Lege Artis Medicinae

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SEPTEMBER 19, 2007

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

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Lege Artis Medicinae

[ANTIHYPERTENSIVE THERAPY IN VIEW OF RECENT CLINICAL STUDIES]

ALFÖLDI Sándor

[Different antihypertensive agents, while having the same blood pressure lowering effect, will have significantly and clinically important different impact on the serum levels of glucose, lipids, insulin, potassium, creatinine, as well as on albumin excretion, heart rate, body weight, central pressure, various hypertensive target organ damages, and, in particular, 24-hour blood pressure dinamics. There is agreement in that the main benefits of first-line antihypertensive agents are related to the lowering of blood pressure itself. Some other drugs, however, have shown preventive and protective cardiovascular properties in certain patient groups, independent of their blood pressure lowering effect as measured traditionally.]

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

[Current Changes to the Domestic Drug Market]

dr. GÁLNÉ Knippel Barbara

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.]

Lege Artis Medicinae

[Ethical dilemmas]

KOVÁCS József

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TÖRÖK Marietta, OROSZ Attila, CHARLOTTA Wollheim, JÖRGEN Hegbrant

[A dialysis provider’s core activities include providing dialysis care with excellent quality, ensuring a low variability across the clinic network and ensuring strong focus on patient safety. In this article, we summarize the pertinent components of the quality assurance and safety program of the Diaverum Renal Services Group. Concerning medical performance, the key components of a successful quality program are setting treatment targets; implementing evidence- based guidelines and clinical protocols and revising targets, guidelines and clinical protocols based on sound scientific data. Consistently, regularly, prospectively and accurately collecting data from all clinics in the network; processing collected data to provide feedback to clinics in a timely manner. The key activities for ensuring patient safety include a standardized approach to education, i.e. a uniform education program including control of theoretical knowledge and clinical competencies; implementation of clinical policies and procedures in the organization in order to reduce variability and potential defects in clinic practice. We point out the importance of auditing clinical practice on a regular basis. By applying a standardized and systematic continuous quality improvement approach throughout the entire organization, it has been possible for Diaverum to progressively improve medical performance and ensure patient safety]

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