Lege Artis Medicinae

[Praise for the damaging publicity]

NAGY N. Péter

NOVEMBER 30, 1992

Lege Artis Medicinae - 1992;2(11)

[I represent the "harmful public" as the title suggests. In a normal situation, this qualification does not bother me, I am used to the situation of a journalist being similar to that of a policeman. Everyone recognises the need for journalists and police officers, but no one wants to meet them. It usually means bad things, or at least the risk of bad things. If this natural state of affairs is not the cause of this discomfort, what is?]



Further articles in this publication

Lege Artis Medicinae

[The beta-adrenoceptor blocking drugs]


[The beta-blockers have been primary in cardiovascular pharmacology since the 1960's. Clinical experiences in the last 25 years have confirmed that the beta-adrenergic blockade is essential in treating the different forms of angina pectoris. Hypertension, hypertrophic cardiomyopathy, and all situations including acute myocardial infarction and some rhythm disturbances qualified by sympathetic overdrive. The beta-blockers have been shown in large scale clinical trials to reduce the cardio vascular morbidity and mortality associated with hypertension and post-infarction period. The possibility of using them as a combined therapy with a great number of other drugs without any difficulties, is very important. Toxicity is rare with beta-blockers and the side effect profile is generally good. There fore, there is no question that the risk/benefit ratio is weighted toward the benefit. Nevertheless there are some problems such as hemodynamic profile, and effects on lipid metabolism, etc. Research has advanced from the first generation to the third generation with direct or indirect effects on the vascular bed, producing strong vasodilation. Because of the above mentioned facts, it is essential to know correctly the pharmacological effects and precise pharmacokinetics, of the beta-blockers.]

Lege Artis Medicinae

[Calcitonin-secreting ovarian strumal carcinoid]


[On the basis of a case report, the clinical picture, pathologic characteristics and possible histogenesis of ovarian strumal carcinoid are discussed. A 3 mm strumal carcinoid, i.e. thyroid tissue intimately mixed with a calcitonin-secreting neuroectodermal tumour, was found in a mature ovarian cystic teratoma of a 38 year old woman. Although the thyroid component demonstrated a typical normal light microscopic appearance, no thyroglobulin and thyroxine were found immunohistochemically. Immunoreactive calcitonin was demonstrated within the tumour cells, even in the transitional zone of the biphasic tissue elements. No amyloid was detected. The argentaffin and argyrophilic reactions were negative. The close relationship between functionally imperfect thyroid tissue and a neuroendocrine marker-secreting tumour seems to be concordant with the theory of the existence of a pluripotential stem cell capable of differentiating multidirectionally.]

Lege Artis Medicinae

[Plasma Exchange]


[As a technique, is one of the indispensable means of supportiv therapy. Possibilities and approaches representing new trends of up to date therapy are offered by its application. Such approaches are, the nonsubstitutive application of IVIG, or exploiting the advantages of the functioning LAK and TIL cells. However, the authors also point out dangers of this technique, therefore plasma exchange should be applied only after thorough consideration. ]

Lege Artis Medicinae

[A new operative technique in the internal carotid artery surgery]

ENTZ László, MOGÁN István, JÁRÁNYI Zsuzsa, PAPP Sándor, NEMES Atilla

[The primary author spent one year at the Vascular Department of Nurenberg Town Hospital where an opportunity presented it self to get acquainted with a new surgical method. The eversion endarterectomy of the carotid artery has been developed by the Nurenberg team in 1985. Since that time more then 1500 operations of this type was performed. Using the experiences gained in Nurenberg, the author introduced this new method at the Budapest Cardiovascular Surgery Clinic as well, and from January 1, 1991 until June 30, 1992, 213 operations were performed. Concerning short term results the new method is acceptable compared to the traditional methods. Owing to the method being a new one, long term results can only be read about from 2 authors. After a five year postoperative period restenosis of 1,3 percent was found after 212 operations by Kieny and after 105 operations, a 1.9 percent was reported by Kasprzak. These results seem to be encouraging if they are compared to the 10–25% restenosis rate of traditional operations. ]

Lege Artis Medicinae

[APSAC Intervention Mortality Study]


[Within 30 days of the infarct, 12.2% of the placebo group and 6.4% of the APSAC group had died. The active agent reduced mortality at 30 days by a mean of 47.5% (21-65%) within a 95% confidence interval. Side effects and adverse effects were rare.]

