Limassol General Hospital

Objectives: This study aimed to analyse the impact of serum sodium and potassium levels on sensorineural hearing loss and tinnitus. Material and Methods: A total of 616 individuals participated-248 with sensorineural hearing loss and tinnitus, 136 with tinnitus only, and 232 controls. All patients received thorough examinations by specialists in otorhinolaryngology and audiology. Additionally, all participants underwent laboratory testing. Results: Serum sodium levels were slightly elevated in the tinnitus group with sensorineural hearing loss compared to both the tinnitus group and the control group, although these differences were not statistically significant (p = 0.27 and p = 0.89). Additionally, this trend was not observed when comparing the tinnitus group to the control group (p = 0.32). The serum potassium levels did not show a significant difference among the three groups (p = 0.155). In the group experiencing sensorineural hearing loss and tinnitus, a significant positive correlation was found between serum sodium levels and the onset of sensorineural hearing loss (p = 0.000, rho = 0.223). Additionally, there was a significant correlation between age and the onset of symptoms (p = 0.000, rho = 0.235). No significant correlations were found regarding serum potassium levels. Patients with hearing levels exceeding 40 dB exhibited slightly higher serum sodium levels (p = 0.56). Both the groups with tinnitus and sensorineural hearing loss, as well as the tinnitus-only group, showed a trend indicating that higher serum sodium levels were associated with greater tinnitus intensities (p = 0.43 and p = 0.62, respectively). A logistic regression analysis indicated that the development of sensorineural hearing loss and tinnitus was significantly associated with changes in serum sodium levels (p = 0.030; OR: 0.186, 95% CI = 0.027-5.550). Additionally, serum sodium levels were found to be significant predictors of more severe hearing loss, defined as hearing levels exceeding 40 dB (p = 0.019; OR: 1.950, 95% CI = 0.504-7.540). Conclusions: The findings of this investigation suggest that changes in serum sodium levels may influence the development and severity of tinnitus and sensorineural hearing loss. Further studies involving more cases are needed to solidify these results.

· Realized returns positively correlate with volatility, when returns are positive · The correlations change from positive to negative, when returns are negative · As in Wang et al. (2017) , the evidence fits Prospect Theory’s reflection principle · The correlations show in cross-sectional and time series analyses of 353 stocks · The correlations emerge in daily, monthly, quarterly, half-yearly and yearly analyses Wang, H., Yan, J. and Yu, J. (2017) demonstrate that the risk-return correlations change from positive to negative depending on whether the stock has accrued capital gains or capital losses. The authors argue that Prospect Theory’s reflection principle provides the most convincing explanation to the asymmetry. The current note complements this evidence, reporting robust significant correlations between the absolute, but not the signed, realized returns on S&P500 stocks and estimates of the stocks’ contemporaneous volatility. The correlations consistently show at the cross-section and across time in analysis of daily, monthly, quarterly, half-yearly and yearly returns.

The objective of the present study was to apply supervised Machine Learning to predict severe complications after equine orchiectomy. A dataset of 612 cases of orchiectomies in stallions was used for the development of a computational model, among which in 8.5% of cases severe complications (colic, continued stallion-like behaviour, evisceration, funiculitis, haemorrhage, and scrotal infection) were diagnosed post-orchiectomy. Three supervised Machine Learning tools were employed: Logistic Regression (12 different models evaluated), Random Forest (64 models), and Gradient Boosting (8 models). For the prediction of the development of severe complications post-orchiectomy, Logistic Regression was the tool that produced the best discrimination measures, where accuracy, precision and recall were 0.9134, 0.8391, and 0.9133, respectively. The results of the analysis for SHapley Additive exPlanations values for the impact of the independent variables in the prediction of the development of complications indicated that (a) the age of the horse and (b) the surgical technique employed were the two variables that mostly influenced the prediction outcome, findings that were unambiguous in the models developed by any Machine Learning tool. The findings of this study indicate that computational models could be used as adjunct tools to support clinical decisions in the peri-operative management of horses.

