Lege Artis Medicinae

[SCIENTIFIC DIGEST]

FEBRUARY 20, 2001

Lege Artis Medicinae - 2001;11(02)

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Lege Artis Medicinae

[The role of steroid hormones in the protection against oxidative stress]

BÉKÉSI Gábor, FEHÉR János

[The incidence of vascular diseases increases in postmenopausal women. This negative trend seems to be controllable favourably by hormone replacement therapy (HRT). Based on the free radical mediated mechanism of atherogenesis the authors try to find the reasons for these observations on the basis of their and others’ data. They consider the increase of activity and amount of neutrophil enzyme myeloperoxydase by certain steroid particulars one of the most important elements of the vasoprotective effect of HRT. This increase diminishes the production of superoxide anion by the inhibition of the NADPH-oxidase enzyme. The observation proved firstly by the authors, that the plasma levels of myeloperoxydase - and so the ability for the inhibition of superoxide anion production by neutrophils - decreases in elderly people, might explain the higher incidence of some free radical mediated illnesses in the elderly. The authors also give a short review of antioxidant effects of steroids in general.]

Lege Artis Medicinae

[The importance of vitrectomy in the management of diabetic retinopathy in proliferative stage]

BERECZKI Árpád

[Vitrectomy is a closed microsurgical technique, by which intraocular tissue, blood and foreign bodies can be removed through a small incision in the pars plana with an automated suction-cutting device (vitrectom), while maintaining normal or slightly elevated intraocular pressure. This technique requires many accessory instruments (microscope, endoillumination, intraocular instruments, endolaser). The main application of vitrectomy is the treatment of severe complications in diabetes mellitus: diabetic retinopathy in the proliferative stage. Vitrectomy is indicated in diabetic retinopathy for the removal of intraocular bleeding and for the treatment of complications of diabetic proliferative vitreoretinopathy (recurring bleeding, tractional and rhegmatogenous retinal detachment). In the case of intraocular bleeding, early vitrectomy is better than delayed, providing good visus (V: 0,5) in 25% of all patients (based on literature data). In retinal detachment cases of tractional origin, surgery provides satisfactory visus for self-care in 2/3rd of all patients.]

Lege Artis Medicinae

[Alphabetic index 1991-2000]

Lege Artis Medicinae

[„There should be someone to hold the hand of the dying!” Deep interviews on the difficulties of caring for the dying]

BOGNÁR Tamás, KOLOSAI Nedda, HEGEDÛS Katalin, PILLING János

Lege Artis Medicinae

[Gastrointestinal stromal tumor]

GONDA Gábor

[Gastrointestinal stromal tumors were subject of much controversy in the last decades. This type of tumors was delineated from the leiomyoma - leiomyosarcoma group. GISTs show variable histological picture, moreover, they are capable of dual (neurogen and myogen) differentiation as it is proved by immunohistochemical and ultrastructural studies. These tumors have relatively good prognosis, only 10-30% of them is malignant, although it is difficult to predict their behaviour in a given case. The most reliable signs of malignancy - cytological pleoimorphism, high mitotic activity, proliferation index above 10 %, and aneuploid DNA content - are generally accepted. The treatment of choice is excision, but not enucleation. Radical surgery is not necessary, since lymph node metastasis is exceptionally rare. Further investigations revealed electronmicroscopical and immunohistochemical (CD 34, CD 117) similarities of tumor cells and interstitial cells of Cajal (ICC) located in the wall of the bowel. The results of these investigations led to the theory that cells of GIST and ICCs are of the same stem cell origin. Molecular genetic studies are also of great help in the differential diagnosis and in predicting the prognosis of GISTs. Mutations in the c-kit gene can not be detected in leiomyomas, so they are thougt to be specific for GISTs. Mutation of exon 11. of chromosome 4. is observed only in malignant GISTs.]

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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

[Dysphagiafelmérések akut stroke-ban]

SZABÓ Pál Tamás, MÛHELYI Viktória, BÉRES-MOLNÁR Katalin Anna, KOVÁCS Andrea, BALOGH Zoltán, FOLYOVICH András

[Stroke associated dysphagia can have serious consequences such as aspiration pneumonia. The Hungarian guideline on nutritional therapy for stroke patients recommends dysphagia assessment, as early screening can optimize disease outcome and hospital cost. Thus far, this may be the first study in Hungarian that has documented a systematic review about the available validated dysphagia assessments of acute stroke. Purpose – The aim of this study was to summarize the instrumentally validated bedside dysphagia screening tools for acute stroke patients, which were published in the last twenty years. Our objective was to describe the characteristics of the validation studies, examine their study design, and sample the sub-tests and the diagnostic accuracy of the assessments. A systematic research was carried out of the literature between 2001 and 2021 in eight scientific databases with search terms appropriate to our objectives. Subjects of the study – 652 articles were found and were reduced to eight. We made a comparative analysis of these. The GUSS test reached a high level of sensitivity compared to the others. In our study sample, the prevalence of instrumentally confirmed dysphagia among acute stroke patients was 56.1%. The focus and the composition of the analyzed studies differed and posed problems such as the ambiguity of the concept of dysphagia, the difference in outcome indicators, or the timing of screening. The GUSS test, which offers domestic management, is a suitable tool for the Hungarian clinical use.]