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Lege Artis Medicinae - 1993;3(07)
Content
Lege Artis Medicinae
JULY 28, 1993
[Features of chronic alcoholic liver and pancreatic diseases]
[The most common organ pathologies caused by alcohol abuse are chronic liver disorders and chronic pancreatitis. The incidence of these diseases has not yet been fully established but both are considered to be widespread in Hungary. Since there are forms which frequently occur without symptoms, clinicians might have difficulties in recognizing them. The diagnosis should be based on the results of laboratory screening tests and the findings of the physical examination. A variety of specific and functional tests should be performed. Morphologic damage of the organ can be assessed by analysing the tissuesample obtained by biopsy. In the course of the disease progression, well characterised clinical entities (syndromes) develop. Features of the most advanced stage are as follows: fibrosis of the gland causing functional insufficiency which manifests itself in marked laboratory and clinical alterations.]
Lege Artis Medicinae
JULY 28, 1993
[Bronchological possibilities to treat the main airway stenosis]
[The review summerizes the recent broncholo gical possibilities to treat the main airway stenosis. The most of the patient have inoperable central endobronchial or endotracheal tumor. However these methods are of considerable palliativ value for recanalization of the main airway and these way for amelioration of the quality of life. The three methods: the LASER phototherapy, the afterloading irradiation and the stent implantation can be available yet in Hungary. ]
Lege Artis Medicinae
JULY 28, 1993
[Antineutrophil cytoplasmic autoantibodies and their pathogenic and diagnostic role in different diseases]
[Antineutrophil cytoplasmic autoantibodies (ANCAs) are found in the circulation of patients with systemic vasculitic syndromes, including Wegener's granulomatosis, polyarteritis nodosa, Churg-Strauss syndrome, and other disorders within the spectrum of autoimmune diseases. ANCAs have specificity for different proteins in the cytoplasmic granules of neutrophils. Two major patterns of ANCA staining are observed by indirect immunofluorescence as say: cytoplasmic (C-ANCA) and perinuclear (P-ANCA). There is in vitro evidence that antineutrophil cytoplasmic autoantibodies are directly involved in the pathogenesis of antineutrophil cytoplasmic autoantibody-as sociated vasculitides. Antineutrophil cytoplasmic autoantibody titers may be useful in modulating treatment regimens.]
Lege Artis Medicinae
JULY 28, 1993
[Cutaneous symptoms and reactive arthritis in giardia lamblia infection]
[ The authors discuss reactive arthritis and cutaneous symptoms as two infrequent complications of giardiasis. The incidence of reactive arthritis and cutaneous symptoms in 569 patients with giardiasis with simultaneous characte risticbiliary and gastrointestinal manifestation was investigated. In the majority of cases, parasitic infection was detected from fresh (warm) bile or, in a smaller proportion of patients, from fresh stool. Nine patients presented with reactive arthritis, 59 with chronic urticaria, 17 with rosacea, 8 with prurigo nodularis, and 2 with erythema nodosum. In all cases, initial therapy consisted of metroni dazol (Klion), using a daily dose of 0.75-1.5 g for 10–15 days. Only those patients whose symptoms were eliminated or substantially diminished and whose duodenal aspirate and stool was devoid of the parasite one month following treatment were considered cured. Sixty seven patients remained Giardia positive after metronidazol treatment. A detailed description of the curative therapeutic combinations in the cases of 64 patients is presented in the paper. Despite repetitive and combination therapy, three patients remained Giardia positive and continued to present with the symptoms of the parasitic disease. The authors emphasize that in patients having cutaneous allergic symptoms, reactive arthritis, or erythema nodosum with simultaneous gastrointestinal symptoms (even of the gastroin testinal symptoms are mild or absent), biliary or gastrointestinal Giardia infection must be considered. ]
Lege Artis Medicinae
JULY 28, 1993
[Color doppler imaging of the eye and orbit]
[Color Doppler Imaging (CDI) has added new dimension to orbital sonography. The indications of this method are basically the vascular and neoplastic diseases of the eye and orbit. After demonstrating the scan technique and normal findings the authors present some pathologic entities, such as reversed flow in ophthalmic artery as a result of occlusion of the internal carotid artery, lack of blood flow in central retinal artery in another ocular ischemic syndrome and the blood flow within a choroidal melanoma. The authors' experience reveals that CDI with pulsed Doppler spectral analysis is a promising new technique for the evaluation of vascular structures of the normal orbit as well as ocular and orbital vascular pathology.]
