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Lege Artis Medicinae - 1994;4(06)
Content
Lege Artis Medicinae
JUNE 29, 1994
[Embryonic diagnostic possibilities prior to implantation]
[A longlasting goal of the medical science has been the prevention of birth defects. Prenatal diagnosis, which is one of the most important subspecialities in modern obstetrics, has developed significantly in the last 10–20 years and has become a powerful tool in fulfiling this aim. The rapid development of the fields of molecular biology, genetics and assisted reproduction has ereated the possibility of introducing the new era of preimplantation genetic diagnosis. Preimplantation genetic diagnosis involves the genetic analyses of the fertilized pre-embryo, without changing its developmental capability or its original characteristics. The most well proven method is the biopsy and rapid genetic analysis by polymerase chain reaction and in situ hybridization of one or two cells removed from the in vitro fertilized pre-embryo. This technique can be used to determine the sex of the pre-embryo or to investigate specific genetic diseases. Numerous other methods have been tried, and the more successful ones are briefly discussed. ]
Lege Artis Medicinae
JUNE 29, 1994
[Aspects of hormonal therapy in prostate cancer]
[The author describes all of the hormonal therapeutic methods presently applied in Hungary and summarizes the recommended therapies for each stage of the disease. The therapeutic alternatives of three groups of patients are discussed. Evidence in the literature demonstrates the advantages of applying hormonal therapy, in cases of incidental prostate cancer found in tissues obtained by TURP, as opposed to the „wait and see" approach. Emphasis is placed upon the ad vantages of hormonal therapy prior to radical prostatectomy, chief among them being the decrease in volume of the prostate, which simplifies the operation. A promt and total androgenic block is the proper therapy for locally advanced prostate cancer or in metastatic prostate cancer.]
Lege Artis Medicinae
JUNE 29, 1994
[Treatment of posttransplant polyglobulia with enalapril]
[Posttransplant polyglobulia is not a rare complication following kidney transplantation. Recently in some publications favourable experiences were reported with angiotensin converting enzyme inhibitors in the treatment of polyglobulia. Among 325 patients having kidneys transplanted by authors, polyglobulia was found in 52 patients (16%) after an average of 19,5 months (2,5– 44,2 months) following the operation. In 48 cases, 5 mg enalapril was given orally, independent of the body-weight, for the treatment of polyglobulia. Among them 12 patients – 2 for allergic skin-reactions and 10 for irregular medication – were rejected from the study. During the monthly follow-up of laboratory parameters (Hbg, serum creatinine, serum bilirubin, serum alcalic phosphatase) as well as in the blood pressure (systolic/diastolic) no substantial (significant) difference was found compared to the starting value in the treated 36 patients. The only essential change was the change in the haematocrit level: there was a significant decrease in the haematocrit level after two months from the starting time and this remained so during the investigation. From this study and follow up the authors recommend treating the poly globulia found after the kidney transplantations with enalapril in place of the bilateral nephrectomy used earlier. This treatment is more pleasant for the doctor and the patient.]
Lege Artis Medicinae
JUNE 29, 1994
[IgE monoclonal gammopathy and amyloidosis]
[ IgE myeloma is a very rare disease with only 38 cases reported in the world literature. The authors describe a case of IgE monoclonal gammopathy leading to primary amyloidosis and death in 5 months. This is the first reported IgE monoclonal gammopathy in Hungary. Diagnosis was based on the immunochemical analysis of the concentrated urine. Histologic analysis relevaled amyloidosis. Despite the fact that IgE myeloma is a rare entity, its clinical presentation is highly variable. This case of IgE myeloma presented itself clinically as amyloidosis. Free light chains could be detected from the patient's serum during the entire course of the clinically active disease. In contrast, heavy chains were not detectable, and therefore immunochemical analysis of the concentrated urine is recommended to help in establishing the diagnosis.]
