Lege Artis Medicinae - 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

["Timely mental health issues, tasks"]

SOMOGYI György

[The meeting, held in the auditorium of the Metropolitan Institute of the State Public Health and Veterinary Service on 14 December 1992, starting at 14.30, was opened by Dr. Sándor Kocsis, Deputy Chief Medical Officer of the Metropolitan Institute, who welcomed the participants from external bodies, institutions, district institutes and the Metropolitan Institute. The meeting was chaired by Dr. György Somosi, Head of Department, Secretary of the Red Cross Organisation of the Institute. In his introductory speech, Dr. Béla Buda dealt with the issues of the international and domestic development of mental health care, its scope of activities, tasks and changes in the perception of the field. He emphasized that the role of mental health and mental health education is growing worldwide. In addition to biological factors in the development, course and prevention of various diseases, the recognition and awareness of psychological causes is gaining ground. The worldwide and, unfortunately, domestic spread of various addictions (alcohol, drugs), which are harmful to health, and the increasing forms of deviant behaviour are also increasing the tasks of mental health. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Antiphospholipid syndrome]

GERGELY Péter

[Antiphospholipid syndrome is a recently recognized clinical entity characterized by the presence of deep vein and cerebral thrombosis, thrombocytopenia and recurrent fetal loss. The syndrome is caused by autoantibodies directed against phospholipid antigens. The clinical syndrome is most frequently associated with systemic lupus erythematosus.]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Intraoperative ultrasonography during laparoscopic cholecystectiomia ]

ANTAL András, SCHMIDT Pál, TAKÁCS Judit, HADIJEV Janaki

[Our preliminary experience with intraoperative ultrasonography during laparoscopic cholecystectomy is presented. The importance of intraoperative diagnostic procedures in biliary surgery such as cholangiography and operativ ultrasonography are discussed.]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Xamoterol in severe heart failure]

MATOS Lajos

[The two groups did not differ from each other in terms of improvement in clinical symptoms. Using a visual analogue scale and the Likart questionnaire, breathlessness appeared to be relieved with the active agent, but the duration of exertion or exercise capacity was found to be the same. Exercise-induced tachycardia and blood pressure elevation were attenuated with xamoterol (p < 0.01). The drug showed no arrhythmogenic effect. At 100 days after randomisation, 32 patients in the xamoterol group (9.1%) had died, compared with 6 (3.7%; p=0.02) of those treated with placebo.]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Alcohol induced organ and tissue injury]

BÉLY Miklós

[The patho-histological characteristics of alcohol induced acute and chronic organ and tissue injuries were reviewed. Neuropathy and brain lesions, gastrointestinal tract in alcoholism, alcoholic liver disease, pancreatitis, cardiomyopathy, aseptic bone necrosis, rhabdomyolysis were discussed based on the literature. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Oral precancerous lesions and conditions]

DOMBI Csaba, CZEGLÉDY Ágota, BÁNÓCZY Jolán

[Each year tumours, including oral cancers, result in more and more deaths in Hungary. The oral cavity has a special position, because the precancerous lesions and conditions which occur in it can be detected by simple procedures. The authors use the latest definitions and disease classifications approved by WHO, to systematize the essential knowledge for the early diagnosis of the most frequent precance roses in Hungary, taking into consideration aspects of clinical morphology, epidemiology, localizational frequency, the risk/level of the tumour and the main principles of treatment. In addition to a detailed description of leukoplakia, erythroplakia, smoker's palate, actinic cheilitis, lichen and sideropenic anaemia, cheilitis glandularis, cornu cutaneum, naevus pigmentosus, discoid lupus erythematosus, submucosus fibrosis, xeroderma pigmentosum and tertiery syphilis are also mentioned. The purpose of the review is to call attention to the fact, that, due to the significant increase in mortality caused by oral tumours, the early diagnostic activity of dentists should be supported by the awareness of general practitioners and a national stomatooncological screening network should be established. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Common stand]

[Resolution of the Board of the Scientific Society for Public Health on tobacco advertising.]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[The use of verapamil in paediatric cardiology]

BUZÁS Emil

[Experience with verapamil, a calcium antagonist drug, in three disorders of paediatric cardiology has been described. The differences concerning the clinical features and drug effect between children, adolescents and adults are underlined. Most of the attention has been paid to paroxysmal supraventricular tachycardia since verapamil is very effective in this dangerous type of attack. The author's own experience based on one county's material confirms its decisive role. The use of verapamil in hypertrophic cardiomyopathy and arterial hypertension is also discussed. In addition, suggestions are made for the use of verapamil in perinatology. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Beyond the limits: the relationship between general medical practice and naturopathy]

