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Volume 1, Issue 2, December 2017

Review Article JRPMS, Vol 1, No 2, December 2017, p.23-30
Nutritional aspects and vitamin D supplementation in ankylosing spondylitis
Aikaterini A. Kalogeropoulou
Keywords: Ankylosing spondylitis, Vitamin D supplementation, Diet, Starch diet, Systemic inflammation
Ankylosing spondylitis (AS) is an inflammatory rheumatic disorder that burdens predominantly the spine and sacroiliac joints. The exact factors that define the development and evolution of the AS remain unclear. The ambiguity around the therapeutic treatment of vitamin D, regarding its immunomodulatory and anti-inflammatory effects in the development of the AS, provides an attractive field of investigation. The connection of the disease with intestinal gut microbiota is well documented, allowing for investigating the role of nutrition, including prebiotics and probiotics, on well-being and functionality of people with AS. The beneficial effect of low starch diet and the anti-inflammatory effect of the Mediterranean diet are landmarks in the development of AS. Additionally, it can be argued that the progression of the disease was compounded, among the Inuit population of Alaska, by the change in their nutrition that was rich in omega-3 polyunsaturated fatty acids and low carbohydrate, to a “Western-Diet” that is high in carbohydrate (sugar and starch) and saturated fat. This review investigates the relationship between diet and disease progression, as well as identifies a dietary pattern that could improve the well-being of people with AS. Finally, this review investigates the therapeutic effect of vitamin D supplementation in the disease progress.
Original Article JRPMS, Vol 1, No 2, December 2017, p.31-37
Circadian clock mechanisms in adrenal adenomas are not related to osteopenia and osteoporosis
Konstantinos Katsoulis, Dimitrios Ioannidis, Georgios Karageorgos, George I. Lambrou
Keywords: Οsteopenia, Οsteoporosis, Αdenoma, Cortisol, Circadian rythm
Background: It is known that humans live under the strong influence of light/dark cycles associated with the day/night changes created by the 24-hour rotation of the earth. Yet, it is possible that the circadian rhythm could be disrupted from the presence of a disease and/or changes in body homeostasis. The aim of the present study was to search for an association in patients with adrenal adenomas between cortisol circadian rhythm and osteopathies. Materials and Methods: Twenty eight patients with a history of adenoma, osteopathy or both participated. Patients were tested for routine biochemical factors as well as cortisol levels at 8 a.m., 1 p.m., 5 p.m. and 11 p.m., as well as ACTH and urine cortisol. Results: Significant differences were observed in SGOT levels Free-T4, FSH and K+ in subjects with and without any history of osteopenia or osteoporosis manifesting lower levels as compared to subjects with a history of osteopenia or osteoporosis. At the same time cortisol remained similar among all patient groups. Discussion: Although there is no conclusive evidence, cortisol levels appear to remain untouched by the disease states and thus it appears that circadian rhythms are regulated through an alternative circuitry.
Case Report Article JRPMS, Vol 1, No 2, December 2017, p.38-40
Conservative treatment of isolated avulsion fracture of the lesser tuberosity of the humerus: A case report
Lazaros P. Athanasiadis, Eftychia T. Petropoulou, Emmanouil M. Neonakis
Keywords: Lesser tuberosity, Isolated fracture, Humerus, Conservative treatment
The fractures of the lesser tuberosity of the humerus commonly present with fracture of the head of the humerus and/or posterior dislocation of the shoulder. We report a case of a 58 year old female that sustained an isolated avulsion fracture of the lesser tuberosity following a fall which is extremely rare. Furthermore, the tendon of the biceps was not displaced and subsequently conservative rehabilitation management was followed with excellent results.
Case Report Article JRPMS, Vol 1, No 2, December 2017, p.41-44
Hearing loss in Camurati Engelmann disease: a case report
Anastasia K. Klagkou, Stavroula Koutroumpi, Constantinos Georganas, Dimitrios Ioakimides, Evaggelos Boulios, Georgia Tseliou
Keywords: Camurati Engelmann disease, Progressive diaphyseal dysplasia, Skull thickening, Hearing loss, TGF/b mutation
Camurati-Engelmann disease (CED) is a rare autosomal dominant disease characterized by heavily thickened long bones, pelvis and skull. Deafness is a common finding, due to the compression of nerves and blood vessels by thickened skull bones, and is usually difficult to manage. Herein, we report a young female diagnosed with CED since her adolescence, with gradual deterioration of hearing of mixed type, where conservative medical treatment proved ineffective, confirming the key role of early decompressive surgery in such cases.
