Lege Artis Medicinae - 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Cephalosporins in the nineties]

GRABER Hedvig

[The cephalosporin group is the largest and most widely used family of antibiotics in the nineties. According to their antimicrobial activity, the cephalosporin derivatives are classified as three generations; in Hungary seven parenteral and three oral compounds are available, while some newer ones are under registration. The chemistry and antimicrobial spectra of the cephalosporins are presented, as well as the main problems of bacterial resistance. Pharmacokinetics, adverse effects, and clinical indications of the individual compounds are discussed. The importance of critical use is emphasized.]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Regionally Organized Cardiac Key European Trial]

MATOS Lajos

[Nisoldipine reduced ST-segment depression and the frequency of silent ischaemic periods compared with placebo, but this did not reach the level of statistical significance. The active agent did not affect the diurnal distribution of ischaemic signs and did not improve exercise capacity.]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[New trends in the nonpharmacological therapy of atrial fibrillation]

KEMPLER Pál, LITTMANN László

[Atrial fibrillation is the most common of all sustained cardiac arrhythmias, and it is often resistant to medical therapy. This paper summarizes ourcurrent understanding of the pathophysiology of atrial fibrillation, surveys the factors which have led to the development of nonpharmacologic therapy, and describes the advantages and disadvantages of these procedures. Potential new research directions are presented. ]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[International Nifedipine Trial on Antiatherosclerotic Therapy]

MATOS Lajos

[ The coronarograms showed that neither the number nor the extent of atherosclerotic lesions observed in the first study changed appreciably over three years in either the nifedipine or placebo group. However, the incidence of new lesions was significantly lower in the active drug group than in the placebo group (0.59 vs 0.82/patient; -28%). Side effects were significantly more frequent in patients taking nifedipine (55/173) than in the placebo group (16/175; p<0.03).]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Acute porphyrias]

TASNÁDI Gyöngyi, NAGY László

[Acute porphyrias - acute intermittent porphyria, variegate porphyria, hereditary coproporphyria and plumboporphyria – are due to lowered activity of the enzymes of the heme biosynthesis. All of them are inherited as autosomal dominants. From the pathobiochemical and clinical points of view there are 4 phases of the disease: genetic phase, compensated latent and decompensated latent phases and the generally life-threatening acute at tack. The clinical symptoms are caused by peripheral and autonomic neuropathy, which are primarily induced by various precipitating factors: in part by endogenous hormones but mainly by drugs, alcohol and severe infections. The diagnosis is based on measurement of the activities of the enzymes and porphyrins and their precursors in urine and feces. The therapy includes the use of glucose infusions administered in large doses and haematin. However the most effective mode of treatment is to prevent the acute syndrome. It is crucial to recognize the disease in the earliest (genetic) phase because in this way it is possible to avoid inducing factors. 91 patients are under permanent control and care by the authors, but there are many more patients in Hungary according to European estimates. Discovery of these patients would serve prevention.]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Treatment of gallstones]

[Recommendation of the Hungarian Gastroenterological Society; Gallstone disease is the most common cause of gallbladder and biliary tract diseases. It occurs in about 10% of the adult population and its prevalence increases with age, with around 10% of men and 20% of women suffering from gallstones around the age of 50.]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[New method for the evaluation of transiently evoked otoacoustic emission on premature neonates]

BÜKI Béla, RIBÁRI Ottó, KATONA Gábor, PYTEL József

[Otoacoustic emission is sound energy evoked during the process of hearing and escaping the inner ear. Since it is only present when hearing is normal it can be used as an objective hearing-test. The authors examined the prognostic value of a new parameter, the duration of the emission, in the screening examination of premature neonates. Otoacoustic emission was measured in 14 premature neonates by the ILO88 (Otodynamics, England). The data were analyzed off-line by a software developed by the authors: duration of the emission was determined by a moving time-window correlation analysis. Hearing threshold was verified by auditory brainstem response audiometry (ABR). In 22 ears emission could be detected. In 4 ears the correlation was lower than 60%, but the duration of the emission was over 6.5 ms, and hearing was normal, according to the results of ABR. A new parameter, the duration of the emission, is suggested for the evaluation of transient otoacoustic emission.]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Intracerebral cavernous angioma with symptoms of transistent ischaemic attack]

FOLYOVICH András, RÓZSA Csilla, KENÉZ József, HORVÁTH Gyula

[The authors present a case study of a patient examined because of intracerebral hemorrhage caused by a cavernous angioma (cavernoma). The clinical picture began with symptoms of transient ischaemic attack (TIA). The diagnostic difficulties and the question of surgical treatment of this relatively rarely diagnosed, although generally benign disease are presented. A short review of literature is given showing the different opinions concerning the doubts of surgical treatment. This report supports the demand, stressed for a long time, that clinical investigation must be started immediately after the first symptoms of TIA. Aspirin (ASA) treatment, which is absolutely necessary, is indicated after CT scan has excluded haemorrhage. ]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Gastric mesenchymal tumour?]

