SZÁNTÓ Dezső, SZŰCS Gabriella, DITRÓI Edit
JUNE 20, 2007
Hungarian Radiology - 2007;81(03-04)
[INTRODUCTION - Prospective randomized examination has been verified association between asymptomatic chronic Helicobacter pylori infection and systemic vascular inflammation and endothelial dysfunction in certain cases. CASE REPORT - A case of a 71 year-old female patient is described with proven coexisting primary tuberculous bronchoadenitis, secondary tuberculous spondylodiscitis and Helicobacter pylori infection as a cause of uncertain abdominal disorder. The patient's height decreased by 9 cm during 6 months, since the onset of the symptoms. The diagnosis was based on respiratory function test, positive rapid ureal test, bronchoscopy, cytologic and microbiological examinations. On dorsolumbal spinal plain films showed wedge, biconcave crus and mass deformities of nine vertebras. High serum level of CRP and C3 complement was suggestive of acute reactive inflammation. Before the introduction of drug therapy an MR examination was planned, however the patient died of an acute myocardial infarct on the 8th day after admission The postmortem findings proved the presence of pulmonary and vertebral tuberculosis, there was no evindence of aortocoronal and spinal vasculitis. The epispinal tissues were not involved. CONCLUSION - The patient’s case history, autopsy findings and the literature data are suggestive of the role chronic Helicobacter pylori infection in the development of spondylodiscitis and the deterioration of the disease.]
Hungarian Radiology
[INTRODUCTION - The prognosis after opening the obstructed infarct-related coronary artery is influenced by several factors. In routine clinical practice revascularization is considered to be successful when the restoration of epicardial blood flow is complete. However, functional impairment in the myocardium can occur even with open epicardial arteries. There are two angiographic parameters closely related to myocardial viability: myocardial blush grade (MBG) that describes the quantity of contrast material in the myocardium, and TIMI myocardial perfusion grade (TMP) that describes its outflow dynamics. Our goal was to assess the prognostic value of these two parameters in the framework of a prospective clinical study. PATIENTS AND METHODS - We compared the two parameters based on visual estimation (MBG and TMP) with those characterizing myocardial impairment, such as ejection fraction (EF), wall motion score index (WMSI), creatine-kinase release and chest pain score in 22 patients with acute myocardial infarction and successful revascularization. Our results were obtained by Spearman's rank correlation and χ2-tests at a confidence interval of 95%. RESULTS - Close correlation with TMP was found in case of both parameters measured by echocardiography (EF: r=0.59, p=0.02; WMSI: r=-0.51, p=0.046). These results were supported by the correlation with creatinekinase release (r=-0.54, P=0.01). By the present number of patients, MBG does not show significant correlation with the measured clinical parameters. Presence of chest pain is associated neither with TMP nor with MBG. CONCLUSIONS - Assessing myocardial perfusion by visual evaluation provides useful prognostic information. The extent of chest pain does not indicate myocardial dysfunction. The clearence of the dye (used in TMP definition) is more characteristic to myocardial viability than maximal contrast density (used in MBG definition).]
Lege Artis Medicinae
[In 2001 4.095.134 chest screening examinations were carried out at 154 fixed and 50 mobile Xray screening stations in Hungary. Currently, screening for tuberculosis is mandatory by law, but a recently issued decree by the Health Minister states that the method is suitable for the screening of lung cancer as well. Unfortunately, the majority of the machines are old and since replacements are long overdue, the assessment with a high technical standard and quality is not always possible. These are the reasons why a plan must be outlined for the necessary improvement and for the renewal of the equipment pool, based on expert opinion. In the literature, there are ongoing spirited discussions on the efficacy of X-ray screening as well as on the possibilities of CT-scans for the identification of lung cancer. The size of the investment needed makes it necessary that costbenefit factors and the possibility of joining the National Health Prevention program should be considered.]
Clinical Neuroscience
Gabapentin is an antiepileptic drug approved for adjunctive therapy for partial seizures. We report a case of a patient who had thrombocytopenia with the dose of 2400 mg/day of gabapentin. The causal relationship between gabapentin and thrombocytopenia was revealed by dramatic increase in thrombocyte count following the cessation of the gabapentin treatment. To our knowledge, this is the first case report with a hematopoietic side effect of gabapentin.
Lege Artis Medicinae
[In the past decade, the epidemiological status of tuberculosis has significantly improved in Hungary. The incidence is today lower than 20 per 100 000 inhabitant, therefore, the laboratory network performing diagnosis needs to look for new challenges. As the yearly number of cases decreases, less examinations will be needed, but a greater emphasis should be placed on shortening the time needed for diagnosis, more efficient culturing, resistance tests and molecular typing performed for epidemiological purposes. Our aim is to provide an overview of the status of the diagnostic network of tuberculosis in Hungary and the future challenges it faces, on the basis of data published by the National Korányi Institute of TBC and Pulmonology and the European Centre for Disease Prevention and Control.]
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Clinical Neuroscience
Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease2.
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Lege Artis Medicinae
[We do not know that the phenotype of the coronavirus would have changed]5.
Lege Artis Medicinae
[Teleconsultations in general practice during coronavirus epidemiological emergency]
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