Georgios Noussios

Efficacy of Paracetamol versus Diclofenac for Grade II Ankle Sprains

Background: Ankle sprains are usually treated with the RICE protocol often with nonsteroidal anti-inflammatory drugs (NSAID) for pain reduction. We evaluated the effect of diclofenac, an NSAID, versus paracematol in the reduction of pain and acute edema of severe ankle sprains. Materials and Methods: Ninety patients, 18 to 60 years old, with Grade II acute ankle sprains were randomized into two groups. Group A (45 patients) received for the first 10 days diclofenac 75 mg orally twice per day. Group B (45 patients) received paracetamol 500 mg orally three times per day for the same period. We evaluated ankle joint edema with the Figure-of-Eight method and with the volumetric method, as well as pain with the Visual Analogue Scale (VAS) in both groups. Results: The patients had no significant differences concerning their baseline values (p > 0.05). The ankle joint edema was decreased in both groups (p < 0.001) but there was more edema in group A than in group B at the third post-traumatic day with both measurement methods (p = 0.028/0.025). By the tenth post-traumatic day no difference was found. Pain decreased in both groups at the third day and at the tenth day (p < 0.001). Conclusion: According to these results, diclofenac and paracetamol had the same effect on pain reduction of ankle sprains but more acute ankle edema was present in patients who were treated with diclofenac than in patients who were treated with paracetamol. Level of Evidence: I, Prospective, Randomized Study

The Effect of Static Stretching on Maximal Voluntary Contraction and Force-Time Curve Characteristics

Objective: To examine the effect of static stretching on maximal voluntary contraction (MVC) and isometric force-time curve characteristics of leg extensor muscles and EMG activity of rectus femoris (RF), biceps femoris (BF), and gastrocnemius (GA). Design: A within subjects experimental design. Participants: Ten healthy students were tested after a jogging and a jogging/stretch protocol. Intervention: The stretching protocol involved a 10 min jog and seven static stretching exercises. Main Outcomes: Measurements included MVC, time achieved to MVC (TMVC), force at 100ms (F100), index of relative force (IRF), index of rate of force development (IRFD), and average integrated EMG activity (AEMG). Results: There were slight but no significant changes in MVC (1%), TMVC (4.8%), F100 (7.8%), IRF (1%), and IRFD (3.5%) between measurement. A significant difference (21%; P < 0.05) in AEMG of RF was found. Conclusions: The present study indicated that a moderate volume of static stretching did not alter significantl...

The role of somatostatin in 67 consecutive pancreatectomies: a randomized clinical trial.

Background: Somatostatin has been found to be effective in the prevention of postoperative complications in pancreatic surgery. It can inhibit the pancreatic secretions that, quite often, are responsible for complications during the postoperative period. Methods: We randomized 67 patients in 2 groups. In the study group (n = 35), somatostatin was administered 30 minutes prior to surgery as well as intraoperatively and postoperatively. No medication was given to the control group (n = 32). Biopsies were taken and processed for electron microscopy and ultrastructural morphometric analysis. Results: Administration of somatostatin reduced the exocrine granule number, and the patients suffered from fewer postoperative complications. Conclusions: Somatostatin reduces granule number and size of pancreatic cells, which can partially explain the prophylactic effect of the drug on early complications of pancreatic surgery, and which is confirmed by the clinical findings.

Combined anomalous origin of a left inferior thyroid artery and a left vertebral artery: a case report

An abnormal origin of a left inferior thyroid artery from the left vertebral artery that in turn originated from the aortic arch was observed on a 72-year-old Caucasian male cadaver during a dissection anatomy practice. We describe in detail the morphology of this extremely rare anatomical variation and refer to its clinical importance.

Role of extended lymphadenectomy in the treatment of pancreatic head adenocarcinoma: review and meta‐analysis

Extended lymph node dissection has been established as the method of choice in the treatment of many digestive malignancies, but its role in the treatment of adenocarcinoma of the pancreas remains controversial.

