Lege Artis Medicinae

[Faces from the Parliament]

ANDRÁS László

OCTOBER 30, 1991

Lege Artis Medicinae - 1991;1(16)

[Gyula Kincses (MDF). I have been an assistant professor of otorhinolaryngology at the University of Debrecen since my graduation. This is my first and only job. Today it is fashionable to claim that 'I was an oppositionist from childhood'. I can't say that. I was more of an alternative figure at university. I had an active cultural life: I was a successful photographer, I founded a jazz club and then the DOTE Gallery, which presented peripheral artists. I went to university as a typical exam-period student, which had the disadvantage that I had to study a lot after I graduated. ]

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Lege Artis Medicinae

[Cardiac rehabilitation a review]

VICTOR Froelicher, CRES P. Miranda

[The questions of cardiac rehabilitation are reviewed evaluating own personal experiences and pertaining current literature. The authors touch upon the question of early mobilization, as well as supervised and non supervised exercise. The criteria for the implementation of coronary angiography and acute revascularization procedures in the early phase of myocardial infarction are established. They review the secondary prevention of myocardial infarction and the effects of rehabilitation training on the patients prognosis.]

Lege Artis Medicinae

[Problems of organ transplantation - donor care]

RETTEGHY Tibor

[The development of the definition of brain death which is fundamental in cadaver organ removal for transplantation purposes is reviewed. Brain stem death, an alternative term for brain death is based primarily on clinical findings namely the irreversible cessation of cephalic reflexes and spontaneous breathing. Hypothermia, metabolic and endocrine abnormalities, prolonged muscle relaxant, sedative or hypnotic drug action should be excluded. The early recognition of potential donor and the maintenance of basic life function at the Intensive Care Unit and the operating theater are essential for the good function of the transplanted organs. Normal homeostasis should be maintained by ensuring adequate fluid intake, good circulation and urine output. Brain death potential donors can exhibit persistent spinal reflexes and spontaneous movement wich may be erroneously interpreted as signs of life. The problem of the determination of brain death under 4 year of age is also discussed although law does not allow to use them as potentional donors in Hungary. ]

Lege Artis Medicinae

[A review of a three year period in general practice]

FARKAS Tibor

[The author summarizes his work as a general practicioner in a village of 2000 people. He aimed to construct racional conditions of health care using technical, educational and organizing tools. Patients are reported to be satisfied and positive tendencies appeared in medicamentum consumption, and the number of sick days decreared from 13 673 to 10 198 per year. Less consultations of specialists and ask for hospital admission war performed. Indispensability of computers in the management of general practice is stressed. ]

Lege Artis Medicinae

[Having got a district]

SZABÓ János

[A beginner young general practicioner summarizes the experiences of his first year of work. Complex preparation for this work at the university, and the build up of the new practice of basic health service is described. Care of hypertension and diabetes is detailed, as an example how important and difficult is to reorganise this part of the work. The first year of experience gives a good possibility to look over the lack of undergraduate teaching This type of data collection and critical analysis seems to be necessary for a better planning of the forthcoming medical work. ]

Lege Artis Medicinae

[Chlamydia Pneumoniae: a new respiratory disease]

MARTON Anna , FÓRIS Katalin, SZALKA András, KÁROLYI Alice

[Current knowledge of Chlamydia pneumoniae, a newly recognized Chlamydia species that causes acute respiratory infection is summarized. Microbiology, classification and the laboratory diagnosis of the organism are discussed. Serological studies in Hungary suggest that almost everyone is infected during lifetime and reinfection is common as well. The organism appears to spread from human to human. Tetracyclin or erythromycin is recommended for the treatment of the Chlamydia pneumoniae infection. ]

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Lege Artis Medicinae

[Familiar faces - the portraits of Habsburg sovereigns]

NÉMETH István

Lege Artis Medicinae

[About the same thing elsewhere, in a different tone]

ANDRÁS László

[It was a gesture of thanks and appreciation that a few days after the publication of the 1992/6 regulation on general practitioners, senior staff from the Ministry of Public Welfare and the OTF presented and discussed it with their colleagues at the LAM Club. Naturally, this was done only after the regulation had been published. They did not receive the same recognition and thanks when they made the same gesture to their colleagues sitting as Members of Parliament in the Committee on Social Affairs and Health. ]

Lege Artis Medicinae

[Treatment of clubfoot with the Ponseti method]

KISS Sándor, TEREBESSY Tamás, HORVÁTH Nikoletta, DOMOS Gyula, GRESITS Orsolya, SZŐKE György

[INTRODUCTION - Congenital clubfoot is a severe developmental disorder. Without treatment, only the lateral border of the foot can be loaded and the sole faces the contralateral side. Good results can usually be achieved with early redression by serial casting (generally from the first week after birth) followed by extensive surgery at age six months (Achilles tendon lengthening, capsulotomy of the talo-crural and subtalar joints). The above procedure has been revolutionised by the method described by Ignacio Ponseti based on his own experiences, which has modified the casting technique and has also radically changed the surgical intervention. In this paper we report our experiences with Ponseti’s method and draw attention to this less invasive procedure. PATIENTS AND METHODS -The essence of Ponseti’s techniqe is reposition of the talonavicular joint, for which the foot is corrected in a different way compared with previous practice. Following redression for 8-10 weeks, percutaneous complete Achilles tenotomy is performed and the foot is fixed for further three weeks. A special orthesis is worn in the following 6 months for 24 hours a day and the same ortézis is suggested for overnights afterwards. In our institution, 171 clubfeet (45 unilateral, 126 bilateral; 84 right, 87 left; 25 girls, 83 boys) were treated between 2007 and 2012. Our results were evaluated with the help of the Pirani score, which is a widely used method for assessment of clubfoot treatment. RESULTS - Results were evaluated at the beginning of the treatment, at the end of redression and after percutaneous Achilles tenotomy. Pirani scores were 4.54±1.30; 1.48±1.02 and 0.59±0.45 respectively. The average dorsal flexion of the ankle joints was 23±12 degrees. CONCLUSION - Our own observations support the good results published in the literature, therefore the less invasive Ponseti method is suggested for the primary treatment of congenital clubfoot.]

Lege Artis Medicinae

[More pains of labour]

ANDRÁS László

[No luck for the Hungarian Medical Chamber's Bureau draft law to discuss the draft law with MPs. About six months ago, the Social Affairs Committee wanted to put the draft on its agenda for debate, but was thwarted by the question of form, which was only apparently a question of form, but in fact of substance: if it is a draft law, who submitted it to the parliamentary committee. A professional body is not entitled to do that. On this basis, the Members did not wish to discuss it at the time - at least now, and let us be precise here! - the draft chamber bill. Since then, the Presidency of the Chamber has revised the drafting in a public debate, has thoroughly liberalised it and would have liked to present it to the Members of Parliament who are doctors, and discuss it, now wisely calling it a working document. Such a meeting is not a statutory forum, has no agenda, and is not intended to be a lobbying exercise in the good sense.]

Lege Artis Medicinae

[The Social Security Health Insurance Fund's Mental Hygiene Board of Trustees]

[The Board of Trustees of the Social Insurance Health Insurance Fund for Mental Hygiene invites applications for the implementation of mental health promotion and mental hygiene programmes from the fund allocated by Parliament from the 1993 social insurance budget, pursuant to Act LXXXIV of 1992. ]