VASS Péter, LUSZTIG Gábor

[Department of Internal Medicine (Dr. Márta Cseh): 76-year-old female patient with history of cataract surgery and ischialgia. She had lost 10 kg in two months prior to her admission to the hospital, and had become anorexic, weak and fatigued. She was admitted because of sudden onset of right arm weakness, numbness and increasing speech difficulties. ]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Overspecialisation in domestic health care]

BODA Domonkos

[Among my notes is the proceedings of a more than 10-year-long consultation on the evils of specialisation. At a time when proposals are being made from many quarters to reform the specialist medical system, it is worth quoting verbatim from some of the above discussion papers. First, however, we must face the question: how can specialisation be challenged at all? Indeed, there is an almost universal view in the medical community that specialisation is necessarily to be welcomed, saying that it is the only way to keep up with science 'today'. The first concern of new graduates is to decide what kind of doctor they want to be, and this is something that students entering university already consider at the beginning of their studies. This seems to be the main objective of continuing training and individual professional development, which in many areas is recognised and confirmed by the authorities. ]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Family therapy, a therapeutic paradox? Part II]

KURIMAY Tamás

[The author provides an overview of theories and practice of family therapy based on national and international literature and experience. He describes the organisational structure of family therapy and its application in medical practice. ]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Application of the "homogeneous disease groups" patient classification system in hospital care analysis]

BOJÁN Ferenc, BELICZA Éva

[I. Length of care and hospital performance; Modern hospital management in market-based and financed health systems and financing is based on a patient classification that expresses the performance value of care cases. Currently, the classification system that best meets this need is the system of "homogeneous disease groups (HBCs)", known in the English literature as "Diagnosis Related Groups (DRGs)".]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[We believed, we knew - we did not believe, we did not know]

FRENKL Róbert

[If we hadn't started our own ordeal - in terms of the exhilarating agonies of starting and editing a newspaper - together with the Hungarian society, which had entered a new phase of its history, with the initial - now protracted - pains of the new socio-political system, then after two years, it might not be necessary and appropriate to reflect and share our experiences with the public. But in historical times, everything is different. Two years can be an epoch. And, like a drop in the ocean, the history of a new medical journal reflects, alongside its obvious peculiarities, the general: the many conflicts of transformation. ]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Looking back - 1991]

LÁSZLÓ András

[It is coincidental, but not without lessons to be learned, that the Parliament debated in parallel the bill on the implementation of the 1991 state budget of the Republic of Hungary and the parliamentary resolution on the 1993 central budget guidelines and the main issues of budgetary policy. (The paragraphs on health and social security in the latter were published in the September supplement to the LAM, while the fate of the parliamentary resolution was reported in the October issue of the LAM.) The economic and political lessons are there, but it is not our place to go into them. We will therefore take a look at the people's welfare chapter of the 'final accounts' on the implementation of the budget, and then turn to the politician who has criticised the opposition.]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[They still work with Szentgyörgyi's instruments]

KRASZNAI Éva

[Veronika Ádám, Professor at the Institute of Biochemistry at Semmelweis University of Medical Sciences, began her report on the situation of the theoretical institutes with a wailing cry at a meeting of the Parliament's Committee on Social, Family and Health Affairs. He desperately complained that specialists from Hungarian universities, including the four medical universities, were emigrating beyond our borders. It is precisely the best ones, who are by far the most satisfied with their employers there, because they have received high-quality training at home. But that standard is no longer sustainable. There is virtually no replacement for teachers: salaries are low, research opportunities are limited. Teachers are trying - not without success - to find work abroad. The situation is no better in terms of teaching resources. ]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[It is hard to be left standing]

LÁSZLÓ András

[György Lazáry was the chairman of the organising committee of the National Conference of Healthcare Entrepreneurs held in Szombathely. His great work was praised by the speakers and rewarded with applause by the participants at the closing ceremony of the conference. He came to Szombathely from Hatvan, where he worked as a surgeon and later as a paediatric surgeon at the Markusovszky Hospital. In his private practice, instead of outpatient care, he can only do diagnostics, as his services are not reimbursed by social insurance. He is the president of the Vas County Association of Private Practice Doctors and secretary of the county branch of the Hungarian Medical Chamber. ]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[An independent discipline; On medical philosophy]

ERDŐS István, MEZEI Judit, NEMES István

[At the end of 1991, a group of philosophers working at SOTE began to map the international literature of medical philosophy, as it became clear that this new discipline, which had been in existence for barely two decades, was playing an increasingly important role in international academia. The link between philosophy and medicine goes back much further, of course, as neither philosophers interested in the life sciences nor philosophising doctors are absent from the history of culture.]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[Children's toys]

NÉMETH István

[Pieter Brueghel the Elder (1525/28-1569), also known as 'Peasant Brueghel', was a pioneer in the history of both landscape and life painting, which became a genre in its own right in the 16th century. His art, rooted in the Christian humanist spirit of his time, but with many innovations in form and content, represents a transition between Hieronymus Bosch and the Dutch realists of the 17th century.]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[About books]

MATOS Lajos

[A review of the book : "Full overview of our body structure and how it works"]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[A monastery medicine]

KAPRONCZAY Károly

[At a time when churches today are looking for ways of fulfilling their old tasks, reviving institutions that were banned in 1950 in the fields of education, health and care for the destitute, it is time to recall the roots.]

HUN 1992;2(12)

Lege Artis Medicinae

DECEMBER 23, 1992

[What is public health]

AJKAY Zoltán

[On the professional experience of the Debrecen "Consensus Conference" (21-22 X. 1992) ]

HUN 1992;2(12)