Lege Artis Medicinae

[52nd Congress of American College of Cardiology]

KISS Róbert Gábor1

MAY 20, 2003

Lege Artis Medicinae - 2003;13(04)

AFFILIATIONS

  1. Semmelweis Egyetem, ÁOK, Kardiovaszkuláris Tanszék

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[Human adult lactose intolerance: diagnosis and therapy]

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[Human adult-onset lactase decline, characterised by a decrease in intestinal lactase enzyme activity is a biologic feature characteristic of the maturing intestine in the majority of the world's population. It demonstrates an autosomal recessive pattern of inheritance and it is regulated primarily by the rate of lactase gene transcription. Ingestion of high quantities of lactose-containing foods by patients with adultonset lactase decline results in intestinal symptoms, including bloating, distension, cramps, flatulence and diarrhoea. Due to the differences in the rates of gastric emptying and intestinal transit as well as the abundance of lactosemetabolising bacteria in the colon, the symptoms of lactose intolerance are often quite variable from persons to person. Lactose intolerance usually leads to self-imposed dietary restriction of dairy products, the main source of calcium intake, therefore it appears to be a risk factor for development of osteoporosis. Consumption of milk with solid foods can reduce symptoms in many individuals. Yoghurt containing active cultures are useful substitute for whole milk. Prehydrolized milk and lactase enzyme containing tablets are also available in the treatment.]

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[The nitrates are one of our oldest medicine. This article summarizes the general and the cardiovascular effect of the nitrates, the question of the nitrate tolerance and the ways of avoiding this. On the basis of the clinical studies the article describes the theoretical and practical results of the nitrate therapy in myocardial infarct and post-MI patients. It also summarizes the cardiac and extracardiac indications of the nitrates with special regard to acute cardiac conditions (acute heart failure, pulmonary edema) and analyses the side effects and the contrindications of the drug.]

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JUHÁSZ Levente Zsolt, KEMÉNY Katalin, LINKA Emese, SÁNTHA Judit, BARTKÓ György

[Introduction - The purpose of our study was to find out whether the Hungarian adaptation of the RBANS (Repeatable Battery for the Assessment of Neuropsychological Status), a brief neurocognitive screening test, is appropriate for the differentation of healthy and non-healthy subject groups, or for the detection of differences between the cognitive performance of patient groups. Patients and method - The test battery was administrated to 38 healthy subjects, 69 schizophrenic patients, and 18 patients suffering from dementia (10 probable Alzheimer-type and eight vascular dementia). Results - There was a significant decrease of performance in all patient groups compared to the healthy group. In the schizophrenic group, the test indicated a deterioration of functioning in all cognitive areas. The patient group with Alzheimer-type dementia performed only slightly better than the schizophrenic group, because the fall of performance was not significant only one of the cognitive areas (in the visuo-spatial tasks) when compared to the healthy group. There was no difference between the performance of patients with vascular dementia and that of healthy subjects in direct memory, verbal and visuo-spatial tasks. The test results indicated an even deterioration of cognitive areas in patients with Alzheimer-type dementia. As for the vascular dementia group, the most vulnerable area proved to be that of attention, while their verbal functions were relatively spared. The deterioration in other cognitive functions shown by schizophrenic subjects was more moderate, but still significant. A comparison of the RBANS scores of the schizophrenic patients in our study and the result of an American study was also carried out. The global indeces showed no difference; only the pattern of the sub-scales was a little different. Conclusion - The Hungarian version of the RBANS seems appropriate for the differentiation of healthy and deteriorated cognitive performance in a Hungarian patient population.]

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[Assessment of early atherosclerosis and decreased arterial elasticity to recognise the cardiovascular dysfunction in high-risk patients has gained importance in the past decade. Since 1990, more than 630 papers have been published in the adult and pediatric literature. Methods of early risk assessment in adults are well determined in international recommendations. The aim of the present work is to review the suggestions of the American Heart Association helping us to find the most appropriate method for the non invasive methods of cardiovascular assessment of young adults and children. Furthermore, multicentric studies should be conducted to create a Framingham like score system for pediatric patients, to render cardiovascular risk assessment much easier for the every day routine.]