Lege Artis Medicinae

[Successful treatment of acne]

KÖRMENDY Miklós

MARCH 21, 2008

Lege Artis Medicinae - 2008;18(03)

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Lege Artis Medicinae

[Cure Without Borders]

FÖLDES Mária Éva

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[Modern surgical treatment of lung cancer]

AGÓCS László

[Lung cancer is one of the most malignant human cancers because of its high incidence and high mortality rate. The 5-year relative survival rate for lung cancer at the initial diagnosis is 5-15%. Stage I or stage II non-small cell lung cancer (NSCLC) are considered early stage disease. Unfortunately, these two stages combined account for only 25 to 30% of tumours at the initial detection. At present, surgical resection remains the recommended treatment for patients with stage I and II NSCLC. Despite negative preoperative staging studies including mediastinoscopy, as many as one fourth of the patients will be found at surgery to have an occult N2 or one nodal station positive metastatic – stage IIIA – disease. Multimodality therapy is preferred for all subsets of stage IIIA patients. In stage IIIB and IV, surgical resection is possible and indicated only in selected cases, including Pancoast tumours, T4N0,1M0 tumours, the presence of satellite nodules in the same lobe, and certain solitary metastases. Patients with clinical stage T1-2 N0 small cell lung cancer (SCLC) may benefit from surgery for confirmation of diagnosis and improved local control when combined with chemotherapy. The mortality and morbidity rates of surgery in the treatment of lung cancer are reasonably low.]

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[Treatment of reflux-type symptoms - Guidelines of the College of Gastroenterology]

SIMON László

Lege Artis Medicinae

[Everyday Biostatistics Jenő Reiczigel, Andrea Harnos, Norbert Solymosi: Biostatistics for Non-Statistician]

SINGER Júlia

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Cyanocobalamin and cholecalciferol synergistically improve functional and histopathological nerve healing in experimental rat model

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Introduction - Peripheral nerve injury (PNI) is a frequent problem among young adults. Hopefully, regeneration can occur in PNI unlike central nervous system. If nerve cut is complete, gold standard treatment is surgery, but incomplete cuts have been tried to be treated by medicines. The aim of the study was to evaluate and compare clinical and histopathological outcomes of independent treatment of each of Vitamin B12 (B12) and Vitamin D3 (D3) and their combination on sciatic nerve injury in an experimental rat model. Materials and methods - Experimental animal study was performed after the approval of BEH Ethics Committee No. 2015/10. 32 rats were grouped into four (n=8) according to treatment procedures, such as Group 1 (controls with no treatment), Group 2 (intraperitoneal 1 mg/kg/day B12), Group 3 (oral 3500 IU/kg/week D3), Group 4 (intraperitoneal 1 mg/kg/day B12+ oral 3500 IU/kg/week D3). Sciatic Functional Index (SFI) and histopathological analysis were performed. Results - SFIs of Group 2, 3, 4 were statistically significantly higher than controls. Group 2 and 3 were statistically not different, however Group 4 was statistically significantly higher than others according to SFI. Axonal degeneration (AD) in all treatment groups were statistically significantly lower than in Group 1. AD in Group 4 was significantly lower than in Group 2 and 3; there was no significant difference between Group 2 and 3. There was no significant difference between Group 1,2 and 3 in Axonolysis (A). But A of Group 4 was significantly very much lower than all others. Oedema- inflammation (OE-I) in all treatment groups were significantly lower than in Group 1; there was no significant difference between Group 2 and group 4. OE-I in Group 2 and 4 were significantly lower than in Group 3. There were no significant differences between Group 1, 2 and 3 in damage level scores; score of Group 4 was significantly lower than of Group 1. Conclusions - B12 and D3 were found effective with no statistically significant difference. But combined use of B12 and D3 improve nerve healing synergistically. We recommend combined use of B12 and D3 after PNI as soon as possible.

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[Chronic administration of antiepileptic drugs without history of unprovoked epileptic seizures are not recommended for epilepsy prophylaxis. Conversely, if the patient suffered the first unprovoked seizure, then the presence of epileptiform discharges on the EEG, focal neurological signs, and the presence of epileptogenic lesion on the MRI are risk factors for a second seizure (such as for the development of epilepsy). Without these risk factors, the chance of a second seizure is about 25-30%, while the presence of these risk factors (for example signs of previous stroke, neurotrauma, or encephalitis on the MRI) can predict >70% seizure recurrence. Thus the International League Against Epilepsy (ILAE) re-defined the term ’epilepsy’ which can be diagnosed even after the first seizure, if the risk of seizure recurrence is high. According to this definition, we can start antiepileptic drug therapy after a single unprovoked seizure. There are four antiepileptic drugs which has the highest evidence (level „A”) as first-line initial monotherapy for treating newly diagnosed epilepsy. These are: carbamazepine, phenytoin, levetiracetam, and zonisamide (ZNS). The present review focuses on the ZNS. Beacuse ZNS can be administrated once a day, it is an optimal drug for maintaining patient’s compliance and for those patients who have a high risk for developing a non-compliance (for example teenagers and young adults). Due to the low interaction potential, ZNS treatment is safe and effective in treating epilepsy of elderly people. ZNS is an ideal drug in epilepsy accompanied by obesity, because ZNS has a weight loss effect, especially in obese patients.]