Lege Artis Medicinae

[About my discussions with the editor-in-chief]

AJKAY Zoltán

MAY 25, 1994

Lege Artis Medicinae - 1994;4(05)

[Probably my problem in this case is that I like three things almost equally: the paper, the editor-in-chief and the debate, and sometimes it's hard to reconcile them. ]

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Lege Artis Medicinae

[Tuberculosis an immunological perspective]

GERGELY Péter

[Tuberculosis is one of the most frequent infections in the world, with at least one third of the world's population carrying the pathogen. The number of active tuberculosis cases is increasing in the industrialized nations. The human immune system is unable to clear M. tuberculosis completely. The immune response in tuberculosis may be summarized as follows: M. tuberculosis is an intracellular pathogen living in the macrophages and evading the cell's effective antibacterial mechanisms. The defense against tuberculosis is a local event, resulting in a labile balance between host and parasite. Bacteria can survive in the tuberculotic granuloma and are prepared at any time to spread the organism in case of defective cell-mediated immunity. Activated macrophages play a pivotal role in the defence against Mycobacteria. The appropriate activation and cooperation of T cells is mandatory to mount a protective immune response. BCG vaccination is inefficient in protecting against adult tuberculosis but does protect newborns from disseminated tuberculosis. New vaccines or vaccination procedures are needed to develop a protective immunity against tuberculosis. ]

Lege Artis Medicinae

[Immunotherapy for tuberculosis clinical aspects of immunological research]

VADÁSZ Imre

[Efforts toward developing an immunotherapy for tuberculosis are based upon the knowledge of delayed hypersensitivity and cellular immunity. The aim of immunotherapy is to strengthen the cellular immunity, enabling the immune system to destroy those persistent bacteria which remain alive following chemotherapy. Chemotherapy combined with an appropriate dose (10%) of dead M. vaccae significantly improved the therapeutic results of tuberculosis patients and reduced their mortality in double blind controlled studies. A beneficial effect was also observed in the treatment of chronic, multidrug resistent cases and in HIV positive tuberculosis patients. The duration of chemotherapy can be considerably shortened when concurrent immuno therapy is utilized.]

Lege Artis Medicinae

[Color and pulsed doppler velocimetry of the uterine artery in the second part of the normal pregnancy]

SZABÓ István, PAULIN Ferenc, RINGÓ János Jun, NÉMETH Lajos, CSABAY László, PAPP Zoltán

[Color Doppler imaging allows accurate identification of the main uterine arteries, which reflect the sum of the resistance of the placental bed and are therefore more likely to provide an overall picture of placental perfusion. In a cross-sectional study of 231 healthy women with singleton pregnancies at 19–40 week's gestation, color Doppler imaging was used to identify the main uterine arteries for subsequent pulsed Doppler studies. Flow velocity waveforms were obtained and indices of impedance, peak systolic blood velocity and mean blood velocity were measured. Impedance to flow decreased, whereas blood velocity increased significantly with gestation. Furthermore, impedance to flow was lower and velocity higher in the placental uterine artery (closest to the main bulk of the placenta) than in the non-placental artery. The changes in the uterine blood flow during normal pregnancy provide indirect evidence for the increase of the maternal blood supply necessary for normal intrauterine development. Definition of the reference ranges of parameters used to characterize blood flow velocity wave forms has an importance in the investigation of complicated pregnancies. ]

Lege Artis Medicinae

[Correspondence]

FENYVESI Tamás

[On outpatient care from the perspective of the hospital outpatient clinic; The doctor's medicine; Renew or reassess; ]

Lege Artis Medicinae

[Epidemological findings of inflammatory bowel diseases in borsod county 1963-1992]

NAGY György, ÚJSZÁSZI László, JUHÁSZ László, MINIK Károly

[The epidemiologic data of inflammatory bowel diseases and the clinical aspects of ulcerative colitis and Crohn's disease were evaluated among the 800 000 inhabitants of Borsod County during three decades. Inflammatory bowel disease cases were continuously gathered from all the hospitals in the county. Patients were examined by standard diagnostic criteria. Consultative endoscopic advice, follow-up, and drugs prescription were provided on the wards. Patients' data were systematically registered and summarized. The following data were recorded: the patients' age, sex, ethnic group, urbanization; family prevalence, anatomical extension, type of course, severity of disease, and the occurance of malignant transformation. The authors registered 913 patients with inflammatory bowel disease, in the 10 hospitals of Borsod County between 1963 and 1992. 488 cases of ulcerative colitis were detected during the first twenty years, which is an incidence rate of 3.1/ 100,000 per year. The incidence during the third decade was 3.6/100,000 per year. 69 patients with Crohn's disease were examined during the first 20 years, and 78 in the third decade. The incidence of ileocolonal Crohn's disease increased from 0.43 to 1.00/100,000 per year. The authors didn't find a significant change in anatomical extension, severity or the clinical course of ulcerative colitis during the three decades. The increase of Crohn's diseases, and especially of isolated colonic types, may reflect improved diagnostic techniques. The incidence of inflammatory bowel disease increased among gypsies, but the incidence in that population was still only half of what was expected in the region. The authors found familial inflammatory bowel disease occurrence in 15 patients. Eight carcinomas were observed in the 766 ulcerative colitis patients, and 2 in the 147 Crohn's disease patients. ]