Lege Artis Medicinae
JULY 28, 1993
[Cooperative new scandinavian enalapril survival study]
[Mortality at the end of the 6th month of treatment was not different in the active versus placebo group (11% vs 9.9%). Irreversible circulatory failure led to death in 4.3% of the enalapril group; the same was 3.4% in the placebo group.]
Lege Artis Medicinae
JULY 28, 1993
[What can we expect from the health reform?]
[As soon as the new tasks - coding, identification of sender, receiver and patient, DRG scores, self intervention scoring system, its monthly changes, marking as belonging to others and "us", splitting of outpatient and inpatient departments, etc., along with the application, invention and introduction of new methods of patient care and new methods - allow my thoughts turn to the goals of health care reform, the search for its essence, its expected effects, its cost/benefit ratios. Especially as these changes are now on the doorstep. ]
Lege Artis Medicinae
JULY 28, 1993
[Survival and ventricular enlargement trial]
[Mortality was significantly reduced in the captopril group (228 deaths, 20%) compared with placebo (275 deaths, 25%). In the captopril-treated group, both fatal and non-fatal cardiovascular events were significantly less frequent: the risk of cardiovascular death was reduced by 21%, the risk of severe circulatory failure was reduced by 37% (p < 0.001), and the risk of reinfarction was reduced by 25% (p < 0.015)]
Lege Artis Medicinae
JULY 28, 1993
[Evaluation of the effect of flunisolide nasal spray with rhinomanometry in allergic rhinitis]
[INTRODUCTION – The authors report their results with flunisolide nasal spray in the treatment of allergic rhinitis. PATIENTS AND METHODS – 36 patients suffering from perennial and 38 ones suffering from seasonal allergic rhinitis were examined. The effect of the nasal spray was evaluated with the comparison of subjective complaint changes to the data received by rhinoscopic examination of the nasal mucosa and to the changes in rhinomanometric examination data. CONCLUSION – Treatment with flunisolide nasal spray favourably affected the symptoms of seasonal and perennial allergic rhinitis. The improving status of patients showed a fairly good correlation with data gained with rhino manometric tests. ]
Lege Artis Medicinae
JULY 28, 1993
[Relapsing polychondritis]
[Relapsing polychondritis is an autoimmune disease of unknown etiology. According to the literature data, it primarily causes inflammation of the cartilaginous tissues, but it may effect other organs and is followed in most cases by complications. The prognosis of relapsing polychondritis is poor. The five year survival rate is 74 percent. Corticosteroids, immunosuppressive agents and recently cyclosporin A has been used in its treatment. Two cases are reported in the study, suggesting that a more benign form of the disease may exist than was expected on the basis of the literature data.]
Lege Artis Medicinae
JULY 28, 1993
[Organisation of hospital and clinical nursing education units]
[The basic objective of the domestic health care system is to broaden the scope and improve the quality of primary care activities. In this context, it is necessary to eliminate obsolete hospital beds and, as the economic situation allows, to raise the quality of hospital care. As this decade-long process of change also represents a fundamental shift in attitudes to health care, the role of nursing care is clearly changing, its tasks and responsibilities are expanding and the quality of care is coming to the fore.]
