Lege Artis Medicinae

[The vulnerable point]

KARDOS Piroska

APRIL 20, 2001

Lege Artis Medicinae - 2001;11(04)

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Lege Artis Medicinae

[Type 2 diabetes in children and adolescents: early complications]

KÖRNER Anna, MADÁCSY László

[INTRODUCTION - The prevalence of type 2 diabetes mellitus in children and adolescents is increasing worldwide. PATIENTS AND METHODS - Authors have investigated the prevalence of type 2 diabetes mellitus and of impaired glucose tolerance among the patients of the 1st Department of Pediatrics at the Semmelweis University between January 1989 and September 1998. RESULTS - During this period, 161 children with impaired glucose tolerance and 34 patients with type 2 diabetes mellitus were diagnosed. There was a female predominance. 53% of the patients were already in puberty. The majority of the patients were obese. Serum triglyceride and cholesterine levels exceeded normal values as compared to age matched healthy children. Ambulatory blood pressure monitoring revealed relative nocturnal hypertension. 35% of the patients also had microalbuminuria. CONCLUSION - In type 2 diabetes mellitus the early signs of late complications can be detected in the young. It reveals the importance of establishing the diagnosis of this disease as soon as possible.]

Lege Artis Medicinae

[Effectiveness of patients’ rights in Hungary]

VAJDA Angéla

Lege Artis Medicinae

[Conclusions of a 1980 year long-term health care prognosis]

FORGÁCS Iván

Lege Artis Medicinae

[Weak-hearted composer of monumental forms - Anton Bruckner]

MALINA János

Lege Artis Medicinae

[Consensus or chaos?]

GRÉTSY Zsombor

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Lege Artis Medicinae

[Cardiovascular prevention - Opportunities of risk reduction, 2010]

NAGY András Csaba

[10 years of experience following the millennium has confirmed again that data on long term cardiovascular morbidity and mortality can be influenced by effective prevention most substantially. Growing body of knowledge and experience in the field of modern cardiovascular prevention is available, but novel and novel milestone studies have been published leading to updating of guidelines, however, we cannot be satisfied with the results. Evidence suggest that despite recent efforts, Hungarian cardiovascular morbidity and mortality has not been reduced significantly and except for some success - acute ST elevation myocardial infarction care in accordance with the European standard - we are behind the other EU countries in cardiovascular mortality of the active (age 30-65 years) age group. Recently several interesting contradiction has been published in the field of prevention, like the effectiveness of aspirin as primer prevention, which changes our common prevention conception. Data have to be also addressed, which can explain the controversial results from a different point of view. Now we are talking about the results of REALITY study, which highlight not only the noncompliance of the patient but that of the physician as well.]

Ca&Bone

[The effect of intranasal salmon calcitonin therapy on bone mineral density in idiopathic male osteoporosis without vertebral fractures]

TÓTH EDIT, CSUPOR EMŐKE, MÉSZÁROS SZILVIA, FERENCZ VIKTÓRIA, NÉMETH Lóránd, VARGHA Péter, HORVÁTH CSABA

[INTRODUCTION -The aim of this study was to examine the effect of intranasal salmon calcitonin therapy on bone mineral density in idiopathic male osteoporosis without vertebral fractures. MATERIALS - The randomised, prospective, controlled trial involved 71 male patients (mean age 59±6 years) suffering from idiopathic osteoporosis (lumbal spine and femoral neck T-score <-2.5) without vertebral deformity. Study design: Treatment protocol: Patients in the control group (n=31) received 400 IU Vitamin D + 1000 mg elemental calcium daily while the treatment group (n=40) received 400 IU Vitamin D, 1000 mg elemental calcium and 200 IU calcitonin nasal spray daily, by an intermittent monthly dose. METHODS - 1. Osteodensitometry: lumbar spine (L2-4) and femoral neck were measured by dual photon absorptiometry (LUNAR DPX-L, USA), whereas non-dominant radius was measured by single photon absorptiometry (NK 364, Gamma, Hungary). 2. Roentgenomorphorphometry was done onthoracic IV to lumbar IV spines and deformity indeces were calculated. The treatment period was 18 months. Examinations were performed at baseline and at the end of treatment.The primary end-point was the change of bone density measured by osteodensitometry. Secondary end-points included the side effects of medication. RESULTS - Nasal calcitonin was associated with significant increase in bone mineral density at the lumbar spine (+3.5±4.3% vs. +0.83±6.4%, p=0.04) and the femoral neck (+3.2±3.9% vs. -0.68±5.7%, p=0.004). No significant difference was observed at the radius between the treatment groups (+1.4±8.8% vs. +1.4±10.9%, p=0.98). No osteoporotic fractures occurred in the treated group, but there were 3 fractures in the control group. Treatment was well tolerated with no premature discontinuations nor significant side effects compared to the control group. CONCLUSION - 200 IU salmon calcitonin nasal spray used daily, intermittently proved to be an effective and safe therapy in male idiopathic osteoporosis.]

