Lege Artis Medicinae

[Aging men and climax of males]

KOPA Zsolt, RIESZ Péter, ROMICS Imre

DECEMBER 21, 2011

Lege Artis Medicinae - 2011;21(12)

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Further articles in this publication

Lege Artis Medicinae

[Genomics, the science of biological complexity]

FALUS ANDRÁS

Lege Artis Medicinae

[Social Responsibilities of a Physician ]

SÓLYOM Antal, BÁLINT Géza

Lege Artis Medicinae

[The choice of antibiotic therapy from the viewpoint of an economist]

KIS Zoltán

[OBJECTIVES - Antimicrobial resistance (AMR) in various bacterial infections is a growing problem in everyday clinical practice. The development of resistance is related to the clinical use of antibiotics, which substantially influences the efficiency of antimicrobial therapy. Inappropriately chosen therapy may increase the cost of treatment because of reduced efficacy and potential unwanted outcomes, adverse effects. Prolonged duration of treatment and increased use of diagnostic and therapeutic resources (including all medication expenses) contribute to the increased costs of treatment. The aim of our study was to demonstrate the differences in the total cost of therapy during hospitalization in certain patient groups, depending on the efficiency of the chosen antibiotic therapy. METHODS - We examined acute abdominal episodes, which represent one of the most typical surgical diseases. We analysed 59 hospital in-patient episodes that occurred in a six-month period, using aggregated hospital data. On the basis of the first choice of antibiotic we compared the average duration of antibiotic therapy and hospital stay, the incidence of medical complications and the cost of all these factors. RESULTS - The available results of our pilot study show that the length of hospital stay and the total cost of treatment may substantially increase even in the short term as a result of an inadequate choice of antibiotic, as the total cost of treatment is affected not only by the daily cost of antibiotic therapy, but also by its efficiency. In the long term, the risk of potentially developing resistance also necessitates an accurate choice of therapy, which requires institutional infection control and the prescription and implementation of protocols. These must be supported by cost-effectiveness analyses that include costs as well as results.]

Lege Artis Medicinae

[On the borderline]

KAPÓCS Gábor

Lege Artis Medicinae

[Bedside decision making - Prognostic functions]

VOKÓ Zoltán

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Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

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