Lege Artis Medicinae

[Health economics in Hungary: great potential, missed opportunities?]

NÉMETH Bertalan

FEBRUARY 05, 2016

Lege Artis Medicinae - 2016;26(01-02)

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Lege Artis Medicinae

[Fragments of Memories – Remembering Zsuzsanna Nagy MD]

NÉMETH István

Lege Artis Medicinae

[Visibility and quality of life: international literature review of the state of LMBTQ healers]

SZÉL Zsuzsanna, CSEKŐ Csilla, GYŐRFFY Zsuzsa

[BACKGROUND - Mental vulnerability is a well-known problem among healthcare professionals. In additional LGBT physicians’ discriminatory experiences and the exposure of minority stress appear to be a greater risk for health problems. METHODS - We collate researches in English by using search terms “LGBT doctors” “LGBT providers” “LGBT physicians”; “attitudes of nurses”; “attitudes of medical students”; “attitudes of doctors”; “LGBT practitioners”, “homophobia among doctors” „“homophobia among physicians”; “LGBT in medical curricula”, “sexual and gender minority”, “minority stress”. We reviewed findings highlighting the disclosure of orientation, experiences, mental and physical health of LGBT healthcare professionals, and physicians’, nurses’, medical students’ and patients’ attitudes towards LGBT students and physicians. RESULTS - At present conditions of LGBT individuals have gained international attention also in academic conversation. Based on the literature lack of safe, supporting environment seems to be the highest problem for LGBT physicians and medical students. Both in Canada and the USA several steps were made to improve attitudes of medical professionals, and decrease discrimination towards LGBT individuals in healthcare system such as creating more supportive environment by ‘Promoting pride’ and integrating LGBT-related content into medical universities’ curriculum. CONCLUSIONS - Our findings suggest that in Canada and the United States the rate of discrimination have decreased meanwhile transparency of LGBT professionals elevated as a result of antidiscrimination policies and the educational development.]

Lege Artis Medicinae

[The Belief in Scientific Knowledge ]

BÁNFALVI Attila

Lege Artis Medicinae

[Effect of rosuvastatin therapy’s introduction on lipid levels and on proportion of target values reaching in patients with familial hypercholesterolemia and familiarity]

SZTANEK Ferenc

[Familial hypercholesterolemia (FH) is a genetically heterogeneous disorders characterized by very high total cholesterol and low-density lipoprotein (LDL) cholesterol levels, and it accelerates the development of atherosclerosis and early cardiovascular disease. FH is most commonly caused by mutations in low-density lipoprotein receptor (LDLR) or apolipoprotein B-100 (APOB) genes. In rest of the cases the mutation is in the proprotein convertase subtilisin/kexin type 9 (PCSK9) gene. Previous studies have shown that rosuvastatin significantly reduces major cardiovascular events in high risk patients. The goal of our study was to investigate the lipid-altering efficacy of simvastatin or atorvastatin therapy compared with high-intensity rosuvastatin therapy in patients with FH and familiarity. Recent work has demonstrated the efficacy of high-intensity rosuvastatin therapy in enabling high-risk and very high-risk patients in lowering significantly plasma levels of total and LDL-cholesterol, which can subtantially affect major cardiovascular events in familial hypercholesterolemia.]

Lege Artis Medicinae

[The Revolution of Art – Russian Avantgarde in the 1910s and the 1920s ]

RÉVÉSZI Valéria

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[Zonisamide: one of the first-line antiepileptic drugs in focal epilepsy ]

JANSZKY József, HORVÁTH Réka, KOMOLY Sámuel

[Chronic administration of antiepileptic drugs without history of unprovoked epileptic seizures are not recommended for epilepsy prophylaxis. Conversely, if the patient suffered the first unprovoked seizure, then the presence of epileptiform discharges on the EEG, focal neurological signs, and the presence of epileptogenic lesion on the MRI are risk factors for a second seizure (such as for the development of epilepsy). Without these risk factors, the chance of a second seizure is about 25-30%, while the presence of these risk factors (for example signs of previous stroke, neurotrauma, or encephalitis on the MRI) can predict >70% seizure recurrence. Thus the International League Against Epilepsy (ILAE) re-defined the term ’epilepsy’ which can be diagnosed even after the first seizure, if the risk of seizure recurrence is high. According to this definition, we can start antiepileptic drug therapy after a single unprovoked seizure. There are four antiepileptic drugs which has the highest evidence (level „A”) as first-line initial monotherapy for treating newly diagnosed epilepsy. These are: carbamazepine, phenytoin, levetiracetam, and zonisamide (ZNS). The present review focuses on the ZNS. Beacuse ZNS can be administrated once a day, it is an optimal drug for maintaining patient’s compliance and for those patients who have a high risk for developing a non-compliance (for example teenagers and young adults). Due to the low interaction potential, ZNS treatment is safe and effective in treating epilepsy of elderly people. ZNS is an ideal drug in epilepsy accompanied by obesity, because ZNS has a weight loss effect, especially in obese patients.]

