Lege Artis Medicinae

[The 150th Anniversary of the Orvosi Hetilap (Medical Weekly)]

dr. KAPRONCZAY Katalin

MAY 16, 2007

Lege Artis Medicinae - 2007;17(04-05)

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Thoughts on the trends of prophylactic antibiotic use in Hungary]

SZALKA András

Lege Artis Medicinae

[Report on the use of gastroenterologic endoscopy in Hungary in 2006]

NAGY György, OROSZ Péter

Lege Artis Medicinae

[Salicyl Therapy, Homeopathy, Medical History ]

dr. GROÁK Lajos

Lege Artis Medicinae

[What does it mean to be a doctor today?]

BANAI János

Lege Artis Medicinae

[The effect of tiotropium in chronic obstructive pulmonary disease in clinical remission]

BÖSZÖRMÉNYI Nagy György

All articles in the issue

Related contents

Clinical Neuroscience

Simultaneous subdural, subarachnoideal and intracerebral hAemorrhage after rupture of a peripheral middle cerebral artery aneurysm

BÉRES-MOLNÁR Anna Katalin, FOLYOVICH András, SZLOBODA Péter, SZENDREY-KISS Zsolt, BERECZKI Dániel, BAKOS Mária, VÁRALLYAY György, SZABÓ Huba, NYÁRI István

The cause of intracerebral, subarachnoid and subdural haemorrhage is different, and the simultaneous appearance in the same case is extremely rare. We describe the case of a patient with a ruptured aneurysm on the distal segment of the middle cerebral artery, with a concomitant subdural and intracerebral haemorrhage, and a subsequent secondary brainstem (Duret) haemorrhage. The 59-year-old woman had hypertension and diabetes in her medical history. She experienced anomic aphasia and left-sided headache starting one day before admission. She had no trauma. A few minutes after admission she suddenly became comatose, her breathing became superficial. Non-contrast CT revealed left sided fronto-parietal subdural and subarachnoid and intracerebral haemorrhage, and bleeding was also observed in the right pontine region. The patient had leucocytosis and hyperglycemia but normal hemostasis. After the subdural haemorrhage had been evacuated, the patient was transferred to intensive care unit. Sepsis developed. Echocardiography did not detect endocarditis. Neurological status, vigilance gradually improved. The rehabilitation process was interrupted by epileptic status. Control CT and CT angiography proved an aneurysm in the peripheral part of the left middle cerebral artery, which was later clipped. Histolo­gical examination excluded mycotic etiology of the aneu­rysm and “normal aneurysm wall” was described. The brain stem haemorrhage – Duret bleeding – was presumably caused by a sudden increase in intracranial pressure due to the supratentorial space occupying process and consequential trans-tentorial herniation. This case is a rarity, as the patient not only survived, but lives an active life with some residual symptoms.

LAM KID

[Medical gratuity: what is the secret of our opportunism?]

BALÁZS Péter

Clinical Neuroscience

[Genetically determined diseases associated with pathological brain iron accumulation and neurodegeneration]

ÁCS Péter, MOLNÁR Mária Judit, KLIVÉNYI Péter, BERNADETTE Kalman

[The rare, genetically determined group of diseases characterized by pathological accumulation of iron in the central nervous system and progressive, typically movement disorder’s symptoms are called NBIA (neurodegeneration with brain iron accumulation). By the rapid development of molecular genetics, it has become apparent that different mutations in numerous genes can lead to pathological cerebral iron accumulation. Simultaneously, it has also been recognized that the age of onset, the symptoms and the prognosis of NBIA disorders are much more diverse than it was previously perceived. To our knowledge, a review article on the most recent clinical data of NBIA has not been published in Hungarian. In the first part of this publication, we survey the general clinical characteristics and the diagnostic algorithm of NBIA diseases and address some considerations for differential diagnostics. In the second part of this review, the particular NBIA disorders are presented in details. The purpose of this article is to provide a clinical overview that may be useful for neurologists, pediatricians and any other medical practitioners interested in this field.]

Lege Artis Medicinae

[In vitro activities of micafungin against invasive clinical isolates of Candida species]

NIKOLOVA Radka

[INTRODUCTION - Micafungin is a new member of the antifungal class echinocandin exhibiting a broad-spectrum activity against Candida spp. MATERIAL AND METHODS - In this study, we collected 246 invasive clinical Candida isolates obtained from 4 diverse medical centers between 01.04.2009 and 01.04.2010. In these isolates we determined the minimum inhibitory concentrations (MIC) of micafungin. RESULTS - Among the 246 isolates 156 (62%) were C. albicans, 26 (11%) C. glabrata, 24 (10%) C. parapsilosis, 16 (7%) C. krusei, 14(6%) C. tropicalis and 10 (4%) other, less frequently isolated Candida spp. Micafungin had good in vitro activity against all Candida spp. tested (except C. parapsilosis), MIC90 range 0,016-0,125 mg/L. According to CLSI criteria, all isolates (except C. parapsilosis MIC90 2 mg/L) can be interpreted as susceptible. CONCLUSIONS - In vitro MIC90 values measured in this study were substantially lower than the maximum serum concentrations that can be achieved after administration of micafungin (8 mg/L after a 75-mg dose). This fact and the fungicid effect of micafungin against Candida species make this compound, which is licenced for the treatment of invasive candidiasis, a promising systemic antifungal agent.]

Lege Artis Medicinae

[The altered role of coagulase-negative staphylococci]

SZALKA András

[Coagulase-negative staphylococci are differentiated from the more virulent Staphylococcus aureus by their inability to produce coagulase enzyme. Currently, more than 40 recognized species of coagulasenegative staphylococci are known. The great majority of these bacteria are normal inhabitants of the human skin and mucous membranes. Therefore, it is very difficult to distinguish isolates that are of clinical significance. Recently, coagulase-negative staphylococci have been increasingly detected to cause clinically significant infections. This is due in most cases to the increasing use of medical devices inserted or implanted in the human body. This overview discusses the various infections caused by these microbes, as well as their pathogenesis, epidemiology, and management.]