Lege Artis Medicinae

[History of medicine]

NÉMETH Éva

MARCH 30, 1994

Lege Artis Medicinae - 1994;4(03)

[Book description History of Medicine from Antiquity to 2020 - Nancy Duin, dr Jenny Sutcliff]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Hormone replacement therapy from a gynaeco oncological point of view]

BŐSZE Péter

[In Hungary, hormone replacement therapy (HRT) has been used more extensively in the last few years. The benefits of HRT in cardio vascular diseases, osteoporosis and quality of life have been well established. Breast cancer and endometrial carcinoma have been considered as contraindications for HRT. A reappraisal of this practice is necessary since we have no evidence that HRT may adversely influence the outcome of these tumours, al though this is theoretically possible since the effect of estrogens on occult metastases is unknown. The relationship between replacement therapy and the uterine sarcomas is of particular concern. HRT is safe in patients successfully treated for carcinoma of the vulva, vagina, uterine cervix and in those with ovarian cancer. Experience suggests that estrogen can also be used safely in women treated previously for endometrial cancer. As far as breast cancer is concerned, it appers logical to discuss the risk-benefit considerations with our patients before embarking on using HRT. Consultation with a gynaecological oncologist prior to HRT in patients with endometrial and/or breast cancer is strongly recommended. ]

Lege Artis Medicinae

[Developing a complex approach to hospice and home-care]

MOLNÁR Lajos, BÖSZÖRMÉNYI Dalma

[The home-care and hospice movement has been sporadically encountered in the hospital and care network for a long time, and we have already seen all that this paper aims to do. Across the country, hospitals and specialist outpatient departments alike are seeking ways and means of providing this care. ]

Lege Artis Medicinae

[Letters - Spontaneous pneumothorax]

KESZLER Pál, RÁCZ Egon

[Dear Editorial Team! In the 30 November 1993 issue, AC Miller and JE Harvey's "Guidelines for the management of spontaneous pneumothorax" was published as a position paper of the British Thoracic Society. It may seem an ungrateful undertaking to enter into a debate with the principles of such a venerable and long-established society.]

Lege Artis Medicinae

[The increasing threat of antibiotic resistance: implications for antibiotic prescribing in community practice]

ROBERT Sutherland

[Infectious diseases caused by bacteria have been treated successfully by antibiotic the rapy for the past half century, and a diversity of antibacterial agents with widely differing mechanisms of action has been developed by the pharmaceutical industry. However the selective pressure of antibiotic usage has inevitably led to the isolation of resistant bacteria and the rate of emergence of antibiotic resistance appears to be increasing rapidly, reducing the effectiveness of existing agents. Factors responsible for the wide dissemination of antibioticresistant bacteria in both community and hospital practice include the acquisition and spread of resistant genes by plasmids and transposons, inappropriate anti biotic usage and social factors. Mechanisms to controll the emergence of antibiotic resistance require optimal usage of antibiotics by clinicians, control programmes to improve hygiene and to reduce the transmission of resistant bacteria within and between communities, and the continued development of new antibacterial agents.]

Lege Artis Medicinae

[Highly located and intrahepatic malignant biliary stenoses treated by interventional radiological procedures]

KÓNYA András, VIGVÁRY Zoltán

[In the palliative treatment for patients with highly located and/or intrahepatic malignant biliary stenoses or obstructions interventional radiological procedures may play a significant part. In 12 patients with obstructive jaundice caused by highly located malignant stenosi(es) or obstruction(s) 23 endoprostheses were implanted. In 5 cases double endoprosthesis placement was performed to connect isolated lobes or segments of the liver. Patients' survival was 4–22 (average 8, 7) months. In 6/12 patients surviving for 4-8 months, occlusion of the endoprostheses did not occur. In the other half of the patients, in whom the disease permitted a longer life-expectancy, prosthesis occlusion led to recurrent jaundice within 3–11 months. In all but one case, in which endoscopic exchange was successful, percutaneous interventions were necessary. Successful endoprosthesis placement was carried out 3 times in one patient and once each another 5 patients following percu taneous extraction (3 times), distal displacement (twice) and endoscopic removal (twice) of the occluded endoprostheses. Authors consider percutaneous endoprosthesis placement an effective procedure in the palliative treatment of the aforementioned patients' group, both for improving their survival and quality of life. They emphasize the fact that lengthy and difficult manipulations are required for these procedures which consequently result in a considerable amount of scattered radiation exposure to those performing the procedures.]

All articles in the issue

Related contents

Clinical Neuroscience

Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

Lege Artis Medicinae

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

KAPÓCS Gábor

Clinical Neuroscience

[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]

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 ]

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. ]