LAM KID

[The story of DEXA machines]

SZINAI T. József, BÁLINT Géza

DECEMBER 23, 2011

LAM KID - 2011;1(03)

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BHATTOA Harjit Pál

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[Osteonecrosis of the jaws: real and unreal scares]

VASZILKÓ Mihály

[Osteonecrosis caused by bisphosphonates has been known for a long time, but it is still not widely known. Some people overestimate the danger caused by this disease, whereas others underrate it. In this paper, we summerise data from the international literature and our experiences concerning 93 patients treated at our clinic. We discuss the already known details of the pathomechanism of this disease, its risk factors, the diagnostic methods, the specific stages of the disease and the treatment approaches. Considering the difficulties of treatment, we can't emphasise enough the importance of prevention, since the development of this complication can be minimised even in patients at risk with dental sanation before the bisphosphonate therapy and/or with further intervention performed with antibiotic preventive therapy. We must also point out the importance of early diagnosis and of directing these patients to the appropriate specialist units.]

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[Extraskeletal effects of parathyroid hormone]

KISS Zoltán, MUCSI István, TÚRI Sándor, SZABÓ András, KISS István, SZEBENI Andrea, KECSKEMÉTI Valéria, TÓTH Miklós, LAKATOS Péter

[The parathyroid gland and its product, parathyroid hormone (PTH) have been subjects of interests in biomedical research for 150 years. Early studies, understandably, concentrated on the primary function: the regulation of serum calcium level. In the past few decades, however, more and more data have shown that, in contrast with the classical view, PTH receptors are expressed not only on bone and kidney cells, but in almost all organs of the human body. Therefore, the effect of PTH obviously cannot be limited to the regulation of bone and mineral metabolism. Systemic symptoms of hyperparathyroidism also became more understandable and explicable by the results of studies on the extraskeletal effects of PTH. Despite the intensive research, the mechanisms of PTH-mediated effects are not well understood in a number of areas. Therefore, it is of great importance to perform further studies in this field, which will hopefully expand our knowledge soon. In our current work, we aim to summarise the nonclassical, extraskeletal effects of PTH (that is, those not related to the regulation of bone metabolism and kidney function) and the results of related studies.]

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ÁRVAI Kristóf, KÓSA János Pál

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[BACKGROUND - A new discovery of the past decade has been the previously unknown relationship between the bone metabolic unit and energy homeostasis. On the basis of data from previous animal and clinical studies, osteocalcin has been considered the major mediator of this relationship. Cathepsin K is a cysteine protease type osteolytic enzyme, which has a role in bone resorption, and which is a pharmaceutical target in the treatment of osteoporosis and bone metastasis. According to data from animal studies, its deficiency or selective inhibition decreases the differentiation of preadipocytes, body weight and serum levels of insulin and glucose in obese mice. The aim of our study was to elucidate the role of cathepsin K in the human bone - metabolic axis in women (n=66). PATIENTS AND METHODS - 21 healthy and 45 glucose intolerant women were examined. OGTT, IVGTT and hyperinsulinaemic euglycaemic clamp were performed to assess carbohydrate homeostasis, insulin secretion, whole-body and muscle glucose utilization (M-1 and M-3). Circulating levels of bone markers and adipokines were measured, and DEXA was used to measure BMD, fat and muscle mass. RESULTS - Cathepsin K levels showed a significant (p<0.05), negative correlation with BMI, body fat percent and OGTT glucose and insulin area under the curve (AUC), and a positive correlation with M values. No correlation was found between cathepsin K levels and IVGTT measurements. CONCLUSION - Cathepsin K - in women - is not only a participant of the bone metabolism - energy homeostasis axis. Its role in human glucose homeostasis differs from what could be expected on the basis of animal experiments, because increasing cathepsin K levels indicate, paradoxically, improving metabolic state in women. Our data suggest that insulin regulation of cathepsin K is mediated by the incretin system.]

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[Introduction of the small size, portable ultrasound machines opened new opportunities in ultrasound imaging. The optimal application of these equipments and the new problems related to the use are widely discussed in the literature. This brief review summarizes the advantages, main indication and limitations of the method. The single most important aspect for the patient is that emergency ultrasound examination should be available regardless of the profession of the doctors. The most difficult question is how to provide and control an optimal education and training for the doctors. Possible solutions are also discussed. It is predictable that the availablity of the portable ultrasound studies will significantly increase the number of examinations, therefore economical consequences must also be considered. The author disagree with the conception, which states that ultrasound machine can be used as a stetoscop in the doctor's pocket.]

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[Aim of the study: To research the origin and story of the Occupational Health Nursing in Hungary, to present the development of the factory nurse institutions which fell into oblivion by this time. Sample and Method: Collect and work up literature sources and legislation systematically issued between 1840 and 1950. Examine extant correspondence and reports of factories, enterprises and finishing-schools functioned before the socialization. The examined issues were the followings: aspects of the selection of those who fill factory nurse scope of activities, their qualification, role and esteem. Results: It was found that factory nurses were not selected out of working women. The first factory nurse course started in 1933 in Budapest. During ten years 150 students fulfilled the two-years full-time course based on the secondary education. Participants of the course had to suit strict admission requirements. Students of the course learnt about health, social, legal and cultural knowledge from noted professionals at that time. Factory nurses performed their activities basically at two locales: inside and outside of the factory. Qualified factory nurses were hold in great honour socially, even their rights were protected by collective agreement. Conclusions: Occupational Health Nurse Education has a 80-years-old history in Hungary, that throw new light upon theories until now about origin of Occupational Health Nursing. ]

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