Intubation after inhalational anesthesia with sevoflurane: in search of the optimal induction technique

Inhalational anaesthesia induction technique goes back to 1846, when the first public administration of inhaled ether was demonstrated in the Ether Dome of Massachusetts General Hospital. Ever since, there has been a dizzying evolution in anaesthetic practice, but the main objectives of anaesthesia have remained unnegotiable. Inhalational sevoflurane induction is still applied in paediatric cases, non-compliant adult patients and in cases of difficult airway¹. Continue reading →

Category: 2021, 2021c, Review Articles
Keywords: inhalational induction, sevoflurane induction, sevoflurane monoinduction
Authors (a/b order): Mitos G., Thoma G., Tsaousi G.

Ginko leaf sign and subcutaneous emphysema in a patient with COVID-19

Subcutaneous emphysema (SE) refers to air in the subcutaneous tissues. Clinical manifestation is generally benign, yet in several cases it can provoke serious complications such as airway compromise, respiratory failure, pacemaker malfunction and tension phenomena. Treatment is usually aiming at the underlined cause, while the air is gradually absorbed from interstitial tissues. However, in extensive cases, surgical intervention may also needed¹. In the present article we present a case report of subcutaneous emphysema in patient with COVID-19 with presence of ginko leaf sign. Continue reading →

Category: 2021, 2021c, Case Reports
Keywords: covid-19, Ginko leaf sign, Subcutaneous emphysema
Authors (a/b order): Aslanidis Th., Pertsas E., Thoma G.

A case-based literature synthesis of extreme hyperferritinemia in critically ill patients with COVID-19

COVID-19 has brought up the interest about hyperferritinemic syndromes. Though often seen in COVID-19, especially within the frame of COVID-CSS, hyperferritinemia needs a systematic diagnostic approach, as co-infections or other causes may also increase ferritin. In this article, we present a case report of extreme hyperferrinemia in an male criticall ill patient with COVID-19 and we perform a short synthesis of the available literature. Continue reading →

Category: 2021, 2021b, Case Reports
Keywords: covid-19, Hemophagocytic Lymphohistiocytosis, Hyperferritinemia, ICU
Authors (a/b order): Aslanidis Th., Flioni EN., Myrou A., Papachristou D., Thoma G.

SEVERE SEPSIS AND STEVENS JOHNSON SYNDROME AFTER INTRAVESICAL BACILLUS CALMETTE-GUERIN (BCG) INSTILLATION. A CASE REPORT AND SHORT REVIEW OF THE LITERATURE

Intravesical bacillus Calmette-Guerin (BCG) therapy, recommended for superficial bladder tumors, triggers side effects in fewer than 5% of patients. Yet, when encountered, high level of suspition and early detection is essential for their succesfull management. In the present article, we present a case of severe sepsis and Steven Johnson syndrome in a male patient after intravesical BCG instillation. Intravesical instillation of Bacillus Calmette-Guérin (BCG) is frequently used as the treatment of choice for carcinoma in situ and non-invasive high-grade superficial tumor of the urinary bladder¹. BCG is a live attenuated strain of Mycobacterium bovis and is the most widely used intravesical agent². Adverse events occur in fewer than 5 % of cases, ranging from mild local symptoms to severe sepsis and death^1-3. In the present article, we report a case of successful management of septic shock with concomitant Steven Johnson syndrome after intravesical BCG instillation and perform a short review of the relevant literature. Continue reading →

Category: 2020, 2020a, Case Reports
Keywords: BCG therapy, bladder tumor, intravesical therapy, Sepsis
Authors (a/b order): Agaliadou-Dioritou U., Aslanidis Th., Karakosta P., Thoma G.

Dose titration of sublingual fentanyl, in relation to transdermal fentanyl dosing in cancer patients

Despite stable background pain, most cancer patients suffer 3-4 episodes of breakthrough pain daily. Aim of the present study was the evaluation of potential correlation between effective doses of sublingual fentanyl citrate, administered for controlling breakthrough pain, with transdermal fentanyl used for background pain. Fifty-six cancer patients were prospectivelly recruited. All patients were suffering episodes of breakthrough pain and managed with transdermal fentanyl 25-300μg/h for their background pain.

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