ACHAIKE IATRIKE Volume 36, Issue 2, October 2017

ACHAIKE IATRIKE OFFICIAL PUBLICATION OF THE MEDICAL SOCIETY OF WESTERN GREECE AND PELOPONNESUS 

EDITORIAL BOARD OF ACHAIKE IATRIKE Editor In-Chief Professor Nicholas G Kounis Department of Medical Sciences, Patras Highest Institute of Education and Technology 7 Aratou Street, Queen Olgas Square, Patras 262 21, Greece, E-mail: [email protected] Deputy Editors Assοciate Professor, Stavros Kakkos, Vascular Surgery Assistant Professor, Stelios Assimakopoulos, Internal Medicine Assistant Editor Dimitris Velissaris, Assistant Professor, Medicine Lydia Leonidou, Attending Physician, Medicine Members of the Editorial Committee Associate Professor Helen Gelastopoulou, Andreas Mitropoulos, Rheumatology Public Health and Epidemiology George Tsiros, General Practice Ioannis Karaindros, Attending Physician, Medicine

SCIENTIFIC COMMITTEE Professor Theodoros Alexandridis, Endocrinologist, Patras, GR Professor Fotios Kalfarentzos, Surgeon, Patras, GR Professor Dimitrios Alexopoulos, Cardiologist, Patras, GR Dr Constantinos Karogiannis, Cardiologist, Patras, GR Vasilios Alivizatos, Consultant Surgeon, Patras, GR Fotios Karvelas, Consultant Surgeon, Patras, GR Assoc. Professor George Antonakis, Obstetrician-Gynaicologist, Patras, GR George Krokidas, Consultant Paediatrician, Patras, GR George Asimakopoulos, Consultant Physician, Sparta, GR Panagiotis Korovesis, Consultant Orthopaedic Surgeon, Patras, GR Panagiotis Christopoulos, Consultant Neurologist-Psychiatrist, Pirgos, GR Professor Stefanos Mantagos, Paediatrician, Patras, GR Associate Professor Periklis Davlouros, Cardiologist, Patras, GR Professor Emeritus Theodoros Maraziotis, Neurosurgeon, Patras, GR Assistant Professor Dimitrios Daoussis, Rheumatologist, Patras, GR Constantinos Panagiotopoulos, Cardiologist, Argos, GR Professor Dimitrios Dougenis, Cardiothoracic Surgeon, Patras, GR Professor Panagiotis Papathanasopoulos, Neurologist, Patras, GR Dionysios Feretis, Consultant Ophthalmic Surgeon, Patras, GR Lecturer Helen Solomou-Liosi, Hematologist, Patras, GR Ageliki Fragoulia, Consultant Physician, Patras, GR Professor Michael Stavropoulos, Surgeon, Patras, GR Professor Emeritus Sotirios Gartaganis, Ophthalmic Surgeon, Patras, GR Associate Director Ioannis Thanasas, Trikala, GR Professor Charalambos Gogos, Physician, Patras, GR Associate Professor Maria Tsironi, Physician, Sparta, GR Professor Panos Goumas, ENT Surgeon, Patras, GR Professor Nicholas Zoumpos, Hematologist, Volos, GR

INTERNATIONAL ADVISORY BOARD Zoe Astroulakis, London, UK Constantinos Chrysostomou, Pittsburgh, PA, USA Petri Kovanen, Helsinki, Finland Thanos Athanasiou, London, UK Nishali Ekanayaka, Colombo, Sri Lanka Anil Kumar, Danville, Pa, USA Murat Biteker, Instabul, Turkey Ruvan Ekanayaka, Colombo, Sri Lanka Nicos Labropoulos, New York, USA Nikos Bouras, London, UK John Elefteriades, New Haven, CT, USA Miltiadis Leon, San Angelo, TX, USA Cihan Cevik, Lubbock, TX, USA Haralambos Gavras, Boston, MA, USA Arum Maskey, Kathmandu, Nepal Yong-Mei Cha, Rochester, MIN, USA Gabriel Gregoratos, San Francisco, CA, USA Susumu Nakae, Tokio, Japan Kanu Chatterjee, San Francisco, CA, USA George Kalliolias, New York, USA Andreas Nicolaides, Nicosia, Cyprus Jack Chen, Atlanta, GA, USA Stamatis Kapetanakis, London, UK Theoharis C Theoharides, Boston, MA, USA Tsung O Cheng, Washington DC, USA Theodore Kondoulis, London, UK Frank J Veith, New York, USA Nicolas Chronos, Atlanta, GA, USA Kyriakos Kirou, New York, USA Elio Venturini, Cecina, Italy

