Lege Artis Medicinae

[INSIGHT]

MATOS Lajos

MAY 20, 2001

Lege Artis Medicinae - 2001;11(05)

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Lege Artis Medicinae

[Selective abortion in twin pregnancies discordant for congenital fetal anomaly]

PATKÓS Péter, HRUBY Ervin, PAPP Csaba, TÓTH-PÁL Ernő, PAPP Zoltán

[INTRODUCTION - In special cases of twin pregnancy where one of the fetuses is affected by severe congenital anomaly or disease confirmed with prenatal diagnostic methods and the other fetus is healthy, selective abortion has been accepted as the method of choice for twenty years to save the healthy sibling and to improve its life expectations. PATIENTS AND METHODS - The authors present their clinical experience of the past 15 years from 14 cases of selective abortion performed in twin pregnancies discordant for congenital fetal anomaly. Indication for the intervention was the anomaly of the second fetus in eleven cases and the anomaly of the first twin fetus in three cases. RESULTS - Out of eleven selective abortions performed on the second twin fetus, only one ended with the loss of the entire pregnancy. All three cases of selective abortion performed on the first twin fetus resulted in abortion of the entire twin pregnancy. All ten surviving fetuses were born living and healthy, followed by unharmed infant and childhood development. CONCLUSIONS - To offer the possibility of selective abortion to the parents seems to be indicated only in those cases of twin pregnancy where the discordant fetal disease or congenital anomaly is severe, placentation is dichorionic or at least diamniotic and where the second twin is affected.]

Lege Artis Medicinae

[Molecular morphological methods in laboratory medicine]

BALÁZS Margit, ÁDÁNY Róza

[Today, the increasing technical arsenal of molecular morphology has not only methodological importance, but also a revolutionary role in diagnostic laboratory medicine. Techniques previously used only in basic research have become widespread in routine diagnostics by now. The development of methodology for detection of genetic alterations has enabled laboratory tests not only to define disease associated pathobiochemical alterations, but also to identify the genetic background of diseases as well. Evolution of these methods caused qualitative changes not only in detection of disease specific alterations, but also in revealing increased individual susceptibility (sometimes at population level) indicating genetic predisposition to the disease. Recently, the classical methodology based on genetic microscopic morphology has been gradually supplemented or even replaced by different in situ hybridization techniques in many laboratories. Using these techniques chromosomal alterations in cells and tissues (including tumor cells) can be detected within one day (or maximum 1-2 days) without in vitro manipulation of cells. These improved techniques allow us to monitor chromosomal changes after the treatment of genetic diseases or define these alterations induced by environmental exposures.]

Lege Artis Medicinae

[Diagnostic problems of ischemic colitis]

DEMETER Pál, SIKE Róbert, SZÉKELY György, KISS Sándor, SZILVÁS Ágnes

[Ischemic colitis is mainly caused by the impaired circulation of the inferior mesenteric artery. Most frequently it occurs as part of general arteriosclerotic disease or impaired left ventricular function, but it may also occur after abdominal aortic reconstruction. In connection with cocaine users, thrombophylia and vasculitis can also happen among young patients. Colonoscopy plays the most important role in making the diagnosis. In case of transitional ischemia conservative treatment is recommended, but surgery is needed in the progressive gangrenous form or when stricture in the colon developed. Authors describe the case of an 80-year-old man and discuss the etiology, clinical aspects, classical and up-to-date methods of diagnostics and the possibilities of conservative treatment.]

Lege Artis Medicinae

[Handling of conflicts through mediators]

DÓSA Ágnes

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[The memory of Pal Gyulay]

KAPRONCZAY Károly

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[Self-monitoring of blood glucose in type 2 diabetes]

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[Self-monitoring of blood sugar levels is an essential element in the treatment of diabetes, it provides an insight to the success of treatment and self-management, the development of metabolic processes, and ensures the early recognition and treatment of significant blood sugar fluctuations. The aim of this study was to evaluate the habits of self-monitoring of sugar levels in patients with type 2 diabetes, and among them the frequency, recognition and treatment of hypo- and hyperglycemia. The research was conducted as a cross-sectional study in 2018 in the Health Centre in Subotica/Serbia. The sample included 107 patients diagnosed with type 2 diabetes. Data were collected through interviews with patients using a customized questionnaire, during the regular control examinations. The patients’ level of blood sugar in the capillary blood was measured by glucometer. The statistical package IBM-SPSS 20.0 and descriptive analytic methods were used for data analysis. The mean age of the sample was 63.7 ± 7.7 years. Two-thirds of them performed opportunistic self-monitoring mostly before breakfast. A large number of patients never recognized variations of blood glucose (in 65% hyperglycemia and in 51% hypoglycemia). However, a month before 81% of patients had hyper- and 31% hypoglycemic episodes respectively. 12% of patients did not take any action in such cases. It is recommended to emphasize again and again the importance and way of self-monitoring at each follow-up examination. The shortcomings identified in the study provide guidelines what to focus on when caring for diabetic patients.]

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