Reliable and reproducible sonographic measurements are essential for accurate liver assessment, both in daily clinical practice and in research. Reference values enable clinicians to differentiate between physiological and pathological findings and thus support diagnostic accuracy, follow-up, and therapeutic decision-making. This comprehensive review synthesizes current evidence on normal liver size as assessed by ultrasound, with a particular focus on measurement techniques, standard values, anatomical variants, and the clinical contexts in which these parameters are relevant. Special attention is given to the influence of patient-related factors such as body constitution, sex, age, and ethnicity. The role of right, left, and caudate lobe measurements is discussed in detail, outlining their relevance in conditions such as hepatomegaly, vascular disorders, or post-resection follow-up. Limitations of currently available data are acknowledged, especially regarding interobserver variability and lack of global uniformity. Future priorities include the establishment of consensus-based international reference standards and the integration of emerging technologies, such as artificial intelligence and advanced image analysis tools, to enhance reproducibility, reduce variability, and improve clinical utility. Ultimately, standardized liver measurements should form an integral part of multiparametric ultrasound examinations to optimize patient care.

The aim of this report is to present, to our knowledge, the first case of Aeromonas (A.) caviae liver abscess. The following manuscript describes a case of a 75-year-old female patient with past medical history of pancreatic cancer, lung cancer, hypothyroidism, hypertension and chronic venous insufficiency who was diagnosed with A. caviae bacteremia and multiple liver abscesses in the right lobe. The patient was treated conservatively, with intravenous antibiotics for two months with adequate recovery. Aeromonas spp. is a Gram-negative, facultative anaerobic microorganism that lives in aquatic environments. There are many subtypes of Aeromonas spp., with the commonest being A. hydrophila, A. sobria and A. caviae. They tend to cause gastrointestinal and hepatobiliary disease in immunocompromised people, mostly those with underlined disease or malignancy of the hepatobiliary tract. Aeromonas spp. has been identified in chlorinated tap water, worldwide. Global warming contributes not only to the reproduction of more bacteria, but also to the development of antibiotic resistance genes and biofilms. Besides the fact that liver abscess due to Aeromonas caviae is rare; the following report highlights a major, public health concern, that is Global warming, and the devastating impact it can have on healthcare.

Macular phototoxicity is a rare form of retinal injury caused by intense light exposure, most commonly from direct sun-gazing or viewing a solar eclipse without adequate eye protection. We report a case of bilateral macular phototoxicity in a 35-year-old female photographer with no significant past medical history, who developed acute central vision loss after approximately one hour of inadvertent sun exposure. She presented 48 hours after the incident with markedly reduced central vision (only light perception centrally) in both eyes, while peripheral vision remained intact. Dilated fundus examination revealed bilateral circumscribed focal foveal hypopigmentation in the absence of other retinal or optic nerve findings. Optical coherence tomography (OCT) scans confirmed foveal phototoxic damage, showing a normal overall contour but with juxtafoveal microcystic changes and hyperreflective lesions at the fovea in both eyes, consistent with acute macular phototoxicity. Conservative management with lubricating eye drops and oral nutritional supplements was implemented. Over the ensuing weeks, her visual acuity improved from an initial profound central scotoma to 20/40 in both eyes at 10 days, and 20/40 (left eye) and 20/30 (right eye) by one month post-exposure. Follow-up OCT demonstrated resolution of macular swelling and reconstitution of retinal layers. By five months, her visual acuity had fully recovered to baseline (20/20); however, a small persistent central scotoma remained in the left eye. This case illustrates the clinical course of macular phototoxicity and highlights the importance of patient education on ocular sun safety. Early recognition is important, as most cases show significant spontaneous recovery, but preventative measures are paramount since treatment options are limited.

