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Abstract

Several Transylvanian chemists and pharmacists have played an important role in the development ad advancement of modern Hungarian chemical sciences. Regarding these prominent personalities we paid tribute in our series to the career and role of Lajos Ilosvay, Lajos Winkler and Tibor Széki in Budapest, Hungary. Pál Scheitz who was born 150 years ago in Marosvásárhely/Târgu-Mures worked at the Chemistry Institute of Professor Lajos Ilosvay. After graduating from the University of Munich and earning a PhD degree, he worked at the University of Kolozsvár/Cluj for a short period of time after which he pursued a full-time academic career at the Budapest University of Technology for the rest of his life. During his relatively short life (1870-1912) he managed to produce some outstanding works in the field of analytical chemistry. His most significant work is a contemporary book on methods of qualitative chemical analysis, which was printed in two editions. His studies and investigations of litmus dyes are also significant, which are still considered to be the most comprehensive studies of the Hungarian scientific literature.

Abstract

In case of chronic diseases patient compliance to long-term treatment is of utmost importance. Patient compliance is generally higher for pharmaceutical forms dispersing in the oral cavity. One classic example for long-term therapy is hypertension. The aim of this study is to obtain nebivolol hydro-chloride containing orally disintegrating tablets. As manufacturing technology, direct compression was chosen and rapid disintegration was aimed to be achieved using superdisintegrants. Various formulae have been developed, containing Kollidon and Polyplasdone in different concentrations, and the obtained dry powder mixtures were studied for their rheological properties. Afterwards these mixtures were compressed to obtain tablets. Active ingredient was embedded in the formulations with the shortest dis-integration times (15 and 18 seconds) and the obtained tablets were studied for disintegration time, mechanical resistance, drug content and dissolution. Our results show that the pharmaceutical formulations containing Kollidon CL 5% or Polyplasdone XL 3% fulfill the requirements of orally disintegrating tablets, having a disintegration time under 3 minutes, proper mechanical resistance (greater than 80N) and the dissolution of the active ingredient is greater than 80% in 30 minutes.

Abstract

The rapid development of molecular biology over the past seventy years led to the molecular understanding of the structure and function of hereditary material in the living world. Through the processing of the gigantic amount of data obtained as a result of technological advances and the exploration of different mechanisms of action, information technology has become an indispensable part of genomic research. This article addresses the background of the genomic and bioinformatics revolution, its application areas, and the perspective of personalized medicine.

Abstract

Introduction: as an outcome of sterile inflammation-inducing acute ischemic processes, many splenic cells enter the circulatory system and migrate into the lesion, defending tissues against the spread of ischemia or enhancing necrosis.

Objective: investigating the therapeutic effect of splenic morphological response to sterile inflammation-inducing myocardial infarction.

Material and method: We examined the weight and structure of the heart and spleen of 106 patients deceased due to acute myocardial infarction. These data were correlated with demographic (personal) and epidemiological data, and disease history. After morphological investigation of archived myocardial and splenic tissue samples, the acute ischemia-induced structural alterations of splenic samples were quantified using a digital morpho-metric method. Results were evaluated in comparison to the myocardial ischemia coefficient. Changes in distribution of ischemia-induced cell types were characterized by defining the immunological phenotypes of macrophages (M1 vs. M2). Spleen samples from patients without history of ischemia were used as controls.

Results: The modification of the spleen weight was associated with an increase in peripheral blood leucocyte levels. Our morphological analysis proved a positive correlation between the ischemia coefficient and the decrease of spleen weight. Structural analysis of splenic tissue revealed the collapse of red pulp sinusoids, a significant size decrease of the white pulp marginal zone (p<0.05), and depleted follicles with irregular margins without any distinct germinative centers. Concurrently, with the proliferation of granulocytes, the increase of M1 macrophages was observed in the myocardium, and a higher M1/M2 ratio was detected in the marginal zone of splenic follicles.

