Lege Artis Medicinae

[LAM Awards 2005]

NAGY Zsuzsa

JANUARY 21, 2006

Lege Artis Medicinae - 2006;16(01)

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Further articles in this publication

Lege Artis Medicinae

[AUTOIMMUNE PATHOGENESIS IN THE BACKGROUND OF PULMONARY ALVEOLAR PROTEINOSIS]

LOSONCZY György

[Pulmonary alveolar proteinosis (PAP) is a rare form of interstitial lung disease. The etiology and pathogenesis of PAP has remained uncertain. It is characterized by the accumulation of surfactant in alveolar space, which leads to impaired oxygen diffusion and lung restriction. Patients develop chronic respiratory failure. Traditional treatment of the disease has been whole-lung lavage. In recent years the role of alveolar macrophages in the removal of surfactant has been discovered with granulocyte-macrophage colony-stimulating factor (GM-CSF) triggering this function of macrophages. In the most frequent “idiopathic” subtype of this disease autoantibodies against GM-CSF have been shown to be present in blood. These autoantibodies block GM-CSF-induced surfactant removal by the alveolar macrophages. Clinical studies indicated that longterm, high dose therapy with GM-CSF can be effective in the cleaning the alveolar space and treating respiratory failure. This new treatment modality makes high-risk whole-lung lavage avoidable.]

Lege Artis Medicinae

[Forum for sleep disturbances]

KRAMER Imre

Lege Artis Medicinae

[New target values for cholesterine levels and new results in effective antilipaemic therapy]

NAGY Viktor

Lege Artis Medicinae

[Wishes and reality]

FRENKL Róbert

Lege Artis Medicinae

[A RARE CAUSE OF CYANOSIS - A CASE REPORT ON SULFHEMOGLOBINEMIA]

HARANGI Mariann, MÁTYUS János, NAGY Erzsébet, NAGY Emőke, PARAGH György, BALLA József, OLÁH V. Anna

[INTRODUCTION - Sulfhemoglobinemia (SHb) is an uncommon cause of cyanosis that is predominantly caused by drugs in adults. CLINICAL CASE - We report on an unusual case of sodium sulfate induced sulfhemoglobinemia in a 61-year-old woman after surgical polypectomy. Fractional hemoglobin derivates were assayed by spectrophotometry and high-performance liquid chromatography (HPLC). The sulfhemoglobinemia ratio was 8.6% in the first sample, and 3.77% a month later measured by spectrophotometry. In the hemolysate a new peak was identified as sulfhemoglobinemia by HPLC. It showed the presence of 9.37% sulfhemoglobinemia in the first sample and 4.88% a month later. After omitting the suspected toxic agent the cyanosis decreased significantly. CONCLUSIONS - The findings underline the importance of routine sulfhemoglobinemia analysis in cases of cyanosis of unknown origin.]

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[The cardiovascular risk of nonsteroidal antiinflammatory drugs]

AMBRUS Csaba, KISS István

[Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most common pain relief and anti-inflammatory medications all over the World, and many formulations are also available over-the-counter. Beyond the well-known gastrointestinal risks, emerging evidence supports increased incidence of cardiovascular events associated with the use of NSAIDs. This cardiovascular risk seems to be independent of the cyclooxygenase selectivity of these drugs. Distinct side effect profiles of various NSAIDs were summarized in a former issue of the Journal: LAM 2014;24(7): 327. In this paper, we aimed to summarize some of the yet unpublished results of a major research project of the European Medicines Agency (EMA), that was conducted in order to establish the relative risk of CV outcomes (myocardial infarction, ischaemic stroke and hospitalization for heart failure) associated with the use of various NSAIDs. In this epidemiological study, seven European healthcare databases on a source population of 35 million subjects were linked and analyzed. Most of the results are currently only available on the project homepage; however, analyses of heart failure data have already been published in a recent issue of The BMJ. ]

Lege Artis Medicinae

[Thoughts on the mission of the LAM]

KAPÓCS Gábor

Lege Artis Medicinae

[LAM Awards 2006]

NAGY Zsuzsa

LAM Extra for General Practicioners

[THE RISK OF NONSTEROIDAL ANTIINFLAMMATORY DRUGS]

FARSANG Csaba, BEDROS J. Róbert, ALFÖLDI Sándor

[Nonsteroidal antiinflammatory drugs (NSAIDs) are among the most frequently used medicines all over the world. In the year 2012 in the LAM, we summarized data on cardiovascular (CV) safety of these drugs. We emphasized that all NSAIDs may potentially be harmful on the CV system, as they can increase the blood pressure, the risk of coronary events (angina, myocardial infarction), and that of stroke, as well as they may deteriorate renal functions. We also outlined that in this respect there are substantial differences between different compounds, and the CV risk does not depend on the ratio of COX- 1/COX-2 selectivity. The newly available data of original papers and metaanalyses shed light on further details. Even naproxen which drug was previously considered the less harmful on CV system can increase the risk of blood pressure, stroke, and gastrointestinal (GI) complications. We have to emphasize that the most important risk of NSAIDs is still the GI bleeding. This adverse effect is significantly less for drugs which are more selective for COX-2 than COX-1 enzyme, but other, pleiotropic effects can also beneficially modify the GI as well as the CV risk. E.g. the aceclofenac was found to be among NSAIDs with the less adverse effects on GI system and is also among those having the less CV risk.]

Lege Artis Medicinae

[To Reward Performance... An Interview with Gyula Szegedi, Member of the Academy, by Elemér Nemesánszky, LAM’s Editor-in-Chief]

NEMESÁNSZKY Elemér, GYIMESI Andrea