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Hypertension and nephrology

SEPTEMBER 30, 2020

[Association between cyclothymic affective temperament and hypertension]

NEMCSIK János, BATTA Dóra, KŐRÖSI Beáta, RIHMER Zoltán

[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]

Clinical Neuroscience

JANUARY 30, 2020

Marchiafava-Bignami disease: Report of three cases

GUNAY Gul, MESUDE Özerden, ZEYNEP Ozdemir, CAHIT Keskinkiliç, HAKAN Selçuk, BATUHAN Kara, AYSUN Soysal

Marchiafava-Bignami disease (MBD) is a rare alcohol-associated disorder characterized by demyelination and necrosis of the corpus callosum. We report three patients who had history of chronic alcoholism, different clinical presentation and MRI findings consistent with the diagnosis of Marchiafava-Bignami disease.

Lege Artis Medicinae

AUGUST 30, 2018

[Depression, anxiety and suicidal behavior. Recognition and care]

RIHMER Zoltán, BLAZSEK Péter, HARGITTAY Csenge, KALABAY László, TORZSA Péter

[Depression and anxiety disorders are major problems both in psychiatric and in general practice because of their frequency and recurring character. Owing to their common complications (suicide, suicide attempts, secondary alcoholism / drug disease, increased cardiovascular and cerebrovascular morbidity and mortality, loss of work, social isolation, etc.) they are the cause of significant individual, family and social burdens. In our paper we review the clinically revealable suicide risk and protective factors that can be observed in depression and anxiety disorders as well as the main aspects of the recognition and care of suicidal patients. With available medicines and non-pharmacological therapies, the vast majority of depressive and anxiety patients can be successfully treated and in most cases we can prevent suicidal behavior associated with these diseases. Besides psychiatrists general practitioners as well play a significant role in preventing suicidal behavior and in the recognition of suicide risk. ]

Lege Artis Medicinae

JULY 20, 2017

[Interdisciplinary aspects of alcoholism and smoking from the perspective of primary care]

DARVAI László, RIHMER Zoltán, BALCZÁR Lajos, CSERHÁTI Zoltán, TÚRI Gergő, BÉLTECZKI Zsuzsa, KALABAY László, TORZSA Péter

[There is a complex and multi-directional relationship between alcoholism, smoking, depression, anxiety disorders, cardiovascular disorders and type 2 diabetes. They are risk factors not only for each other but - because of their relationship with depression - also for suicide. The effect of successful therapy of depression and anxiety plays a role not only in reducing suicide but also in reduction of alcoholism, cardiovascular morbidity and mortality, and smoking. Therefore, the effect of the appropriate specific treatments appears (even to a lesser extent) also in the field of another medical discipline. On the other hand, the reduction of smoking may be - in addition to decreasing mortality and morbidity of chronic obstructive pulmonary disease, lung cancer, ischemic heart disease, and so on - a causal factor in decreasing suicidal morbidity and mortality, as well as in decreasing morbidity of depression. The purpose of this article is to raise awareness of the relevant professions and healthcare financiers and decision-makers to these hidden benefits (appearing in other fields of expertise). The presented data justify not only the better funding for Mental Health Services but also the extension of the competence of primary care physicians to the mild and moderate (not psychotic and not suicidal) depression and anxiety disorders. ]

Journal of Nursing Theory and Practice

APRIL 30, 2015

[The role of self-help groups in the treatment of alcoholism]

PRÍMA Erika

[Alcoholism is one of the best-known addictions. The results of both international and national surveys illustrate the health consequences of the excessive consumption of alcoholic beverages, and its link with alcoholic disease and the associated dangers, but we still find a high proportion of people who show unrestrained consumption. Is there a genuine desire to recover, is there motivation, and where should one look for help? Such assistance could take the form of a self-help group, where addicts who want to quit, those in the various stages of recovery, or those who have already recovered, can meet up. The aim is to achieve and maintain abstinence, and prevent a relapse. The author presents the process and benefits of self-help, from the perspective of addiction. Her study proves that the treatment of alcoholism requires a complex approach, and one in which we can ascribe a key role to self-help groups.]

Hypertension and nephrology

MARCH 22, 2013

[Causes of and therapeutic opportunities in resistant hypertension]

SIMONYI Gábor, GENCSI Kristína

[Hypertension is an independent cardiovascular risk factor and one of the most frequent diseases in Hungary. In the treatment of hypertensive patients usually more than two drugs are needed for the appropriate blood pressure control. Resistant hypertension (RH) is defined when blood pressure remains above target value despite full doses of antihypertensive medications, which consist of at least three different classes of drugs including a diuretic administered in maximal doses. The frequency of RH can reach 20-30% among hypertensive patients. RH increases the cardiovascular risk because of the lack of target blood pressure. RH is multifactorial and it is important to exclude pseudo-resistant hypertension (e.g. poor compliance, white coat effect). In the background of RH we can find lifestyle factors (e.g. obesity, excessive salt intake, alcoholism, etc.) and a variety of drugs (e.g. non-steroids, corticosteroids, sympathomimetics). In the pathogenesis of RH the increased activity of the sympathetic nervous system has an important role. In the treatment of RH we should manage lifestyle factors and it is important to assess the drugs and diseases (e.g. sleep apnea, chronic kidney disease, diabetes mellitus) which may cause increased blood pressure. It is no exact recommendations for the treatment of RH. Therapy often consists of 4-5 various drugs in combination. An important role has the device therapy of RH in recent years (e.g. stimulation of the carotid baroreceptors and renal denervation) as well.]