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Clinical Neuroscience

Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in essential tremor

TAK Zeynal Abidin Ali, SENGUL Yildizhan

Introduction - Although essential tremor (ET) is the most common cause of tremor, the pathology and underlying mechanisms have not fully understood yet. In addition to kinetic tremor, patients may present several types of tremor, gait ataxia, hearing deficits and eye movement abnormalities. Non-motor symptoms and signs have also added to definition of ET. There is significant evidence indicating the neurodegenerative nature of the disease. New studies indicate that inflammation may have a place in the etiology. The neutrophil-to lymphocyte ratio (NLR) and the platelet-to lymphocyte ratio (PLR) have recently begun to be used as a marker of systemic inflammation. Our study aims at finding a clue for systemic inflammation in ET. Methods - 67 patients with ET and 40 healthy controls were recruited for the study. The total white blood cells (WBC), absolute neutrophil count, lymphocyte count and platelet count were retrieved. The NLR was calculated by dividing the neutrophil count by the lymphocyte count and the PLR was calculated by dividing the platelet count by the lymphocyte count. Results - Patient and control groups were similar in terms of age and gender. The mean age of patient group was 25.29 ± 8.24 years and that of control group was 26.77 ± 6.73 years. The NLRs were 1.85 ± 0.58 in the patient group and 1.96 ± 0.53 in the control group. For the patient group and the control group the PLRs were 103.52 ±32.80 and 91.26 ± 31.57 respectively. There were no statistically significant differences between the participants for both NLR and PLR. Conclusion - The pathophysiological mechanism for essential tremor (ET) remains unclear. However, there is an increasing amount of research being conducted on the subject. Discussions about ET’s definition as a neurodegenerative disease are ongoing. Although previous studies showed that neuroinflammation could be a part of etiology of disease, this study has failed to demonstrate systemic inflammation in ET.

Clinical Neuroscience

[Editor’s note]

RAJNA Péter

[Editor’s note 2007;60(03-04) ]

Clinical Neuroscience

[Early experiences in surgical treatment of thoracic disc herniation from posterior transdural approach at Neurosurgery Clinic Szeged University]

MÁRKOS-GERGELY Gellérd, WATFA Kerim, BALÁZSFI Márton, SZEGETI Andrea, BARZÓ Pál

[Background – Because of the rare occurrence of thoracic disc herniation and surgery needed treatment the used approaches and their efficiency are still subjects of discussions. In Hungarian practice, the most frequent explorations are costotransversectomy and laminectomy, but there are many other important methods available like thoracoscopic and posterior transdural approaches. This case report will present the benefits and the surgical procedure of posterior transdural sequesterectomy, carry out for the first time in Hungary at the Neurosurgical Department on Szeged University. Case presentation – A 50-year-old female patient with achondroplasic nanism has been operated several times since 2011. She suffered from a progressive, multi-segment affected degenerative discopathy and myelopathy. Finally in the background of the recurrent paraparesis was confirmed thoracic disc herniations at the levels of T8 and T9. The use of intraoperative electrophysiology was not feasable, because the earlier described cervical myelopathy. For this reason we used the posterior transdural approach, as the best and safest, visual control warranted technique. Conclusions – The posterior transdural approach offers an alternative option for experienced surgeons, furthermore in contrast with traditional, technically difficult to implement or special instrumentation demanding approaches this technique seems to be more efficient.]

Lege Artis Medicinae

[LETTER OF THE EDITORS IN CHIEF]

FARSANG Csaba, KAPÓCS Gábor

Journal of Nursing Theory and Practice

[XXIV.Congress of the Hungarian Heart Surgery Society]

DEÁK András

[The 60th anniversary of the first open heart surgery in Hungary is shortly celebrated by the Hungarian cardiac surgeons, who held their annual meeting in Pécs. The conference on recent professional and scientific results and innovations of the Hungarian cardiac surgical centres provided an opportunity for healthcare professionals (including the perfusionists unique in this field) to report on their current professional results and experiences within scientific lectures and discussions.]