Lege Artis Medicinae

[57th Annual Meeting of the American Association for the Study of Liver Diseases]

PÉTER Zoltán

FEBRUARY 22, 2007

Lege Artis Medicinae - 2007;17(02)

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Further articles in this publication

Lege Artis Medicinae

[Zoonoses in focus]

LAKOS András

Lege Artis Medicinae

[ASSESSMENT OF THE QUALITY OF LIFE AND THE ATTITUDES TO AGEING OF ELDERLY PEOPLE]

TRÓZNAI Tibor, KULLMANN Lajos

[BACKGROUND - The WHOQOL-OLD questionnaire was developed in a multicultural way. The authors were involved in this work as members of the international task force. In order to improve services for the elderly by learning their attitudes to ageing, an Attitudes to Ageing Questionnaire (AAQ) was also developed by the working group. In the present study the authors assessed a sample of Hungarian elderly people by these two methods. Answers by elderly persons related to their quality of life, social and health conditions, as well as their attitude to ageing were analysed. PERSONS AND METHOD - A total of 333 (190 unhealthy and 143 healthy) persons over sixty years of age filled in the questionnaires either by themselves or through verbal interview. The participants’ compliance with the research was generally good. The study sample reflected the general features of the Hungarian elderly population. For statistical analysis the Microsoft SPSS for Windows version 11.0 programme was used. RESULTS - Better health condition, better mood, and a better ability for self-care improve the quality of life. Better attitudes to ageing are associated with better quality of life. CONCLUSIONS - The use of the WHOQOLOLD questionnaire is recommended in the daily practice to assess elderly Hungarians’ quality of life. The results highlight the significance of mental health in the development of the elderly persons’ attitude to ageing. The use of the new questionnaires may help change negative stereotypes related to ageing.]

Lege Artis Medicinae

[A RARE, HISTOLOGICALLY COMPLEX LIVER TUMOUR]

HIDVÉGI Judit, BAJTAI Attila, VARGA Árpád

[INTRODUCTION - Among the primary malignant tumours of the liver, hepatoblastoma is extremely rare in adults in contrast to its frequency in children. Only 23 such cases have been published to date. Mixed tumour of the liver and carcinosarcoma of the liver are used as synonyms for adult hepatoblastoma. The tumours have both mesenchymal and epithelial components (hepatocellular or cholangiocellular carcinoma) with focal bone and/or cartilage formation. CASE REPORT - A 78-year-old woman was admitted to the surgery department with increasing anaemia and persistent abdominal pain. An emergency operation was performed. Her peritoneal cavity was filled with blood due to the rupture of a tumour that occupied the right lobe of the liver. The neoplasm could only be removed partially. Despite an intensive care, the patient's state could not be stabilized and she died a day after the operation. The histological diagnosis was carcinosarcoma of the liver with an AFP- and cytokeratin-positive epithelial component and a spindle cell component positive for vimentin. The osteogen sarcoma found in the tumour was strongly positive for the S-100 protein. DISCUSSION - The authors review the hypotheses for the formation of adult primary hepatoblastoma, a combined tumour, they describe their various types and the immunohistochemical tests that are used in their identification.]

Lege Artis Medicinae

[Crosshairs on Psychoanalysis Attila Bánfalvi: Loss of Depth]

MAGYAR László András

Lege Artis Medicinae

[DIURETICS IN CARDIOLOGY: PRESCRIBE OR USE?]

NAGY Viktor

[Diuretics are essential therapeutic tools. They effectively reduce blood pressure and have been shown in numerous hypertension clinical trials to reduce both cardiovascular and cerebrovascular morbidity and mortality. In addition, they are important components of the treatment of heart failure with apparent signs of congestion. While thiazides are recommended in mild forms, loop diuretics are used in the severe stages of congestive heart failure. Loop diuretics and thiazides often induce hypokalaemia, which has been demonstrated to be not as benign as thought before. Diuretic-induced hypokalaemia seems to be aldosterone dependent. Aldosterone levels increase during diuretic therapy. Aldosterone antagonists are unique among diuretics in that they improve survival of patients with heart failure independent of their effect on sodium metabolism. Because of this, diuretic treatment lives its renaissance in cardiology.]

