Lege Artis Medicinae

[Diagnostic problems of ischemic colitis]

DEMETER Pál, SIKE Róbert, SZÉKELY György, KISS Sándor, SZILVÁS Ágnes

MAY 20, 2001

Lege Artis Medicinae - 2001;11(05)

[Ischemic colitis is mainly caused by the impaired circulation of the inferior mesenteric artery. Most frequently it occurs as part of general arteriosclerotic disease or impaired left ventricular function, but it may also occur after abdominal aortic reconstruction. In connection with cocaine users, thrombophylia and vasculitis can also happen among young patients. Colonoscopy plays the most important role in making the diagnosis. In case of transitional ischemia conservative treatment is recommended, but surgery is needed in the progressive gangrenous form or when stricture in the colon developed. Authors describe the case of an 80-year-old man and discuss the etiology, clinical aspects, classical and up-to-date methods of diagnostics and the possibilities of conservative treatment.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[The memory of Pal Gyulay]

KAPRONCZAY Károly

Lege Artis Medicinae

[Helicobacter pylori infection and practical questions of therapy]

RÁCZ István

[According to our knowledge, Helicobacter pylori is a major factor in the pathogenesis of peptic ulcer disease. The prevalence of Helicobacter pylori infection is 70-80% in ulcer patients with the bacteria colonising the mucous surface of the antral mucosa. Eradication therapy against the bacteria leads to complete healing of ulcer disease in about 85-90% of cases. Indications for the eradication and recommended treatment modalities are outlined in several consensus reports; however, in everyday practice a case by case decision is necessary. Present paper summarises two different cases. In the first, the patient has suffered from several relapses of ulcer disease and a successful eradication was performed. Despite of the healing of the ulcer, this patient continued to have prolonged dyspeptic symptoms which called for maintenance antisecretory therapy. The second case is an example that even in a Helicobacter pylori infected patient there could be other reasons for the ulcer pathogenesis. Thorough examinations revealed duodenal manifestation of Crohn’s disease as the background. The message of presented cases is that in each patient individual adaptation of diagnostic and therapeutic algorithms is recommended.]

Lege Artis Medicinae

[MIDAS]

MATOS Lajos

Lege Artis Medicinae

[Case report: gastrointestinal pyogenic granuloma]

SIKE Róbert, SZÉKELY György, DEMETER Pál, SÁPI Zoltán

[In this presentation authors would like to report a case with a lesion related to a ventricularly located pyogenic granuloma. A 65-year-old man was hospitalized with symptoms of acute gastritis. Despite symptomatic treatment for two days he was still in poor condition. Upper panendoscopy revealed Helicobacter pylori associated gastritis and a polypoid lesion with the size of a bean close to the cardia. The histology examination of the lesion verified pyogenic granuloma with gastric localization. After complete Helicobacter pylori eradication followed by PPI and H2 blocker-therapy, the polypoid configuration gradually decreased and after approximately one year it could not be detected and the patient remained symptomfree. According to literature data, pyogenic granuloma is extremely rare in the gastrointestinal tract except for the oral cavity which is the reason why authors intended to call the attention for this rare occurrence.]

Lege Artis Medicinae

[Report about Gastroenterology Endoscopic Activities in Hungary in 2000]

NAGY Görgy, JUHÁSZ László

All articles in the issue

Related contents

Clinical Neuroscience

Creutzfeldt-Jakob Disease: A single center experience and systemic analysis of cases in Turkey

USLU Ilgen Ferda, ELIF Gökçal, GÜRSOY Esra Azize, KOLUKISA Mehmet, YILDIZ Babacan Gulsen

