Lege Artis Medicinae

[SCIENTIFIC DIGEST]

APRIL 20, 2003

Lege Artis Medicinae - 2003;13(03)

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Lege Artis Medicinae

[Severe acute respiratory syndrome]

BÁNHEGYI Dénes

Lege Artis Medicinae

[VIII. National Congress on Antibiotics]

SZÉKELY Éva

Lege Artis Medicinae

[Proteomics - the new challenge]

HUDECZ Ferenc

[The term ”proteome” (proteome, PROTEin complement to a genOME) by now a generally accepted expression in biomedical science meaning a complete complements of proteins. The discipline ”proteomics”, coined after proteome, deals with the analysis of the complete set of proteins occurring in the living organism. This includes the identification and quantification of proteins, the determination of protein localisation, modifications, interactions, activities and function. Performing comparative studies is an important part of proteomics for the analysis of proteins in health and disease. The knowledge generated is already used for improved diagnostic procedures and development of new drugs and therapies. During the proteome analysis, as outlined in this paper, even very small quantities (concentrations) of proteins are measured, then the protein is identified and its structure is elucidated. This procedure is followed by functional studies. An important part of proteomics is the collection and validation of numerical databases suitable for data mining. There is a general understanding that methodology driven research (e.g. NMR, mass spectrometry, DNA chips) is also an integrated part of this discipline. It is already sensed that the analysis of proteome can lead to the discovery of new proteins proving targets for drug research and to the establishment of new procedures with a perspective of improved diagnosis and therapy.]

Lege Artis Medicinae

[Benefit of combined clopidogrel-aspirin platelet aggregation inhibition in acute coronary syndrome and after percutaneous coronary angioplasty]

KELTAI Mátyás

[Platelet aggregation inhibition is equally important both in conservative and interventional cardiological treatment of acute coronary syndrome. Recently, results from three important trial were published. All three proved the efficacy of the combined aspirin + clopidogrel treatment. The basic results of the three clinical trials (CURE, PCI-CURE, CREDO) are summarized in the article. In the CURE trial the combined primary endpoint was reached in 11.4% of the patients in the control group and in 9.3% in the clopidogrel group. The relative risk reduction was 20%. The combined primary endpoint included CV mortality, MI and stroke. The treatment effect was mostly detectable in the prevention of MI and stroke. In the PCI-CURE trial 2658 patients of the CURE trial were analysed. All of them were treated by coronary angioplasty. In this group the primary endpoint (CV death, nonfatal MI, urgent revascularisation) was reached in 6.4% of the aspirin treated and in 4.5% of the aspirin + clopidogrel treated patients. The relative risk reduction was 30%. The CREDO trial investigated patients after coronary angioplasty. The indication of angioplasty was either acute or chronic. All patients received combined aspirin + clopidogrel but only for four weeks in the control group or for one year in the treatment group. The combined primary endpoint was decreased by 26.9%. In all the 3 trials the risk of bleeding was slightly but significantly increased by the combined aspirin + clopidogrel treatment. Clinical application: based on the results of the 3 trials it is concluded that combined aspirin + clopidogrel treatment is indicated in all patients with acute coronary syndrome, independently from the treatment strategy. The treatment should be continued for one year. This is also applicable for all patients treated with coronary angioplasty.]

Lege Artis Medicinae

[Extraintestinal manifestations in inflammatory bowel diseases]

LAKATOS László

[Inflammatory bowel diseases (IBD) are systemic disorders. Bowel symptoms are the predominant manifestations, however during the course of the disease a lot of intestinal and extraintestinal complications may occur. Systemic complications are responsible for substantial co-morbidity and they have negative influence on the quality of life. A part of the extraintestinal symptoms seem to have common pathogenetic background with IBD, while others are the consequences of subsequent metabolic and endocrine abnormalities or may relate to local complications and adverse effects of treatment. Growing evidence is available on the role of genetic and immunologic factors in the pathogenesis of extraintestinal manifestations. Most important systemic complications are: peripheral and axial arthritides, osteoporosis, uveitis, erythema nodosum, pyoderma gangraenosum, primary sclerosing cholangitis, nonalcoholic steatohepatitis, different types of anaemia, thromboembolism, kidney stones and urinary complications. Cooperation with the specialists is very important in the diagnosis and treatment of these comlications. During followup of IBD patients special attention is needed to monitor possible extraintestinal manifestations.]

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[Vaccines against COVID-19 pandemic]

FALUS András, SZEKANECZ Zoltán

[The rapidly spreading SARS-CoV2 respiratory virus has evoked an epidemic with serious aftermath around the world. In addition to the health effects, the global economic damage is actually unpredictable. At the same time, the pandemic has launched a series of unprecedented collaborative scientific research, including the development of vaccines. This study summarizes up-to-date information on vaccines, immune memory, and some emerging clinical effects.]

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

[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.]

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.]

Clinical Neuroscience

[Tracing trace elements in mental functions]

JANKA Zoltán

[Trace elements are found in the living organism in small (trace) amounts and are mainly essential for living functions. Essential trace elements are in humans the chromium (Cr), cobalt (Co), copper (Cu), fluorine (F), iodine (I), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), and questionably the boron (B) and vanadium (V). According to the biopsychosocial concept, mental functions have biological underpinnings, therefore the impairment of certain neurochemical processes due to shortage of trace elements may have mental consequences. Scientific investigations indicate the putative role of trace element deficiency in psychiatric disorders such in depression (Zn, Cr, Se, Fe, Co, I), premenstrual dysphoria (Cr), schizophrenia (Zn, Se), cognitive deterioration/de­mentia (B, Zn, Fe, Mn, Co, V), mental retardation (I, Mo, Cu), binge-eating (Cr), autism (Zn, Mn, Cu, Co) and attention deficit hyperactivity disorder (Fe). At the same time, the excess quantity (chronic exposure, genetic error) of certain trace elements (Cu, Mn, Co, Cr, Fe, V) can also lead to mental disturbances (depression, anxiety, psychosis, cognitive dysfunction, insomnia). Lithium (Li), being efficacious in the treatment of bipolar mood disorder, is not declared officially as a trace element. Due to nutrition (drinking water, food) the serum Li level is about a thousand times less than that used in therapy. However, Li level in the red cells is lower as the membrane sodium-Li countertransport results in a Li efflux. Nevertheless, the possibility that Li is a trace element has emerged as studies indicate its potential efficacy in such a low concentration, since certain geographic regions show an inverse correlation between the Li level of drinking water and the suicide rate in that area. ]