Conclusion: On the background of acute ischemia, time critically determines the dynamic structural changes of the spleen. Along with reducing the marginal zone, immunomodulation targeting its cellular composition will be a putative therapeutic approach in the future.

Abstract

Urinary tract infections are the third most common infections in human medicine worldwide. Citrobacter species present a challenge to both clinicians and clinical microbiologists, due to various intrinsic and acquired resistance mechanisms. This study includes microbiological and resistance data on urine samples positive for Citrobacter spp. between January 1, 2008 and December 31, 2017 at the Department of Clinical Microbiology, University of Szeged. Citrobacter species represented 0.7% (n=129) of outpatient samples and 0.6% (n=138) of inpatient samples. Their higher prevalence at advanced age (> 60 years) is consistent with that reported in the literature, whereas the clinical origin (inpatient/outpatient) of the urine specimens did not influence their isolation rates. Overall, the highest levels of resistance were observed with ceftriaxone (29.8% and 47.5%), whereas in case of gentamicin (8.3% and 25.4%) and fosfomycin (9.3 and 13.8%), the lowest level of resistance was detected, respectively. As these pathogens may cause nosocomial epidemics (usually in vulnerable patients groups), close and continuous monitoring is required at both institutional and national level.

Abstract

Background: Finding the appropriate treatment for advanced rectal cancer patients represents a challenge for surgeons. Determining the right diagnosis and the proper treatment requires multidisciplinary collaboration. Our aim is to present a case with advanced stage rectum cancer, who received successful multidisciplinary treatment.

Material and method: A prospective multidisciplinary research is being conducted at our Department from 2018 within which patients with malignant rectal cancer are examined. Patients’ treatment is realized by the same multidisciplinary team. The patient’s preoperative investigations included MRI and a lymph node map designated by radiologists.

Results: In case of a 60-year-old patient the preoperative MRI showed a stenotic formation in the middle level of the rectum that penetrated the seminal vesicle. During surgery, we found a 10x10 cm stenotic, perforated rectal cancer, which penetrated the bladder, seminal vesicle, prostate and sacrum, respectively a metastatic lesion in the livers 8th segment. During surgery R2 recto-sigmoid resection was performed with colostomy. The patient was mobilized on the first postoperative day and bowel movements were regained on the second day. The patient left the hospital on the eighth postoperative day.

Conclusions: Adequate treatment of patients with advanced rectal cancer can be achieved only through multidisciplinary co-operation. Preoperative radiological examinations are mandatory. A map representing the positive colorectal lymph nodes, implemented by the radiologists, can significantly help the surgeons and pathologists.

Abstract

Factor replacement is currently the standard of care to prevent or treat bleeding episodes in haemophilia patients. This study examined current prescribing practices of factor therapy for patients at haemophilia treatment centres (HTCs) in the United States.

Aims

The aims were to evaluate the driving forces for prescribing factor products, to evaluate current attitudes and knowledge toward factor product and industry, and to discuss the implications for health care providers in practice.

Methods

An anonymous electronic survey was distributed to 744 HTC health care providers (HCPs); 118 responses were analysed.

Results

The most common driving force for HCPs to change a patient's factor product was poor response to current therapy, while the most common perception of patients’ motivation to switch products was the potential for fewer infusions. HCPs with strong influence over the prescribed therapy identified inadequate pharmacokinetic (PK) studies as an important driving force; patients/caregivers perceived as having a strong influence over which therapy is prescribed selected less frequent dosing as an important motivator. HCPs who allow patients/caregivers to have a strong influence over which factor is prescribed were more likely to cite patient/caregiver request as a significant driving force for change in therapy.

Conclusion

The haemophilia treatment landscape continues to evolve and is becoming increasingly complex. The multitude of treatment options available now offer choices, presenting a need to focus on patient-centric prophylaxis.

