Szemészet, 2016 (153. évfolyam, 1-4. szám)
2016-06-01 - Supplementum
Kongresszusi összefoglalók Current issues of anticoagulation and platelet aggregation inhibition Kálmán Tóth 1st Department of Medicine, Medical Center University of Pécs, Pécs Cardiovascular mortality increased to over 17 million per year in the last two decades across the world representing 29% of the total mortality. It is estimated that this number will reach 25 million and the mortality rate will increase by 37% by 2020 if the current trends remain unchanged. The largest portion of such deaths is of coronary heart disease origin. Antiplatelet drugs have a key role not only in treating both acute and stable forms of the disease but also in prevention, in some cases used even in combination. However, in addition to their outstanding cardiovascular efficiency, the use of these drugs also carries a risk, mainly due to bleeding events. As for the bleeding complications, gastrointestinal hemorrhages are to be specifically highlighted. It is therefore very important that in compliance with guidelines, we should also pay attention to individualized medication, whereby we should consider, where appropriate, the duration of dual platelet aggregation inhibition and in order to prevent bleeding also the possibilities of gastric protection. Another very important issue is how to deal with the increased risk of bleeding in case of surgeries. Atrial fibrillation is the most common arrhythmia requiring hospitalization it affects 4% of the population above the age of 60 and 10% above the age of 80. Its prevalence in developed countries is expected to increase from 2.5 to 3 times by 2050. At least one third of patients with atria! fibrillation may be asymptomatic. At the same time, it seriously increases the risk of stroke, heart failure, and death. One of the most important aims of its treatment is the prevention of thromboembolic events, e.g. stroke. For this purpose patients should be given continuous, lifelong oral anticoagulants. Patients with atrial fibrillation undergoing acute coronary syndrome and percutaneous coronary intervention represent a major challenge as in such cases - temporarily - triple inhibition shall be used, i.e. dual platelet aggregation inhibition + oral anticoagulants, which greatly increase the risk of bleeding. The application of novel types of oral anticoagulants offers a new opportunity, which significantly reduces the risk of bleeding in particular in the case of intracranial hemorrhages. The lecture gives an insight into the above therapeutic strategies and discusses the procedures applicable in the event of surgery in terms of patient safety. E05 Új adatok a cukorbetegség okozta szövődményekkel kapcsolatban Wittmann István1, Kempler Péter2, Rokszin György3, Abonyi-Tóth Zsolt34, Kiss Zoltán5, Jermendy György5 'Pécsi Tudományegyetem, Általános Orvostudományi Kar II. sz. Belgyógyászati Klinika és Nephrologiai Centrum, Pécs "Semmelweis Orvostudományi Egyetem, Általános Orvostudományi Kar I. sz. Belgyógyászati Klinika, Budapest 3RxTarget Kft., Szolnok 4Szt. István Egyetem, Budapest 5MSD Pharma Hungary Kft., Budapest 6Bajcsy-Zsilinszky Kórház, Budapest Biztosítási adatok teljes körű elemzése alapján tudjuk, hogy hazánkban jelenleg 772 000 cukorbeteget tartanak számon. A betegek 54%-a nő és 46%-a férfi. Az összes cukorbeteg 94%-a 2-es típusú. A 2-es típusú cukorbetegség prevalenciája 2001 és 2014 között 71%-kal emelkedett. A 70 év felettiek 20%-a szenved 2-es típusú cukorbetegségben. A 2-es típusú cukorbetegek kezelésére fordított összeg 2001-ben 188, 2010-ben 199 és 2014-ben 216 milliárd forint volt, amit euróbán kifejezve 711, 723 és 698 millió eurónak adódik. A szövődményeket illetően, az alsó végtagi amputáció a 2005-ös 3475 esetről 2014-re 3658 lett, miközben a 2-es típusú cukorbetegség prevalenciája jelentősen emelkedett, így az amputáció relatív előfordulása 0,58%-ról 0,50%-ra (szignifikánsan) csökkent. A szívinfarktus előfordulása a vizsgált periódus első 5 évében (2001-2004) 3,9%, az utolsó 5 évében (2010-2014) 2,7% lett, ami 31%-os kockázatcsökkenésnek felel meg. Ugyanebben a periódusban a stroke kockázata 26%-kal mérséklődött. A standardizált halálozás a 2001-es 4,0%-ról 2014-re 3,7%-ra esett vissza. Mindezek az adatok arra utalnak, hogy a cukorbetegség prevalenciájának hatalmas növekedése ellenére, a modern kezelési eljárások mellett, a cukorbetegség kezelésének költsége csökkent és a szövődmények, illetve a mortalitás kockázata jelentősen mérséklődött. New data related to diabetic complications István Wittmann1, Péter Kempler2, György Rokszin3, Zsolt Abonyi-Tóth34, Zoltán Kiss5, György Jermendy6 'University of pecs, II. Internal Clinic and Nephrology Centre, Pécs "Semmelweis University, I. Internal Clinic, Budapest "RxTarget Kft., Szolnok 4Szt. István University, Budapest 5MSD Pharma Hungary Kft., Budapest BBajcsy-Zsilinszky Hospital, Budapest The review of health insurance full set data proves that in Hungary 772.000 diabetic patients are registered. The rate of females to males is 54/46%. The majority, 94% of the diabetic population has type 2 diabetes. Prevalence of type 2 diabetes increased by 71% between years 2001 and 2014- The prevalence of diabetes at an age > 70 is 20%. The costs of type 2 diabetes for the health insurance increased in Hungarian forints from 188 billion in 2001, to 199 in 2010 and to 216 in 2014, which corresponds to 711, 723 and 698 million Euros, respectively Regarding diabetic complications, it is noteworthy that the number of leg amputations was 3475 cases in 2005, and 3658 cases in 2014- During this period the prevalence of type 2 diabetes increased, which is why the relative prevalence of amputation decreased from 0.58% to 0.50%. Prevalence of myocardial infarction decreased from 3.9% of the first 5 years of the observational period (2001-2004) to 2.7% of the last 5 years period of2010-2014, which corresponds to a 31% relative risk reduction. During the same periods a 26% relative risk reduction of stroke was observed. The standardized mortality rate was 4-0% in 2001, which dropped to 3.7% in 2014- In summary, at an increasing prevalence of type 2 diabetes, the use of latest drug therapies decreased the costs of patient management while the risk of complications and mortality also dropped.
