Lege Artis Medicinae

[Is bankruptcy threatening social security?]

LÁSZLÓ András

AUGUST 26, 1992

Lege Artis Medicinae - 1992;2(08)

[Interpellation of László Mádi FIDESZ MEP to the Minister of Finance and the Minister of Welfare. Delivered on 9 June 1992 ]

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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]

MONOS Emil

[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]

DIMITRIJE Katalinic

[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]

BENDER Tamás

[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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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.]

Clinical Neuroscience

Life threatening rare lymphomas presenting as longitudinally extensive transverse myelitis: a diagnostic challenge

TOLVAJ Balázs, HAHN Katalin, NAGY Zsuzsanna, VADVÁRI Árpád, CSOMOR Judit, GELPI Ellen, ILLÉS Zsolt, GARZULY Ferenc

Background and aims – Description of two cases of rare intravascular large B-cell lymphoma and secondary T-cell lymphoma diagnosed postmortem, that manifested clinically as longitudinally extensive transverse myelitis (LETM). We discuss causes of diagnostic difficulties, deceptive radiological and histological investigations, and outline diagnostic procedures based on our and previously reported cases. Case reports – Our first case, a 48-year-old female was admitted to the neurological department due to paraparesis. MRI suggested LETM, but the treatments were ineffective. She died after four weeks because of pneumonia and untreatable polyserositis. Pathological examination revealed intravascular large B-cell lymphoma (IVL). Our second case, a 61-year-old man presented with headache and paraparesis. MRI showed small bitemporal lesions and lesions suggesting LETM. Diagnostic investigations were unsuccessful, including tests for possible lymphoma (CSF flow cytometry and muscle biopsy for suspected IVL). Chest CT showed focal inflammation in a small area of the lung, and adrenal adenoma. Brain biopsy sample from the affected temporal area suggested T-cell mediated lymphocytic (paraneoplastic or viral) meningoencephalitis and excluded diffuse large B-cell lymphoma. The symptoms worsened, and the patient died in the sixth week of disease. The pathological examination of the presumed adenoma in the adrenal gland, the pancreatic tail and the lung lesions revealed peripheral T-cell lymphoma, as did the brain and spinal cord lesions. Even at histological examination, the T-cell lymphoma had the misleading appearance of inflammatory condition as did the MRI. Conclusion – Lymphoma can manifest as LETM. In cases of etiologically unclear atypical LETM in patients older than 40 years, a random skin biopsy (with subcutaneous adipose tissue) from the thigh and from the abdomen is strongly recommended as soon as possible. This may detect IVL and provide the possibility of prompt chemotherapy. In case of suspicion of lymphoma, parallel examination of the CSF by flow cytometry is also recommended. If skin biopsy is negative but lymphoma suspicion remains high, biopsy from other sites (bone marrow, lymph nodes or adrenal gland lesion) or from a simultaneously existing cerebral lesion is suggested, to exclude or prove diffuse large B-cell lymphoma, IVL, or a rare T-cell lymphoma.

Clinical Neuroscience

[The importance of patient reported outcome measures in Pompe disease]

MOLNÁR Mária Judit, MOLNÁR Viktor, LÁSZLÓ Izabella, SZEGEDI Márta, VÁRHEGYI Vera, GROSZ Zoltán

[In recent decades it has become increasingly important to involve patients in their diagnostic and treatment process to improve treatment outcomes and optimize compliance. By their involvement, patients can become active participants in therapeutic developments and their observations can be utilized in determining the unmet needs and priorities in clinical research. This is especially true in rare diseases such as Pompe disease. Pompe disease is a genetically determined lysosomal storage disease featuring severe limb-girdle and axial muscle weakness accompanied with respiratory insufficiency, in which enzyme replacement therapy (ERT) now has been available for 15 years. In our present study, patient reported outcome measures (PROMs) for individuals affected with Pompe disease were developed which included questionnaires assessing general quality of life (EuroQoL, EQ-5D, SF36), daily activities and motor performance (Fatigue Severity Score, R-PAct-Scale, Rotterdam and Bartel disability scale). Data were collected for three subsequent years. The PROM questionnaires were a good complement to the physician-recorded condition assessment, and on certain aspects only PROMs provided information (e.g. fatigue in excess of patients’ objective muscle weakness; deteriorating social activities despite stagnant physical abilities; significant individual differences in certain domains). The psychological effects of disease burden were also reflected in PROMs. In addition to medical examination and certain endpoints monitored by physicians, patient perspectives need to be taken into account when assessing the effectiveness of new, innovative treatments. With involvement of patients, information can be obtained that might remain uncovered during regular medical visits, although it is essential in determining the directions and priorities of clinical research. For all orphan medicines we emphasize to include patients in a compulsory manner to obtain general and disease-specific multidimensional outcome measures and use them as a quality indicator to monitor treatment effectiveness.]

Clinical Neuroscience

[The role of anaerobic bacteria in brain abscesses: a literature review]

URBÁN Edit, GAJDÁCS Márió

[Brain abscesses are potentially serious, life-threatening diseases that pose a complex diagnostic challenge not only to neurosurgeons but also to clinical microbiologists, neurologists, psychiatrists, infectologists. The etiology of brain abscess is usually polymicrobial, most commonly involving a variety of aerobic and obligate anaerobic bacteria. Epidemiological studies on the anaerobic etiology of brain abscesses are common between the time period of 1960s and 1980s, but today there are very few new publications on the subject. The role of anaerobic bacteria in this disease was presumably underdiagnosed for a very long time, as many laboratories did not have the adequate laboratory capabilities for their cultivation and identification. The purpose of this review is to summarize the available literature on the etiology of obligate anaerobic bacteria in brain abscesses, including their prevalence and current therapeutic recommendations.]

Lege Artis Medicinae

[Interrelations of social phobia, trait anxiety, perfectionism and psychological protective factors in a young female population: Cluster analysis]

DOBOS Bianka, PIKÓ Bettina

[Deterioration of social functions and quality of life and lower level of satisfaction with life are often joining to axiety disorders. Considering the higher prevalence rates across anxiety disorders for women, the aim of this study was to examine the relationship of social phobia with trait anxiety, perfectionism, use of pharmaceuticals, self-efficacy and life satisfaction in a group of young female participants. Online, self-administered questionnaire was used as a method of data collection at different social network sites. The sample consisted of young women aged between 14–35 years (N = 435, M = 27.3 years; SD = 5.9). The questionnaire con­tained items of socio-demographic variables, use of pharmaceuticals as well as mental background variables (Social Pho­bia In­ventory, State-Trait Anxiety In­ven­tory, Mul­ti­dimensional Perfectionism Scale, Ge­neral Perceived Self-Efficacy Scale, Sa­tis­faction with Life Scale). Besides correlation analysis, cluster analysis was conducted. rait anxiety shows strong correlation with social phobia, perfectionism and use of pharmaceuticals. After examining all variables three clusters were emerging: 1) high level of trait anxiety with social phobia, moderate perfectionism, low levels of self-effcacy and satisfaction with life; 2) trait anxiety below the average without social phobia, high self-efficacy and satisfaction with life; 3) trait anxiety above the average with moderate phobia, high perfectionism with high self-efficacy and moderate life satisfaction. Results of our study show that social phobia strongly interrelates not only with trait anxiety as a stable part of personality but with self-estimated lower well-being and lack of mental protective factors. ]