Lege Artis Medicinae

[Funding at every level]

ANDRÁS László

SEPTEMBER 30, 1992

Lege Artis Medicinae - 1992;2(09)

[Interview with Gyula Pulay, Deputy State Secretary for Public Welfare]

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Lege Artis Medicinae

[Echocardiography in the management of acute myocardial infarction]

LENGYEL Mária

[The author presents a detailed review of the role of echocardiography (echo) in the management of acute myocardial infarction (AMI). The echo diagnosis of AMI is based on segmental wall thinning and akinesia with a 90% accuracy. Echo has made a major impact on the immediate diagnosis of mechanical complications in the hemodynamically compromised patient with AMI. These mechanical complications which include myocardial rupture of the free wall or the septum or the papillary muscle, may be successfully treated by prompt surgical intervention. Echo diagnosis has an important role in the management of other complications of the acute, subacute and chronic phases of infarction as well, such as pericardial effusion, left ventricular thrombus, left ventricular aneurysm and pseudoaneurysm. Therapeutic strategies are thoroughly affected by systolic and diastolic function assessed by echo. Echo has a basic role in the algorithm of postinfarction anticoagulant treatment. Besides rest echo, early stress echo has a definite prognostic value in predicting multivessel disease and identifying viable myocardium which requires revascularisation procedures. The indications for echo in the acute phase and before discharge are summarized according to recent American recommendations. ]

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[Clinical and immunological aspects of polymyositis and dermatomyositis]

DANKÓ Katalin, ZILAHI Zsolt, SZEGEDI Gyula

[Polymyositis and dermatomyositis are autoimmune diseases characterized by muscle weakness, tenderness, occasionally pain, and ultimately atrophy and fibrosis of the muscles. The extraskeletal manifestations, particularly the cardiopulmonary, oropharyngeal, gastrointestinal involvement, are described. Studies of autoantibodies and cellular immune function support a central role for disordered immunity in the pathogenesis. The myositis-specific autoantibodies, expecially those directed at certain enzymes important in protein synthesis are found in a clinically distinct subset of patients. ]

Lege Artis Medicinae

[Right ventricular infarction]

KISS Gabriella

[Right ventricular infarction (RVI) may occure as isolated or, more often, associated with left ventricular – inferior or occasionally anterior - infarction. The diagnosis of RVI is based first of all on the characteristic clinical symptoms, on the ECG pattern and on the results of 2D-echo-cardiography. The exact localisation of the infarction has vital significance in the therapy of the acute phase. The mortality can be substantially decreased with adequate therapeutic measures even in severe cases. The prospective prognosis of RVI is more favourable than that of left ventricular infarcti on. The author presents the most important diagnostic and therapeutic features related to RVI. ]

Lege Artis Medicinae

[Role of platelet function in the pathogenesis of alzheimer's disease]

HASITZ Mária, LIPCSEY Attila, RÁCZ Zoltán

[Dementias, especially those of Alzheimer type represent very serious types of disease in the elderly. Amounting evidence suggests that Alzheimer's disease is reflected in the platelets of the patients. Our results and the data of scientific literature have been summarized. In vitro parameters of platelet shape and aggregation were compared. Platelet shape, characterized by aggregometer oscillation amplitude, and the initial rate of 50 uM ADP-induced aggregation have been recommended for supporting the diagnosis of Alzheimer's disease or Alzheimer-type senile dementia. Our results and those of others revealed that the function of the Alzheimer platelet is influenced by two effects: the plasma medium and the genetic background resulting in the change of the platelets. The results suggest that both effects are involved in the vitro functions detected.]

Lege Artis Medicinae

[The role of ultrasound in the diagnosis of septic hip prosthesis loosening]

FÖLDES Károly, BÁLINT Péter, GAÁL Marianna, KISS Csaba, BÁLINT Géza

[The aim of the authors is the application of non-invasive ultrasound examination to the detection of complications after hip joint arthroplasty. Their recent work has been a trial to explore the kind of diagnostic assistance of ultrasound in case of suspected endoprosthetic infection. 39 patiens have been examined after hip joint arthroplasty. Out of this sample there was a suspected clinical infection in 20 cases. The rest 19 patients had no complaints and made the control group. Out of the patients with complaints effusion was detected around the neck of the prosthesis by means of US in 7 cases. Out of these in 10 cases reoperation in 6 cases US guided joint aspiration verified our US results. The authors made conclusion that as to patients having complaints of pain after hip joint arthroplasty very useful assistance in avoiding infection may be given by quided ultra sound aspiration.]

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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. ]

