Lege Artis Medicinae

[Letter from the editor]

KAPÓCS Gábor, FRENKL Róbert

AUGUST 20, 2003

Lege Artis Medicinae - 2003;13(06)

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Lege Artis Medicinae

[Antithrombotic strategies in acute coronary syndromes and percutaneous coronary interventions]

DEREK L. Connolly, GREGORY Y. H. Lip, BERNARD S. P. Chin

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[Diagnosis and therapy of insect sting allergy]

BÁNKÚTI Beáta

[Over the past 20 years great progress has been made in understanding the pathogenesis, diagnosis and treatment of allergic reactions caused by insect stings. The incidence of insect sting allergy in a general population is about 0.4- 3% but anaphylaxis to Hymenoptera venom can be fatal. The diagnosis of venom allergy is based on the history suggesting an allergic reaction and on the demonstration of the persistence of specific IgE antibody either by skin tests or RAST. Patients who had a severe allergic reaction and has positive venom skin test or RAST result should be advised to receive venom immunotherapy (VIT). The risk for subsequent life-threatening systemic sting reactions can be significantly reduced with VIT. VIT should be continued for at least 3 to 5 years and provides about 90 % protection from insect sting anaphylaxis.]

Lege Artis Medicinae

[Classification of lung fibroses - The clinical value of classification of idiopathic interstitial pneumonias]

ZSIRAY Miklós

[The new classification by ATS/ERS classifies clinical, radiological and prognostic data to the reports of bronchial biopsies. Our article discusses the clinical value of the pathological results including a brief review of 7 sub-groups and the failures of the differential diagnosis. The identification of each entity can be carried out exactly only from surgical specimens obtained mostly with videothoracoscop.]

Lege Artis Medicinae

[The connection between gastroesophageal reflux disease and obstructive sleep apnoea]

DEMETER Pál, VÁRDI Visy Katalin

[Clinical knowledge on the gastroesophageal reflux disease has been increased with the subject of extragastrointestinal complications in the last decade. Because of cardiological, pulmonological, laryngeal and dental complications, an interdisciplinary approach is required. The non-cardiac chest pain, bronchial asthma, chronic bronchitis, chronic caugh, posterior laryngitis and acidic damage of dental enamel are the most important complications. Authors study a less common connection between the gastroesophageal reflux disease and obstructive sleep apnoea. Sleeping can be considered as a risk factor of the reflux event by itself, because of the decrease of primary peristalsis, producing of saliva, and acidic and volume clearance of oesophagus as well. During obstructive sleep apnoea negative intrathoracic pressure increases extremely, resulting in increased transdiaphragmatic gradient of pressure as well. In addition, the powerful movement of diaphragm twitches the lower oesophageal sphincter through the phrenoesophageal ligament. These two mechanism practically promotes the reflux event in patients with obstructive sleep apnea. The new challenge for the gastroenterologists is to further research this new connection, to play more active role in the complex therapy, and to have a new diagnostic approach of serious gastroesophageal reflux disease.]

Lege Artis Medicinae

[Modern antibiotic therapy - The antibiotic therapy of community acquired pneumonias in adults based on gudelines]

KOVÁCS GÁBOR

[Most therapies in the treatment the community acquired pneumonia are empirical. There are several different guidelines helping to choose the right antibiotic. These guidelines contain the background of the epidemiology, diagnosis and microbiology. However the center of the interest is the therapeutic guide. The guidelines are worth as much as you make from those.]

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