Lege Artis Medicinae

[An Endless Story?]

BÁNFALVI Attila

AUGUST 20, 2010

Lege Artis Medicinae - 2010;20(08)

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Lege Artis Medicinae

[Variations to the Kreutzer Sonata – Leo Tolstoy Passed Away 100 Years Ago]

KISS László

Lege Artis Medicinae

[A chance to concretize the teratogenic risk: healthy babies born to mother with isotretinoin treatment during pregnancy]

TIMMERMANN Gábor, KONDÉR Béla, GIDAI János, CZEIZEL Endre

[The teratogenic risk means the probability of the occurrence of congenital abnormalities in fetuses after the exposure of teratogenic agents, mainly drugs during pregnancy. The recent highresolution ultrasound scanning may help us to concretize this teratogenic risk. The Genetic, Teratogenic and Family Planning Counseling Clinic of the authors in Budapest were visited by 10,557 couples or client between 1998 and 2007. Ten pregnant women visited this Clinic due to the isotretinoin (Roaccutan) treatment during pregnancy during the 10 years study period. At present Roaccutan is the most teratogenic drug among the medicinal products in Hungary because its teratogenic risk is 25% for a characteristic pattern of congenital abnormality syndrome including a/microtia, ventriculomegaly and contruncal cardiovascular malformation. These fetal defects are detectable by the high-resolution ultrasound scanning between 18th and 20th gestational week of pregnant women. Thus this examination was recommended for the 10 pregnant women with unintended use of isotretinoin (Roaccutan ) in early pregnancy. Six pregnant women followed our advice and the repeated ultrasound scanning was not able to detect the above-mentioned characteristic defects and all the 6 newborns were healthy after birth. In conclusion the recent highresolution ultrasound examination provides a chance for the diagnosis of certain fetal defect between 18th and 20th gestational week of pregnant women. The Hungarian law allows these pregnant women to decide the termination of pregnancy until 20th (24th) gestational week after the diagnosis of severe fetal defects. However, this approach can protect the life of the major part of fetuses in pregnant women at high risk.]

Lege Artis Medicinae

[Shall we save?]

KIS János Tibor

Lege Artis Medicinae

[Tiotropium as a first maintenance drug in COPD: secondary analysis of the UPLIFT trial]

BALIKÓ Zoltán

Lege Artis Medicinae

[On the safety of angiotensin-receptor blockers - A new attack on this drug class]

FARSANG Csaba

[Up until now, angiotensin-receptor blockers have been considered to be the safest cardio-, cerebro-, reno- and vasculoprotective drugs. In a previous metaanalysis, ARBs were accused of increasing the risk of myocardial infarction, but a number of metaanalyses and randomised, controlled trials have disproved this hypothesis. In a recent metaanalysis, ARBs were associated with an increased risk of tumours. The author reviews this issue, discusses the flaws of the above metaanalysis and, on the basis of the most up-to-date data in the literature, expert opinions and official statements (FDA, EMA), concludes that members of this drug class should continue to be used according to their approved indications, which is supported by their cardio-, reno-, cerebro- and vasculoprotective effects demonstrated in a number of appropriate, large-scale clinical studies.]

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GEREVICH József

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HIRDI Henriett Éva

[Aim of the study: To research the origin and story of the Occupational Health Nursing in Hungary, to present the development of the factory nurse institutions which fell into oblivion by this time. Sample and Method: Collect and work up literature sources and legislation systematically issued between 1840 and 1950. Examine extant correspondence and reports of factories, enterprises and finishing-schools functioned before the socialization. The examined issues were the followings: aspects of the selection of those who fill factory nurse scope of activities, their qualification, role and esteem. Results: It was found that factory nurses were not selected out of working women. The first factory nurse course started in 1933 in Budapest. During ten years 150 students fulfilled the two-years full-time course based on the secondary education. Participants of the course had to suit strict admission requirements. Students of the course learnt about health, social, legal and cultural knowledge from noted professionals at that time. Factory nurses performed their activities basically at two locales: inside and outside of the factory. Qualified factory nurses were hold in great honour socially, even their rights were protected by collective agreement. Conclusions: Occupational Health Nurse Education has a 80-years-old history in Hungary, that throw new light upon theories until now about origin of Occupational Health Nursing. ]

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Lege Artis Medicinae

[Path of life in the society with a diagnosis of a psychiatric disease ]

BÁNYAI Borbála, LÉGMÁN Anna

[INTRODUCTION - The aim of our study is to show how people can live with a diagnosis of a psychiatric disease, a schizophrenia diagnosis in Hungary. METHODOLOGY - We made 25 narrative life story interviews with Hungarian people diagnosed with mental illnesses. We examined what the main obstacles and supporting factors may be in the life stories regarding the independent lifestyle and participation in community. RESULTS - According to the interviewees the main obstacles are their states or diseases, the stigmas after their diagnoses, the function of the psychiatric care system and the lack of self-reliance following the patient role. They mentioned the family and their own motivations as supporting factors. CONCLUSION - The examination of the institutional functions can reveal what the supporting factors may be which can facilitate the social participation of people diagnosed with mental illnesses on the level of the system. ]

Lege Artis Medicinae

[The End of the Story]

dr. MAKÓ János