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[Trace elements are found in the living organism in small (trace) amounts and are mainly essential for living functions. Essential trace elements are in humans the chromium (Cr), cobalt (Co), copper (Cu), fluorine (F), iodine (I), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), and questionably the boron (B) and vanadium (V). According to the biopsychosocial concept, mental functions have biological underpinnings, therefore the impairment of certain neurochemical processes due to shortage of trace elements may have mental consequences. Scientific investigations indicate the putative role of trace element deficiency in psychiatric disorders such in depression (Zn, Cr, Se, Fe, Co, I), premenstrual dysphoria (Cr), schizophrenia (Zn, Se), cognitive deterioration/de­mentia (B, Zn, Fe, Mn, Co, V), mental retardation (I, Mo, Cu), binge-eating (Cr), autism (Zn, Mn, Cu, Co) and attention deficit hyperactivity disorder (Fe). At the same time, the excess quantity (chronic exposure, genetic error) of certain trace elements (Cu, Mn, Co, Cr, Fe, V) can also lead to mental disturbances (depression, anxiety, psychosis, cognitive dysfunction, insomnia). Lithium (Li), being efficacious in the treatment of bipolar mood disorder, is not declared officially as a trace element. Due to nutrition (drinking water, food) the serum Li level is about a thousand times less than that used in therapy. However, Li level in the red cells is lower as the membrane sodium-Li countertransport results in a Li efflux. Nevertheless, the possibility that Li is a trace element has emerged as studies indicate its potential efficacy in such a low concentration, since certain geographic regions show an inverse correlation between the Li level of drinking water and the suicide rate in that area. ]

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ÁDÁM Szilvia, DOMBRÁDI Viktor, MÉSZÁROS Veronika, BÁNYAI Gábor, NISTOR Anikó, BÍRÓ Klára

[Background – The two free-to-use versions of the Oldenburg Burnout Inventory (OLBI) have been increasingly utilised to assess the prevalence of burnout among human service workers. The OLBI has been developed to overcome some of the psychometric and conceptual limitations of the Maslach Burnout Inventory, the gold standard of burnout measures. There is a lack of data on the structural validity of the Mini Oldenburg Burnout Inventory and the Oldenburg Burnout Inventory in Hungary. Purpose – To assess the structural validity of the Hungarian versions of the Oldenburg Burnout Inventory and the Mini-Oldenburg Burnout Inventory. Methods – We enrolled 564 participants (196 healthcare workers, 104 nurses and 264 clinicians) in three cross-sectional surveys. In our analysis we assessed the construct validity of the instruments using confirmatory factor analysis and internal consistency using coefficient Cronbach’s α. Results – We confirmed the two-dimensional structure (exhaustion and disengagement) of the Mini-Oldenburg Inventory and a shortened version of the Oldenburg Burnout Inventory Internal consistency coefficient confirmed the reliability of the instruments. The burnout appeared more than a 50 percent of the participants in every subsample. The prevalence of exhaustion was above 54.5% in each of the subsamples and the proportion of disengaged clinicians was particularly high (92%). Conclusions – Our findings provide support for the construct validity and reliability of the Hungarian versions of the Mini-Oldenburg Burnout Inventory and a shortened version of the Oldenburg Burnout Inventory in the assessment of burnout among clinicians and nurses in Hungary.]

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[Stroke associated dysphagia can have serious consequences such as aspiration pneumonia. The Hungarian guideline on nutritional therapy for stroke patients recommends dysphagia assessment, as early screening can optimize disease outcome and hospital cost. Thus far, this may be the first study in Hungarian that has documented a systematic review about the available validated dysphagia assessments of acute stroke. Purpose – The aim of this study was to summarize the instrumentally validated bedside dysphagia screening tools for acute stroke patients, which were published in the last twenty years. Our objective was to describe the characteristics of the validation studies, examine their study design, and sample the sub-tests and the diagnostic accuracy of the assessments. A systematic research was carried out of the literature between 2001 and 2021 in eight scientific databases with search terms appropriate to our objectives. Subjects of the study – 652 articles were found and were reduced to eight. We made a comparative analysis of these. The GUSS test reached a high level of sensitivity compared to the others. In our study sample, the prevalence of instrumentally confirmed dysphagia among acute stroke patients was 56.1%. The focus and the composition of the analyzed studies differed and posed problems such as the ambiguity of the concept of dysphagia, the difference in outcome indicators, or the timing of screening. The GUSS test, which offers domestic management, is a suitable tool for the Hungarian clinical use.]

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[Interrelations of social phobia, trait anxiety, perfectionism and psychological protective factors in a young female population: Cluster analysis]

DOBOS Bianka, PIKÓ Bettina

[Deterioration of social functions and quality of life and lower level of satisfaction with life are often joining to axiety disorders. Considering the higher prevalence rates across anxiety disorders for women, the aim of this study was to examine the relationship of social phobia with trait anxiety, perfectionism, use of pharmaceuticals, self-efficacy and life satisfaction in a group of young female participants. Online, self-administered questionnaire was used as a method of data collection at different social network sites. The sample consisted of young women aged between 14–35 years (N = 435, M = 27.3 years; SD = 5.9). The questionnaire con­tained items of socio-demographic variables, use of pharmaceuticals as well as mental background variables (Social Pho­bia In­ventory, State-Trait Anxiety In­ven­tory, Mul­ti­dimensional Perfectionism Scale, Ge­neral Perceived Self-Efficacy Scale, Sa­tis­faction with Life Scale). Besides correlation analysis, cluster analysis was conducted. rait anxiety shows strong correlation with social phobia, perfectionism and use of pharmaceuticals. After examining all variables three clusters were emerging: 1) high level of trait anxiety with social phobia, moderate perfectionism, low levels of self-effcacy and satisfaction with life; 2) trait anxiety below the average without social phobia, high self-efficacy and satisfaction with life; 3) trait anxiety above the average with moderate phobia, high perfectionism with high self-efficacy and moderate life satisfaction. Results of our study show that social phobia strongly interrelates not only with trait anxiety as a stable part of personality but with self-estimated lower well-being and lack of mental protective factors. ]