LAM Extra for General Practicioners - 2011;3(04)

LAM Extra for General Practicioners

OCTOBER 20, 2011

[Changes in infectology over the past two decades]

SZALKA András

[Infectious diseases and various infections are the major causes of morbidity and mortality in developing as well as in industrialised countries. Despite the advances in the past decades in our understanding of microbes, efficient treatment of diseases and preventive approaches, more than 13 million people die every year due to infectious diseases. In the past two decades, more and more new pathogens and infections diseases have been emerging and old diseases that were almost forgotten have re-emerged. There are many new diseases for which we do not have or have hardly any efficient antimicrobial drugs and no efficient vaccines. Despite an increasing frequency of multi- and panresistant microbes, the development of new antibiotics to be used against these infections is unlikely to occur in the near future. The big pharmaceutical companies have stopped the research of antibiotics. In this situation, the only option we have is to use antibiotics rationally and to take prevention and control of infections seriously, both in the outpatient system and in hospitals. Preserving the effectiveness of currently used antibiotics is in everyone’s interest and is everyone’s responsibility]

HUN 2011;3(04)

LAM Extra for General Practicioners

OCTOBER 20, 2011

[Similarities and differences in the renal effects of statins]

ÁBRAHÁM György

[By efficiently reducing serum cholesterol level, statins significantly decrease both cardiovascular morbidity and mortality. Decreasing LDL-cholesterol level by 1% reduces coronary mortality risk by 1%, whereas increasing HDL-cholesterol level by 1% reduces the risk by 3%. At the same time, renal failure significantly increases cardiovascular events and/or mortality compared with the population mean. It is an exciting question whether statins are able to prevent and decelerate the deterioration of kidney function deterioration, preserve GFR and decrease albuminuria. Depending on the strength of their effect, statins have different cholesterol-lowering capacity (rosuvastatin and atorvastatin are especially effective). An important question is whether these differences can be detected in the renal function as well. The results of experimental data and major clinical trials (e.g. AURORA, PLANET I-II, SHARP) are often controversial. Nevertheless, statin therapy has advantages for patients with kidney diseases, although to a lesser extent than it has in the normal population.]

HUN 2011;3(04)

LAM Extra for General Practicioners

OCTOBER 20, 2011

[Advantages of fixed Combinations in the treatment of Hypertensive patients ]

FARSANG Csaba

[In 60-70% of patients with hypertension, a significant decrease in blood pressure can only be achieved by a combination of antihypertensive drugs. International as well as national guidelines emphasise the numerous advantages and the importance of combination treatment. Fixed combinations are particularly advantageous, as their use improves patients’ compliance. This paper summarises the available information on the possible combinations of the nine major antihypertensive drug groups distributed in Hungary, and for details the results published on the recently approved and introduced fixed combination of telmisartan and amlodipine.]

HUN 2011;3(04)

LAM Extra for General Practicioners

OCTOBER 20, 2011

[Újdonságok az ischaemiás stroke másodlagos prevenciójában a 2011-es amerikai ajánlás alapján]

CSIBA László

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HUN 2011;3(04)

LAM Extra for General Practicioners

OCTOBER 20, 2011

[Acute hepatitis caused by herpes simplex virus 1]

PATYI Márta, SEJBEN István, VÁGÓ Tibor, CSERNI Gábor, KISS Antal Zsolt, KISS József Zoltán

[INTRODUCTION - Herpes simplex virus is a rare and severe disease, which is often lethal, especially in children and those who underwent transplantation. Rapid diagnostic help determines therapy and facilitates recovery of the patient. CASE REPORT - The authors present a case of a 46-year-old patient with no underlying disease, in whom the diagnosis of hepatitis caused by herpes simplex-1 virus was suggested after histological evaluation of a blind liver biopsy specimen. The diagnosis was later confirmed by immunomorphological examination. The patient’s hepatitis resolved following acyclovir therapy, but he developed nosocomial pneumonia, sepsis caused by Candida albicans and anuria. The patient recovered due the joint efforts of an infectologist, a pathologist, an intensive care specialist and a nephrologist. CONCLUSION - During examination of the patient, immune suppression was not indicated either by HIV-serology or bone marrow biopsy. thus the findings were presumably explained by a generalised infection in an immunocompetent host. In the case described, histological examination of the liver biopsy was a life-saving procedure, because it allowed timely and efficient treatment.]

HUN 2011;3(04)