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Lege Artis Medicinae - 1992;2(04)
Content
Lege Artis Medicinae
APRIL 29, 1992
[Malnutrition syndrome in childhood part I.]
[Malnutrition is a chrocic nutritional disorder resulting from insufficient intake of caloric energy and/or some the fundamental nutrients. Since it is the most common public health problem in the world it has a great impact on pediatric morbidity and mortality. The etiology is extremely complex. When one considers the less severe symptoms and signs caused by vitamin-, mineral-, and trace element deficiencies, it is apparent that not only children living in underprivileged countries are affected. In the course of making the diagnosis an assessment of the nutritional status should also be made, especially considering the above-mentioned marginal nutritional deficiencies. The most common manifestation of nutritional disorders is anemia, which is mostly caused by lack of iron, vitamin B12, folic acid and can be complicated by infections. Nutritional requirements can be affected by several drugs. That is why this medication-nutrition interaction has to be kept in mind during treatment. The interaction of malnutrition and infection is very important, primarily for three reasons: mechanisms by which infection complicates the metabolic and nutritional status of the host; importance of suboptimal nutritional status on susceptibility and severity of intercurrent infections; clinical and therapeutic implication of these interactions. ]
Lege Artis Medicinae
APRIL 29, 1992
[The bleeding time]
[The bleeding time is considered to be the best screening test for the detection of disorders of primary haemostasis. Despite a large number of bleeding time tests, the exact pathophysiological background of the prolonged bleeding time is unknown. The significance of the cellular (platelet) von Willebrand protein is emphasized. A sensitive method (Ivy) and standardized devices (Simplate) are suggested. Examination of the bleeding time in cases of von Willebrand disease and congenital or acquired thrombocytopathy is essential. Specific recommendations regarding the rational use of the bleeding time (diagnostic algorythm) are presented. ]
Lege Artis Medicinae
APRIL 29, 1992
[Clinical importance of pharmacogenetic investigation]
[This is a brief review on the most important monogenically determined metabolic polymorphisms, their biochemical background and clinical significance. Relevant data from literature are also featured. The authors review data on possible connections between metabolic polymorphism and the risk of certain diseases.]
Lege Artis Medicinae
APRIL 29, 1992
[Correspondence]
[Includes the following letters : Little Hungarian point system; ...and the injured?; Abuse of psychosomatics the organic dimension of psychiatry; Psychogenic horsekick; ]
Lege Artis Medicinae
APRIL 29, 1992
[P300 wave evoked by visual and acustic stimuli in parkinsonian patients with or without dementia]
[Authors analysed the relationship between cognitive function disturbance observed in patients with Parkinson's disease and clinical features of the disease. Relationship between the latency prolongation of the P 300 wave and the duration of substitution therapy, clinical form and severity of the disease (the Hoehn-Yahr stage) was examined. 75 randomly selected young patients with Parkinson's disease were divided in to two groups: one with and the other without dementia as determined by the Wechsler. Hunt and Mini Mental State tests. The latency of the P 300 wave using visual and acoustic stimuli was determinated. Significant prolongation of the latency of P 300 wave evoked both by visual and acoustic target stimuli was found in parkinsonian patients with dementia. Patients with dementia have longer duration of disease and substitution therapy. The akinetic-rigid form of the disease was more frequent in this group as well. A significant part of younger patients are chacarterised not only with motor but with cognitive function disturbance, too. Determination of the latency of P 300 wave helps to select these patients and to choose the adequat therapy. ]
Lege Artis Medicinae
APRIL 29, 1992
[Monitoring the immunophenotype of mononuclear cells in the cerebrospinal fluid acute lymphoid leukemia patients]
