Open and arthroscopic synovectomy in hemophilic arthropathy of the knee.

Open and arthroscopic synovectomies of the knee in patients with classic hemophilia were evaluated with regard to effectiveness in reducing bleeding episodes, the effect on range of motion (ROM), and roentgenographic progression of hemophilic arthropathy. Eleven patients underwent 13 synovectomies (eight open, five arthroscopic). The average follow-up periods were 7.9 years and 2.2 years for the open and arthroscopic groups, respectively. Both procedures significantly reduced recurrent hemarthroses. Knee ROM in the open synovectomy group was decreased or unchanged in 75% and minimally increased in 25%, whereas there was an increased in 80% and a decrease in 20% of the knees in the arthroscopic group. Furthermore, 62.5% of the knees required manipulation to improve ROM in the open synovectomy group, versus 0% in the arthroscopic group. Hemophilic arthropathy progressed in most knees in both groups. The arthroscopic group had a longer operative procedure (122 versus 59 minutes), but required less hospitalization (9.4 versus 23.1 days) and 25.6% less Factor VIII replacement. Both techniques reduce hemarthroses. There is usually a net loss of ROM with the open versus a net gain with the arthroscopic procedure, and roentgenographic progression hemophilic arthropathy is slowed but not halted after synovectomy.     

Association of demographic, clinical and treatment variables with quality of life of patients with epilepsy in Greece

PURPOSE: The aim was to study the influence of patients' age, frequency and type of seizures, disease duration, number of AEDs and use of benzodiazepines on the quality of life of patients with epilepsy. PATIENTS AND METHODS: We consecutively identified 223 patients with epilepsy who attended the epilepsy outpatient clinics at three university hospitals in Greece. Quality of life was evaluated by QOLIE-31. One-way analysis was used to assess the association of the studied factors and QOLIE-31 subscales. After checking for co-linearity, we performed multivariate stepwise linear regression analysis with all the variables that on univariate analysis showed a statistically significant effect on each subscale of QOLIE-31 to explore which of the studied factors affect independently on QOLIE-31 scores. RESULTS: Of a total of 223 patients, 118 (52.95%) were men; mean age was 35.18 +/- 13.22; mean duration of the disease was 13 years; 58 (26%) patients had generalized seizures, 93 (41.7%) had PS, and 72 (32.3%) of the patients had PsG; 85 (38.1%) were on polytherapy and 38 (17%) were taking benzodiazepines. Independent factors affecting QoL were: seizure frequency (Overall QoL P = 0.0001, Seizure worry and Emotional well-being P < 0.0001, Energy/fatigue and Social functioning P = 0.01); duration of the disease (Overall QoL and Energy/fatigue P = 0.01, Seizure worry P = 0.008, Cognitive functioning P < 0.0001); polytherapy only for the Emotional well-being P < 0.0001; and use of benzodiazepines (Overall QoL, Energy/fatigue, Social functioning P = 0.002, Cognitive functioning P < 0.0001). CONCLUSION: Our findings suggest that QoL in epileptic patients might be affected, in addition to the other established factors (high frequency of seizures and polytherapy), by the daily use of benzodiazepines as adjunctive therapy. Change of medical strategy concerning this medication may lead to improving the QoL of these patients.     

32-channel 3 Tesla receive-only phased-array head coil with soccer-ball element geometry.

A 32-channel 3T receive-only phased-array head coil was developed for human brain imaging. The helmet-shaped array was designed to closely fit the head with individual overlapping circular elements arranged in patterns of hexagonal and pentagonal symmetry similar to that of a soccer ball. The signal-to-noise ratio (SNR) and noise amplification (g-factor) in accelerated imaging applications were quantitatively evaluated in phantom and human images and compared with commercially available head coils. The 32-channel coil showed SNR gains of up to 3.5-fold in the cortex and 1.4-fold in the corpus callosum compared to a (larger) commercial eight-channel head coil. The experimentally measured g-factor performance of the helmet array showed significant improvement compared to the eight-channel array (peak g-factor 59% and 26% of the eight-channel values for four- and fivefold acceleration). The performance of the arrays is demonstrated in high-resolution and highly accelerated brain images.     

Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry

Journal of Neurology - Up to date there is no population-based study from Greece providing long-term data on incidence of both all-cause mortality and stroke recurrence for patients with first ever...