Lege Artis Medicinae

[Zoonoses in focus]

LAKOS András

FEBRUARY 22, 2007

Lege Artis Medicinae - 2007;17(02)

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Altering cannabinoid signaling during development disrupts neuronal activity]

Lege Artis Medicinae

[For Geriatrists]

dr. IMRE Sándor

Lege Artis Medicinae

[THE ROLE OF ENZYME REPLACEMENT THERAPY IN PANCREATIC DISEASES ASSOCIATED WITH MALDIGESTION]

TAKÁCS Tamás

[The pancreas synthesizes and secretes more than 20 digestive enzymes that hydrolyze the major nutritive components, i.e., carbohydrates, fat and protein, within the lumen of the small bowel. In several pancreatic diseases the secretory capacity of the pancreas gradually decreases and the release of pancreatic juice becomes blocked resulting in the characteristic symptoms of maldigestion. Pancreas-associated maldigestion is most often caused by chronic pancreatitis, which can be diagnosed primarily by imaging beside history and clinical symptoms. There is no decisive serological test. The goal of the treatment of pancreatic insufficiency is to reduce symptoms (bloating, abdominal pain, weight loss, and, most importantly, steatorrhea) and improve digestion. One way to do this is to replace pancreatic enzymes. The efficiency of the available enzyme preparations can be increased by the improvement of lipase activity.]

Lege Artis Medicinae

[THE DIFFERENTIATION OF CHRONIC PANCREATITIS FROM PANCREATIC CANCER]

CZAKÓ László

[The poor prognosis of pancreatic cancer is mainly due to late diagnosis. The differentiation between pancreatic cancer and chronic pancreatitis is difficult, because the two diseases cause similar clinical symptoms and morphological alterations. Furthermore, chronic pancreatitis is associated with an increased risk of malignant transformation, thus the two diseases may be present simultaneously. The recent developments in molecular genetic tests and in imaging techniques, such as multidetector computed tomography, magnetic resonance cholangio- pancreatography, endoscopic ultrasoundguided fine needle aspiration and positron emission tomography/computed tomography, have fundamentally transformed the differentiation of the two disorders. This paper provides a systematic review of the recent evidence-based results concerning the differentiation of pancreatic cancer and chronic pancreatitis.]

Lege Artis Medicinae

[ASSESSMENT OF THE QUALITY OF LIFE AND THE ATTITUDES TO AGEING OF ELDERLY PEOPLE]

TRÓZNAI Tibor, KULLMANN Lajos

[BACKGROUND - The WHOQOL-OLD questionnaire was developed in a multicultural way. The authors were involved in this work as members of the international task force. In order to improve services for the elderly by learning their attitudes to ageing, an Attitudes to Ageing Questionnaire (AAQ) was also developed by the working group. In the present study the authors assessed a sample of Hungarian elderly people by these two methods. Answers by elderly persons related to their quality of life, social and health conditions, as well as their attitude to ageing were analysed. PERSONS AND METHOD - A total of 333 (190 unhealthy and 143 healthy) persons over sixty years of age filled in the questionnaires either by themselves or through verbal interview. The participants’ compliance with the research was generally good. The study sample reflected the general features of the Hungarian elderly population. For statistical analysis the Microsoft SPSS for Windows version 11.0 programme was used. RESULTS - Better health condition, better mood, and a better ability for self-care improve the quality of life. Better attitudes to ageing are associated with better quality of life. CONCLUSIONS - The use of the WHOQOLOLD questionnaire is recommended in the daily practice to assess elderly Hungarians’ quality of life. The results highlight the significance of mental health in the development of the elderly persons’ attitude to ageing. The use of the new questionnaires may help change negative stereotypes related to ageing.]

All articles in the issue

Related contents

Lege Artis Medicinae

[In the focus: The disturbances of gastric acid production and their treatment]

LONOVICS János, SIMON László

Clinical Neuroscience

[DIZZINESS - VERTIGO WARNING SYMPTOMS IN VERTEBROBASILAR ISCHEMIA PART II.]

FAZEKAS András

[Dizziness and vertigo - like headache - are the most common complaints which lead patients to visit the doctor. In spite of the headache - which may be primary (e.g. migraine) or symptomatic - dizziness and vertigo do not appear to be a separate nosologic entity but rather the symptoms of several neurological disorders. For differential diagnosis, interdisciplinary thinking and activity is needed because the vestibular, neurological and psychiatric disorders might have a common role in the development of symptoms and further overlapping can also occur. The vascular disorders of the vertebrobasilar system are discussed in detail in this review. The importance, occurrence and causes of vertigo as a warning symptom is in the focus. The author draws attention to life-threatening conditions with acute onset in cases of the posterior scale ischemia and emphasizes the importance of the correct and early diagnosis. The author tries to clear up the nihilistic aspect in treating of stroke and stresses the necessity of thrombolysis and interventional radiological procedures which may be the only chance for the recovery of the patients. The pharmacological prevention of recurrent vascular events is also important and obligatory for the clinicians.]

