Lege Artis Medicinae

[A paradigm shift in healthcare]

TÖRŐCSIK Mária

JULY 14, 2008

Lege Artis Medicinae - 2008;18(06-07)

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Lege Artis Medicinae

[UNSOLVED THERAPY - COMPLEX TREATMENT OF BUERGER’S DISEASE]

SZOMJÁK Edit, DÉR Henrietta, KEREKES György, VERES Katalin, DEZSŐ Balázs, TAKÁCS István, TÓTH Judit, MÓZES Péter, SOLTÉSZ Pál

[INTRODUCTION - Buerger’s disease is a nonatherosclerotic, segmental, inflammatory, progressive obliterative disease of the blood vessels that most commonly affects the small and medium-sized arteries and also the veins of the lower limb. It is strongly associated with tobacco use. CASE REPORT - A 37-year-old heavy smoker forest worker presented with severe gangrenous changes on the fingers as the upper limb manifestations of Buerger’s disease, which required acral amputation. After complex medical treatment, pharmacological sympathectomy on the left side and surgical sympathectomy on the right side, bilateral conserving necrectomy, cessation of smoking and 2 cycles of cyclophosphamid, the patient's status significantly improved, his pain diminished and, although to a limited extent, he could use both hands. CONCLUSIONS - Buerger’s disease is a disorder with unclear aethiology and is difficult to diagnose. Despite of a good prognosis, a causal treatment is not yet possible, so any antithrombotic, haemorheological, vasodilator or immunosuppressive therapy that have been reported to have beneficial effect should be considered for treatment.]

Lege Artis Medicinae

[“I Want Magic!” A Discussion with Dóra Elek, Director of the Baltazár Theatrical Group]

GYIMESI Ágnes

Lege Artis Medicinae

[Multifocal nodular hepatic steatosis]

BAJOR Judit

Lege Artis Medicinae

[Tiotropium treatment of patients with simultaneous chronic obstructive pulmonary disease and asthma]

BALIKÓ Zoltán

Lege Artis Medicinae

[Stem cell therapy: A new approach to treat vascular stenosis]

BODA Zoltán

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Lege Artis Medicinae

[Second game, 37th move and Fourth game 78th move]

VOKÓ Zoltán

[What has Go to do with making clinical decisions? One of the greatest intellectual challenges of bedside medicine is making decisions under uncertainty. Besides the psychological traps of traditionally intuitive and heuristic medical decision making, lack of information, scarce resources and characteristics of doctor-patient relationship contribute equally to this uncertainty. Formal, mathematical model based analysis of decisions used widely in developing clinical guidelines and in health technology assessment provides a good tool in theoretical terms to avoid pitfalls of intuitive decision making. Nevertheless it can be hardly used in individual situations and most physicians dislike it as well. This method, however, has its own limitations, especially while tailoring individual decisions, under inclusion of potential lack of input data used for calculations, or its large imprecision, and the low capability of the current mathematical models to represent the full complexity and variability of processes in complex systems. Nevertheless, clinical decision support systems can be helpful in the individual decision making of physicians if they are well integrated in the health information systems, and do not break down the physicians’ autonomy of making decisions. Classical decision support systems are knowledge based and rely on system of rules and problem specific algorithms. They are utilized widely from health administration to image processing. The current information revolution created the so-called artificial intelligence by machine learning methods, i.e. machines can learn indeed. This new generation of artificial intelligence is not based on particular system of rules but on neuronal networks teaching themselves by huge databases and general learning algorithms. This type of artificial intelligence outperforms humans already in certain fields like chess, Go, or aerial combat. Its development is full of challenges and threats, while it presents a technological breakthrough, which cannot be stopped and will transform our world. Its development and application has already started also in the healthcare. Health professionals must participate in this development to steer it into the right direction. Lee Sedol, 18-times Go world champion retired three years after his historical defeat from AlphaGo artificial intelligence, be­cause “Even if I become the No. 1, there is an entity that cannot be defeated”. It is our great luck that we do not need to compete or defeat it, we must ensure instead that it would be safe and trustworthy, and in collaboration with humans this entity would make healthcare more effective and efficient. ]

