Lege Artis Medicinae

[The 17th Congress of the European Respiratory Society]

BALIKÓ Zoltán

NOVEMBER 20, 2007

Lege Artis Medicinae - 2007;17(11)

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Lege Artis Medicinae

[Surgical aspects of the gastrointestinal diseases]

JAKAB Ferenc

Lege Artis Medicinae

[One Hundred Chest Compressions per Minute A Discussion with Cardiologist Lajos Matos ]

NÉMETH Éva

Lege Artis Medicinae

[Scientific digest]

Lege Artis Medicinae

[PAIN RELIEF IN THE CLINICAL PRACTICE - THE USE OF MAJOR ANALGETICS]

HORVÁTH J. Attila

[The use of opioids to relieve strong, unbearable pain is a method that has been known for thousands of years and is still effective today. In contrast to the earlier view, opioids today are not only given to cancer patients. The application area of morphine derivatives is generally the relief of exceptionally strong pain regardless of the diagnosis, but opiates are undoubtedly most commonly used to treat cancer-related or strong acute pain. Strong pain reducers are used much more in developed countries for the treatment of non-cancer related severe pain refractory to other approaches. Today the use of opiates and their derivatives (fentanyl, oxycodon) for non-cancer related pain relief is recognized by the national health insurance in that it allows general practitioners to prescribe them, upon the recommendation of a neurosurgeon, orthopaedic surgeon, traumatologist or rheumatologist, with a significant 90% subsidy for six months to ensure easy access for patients in severe, refractory pain due to degenerative musculoskelatal diseases (ICD: M47, M48, M16.9, M17.9, M54.4, M51.0, M51.1). The indications of opioid use, however, are not limited to strong nociceptive pain since they are also effective in certain types of peripheral neuropathic pain. In brief, a basic principle of the use of major analgetics is that their indication is primarily based on the intensity of pain and not on the nature of the disease, even though the latter has a major influence on the clinician's strategy of pain relief.]

Lege Artis Medicinae

[HUMAN LEUKOCYTE INTERFERON IN THE TREATMENT OF CHRONIC HEPATITIS C]

TELEGDY László, HORVÁTH Gábor, TOLVAJ Gyula, MAKARA Mihály, MONTSKÓ Valéria, OZSVÁR Zsófia, NEMES Zsuzsanna, PÉTERFY Zoltán, SZENTGYÖRGYI László

[INTRODUCTION - Approximatively 50% of the patients with chronic hepatitis C do not respond properly to pegylated interferon-alpha+ribavirin treatment and according to the therapeutic guidelines their treatment must be interrupted. The authors examined whether their further medication with human leukocyte interferon is justified. PATIENTS AND METHODS - Thirty-eight patients with chronic hepatitis C were treated with human leukocyte interferon who had responded to pegylated interferon-alpha-ribavirin treatment, but dropped out of the treatment scheme based on the therapeutic criteria on week 12 or 24. RESULTS - While only 3 patients responded with persistent virological negativity, mean alanine aminotransferase (ALT) levels decreased during treatment and persistently remained lower than the baseline levels. Except for the three responders, the HCV viral load as determined by polymerase chain reaction did not decrease but even increased on average. Patients tolerated the treatment well. Known side-effects were observed in 6 cases, and treatment had to be interrupted in one case. These are proportionally far less than the respective 20 to 25% and 5 to 15% reported for peginterferon-ribavirin treatment. CONCLUSION - Even though virological recovery is rare, the reduction in inflammatory activity, the expected slowing of progression, and, in particular, the definite improvement of the cryoglobulinaemic purpura and vasculitis warrant switching to human leukocyte interferon treatment in selected cases.]

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