PAST EDITORS IN CHIEF Alekos Maraslis (1975-1985) Athanasios Diamandopoulos (1993-1996) Athanasios Diamandopoulos (1986-1991) Mariana Stamatiadou (1997-1998) Constantinos Chrysanthopoulos (1991-1992) Athanasios Diamandopoulos (1998-2005) 84 ΑΧΑΪΚΗ ΙΑΤΡΙΚΗ Τόμος 36ος, Τεύχος 2, Οκτώβριος 2017

INSTRUCTION TO AUTHORS 

General Patient photos, name, initials, or hospital numbers, should not be included in video footage, recordings, ACHAIKE IATRIKE (Ach Iatr) is a peer-reviewed written descriptions, photographs, and pedigrees unless journal launched in 1975 and constitutes the official the information is essential for scientific purposes. In publication of the Medical Society of Western Greece this case, written informed consent for publication in and Peloponnesus, which was founded in Patras in 1912 print and electronic form from the patient or relatives is and, is the most long-lived Medical Society in Greece, necessary. If such consent is made subject to any condi- after the Medical Society of Athens. It publishes papers of tions, the editorial committee must be made aware of members of the Society. Contributions from non members all such conditions. Written consents must be provided and international scientists are also welcomed. Papers to the editor on request. written in English language are particularly supported and encouraged. Statement of Human and Animal Rights These articles deal with scientific developments from In manuscripts describing human research the authors all fields of medicine. The priority in acceptance of must indicate clearly that all experimental procedures manuscripts for publication is given for original, high were carried out in accordance with the ethical standards scientific and academic quality manuscripts. The journal of the responsible institutional committee for human considers papers written in proper Greek language with experimentation and with the Helsinki Declaration of complete and detailed abstract, authors, departments, 1975, as revised in 2000. When reporting on animal key words, and correspondence details in English. The research, the authors should also indicate that procedures first author of the paper accepted for publication should followed the institutional and national guides for the care understand that the Editorial Committee retains the right and use of laboratory animals. to make corrections especially grammatical or syntactical, which do not change the text of the manuscript, when Ethics these are deemed necessary. Manuscripts containing original material are accepted Peer review process for consideration for publication with the understanding that neither the article nor part of the article has been All articles submitted to the ACHAIKE IATRIKE, after or will be published elsewhere before appearing in the an initial assessment by the editors, undergo a thorough journal. (This restriction does not apply to abstracts; peer review process utilising a double-blind system in- published abstracts, however, should not exceed 300 volving two or more reviewers, before a final decision words). If any of the manuscript’s figures or tables have is taken by the Editorial Committee. previously been published elsewhere, permission for their use must be obtained from the copyright holder. Conflict of interest Accepted papers become the permanent property of the The authors should disclose at the time of submission any Medical Society of Western Greece and Peloponnesus financial arrangement they may have with a company and may not be reproduced in whole or in part without whose product figures prominently in the manuscript the written consent of the Society. Statements and sug- or with a company making a competing product. For gestions published in manuscripts are under the authors review articles or editorials, the authors should not have responsibility and do not reflect the opinion of the editor any financial interest in a company or its competitor that and associates. makes a product discussed in the article. Types of papers Informed Consent The journal publishes the following type of papers: Studies on patients or volunteers require ethics com- 1. Editorials: up to 4 typed double spaced pages with mittee approval and informed consent which should be no more than 10 contemporary references. Editorials documented in the paper. are solicited by the Editor. ACHAIKE IATRIKE Volume 36, Issue 2, October 2017 85