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[Comment to the article titled “Exploratory study of outcomes of blood sample mass examinations by rank correlations”]

Lege Artis Medicinae

[The author’s response to the comment on “Exploratory study of outcomes of blood sample mass examinations by rank correlations”]

Clinical Neuroscience

The etiology and age-related properties of patients with delirium in coronary intensive care unit and its effects on inhospital and follow up prognosis

ALTAY Servet, GÜRDOGAN Muhammet, KAYA Caglar, KARDAS Fatih, ZEYBEY Utku, CAKIR Burcu, EBIK Mustafa, DEMIR Melik

Delirium is a syndrome frequently encountered in intensive care and associated with a poor prognosis. Intensive care delirium is mostly based on general and palliative intensive care data in the literature. In this study, we aimed to investigate the incidence of delirium in coronary intensive care unit (CICU), related factors, its relationship with inhospital and follow up prognosis, incidence of age-related delirium and its effect on outcomes. This study was conducted with patients hospitalized in CICU of a tertiary university hospital between 01 August 2017 and 01 August 2018. Files of all patients were examined in details, and demographic, clinic and laboratory parameters were recorded. Patients confirmed with psychiatry consultation were included in the groups of patients who developed delirium. Patients were divided into groups with and without delirium developed, and baseline features, inhospital and follow up prognoses were investigated. In addition, patients were divided into four groups as <65 years old, 65-75 yo, 75-84 yo and> 85 yo, and the incidence of delirium, related factors and prognoses were compared among these groups. A total of 1108 patients (mean age: 64.4 ± 13.9 years; 66% men) who were followed in the intensive care unit with variable indications were included in the study. Of all patients 11.1% developed delirium in the CICU. Patients who developed delirium were older, comorbidities were more frequent, and these patients showed increased inflammation findings, and significant increase in inhospital mortality compared to those who did not develop delirium (p<0.05). At median 9-month follow up period, rehospitalization, reinfarction, cognitive dysfunction, initiation of psychiatric therapy and mortality were significantly higher in the delirium group (p<0.05). When patients who developed delirium were divided into four groups by age and analyzed, incidence of delirium and mortality rate in delirium group were significantly increased by age (p<0.05). Development of delirium in coronary intensive care unit is associated with increased inhospital and follow up morbidity and mortality. Delirium is more commonly seen in geriatric patients and those with comorbidity, and is associated with a poorer prognosis. High-risk patients should be more carefully monitored for the risk of delirium.

Hypertension and nephrology

[Polycystic kidney]

DOLGOS Szilveszter, TÁRNOKI Ádám Domonkos, TÁRNOKI Dávid László

[The most common monogenic nephropathy is a congenital, cystic, bulky process in the kidney that leads to a gradual deterioration in renal function. Renal failure is often associated with cystic liver or pancreatic lesions, cerebral artery aneurysm, or mitral prolapse.]

Clinical Neuroscience

Autonomic nervous system may be affected after carpal tunnel syndrome surgery: A possible mechanism for persistence of symptoms after surgery

ONDER Burcu, KELES Yavuz Betul

After carpal tunnel surgery, some patients report complaints such as edema, pain, and numbness. Purpose – The aim of this study was to evaluate autonomic nervous system function in patients with a history of carpal tunnel surgery using sympathetic skin response (SSR). Thirty three patients (55 ±10 years old) with a history of unilateral operation for carpal tunnel syndrome were included in the study. The SSR test was performed for both hands. Both upper extremities median and ulnar nerve conduction results were recorded. A reduced amplitude (p=0.006) and delayed latency (p<0.0001) were detected in the SSR test on the operated side compared to contralateral side. There was no correlation between SSR and carpal tunnel syndrome severity. Although complex regional pain syndrome does not develop in patients after carpal tunnel surgery, some of the complaints may be caused by effects on the autonomic nervous system.