Hospital Chronicles Hospital Chronicles en-US Hospital Chronicles 1790-7306 Authors who publish with this journal agree to the following terms:<br /><p>a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="" target="_new">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</p><p>b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</p><p>c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="" target="_new">The Effect of Open Access</a>).</p> Artificial Intelligence: Are we creating a new Frankenstein? <p>Mary Shelley&nbsp;(1797-1851) is an English novelist best known for her&nbsp;Gothic novel<a href="#_ftn1" name="_ftnref1">[1]</a> <em>Frankenstein or The Modern Prometheus</em>, written in 1818. In this novel, Victor Frankenstein, an excellent young scientist&nbsp;specialized in chemistry but also connoisseur of other sciences, develops a genius technique to impart life in a huge humanoid that he constructed using parts of dead human bodies. However, when he sees his creature come into life he abandons it terrified. As the creature wanders without an aim or help, it faces human enmity and that transforms it to a maniac for vengeance, extremely directed against its creator. It does not hesitate to murder the persons who are most precious to Victor, including his younger brother and even his bride at the night of their wedding. Victor starts a desperate chase of his creature that leads him to the North Pole, where he dies of exhaustion. The Creature, seeing him dead, mourns for him and, having decided to die too, drifts away on an ice raft and is&nbsp; soon "lost in darkness and distance", never to be seen again.<sup>1</sup> Although the “Creature” remains nameless in the novel, it is usually referred in every-day practice with the name of its creator. That’s why the name “Frankenstein” is often used metaphorically to describe an evil existence that causes death and destruction (fig. 1).</p> Athanasios G. Yalouris ##submission.copyrightStatement## 2019-07-24 2019-07-24 14 1 3 6 10.2015/hc.v14i1.867 A Clinical Prospective Study: Corneal alterations after cataract surgery with the technique of phacoemulsification <p><strong>Abstract</strong></p> <p>&nbsp;&nbsp; The purpose of this study is to investigate the effect of ultrasound energy used during phacoemulsification on corneal structure, which is the most important refractive part of the eye. This will be achieved with the comparison of preoperative and postoperative parameters related to corneal thickness and endothelium and their correlation with clinical, intrasurgical and imaging diagnostic findings.</p> <p>&nbsp;&nbsp; Methods: This is a clinical prospective study conducted in Evangelismos G.H.A. The patients’ enrollment was based on detailed medical history assessment, medication records as well as meticulous slit lamp examination, tonometry, best corrected visual acuity evaluation and thorough fundoscopy. Nuclear cataract sclerosis was evaluated with Lens Opacities Classification System III, and patients were scheduled for surgery. Preoperatively, with the use of specular microscopy (Tomey EM-3000; Tomey, Tennenlohe, Germany), &nbsp;central corneal thickness and several endothelial indices were recorded. The same measurements took place the 1<sup>st</sup>, 7<sup>th</sup> and 30<sup>th</sup> postoperative day. All the surgical operations were done without complications.</p> <p>&nbsp;&nbsp; Results: statistical analysis from preoperative and postoperative data showed that central corneal thickness, although elevated during the 1<sup>st</sup> and 7<sup>th</sup> postoperative day, did not present statistical significant difference in the final evaluation, with a mean elevation of only 3,9μm. Endothelial cell density levels though were reduced in all postoperative measurements (p&lt;0,001). The final percentage endothelial cell loss was18,58%, with the most profound loss being accounted in the first postoperative week. Corneal edema and endothelial cell loss were correlated with poor visual acuity, reduced corneal curvature, increased nuclear sclerosis and prolonged time of ultrasound metrics.</p> <p>&nbsp;&nbsp; Conclusion: the use of confocal microscopy is a useful tool in pointing significant differences of corneal structure after uneventfull cataract phacoemulsification. The evaluation of a larger cohort of patients and a prolonged follow up procedure could give further information concerning corneal alterations after surgery.</p> <p><strong>Key words: </strong>cataract, phacoemulsification, cornea, lens, endothelium, ultrasound, confocal microscopy</p> <p><strong>List of Abbreviations: </strong>CCT<strong>:</strong> central corneal thickness, SD: standard deviation, CV: coefficient of variation, <strong>, </strong>ECD: endothelial cell density, ECL%: endothelial cell loss<strong>%,</strong></p> <p>&nbsp;</p> <p><strong>&nbsp;</strong></p> <p>&nbsp;</p> Angela I. Karekla Charalampia Linardi Antonios Morfopoulos Ioannis K. Lamprinakis ##submission.copyrightStatement## 2019-07-24 2019-07-24 14 1 7 12 10.2015/hc.v14i1.839 Could Immunophenotype Guide Molecular Analysis in Patients with Myeloid Malignancies? <p><strong>Objective: </strong>Immunophenotype has been correlated with molecular aberrations in several studies. The aim of this study was the discovery of immunophenotypic features related to mutations in AML and MDS patients connected to prognostic factors. Moreover, an effort to evaluate a method for the detection of the most common <em>NPM1 </em>mutations of exon12 and Internal Tandem Duplications (ITD) mutations of <em>FLT3</em> gene by flow cytometry was performed.