Lege Artis Medicinae

[From the top it would still be there]

LÁSZLÓ András

OCTOBER 28, 1992

Lege Artis Medicinae - 1992;2(10)

[For those of you who have never been to the LAM Club - those who have been to the Hotel Agro will know that the large fifth-floor terrace of the restaurant offers a more beautiful and spacious view of Budapest and the Buda Hills than you could imagine. It's quiet, the smoke, dirt and noise of the city don't reach here anymore, only occasionally a Csepel truck or an Ikarus bus wanders by and breaks the silence, spewing its stench. It's good that they come, without them we would imagine ourselves out of time and space, perhaps we would forget where we came from and where we are going back to. On this terrace, facing this panoramic view, in pleasant - still pleasant - summer weather, invited guests and members of our club gathered to exchange ideas on the present and future of our patient care. ]

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Lege Artis Medicinae

[Diagnosis and treatment of acute obstetrical DIC]

RÁKÓCZI István

[Modern management of acut obstetrical diffuse intravascular coagulation (DIC) was evaluated. A large variety of obstetrical conditions are associated with acute DIC such as amniotic fluid embolism, abruptio placentae, intrauterine infection (septic abortion), dead fetus syndrome and prolonged shock of any aetiology. Typically, acute obstetrical DIC is associated with haemorrhage (mainly vaginal bleeding) and shock. The whole blood coagulation time, platelet count and fibrinogen level are the most clinically useful indicators in evaluating the patient with acute DIC. Management of acute DIC includes prompt treatment of precipitating factors (delivery of fetus in placental abruption, evacuation of the uterus in septic abort union plus administration of antibiotics, delivery of a dead fetus by induction of labor). Careful attention to fluid and blood cell replacement is needed to prevent and treat hemorrhagic shock. The coagulation failure is treated with fresh-frozen plazma or cryoprecipitate and platelets. In acute obstetrical DIC complicated by hemorrhage heparin has no use and will only cause the bleeding to worsen. Recently several clinical studies indicate that antithrombin III concentrates are efficacious in DIC.]

Lege Artis Medicinae

[Disseminated intravascular coagulation in the newborn]

GOLDSCHMIDT Béla

[A review is given on disseminated intravascular coagulation in the newborn period. DIC is not a single disease entity, but a complication of several underlying diseases. The author summarizes the physiologic and pathophysiologic conditions which promote the development of this blood coagulation disorder in this age. Further on the clinical symptoms, the difficulties of laboratory analysis as well as of differential diagnosis are discussed. Finally a detailed description of the treatment of the neonatal DIC syndrome is given. ]

Lege Artis Medicinae

[The risk of ischemic heart disease in patients with ischemic cerebrovascular disease]

HORVÁTH Sándor

[A strong association is supported between ichemic cerebrovascular and heart diseases by several studies. Death is more commonly caused by myocardial infarction than by stroke itself in patients with asymptomatic carotid stenosis, amaurosis fugax, transient ischemic attack or ischemic stroke. Signs and symptoms of ischemic cerebrovascular diseases or asymptomatic atherosclerosis of the arteries of the neck are harbinger for both myocardial and cerebrovascular infarction. Patients suffering from ischemic cerebrovascular diseases should be routinely investigated, treated and cared for coronary artery disease in order to prolong survival. ]

Lege Artis Medicinae

[Results and perspective of gene therapy in the treatment of primary immunodeficiency]

SÓFI Gyula, MARÓDI László

[During the last decade research has been directed toward gene-replacement therapy of genetic disorders, including primary immunodeficiencies. Efficient methods for gene transfer were developed to correct the gene defect in adenosine desaminase deficiency, leukocyte adhesion deficiency and chronic granulomatous disease. Somatic gene therapy in a patient with ADA deficiency was performed two years ago. This paper summaries inicial clinical applications of gene transfer and gene therapy in primary immunodeficiency and the future prospects of gene therapy in cohort of patients. ]

Lege Artis Medicinae

[Third International Study of Infarct Survival]

MATOS Lajos

[There was no significant difference in 35-day mortality between the aspirin + heparin and aspirin-only groups. The incidence of re-infarction was slightly lower with aspirin plus heparin (2p <0.09). When patients also received heparin in addition to aspirin, transfusion was needed more often and non-cerebral haemorrhage was more frequent (2p < 0.01) Combining the results of ISIS-3 and GISSI-2, mortality was significantly reduced during the treatment period (p < 0.01). There was no appreciable difference in mortality or re-infarct incidence between the use of streptokinase or APSAC, but there were more allergic events in the APSAC group. There was no difference in 6-month survival between the two groups. There was no difference in the efficacy of streptokinase and tPA treatment at either 0-35 days or 6 months survival. Allergies were less frequent with tPA, but non-cerebral haemorrhage was more frequent. Treatment with tPA led to stroke significantly more often than streptokinase (2p < 0.01). Combining the data from the similar GISSI-2 trial and ISIS-3, no difference was observed between streptokinase and tPA in either mortality between 0-35 days or survival at 6 months. ]

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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.]