Lege Artis Medicinae

[ABNORMAL ALBUMINURIA IS A CARDIOVASCULAR RISK FACTOR IN DIABETIC PATIENTS - ACHIEVING THERAPEUTIC GOAL IN PRACTICE]

WITTMANN István1, WAGNER László1, WAGNER Zoltán1, MOLNÁR Gergő Attila1, TAMASKÓ Mónika1, LACZY Boglárka1, MARKÓ Lajos1, MOHÁS Márton1, NAGY Judit1

DECEMBER 20, 2005

Lege Artis Medicinae - 2005;15(12)

[The stages of abnormal albuminuria are microand macroalbuminuria. The isolated abnormal albuminuria is a special form of proteinuria. For the detection of abnormal albuminuria one can use immunological or liquid chromatographic methods. The latter seems to be more appropriate than the immunological methods for the measurement of albuminuria in normo- and microalbuminuric diabetic patients. In diabetes mellitus, the circulating glycated and oxidized albumin is degraded and eliminated in the kidney. Decrease of the glomerular filtration rate is a valuable measure of renal insufficiency and this loss of kidney function is followed by the decrease of albuminuria as a sign of the glomerular closure. Albuminuria is an important cardiovascular risk factor and the decrease of the abnormal albuminuria is associated with a diminishing cardiovascular risk. Thus, albuminuria is a cardiovascular therapeutic target, as well. Therefore, the major points of the management of diabetic albuminuria are the achievement of euglycaemia, the use of angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers.]

AFFILIATIONS

  1. Pécsi Tudományegyetem, Általános Orvostudományi Kar, II. Sz. Belgyógyászati Klinika és Nefrológiai Centrum

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[THE EFFECT OF BALNEOTHERAPY AND HIDROTHERAPY IN LOCOMOTOR DISEASES - AN OLD THERAPY REBORN]

BENDER Tamás

[Hungary is respected as an “Empire of thermal water” and balneotherapy has been an important part of health tourism. Recently, an increasing number of articles have been published which investigate the effect of thermal water on patients suffering from locomotor diseases. Balneotherapy has a beneficial painkiller effect and improves the quality of life in several cases of inflammatory and degenerative disorders of joint and bone diseases. The physical effect in its mechanism plays much greater role than the chemical one. A great number of evidence can be found in the medical databases proving the positive effect of balneotherapy in musculoskeletal diseases. Balneotherapy stands as an important factor in the National Development Plan of Hungary but we should like to emphasise that without basic research there is no effective balneotherapy.]

Lege Artis Medicinae

[Results of IDEAL study]

CZURIGA István

Lege Artis Medicinae

[In the focus: locomotor diseases]

GÉHER Pál

Lege Artis Medicinae

[PENILE VEIN THROMBOSIS AT YOUNG AGE]

KOVÁCS GÁBOR, GASZTONYI Beáta, BATTYÁNY István, NAGY Ágnes, BUZOGÁNY István, KASSAI Miklós, HUNYADY Béla, LOSONCZY Hajna

[INTRODUCTION - Mondor’s disease is an uncommon disorder occuring mostly in middleaged women and characterized by superficial thrombophlebitis classically involving the thoraco- epigastric veins. Rarely, cases have been reported in atypical sites (upper arms, abdomen, groin and penis). CASE REPORT - This is the first case being published in the Hungarian literature. The young male patient's complaints were caused by penile vein thrombosis which was demonstrated on physical examination and Doppler ultrasonography. Since hereditary thrombophilia and malignancy has been ruled out, we assume that local trauma and venous stasis caused by previous abdominal surgery have been the etiological factors of the disease. CONCLUSION - We give a review of the literature and would like to draw the attention to this rare type of thrombosis, its risk factors and the difficulties of the therapy.]

Lege Artis Medicinae

[SEROTYPE AND ANTIBIOTIC SENSITIVITY DETERMINATION OF SELECTED ISOLATES OF INVASIVE STREPTOCOCCUS PNEUMONIAE STRAINS]

PÁSZTOR Mónika

[INTRODUCTION - Streptococcus pneumoniae (S. pneumoniae) is a very important pathogene of community acquired invasive infections. The aim the study was to collect data on the serotype distribution of invasive S. pneumoniae strains in Hungary and their resistance. In the light of the results it can be determined how effective the currently available polysaccharide vaccine is against the infections caused by invasive S. pneumoniae strains. MATERIALS AND METHODS - The seroprevalence and antibiotic sensitivity of 44 randomly selected isolates of Streptococcus pneumoniae isolated from sterile sites of human body were analysed over a 4 year period (2000-2003). Samples were randomly analysed by the Quellung method. Detection of sensitivity of S. pneumoniae to penicillin and erythromycin were carried out by disc diffusions and E-test method in the microbiological laboratory of the St. Laszlo Hospital. RESULTS - The invasive isolates belong to 22 different serotypes. The prevalence of penicillin and erythromycin sensitivity was 79,5%, and 68% respectively. CONCLUSION - The 23 valent polysaccharide vaccine could provide coverage of 82% of invasive pneumococcal diseases caused by strains analysed in this study.]

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[Results of epidemiological studies indicate the atherosclerotic renal artery stenosis is a common condition, thus development of its diagnostics and therapy has significant importance. Renal artery narrowing can cause hypertension, renal function decline, cardiac failure and the increased cardiovascular risk seriously affects survival perspective of the patients. The evolution of MR technology has a prominent role in renovascular diagnostics. Beyond the detection of arterial stenosis this technique is capable of the functional characterization of the stenosis and the detailed description of the regional kidney tissue damage. Based on the results of clinical studies the relevance of revascularization of the renal artery stenosis remains uncertain. The trials focusing on this issue show methodological imperfections. It remains to be elucidated whether these methodological problems will be tackled in the future based on the present information. This review focuses on the actual findings corresponding to these problems.]

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[INTRODUCTION - Data on bone mineral density (BMD) in diabetes mellitus are contradictory in the literature. Early studies described a decreased bone mineral density in type 1 diabetes mellitus (T1DM), but recent studies report no osteopenia in T1DM.The BMD may depend on the quality of treatment for diabetes mellitus and on the presence of chronic complications. In type 2 diabetes mellitus (T2DM) the BMD is not decreased, occasionally it can even be increased. PATIENTS AND METHODS - Bone mineral density was measured in 122 regularly controlled diabetic patients (T1DM: n=73, mean age: 43.6±11.1 years,T2DM: n=49, mean age: 61.8±9.8 years) by dual energy X-ray absorptiometry at the lumbar spine and at the femur. Results were compared to those of 40 metabolically healthy control persons with a mean age of 47.5±11.9 years.The patients’ carbohydrate metabolism was assessed by the average HbA1c level of the last three years.These values were 7.9±1.4 % in T1DM, and 7.5±1.7 % in T2DM. BMDs were classified based on the T-score and Z-score using the WHO criteria. RESULTS - There was no significant difference in T1DM or in T2DM compared to the reference group in the prevalence of either osteoporosis or of osteoporosis and osteopenia combined. CONCLUSION - BMD was not found to be decreased in patients with well-controlled metabolism compared to healthy controls.]