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Lege Artis Medicinae - 2019;29(03)
Content
Lege Artis Medicinae
MARCH 20, 2019
Lege Artis Medicinae
MARCH 20, 2019
Lege Artis Medicinae
MARCH 20, 2019
[Five nine year results of „Comprehensive Health Screening of Hungary 2010-2020-2030”]
[2010 a new, complex screening program started in Hungary, named Nationwide Comprehensive Health Protection Screening Program in Hungary 2010-2020-2030. The screening was installed on a specially furnished lorry, which is able and will be able to get anywhere from big cities to the smallest villages. The Program as part of the “Heart and Vascular National Program” works with the support of 74 professional-scientific societies and companies. The screening program took place in a specially furnished lorry. The lorry has an easy access to the disabled, operation was performed with the quality control and permission of ÁNTSZ. Near the lorry there were activities for the preservation of health and prevention of illnesses. Within the framework of the Program in the largest mobile diagnostics center in Hungary 37 comprehensive surveys in free form. This enormous special screening station allows 5,100 tests to be performed at each of the 200 screening stations nationwide. The screening program for over 20 years provides 15 million trials on 3,000 scenes and 1 million adult visitors in free humanitarian. The European National Health Program and the National Program for the Prevention and Treatment of Cardiovascular Diseases co-ordinated by the Association of Hungarian Medical Associations (MOTESZ) are implemented by consensual cooperation. Based on the results, it was re-confirmed that Hungarian population belonged to the high risk group in several aspects. Authors also outlined solution plans for general risk reduction and disease prevention. ]
Lege Artis Medicinae
MARCH 20, 2019
[The atherosclerosis can not only be prevented, but also can be cured ]
[The process of atherosclerosis nowadays plays an important role in the health care not just as a major cause of the most common cardiovascular diseases which lead to death, but also as a major factor in the loss of age-related elasticity in the blood vessels. Over the past two decades, large studies have shown that the treatment of high cholesterol levels can reduce the frequency of cardiovascular events and death and have confirmed the ability to reduce the already existing atherosclerotic plaque, which is almost unique in pharmacotherapy. Using lipid lowering therapy, if we do it properly, we can not only prevent vascular events, but can also cure atherosclerosis. Currently there are three drug groups (statins, ezetimibe and PCSK9- inhibitors), which have complete evidence that their use can reduce the number of cardiovascular events and plaque regression can be achieved. Despite many convincing clinical trials, lipid-lowering therapy is on the cardiovascular prevention palette in the just tolerated or forced applied category. In order to take advantage of its potentials at an appropriate level, as doctors, we have to approach to it by considering its importance. We should communicate to our patients that it’s about a life-long treatment, which not only can reduce the possibility of cardiovascular events, but also can slow down the aging process of the arteries. ]
Lege Artis Medicinae
MARCH 20, 2019
[The modern therapy of lipid disorders in the daily practice ]
[Elevated LDL-C and/or triglycerides and decreased HDL-C levels contribute to development of vascular lesions. In the absence of detectable vascular disease the lipid values of providing vascular protection preferably with a healthy diet, regular physical activity and by trying to get out of harmful passions. If the healthy lifestyle is not effective enough, lipid-lowering medication may also be necessary in primary prevention. In the cases of inherited lipid disorders and in patients with high or very high cardiovascular risk it is necessary to take lipid lowering medications in effective dose. The Hungarian and the international guidelines have been formulated the targets of lipid values for vascular protection. The paper is trying to help for everyday medical practice, how to treat the dyslipidemic patients with the application of widely available lipid parameters and lipid lowering medications effectively. ]
Lege Artis Medicinae
MARCH 20, 2019
[Physiological-pathological muscle atrophy in elderly - interventions potencially inhibiting this progressive process ]
[In old and very old age, one of the most prevalent signs of aged body’s decline is the progressive loss of muscle mass and function. First itself the physiological aging process can be dominant in the complex causative background but later it is usually intertwined with pathological mechanisms. The importance of muscle system is extremely high in the physiological regulation of various vital life processes The paper also points out the far-reaching consequences of sarcopenia syndrome that leads to general weakness, falls, traumas, acceleration of co-morbidities, rapidly declining self independence, ultimately frailty syndrome, and death. The initial body mass index has been recently replaced by a more adequate, more complex diagnostic approachment of sarcopenia that evaluates both muscle mass/strength and physical performance. Prevention or breaking the process of sarcopenia needs complex intervention which includes special fast protein rich diet with leucin and vitamin D combined with frequent physical exercise. ]
Lege Artis Medicinae
MARCH 20, 2019
[Is it necessary? - Opinions and experiences about a first aid programme for children - pilot study]
[INTRODUCTION - Starting first aid education in early childhood can be an effective method of knowledge transfer. AIM - Our aim was to examine first aid education related opinions of kindergarten- and primary school children, educators, and parents. MATERIALS AND METHODS - 871 people (children, educators, parents) were involved in our study. Opinions were measured with self-administered questionnaires, containing mainly open questions. RESULTS - General opinion of parents and educators on first aid education in childhood were mainly positive, but they also gave negative ones. The majority of participants had a positive opinion about our completed program. Based on the opinions of parents and educators first aid education is recommended by health care professionals. Opinions were independent from gender, age, lenght of time of working with children in all cases (p>0.05). CONCLUSIONS - General opinion of parents and educators was varied, but it was generally positive concerning our program. Based on this results opinions can be changed with concrete activities. ]
Lege Artis Medicinae
MARCH 20, 2019
[How can we reach more effective antihypertensive treatment in diabetic patients with hypertension?]