Abstract Background and Aims Systemic lupus erythematosus (SLE), as a multifaceted autoimmune disease, is characterized by significant alterations in adaptive immunity. T follicular helper (TFH) cells are specialized to select high-affinity B cells in germinal centers. As their role in peripheral circulation is still unknown, we aimed to investigate the interaction between peripheral B and TFH cells in patients with SLE Method In this cross-sectional study, flow cytometry was performed estimate B lymphocytes and their subpopulations, IgD+CD27−, IgD+CD27+, IgD−CD27+, IgD−CD27−, in 63 patients with SLE and 48 healthy controls (HC), and results were correlated with peripheral TF cells, and their subtypes, TFH1, TFH2, TFH17, TF regulatory (TFR) and TF cells expressing ICOS (TFICOS). SLE patients were classified as active and non-active disease based on systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K). Results Patients with SLE (Male/Female 5/58, Age = 39 ± 13.5 yrs, 50/63 with lupus nephritis) compared to healthy Controls (HC), had significantly increased levels of neutrophils, 4728 (3200) vs. 3400 (1100)/μL, P < 0.001 and neutrophil/lymphocyte ratio 3.08 (3.7) vs. 1.9 (1.2), P < 0.001, reduced Lymphocytes 1537 (871) vs. 2000 (1000)/μL, P < 0.001, CD19 78.5 (144) vs. 186 (100) P < 0.001 and their subtypes IgD+CD27−, IgD+CD27+, IgD−CD27+, IgD−CD27− [39 (101) vs. 107 (76) P = <0.001, 4.3 (9.1) vs. 17 (27) <0.001, 15.7 (18) vs. 26 (44) <0.001, 10.7 (20) vs. 19 (23) 0.003 respectively). TFH1 and TFICOS proportion predominated in SLE patients (P = 0.005, P = 0.02) as well as the ratio of TFH1/TFH2 (P = 0.008). There were no significant differences in B lymphocytes between patients with active (n = 32) and non-active (n = 31) disease, although a substantial redistribution of B cell subpopulations included increase in IgD−-CD27− cells. In non-active SLE patients (SLEDAI-2K ≤4) strong correlations were evident between TF with CD19, IgD+CD27−, IgD+CD27+, IgD−CD27+ and IgD−CD27− (r = 0.6, P = 0.04; r = 0.6, P = 0.04; r = 0.6, P = 0.02; r = 0.7, P = 0.003, respectively). Moreover, IgD−CD27+ cells also correlated with TFH1, TFH2, TFH17 (r = 0.7, P = 0.01; r = 0.7, P = 0.01; r = 0.6, P = 0.02, respectively). No such correlations were evident in the active SLE group (SLEDAI-2K >4). Conclusion Immune alterations still exist in non-active SLE, including redistribution of B lymphocyte subtypes and their significant cross talk with peripheral TF cells, which may act as a memory reservoir to sustain B lymphocytes activation.

Introduction and objective:The background of tinnitus is complex, involving various symptoms and triggering factors observed in clinical practice. This investigation aims to analyze how these associated symptoms and triggering factors impact tinnitus severity. Method: 165 patients with primary subjective tinnitus participated. Each participant underwent comprehensive tinnitus management, which included assessing associated symptoms and identifying triggering factors. Additionally, all patients completed the Tinnitus Handicap Inventory. Results:Analyzing demographic features, there is a noted predominance of males up to 40 years of age, after which females are more prevalent. Bilateral symptoms (54.5%) and left-sided symptoms (27.8%) were the most common. A significant portion of the population (72.1%) reported experiencing constant tinnitus. Vertigo (60%) and hearing loss (45.5%) were the most frequently reported associated symptoms. Headaches (41%) and a sensation of ear fullness (35%) occurred with slightly lower frequency. Upper airway infection symptoms were observed in 21% of cases, while symptoms like tingling sensation and facial palsy were reported at low rates of 8.4% and 2.4%. A silent environment was identified as a triggering factor for tinnitus in nearly all cases (90.3%), followed by stress (66.7%). Difficulty in falling asleep was relatively uncommon, occurring in only 27.3% of the population. Issues related to the cervical spine joints and the temporomandibular joint were reported in 24% and 17% of cases, respectively. The effects of weather fronts (6%) and noise triggering (3%) were less frequently noted. Multinomial logistic regression analysis revealed that higher age (over 50 years) (p = 0.019*; OR: 0.259, 95% CI = 0.084–0.800) and issues related to the cervical spine (p = 0.013*; OR: 4.860, 95% CI = 1.405–16.812) significantly predicted more severe tinnitus. Conclusion:The most common associated symptoms and triggering factors include vertigo, hearing loss, and headache, along with a silent environment and stress. Cervical spine issues and higher age significantly predict more severe tinnitus. Orv Hetil. 2025; 166(31): 1203–1208.