Lege Artis Medicinae

[ALDOSTERONE AT THE BEGINNING OF THE 21ST CENTURY]

GLÁZ Edit, SZŰCS Nikolett, VARGA Ibolya

FEBRUARY 20, 2005

Lege Artis Medicinae - 2005;15(02)

[The discovery of aldosterone as the principal mineralocorticoid hormone led to a new era in the study of the regulation and the pathological/clinical relevance of the fluid-salt homeostasis and blood pressure. Here, we discuss briefly the history of the discovery of aldosterone, its biosynthesis, the mechanism of action, regulation and the diseases which are associated with its pathologically increased production and hypertension: primary and secondary hyperaldosteronisms. Considering their clinical significance, we focus on primary hyperaldosteronisms as they represent a considerable portion of secondary hypertensions that can be definitively cured. Differential diagnosis issues related to other forms of hypertension of different origins are discussed in detail. Recent findings of the past fifteen years indicate that besides its classical genomical actions aldosterone has much more diverse non-genomic actions as well including proinflammatory and profibrotic effects even in physiological concentrations. Based on these observations, aldosterone can be regarded as a risk hormone in the aetiology of cardiomyopathies, vasculopathies and neuropathies and therapeutical consequences are also discussed.]

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Lege Artis Medicinae

[SEVERE CASE OF HYPOSMOTIC HYPERVOLAEMIA DUE TO WATER INTOXICATION]

BOTOS Péter, MARTON Sándor, KISS Katalin, KOZMA Zsolt, GION Gábor

[INTRODUCTION - The regulation of fluid and electrolite homeostasis is of crucial importance to maintain the normal biochemical processes of the body. Any sudden and remarkable change in the salt and water metabolism may result in serious consequences. CASE REPORT - In the case report the authors describe the history of a 17 old patient, who was admitted to the Emergency Department following seizures, with mental confusion, hyperpyrexia and hyponatremia. CONCLUSION - The aim of the authors was to present a severe case of hyposmolar hypervolaemia of uncommon etiology. They focus on the importance of the anamnestic history emphasizing the significance of diffrential diagnosis and demonstrate the therapeutic considerations.]

Lege Artis Medicinae

[LONG-TERM OXYGEN TREATMENT]

SOMFAY Attila

[Long-term oxygen therapy is the only treatment that has been shown to significantly improve life expectancy in patients with severe chronic obstructive pulmonary disease (COPD) exhibiting marked hypoxemia. There has been sginificant advances in the longterm oxygen therapy in the last two decades caused by the technological improvements in oxygen delivery systems as well as our better knowledge of the beneficial effects of the longterm oxygen therapy including better quality of life, exercise tolerance and pulmonary hemodynamic effects. This expansive therapy requires the documentation of chronic arterial hypoxemia by arterial blood gas analysis or pulsoximetry which should be reassesed during chronic care of these patients. Besides hypoxaemia, the consequences of tissue hypoxia induced by different problems in the oxygenation chain should also be considered. Indication of long-term oxygen therapy is optimally based on evidence and pathophysiology, thereby the undesirable placebo effect or psychological addiction to oxygen can be reduced. Late laboratory diagnostics and poor patient compliance are the main determinants of undertreatment. The real value of the long-term oxygen therapy in indications other than hypoxaemic COPD requires more controlled studies.]

Lege Artis Medicinae

[SCIENTIFIC DIGEST]

Lege Artis Medicinae

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