Lege Artis Medicinae - 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Diagnosis and treatment of neck pain II. Treatment]

BÁLINT Géza, SZEBENYI Béla, BÁLINT Péter

[The treatment of neck pain – such as the diagnostic procedure – requires the collaboration of the general practicioner and rheumatologic, neurologic; traumatologic and orthopedic experts. This part of the article interpretes methods and possibilities which can be made or prescribed by all the collegues for such patients. In case of acute neck pain bedrest, fixing instruments, peros medicamentation, local injections and physiotherapy are recommended. Patients suffering from chronic neck pain should be treated with active gymnastics, physiotherapic and relaxation methods rather than with oral therapy to avoid medical polypragmasy. Psychic running of these patients are emphasised. The authors conclude that general practicioners should play greater role in the treatment of neck pain, such as of arthrosis or backache.]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Congenital haemorrhagic diathesis in childhood- an update]

ZIMONYI Ilona, MAROSI Anikó, JÁNKY Ilona

[Following 164 haemophilic children in the Heim Pál Children's Hospital the authors call attention to the increased responsibility of paediatricians in diagnosis and long term care. They highlight haemarthroses leading to disableness, dental care, and the hazards of the treatment, such as changes in the immunstatus, transfer of infections, and the appearence of inhibitors. Hepatitis B profilaxis, introduced last year is mentioned as a favorable result. They call attention to the bad school results of the patients with average intelligence, the difficulties in the choice of profession and adaptation. They emphasize that the solution of the problems is an averall social duty. Finally, problems to be solved in the near future are listed. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[The clinical pathology of prostatic carcinoma]

KISS Ferenc

[On the basis of the actual state of art, the main tasks of clinical pathologists in the diagnostics of prostatic carcinoma may be summarized as follows: Recognition and differential diagnosis of prostatic adenocarcinoma. Estimation of tumour prognosis by means of a reliable histological grading system and establishing the pathological stage. Checking the efficacy of (hormonal) treatment relying upon histological features. An increasing effort to a better understanding and diagnosis of premalignant changes (dysplasia, prostatic intraepithelial neoplasia). In favour of individual characterization of a tumour, one should utilize the attainable modern investigative methods.]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[The role of the estracyt therapy in the treatment of prostatic cancer]

HATÁR András, LENGYEL István

[The authors – after summarizing the literature data – report the experiences of 57 prostatic cancer patients treated with Estracyt. The therapy was introduced as a primary one in 22 cases, and as a secondary treatment in 35 ones. It was administered mostly in T3-4 stadium cases with proved metastases. There was a complete regression in 8, partial regression in 15, while temporary regression in 14 cases (totally 64,9%). It is suggested, that the product can be used ensuring regression by the development of hormone resistance, by anaplastic tumors, and at the evolving of the recidiva following surgery or irradiation. A complete regression can be reached relatively rarely in advanced tumors. It can be used in either primary or secondary therapy. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Diagnosis and therapy of prostate cancer]

KISBENEDEK László

[Prostate cancer is the third most common cancer in men. The majority of patients present to a doctor at an advanced stage with a tumour that has spread beyond the organ boundaries or with regional lymph node and haematogenous bone metastases. Correct treatment is based on correct clinical staging.]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Dental and oral symptoms in diabetes mellitus]

ALBRECHT Mária, BÁNÓCZY Jolán, DINYA Elek, IFJ. TAMÁS Gyula

[Results of dental examination in 1600 diabetic patients and 623 nondiabetic textile workers were compared. Standard methods – recommended by WHO (1977) – were used to the examination. The condition of caries was assessed with DMF-T mean values, periodontal changes with the use of Russell's Periodontal Index (Pl), and the degree of oral hygiene with the OHI-S index. Statistical evaluation of the data was made with the BMDP program package using chi-square test, correlation and analysis of variance. The DMF-T index in diabetic patients was higher (p < 0.01), considering the distribution of its components the average number of carious teeth was lower (p < 0.0001), in patients above 30 years more extracted teeth (M) were found (p < 0.0001) than in the controls. Diabetics lose their teeth mainly due to periodontal disease, which is also supported by the increased Pl mean values (p < 0.001). Poor oral hygiene was accompanied by an increase of oral mucosal alterations. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Experiences using the naclof eye drop after intraocular lense implantation]

