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Lege Artis Medicinae - 1994;4(01)
Content
Lege Artis Medicinae
JANUARY 31, 1994
[Influence of alcohol on the nervous system]
[Prevention and treatment of addictions such as alcoholism require a multidisciplinary approach. Sociological and social psychiatric studies have revealed many factors which may play a part in the development of alcoholism, however biological studies increasingly indicate an organic origin of alcoholism. The aim of the present comprehensive study was to summarise the clinical manifestations of alcohol toxicity based on biological alterations. The results of genetic and immunological studies are summarized. Some aspects of the investigations in the field of biogenic amines are presented. The primary toxic, long lasting withdrawal effects are discussed, from the clinical point of view.]
Lege Artis Medicinae
JANUARY 31, 1994
[Contrast media for magnetic resonance imaging in clinical practice]
[The author's main goal is to introduce the generally available contrast media for magnetic resonance imaging. After a brief survey of this topic, the principal agents are classified into three main subgroups. The four Ti-type contrast agents are compared and discussed on the basis of the available data in the literature. Finally, the possible future direction of contrast media research in MRI is discussed. ]
Lege Artis Medicinae
JANUARY 31, 1994
[Correspondence - The doctor's relationship with patients]
[It's been a decade since I read in a Hungarian medical journal about the doctor's behaviour, his attitude, his relationship with the patient, his colleagues, his co-workers. Based on my decades of medical practice (and my frequent illness - which has only prevented me from practising my profession in the last two years), I will try to summarise what the patient's expectations of the doctor are, and how well the doctor can meet them.]
Lege Artis Medicinae
JANUARY 31, 1994
[The present and future of radiology]
[Conversation with Professors Charles Gooding and Gretchen Gooding]
Lege Artis Medicinae
JANUARY 31, 1994
[EEG mapping in focal cerebral disorders]
[EEG mapping is a new method which serves for processing the data of the quantitative analysis of the brain electrical activity. In its final form it is a neuroimaging technique. The present study was designed to examine the localization reliability and clinical utilization of the mapping. 103 patients with focal cerebral disorders were investigated: 70 patients with cerebrovascular diseases, 33 patients with tumour, epilepsy, migraine, meningoencephalitis, subdural haematoma, subarachnoid cyst. The EEG mapping, the routine EEG and the CT were performed and their findings were compared. In comparison with the traditional EEG, the mapping has the advantage that it can detect the alpha asymmetry. It shows the focal, functional damages more correctly than the EEG does. The mapping provides information about the ischemic lesions before the CT can visualize the tissue hypodensity. In comparison with the CT, the mapping has a good localization reliability although there are some sources of error in the method. It can detect minimal cerebral damages. It is applicable for follow-up studies on transient ischemic attacks. ]
Lege Artis Medicinae
JANUARY 31, 1994
[MTC-pertechnetate scintigraphy used to identify bleeding from meckel's diverticulum]
[99 mTc-pertechnetate scinti graphy has got an important diagnostic role in pediatrics, as it can detect ectopic ventricular mucosa, and Meckel's diverticulum. In this paper the case of a 12-year-old boy is reported who has presented recurrent rectal bleedings and abdominal pain due to an undiagnosed Meckel's diverticulum for three years. The patient was admitted with serious rectal bleeding and melena. On admission aortography and selective angiography did not give valuable information about the origin of the bleeding. Previous surgical report on laparotomy necessitated by appendicitis at the age of 3,5 years impeded the diagnosis describing the lack of Meckel's diverticulum. The source of bleeding was identified with red blood cell scintigraphy and the presence of Meckel's diverticulum was confirmed with laparotomy. His topathological examination revealed ectopic gastric mucosa in the diverticulum. 99 mTc red blood cell imaging has a valuable diagnostic role in the localization of gastrointestinal bleeding. The examination can be performed repeatedly, and it should be used before aortography and selective angiography. It is emphasized here that Meckel's diverticulum must be considered in any patients presented with rectal bleeding without fever and clinical or laboratory signs of infection or inflammation.]
Lege Artis Medicinae
JANUARY 31, 1994
[Reflections on breast cancer screening]
[The author reviews opinions concerning advantages and disadvantages of breast cancer screening, summarizes the results of screening, and makes proposals for introducing breast cancer screening in Hungary. The urgency of this proposal is emphasized. A system of central support is necessary, but it would be worthwhile to bring this proposal to the attention of potential foreign sponsors as well. A „minimal program" should include efforts at increasing public awareness of self screening and expanded clinical examinations. The formation of „Breast Clubs” among patients and „Breast Teams” among competent physicians in each institute is considered desirable. Uniformity in the teaching of breast diagnostics and therapy is deemed important. ]
Lege Artis Medicinae
JANUARY 31, 1994
[Emergency circulatory support]
[Many drugs enhance cardiac performance by improving tissue blood supply, but this is often achieved at the cost of increasing the oxygen demand of the myocardium. This can be critical when cardiac function is significantly impaired or ischaemia is the underlying cause of dysfunction. The use of combination drug therapy to restore cardiovascular balance requires a precise knowledge of the pharmacodynamics and interactions of the individual agents, so that the treatment plan can be tailored to best suit the individual patient. In some situations, the combined administration of inotropic agents and vasodilators is desirable to reduce the cardiac workload. In other cases, vasopressors are necessary to restore a minimum perfusion pressure. The present communication reviews this class of drugs and the mechanical circulatory support devices that can be used in the event of failure of pharmacological treatment. ]
Lege Artis Medicinae
JANUARY 31, 1994
[Healthcare in developed countries - what will be the main changes in the 1990s?]
