Lege Artis Medicinae

[Lege artis paramedicinae]

BÁLINT Géza

DECEMBER 25, 1991

Lege Artis Medicinae - 1991;1(18)

[We have been reading and leafing through LAM for a year. We study its excellent educational articles, its original communications, ponder the Reflections, eagerly dive into the Parliamentary Reports, the Reform column, learn about the thoughts of Medicus Immaturus, enjoy the history and fine arts columns.]

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Lege Artis Medicinae

[Metoprolol treatment in dialated cardiomyopathy]

DÉKÁNY Miklós, NYOLCAS Noémi, FIÓK János, VÁNDOR László, SEREG Mátyás, BALOGH Ildikó

[Authors applied metoprolol for treating heart failure in with dilated cardiomyopathy. Patients were given digitalis, diuretics as well as ACE-inhibitor and vasodilator drugs. The grade of heart failure was according to NYHA classification in the mean 2.5 class. For assessing the effect of metoprolol clinical variables and results of non-invasive tests were evaluated and compared in 3 consecutive periods: 1) before starting metoprolol, 2) 2–4 weeks after reaching its definitive dose (short-term effect), 3) 3-6 months later (medium-term effect). Early intolerance appeared in 3 patients; signi ficant progression of heart failure in 2 and hypotension causing complaints in 1. Evaluating the actually treated 17 patients clinical signs of heart failure (NYHA class) decreased, left ventricular ejection fraction improved, though not significantly in case of every considered variables, left atrial filling pressure decreased, exercise capacity did not alter, rate-pressure product decreased at rest and at low level of exercise as well. The authors stress the significance of "up-regulation" of myocardial beta-1 receptors in the reduction of myocardial toxic catecholamin effect and myocardial oxygen demand as well as in the increase of myocardial blood supply. Referring to the data of the respective literature and to their own experiences the authors suggest metoprolol treatment in cases of dilated cardiomyopathy, where previus therapy did not prove to be efficient.]

Lege Artis Medicinae

[Role of oxygen derived free radicals during myocardial reperfusion]

KÓNYA László , FEHÉR János, JUHÁSZ Nagy Sándor

[Oxygen derived free radicals are now considered to be important contributors to tissue (myocardium) injury associated with ischemia and reperfusion. Normaly the tissue concentration of these toxic intermediate products of oxygen is strietly limited, but production of oxygen free radicals overwhelming the capacity of the tissue elimination may cause serious damage. Thus reperfusion has it's own danger with the extension of the injury produced by the ischemia alone. Several experi mental studies have shown that different free radical scavengers can reduce the post-ischemic tissue injury, however, there are contradictory results and unresolved problems. Further investigation is necessary to establish the relevance of oxygen free radical mediated myocardial injury and the effective antioxidant treatment. ]

Lege Artis Medicinae

[Cure]

MATOS Lajos

[Belfast Metoprolol Study; Helsinki Heart Study]

Lege Artis Medicinae

[Autoimmunity and the network of the antibody-forming cells: the "immunological homunculus"]

UHER Ferenc

[Frank M. Burnet's clonal selection theory declares the deletion and/or anergy of self-reactive clones to be the fundamental mechanism responsible for self tolerance. There is ample evidence, however, that all healthy individuals have lymphocytes and , natural” antibodies that recognize self structures. In the 1970s, Niels K. Jerne postulated the network theory. It is based on the idea that the idiotype, the region of an immunoglobulin that is unique because it comprises the antigen-binding portion of the molecule, can act as both antigen and antibody within the same individual. Network theory views the immune system as a single, highly interconnected system, through idiotypes, a web of V domains. Antonio Coutinho adressed this problem and divided the repertoire of the B lymphocytes into two parts. He suggested that a set of naturally activated cells and the immunoglobulins they secrete, is reflected in the autonomous immune activities of the self-related network as the central immune system. In contrast, immune responses to external antigens are essentially allonomous clonal activities of another set of resting, rapidly turning over lymphocytes that follow the predictions of the clonal selection theory, making up the peripheral part of the system. Finally, Irun R. Cohen suggested that some, perhaps all, major autoantigens are indeed dominant because each one of them is encoded in the organizational structure of the immune system. This picture was termed the immunological homunculus by its analogy to the picture of the body encoded in the central nervous system. ]

Lege Artis Medicinae

[Modern therapy of intracerebral and subarachnoidal hemorrhages]

LEEL-ŐSSZY Lóránt

[The frequency of the intracerebral hemorrhages among the strokes is most commonly quoted around 10 percent. The rupture of an intracranial aneurysm is often complicated with subarachnoideal hemorrhage as well as with intracerebral hematoma therefore this latter type of intraparenchymal hemorrhage may also be discussed in this topic. The modern imaging procedures (Computed to mography, Nuclear magnetic resonance) are of crucial importance in the urgent and exact diagnosis of intracranial hemorrhages. The first essential step in the diagnosis of stroke is to distinguish the ischemic lesion from the hemorrhage by means of CT. When an intra cerebral hemorrhage threatens life and the patient's condition is relatively good there must be an urgent decision considering the choice between medical therapy or surgical intervention. Although clearcut indications for surgery are now available, the clinical and computed tomographic guidelines play indi vidually an important role in the final decision. The individual judgment is always desirable in every case of intracerebral hemorrhage as well as in the surgical intrvention of intracranial aneurysm during the acute phase (two days).]

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Related contents

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

[Focus on Lege Artis Medicinae (LAM)]

VASAS Lívia, GEGES József

[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]

Lege Artis Medicinae

[30 years in diabetology reflected on the pages of Lege Artis Medicinae – 1990-2020]

WINKLER Gábor

[Commemorating the 30th anniversary of foundation the journal Lege Artis Me­di­cinae, the author endeavours to review the main developments of diabetology in the same period and arranges their reflections on the journal’s pages. He points out that similar to many other disciplines, the history of development has extremely been rich in the past three decades, thus he focused only on a few issues. The author analyses the changes in the treatment of type 2 diabetes and highlights specific aspects like the importance of early metabolic control, individualized treatment choices, a risk-oriented approach instead of a glucocentric direction, and the role of patient education and a health-conscious lifestyle, which have resulted in the holistic approach of our therapeutic strategy. While using relevant quotes, the author shows that the readers of the journal were also able to keep pace with all events and they were always provided with relevant information by au­thentic specialists of diabetology. ]

Lege Artis Medicinae

[-Amicus Plato sed magis amica veritas-]

SZEBENYI Béla

[In each of the first 6 issues of Lege Artis we could read a thoughtful and forward-looking summary of the present and future problems of the Hungarian health care system, including the titles: Systemic change in health care, Reform change or system change, Where to go from here, health care, Can health care be transformed? The requirements of modern governance and management in health care, and SOTE: Questions and answers for reform. (1, 2, 3, 4, 5, 6,). If we agree that a correct analysis of the current situation and future of the medical profession and health workers is a sine qua non for any way forward, we must wonder why there is not a single mention (!) of the basic characteristic of these groups, their numbers. ]

Lege Artis Medicinae

[Correspondence]

STUMPF János

[It was a great pleasure to read the "Programme for Action" published as an annex to Lege Artis Medicinae. A concept has been born, and it seems to have been widely discussed. This in itself is a new element in our health policy, which is the most welcome sign of a change of approach. ]