Lege Artis Medicinae

[In the Shadow of Death ]

FERENCZI Andrea

SEPTEMBER 20, 2015

Lege Artis Medicinae - 2015;25(08-09)

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Lege Artis Medicinae

[Pleiotrop effect of rosuvastatin: clinical revelance of decreasing the mean platelet volume]

PUKOLI Dániel, SEMJÉN Judit, SZÉKELY Anita, RAJDA Cecília

[INTRODUCTION -Activated platelets play a key role in the patomechanism of cardiovascular diseases. One biomarker of platelet activation is mean platelet volume (MPV). Increased MPV level is connected to higher cardiovascular risk. Statins are frequently used in vascular diseases. We examined the effect of rosuvastatin on platelets in serum. METHODS - The patient were divided in medium risk and high risk (suffering ischaemic stroke) groups. Altogether parameters (total-, HDL, LDL-cholesterol, MPV) of 66 patients were examined before and after rosuvastatin treatment. RESULTS - Rosuvastatin decreased the cholesterol and MPV levels in both groups. This effect was greater in the high risk group. DISCUSSION - According the our findings rosuvastatin decreases the MPV both in hypercholesterolaemic and ischaemic stroke patients. The high LDL level causes increased platelet activation leading to increased thrombosis. This cascade worsens the underlying pathways in cardiovascular diseases. We found that aspirin taken together with rosuvastatin has a greater effect on decreasing the MPV. This probably doubles the antithrombotic effect. ]

Lege Artis Medicinae

[Scientific Medicine and Complementary Medicine: Unresolvable Opposites or Mutually Supportive Systems? ]

PIKÓ Bettina

Lege Artis Medicinae

[Evaluation of body image by means of body shape test and the priming phenomenon]

KOVÁCS Gyöngyvér Xénia, PRIEVARA Dóra Katalin, PIKÓ Bettina

[INTRODUCTION - Body image plays a significant role in the way how the individuals evaluate their own health and in the motivation for health promotion and disease prevention. Consumer culture provides controversial messages for the population, on one hand it motivates to try foods of high calories, on the other hand it also supports the thin body for the ideal. Not surprisingly, besides obesity, eating disorders and distorted body image disorders also tended to increase during the past decades. Therefore, it would be relevant to investigate the background variables of body image. METHODS - One hundred and sixty seven healthy working adults participated in our study that included a self-completed, voluntary and anonymous questionnaire with a focus on the so called body shape test. First, based on projecting figures on slides, the participants evaluated their own figure and the ideal one as perceived by them. Then we projected figures of skinny models. After this they re-evaluated themselves. The goal of this investigation was to detect the priming effect of projecting slim figures that is frequently used in the media. RESULTS - Based on the projection of the skinny models, there was a change in 55.6% of the sample in the evaluation of one’s own figure. On a Likert-type scale of 1-7 points, previously they had evaluated themselves with an average of 3.23 points (thinness scale) that turned into 3.35 after the projection of the skinny models. In addition, their view about their own ideal body (4.57 points), and about female and male ideal body also changed into a slimmer one. These changes were statistically significant (p < .001) by paired t-test both for men and women. Finally, men and women did not show significant difference in the evaluation of female and male ideal body. CONCLUSIONS - These results justified the role of the pictures’ priming effect in body image both in terms of the perception of one’s own figure and the ideal body. The change was particularly relevant in the case of evaluation of one’s own figure due to the choice of the slimmer body as compared to the view of the ideal body. Evaluation of female and male ideal body was similar to the first projection of the pictures as compared to what they would think as ideal for themselves. After the projection images of the female and male ideal body moved to the slimmer figures in a smaller account as compared to the own ideal body image. All these suggest that pictures projected by the media may have a significant role in the population’s body image. Clarifying the phenomenon may help in health promotion and dieting related disease prevention. ]

Lege Artis Medicinae

[Hungarian Health Politics: Currently and in a Historical Perspective ]

BALÁZS Péter

Lege Artis Medicinae

[Causes and pathological appearances of ischemic heart diseases]

MAGYAR Éva, FECSKE Éva, SALAMON Ferenc

[The myocardial ischemia is caused by insufficient offer of oxygen, it can be caused by damage of coronary arteries which is called coronary heart disease, and might be non coronary in origin, this is the relative coronary insufficiency. The reason of coronary heart diesease is the stenosis or occlusion of the lumen of subepicardial main coronary branches as well as intramyocardial small vessels. The type of alterations either of the main or the small vessels are mentioned. The myocardial bridge play an important part in genesis of intimal plaques. The discrepancy occuring between the actual oxygen demand and oxygen offer causes the relative coronary insufficiency, such as myocardial hypertrophy, anemia, shock, fever etc. The myocardial damages, those of caused ischemia can be devided pathologically irreversibile lesions (infarction, coagulative and colliquation myocytolysis) and ischemic heart disease (ischemic cardiomypathy) and clinically angina pectoris and sudden death. The irreversible lesions are detailed in morphological point of view, and differenece between the regional and subendocardial infarction is accentuated.]

