Lege Artis Medicinae

[Excerpts from publications of Hungarian authors published in foreign journals]

OCTOBER 01, 2000

Lege Artis Medicinae - 2000;10(10)

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Lege Artis Medicinae

[Antibacterial therapy: 2000 balance and perspectives]

GRABER Hedvig

[Following a brief history of antibacterial therapy and evaluating the achievements and damages occurred, authors focus on today's problems and the following statements are made: Principles of treatment are clearly defined, however the choice of antibiotics may vary in time and in regions according to the differences in bacterial resistance. Antibacterials of the last decade (III-IV. generation fluoroquinolones, streptogramins, oxazolidinones, new vancomycine analogues) are intended to be effective against multiresistant Gram-positive cocci. Beside bacterial resistance, the most difficult therapeutic problems are the infections in the immunocompromised patients. The role of infection in the pathogenesis of certain diseases, e.g. ventricular/duodenal ulcer and probably atherosclerosis, has only recently been discovered; here new prospects may open for antibacterials. Data of the antibiotic utilization in Hungary show radical changes in the last years. Conclusion: the immense power of antibiotics still has its limits: to conquer bacterial disease successfully the intelligent combination of antibiosis, asepsis and immunization are required. ]

Lege Artis Medicinae

[Group Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico - Prevenzione]

MATOS Lajos

Lege Artis Medicinae

[Molecular mechanisms of cardiac hypertrophy and heart failure]

MIKALA Gábor, PETŐ Mónika, VÁLYI Nagy István, CSÁSZÁR Albert

[In this review, the most important molecular mechanisms leading to cardiac muscle hypertrophy and consequentially to heart failure are detailed. In numerous instances, understanding molecular mechanisms offers the possibility for pharmacotherapeutic intervention. First, trimeric G-proteins and their attached intracellular signaling pathways are introduced, with special emphasis on the pathways elucidated by transgenic animal models. In this area, there are several clinically effective drugs to influence cardiac hypertrophy, including ACE inhibitors, angiotensin receptor antagonists, as well as a- and B-adrenergic receptor blockers. Mitogen activated protein kinases participate later in the hypertrophic cascade. There are ongoing investigations on the potential therapeutic use of lipid-soluble statins these are indirect inhibitors of Ras-farnesylation. Altered cellular Ca2+-homeostasis is fundamental with respect to cardiac muscle hypertrophy and heart failure. The third part of this article investigates the role of the calcium/calmodulin dependent protein phosphatase called calcineurin in these processes. Administration of cyclosporin A or tacrolimus (both are inhibitors of calcineurin) may not be recommended in most forms of cardiac hypertrophy, however, in certain settings they may prove to be valuable therapeutic agents. One of the most serious, not yet properly addressed problem of late stage heart failure is the development of ventricular arrhythmias caused by repolarization abnormalities. Certain mechanisms of this phenomenon are highlighted with a special note on Nat-Cat exchange inhibitors as one of future therapeutic agents of much promise. ]

Lege Artis Medicinae

[The role of MR angiography in the examination of intracranial aneurysms: A comparative study]

P. Nagy Zoltán, BAJZIK Gábor , BOGNER Péter, BERÉNYI Ervin, SZÁSZ Krisztina, KOPA János, REPA Imre

[MR imaging has recently emerged for visual representation of blood vessel structures as well. With MR angiography (MRA), appropriate diagnosis can be established for a number of pathologies involving the arteries and veins. In this report, authors analyse the significance of MR and MRA examinations in the diagnostics of intracranial aneurysms of 87 cases, comparing these procedures with results obtained by digital subtraction angiography (DSA), which is regarded as the gold standard method. In 52 patients where surgical intervention was performed, intraoperative findings were used as control. MR - MR angiographic examination was very sensitive in detecting aneurysms larger than 3 mm (98%), the rate of depicting smaller aneurysms proved to be lower (56%), the overall sensitivity was 79%. MRA is an excellent non invasive diagnostic tool in the examination of intracranial aneurysms. The method can not replace catheter angiography completely but its application is justified and useful in many cases. Occasionally, aneurysms not seen on DSA can be depicted with MR angiography. ]

Lege Artis Medicinae

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

KAPÓCS Gábor

Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[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. ]

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 ]

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

[Diagnosis and treatment of microvascular coronary heart disease. Specialities of conditions in Hungary]

SZAUDER Ipoly

[Invasive investigations show that in two-thirds of patients the myocardial ischaemia persists without obstructive coronary disease and any other heart conditions (INOCA). The underlying cause may be microvascular dysfunction (CMD) with consecutive microvascular coronary disease (MVD) and microvascular or epicardial vasospastic angina (MVA). The modern practice of clinical cardiology while using the developed non-invasive cardiac imaging permits exact measuring of the coronary flow with its characteristic indices. All of these improve the diagnosing of CMD-induced myocardial ischemia and provide opportunity to determine primary MVD cases. Since the recognition and treatment of MVD is significantly underrep­resented in the Hungarian medical care, the primary stable microvascular angina (MVA) is described in detail below with its modern invasive and non-invasive differential diagnosis and treatment, concerning especially its frequency provoked by high blood pressure and female coronary heart diseases. There are highlighted all recommended diagnostic procedures available under domestic conditions.]