination, anterior segment optical coherence tomography densitometry, aesthesiometry, and specular microscopy. Patients were treated conservatively for seven days, including antibiotics, systemic corticosteroids, and autologous serum eye drops, followed by amniotic membrane transplantation (AMT), and four eyes underwent cataract surgery. Results: All patients were male, with a mean age of 40.1 f 7.5 years. Ten patients reported traumatic corneal injury and one painful exposure keratopathy as the reason for anesthetic use. Eleven eyes (78.57 %) achieved complete epithelialization with improvement in visual acuity and corneal transparency; two eyes had persistent epithelial defects, which necessitated a second AMT, and in one, a corneal abscess formed that necessitated evisceration. Visual acuity improved from 0.023 f 0.009 to 0.16 f 0.041 (p =0.003). Four eyes underwent successful cataract surgery. Optical coherence tomography densitometry values at presentation were, on average, 64.04 f 10.45 standardized greyscale units (GSU) and changed to 61.28 f 9.03 GSU (p =0.096). The mean pain score of the patients was 8.6 f 0.9 upon admission and 2.36 f 2.2 at the last follow-up visit (p =0.003). Aesthesiometry improved significantly from 192.14 f 5.34 mg/S to 97.21 f 10.86 mg/S (p =0.001). The mean endothelial cell density was 1409.18 f 516.03 and changed significantly to 1385.73 Conclusions: Topical anesthetic abuse should be kept in mind in the differential diagnosis of ring infiltrates and nonhealing ulcers. Prevention of trauma and strict pharmaceutical regulations are key to avoiding this debilitating disease. A combined conservative and surgical approach, including autologous serum, amniotic membrane, and phacoemulsification, could result in visual rehabilitation in TAA patients. HIPPOKRATIA 2024, 28 (3):120-125.
Background: Heart failure is a detrimental complication of type 2 diabetes mellitus (T2DM). Considering the different pharmacologic effects of dipeptidyl-peptidase 4 (DPP-4) inhibitors and sulfonylureas, the investigator hypothesized that these medications may exert distinct effects on heart function in diabetic individuals. Methods: We conducted a cross-sectional study at a tertiary medical center in Taiwan, which enrolled adult patients with T2DM who were receiving either DPP-4 inhibitors or sulfonylureas. We excluded eligible candidates with preexisting heart failure. Participants underwent echocardiography and blood sampling at the Cardiology outpatient clinic. Results: We enrolled in the study 252 participants classified according to their glucose-lowering medications. Clinical characteristics including age (67.8 vs 67.5 years, p =0.83), systolic blood pressure (130 vs 133 mm Hg, p =0.24), and glycated hemoglobin A1c (7.4 vs 7.7 %, p =0.1) were similar between treatment groups. According to ventricular ejection fraction measurements, enrolled patients receiving DPP-4 inhibitors were associated with more favorable heart function than recipients of sulfonylureas (58.4 vs 51.6 %, p =0.001). Conclusion: Glucose-lowering medications have distinct effects on heart function. Participants receiving DPP-4 inhibitors were associated with better heart function than recipients of sulfonylureas. Therefore, glucose-lowering drugs should be selected based on their potential effects on heart function. HIPPOKRATIA 2024, 28 (3):115-119.
