Hungarian Radiology

[Advisory Meeting of the European radiographers]

VANDULEK Csaba

JUNE 20, 2006

Hungarian Radiology - 2006;80(03-04)

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Hungarian Radiology

[Markusovszky memorial session]

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[CALENDAR OF RADIOLOGICAL EVENTS]

Hungarian Radiology

[Quality insurance in radiology]

FEHÉR Lászlóné

Hungarian Radiology

[REVIEW OF THE LITERATURE]

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Hungarian Radiology

[The history of the National Institute of Radiology and Radiation Physics]

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Related contents

Clinical Neuroscience

The prevalence of sarcopenia and dynapenia according to stage among Alzheimer-type dementia patients

YAZAR Tamer, YAZAR Olgun Hülya

Aim - In this study, the aim was to identify the prevalence of sarcopenia and dynapenia according to disease stage among Alzheimer-type dementia (AD) patients and collect data to suggest precautions related to reducing the disease load. Method - The study was completed with 127 patients separated into stages according to Clinical Dementia Rating Scale (CDR) criteria and 279 healthy volunteers aged 18-39 years and 70-80 years abiding by the exclusion criteria who agreed to participate in the research. Our prospective and cross-sectional study applied the CDR and mini mental test (MMSE) to patients with disorder in more than one cognitive area and possible AD diagnosis according to NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association) diagnostic criteria. The patient and control groups had skeletal muscle mass index (SMMI), muscle strength and physical performance assessed with sarcopenia diagnosis according to European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria. Results - In our study, in parallel with the increase in disease stage of AD patients, the prevalence of sarcopenia (led by severe sarcopenia) and dynapenia was higher compared to a control group of similar age. Conclusion - In chronic, progressive diseases, like AD, identification of changes in parameters, like muscle mass and strength and reductions in physical performance in the early period, is important for identification and to take precautions in the initial stages considering the limitations of the preventive effects of treatment applied after diagnosis of AD.

Hypertension and nephrology

[Risk categories, goals and treatment of hypercholesterolemia in Europe and in the recommendations of the AHA/ACC]

PADOS Gyula, KARÁDI István, AUDIKOVSZKY Mária, REIBER István, PARAGH György

[Hypercholesterolemia is one of the most important major risk factors that can be most influenced. Its treatment is based on guidelines. In 2013 in Hungary the common guideline of 17 societies (MKKK) as well as the recommendations of EAS/ESC and those of IAS are at disposal. These recommendations have established similar risk categories and strict LDL-cholesterol goals (<1.8 mmol/l). On 12 November, 2013, in the USA after a long drawn debate the AHA/ACC - without any lipid association - issued a new cholesterol (Ch) guideline, which drasticly differs from the existing national and European recommendations. According to AHA/ACC each patient with cardiovascular disease or diabetes should be treated with statin, irrespective of the Ch value, All patients with a LDL-Ch level over 4.9 mmol/l should also be treated with statin. In primary prevention those with values between 1.8-4.9 (LDL-Ch), or 3.5-8.0 mmol/l (Ch) would also be given statin, if their risk is more than 7.5%, with the new calculator system (“Statin Benefit Groups”). These recommendations would eliminate the classic risk categories (very-high, high, moderate risk), would abolish the system of treatment goals, as well as the regular Ch test. The non-statin therapy is not supported even in combinations. A big part of the population with low Ch level would also receive statin based on the results with the calculator, meaning that in the USA the number of those treated might double. Not only the European (e.g. EAS/,ESC) but even American societies (National Lipid Association 2013-2014) (e.g. NLA) oppose to the new guideline of AHA/ACC.]

