Lege Artis Medicinae

[British waist - Hungarian waist]

BÁLINT Géza

JUNE 29, 1994

Lege Artis Medicinae - 1994;4(06)

[It's great that many of the articles in the British Medical Journal are also available in Hungarian. It's great that some of the articles are also taken over by LAM. This is what we read in the February issue of the journal this year. A. Frank, a British rheumatologist and rehabilitation specialist, gave an excellent summary of low back pain. I consider this article to be extremely important, as it can draw the attention of our health organisers, public health and insurance professionals to a subject that national experts have been trying in vain to draw attention to for years: that is, that low back pain is not a fatal disease in most cases (if we ignore its possible infectious or tumour origin!), but it can impair the quality of life, make you physically and mentally disabled and cost a lot of money. Some British figures: 12.5% of all sick days are due to back pain. ]

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Lege Artis Medicinae

[Embryonic diagnostic possibilities prior to implantation]

SZTANYIK László, URBANCSEK János, BÁRÁNDY Zsolt, TÓTH-PÁL Ernő, PAPP Zoltán

[A longlasting goal of the medical science has been the prevention of birth defects. Prenatal diagnosis, which is one of the most important subspecialities in modern obstetrics, has developed significantly in the last 10–20 years and has become a powerful tool in fulfiling this aim. The rapid development of the fields of molecular biology, genetics and assisted reproduction has ereated the possibility of introducing the new era of preimplantation genetic diagnosis. Preimplantation genetic diagnosis involves the genetic analyses of the fertilized pre-embryo, without changing its developmental capability or its original characteristics. The most well proven method is the biopsy and rapid genetic analysis by polymerase chain reaction and in situ hybridization of one or two cells removed from the in vitro fertilized pre-embryo. This technique can be used to determine the sex of the pre-embryo or to investigate specific genetic diseases. Numerous other methods have been tried, and the more successful ones are briefly discussed. ]

Lege Artis Medicinae

[Aspects of hormonal therapy in prostate cancer]

ROMICS Imre

[The author describes all of the hormonal therapeutic methods presently applied in Hungary and summarizes the recommended therapies for each stage of the disease. The therapeutic alternatives of three groups of patients are discussed. Evidence in the literature demonstrates the advantages of applying hormonal therapy, in cases of incidental prostate cancer found in tissues obtained by TURP, as opposed to the „wait and see" approach. Emphasis is placed upon the ad vantages of hormonal therapy prior to radical prostatectomy, chief among them being the decrease in volume of the prostate, which simplifies the operation. A promt and total androgenic block is the proper therapy for locally advanced prostate cancer or in metastatic prostate cancer.]

Lege Artis Medicinae

[Treatment of posttransplant polyglobulia with enalapril]

JÁRAY Jenő, HEMANGSHU Podder, HÍDVÉGI Márta, REMPORT Ádám, PERNER Ferenc

[Posttransplant polyglobulia is not a rare complication following kidney transplantation. Recently in some publications favourable experiences were reported with angiotensin converting enzyme inhibitors in the treatment of polyglobulia. Among 325 patients having kidneys transplanted by authors, polyglobulia was found in 52 patients (16%) after an average of 19,5 months (2,5– 44,2 months) following the operation. In 48 cases, 5 mg enalapril was given orally, independent of the body-weight, for the treatment of polyglobulia. Among them 12 patients – 2 for allergic skin-reactions and 10 for irregular medication – were rejected from the study. During the monthly follow-up of laboratory parameters (Hbg, serum creatinine, serum bilirubin, serum alcalic phosphatase) as well as in the blood pressure (systolic/diastolic) no substantial (significant) difference was found compared to the starting value in the treated 36 patients. The only essential change was the change in the haematocrit level: there was a significant decrease in the haematocrit level after two months from the starting time and this remained so during the investigation. From this study and follow up the authors recommend treating the poly globulia found after the kidney transplantations with enalapril in place of the bilateral nephrectomy used earlier. This treatment is more pleasant for the doctor and the patient.]

Lege Artis Medicinae

[IgE monoclonal gammopathy and amyloidosis]

JÁKÓ János, KASZÁS Ilona, GESZTESI Tamás

[ IgE myeloma is a very rare disease with only 38 cases reported in the world literature. The authors describe a case of IgE monoclonal gammopathy leading to primary amyloidosis and death in 5 months. This is the first reported IgE monoclonal gammopathy in Hungary. Diagnosis was based on the immunochemical analysis of the concentrated urine. Histologic analysis relevaled amyloidosis. Despite the fact that IgE myeloma is a rare entity, its clinical presentation is highly variable. This case of IgE myeloma presented itself clinically as amyloidosis. Free light chains could be detected from the patient's serum during the entire course of the clinically active disease. In contrast, heavy chains were not detectable, and therefore immunochemical analysis of the concentrated urine is recommended to help in establishing the diagnosis.]

Lege Artis Medicinae

[News]

[The 1st National AIDS Conference; Pharmaceutical production with international cooperation; The turbuhaler in Hungary; Markusovszky Memorial Medal for the President of the Chamber; IV. annual meeting of the Hungarian Psychiatric Society; Astra scholarship for gastroenterologists]

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[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

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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

[History of vaccine production in Hungary ]

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[This study presents the complete history of the Hungarian vaccine production, partly in association with the process of fighting vaccine-preventable infectious diseases, and underlines the fact that every government actively contributed to the age-adjusted mandatory vaccination schedule of the past 140 years. It demonstrates the various achievements from the smallpox lymph production through the launch of diphtheria serum production at Phylaxia and the establishment of the National Public Health Institute (OKI) with its vaccine production and the later institutional transformation of OKI into Humán as economic corporation to its closure. Among all OKI’s vaccine production activities, this study focuses on the production of influenza vaccines, due to its international importance in the 1960s and 1970s. The vaccine production against diphtheria tetanus and pertussis stands out from Humán’s activities, and the tetanus component of this vaccine is still used in the products of a multinational vaccine manufacturer. ]