Lege Artis Medicinae

[Computer assisted diagnostics of malformation syndromes promotes interdisciplinary cooperation between clinical specialities]

BODA Domonkos1

DECEMBER 28, 1994

Lege Artis Medicinae - 1994;4(12)

[Experiences obtained from the diagnostic work up of 44 malformation syndrome cases using four computer assisted diagnostic programmes is presented. This method, in addition to many other advantages, significantly improves the diagnostic possibilities in these very rare cases, and may further promote the interdisciplinary cooperation between various clinical specialities.]

AFFILIATIONS

  1. Szent-Györgyi Albert Orvostudományi Egyetem, Gyermekklinika Szeged

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[The first 15 years of the AIDS epidemic ]

FÖLDES István

[AIDS represents the most exciting infectious disease of the last 15 years. In addition to the fact that there are more than 4 million estimated AIDS patients and more than 16 million estimated HIV-infected individuals this can be explained by the peculiar features of the disease, including limited routes of infection, long latency period, a quasi 100% lethality, diversity of the clinical picture, difficulties in therapy and vaccination, the theoretically 100% possibility of prevention and the serious social problems associated with AIDS. After giving a short review of the development of our knowledge about AIDS, the author to explains the special features of AIDS mentioned above on the basis of the structure, regulation and replication cycle of the virus. The primary conclusion is that education and prevention should be stressed in the battle against AIDS.]

Lege Artis Medicinae

[The role of transesophageal echocardiography in the investigation of stroke]

LENGYEL Mária

[Ischaemic infarction accounts for 85% of stroke aetiology (1). Approximately 60-70% of these are of cerebrovascular, i.e. carotid arteriosclerosis, origin (2). The proportion of cardiogenic embolism was previously estimated at 15% (1), but autopsy data suggest that embolism is the cause of half of fatal strokes (3). There are two reasons for this large discrepancy: 1) the intracardiac source is difficult to identify in vivo; 2) cardiogenic embolism has a more severe outcome than stroke of other origin. Probably both are true, but there is no doubt that before the introduction of transesophageal echocardiography (TE), the detection of intracardiac sources was rare and uncertain.]

Lege Artis Medicinae

[A multicentre, randomised, crossover, double-necked trial of contamination of conventional and bow-tie dressings in routine obstetric and gynaecological practice]

MARINKO M Biljan, CHARLES A Hart, DEBORAH Sunderland, PAUL R Manasse, CHARLES R Kingsland

[In the 19th century, the usual dress of doctors was a small bow tie tied in a flat knot "once round" in addition to a stiff standing collar (1). As fashions have changed, the wearing of bow ties has become less common and is now worn almost exclusively by a small minority of obstetricians, who often claim that they are more hygienic than the traditional tie in the delivery room, which is contaminated with blood and amniotic fluid. There is currently no evidence for this. We therefore examined the contamination of traditional and bow ties worn by obstetricians during a typical working week. ]

Lege Artis Medicinae

[Clinical and laboratory parameters in ulcerative colitis]

NAGY Ferenc, PAPÓS Miklós, CSERNAY László

[The clinical and laboratory parameters which correlate with the intensity of the inflammatory process in ulcerative colitis patients were analyzed in this study. The severity of the inflammatory process was assessed with leukocytescinti graphy by colorectal segments using a scoring method in 36 patients (group A). The sum of the segmental scores were considered to represent the intensity of the inflammatory process and were compared with clinical and laboratory parameters. From among the 36 patients, acute ulcerative colitis was established with biopsy in 30 cases. Two toxic patients were not tested and four patients had inactive disease. In 20 (16 acute, 4 inactive) of 36 patients, the intensity of the inflammatory process was assessed by segments with score values of biopsy samples and leukocyte scintigraphy (group B). The sum of the score values was used to determine the correlation of the two methods. The intensity of the inflammatory process assessed by scintigraphy showed a good correlation (r = 0.6564, p = 0.0016) with histological findings (group B), as well as with the ESR (r = 0.6398), serum fibrinogen (r = 0.5424), alfa2 globulin level (r = 0.4721), number of bloody stools (r = 0.4605), and the thrombocyte count (r = 0,4594) in group A. Five clinical and laboratory parameters proved to be suitable to assess the actual severity of the inflammatory process in ulcerative colitis. The values of the parameters may help to choose the right examination in new cases and to evaluate the efficacy of the therapy. ]

Lege Artis Medicinae

[Prenatal diagnosis of endocardial fibroelastosis]

KÁDÁR Krisztina, KIRÁLY László

[The authors report two cases of prenatally diagnosed endocardial fibroelastosis with echocardiography for the first time in Hungary. This disease is rare and usually fatal. Diagnoses were confirmed by autopsy and in one case by postnatal echocardiography as well. Principles for the diagnosis of endocardial fibroelastosis are discussed. Echocardiography makes possible the prenatal diagnosis of endocardial fibroelastosis and is recommended from the 18th week of pregnancy in high risk individuals.]

