Lege Artis Medicinae - 1993;3(12)

Lege Artis Medicinae

DECEMBER 29, 1993

[The significance of vasodilator drugs and angiotensin converting enzyme inhibitors in the treatment of congestive heart failure]

JÁNOSI András

[The significance of angiotensin converting enzyme inhibitors in the treatment of congestive heart failure is outlined. The results of multicenter, randomized trials are summarized confirming the beneficial effect on survival of vasodilator therapy and/or angiotensin converting enzyme inhibitors in the treatment of patients with congestive heart failure.]

Lege Artis Medicinae

DECEMBER 29, 1993

[Medical management of inland catastrophes]

FARKAS József

[The author details the medical consequences of disasters and mass casualty situations. The concept of disaster is definied and compared with that of mass accident. It is pointed out that in principle there are no essential differences between them since both disasters and mass accidents require the application of compromise medicine princliples at the site of the catastrophe and during the course of the hospital treatment. The main point of medical support at the site is the triage based on a... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[The value of colposcopical and cytological examination in the screening of cervical intraepithelial neoplasia]

PETE Imre, BŐSZE Péter, TÓTH Vera, LEHOCZKY Győző

[ From 1980 to 1991, 1379 women with abnormal colposcopic and/or cytologic findings were examined at the Department of Gynecological Oncology at the National Institute of Oncology, Budapest. The sensitivity and specificity of these screening tests were studied retrospectively. All women underwent either cervical excision or conisation. Cytological and colposcopical findings were compared with the histological findings. Sensitivity and specificity of cytology were 49% and 77%, retrospectively.... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[Digoxin 2 days a week; Can what is wrong be safe?]

[The last 20-25 years have seen significant advances in the use of medication. Blood levels of drugs can now be measured using available laboratory methods, and many effects can now be accurately measured in addition to general clinical monitoring. This has created the basis for the everyday use of pharmacokinetics and pharmacodynamics and a separate discipline, clinical pharmacology.]

Lege Artis Medicinae

DECEMBER 29, 1993

[Coronary Angioplasty Versus Excisional Atherectomy Trial]

MATOS Lajos

[Atherectomy reduced coronary stenosis 50% or more often (89%) than angioplasty (80%, p<0.001), and the acute increase in vessel diameter was more pronounced (p<0.001). Atherectomy was associated with more early complications (11%) than angioplasty (5%, p<0.001) and hospital costs were also higher ($11 904 vs $10 637, p<0.006). After six months, the restenosis rate was 50% for atherectomy and 57% for angioplasty (p<0.06). However, the probability of infarction or death at six months was higher... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[Correspondence]

CSISZÁR Péter, FEKETE János

[Hospitals and clinics that perform operative laparoscopy do not have a consensus after surgery on whether and which drain should be inserted to drain the pelvis and abdominal cavity. A review of the literature shows that the use of a drain is almost mandatory after surgery for inflammatory diseases (1, 2). The insertion of a drain is also recommended for laparoscopies for ectopic pregnancies, one of the highest risk groups (3, 4, 5).]

Lege Artis Medicinae

DECEMBER 29, 1993

[Preoperative staging of nodal status in non-small cell lung cancer]

MONOSTORI Zsuzsanna, REPA Imre, HEILER Zoltán, KOSTIC Szilárd, EGERVÁRY Márta, BADÁR Éva

[ Exact preoperative staging according to the TNM classification is a prerequisite for establishing an adequate treatment plan for patients with lung cancer. The presence of tumor in N1 nodes influences the extent of resection, while its presence in N2 nodes determines the type of surgical resection, or sometimes excludes exploration of the chest. The correlation between pre- and intraoperative nodal staging based on pathological findings was analysed in 227 patients with non-small cell lung... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[The role of protein S deficiency in thromboses of young persons]

MOHAMED A. Lateiwish, RÓNA-TAS Ágnes, VAJDA Zoltán, SAS Géza, BLASKÓ György, HORVÁTH Ferenc

[ Inherited dificiency of anti coagulant proteins increases the propensity for venous thromboses. There is an increasing evidence that inherited deficiency of tissue inhibitors plays a role in arterial thromboses as well. During the past two years 130 thrombophilic patients were investigated. Routine chemical and hematological laboratory examinations, the quantification of protein C and protein S activity and the measurement of their antigen concentration, as well as the euglobinlysis time and... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[The intestinovesical fistulas - diagnosis and surgical treatment]

NAGY Ferenc, MAGYARSÓKI Ferenc, MÁTYUS Lajos, VARGA Tibor, JANKOVICH Mihály

[The authors present a literature review and summary about vesicoin testinal fistulas. They report their diagnostic and treatment experience in 10 cases of vesicointestinal fistula. The patients having been operated for inflammatory fistulas were healed except one case, and the patients having got a tumor died of the malignant progression. Symptoms of fistulas are various. In the diagnosis urography was helpful, cystography and cystoscopy allowed the observation of a fistulous orifice, while... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[Treating high blood pressure in New Zealand]