Lege Artis Medicinae
JULY 28, 1993
[Questions and answers about acupuncture An overview of modern research]
[There seems to be no other method in Western medical practice that has attracted as much publicity and created as much controversy in the last 20 years as the ancient acupuncture treatment. Although acupuncture has been a common, everyday practice for people in Asia for over 2,000 years, many in the Western world still regard it as something strange, exotic and mystical. The following article addresses the most common questions about acupuncture. Where does it come from? How does it work? What are its effects? ]
Lege Artis Medicinae
JULY 28, 1993
[Attempts at quality assurance in German hospital practice]
[The requirements for quality assurance measures are becoming more demanding, because who would want to be subject to criticism that the services they provide are not up to the quality expected. Thus, in 1986, the German Hospital Association (the body responsible for maintaining hospitals - the translator) concluded an agreement with the Federal Medical Association which provided for close cooperation between the two organisations in the development of quality assurance and the introduction of appropriate measures. ]
Lege Artis Medicinae
JULY 28, 1993
[An information system for primary care designed with funding aspects in mind]
[It is a truism that health care reform is a matter of urgency. The structure of the health system is unsustainable and its financial unsustainability is foreseeable. Thus, there are compelling reasons to think about reform from a funding perspective. In this respect, action has been taken first in the most underdeveloped area, primary care. ]
Lege Artis Medicinae
JULY 28, 1993
[Letter to my colleagues]
[It is with bewilderment, sometimes annoyance and growing unease that I watch the torrent of title and rank bias that is flooding our public life and infiltrating our academic life.]
Lege Artis Medicinae
JULY 28, 1993
[Comment on a letter]
[As chairman of the editorial board, I can testify that at one of our usual bi-weekly, often stormy meetings of the narrow circle responsible for the publication of LAM - the editor in charge, the columnists and the editor-in-chief - we were delighted to receive a letter from our co-editor, Dr Matos.]
Lege Artis Medicinae
JULY 28, 1993
[Entrepreneurial healthcare?]
["In October, when we were at the first conference of entrepreneurial doctors in Szombathely, the idea was planted in our minds, everyone was very enthusiastic and became convinced that entrepreneurship is worthwhile, and since then our doubts have become stronger" - said a female doctor in Nyíregyháza, summing up the mood of the recent conference. Just eight months have passed. The mood has certainly not changed because most of the participants are now from Eastern Hungary and not Western Hungary, or because, in the words of László Németh, "Europe is going eastwards". Since then, a few government decrees have been issued and a few government statements have been made, which have "sawed through" the intentions of business - as Csaba Huszár, Chairman of the MOK Legal and Economic Committee, put it succinctly.]
Lege Artis Medicinae
JULY 28, 1993
[Tooth extraction as a fairground amusement]
[Tooth extraction is not a completely painless medical procedure today, and was even less so in the 17th century. In the Dutch painter Gerard van Honthorst's 1628 portrait on our front cover, the patient's pain-warped face is a perfect illustration of the agony endured by anyone who would undertake such a torture.]
Lege Artis Medicinae
JULY 28, 1993
[About the 8th World Congress on Cervical Pathology and Colposcopy]
[The congresses of the International Federation for Cervical Pathology and Colposcopy (IFCPC) are held every 3 years. In May 1993, the 8th World Congress was held in Chicago. The congress, which was organized with great thoroughness and chaired by Professor George D. Wilbanks, was attended by approximately 1,000 participants. In addition to the pathology and treatment of cervical lesions, diseases of the uterine cavity, dystrophic and cancerous lesions of the vagina and vulva were discussed. The main topics were summarised by invited speakers. The summary presentations were accompanied by a number of presentations and posters presenting original material. Special emphasis was given to workshop programmes and video presentations. ]
Lege Artis Medicinae
JULY 28, 1993
[The principle of "informed consent" to medical interventions in modern medical ethics Part II]
[A patient who is of age and has capacity has the right to refuse any medical intervention or treatment. However, in Hungary, an exception to this rule is made for interventions necessary to prevent imminent danger to life, for which the patient's consent is not required. This exception is not generally recognised in the Anglo-Saxon legal system.]
Lege Artis Medicinae
JULY 28, 1993
Lege Artis Medicinae
JULY 28, 1993
[The beginnings of domestic medical instrument making]
[ The existing literature on the history of medical instruments in Hungary is almost entirely concerned with the Roman period, and not much has been published on the history of instruments in Hungary. It is not easy to shed light on the history of Hungarian medical instruments, since foreign products always tried to outsell domestic ones, which were obviously cheaper and better, so it is only natural that the user would choose a foreign product. ]
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