Lege Artis Medicinae

[Differences in the Prolonged Use of Drugs for Chronic Obstructive Pulmonary Disease]

BALIKÓ Zoltán

SEPTEMBER 19, 2007

Lege Artis Medicinae - 2007;17(08-09)

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Lege Artis Medicinae

[ANTIHYPERTENSIVE THERAPY IN VIEW OF RECENT CLINICAL STUDIES]

ALFÖLDI Sándor

[Different antihypertensive agents, while having the same blood pressure lowering effect, will have significantly and clinically important different impact on the serum levels of glucose, lipids, insulin, potassium, creatinine, as well as on albumin excretion, heart rate, body weight, central pressure, various hypertensive target organ damages, and, in particular, 24-hour blood pressure dinamics. There is agreement in that the main benefits of first-line antihypertensive agents are related to the lowering of blood pressure itself. Some other drugs, however, have shown preventive and protective cardiovascular properties in certain patient groups, independent of their blood pressure lowering effect as measured traditionally.]

Lege Artis Medicinae

[BENEFICIAL EFFECT OF INSULIN DETEMIR ON THE BODY WEIGHT OF DIABETICS]

BECHER Péter

[Detemir is the newest base insulin analogue. In phase III trials and the PREDICTIVE study, the use of insulin detemir in various treatment regimens (basal-bolus or in combination with an oral antidiabetic) did not lead to weight gain in either types of diabetes, in contrast to what is usually observed with insulin therapy. Similar results were obtained when neutral protamine Hagedorn insulin or glargine were replaced by detemir, or insulin-naive patients received detemir as a new therapeutic regime. The mechanism of the beneficial effect on body weight is not clear yet. It may be related to the reduction in the number of hypoglycaemic episodes. It may also be associated with a stronger action of detemir on hepatocytes compared to peripheral tissues due to its acylation, which results in an effective suppression of hepatic glucose output without promoting lipogenesis in the adipocytes. Detemir reaches the insulin receptors of the hypothalamus faster than regular insulin, therefore, satiety develops in a shorter time. These hypotheses still require further studies.]

Lege Artis Medicinae

[INFLAMMATORY BOWEL DISEASE IN CHILDREN]

BODÁNSZKY Hedvig, VERES Gábor

[The term inflammatory bowel disease includes two similar, but distinct intestinal diseases so far of unknown ethiology - ulcerative colitis and Crohn’s disease. They used to be considered diseases of young adults, but in recent decades they have become more common among children, with characteristics different from those in adults. In the past they were considered severe, incurable diseases, but today, owing to modern nutrition, medical and surgical treatment, both diseases have became well manageable, even though complete recovery can not yet be expected.]

Lege Artis Medicinae

[Authorization and Marketing of Medicines in the European Union Member States]

BORVENDÉG János

Lege Artis Medicinae

[Practical Interpretation of Recent Rules for Drug Prescription Experience and Problems in Gastroenterology]

DOBOS Éva, NEMESÁNSZKY Elemér

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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.

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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.

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