Original Article JRPMS, Vol 1, No 2, December 2017, p.45-49
The significance of orbital floor exploration during open reduction of zygomaticomaxillary complex fractures
Christos Krasadakis, Dimosthenis Igoumenakis, Ourania Schoinohoriti, Constantinos Mourouzis, Georgios Rallis
Keywords: Zygomaticomaxillary complex fractures, ZMC, Open reduction, Orbital floor defects, Reconstruction
Objective: Zygomaticomaxillary complex (ZMC) fractures represent a common type of facial fractures, sometimes associated with defects of the orbital floor that may escape diagnosis, unless investigated intraoperatively following open reduction. The aim of the study was to determine the frequency of orbital floor defects among cases of ZMC fractures treated with open reduction in our Department and to share our experience in the diagnostic and therapeutic approach of such defects. Patients and methods: The files of all patients, treated in our Department for ZMC fractures from January 2010 to October 2014 were retrieved and reviewed retrospectively. Specific related data were registered and submitted to thorough analysis. Results: Based on our findings a considerable percentage (34.1%) of the patients with ZMC fractures demonstrated considerable defects of the orbital floor; these were diagnosed through intraoperative exploration of the orbital floor following open reduction of the fractures and appropriately treated. Conclusions: Orbital floor defects associated with ZMC fractures may remain undiagnosed and therefore untreated, unless routine exploration of the orbital floor is performed following open reduction of the fractures. This could result in severe morbidity, including enofthalmos, restricted ocular mobility and impaired visual acuity.
Review Article JRPMS, Vol 1, No 2, December 2017, p.50-54
The history and recent advancements in antinuclear antibody testing
Dimitra Moschou, Elena Pipi, Alexandra Tsirogianni
Keywords: Antinuclear antibody, Indirect immunofluorescence pattern, ANA results
The antinuclear antibody (ANA) testing is an indispensable diagnostic tool for the management of systemic autoimmune rheumatic diseases (SARD). From the initial discovery of ANA identification until today there has been considerable technical progress in ANA testing and standardisation which has allow the development of commercial ANA assay kits that are widespread used in clinical and research practice. In this mini-review we explore the history and recent advancements in ANA testing and provide guidelines to the laboratory interpretation and clinical assessment of ANA results.
Original Article JRPMS, Vol 1, No 2, December 2017, p.55-64
Basic laboratory bone profile in Greek patients with galactose metabolic disorders
Maria Kalogerakou, Kleopatra H. Schulpis, Artemis Doulgeraki, George I. Lambrou
Keywords: Galactosaemia, Vitamin D, Creatinine, BMI, HDL
Objective: the investigation of the relationship between different basic biochemical parameters of bone metabolism in galactosaemia patients. Methods: Study participants included twenty two patients with an average age 7.97±5.1 years, early diagnosed by newborn screening and dietary treated. Serum biochemical factors including calcium, phosphate, magnesium, alkaline phosphatase (ALP), creatinine, albumin, lipidaemic factors, vitamin-D, hemoglobin and ferritin were determined during a routine biochemical physical examination. Z-BMI, Z-Wt and Z-Ht were estimated for the assessment of normal or delayed growth. Results: Estimated biochemical variables did not demonstrate significant differences between patient groups (e.g. males-females, galactosaemia subtypes). Creatinine manifested lower values whereas ALP manifested highest values as compared to reference ranges. Significant differences were observed with respect to BMI estimates as well as Vitamin D vs. age, body weight vs. height in females. Vitamin D was negatively correlated to creatinine and HDL. Calcium was negatively correlated to creatinine, in all patients. Conclusion: These findings suggest that there is a place for periodic monitoring of basic biochemical bone profile in galactosaemic patients, in order to detect early subtle changes in bone metabolism.