Lege Artis Medicinae

[Regionally Organized Cardiac Key European Trial]

MATOS Lajos1

DECEMBER 23, 1992

Lege Artis Medicinae - 1992;2(12)

[Nisoldipine reduced ST-segment depression and the frequency of silent ischaemic periods compared with placebo, but this did not reach the level of statistical significance. The active agent did not affect the diurnal distribution of ischaemic signs and did not improve exercise capacity.]

AFFILIATIONS

  1. Országos Kardiológiai Intézet

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Further articles in this publication

Lege Artis Medicinae

[Cephalosporins in the nineties]

GRABER Hedvig

[The cephalosporin group is the largest and most widely used family of antibiotics in the nineties. According to their antimicrobial activity, the cephalosporin derivatives are classified as three generations; in Hungary seven parenteral and three oral compounds are available, while some newer ones are under registration. The chemistry and antimicrobial spectra of the cephalosporins are presented, as well as the main problems of bacterial resistance. Pharmacokinetics, adverse effects, and clinical indications of the individual compounds are discussed. The importance of critical use is emphasized.]

Lege Artis Medicinae

[New trends in the nonpharmacological therapy of atrial fibrillation]

KEMPLER Pál, LITTMANN László

[Atrial fibrillation is the most common of all sustained cardiac arrhythmias, and it is often resistant to medical therapy. This paper summarizes ourcurrent understanding of the pathophysiology of atrial fibrillation, surveys the factors which have led to the development of nonpharmacologic therapy, and describes the advantages and disadvantages of these procedures. Potential new research directions are presented. ]

Lege Artis Medicinae

[International Nifedipine Trial on Antiatherosclerotic Therapy]

MATOS Lajos

[ The coronarograms showed that neither the number nor the extent of atherosclerotic lesions observed in the first study changed appreciably over three years in either the nifedipine or placebo group. However, the incidence of new lesions was significantly lower in the active drug group than in the placebo group (0.59 vs 0.82/patient; -28%). Side effects were significantly more frequent in patients taking nifedipine (55/173) than in the placebo group (16/175; p<0.03).]

Lege Artis Medicinae

[Acute porphyrias]

TASNÁDI Gyöngyi, NAGY László

[Acute porphyrias - acute intermittent porphyria, variegate porphyria, hereditary coproporphyria and plumboporphyria – are due to lowered activity of the enzymes of the heme biosynthesis. All of them are inherited as autosomal dominants. From the pathobiochemical and clinical points of view there are 4 phases of the disease: genetic phase, compensated latent and decompensated latent phases and the generally life-threatening acute at tack. The clinical symptoms are caused by peripheral and autonomic neuropathy, which are primarily induced by various precipitating factors: in part by endogenous hormones but mainly by drugs, alcohol and severe infections. The diagnosis is based on measurement of the activities of the enzymes and porphyrins and their precursors in urine and feces. The therapy includes the use of glucose infusions administered in large doses and haematin. However the most effective mode of treatment is to prevent the acute syndrome. It is crucial to recognize the disease in the earliest (genetic) phase because in this way it is possible to avoid inducing factors. 91 patients are under permanent control and care by the authors, but there are many more patients in Hungary according to European estimates. Discovery of these patients would serve prevention.]

Lege Artis Medicinae

[Treatment of gallstones]

[Recommendation of the Hungarian Gastroenterological Society; Gallstone disease is the most common cause of gallbladder and biliary tract diseases. It occurs in about 10% of the adult population and its prevalence increases with age, with around 10% of men and 20% of women suffering from gallstones around the age of 50.]

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Related contents

Lege Artis Medicinae

[A short chronicle of three decades ]

KAPRONCZAY Katalin

[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.]