BOYTHA Zsuzsanna

[Steroid containing eye drops play essential role in the treatment following cataract extraction and intraocular lense implantation. They have a very good effect on decreasing inflammation but their side effect of increasing the intraocular pressure is well known. That's why all over the world non-steroidal antiinflammatory eye drops are examined having no influence on the intraocular tension. The clinical effect Diclophenac-Na (Naclof, Dispersa AG., Switzerland) was examined following cataract surgery with implantation in the Department of Ophthalmology of the P. m. T. Semmelweis (St. Roch) Hospital, on 50 patients. While using the eyedrop 9 symptomps were evaluated at slitlamp examinations on the base of a four points subjective scale on the 1st, 3–4th, 10–14th intraocular lense postoperative days. The efficiency of the eye drop was found to be excellent at 34 patients (68%) and good at 16 patients (32%). There were no local or systemic side effects observed. The tolerance against the preparation was excellent at 47 patients (94%) and good at 3 patients (6%). The intraocular pressure did not increase in any of the cases. According to our experiences the clinical efficiency of the Naclof eyedrop is nearly the same as that of the steroid containing drops without side effect. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Does the use of barium in a stomach x-ray influence the following ultrasoung exam]

KISS Marianna, SELMECZI Andrea

[There is a general opinion that the presence of barium in the gastrointestinal tract (after the examination of the stomach or the large intestine) may influence the following abdominal ultrasound examination. In this study we have planned to decide whether this statement is also true in case of modern, good quality equipment, for this attitude can cause delay in the diagnostic procedure. Seventy ultrasound pictures of 35 patients were retrospectively analyzed by two radiologists according to the double blind method using a „score-system" (0—4). Five anatomic regions were examined, in 20 patiens before and after a stomach examination and in 15 ones before and after a double-contrast stomach examination. The results suggest that the barium doesn't cause any worsening of the quality of sonograms, probably the gas applied with the contrast medium. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Idiopathic arterial calcification of infancy]

SZABÓ Zsuzsanna

[Idiopathic arterial calcification of infancy is a rare disease of undetermined etiology characterized by deposition of calcific material along the internal elastic membrane of arteries and accompanied by simultaneous proliferation of the fibrous tissue of the intima resulting in luminal narrowing. The history of an one month old infant has been reported. The clinical signs were characterized by heart failure and hepatic injury caused by idiopathic arterial calcification. In connection with the author's own case literature data on the etiology and mechanism of calcification and the clinical and morphological features of the disease have been reviewed. This case is distinguished from others by the fact that the disease was combined with hepatic injury. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Actual problems in public health service]

SOMOSI György

[In the period of 1980–1989 the most important data of public health in Hungary are summarized. In the field of infectious diseases further imporovement can be expected from the new vactinations. Decreasing the number of food poisoning, occupational diseases and accidents demands complex hygienic work. Prevention of nosocomial infections attitude requires the improvement of objective conditions as well as the attitude of the staff. The author deals with the environmental effects influencing public health. The possibilities for preventing environmental injury is also described. The role of the survaillance method in the investigation of public health is emphasised and suggestions are given to improve the work in this field. The author lays stress on the cooperation between public health institutions interested in prevention and institutions of other concern; epidemiological examinations; spreading of the survaillance method; increasing the effectiveness of the local control system; developing the instrumentation of laboratories; improving hygienic knowledge. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Reflections on the teaching of medicine]

SZENDE Béla

[The aim of medical education is to train doctors who love their profession and their fellow human beings, who are competent in their profession and who practice it effectively and with spiritual awareness. A teaching staff possessing these qualities and able and willing to pass on their knowledge is a prerequisite for education. A further condition is the financial and intellectual independence of the teaching (and training) staff, which also presupposes that the state provides the financial conditions for education. In Hungary, given the size of the country and the financial and quality conditions for medical training, private medical training is out of the question.]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Proposal for a compulsory sickness insurance scheme]

PERÉNYI László

[In line with the legal obligation imposed by Parliament and the government's programme, the National Directorate General of Social Insurance has drawn up a concept for the reform of social insurance. The concept identifies the separation of the various branches and the establishment of a sickness insurance system as one of the fundamental tasks of the reform. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Correspondence]