INSTRUCTION TO AUTHORS 

2. Comprehensive Reviews: Up to 10 typed double- 2. Second page: Include a brief, structured abstract of space pages no more than 200 words as follows: Objective and 3. Clinical or experimental papers: Up to 10 typed background, methods, results and conclusion in case double space pages of clinical or experimental articles. List 3-5 key words for indexing. 4. Case reports: Up to 6 typed double-space pages with no more than 10 references. 3. Following pages: Include introduction, material and methods, results and discussion for clinical or experi- 5. “The general Practitioner”: Physicians, irrespec- mental studies. For case reports include, introduction, tively if they are in private practice or work in an report of the case, discussion, conclusion. institution, are strongly encouraged to submit for publication any interesting case or subject which he 4. Include any relevant table or figure. has encountered in his everyday practice of unusual, 5. The last page: Include numbered references in the strange, peculiar or even humorous course and end- order in which they are cited in the text according ing, up to 5 typed double spaced pages. to the Vancouver system as the following examples. 6. Nursing and allied disciplines: Every scientist Listing all authors when there are six or fewer; when working in nursing or allied sciences is encouraged to there are seven or more, list the first three names, submit papers of no more than 5 types double-space followed by “et al.”: pages. • Journal article: Zavras GM, Papadaki PJ, Kokkinis 7. Student and other news: medical students and SE, et al. Kounis syndrome secondary to allergic students of other health disciplines are also strongly reaction following shellfish ingestion. Int J Clin encouraged to submit thoughts, views or even sci- Pract 2003; 57:622-624. entific work up to 5 typed double spaced pages. • Textbook: Hudson R. Cardiovascular Pathology, 1st ACHAIKE IATRIKE also publishes letters to the editor, edition. Edward Arnold (publisher) Ltd, London, interesting images, scientific quizzes, vignettes and the 1965; 1341-1350. news of the society of western Greece and Peloponnesus. • Book chapter: Opie LH. Mechanism of cardiac contraction and relaxation. In: Braunwald E, edi- Manuscript format tor. Heart Disease, 5th ed. Philadelphia: Saunders; 1. First page: Include a brief and descriptive title of 1997; 360-393. the article, the author’s full names with academic degrees, hospital and academic affiliations and the Paper Submission name, address, telephone, fax, and e-mail of the Submit papers electronically to the following address: author responsible for correspondence. [email protected]

PRODUCTION: TECHNOGRAMMAmed 380, Messogeion Ave., GR–15341 Ag. Paraskevi, Athens, Greece Tel.: +30 210.6000.643 - Fax: +30 210.600.22.95, e-mail: [email protected] 86 ΑΧΑΪΚΗ ΙΑΤΡΙΚΗ Τόμος 36ος, Τεύχος 2, Οκτώβριος 2017

Περιεχόμενα Contents

Γράμμα του Διευθυντή της Σύνταξης Ένα Δύσκολο Δίλημμα για Καρδιολόγους, Χειρουργούς Letter from the Editor και Αναισθησιολόγους: Περιεγχειρητική Χορήγηση Αντιαιμοπεταλιακών σε Ασθενείς με Εμφυτευμένα Stents...... 88 Deciphering the Perioperative Management of Dual-Antiplatelet Therapy in Stented Patients...... 88 Νικόλαος Κούνης, Πάτρα / Nicholas Kounis, Patras, Greece Άρθρο Σύνταξης Αντιδράσεις Υπερευαισθησίας στους Χημειοθεραπευτικούς Παράγοντες: Editorial Οξείες και Καθυστερημένες Αντιδράσεις στις Ανθρακυκλίνες...... 91 Hypersensitivity Ρeactions to Chemotherapeutic Agents: Acute and Late Cardiac Effects with Αnthracyclines...... 91 Νικόλαος Κούνης, Γεώργιος Δ Σούφρας, Πάτρα, Ιωάννα Κόνιαρη, Λονδίνο / Nicholas G Kounis, George D Soufras, Patras, Greece, Ioanna Koniari, London, England Κλινική Μελέτη Η Συμβολή και Μελέτης της Βιταμίνης D στην Επίπτωση του Βρογχικού Clinical Study Άσθματος και στη Διαχείρισή του...... 94 Contribution and Consideration of Vitamin D in the Repercussion of Bronchial Asthma and its Management...... 94 Iωάννης Κ Γαλαριώτης, Πάτρα / Ioannis K Galariotis, Patras, Greece Οφέλη και Επιπλοκές από τη Χρήση Νεώτερων Αντιπηκτικών Φαρμάκων στη μη Βαλβιδική Κολπική Μαρμαρυγή με Έμφαση στους Ηλικιωμένους..... 98 Benefits and Complications from the Use of Newer Anticoagulants in Nonvalvular Atrial Fibrillation with Emphasis on the Elderly...... 98 Σταύρος Μαντζούκης, Ιωάννινα / Stavros Mantzoukis, Ioannina, Greece Ανασκόπηση Αναστρέψιμα Αίτια Άνοιας – Άνοια και Έλλειψη Βιταμίνης Β12...... 103 Review Reversible Causes of Dementia - Dementia and Lack of Vitamin B12...... 103 Μαρίνα Γερασίμου, Ιωάννινα / Marina Gerasimou, Ioannina, Greece Ο Ειδικός Ρόλος της Φλεγμονής στην Παθογένεια του Καρκίνου του Πνεύμονα...... 108 The Special Role of Inflammation in Pathogenesis of Lung Cancer...... 108 Νικόλαος Α Χρυσανθακόπουλος, Αθήνα / Nikolaos A Chrysanthakopoulos, Athens, Greece Eνδομητρίωση Kοιλιακού Tοιχώματος...... 127 Εndomitriosis of Αbdominal Wall...... 127 Ιωάννης Κ Θανασάς, Τρίκαλα / Ioannis K Thanasas, Trikala, Greece Nεότερες Θεραπευτικές Στρατηγικές στην Aντιμετώπιση της Φυματίωσης κατά την Kύηση...... 135 New Therapeutic Strategies in the Treatment of Tuberculosis During Pregnancy...... 135 Ιωάννης Κ Θανασάς, Ιωάννης Οικονόμου, Τρίκαλα / Ioannis K Thanasas, Ioannis Oikonomou, Trikala, Greece ACHAIKE IATRIKE Volume 36, Issue 2, October 2017 87

