Lege Artis Medicinae

[News in the therapy of age-related macular degeneration]

RÉCSÁN Zsuzsa

JULY 20, 2014

Lege Artis Medicinae - 2014;24(07)

[Age-related macular degeneration is the leading cause of serious visual deterioration in elderly people. The progressive, degenerative maculopathy involves both eyes. The serious visual impairment is caused by geographic atrophy and subretinal neovascularization. Interaction between environmental and genetic factors is fundamental in the development of this multifactorial disease. Significant risk factors are the age, positive familiy history and smoking. In early stages, prevention and vitamin supplementation play important role. Modern therapy of subretinal neovascularization is the inhibition of VEGF. No known treatment has been yet available for geographic atrophy.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Return of Clinical Ethics ]

NEMES László

Lege Artis Medicinae

[Current Bioethical Questions in Germany ]

KAPOCSI Erzsébet

Lege Artis Medicinae

[In vitro diagnostic medical testing laboratories and EU standards; basic elements]

DEBRECZENI Lóránd, FEKETE Mátyás, VÁSÁRHELYI Barna

[In the “in vitro diagnostic testing medical laboratories” particular attention should be paid to the confidental and reliable operation as to 60-75% of the information for medical decisions are derived from laboratory tests. The high-quality laboratory work is based on the standards created by the national professional boards. Laboratories in Hungary (as any other country around the world) should comply with the various directives and/or standards set out requirements: MSZ EN ISO 15189:2013, MSZ EN ISO 22870:2006, MSZ EN ISO 15197:2013, Guide to the Expression of Uncertainty in Measurements (GUM), guidelines of the International Union of Pure and Applied Chemistry (IUPAC), etc. Special attention should be devoted to the quality of the work (internal and external quality assurance). Participation in proficiency testing (MSZ EN ISO 17043:2010) is a must, where the results are evaluated by statistical methods as defined by the ISO 13528:2005 standard. Some aspects are summarized how to select appropriate laboratory services.]

Lege Artis Medicinae

[Amlodipine/atorvastatin fix combination in general practice]

ÁBRAHÁM Erzsébet Judit

[In total 50 patients with hypertension and dyslipidaemia received combined antihypertensive and antilipid treatment. The main component of therapy was a fixed combination of amlodipine/ atorvastatin in different dose variations. The goal of the observation was to achieve optimal target blood pressure and lipid profile. During the six- month therapy, the baseline average blood pressure value was 161/90 mmHg and it decreased to 133/84 mmHg. The lipid profile also changed successfully. The average value of total cholesterol decreased from 5.9 mmol/l to 4.76 mmol/l. Over the six month period, amlodipine/ ator vastatin usage not only decreased the number of the heart and vascular system events, but increased the patients medicine compliance and therapy loyalty.]

Lege Artis Medicinae

[Edvard Munch’s Mood Disorder ]

KÖVES Péter

All articles in the issue

Related contents

Clinical Neuroscience

[ASSOCIATION OF APOLIPOPROTEIN E POLYMORPHISM WITH AGE-RELATED MACULAR DEGENERATION AND ALZHEIMER’S DISEASE IN SOUTH-WESTERN HUNGARY]

KOVÁCS Á. Katalin, PÁMER Zsuzsanna, KOVÁCS Attila, FEKETE Sándor, MISETA Attila, KOVÁCS Bálint, KOVÁCS L. Gábor

[Background - Age-related macular degeneration (AMD) and Alzheimer dementia (AD) show similarities (advanced age, formation of deposits of similar content). Recently apolipoprotein E 2 (apoE 2) has been associated with AMD, while apoE4 with AD. The question of coexistence, especially with respect to the genetic background has not been studied earlier. We investigated, therefore, the occurrence of AMD in AD patients and compared their lipid profile and apoE polymorphism. Methods - 49 AMD, 32 AD and 27 control patients were examined (risk factors, visual acuity, slit lamp biomicroscopy, fundoscopy). Following measurement of triglyceride, total and HDL cholesterol levels, apoE mutation analysis was performed. Results - AMD was found in 8% of the cooperating AD patients. The prevalence of the apoE 4 isoforms in the AMD, AD and the control patients was 2%, 47% and 22%, while that of apoE 2 was 17%, 6% and 7%, respectively. The prevalence of apoE 3 isoform was 82%, 41% and 71%, respectively. Triglyceride, total and HDL cholesterol were in the reference range; however, AD patients were characterized by a lower total cholesterol value. Conclusions - The new finding of this publication is the rare occurrence of AMD among AD patients. The higher frequency of apoE 4 among the AD population, and the higher frequency of apoE 2 among AMD patients in the South-Western region of Hungary confirms the findings of other investigators.]

Lege Artis Medicinae

[RECENT ADVANCEMENTS IN THE DIAGNOSIS AND TREATMENT OF AGE-RELATED MACULAR DEGENERATION]

SERES András István

[Age-related macular degeneration is the leading cause of blindness in developed countries. In the last few years, new therapeutic approaches such as photodynamic therapy and intravitreal injections of vascular endothelial growth factor antagonists were introduced that do not only prevent disease progression but also give the hope of vision improvement. Of the new diagnostic methods, the use of optical coherence tomography improves diagnosis and also permits the qualitative measurement of therapeutic effects. Given the current high price of the new drugs and the need for frequent re-treatments, a significant increase in the economic burden of the disease is foreseeable.]

Clinical Neuroscience

The etiology and age-related properties of patients with delirium in coronary intensive care unit and its effects on inhospital and follow up prognosis

ALTAY Servet, GÜRDOGAN Muhammet, KAYA Caglar, KARDAS Fatih, ZEYBEY Utku, CAKIR Burcu, EBIK Mustafa, DEMIR Melik

Delirium is a syndrome frequently encountered in intensive care and associated with a poor prognosis. Intensive care delirium is mostly based on general and palliative intensive care data in the literature. In this study, we aimed to investigate the incidence of delirium in coronary intensive care unit (CICU), related factors, its relationship with inhospital and follow up prognosis, incidence of age-related delirium and its effect on outcomes. This study was conducted with patients hospitalized in CICU of a tertiary university hospital between 01 August 2017 and 01 August 2018. Files of all patients were examined in details, and demographic, clinic and laboratory parameters were recorded. Patients confirmed with psychiatry consultation were included in the groups of patients who developed delirium. Patients were divided into groups with and without delirium developed, and baseline features, inhospital and follow up prognoses were investigated. In addition, patients were divided into four groups as <65 years old, 65-75 yo, 75-84 yo and> 85 yo, and the incidence of delirium, related factors and prognoses were compared among these groups. A total of 1108 patients (mean age: 64.4 ± 13.9 years; 66% men) who were followed in the intensive care unit with variable indications were included in the study. Of all patients 11.1% developed delirium in the CICU. Patients who developed delirium were older, comorbidities were more frequent, and these patients showed increased inflammation findings, and significant increase in inhospital mortality compared to those who did not develop delirium (p<0.05). At median 9-month follow up period, rehospitalization, reinfarction, cognitive dysfunction, initiation of psychiatric therapy and mortality were significantly higher in the delirium group (p<0.05). When patients who developed delirium were divided into four groups by age and analyzed, incidence of delirium and mortality rate in delirium group were significantly increased by age (p<0.05). Development of delirium in coronary intensive care unit is associated with increased inhospital and follow up morbidity and mortality. Delirium is more commonly seen in geriatric patients and those with comorbidity, and is associated with a poorer prognosis. High-risk patients should be more carefully monitored for the risk of delirium.