Lege Artis Medicinae - 2015;25(08-09)

Lege Artis Medicinae

SEPTEMBER 20, 2015

[Causes and pathological appearances of ischemic heart diseases]

MAGYAR Éva, FECSKE Éva, SALAMON Ferenc

[The myocardial ischemia is caused by insufficient offer of oxygen, it can be caused by damage of coronary arteries which is called coronary heart disease, and might be non coronary in origin, this is the relative coronary insufficiency. The reason of coronary heart diesease is the stenosis or occlusion of the lumen of subepicardial main coronary branches as well as intramyocardial small vessels. The type of alterations either of the main or the small vessels are mentioned. The myocardial bridge play an important part in genesis of intimal plaques. The discrepancy occuring between the actual oxygen demand and oxygen offer causes the relative coronary insufficiency, such as myocardial hypertrophy, anemia, shock, fever etc. The myocardial damages, those of caused ischemia can be devided pathologically irreversibile lesions (infarction, coagulative and colliquation myocytolysis) and ischemic heart disease (ischemic cardiomypathy) and clinically angina pectoris and sudden death. The irreversible lesions are detailed in morphological point of view, and differenece between the regional and subendocardial infarction is accentuated.]

Lege Artis Medicinae

SEPTEMBER 20, 2015

[Perioperative management of patients taking new oral anticoagulants - dabigatran in focus]

MÁRK László

[Appearance of new oral anticoagulants (NOAC) on the market requires a basically new approach from the doctors compared to vitamin K antagonists (VKA), the only oral anticoagulants used for several decades. These new drugs are at least as effective in the prevention of thrombotic events as the old ones and have the advantage that no regular laboratory monitoring is needed. Compared to the VKA a different management is required also in the perioperative care of patients taking NOAC. There is no need for bridge therapy, i.e. low-molecular-weight heparin (LMWH). The smaller surgical procedures can be performed 24 hours after the last dose of NOAC if it is administered once a day or 12 hours in case of agents administered twice a day. When a large surgical procedure is planned the drug should be stopped 24-96 hours before. The therapy should be resumed 6-8 hours after the procedure in low, 48-72 hours later in high bleeding risk cases. In a Canadian prospective study a protocol was used in which the stopping and resumption of dabigatran was recommended based on the bleeding risk and its half-life depending on the renal function. In 541 surgeries (60% with standard, 40% with increased bleeding risk) the occurrence of serious bleeding events was 1.8%, that of minor bleedings 5.2%. During the study one thrombotic event (TIA) occurred (0.2%). At the end of the article the author also makes a recommendation for stopping and resuming dabigatran therapy in case of tooth extraction, endoscopic biopsy and cholecystectomy.]

Lege Artis Medicinae

SEPTEMBER 20, 2015

[Pleiotrop effect of rosuvastatin: clinical revelance of decreasing the mean platelet volume]

PUKOLI Dániel, SEMJÉN Judit, SZÉKELY Anita, RAJDA Cecília

[INTRODUCTION -Activated platelets play a key role in the patomechanism of cardiovascular diseases. One biomarker of platelet activation is mean platelet volume (MPV). Increased MPV level is connected to higher cardiovascular risk. Statins are frequently used in vascular diseases. We examined the effect of rosuvastatin on platelets in serum. METHODS - The patient were divided in medium risk and high risk (suffering ischaemic stroke) groups. Altogether parameters (total-, HDL, LDL-cholesterol, MPV) of 66 patients were examined before and after rosuvastatin treatment. RESULTS - Rosuvastatin decreased the cholesterol and MPV levels in both groups. This effect was greater in the high risk group. DISCUSSION - According the our findings rosuvastatin decreases the MPV both in hypercholesterolaemic and ischaemic stroke patients. The high LDL level causes increased platelet activation leading to increased thrombosis. This cascade worsens the underlying pathways in cardiovascular diseases. We found that aspirin taken together with rosuvastatin has a greater effect on decreasing the MPV. This probably doubles the antithrombotic effect. ]

Lege Artis Medicinae

SEPTEMBER 20, 2015

[Verruca like terime in armpit with unusual location]

VERTSE Gergely, NAGY Jenő, SZELECZKY Márton, IVÁNYI András, SVASTICS Egon

[Authors present a case of a patient suffering from a verrucous lesion in the right armpit. The patient underwent a succesful operation. Histological report revealed verrucous carcinoma. The site of origin is uncommon, and there was no previous history of any inflammation at the involved region. General characteristic features of verrucous carcinoma are also shortly described.]

Lege Artis Medicinae

SEPTEMBER 20, 2015

[Evaluation of body image by means of body shape test and the priming phenomenon]

KOVÁCS Gyöngyvér Xénia, PRIEVARA Dóra Katalin, PIKÓ Bettina

[INTRODUCTION - Body image plays a significant role in the way how the individuals evaluate their own health and in the motivation for health promotion and disease prevention. Consumer culture provides controversial messages for the population, on one hand it motivates to try foods of high calories, on the other hand it also supports the thin body for the ideal. Not surprisingly, besides obesity, eating disorders and distorted body image disorders also tended to increase during the past decades. Therefore, it would be relevant to investigate the background variables of body image. METHODS - One hundred and sixty seven healthy working adults participated in our study that included a self-completed, voluntary and anonymous questionnaire with a focus on the so called body shape test. First, based on projecting figures on slides, the participants evaluated their own figure and the ideal one as perceived by them. Then we projected figures of skinny models. After this they re-evaluated themselves. The goal of this investigation was to detect the priming effect of projecting slim figures that is frequently used in the media. RESULTS - Based on the projection of the skinny models, there was a change in 55.6% of the sample in the evaluation of one’s own figure. On a Likert-type scale of 1-7 points, previously they had evaluated themselves with an average of 3.23 points (thinness scale) that turned into 3.35 after the projection of the skinny models. In addition, their view about their own ideal body (4.57 points), and about female and male ideal body also changed into a slimmer one. These changes were statistically significant (p < .001) by paired t-test both for men and women. Finally, men and women did not show significant difference in the evaluation of female and male ideal body. CONCLUSIONS - These results justified the role of the pictures’ priming effect in body image both in terms of the perception of one’s own figure and the ideal body. The change was particularly relevant in the case of evaluation of one’s own figure due to the choice of the slimmer body as compared to the view of the ideal body. Evaluation of female and male ideal body was similar to the first projection of the pictures as compared to what they would think as ideal for themselves. After the projection images of the female and male ideal body moved to the slimmer figures in a smaller account as compared to the own ideal body image. All these suggest that pictures projected by the media may have a significant role in the population’s body image. Clarifying the phenomenon may help in health promotion and dieting related disease prevention. ]

Lege Artis Medicinae

SEPTEMBER 20, 2015

[The place of palliative endocrine therapy in the treatment of a premenopausal breast cancer patient]

BÁNHEGYI Róbert János, VARGÁNÉ Tamás Rózsa, ZSILÁK János, FÜLÖP Ferenc, FÜLÖP Norbert, PIKÓ Béla

Lege Artis Medicinae

SEPTEMBER 20, 2015

Lege Artis Medicinae

SEPTEMBER 20, 2015