Biomedical subjects
Publications and source records attributed to T Thomaidis.
Arcanobacterium haemolyticum was cultured from pharyngeal specimens obtained from 12 of 129 children with pharyngotonsillitis, some of whom had a scarlatiniform rash. This organism should be considered to be a cause of infections that are clinically similar to those caused by beta-hemolytic streptococci.
A retrospective study was undertaken to estimate the incidence of hydatidosis among Greeks over 18 years of age. Discharge and operating room records in all community and private hospitals during the period 1 January 1969 to 31 December 1975 were reviewed, and new hydatid patients were registered. Hydatid disease was diagnosed in 4,202 adults. The average annual incidence of all hospital cases was 9.77 per 100,000 population. The diagnosis was confirmed at surgery in 3,397 patients (80.84%). The average annual surgical incidence was 7.89 per 100,000 inhabitants. The incidence of the disease varied among different geographic areas in the country; its percentage was highest in rural areas. In this series, both sexes were equally involved (P greater than 0.1). Solitary organ involvement occurred in 95.88% of cases. Cysts were localized in the liver in 69.64% and in the lungs of 23.43% of the cases with single organ involvement. Liver involvement was more frequent in women, while lung involvement was more frequent in men (P less than 0.001).
Athens University teachers' and students' views and opinions on general issues in medical education were recorded by the method of written questionnaires. This was undertaken in an attempt to have basic material necessary for possible reform of the present system. Eleven professors, fifty associate professors, eighty-three lecturers, 107 assistants, sixty final-year students and eighteen teachers, who had just finished a course in educational techniques, responded to the thirty-six items of a Greek-oriented questionnaire especially prepared for this purpose. Results were analysed and presented in topics such as evaluation, students' characteristics, ways of training, and characteristics of the effective university teacher. Commonly accepted issues were: frequent examinations; repeated orientation and guidance of students; examination to evaluate both students and teachers; smaller group tutorial teaching; student participation in curriculum planning; lesser factual details; teaching how to search into the sources of knowledge; inspiration of life learning. It is concluded that there are several key issues shared in common among both senior and junior teachers and students. Reform which is desirable can thus be widely accepted.
The surgical incidence of hydatidosis in the Greek population aged 0-18 years was investigated. Discharge and operating room records from 1 January 1969 through 31 December 1975 in all hospitals of the country were reviewed. Data were statistically analyzed according to geographical and annual distribution of the disease, age, sex, and organ affected. Of a total of 4,566 patients with hydatidosis, 534 (11.7%) were 0-18 years old. By extrapolation, operations in this age group were performed at a rate of 2.7/100,000 population per year. Surgical incidence of hydatidosis varies among different geographical areas in Greece; its percentage is highest in rural areas. The disease is more frequent in boys than in girls (P less than 0.01). Lungs and liver are the most commonly involved organs (94.2%). Lung involvement is more frequent in boys (73.0%) than in girls (50.5%) (P less than 0.001).
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18 thalassaemic children, aged 3.5 to 13 years comprise our clinical material. In 14 of them clinically elicited spleen markings, haematocrit, blood platelet count and red cell morphology were studied daily for the whole period between transfusions. In 10 patients considerable changes in spleen size were noticed. According to out clinical observations the spleen size starts decreasing 1 to 3 d after blood transfusion up to the 10th posttransfusion day fluctuating thereafter to reach its maximum size again prior to the next blood transfusion. The decrease of spleen size was followed by an increase of haematocrit and blood platelet count and vice versa. 4 additional children were studied clinically only twice: prior to and 7 to 10 d after blood transfusion. A definite decrease of the spleen size following blood transfusion was observed. Spleen and liver 99mTc-sulfur colloid uptake was studied in 10 of the above children prior to and 7 to 10 d after blood transfusion. Statistically significant post-transfusion increase of the spleen uptake was demonstrated. Our findings suggest that (a) splenic size is relevant to blood volume sequestrated int this organ, (b) splenic radioactive uptake increases with its post-transfusion reduction in size.
