Lege Artis Medicinae

[“I am no Poet, You are Gabi the Poet” – Gábor Karinthy ]

FALVAY Dóra

FEBRUARY 12, 2017

Lege Artis Medicinae - 2017;27(01-02)

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Bayesian and frequentist T-test and ANOVA]

MOLNÁR D. László

[T-test and ANOVA are just special cases of linear models. With these models measured values of a continuous variable (e.g. blood pressure) can be compared in two or more groups (e.g. treatment groups). In real life medical application of the frequentist linear models the data often fail the assumptions (e.g. normality and equal variances) originally needed to derive the mathematical equations and distributions for these models. Bayesian linear models are robust, flexible and transparent analogues and alternatives of the frequentist models. Bayesian statistical models can also be useful, when the data do comply with the prescribed conditions for the t-test or ANOVA. An advantage of the bayesian method is the possible incorporation of any prior knowledge into the models. It must be borne in mind, however, that there are many frequentist methods that can be used even if the distributions are not normal, or in the case of heteroscedasciticy or other model inadequacy as well. It is worth mentioning that even the frequentist Lasso (least absolute shrinkage and selection operator) is in near relationship with the Bayesian method, since it is a linear regression method, where the traditional fitting algorithm is modified with a constraint, and some information will be discarded in order to focus on the most relevant coefficients and make the model interpretation easy. Cal­culations were performed in R, primarily with the BayesFactor package developed by Morey and Rouder in 2015. ]

Lege Artis Medicinae

[The Independence War of a Widow – Zsuzsanna Kossuth was Born 200 Years Ago ]

CZIGLÉNYI Boglárka

Lege Artis Medicinae

[Leaving the Persistent Present of Traumas – The Method and Therapeutic Experiences of Art Therapist Péter Mezey ]

CZIGLÉNYI Boglárka

Lege Artis Medicinae

[Screening for depression and suicidal risk in family and general medical practice]

RIHMER Zoltán, SZILI Ilona, KALABAY László, TORZSA Péter

[According to both international and national studies the point prevalence of diagnosed major depression requiring treatment is 6-10 percent in general practice. As un­treated depression is the most important risk factor for suicide, early detection and effective management of depression (especially depression which predisposes sui-cide) are critical in prevention. According to international and national studies the re-cognition of major depression in primary care significantly contributes to the decline of suicide mortality. In our article we present two short questionnaires used for re-cognising depression and acute suicide risk and we describe their use in family/ general practice. We aim to raise awareness of the need of a systematic, nationwide sui-cide prevention programme which is supported on government level as well. ]

Lege Artis Medicinae

[Diseases of the kidneys due to non-cancer mortality characteristics of Hungary between 2005-2014]

PAKSY András, KISS István

[The authors review the time of 10 years between 2005-2014 concerning the development of the mortality rate of kidney diseases in Hungary. They’ve compared the Hungarian mortality data with the ones from three other countries, namely Austria, the Czech Republic and Germany. The analyses included kidney diseases originated from hypertension, glomerulonephritis and tubulointerstitial kidney diseases, kidney failure and polycystic kidney diseases. They weren’t concerned about kidney tumors or diabetes originated kidney diseases because of the lack of data concerning the latter. The mortality data were retrieved from the KSH Demography Yearbook and the European Detailed Mortality Data-base (DMDB). The statistically examined causes of death only add up to 1.2% of the total causes of death, but with the aging of the population this proportion will surely grow. During the last 10 years, the mortality of cardiovascular diseases decreased significantly, namely the mortality of ischaemic heart disease and stroke, but the mortality of hypertension increased. These processes can also be seen in Austria, the Czech Republic and Germany. The mortality connected to primal kidney diseases decisively concerns people aged over 70. The glomerular diseases’ standardized rate is significantly higher in Hungary than in the compared countries. The tubulointerstitial kidney diseases’ mortality rate decreased over the last 10 years and we are in the middle of the international field in this regard. During the evaluation of the mortality of kidney diseases it is important to consider that in the statistics every death can only have one cause nominated, which can be (correctly) the basic disease causing the kidney disease or in other cases the kidney disease itself. This problem makes it more difficult to compare data internationally. Only 20-30 patients die of acute kidney disease on a yearly basis which is a low mortality rate even by international standards but the above-mentioned problem still exists. Of all of them the chronic kidney disease is the most significant one and between 2005-2014 the number of deaths and their rate connected to it decreased, but with the aging of the population the morbidity of kidney diseases will surely increase. Analyzing the data of all the primer kidney diseases it can be determined that between 2005-2014 the mortality rate showed a decreasing tendency, so our international situation can be viewed positively. It is important to note though that the mortality of this disease type includes patients of lower average age in Hungary than in the more developed countries. The mortality rate of polycystic kidney disease hasn’t changed significantly during the past 10 years. Although some patients live to many years, the average age of the dead is significantly lower compared to the ones of other kidney disease types. The cases below the age of 1 year of the latter add up to 10%. The comparison between the countries concerning the po­lycystic kidney disease shows that the standardized mortality rate is higher in Hun­gary.]

All articles in the issue

Related contents

Lege Artis Medicinae

[Recognize Ourselves in our Dependencies! – A Discussion with Toxicologist Gábor Zacher]

NEMESI Zsuzsanna

Hypertension and nephrology

[Terciary hyperparathyreosis or not? ? You cannot solve it alone: combined treatment in severe osteitis fibrosa cystica]

HERSZÉNYI Eszter, PATÓ Éva, SZALAY László, BÍRÓ Zsolt, György Andrea, DEÁK György

[Phosphate retention, consequential rise of the phosphaturic fibroblast growth factor-23 that decreases the level of calcitriol resulting in hypocalcemia facilitates the development of secondary hyperparathyroidism (sHPT) in chronic kidney disease (CKD). Hyperphosphatemia, hypocalcemia and low calcitriol level result in increasing secretion of parathormone (PTH). While sHPT occures frequently in CKD, the development of therapy-resistant and hypercalcemic tertiary hyperparathyroidism is rare due to current therapeutic approaches. We present the case of a 41 year old, treated schizophrenic, hemodialized male patient with severe osteitis fibrosa cystica, severe hyperparathyroidism (PTH 2500 pg/ml) - considered to be tertiary - and with repeated pathologic fractures. While hospitalized, the patient was under supervised, combined therapy with the vitamin D receptor activator paricalcitol and the calcimimetic cinacalcet that resulted in marked decrease of PTH level to 1589 pg/ml. However, after discharge from the hospital due to the lack of compliance he failed to take his medications and PTH had risen to the initial level. This case demonstrates that severe hyperparathyroidism thought to be therapy resistant responds well to a combination of paricalcitol and cinacalcet however, patient compliance is essential to therapeutic success.]

Lege Artis Medicinae

[Modern antibiotic therapy - The antibiotic therapy of community acquired pneumonias in adults based on gudelines]

KOVÁCS GÁBOR

[Most therapies in the treatment the community acquired pneumonia are empirical. There are several different guidelines helping to choose the right antibiotic. These guidelines contain the background of the epidemiology, diagnosis and microbiology. However the center of the interest is the therapeutic guide. The guidelines are worth as much as you make from those.]

Hungarian Radiology

[Vadon Gábor professor’s photo exhibition - Sopron Ultrasound Days, October 2009.]

BARANYAI Tibor

Journal of Nursing Theory and Practice

[Together with You for Others – a Report about the Chamber’s Campaign to Promote Healthcare Profession ]

BALOGH Zoltán, BABONITS Tamásné