Lege Artis Medicinae

[Call for the LAM Awards]

JANUARY 22, 2008

Lege Artis Medicinae - 2008;18(01)

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Lege Artis Medicinae

[Two Seconds]

TAMÁS László

Lege Artis Medicinae

[Most recent data on drug-eluting stents]

FÜLÖP Gábor, BERTA Balázs, MERKELY Béla

Lege Artis Medicinae

[THE EPIDEMIOLOGY OF CEREBROVASCULAR DISEASES IN HUNGARY AFTER THE MILLENNIUM]

VOKÓ Zoltán, SZÉLES György, KARDOS László, NÉMETH Renáta, ÁDÁNY Róza

[INTRODUCTION - Here we present the descriptive epidemiology of stroke in Hungary including mortality, morbidity, functional limitation and inpatient care based on the most recent health statistical data. METHODS - Mortality data were analysed by direct and indirect standardisation, and geographical mapping based on empirical Bayesian smoothing. Morbidity data were obtained from the General Practitioners’ Morbidity Sentinel Station Program and the National Health Surveys. The latter also provided data on functional limitation. Data on inpatient service were taken from the European Hospital Morbidity Database of WHO. RESULTS - Hungarian stroke mortality continued to decrease in recent years, and the slope of the decrease was larger than in Western Europe. Stroke mortality was highest in the Northern- Hungarian Region, and in Somogy and Zala counties. The incidence of stroke was 1.5-2 times higher than in the developed countries in most age groups. Over 64 years of age, a decline of stroke incidence was observed, especially in men. In this age group approximately 10% of men and 7% of women had already had a stroke. Of these patients more than 10% needed assistance to get out of the bed, dress up, or eat. Hospitals reported more than 60 000 stroke cases in 2005. CONCLUSION - Despite the promising trends in stroke mortality and now also in morbidity, both indices are still rather high in Hungary compared to those in Western-Europe. The relatively favourable epidemiological changes, however, may be overridden by the increased stroke burden resulting from the aging of the population.]

Lege Artis Medicinae

[Liver transplantation in adulthood - For whom is it indicated and how they can get it in Hungary?]

GERLEI Zsuzsanna

Lege Artis Medicinae

[“Everyone Will Account Once with their Talents Received...” An Interview with Pathologist Professor Gábor Kendrey by Elemér Nemesánszky]

NEMESÁNSZKY Elemér

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[Diagnosis and therapy of cerebrovascular diseases - Retrospection to the efforts for managing patients with stroke in the last two decades in Hungary]

NAGY Zoltán

[The first Hungarian guideline regarding management of stroke patients has been published in 1990 (LAM). In the past 21 years, clinical practice in stroke care has improved significantly in Hungary and is currently performed according to evidencebased protocols issued by international and national consensus meetings. Currently the EUSI guideline published in 2008 and the management protocol written in the same year by the board of the Hungarian Stroke Society are followed. The most important changes of the past 20 years in stroke management have been the following: the priority concept and lysis therapy have become common in daily practice, emergency examination has been performed in selected TIA cases and an up-to-date practice has been established in stroke prevention. The increasing number of lysis therapy each year demonstrates an improving organisation of stroke care and improving professional preparedness. In selected stroke centres, all the modern technical facilities are available, on the other hand, substantial development is needed in a number of stroke units. A national stroke registry and quality control are warranted for further professional development in Hungary.]

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[Varietas Delectat An Interview with Gastroenterologist/Radiologist István Balogh MD, by Elemér Nemesánszky, LAM’s Editor-in-Chief]

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[Interventional neuroradiological treatment of a symptomatic basilar artery stenosis in the background of recurrent brainstem transient ischemic attack]

LOVÁSZ Rita, NÉMETH Csilla, LÁZÁR István, VALIKOVICS Attila

[INTRODUCTION - Symptomatic stenosis of the basilar artery carries high risk of brainstem stroke. In case of acute thrombotic occlusion of the basilar artery the mortality is over 70%. Besides best medical treatment, angioplasty was employed for 30 years previously, but the results were only acceptable after the advent of flexible intracranial stents. We report our case to call attention to the availibility of this interventional neuroradiological procedure. CASE REPORT - A 64 years old male patient was admitted to our hospital with intermittant diplopia. 90% stenosis of proximal basilar artery was reported by DSA. After balloon dilatation, intracranial stent was placed into the lesion. Symptoms have not recurred three months following the intervention. Control TCD and MR-angiography were performed, and good blood flow ratio was detected in the vertebrobasilar system. CONCLUSION - In the background of recurrent brainstem TIA a basilar artery stenosis has to be searched because the development of a definitive brainstem stroke can be prevented by interventional neuroradiological procedure.]