[Platina’s Renaissance Cookbook ]
MAGYAR László András1
NOVEMBER 03, 2015
Lege Artis Medicinae - 2015;25(10)
MAGYAR László András1
NOVEMBER 03, 2015
Lege Artis Medicinae - 2015;25(10)
Lege Artis Medicinae
Lege Artis Medicinae
[The respiratory tract infections, first of all severe pneumonia are associated with severe cardiovascular adverse events the significance of which that had not been recognised so far. Among the adverse events, the development of acute coronaria syndromes, heart failure, arrhythimias are the most important ones leading to significatly higher mortality even after several years. In the development of acute coronaria syndrome , the proinflammatory activites play the cenral role leading to the instability of coronaria plaques and plaque rupture associated with formation of platelet thrombi. The constriction of coronariae, peripherial vasodilatation and hypoxia also contribute to the deleterius complications. The role of pneumococci in this process seems to be especially significant since this pathogen exhibit a unique direct cardiotoxic effect, namely directly invades the myocardium and produce cardiotoxic substances. As a consequence, impairement of cardiomyocite function and contractility and formation of microscopic lesions in which later collagen deposition and long-term cardiac scarring can be detected. These pathological processes are developed despite of antibiotic treatment, consequently, vaccination against pneumococcal infection seems to be the only method for efficacious prevention of the myocardium damage and cardiovascular adverse events. According to the results of the CAPITA study, the conjugate polisaccharide vaccine decrease the number of pneumococcal pneumonia and invasive pneumococcal infections by 45 and 75% resp. in the elderly population. The recognition of the direct and indirect role of pneumococci in the development of early and late cardiovascluar adverse events gives a new aspect of the beneficial effect of efficacious vaccination.]
Lege Artis Medicinae
[The level of glycaemic control necessary to achieve optimal outcomes in subjects with type 1 diabetes mellitus typically requires intensified insulin therapy using multiple daily injections or continuous subcutaneous insulin infusion (CSII). For CSII, the insulins of choice are the rapid-acting insulin analogues: insulin aspart, insulin lispro and insulin glulisine. The advantages of CSII over multiple daily injections in adult and paediatric populations with type 1 diabetes include superior glycaemic control, lower insulin requirements and better health-related quality of life/patient satisfaction. An association between CSII and reduced hypoglycaemic risk is more consistent in children/adolescents than in adults. The use of CSII is widely recommended in both adult and pediatric type 1 diabetes mellitus populations, but is limited in pregnant patients. The review also discusses the result of the “A non-interventional trial to observe the effect of the use of Accu Chek Combo device on quality of life and metabolic control“(COM-1101-HU 1.3).]
Lege Artis Medicinae
[INTRODUCTION - One of the basic elements of cardiovascular prevention is lipid lowering therapy, the quality of which is indicated by the increasing rate of lipid target values achieved during recent years. Further improvement is needed and for this the enhancement of patient adherence to statin treatment is a possible way. PATIENTS AND METHODS - The prescription habits in 81 patients taking statins (41 atorvastatin and 40 rosuvastatin) from 392 randomly selected ones for another study were analysed from the database of general practitioner in the village called Méhkerék in Békés County, Hungary. RESULTS - The statin adherence of the patients was evaluated in two different ways: the estimation by the general practitioner and the determination of prescribed drug boxes during one year. There was no significant difference between the two methods. Similarly, no significant difference was found between the atorvastatin or rosuvastatin adherence. The reduction of total cholesterol was significantly greater in patients taking rosuvastatin (p=0.03). A significant correlation was found between the prescribed box numbers and the decrease of LDL- and total cholesterol. CONCLUSIONS - The patients’ adherence seems to be independent from the type of statin. For the evaluation of patient adherence the GP's simple estimation and determination of prescribed drug boxes during one year are equally appropriate. This suggests, that the GP would be able to select those patients whose education needs longer time. ]
Lege Artis Medicinae
[The small cell lung cancer is characterized as a rapidly proliferating systemic neoplasm, where the basic treatment modality is the chemotherapy . Even in the surgically treated cases the platina based chemotherapy combination is obligatory before and after the surgical resection, combined with preventiv cranial irradiation to minimize the risk of the cranial metastases. The platina based chemo-radiotherapy is the gold standard in the locally advanced cases. Palliativ local irradiation could be useful for pain relief or decompression in the metastatic cases. Prophylactic cranial irradiation strongly recommended in any cases. There are no newly developed drugs for the treatment of SCLC, however it is a chemosensitive carcinoma. Topotecan could be effective in second or third line therapy , especially in brain metastasis.]
Hungarian Radiology
Lege Artis Medicinae
[Diuretics are essential therapeutic tools. They effectively reduce blood pressure and have been shown in numerous hypertension clinical trials to reduce both cardiovascular and cerebrovascular morbidity and mortality. In addition, they are important components of the treatment of heart failure with apparent signs of congestion. While thiazides are recommended in mild forms, loop diuretics are used in the severe stages of congestive heart failure. Loop diuretics and thiazides often induce hypokalaemia, which has been demonstrated to be not as benign as thought before. Diuretic-induced hypokalaemia seems to be aldosterone dependent. Aldosterone levels increase during diuretic therapy. Aldosterone antagonists are unique among diuretics in that they improve survival of patients with heart failure independent of their effect on sodium metabolism. Because of this, diuretic treatment lives its renaissance in cardiology.]
1.
2.
Clinical Neuroscience
Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease3.
4.
5.
1.
Clinical Neuroscience
[Cases of inborn errors of metabolism diagnosed in children with autism ]2.
Clinical Neuroscience
[The first Hungarian patient with Guillain-Barre syndrome after COVID-19]3.
Clinical Neuroscience
Retinal morphological changes during the two years of follow-up in Parkinson’s disease4.
COMMENTS
0 comments