Hypertension and nephrology

[Hypertonology License]

KISS István

SEPTEMBER 20, 2014

Hypertension and nephrology - 2014;18(03-04)

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Hypertension and nephrology

[Signaling pathways in renal fibrosis]

ROKONAY Réka, SZIKSZ Erna, LIPPAI Rita, PAP Domonkos, VERES-SZÉKELY Apor, REUSZ György, SZABÓ Attila, VANNAY Ádám

[Myofibroblasts are the main effector cells of tissue fibrosis in chronic kidney disease. These cells are the main source of collagen rich extracellular matrix in the fibrous tissue. Recent hypotheses suggest that pericytes are the major progenitors of myofibroblasts. Platelet derived growth factor, transforming growth factor β and Wingless/Int signaling pathways play important role in pericyte activation. There are experimental evidences that blocking this pathways inhibits tissue fibrosis, therefore they might be targets for the development of antifibrotic drugs in the future.]

Hypertension and nephrology

[Chronic Renal Disease and the Role of Uric Acid in Hypertension and Cardiovascular Diseases]

KÉKES Ede

Hypertension and nephrology

[Importance of Reynolds-score system on cardiovascular risk assessment]

MÓCZÁR Csaba

[The author summarizes knowledge about Reynolds risk assessment system based on data of references and own experiences. The first part of article is about how the results of study of pathogenesis of atherosclerosis were converted into new risk assessment systems. One result of this process is the Reynolds system wich is consisted of traditional riks factors, high sensitive C-reactive protein and the patients’ family medical history. He demonstrates essence of Reynolds system and process of it’s validity. The author deals with comparison of Reynolds system with other traditional risk assessment systems. The practical issues of application of Reynolds system are detailed in the conclusion of the article.]

Hypertension and nephrology

[The Spring Congress of the Hungarian Society of Hypertension Budapest, 17 May 2014]

KÉKES Ede

Hypertension and nephrology

[Serum uric acid in primary hypertension: cause or consequence? - Data from SEPHAR II Survey]

DOROBANTU Maria, TAUTU Oana-Florentina, BUZAS Roxana, LIGHEZAN Daniel

[Objectives: To evaluate a possible link between serum uric acid (SUA) levels, arterial stiffness and atherogenic index of plasma on one hand and renal function on the other and to test the role of SUA in the assessment of total cardiovascular risk. Materials and methods: We studied serum uric acid levels (SUA) in 1975 subjects included in SEPHAR II survey. We measured arterial stiffness parameters, calculated atherogenic index of plasma and estimated glomerular filtration rate (eGFR) by MDRD and CKD-EPI formulae and assessed total cardiovascular risk according to current ESH-ESC risk stratification chart. Results: The highest SUA values were recorded in subjects with grade III HT and were correlated with increased arterial stiffness and with increased atherogenic index of plasma. The lowest eGRF values, assessed by both MDRD and CKD-EPI, were observed among subjects with hyperuricemia and a significant indirect correlation between SUA and eGFR was evidenced. A proportional correlation between SUA values and total CV risk was also obtained. Conclusions: The study supports SUA implication in the pathogenesis of elevated blood pressure and the role of uric acid as a cardiovascular risk factor, particularly for the development of hypertension and renal disease.]

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LAM Extra for General Practicioners

[ACCIDENT PREVENTION AND FIRST AID KNOWLEDGE AMONG KINDERGARTEN CHILDREN’S PARENTS]

BÁNFAI Bálint, RADNAI Balázs, MARTON József, PÉK Emese, DEUTSCH Krisztina, BETLEHEM József

[INTRODUCTION - Based on statistics, accidents from various mechanisms are among the most common causes of death all over the world. Children are mostly affected in this situations. Our aim was to examine the first aid and accident prevention knowledge and attitude of the parents. PATIENTS AND METHODS - In this study parents of 3-7 years old children were involved in six kindergarten located in Hungary. A self-fill-in questionnaire was used to collect data. In the investigation 307 parents (N=307) were included. Out of them 234 respondents filled out the questionnaire correctly. The statistical analysis was made with SPSS 20.0 statistical software. For analyses deescriptive statistics, Chisquare- test and ANOVA were used. RESULTS - Three-quarters of the children have suffered at least one accident earlier (74.3%). Most of the accidents occured at home (88.5%). 174 parents attended first aid course earlier (74.4%), the previous knowledge is based mainly on the driving license (81.6%). Based on the answers it is important to teach children first aid (70.5%) and prevention (89.7%) knowledge in the kindergarten. There were only 10 parents, who answered all the situation questions correctly (4.3%). Between the subjective judgment of the financial status and the correct answers we found a significant correlation (p=0.03). The previously accomplished first aid training (p<0.05) and the educational attainment (p=0,029) had a positive impact on the results. CONCLUSION - The level of first aid knowledge of parents is lower than expected. Participate in first aid courses the level of knowledge could increase. It would be important, because some of the accidents can be prevented by acquiring proper knowledge.]

Lege Artis Medicinae

[VASCULARIS NEUROLOGY AS A NEW DIRECTION IN CLASSICAL NEUROLOGY]

NAGY Zoltán

[In the last decades the classical clinical specialties have further differentiated. Increasing number of different new subspecialties were born due to the consequences of the robust progress in basic sciences and medical technology. This process has further accelerated due to the new challenges and possibilities in patients' care. Similar tendencies could be seen in neurology. Recently, significant demand has arisen for educational programs for neurologists who want to be familiar in stroke management. These tendencies are also substantiated by stroke epidemiology. In industrialized countries rapid increase in stroke morbidity has been predicted by the increasing life-expectancy. The management of different acute stroke syndromes, the rehabilitation and treatment of post-stroke states needs education and special skills in the field of vascular neurology. Special postgraduate educational programs in vascular neurology (stroke-ology) are formulated in USA as a new subspecialty and it is under preparation in some countries in Europe as well. In Hungary, the Hungarian Stroke Society has initiated the special clinical training and educational programs as preconditions of issuing a license in vascular neurology.]

Hypertension and nephrology

[The Classics of Hypertonology 2. – Professor Lennart Hansson, 1941-2002]

KÉKES Ede, FARSANG Csaba

Hypertension and nephrology

[Hypertension License 2016]

SZÉKÁCS Béla, KÉKES Ede, KISS István

Lege Artis Medicinae

[Motor vehicle accident with complete loss of consciousness due to vasovagal syncope]

VARGA Emma, WÓRUM Ferenc, SZABÓ Zoltán, VARGA Mihály, BARTA Kitti, LŐRINCZ István

[INTRODUCTION - Vasovagal syncope is one of the most common causes of complete or partial loss of consciousness, causing harm to drivers or innocent bystanders. CASE REPORT - In our case, we report the case of a 60-year-old man who was admitted to hospital after a serious motor vehicle accident due to loss of consciousness. The process and results of complete cardiologic and neurological assessment are presented. The case report illustrates the importance of recognition of patients with a high risk for incapacitating symptoms due to vasodepressor type vasovagal syncope as well as the use of head-up tilt-table test to determine the diagnosis and also to guide combined management. CONCLUSION - As transient loss of consciousness during driving may cause potentially fatal accident, it has to be taken into consideration during decision making when issuing driving license for patients with vasovagal syncope.]