Lege Artis Medicinae

[Holistic Approach in Ancient Egypt ]

ANDRÁSSY Gábor, KULCSÁR Emese, MAGYAR Erzsébet, FRECSKA Ede

MARCH 20, 2015

Lege Artis Medicinae - 2015;25(03)

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Lege Artis Medicinae

[The real cost of caring for seriously ill patients - compassion fatigue or satisfaction]

KEGYE Adrienne, ZANA Ágnes, RÉVAY Edit, HEGEDÛS Katalin

[The improvement of the Hungarian hospice network and the increasing number of people dealing with the seriously ill are reflected by the annual hospice reports (2001-2013). However these reports also draw the attention to the cumulating mental and spiritual burdens of carers which can lead to fatigue and burnout. On the base of practical experience we surveyed the mental and spiritual condition of the caregivers of seriously ill patients and also reviewed research findings and the professional literature on the exposure to imperilment. The grounds of professional literature’s research were the Hungarian and international databases. We favoured studies published in Hungarian or English between 2000 and 2014 primarily on carers working in palliative and hospice service. One of the main profits of reviewing the professional literature is getting more detailed information on the mental state of professional caregivers. Relatively new element in researches is studying the relation between burnout and compassion satisfaction and compassion fatigue. It includes studying of symptoms and coping strategies. These all enable a better understanding of causes and help us to support hospice carers with more effective methods to protect them from mental and spiritual exhaustion.]

Lege Artis Medicinae

[Protection of gastrointestinal system in cardiovascular diseases]

FARSANG Csaba, TULASSAY Zsolt

[Cardiovascular preventive drugs (nonsteroidal antiinflammatory drugs, aspirin, inhibitors of platelet aggregation, anticoagulants) are among the most frequently used medicines all over the world. Gastrointestinal (GI) complications (hemorrhage, ulceration, perphoration) are among the most frequent side effects of these drugs, however, differences in their pharmacodynamics properties and other pleiotropic effects may substantially modify these unwanted events. Authors, based on international and Hungarian guidelines, summarize the most important data for GI protection, focusing on the use of H-2 receptor blockers and proton pump inhibitors.]

Lege Artis Medicinae

[The role of hypoxia in tissue regeneration and in development of amplified aggressive fenotypes in malignant cancer]

HUNYADI János

[Several diseases are accompanied by hypoxic stress; elimination of it is an important physiological process. Our body provides a protective function which delays damage and destruction by hypoxia. In case of necrosis, it provides the mop up of the damaged area. This security system starts the regeneration in cells of the hypoxic zone which surrounds the necrotic area, resulting in the survival of the cells in hypoxic environment and ensuring the handling of the necrosis. The key molecules of the system are the hypoxia-induced factor molecules. The review discusses the physiological role of tissue hypoxia and normoxia and its effects on tissue regeneration. The physiological system triggered by the hypoxia-induced factor plays an important role in embryonic development, in wound healing and in numerous diseases (eg. myocardial infarction, stroke, vaculities, etc). Unfortunately, this system also plays a key role in several malignant tumors by rising the development of cells with increased aggressive fenotypes as well. The physiological process of regeneration starts in the hypoxic tumor cells aided by the hypoxia-induced factor system. The process results in neovascularization, and in the case of tissue damage, in the mop up of the necrotic tissue and in the restoration of tissue oxygenisation. However, after the formation of the new vascular network, tumor cells accustomed to hypoxia will not die but keep their original uncontrolled proliferation and anaerobic nature. Moreover the malignant nature of the cells will be increased by the genetic changes generated by the system of hypoxia- induced factors. The role of the hypoxia-induced factor system in tumor progression is discussed by the example of one of the most malignant tumors, malignant melanoma.]

Lege Artis Medicinae

[Experiences with fix combination of amlodipin-atorvastatin according to the ESH/ESC hypertension recommendation 2013]

NAGY Gergő

[BACKGROUND - Hypertension is a widespread disease in Hungary and worldwide as well. Combination products containing more effective agents in one pill have an increasing role in the treatment strategy. One of the most often used products is Amlator, in which the advantageous features of amlodipine and atorvastatin are combined. METHOD - During my investigation I treated a patient with just diagnosed hypertension, prescribing Amlator 20/5 pill once a day. Blood pressure measurements were registered at home in a blood pressure diary. After two months laboratory and ABPM measurements were administered again. Gathered data was compared and changes were analysed. RESULTS - During the first ABPM measurement the mean blood pressure was 150/90 mmHg. Laboratory measurements showed a moderate increase in cholesterol level (6.1 mmol/l), lipid values were in the normal range (LDL 3.0 mmol/l, HDL 2.61 mmol/l) and hypertriglyceridemia wasn’t observed either (0.97 mmol/l). The blood pressures measured at home showed a significant decrease using the prescribed medication. During the first month the average blood pressure was 133/80 mmHg. This shows an 11.3% decrease of the systolic value. At the second monthly inspection a decrease in the cholesterol level was noted (cholesterol 5.0 mmol/l, LDL 2.31 mmol/l, HDL 2.2 mmol/l, triglyceride 0.96 mmol/l). This is a 14.7% decrease. The second ABPM measurement showed a significant decrease in both the systolic and diastolic blood pressure values. The average blood pressure was 124/78 mmHg, which means a 17.3% decrease of the systolic value. CONCLUSION - Amlator proved to be an effective treatment of both hypertension and hypercholesterolemia.]

Lege Artis Medicinae

[Double thyroid cancer]

HAJDU Mária, KRUTSAY Miklós

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[In the first part of this review the definition of vertigo/dizziness was discussed. The major difference between the two signs is the exsistence of the direction, which is specific for vertigo. Dizziness is a frequent complaint in the clinical practice. Its frequency is increasing with advance of age, to intimate the play of declining cognitive process in the pathogenesis of its. The popular health significance of vertigo is in the rowing number of the patients. The onset of the most cases with acute vertigo appears between secundums and minutes so the patients will be provided in circumstances of emergency department. First of all three form schould be take into account: neuronitis vestibularis, benign paroxysmal positional vertigo and Meniere syndrome. Without tipical periferal signs of vertigo, central cause should be searched, principally stroke (lysis possibility). The differential diagnose of the different dizzeness/vertigo forms according to the elapsed time of the onset or congenital and acquired nystagmus was created in tables. The recommendations of the therapy of acute and chronic dizziness/ vertigo syndroms are, lack of results of evidence based trials doubtful. The more often used drugs based on clinical trials are discussed as vinpocetine, betahistine and piracetam. The in vitro and in vivo data suggest that the last molecule is eligible to use both in periferal and central type of vertigo syndroms.]

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Association of anterior thoracic meningocele and azygos lobe of the lung

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Here we report an anterior thoracic meningocele case. Twoyears- old female patient was presented with kyphosis. Azygos lobe of the lung was also demonstrated during radiological studies. Posterolateral thoracotomy incision and extralpeural approach was performed for excision of the anterior meningocele to untether the cord. Although both anomalies are related to faulty embryogenesis and it is well known that faulty embryogenesis may also reveal coexisting abnormalities, we could not speculate a common mechanism for anterior thoracic meningocele and azygos lobe of the lung association.

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