Lege Artis Medicinae

[Oncohematology in the focus - Reader’s questions answered by dr. Judit Demeter]

DEMETER Judit

SEPTEMBER 19, 2007

Lege Artis Medicinae - 2007;17(08-09)

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Lege Artis Medicinae

[Lifestyle Medicines]

dr. TÖRÔCSIK Mária

Lege Artis Medicinae

[THE USE OF ACID SUPPRESSANTS IN PANCREATIC DISEASES]

GERVAIN Judit

[The histamine-2 receptor antagonists and the proton pump inhibitors are part of current therapeutic protocols for most diseases of the pancreas. Acid suppression is definitely recommended to improve the effect of enzyme supplements in chronic pancreatitis and in maldigestion that develop after certain gastric and pancreatic surgeries. For this purpose proton pump inhibitors should be used since they are effective and provide lasting inhibition. In cystic fibrosis, their use is indicated already in the sub-clinical stage and they are also part of the basic protocol for the treatment of Zollinger-Ellison syndrome. Acid suppressants are not routinely used in the therapeutic protocols of acute pancreatitis. Their use is well-grounded in necrotizing pancreatitis in the stage of multiple organ failure to prevent the development of stress ulcer. During enteral tube feeding, their use is indicated to protect the permanently empty stomach and because of the frequent reflux symptoms. The risk of bacterial overgrowth, which is often considered a contraindication, is insignificant if jejunal tube feeding is applied and antibiotic treatment is frequently administered.]

Lege Artis Medicinae

[Diseased or Possessed?]

dr. BÁNFALVI Attila

Lege Artis Medicinae

[ANALYIS OF MOTIVATIONS OF SMOKING CESSATION]

SUSÁNSZKY Éva, SZÁNTÓ Zsuzsa, KOPP Mária

[INTRODUCTION - The aim of the study was to explore the differences in motivations between successful quitters and smokers who just consider quitting. Self-reported motivations of exsmokers' smoking cessation and the reasoning of current smokers who consider quitting were analyzed. SUBJECTS AND METHODS - The study is based on Hungarostudy Health Panel conducted in 2005, which is the second wave of Hungarostudy 2002, a national representative health survey of the adult Hungarian population. Of the subjects involved in this follow-up study, data from 3701 persons could be analyzed. RESULTS - About half of the respondents had never smoked, one fifth of them had quitted and 28 percent smoked. More than half of the current smokers (52%) contemplated on giving up smoking. Among ex-smokers and contemplating current smokers alike (38-40%), disease prevention was mentioned as the single most important reason of cessation. Financial reasons were mostly mentioned by current smokers; ex-smokers were more likely to explain their decision with deteriorating health, the occurrence of certain diseases. Among these, cardio-vascular morbidity played the most important role in smoking cessation while cancers, respiratory disease and diabetes also significantly increased the odds of quitting. Social pressure was a reason for quitting mostly among women and elderly persons. Among current smokers, those living in partner relationship and the better-off tended to entertain thoughts of quitting because of social pressure. CONCLUSION - The results confirm the importance of cardiovascular diseases in smoking cessation: although people emphasize primary preventive purposes of their cessation efforts, in fact secondary prevention, i.e., existing circulatory and heart problems play the major role both in actual cessation and in quitting considerations.]

Lege Artis Medicinae

[ANTI-TNF-α ANTIBODY THERAPY IN CROHN’S DISEASE]

LAKATOS Péter László, LAKATOS László

[Crohn’s disease is a chronic inflammatory disorder which may affect any part of the gastrointestinal tract. Its pathogenesis is only partially understood; various environmental and host (e.g., genetic, epithelial, immune and nonimmune) factors are involved, together initiating a chronic uncontrolled inflammation, which is partly due to an imbalance between pro- and anti-inflammatory cytokines, and a defective apoptosis of lamina propria T cells. Among proinflammatory cytokines, tumour necrosis factor- α (TNF-α) seems to play a central role in Crohn’s disease. Over the past years, the increasing knowledge on the pathogenesis of Crohn’s disease has led to the development of a number of biological agents targeting specific molecules involved in gut inflammation, including TNF-α and its receptors. This paper reviews the rationale for the use of TNF-α inhibitors in the treatment of Crohn’s disease.]

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[Eight questions and answers about anxiety in the elderly in family practice ]

CSATLÓS Dalma, VAJDA Dóra, MOHOS András, GONDA Xénia

[Anxiety is one of the most common psychological disorders in the elderly. Physical illnesses contribute to its development, but the opposite is also true: anxiety adversely affects the prognosis of many somatic illnesses, thus significantly enhancing morbidity and mortality. Therefore, the recognition and adequate treatment of anxiety disorders in the elderly are especially important in family practice, too. With the increase of life expectancy, the problems and illnesses of the elderly receive more and more attention in medical practice and anxiety cannot be ignored either, because the early detection of its symptoms improves the quality of life and reduces the chance of bad prognosis. ]

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[A brief survey is offering of debates on two long-standing questions in stress studies and theories: 1) question of stress nonspecificity (i.e. homo- or heterogeneity in stress responses), and 2) what is the functional role of central catecholamines in stress mechanisms, especially in stress signaltransduction and in the realization of stress responses.]

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[Focus on the diagnosis and therapy of chronic cough]

SZILASI Mária

[Cough by itself is not a disease but a part of a complex defense mechanism protecting from harmful materials entering the airways and cleaning the lungs and airways from potentially harmful materials. Normally, cough is accompanied by other defense mechanisms (bronchoconstriction and secretion of sputum) that increase the effectiveness of cough. Cough generally is caused by intrapulmonary disorders, but may be related to extrapulmonary lesions that are not easy to diagnose. In every case, an etiological diagnosis has to be the aim because this is the only way to proper treatment. From the abundance of reasons for cough, upper airway cough syndrome, asthma, chronic obstructive pulmonary disease, and gastro-esophageal reflux disease are discussed in detail.]

Lege Artis Medicinae

[Addictions in the focus - Readers’ questions answered by dr. János Szemelyácz]

SZEMELYÁCZ János