Lege Artis Medicinae

[Unparalleled Exhibitions in Budapest ]

NAGY Zsuzsanna

NOVEMBER 20, 2013

Lege Artis Medicinae - 2013;23(10-11)

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Lege Artis Medicinae

[Titration of insulin glargin in type 2 diabetic patients treated with oral agents and with necessity of basal insulin in everyday medical practice ]

VÁNDORFI Győző, KOVÁCS GÁBOR

[INTRODUCTION - Early insulin treatment is a widely accepted option for combination glucose-lowering therapy, and its most common form is basal insulin supported oral therapy (BOT). Due to its 24-hour action and lack of peaks in plasma insulin concentrations, insulin glargine is an ideal choice for BOT. METHODS - We conducted a prospective, non-interventional study to evaluate the efficiency and safety of dose titration, the period of time necessary to reach the target fasting blood glucose level, and the changes in glargine insulin dose. The study group included patients with type 2 diabetes who had been treated with insulin glargine in BOT regimen for no longer than four weeks. The follow-up period was six months. RESULTS - During the study period, the mean fasting plasma glucose was decreased from 9.8 mmol/L to 6.7 mmol/L, the mean HbA1c level decreased from 8.8% to 7.3%, and the mean postprandial glucose level decreased from 11.5 mmol/L to 8.2 mmol/L. Mild hypoglycaemic episodes occurred in 6.5% of patients in the first 3 months and in 6.9% of patients between months 3 and 6. During the same periods, severe hypoglycaemic episodes occurred in 0.08% and 0.17% of patients, respectively. Both mean body weight and mean BMI decreased during the study period. The average daily dose of glargine continuously increased during the observation period from baseline 10.42 IU to 17.69 IU. DISCUSSION - In the study population, glargine therapy in BOT regimen significantly improved glycaemic control, while a slight but statistically significant reduction was observed in the patients’ body weight. The daily dose of insulin glargine increased during titration, and the therapy proved to be safe.]

Lege Artis Medicinae

[A General Practitioner and Diary Writer Around Leo Tolstoy ]

MOLNÁR László

Lege Artis Medicinae

[Variations on alfa and beta adrenerg blockers]

NYÁRÁDI Attila

Lege Artis Medicinae

[Infection. Control?]

BARCS István

Lege Artis Medicinae

[Therapeutic options for the treatment of neuroendocrine tumors]

TÓTH Miklós

[This paper provides an overview of the latest clinical advances regarding state-of-theart treatment of neuroendocrine tumours. The first-line treatment of any localized neuroendocrine tumour is surgical removal of the tumour. The only exceptions are certain small gastric carcinoids and small, hormonally inactive pancreatic tumours associated with multiple endocrine neoplasia type I. The treatment strategies of disseminated neuroendocrine tumours should be based on a pathological diagnosis that uses the 2010 WHO classification (neuroendocrine tumours G1 and G2, neuroendocrine carcinoma G3). Debulking surgery and radiofrequency ablation can be used effectively not only as an anti-tumour treatment but also in patients with severe symptoms and hormone overproduction resistant to treatment. The use of somatostatin-analogs is considered to be standard treatment in functional neuroendocrine tumours of any origin, as well as in the anti-tumour therapy of G1/G2 small intestinal neuroendocrine tumours. For progressive G1-G2 neuroendocrine pancreatic tumours, streptozocin-based combined chemotherapy is the first-line treatment. Targeted drug therapies, such as mTOR inhibitors and tyrosine kinase inhibitors are used as second- or third-line agents in patients with inoperable pancreatic neuroendocrine tumours. Peptide receptor radiotherapy is increasingly used in Europe; however, its final place amongst other therapeutic modalities remains to be investigated.]

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[Anniversary Meeting of the Mihály Erdélyi Memorial Medal Foundation The 100th Anniversary of the Birth of Mihály Erdélyi MD Budapest, 7 February 2008]

BOHÁR László

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[FOREWORD TO THE PROCEEDINGS OF THE “SELYE SYMPOSIUM - 2013”, HELD AT THE HUNGARIAN ACADEMY OF SCIENCES, BUDAPEST, HUNGARY, MAY 8, 2013]

SOMOGYI Árpád, SZABÓ Sándor, ROGER Guillemin,

Lege Artis Medicinae

[Trends of mortality amenable to health care in Hungary and in the Central Region, 1996-2006]

NAGY Csilla, JUHÁSZ Attila, PÁLDY Anna

[INTRODUCTION - Despite of the decreasing trend of amenable mortality it is a significant contributor to social and economic loss due to premature death. This paper assesses the trends of amenable mortality over time, its contribution to the years of potential life lost (YPLL), furthermore reveals the spatial inequalities of the amenable mortality in the central region in relation to socioeconomic status and number of the inhabitants of municipalities. METHODS - This study describes the trend of the years of potential life lost due to amenable mortality during the period 1996-2006 in Hungary, in Pest county and in Budapest. The spatial epidemiological analysis of the amenable mortality was carried out by using smoothed indirectly standardised mortality ratio calculated by full hierarchical Bayesian methods at municipality level. The association between the spatial distribution of amenable mortality and socio-economic status was assessed by using a “Deprivation Index” elaborated by the authors. RESULTS - The years of potential life lost of males were 7207 (per 100 000) and respectively for females these value was 3870 (per 100 000) in Hungary in 2006. The amenable mortality is a significant contributor to years of potential life lost despite its decreasing trend. The amenable mortality accounted for approximately one third of the males’ and the females’ years of potential life lost. The risk of amenable mortality is higher in the less populated areas and the less-favoured socioeconomic situation coexists with high mortality risk. CONCLUSION - Approximately in average 32 000 persons died due to amenable mortality per year during the investigation period in Hungary. The results of the study provide essential information to the local policy-makers, and managing health professionals. The results can be used principally to inform planning healthcare development programs.]

Lege Artis Medicinae

[“WHAT DO YOU THINK HAPPENS TO THOSE WHO RARELY GO OUTDOORS?”]

PLUHÁR F. Zsuzsanna, KOVÁCS Szilvia, PIKÓ Bettina, UZZOLI Annamária

[INTRODUCTION - The surrounding environment plays an important role in the development of psychosomatic symptoms. This study examines what children think of the consequences of not going outdoors for long periods. METHODS - Data were collected using the “draw-and-write” technique that besides the written answers allows children to express their thoughts in drawings. The questionnaire contained open-ended questions both on sociodemographic data and on the children’s notion of the relationship between environment and health or illness. Questionnaire submission was voluntary and anonymous. The study subjects were 9 to 11-year-old pupils (n=448, 44.6% boys, 55.4% girls) from six primary schools, two in Budapest, and one each in Pest, Jász-Nagykun-Szolnok, Csongrád and Békés counties. The primary schools were selected so as to represent various environmental locations, such as urban, town, suburban residential, area of blocks of flats. RESULTS - We found that all children agreed in that those who don't go outdoors for a long time will, in one way or another, get sick. Illnesses mentioned in the answers were classified in two categories, physical and mental. Physical health problems were further divided into four subcategories: symptoms (e.g., anaemia, pallor, fever, weak joints or bones); diseases; obesity; death. Mental health problems were divided into two subcategories: actual psychiatric diseases (e.g., depression) and symptoms, such as unhappiness, sadness, anger. CONCLUSIONS - We conclude that children in this study sample reckon the close connection between staying indoors for prolonged periods and the development of symptoms and disease.]

Lege Artis Medicinae

[The Language of Crisis and Change Márta Erdős: Connection in Language, Budapest, Typotex]

FERENCZI Andrea