Lege Artis Medicinae

[GENDER ASSOCIATED DIFFERENCES IN THE PROGRESSION OF RENAL DISEASES]

MÜLLER Veronika, SZABÓ Attila

JANUARY 21, 2004

Lege Artis Medicinae - 2004;14(01)

[Increasing evidence suggests an important role of gender in the incidence, progression and different therapeutic possibilities of several diseases. Recent data demonstrated gender associated differences in the development and progression of chronic renal diseases. Present work reviews sexual dimorphism in different chronic renal diseases, summarizes underlying pathophysiological processes and therapeutic possibilities focusing on the role of gender. New evidences may present the base of gender based therapies in the future.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[LOCAL INEQUALITIES IN THE UTILIZATION OF SPECIAL HOME NURSING IN THE SOUTH-TRANSDANUBIAN REGION]

BONCZ Imre, SÁNDOR János, OLÁH András, BETLEHEM József, SEBESTYÉN Andor, KISBENEDEKNÉ Gulyás Kinga, DÓZSA Csaba

[INTRODUCTION - The aim of this study is to analyse the local inequalities in the access and utilization of special home nursing within Hungary focusing on the South-Transdanubian Region. DATA AND METHODS - In the first part of the study we compared the indicators of the access and utilizations of special home nursing at national and county level. In the second part of the analyses we made a detailed analyses of utilization data of home nursing in the three counties (Baranya, Somogy, Tolna) of the South- Transdanubian Region of Hungary. Data is derived from the financial database of the National Health Insurance Fund of Hungary for the period 1998-2002. RESULTS - The access of population to the special home nursing increased from 83,8% (1998) to 95,1% (2002). The utilization rate increased from 74,8% (1998) to 84,1% (2002). Within the South-Transdanubian Region we found significant local inequalities in the utilization of services (number of cases, number of visits), which were represented by the tools of geographical information system. CONCLUSIONS - There have been significant differences in the access and utilization of home nursing with remarkable within country inequalities.]

Lege Artis Medicinae

[Cardiovascular aspects of impaired glucose tolerance: A review through the STOP-NIDDM Trial]

BOSNYÁK Zsolt, KERÉNYI ZSUZSA

Lege Artis Medicinae

[A NEW DISCIPLINE IN THE CENTER OF MEDICAL RESEARCH AND CLINICAL PRACTICE - THOUGHTS ON BIOINFORMATICS]

FALUS ANDRÁS, BERKE Tamás, ORTUTAY Csaba Péter, SUHAI György

[Bioinformatics is one of the most important element of genomic research revolutionising biomedical science. This review describes the phenomena of genomic variance and comparative genomics. Briefly, the review summarises the identification procedure of new genes and gene expression patterns highly important in diagnostics. Bioinformatic procedures make possible the rapid detection of pathogens and have principal role in molecular drug design technologies.]

Lege Artis Medicinae

[THE METABOLIC SYNDROME CLINICAL APPEARANCE, DIAGNOSIS, PATHOMECHANISM]

KÉKES Ede, CZURIGA István

[The metabolic syndrome has gone by several names over the past two decades. The diagnostic criteria were proposed by the ATP III of NCEP in 2001 and were accepted by European Society of Cardiology and European Society of Hypertension in 2003. The criteria (abnormal waist rate, HDLcholesterol, triglyceride, blood pressure and fasting glucose) are listed and the presence of any three of these factors is considered sufficient for diagnosis. The prevalence of syndrome affects about a quarter of the Hungarian population with hypertension. The metabolic syndrome is associated with premature cardiovascular morbidity and mortality including an excess of sudden deaths. According to the recent literature data the main component of the syndrome, the obesity, especially with abdominal fat distribution is associated with hypertension, hyperinsulinemia and insulin resistance with related abnormalities of carbohydrate and lipid metabolism. The low HDL cholesterol, high triglyceride level and the small, dense LDL cholesterol particles are the parts of lipid component of syndrome. A variety of environmental (obesity, smoking, physical inactivity) and genetic factors (genetic mutations of lipoprotein lipase, hepatic lipase, CETP and PPA receptors) and the impaired FFA metabolism have all been related to lipid abnormalities. Sympathetic hyperfunction participates in the pathogenesis and complications of metabolic syndrome. Possible factors augmenting sympathetic activation include alterations of insulin, leptin, FFA, cytokines, sleep apnoe. Other important factors as the endocrin concept, the hypothalamus-hypophysis- adrenal axis, endothelial dysfunction are discussed. The impaired muscle insulin stimulated glycogen synthesis (FFA induced GLUT-4 inhibition) is the major cellular factor of insulin resistance. There is a continuous process from the insulin resistance state (with hyperinsulinemia) into the 2T diabetes mellitus (with hypoinsulinemia).]

Lege Artis Medicinae

[CURE]

MATOS Lajos

All articles in the issue

Related contents

Hypertension and nephrology

[Cerebrovascular diseases in patients with chronic kidney disease]

KISS István, NAGY Judit

[The reason of the unfavourable life expectancy of patients with chronic kidney disease (CKD) is not only the development of end-stage renal failure but the frequent appearance of cardiovascular diseases (CVD). Chronic kidney damage itself is a cardiovascular risk state and the occurrence of CVD/associated diseases is significantly higher in chronic kidney failure. Beside risk stratification and valid treatment of CVD (hypertension, diabetes mellitus, ischemic heart disease e.g.) we and the international nephrological community have left the cerebrovascular diseases of CKD patients out of consideration. However, up to 50% of patients suffering a stroke will die immediately, only 10% of stroke survivors can continue his/her profession, but the others will be permanently disabled. High blood pressure is a strong predictor of stroke and of other CVD in most of the patients. In stroke risk reduction it is particularly important to reach the target blood pressure values. The main object of the “Live under 140/90 mmHg” programme of the Hungarian Society of Hypertension is to familiarize with target blood pressure itself and how to reach target blood pressure. In 2010, prevention, early diagnosis and management of stroke are the most important challenges of this programme (The Brain Control Programme). We think it is advisable to prepare and publish a clinical practice guideline in collaboration with stroke societies which is similar to the guidelines of international societies and of the Hungarian Society of Stroke but specific for CKD patients. This guideline would help to give a uniform, up-to-date treatment for the cerebrovascular diseases of CKD patients.]

Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

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.

Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

Hypertension and nephrology

[Association between cyclothymic affective temperament and hypertension]

NEMCSIK János, BATTA Dóra, KŐRÖSI Beáta, RIHMER Zoltán

[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]