Lege Artis Medicinae - 2003;13(06)

Lege Artis Medicinae

AUGUST 20, 2003

Lege Artis Medicinae

AUGUST 20, 2003

[Modern antibiotic therapy - The antibiotic therapy of community acquired pneumonias in adults based on gudelines]

KOVÁCS GÁBOR

[Most therapies in the treatment the community acquired pneumonia are empirical. There are several different guidelines helping to choose the right antibiotic. These guidelines contain the background of the epidemiology, diagnosis and microbiology. However the center of the interest is the therapeutic guide. The guidelines are worth as much as you make from those.]

Lege Artis Medicinae

AUGUST 20, 2003

[Classification of lung fibroses - The clinical value of classification of idiopathic interstitial pneumonias]

ZSIRAY Miklós

[The new classification by ATS/ERS classifies clinical, radiological and prognostic data to the reports of bronchial biopsies. Our article discusses the clinical value of the pathological results including a brief review of 7 sub-groups and the failures of the differential diagnosis. The identification of each entity can be carried out exactly only from surgical specimens obtained mostly with videothoracoscop.]

Lege Artis Medicinae

AUGUST 20, 2003

[The connection between gastroesophageal reflux disease and obstructive sleep apnoea]

DEMETER Pál, VÁRDI Visy Katalin

[Clinical knowledge on the gastroesophageal reflux disease has been increased with the subject of extragastrointestinal complications in the last decade. Because of cardiological, pulmonological, laryngeal and dental complications, an interdisciplinary approach is required. The non-cardiac chest pain, bronchial asthma, chronic bronchitis, chronic caugh, posterior laryngitis and acidic damage of dental enamel are the most important complications. Authors study a less common connection between the gastroesophageal reflux disease and obstructive sleep apnoea. Sleeping can be considered as a risk factor of the reflux event by itself, because of the decrease of primary peristalsis, producing of saliva, and acidic and volume clearance of oesophagus as well. During obstructive sleep apnoea negative intrathoracic pressure increases extremely, resulting in increased transdiaphragmatic gradient of pressure as well. In addition, the powerful movement of diaphragm twitches the lower oesophageal sphincter through the phrenoesophageal ligament. These two mechanism practically promotes the reflux event in patients with obstructive sleep apnea. The new challenge for the gastroenterologists is to further research this new connection, to play more active role in the complex therapy, and to have a new diagnostic approach of serious gastroesophageal reflux disease.]

Lege Artis Medicinae

AUGUST 20, 2003

[Diagnosis and therapy of insect sting allergy]

BÁNKÚTI Beáta

[Over the past 20 years great progress has been made in understanding the pathogenesis, diagnosis and treatment of allergic reactions caused by insect stings. The incidence of insect sting allergy in a general population is about 0.4- 3% but anaphylaxis to Hymenoptera venom can be fatal. The diagnosis of venom allergy is based on the history suggesting an allergic reaction and on the demonstration of the persistence of specific IgE antibody either by skin tests or RAST. Patients who had a severe allergic reaction and has positive venom skin test or RAST result should be advised to receive venom immunotherapy (VIT). The risk for subsequent life-threatening systemic sting reactions can be significantly reduced with VIT. VIT should be continued for at least 3 to 5 years and provides about 90 % protection from insect sting anaphylaxis.]

Lege Artis Medicinae

AUGUST 20, 2003

[Current status of lung transplantation in Hungary in adults based on gudelines]

LANG György, VADÁSZ Pál, AGÓCS László, CSISZÉR Eszter, CZEBE Krisztina, KLEPETKO Walter

[During the last decade lung transplantation became an accepted treatment option for endstage lung disease of different origin. Technical problems of the early period have been solved completely during the course of time and the operation has found its place as a routine procedure. The shortage of donor lungs has stimulated the development of new operative techniques. Parallel to achievements in surgical treatment, significant progress in immunosuppressive therapy was obtained. Long-term survival following lung transplantation however remains limited by the onset of bronchiolitis obliterans syndrome. Since Vienna serves as a leading centre for lung transplantation in Middle-Europe, between 05/03/1996 and 17/01/2003 21 Hungarian patients underwent lung transplantation here. In close co-operation with the Vienna Lung Transplant Group, the Hungarian specialists prepare for introduction of lung transplantation in Hungary.]

Lege Artis Medicinae

AUGUST 20, 2003

[Motor vehicle accident with complete loss of consciousness due to vasovagal syncope]

VARGA Emma, WÓRUM Ferenc, SZABÓ Zoltán, VARGA Mihály, BARTA Kitti, LŐRINCZ István

[INTRODUCTION - Vasovagal syncope is one of the most common causes of complete or partial loss of consciousness, causing harm to drivers or innocent bystanders. CASE REPORT - In our case, we report the case of a 60-year-old man who was admitted to hospital after a serious motor vehicle accident due to loss of consciousness. The process and results of complete cardiologic and neurological assessment are presented. The case report illustrates the importance of recognition of patients with a high risk for incapacitating symptoms due to vasodepressor type vasovagal syncope as well as the use of head-up tilt-table test to determine the diagnosis and also to guide combined management. CONCLUSION - As transient loss of consciousness during driving may cause potentially fatal accident, it has to be taken into consideration during decision making when issuing driving license for patients with vasovagal syncope.]

Lege Artis Medicinae

AUGUST 20, 2003

[Carotid artery auscultation]

MAGYAR M. Tünde, EUN-MI Nam, CSIBA László, RITTER A. Martin, BERND E. Ringelstein, DIRK W. Droste