Hungarian Radiology

[Recommendations on the Internet Radiology on the Internet]

BÁGYI Péter

APRIL 20, 2003

Hungarian Radiology - 2003;77(02)

COMMENTS

0 comments

Further articles in this publication

Hungarian Radiology

[Decades in X-Ray Radiography György Luzsa MD]

LOMBAY Béla

Hungarian Radiology

[Treatment of ureter stenosis of the transplanted kidney using invasive radiological methods]

DOROS Attila, WESZELITS Viola, PUHL Mária, RUSZ András, JANSEN Judit

[INTRODUCTION - Stenosis, occlusion and necrosis of the ureter after kidney transplantation occur in 2-13%. The therapeutic choices are surgery or minimally invasive endourological and percutaneous procedures. We analysed our therapeutic plan and results using percutaneous dilatation and stenting. PATIENTS AND METHODS - The patients after kidney transplantation are regularly examined by ultrasound. In cases of suspected obstruction we perform scintigraphy and CT-urography, and if indicated, we place percutaneous nephrostomy. Between July of 2000 and September of 2002, 15 stenosis in 14 patients were dilated and stented percutaneously. RESULTS - We found one restenosis after 6 months due to compression. This patient underwent surgery, but after the operation another stenosis has developed. We treated it percutaneously. One nephrectomy had to be performed due to serious infection. In one patient stent migration occured and surgical intervention was performed. 12 patients have free urine passage and good kidney function as a result of percutaneous therapy. CONCLUSION - We have good results with percutaneous ureter dilatation and stenting, but our follow-up time (31 months) must be longer for the evaluation of long-term results. The percutaneous treatment can partly replace endourological and surgical methods or can be combined with each other.]

Hungarian Radiology

[Eight Decades of the Society of Hungarian Radiologists 1922-2002]

MÓZSA Szabolcs

Hungarian Radiology

[No Limits Optimism After ECR 2003]

LOMBAY Béla

Hungarian Radiology

[On the Privatization of University Radiology Clinics]

PALKÓ András

All articles in the issue

Related contents

Clinical Neuroscience

[Interdisciplinary approach of vestibular system impairment]

PONGRÁCZ Endre

[In the first part of this review the definition of vertigo/dizziness was discussed. The major difference between the two signs is the exsistence of the direction, which is specific for vertigo. Dizziness is a frequent complaint in the clinical practice. Its frequency is increasing with advance of age, to intimate the play of declining cognitive process in the pathogenesis of its. The popular health significance of vertigo is in the rowing number of the patients. The onset of the most cases with acute vertigo appears between secundums and minutes so the patients will be provided in circumstances of emergency department. First of all three form schould be take into account: neuronitis vestibularis, benign paroxysmal positional vertigo and Meniere syndrome. Without tipical periferal signs of vertigo, central cause should be searched, principally stroke (lysis possibility). The differential diagnose of the different dizzeness/vertigo forms according to the elapsed time of the onset or congenital and acquired nystagmus was created in tables. The recommendations of the therapy of acute and chronic dizziness/ vertigo syndroms are, lack of results of evidence based trials doubtful. The more often used drugs based on clinical trials are discussed as vinpocetine, betahistine and piracetam. The in vitro and in vivo data suggest that the last molecule is eligible to use both in periferal and central type of vertigo syndroms.]

Clinical Neuroscience

[Decisional collisions between evidence and experience based medicine in care of people with epilepsy]

RAJNA Péter

[Background – Based on the literature and his long-term clinical practice the author stresses the main collisions of evidence and experience based medicine in the care of people with epilepsy. Purpose – To see, what are the professional decisions of high responsibility in the epilepsy-care, in whose the relevant clinical research is still lacking or does not give a satisfactory basis. Methods – Following the structure of the Hungarian Guideline the author points the critical situations and decisions. He explains also the causes of the dilemmas: the lack or uncertainty of evidences or the difficulty of scientific investigation of the situation. Results – There are some priorities of experience based medicine in the following areas: definition of epilepsy, classification of seizures, etiology – including genetic background –, role of precipitating and provoking factors. These are able to influence the complex diagnosis. In the pharmacotherapy the choice of the first drug and the optimal algorithm as well as the tasks during the care are also depends on personal experiences sometimes contradictory to the official recommendations. Same can occur in the choice of the non-pharmacological treatments and rehabilitation. Discussion and conclusion – Personal professional experiences (and interests of patients) must be obligatory accessories of evidence based attitude, but for achieving the optimal results, in some situations they replace the official recommendations. Therefore it is very important that the problematic patients do meet experts having necessary experiences and also professional responsibility to help in these decisions. ]

Hungarian Radiology

[Pediatric Radiology]

LOMBAY Béla

Clinical Oncology

[Management of renal cancer]

MARÁZ Anikó, SZŰCS Miklós

[Targeted anti-cancer agents are used as standard therapies in case of advanced or metastatic clear cell renal carcinoma. Neovascularisation plays an important role in the progression of hypervascularized cancers. Vascular endothelial growth factor (VEGF) is the key molecule in this mechanism. Most of the registered agents inhibit the angiogenesis by blocking the VEGF signalling pathway. It can occur if an antibody binds to the VEGF, so the linkage to the receptor is blocked. This happens in case of bevacizumab. Another mechanism is the inhibition of the intracellular compound of VEGF receptor by tyrosine kinase inhibitors (TKI). Sorafenib, sunitinib, pazopanib and axitinib belong to this group. Other well-known mechanism of action is the inhibition of mammalian target of rapamycin (mTOR) receptor, like temsirolimus and everolimus. Based on randomised controlled trials sunitinib, pazopanib or IFNα-bevacizumab combination is recommended fi rst-line according to the international recommendations in case of good and moderate prognosis. For patients with poor prognosis temsirolimus is the standard therapy. In second-line, after ineffective cytokine therapy, sorafenib, pazopanib and axitinib are the supported options. If TKI is ineffective, everolimus or axitinib can be administered. In the latest recommendations sorafenib is another possible option (off label). After two TKIs, only everolimus is registered for third-line therapy. Life expectancy of patients can further be improved as the number of targeted drugs increases, more effective agents appear and as appropriate sequences and their benefi cial effects are recognised.]

Ca&Bone

[Recommendations for the diagnosis and treatment of childhood bone metabolic diseases]

HOSSZÚ ÉVA, PÉTER Ferenc, BALOGH Zsolt, BITTERA István, FÁBIÁN Katalin