[The aim of my thesis is to assess what changes are to be expected in the health sector in the 1990s. In my summary I have outlined some possible lessons for Eastern Europe. Will Eastern Europe learn from the mistakes of other countries and be able to go beyond Western European practice by adopting wiser health policies? Where would this kind of wisdom lead?]
Lege Artis Medicinae
JANUARY 31, 1994
[Performance funding: dream or reality? Part II]
[Within the institutions, the transition to the new funding system creates a completely new situation. At the same time as the contracts were signed, the inpatient institutions also received the first data on the number and proportion of HBCS cases in each unit, ward or department in the month. This created a database for the analysis of inpatient morbidity in institutions, a continuous possibility to identify the underlying causes of cost overruns and to make comparisons within institutions. ]
Lege Artis Medicinae
JANUARY 31, 1994
[On the borderline between inertia and possibility]
[In this issue, we present a paper written by Dr. Zsófia Simek, which draws some of its conclusions from epidemiological observations of the last quarter of a century, and aims to draw the attention of the scientific community and society to one of the main causes of the decline of our population, namely excessive alcohol consumption and the possibilities of controlling it. There is something grotesque about addressing my questions to my co-author, a friend and colleague who is very close to me, my teacher and well-known expert in psychiatric epidemiology, and sharing my pondering concerns with her in public. ]
Lege Artis Medicinae
JANUARY 31, 1994
[On FIDESZ's health programme]
[Interview with Imre Frajna, Member of Parliament, member of the Social Affairs Committee. The LAM and its Annex have dealt at length and repeatedly with the health policy concept of the parliamentary parties, communicating these programmes or their drafts. Apart from the various small farmers' groups, only the FIDESZ programme has not been discussed in these columns, but not elsewhere. As a preliminary question, I asked Imre Frajna, the only medical representative of the Young Democrats, about the reason for this.]
Lege Artis Medicinae
JANUARY 31, 1994
[TB Law '94]
[In November, the government submitted four different bills to Parliament on the social security budget. On the implementation of the 1992 budget of the Social Insurance Fund, on the 1993 supplementary budget of the Social Insurance Fund, on the Social Insurance Fund and on the 1994 supplementary budget of the Social Insurance Fund. The most important common feature of these bills is that, for the first time in the recent history of social security, they were submitted by the Minister of Finance, not by the Minister of Social Welfare, on behalf of the Government, and that, also for the first time, they were drafted not by the Government, nor by a budgetary institution - the OTF was one - but by the recently established insurance municipalities.]
Lege Artis Medicinae
JANUARY 31, 1994
[Public body or anglers' association submitted to the committee]
[It seemed that at the end of the long, tortuous journey of the MOK law would reach a crossroads in October. The House Committee had put its detailed debate on the plenary agenda for 18 October, thus instructing the specialised committees - the Social Affairs and Constitutional Affairs Committees - to complete their debate on the amendments and to formulate their committee position on each issue. They failed, and the plenary debate was postponed indefinitely. Why did it fail? What is the reason for the new delay? ]
Lege Artis Medicinae
JANUARY 31, 1994
[József Fodor and the environment protection]
[At the turn of the last century, the struggle for national independence and the modernisation of the country's social and economic conditions was being fought for, and Hungarian intellectuals were at the service of this struggle. A significant part of this was the medical profession, which was closely concerned with social issues. It is no coincidence that there were many public figures among the medical profession in this period. ]
Lege Artis Medicinae
JANUARY 31, 1994
[How can the principle of consent be applied in the Hungarian healthcare system?]
[In my opinion, public opinion and the majority of Hungarian doctors have now reached a consensus on the need to inform patients about their medical treatment, and not to perform surgery or any other medical intervention without the patient's consent. Many people, however, ask the question: is today's Hungarian legislation in line with the international application of the principle of informed consent, and under what conditions can this principle be implemented in Hungary? ]
Lege Artis Medicinae
JANUARY 31, 1994
[Eroticism in medieval art]
[It is almost a cliché to talk about the spiritualism and conservatism of medieval culture, which was imbued with the spirit of Christian religiosity. In this sense, it may seem a little surprising to search for a theme in medieval art that seems to be completely alien to its nature. It is true that the eroticism of late antiquity, manifested in orgiastic cults, disappeared from Western culture with the rise of Christianity.]
Lege Artis Medicinae
JANUARY 31, 1994
[For the renewal of alcoholology]
[In the near future, the National Institute of Alcoholics will publish a collection of studies and articles with the same title as this outline and attention-grabbing essay, series 25 and 26 in its "life's work" series. The volumes, which attempt to describe the professional (and political) struggles of the last twenty years or so, give a taste of our insights and the broadening of our outlook, in more or less chronological order, and report on the professional, professional-political and power resistance that we have had to overcome, sometimes with arguments, sometimes with trickery. ]
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