Hypertension and nephrology

[My teacher, Pál Gömöri (1905-1973)]

RADÓ János

JUNE 10, 2011

Hypertension and nephrology - 2011;15(03)

[Great Hungarian physicians have contributed a lot to the development of international medical science. Pál Gömöri was one of them. It is impossible to list the versatility of his scientific interests, but one of his ambitions was the introduction of the investigational methods of renal nuclear medicine to Hungary. The author’s feeling is that his own activity in renal nuclear medicine concerning “diuretic renography” was inspired partly by the information which was learned from Gömöri. The scientific results produced by Gömöri will be preserved in the libraries and on the internet. The spirit of his medical teaching, however, must be passed over by his students and followers, to provide his remembrance to fade as late as possible ]

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[Background: Cardiovascular (CV) diseases are the leading cause of death among renal transplant patients (TX). Ambulatory arterial stiffness index (AASI) has been suggested to individually predict the cardiovascular morbidity and mortality. Our aim was to evaluate the relationship between traditional and nontraditional risk factors and AASI in renal transplant children. Patients and methods: In our cross-sectional study, 35 TX patients (15.6±4.3 years of age) were investigated with 24-h ambulatory blood pressure monitoring and AASI was defined. Anthropometric data, metabolic parameters and body composition values were also assessed. Results: By univariate regression analysis, BMI, volume excess, systolic blood pressure SD score, mean pulse pressure, diastolic diurnal index, nocturnal diastolic blood pressure fall, and the presence of hypertension showed positive correlation with AASI (respectively r=0.53, 0.39, 0.34, 0.33, 0.41, –0.42; p<0.05). Hypertensive patients had higher AASI values (0.47±0.13 vs. 0.36±0.18; p=0.04), which may be due to the longer duration of dialysis and longer time since transplantation (p<0.05). BMI SDS and nocturnal diastolic blood pressure fall remained to be the main predictors of AASI in the whole (R2=0.44, SE=0.14, β=0.34 and –0.30, p=0.03) and in the hypertensive group (R2=0.48, SE=0.10, β=0.47 and –0.41, p=0.01 and 0.02). Conclusion: Early transplantation then the early treatment of obesity and hypertension may be essential in the prevention of target organ damage and CV mortality in children after kidney TX.]

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[Too early publication? (priority of the Hungarian authors was saved by a South- American radiologist)]

RADÓ János

[It is supposed that the invention of diuretic (furosemide) renography was a premature discovery. This is suggested by the fact that it was rediscovered by more than one people. Author supported this contention by a statistical analysis of „citation intervals” performed on the basis of Garfield’s suggestions. The length of the time from the description of the procedure to the appearance of citations („citation interval”) proved to be an average of 21.3±9.6 (SD) years, significantly longer than in the case of the author’s five important other recognitions combined, where the average citation interval was 8.7±7.4 (SD) years (p<0.01). Camargo a South-American radiologist who first confirmed the original study, was later just in time the editor of a North American journal to save the priority of the original inventor Hungarian authors. In medical science the investigators take the risks in the interest of the patients including „publishing too early”.]