RESUMEN
The healthcare system in Greece has undergone significant changes over the past 10 years. While there have been some positive developments, such as improvements in primary care and public health, there are still many challenges that need to be addressed. One of the major changes in the Greek healthcare system over the past decade has been the impact of the country's economic crisis. The government has had to implement a series of austerity measures, including significant cuts to healthcare funding. This has had a negative impact on the availability and quality of care, particularly for those on low incomes or living in rural areas.
RESUMEN
INTRODUCTION: Drug-induced diffuse alveolar hemorrhage (DAH) has been associated with the administration of various medications, among which levonorgestrel (LN) has not been reported until now. CASE PRESENTATION: This case study describes a 42-year-old woman who presented with hemoptysis, hypoxemia, and radiological depiction of ground glass opacities, 3 days after she had received emergency contraceptive medication containing levonorgestrel. Emergent bronchoscopy was performed, and BAL was diagnostic of diffuse alveolar hemorrhage (DAH). A thorough diagnostic approach was followed, in order to detect the underlying pathological condition that induced DAH. The absence of other identifiable pathological conditions in this patient raised suspicion of LN's potential causative role. CONCLUSION: DAH has not been reported as an adverse effect of LN until now. However, LN has been found to exert immunomodulatory effects and to present potential for manifestations of vasculitis as well as severe hypersensitivity reactions. These mechanisms may have been implicated in the development of DAH in our patient, who presented no other pathological conditions.
RESUMEN
High creatine kinase (CK) levels can be associated with many disorders, including neuromuscular, cardiac, metabolic, endocrine and traumatic. Idiopathic hyperCKemia is a diagnostic dilemma for physicians even though its long-term prognosis is usually benign. We report a case of a Caucasian 61-year-old woman who presented as completely asymptomatic to her general practitioner with a serum CK (sCK) level at 6,122 IU/l. A complete diagnostic evaluation, including physical and laboratory examinations, electromyogram and muscle biopsy were negative for any neuromuscular or other disorder. Two years later the patient remains asymptomatic, active and overall healthy but sCK levels remain elevated, ≤6,591 IU/l (>50-fold higher than normal values).