BÁLINT Géza

[It was with a sincere and eager curiosity to find a solution that I read Dr. Gyula Kincses' article "Thoughts on the financing background of family medicine" (LAM 1991; 9-10: 618-625), and then re-read it again and again. Finally, a very concrete, excellent proposal after all the words, slogans and empty balloons! At last, a well thought-out system which takes into account and tries to take into account not only the various activities of the doctor (prevention, treatment, care), not only the health of the population entrusted to him, but also the training and knowledge of the doctor, the structure of his area of activity, his municipality! At last, a blueprint that can be developed, quantified, tested and used as the basis for a fruitful debate. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[-Amicus Plato sed magis amica veritas-]

SZEBENYI Béla

[In each of the first 6 issues of Lege Artis we could read a thoughtful and forward-looking summary of the present and future problems of the Hungarian health care system, including the titles: Systemic change in health care, Reform change or system change, Where to go from here, health care, Can health care be transformed? The requirements of modern governance and management in health care, and SOTE: Questions and answers for reform. (1, 2, 3, 4, 5, 6,). If we agree that a correct analysis of the current situation and future of the medical profession and health workers is a sine qua non for any way forward, we must wonder why there is not a single mention (!) of the basic characteristic of these groups, their numbers. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[It has begun....]

[The month of May was almost a month of inactivity for the parliamentary committee. They prepared the debate day on youth, which was almost drowned in indifference by scandals deemed more important, they dangled the gambling bill, the forthcoming house rules and waited to do what they had been dithering about: the decades-long overhaul of social security and health care.]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Introductory visits]

[On 6 June, Pál Kertai, the newly appointed national chief medical officer, and Tamás Pál, the chief pharmacist, "made their debut" before the Parliament's Health Committee. The quotation marks are justified by the fact that both, in particular Professor Kertai, are old acquaintances of the members of the committee, having recently chaired working committees as ministerial commissioners.]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[The twilight of parasolvency?]

ANDRÁS László

[On 4 June, the members of the Committee on Social Affairs, Family and Health had a first reading of the government's first reading of the ideas on the reform of social security and health care submitted to Parliament. As usual, they did not debate or criticise the proposal, but listened to their experts and asked questions to the representatives of the proposers, in this case András Jávor, State Secretary for Social Welfare, and Sándor Fekete, Head of the National Social Insurance Directorate. Towards the end of the session, questions were put by Tamás Freund (SZDSZ).]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[On the right to freedom of conscience of a doctor]

ÁDÁM György

[Freedom of conscience - is commonly understood to mean the civil liberty right whereby a person may not be compelled (is not compelled) to engage in conduct (activity, action, conduct or abstention from action) that is incompatible with his or her conscience, moral convictions, moral outlook or worldview. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[The chronicle of haemophilia]

ISTVÁN Lajos

[There are numerous cultural, historical and medical records of haemophilia, which date back to the 2nd century BC. These provide an opportunity to study the nature, symptoms and heredity of the disease retrospectively. ]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[Visit to the doctor]

NÉMETH István

[The cover shows a life portrait of a medical examination, which was transferred from the Esterházy Collection to the Museum of Fine Arts and is currently on display at the Semmelweis Museum of Medical History. A languid young woman is lying on a four-poster bed, apparently in a very weakened state, barely able to raise her arms so that the doctor sitting next to her can check her pulse. The timid but hopeful look on her face and the worried expression on the doctor's face suggest that this is probably a serious case.]

HUN 1991;1(13)

Lege Artis Medicinae

JULY 31, 1991

[The old rector is not dead, long live the new one]

KISS Péter

[Well, we understand that, too, and we understand that there should be no lynch mobs, no electoral fraud, if not in a nice, democratic way, as the starry nightmare of a constitutional state demands. The new Rector, Professor Miklós Réthelyi (yes, in the eyes of the students he is such that they can add the word 'Mr' to his name and rank with respect), in other words, in the person of Rector Réthelyi we have installed one of the most popular teachers of the university in the Rector's chair. That is, we would have just put him there, because until Professor Réthelyi's official appointment he had the velvet chair put in the corner of the boardroom. Finally, a rector with a sense of style. ]

HUN 1991;1(13)