Lege Artis Medicinae

[Dear Editorial Team!]

GYENES Géza

JANUARY 01, 1991

Lege Artis Medicinae - 1991;1(01 KLSZ)

[We respectfully send you the position paper of the FAKOOSZ on the "Action Programme", which we have prepared at the request of Dr. István Mikola, State Secretary. We would ask you, if possible, to publish an extract of this document in your newspaper. Our association aims to formulate, coordinate, defend, represent and constantly assert the interests of district doctors working in villages in accordance with their specific living and working conditions. It operates independently of political parties, denominations, the medical trade union and the MOK. In addition to advocacy, we also provide charitable and economic services to our members, the profits from which are donated to the FAKOOSZ Foundation. Our membership is open to all doctors of Hungarian nationality working in the rural districts and municipalities attached to the town, as well as to doctors of non-Hungarian nationality who are resident in Hungary or have a residence permit. ]

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Further articles in this publication

Lege Artis Medicinae

[Resolution of the plenary meeting of the Scientific Council for Health of 21 October 1991]

[The Plenary Session of the Scientific Council for Health has formulated the following opinion on the "Action Programme for the Renewal of our Health Care System" and the "Basic Concept of the Financing System of the Hungarian Health Care System".]

Lege Artis Medicinae

[Summary of comments]

[The Ministry of Public Welfare has published a working paper entitled Action Programme for the Renewal of our Health System for discussion in the Medical Weekly and in the pages of Lege Artis Medicinae. The programme has received many comments, opinions and suggestions. In addition to our medical colleagues, economists, sociologists, churchmen, lawyers, entrepreneurs, health professionals, politicians and parliamentarians have also contributed. The majority of the 269 analytical reflections - just over 5,000 pages - were written by institutions, university clinics, hospital doctors' groups, district medical associations, scientific associations, bodies of interest representation bodies (Hungarian Medical Chamber, EDDSZ), the Health Science Council, health and social committees of local authorities, regional and expert working groups of social security institutions and many others. The reflections have been examined in detail by experts from the Ministry and members of the working committee that drew up the programme. They provided many good ideas and useful suggestions for the final version of the programme. We thank all those who took the trouble to contribute with constructive comments and good intentions to the design of the new health care system and the new way of working. The most representative comments are published as promised and a summary of the lessons learnt from the processing of the material is presented in a bundle.]

Lege Artis Medicinae

[Meeting of the International Social Security Association in Budapest]

[From 28 October to 1 November, the 239-member International Social Security Association (ISSA) Standing Committee on Health and Sickness Insurance held its twenty-fifth meeting in Budapest.Experts from 33 countries (nearly 100 participants) discussed the most topical issues of health care in their countries over five days.]

Lege Artis Medicinae

[Old and new pitfalls: comments on health care reform]

OROSZ Éva

[The following is an extract from a forthcoming book, the manuscript of which closed at the beginning of September, so it does not respond to the Ministry of Public Welfare programme that has been published since then - although it is still relevant. ]

All articles in the issue

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Lege Artis Medicinae

[Dear Reader! Greetings to the 30th anniversary of founding the LAM]

KAPÓCS Gábor

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.]

Clinical Neuroscience

[Rehabilitation results after severe traumatic brain injury ]

DÉNES Zoltán, MASÁT Orsolya

[To assess the rehabilitation outcome after severe traumatic brain injury. Retrospective evaluation of the rehabilitation process and prospective follow-up five years after discharge. Patients – Patients treated in 2013 at the Traumatic Brain Injury Unit, National Institute for Medical Rehabilitation were included in the study (n = 232). Ninety-nine of 232 patients were treated with severe traumatic brain injury. Data were available for 66/99 patients (67%). Fifty patients (13 women and 37 men) were successfully contacted for follow-up (51%), three patients deceased. The mean age of the patients was 42 years (range: 22-72). The majority of them (36/50) was injured in traffic accidents. The mean duration of coma and post-traumatic amnesia were 19 (1-90) and 45 days (5-150), respectively. Patients were admitted for rehabilitation on the 44th (11-111) day after the injury and were rehabilitated for 95 days (10-335). Thirty-eight patients became independent at daily living activity during the rehabilitation period, and none during the follow-up. Two patients needed moderate and one a little help for the daily life. After successful rehabilitation 4 patients continued their higher education, 24 patients worked (six in sheltered, six in the original, 12 in other workplaces). Twenty-two patients did not have permanent jobs, two of whom were retired. The majority of the patients were successfully reintegrated into society. More than half of the patients returned to work or continued their studies. These successes were greatly facilitated by the 40 years of experience and the multidisciplinary team working in the National Institute for Medical Rehabilitation. ]

Clinical Neuroscience

[Rehabilitation possibilities and results after neurosurgical intervention of brain tumors ]

DÉNES Zoltán, TARJÁNYI Szilvia, NAGY Helga

[Objectives - Authors examined the rehabilitation possi­bi­lities, necessities, and results of patients after operation with brain tumor, and report their experiences. Method - Retrospective, descriptive study at the Brain Injury Rehabilitation Unit, in National Institute for Medical Rehabilitation. Patients - Patients were admitted consecutively after rehabilitation consultation, from different hospitals, following surgical intervention of brain tumors, between 01 January 2001 and 31 December 2016. Patients participated in a postacute inpatient rehabilitation program, in multidisciplinary team-work, leaded by Physical and Rehabilitation Medicine specialist included the following activities: rehabilitation nursing, physical, occupational, speech, psychological and neuropsychological therapy. Results - At the rehabilitation unit, in the sixteen-year period 84 patients were treated after operation with brain tumor. Patients arrived at the unit after an average of 41 days to the time of the surgical intervention (range: 10-139 days), and the mean length of rehabilitation stay was 49 days (range: 2-193 days). The mean age of patients was 58 years (20-91), who were 34 men and 50 women. The main symptoms were hemiparesis (64), cognitive problems (26), dysphagia (23), aphasia (16), ataxia (15), tetraparesis (5), and paraparesis (1). The mean Barthel Index at the time of admission was 35 points, whereas this value was 75 points at discharge. After the inpatient rehabilitation, 73 patients improved functionally, the status of 9 patients did not show clinically relevant changes, and 2 patients deteriorated. During the rehabilitation 10 patients required urgent interhospital transfer to brain surgery units, 9 patients continued their oncological treatment, two patients continued rehabilitation treatment at another rehabilitation unit, and after rehabilitation 73 patients were discharged to their homes. Conclusions - Inpatient rehabilitation treatment could be necessary after operation of patients with brain tumor especially when functional disorders (disability) are present. Consultation is obligatory among the neurosurgeon, rehabilitation physician and the patient to set realistic rehabilitation goals and determine place and method of rehabilitation treatment, but even at malignancies cooperation with oncological specialist also needed. Authors’ experience shows benefits of multidisciplinary rehabilitation for patients after brain tumor surgery. ]

Hypertension and nephrology

[Risk of drug-drug interactions in hemodialyzed patien]

SZABÓ Alexandra, HARIS Ágnes

[Hemodialysis patients usually need large number of medications fór treatment of their multiple comorbidities. Because of the polypharmacy we have to count on several drug-drug interactions, which might necessitate modification of types and dosages of drugs, based on the patient's actual condition and current treatment. The use of anticoagulants causes everyday problems, because these drugs have high pharmacokinetics potency, and on the other hand their administration is indispensable. In our investigation we aimed to analyze the drug therapy of chronic hemodialysis patients in the Szent Margit Hospital Taraba István Dialysis Unit, and present the clinical pharmacist's role in the hospital team.]