Lege Artis Medicinae

[Either you sink or swim?]

KAPÓCS Gábor

APRIL 20, 2002

Lege Artis Medicinae - 2002;12(04)

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Lege Artis Medicinae

[Statin for everyone? - Aspects of treatment]

CSÁSZÁR Albert

Lege Artis Medicinae

[Recognition of mental disorders in primary care]

FÜREDI János, RÓZSA Sándor, SZÁDÓCZKY Erika, ZÁMBORI János

[BACKGROUND - Several studies have shown that a substantial part of patients with mood and anxiety disorders seeks help at their primary care physician. It is well known that recognition of these disorders cause difficulties for general practitioners. In our study starting in 1998, we attempted to map the psychiatric disorders present in primary care patients. This paper investigates the factors that may contribute to the difficulties in recognition and diagnosis of mental disorders. METHOD - 1815 primary care patients in 12 general practice offices has been evaluated for mood and/or anxiety disorders with DIS interview. The DIS diagnosis was compared with complaints and symptoms of patients and diagnosis given by their GPs. RESULTS - Diagnosis given by GPs and DIS evaluation showed low concordance. The main factor in this proved to be the presence of somatic disorders, whereas socio-demographic factors played little role. The highest concordance of diagnosis was found when acute or chronic somatic disorders were not present.]

Lege Artis Medicinae

[Rapunsen-syndrome]

HEGEDŰS Melinda, MAROS Éva, REGLŐDI Dóra

Lege Artis Medicinae

[Rapid-acting human insulin analogues: new possibilities in the therapy of diabetes mellitus]

KERÉNYI ZSUZSA, TAMÁS GYULA

[Modifications of the insulin molecule at the end of the B chain resulted in the development of some new, more physiological meal-related insulins, the rapid acting human insulin analogues. This survey summarises the characteristics (structure, absorption, immunogenicity, efficacy and safety) and the conditions of clinical application of the rapid-acting insulin analogues available at the moment in Hungary. Furthermore, authors evaluate the effect of application of rapid-acting insulin analogues on the quality of life and glycaemic control of the patients. The collaboration between the well-prepared health-care team and the well-educated and cooperative diabetic patient using rapid-acting insulin analogue could lead to a level of freedom of lifestyle that approximates that of healthy people.]

Lege Artis Medicinae

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MATOS Lajos

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[The Effects of the Children’s Temperament and their Parents’ Dental Fear on developing Dental Fear]

APRÓ Zoltán, NÉMETH Anikó

[The aim the present study was to assess the level of dental fear among 5-7 years old children and its correlations with dental-hygienic habits and their temperament. Furthermore, the relationship of the dental fear of parents and children was also analysed. This cross-sectional study was conducted by the means of a self-constructed questionnaire in 2017. The responses of 70 people were analysed with the help of SPSS 22.0; descriptive statistics, 2-sample T-probes, Mann-Whitney probes, analyses of variance and correlations were calculated (p<0.05). High level of dental fear was detected by 30% of the included children. There was no correlation between the dental fear of the parents and their children’s. Dental fear had no effect on the frequency of tooth-brushing. Children’s dental fear had no correlation with either previous painful experiences at the dentist’s or the temperament of the child. Dental fear is present among children and not only family but dental hygienists might play an important role in reducing it. ]

Clinical Neuroscience

Comparison of pramipexole versus ropinirole in the treatment of Parkinson’s disease

