Lege Artis Medicinae

[27th congress of the Society of Hungarian Oncologists]

LANDHERR László

APRIL 22, 2008

Lege Artis Medicinae - 2008;18(04)

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[Pain and Pain Relief in Rheumatology]

GAÁL János

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[Facts and myths in the management of acute stroke]

CSIBA László, KOVÁCS Katalin Réka

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[Hereditary angioneurotic oedema]

FARKAS Henriette

Lege Artis Medicinae

[PRIMARY TUMOURS OF UNKNOWN ORIGIN WITH CERVICAL LYMPH NODE METASTASES - A RETROSPECTIVE STUDY]

GARAI Tibor, NÉMETH Zsuzsanna, TOMPOS Tamás, ZEMPLÉN Béla

[ITRODUCTION - Primary tumours are defined unknown if, despite of the presence of histologically verified metastases, the site of origin cannot be revealed even with complex investigations. On average, 5% of patients with cervical lymph node metastases belong to this group. The incidence of cervical lymph node tumours increases with age, with more than 60% arising from malignancies in patients over 40. PATIENT AND METHODS - In this retrospective study, the authors review the history of 29 patients treated or examined in their department between January 2002 and November 2006 with the starting diagnosis of cervical lymph node metastasis from a primary tumour of unknown origin. All patients had a thorough physical examination, indirect upper respiratory tract endoscopy, and aspiration cytology. In the search for the primary tumour the use of both traditional X-ray studies and modern imaging techniques are justified. RESULTS - Of the 29 patients, five did not present after surgery, and one patient died. The location of the primary tumour could be determined in 12 of the remaining 23 patients during the follow-up period. These included the palatine tonsil in four cases, the lung in three patients, the lower pharynx in two patients, and one case each of the lingual radix, the larynx and the nasal pharynx. The histology of the metastases was mostly squamous cell carcinoma and they were located in the upper parajugular region. The investigation of the remaining patients is continued. CONCLUSION - In cases of cervical lymph node metastases that histologically turn out to be squamous cell carcinoma, the primary tumour should first be searched for in the head-and-neck region, followed by the lungs. On the other hand, high-grade nasopharyngeal carcinomas warrant the search in the Waldeyer ring. The authors emphasize the importance to keep the proper order of the diagnostic and therapeutic steps and to manage these patients in experienced institutions.]

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GERLINGER Imre

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[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

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[Diuretics have remained the cornerstone of the antihypertensive treatment since their widespreading in the 1960s. According to the 2018 ESC/ESH Guidelines for the management of arterial hypertension, in the absence of evidence from direct comparator trials and recognizing that many of the approved single-pill combinations are based on hydrochlorothiazide, this drug and thiazide-like indapamide can be considered suitable antihypertensive agents. In the 2018 Hungarian guidelines indapamide is named as the most efficacious diuretic in the treatment of patients with hypertension. The aim of the publication is redefining thiazide- and thiazide-like diuretic use in the treatment of hypertensive patients, with particular attention to presently available hydrochlorothia­zide and indapamide, and their combination drugs in Hungary.]

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[Focus on Lege Artis Medicinae (LAM)]

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[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]

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[LAM 30: 1990–2020. Facing the mirror: Three decades of LAM, the Hungarian medicine and health care system]

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[A short chronicle of three decades ]

KAPRONCZAY Katalin

[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]