Lege Artis Medicinae

[A Bit of Architecture...]

GRÉTSY Zsombor

MAY 21, 2006

Lege Artis Medicinae - 2006;16(05)

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Lege Artis Medicinae

[Risk of death - with or without metabolic syndrome]

NAGY Viktor

Lege Artis Medicinae

[NEW DATA ABOUT INFLAMMATORY MYOPATHIES]

DANKÓ Katalin, PONYI Andrea, CONSTANTIN Tamás

[Idiopathic inflammatory myopathies are systemic autoimmune diseases with an immune-mediated inflammation of the striated muscles which lead to progressive muscle weakness. Their cause is still unknown, but recently the understanding of the molecular immunopathology has improved, which may as well offer therapeutic targets in the future. The aim of this review is to present currently available data on the most important factors and processes that are involved in the pathogenesis of these diseases. Although glucocorticoids remain the cornerstone of the treatment for the major forms of idiopathic inflammatory myopathies, there are other efficacious immunosuppressive agents with fewer side effects. The authors discuss classic treatment regimens as well as more recent therapeutic approaches.]

Lege Artis Medicinae

[BETA-CELL DYSFUNCTION AND PROTECTION IN TYPE 2 DIABETES]

VÁNDORFI Győző, URICH Elemér

[Type 2 diabetes is caused by increased insulin resistance coupled with the disturbance of the secretion function of beta-cells. While the importance of insulin resistance has been emphasized in the last two decades, the pathogenetic role of beta-cell dysfunction has received less attention. Regarding this latter, several underlying mechanisms have been implicated, including increased secretory demand due to insulin resistance, glucose toxicity, lipotoxicity, islet cell amyloid deposition, and insulin resistance of the beta-cells themselves. In the milestone UKPDS (United Kingdom Prospective Diabetes Study) trial the metabolic status of the patients gradually deteriorated after 1 to 2 year of temporary improvement despite of an intensive sulfonylurea, insulin or metformin treatment. Progression of the disease could be slowed down but not stopped, which was attributed to progressive beta-cell failure. In this regard the insulinsensitizer thiazolidinediones, having recently joined the therapeutic palette, are promising because they protect and spare beta-cells through several ways. However, as the disease carrier progresses, it can reach a point when without using insulin the treatment cannot be successful anymore. Early use of thiazolidinediones may result in a marked delay of this point. This concept is supported by studies completed so far, and further clinical trials are ongoing so as to strengthen the evidence.]

Lege Artis Medicinae

[MEDICINAL HERBS IN THE TREATMENT OF LIVER DISEASES]

SCHULLER János

[Today, alternative medicine is increasingly popular among patients. Patients with liver diseases surprisingly often use complementary treatment, mainly medicinal herbs, with or without the knowledge of their physician. This is one of the reasons why doctors may not ignore alternative medicine. Another reason is that twenty to thirty percent of medicaments now used in conventional therapy were originally produced from herbs. This means that some of the herbal medicines now applied in alternative therapy may become a conventional drug in the future. This paper reviews publications of evidencebased medicine on herbal medicines most often used in the treatment of liver diseases, including silymarin, glycyrrhizin, phyllantus amarus, CH- 100, LIV.52, sho-saiko-to, bin-gan, compund 861 and oxymatrine. It is important for physicians to be also knowledgeable about potentially hepatotoxic medicinal herbs.]

Lege Artis Medicinae

[In the focus: depression]

RIHMER Zoltán

All articles in the issue

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Ca&Bone

[Comparison of osteodensitometric and quantitative bone ultrasound parameters among patients with pseudopseudohypoparathyroidism, pseudohypoparathyroidism type Ia and primary hyperparathyroidism]

CSUPOR EMŐKE, SZABOLCS István, FERENCZ VIKTÓRIA, GÓTH Miklós, IVÁN Gabriella, GYŐRI Gabriella, KOVÁCS LÁSZLÓ, TÓTH EDIT, MÉSZÁROS SZILVIA, HORVÁTH CSABA

