Lege Artis Medicinae

An Englishman in Szeged


JULY 29, 1992

Lege Artis Medicinae - 1992;2(07)

In the last 2 weeks of April, I hosted a couple from England. The male member of the couple is a fifth year medical student in Sheffield. During their visit we talked a lot about the situation of Hungarian doctors and medical students. It occurred to me that it would be worthwhile to present what's new on this front in the UK. Of course, only a short extract from these long conversations is given here. I hope that no one will have any difficulty in understanding the English version.



Further articles in this publication

Lege Artis Medicinae

[The role of prostacyclin in the function of the gastric mucosa]

BÁLINT Gábor Sándor

[The intracellular effect of exogenously admi nistered prostacyclin in the gastric mucosa seems to be a polyphasic one, namely: 1. effect on the cyclic nucleotide (CAMP, CGMP) turnover, 2. effect on the calmodulin-content, 3. DNA and RNA changes 4. influence on protein synthesis 5. new cell formation. Besides the endogenous prostacyclin exerts a natural protection against damaging noxae, thus maintaining the physiological integrity of the mucosa. ]

Lege Artis Medicinae

[What is the cause of delay in the diagnosis of the primary sjögren's syndrome?]


[Primary Sjögren's syndrome is the most frequent polysystemic autoimmune disease after rheumatoid arthritis. Keratoconjunctivitis sicca and xerostomia are characteristic of primary Sjögren's syndrome but the evolution of these signs may exist for years, and only one of them may be observed for a long time. Arthritis and enlargement of the parotid and submandibular glands are rarely observed as first symptom. The diagnosis of primary Sjögren's syndrome is based on the evaluation of the obligate signs. Clinical experience shows that there are many patients with undiagnosed Sjögren's disease. The authors would like to demonstrate the importance of the characteristic sings of primary Sjögren's syndrome, and the clinical and immunoserological tests which are useful in the diagnosis of the disease.]

Lege Artis Medicinae

[Clinical principles in the diagnosis and therapy of disseminated intravascular coagulation]

SAS Géza

[Psychologically intravascular coagulation of the blood is hampered by the endothelium, the inhibitors of the coagulation system and the circulation as well. Various pathological events may the diffuse activation of the blood coagulation factors causing disseminated intravascular coagulation. The two main consequences of the DIC are ischaemia in the organs concerned and the consumption of the blood coagulation factors. The activation of the fibrinolytic system improves the former though aggravates the latter pathological events. In the prevention and therapy the effective treatment of the basic disease is of primary importance. Thorough evaluation of the clinical symptoms and the laboratory data can help in the diagnostics. Heparin can be administered only in the hypercoagulative-consumptive forms of the DIC if bleeding does not exist actually. In recent years, the administration of the anti thrombin concentrate has come into prominence because it can promote the restitution of the coagulation system without increase of bleeding. Antifibrinolytic (Gordox) therapy is advised only in cases of extreme hyperfibrinolytic activity. ]

Lege Artis Medicinae

[Laboratory diagnosis of disseminated intravascular coagulation]

HORVÁTH Andrea Rita, MUSZBEK László

[Disseminated intravascular coagulation (DIC) is a highly dynamic process with a broad spectrum of clinical manifestations and laboratory findings. There is no specific laboratory test for the diagnosis of DIC. For the reliable diagnosis of DIC we recommend a test-panel which can be divided into three groups: 1, The screening tests include the measurement of prothrombin time, activated partial thromboplastin time, trombin time, platelet count and detection of fibrin monomers; 2, The diagnosis of DIC can be confirmed with the help of additional assays, such as the determination of fibrin degradation products, antithrombin III or the detection of fragmentocytes in peripheral blood smear; 3, Special tests such as determination of clotting factors, reptilase time, activation peptides and thrombin-antithrombin III complexes may serve as useful tools in the differential diagnosis and in the scientific evaluation of the mechanisms of DIC. In this paper the advantages and disadvantages of different laboratory tests used in the diagnosis of DIC are also critically evaluated. ]

Lege Artis Medicinae

[Tissue banking: possibility and challenge]


[The development of the tissue banking techniques has made possible the production of wide range of differently preserved collagen based tissue grafts (skin, bone, dura mater, fascia lata). Excellent clinical results have been obtained by the application of allogeneic and xenogeneic grafts. The article summarizes the activity fields of tissue banks in the USA and in Europe. The review presents the most important aspects of tissue banking, antigenicity, sterility, preservation and storage of different grafts. ]

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[The Multiple Sclerosis Registry of Szeged]