PATRICK C Pietroni

[Traditional medical relationships are "designed" to operate under stable, unchanging conditions. It is clear that the next five years will be neither stable nor unchanging in primary care and public health. For the first time, GPs will be working within a managed health network and the former autonomy that defined their administrative practice will soon disappear. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[DEFIANT]

MATOS Lajos

[The mean baseline left ventricular ejection fraction was 41%. The active agent increased early diastolic peak velocity by 0.06 ms at the mitral valve tip. The time-velocity integral increased by 1.2 cm. These indicate that early diastolic flow across the mitral valve is increased. An important factor appeared to be the decreased isovolumic relaxation time, which was shortened by 14.7 ms, whereas neither heart rate, blood pressure nor minute volume changed, so that a reduction in afterload could not play a role in the differences. During exercise, the nisoldipine group's power output increased by 12 W. These results suggest that nisoldipine-CC improves diastolic ventricular function and exercise performance in the study group. The effect is either due to the anti-ischaemic property of the drug or indicates an improvement in myocardial relaxation. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Immunohistochemical examination of the TGF-a and TNF-a content of breast cancer tissues and its prognostic relevance]

BEBŐK Zsuzsa, NÉMETH Péter, MÁRKUS Béla, BRITTIG Ferenc

[ The tumour-biological roles of different growth factors and cytotoxic cytokines have been intensively studied. Expression of TGF-a and TNF-a was investigated in breast cancers using monoclonal anti-TGF-a and anti-TNF-a antibodies produced previously by our laboratory. Retrospective analysis was performed in 35 histopathological specimens of breast cancer patients clinically worked up and observed during 4-5 years after the surgical treatment. Correlations were analysed between TGF-a and TNF-a positivity and the TNM score, lymphnode metastases and the survival time of the patients. Corresponding to our previous experiments, anti-TGF-a and anti-TNF-a monoclonal antibodies are relevant both in native (cryostat) and routine formol-paraffin histological sections. According to the results of our retrospective study, TGF-a positive cases had a worse clinical prognosis, however, the TNF-a positive or double positive cases showed a better clinical prognosis during the long term observation. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[The role of non-operative treatment in esophageal performations]

ALTORJAN Áron, KISS János, VÖRÖS Atilla, BOHÁK Ágnes

[The authors give an account of their experience with the non-operative management of the esophageal perforations. Non-operative therapy implies that the patient receives nothing by mouth for a minimum period of 7 days – and that broadspectral antimicrobial therapy and intravenous hyperalimentation are prescribed. No direct attempt is made to close the esophageal injury. The authors have established criteria for the non-operative management of esophageal perforations. They warn that failure to show signs of improvement within 24 hours of non-operative therapy should prompt a consideration for operative intervention. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Troubles of the masticatory system among inpatients with locomotor diseases]

FARKASFALVI Mária

[The survey examined the deviations of the masticatory system among 550 inpatients with locomotor diseases in the National Institute of Rheumatology and Physiotherapy. The system consisting of eleven parameters demonstrated that 468 patients (85%) suffered of dysfuction. The volume of the functional disturbance was demonstrated by the increase of the points. The temporomandibular dysfunction is a special illness of the locomotor disease originating from the deviations of position as well as the movement of the skull and the jaw. The symptoms of the functional disturbance result from the unsuccessful correcting efforts of the organism to improve the static and movemental deviations of the masticatory system.]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Rogers' person-centred psychotherapy]

PINTÉR Gábor

[Person-centred-therapy is the central pillar of humanistic psychology, the "third force" in psychology, alongside psychoanalysis and behaviourism. Some authors classify it as one of the 'dynamic tendencies' (1), referring to its roots in psychoanalysis. However, it is just as much its opposite. Today, it is most appropriately considered to be one of the so-called phenomenological (experiential) tendencies. Their main feature is that they see behaviour change as possible through the mediation of changes in the person's perception, since they believe that the main determinant of behaviour is the individual's perceptual system. These include, for example, Berne's Transactional Analysis, Perls' Gestalt therapy and the cognitive orientations, in addition to Rogers.]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Ownership and efficiency in transforming outpatient care]

DONÁTH Ferenc

[A fundamental question of how changes in health care today and in the future will affect the health of the population. To answer this question, we can look at the effectiveness of health care institutions with different characteristics. This paper does not draw lessons, but seeks to draw on the knowledge gained in the past system to provide a direction for continuing the changes already underway. The conclusions relate primarily to institutions and conditions in Budapest and in large cities. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[The link between environment and health]

KISS Róbert

[We often hear that environmental protection is preventive health protection, but I think it is more than that. It's more than that, because it protects not only human health but the whole system - the environment - in which humans exist. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[The situation of health insurance at the end of 1992]

ANDRÁS László

[The current practice in Hungary is to provide health insurance services under the social security system, which includes pension insurance. This is despite the fact that the separation of funds and services was already provided for by a parliamentary resolution and later by law. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Reform or funding change?]

