Lege Artis Medicinae

[CARDIOVASCULAR EFFECTS OF SULFONYLUREAS]

NIESZNER Éva, BARANYI Éva, PRÉDA István

FEBRUARY 22, 2007

Lege Artis Medicinae - 2007;17(02)

[Sulfonylureas, used as base therapy in type 2 diabetes, specifically block ATP-dependent potassium channels (K+ ATP). While in pancreatic beta cells these channels have an essential role in insulin release, they are also involved in cardiovascular adaptive mechanisms. Ion channels with similar morphology may have different pathophysiological effects in the human body. This raises the question, is it necessary to count with some damage to the cardiovascular protective mechanism when using sulfonylurea to induce insulin secretion. Is this indeed a relevant clinical problem today? The answer may lay in the different organ-specific effects of sulfonylureas.]

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[A RARE, HISTOLOGICALLY COMPLEX LIVER TUMOUR]

HIDVÉGI Judit, BAJTAI Attila, VARGA Árpád

[INTRODUCTION - Among the primary malignant tumours of the liver, hepatoblastoma is extremely rare in adults in contrast to its frequency in children. Only 23 such cases have been published to date. Mixed tumour of the liver and carcinosarcoma of the liver are used as synonyms for adult hepatoblastoma. The tumours have both mesenchymal and epithelial components (hepatocellular or cholangiocellular carcinoma) with focal bone and/or cartilage formation. CASE REPORT - A 78-year-old woman was admitted to the surgery department with increasing anaemia and persistent abdominal pain. An emergency operation was performed. Her peritoneal cavity was filled with blood due to the rupture of a tumour that occupied the right lobe of the liver. The neoplasm could only be removed partially. Despite an intensive care, the patient's state could not be stabilized and she died a day after the operation. The histological diagnosis was carcinosarcoma of the liver with an AFP- and cytokeratin-positive epithelial component and a spindle cell component positive for vimentin. The osteogen sarcoma found in the tumour was strongly positive for the S-100 protein. DISCUSSION - The authors review the hypotheses for the formation of adult primary hepatoblastoma, a combined tumour, they describe their various types and the immunohistochemical tests that are used in their identification.]

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[That Place in the World... A Discussion with Zsolt Bugarszki, General Manager of Soteria Foundation and Professional Lead Ibolya Hegedűs]

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Lege Artis Medicinae

[DIURETICS IN CARDIOLOGY: PRESCRIBE OR USE?]

NAGY Viktor

[Diuretics are essential therapeutic tools. They effectively reduce blood pressure and have been shown in numerous hypertension clinical trials to reduce both cardiovascular and cerebrovascular morbidity and mortality. In addition, they are important components of the treatment of heart failure with apparent signs of congestion. While thiazides are recommended in mild forms, loop diuretics are used in the severe stages of congestive heart failure. Loop diuretics and thiazides often induce hypokalaemia, which has been demonstrated to be not as benign as thought before. Diuretic-induced hypokalaemia seems to be aldosterone dependent. Aldosterone levels increase during diuretic therapy. Aldosterone antagonists are unique among diuretics in that they improve survival of patients with heart failure independent of their effect on sodium metabolism. Because of this, diuretic treatment lives its renaissance in cardiology.]

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[The importance of hypertension in type 2 diabetes mellitus, the method of continuous blood pressure control and patient’s careas well as the forms of non-drug and drug therapy have been disclosed by presenting therapeutical recommendations from American, European scientific societies and international organizations. It has been established that the principles of care and treatment of hypertonia have basically remained unchanged in diabetes all over the world, despite the recent widespread debate over the interpretation of normal blood pressure and the consideration of the benefits of intensive or standard treatment.]

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[INCRETIN MIMETICS AND INCRETIN ENHANCERS: NEW THERAPEUTIC TOOLS IN THE TREATMENT OF PATIENTS WITH TYPE 2 DIABETES MELLITUS]

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