Lege Artis Medicinae

[“Dog’s cosmic barking” – Zsuzsanna Nemesi Nagy ]

ABODY Rita

DECEMBER 21, 2020

Lege Artis Medicinae - 2020;30(12)

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Lege Artis Medicinae

[LAM 30: 1990–2020. Facing the mirror: Three decades of LAM, the Hungarian medicine and health care system]

KAPÓCS Gábor

Lege Artis Medicinae

[History of vaccine production in Hungary ]

ÓCSAI Lajos

[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. ]

Lege Artis Medicinae

[Risk of nonsteroidal antiinflammatory drugs. Focus on aceclofenac]

FARSANG Csaba

[Nonsteroidal antiinflammatory drugs (NSAIDs) are among the most frequently used pharmaceuticals. Nevertheless, a number of studies emphasized that NSAIDs were damaging not only the gastrointestinal (GI), but also the cardiovascular (CV) system, could increase the blood pressure, the frequency of coronary events (angina, myocardial infarction) and stroke incidence, as well as they might deterio­rate renal functions. The National Institute for Health and Care Excellence (NICE) did not find evidence that administering NSAIDs could increase the risk of developing COVID-19 or worsened the condition of COVID-19 patients. However, unwanted effects of specific drugs differ substantially in their occurrence and seriousness as well. It seemed to be for a long time that the NSAIDs provoked higher GI-risk was closely related to the COX1/COX2 selectivity, like the cardiovascular (CV) risk to the COX2/COX1 selectivity, however, the recent data did not prove it clearly. Based on the available literature while pondering the gastrointestinal and cardiovascular adverse events, among all NSAIDs the aceclofenac profile seemed to be the most favourable.]

Lege Artis Medicinae

[The LAM’s 30 years]

FARSANG Csaba

Lege Artis Medicinae

[30 year history of surgery and the surgeon’s future ]

KUPCSULIK Péter

[During the past 3 decades, laparoscopic surgery has launched a revolution in operative medicine. The German gynaecologist Kurt Semm transformed the diagnostic laparoscopy for therapeutic procedure, as he performed the first laparoscopic ap­pen­dectomy. The surgeon Erich Mühe contributed with laparoscopic cholecystectomy to the set of surgical instruments. All over the world, a wide spectrum of laparoscopic procedures has been app­lied. Several laparoscopic procedures are now preferred over open approaches. Morbid obesity is associated with significant comorbidity and mortality. In­suffi­ciency of dietary measures lead to development of surgical interventions that resulted in unexpected excellent outcomes. “Metabolic surgery” was born. New methods and rising market of socio-medical requirements inspired progress in plastic surgery. Thanks to innovations in technology, reconstructive breast surgery has opened new ways. In the 1990s the prototype of “mas­ter–slave” robot controlled by a surgeon was constructed. Future of robotic surgery depends on cost reduc­tion, development of new technologies and creating the best applications. Coo­pe­ra­tion with partner medical specialities is essential for further development in surgery. Despite of obvious impact of new technologies the surgeon's way of thinking, personal qualities decision-making and professional knowledge remain cru­cial for further evolution. ]

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Lege Artis Medicinae

[Correspondence]

KÖVES Péter

["Let's play cards"; you could say it's a collective gamble that costs a lot of money and the payoff is as uncertain as a dog's dinner. Everyone expects a lot from it: we, the primary care doctors (at present, district, general practitioners and family doctors in the process of metamorphosis), and the patients, who are increasingly waiting outside the doors of our surgeries. ]

Hungarian Radiology

[A Response to Zsuzsanna Kis and István Berecz]

PALKÓ András

LAM Extra for General Practicioners

[Nemesi Zsuzsanna]

Lege Artis Medicinae

[Fine Art Column]

KESERŰ Katalin

["Not forced"; in Ferenc Banga's drawings, this is what is striking. Indeed, the line chosen is also ambiguous. For example, the waggon winding into the crescent of the moon (Force of the Spirit) links the magician with cosmic forces (one can think of mythology: Samson's tresses or the fairytale devil).]

Lege Artis Medicinae

[Dilemma of the use of ionic or nonionic contrast media]

POKORNY Lajos, VADON Gábor

[The conventional contrast media are cheaper, the newer contrast media - apparently more favourable for the patients – are more expensive. On the basis of large clinical and experimental material authors are analysing the effects and usability of the different contrast agents. The examinations were performed on 812 patients and on 140 dog kidneys. On the patients different angiographies were carried out. After the injection of the contrast medium we registered the the subjective sensations, side effects, complications as well as the changes of blood pressure, pulse rate, UN, Se Bi, SGOT and the qualitative changes of the protein content of the urine. On the dogs selective renal angiographies were performed, 3 and 24 hours later histological examinations were made. The patients tolerated better the new low osmolality contrast media, the number of side effects was significantly smaller. In experiment we saw the fewest irregular angiogramms and the fewest histological changes after the use of the new nonionic contrast media. According to the calculations of some authors it would be worth to use the nonionic contrast media of new type in all examinations because of not requiring general anaesthesia, medicaments to fight off complications and decrease the nursing period. In today's economical situation we can't afford in our country not to use the cheaper, conventional contrast media. Use of the new low osmolarity contrast media intravasculary is justified, but it is imperative on the patients of high risk groups, in the examination of children and sensitive organs (nervous system, coronary vessels, kidney).]