Lege Artis Medicinae

[GEMICA]

MATOS Lajos

APRIL 20, 2001

Lege Artis Medicinae - 2001;11(04)

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Lege Artis Medicinae

[Percutaneous coronary intervention in ischaemic heart disease]

VOITH László

[In ischaemic heart disease, if the medically treated patient’s anginal complaints and/or ischaemic symptoms are persistent, coronary angiography, and according to its results, coronary intervention (surgery or dilatation) may become necessary. The intervention is required in critical stenosis (>70% diameter) of the main vessels, the emergency depends on the clinical situation. Basic method of coronary angioplasty is the balloon dilatation, other tools (stent, rotablator, laser wire, atherectomy device, etc.) are also available. Periprocedural anticoagulant (heparin) and platelet aggregation inhibitor (aspirin, ticlopidine, GP IIb/III/a receptor blocker) treatment is required, the latter after the procedure as well. After stent implantation the lumen of the vessel is bigger and the incidence of major adverse cardiac events (acute myocardial infarction, repeated intervention, fatal outcome) is diminished. Decrease of serum lipid level improves the outcome of coronary angioplasty. It is applicable successfully for multiple lesions, occluded vessels, stable and unstable angina, in the early phase of myocardial infarction, in patients who underwent coronary surgery, and in old age too. Risk factors of the intervention are: tortuous vessel, significant calcification, stenosis in angle or ostium, luminal thrombus, urgent intervention, old age, female gender, congestive heart failure, unstable condition and acute myocardial infarction. When indicating the intervention, besides the probable results, it is necessary to consider the possibility of complications (myocardial infarction, malignant rhythm disorders, acute heart failure, bleeding, etc.). In left main stem stenosis, 3 vessel disease and in the case of 1 functioning coronary artery surgery would be preferable. With the present facilities the ratio of urgent surgical intervention as well as the mortality is below 1%.]

Lege Artis Medicinae

[New oral antidiabetic agents - New aspects in the management of type 2 diabetes mellitus]

GERŐ László

[During the past years several new oral antidiabetic agents have become available and more new drugs of this type are expected to appear on the market. New products appeared in both groups of insulin sensitizers and insulin secretagogues. Modern insulin secretagogues are characterized by immediate and short action. As a consequence, insulin secretion will approach the physiological secretory pattern. The rapid, short-term insulin output prevents the abnormal increase of postprandial glucose level and - at the same time - the danger of late hypoglycemia will decrease. The combination of insulin sensitizers with the new insulin secretagogues provides the possibility to apply the basisbolus therapeutical principle to type 2 diabetic patients treated with oral agents.]

Lege Artis Medicinae

[Weak-hearted composer of monumental forms - Anton Bruckner]

MALINA János

Lege Artis Medicinae

[Postgraduate training for diabetologists - Report]

GYIMESI András

Lege Artis Medicinae

[Behavioral science approach to the nursing profession]

PIKÓ Bettina

[Study of psychosocial work environment in health care and in other non-profit organizations has not gotten priority so far. Workers in the units that are organized by inefficient management skills are more susceptible to the harmful psychological, health and social consequences of everyday work. The main goal of present analysis was to investigate nurses’ work conditions and their psychosomatic health as a part of the ongoing Nurse Study in Csongrád county. 420 nurses participated in the study among whom 218 were registered and 202 student nurses. Selfadministered questionnaire was used as a method of data collection which contained various items on sociodemographics, psychosomatic symptoms, other psychosocial health variables, job-related stress and emotional load, and social support from peers. Based on the results of the multiple regression analyses it can be concluded that nurses’ psychosomatic health was mainly influenced by the characteristics of their psychosocial work environment. The management should pay attention to establish team structures which could help in coping with job-related stress and providing social support.]

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