Lege Artis Medicinae

[Public forum of the College of Gastroenterology]

SIMON László

JULY 14, 2008

Lege Artis Medicinae - 2008;18(06-07)

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Lege Artis Medicinae

[UNSOLVED THERAPY - COMPLEX TREATMENT OF BUERGER’S DISEASE]

SZOMJÁK Edit, DÉR Henrietta, KEREKES György, VERES Katalin, DEZSŐ Balázs, TAKÁCS István, TÓTH Judit, MÓZES Péter, SOLTÉSZ Pál

[INTRODUCTION - Buerger’s disease is a nonatherosclerotic, segmental, inflammatory, progressive obliterative disease of the blood vessels that most commonly affects the small and medium-sized arteries and also the veins of the lower limb. It is strongly associated with tobacco use. CASE REPORT - A 37-year-old heavy smoker forest worker presented with severe gangrenous changes on the fingers as the upper limb manifestations of Buerger’s disease, which required acral amputation. After complex medical treatment, pharmacological sympathectomy on the left side and surgical sympathectomy on the right side, bilateral conserving necrectomy, cessation of smoking and 2 cycles of cyclophosphamid, the patient's status significantly improved, his pain diminished and, although to a limited extent, he could use both hands. CONCLUSIONS - Buerger’s disease is a disorder with unclear aethiology and is difficult to diagnose. Despite of a good prognosis, a causal treatment is not yet possible, so any antithrombotic, haemorheological, vasodilator or immunosuppressive therapy that have been reported to have beneficial effect should be considered for treatment.]

Lege Artis Medicinae

[“I Want Magic!” A Discussion with Dóra Elek, Director of the Baltazár Theatrical Group]

GYIMESI Ágnes

Lege Artis Medicinae

[Multifocal nodular hepatic steatosis]

BAJOR Judit

Lege Artis Medicinae

[Tiotropium treatment of patients with simultaneous chronic obstructive pulmonary disease and asthma]

BALIKÓ Zoltán

Lege Artis Medicinae

[Stem cell therapy: A new approach to treat vascular stenosis]

BODA Zoltán

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[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]

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Interest in the hippocampal formation and its role in navigation and memory arose in the second part of the 20th century, at least in part due to the curious case of Henry G. Molaison, who underwent brain surgery for intractable epilepsy. The temporal association observed between the removal of his entorhinal cortex along with a significant part of hippocampus and the developing severe memory deficit inspired scientists to focus on these regions. The subsequent discovery of the so-called place cells in the hippocampus launched the description of many other functional cell types and neuronal networks throughout the Papez-circuit that has a key role in memory processes and spatial information coding (speed, head direction, border, grid, object-vector etc). Each of these cell types has its own unique characteristics, and together they form the so-called “Brain GPS”. The aim of this short survey is to highlight for practicing neurologists the types of cells and neuronal networks that represent the anatomical substrates and physiological correlates of pathological entities affecting the limbic system, especially in the temporal lobe. For that purpose, we survey early discoveries along with the most relevant neuroscience observations from the recent literature. By this brief survey, we highlight main cell types in the hippocampal formation, and describe their roles in spatial navigation and memory processes. In recent decades, an array of new and functionally unique neuron types has been recognized in the hippocampal formation, but likely more remain to be discovered. For a better understanding of the heterogeneous presentations of neurological disorders affecting this anatomical region, insights into the constantly evolving neuroscience behind may be helpful. The public health consequences of diseases that affect memory and spatial navigation are high, and grow as the population ages, prompting scientist to focus on further exploring this brain region.

Lege Artis Medicinae

[A short chronicle of three decades ]

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[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

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