Lege Artis Medicinae

[Diagnosis and treatment of microvascular coronary heart disease. Specialities of conditions in Hungary]

SZAUDER Ipoly

[Invasive investigations show that in two-thirds of patients the myocardial ischaemia persists without obstructive coronary disease and any other heart conditions (INOCA). The underlying cause may be microvascular dysfunction (CMD) with consecutive microvascular coronary disease (MVD) and microvascular or epicardial vasospastic angina (MVA). The modern practice of clinical cardiology while using the developed non-invasive cardiac imaging permits exact measuring of the coronary flow with its characteristic indices. All of these improve the diagnosing of CMD-induced myocardial ischemia and provide opportunity to determine primary MVD cases. Since the recognition and treatment of MVD is significantly underrep­resented in the Hungarian medical care, the primary stable microvascular angina (MVA) is described in detail below with its modern invasive and non-invasive differential diagnosis and treatment, concerning especially its frequency provoked by high blood pressure and female coronary heart diseases. There are highlighted all recommended diagnostic procedures available under domestic conditions.]

Clinical Neuroscience

[Is the implementation of Vojta therapy associated with faster gross motor development in children with cerebral palsy? ]

SANZ-MENGIBAR Jose Manuel , MENENDEZ-PARDIÑAS Monica , SANTONJA-MEDINA Fernando

[Vojta therapy has been reported as clinically beneficial for strength, movement and gross motor activities in individual cases and is being included within the second of three levels of evidence in interventions for cerebral palsy. The goal of this study is to understand the effect of Vojta therapy on the gross motor function. Our clinical trial followed a one group, pre-post design to quantify rates of changes in GMFM-88 after a two-months period undergoing Vojta therapy. A total of 16 patients were recruited. Post-intervention acceleration rates of GMFM-88-items acquisition (0.005; p<0.001) and Locomotor Stages (1.063; p<0.0001) increased significatively following Vojta the­rapy intervention. In this study, Vojta therapy has shown to accelerate the acquisition of GMFM-88-items and Loco­motor Stages in children with cerebral palsy younger than 18 months. Because functional training was not utilised, and other non-Vojta therapy intervention did not influence the outcome, Vojta therapy seems to activate the postural control required to achieve uncompleted GMFM-88-items. ]

Clinical Neuroscience

Neuroscience highlights: Main cell types underlying memory and spatial navigation

KRABOTH Zoltán, KÁLMÁN Bernadette

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.

Clinical Neuroscience

[Disease burden of Duchenne muscular dystrophy patients and their caregivers]

PÉNTEK Márta, HERCZEGFALVI Ágnes, MOLNÁR Mária Judit, SZŐNYI László Pál, KOSZTOLÁNYI György, PFLIEGLER György, MELEGH Béla, BONCZ Imre, BRODSZKY Valentin, BAJI Petra, SZEGEDI Márta, POGÁNY Gábor, GULÁCSI László

[Background and purpose - Data on the disease burden of Duchenne Muscular Dystrophy are scarce in Hungary. The aim of this study was to assess patients’ and their caregivers’ health related quality of life and healthcare utilisations. Methods - A cross sectional survey was performed as part of the European BURQOL-RD project. The EQ-5D-5L and Barthel Index questionnaires were applied, health care utilisations and patients’ informal carers were surveyed. Results - One symptomatic female carer, 50 children (boys 94%) and six adult patients (five males) participated in the study, the latter two subgroups were included in the analysis. The average age was 9.7 (SD=4.6) and 24.3 (SD=9.8) years, respectively. Median age at time of diagnosis was three years. The average EQ-5D score among children and adults was 0.198 (SD=0.417) and 0.244 (SD=0.322), respectively, the Barthel Index was 57.6 (SD=29.9) and 53.0 (SD=36.5). Score of satisfaction with healthcare (10-point Likert-scale) was mean 5.3 (SD=2.1) and 5.3 (SD=2.9). 15 children were hospitalised in the past 12 months for mean 12.9 (SD=24.5) days. Two patients received help from professional carer. 25 children (mean age 11.1, SD=4.4 years) were helped/supervisied by principal informal carer (parent) for mean 90.1 (SD=44.4) hours/week and further family members helped in 21 cases. Correlation between EQ-5D and Barthel Index was strong and significant (0.731; p<0.01) as well as with informal care time (-0.770; p<0.01), but correlation with satisfaction with health care was not significant (EQ-5D: 0.241; Barthel Index: 0.219; informal care: -0.142). Conclusion - Duchenne muscular dystrophy leads to a significant deterioration in the quality of life of patients. Parents play outstanding role in the care of affected children. This study is the first in the Central and Eastern European region that provides quality of life data in this rare disease for further health economic studies.]

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