Hungarian Immunology

[CONFERENCE CALENDAR]

DECEMBER 20, 2002

Hungarian Immunology - 2002;1(04)

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Further articles in this publication

Hungarian Immunology

[The new Department of Immunology and Rheumatology in Pécs]

CZIRJÁK László

Hungarian Immunology

[3rd International Congress of Autoimmunity - the congress report]

SZEKANECZ Zoltán

Hungarian Immunology

[History of immunology in Hungary Part II]

KARASSZON Dénes, CSABA Béla

Hungarian Immunology

[IN MEMORIAM]

CZIRJÁK László

Hungarian Immunology

[Molecular and cellular basis of fibrosis: recent insights to the pathomechanism of scleroderma from animal models and fibroblast studies]

LAKOS Gabriella, SHINSUKE Takagawa, JOHN Varga

[Scleroderma is a chronic, progressive connective tissue disorder featuring inflammation, fibrosis, vascular injury, and immunologic abnormalities. Fibrosis, a hallmark of the disease, is characterized by excessive synthesis and deposition of extracellular matrix components, mainly type I collagen in affected tissue. The key target organs are the skin, lungs, kidneys, gastrointestinal tract and heart. The pathogenesis of fibrosis remains poorly understood, and effective treatments are lacking. While unifying concept to explain the pathogenesis of fibrosis has not yet emerged, multiple alterations result in the development of pathological tissue fibrosis have been recently identified. Transforming growth factor-β, a potent profibrotic cytokine plays a key role in the process. There is growing knowledge on identifying the cytokine and growth factor mediators of fibrosis, characterizing their interactions, and in delineating the cellular and molecular signaling pathways that are activated by these mediators. This review summarizes recent results obtained from fibroblast studies, animal models, and gene expression experiments. A major goal of investigations into the pathomechanism of fibrosis is identifying new therapeutic targets for scleroderma.]

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Hypertension and nephrology

[Monitoring of effectiveness of ramipril-amlodipine fixed combination, a non-interventional trial (Ramona study). Subgroup analysis of patients with chronic kidney disease]

SIMONYI Gábor

[Hypertension and chronic kidney disease are independent cardiovascular risk factors. The 5th Cardiovascular Consensus Conference has recommended chronic kidney disease in high-risk category. In chronic kidney disease hypertension is observed in most cases. In patients with chronic kidney disease blood pressure targets are as 140/90 mmHg blood pressure below must be achieved without overt proteinuria. In chronic kidney disease combined antihypertensive therapy treatment should be initiated according the Hungarian Society of Hypertension recommendations. Aims: Monitoring the effectiveness and safety of the fix combination of ramipril/amlodipine Egiramlon® therapy in chronic kidney disease suffering from mild or moderate hypertension despite antihypertensive treatment. Patients and methods: Open, prospective, phase IV clinical observational study, which involved known chronic kidney disease (age over 18 years) with mild or moderate hypertension. Ramipril/amlodipine fixed combination (5/5, 5/10, 10/5 or, 10/10 mg) were administered or titrated in three visits, during the 4 months of trial period. The doses of the fixed combination drugs were determined individually during the visits by the 923 physicians involved in the study. The target blood pressure value was <140/90 mmHg according the new guidelines of ESH/ESC. Results: 70.1% of total patient (9169) was fulfilled the protocol during the four month of trial (6423 patients). In this population 194 patients suffered from chronic kidney disease. The age of patients was 68.52±1.84 (mean±SD) years, 85 (43.8) women and 109 (56.2%) men. 74.74% of total patients with chronic kidney disease has reached target blood pressure at the end of 4th month (primary endpoint). The blood pressure has decreased significantly (all p<0.0001) from 158.04/90.46±9.97/8.30 mmHg (1. visit) to 138.77/82.12±10.68/7.21 mmHg 2. visit and to 130.40/78.59±7.56/5.75 at the and of trial (3. visit), it means -27.64/- 11.87 mmHg decrease from the beginning of the 4th Month (3. visit). eGFR level increased significantly from 46.3±16.49 ml/min/1,73m2 to 49.0±19.58 ml/min/1,73m2. Patients suffered from chronic kidney disease have tolerated well the various doses of fixed combination of ramipril/amlodipine, and adverse events have no occurred correlation of treatment.]

Hypertension and nephrology

[Risk estimates of advanced chronic kidney disease and predicting mortality in dialyzed patients]

KULCSÁR Imre, KULCSÁR Dalma

[In mostly the second part of the last decade lots of epidemiological study have been released about the progression of the chronic kidney disease (CKD) and theirs connection with the risk of death. The fact that lots of nephrologist from all over the world (from Canada to New-Zealand) are pretty much interested in this topic is absolutely proved by national (REIN Study – French Registry) and international (KDIGO Controversies Conference, DOPPS 1-5, or the European AROII Study) researchers with these epidemiological questions in their focus. The risk estimation facts that are able to show the life expectancy of patients with CKD 3-5 (expected time to dialysis or mortality risk before renal replacement therapy – RRT) and the early or hopefully longer survival odds of the dialyzed ones could be very useful not only for the medical stuff but also for the patients. In case of the predialyzed patients the focus has to be on the Bansal score and also on the Kidney Failure Risk Equation (KFRE) scores (with 4 and 8 variable); on the other hand in dialyzed patients the REIN score that prognose a short-term survival and the Cohen model (both are easy calculated with webcalculators) are in the highlight of importance. There is not a big difference (2- 7%) in validated researches between the prognosed and the real survival dates. Despite of this prediction has to always be evaluated individually in favour of the best decision we can make for the patients and in order to choose the right treatment: conservative therapy, dialysis or transplantation.]

Hypertension and nephrology

[Lipid-lowering treatment in chronic kidney disease in light of new studies and recommendations]

MÁTYUS János

[Summary – Chronic kidney disease (CKD), which affects 10-14% of the population, dramatically increases the incidence and severity of cardiovascular (CV) disease, leading to death in the majority of patients before kidney replacement therapy. The current CV risk scorecards in CKD significantly underestimate the real risk and are therefore not applicable. For CV risk assessment it is recommended to use the combined GFR/proteinuria table also, which is used for CKD classification, was also adopted by the Hungarian CV Consensus Conference last year. The benefit of cholesterol- lowering treatment has also been demonstrated in CKD, and a 1 mmol/l reduction in LDL-c, as in the general population, reduces the incidence of major CV events by 20%. Recent clinical trials have clearly indicated that the lower the LDL-c values achieved, the lower the risk of future CV events, and therefore the new recommendations have tightened the LDL-c values to be achieved. ]

Lege Artis Medicinae

[The First Mindfulness Conference in Hungary ]

BRYS Zoltán, KIS János Tibor, SIMONCSICS Eszter

[Those familiar with psychology are no strangers to the here-and-now attention exercises Wilhelm Reich asked his clients to allow the present moment to be observed. The here-and-now focus later become the focus of neo- and postreichian movements and a number of other psychotherapeutic movements too. Among the analysts Jung, Horney and Fromm showed a interest in the present-focused Zen Buddhist practices...]

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[Conference report: XXI. Annual Meeting of the Hungarian Psychiatric Association]

BRYS Zoltán, KAPÓCS Gábor

[The Hungarian Psychiatric Society's 2016 Annual Meeting was held in Siófok, Hungary, under the title The Changing Face of Psychosis. The diverse programme of the three-day conference was so rich that we often wished to be present in two or more interesting sessions at the same time.]