ANDRÁS László

[László Székelyhidi, MDF keynote speaker: ... I have to speak separately about the changes planned in health care from 1 July 1993, the continuation of the reform, the extension of performance funding. The first steps will be taken to introduce task financing methods applicable to specialised care, as well as normative hospital financing. Legal and technical preparations are underway in inpatient and outpatient specialised care, although a number of consultations are still needed to finalise the financing arrangements. The group believes that the Ministry of Public Welfare and the OTF should speed up work in this area, as the mistakes made in the reform of primary care could serve as a lesson. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

["The mandarin paid as long as he was healthy"]

KRASZNAI Éva

[With the changes in economic life - the break-up of large companies, privatisation, job losses, etc. - it seems that the health care systems of the former large companies, which were and are still working in the medical practices of the former large companies, are in a difficult situation. Now that the practices have been preserved and, like the straw that broke the camel's back, their equipment has not been dismantled. Already where there are still doctors and the assistants who serve them. The situation on the occupational health - or, as it is now called, occupational health - front is desperate. This is an area in which, until now, there has been no legislative re-regulation. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Advertising for a medical practice]

LOTZ Károly

[Interpellation of Dr. Károly Lotz (SZDSZ):The former Csepel Iron and Metal Works Trust decided to build a medical clinic for its employees in the early 1970s, which was handed over as one of the most modern clinics in the capital on 20 August 1978. As the construction costs exceeded the Trust's capacity, the Ministry of Health contributed HUF 15 million to the construction costs at the time - an estimated HUF 200 million today. This was then one third of the total cost of construction. ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Everyday talk, therapeutic conversation]

LŐRINCZ László

[Natural language, as we speak it every day, "simply serves life", writes Bally. "It drives speech in the service of action. There is persuasion, request, command, defence." The twists and turns of everyday speech show that to be expressive, to influence the other, "language must incessantly distort concepts, place them in a different tonality." It is illogical, for example, to say: run like the wind. Pleonasm: I saw it with my own eyes. We can say the opposite of what we think: "don't bother yourself." Bally goes on to say, "Where language does not provide the speaking individual with adequate means of expression for the form of thought, the pronunciation, the gesture, the facial expression, make up for the deficiency. One cannot name something without putting into it a minimum of expressivity, if not otherwise, by the way one pronounces its name" (1). ]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Healing and helping saints in art]

KOVÁCS Zoltán

[People have prayed to the saints since the Middle Ages, in the midst of the various difficulties of their lives, but a particular group of saints have been particularly revered. The cult of the saints known as the "fourteen helpers" originated in southern Germany sometime in the 14th century and spread to other parts of Europe in the following centuries. What these saints have in common is that before they died, they all asked and received the grace from God to intercede for those who prayed to them. The cult, which originated in the Rhineland, gradually spread to other parts of Germany, Sweden and even Hungary.]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Ethics in epidemiology]

JENEI Ilona

[Do epidemiologists need a code of ethics? This was the question discussed at the Industrial Epidemiology Forum Conference, which brought together bioethicists, epidemiologists and industry professionals to discuss the current state of epidemiology in the United States from an ethical perspective and to develop a draft professional code of ethics (1).]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Clinical manual]

[A Hungarian translation of a very useful textbook was published at the end of last year. The original was published in German and edited by three young doctors from the Medical University of Lübeck. The authors of the Springer Hungarica handbook have set the following as their aim:]

HUN 1993;3(02)

Lege Artis Medicinae

FEBRUARY 24, 1993

[Contributions to the development of domestic industrial health]

KAPRONCZAY Károly

[One of the important tasks of Hungarian historical research is to trace the development of Hungarian labour and industrial health care, to identify certain periods and to explore their interrelations. The European history of this field also requires considerable effort, since the organisation of industrial health care can look back on a history of barely a hundred years and medical research only began in the mid-19th century. The link between medical and legal issues relating to accident and sickness insurance for industrial workers is also a pressing factor, since it was in the second half of the last century that the industrialised countries began to have laws and institutions of this kind.]

HUN 1993;3(02)