[INTRODUCTION - Parathyroid hormone (PTH) excretion is increased both in primary hyperparathyroidism (pHPT) and in pseudohypoparathyroidism type Ia (PHP Ia). Pseudo-pseudohypoparathyroidism (P-PHP) is considered to be the normocalcemic form of pseudohypoparathyroidism type Ia. Our aim was to assess bone mineral content and bone quality as well as to determine whether these parameters are related to PTH levels in the above mentioned disorders. PATIENTS AND METHOD - 10 patients with pseudopseudohypoparathyroidism (P-PHP, age: 41.6 ±5.4 ys) were compared to 10 patients with primary hyperparathyroidism (pHPT) and to 10 healthy subjects, matched for age and gender. Moreover, nine patients with pseudohypoparathyroidism type Ia (PHP, age: 34.2 ±5.43 ys) were compared to nine age- and gender-matched patients with primary hyperparathyroidism and to nine healthy controls, respectively.The occurrence of previous bone fractures was recorded and bone mass was measured (by dual photon absorptiometry on the axial bones and by single photon absorptiometry on the forearm). Quantitative ultrasound (QUS) examination was performed both on the calcaneus by broadband ultrasound attenuation (BUA, dB/MHz) and speed of sound (SOS, m/s) measurements and on the proximal phalanges by amplitude-dependent speed of sound (AdSOS, m/s) measurements. In addition, some laboratory parameters of calcium metabolism were tested. RESULTS - No difference was found between PHP Ia and pHPT in bone mass.The lowest value was observed at the radius. Among the QUS parameters, pathologically low AdSOS was found at the phalanges in PHP Ia and it was lower than in pHPT patients, whereas at the calcaneus BUA showed a similar tendency. Bone mass did not significantly differ between P-PHP and healthy controls, it was decreased, however, at the forearm in the patients. Pathological AdSOS was found in P-PHP, which was lower than in pHPT. SOS at the calcaneus was lower in P-PHP than in pHPT, though it was not considered pathological. Laboratory results were typical for the diseases and the radiological examinations confirmed the diagnosis. Bone fractures occurred in three and two patients with PHP Ia and P-PHP, respectively, while no fractures were recorded in the pHPT and healthy groups. CONCLUSION - Bone loss among patients with PHP Ia is considered to be the impact of PTH excess on bone tissue.The deterioration of bone quality and architecture may play a role in the development of bone fractures.]

Lege Artis Medicinae

[The healing environment: The landscape architecture’s aspects of the psychiatric institutional gardens development]

VEISZ Adrienn, ILLYÉS Zsuzsa

[According to researches, the surrounding environment of the people has a significant impact on the human well-being, its perception of welfare and may influence its health condition. Even the sight of a spacious, well-maintained, healthy densely vegetated area can strengthen the human body, so it may promote patients by the healing process. On the one hand, this study aims to overview the international literatures and best practises of the healingand therapeutic gardens. Our other goal was to show the potential feasibility of the theoretical principles by preparing analysis, evaluation and a detailed conception plan for a chosen institution garden. We also formulated generally applicable design guidelines for psychiatric home garden design. This research is aimed to contribute the creation an important objective of the European Union, to achieve equal opportunities.]

Journal of Nursing Theory and Practice

[How to break medical bad news? The importance of the course for breaking medical bad news and an evaluation of his curriculum]

MÁTÉ Orsolya, PUSZTAFALVI Henriette, BRANTMÜLLER Éva

[Breaking bad news to patients is a difficult task for health care professionals and there are many unsolved issues in this area. There are several ways of delivering bad news and the quality of the communication could affect the whole life of the patient. However the wrongly delivered bit of bad news could not only cause a crisis for the recipient but will create a stressful situation for the communicator. The course created at the University of Pécs, Faculty of Health Sciences is specified to the delivery of bad news with modern communication methods, which uses video feedback method to analyse and develop the participants’ communicational attitude, thus providing potent aid for the acquisition of the proper communicational techniques, from which both the patient and the care giver can profit.]

Clinical Neuroscience

[Sleep disordered breathing and epilepsy: relationships and therapeutic considerations]

FALUDI Béla, BÓNÉ Beáta, KOMOLY Sámuel, JANSZKY József

[The importance of the sleep related breathing disorders (obstructive sleep apnea syndrome, central sleep apnea, and Cheyne-Stokes breathing) in the pathophysiology crebro- and cardiovascular disorders is well known. The relationship of sleep related breathing abnormalities and epilepsy is also important but underestimated in the daily practice. The relation is bidirectional. The breathing abnormalities in sleep may play important role in generating epileptic seizure, but the adverse effect of seizure and antiepileptic therapy (generation of apneas and hypopneas) may worsen the seizure control. The effect of new therapies (vagal nerve and deep brain stimulation) on the sleep architecture and sleep disordered breathing must be examined and discussed. Here we present a brief case of epileptic patient with deep brain stimulation therapy on sleep as well. The examination of the sleep related breathing abnormalities in epilepsy patient may help improve the effectiveness of antiepileptic therapy.]

Lege Artis Medicinae

[A Bit of Astronomy]

GRÉTSY Zsombor