Lege Artis Medicinae

[Abscessus lienis?]

HAJDU Mária, KRUTSAY Miklós, CHANIS William

AUGUST 20, 2010

Lege Artis Medicinae - 2010;20(08)

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Lege Artis Medicinae

[The drug-treatment of atherosclerosis by statins]

KÉKES Ede

[The pathogenesis of atherosclerosis is a complex and complicated process. The rule of some factors (lipoproteindeposition, oxidative stress, lipid peroxidation, endothel dysfunction, etc) is well known, but others are not yet clarified. Conventional, metabolic and some special residual factors have also influenced for the starting process. One of them, the lipid profile is the most important. Statins are able to decrease the lipid levels - LDL cholesterol - significantly to the physiological level. These drugs are essential for the primer and secunder cardiovascular prevention moreover it is advisable to give in acute coronary syndrome as well. The most excellent statin is rosuvastatin, because of beneficial effect to decreasing LDL cholesterol level and cardiovascular events. Rosuvastatin is able to produce a regression of atherosclerotic process int he vessel walls. Presumably this effect can be explained by their pleiotrop property.]

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[Group therapy for alcohol-dependent patients using autobiography reconstruction]

SZABÓ József, GEREVICH József

[A group therapy method was built on results of previous researches using narrative psychological approaches. Our primary technic was narative restructuring. Alcohol addicted patients’ language expression mode of their autobiographies was modulated similar to recovering ones’. We supposed it had therapeutic effect, that could be measured by the Hopelessness Scale (HS) and the Means Ends Problem Solving Test (MEPS). We recorded the tests before and after the therapeutic process, and the differences of their datas were compared (t-test) to similar ones from control persons, who participated in any other group therapy. Significant difference was experienced. Our method reduced hopelessness and increased problem solving more effectively, than other group therapies.]

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[Modern beta-blocker therapy from the cardiologist’s viewpoint]

ÉDES István

[Following the publication of some large, randomised trials (LIFE, ASCOT), the benefits of the use of beta-blockers in hypertension have been questioned. On the basis of these clinical trials it has been posited that beta-blockers administered for the treatment of hypertonia are less effecient for stroke prevention. It has been suggested that first-generation beta-blockers (atenolol) have adverse metabolic effects (insulin sensitivity, lipid parameteres), which might contribute to the differences observed in clinical outcomes. On the basis of a number of clinical trials and meta-analyses performed in recent years it is now evident that the most important goal is to reach target blood pressure levels, which is usually achieved by combination therapy. Choosing drugs on the basis of strict protocols is less important. In general, beta-blockers remain one of the most important drug class for the treatment of hypertension. The author reviews the pharmacology of the cardioselective, vasodilatory drug nebivolol in detail, as well as clinical trials on nebivolol. Nebivolol has a neutral (or rather beneficial) effect on metabolic parameters (lipid parameters, blood glucose level and insulin sensitivity) as well as on left ventricular function. If hypertension is associated with cardiovascular diseases (left ventricular dysfunction, ischaemic hears disease, atrial fibrillation), nebivolol offers an excellent therapeutic alternative due to its excellent tolerability and side effect profile.]

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