R Jackson, P Barham, L McLennan, J Bills, T Birch, S MacMahon, T Maling

[Our report, commissioned by the New Zealand National Advisory Committee on Core Health and Disability Support Services, focuses on the management of hypertension. Our recommendation is that when deciding whether to start medication for hypertension, we should consider primarily the estimated absolute risk of cardiovascular disease and not just the blood pressure value. Treatment should generally be initiated in patients with a systolic blood pressure of 150-170 mm Hg and/or a diastolic blood... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[Performance funding: dream or reality? Part I]

AJKAY Zoltán

[Today is a time of almost unbelievably rapid change. For decades our main concern has been that nothing has happened, nothing has changed. Now all our energy and knowledge is needed to adapt to at least one of the most fundamental and serial changes. Even those in the health sector who have been waiting, advocating and developing reforms for decades are somewhat surprised at the changes that are unfolding in response to fundamental influences. Only now are we beginning to sense the scale of... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[On the draft budget of the social security funds for 1994]

GERENCSÉR László

[The use of public funds is planned in the general government balance. The general government balance is made up of four subsystems: - the central budget, - the budget of the earmarked public funds, - the budget of the local (regional or local) governments, - the budget of the social security system, which consists of two separate funds (pension and health insurance). The management of public finances is governed by the Public Finance Act, which requires each subsystem to prepare an annual... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[Advent reflections]

FRENKL Róbert

[Around Christmas, the concepts of new beginnings, peace, family... with all their positive connotations make us think. Is there a new beginning in Hungarian healthcare? There have been staff changes before. In the past, deputy ministers, today deputy state secretaries, are the better-off colleagues whose main task is to attend meetings and 'specialise', explain the inexplicable, smile and shake hands, inspire hope, knowing that there is little hope. And they chair the committees whose long,... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[On the reform of inpatient care]

[Before I share my thoughts on the first experiences of the introduction of the hospital reform, allow me to say a few words about the relationship between the Ministry of Public Welfare and the Hungarian Hospital Association. I consider the role and the participation of the Hospital Association very important in the professional work related to the preparation of the legislation and the everyday practice, and therefore we invite the representatives of the Association to more and more meetings,... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[What we heard at the LAM club; Tools for reconciliation in the health sector]

KRASZNAI Éva

[In addition to an interested participation of professionals, "Tools for reconciliation in the health sector" was the topic of the LAM Club meeting in early October. The topicality of the subject was the events at the intensive care unit of the Imre Haynal University of Science - the nurses' strike. The evening was hosted by István Kamenitzky, a member of the Board of the Health Insurance Self-Government. Invited guests were Endre Bor dán, Head of the Department of the Ministry of Public... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[3rd International Conference on Preventive Cardiology]

KÖKÉNY Mihály, ÖSTÖR Erika

[After Moscow (1985) and Washington (1989), the Norwegian capital hosted the third international conference on cardiovascular prevention. It is no coincidence that the organisers chose this Scandinavian country, which boasts not only excellent epidemiological studies but also a commitment to health as a government policy.]

Lege Artis Medicinae

DECEMBER 29, 1993

[The first Hungarian pathologist teacher]

KISS László

[In April 1844, a twenty-six-year-old medical student successfully defended his thesis in Vienna, which was appended to his treatise De vita plantarum in genere (The Reproduction of Plants). The sixth of the ten theses read: Fons floritionis medicinae modernae in Anatomia pathologica quaerendus est, i.e. the source of the flowering of modern medicine is to be found in pathology. The young doctor-designate's mother died just before the inauguration, so he went to his hometown of Buda, postponing... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[More than a hundred million gesture for the health sector]

NAGY András László

[The main planned expenditure of the 1994 state budget was HUF 1 057 billion 468 million. This amount increased by HUF 130 billion 226 million as a result of amendments adopted by Parliament. More than one third of the increase was allocated to the Ministry of Public Welfare, whose budget, according to experts, was planned more generously than usual.]

Lege Artis Medicinae

DECEMBER 29, 1993

[The doctors' duel]

SHEILA Canby

[The Persian poet Gandjevi Nizami (c.1140-1209) probably never imagined that the stories in his great work, the Khamseh, would later be turned into lavishly decorated codices.]

Lege Artis Medicinae

DECEMBER 29, 1993

[Leonardo's Madonna of the Rock is the intercessor Mother of God]

VÉGH János

[The Madonna in the Rocks is undoubtedly one of Leonardo's most important works. Just as the artist himself is a transition between the Quattrocento, which was increasingly able to deal with vivid details, and the more summary Cinquecento, which spoke the language of solemn, large forms, so this work belongs in some ways to the early Florentine period, which was more meticulous and not exactly but richly exploited in its variety of colours, but on the other hand it is most easily related to the... tovább »

Lege Artis Medicinae

DECEMBER 29, 1993

[The importance of the arts in the life of a doctor]

KOVÁCS József

[Mihály Bálint (1) is credited with the introduction of the concept of "medical medicine". The word expresses the everyday experience that the most commonly used 'medicine' in medical practice is the medical personality itself. The doctor uses this 'medicine' mostly unconsciously, with an instinctive naturalness, yet its use is an important element in every doctor-patient encounter, and the quality of this 'tool' and the professionalism with which it is used have a significant influence on the... tovább »