Lege Artis Medicinae

[“With Others, For Others...” An Interview with Surgeon Professor János Kiss by Elemér Nemesánszky]

NEMESÁNSZKY Elemér

MAY 26, 2008

Lege Artis Medicinae - 2008;18(05)

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Lege Artis Medicinae

[RETREATMENT OF CHRONIC HEPATITIS C IN PREVIOUS NONRESPONDERS]

TORNAI István

[Only approximately 50% of patients with chronic hepatitis C virus (HCV) genotype 1, the prevailing genotype in Hungary, show a sustained virologic response (SVR) when treated with the combination of peginterferon alfa and ribavirin. The number of patients who do not respond to this treatment is continuously increasing. The appearance of increasingly efficient treatment modalities was seen in the past 15 years, but now no new drugs are expected for a few years. There is a growing need for retreatment to prevent possible progression of the disease. The best candidates for retreatment are identified based on the data of the previous treatment; the dosage of the drugs used, dose reductions and their causes, the kinetics of the virologic response, the patient’s compliance, and every correctable and non-correctable factor should be carefully analysed. When the previous treatment with peginterferon and ribavirin failed to induce response, retreatment is only recommended if correctable factors can be identified. Repeated treatment may result in sustained virologic response usually if a longer duration and/or higher dose of ribavirin is applied. Since the best possible outcome of retreatment is sustained virologic response in 10 to 30% of patients, which is significantly lower than the results achieved in naive patients, every effort has to be made to increase the efficacy of the first treatment. For patients in whom no sustained virologic response can be achieved, a maintenance therapy with low dose interferon may be considered, although its benefit is yet to be proven. New small molecules are under development, which may bring further hope for nonresponders to current standard therapy.]

Lege Artis Medicinae

[STRADIVARIUS (STrategy to Reduce Atherosclerosis Development InvolVing Administration of Rimonabant - the Intravascular Ultrasound Study)]

MATOS Lajos

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[LAM Awards 2007]

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[So Who Owns the World After All? Péter Esterházy: Rubens and the Non-Euclidean Women]

dr. KRAMER Imre

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[The most common disorders seen in the paediatric gastroenterology clinic]

ARATÓ András

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Introduction - Peripheral nerve injury (PNI) is a frequent problem among young adults. Hopefully, regeneration can occur in PNI unlike central nervous system. If nerve cut is complete, gold standard treatment is surgery, but incomplete cuts have been tried to be treated by medicines. The aim of the study was to evaluate and compare clinical and histopathological outcomes of independent treatment of each of Vitamin B12 (B12) and Vitamin D3 (D3) and their combination on sciatic nerve injury in an experimental rat model. Materials and methods - Experimental animal study was performed after the approval of BEH Ethics Committee No. 2015/10. 32 rats were grouped into four (n=8) according to treatment procedures, such as Group 1 (controls with no treatment), Group 2 (intraperitoneal 1 mg/kg/day B12), Group 3 (oral 3500 IU/kg/week D3), Group 4 (intraperitoneal 1 mg/kg/day B12+ oral 3500 IU/kg/week D3). Sciatic Functional Index (SFI) and histopathological analysis were performed. Results - SFIs of Group 2, 3, 4 were statistically significantly higher than controls. Group 2 and 3 were statistically not different, however Group 4 was statistically significantly higher than others according to SFI. Axonal degeneration (AD) in all treatment groups were statistically significantly lower than in Group 1. AD in Group 4 was significantly lower than in Group 2 and 3; there was no significant difference between Group 2 and 3. There was no significant difference between Group 1,2 and 3 in Axonolysis (A). But A of Group 4 was significantly very much lower than all others. Oedema- inflammation (OE-I) in all treatment groups were significantly lower than in Group 1; there was no significant difference between Group 2 and group 4. OE-I in Group 2 and 4 were significantly lower than in Group 3. There were no significant differences between Group 1, 2 and 3 in damage level scores; score of Group 4 was significantly lower than of Group 1. Conclusions - B12 and D3 were found effective with no statistically significant difference. But combined use of B12 and D3 improve nerve healing synergistically. We recommend combined use of B12 and D3 after PNI as soon as possible.

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[The effect of nonsteroidal anti-inflammatory drugs on articular cartilage]

GÁTI Tamás, JUHÁSZ István, ROJKOVICH Bernadette

[In developed countries, the treatment of osteoarthritis costs up to 1-2% of the GNP. The poor hygroscopy of hyaline cartilage and of glycosaminoglycan (GAG) molecules that are components of proteoglycans plays a key role in the development of the disease. Age-related osteoarthritis mostly affects the weight-bearing joints of the lower extremities, the hips and knees, and - more frequently than the former ones - the small joints of the hands, causing chronic pain and disability. Nonsteroidal anti-inflammatory drugs (NSAIDs) used for the treatment of osteoarthritis-related pain influence not only pain but also cartilage metabolism, and - among others - GAG molecules. NSAIDs diminish the biosynthesis of prostaglandins (PG) that have a role in inflammatory processes, and influence oxygen free radicals, the levels of interleukins (ILs) and the function of metalloproteinases. The ideal NSAID for the joints stimulates cartilage formation, reduces cartilage resorption, and the level of katabolic cytokines. Aceclofenac was found to have the most beneficial effect on multiple aspects of cartilage metabolism.]

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