Lege Artis Medicinae

[Hungarian Society for Quality Assurance in Health Care]

GULÁCSI László, BALITZKY Alexandra

AUGUST 26, 1992

Lege Artis Medicinae - 1992;2(08)

[The Hungarian association was established to facilitate cooperation between Hungarian professionals in the field of quality assurance, to become a member of the International Society For Quality Assurance In Health Care and to join international programmes, starting with the COMAC programme. The inaugural meeting and the first seminar were held on 11 and 12 June 1992 in Debrecen, in the Bartók Hall of the Golden Bull Hotel. The aim of the association is to serve as an independent professional forum in Hungary, in cooperation with the Hungarian member organisations and international organisations working in similar fields.]



Further articles in this publication

Lege Artis Medicinae

[The significance of interleuktin-6, it's molecular regulation in acute phase reaction]

FALUS András, BÍRÓ Judit, RÁKÁSZ Éva

[The multiple effectiveness of a hormone-like cytokine, interleukin-6 (IL-6) is highly important in a series of immunological, neuroendocrinological and inflammatory reactions of the mammalian organism. In this review a complex view of the gene and its regulation of IL-6 and the significance of the cytokine network in acute phase reaction is discussed. Manipulation of this complex network studied by the methodology of molecular biology and genetics provides entirely new approaches for the biotechnological and pharmacological regulation of inflammation.]

Lege Artis Medicinae

[Call for support for the Healthy Breasts Foundation]


[Hungary is one of the world's leading countries in the grim international statistics on cardiovascular disease mortality, with around 80 000 people dying every year from serious cardiovascular disorders. This figure represents nearly 55% of all deaths! The vast majority of heart disease is related to the failure of the heart's own coronary arteries, and a significant proportion of brain disease is related to damage to the brain vessels themselves.]

Lege Artis Medicinae

[The application of argon laser in cosmetological therapy]


[The author was one of the first in 1976 who began to use the various types of lasers for plastic-esthetical reasons and for therapy of skin lesions. He considers the indication spectrum of the argon laser to be the largest and its results are the best. The author summarizes and makes known the tissue-effects of the argon laser and compaes it with the tissue-destruction of other lasers and classical methods. The quality of the tissue destruction determines the indications and the applications, among them the therapy of the port wine syndrome. In the author's opini on, not the exposition time and the energy of the argon laser could be exactly determined. The experience of the physician plays the most important tole in the therapy. ]

Lege Artis Medicinae

[The mode of action of bath therapy]


[Bath therapy includes both hydro- and balneotherapy. During hydrotherapy the patient is treated by the physical parameters of the water. The effect of balneotherapy is based on the penetration of the mineral water. Its me chanism is not yet clear. There are several double-blind studies which prove the benefits of balneotherapy. Further studies are needed to judge the objective effects of balneotherapy. ]

Lege Artis Medicinae

[Correlation between clinical data and histologycal findings assessing the severity of ulcerative colitis]

NAGY Ferenc, KARÁCSONY Gizella

[ A knowledge of the current activity of ulcerative colitis is essential in planning appropiate follow-up. Histological findings obtained from 209 colonoscopies were compared with the values of 22 clinical variables. One way analysis of variance was carried out. Of the 22 variables 11 proved to be significantly different between the groups of the clinically valuable classification (inactive, chronic, acute). Each of the three groups differed in the number of bloody stools. The acute inflammatory process was characterized by the high numbers of bowel movements, mucus and bloody mucus defecation, bowel movements at night, and haematocrit values suggesting anaemia. The serum iron levels in the inactive group differed significantly from the levels of both the acute and the chronic groups. The count of thrombocyte and the general well being were found to be valuable only in the differentiation between the acute and the inactive inflammatory processes. The computed haematocrit value proved to be useful in distinguishing the acute stage from the inactive and the chronic process. Out of the 22 variables only 11 had clinical importance in the evaluation of the activity of ulcerative colitis. ]

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


Clinical Neuroscience

[The connection between the socioeconomic status and stroke in Budapest]


[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]

Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]


[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. ]

Clinical Neuroscience

Comparison of direct costs of percutaneous full-endoscopic interlaminar lumbar discectomy and microdiscectomy: Results from Turkey

ÜNSAL Ünlü Ülkün, ŞENTÜRK Salim

Microdiscectomy (MD) is a stan­dard technique for the surgical treatment of lumbar disc herniation (LDH). Uniportal percutaneous full-endoscopic in­terlaminar lumbar discectomy (PELD) is another surgical op­tion that has become popular owing to reports of shorter hos­pitalization and earlier functional recovery. There are very few articles analyzing the total costs of these two techniques. The purpose of this study was to compare total hospital costs among microdiscectomy (MD) and uniportal percutaneous full-endoscopic interlaminar lumbar discectomy (PELD). Forty patients aged between 22-70 years who underwent PELD or MD with different anesthesia techniques were divided into four groups: (i) PELD-local anesthesia (PELD-Local) (n=10), (ii) PELD-general anesthesia (PELD-General) (n=10), (iii) MD-spinal anesthesia (MD-Spinal) (n=10), (iv) MD-general anesthesia (MD-General) (n=10). Health care costs were defined as the sum of direct costs. Data were then analyzed based on anesthetic modality to produce a direct cost evaluation. Direct costs were compared statistically between MD and PELD groups. The sum of total costs was $1,249.50 in the PELD-Local group, $1,741.50 in the PELD-General group, $2,015.60 in the MD-Spinal group, and $2,348.70 in the MD-General group. The sum of total costs was higher in the MD-Spinal and MD-General groups than in the PELD-Local and PELD-General groups. The costs of surgical operation, surgical equipment, anesthesia (anesthetist’s costs), hospital stay, anesthetic drugs and materials, laboratory wor­kup, nur­sing care, and postoperative me­dication diffe­red significantly among the two main groups (PELD-MD) (p<0.01). This study demonstrated that PELD is less costly than MD.

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.]