Lege Artis Medicinae

[Getting in Harmony]

KOLIN Péter

DECEMBER 19, 2008

Lege Artis Medicinae - 2008;18(12)

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Lege Artis Medicinae

[Similar to Similar – Homeopathy in Hungary]

KÖLNEI Lívia

Lege Artis Medicinae

[NON-ISCHEMIC MYOCARDIAL DISEASES]

MAGYAR Éva, NAGY Pál

[Myocardial diseases are leading morbidity and mortality statistics. There is a group of non-coronary myocardial diseases with heterogeneous background, the majority of them being fatal, or causing sudden cardiac death. Knowledge of genetic and molecular biology techniques has facilitated identification of etiology and pathogenesis of primary myocardiopathies, thus opening up new prospects of diagnostics and therapy. Secondary myocardiopathies are of known origin; they include myocarditides, systemic and endocrine myocardiopathies and myocardial alterations induced by medical drugs and narcotic drugs. WHO has issued a recommendation for grouping primary and secondary myocardial diseases on a pathological and morphological basis. A review of these diseases based on the WHO recommendation, the authors clinical experience, and literature data is given.]

Lege Artis Medicinae

[Coecum or Not?]

BALOGH István

Lege Artis Medicinae

[UPLIFT study]

MAGYAR Pál

Lege Artis Medicinae

[World, crisis, change]

KAPÓCS Gábor

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[Getting Rid of Cigarette...]

VADÁSZ Imre

Hypertension and nephrology

[Covid-19 and the kidney]

PATÓ Éva, DEÁK György

[Covid-19 pandemy has emerged from Wuhan, China in December 2019. The infection affects not only the lung but other organs such as the kidney, as well. The relation between Covid-19 infection and the kidney is bidirectional. On one hand, Covid-19 infection may cause kidney damage in 50-75% of the cases resulting in proteinuria, haematuria and acute kidney injury (AKI). The etiology of AKI is multifactorial. Main pathogenic mechanisms are direct proximal tubular cell damage, sepsis-related haemodinamic derangement, citokine storm and hypercoagulability. The virus enters proximal tubular cells and podocytes via the ACE2 receptor followed by multiplication in the lysomes and consequential cell lesion. Histopathology shows acute tubular necrosis and acute tubulointerstitial nephritis. AKI is a strong predictor of mortality in critically ill patients. On the other hand, the risk of Covid-19 infection and mortality is substantially increased in patients with chronic kidney disease – especially in those with a kidney transplant or on dialysis – due to their immunocompromised status. Among haemodialysis patients, infection may spread very easily due to the possibility of getting contacted in the ambulance car or at the dialysis unit. The mortality rate of patients on renal replacement therapy with Covid-19 infection is 20-35%. In order to avoid mass infection it is obligatory to employ preventive measures and implement restricions along with (cohors) isolation of infected patients. In Hungary, every dialysis or kidney transplant patient with Covid-19 infection should be admitted to dedicated Covid-19 wards.]

Lege Artis Medicinae

[The real cost of caring for seriously ill patients - compassion fatigue or satisfaction]

KEGYE Adrienne, ZANA Ágnes, RÉVAY Edit, HEGEDÛS Katalin

[The improvement of the Hungarian hospice network and the increasing number of people dealing with the seriously ill are reflected by the annual hospice reports (2001-2013). However these reports also draw the attention to the cumulating mental and spiritual burdens of carers which can lead to fatigue and burnout. On the base of practical experience we surveyed the mental and spiritual condition of the caregivers of seriously ill patients and also reviewed research findings and the professional literature on the exposure to imperilment. The grounds of professional literature’s research were the Hungarian and international databases. We favoured studies published in Hungarian or English between 2000 and 2014 primarily on carers working in palliative and hospice service. One of the main profits of reviewing the professional literature is getting more detailed information on the mental state of professional caregivers. Relatively new element in researches is studying the relation between burnout and compassion satisfaction and compassion fatigue. It includes studying of symptoms and coping strategies. These all enable a better understanding of causes and help us to support hospice carers with more effective methods to protect them from mental and spiritual exhaustion.]

Hungarian Radiology

[The value and the risk of X-ray studies in case of infants and children]

WEISENBACH János, TÓTH Áron, KHEZRI Seddiq

[INTRODUCTION - Nowadays the question of roentgenological examination's quantity and indications are getting more and more relevant and debated because of their riskbenefit factors. The authors did not find any publication in the Hungarian literature that carefully studied and measured the amount of radiation doses that are involved in patient's examinations concerning their diagnostic values. PATIENTS AND METHODS - 6094 roentgenological examination's indications and the radiation doses used were studied by the authors at the Department of Paediatrics of Pécs University. The data were analyzed from the examinations of chest, skull and limbs as conventional techniques, urological examinations e.g cystourethrography and intravenous urography, and the CT examinations done during 1999. The results were analysed concerning their effective diagnostic values. Conclusions were based on the results of 6094 examinations. RESULTS - 1591 chest X-ray examinations were performed due to the suspicion of infection. A high proportion of these examinations was negative (345) and 862 showed bronchitis. Similarly in traumatological skull X-ray examinations 225 of 343 were negative. One third of cystourethrographic examinations were also negative. In the case of intravenous urography the number of examinations done was low (30) and the results of those were of great value. CONCLUSION - Based on our results, the chest X-ray examinations with the indication of pneumonia and the traumatological cases of skull and limbs, the patients should be examined more carefully clinically before considering roentgenogical examinations in order to reduce the abundant examples of radiation induction.]

Clinical Neuroscience

[Dostoyevsky’s epilepsy in the light of recent neurobiological data]

TÉNYI Dalma, RAJNA Péter, JANSZKY József, HORVÁTH Zsuzsanna, TÉNYI Tamás, GYIMESI Csilla

[Background and purpose -Since the 1960s several theories have developed on the epilepsy of Fyodor Mikhailovich Dostoyevsky. Probably the most exciting and still actual question might be the subject of the „ecstatic aura”, he described in his novels based on his own experiences. During this extremely rare seizure onset the patients experience a strong sense of happiness, harmony and wholeness. The symptomatogenic zone of ecstatic seizures were considered to be of temporal lobe origin for a long time. Lately though this theory seems to be questioned based on the results of SPECT and deep brain EEG monitoring techniques in addition to the enrichment of our knowledge concerning the function of the insular cortex. Methods - Literary and scientific overview on the subject of Dostoyevsky’s epilepsy, with special concern to his ecstatic seizures. Results and conclusion - According to new electrophysiology and imaging techniques ecstatic seizures - including the seizure onset of Dostoyevsky - could rather be connected to the insular cortex.]