<strong> Method:</strong> Patients with de novo myeloid neoplasms [ AML and MDS (AML-M3 patients were excluded)] were included.<em> FLT3/</em>ITD/TKD and <em>NPM1 </em>mutations were detected by PCR and fragment analysis. The immunophenotypic analysis was performed by multi-dimensional flow cytometry (FC) with a standardized panel of monoclonal antibodies on peripheral blood or bone marrow samples. <em>Nucleophosmin</em> Antibody and CD135 were used for the mutations immunophenotypic detection.<strong> Results:</strong> <em>NPM1</em> and/or <em>FLT3</em> mutations correlated with low or no expression of more immature cells markers such as CD34, CD117, HLADR, as well as higher expression of more mature markers such as CD11b. The higher expression of CD33 should be mentioned as well. The presence of <em>NPM1</em>mut and <em>FLT3/</em>ITD does not seem to be detectable by FC at least using these two monoclonal antibodies. The presence of CD7 aberrant lymphoid marker’s expression was associated with <em>FLT3</em>mut, <em>NPM1</em><sub>wt </sub>genotype. CD56 or CD2 positivity was found only in patients’ samples negative for <em>NPM1</em> and/or <em>FLT3</em> mutations. <strong>Conclusions: </strong>Certain immunophenotype findings including the presence of aberrant lymphoid markers may be indicative of the presence of mutations in <em>NPM1</em> and <em>FLT3</em> linked to prognosis.</p> Chara Giatra Eirini Tziotziou Katherina Psarra Maria Garofalaki Eirini Grigoriou Stamatis Karakatsanis Evaggelia Nikolou Sossana Delimpasi Tatiana Tzenou Stavros Gigantes Ioannis Baltadakis Dimitrios Karakasis Ioannis Tsonis Violetta Kapsimali Flora Kontopidou Maria Pagoni Themistokles Karmiris Alexandra Tsirogianni Nikolaos Harhalakis ##submission.copyrightStatement## 2019-07-24 2019-07-24 14 1 13 23 10.2015/hc.v14i1.860 The adverse reactions to contrast media during percutaneous coronary interventions; keep in mind the non-idiosyncratic reactions. <p><strong>Background</strong>: Iodinated contrast media (ICM) have been among the most commonly used agents in the modern era of medicine and have become of paramount importance in the field of interventional cardiology. Although ICM have an overall good safety profile, severe or life-threatening reactions can occur as well.</p> <p><strong>Description of case</strong>: Herein, we report the case of a 74-year-old female patient who presented with a non-ST elevation myocardial infarction and underwent a successful percutaneous coronary intervention (PCI). At completion of the procedure, the patient complained of dizziness and a metallic taste. She became severely hypotensive with simultaneous bradycardia, simulating a vasovagal reaction. The persistence, however, of the reaction despite initial appropriate measures, guided our thought to a non-idiosyncratic reaction to the contrast media. The patient was hemodynamically stabilized with administration and up-titration of vasopressors and transferred to the coronary care unit, where she developed the full-blown clinical picture of an ICM adverse reaction. She was discharged 8 days later with no further complications. &nbsp; &nbsp; &nbsp;&nbsp;</p> <p><strong>Conclusion</strong>: Non-idiosyncratic reactions to contrast media during a PCI can be misinterpreted as a complication of the procedure per se or as a vasovagal reaction. A high level of clinical suspicion is warranted to ensure prompt recognition and appropriate management.</p> Ioannis Kaplanis George Michas Sofia Arapi George Karvelas Athanasios Trikas ##submission.copyrightStatement## 2019-07-24 2019-07-24 14 1 24 26 10.2015/hc.v14i1.848 Sustained serotonin syndrome in a treatment-resistant depressed patient during maintenance treatment with combination of three serotonergic agents <p>Serotonin syndrome (SS) is a relatively rare but potentially life-threatening&nbsp; condition caused by agents affecting serotonin (5-Hydroxytryptamine; 5-HT) metabolism or acting as direct 5-HT receptor agonists or both.<sup>1</sup>5-HT is a monoamine neurotransmitter synthesized from the amino acid tryptophan. In the central nervous system,it regulates functions such as mood, appetite, sexual activity, sleep and some cognitive functions. Peripherally, 5-HT promotes &nbsp;platelet &nbsp;aggregation and also affects peristalsis and vascular tone<sup>2,3</sup>. A large number of agents, such as antidepressants (monoamine oxidase inhibitors-MAOIs, tricyclic antidepressants-TCAs, selective serotonin reuptake inhibitors-SSRIs, serotonin-norepinephrine reuptake inhibitors-SNRIs, buspirone, St. John’s wort),antibiotics (linezolid), antiemetics (ondansetron) antimigraine medications (sumatriptan), drugs of abuse (amphetamine, cocaine, LSD, ecstasy), herbal supplements and others have been associated with SS<sup>1</sup>.The vast majority of antidepressants can cause SS either by direct receptor agonism (buspirone), through decreased reuptake of 5-HT(SSRIs, SNRIs, TCAs) or &nbsp;decreased &nbsp;5-HT breakdown(MAOIs)<sup>1</sup>. Lithium is used in combination with other antidepressants and has also been implicated in the development of SS<sup>4,5</sup>.</p> Stavroula Theodoropoulou Vasiliki Triantafyllou Georgios Konstantakopoulos Evangelia Bellou Athanasios Yalouris ##submission.copyrightStatement## 2019-07-24 2019-07-24 14 1 27 30 10.2015/hc.v14i1.857 Diabetes News/Recent Literature Review/Forth Quarter 2018 <p><strong>Diabetes News/Recent Literature Review/Forth Quarter 2018</strong></p> Pinelopi Grigoropoulou ##submission.copyrightStatement## 2019-07-24 2019-07-24 14 1 31 32 10.2015/hc.v14i1.866 Infectious Diseases Corner <p>NO</p> Natalia G. Vallianou ##submission.copyrightStatement## 2019-07-24 2019-07-24 14 1 33 34 10.2015/hc.v14i1.861