Lege Artis Medicinae

[Analgesic nephropathy in Hungary: the HANS study]

PINTÉR István, MÁTYUS János, CZÉGÁNY Zoltán, HARSÁNYI Judit, HOMOKI Marietta, KASSAI Miklós, KISS Éva, LADÁNYI Erzsébet, LŐCSEY Lajos, MAJOR Lajos, MISZ Mihály, NAGY Lajos, POLNER Kálmán, RÉDL Jen

NOVEMBER 21, 2004

Lege Artis Medicinae - 2004;14(11)

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[The 46th Congress of the Hungarian Society of Gastroenterology]

ABONYI Margit

Lege Artis Medicinae

[BENIGN SOLITER FIBROTIC TUMOR OF THE PLEURA - A CASE REPORT]

BOHÁCS Anikó, TAMÁSI Lilla, SOMOSKÖVI Ákos, MÉSZÁROS Zsolt, SÁPI Zoltán, BÁRTFAI Zoltán

[INTRODUCTION - Rare asymptomatic pleuropulmonary neoplasms can represent serious differencial diagnostic difficulties both for clinicans and pathologists. Immunohistochemical tests are essential tools for the diagnosis of soliter fibrotic tumor of the pleura. These tests are also of diagnostic and prognostic importance. CASE REPORT - The report summarizes the case of an asymptomatic 63 years old man. The patient was admitted to hospital with a parahilar infiltrate of the right lung. Based on this chest X-ray abnormality pulmonary malignancy was suspected. The patient was referred to surgical intervention and the diagnosis of was based on post-surgical histology. These fibrotic tumors have typical immunohistochemical features. Although the histomorphology of the tumor suggested the presence of a benign tumor the p53 positivity and focal CD34 positivity indicated the possibility of malignant transformation as well. The patient is alive 17 months after surgery and there is no relapse of the disease. CONCLUSION - Although histologically benign, soliter fibrotic tumors of the pleura may occasionally transform into malignant variants. Therefore complete surgical resection and longterm clinical and close radiological follow-up is recommended for these patients. Clinician can plan well ahead the frequency and time of the follow-up with the help of the prognostic factors of hystology.]

Lege Artis Medicinae

[PHYSICAL AND PSYCHOLOGICAL CONDITION OF HEALTH CARE WORKERS DEALING WITH THE SERIOUSLY ILL]

HEGEDÛS Katalin, RISKÓ Ágnes, MÉSZÁROS Eszter

[INTRODUCTION - Health care professionals undertaking treatment/nursing of the seriously ill are equally overburdened emotionally, intellectually and physically. This condition might have several, sometimes irreversible negative consequences: avowed difficulties within the communication with patients, families and colleagues, various harms of accumulating, unprocessed stress, severe physical and psychological symptoms of mental burn-out which is very frequent and failures and difficulties of the private life. In our survey we aimed to gain a realistic image of the physical and psychological condition and quality of life of professionals working in Hungarian clinical care in order to provide with indelayable help. METHODS - The basis of the survey was a version of the Hungarostudy 2002 questionnaire, modified for health care professionals. In our sample there were 200 health care professionals dealing with seriously ill and in the control groups 1356 non health care professionals, and 227 health care professionals, choosen from the Hungarostudy survey. In all three groups the proportion of gender, age and education were the same. The results were analysed by the SPSS 10.0 statistical program and the relationship analysis was completed by ANOVA test. RESULTS - The analysis of the answers of those attending in our questionnaire survey - compared to those working in other health care field and to the control group of non health care workers - proves that the ratio of exhaustion and stress-dependent physical and psychological symptoms are prominently, in many cases significantly higher among health care workers dealing with the seriously ill, addiction is more frequent and social net is more unfavourable. These data are even worse for nurses than for doctors and other graduates. CONCLUSION - In treating difficult cases we can start to help with special education that should be general both in gradual and postgradual training.]

Lege Artis Medicinae

[THE ROLE OF ORAL ANTIDIABETIC AGENTS AND ACE INHIBITORS IN THE PREVENTION OF TYPE 2 DIABETES MELLITUS]

KEMPLER Péter

[Nowadays Type 2 diabetes is considered as a cardiovascular disease,. The cause of death among 80% of people with Type 2 diabetes is of cardiovascular origin, with the most common cause of death of myocardial infarction. Optimal solution would be the prevention of the disease and there are also some possibilities for intervention. The present paper summarises the role of antidiabetic agents and ACE inhibitors in the prevention of Type 2 diabetes mellitus. The incidence rate of Type 2 diabetes decreased by 36% using acarbose in the STOP NIDDM Trial and by 31% using metformin in the Diabetes Prevention Program. The rate of risk reduction regarding the incidence of Type 2 diabetes during the ALLHAT Study compared the subjects treated with thiazid diuretics among those treated with amlodipine was 25% by the end of the second year and 16% by the end of the fourth year, while the corresponding data for patients treated with lisinopril were 40% and 30%, respectively. The action of lisinopril on the better bioavailability of Insulin like growth factor I. (IGF-I) probably contributes to the beneficial effect of lisinopril on insulin sensitivity.]

Lege Artis Medicinae

[ACTION ]

MATOS Lajos

All articles in the issue

Related contents

Clinical Neuroscience

Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

Clinical Neuroscience

Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

Clinical Neuroscience

[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]

Clinical Neuroscience

Evaluation of the effectiveness of transforaminal epidural steroid injection in far lateral lumbar disc herniations

EVRAN Sevket, KATAR Salim

Far lateral lumbar disc herniations (FLDH) consist approximately 0.7-12% of all lumbar disc herniations. Compared to the more common central and paramedian lumbar disc herniations, they cause more severe and persistent radicular pain due to direct compression of the nerve root and dorsal root ganglion. In patients who do not respond to conservative treatments such as medical treatment and physical therapy, and have not developed neurological deficits, it is difficult to decide on surgical treatment because of the nerve root damage and spinal instability risk due to disruption of facet joint integrity. In this study, we aimed to evaluate the effect of transforaminal epidural steroid injection (TFESI) on the improvement of both pain control and functional capacity in patients with FLDH. A total of 37 patients who had radicular pain caused by far lateral disc herniation which is visible in their lumbar magnetic resonance imaging (MRI) scan, had no neurological deficit and did not respond to conservative treatment, were included the study. TFESI was applied to patients by preganglionic approach. Pre-treatment Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores of the patients were compared with the 3rd week, 3rd month and 6th month scores after the procedure. The mean initial VAS score was 8.63 ± 0.55, while it was 3.84 ± 1.66, 5.09 ± 0.85, 4.56 ± 1.66 at the 3rd week, 3rd month and 6th month controls, respectively. This decrease in the VAS score was found statistically significant (p = 0.001). ODI score with baseline mean value of 52.38 ± 6.84 was found to be 18.56 ± 4.95 at the 3rd week, 37.41 ± 14.1 at the 3rd month and 34.88 ± 14.33 at the 6th month. This downtrend of pa­tient’s ODI scores was found statistically significant (p = 0.001). This study has demonstrated that TFESI is an effective method for gaining increased functional capacity and pain control in the treatment of patients who are not suitable for surgical treatment with radicular complaints due to far lateral lumbar disc hernia.