Lege Artis Medicinae
JUNE 29, 1994
[News]
[The 1st National AIDS Conference; Pharmaceutical production with international cooperation; The turbuhaler in Hungary; Markusovszky Memorial Medal for the President of the Chamber; IV. annual meeting of the Hungarian Psychiatric Society; Astra scholarship for gastroenterologists]
Lege Artis Medicinae
JUNE 29, 1994
[The relationship between premature mortality and marital status in hungary]
[The relationship between mortality and the marital status of Hungarians aged 30–64 was analyzed for the period 1970–1990. The lowest mortality rate was found among married men and women, independent of age. The risk of mortality among unmarried men and women is greater in the age group 30–49 than in the age group 50–59. In both age groups the relative mortality risk of widowed and divorced men is higher than that of the corresponding women. As compared with the married population, the relative mortality risk of men and women who never married is less pronounced, especially in the age group 50– 59. From the late 1970s, the relative mortality risk of divorced men has increased to the greatest extent. As a consequence, in 1980s, the divorced men proved to be the group at greatest risk. ]
Lege Artis Medicinae
JUNE 29, 1994
[Intraoperative transesophageal echocardiography]
[The authors assessed the value of intraoperative transesophageal echo cardiography in the completion of the preoperative diagnosis and in the evaluation of the surgical result. Examinations were performed in the course of 37 cardiac surgeries. 26 cases were mitral valve procedures or reoperations while 2 cases were aortic valve repairs. These were elective examinations for the purpose of evaluating surgical results. In 4 cases elective examinations were performed to complete the preoperative diagnosis. In 5 cases, intraoperative transesophageal echocardiography was requested by the surgeon during the operation. The intraoperative transesophageal echocardiography included 2D echo, color, pulsed wave and continuous wave Doppler techniques. Intraoperative transesophageal echocardiography was performed on all patients with no complications. On the basis of the structural and haemodynamic information obtained by this procedure, it surgical outcome was assessed and the questions posed by surgeons were answered. In 14 cases, the result of surgery was insufficient. In 12 of these cases, the operation was successfully completed with an altered surgical strategy based on the results of the intraoperative transesophageal echocardiography, and thus early reoperation was prevented. In 2 patients, the surgical procedure could not be completed due to an increased operative risk, despite the insufficient result. Intraoperative transesophageal echocardiography is a safe method to assist in completing the preoperative diagnosis and to evaluate the results of surgery. ]
Lege Artis Medicinae
JUNE 29, 1994
[Familiar breast cancer]
[There is now clear evidence that a small proportion of breast cancers, perhaps 4-5%, are due to high penetrance dominant genes (1-4). The publicity surrounding the issue of breast cancer today, the national screening programme (5) and attempts at prevention have increasingly focused the attention of affected families on the disease. This has led to the need for advice on risk factors and what to do about them. Women want to know about the risk not only for themselves but also for their daughter.]
Lege Artis Medicinae
JUNE 29, 1994
[Possibilities for IT modelling of health education activities]
[Community diagnosis, model experiments, teamwork, and IT network]
Lege Artis Medicinae
JUNE 29, 1994
[Performance of nine months of specialised care]
[In March 1994, inpatient and outpatient specialised care delivered outstanding performance data compared to the average of the previous eight months and to the baseline. The data for the month of March clearly show an increase in the number of cases, weight and chronic care days. The data of the facilities reporting extreme performance will be reviewed on the spot by the Chief Medical Officers of the County Directorates.]
Lege Artis Medicinae
JUNE 29, 1994
[British waist - Hungarian waist]
[It's great that many of the articles in the British Medical Journal are also available in Hungarian. It's great that some of the articles are also taken over by LAM. This is what we read in the February issue of the journal this year. A. Frank, a British rheumatologist and rehabilitation specialist, gave an excellent summary of low back pain. I consider this article to be extremely important, as it can draw the attention of our health organisers, public health and insurance professionals to a subject that national experts have been trying in vain to draw attention to for years: that is, that low back pain is not a fatal disease in most cases (if we ignore its possible infectious or tumour origin!), but it can impair the quality of life, make you physically and mentally disabled and cost a lot of money. Some British figures: 12.5% of all sick days are due to back pain. ]
Lege Artis Medicinae
JUNE 29, 1994
[Specificities of health in Switzerland]
[By presenting the Swiss health care system, I would like to draw attention to the links between the structure of a system and financial expenditure. In Switzerland, in line with the political structure of the state, the health system is based on a federal system (Figure 1). The Constitution also guarantees the autonomy of the cantons and communes in the area of health. The core of this system is a shared taxation system [Commune, Canton (Voivodeship), Federation (State)].]
