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Lege Artis Medicinae - 2000;10(10)
Content
Lege Artis Medicinae
OCTOBER 01, 2000
[Antibacterial therapy: 2000 balance and perspectives]
[Following a brief history of antibacterial therapy and evaluating the achievements and damages occurred, authors focus on today's problems and the following statements are made: Principles of treatment are clearly defined, however the choice of antibiotics may vary in time and in regions according to the differences in bacterial resistance. Antibacterials of the last decade (III-IV. generation fluoroquinolones, streptogramins, oxazolidinones, new vancomycine analogues) are intended to be effective against multiresistant Gram-positive cocci. Beside bacterial resistance, the most difficult therapeutic problems are the infections in the immunocompromised patients. The role of infection in the pathogenesis of certain diseases, e.g. ventricular/duodenal ulcer and probably atherosclerosis, has only recently been discovered; here new prospects may open for antibacterials. Data of the antibiotic utilization in Hungary show radical changes in the last years. Conclusion: the immense power of antibiotics still has its limits: to conquer bacterial disease successfully the intelligent combination of antibiosis, asepsis and immunization are required. ]
Lege Artis Medicinae
OCTOBER 01, 2000
Lege Artis Medicinae
OCTOBER 01, 2000
[Molecular mechanisms of cardiac hypertrophy and heart failure]
[In this review, the most important molecular mechanisms leading to cardiac muscle hypertrophy and consequentially to heart failure are detailed. In numerous instances, understanding molecular mechanisms offers the possibility for pharmacotherapeutic intervention. First, trimeric G-proteins and their attached intracellular signaling pathways are introduced, with special emphasis on the pathways elucidated by transgenic animal models. In this area, there are several clinically effective drugs to influence cardiac hypertrophy, including ACE inhibitors, angiotensin receptor antagonists, as well as a- and B-adrenergic receptor blockers. Mitogen activated protein kinases participate later in the hypertrophic cascade. There are ongoing investigations on the potential therapeutic use of lipid-soluble statins these are indirect inhibitors of Ras-farnesylation. Altered cellular Ca2+-homeostasis is fundamental with respect to cardiac muscle hypertrophy and heart failure. The third part of this article investigates the role of the calcium/calmodulin dependent protein phosphatase called calcineurin in these processes. Administration of cyclosporin A or tacrolimus (both are inhibitors of calcineurin) may not be recommended in most forms of cardiac hypertrophy, however, in certain settings they may prove to be valuable therapeutic agents. One of the most serious, not yet properly addressed problem of late stage heart failure is the development of ventricular arrhythmias caused by repolarization abnormalities. Certain mechanisms of this phenomenon are highlighted with a special note on Nat-Cat exchange inhibitors as one of future therapeutic agents of much promise. ]
Lege Artis Medicinae
OCTOBER 01, 2000
[The role of MR angiography in the examination of intracranial aneurysms: A comparative study]
[MR imaging has recently emerged for visual representation of blood vessel structures as well. With MR angiography (MRA), appropriate diagnosis can be established for a number of pathologies involving the arteries and veins. In this report, authors analyse the significance of MR and MRA examinations in the diagnostics of intracranial aneurysms of 87 cases, comparing these procedures with results obtained by digital subtraction angiography (DSA), which is regarded as the gold standard method. In 52 patients where surgical intervention was performed, intraoperative findings were used as control. MR - MR angiographic examination was very sensitive in detecting aneurysms larger than 3 mm (98%), the rate of depicting smaller aneurysms proved to be lower (56%), the overall sensitivity was 79%. MRA is an excellent non invasive diagnostic tool in the examination of intracranial aneurysms. The method can not replace catheter angiography completely but its application is justified and useful in many cases. Occasionally, aneurysms not seen on DSA can be depicted with MR angiography. ]
Lege Artis Medicinae
OCTOBER 01, 2000
Lege Artis Medicinae
OCTOBER 01, 2000
Lege Artis Medicinae
OCTOBER 01, 2000
[Molecular mechanisms of the link between obesity, insulin resistance and type 2 diabetes]
[Causal link between obesity and type 2 diabetes has already been generally accepted. Alterations in the regulation of central nervous control of food intake, in the adaptive termogenesis and in the endocrinological function of the adipose tissue have foremost importance. Concerning the control of food intake leptin, Agouti-related protein as well as the pro-opiomelanocortin system and its receptors may have pivotal role in developing insulin resistance. In altering the control of adaptive termogenesis leading to obesity and concomittant insulin resistance, the mutations of the Bz-adrenergic receptors and the uncoupling proteins are important factors. Key mediators found in adipose tissue regulating insulin sensitivity are the non-esterified fatty acids, components of the tumor necrosis factor system and leptin, with the peroxysome proliferator activating receptor being the main genetic regulator of these adiposity signal molecules, ]