Hypertension and nephrology

NOVEMBER 20, 2010

[Is there a connection between neuropathy and hypertension?]

ISTENES Ildikó, KERESZTES Katalin, KEMPLER Péter

[Neuropathy is usually not an independent entity, its symptoms usually occur as part of other underlying diseases. Diabetes, chronic alcoholism, chronic liver diseases and chronic kidney diseases belong to the most important pathogenetic factors of neuropathy. It is less well known that neural damage may occur among patients with hypertension as well. Autonomic and sensory nerve dysfunction are considered as progressive forms of neuropathy. Both of them are associated with poor prognosis while quality of life is also significantly impaired among these patients. Key clinical characteristics of sensory and autonomic neuropathy are reviewed. There is a relationship between autonomic neuropathy and hypertension in patients with diabetes. Parasympathetic neuropathy and as a consequence relative sympathetic overactivity seems to have a pathogenetic role in this respect. The prevalence of previously unknown hypertension is doubled in diabetic patients with autonomic neuropathy - ambulatory blood pressure monitoring is suggested to be performed among these patients. The authors provided evidence that autonomic and sensory nerve dysfunctions are frequent complications of essential hypertension as well, which are closely related to traditional cardiovascular risk factors. Their observations may confirm the role of vascular factors in the pathogenesis of neuropathy.]

Lege Artis Medicinae

OCTOBER 18, 2006

[’THE CYCLE OF VIOLENCE’ IN THE LIFE OF ALCOHOLICS]

GEREVICH József, BÁCSKAI Erika

[INTRODUCTION - ’The cycle of violence’ have long been a known phenomenon. The present research is aimed at answering the question of whether abuse suffered in childhood creates a tendency to aggressive behaviour in adulthood and whether there is a connection between these two forms of behaviour. METHODS - The sample studied comprised 235 clinically treated alcoholics. The instruments used for the investigation were the European Addiction Severity Index (EuropASI), the Buss and Perry Aggression Questionnaire, and the Janus Questionnaire. RESULTS - The most important finding is that persons who were physically abused in childhood by their parents were very likely to strike or beat someone in the course of their lives (χ2=9.79, p<0.001). Within the most aggressive group, 18 % had not suffered abuse in childhood, while 81 had been abused (χ2=13.25, p<0.001). If the patient had been physically abused, struck or beaten, that person later abused, struck or beat someone else (Pearson r=.397). CONCLUSION - The results draw attention to the importance of preventing and treating aggression in alcoholics undergoing clinical treatment.]

Clinical Neuroscience

JULY 10, 2004

[Prognosis and classification of hypertensive striatocapsular haemorrhages]

HORNYÁK Csilla, KOVÁCS Tibor, PAJOR Péter, SZIRMAI Imre

[Introduction - Nontraumatic intracerebral haemorrhage accounts for 10 to 15% of all cases of stroke. Patients and method - In our study hypertensive striatocapsular haemorrhages were divided into six types on the basis of arterial territories: posterolateral, lateral, posteromedial, middle, anterior and massive (where the origin of the hemorrhage can not be defined due to the extensive damage of the striatocapsular region) type. We analysed laboratory data, clinical presentations and risk factors as alcoholism, smoking and hypertension of 111 cases. The size of the hematoma, midline shift and severity of ventricular propagation were measured on the acute CT-scan. The effect on the 30-day clinical outcome of these parameters were examined Results and conclusion - According to our results, the most important risk factor of hypertensive intracerebral haemorrhage was chronic alcoholism. Blood cholesterol, triglyceride levels and coagulation status had no effect on the prognosis, but high blood glucose levels Significantly worsen the clinical outcome. In our study, lateral striatocapsular haemorrhage was the most common while middle one was the least common type. The overall mortality is 42%, but differs by the type. The 30-day outcome significantly depends on the type of the haemorrhage, the initial level of consiousness, the size of the haematoma, the severity of ventricular propagation, the midline shift and the blood glucose levels. The clinical outcome proved to be the best in the anterior type, good in the posteromedial and lateral types. The prognosis of the massive type is poor. In our study, the classes and the mortality of the striatocapsular haemorrhages was different from the literature data. The higher mortality in our cohort could be due to the longer follow-up and the severe accompanying diseases of our patients.]

Lege Artis Medicinae

FEBRUARY 20, 2002

[Data on health-behaviour in samples from counties with high and low suicide rates]

ZONDA Tamás, PAKSI Borbála

[Authors conducted a comparative sociological, social-psychiatric survey in the summer of 2000 on a representative sample (1000- 1000 people) from counties with high and low suicide rates (Bács-Kiskun and Vas). They also studied the so-called "health-behaviour" of subjects since it was supposed that negation or refusal of medical help are forms of latent auto-agressivity, probably of common origin with "direct" self-harm (alcohol abuse, smoking, suicide), from deeper behavioural roots. The rates of morbidity and mortality of the two counties do not differ each other significantly with the exception of alcoholism. In spite of this facts, people living in the Great Hungarian Plain (Alföld) regard themselves in worse health condition than people in western countryside, presenting as patients in the health care system more frequently in the Alföld. Authors did not find any connection between the quality of health behaviour and the sharply divergent suicide rates of the two territories. Studying the two sample as a whole, they found marked problems in the field of health behaviour in both counties. They also stress that suicide and alcoholism in Hungary are very closely connected entities. Authors suggest that tasks for the public health service in this matter are significant.]