Lege Artis Medicinae

[10 physicians was gratified LAM Adherence Academy competition]

PÁLL Csilla

JUNE 20, 2014

Lege Artis Medicinae - 2014;24(05-06)

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Lege Artis Medicinae

[Posttraumatic growth among cancer patients]

TANYI Zsuzsanna

[In addition to studies of the negative effects of psychological trauma, recognition of benefit of highly distressing life experiences is increasingly becoming the focus in psycho-traumatology, usually under the name of posttraumatic growth (PTG). The recent review first demonstrates the domains of PTG and factors in the development of PTG. After this, the most frequent domains and the prevalence of PTG in the case of cancer patients are discussed. Finally, the paper tries to answer the question whether there is any relationship between PTG and physical health. ]

Lege Artis Medicinae

[A Traveller’s Diary – Curiosities in Il Gesù, Rome]

KRUTSAY Miklós

Lege Artis Medicinae

[What makes youth happy today? Relationships between religion, spirituality and mental well-being among high school students]

PIKÓ Bettina, KOVÁCS Eszter, KRISTON Pálma

[INTRODUCTION - Studies suggest that traditional religiosity is more and more neglected among adolescents, however, not implying to the lack of religiousness or spirituality. Religion/spirituality is still a significant protective factor. Therefore, the main goal of the present paper was to analyze indicators of mental well-being in a sample of high school students in light of religious/spiritual variables. METHODS - The data collection of the questionnaire survey (2010) was going on among 656 high school students in Sze­- ged (age range between 14-21 years, mean=16.5 years, S.D.=1.5 years of age, 49.1% of the sample was female). Depressive symptomatology, satisfaction with life and optimism were dependent variables and indicators of spirituality/religiosity were the independent ones. Beyond descriptive statistics, correlation and multiple regression analyses (stepwise method) were applied in the calculations. RESULTS - Our results show that for today’s youth happiness is primarily associated with their existential well-being: those who see a meaning in life, who have goals in life and believe that they are able to see through and understand life events, tend to be more satisfied with life, more optimistic and less depressed. Besides, spiritual belief may also contribute to life satisfaction whereas importance of religiosity may be a protective factor in the case of depression. CONCLUSIONS - Based on these results we may conclude that existential well-being (that is, finding a meaning in life) is a prominent spiritual variable. Data also suggest, however, that youth’s mental well-being only partially comes from religiosity, mostly it stems from other resources. More research is needed to detect this. All in all, as it appears that youth do need a belief in a meaning in life, similar to other age groups.]

Lege Artis Medicinae

[Failures of Géza Csáth: Self-Remedy and Women ]

BARNA Bianka, GEREVICH József

Lege Artis Medicinae

[Economic benefits of subcutaneous rapid push versus intravenous immunoglobulin infusion therapy in adult patients with primary immune deficiency]

LIPTÁK Judit

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[Advanced Parkinson’s disease characteristics in clinical practice: Results from the OBSERVE-PD study and sub-analysis of the Hungarian data]

TAKÁTS Annamária, ASCHERMANN Zsuzsanna, VÉCSEI László, KLIVÉNYI Péter, DÉZSI Lívia, ZÁDORI Dénes, VALIKOVICS Attila, VARANNAI Lajos, ONUK Koray, KINCZEL Beatrix, KOVÁCS Norbert