GENCLER Onur Serdar , OZTEKIN Nese , OZTEKIN Fevzi Mehmet

Parkinson’s disease is a progressive neurodegenerative disease characterized by motor and non-motor symptoms. Levodopa is the most effective drug in the symptomatic treatment of the disease. Dopamine receptor agonists provide sustained dopamin-ergic stimulation and have been found to delay the initiation of levodopa treatment and reduce the frequency of various motor complications due to the long-term use of levodopa. The primary aim of this study was to compare the efficacy of potent nonergoline dopamine agonists pramipexole and ropinirole in both “dopamine agonist monotherapy group” and “levodopa add-on therapy group” in Parkinson’s disease. The secondary aims were to evaluate the effects of these agents on depression and the safety of pramipexole and ropinirole. A total of 44 patients aged between 36 and 80 years who were presented to the neurology clinic at Ministry of Health Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey and were diagnosed with idiopathic Parkinson’s disease, were included into this randomized parallel-group clinical study. Dopamine agonist monotherapy and levodopa add-on therapy patients were randomized into two groups to receive either pramipexole or ropinirole. The maximum daily dosages of pramipexole and ropinirole were 4.5 mg and 24 mg respectively. Patients were followed for 6 months and changes on Unified Parkinson’s Disease Rating Scale, Clinical Global Impression-severity of illness, Clinical Global Impression-improvement, Beck Depression Inven­tory scores, and additionally in advanced stages, changes in levodopa dosages were evaluated. Drug associated side effects were noted and compared. In dopamine agonist monotherapy group all of the subsections and total scores of Unified Parkinson’s Disease Rating Scale and Clinical Global Impression-severity of illness of the pramipexole subgroup showed significant improvement particularly at the end of the sixth month. In the pramipexole subgroup of levodopa add-on therapy group, there were significant improvements on Clinical Global Impression-severity of illness and Beck Depression Inventory scores, but we found significant improvement on Clinical Global Impression-severity of illness score at the end of the sixth month in ropinirole subgroup too. The efficacy of pramipexole and ropinirole as antiparkinsonian drugs for monotherapy and levodopa add-on therapy in Parkinson’s disease and their effects on motor complications when used with levodopa treatment for add-on therapy have been demonstrated in several previous studies. This study supports the effectiveness and safety of pramipexole and ropinirole in the monotherapy and levodopa add-on therapy in the treatment of Parkinson’s disease.

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[The role of intergenerational stress in the background of anorexia nervosa]

TÚRY Ferenc, PÁSZTHY bea

[In childhood and adolescence, family therapy is a crucial therapeutic method in the treatment of anorexia nervosa. Among the family stress factors there are the tensions often too obvious between the parental and grandparental generations. Three case reports are presented, where the transgenerational tensions played an important role in the family of a young patient, suffering from anorexia nervosa. During the family therapy, the treat­ment of interrelated family stress factors and focusing on transgenerational relations proved to be crucial in the successful outcomes. While treating anorexia nervosa by family therapy there are not only important the recognition and treatment of tensions within the nuclear family, but also those of stressed relations emerging from grandparental generation through multigenerational transfer mechanisms. This treatment may be successful either with the grandparent’s inclusion, or exclusion. ]

Lege Artis Medicinae

[Commemorating the Lipótmező. Part 1.]

RIHMER Zoltán

[“What did Lipótmező mean to you?” My friends and acquaintances asked frequently this question in the past decades, concerning the National Institute for Psychiatry and Neurology or well known as the Lipótmező my past workplace and the role it played in my life thus far. It is difficult to give a short answer, but the three and a half decades I have spent there were certainly of decisive importance in my professional and private life as well. Since I was banned from tobacco smoking due to my disease ten years ago, I cannot keep my pipe in my mouth any more. Thus, I decided to recollect the dearest stories kept in my memory, which had the deepest impact on me during my 35 years in Lipótmező both as a doctor and as a man. ]

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[Bradykinin-cytokin-storm and its pathomechanism in very severe Covid-19]

SZÉKÁCS Béla, VÁRBÍRÓ Szabolcs, KÉKES Ede, DEBRECZENI Lóránd

[The authors review the pathomechanism of severe COVID-19 leading to systemic uncontrollable inflammation, thrombotic events and other complications. The review includes the extremely complex interactions between the infecting coronavirus and the in loco cellular-tissue contact system, the kinin-kallikrein and the renin-angiotensin systems. Authors critically evaluate some potential therapeutic interventions aiming at the mitigation of the dominant bradykinin-cytokine storm in the background of severe COVID-19 by inhibiting bradykinin formation, facilitating its degradation, or blocking either the B2 receptor or the bradykinin induced cytokine response.]