Lege Artis Medicinae

[Based on recent evidences, for what kind of diseases are the Hungarian thermal waters beneficial?]

BENDER Tamás

MARCH 20, 2017

Lege Artis Medicinae - 2017;27(03)

[Hungary has extremely favorable geothermal facilities, resulting in a leadership role in the usage of thermal water for medical purposes and for publishing medical studies. In the recent decades, a total of 40 balneological subject studies were published in English language journals with impact factors, among these 25 original articles dealing with musculoskeletal disorders, as well as inflammatory and metabolic parameters, dermatological and gynecological diseases; besides these, five experimental works and ten reviews, editorial letters, and other issues. In addition, 20 papers have been published in Hungarian medical journals on the topic of musculoskeletal disorders, including six double-blind clinical studies and six single-blind studies. Based on the published domestic and foreign publications, as other studies have not refuted, Hungarian mineral waters, irrespective of mineral content and concentration of the water, have pain killing effect at patients suffering from degenerative musculoskeletal disorders, chronic low back pain and sometimes improve the quality of life of the patients. Based on small number of data the sulfur and salt bath may be beneficial for dermatologic and gynecologic disorders, while carbon dioxide bath, dry carbonic snow, and mofetta may be beneficial in cardiac and vascular rehabilitation; radon bath and radon cave affect the endocrine system; however, to prove it, a study of a large number of patients are required. ]

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Lege Artis Medicinae

[Who are the happy family physicians in Hungary?]

GYŐRFFY Zsuzsa, TORZSA Péter

[INTRODUCTION - Mental and somatic morbidity of healers is the most commonly researched issue in physician related studies. Few of them focus on the positive as-pects of the physicians’ profession though. METHODS - A focus group qualitative study of family physicians (n=14), who work in Budapest, was conducted. Three important topics were analyzed in this study - the positive aspects of the daily routine, the issue of the work-family balance and the decisive aspects of the patient - doctor relationship. RESULTS - The main positive elements of the family physicians’ professional lives are the independent working conditions, the diversity of patients, an intensive relationship with families and communities, and a special patient-doctor relationship. Beside professional fulfilment, the possibility of ba­lance between work,family and private time are the key components of their wellbeing. CONCLUSIONS - According to both our results and the findings of international literature, the happiness of family physicians depends on independence. This independence is present in their professional life, in the balance of work and family life and in time management as well.]

Lege Artis Medicinae

[The Hospital of the Holy Spirit in Rome ]

KRUTSAY Miklós

Lege Artis Medicinae

[MOTESZ]

KISS István, TÍMÁR József, KARÁDI István, OBERFRANK Ferenc

Lege Artis Medicinae

[Madness and Hatred, or Why is Edgardo the Exiled in the Family Crypt? ]

WINKLER Gábor

Lege Artis Medicinae

[Experiences of loss, grief, coping strategies in pre- and perinatal care]

ZSÁK Éva, HEGEDÛS Katalin

[Pre- and perinatal losses tend to be­come a phenomenon of complicated grief, a burden for the parents, for their families and for the helping professionals, yet it is a little studied topic. Our aim is to systematically review the literature concerning the grief experienced by the health care staff, caused by pre- and perinatal loss to present an overall picture of the international and national attitudes and existing solutions. The importance and complexity of the problem need greater attention, the existence of active and up-to-date programmes on all professional levels. ]

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Lege Artis Medicinae

[THE EFFECT OF BALNEOTHERAPY AND HIDROTHERAPY IN LOCOMOTOR DISEASES - AN OLD THERAPY REBORN]

BENDER Tamás

[Hungary is respected as an “Empire of thermal water” and balneotherapy has been an important part of health tourism. Recently, an increasing number of articles have been published which investigate the effect of thermal water on patients suffering from locomotor diseases. Balneotherapy has a beneficial painkiller effect and improves the quality of life in several cases of inflammatory and degenerative disorders of joint and bone diseases. The physical effect in its mechanism plays much greater role than the chemical one. A great number of evidence can be found in the medical databases proving the positive effect of balneotherapy in musculoskeletal diseases. Balneotherapy stands as an important factor in the National Development Plan of Hungary but we should like to emphasise that without basic research there is no effective balneotherapy.]

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.]

Clinical Neuroscience

[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]

Clinical Neuroscience

Creutzfeldt-Jakob Disease: A single center experience and systemic analysis of cases in Turkey

USLU Ilgen Ferda, ELIF Gökçal, GÜRSOY Esra Azize, KOLUKISA Mehmet, YILDIZ Babacan Gulsen

We aimed to analyze the clinical, laboratory and neuroimaging findings in patients with sporadic Creutzfeldt-Jakob disease (CJD) in a single center as well as to review other published cases in Turkey. Between January 1st, 2014 and June 31st, 2017, all CJD cases were evaluated based on clinical findings, differential diagnosis, the previous misdiagnosis, electroencephalography (EEG), cerebrospinal fluid and cranial magnetic resonance imaging (MRI) findings in our center. All published cases in Turkey between 2005-2018 were also reviewed. In a total of 13 patients, progressive cognitive decline was the most common presenting symptom. Two patients had a diagnosis of Heidenhain variant, 1 patient had a diagnosis of Oppenheimer-Brownell variant. Seven patients (53.3%) had been misdiagnosed with depression, vascular dementia, normal pressure hydrocephalus or encephalitis. Eleven patients (87%) had typical MRI findings but only 5 of these were present at baseline. Asymmetrical high signal abnormalities on MRI were observed in 4 patients. Five patients (45.4%) had periodic spike wave complexes on EEG, all appeared during the follow-up. There were 74 published cases in Turkey bet­ween 2005 and 2018, with various clinical presentations. CJD has a variety of clinical features in our patient series as well as in cases reported in Turkey. Although progressive cognitive decline is the most common presenting symptom, unusual manifestations in early stages of the disease might cause misdiagnosis. Variant forms should be kept in mind in patients with isolated visual or cerebellar symptoms. MRI and EEG should be repeated during follow-up period if the clinical suspicion still exists.