Lege Artis Medicinae

[Address of the Semmelweis University of Medicine]

NEMÉNYINÉ Tahin Emma

SEPTEMBER 25, 1991

Lege Artis Medicinae - 1991;1(15)

[Coats of arms refer to a significant characteristic, an important feature, a worthy deed or merit of the person who wears them, and in them we honour our historical traditions. The coat of arms of Semmelweis University of Medical Sciences, its distinctive emblem, reflects not only the present of the long-established Universitas, but also its intellectual heritage. The coat of arms of our University has a tradition going back more than half a millennium. ]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[On pulmonary tuberculosis]

SCHWEIGER Ottó

[The author evaluates the epidemiological conditions of pulmonary tuberculosis in Hungary. The number of new cases decreases year after year. Being the disease infectious afterall, efforts must be continued against it adapted to the new epidemiological situation. This requires the collaboration of all the medical network systems as the pulmonological one is inefficient itself. Though the disease is rare, it cannot be forgotten and in certain cases tuberculosis must be borne in mind as well.]

Lege Artis Medicinae

[The differential diagnosis of pulmonary tuberculosis]

BÖSZÖRMÉNI Miklós

[Since the number of tuberculous patients is constantly decreasing, the diagnosis of pulmonary tuberculosis is a new challenge for physicians. That produces a lifethreatening danger specially for old tuberculous patients. Primary infection – since the clinical tuber culosis of children practically disappeared in Hungary - can be established mostly on young people with general symptoms, who's tuberculin-reaction shows hyperergy. The specific etiology of pleurisy can be determined by the exclusion of other etiologies on young tuberculin-positive people, but a thoracoscopic biopsy may be needed. Tuberculous bronchadenitis is a rarity, but must be differentiated from sarcoidosis or malignant mediastinal lymph nodes. In infiltrative lung diseases, primary and se condary pneumonias (caused in first line by lung cancer) and pulmonary infarctions are much more frequent, than tbc. The most difficult is the differential diagnosis of disseminated pulmonary diseases. The author warns against the too early application of aggressive diagnostic methods (BAL and especially lung biopsy by thoracotomy). He emphasizes in these situations the advantages of an antituberculous treatment without diagnosis (especially in old patients). In coin lesions the very specific transthoracic needle biopsy should be preferated. The author refers to the new researches objecting the rapid detection of BK in the sputum of paucibacillary patients, but is meaning, that the indirect ways of diagnosis mentioned in this paper would be necessary for a long time.]

Lege Artis Medicinae

[The importance of tuberculosis in childhood]

ANDRÁSOFSZKY Barna

[Nowadays tuberculosis has already become a rare disease in childhood in Hungary but the danger of the infection is still present for the several thousand (over 3500) disease manifestations among adults. The main task of the pediatricians is prevention, however the disease should be borne in mind in case of unelucidated chronic cases. In suspicion of meningitis basilaris it is necessary to start the treatment at once. Until now the maintanence of the BCG vaccination by age groups (new-born, 11 and 18 years) was justified, but it needs further restriction due to the advance in epidemic situation.]

Lege Artis Medicinae

[Some problems and characteristics of pulmonary mycobacteriosis in hungary]

KOZMA Dezső, VINCZE Egon, DÁVID Sándor, KISHINDI Katalin, ALEXY György

[360 cases of pulmonary mycobacteriosis caused by atypical mycobacteria were observed between 1980 and 1989. M. xenopi proved to be the most frequent pathogen (in 67% of the cases) followed by M. kansasii and M. avium intracellulare. The disease was common in urban-industrial areas. The yearly incidence of disease has not been increased during the observed period. 86% of patients were male with the mean age of 55 years. Underlying diseases such as pulmonary tuberculosis and chronic obstructive lung disease were found frequently. The symptoms of the disease were uncharacteristic. Thin-wall cavities with the lack of an infiltrate appeared in 24% of the patients. Malignancy and pulmonary aspergillosis were the two more frequent concomitant diseases. The occurence of lung cancer and also other organ cancers were significant higher among these patients than in the normal population between 40–69 years of age. Findings of histopathology were indistinguishable from tuberculosis among M. kansasii cases. A relative lack of caseousiting necrosis, forced fibrosis, foreign body reaction and abortive granuloma formation appeared among M. xenopi and M. avium-intracellulare cases. ]

Lege Artis Medicinae

[An update on BCG vaccination]

NYERGES Gáborné, DRINÓCZY Mária

[Tuberculosis is still a serious and wide-spread disease affecting mainly people living under poor hygienic conditions. Double infections with HIV + M. tuberculosis, however, may worsen the epidemiological situation both in developing and highly developed countries. Since its introduction, BCG vaccine has undergone several changes regarding the production strain and other characteristics. Though, the effectivity of BCG vaccination has been often questioned, it is indisputable that the vaccine protects young children against the disease. In Hungary, lyophilised „Paris" BCG strain has been safely and successfully used for vaccinating new-borns and revaccinating children for 30 years. The tbc incidence of the population under 14 years of age has been very low. Due to the relatively high tbc incidence among adults and the unfavourable tendency in the epidemiology of tbc in the world, however, no changes in the present BCG vaccination schedule are advisable. Moreover revaccination regardless to the tuberculin status should be considered. ]

All articles in the issue

Related contents

Clinical Neuroscience

Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

Lege Artis Medicinae

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

KAPÓCS Gábor

Clinical Neuroscience

[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]

Lege Artis Medicinae

[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.]

Lege Artis Medicinae

[Focus on Lege Artis Medicinae (LAM)]

VASAS Lívia, GEGES József

[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.]