Lege Artis Medicinae

[Sine morbo]

SIPKA Sándor

JULY 20, 2015

Lege Artis Medicinae - 2015;25(06-07)

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Lege Artis Medicinae

[-Amicus Plato sed magis amica veritas-]

SZEBENYI Béla

[In each of the first 6 issues of Lege Artis we could read a thoughtful and forward-looking summary of the present and future problems of the Hungarian health care system, including the titles: Systemic change in health care, Reform change or system change, Where to go from here, health care, Can health care be transformed? The requirements of modern governance and management in health care, and SOTE: Questions and answers for reform. (1, 2, 3, 4, 5, 6,). If we agree that a correct analysis of the current situation and future of the medical profession and health workers is a sine qua non for any way forward, we must wonder why there is not a single mention (!) of the basic characteristic of these groups, their numbers. ]

Hypertension and nephrology

[Antihypertensive therapy in patients with COPD - the significance of nebivolol]

FARSANG Csaba

[The occurrence of hypertension associated with chronic obstructive pulmonary disease (COPD) is increasing. Recognising COPD is important in order to choose the appropriate antihypertensive drugs. Anti-hypertensive drugs that can be used to treat patients with hypertension and COPD include diuretics, ACE-inhibitors, angioten-sine receptor blockers (AT1 receptor antagonists) and calcium antagonists, as well as cardioselective beta blockers, as these drugs decrease total and cardiovascular mortality. Of these agents, the importance of the most cardioselective one, nebivolol should be stressed, as this drug has no clinically significant effect on parameters of respiratory function, and, through its additional effects (namely by increasing the synthesis of NO), it has a beneficial effect on COPD-related deterioration of respiratory functions, haemodynamic alterations (cor pulmonale) and local factors that participate in the respiratory inflammation and endothelial dysfunction.]

Hypertension and nephrology

[PAX2: lotium et visus sine pace]

VIOLETTA Antal, KERTI Andrea, JÁVORSZKY Eszter, MÁTTYUS István, REUSZ György, SZABÓ Attila, VÁRKONYI Ildikó, MAKA Erika, TORY Kálmán

[The autosomal dominant papillorenal syndrome results from primarily de novo mutations of PAX2. It encodes a transcription factor expressed in the kidney, urinary tract, nervous system, eye and the ear. Its haploinsufficiency causes primarily hypoplastic and hyperreflective kidney, or other forms of CAKUT. The clinical appearance may be dominated by nephrotic-range proteinuria with focal segmental glomerulosclerosis. The renal survival rate is highly variable: most of the recognized cases lead to ESRD during the first four decades of life. PAX2 mutations cause typical optic papillary alterations, most frequently papillary dysplasia. In contrast to the name of the syndrome, one fourth of the affected patients do not develop ocular involvement. Hearing impairment is associated in less than 10% of the patients. The affected members of the five families that we identified with PAX2 loss-of-function mutations, developed end-stage renal disease during the 2-4. decades of life.]