Περιεχόμενα Contents

Βραχεία Αναφορά Το Διαβητικό Πόδι και η Σύγχρονη Αντιμετώπισή του...... 144 Short Report Diabetic Foot Assessment and Τherapy...... 144 Ιωάννης Ντούβας, Ιωάννης Τσολάκης, Πάτρα / Ioannis Ntouvas, Ioannis Tsolakis, Patras, Greece Μη Αλκοολική Λιπώδης Νόσος Ήπατος...... 147 Non–Alcoholic Fatty Liver Disease...... 147 Ιωάννα Αγγελετοπούλου, Χρήστος Τριάντος, Πάτρα / Ioanna Ageletopoulou, Christos Triantos, Patras, Greece Αντιμετώπιση Επιπολής και εν τω Βάθει Φλεβικής Θρόμβωσης...... 149 Superficial and deep vein thrombosis*...... 149 Σταύρος Κάκκος, Ιωάννης Τσολάκης, Πάτρα / Stavros Kakkos, Ioannis Tsolakis, Patras, Greece Eιδικό Άρθρο Η Νηστεία σαν Άσκηση Πειθαρχίας...... 151 Special Article Fasting as Discipline Exercise ...... 151 Ανδρέας Ι Μητρόπουλος, Πάτρα / Αndreas I Mitropoulos, Patras, Greece Γράμμα στον Διευθυντή Σύνταξης ...... 154 Letter to the Editor ...... 154 Νικόλαος Αχ Βαΐτσης, Λάρισα / Nikolaos Ach Vaitsis, Larissa, Greece Απάντηση στο Γράμμα ...... 155 στο Διευθυντή της Σύνταξης ...... 155 Reply to the Letter to the Editor Γεώργιος Μερεκούλιας, Πάτρα / George Merekoulias, Patras, Greece Νέα της ΙΕΔΕΠ Αναφορά στην Προσυνεδριακή Ημερίδα IEDEP News του 13ου Παμπελοποννησιακού Συνεδρίου...... 157 Report from the Pre-congress Medical Day of the 13th Pampeloponnese Medical Congress...... 157 Σταύρος Κάκκος, Πάτρα / Stavros Kakkos, Patras, Greece Φιλοσοφική Προσέγγιση του Πολλαπλού Ρόλου και της Σημαντικής Λειτουργίας του Αγγειακού μας Δικτύου...... 158 Philosophical Approach of the Multiple Role and the Important Function of our Vascular Network...... 158 Ανδρέας Ι Μητρόπουλος, Πάτρα / Αndreas I Mitropoulos, Patras, Greece Eυρετήριο 36ου Τόμου ...... 159 Glossary-Volume 36, 2017 ...... 159 Ευρετήριο Συγγραφέων 36ου Tόμου ...... 159 Authors-Volume 36, 2017 ...... 159 Ευχαριστήριο 36ου Tόμου ...... 162 Thanks to Reviewers-Volume 36, 2017 ...... 162