[Insomnia - one of the most prevalent sleep complain - has a great impact on the everyday life. Basically two different form of insomnia can be defined: the insomnia disorder and the co-morbid insomnias. To treat adequately determination of background pathology is essential, which is based on the help of Sleep Medicine Centers. According to the newest guidelines, the treatment of insomnia disorder is based on cognitive behavioural therapies followed by pharmaceutical intervention. In this review we provide the short description of cognitive behavioural therapies and basic principles of hypnotic drugs. Despite the availability of insomnia guidelines the huge variation of the insomnia medication can be seen in the daily practice. Due to the above mentioned reasons we summarize the good clinical practice of hypnotic drug administration for insomnia patients.]

[Traumatic brain injury (TBI) is recognized to be the main cause of death and disability in the first four decades representing a major socio-economical problem worldwide. Recent communications revealed a particularly worrying image about the quality of care for TBI in Hungary. For any improvement a systematic approach characterized by utilization of scientific evidence based guidelines forming the basis for close monitoring of the actual care are considered a prerequisite. In Hungary the first evidence based guidelines in the field of TBI have been issued by the National Society for Anesthesiology and Intensive Care more than two decades ago followed by joint guidelines of the Hungarian Neurosurgical Society and the Hungarian College of Neurosurgeons. These publications were primarily based on the work of the European Brain Injury Consortium as well as guidelines issued by the Brain Trauma Foundation. Recent renewal of the latter and a need to refresh the outdated national guidelines was met by a call from regulatory authorities to issue the updated version of the Hungarian TBI-guidelines. The present review is aimed to briefly summarize the most fundamental elements of the national head injury guidelines that would hopefully be officially issued in a far more detailed format soon.]

[The incidence and prevalence of heart failure (HF) is constantly increasing, its mor­bidity and mortality are still high, thus the disease burden is huge and its proper treatment is of paramount importance. Subs­tantial evidence on improving its prognosis remains available only by the treatment of chronic heart failure with reduced left ventricular function (HFrEF). There have been published a number of “milestone” studies in the last decades, the results of which fundamentally determined the HF therapy until recently. Baseline therapy for HFrEF has been placed on three pillars for a long time: angiotensin-converting-en­zyme inhibitors (ACEI), beta-blocker (BB), and mi­ne­ralocorticoid receptor antagonist (MRA) are included in different heart failure guide­lines with I/A level recommendation. The ground-breaking highly important PARADIGM-HF study was published in 2014, and examined an entirely new class of drugs, the sacubitril/valsartan, which belongs to the group of angiotensin receptor blocking/neprilysin inhibitors (ARNI) in HFrEF patients. Results of this study showed that sacubitril/valsartan significantly reduced the primary composite endpoint of CV mortality and HF hospitalization by 20% and reduced overall mortality by 16% compared to an active comparator enalapril, which has the broadest evidence in HFrEF therapy. The 2016 European Society of Cardiology (ESC) HF guidelines recommended the use of sacubitril/valsartan with an I/B evidence level as a replacement for an ACEI to further reducing the risk of HF hospitalization and death of out-patients with HFrEF who remained symptomatic despite optimal treatment with an ACEI, a BB and an MRA. Later, several smaller studies concerned sacubitril/valsartan with slightly different indications and in other patient groups. The PIONEER-HF study demonstrated that early initiation of sacubitril/valsartan therapy after the stabiliza­tion of acute HF is safe and effective in HFrEF patients, reduces more rapidly the NT-proBNP levels - which correlates with HF prognosis -, than the enalapril. The TRANSITION and TITRATION studies provided useful information on the initiation of sacubitril/valsartan therapy and the strategy of dose titration. The appearance of sacubitril/valsartan opened a new era in HFrEF therapy a few years ago, an era we are actually experiencing in Hungary. Thanks to SGLT-2 inhibitors, it is also possible that we are at the door of an even newer therapeutic era. This question is expected to be answered in the new ESC HF-guidelines to be published soon this year. ]

[The incidence of chronic kidney disease continuously increases worldwide. Studies suggest that kidney disease is an as powerful cardiovascular risk factor as diabetes mellitus. Because of the high prevalence of lipid disorders, it is likely that dyslipidaemia plays a major role in the high cardiovascular risk of these patients. Evidence supports treating dyslipidaemia in patients with mild or moderate kidney disease, but the results of statin trials in dialysed patients are inconclusive. A practical treatment algorithm is proposed considering the special aspects, the effectiveness and safety of the drugs in the whole spectrum of kidney disease.]

[Diuretics (especially thiazide derivatives and indapamide that also has vasodilator efficacy) are considered as first line treatment in hypertension. They are particularly favourable in the treatment of overweight, elderly, isolated systolic hypertensive patients suffering from type 2 diabetes and metabolic syndrome or in mild renal and cardiac insufficiency. They can be ideally combined with other antihypertensive agents (primarily with angiotensin-converting enzyme inhibitors, angiotensin receptor blocking agents és béta-blockers). If hypertension is associated with left ventricular hypertrophy or stroke indapamide is the appropriate choice. In case of left ventricular dysfunction and heart failure thiazide and/or furosemide is the adequate option. Low dose diuretics have no clinically relevant side effects and reduce cardiac mortality to the same extent as other pharmaceutical interventions.]