Clinical Neuroscience

[Pneumococcal meningitis in a pregnant woman]

SCHAREK Petra, JEKKEL Csilla, BUDAI József, SZILASI Zsuzsanna, HELFERICH Frigyes, ÁRVA Ilona, VÁRADI András, LÉTAY Erzsébet, KATONA Katalin, RÓKUSZ László

[Bacterial meningitis is a life-threatening disease. The incidence of meningitis is about 2.6-6 cases per 100.000 adults per year in developed countries. The most common causative microorganisms are Sreptococcus pneumoniae and Neisseria meningitidis. A 33-year-old multigravida, at 24 week of gestation was admitted to the hospital because of ear pain, haedache, fever and confusion. Lumbal puncture was performed and cerebrospinal fluid analysis showed signs of bacterial meningitis. Latex agglutination test was positive for S. pneumoniae, Gram-positive diplococci have seen under microscope and later cultivation verified S. pneumoniae as the causative agent. After ceftriaxon, dexamethasone administration and treatment in intensive care unit, left side mastoidectomy was performed since cranial computed tomography showed acut exacerbation of chronic mastoiditis on the left side. After extubation, mobilisation and 14 days antibiotic treatment the patient, who had residual hearing loss on the left side, was discharged from the hospital. During the treatment the foetal parameters were normal. The patient at 39 week of gestation gave birth to a healthy infant. Forty-eight case reports have been published in this topic around the world until April, 2012. The most common causative agents were S. pneumoniae and Listeria monocytogenes. Because of the little amount of data, it is hard to appreciate the actual incidence and prognosis of this life-threatening illness both for mother and infant. As far as we know this is the first published case report of meningitis during pregnancy in Hungary. By this article we would like to draw attention to the importance of teamwork, of prevention of brain abscess formation and of the removal of the infection’s focus.]

Hypertension and nephrology

[Hyperuricemia and cardiovascular risk: new treat to target principle in focus]

ALFÖLDI Sándor

[Hyperuricemia is frequent and its prevalence is increasing as it correlates with obesity and metabolic syndrome by several different mechanisms. Furthermore, recently several data are available for the cardiovascular and renal protective effect of allopurinol in the treatment of hyperuricemia and gout. The new European EULAR guidelines suggested treat to target principle in urat lowering therapy of gout. The uric acid target is below 360 µmol/l in mild to moderate gout. The guidelines unequivocally stated, that allopurinol is the first line uric acid lowering drug. Allopurinol treatment should be started immediately at the diagnosis and should be continued lifelong.]

Clinical Neuroscience

[BRAIN LATERALIZATION AND SEIZURE SEMIOLOGY: ICTAL CLINICAL LATERALIZING SIGNS]

HORVÁTH A. Réka, KALMÁR Zsuzsanna, FEHÉR Nóra, FOGARASI András, GYIMESI Csilla, JANSZKY József

[Clinical lateralizing signs are the phenomena which can unequivocally refer to the hemispheric onset of epileptic seizures. They can improve the localization of epileptogenic zone during presurgical evaluation, moreover, their presence can predict a success of surgical treatment. Primary sensory phenomena such as visual aura in one half of the field of vision or unilateral ictal somatosensory sensation always appear on the contralateral to the focus. Periictal unilateral headache, although it is an infrequent symptom, is usually an ipsilateral sign. Primary motor phenomena like epileptic clonic, tonic movements, the version of head ubiquitously appear contralateral to the epileptogenic zone. Very useful lateralization sign is the ictal hand-dystonia which lateralizes to the contralateral hemisphere in nearly 100%. The last clonus of the secondarily generalized tonic-clonic seizure lateralizes to the ipsilateral hemisphere in 85%. The fast component of ictal nystagmus appears in nearly 100% on the contralateral side of the epileptic focus. Vegetative symptoms during seizures arising from temporal lobe such as spitting, nausea, vomiting, urinary urge are typical for seizures originating from non-dominant (right) hemisphere. Ictal pallor and cold shivers are dominant hemispheric lateralization signs. Postictal unilateral nose wiping refers to the ipsilateral hemispheric focus compared to the wiping hand. Ictal or postictal aphasia refers to seizure arising from dominant hemisphere. Intelligable speech during complex partial seizures appears in non-dominant seizures. Automatism with preserved consciousness refers to the seizures of non-dominant temporal lobe.]