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The renal-vertebral index is a simple method of evaluating the renal length in children and is convenient for everyday clinical work. The results of 822 normal children aged between 3 days and 14 years are reported. Infants of up to 1 year were found to have an index of about 4 to 5, pre-school children are an index of 3 1/2 to 4 1/2, and schoolchildren an index of 3 1/2 to 4. There was no significant difference in renal-vertebral index between boys and girls.
A 13-year-old boy with homozygous beta-thalassemia who developed clinically manifest and biochemically proven hypoparathyroidism is described. The latter disease was attributed to hemosiderosis. Laboratory abnormalities were corrected after 1 alpha-hydroxy-vitamin D3 was administered.
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A 12-year-old female with lymphosarcoma responding to treatment including vincristine and cyclophosphamide developed clinical and laboratory findings compatible with the syndrome of inappropriate secretion of antidiuretic hormone. Some additional findings were observed, i.e. uremia, hypopotassemia and alkalosis, that have not so far been recorded in that syndrome. All abnormalities were corrected upon water restriction. A similar episode occurred after a 2nd drug course. It too was corrected upon water restriction. The patient was clinically free from her malignancy in both episodes. It is suggested that our child had probably an expanded form of the syndrome of inappropriate secretion of antidiuretic hormone.
In an infant of 15 months with the diencephalic syndrome, urinary excretion of norepinephrine was moderately raised and epinephrine greatly so. It is suggested that catecholamine secretion may be due to sympathetic stimulation at the level of the diencephalon, by a space-occupying lesion pressing on the thalamohypothalamic pathway. Some of the symptoms of the diencephalic syndrome such as euphoria, irritability, skin pallor, and hypertension may be the result of catecholamine secretion.
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Serum antitoxoplasma titres were determined simultaneously by the direct agglutination and the indirect immunofluorescent tests in 52 children aged 2 to 16 years having chronic lymph node enlargement, mainly cervical. Direct agglutination titres were raised (64 to 4096) in 22 children (42%), but rarely in the control groups of children with acute suppurative lymphadenitis, and healthy children, adults, nurses, and physicians. It is concluded that toxoplasmosis is commoner in Greek children than previously believed, and that it should be included in the differential diagnosis of lymphoglandular enlargement. Clinically the condition is mild and may be self-limited, but it should be treated promptly with trimethoprim-sulphamethoxazole, in order to prevent reactivation in adult life.
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Twenty-two children aged from 3 years 6 months to 12 years with erythema nodosum (EN) were grouped according to aetiology into streptococcal, tuberculous, and those whose aetiology was undetermined. Serum IgE levels were determined in all by the radioimmunosorbent technique. Levels were higher (mean value 991 units/ml) in streptococcal EN than in those of the other two groups (mean value 68 units/ml and 97 units/ml, respectively) and healthy age-matched controls (mean value 60 units/ml). Increase of IgE levels in individual cases of streptococcal EN did not correlate with severity of the clinical manifestations characteristic of that group.
Immunoglobulins M, G and A were studied in 88 children with meningococcal meningitis and septicaemia. No difference in the level of immunoglobulins was noted between patients and age matched controls. Serial estimations of serum samples taken on admission to the hospital, 48 h after starting treatment, and on the day of discharge showed a marked increase of IgM levels in almost all patients at discharge irrespective of age or sex. Data of this study do not support the theory that IgM deficiency is the cause which favors the development of meningococcal disease.
A 14-year-old girl with recent onset of diabetes developed a severe systemic allergic reaction to beef-pork insulin on the third day of insulin therapy. The same reaction developed following the injection of pork insulin and monocomponent insulin. The patient was induced to tolerate pork insulin by systemic desensitization to this insulin over an interval of 6 days. Peripheral blood lymphocytes from the patient cultured in the presence of insulin responded by increased blast cell transformation, as compared with controls, who either had previously presented local allergic reactions to insulin or never had manifested insulin allergy.