Lege Artis Medicinae

[“Notes from the House of Dead“ - The pathologist is for the patients as well]

KULKA Janina

MAY 20, 2004

Lege Artis Medicinae - 2004;14(05)

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Further articles in this publication

Lege Artis Medicinae

[16th National Conference of the Supervisors of General Practitioners]

KRAMER Imre

Lege Artis Medicinae

[9th Debrecen Cardiology Days]

PÁLVÖLGYI Nóra, MOHÁCSI Attila

Lege Artis Medicinae

[NEUROFIBROMATOSIS, MALIGNANT MELANOMA AND HYPERTHYREOIDISM IN A HCV POSITIVE PATIENT]

FOLHOFFER Anikó, HORVÁTH Andrea, CSÁK Tímea, NÉBENFÜHRER László, TELKES Márta, IVÁNYI András, SZALAY Ferenc

[INTRODUCTION - Similar occirrence of neurofibromatosis and malignant melanoma is rare. We report a patient with neurofibromatosis, cutaneous melanoma, hyperthyreoidism and HCV positivity. CASE REPORT - A 43-year-old woman has been under care for neurofibromatosis for 16 years when she presented with increased serum ?- glutamyltransferase, alkaline phosphatase activity and anti-HCV antibody positivity at regular checkup. A pigmented lesion removed from her back histologically proved to be cutan melanoma. Interferon treatment was applied. She lost 8 kilograms in half a year which was caused not by the tumor progression, but hyperthyreoidism. A rapid clinical and laboratory improvement was observed for thyreostatic treatment and she regained her bodyweight. One year later she presented with a cough caused by pulmonary tumor. The tumor was surgically removed and histologically diagnosed as metastasis of melanoma. Cytostatic treatment was applied and she became asymptomatic. Four years after the diagnosis of melanoma she died of apoplexy. During the autopsy there was no sign of either melanoma or liver disease. CONCLUSIONS - The careful investigation of skin should be emphasised even in case of long established neurofibromatosis. The presented case shows an association of malignant melanoma and neurofibromatosis. In the background of loss of bodyweight even in a patient with history of malignant disease other causes should also be searched such as hyperthyreoidism especially during interferon therapy.]

Lege Artis Medicinae

[CALM]

MATOS Lajos

Lege Artis Medicinae

[CURRENT STATUS OF THE DIAGNOSTICS AND THERAPY OF UROLOGICAL TUMOURS]

ROMICS Imre

[Significant amount of urological patients have malignant disease. Prostate cancer is the second most frequent cancer in males associated with high mortality and decreased quality of life. Hence the importance of early diagnosis. Furthermore, diagnostical protocols, operative and conservative therapeutic modalities are summarised. Hematuria is the most frequent sign of bladder cancer. Diagnostical, surgical and adjuvant therapeutical differencies of the superficial and muscle invasive bladder cancers are discussed. The urinary deviation after cystectomy could be associated with complications therefore regular follow up of patients is necessary. The standard therapy of renal cancer is surgical. Unfortunately its mortality has not change during past years. Testicular cancer is the disease of young males. If diagnosed early, most cases are curable. Therapy is complex, involving surgical, chemoand radiation therapy as well. Penis cancer is a rare disease, but highly malignant. In advanced stage patients are incurable.]

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We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

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