Scrotal cooling and its benefits to male fertility: a systematic review.

The aim of this study was to systematically review the evidence for the impact of scrotal cooling on spermatogenesis. EMBASE (1980-2010) and MEDLINE (1950-Sept. 2010) databases were searched using the terms 'male infertility or subfertility or fertility', combined with a separate search of 'scrotal cooling', without any limits or restrictions. A total of eight articles met the criteria for inclusion in the study. There was insufficient evidence to draw any firm conclusions about the impact of scrotal cooling on male fertility. A positive trend of improved male fertility was however observed. There is therefore a need for well designed randomised controlled trials.

Guidelines adherence for patients with community acquired pneumonia in a Greek hospital.

BACKGROUND AND OBJECTIVES: Community acquired pneumonia (CAP) remains an important cause of morbidity and mortality, with significant economical and social cost. Adherence to the international guidelines for the empiric treatment of CAP can improve patients' prognosis, reduces the need and shortens the length for hospitalization. However, adherence to guidelines varies among physicians. MATERIAL AND METHODS: We performed a prospective observational study in 252 immunocompetent hospitalized patients so as to investigate whether the 2003 Infectious Diseases Society of America update of practice guidelines and the Greek national guidelines for CAP are followed by chest physicians working in "Sotiria" General Hospital in Athens, Greece. RESULTS: Total mortality rate was 12.3%. One hundred twenty (48%) patients were admitted to the Hospital, despite the fact that they were classified as risk class I or II according to the Fine criteria. Accordance to CAP guidelines, as far as the initial antibiotic regimen is concerned, was found to be poor (152 patients, 60%). A trend towards a shorter length of hospitalization was observed in patients treated with an initial antibiotic regimen in accordance to guidelines compared to those receiving an initial antibiotic regimen in discordance to guidelines. DISCUSSION: The implementation of CAP guidelines by chest physicians working in a Greek Hospital for Thoracic Diseases is poor. Improvement of adherence to guidelines may shorten the length of hospitalization and reduce the financial burden for the National Health System.

Sudden sensorineural hearing loss after varicose vein surgery under general anesthesia. Case report.

Sudden sensorineural hearing loss following non-otologic surgery, under general anesthesia, is an extremely rare complication. Furthermore, postoperative deafness has more commonly been associated with cardiac surgery. This acute dysfunction of the inner ear consists a controversial subject in terms of etiopathogenic mechanisms and treatment modalities. We present the case of a 60-year-old male patient who underwent varicose vein surgery under general anesthesia and presented immediately after the operation bilateral and profound impairment of his hearing acuity. A high index of suspicion is required to early diagnosis of this complication, although prompt treatment does not guarantee a good outcome.