We aimed to analyze the clinical, laboratory and neuroimaging findings in patients with sporadic Creutzfeldt-Jakob disease (CJD) in a single center as well as to review other published cases in Turkey. Between January 1st, 2014 and June 31st, 2017, all CJD cases were evaluated based on clinical findings, differential diagnosis, the previous misdiagnosis, electroencephalography (EEG), cerebrospinal fluid and cranial magnetic resonance imaging (MRI) findings in our center. All published cases in Turkey between 2005-2018 were also reviewed. In a total of 13 patients, progressive cognitive decline was the most common presenting symptom. Two patients had a diagnosis of Heidenhain variant, 1 patient had a diagnosis of Oppenheimer-Brownell variant. Seven patients (53.3%) had been misdiagnosed with depression, vascular dementia, normal pressure hydrocephalus or encephalitis. Eleven patients (87%) had typical MRI findings but only 5 of these were present at baseline. Asymmetrical high signal abnormalities on MRI were observed in 4 patients. Five patients (45.4%) had periodic spike wave complexes on EEG, all appeared during the follow-up. There were 74 published cases in Turkey bet­ween 2005 and 2018, with various clinical presentations. CJD has a variety of clinical features in our patient series as well as in cases reported in Turkey. Although progressive cognitive decline is the most common presenting symptom, unusual manifestations in early stages of the disease might cause misdiagnosis. Variant forms should be kept in mind in patients with isolated visual or cerebellar symptoms. MRI and EEG should be repeated during follow-up period if the clinical suspicion still exists.

LAM Extra for General Practicioners

[Special problems of hypertension in women]

KAPOCSI Judit, DEÁK György

[Menopause and pregnancy are especially vulnerable periods of women’s life regarding hypertension. The “Guidelines for the Management of Arterial Hypertension”, issued by the European Society of Hypertension and the European Society of Cardiology, dedicates a separate chapter to hypertension in women. The renewed guidelines of the Hungarian Society of Hypertension also pays a special attention to hypertension detected during pregnancy. In this article, the euthors review the topics of hypertension detected during menopause and pregnancy, discussing pathomechanism and therapy.]

Lege Artis Medicinae

[Current diagnostics and treatment of adolescent hypertension]

PÁLL Dénes, KATONA Éva, FÜLESDI Béla, JENEI Zoltán, POLGÁR Péter, PARAGH György, KAKUK György

[As the prevalence of hypertension in young people aged 14-18 is reported to be 1-1.5%, regular blood pressure measurement is proposed by the international committees in the adolescence, at least once a year. To establish the diagnosis of hypertension, repeated blood pressure measurements and sex-, age-, heightand weigt-based nomograms are needed. If casual blood pressures are consequently elevated, an ABPM measurement may provide additional informations, e.g. about white coat hypertension, daytime and nighttime blood pressure patterns and target organ damage. Thus, in such cases ABPM measurement is proposed to become the part of the routine examination. Following the diagnosis of hypertension in the adolescent, a further important step is to clarify the causes of the disease. In the majority of adolescent cases, essential hypertension is the diagnosis, but secondary (especially renal causes) are more frequent than in adulthood. First line treatment of adolescent hypertension is definitely non-pharmacologic. Pharmacologic treatment may be indicated if blood pressure is significantly increased (diastolic blood pressure, especially), if secondary hypertension is diagnosed or target-organ damage is present, or there are consistent complains related to the increased blood pressure. Treatment can be initiated with any of the antihypertensive drugs used in adults, but most frequently the use of beta-blockers and ACEinhibitors is recommended.]

Hypertension and nephrology

[Erythropoiesis-stimulating agents and oxidative stress in hemodialysis patients]

MONOSTORI Péter, S. VARGA Ilona, KISS József Zoltán, KISS István, HASZON Ibolya, PAPP Ferenc, SÜMEGI Viktória, BERECZKI Csaba, NÉMETH Ilona, TÚRI Sándor

[Oxidative stress plays an important role in the elevation of the cardiovascular risk of patients with chronic kidney insufficiency. The oxidative stress becomes more severe together with the deterioration of the renal function, and the hemodialysis sessions may also induce repetitive oxidative insults. Erythropoesis-stimulating agents (ESAs) may alter the level of oxidative stress via their effects on hematopoiesis, resulting in indirect effects on changes of iron metabolism and the levels of antioxidants. We review the current knowledge about the administration of ESAs as concerns effects on oxidative parameters in hemodialysis patients. We discuss the relationship between the characteristics of the ESA therapy (type, administration frequency and dosage of ESA, length of the therapy, administration withdrawal) and the oxidative stress in view of earlier and recent research.]

Clinical Oncology

[Treatment of neuroendocrine tumors]

PETRÁNYI Ágota

[Recently, the therapeutic possibilities for the locally invasive or metastatic neuroendocrine tumors developed signifi cantly, although we have no widely accepted predictive or prognostic factors, which could help to design the most effective sequential therapy. To make therapeutic strategy the internationally accepted clinical guidelines should be considered. The therapeutic activity has to be performed in oncological centers with the support of a multidisciplinary team.]