Lege Artis Medicinae

[Paradigm changes in psychiatrics]

HARANGOZÓ Judit, TRINGER László, GORDOS Erika, KRISTÓF Róbert, WERRNIG Róbert, SLEZÁK Adrienne, LŐRINTZ Zsuzsa, VARGA Attila, BULYÁKI Tünde

Journal of Nursing Theory and Practice

[Nursing career of the high-school students]

TISÓCZKI Evelin, BALOGH Zoltán

[Aim of the research: The aim of the study is to analyze the trends of student orientation in the age and compulsory education process by age group. In our research, we would like to answer the question of how much „popularity” the health care profession as a professional area among students participating in Hungarian public education. If you feel this area of expertise close to you, what kind of vision you have. Research and sampling methods: A self-constructed questionnaire was administered during 24 Oct 2017 - 13 Jan 2018. In all counties of Hungary, the authors sent it to at least one of the training sites and filled up with me (N=329). These training sites are involved in healthcare training. Data were analysed with SPSS 15.0 for Windows statistical program. Chi square, Mann-Whitney tests were applied (p <0,05). Results: Out of the 159 people (48%), 170 (52%) in the family have healthcare workers. When performing the controls of the distributions, we can conclude that there is no significant difference in the distribution between the two groups, so there is the same number - that is, statistically significant difference - of the proportion of those willing to choose the health care path. In terms of career choice, 276 (86%) of respondents believe it is likely to be oriented towards the health care path, with 46 people (14%) planning their life is in another direction. Seven of its principal did not answer the question. By completing the Mann-Whitney test, we can conclude that there is no significant difference between the two groups in the medians, so there is no difference - that is, statistically significant difference - with respect to career choice as a nursing profession’s esteem. Of the 329 participants, 215 (65%) replied that they would like to work as a nurse, while 114 (35%) responded that they would not choose this job. Conclusion: Don’t influence significantly the career entrant if there is a healthcare worker in the family. Who stand in front of career choice don’t influence significantly the appreciation but is more motivated by sympathy and helplessness toward another person.]

Ca&Bone

[Bone metabolism and body mass index in postmenopausal women]

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[INTRODUCTION - In addition to several other causes constitutional factors play an important role in the development of osteoporosis.Various aspects of bone metabolism were examined to explain the differences in bone density between women with low and high body mass index (BMI). PATIENTS AND METHOD - One hundred and ninetytwo postmenopausal women were included in the study. Bone density was measured by forearm densitometry.To assess bone formation, serum osteocalcin levels were measured, while the rate of bone absorption was estimated from C-terminal telopeptide levels of collagen type I measured in urine and blood. RESULTS - The prevalence of osteoporosis was higher in women with low BMI than in those with normal or higher BMI. Bone metabolism - both formation and absorption - was increased in both groups, however, in women with low BMI this increase was more pronounced and bone metabolism tended to be shifted to absorption compared to patients with normal or higher BMI. CONCLUSION - Postmenopausal lean women have accelerated bone metabolism compared to obese women. This fact and the shift to absorption may be the main reasons for the higher frequency of osteoporosis found by densitometry in women with low BMI than in those with higher BMI.]

Lege Artis Medicinae

[Mirror neurons and interpersonality in the paradigm of embodied mind]

HORVÁTH Lajos, SZABÓ Attila

[In this paper, our aim is to scrutinise the psychology and phenomenology of interpersonal relationships from an interdisciplinary viewpoint. This multi-perspectival examination has a key concept: we critically discuss the interdisciplinary dialogues and philosophical appraisals regarding the issue of mirror neurons. Empathy and resonance phenomena have philosophical, psychological, and biomedical importance. Our paper, by applying certain philosophical and empirical results of the overarching paradigm of embodiment, attempts to shed light on several semantic problems, which could come up with respect to the function of mirror-neurons. In conclusion, we would like to attempt to utilise the results of contemporary phenomenology in order to clear some semantic problems, considering the features of mirroring and resonant behaviour.]