Lege Artis Medicinae
JUNE 29, 1994
[Deepening relations in Germany]
[The State or the Province has a duty of care \ in the sense of "buying" knowledge from doctors. The doctor, on the other hand, assumes the duty of care. All this takes place within a framework of democratic self-government, i.e. the State delegates its obligation to the appropriate public bodies, such as the Chamber of Physicians or, in the case of outpatient care, the Association of General Practitioners (POSZ). (It is the same for dentists and pharmacists...) The members of these bodies are doctors, officials who are drawn from the various strata of the medical profession according to the rules of the game of parliamentary democracy.]
Lege Artis Medicinae
JUNE 29, 1994
[Forum in two locations]
[Hungarian-German Medical Cooperation Association of the Care Deutschland, organized by the Association of Hungarian Medical Societies and Associations, held a professional forum in Budapest, at the Péterffy Sándor Street Hospital, and in Szolnok, at the Municipal Cultural Centre, on the topic "The opportunities of private medical practice, with special regard to diagnostic and non-operative specialties". ]
Lege Artis Medicinae
JUNE 29, 1994
[Who is to blame for the failure of this year's TB funding rules in the LAM club]
[As the parliamentary elections approached, the LAM Club organisers pondered at length how to find apolitical, "party-neutral" topics for the bi-weekly meetings. The discussion of this year's rules on health care funding seemed to be the right topic. They were wrong, the club's guests enjoyed one of the most sharply political debates. This was due firstly to recent events, and secondly to the temperament and political nature of the debate leader, Róbert Frenkl. Professor Frenkl - Editor-in-Chief of LAM - is not only an elected member of the Board of the Health Insurance Self-Government, but also ran in the elections as a candidate for the Republican Party. ]
Lege Artis Medicinae
JUNE 29, 1994
[From victim to key witness]
[János Arany's immortal lines hold the key to the mystery of a historical detective story set in 1457. In Prague, after a short illness, the 17-year-old (Habsburg) László, the first of the Czechs and the fifth king of the Hungarians, closed his eyes for ever.]
Lege Artis Medicinae
JUNE 29, 1994
[The relationship between fertility and health]
[Hungary's demographic data show an ageing population, a declining trend in fertility and a slowly shrinking population (1). This negative phenomenon has been observed since the late 1950s. From 1958 onwards, the net reproductive coefficient fell below the reference value. The childcare allowance scheme introduced in 1967, although well received, had a moderate and temporary impact on fertility.]
Lege Artis Medicinae
JUNE 29, 1994
[The cult of physical beauty in Renaissance art]
[This new intellectual movement, which first appeared in Italy in the 15th century, radically broke with the "barbaric" values of the Middle Ages.]
Lege Artis Medicinae
JUNE 29, 1994
[Nursing education in England]
[An essential element of the reform of Hungarian healthcare is to change the way we think about care and its role in healthcare. A necessary corollary of this fundamental change is the modernisation of the health education system, including the upgrading of nursing education (curricula, practical training) to an appropriate standard.]
1.
Clinical Neuroscience
[Headache registry in Szeged: Experiences regarding to migraine patients]
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Clinical Neuroscience
[The new target population of stroke awareness campaign: Kindergarten students ]
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Clinical Neuroscience
Is there any difference in mortality rates of atrial fibrillation detected before or after ischemic stroke?
27. NOV
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Clinical Neuroscience
Factors influencing the level of stigma in Parkinson’s disease in western Turkey
27. SEP
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Clinical Neuroscience
[The effects of demographic and clinical factors on the severity of poststroke aphasia]
18. JUL
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