[Cerebrospinal fluid and blood samples were drawn at scheduled intervals from recently diagnosed or recurrent acut lymphoid leukaemia patients undergoing combined cytostatic therapy. The immunophenotype of mononuclear cells, separated from the samples, was determined and compared. It was found that the number of non-pathological mononuclear cells increased from time to time during the intense treatment period of ALL patients with high malignancy or recur rence and that their phenotype was similar to the actual surface markers of peripheral lymphocytes. According to findings in the literature based on monitoring other parameters, this phenomenon may be due to the increased permeability of the blood brain barrier, injured by intense chemotherapy and radiotherapy, or to reactive cell proliferation. ]
Lege Artis Medicinae
APRIL 29, 1992
[Congenital osteogenesis associated with arteriopathy calcificans infantum]
[A 25-year-old mother was treated with clomifen (Clostilbegyt) during her pregnancy by accident. Ultrasound scan - performed at the 32nd gestational week – showed polyhydramnion and abnormally short, deformed fetal limbs. The newborn male infant died 20 minutes after cesarean section. Autopsy revealed osteogenesis imperfecta accompanied by a rare vessel alteration, arteriopathia calcificans infantum. The possible connection between the two diseases and the estrogen therapy is discussed. ]
Lege Artis Medicinae
APRIL 29, 1992
[Ultrasound examination of the hip]
[Sonography is coming to the forefront in musculoskeletal diagnosis complementing other imaging modalities. This field began to develop with ultrasound examination of the hip. We examined cases in three different age groups. In infants, various degrees of hip dysplasia were assessed. In small children, ultrasound assisted in diagnosing the cause of hip pain. In adults, ultrasound proved to be useful in differentiating inta- and extraarticular pathological processes. Our results demonstrate that, with experience, hip ultrasound examinations can be carried out with considerable accuracy. ]
Lege Artis Medicinae
APRIL 29, 1992
[Haptoglobin polymorphism in hungary]
[ Haptoglobin phenotyping, in used for the past 40 years, retains its timeliness. In this paper, the authors present the results of investigations both present and previous in this field. Using the method of Smithies (1), 2609 blood samples collected from every Hungarian county were tested with starch gel electrophoresis. The results of the nation-wide haptoglobin phenotyping indicate that the mean values of the haptoglobin phenotype frequencies in different parts of the country correspond to the results of a previous study in which only Budapest inhabitants were investigated. At the same time, a significant difference was found in the haptoglobin phenotype frequency and distribution of people living in the Western and Eastern parts of Hungary. A lower Hp frequency was observed in the inhabitans of the Eastern part of Hungary as compared to those living in the Western part. An exceptions to this observation was seen in the case of Veszprém and Baranya counties where the Hp frequency was lower than expected. Studies of the different genetic markers indicate that in greater geographical areas (e. g. Bodrogköz), gene frequencies are kept stable from generation to generation. The same is true for the ratio of the Hp1 and Hp2 genes which determine the frequency of haptoglobine phenotypes. Consequently the latter gene can be used to the reconstruct the ethnical history of Hungarian people.]
Lege Artis Medicinae
APRIL 29, 1992
[Gastrostomy Laparoscopes]
[Various pathological conditions can prevent patients from feeding orally, even with a functioning gastrointestinal tract. Enteral feeding is better, safer and cheaper than parenteral feeding for long-term feeding of such compromised patients. One way of providing long-term enteral feeding is to use a nasogastric tube, which a significant proportion of patients cannot tolerate for long periods because of its irritating effect. Another option is surgical gastrostomy, but the surgical complication rate is very high (6-56%). A new option for enteral feeding is the continence gastrostomy on the one hand, and the percutaneous endoscopic gastrostomy on the other, which reduces the chance of complications. In the case of obstructive laesions of the upper alimentary tract, the gastroscopic technique cannot be used and a laparoscopic gastrostomy can be performed instead. ]
Lege Artis Medicinae
APRIL 29, 1992
[The importance of dementia screening in clinical practice ]
[Dementia is one of the biggest public health problems of our time. The number of people who need care is very high: it is generally accepted, for example, that the prevalence rate is only 10% in the 65 and over age group. The aim of the present summary is to present the (differential) diagnostic rationale and to outline correctly the various testing procedures in modern diagnostics, and to review the practical implications for the general practitioner.]