Clinical Neuroscience

The timing of weaning alters the vulnerability to stress-induced gastric erosion in adult rats

LUDMILA Filaretova, LUDMILA Vataeva, ZELENA Dóra

Background - Weaning is an important period of life and its timing may influence the resilence for later stress. One of the most important stress-related disorder is gastric ulceration. Purpose and methods - Therefore we aimed to investigate the sensitivity of gastric mucosa to cold (at 16°C) water immersion stress (WIS for 3h) in adult (75-day-old) female and male rats after weaning them at different timepoints (at 17, 21, 30, 36 or 42 postnatal days). The connection with stress was studied by comparing control groups to those underwent WIS at the time of weaning and measuring corticosterone levels at the time of collecting the stomach samples. Results - The timing of weaning has strong impact on all studied parameters. Stress-induced erosion development was the smallest in rats weaned at 36-day independently from preconditioning with WIS at weaning, or sex, despite a clear sex-effect on blood corticosterone levels and body weight. WIS at weaning influenced only the body weight in adult rats weaned at 30-day, being higher in stressed than in control groups. There was no clear overall correlation between erosion area and blood corticosterone measures. Conclusions - Taken together our results confirm that the timing of weaning has long-lasting impact on the resiliance of gastric mucosa to ulcerogenic stressful events. In rats the postnatal day 30-36 seems to be optimal for weaning in both sexes as both earlier and later weaning increased vulnerability. Females seems to be more vulnerable to the effect of weaning than males.

Lege Artis Medicinae

[PROBLEMS WITH THE COMPLIANCE OF SCHIZOPHRENIC PATIENTS - CAUSES, CONSEQUENCES AND STRATEGIES FOR ITS MANAGEMENT]

BARTKÓ György

[As many as 80% of patients with schizophrenia have serious problems with the compliance at some point during their course of their treatment. In most cases, patients are partially compliant, taking only a portion of their prescribed medication. Early warning signs of such partial compliance may confuse some clinicians with non-response to treatment and may result in switching these patients to alternative oral antipsychotic drugs. This review focuses on factors that can contribute to partial compliance such as poor insight, negative attitude or subjective response toward medication, cognitive dysfunction, treatment-related side effects, substance abuse and complicated treatment regimen. Partial compliance is among the most common causes of psychotic relapse and the need for rehospitalisation. The reduced incidence of adverse side effects such as extrapyramidal symptoms with atypical antipsychotic agents has the potential to improve compliance in the maintenance treatment of schizophrenia. Administration of a long-acting injectable antipsychotic provides confirmation of whether patients have taken their medication. Furthermore, it allows physicians to distinguish non-response and non-compliance. Strategies for managing partial compliance include the use of a long-acting injectable atypical antipsychotic, psychoeducation and cognitive-behavioural interventions.]

Journal of Nursing Theory and Practice

[Possible protective factors in the wound healing in light of survey]

PAKAI Annamária, TÓTH Marianna, VÁRADYNÉ HORVÁTH Ágnes, OLÁH András, HORVÁTH Örs Péter

[Purpose of the study: to investigate the correlation between the surgical procedure and the disorders of wound-healing, furthermore to examine the impact of the matter of suture on the incidence of wound healing problems. Methods and material: The survey was carried out at Surgical Clinic of the University of Pécs, among patients between 18 to 85 years who had been undergone an elective abdominal surgery between 2009-2010 (n=105). In the course of the document analysis the authors reviewed socio-demographic data and the preoperative and postoperative parameters. The authors applied descriptive statistics with SPSS 17 moreover two-sample t- test, khi square test and logistic regression (p<0,05). Results: The incidence of wound-healing disturbance is higher in the case of using draine, however it is lower if Triclosan suture is used (p<0,05). Conclusion: A number of Hungarian and international study reports that many factors can be responsible for surgical site infections. The results point out the significance of Evidence Based Nursing wound attendance in the context of team work. ]