Gastroenterology

Lege Artis Medicinae

SEPTEMBER 30, 2023

[The practice of periprocedural anticoagulation – birth of a local consensus]

BENCZÚR Béla, RODEK Gyula, SIMON János

[The problem of periprocedural anticoa­gulation is emerging more and more frequently in the day-to-day patient care. There is fundamental the interdisciplinary approach spanning the borders of different specialties by establishing the “anticoagulant team” including specialists as cardiologist, anesthesiologist and surgical experts for hands-on interventions (surgeon, traumatologist, obstetrician, endoscopic spe­cialist etc.) and even the GPs as well. Such a communication can help considerably in the patient management and it would be useful to define local protocols and consensus papers adapted for the concerning hospitals. This review provides an overview of the points of considerations, the proposed practice of interruption and re-ad­ministration of oral anticuagulants, and the treatment of bleedings. ]

HUN 2023;33(8-9)

Hypertension and nephrology

SEPTEMBER 13, 2023

[ANCA associated vasculitis in childhood]

MIKES Bálint, CSIZEK Zsófia, HORVÁTH Orsolya, KAUCSÁR Tamás, KARDOS Magdolna, SZABÓ József Attila, REUSZ György Sándor

[ANCA-associated vasculitis is a systemic autoimmune disease with a severe course and a high percentage of renal involvement. It is much more common in the adult population than in children, so there are few large case-control studies in pediatric population. We present case reports of six children treated for ANCA-associated vasculitis over the past five years. In addition to the case presentation, we will also discuss current immunosuppressive therapeutic options and the issue of plasmapheresis. We describe the initial symptoms and the time between the onset of symptoms and diagnosis. We present the initial laboratory data and a 12-month retrospective follow-up of renal function. We also describe the therapies used in our patients. Given the small number of cases, we do not aim to present detailed statistical conclusions.]

HUN 2023;27(04)

Hypertension and nephrology

SEPTEMBER 13, 2023

[Chronic kidney disease as cardiovascular risk factor]

SIMONYI Gábor

[Chronic kidney disease (CKD) is one of the major risk factors for cardiovascular disease (CVD). More than 50% of patients with CKD die from CVD before starting dialysis. The relationship between CKD and CVD is explained by several mechanisms, including arterial stiffness, inflammation, oxidative stress, anaemia, calcium-phosphorus metabolism disorder and renin-angiotensin-aldosterone system activation. In order to reduce the cardiovascular risk of patients with CKD, it is important to recognize and treat CKD early, as well as to optimize the traditional and non-traditional risk factors. The aim of this review is to summarize the associations between CKD and CVDs, as well as the prevention and treatment options.]

HUN 2023;27(04)

Lege Artis Medicinae

JULY 31, 2023

[Who seeks, shall find often – deceptive recurrent pulmonary infiltrates]

CZIGÁNY Diána Gréta, SINKOVICZ András, PARAICZ Gábor, GYÔRI Zsófia, SZÁNTÓ Árpád

[Pulmonary infiltrates can appear in many diseases. Instead of air, alveoli are filled by white blood cells, tumor cells, blood, pus, protein, etc., and result in athelectasia. Among all etiological factors of infiltrates, community-acquired pneumonia occurs most frequently, which is one of the lead­ing causes of mortality and morbidity worldwide. 
By definition, it is an infection through li­ving pathogens, affecting the interstitium, alveolar space and terminal pulmonary airways. However, we often do not succeed to recognize the infectious agent in the back­ground thus it may be presumed that the changes demonstrated by imaging mo­dalities, albeit supported by the symptoms, do not present a pneumonia indeed.
This study concerns a case of a 58-year-old woman diagnosed with pneumonia and trea­ted regularly by antibiotics. Although her condition temporarily improved, the complaints (asphyxiation, fever, weakness) returned regularly, her CRP levels were re­peatedly elevated, and the chest CT scans showed bilateral pulmonary infiltration. Bronchoscopy samples were used for culture and lower respiratory PCR which with negative blood culture ruled out the pneumonia. Further tests and an immunological consultation verified ANCA-positive granulomatosis with polyangiitis behind her worsening condition.
This case study draws our attention to the importance of reporting recurrent pneumonia to a pulmonologist and demonstrates the significance of microbiological sampl­ing and deep respiratory PCR in recogniz­ing similar conditions.  ]

HUN 2023;33(6-7)

Clinical Neuroscience

JULY 30, 2023

Post-acute sequelae of COVID-19 in young adults: Mental fatigue and decreased cognitive flexibility

SEDAT YASIN, ERMAN ALTUNISIK, YASEMIN Ekmekyapar FIRAT

Post-acute sequelae of COVID-19 (PASC) describes the occurrence of persistent symptoms following COVID-19 infection. Neurological and psychiatric symptoms may include fatigue, post-exertional malaise, cognitive complaints, sensorimotor symptoms, headache, insomnia. The aim of this study was to evaluate the long-term effects of COVID-19 infection on mental fatigue and cognitive flexibility in young adults.

ENG 2023;76(7-8)

Clinical Neuroscience

JULY 30, 2023

Neurological comorbidities and novel mutations in Turkish cases with neurofibromatosis type 1

AHMET EVLICE, ATIL BIŞGIN, FILIZ KOÇ

Neurofibromatosis type 1 (NF1) is a rare, autosomal dominant multisystemic disease. The NF1 gene is localized on chromosome 17q11.2. Patients with NF1 have different clinical presentations and comorbidities. The aim of the present study is to determine the novel mutations and neurological comorbidities of NF1. Patients who were diagnosed with NF1 by clinical criteria of the National Institutes of Health were included in the study.

ENG 2023;76(7-8)