[Changes in the treatment of childhood asthma with inhalational steroids]
JULY 20, 2002
Lege Artis Medicinae - 2002;12(06-07)
JULY 20, 2002
Lege Artis Medicinae - 2002;12(06-07)
[Since about 30 years, inhalational steroids are the most important drugs in the treatment of persistent (chronic) asthma. According to the severity of the disease, small, medium and high doses of steroids should be given, often together with long lasting beta-agonists. In the last years the therapeutical advice was simplified as the cromolyns and the theophyllins were almost excluded. Leukotrien antagonists appeared either in combination or as monotherapy. Using conventional doses in inhalational steroid therapy there are hardly any side effects, but it is important to give the smallest possible effective dose while achieving maximum bioavailability. Patients all over the world - including Hungary - do not receive optimal antiasthmatic therapy or use drugs ideally, which is especially true to inhalational steroids, resulting in a treatment much less efficient than possible.]
Lege Artis Medicinae
[This paper provides an overview on major elements of the age of genomics: including the human genome programme, principles of gene chip technology and data management by bioinformatics. The manuscript provides examples from the fields of oncology, infectology and allergy. The possibility of ”in silico” research on computers is also presented with the shadows of the post-genomic era and the significance of changes in the biomedical paradigm.]
Lege Artis Medicinae
[Measuring quality of life (QoL) has a growing importance in the field of health technology assessment. It is especially true for chronic diseases, such as psoriatic arthritis, which has significant impact on patients’ quality of life through the intensity of symptoms and the duration of the disease. The quality of life measurement can only be reliable and valid if an appropriate instrument is used. One of the most critical elements of the validity of quality of life intruments is the method used for adapting the questionnaire to foreign languages. Authors present their results and experience in the Hungarian adaptation of the Psoriatic Arthritis Quality of Life (PSAQoL) questionnaire.]
Hypertension and nephrology
[This consensus document is intended to provide guidance for the effective and efficient treatment of asymptomatic individuals with high uric acid levels and gout patients.]
Introduction - Peripheral nerve injury (PNI) is a frequent problem among young adults. Hopefully, regeneration can occur in PNI unlike central nervous system. If nerve cut is complete, gold standard treatment is surgery, but incomplete cuts have been tried to be treated by medicines. The aim of the study was to evaluate and compare clinical and histopathological outcomes of independent treatment of each of Vitamin B12 (B12) and Vitamin D3 (D3) and their combination on sciatic nerve injury in an experimental rat model. Materials and methods - Experimental animal study was performed after the approval of BEH Ethics Committee No. 2015/10. 32 rats were grouped into four (n=8) according to treatment procedures, such as Group 1 (controls with no treatment), Group 2 (intraperitoneal 1 mg/kg/day B12), Group 3 (oral 3500 IU/kg/week D3), Group 4 (intraperitoneal 1 mg/kg/day B12+ oral 3500 IU/kg/week D3). Sciatic Functional Index (SFI) and histopathological analysis were performed. Results - SFIs of Group 2, 3, 4 were statistically significantly higher than controls. Group 2 and 3 were statistically not different, however Group 4 was statistically significantly higher than others according to SFI. Axonal degeneration (AD) in all treatment groups were statistically significantly lower than in Group 1. AD in Group 4 was significantly lower than in Group 2 and 3; there was no significant difference between Group 2 and 3. There was no significant difference between Group 1,2 and 3 in Axonolysis (A). But A of Group 4 was significantly very much lower than all others. Oedema- inflammation (OE-I) in all treatment groups were significantly lower than in Group 1; there was no significant difference between Group 2 and group 4. OE-I in Group 2 and 4 were significantly lower than in Group 3. There were no significant differences between Group 1, 2 and 3 in damage level scores; score of Group 4 was significantly lower than of Group 1. Conclusions - B12 and D3 were found effective with no statistically significant difference. But combined use of B12 and D3 improve nerve healing synergistically. We recommend combined use of B12 and D3 after PNI as soon as possible.
Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing/short-lasting unilateral neuralgiform headache with cranial autonomic features (SUNCT/SUNA) is a rare severe headache. At the time of an attack, it can hinder a patient from eating and requires acute intervention. The sphenopalatine ganglion is an extracranial parasympathetic ganglion with both sensory and autonomic fibers. Sphenopalatine ganglion block has long been used in the treatment of headache, particularly when conventional methods have failed. Here, we present a patient who was resistant to intravenous lidocaine, but responded rapidly to sphenopalatine ganglion block during an acute episode of SUNCT/SUNA.
Acquired idiopathic generalised anhidrosis is an uncommon sweating disorder characterized by loss of sweating in the absence of any neurologic, metabolic or sweat gland abnormalities. Although some possible immunological and structural mechanisms have been proposed for this rare entity, the definitive pathophysiology is still unclear. Despite some successfully treated cases with systemic corticosteroid application, the dose and route of steroid application are controversial. Here, we present a 41-year-old man with lack of generalised sweating who has been successfully treated with high dose pulse intravenous prednisolone. We have discussed his clinical and histopathological findings as well as the treatment options in view of the current literature.
[Chronic administration of antiepileptic drugs without history of unprovoked epileptic seizures are not recommended for epilepsy prophylaxis. Conversely, if the patient suffered the first unprovoked seizure, then the presence of epileptiform discharges on the EEG, focal neurological signs, and the presence of epileptogenic lesion on the MRI are risk factors for a second seizure (such as for the development of epilepsy). Without these risk factors, the chance of a second seizure is about 25-30%, while the presence of these risk factors (for example signs of previous stroke, neurotrauma, or encephalitis on the MRI) can predict >70% seizure recurrence. Thus the International League Against Epilepsy (ILAE) re-defined the term ’epilepsy’ which can be diagnosed even after the first seizure, if the risk of seizure recurrence is high. According to this definition, we can start antiepileptic drug therapy after a single unprovoked seizure. There are four antiepileptic drugs which has the highest evidence (level „A”) as first-line initial monotherapy for treating newly diagnosed epilepsy. These are: carbamazepine, phenytoin, levetiracetam, and zonisamide (ZNS). The present review focuses on the ZNS. Beacuse ZNS can be administrated once a day, it is an optimal drug for maintaining patient’s compliance and for those patients who have a high risk for developing a non-compliance (for example teenagers and young adults). Due to the low interaction potential, ZNS treatment is safe and effective in treating epilepsy of elderly people. ZNS is an ideal drug in epilepsy accompanied by obesity, because ZNS has a weight loss effect, especially in obese patients.]
Clinical NeuroscienceAlexithymia is associated with cognitive impairment in patients with Parkinson’s disease
Lege Artis Medicinae[COVID-19-cardiology at spring, 2020]
Clinical NeuroscienceLate carcinomatous meningitis as vertigo
Hypertension and nephrology[Continuing medical education]
Hypertension and nephrology[Ventricular arrhythmia]
Hypertension and nephrology[Treatment and care of hypertensive patients during and after the Covid-19 pandemic. Possibilities and effectiveness of telemedicine]
Hypertension and nephrology[Post-career development of cardiometabolic changes and hypertension in competitive athletes]
Hypertension and nephrology[Kidney transplantation in Hungary]