Hypertension and nephrology

[The Authors’ Response to László Bajnok’s Comment]

KÉKES Ede, VÁLYI Péter

DECEMBER 12, 2019

Hypertension and nephrology - 2019;23(06)

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Further articles in this publication

Hypertension and nephrology

[Hypertension and brain function. Correlation of high blood pressure and demencia in aging. Hypertension in young-middle adults - demencia in elderly]

SZÉKÁCS Béla, KÉKES Ede

[The cerebral vascular damage caused by hypertension is manifested primarily in cognitive dysfunction, which is caused by hypoperfusion of brain tissue, ischemic, or bleeding stroke, or white matte injury. Hypertension may not only result in cerebral damage to the vascular background - dementia -, but may also contribute to the development and progression of classical gene-related Alzheimer’s disease. Blood pressure gradually increases in the elderly and in the very elderly, and the frequency of hypertension-mostly as isolated systolic hypertension - is 50% to 70%. High blood pressure predominately, or in full, means not only an increase in the circulatory resistance of the small children, but also, as part of the aging of the body, the rigidity (stiffness) of the arteries. At the same time, the incidence of dementia, along with age, rises sharply - up to 20% in those over 65 years of age, and over 40% in 80-90 years of age. The relationship between high blood pressure and dementia from the young age to the very old age may change as a function of current age. In the very old age of life, the varying influence of other pathological factors other than hypertension is becoming more and more important in the deterioration of both the vascular structure and the brain function. In this late stage of life, the very advanced rate of aging and nutritive blood flow often require higher perfusion pressure, and the not enough thought-out blood pressure reduction can be more damaging than a protective effect on brain condition or function. SPRINT MIND - the Intense Blood Pressure Reduction - hasn’t resolved the question, and we can legally assume that the 130-140 Hgmm SBP. Is the most favorable for dementia. The value of DBP 70 Hgmm is definitely unfavorable.]

Hypertension and nephrology

[The effect of the β-blockers on left ventricular sytolic and diastolic function]

MOSER György

[The author surveys the pharmacodynamic effects, by which the β- blockers can exercise an influence on systolic and diastolic function. He points out, that the constituents of the effect can be separated only in didactic aspect, its worthwile to take the situation of their interdependence. Analyses the how the when and the wherefore the hemodynamic state determines the component of the complex mode of action that sets off. Deals with the problem, that what kind of effects are desired in certain clinical settings and which of those are deletorious. On emphasized he discusses the greatest danger of the β-blockade, the negative inotropic effect, and the mode of its offset or rather counteraction of its hemodinamic result.]

Hypertension and nephrology

[Risks Associated with the Use of Electronic Cigarette and Electronic Devices that Simulate Tobacco Smoking]

KÉKES Ede, VÁLYI Péter

Hypertension and nephrology

[Effects of Catheter Ablation or Antiarrhythmic Medicinal Treatment of Patients with Atrial Fibrillation on Mortality, Hemorrhage, the Frequency of Stroke and Sudden Cardiac Death: the CABANA Randomized Study Raising an Issue – Significance]

VÁRALLYAY Zoltán

Hypertension and nephrology

[Accredited Postgraduate Training]

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Autonomic nervous system may be affected after carpal tunnel syndrome surgery: A possible mechanism for persistence of symptoms after surgery

ONDER Burcu, KELES Yavuz Betul

After carpal tunnel surgery, some patients report complaints such as edema, pain, and numbness. Purpose – The aim of this study was to evaluate autonomic nervous system function in patients with a history of carpal tunnel surgery using sympathetic skin response (SSR). Thirty three patients (55 ±10 years old) with a history of unilateral operation for carpal tunnel syndrome were included in the study. The SSR test was performed for both hands. Both upper extremities median and ulnar nerve conduction results were recorded. A reduced amplitude (p=0.006) and delayed latency (p<0.0001) were detected in the SSR test on the operated side compared to contralateral side. There was no correlation between SSR and carpal tunnel syndrome severity. Although complex regional pain syndrome does not develop in patients after carpal tunnel surgery, some of the complaints may be caused by effects on the autonomic nervous system.

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A rare entity of acquired idiopathic generalised anhidrosis which has been successfully treated with pulse steroid therapy: Does the histopathology predict the treatment response?

ÖKTEM Özdemir Ece, ÇANKAYA Şeyda, UYKUR Burak Abdullah, ERDEN Simsek Nazan, YULUG Burak

Acquired idiopathic generalised anhidrosis is an uncommon sweating disorder characterized by loss of sweating in the absence of any neurologic, metabolic or sweat gland abnormalities. Although some possible immunological and structural mechanisms have been proposed for this rare entity, the definitive pathophysiology is still un­clear. Despite some successfully treated cases with systemic corticosteroid application, the dose and route of steroid application are controversial. Here, we present a 41-year-old man with lack of genera­lised sweating who has been successfully treated with high dose pulse intravenous prednisolone. We have discussed his clinical and histopathological findings as well as the treatment options in view of the current literature.

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