A fejfájások osztályozása, az önálló fejfájásbetegségek és kezelésük

 Classification of headaches, primary headaches and  their  treatment

Dr. Bozsik György, Prof. Dr. Jelencsik Ilona

Abstract

Only severe, recurrent, frequent headaches require medical consultation. Nevertheless, headache is one of the most common complaints of patients visiting outpatient services. 2 % of  population need help of  the general practitioner every year because of headaches. If there is no underlying structural brain damage, nor disease of organs of the head, the patient should have "primary headache".  According to the International Headache Society (IHS) classification this group includes migraine, tension type headache and cluster headache.  The diagnosis of a primary headache disorder is based on the criteria of the IHS and requires detailed history taking, physical examination and exclusion of possible secondary (symptomatic) headaches.

The trigeminovascular system seems to be the final common pathway for expression of neurovascular head pain. Brainstem aminergic nuclei probably start migraine and modulate afferent nociceptive information. The fundamental driving process in cluster headache possibly arises in the diencephalic pacemakers. The vascular nociceptor may be hypersensitive in migraine while in tension type headache the hypersensitivity of myofascial nociceptor should be more prominent.

All primary headache patients need effective acute medication and the trigeminovascular system provides a therapeutic target for specific attack treatment. Frequent  primary headaches that produce disability may require preventive treatment .

The goals and possibilities of treatment in primary and selected secondary headache disorders are discussed.

 

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Fej- és arcfájdalmak
Painful  conditions of  the head and face

Dr. Rácz Edit, Dr. Molnár Péter

 We can’t divide in two parts the head and facial pains in everyday practice, so we’d like to talk about them together. Headache can be separate illness or can follow another deases. We can use conservative and – more often - invasive technics in this treatment after we decided the reasons

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XXX Gyermekkori malignus daganatos betegségek a háziorvosi gyakorlatban
Childhood malignant  tumors in family  practice

Dr. Hauser Péter

 

Summary:

Care of the children with malignant tumor is summerized in the practice of family doctors from the aspects of diagnostic procedure, chemotherapy, irradiation, palliative treatment and rehabilitation.

 

 

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 Az alvás alatti obstruktív apnoe vizsgálata és kezelése

Investigation and treatment of sleep apnoe

Dr. Juhász János

 

Summary

Sleep disordered breathing (SDB) is characterized by pathological breathing pattern during sleep resulting in a complex disorder of the autonomic vegetative control. Obstructive sleep apnea (OSA) represents the most common SDB. The OSA is characterized by recurrent pharyngeal occlusions, hypoxemia and arousals during sleep associated with reveral clinical symptoms and complains including the most frequent snoring and excessive daytime sleepiness. The SDB and its consequtive effects on the heart, circulation and central nervous system can be assessed by polysomnography (PSG) through recording the breathing, heart function as well as brain- and muscle activity during sleep. Beyond PSG, screening and ambulatory diagnostic also gain on significance in the daily praxis. The therapy of OSA includes trachostomy, weight reduction, intranasal- and pharyngeal surgery, oral appliances and nasal continuous positive airway pressure (nCPAP) which represents the most effective method by keeping upper airway patent through a pneumatic splint. OSA is associated with several functional disorders as well as increased morbidity and mortality in the long term. Untreated OSA results in increased risk for myocardial infarction, stroke, heart failuire and cardiomyopathy. Beyond the individual health risk OSA is also associated with major impact on society and economy.

 

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