LAM Extra for General Practicioners

[Acute hepatitis caused by herpes simplex virus 1]

PATYI Márta1, SEJBEN István2, VÁGÓ Tibor2, CSERNI Gábor2, KISS Antal Zsolt3, KISS József Zoltán3

OCTOBER 20, 2011

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

[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.]

AFFILIATIONS

  1. Bács-Kiskun Megyei Önkormányzat Kórháza Kórházhigiénés Osztály
  2. Bács-Kiskun Megyei Önkormányzat Kórháza Patológia
  3. Bács-Kiskun Megyei Önkormányzat Kórháza Központi Intenzív és Aneszteziológiai Osztály

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[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.]

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[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]

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[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.]

Hungarian Radiology

[Sarcoidosis involving liver and spleen, and with hypercalcemia]

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Clinical Neuroscience

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

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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.