Lege Artis Medicinae

[Introduction - Metabolic Syndrome]

PADOS Gyula

OCTOBER 01, 2000

Lege Artis Medicinae - 2000;10(10)

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Lege Artis Medicinae

[Antibacterial therapy: 2000 balance and perspectives]

GRABER Hedvig

[Following a brief history of antibacterial therapy and evaluating the achievements and damages occurred, authors focus on today's problems and the following statements are made: Principles of treatment are clearly defined, however the choice of antibiotics may vary in time and in regions according to the differences in bacterial resistance. Antibacterials of the last decade (III-IV. generation fluoroquinolones, streptogramins, oxazolidinones, new vancomycine analogues) are intended to be effective against multiresistant Gram-positive cocci. Beside bacterial resistance, the most difficult therapeutic problems are the infections in the immunocompromised patients. The role of infection in the pathogenesis of certain diseases, e.g. ventricular/duodenal ulcer and probably atherosclerosis, has only recently been discovered; here new prospects may open for antibacterials. Data of the antibiotic utilization in Hungary show radical changes in the last years. Conclusion: the immense power of antibiotics still has its limits: to conquer bacterial disease successfully the intelligent combination of antibiosis, asepsis and immunization are required. ]

Lege Artis Medicinae

[Group Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico - Prevenzione]

MATOS Lajos

Lege Artis Medicinae

[Molecular mechanisms of cardiac hypertrophy and heart failure]

MIKALA Gábor, PETŐ Mónika, VÁLYI Nagy István, CSÁSZÁR Albert

[In this review, the most important molecular mechanisms leading to cardiac muscle hypertrophy and consequentially to heart failure are detailed. In numerous instances, understanding molecular mechanisms offers the possibility for pharmacotherapeutic intervention. First, trimeric G-proteins and their attached intracellular signaling pathways are introduced, with special emphasis on the pathways elucidated by transgenic animal models. In this area, there are several clinically effective drugs to influence cardiac hypertrophy, including ACE inhibitors, angiotensin receptor antagonists, as well as a- and B-adrenergic receptor blockers. Mitogen activated protein kinases participate later in the hypertrophic cascade. There are ongoing investigations on the potential therapeutic use of lipid-soluble statins these are indirect inhibitors of Ras-farnesylation. Altered cellular Ca2+-homeostasis is fundamental with respect to cardiac muscle hypertrophy and heart failure. The third part of this article investigates the role of the calcium/calmodulin dependent protein phosphatase called calcineurin in these processes. Administration of cyclosporin A or tacrolimus (both are inhibitors of calcineurin) may not be recommended in most forms of cardiac hypertrophy, however, in certain settings they may prove to be valuable therapeutic agents. One of the most serious, not yet properly addressed problem of late stage heart failure is the development of ventricular arrhythmias caused by repolarization abnormalities. Certain mechanisms of this phenomenon are highlighted with a special note on Nat-Cat exchange inhibitors as one of future therapeutic agents of much promise. ]

Lege Artis Medicinae

[The role of MR angiography in the examination of intracranial aneurysms: A comparative study]

P. Nagy Zoltán, BAJZIK Gábor , BOGNER Péter, BERÉNYI Ervin, SZÁSZ Krisztina, KOPA János, REPA Imre

[MR imaging has recently emerged for visual representation of blood vessel structures as well. With MR angiography (MRA), appropriate diagnosis can be established for a number of pathologies involving the arteries and veins. In this report, authors analyse the significance of MR and MRA examinations in the diagnostics of intracranial aneurysms of 87 cases, comparing these procedures with results obtained by digital subtraction angiography (DSA), which is regarded as the gold standard method. In 52 patients where surgical intervention was performed, intraoperative findings were used as control. MR - MR angiographic examination was very sensitive in detecting aneurysms larger than 3 mm (98%), the rate of depicting smaller aneurysms proved to be lower (56%), the overall sensitivity was 79%. MRA is an excellent non invasive diagnostic tool in the examination of intracranial aneurysms. The method can not replace catheter angiography completely but its application is justified and useful in many cases. Occasionally, aneurysms not seen on DSA can be depicted with MR angiography. ]

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