[Hypertension is the leading “silent killer” accounting for 10 million deaths worldwide. It frequently occures together with other metabolic risk factors, including type-2 diabetes mellitus and dyslipidemia augmenting the global cardiovascular risk of patients. Their treatment and reaching target blood pressure means a real challenge for practising physicians. According to the recent hypertension guidelines RAAS-inhibitors are the first choice agents which can be excellently combined with diuretics. RAAS-inhibitor based therapy frequently needs to be completed with Ca-antagonist to which statin should be added in the presence of metabolic risk factors. The benefits of amlodipin/atorvastatin fixed combination are multiple: both agents are capable to inhibit the progression of atherosclerosis and to reach blood pressure and LDL target values. In addition the well-known poor statin-adherence can be improved with fixed combination which can contribute to the reduction of risk of these high-risk subjects. ]
Lege Artis Medicinae
MARCH 20, 2019
[Long-term CPAP compliance among Sleep Apnea Patients at the Sleep Laboratory of the Hungarian Defense Forces Medical Center ]
[Obstructive sleep apnea syndrome (OSAS) is the most common sleep disorder, with a prevalence of 2-4% in the overall population. It is a risk factor for cardiovascular diseases and its daytime symptoms significantly impair the patients’ quality of life and increase the risk of work and road accidents. Its first-line treatment is the CPAP device (Continuous Positive Airway Pressure) the effectiveness of which is significantly determined by the compliance of the patient. Although the issue of compliance in such treatment is a very important factor, long-term studies including a large number of patients have not been published yet, and there are no known data about it in Hungary. OBJECTIVE - Examining the long-term compliance of CPAP among OSAS patients in a sleep laboratory in Hungary. METHOD - 3403 OSAS patients were selected for our study between January 1, 2007, and September 30, 2017. The diagnosis and titration of effective CPAP pressure were determined by polysomnography. Patients were controlled after 2 months of therapy and then every 6 and 12 months. During the care, their compliance value was determined by data downloaded from their device's memory card. RESULTS - The mean age (± SD) of patients was 59.0 (± 10.5) years, most of them were male, 2676 (78.6%), their average body mass index (BMI) was 32.6 (± 5.25) kg/m2, their average Epworth Sleepiness Scale score was 11.4 (± 5.0), their average Apnea-Hypopnoe index was 51.0 (± 19.5) events/hour. The average usage time of the CPAP device was 5.0 (± 1.9) hours. 72.3% of the patients used the device for over 4 hours and 27.7% used it for less than 4 hours. 34.7% of the patients used the device for more than 6 hours. The Epworth Sleepiness Score showed a significant and dose-dependent improvement over CPAP treatment, with a greater improvement among patients who used the machine for longer hours. The highest score improvement was achieved by users who used CPAP between 6-7 hours, averaging 7.3 (± 3.2) points (p <0.001). CONCLUSIONS - Our present study shows that high average compliance can be achieved among well-adjusted and well-maintained patients. ]
Lege Artis Medicinae
MARCH 20, 2019
Lege Artis Medicinae
MARCH 20, 2019
[Psychology of machiavellism - ruthless tactics]
[This type of man, who pursues his goals in a cold, manipulative and tactical way, has long been a subject of interest to psychologists. The Jungian Trickster is probably a similar character: the hyper-rational archetype endowed with various deceptive tactics, can be found in most mythologies. He is sometimes a kindly, likeable character, but often ruthlessly cunning. Later, Erich Fromm defiend the Exploitative Orientation: for such a person, Fromm says, all the sources of good are outside the self; he is characterised by caprice, violence, exploitation and exploitation wherever he can, distrust and cynicism...]
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