Lege Artis Medicinae

[ Gratitude money in Hungarian healthcare; Who, to whom, why, how much?]

NAGY András László

SEPTEMBER 01, 2000

Lege Artis Medicinae - 2000;10(09)

[In the last year, it was brought to life almost at the same time Minister of Health, the so-called Thanksgiving Committee, and began research - commissioned and supported by the Central European University and the State Treasury - by Tárki (Géza Bognár and Róbert Iván Gál, supervisor János Kornai). The studies summarizing the results of the two programs also became known at almost the same time (the report of the Thanksgiving Committee has since been published in book form by Springer Publishing). In our series, we browse in parallel a Commission report focusing on theoretical approaches and a study based on sociological facts (public and medical opinions, data disclosure).]

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Lege Artis Medicinae

[Bacteriophage therapy and prophylaxis; Renewal of earlier expectations]

MILCH Hedda

[Bacteriophages were discovered 84 years ago by the observation of a lysis of a bacterial culture. The aim of the earliest attempts was the therapeutic employment of bacteriophages. The experiments controlled unsatisfactorily, could not fulfill expecations and successful antibiotic testing resulted the rejection of bacteriophage therapy. Bacteriophages gained importance in biology in the 1950s, as model viruses in biological and genetic research. The decrease in the success of antibiotic therapy caused to renew efforts in experimental phage therapy. The author reviews the early studies carried out mainly on animals as well as human experiments with bacteriophages purified by genetic methods. According to the results, bacteriophage therapy may be effective under certain circumstances for the infections not treatable by antibiotics, and in the case of antiobiotic-susceptible bacteria it can supplement therapy.]

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[Chemokine research in the last decade has provided new results in several areas of biomedicine. Investigation and characterization of chemokines resulted in better understanding and modeling complex pathophysiological and immunological processes. Chemokine research opened up entirely new aspects on the defense against pathogenic agents as well as on the processes of inflammation and angiogenesis. With the amount of clinical data growing steadily, it is clear that chemokines could play very important role not only in solving the problems of the oretical and experimental biology but also with their application in clinical diagnostics and therapy. ]

Lege Artis Medicinae

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Lege Artis Medicinae

[Effect of calcium channel blocking drugs on the periodontal status of hospitalised patients]

KEGLEVICH Tibor, ZSIDRÓ Emese, BENEDEK Erika, BARNA István, SZEGEDI Zsolt, SCHWAB E. Richárd, GERA István

[Ca2+-channel blockers play crucial role in the chronic treatment of hypertension and cardiac arrhythmia. One of the side effects of the chronic nifedipine treatment is gingival enlargement. The pathomechanism of this side effect is not fully understood. The main objective of the present study was to evaluate the potential role of different factors in the development and severity of gingival hyperplasia. The incidence and severity of gingival enlargement were examined around the six surfaces of all fully erupted teeth in 243 hospitalized patients with the modified Angelopoulus-Goaz Gingival Hyperplasia Index. 172 patients in the study group were on Ca2+ channel blockers for at least three months prior to the examination while 71 inpatients served as controls. Gingival hyperplasia occurred in 87% of the test group and in 53% of the control group. Severe gingival enlargement occurred in 35% in the test group and only in 2% of the control group. The age and gender of the patient, the daily dose of the medication, the duration of the administration of the drug showed no correlation with the extent and severity of gingival hyperplasia. Only oral hygiene showed statistically significant correlation with the severity of gingival enlargement. The only clinical parameter influencing the extent and severity of gingival enlargement associated with Ca2+-channel blocker drugs was the quality of oral hygiene. ]

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NALBANTOGLU Mecbure, AKALIN Ali Mehmet, GUNDUZ Aysegul, KIZILTAN Meral

Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission. Autonomic dysfunction is not a commonly known association with MG. We conducted this study to evaluate autonomic functions in MG & subgroups and to investigate the effects of acetylcholinesterase inhibitors. This study comprised 30 autoimmune MG patients and 30 healthy volunteers. Autonomic tests including sympathetic skin response (SSR) and R-R interval variation analysis (RRIV) was carried out. The tests were performed two times for patients who were under acetylcholinesterase inhibitors during the current assessment. The RRIV rise during hyperventilation was better (p=0.006) and Valsalva ratio (p=0.039) was lower in control group. The SSR amplitudes were lower thereafter drug intake (p=0.030). As much as time went by after drug administration prolonged SSR latencies were obtained (p=0.043).Valsalva ratio was lower in the AchR antibody negative group (p=0.033). The findings showed that both ocular/generalized MG patients have a subclinical parasympathetic abnormality prominent in the AchR antibody negative group and pyridostigmine has a peripheral sympathetic cholinergic noncumulative effect.

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[LAM 30: 1990–2020. Facing the mirror: Three decades of LAM, the Hungarian medicine and health care system]

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[The Comprehensive Aphasia Test in Hungarian]

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[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

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.]

Lege Artis Medicinae

[History of vaccine production in Hungary ]

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[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. ]