Lege Artis Medicinae

[It is No Blasphemy!]

GRÉTSY Zsombor

APRIL 21, 2006

Lege Artis Medicinae - 2006;16(04)

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Lege Artis Medicinae

[QUALITY OF LIFE MEASUREMENTS IN BRONCHIAL ASTHMA]

MÉSZÁROS Ágnes

[Bronchial asthma is a chronic disease with symptoms that significantly influence the daily life of patients causing difficulties in almost every area of life. The author reviews his own results and those published by others on the impact of asthma on the quality of life. The patients' quality of life was assessed using the general quality of life questionnaire EuroQol as well as the disease-specific St. George's Respiratory Questionnaire. Asthma was classified by severity according to GINA, an international classification system. The results of the study provide numerical proof of the concept that due to their disease, patients with asthma have lower quality of life indices than the non-asthmatic population. On examining the effect of age, sex and respiratory functions as factors that influence quality of life, the results indicate that the quality of life of women with asthma is lower compared to men, which is a warning that more attention should be paid on the care of women with bronchial asthma. Since there is only a moderate correlation between respiratory functions and quality of life (r=0.37), the extent of respiratory tract obstruction assessed by objective measurements is not indicative of how the patient is doing. Despite of having normal values, some patients are commonly anxious, are subjects to many real or pseudo-attacks, which in turn leads to greater drug consumption, and judge their state more severe in the symptom diary than actually it is. The findings indicate that beside considering clinical state, symptoms and laboratory results, asthma care should place greater emphasis on the patients’ self-judged quality of life and their own view on their disease.]

Lege Artis Medicinae

[ENDOSCOPIC AND INTRAVENOUS PROTON PUMP INHIBITOR THERAPIES IN THE TREATMENT OF GASTRODUODENAL ULCER BLEEDING]

DÖBRÖNTE Zoltán

[Gastroduodenal peptic ulcer disease accounts for nearly 50% of the cases of acute upper gastrointestinal tract bleeding. Despite early endoscopic diagnosis and treatment, bleeding recurs in 15-20% of the cases within 72 hours. Mortality of recurrent bleeding is high (25-30%), therefore, the main goal of the treatment of patients with bleeding peptic ulcer is not only to stop the bleeding but also to prevent recurrence. The most effective way of the endoscopic therapy is the combination of injection (epinephrine) and thermal coagulation, with supplemental clip placement in spurting arterial bleeding. Overlying adherent clot should be removed after epinephrine has been injected into the ulcer base and the exposed vessel lesion should be coagulated. Proton pump inhibitors promote platelet aggregation and inhibit the proteolytic digestion of clots by raising the pH of gastric juice. The nearly neutral pH necessary for clot stability can be achieved by an intravenous bolus injection of the proton pump inhibitor followed by continuous infusion for 72 hours, after which an oral proton pump inhibitor should be used to prevent late recurrence of bleeding. Proton pump inhibitors can thus contribute significantly to the maintenance of primary haemostasis in patients with bleeding peptic ulcer. Beside omeprazole and pantoprazole that have been available as intravenous proton pump inhibitors, intravenous esomeprazole is a promising new product for the treatment of bleeding peptic ulcer since it ensures a faster and more pronounced intragastric pH increase.]

Lege Artis Medicinae

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Lege Artis Medicinae

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FEKETE György

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