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Lege Artis Medicinae - 2008;18(10)
Content
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
[VERTIGO IN NEUROLOGICAL DISEASES]
[Peripheral and central vestibular syndromes are characterized by the combination of the four symptoms such as: vertigo, nystagmus, imbalance and nausea. Vertigo is the disturbance of the cortico-spatial orientation. Nystagmus is regarded as a secondary symptom caused by direction specific disequilibrium of the vestibulo- ocular reflex. Imbalance is caused by the abnormal activation of vestibulo-spinal pathways. Nausea is due to the activation of the medullary vomiting center. It is important that clinicians can establish an adequate diagnosis and differentiate vertigo and dizziness. The author - without the aim of completeness - discusses the types of vertigo caused by the most important disorders of the central nervous system, emphasizing the role of general practitioners in the diagnostic and therapeutic algorhytm.]
Lege Artis Medicinae
OCTOBER 19, 2008
[IBANDRONATE IN THE TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS]
[Postmenopausal osteoporosis affects 7-10% of the population of developed countries. During the past decade, a number of new therapeutical modalities have been made available. Among these, bisphosphonates mean the mainstay of medical treatment. Ibandronate belongs to the amino-bisphosphonate group of these drugs. Amino-bisphosphonates act via the mevalonate metabolic pathway, thus, inhibiting protein prenylation. Several clinical studies have shown a significant reduction in the fracture risk of osteoporotic patients treated with ibandronate. This compound can be administered orally once a month or intravenously once in every 3 months. Longer dosing intervals stimulate patient compliance, and consequently increase efficacy and cost effectiveness.]
Lege Artis Medicinae
OCTOBER 19, 2008
[THE PLEIOTROPIC EFFECTS OF LOSARTAN - THE IMPORTANCE OF DECREASING URIC ACID LEVEL]
[Nowdays the goal of the antihypertensive treatment is to decrease the cardiovascular risk of the patients by treating the associated diseases and possible hypertensive end-organ damages. Losartan is an antihypertensive drug with all these capabilities and placebo-like side-effect profile. Besides the most important effects of losartan, which are mediated by blocking the angiotensin II. type 1. receptors, it also has other, molecule specific beneficial effects. The most important, well documented pleiotropic effect of losartan is its uricosuric effect. The pleiotropic effects together with the blockade of the angiotensin II. receptors are considered more and more important in the hypertensive end-organ protection and in the treatment of associated diseases in hypertensive patients.]
Lege Artis Medicinae
OCTOBER 19, 2008
[ANTI-VEGF THERAPY WITH BEVACIZUMAB IN BREAST CANCER]
[The growth of new blood vessels, angiogenesis is important for tumour progression and metastasis. Vascular endothelial growth factor (VEGF) plays multiple roles in cancer development. Due to it the VEGF seems to be an optimal therapeutic target in breast cancer therapy. The plasma level of this growth factor is highest early in disease suggests that anti-VEGF agents may provide their greatest benefit in firts-line chemotherapy with metastatic breast cancer (MBC). A phase III trial, E2100 evaluated weekly paclitaxel with or without bevacizumab (Avastin), the specific humanised anti-VEGF monoclonal antibody in patients with previously untreated locally recurrent or MBC, doubling of progressionfree survival for all patient subgroups. Bevacizumab is generally well tolerated. The most common adverse events observed in trials hypertension, proteinuria, and wound-healing complications, most of which are grade 1-2 in severity. The registration of bevacizumab for MBC therapy brings new hope for patients. Novel approach of bevacizumab for MBC would be combination chemotherapy and different targeted therapies. Phase III clinical trials of bevacizumab are ongoing in different stages in different settings.]
Lege Artis Medicinae
OCTOBER 19, 2008
[THE ROLE OF HYDROMORPHONE IN PAIN KILLING]
[The hydromorphone is a potent semisynthetic opioid agonist which is available in several forms including injection immediately release or retard tablets. Its analgesic efficacy surpasses morphine. The absorption of oral osmotic retard tablet is independent from food- or alcoholconsumption providing steady plasma concentration by once daily application. The clinical pharmacology of hydromorphone is summarized.]
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
[SEVERE NECROTISING PRIMARY VASCULITIS - CASE REPORT]
[INTRODUCTION - Vasculitis is an inflammatory disorder of the vessels, often associates with necrosis. The primary (idiopathic) form caused by distinct immunological mechanisms, the secondary form caused by infection, tumor, drugs or systemic autoimmune disease. CASE REPORT - 57-year-old smoking female patient with a medical history of the left ankle fracture. Four days earlier had sore throat, at admission was febrile and generally weak and had severe pain in her lower extremities. Physical examination revealed numerous livid alterations in both lower extremities, necrotic change of some toes and new onset of diastolic hypertension. Elevated serum transaminase levels, severe thrombopenia, anemia, leukocytosis suggested the possibility of thrombotic thrombocytopenic purpura and vasculitis. Tests ruled out septic embolism, therefore we applied high dose steroid treatment and plasma exchange. Meanwhile the results fulfilled the classification criteria of polyarteritis nodosa (vasculitis, livedo reticularis, polyneuropathia and new onset of diastolic hypertension), accordingly we synchronized the treatment with fractionally administered intravenous cyclophosphamide. The process revealed responsive to therapy and the substantive function of the legs remained after surgical removal of the necrotic areas. CONCLUSIONS - Early rapid diagnosis of vasculitis is fundamental and we emphasize the significance of the efficient treatment.]
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
Lege Artis Medicinae
OCTOBER 19, 2008
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