Lege Artis Medicinae

[Diseases of the kidneys due to non-cancer mortality characteristics of Hungary between 2005-2014]

PAKSY András, KISS István

[The authors review the time of 10 years between 2005-2014 concerning the development of the mortality rate of kidney diseases in Hungary. They’ve compared the Hungarian mortality data with the ones from three other countries, namely Austria, the Czech Republic and Germany. The analyses included kidney diseases originated from hypertension, glomerulonephritis and tubulointerstitial kidney diseases, kidney failure and polycystic kidney diseases. They weren’t concerned about kidney tumors or diabetes originated kidney diseases because of the lack of data concerning the latter. The mortality data were retrieved from the KSH Demography Yearbook and the European Detailed Mortality Data-base (DMDB). The statistically examined causes of death only add up to 1.2% of the total causes of death, but with the aging of the population this proportion will surely grow. During the last 10 years, the mortality of cardiovascular diseases decreased significantly, namely the mortality of ischaemic heart disease and stroke, but the mortality of hypertension increased. These processes can also be seen in Austria, the Czech Republic and Germany. The mortality connected to primal kidney diseases decisively concerns people aged over 70. The glomerular diseases’ standardized rate is significantly higher in Hungary than in the compared countries. The tubulointerstitial kidney diseases’ mortality rate decreased over the last 10 years and we are in the middle of the international field in this regard. During the evaluation of the mortality of kidney diseases it is important to consider that in the statistics every death can only have one cause nominated, which can be (correctly) the basic disease causing the kidney disease or in other cases the kidney disease itself. This problem makes it more difficult to compare data internationally. Only 20-30 patients die of acute kidney disease on a yearly basis which is a low mortality rate even by international standards but the above-mentioned problem still exists. Of all of them the chronic kidney disease is the most significant one and between 2005-2014 the number of deaths and their rate connected to it decreased, but with the aging of the population the morbidity of kidney diseases will surely increase. Analyzing the data of all the primer kidney diseases it can be determined that between 2005-2014 the mortality rate showed a decreasing tendency, so our international situation can be viewed positively. It is important to note though that the mortality of this disease type includes patients of lower average age in Hungary than in the more developed countries. The mortality rate of polycystic kidney disease hasn’t changed significantly during the past 10 years. Although some patients live to many years, the average age of the dead is significantly lower compared to the ones of other kidney disease types. The cases below the age of 1 year of the latter add up to 10%. The comparison between the countries concerning the po­lycystic kidney disease shows that the standardized mortality rate is higher in Hun­gary.]

Hypertension and nephrology

[Public Statement of the Hungarian Society of Hypertension – Treatment of Hypertension: the 2018 European Recommendation should be Followed Still]

MAGYAR Hypertonia Társaság

Clinical Neuroscience

[Our clinical experience with zonisamide in resistant generalized epilepsy syndromes]

KELEMEN Anna, RÁSONYI György, NEUWIRTH Magdolna, BARCS Gábor, SZŰCS Anna, JAKUS Rita, FABÓ Dániel, JUHOS Vera, PÁLFY Beatrix, HALÁSZ Péter

[Purpose - Zonisamide is licensed in the European Union for adjunctive therapy for partial epilepsy, but its efficacy in generalized epilepsy was less explored. Methods - This prospective observational study included 47 patients (mean age 29 years, range 3-50) with different resistant generalized epilepsy syndromes: idiopathic generalized syndromes (IGE) 15 patients, (juvenile myoclonic epilepsy four, absence epilepsy four, myoclonic absence two, unclassified IGE five), progressive myoclonic epilepsy type 1 (PME1) four, severe myoclonic epilepsy of infancy (SMEI) three, borderline SMEI three, Lennox-Gastaut syndrome/secondary generalized epileptic encephalopties 23 patients. All patients were followed up for at least six months. The mean dose given was 367 mg/day (range 100-600 mg/day), the patients received at least one and no more than two concomitant AE. Response was defined as more than 50% seizure reduction or seizure freedom. Results - The best effect was achieved in PME one, all the patients were responders. Myoclonic seizures were reduced 80%, none of the patients had generalized tonic clonic (GTC) seizures. In two of the four patients all other antiepileptics were tapered of (including piracetam), so they were GTC seizure and almost myoclonia free on zonisamide only. Responder rates were in GEFS ± SME 62.5%, in resistant IGE 62.5%, and in epileptic encephalopathies 33.3% patients. Tolerance after initial efficacy developed in six patients. Adverse effects were mild: weight loss, somnolence and confusion were repeatedly reported. Three patients reported cognitive improvement. Conclusion - Clinical benefit of a broad spectrum antiepileptic zonisamide extends across seizure types, ages and epilepsy syndromes. The efficacy in PME proved to be excellent.]