BENCSIK Krisztina, SANDI Dániel, BIERNACKI Tamás, KINCSES Zsigmond Tamás, FÜVESI Judit, FRICSKA-NAGY Zsanett, VÉCSEI László

[Multiple sclerosis (MS) is a rare disease of the central nervous system considering the total population, the prevalence in Hungary is 83.9/100.000. The first MS registry was established in Denmark in the middle of the 1950’s. This was followed by the establishment of several national, then international databases with the number of enrolled patients in the hundred-thousands. At the beginning, the primary goal of the registries were the epidemiological surveys, focusing on the number of patients, the prevalence, the incidence, the mortality and the co-morbidity. As of today, however, with the rapid advancement and development of new disease modifying therapies (DMT) with different effectiveness and adverse reactions, the therapeutic use of the registries became even more essential: the modern, up-to-date, well established registries become integral part of the DMTs’ monitorization. The Multiple Sclerosis Registry of Szeged was first established as a “paper-based” database, then, in 2012, it was upgraded to an electronic, easily contactable and useable internet-based registry. As of today, it contains the socio-demographic and clinical data of more than 600 patients; we constantly add new patients as well as keep the registry up-to-date with the refreshment of old patients’ data. Aside from the “classical” clinical data, it can be used for the recording and assessment of the MRI scans and the data on psychopathological and quality of life assessments, which are becoming more and more important in everyday MS management. The establishment of the internet-based registry incredibly helped both the monitorization of the effectiveness of DMTs, and the success of the new epidemiological and psychopathological surveys. ]

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[Unattended automated office blood pressure measurement versus classic office automated blood pressure measurement in a hypertension outpatient clinic]


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Lege Artis Medicinae

[Frequency and risk factors of “de novo” tumors after kidney transplantation ]


[After kidney transplantation, the administration of immunosuppressive therapy not only renders the patient susceptible to infections, but it may also damage the function of tumor cell recognition and elimination. Our study was performed at the Department of Surgery, University of Szeged. After establishing the inclusion criteria, 570 patients were involved in the study. We examined the age, sex, immunosuppressive therapy of the patients, and searched for the rela­tionship between the different immunosuppressive agents and the type of the tumor. In 81 cases, de novo cancer was diagnosed. Among patients treated with cyclosporin and tacrolimus there was no significant difference in the mean age (p = 0.734) and body mass index (p = 0.543). There was no significant difference in graft function between the two groups of patients (Tac vs Cyc; 44 vs 20). Related to the time passed since the trans­plantation to diagnosing the tumors the earliest were prostate and cervix cancers however without significant difference. Skin cancers are the most frequent followed by post-transplant lym­pho­prolife­ra­tive diseases. The increasing risk of developing tumors is mainly due to immunosuppressive therapy. ]

Clinical Neuroscience

Additional value of tau protein measurement in the diagnosis of Creutzfeldt-Jakob disease

CSEH Katalin Edina, VERES Gábor, DANICS Krisztina, SZALÁRDY Levente, NÁNÁSI Nikolett, KLIVÉNYI Péter, VÉCSEI László, ZÁDORI Dénes

Since the definite diagnosis of Creutzfeldt-Jakob disease (CJD) can currently only be provided by autopsy, there is a special need for fine diagnostic tools in live patients to achieve accurate diagnosis as early as possible. The aim of this study was to perform a preliminary retrospective analysis on the utility of the measurement of total Tau (tTau) and some other biomarkers from the cerebrospinal fluid (CSF) of patients with rapidly progressive dementia in the diagnostic work up of CJD. Beside the assessment of relevant clinical data and the findings of electroencephalography and brain magnetic resonance imaging, the presence of 14-3-3 protein and the levels of tTau were determined by Western blot technique and enzyme-linked immunosorbent assay from the CSF of 19 patients diagnosed with rapidly progressive dementia between the period of 2004-2017 at the Department of Neurology, University of Szeged. This preliminary study provided 100% sensitivity for 14-3-3, and interestingly, only 40% specificity to support the clinical diagnosis of CJD. Regarding tTau, the sensitivity values were calculated to be 100% or 83%, whereas the specificity values were 71% or 86%, depending on the applied cut-off levels. The poor specificity of 14-3-3 is not in line with literature data and may be the result of the small number of patients in the cohort with non-prion disease, predominantly consisting of disorders with considerable tissue damage, whereas tTau presented good sensitivity and specificity values. The combined application of these and novel chemical biomarkers may increase both sensitivity and specificity to a desired level.

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Association of cardiovascular risk factors and Parkinson’s disease - case-control study in South East Hungary


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