Bilateral rectus femoris intramuscular haematoma following simultaneous quadriceps strain in an athlete: a case report

IntroductionBilateral rectus femoris haematoma following a simultaneous strain of the quadriceps muscles is a very rare condition.Case presentationWe report the case of a 21-year-old Greek Caucasian female rowing athlete who was injured on both thighs. She complained of pain and inability to walk. Physical examination revealed tenderness over the thighs and restriction of knee movement. The result of a roentgenogram was normal, and there was no evidence of fracture or patella displacement. Magnetic resonance imaging revealed haematoma formation in both the rectus femoris muscles. The diameters of the left and right haematomas within the muscles were 6 cm and 5 cm, respectively. Therapeutic approaches included compression bandages, ice application, rest, elevation, and administration of muscle relaxant drugs. Active stretching and isometric exercises were performed after three days. The patient was able to walk using crutches two days after the initiation of treatment. On the seventh day, she had regained her full ability to walk without crutches. Non-steroidal anti-inflammatory drugs were administered on the fifth day and continued for one week. Six weeks later, she had pain-free function and the result of magnetic resonance imaging was normal. She was able to resume her training programme and two weeks later, she returned to her previous sport activities and competitions.ConclusionThere are references in the literature regarding the occurrence of unilateral quadriceps haematomas following strain and bilateral quadriceps tendon rupture in athletes. Simultaneous bilateral rectus femoris haematomas after a muscle strain is a rare condition. It must be diagnosed early. The three phases of treatment are rest, knee mobilization, and restoration of quadriceps function.

Levator claviculae muscle: a case report

In the current study a levator claviculae muscle, found in a 65-year old male cadaver, is presented. We describe the topography and morphology of this accessory muscle, which may be found in 1-3% of the population. Moreover, we discuss the embryologic origin of the muscle along with its clinical importance.

Solid Serous Adenoma of the Pancreas: A Case Report and Review of the Literature

Herein, we report a case of a solid-type serous cystadenoma of the pancreas which is the 16th case reported worldwide and the first ever reported in Greece. Magnetic resonance imaging showed a hypervascular mass in the tail of the pancreas of a 72-year-old female who presented with mild abdominal pain. Distal pancreatectomy was performed by laparotomy and histological and immunohistochemical examination revealed a solid-type serous cystadenoma of the pancreas. Preoperative diagnosis of a solid-type serous cystadenoma of the pancreas is difficult, and, due to its benign nature, simple excision of the tumor is the recommended treatment.

A systematic classification of the vertebral artery variable origin: clinical and surgical implications

Several congenital anomalies regarding the right (RVA) and left (LVA) vertebral artery have been described. The current paper aims to perform a systematic literature review of the variable vertebral artery (VA) origin from the aortic arch (AOA) and its branches. The incidence of these variants and the ensuing AOA branching pattern are highlighted. Atypical origin cases were found more commonly unilaterally, while LVA presented the majority of the aberrancies. The LVA emersion from the AOA (3.6%) and the RVA from the right common carotid artery (RCCA) (0.14%) were the commonest origin variations. Aberrant RVA origin as last branch of the AOA is very rare. Eighteen cases (0.12%) with an aberrant right subclavian artery (ARSCA) were found. Among them, the RVA originated from the RCCA and right subclavian artery in 94.4 and 5.6%, respectively. Sporadic cases had an AOA origin bilaterally; RVA and LVA had a double origin in 0.027 and 0.11%, respectively. A dual origin was detected in 0.0069%, bilaterally. The atypical VA origin may coexist with: (i) an ARSCA, (ii) a common origin of brachiocephalic artery and left common carotid artery (the misnomer bovine arch) and (iii) a bicarotid trunk. The aberrant VA origin favors hemodynamic alterations, predisposing to cerebrovascular disorders and intracranial aneurysm formation. Detailed information of VA variants is crucial for both endovascular interventionists and diagnostic radiologists involved in the treatment of patients with cerebrovascular disease. Such information may prove useful to minimize the risk of VA injury in several procedures.

Correction: Ioannis Dimitriou et al, Palmaris Longus Muscle’s Prevalence in Different Nations and Interesting Anatomical Variations: Review of the Literature

[This corrects the article DOI: 10.14740/jocmr2243w.].