[The majority of patients with advanced Parkinson’s disease are treated at specialized movement disorder centers. Currently, there is no clear consensus on how to define the stages of Parkinson’s disease; the proportion of Parkinson’s patients with advanced Parkinson’s disease, the referral process, and the clinical features used to characterize advanced Parkinson’s disease are not well delineated. The primary objective of this observational study was to evaluate the proportion of Parkinson’s patients identified as advanced patients according to physician’s judgment in all participating movement disorder centers across the study. Here we evaluate the Hungarian subset of the participating patients. The study was conducted in a cross-sectional, non-interventional, multi-country, multi-center format in 18 countries. Data were collected during a single patient visit. Current Parkinson’s disease status was assessed with Unified Parkinson’s Disease Rating Scale (UPDRS) parts II, III, IV, and V (modified Hoehn and Yahr staging). Non-motor symptoms were assessed using the PD Non-motor Symptoms Scale (NMSS); quality of life was assessed with the PD 8-item Quality-of-Life Questionnaire (PDQ-8). Parkinson’s disease was classified as advanced versus non-advanced based on physician assessment and on questions developed by the Delphi method. Overall, 2627 patients with Parkinson’s disease from 126 sites were documented. In Hungary, 100 patients with Parkinson’s disease were documented in four movement disorder centers, and, according to the physician assessment, 50% of these patients had advanced Parkinson’s disease. Their mean scores showed significantly higher impairment in those with, versus without advanced Parkinson’s disease: UPDRS II (14.1 vs. 9.2), UPDRS IV Q32 (1.1 vs. 0.0) and Q39 (1.1 vs. 0.5), UPDRS V (2.8 vs. 2.0) and PDQ-8 (29.1 vs. 18.9). Physicians in Hungarian movement disorder centers assessed that half of the Parkinson’s patients had advanced disease, with worse motor and non-motor symptom severity and worse QoL than those without advanced Parkinson’s disease. Despite being classified as eligible for invasive/device-aided treatment, that treatment had not been initiated in 25% of these patients.]

Lege Artis Medicinae

[Hypertension and twenty years of LAM]

FARSANG Csaba

[The author reviews significant results related to hypertension with special emphasis on papers published in the LAM during the past twenty years. The history of hypertensiology, important aspects of hypertension research, therapeutic guidelines, antihypertensive agents and their combinations are also discussed. A brief section is dedicated to the expected future development of hypertension research and new directions of antihypertensive therapy.]

Lege Artis Medicinae

[End-of-life care]

GRABER Hedvig, MAGYAR Tamás

[Recently, physicians and medical literature are more concerned about end-of-life care. A review is given of studies dealing with the rights of the dying patient, with advance directives and with possible treatments in the last days of life. A survey was done in author's department on medical therapy of the terminal period of 103 inpatients, died between 01. 10. 2001. and 31. 03. 2002. Comparing these data with those of American, Finnish etc. authors, the treatments seem to be more generous - probably because in Hungary it is not (yet?) usual to ”declare” endof- life care and to withdraw active therapy. However, indication of antibiotics seems to be more clinical (28.1%, vs. 42%-88% given by similar foreign data). Antibiotics are not palliative means, however, they may be administered in the last days, if the patient is suffering from a terminal infection. Indications and choice of antibiotics are suggested in these cases; medical and ethical problems discussed. Physicians can relieve the physical and mental distressing symptoms of the dying patient and ensure human dignity and peace of the last days.]

Lege Artis Medicinae

[How can the fixed-dose atorvastatin/amlodipin combination help better adherence of patients to therapy?]

KIRÁLY Csaba, BENCZÚR Béla

[Among the main risk factors of cardiovascular disease which is the leading cause of death dyslipidemia has a great importance beyond hypertension, diabetes, smoking and obesity. These conditions rarely occure as isolated ones but very often a clustering of major CV risk factors within individual patients can be observed called metabolic syndrome. It’s a great challenge to convince asymptomatic but high-risk adults that they have to take a lot of medicine for a long time period uninterruptedly to prevent future vascular events (eg. MI or stroke) in the primary care settings. Mainly the low statin-adherence means the greatest problem particularly if a subject should take statin beside two or more drugs despite statins have the most prominent evidences in the field of cardiovascular prevention. The efficacy in improving adherence to therapy of fixed-dose atorvastatin/amlodipin combination was investigated in this paper based on the experiences of case reports derived from our clinical practice.]

Hypertension and nephrology

[Blood pressure self-measurement with telemonitoring technology]

KÉKES Ede, KISS István, SAMU Antal, SZEGEDI János, MEZEI Rudolf

[Authors present the guidelines, indications and utility value of home selfmeasurements of blood pressure. They report the results of the most important clinical studies. They analyze the methodology of the measurements within telemedicinal solutions and describe the consultative scopes associated with the measurement methods already applied in clinical practice. Their own telemonitoring system - called Medistance - is then presented. They have created three modules for the long term registration of blood pressure in hypertensive patients: 1. an individual module for the hypertensive patients, the elderly, the family, for patients with high cardiovascular risk and for the physicians. 2. a module for the pharmaceutical care, 3. a module for the communities (social homes, club for the elderly, etc.). The Medistance system is functioning for two years in our count]