Lege Artis Medicinae
OCTOBER 01, 2000
[Metabolic syndrome - metabolic risk factors]
[Since abdominal type obesity, diabetes mellitus and the metabolic syndrome were classified as primary coronary risk factors beside hypercholesterolaemia and smoking, five out of six of the most significant risk factors are regarded of metabolic origin. Simultaneous occurrence of these factors are far more frequent in the population. The composition and background of this syndrome were subject of numerous analyses and classification from syndrome-X to metabolic syndrome. Reaven finds insulin resistance and compensatory hyperinsulinism as the primary cause, while Matsuzava et al regards visceral type obesity (visceral fat syndrome), and Björntrop views the increase in sympathetic tone (civilization syndrome) as fundamental. In the diagnostics and therapy of the metabolic syndrome we should consider all factors mentioned above. We have to establish the presence of three or more classic risk factors for a firm diagnosis. In the therapy, decreasing the body weight with diet and exercise is crucial, with adjuvant drug therapy of antidiabetics, insulinsensitizers, lipid lowering agents and antihypertensives, as needed. ]
Lege Artis Medicinae
OCTOBER 01, 2000
[Diabetes mellitus and hypertension - Facts, questions and thoughts]
[Using the new diagnostic criteria by WHO/ISH, the frequency of hypertension in type 1 diabetic patients is 15-61%, reaching 51-73% in type 2 cases. The combination of diabetes mellitus with hypertension increases the risks of stroke and cardiovascular diseases further compared to non-diabetic hypertensive patients. Authors review new recommendations concerning the diagnosis and treatment goals of hypertension in different types of diabetes mellitus. Most recent studies supporting these recommendations are also critically analysed. Theoretical advantages of new drugs and drug combinations in the therapy of hypertensive diabetics are reviewed. The strategy of treatment according to the cardiovascular riskprofile of diabetic patients is discussed in detail in the report. For the prevention of target-organ damage, the evidence based combination of ACE inhibitors and long-acting calcium channel blockers was strongly recommended. In about 70% of diabetic patients a combination of two drugs, in one-third of the cases a combination of three or four preparations seemed to be necessary, including low-dose diuretics and/or cardioselective beta-blockers. ]
Lege Artis Medicinae
OCTOBER 01, 2000
Lege Artis Medicinae
OCTOBER 01, 2000
[Municipal Health Days - fourth]
[Zoltán Kovács, Chief Physician of Békéscsaba, Chairman of the Conference Organizing Committee, said that the aim of the conference was to provide social control to the current health legislative processes, as well as to offer the opportunity for dialogue to the various actors of health care: representatives of local governments, public administration bodies and professional organizations.]
Lege Artis Medicinae
OCTOBER 01, 2000
[Manifestation of role conflicts among female doctors]
[The basis of this study is an empirical survey performed in September 1999 among the female employees with medical degree at the Scientific University of Szeged, Faculty of General Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Centre (at the time of the survey: Albert Szent-Györgyi Medical University). The main goal of the survey was to explore the burden from the workplace, family and household contributing to overstrain, role conflicts and health problems. Our research intends to elucidate the different levels of incompatibility in the life of female doctors caused by professional and family duties. Present study summarizes the most important results in the following fields: professional progress, workload, personal state of health, maintaining health, manifestation of role conflicts. ]
Lege Artis Medicinae
OCTOBER 01, 2000
Lege Artis Medicinae
OCTOBER 01, 2000
Lege Artis Medicinae
OCTOBER 01, 2000
1.
Clinical Neuroscience
[Headache registry in Szeged: Experiences regarding to migraine patients]
21. MAY
2.
Clinical Neuroscience
[The new target population of stroke awareness campaign: Kindergarten students ]
21. MAY
3.
Clinical Neuroscience
Is there any difference in mortality rates of atrial fibrillation detected before or after ischemic stroke?
27. NOV
4.
Clinical Neuroscience
Factors influencing the level of stigma in Parkinson’s disease in western Turkey
27. SEP
5.
Clinical Neuroscience
[The effects of demographic and clinical factors on the severity of poststroke aphasia]
18. JUL
1.
2.
Clinical Oncology
[Pancreatic cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up]
29. AUG
3.
Clinical Oncology
[Pharmacovigilance landscape – Lessons from the past and opportunities for future]
29. AUG
4.
5.