All articles in the issue

Related contents

Lege Artis Medicinae

[The history of acute stroke care in Hungary ]

BERECZKI Dániel

[Stroke is one of the most frequent causes of death and the most important cause of permanent disability worldwide and also in Hungary. The Hungarian medical literature has mentioned this disease and has been giving recommendations for its treatment since 1690. Initially folk medicines, herbal preparations and phlebotomy were used as standard therapy. Later, cooling the head joined these methods. Pharmacy preparations emerged at the middle of the 19th century. From the middle of the 20th century, products of the pharmaceutical industry like blood flow enhancers and neuroprotective drugs were in the frontline of the acute care. Anti­hy­per­ten­sive, antithrombotic and lipid-lowering medications became part of stro­ke prevention. Imaging techniques – mainly computer tomography of the brain and ultrasound examination of the cervical large arteries – have radically changed the diagnostics of cerebrovascular diseases from the middle of the 1980s. Since the 1990s, diagnostic and therapeutic decisions are based on reliable evidence from good quality clinical trials. Since the beginning of the 21st century, reperfusion treatments (intravenous thrombolysis and mechanical thrombectomy) re­present the most effective emergency care. The current direction is the extension of the therapeutic time-window of reperfusion treatments based on sophisticated neruoimaging. This review provides a brief summary of the development of stroke care in the last three and a half centuries as reflected in the Hungarian medical literature. ]

Clinical Oncology

[Pregnancy and cancer]

NAGY Zsuzsanna, SZILLER István, VALTINYI Dorottya, HORVÁTH Orsolya

[The joint appearance of pregnancy and cancer is rare. It is highly recommended that the tumorous pregnant should be managed by a multidisciplinary team. The early diagnosis is very important, but it is not easy, because the symptoms of pregnancy and cancer are rather similar. Imaging diagnosis has to avoid ionizing radiation (e.g. PET/CT). The same is true for chemotherapy in the fi rst trimester, due to the increased risk of developmental abnormalities. Consequently, radiation therapy is not allowded throughout the pregnancy, and the chemotherapy in the fi rst trimester is a strong indication for the interruption of pregnancy. Surgery, with good practice, usually can be performed without complications. Chemotherapy, given in the second and third trimester generally follows the standard protocols with a low frequency of developmental errors. Early delivery should not be encouraged, except the delay has a hazardous effect on the mother and/or on the child. The pregnant should be informed about all steps to be an active part of the fi nal decision.]

Hungarian Radiology

[Male breast cancer]

GÖBLYÖS Péter

[Male breast cancer does not get a sufficient attention which would be appropriate due to its special features. Diagnostical and therapeutical protocols are not existing, a national center and international collaboration would be necessary. Incidence of male breast cancer is one percent of the female breast cancers, and 5 percent of all male cancers. The absolute number of the cases increased in the past years. The mutation of gene BRCA2 plays the main role in the male breast cancer. The breast cancer of the men is a "late disease", because often neither the doctor nor the patient considers this opportunity. The diagnosis is often established at an advanced stage. Cancer can occur on both sides, but the right breast is more often affected. Staging is the same as in female patients. Prognosis is poorer than in females, the tumor-receptor rate is better, HER2 in men does not plays any role. Basic principles of diagnostics and therapy are same as in females, mainly because there is no consensus about the treatment of the male breast cancer. The same proved protocols are used in men which are applied in women. The ground-method is surgery, reduced radicality and mastectomy is usually applied. Males react on hormone therapy better, than women, mainly chemotherapy is suggested. Follow up of the patients and the psychological support is extremely important. A multidisciplinary collaboration is necessary in the treatment of the male patient, and education is of great importance.]

Clinical Neuroscience

[Rehabilitation of communication by computer controlled synthesized speech]

FOLYOVICH András, VASTAGH Ildikó, PATAKI László, CSÜRKI Mária, PATAKI Klára

[A method of speech rehabilitation by computer aided synthesized speech is reported. This method is useful in patients with severe dysarthria, dysphonia and motor aphasia, when agraphia and alexia are not present. The improved communication helps the patients to adapt to their milieu and decreases social isolation. A case history is given of a patient who uses this method successfully during her daily activities. The speech therapy was significantly supported by the use of computer for synthesized speech. The 48-year old woman underwent a cardiac operation (implan tation of artificial valve) due to previous myocarditis and mitral insufficiency before the present neurological complication. She suffered multiple ischemic attacks leading to the loss of motor performance of speech.]

Lege Artis Medicinae

[THE PRACTICE AND RESULTS OF OSTEOPOROSIS MANAGEMENT IN HUNGARY]

POÓR Gyula

[Osteoporosis poses a major public health problem worldwide due to the extreme number of patients and to the deterioration of quality of life, disability, excess mortality and costs associated with consequent fractures. Representative studies of the author’s group have previously shown that the average bone mineral density values of the Hungarian population are among the lowest in Europe while the prevalence of vertebral fractures is among the highest in international comparison. This revelation has led to the development of a National Osteoporosis Programme, the key element of which being the setting up of a network of osteoporosis centres that are based on the collaboration of various medical specialists, the availability of advanced diagnostic tools and outstanding therapeutic opportunities. On describing the 10-year activity of the centres, the main diagnostic, prevention and management approaches of osteoporosis are discussed. According to the WHO classification the diagnosis of osteoporosis is based on a low bone mineral density finding supported by the laboratory and radiological exclusion of other metabolic bone diseases and secondary forms of osteoporosis. According to the up-to-date treatment guidelines of osteoporosis, when considering medical treatment, preference should be given to patients with high fracture risk in giving drugs with extensive antifracture efficacy that has been confirmed by studies of evidencebased medicine. Among these drugs the most important are the antiresorptive bisphosphonates that have widely been used in Hungary and the bone forming teriparatide that is expected to gain wider use in the near future with the introduction of public health insurance financing. The efficacy of these specific antiosteoporotics is increased by supplementation with calcium and vitamin D. The internationally acknowledged Hungarian osteoporosis management system offers to Hungarian patients outstanding standards for the prevention and management of osteoporosis.]