Lege Artis Medicinae

[SCIENTIFIC DIGEST]

FEBRUARY 21, 2004

Lege Artis Medicinae - 2004;14(02)

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Lege Artis Medicinae

[PRIMARY TUBULOINTERSTITIAL NEPHRITIS]

FERENCZI Sándor

[Primary tubulointerstitial nephritis is characterised by an inflammatory infiltrate of tubulointerstitial space. The infiltrate consists of T and B lymphocytes, monocytes, macrophages, neutrophyl and eosinophyl granulocytes in varying degree. It is associated with interstitial oedema and different level of tubular damage. The disease exists in acute and chronic form. The main causes of this condition are: drugs, infection, systemic diseases, malignancy and in some cases the disease is idiopathic. The pathogenesis in most cases is immune-mediated. The secondary form of tubulointerstitial nephritis can occur in primary glomerular and vascular disease and is characterised by tubulointerstitial fibrosis and tubulus atrophy. The morphological alterations are major determinants of the progression of chronic renal disease. In both forms of tubulointerstitial nephritis the development of renal insufficiency is often observed.]

Lege Artis Medicinae

[LIPS ]

MATOS Lajos

Lege Artis Medicinae

[QUO VADIS ]

MATOS Lajos

Lege Artis Medicinae

[LARGE VESSEL MANIFESTATION OF GIANTCELL ARTERITIS]

KOLOSSVÁRY Endre, PINTÉR Hajnalka, ERÉNYI Éva, KOLLÁR Attila, FARKAS Katalin, KISS István, HARCOS Péter, SIMON Károly

[The diagnosis of giant-cell arteritis is a real challenge for clinicians. There are several reasons for the difficulties in establishing the diagnosis. This disease is associated to rare conditions, therefore most physicians lack clinical experience. This condition shows very heterogeneous manifestation, the intensity of the symptoms vary in time. Early diagnosis is of great importance in order to prevent ischemic complications. Among these complications one should emphasise the role of anterior ischemic optic neuropathy that may result in abrupt blindness. In this case report, we show a rare socalled large vessel manifestation of giant-cell arteritis. This form of the disease needs different approach in diagnosis where color duplex ultrasonography may have distinguished importance. The final verification of the diagnosis is based on histology. However the lack of all histological criteria do not exclude the presence of giant-cell arteritis.]

Lege Artis Medicinae

[THE HISTORY OF FLUOROQUINOLONES]

LUDWIG Endre

[During the 40 year history of quinolones, from the first compounds (nalidixic acid, oxolinic acid, norfloxacin) suitable only for the treatment of mild urinary tract infections, an important group of antimicrobials was developed that can be used for the treatment of serious Gramnegative (ciprofloxacin, ofloxacin) and Grampositive (levofloxacin, moxifloxacin) infections. With the changes in the antimicrobial spectrum of the new derivatives it seems, that the clinical indications of the mainly anti-Gram-positive and the mainly anti-Gram-negative fluoroquinolones can be separated. We also learned the characteristics of their antibacterial activity that makes the optimal administration possible assuring the maximum clinical efficacy and the minimal development of bacterial resistance. The activity of fluoroquinolones can also be compromised by bacterial resistance so to preserve their clinical value it is important to follow the above mentioned principles in their use.]

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Related contents

Hypertension and nephrology

[Association between cyclothymic affective temperament and hypertension]

NEMCSIK János, BATTA Dóra, KŐRÖSI Beáta, RIHMER Zoltán

[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]

Lege Artis Medicinae

[Focus on Lege Artis Medicinae (LAM)]

VASAS Lívia, GEGES József

[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]

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.]

Clinical Neuroscience

[Decisional collisions between evidence and experience based medicine in care of people with epilepsy]

RAJNA Péter

[Background – Based on the literature and his long-term clinical practice the author stresses the main collisions of evidence and experience based medicine in the care of people with epilepsy. Purpose – To see, what are the professional decisions of high responsibility in the epilepsy-care, in whose the relevant clinical research is still lacking or does not give a satisfactory basis. Methods – Following the structure of the Hungarian Guideline the author points the critical situations and decisions. He explains also the causes of the dilemmas: the lack or uncertainty of evidences or the difficulty of scientific investigation of the situation. Results – There are some priorities of experience based medicine in the following areas: definition of epilepsy, classification of seizures, etiology – including genetic background –, role of precipitating and provoking factors. These are able to influence the complex diagnosis. In the pharmacotherapy the choice of the first drug and the optimal algorithm as well as the tasks during the care are also depends on personal experiences sometimes contradictory to the official recommendations. Same can occur in the choice of the non-pharmacological treatments and rehabilitation. Discussion and conclusion – Personal professional experiences (and interests of patients) must be obligatory accessories of evidence based attitude, but for achieving the optimal results, in some situations they replace the official recommendations. Therefore it is very important that the problematic patients do meet experts having necessary experiences and also professional responsibility to help in these decisions. ]

Clinical Neuroscience

[Account on the scientific meeting of Környey Society in 2010. Part 2.]