Lege Artis Medicinae

[A French Poet as a Dietitian]

KIS Domokos Dániel

NOVEMBER 20, 2007

Lege Artis Medicinae - 2007;17(11)

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Scientific digest]

Lege Artis Medicinae

[PAIN RELIEF IN THE CLINICAL PRACTICE - THE USE OF MAJOR ANALGETICS]

HORVÁTH J. Attila

[The use of opioids to relieve strong, unbearable pain is a method that has been known for thousands of years and is still effective today. In contrast to the earlier view, opioids today are not only given to cancer patients. The application area of morphine derivatives is generally the relief of exceptionally strong pain regardless of the diagnosis, but opiates are undoubtedly most commonly used to treat cancer-related or strong acute pain. Strong pain reducers are used much more in developed countries for the treatment of non-cancer related severe pain refractory to other approaches. Today the use of opiates and their derivatives (fentanyl, oxycodon) for non-cancer related pain relief is recognized by the national health insurance in that it allows general practitioners to prescribe them, upon the recommendation of a neurosurgeon, orthopaedic surgeon, traumatologist or rheumatologist, with a significant 90% subsidy for six months to ensure easy access for patients in severe, refractory pain due to degenerative musculoskelatal diseases (ICD: M47, M48, M16.9, M17.9, M54.4, M51.0, M51.1). The indications of opioid use, however, are not limited to strong nociceptive pain since they are also effective in certain types of peripheral neuropathic pain. In brief, a basic principle of the use of major analgetics is that their indication is primarily based on the intensity of pain and not on the nature of the disease, even though the latter has a major influence on the clinician's strategy of pain relief.]

Lege Artis Medicinae

[Music Therapy in the Treatment of Cancer Patients ]

KOLLÁR János

Lege Artis Medicinae

[HUMAN LEUKOCYTE INTERFERON IN THE TREATMENT OF CHRONIC HEPATITIS C]

TELEGDY László, HORVÁTH Gábor, TOLVAJ Gyula, MAKARA Mihály, MONTSKÓ Valéria, OZSVÁR Zsófia, NEMES Zsuzsanna, PÉTERFY Zoltán, SZENTGYÖRGYI László

[INTRODUCTION - Approximatively 50% of the patients with chronic hepatitis C do not respond properly to pegylated interferon-alpha+ribavirin treatment and according to the therapeutic guidelines their treatment must be interrupted. The authors examined whether their further medication with human leukocyte interferon is justified. PATIENTS AND METHODS - Thirty-eight patients with chronic hepatitis C were treated with human leukocyte interferon who had responded to pegylated interferon-alpha-ribavirin treatment, but dropped out of the treatment scheme based on the therapeutic criteria on week 12 or 24. RESULTS - While only 3 patients responded with persistent virological negativity, mean alanine aminotransferase (ALT) levels decreased during treatment and persistently remained lower than the baseline levels. Except for the three responders, the HCV viral load as determined by polymerase chain reaction did not decrease but even increased on average. Patients tolerated the treatment well. Known side-effects were observed in 6 cases, and treatment had to be interrupted in one case. These are proportionally far less than the respective 20 to 25% and 5 to 15% reported for peginterferon-ribavirin treatment. CONCLUSION - Even though virological recovery is rare, the reduction in inflammatory activity, the expected slowing of progression, and, in particular, the definite improvement of the cryoglobulinaemic purpura and vasculitis warrant switching to human leukocyte interferon treatment in selected cases.]

Lege Artis Medicinae

[INFLAMMATION AND ATHEROSCLEROSIS]

JAKAB Lajos

[The role of vascular wall inflammation in the pathogenesis of atherosclerosis is becoming increasingly clear. However, the causal relationship between the inflammation and the course of atherosclerosis, which begins in childhood and continues for life, is debated in the literature. The interpretation of the basic pathophysiologial essence of inflammation is also controversial. This paper summarizes the basics and various features of inflammation, the body's defensive and aversive reaction. The “acute phase reaction syndrome” is a general, immediate, non-specific defense reaction of the organism, which is strongly associated with the specific, adaptive immune response. There are inflammatory processes that are chronic from the start. When looking at the main types and functions of the arterial wall proteoglycans, it is clear that they, along with the lipoprotein receptors and HDL cholesterol, are closely connected to the process, course and characteristics of the inflammation. The arterial wall proteoglycans are definitely capable of directly and indirectly influencing the inflammatory process. The issue of a possible target of statin derivatives other than the inhibition of cholesterol biosynthesis has not been resolved. Atherosclerosis may be considered a primarily chronic individual vasculitis syndrome that involves all layers of the blood vessels, and is determined by the risk factors and by the special structure of the arterial wall. The presence of inflammation is a prerequisite to the development and throughout the entire course of atherosclerosis.]

All articles in the issue

Related contents

Hungarian Radiology

[16th French-Hungarian Radiological Symposium - Budapest, 16th-18th April, 2008]

– H. E. –

Lege Artis Medicinae

[Poet and hedonist - Franz Schubert]

MALINA János

Hungarian Radiology

[13th French-Hungarian Radiologic Symposium and 5th Eastern-Central European Francophone Congress of Radiology]

- va -

Lege Artis Medicinae

[Friedrich Schiller – a Physician or a Poet Prince?]

BECHER Péter, PATAI Árpád, MÁJER Katalin

Lege Artis Medicinae

[Pycnogenol in the clinical practice of French maritime pine bark extractum]

KISS István, TAVASZY Mariann, FARSANG Csaba

[Polyphenols, which belong to the group of flavonoids, can be found in a number of plants, and are present in a high concentration in the French maritime pine bark. The authors summarise results of large-scale experimental and clinical studies on pycnogenol, the standardised extract of French maritime pine bark. Pycnogenol decreases production and effects of free radicals (antioxidant effect). It has antiinflammatory properties, and, by the stimulation of eNOSsynthesis, it increases the production of vasodilatory compounds (e.g. NO, prostacyclin) and decreases that of vascoconstrictor compounds (endothelin-1, thromboxane) materials. These changes lead to vasodilation, which results in increased tissue perfusion and decreased blood pressure. Pycnogenol also decreases platelet aggregation and LDL-cholesterol level and increases HDL-cholesterol level. Its antidiabetic effect has also been shown. Consequently, it may substantially decrease cardiovascular risk. In addition to these results, pycnogenol has been also found to have antibacterial and antiviral effects. It has been successfully used in children with attention deficit hyperactivity disorder, as well as in adults with dysmenorrhea, climacterial disturbances, glaucoma or asthma bronchiale.]