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- Dezsi, Livia, et al.
(författare)
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Inclusion body myositis - a rarely recognized disorder
- 2013
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Ingår i: Ideggyogyaszati Szemle - Clinical Neuroscience. - Budapest, Hungary : Literatura Medica Kiado. - 0019-1442. ; 66:3-4, s. 89-101
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Forskningsöversikt (refereegranskat)abstract
- Inclusion body myositis is the most common disabling inflammatory myopathy in the elderly. It is more frequent in men and after the age of 50 years. Inflammatory and degenerative features coexist. There is a T-cell mediated autoimmunity driven by in situ clonally expanded cytotoxic CD8-positive T-cells invading non-necrotic muscle fibres expressing MHC-I antigen. The hallmarks of degeneration are the deposition of protein aggregates and the formation of vesicles. The course of the disease is slow and the diagnosis is usually set after several years. The muscle weakness and wasting is assymetric, affecting predominantly distal muscles of the upper extremity and proximal muscles of the legs. The signs and clinical course can be characteristic, but the diagnosis is established by muscle biopsy. less thanbrgreater than less thanbrgreater thanThere is currently no evidence based effective treatment for sIBM. Prednisone, azathioprine, methotrexate, cyclosporine and IFN-beta failed. Oxandrolon did not improve symptoms. Treatment with intravenous immunglobuline (IVIG) induced in some patients a transient improvement of swallowing and of muscle strenght, but the overall study results were negative. less thanbrgreater than less thanbrgreater thanA T-cell depleting monoclonal antibody (alemtuzumab), in a small uncontrolled study slowed down disease progression for a six-month period. Repeated muscle biopsies showed the reduction of T-cells in the muscle and the suppression of some degeneration associated molecules. An effective therapeutic mean should act on both aspects of the pathomechanism, on the inflammatory and the degenerative processes as well.
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- Szabó, Zoltán, et al.
(författare)
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Kiegészítő klinikai módszer a nyitott szívműtéteknél fellépő légembolisatio csökkentésére : [A complementary clinical method to minimize air embolism during open-heart surgery]
- 2008
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Ingår i: Magyar Sebeszet. - : Akademiai Kiado. - 0025-0295 .- 1789-4301. ; 61, s. 57-59
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Tidskriftsartikel (refereegranskat)abstract
- Air from the left heart is ejected even up to several hours after cardiopulmonary bypass (CPB) despite the use of CO 2 . The following method is complementary in addition to surgical de-airing in order to further reduce the chance of air embolism, especially from the pulmonary veins. After re-expanding the lungs with standard bag inflation, the ventilation is restarted in consultation with the surgeon. The ventilator is set to the respiratory minute volume used before the CPB but at a respiratory frequency of 10/minutes whereas the regularly beating heart is filled from the heart lung machine. Transoesophageal echocardiography (TEE) reliably controls the effect.
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- Szentgyörgyi, Lajos, et al.
(författare)
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Intraoperative fires caused by alcoholic skin antiseptic and diathermy
- 2008
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Ingår i: Magyar sebészet. - 0025-0295. ; 61, s. 71-73
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Tidskriftsartikel (refereegranskat)abstract
- UNLABELLED: The authors describe two intraoperative fires during cardiac surgery. In both cases, in addition to the usual disinfection and isolation of the operating field, they wanted to reduce the infection hazard and to restore the partly ruined isolation by 70% alcoholic skin antiseptic solution. Soon after the disinfection, but before the evaporation of alcohol, diathermy was used and caused fire. In case of the first patient the fire spread over the isolation film and resulted second grade (5%) and third-grade (1%) burn injury which required plastic surgery. In the second case the patient's beard caught fire causing second-grade (1%) burn that was treated locally. Despite these burn injuries both patients recovered after the heart surgery. These two intraoperative fires are 0.003-0.004% of all surgical procedures.CONCLUSION: Fires during surgery are rare and might have serious consequences. They can be prevented by keeping the discipline of work and instructions of fire protection. The best way of prevention is regular education of all the staff (doctors, nurses, etc.) working in the operating theatre.
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