Hungarian Radiology

[XV. French-Hungarian Symposium of Radiology]

KOCSIS Beáta

JUNE 20, 2007

Hungarian Radiology - 2007;81(03-04)

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Hungarian Radiology

[The quality control of radiological equipments in Hungary]

PELLET Sándor, PORUBSZKY Tamás, BALLAY László, GICZI Ferenc, MOTOC Anna Mária, VÁRADI Csaba, TURÁK Olivér, GÁSPÁRDY Géza

Hungarian Radiology

[Imaging of mesenterial panniculitis - Case report]

KOVÁCS Anita, KISS Ildikó, PALKÓ András

[INTRODUCTION - Mesenterial panniculitis is a rare benign disorder, however it is important to be familiar with, because of the difficulties in differential diagnosis. Authors describe the characteristic imaging signs of the disease based on their two cases. CASE REPORTS - Two male patients (72 and 62 years old) presented with uncertain abdominal pain and weight loss. Acute pancreatitis, chronic gastritis and duodenitis are noted in their case history. The laboratory parameters were normal and the physical examination revealed a palpable epigastrial terime in both patients. Abdominal ultrasound and CT examinations depicted different degree of mesenterial infiltration with lymph node enlargement. Histological analysis of the biopsy sample proved the process to be benign in the first patient. The mass was surgically removed in the second one and histology proved mesenterial panniculitis. CONCLUSION - Mesenterial panniculitis is a benign, chronic non-specific inflammatory disorder. Its appearance may simulate malignant diseases, thus making differential diagnosis is important. Abdominal ultrasound, CT and result of image guided biopsy play an important role in the diagnosis, in case of which conservative therapy and regular follow-up is sufficient.]

Hungarian Radiology

[Goals and plans of the Hungarian College of Radiologists in 2006-2007]

PALKÓ András

Hungarian Radiology

[REVIEW OF THE LITERATURE]

GYENES György, WENINGER Csaba

Hungarian Radiology

[Radiological diagnostics in head and neck malignancies - Onco Update, 2006]

GŐDÉNY Mária, BODOKY György

[Imaging plays a crucial role in defining disease burden and thus therapy planning in head and neck cancer (HNC). Lately accuracy of pretreatment staging has become critical since non-surgical therapy has become a widely accepted treatment possibility. The referring clinician is responsible for accurate data collection, pretreatment staging, evaluation of therapy response and post-treatment evaluation of the HNC. Correctness of these highly depends on the expertise and experience of the evaluating radiologist therefore being familiar with the latest literature is essential. This article is a review of papers published in 2005 and 2006 focusing on the clinical significance of the latest imaging results in head and neck cancer diagnostics.]

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Clinical Neuroscience

[Advanced Parkinson’s disease characteristics in clinical practice: Results from the OBSERVE-PD study and sub-analysis of the Hungarian data]

TAKÁTS Annamária, ASCHERMANN Zsuzsanna, VÉCSEI László, KLIVÉNYI Péter, DÉZSI Lívia, ZÁDORI Dénes, VALIKOVICS Attila, VARANNAI Lajos, ONUK Koray, KINCZEL Beatrix, KOVÁCS Norbert

[The majority of patients with advanced Parkinson’s disease are treated at specialized movement disorder centers. Currently, there is no clear consensus on how to define the stages of Parkinson’s disease; the proportion of Parkinson’s patients with advanced Parkinson’s disease, the referral process, and the clinical features used to characterize advanced Parkinson’s disease are not well delineated. The primary objective of this observational study was to evaluate the proportion of Parkinson’s patients identified as advanced patients according to physician’s judgment in all participating movement disorder centers across the study. Here we evaluate the Hungarian subset of the participating patients. The study was conducted in a cross-sectional, non-interventional, multi-country, multi-center format in 18 countries. Data were collected during a single patient visit. Current Parkinson’s disease status was assessed with Unified Parkinson’s Disease Rating Scale (UPDRS) parts II, III, IV, and V (modified Hoehn and Yahr staging). Non-motor symptoms were assessed using the PD Non-motor Symptoms Scale (NMSS); quality of life was assessed with the PD 8-item Quality-of-Life Questionnaire (PDQ-8). Parkinson’s disease was classified as advanced versus non-advanced based on physician assessment and on questions developed by the Delphi method. Overall, 2627 patients with Parkinson’s disease from 126 sites were documented. In Hungary, 100 patients with Parkinson’s disease were documented in four movement disorder centers, and, according to the physician assessment, 50% of these patients had advanced Parkinson’s disease. Their mean scores showed significantly higher impairment in those with, versus without advanced Parkinson’s disease: UPDRS II (14.1 vs. 9.2), UPDRS IV Q32 (1.1 vs. 0.0) and Q39 (1.1 vs. 0.5), UPDRS V (2.8 vs. 2.0) and PDQ-8 (29.1 vs. 18.9). Physicians in Hungarian movement disorder centers assessed that half of the Parkinson’s patients had advanced disease, with worse motor and non-motor symptom severity and worse QoL than those without advanced Parkinson’s disease. Despite being classified as eligible for invasive/device-aided treatment, that treatment had not been initiated in 25% of these patients.]

