Lege Artis Medicinae

[A Nutritional Science Experiment in the Bible?]

CSAPÓ Gábor

JANUARY 20, 2010

Lege Artis Medicinae - 2010;20(01)

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Lege Artis Medicinae

[Vitality generators]

BAGDY Emőke

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[Community psychiatry and evidence-based modern psychiatric care]

MAJ Mario, KURIMAY Tamás

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[Some thoughts about the possibilites to reform psychiatric care]

KURIMAY Tamás

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[Special problems of hypertension in women]

KAPOCSI Judit, DEÁK György

[Menopause and pregnancy are especially vulnerable periods of women’s life regarding hypertension. The “Guidelines for the Management of Arterial Hypertension”, issued by the European Society of Hypertension and the European Society of Cardiology, dedicates a separate chapter to hypertension in women. The renewed guidelines of the Hungarian Society of Hypertension also pays a special attention to hypertension detected during pregnancy. In this article, the euthors review the topics of hypertension detected during menopause and pregnancy, discussing pathomechanism and therapy.]

Lege Artis Medicinae

[The changing concept of the metabolic syndrome in the past two decades]

HALMOS Tamás, SUBA Ilona

[The introduction of the concept of the metabolic syndrome (MS) (1988) had a great significance from both a theoretical and a clinical point of view. The concept and the assesment of this syndrome has been widely criticized during the past two decades, however, many new components and even new diseases have been added to its defintion. These significant changes motivated us to complete and modify our previous review on this topic published in this journal more than ten years ago. In addition to the classical concept of MS, we discuss its various definitions, in which no consensus has been reached. Besides the two characteristic features, insulin resistance and hyperinsulinism, we discuss the etiological role of endothelial dysfunction, overactivity of the symphato-adrenal system, endocrine activity of the adipose tissue, and low-degree inflammation. We also discuss the roles of the Peroxisome- Proliferator Activated Receptor system and the ubiquitin proteasome system in certain metabolic and inflammatory processes. Recently, the causal unity of the syndrome has been questioned, which has generated an extended and still ongoing debate. For the clinicians, however, the most important fact is that individuals with the characteristic symptoms of the syndrome represent a significant number of the population and are at hight risk of severe cardiovascular conditions. Finally, we outline the newly discovered relationships of the syndrome with other diseases that have a great public health importance, such as cancers, Alzheimer disease, sleep apnoe, nonalcoholic fatty liver disease and chronic obstructive pulmonary disease. We also discuss the supposed common pathomechanisms of these conditions. These associations further increase the significance of MS in terms of both therapy and prevention.]

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[Stroke associated dysphagia can have serious consequences such as aspiration pneumonia. The Hungarian guideline on nutritional therapy for stroke patients recommends dysphagia assessment, as early screening can optimize disease outcome and hospital cost. Thus far, this may be the first study in Hungarian that has documented a systematic review about the available validated dysphagia assessments of acute stroke. Purpose – The aim of this study was to summarize the instrumentally validated bedside dysphagia screening tools for acute stroke patients, which were published in the last twenty years. Our objective was to describe the characteristics of the validation studies, examine their study design, and sample the sub-tests and the diagnostic accuracy of the assessments. A systematic research was carried out of the literature between 2001 and 2021 in eight scientific databases with search terms appropriate to our objectives. Subjects of the study – 652 articles were found and were reduced to eight. We made a comparative analysis of these. The GUSS test reached a high level of sensitivity compared to the others. In our study sample, the prevalence of instrumentally confirmed dysphagia among acute stroke patients was 56.1%. The focus and the composition of the analyzed studies differed and posed problems such as the ambiguity of the concept of dysphagia, the difference in outcome indicators, or the timing of screening. The GUSS test, which offers domestic management, is a suitable tool for the Hungarian clinical use.]

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