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Lege Artis Medicinae - 2020;30(04-05)
Content
Lege Artis Medicinae
APRIL 18, 2020
Lege Artis Medicinae
APRIL 18, 2020
[What is worth to know about COVID-19 for (not only) a cardiologist]
[SARS-CoV-2 virus infection sprang from Wuhan the capital of the Chinese Hubei province, at the end of 2019 and caused a worldwide pandemic with 1.5 million confirmed cases and claimed almost 100 000 victims until the beginning of April, 2020. First analyses of Chinese COVID-patients confirmed that diabetes, hypertension, and cardiovascular diseases were highly prevalent among SARS-CoV2 infected patients, and might be associated with poor outcome. As previously shown for SARS-CoV-1, SARS-CoV-2 similarly utilizes ACE2 as receptor for viral alveolar cell entry. A suspicion has arisen that the widely used ACE-inhibitor/ARB therapy could be potentially harmful for patients suffering from COVID-19 infection as these agents upregulate the ACE2-expressions. From the other point RAAS-blockade might be beneficial due to fact that ACE2 counters the deleterious effects of Angiotensin II. Authors provide a comprehensive overview of the most recent literature and summarize the link between COVID-19 and cardiovascular disease. It is important to emphasize that there are no available human evidences confirming if the RAAS-inhibitor therapy were harmful or helpful in patients suffering from COVID-19.]
Lege Artis Medicinae
APRIL 18, 2020
[Interrelations between antidepressants and diabetes]
[Diabetes and depression are frequent comorbidities. They are a heavy burden by themselves, however, as comorbidities increase additionally the number of diabetes-related complications, morbidity, and mortality. In the background of interrelations, there are both well-known and hypothetical mechanisms. The aim of the present review is to outline these interrelations between antidepressants and diabetes and to discuss the effect of medications on carbohydrate metabolism respectively. Antidepressant treatment on the one hand may improve mood, cognitive function and medication adherence leading to an improved glucose metabolism, on the other hand through their metabolic side effects, they may worsen carbohydrate metabolism. Concerning metabolic side effects, selective serotonin reuptake inhibitors are the safest, while tricyclic antidepressants and monoamine oxidase inhibitors should be administered under close monitoring. Serotonin and noradrenaline reuptake inhibitors may deteriorate glycaemic control via increased noradrenergic activation. Novel antidepressants, however, have a neutral or positive impact on glycaemic measures. Screening for and temporally adjusted treatment of depression may decrease the risk of comorbidities generated complications. While caring for diabetic patients with depression, one should consider metabolic side effects of antidepressants and close monitoring of carbohydrate metabolism.]
Lege Artis Medicinae
APRIL 18, 2020
[The relationship of traumatic experiences and eating disorders – therapeutical options]
[In the etiology of eating disorders (especially bulimia nervosa and binge eating) traumatic experiences (sexual, physical, emotional abuse, neglect) play an important role. Traumatization can have a serious impact, which is influenced by the parameters of the traumatization, risk and protective factors, and the resiliency of the traumatized patient. The consequences may lead to the development of specific psychiatric and somatic disorders, and may cause lifetime revictimization. The exploration of data related to the traumatization is essential in eating disorders as well. If traumatic expericences can be detected in the background of eating disorders, the targeted therapy of eating disorders while applying its specific elements should also follow the guidelines of the general trauma-therapy. Providing safety in therapeutical relationship is fundamental. The therapeutic options are extensive. Along with psychodynamically oriented therapies, the newer methods based on cognitive-behavioral therapy (e.g., dialectic behavior therapy, integrative cognitive analytic therapy) are also proposed. Hypnotherapy can also be useful. ]
Lege Artis Medicinae
APRIL 18, 2020
[About general practitioners in Hungary - without political roadblocks]
[A brief introduction about the primary care’s evolution is rather improving the clear sight since it supports our right judgement and helps to draw right consequences. Thus, we are able to realise more precisely our strategic aims, actual domestic problems, and the forced pathways indicated by the prevailing trends and the action radius of our reform endeavours. The present study shows hidden risks encoded in human resources, specialists’ services and shed light into the grey zone of remuneration. Indeed, the trends are alarming, the spaces are narrow for actions nevertheless we can escape our century old legacy by innovative solutions. While re-thinking totally the whole system nevertheless maintaining all immanent principles we can just in the short run revitalise our ailing primary health care. ]
Lege Artis Medicinae
APRIL 18, 2020
[Digitally-assisted treatment planning in precision oncology]
[The progress of molecular information based on personalized precision medicine has reached a new milestone. Actually, about 6 million mutations of 600 genes may be related to the development of cancer, and on average, 3-4 of these “driver” mutations are present in each patient. Due to the progress in molecular diagnostics, we can now routinely identify the molecular profile of tumors in clinical settings. By clinical translation, there are actually available more than 125 targeted pharmaceuticals and hundreds of such therapies are under clinical trial. As a result, we have many first-line and licenced treatment options to be elected by molecular information as the optimal one for every patient. There is an increasing need for complex informatics solutions by medical software. Geneticists, molecular biologists, molecular pathologists, molecular pharmacologists are already using bioinformatics and interpretation software on their daily work. Today, online digital tools of artificial intelligence are also available for physicians for assisted treatment planning. Telemedicine, videoconferencing provide solutions for interdisciplinary virtual molecular tumor boards, which democratizes the access to precision oncology for all doctors and patients. ]
Lege Artis Medicinae
APRIL 18, 2020
Lege Artis Medicinae
APRIL 18, 2020
Lege Artis Medicinae
APRIL 18, 2020
Lege Artis Medicinae
APRIL 18, 2020
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Clinical Neuroscience
Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease
08. JUN
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Lege Artis Medicinae
[We do not know that the phenotype of the coronavirus would have changed]
25. OCT
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Lege Artis Medicinae
[Teleconsultations in general practice during coronavirus epidemiological emergency]
25. OCT