Lege Artis Medicinae

[Effects of drugs on permanent pacemakers]

BŐHM Ádám1, ZÁMOLYI Károly1

MAY 27, 1992

Lege Artis Medicinae - 1992;2(05)

[Several antiarrhythmics can alter pacing thresholds. Especially, the Class 1 C drugs may increase the threshold. Corticosteroids and sympathomimetic agents lower the threshold. Some drugs must be avoided in pacemaker dependent patients. The potential pacemaker-drug interaction must always be considered when prescribing a new drug. Significant clinical sensing problems have not been recognized with antiarrhythmic drugs. The sensor function of rate responsive pacemakers can be altered by concomitant drug therapy. ]

AFFILIATIONS

  1. Orvostovábbképző Egyetem II. Belgyógyászati Klinika Budapest

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Lege Artis Medicinae

[Treatment of endodermal thyroid cancers]

ÉSIK Olga, NÉMETH György

[Following staging procedures, differentiated thyroid cancers i. e. papillary and follicular carcinomas, are surgically treated with intra- or extracapsular total thyroidectomy (depending on the anatomical extent of the disease) and selective lymphnode dissection. Postoperative complementary use of adjuvant external and systemic radiotherapy is the general practice. External irradiation decreases local/regional relapses in all cases. Radioiodine treatment decreases local/regional/ distant recurrences in cases of tumour cells capable of iodine uptake. Life-long thyroxine medication is required, with a TSH-suppressive dose for relapse prevention and hormone substitution. This treatment regimen, a careful follow-up, and adequate rescue therapy are the prerequisites of the generally excellent patient prognosis, i. e. a survival probability measurable in decades. In anaplastic carcinoma following extracapsular total thyroidectomy and lymph node dissection, external irradiation is always indicated. Chemotherapy has a benefical effect on survival. Hormone replacement therapy is necessary to substitute for the missing metabolic effect of the thyroid. This combined modality treatment leads to some improvement with regard to the prognosis of this poor-risk type of cancer. ]

Lege Artis Medicinae

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BAKSAI László, PHILIP W. H. Esker

[Malnutrition is a chronic nutritional disorder resulting from insufficient intake of caloric energy and/or some fundamental nutrients. Since it is the most common public health problem in the world it has a great impact on pediatric morbidity and mortality. The etiology is extremely complex. When one considers the less severe symptoms and signs caused by vitamin-, mineral-, and trace element deficiencies, it is apparent that not only children living in underprivileged countries are affected. In the course of making the diagnosis an assess ment of the nutritional status should also be made, especially considering the above-mentioned marginal nutritional deficiencies. The most common manifestation of nutritional disorders is anemia, which is mostly caused by lack of iron, vitamin B12, folic acid and can be complicated by infections. Nutritional requirements can be affected by several drugs. That is why this medication-nutrition interaction has to be kept in mind during treatment. The interaction of malnutrition and infection is very important, primarily for three reasons: mechanisms by which infection complicates the metabolic and nutritional status of the host; importance of suboptimal nutritional status on susceptibility and severity of intercurrent infections; clinical and therapeutic implication of these interactions. ]

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[The authors performed serial examinations by a high resolution transvaginal transducer during the first trimester of pregnancy to show the most important stages of the early embryonal development. This is a preliminary study to a prospective, detailed screening programme in the first trimester of pregnancy. The earliest sign of pregnancy can be detected at the 29–31st days of menstrual age using vaginal transducer. During the 5th week the (secondary) yolk sac can be seen, which is an unambiguous evidence of an intrauterine pregnancy. The living embryo can be de monstrated on 36–38th days with the help of the pulsation of the embryonic heart tube. Certain embryonic structures appear in a defined order (developmental „calendar"). The physiologic midgutherniation can be observed during 7–11th weeks. Transvaginal sonography has gained popularity only recently due to technical advances. The main fields of use became gynaecology and early pregnancy, for there is no need to have a full bladder, for the lack of disturbing tissue layers. This method is essentially a combination of the bimanual gynaecological and the ultrasound examination. ]

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Clinical Neuroscience

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Lege Artis Medicinae

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