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[Interdisciplinary approach of vestibular system impairment]

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[In the first part of this review the definition of vertigo/dizziness was discussed. The major difference between the two signs is the exsistence of the direction, which is specific for vertigo. Dizziness is a frequent complaint in the clinical practice. Its frequency is increasing with advance of age, to intimate the play of declining cognitive process in the pathogenesis of its. The popular health significance of vertigo is in the rowing number of the patients. The onset of the most cases with acute vertigo appears between secundums and minutes so the patients will be provided in circumstances of emergency department. First of all three form schould be take into account: neuronitis vestibularis, benign paroxysmal positional vertigo and Meniere syndrome. Without tipical periferal signs of vertigo, central cause should be searched, principally stroke (lysis possibility). The differential diagnose of the different dizzeness/vertigo forms according to the elapsed time of the onset or congenital and acquired nystagmus was created in tables. The recommendations of the therapy of acute and chronic dizziness/ vertigo syndroms are, lack of results of evidence based trials doubtful. The more often used drugs based on clinical trials are discussed as vinpocetine, betahistine and piracetam. The in vitro and in vivo data suggest that the last molecule is eligible to use both in periferal and central type of vertigo syndroms.]

Journal of Nursing Theory and Practice

[Work Values Preference among hospital midwives]

GEBRINÉ ÉLES Krisztina, SÁRVÁRY Andrea, SÁRVÁRY Attila, TAKÁCS Péter, LAMPEK Kinga

[The Aim of the Study: The aim of the research was to explore the structure of work values among midwives. Material and Method: Cross sectional study was used with Super‘s Work Values Inventory from 13 hospitals across Hungary. Our questionnaire was divided into 370 midwives, 224 were evaluated. We calculated mean and standard deviation in descriptive statistical analysis. We did factor analysis; variance analysis and post-hoc LSD (Least Significant Difference) test. Results: The most preferred work values were altruism, finances and hierarchy. The level of education influenced the hierarchy of work values. The factor analysis separated two secondary factors: working condition and the self-realisation. There was a significant difference between midwives with OKJ education level and midwives with BSc degree (p=0,014), and other qualifications (p=0,033). Conclusions: Our results suggest that a higher level of education gives the foundation of professional competencies which enable the employee to take conscious consideration of other employee’s views in health care. ]

Lege Artis Medicinae

[PAIN AND PAIN CONTROL IN RHEUMATOLOGY]

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[In developed industrial countries the overall population prevalence of chronic rheumatic pain is around 35%. A classification that is useful in everyday practice is based on the origin of musculoskeletal pain and lists pain associated with degenerative joint diseases, pain related to metabolic bone diseases, non-articular and soft tissue rheumatism, and pain due to inflammation. In chronic pain syndrome pain itself has lost its adaptive biological role, and presents as a pathogenetic factor in its own right, accompanied by significant vegetative and psychological symptoms. Therapeutic exercise is of basic importance in the management of rheumatic pain. It is supplemented by various pharmacologic and nonpharmacologic methods. The latter include, among others, fomentations, packs, balneo- and hydrotherapeutic methods, electro-, mechanoand thermotherapeutic approaches. Pharmacological therapy usually means the use of simple analgesics, non-steroidal antiinflammatory drugs, steroids, minor opiates, and, lately, also major opiates, which may be supplemented by adjuvant agents such as tricyclic antidepressants and anticonvulsive drugs. When indicating the most often used non-steroidal antiinflammatory drugs, their potential side effects should carefully be considered. Invasive pain-killing methods on the border area between anaesthesiology and rheumatology (epidural steroid administration, ganglionic blockade, intravenous regional blockade) are applied in cases that do not respond to conventional therapy, and sometimes also as successful first-line intervention.]

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[How to break medical bad news? The importance of the course for breaking medical bad news and an evaluation of his curriculum]

MÁTÉ Orsolya, PUSZTAFALVI Henriette, BRANTMÜLLER Éva

[Breaking bad news to patients is a difficult task for health care professionals and there are many unsolved issues in this area. There are several ways of delivering bad news and the quality of the communication could affect the whole life of the patient. However the wrongly delivered bit of bad news could not only cause a crisis for the recipient but will create a stressful situation for the communicator. The course created at the University of Pécs, Faculty of Health Sciences is specified to the delivery of bad news with modern communication methods, which uses video feedback method to analyse and develop the participants’ communicational attitude, thus providing potent aid for the acquisition of the proper communicational techniques, from which both the patient and the care giver can profit.]