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Kostas Sideridis

Publications and source records attributed to Kostas Sideridis.

9 recordsLinked to original sources
PubMed2006

True incidence and clinical significance of pneumoperitoneum after PEG placement: a prospective study.

BACKGROUND: PEG is a widely used method for providing nutritional support. Although pneumoperitoneum is a known finding after PEG placement, its true incidence is subject to debate. Small retrospective studies have found varied rates of free air after PEG placement. PATIENTS: There were a total of 65 patients. OBJECTIVE: To assess the true incidence of pneumoperitoneum and its clinical significance. DESIGN: Prospective study. SETTING: Long Island Jewish Medical Center. INTERVENTIONS: We obtained upright and anterior-posterior chest radiographs of 65 patients within 3 hours after PEG placement. Type of PEG tube, gauge of the needle used, number of sticks, and indications were recorded. The presence of pneumoperitoneum on the initial chest film was considered to be a positive finding. After a positive result, a repeat chest film was obtained 72 hours later to determine whether there was progression or resolution of the free air. Patients enrolled in the study were also monitored clinically for evidence of peritonitis. MAIN OUTCOME: Of the 65 patients who underwent PEG placement, 13 developed a pneumoperitoneum on the initial chest radiograph; there was complete resolution of pneumoperitoneum at 72 hours in 10 of the 13 patients. In 3 patients, the free air persisted but was of no clinical significance. MEASUREMENTS: The free air was quantified by measuring the height of the air column under the diaphragm and was graded with a scoring system (0, no air; 1, small; 2, moderate; 3, large). RESULTS: Eleven patients who underwent PEG died during the hospitalization; none of the deaths were related to the PEG placement or pneumoperitoneum. The other 54 patients were discharged to a skilled nursing facility. No patients in the study had clinical evidence of peritonitis. There were no adverse events, ie, infection or bleeding, associated with the PEG placement in any of the patients. CONCLUSIONS: Our data suggest that pneumoperitoneum after PEG placement is common and, in the absence of clinical symptoms, is of no clinical significance and does not warrant any further intervention.

Adult↗
PubMed2006

Protracted hiccups due to severe erosive esophagitis: a case series.

BACKGROUND: Hiccups although a common annoyance of life, have been linked with significant morbidity and even death. There are numerous causes of prolonged hiccups, including diseases of the gastrointestinal tract. Hiccups are reported to represent an atypical manifestation of gastroesophageal reflux disease. CASES: We report 4 cases of prolonged hiccups in patients who failed to respond to initial treatment with abortive neurologic medications and who subsequently improved on proton-pump inhibitors. Endoscopic examination revealed severe reflux esophagitis. CONCLUSION: Hiccups are an atypical manifestation and may represent a more severe course of gastroesophageal reflux disease.

Adult↗
PubMedDate not supplied

Dengue fever: diagnostic importance of a camelback fever pattern.

We present a case of imported dengue fever in a 52-year-old man acquired during a recent trip to Ecuador. Fever in a returning traveler from tropical areas often presents a diagnostic problem for clinicians. Our patient presented with severe arthralgias and myalgias and had a camelback/saddleback fever pattern accompanied by relative bradycardia, which was a clue to the diagnosis. He had conjunctival suffusion and the truncal rash, but adenopathy was not present. He also had a generalized headache and abdominal pain. Nonspecific laboratory abnormalities included leukopenia, lymphopenia, atypical lymphocytes, thrombocytopenia, and mildly increased serum transaminases. Clinicians should consider dengue fever in the differential diagnosis in travelers returning from dengue fever endemic areas of Southeast Asia, Latin America, and Africa. Although early findings are nonspecific, a truncal rash accompanied by leukopenia and thrombocytopenia, if followed by biphasic fever pattern (ie, camelback/saddleback fever curve with relative bradycardia), suggest dengue fever as the primary diagnostic consideration.

Bradycardia↗