All articles in the issue

Related contents

Lege Artis Medicinae

[Risk of nonsteroidal antiinflammatory drugs. Focus on aceclofenac]


[Nonsteroidal antiinflammatory drugs (NSAIDs) are among the most frequently used pharmaceuticals. Nevertheless, a number of studies emphasized that NSAIDs were damaging not only the gastrointestinal (GI), but also the cardiovascular (CV) system, could increase the blood pressure, the frequency of coronary events (angina, myocardial infarction) and stroke incidence, as well as they might deterio­rate renal functions. The National Institute for Health and Care Excellence (NICE) did not find evidence that administering NSAIDs could increase the risk of developing COVID-19 or worsened the condition of COVID-19 patients. However, unwanted effects of specific drugs differ substantially in their occurrence and seriousness as well. It seemed to be for a long time that the NSAIDs provoked higher GI-risk was closely related to the COX1/COX2 selectivity, like the cardiovascular (CV) risk to the COX2/COX1 selectivity, however, the recent data did not prove it clearly. Based on the available literature while pondering the gastrointestinal and cardiovascular adverse events, among all NSAIDs the aceclofenac profile seemed to be the most favourable.]

Hypertension and nephrology

[Hypertension, cognitive function and dementia – Significance of antihypertensive therapy]

GAJDÁN Nikolett, ÁBRAHÁM György

[The significance of hypertension as one of the major cardiovascular risk factor is unquestionable. By achieving target blood pressure values differentiated by age and comorbidities, the risk of cardiovascular events can be significantly reduced. However, it is essential to the quality of life the patient spends the extra years of life thus gained. This is a really complex issue affecting many co-disciplines, but one of the most important of these is the mental health, maintaining cognitive functions, and avoiding dementia. High blood pressure impairs the blood supply to the target organs, including the brain, by damaging the smooth muscle of the arteries and accelerating atherosclerosis, which increases the risk, the frequency and the severity of mental decline in proportion to the degree of tension. This means serious implications not only for the individual, but for the family and the society, as well. A particular contradiction is that treating blood pressure to the target range does not automatically means preserving cognitive functions and avoiding the risk of dementia. Meta-analyzes of large studies have shown differences between the individual antihypertensive groups have been confirmed in this respect as well. Inhibitors of the renin-angiotensin system and calcium antagonists – mainly dihydropyridines – appear to be a priority in this regard. The authors provide an overview of the relationship between hypertension and mental abilities, with a review of the literature on the effects of antihypertensive therapy, with particular reference to the effects on cognitive function and dementia. ]

Lege Artis Medicinae

[The role of prostacyclin in the function of the gastric mucosa]

BÁLINT Gábor Sándor

[The intracellular effect of exogenously admi nistered prostacyclin in the gastric mucosa seems to be a polyphasic one, namely: 1. effect on the cyclic nucleotide (CAMP, CGMP) turnover, 2. effect on the calmodulin-content, 3. DNA and RNA changes 4. influence on protein synthesis 5. new cell formation. Besides the endogenous prostacyclin exerts a natural protection against damaging noxae, thus maintaining the physiological integrity of the mucosa. ]

Lege Artis Medicinae

[The praise of transience]


[You know, you're all going to die! - I began my lecture on death to the medical students sitting peacefully in the lecture theatre. The statement was greeted with a broad smile. The reaction was not unexpected, as I had "brought to their attention" something that all children are aware of. Or rather! Of course not! ]

Clinical Neuroscience

[Immune responses and neuroimmune modulation in the pathogenesis of acute ischemic stroke and poststroke infections]

PAPP Viktória, MOLNÁR Tihamér, BÁNÁTI Miklós, ILLÉS Zsolt

[Acute-onset cerebrovascular diseases are connected to a number of immunological changes. Here, we summarize immune responses participating in the evolution of atherosclerotic plaques and poststroke local immune responses in the injured CNS as well as in the systemic circulation. Ischemic injury of the CNS alters the balanced neuroimmune modulation resulting in CIDS, the central nervous system injury-induced immune deficiency syndrome. Due to the immunodepression and reduced pro-inflammatory immune responses, the susceptibility for infection is increased; indeed, poststroke infection plays a major role in stroke-related mortality. On the other hand, CIDS may protect against damaging autoimmune responses elicited by exposed CNS antigens. Investigation of immune responses related to ischemic stroke may result in novel therapies indicated by an increasing number of experimental and clinical trials altering poststroke immune responses and preventing infections.]