Lege Artis Medicinae

[Throat catarrh]

GERLINGER Imre

JUNE 20, 2011

Lege Artis Medicinae - 2011;21(06-07)

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Further articles in this publication

Lege Artis Medicinae

[A new approach to the treatment of diabetic retinopathy - PPAR-α agonist activity of fenofibrate]

CSÁSZÁR Albert

[Diabetic retinopathy (DR) is a leading cause of visual impairment worldwide. It affects nearly half of patients with diabetes and its severity increases with the progress of diabetes. Glycotoxicity, lipotoxicity and hypertension are the main risk factors for the development of DR. The control of glucose homeostasis and blood pressure are the main noninvasive approaches that might have a role in the treatment of this condition. On the basis of new studies, RAS inhibitors and fenofibrate are promising candidates that can be used to retard DR progression and/or induce its regression. Two large-scale studies (FIELD, ACCORD Eye) have demonstrated that fenofibrate therapy significantly reduces the need for laser treatment of DR. The efficiency of this therapy, which is independent of lipid changes, is primarily attributable to the PPAR-α agonist activity of fenofibrates. According to guidelines that discuss the new therapeutic approaches of DR, fibrate therapy is a promising new option for preventing the progression of DR.]

Lege Artis Medicinae

[At the Forefront of Modern Art: The Eight Painters]

NEMESI Zsuzsanna

Lege Artis Medicinae

[The role of radical prostatectomy in the management of locally advanced prostate cancer]

MAJOROS Attila, NYIRÁDY Péter, RIESZ Péter, ROMICS Imre

Lege Artis Medicinae

[An Instant Culture Demands for Medicine – An Interview with Béla Buda]

NAGY Zsuzsanna

Lege Artis Medicinae

[Inhibition of thrombocyte aggregation in patients with lower-limb vasoconstriction - Do we really treat them well?]

JÁRÁNYI Zsuzsanna

[Due to the prevalence and significant mortality of peripheral vascular diseases, their treatment requires special attention. PATIENTS - We examined 45 patients awaiting vascular surgery at the Department of Cardiovascular Surgery at Semmelweis University. RESULTS - We have demonstrated that the routine administration of acetylsalicylic acid was ineffective in the majority (60%) of patients, especially in the at-risk groups. In contrast, clopidogrel therapy was ineffective in only 11% of patients. CONCLUSIONS - On the basis of the literature and our own studies, we consider clopidogrel as the first-choice drug for the inhibition of thrombocyte aggregation in all patients with vascular disease, and for primary prevention in at-risk groups.]

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Lege Artis Medicinae

[SEVERE NECROTISING PRIMARY VASCULITIS - CASE REPORT]

GRIGER Zoltán, SZÁNTÓ Antónia, SZABÓ Nóra Anna, SOLTÉSZ Pál, ZEHER Margit

[INTRODUCTION - Vasculitis is an inflammatory disorder of the vessels, often associates with necrosis. The primary (idiopathic) form caused by distinct immunological mechanisms, the secondary form caused by infection, tumor, drugs or systemic autoimmune disease. CASE REPORT - 57-year-old smoking female patient with a medical history of the left ankle fracture. Four days earlier had sore throat, at admission was febrile and generally weak and had severe pain in her lower extremities. Physical examination revealed numerous livid alterations in both lower extremities, necrotic change of some toes and new onset of diastolic hypertension. Elevated serum transaminase levels, severe thrombopenia, anemia, leukocytosis suggested the possibility of thrombotic thrombocytopenic purpura and vasculitis. Tests ruled out septic embolism, therefore we applied high dose steroid treatment and plasma exchange. Meanwhile the results fulfilled the classification criteria of polyarteritis nodosa (vasculitis, livedo reticularis, polyneuropathia and new onset of diastolic hypertension), accordingly we synchronized the treatment with fractionally administered intravenous cyclophosphamide. The process revealed responsive to therapy and the substantive function of the legs remained after surgical removal of the necrotic areas. CONCLUSIONS - Early rapid diagnosis of vasculitis is fundamental and we emphasize the significance of the efficient treatment.]

Lege Artis Medicinae

[Atypical forms of the gastroesophageal reflux disease]

KIS János Tibor, NEMESÁNSZKY Elemér

[There is growing interest in the gastroenterology literature towards gastroesophageal reflux disease (GERD) these days. The prevalence of the disease is much higher than estimated earlier and it frequently appears in atypical forms. Literature data suggests that 30-40% of the individuals suffer from gastroesophageal reflux disease. A broad spectrum of presentation of gastroesophageal reflux disease exists, e.g. noncardiac chest-pain, ear-nose-throat symptoms, pulmonary symptoms, dental erosions, chronic cough and hiccups. Atypical forms often cause diagnostic and treatment difficulties. Authors analyze the frequency, morbidity and the pathomechanism of the extraesophageal manifestations, based on self-experience. The main goal of the review is to help to establish the diagnosis of GERD, to recognize its atypical signs and to outline the diagnostic steps to be taken. Most up-to-date treatment strategies are also presented. By the demonstration of interesting cases, authors emphasize the diagnostic importance of intragastric pH-monitoring.]

LAM Extra for General Practicioners

[“Lump in one’s throat” - Diagnostic and therapeutic failures]

GERLINGER Imre

Lege Artis Medicinae

[SEVERE NECROTISING PRIMARY VASCULITIS]

GRIGER Zoltán, SZÁNTÓ Antónia, SZABÓ Nóra Anna, SOLTÉSZ Pál, ZEHER Margit

[INTRODUCTION - Vasculitis is an inflammatory disorder of the vessels, often associates with necrosis. The primary (idiopathic) form caused by distinct immunological mechanisms, the secondary form caused by infection, tumor, drugs or systemic autoimmune disease. CASE REPORT - 57-year-old smoking female patient with a medical history of the left ankle fracture. Four days earlier had sore throat, at admission was febrile and generally weak and had severe pain in her lower extremities. Physical examination revealed numerous livid alterations in both lower extremities, necrotic change of some toes and new onset of diastolic hypertension. Elevated serum transaminase levels, severe thrombopenia, anemia, leukocytosis suggested the possibility of thrombotic thrombocytopenic purpura and vasculitis. Tests ruled out septic embolism, therefore we applied high dose steroid treatment and plasma exchange. Meanwhile the results fulfilled the classification criteria of polyarteritis nodosa (vasculitis, livedo reticularis, polyneuropathia and new onset of diastolic hypertension), accordingly we synchronized the treatment with fractionally administered intravenous cyclophosphamide. The process revealed responsive to therapy and the substantive function of the legs remained after surgical removal of the necrotic areas. CONCLUSIONS - Early rapid diagnosis of vasculitis is fundamental and we emphasize the significance of the efficient treatment.]

Lege Artis Medicinae

[“Lump in one’s throat” - Diagnostic and therapeutic failures]

GERLINGER Imre