Lege Artis Medicinae
APRIL 29, 1992
[The issue of secondary prevention and screening]
[The evolution of morbidity and mortality rates has highlighted the major epidemiological shift of the second half of the 20th century, with the predominance of chronic non-communicable diseases in civilised countries. These diseases now have very different characteristics from the acute, inflammatory and often infectious diseases that had previously predominated.]
Lege Artis Medicinae
APRIL 29, 1992
["De summa scholarum necessitate"]
[Indeed, the words of János Csere Apáczai, spoken more than three hundred years ago, seem to echo the problems of our present day! Beyond space and time, it is perhaps worth reflecting on his noble thoughts, delivered with a noble eloquence and soaring eloquence! ]
Lege Artis Medicinae
APRIL 29, 1992
[Card again and still]
[The correspondent has vowed to stop bothering his readers with further rounds of debates on insurance cards. He got into trouble when representatives of the Hungarian Medical Chamber asked Deputy State Secretary Bertalan Andréka about rumours of a change in the form and distribution of the cards, which had already become accepted, before a parliamentary committee. At the time, the ministry official dismissed the rumours as unfounded, although he did not rule out the possibility that the society's insurance managers might want to put forward new ideas to the management meeting. This was two weeks after the planned introduction date of 1 January.]
Lege Artis Medicinae
APRIL 29, 1992
Lege Artis Medicinae
APRIL 29, 1992
[The recently founded]
[The Professional College of Health Informatics was recently established, chaired by Dr István Bordás, Director of the Information Centre for Health Care at the Ministry of Public Welfare, and we asked him to present the work of the College. ]
Lege Artis Medicinae
APRIL 29, 1992
[Health workplan and programme]
[The 1992 Work Plan of the College of Health Informatics; The Programme of the LIGA Health Alliance]
Lege Artis Medicinae
APRIL 29, 1992
[Medical ethics issues in the province of Ontario, Canada]
[The invitation to the University of Toronto gave me the opportunity to study the Canadian health care system, the doctor-patient relationship, and the teaching and research programme of the University's Institute of Bioethics inspired me to learn about some of the current medical issues in Canadian culture. ]
Lege Artis Medicinae
APRIL 29, 1992
[Health care institutions in ancient Hellas]
[The origins of the cult of Asclepius, the "Asclepeia" as a healing institution; The organizational framework of healing, the staff, the way of healing; The question of donation; Employed physicians; The way of holding the office of city doctor; Remuneration; Privileges; The duties and obligations of physicians; The scenes of healing; The hierarchy of "specialization" of physicians and their organizations; ]
Lege Artis Medicinae
APRIL 29, 1992
[Hospital internships in Madrid]
[I spent one month of my sixth year of paediatrics training in a hospital in Madrid, with the help of HuMSIRC. I think it is worthwhile to share my sometimes surprising, sometimes moving and sometimes inspiring experiences of Spain being 'different' , or of the identities that exist, in comparison with the hospitals I have visited in my own country, in order to encourage those who are planning to travel or those who want to make a change at home. ]
Lege Artis Medicinae
APRIL 29, 1992
[Fine Art Column]
["As long as you are alive among the living..." In the Iliad we read: '... for he who is a physician is worth as many, if he has to cut out an arrow and administer medicine' (translated by G. Devecseri) From the Homeric epic we know the names of two physicians in the Achaean army....]
Lege Artis Medicinae
APRIL 29, 1992
[About books]
[A review of the book written by: Heinz Schepank:" On the rates of psychogenic disorders"]
1.
Clinical Neuroscience
[Headache registry in Szeged: Experiences regarding to migraine patients]
21. MAY
2.
Clinical Neuroscience
[The new target population of stroke awareness campaign: Kindergarten students ]
21. MAY
3.
Clinical Neuroscience
Is there any difference in mortality rates of atrial fibrillation detected before or after ischemic stroke?
27. NOV
4.
Clinical Neuroscience
Factors influencing the level of stigma in Parkinson’s disease in western Turkey
27. SEP
5.
Clinical Neuroscience
[The effects of demographic and clinical factors on the severity of poststroke aphasia]
18. JUL
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