Clinical Oncology

[Complications of infusion treatment with emphasis on extravasation of cytostatics]

HARISI Revekka

[The extravasation of cytostatics is the most signifi cant complication of infusion therapy in cancer treatment. Extravasation refers to the inadvertent infi ltration of cytostatic drugs into subcutaneous or subdermal tissues surrounding the intravenous or intraarterial administration site. According to literature data incidence estimates between 0,01-7%. Extravasated drugs are classifi ed according to their potential for causing damage as vesicant, irritant and nonvesicant. Knowledge of risk factors, the patientrelated and treatment-related ones is important to minimize the occurrence of extravasation. In order to reduce the risk of extravasation, the staff involved in the tumor infusion therapy must be specially trained to implement several preventive and therapeutical protocols. In 2012, ESMO-EONS has put together a new comprehensive treatment protocol on the topic of cytostatics extravasation. Protocol recommended that every oncological department, who administers chemotherapy have to have extravasation trained team and a standby extravasation kit. According to the new ESMO-EONS guideline subcutaneous corticoids are not recommended, anymore. In case of mechloretamine extravasation the recommendation is immediate subcutaneous injection of sodium thiosulfate. After extravasation of anthracyclines, mitomycin C and platin salts the best treatment opportunity is subcutan dimethyl sulfoxide administration. In case of anthracyclines’ extravasation intravenous dexrazoxane treatment is also effective. Hyaluronidase, injected into or under the skin, facilitates absorption of extravasated drugs because of increases connective tissue permeability, promotes the spreading and reduces the local concentration of the extravasated citostatic agents. Hyaluronidase might be effi cacious in preventing skin necrosis by extravasation due to vinca alkaloids. The treatment of unresolved tissue necrosis or pain lasting more than 10 days is surgical debridement. Because of the medical and juristic importance of the extravasation event, it is necessary to establish uniform guidelines for treatment of extravasation, in all Hungarian Oncological Centers.]

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. ]

Ca&Bone

[Relationship of cardiovascular risk factors and bone status in a large adult population of the Balaton Region]

BUDAY BARBARA, IZSÓNÉ KATZ MELITTA, NAGY ELVIRA, PAPP ZSUZSA, KORÁNYI LÁSZLÓ

[BACKROUND - Numerous international studies have investigated the relationship between bone metabolism and type 2 diabetes mellitus. The results are controversial, there are those proving an increasing effect of diabetes on bone density but we know data that prove the opposite results. Our aim was to investigate the relationship between bone density, obesity and carbohydrate metabolism on a large Hungarian population. PATIENTS AND METHODS - The data from a large population screening (n=6287, mean age 56±13 years, men: n=1561, women: n=4726), carried out in the Balaton Region, Hungary, were analyzed (anthropometry, blood glucose and total cholesterol, blood pressure, calcaneus ultrasound T-score). RESULTS - Analyzing the relationship between type 2 diabetes and osteoporosis/osteopenia, we found, that the prevalence of osteopenia is significantly higher in diabetic women between 50-60 years of age than that of normal glucose tolerance, (50 vs. 36.34%, OR: 1.711, 95% CI: 1.076-2.722, p<0.022), however in different age groups and in males there were no significant differences, similar to the metabolic syndrome which did not influence the prevalence of osteoporosis/osteopenia. In normal weight (male and female) diabetic population over 60 years of age, the frequency of osteoporosis/ ostepenia was much higher, than in the normal weight normal glucose tolerance group, which difference was borderline-significant in the case of osteoporosis (63.63 vs. 26.2%, OR: 2.71, 95% CI: 0.969-7.6, p=0.054), and did not reach it with osteopenia (53.38 vs. 43.31%, p=0.359). In the same age group, within the “all glucose intolerant” and “all normal glucose tolerance” groups the prevalence of osteoporosis/osteopenia did not differ. We found significant correlation between BMI and T score only in women and it was strongest in age group of over 70 years (r=+0.23, p<0.001). CONCLUSION - Our data suggest that the increased bone density often measured in type 2 diabetic patients is actually the consequence of the accompanying obesity, and not of diabetes itself, which is rather a risk factor for bone loss.]

Hungarian Radiology

[Sessions, 2007 year performance and 2008 year plans of the Hungarian College of Radiologists]

PALKÓ András