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Clinical Neuroscience

[Vinpocetin in neurological diseases]

SZAPÁRY László, KÉSMÁRKY Gábor, TÓTH Kálmán, MISNYOVSZKY Melinda, TÓTH Tímea, BALOGH Ágnes, NAGY Krisztián, NÉMETH György, FEHÉR Gergely

[Introduction - Stroke is the third leading cause of death worldwide (following cardiovascular and cancer mortality) and associated with serious disability for the vast majority of patients. There is no salvage therapy for irreversibly damaged brain areas, improving the circulation of the surrounding hypoperfused territories may be associated with benefitial clinical states. Cerebral hypoperfusion may play a role in the pathogenesis of other kind of neurological diseases, improvement of global circulation may have a preventive effect on these conditions. Aims - The aim of our study was to review the experimental and clinical articles focusing on the role of vinpocetin in different neurological conditions. Results - Vinpocetin appears to have several different mechanisms of action that allow for its antiinflammatory, antioxidant, vasodilating, antiepileptic and neuroprotective activities in experimental conditions. On the other hand, several meta-analysis of the existing studies in acute stroke examining short and long term fatality rates with vinpocetin was unable to assess efficacy. In chronic cerebrovascular patients, vinpocetin improves impaired hemorheological variables, has significant vasodilating properties, improves endothelial dysfunction, neuroimaging studies showed selective increase in cerebral blood flow and cerebral metabolic rate, all of which are potentially beneficial in cerebrovascular disease and may improve cognitive functions. Summary - Based on the above mentioned results vinpocetin plays an important role both in basic research and in clinical management of different neurological diseases.]

Lege Artis Medicinae

[How many cardiovascular events can be avoided by a lipid lowering therapy based on preventive guidelines?]

MÁRK László

[The lipid lowering therapy became one of the most important elements in the cardiovascular prevention, yet it is not appropriately evaluated neither by the doctors, nor by the patients. The lipid goal attainment should to be improved according to Hungarian and international data. Using a recommendation guided lipid lowering therapy the most benefit can be expected in the patients at very high risk who alrea­dy had a cardiovascular event, where the LDL-cholesterol goal is 1.8 mmol/L. Calculating upon the data of 170000 patients of Cholesterol Treatment Trialists’ Collaboration a decrease of LDL-cholesterol level from 2.5 mmol/L to 1.8 in 100 patients in 10 years would avoid 3 myocardial infarctions, strokes or death, lowering that from 3.5 mmol/L to the goal would prevent these 3 events within 5 years. Using the traditional LDL-cholesterol lowering medication, high dose statin and ezetimibe, if the attitude of doctors and the compliance of patients would be ideal, the 1.8 mmol/L goal attainment rate would be over 80%. Unfortunately, up to now the reimbursed administration of ezetimibe in Hungary is still bound to a specialist’s recommendation, adding it to any dose of any statin an additional 20% LDL-cholesterol can be expected. The reimbursed administration of PCSK9-inhibitors is possible only based on a special request to National Health Insurance Fund. To achieve a better national cardiovascular morbidity and mortality the attitude of the doctors and the adherence of the patients to the lipid lowering therapy should be improved (it’s the goal of the present paper as well).]

Lege Artis Medicinae

[CURRENT PRACTICE AND PROBLEMS IN RESUSCITATION]

DIÓSZEGHY Csaba

[Cardiopulmonary resuscitation is the progressive management of sudden cardiac arrest with the goal of restoring spontaneous circulation and preserve vital organ functions. Sudden cardiac death occuring out of hospital is still one of the major causes of death among otherwise healthy and young population however, approppriate management - certainly including resuscitation as the first step - might provide a reasonably good quality of life. Long term outcome of resuscitation is mainly determined by the links of the Chain of Survival, eg. early access, early CPR, early defibrillation and early advanced care. The aim of this review is to present the upto- date concepts for the best management of these survival links.]

Lege Artis Medicinae

[Dignified death - misunderstood]

FRENKL Róbert

Lege Artis Medicinae

[Causes and pathological appearances of ischemic heart diseases]

MAGYAR Éva, FECSKE Éva, SALAMON Ferenc

[The myocardial ischemia is caused by insufficient offer of oxygen, it can be caused by damage of coronary arteries which is called coronary heart disease, and might be non coronary in origin, this is the relative coronary insufficiency. The reason of coronary heart diesease is the stenosis or occlusion of the lumen of subepicardial main coronary branches as well as intramyocardial small vessels. The type of alterations either of the main or the small vessels are mentioned. The myocardial bridge play an important part in genesis of intimal plaques. The discrepancy occuring between the actual oxygen demand and oxygen offer causes the relative coronary insufficiency, such as myocardial hypertrophy, anemia, shock, fever etc. The myocardial damages, those of caused ischemia can be devided pathologically irreversibile lesions (infarction, coagulative and colliquation myocytolysis) and ischemic heart disease (ischemic cardiomypathy) and clinically angina pectoris and sudden death. The irreversible lesions are detailed in morphological point of view, and differenece between the regional and subendocardial infarction is accentuated.]