Lege Artis Medicinae

[Trauma in Five Movements Ágnes Heller: Trauma]

FERENCZI Andrea

MARCH 19, 2007

Lege Artis Medicinae - 2007;17(03)

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Lege Artis Medicinae

[THE ROLE OF SIMVASTATIN IN THE TREATMENT OF DIABETIC DYSLIPIDAEMIA]

BALOGH Zoltán, PARAGH György

[Patients with type 2 diabetes have markedly increased cardiovascular morbidity and mortality. Type 2 diabetes is typically associated with atherogenic dyslipidaemia, which is characterized by elevated triglycerides, low plasma levels of high-density lipoprotein cholesterol, and an increased ratio of small, dense lowdensity lipoprotein particles. Current treatment guidelines stress the importance of lipidlowering therapy in reducing cardiovascular risk in diabetic patients. Statins currently represent the cornerstone of dyslipidaemia management, based on their ability to efficiently reduce cardiovascular risk through lowering low-density lipoprotein cholesterol. They have, however, a relatively modest effect on the components of atherogenic dyslipidaemia, since they reduce triglycerides by only 15 to 35% and elevate high-density lipoprotein cholesterol by less than 10%. This raises the need for combining statins with other lipid-lowering drugs (ezetimibe, nicotinic acid, fibrate) at an early stage of type 2 diabetes. Authors review the role of simvastatin monotherapy in the treatment of diabetic dyslipidaemia and summarize the results of studies on simvastatin as part of a combined lipid-lowering treatment.]

Lege Artis Medicinae

[19th World Congress of Diabetology]

HIDVÉGI Tibor

Lege Artis Medicinae

[The initial symptoms of severe sepsis - A multidisciplinar diagnostic guideline by the Hungarian Sepsis Forum for the reduction of hospital mortality from septic processes]

BOGÁR Lajos, LUDWIG Endre

Lege Artis Medicinae

[Diagnosis of early-stage chronic pancreatitis by secretin-enhanced magnetic resonance cholangiopancreatography]

CZAKÓ László, TAKÁCS Tamás

Lege Artis Medicinae

[Endocrinology in the focus - Readers’ questions answered by professor dr. Edit Gláz and dr. Péter Igaz]

GLÁZ Edit, IGAZ Péter

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SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

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We aimed to analyze the clinical, laboratory and neuroimaging findings in patients with sporadic Creutzfeldt-Jakob disease (CJD) in a single center as well as to review other published cases in Turkey. Between January 1st, 2014 and June 31st, 2017, all CJD cases were evaluated based on clinical findings, differential diagnosis, the previous misdiagnosis, electroencephalography (EEG), cerebrospinal fluid and cranial magnetic resonance imaging (MRI) findings in our center. All published cases in Turkey between 2005-2018 were also reviewed. In a total of 13 patients, progressive cognitive decline was the most common presenting symptom. Two patients had a diagnosis of Heidenhain variant, 1 patient had a diagnosis of Oppenheimer-Brownell variant. Seven patients (53.3%) had been misdiagnosed with depression, vascular dementia, normal pressure hydrocephalus or encephalitis. Eleven patients (87%) had typical MRI findings but only 5 of these were present at baseline. Asymmetrical high signal abnormalities on MRI were observed in 4 patients. Five patients (45.4%) had periodic spike wave complexes on EEG, all appeared during the follow-up. There were 74 published cases in Turkey bet­ween 2005 and 2018, with various clinical presentations. CJD has a variety of clinical features in our patient series as well as in cases reported in Turkey. Although progressive cognitive decline is the most common presenting symptom, unusual manifestations in early stages of the disease might cause misdiagnosis. Variant forms should be kept in mind in patients with isolated visual or cerebellar symptoms. MRI and EEG should be repeated during follow-up period if the clinical suspicion still exists.

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