Abstract

Background

Pain associated with bleeding disorders has been demonstrated to have an impact on patients’ and families’ quality of life. Both acute and chronic pain are common experiences and require attention by professionals working in haemophilia treatment centres (HTCs). The benefits of psychological pain management strategies such as cognitive behaviour therapy and self-management skills training are well documented; however, it is not well understood how Canadian social workers involved in haemophilia care perceive and provide pain management support to patients.

Aims

To explore the current understanding of pain management and practice as well as the education needs of members of Canadian Social Workers in Hemophilia Care (CSWHC).

Method

Twelve semi-structured qualitative interviews were conducted with members of CSWHC. Transcribed interviews were coded with NVivo software and thematically analysed.

Results

The four key themes reflecting the experiences of social workers are: 1) Limited comprehension of key issues related to pain; 2) Conditioning to push through pain; 3) Expanding pain knowledge to enhance practice; 4) How we practice social work and choose to step in.

Conclusion

The current practice of CSWHC members aligns with literature in three main areas including assessment, instrumental services, and counselling. Social workers support the development of pain education and practical resources for patients with haemophilia who experience pain. While formal education, advocacy, and policy development of pain assessment and management are recognised, these areas require further research and development.

Abstract

Background

X-linked adrenoleukodystrophy (X-ALD) is an inherited metabolic disease which causes demyelination of the white matter of the brain. The symptoms include mental impairment, progressive paresis, impaired motor coordination, and epileptic seizures. Diagnosis is established mainly by genetic testing. Currently, the recommended treatment is haematopoietic stem cell transplantation (HSCT).

Goal

The aim of the study was to present the case of a patient suffering from X-ALD, who developed symptoms of bipolar disorder in the initial phase of the disease prior to the onset of characteristic neurological symptoms.

Case presentation

In 2015, a 33-year-old patient was admitted to a psychiatric department due to aggressive behaviour he showed towards his wife and other family members. He had been treated for a depressive episode in 2005, and for a manic episode without psychotic symptoms earlier in 2015. During the successive psychiatric hospitalizations, in addition to psychopathological symptoms, the patient had been observed to have neurological symptoms, which included progressive paraparesis and ataxia. In 2018, based on imaging and genetic tests, the patient was diagnosed with X-ALD. The patient's condition gradually deteriorated; with time, he was unable to move on his own. During a hospital stay in 2019, he was transferred to an internal medicine department due to a progressive urinary tract infection, which, however, could not be controlled, and the patient died.

Conclusions

  1. X-ALD is a rare metabolic illness. In the early stages of the disease, various psychopathological symptoms, including affective disorders, are observed.
  2. Early initiation of adequate treatment increases the chances of extending the patient's life.
  3. In the present case, the patient did not die due to the underlying disease, but due to causes typical of bed-bound patients, i.e. complications of progressing infection.

Abstract

Introduction: Cotard's syndrome (CS) is a rare set of psychopathological symptoms, the main symptom of which is nihilistic delusions concerning the negation of the existence of internal organs or the entire body

Aim, material and methodology: The aim of the study is to present a case of a patient treated for postpartum depression who developed Cotard's syndrome. The patient's symptoms began immediately after her daughter. The clinical picture was dominated by anxiety and apathy, nihilistic delusions about the atrophy of the urethra and other lower abdominal organs, and olfactory hallucinations - she could smell rot.

Discussion: The available literature on Cotard’s Syndrome does not allow us to indicate a certain reason for its development. Perhaps the birth of the first child - the woman doubted herself as a mother, she was afraid that she would hurt the cause of the disorders observed and described by us was transient ischemia of the CNS during delivery.

Conclusions: Cotard's syndrome can develop in the course of many mental and somatoform disorders. The described case is, to our knowledge, the first description of Cotard’s Syndrome in the deprivation period. Difficulties in establishing the etiopathogenesis and pathophysiology of Cotard’s Syndrome translate into therapeutic problems. It has been suggested that the treatment of the underlying disorder on the basis of which CS is developed remains the most effective method of therapy.