Lege Artis Medicinae

[Love Lured Back, or the Violent Hope ]


OCTOBER 20, 2016

Lege Artis Medicinae - 2016;26(09-10)



Further articles in this publication

Lege Artis Medicinae

[Life Practices – On the Practice of Antique Philosophy ]


Lege Artis Medicinae

[Processing the Past after a Stroke ]


Lege Artis Medicinae

[Many faces of thyroid hormone deficiency]


[The timely detection of thyroid hormone deficiency is crucial to inhibit the dangerous consequences of related diseases, such as obesity, cardiovascular diseases, type 2 diabetes mellitus, breast cancer, bone wasting, menstruation disturbance, and goitrogenesis. Subclinical hypothyroidism (<10 mU/l TSH) can initiate the above mentioned symptoms and diseases, therefore its early detection and treatment is necessary. The manuscript details from a practical point of view the causes leading to thyroid hormone deficiency, their consequences and gives recommendation for starting the treatment. The increased occurrence of breast and colorectal cancers associated with thyroid hormone deficiency is explained, and the attention to concomitantly elevated prolactin levels is called. Finally, the paper gives proposals for the clinical practice, when we should think of thyroid hormone deficiency and reports on the algorithm of the treatment of subclinical hypo­thyroidism recommended by the European Thyroid Association (ETA) in 2013.]

Lege Artis Medicinae

[Basics of the medical use of ayahuasca: physiology of dimethyltryptamine]


[Ayahuasca is a brew made of two admixture plants containing dimethyltryptamine (DMT) and b-carbolines (harmine and tetrahydroharmine). The indigenous groups of the Amazonas basin have been using it for centuries as an ethnomedical substance in healing and spiritual-religious rituals. During the last two decades the brew has raised increased scientific and public interest worldwide about its healing effects. Present paper addresses the therapeutic potentials of ayahuasca use and outlines the cellular mechanisms behind - in focus of the s-1 receptor mediated action of DMT. The scientific investigation of ayahuasca is complicated by methodical problems, legal issues, and sociocultural preconceptions.]

Lege Artis Medicinae

[Physician attitudes concerning complementary and alternative medicine]

ZÖRGŐ Szilvia, GYŐRFFY Zsuzsa

[INTRODUCTION - A crucial challenge for XXI. century health care is the presence of complementary and alternative medicine (CAM). A marked question of professional discourse has been characterizing patient CAM use, yet the attitudes, knowledge, and opinions of physicians have received far less attention. METHODS - This qualitative study involves semi-structured interviews conducted with 45 physicians. The narratives were scrutinized by employing Interpretative Phenomenological Analysis (IPA) via At­las.ti software. RESULTS - The narratives were coded ac­cording to attitudes and opinions concerning CAM, and subsequently participants were placed into 3 main groups. The first group is distinguished by a total rejection of CAM (n=11), while at the other end of the continuum, participants integrated biomedicine with CAM therapies (n=8). Those participants in between the two poles (rejection and integration) were characterized as „acceptance with reservations” and signify a heterogeneous category regarding composition and attitudes. COMMENTS - Most participants in our sample belonged to the „acceptance with reservations” category, that is, physicians who do not employ CAM in their praxis, albeit support their patients should they decide to utilize a CAM modality. Our inquiry aims to serve as a precursor to a quantitative study concerning CAM use.]

All articles in the issue

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[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. ]

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[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.]

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[History of the development of wound care]

SZABÓNÉ Révész Erzsébet

[The onset of wound care dates back thousands of years. To make the wet wound treatment used today so effective can be a bumpy road. Knowledge of local processes required for wound care, mapping of the effectiveness of materials needed for wound care, treatment of bleeding suppression and traumatic shock caused by injury, destruction of pathogens entering the wound, ensuring optimal hygiene during wound care, treatment of the underlying disease in chronic wounds, all contributed to our ability to provide effective care today. The series of wars over the millennia have greatly aided the development of wound healing, as many developments are still known today that were already used by the army before they spread into everyday practice. ]

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[The examination of burnout among healthcare workers]

FEJES Éva, MÁK Kornél, POHL Marietta, BANK Gyula, FEHÉR Gergely, TIBOLD Antal

[Health reforms in recent decades have been largely based on economic considerations and have led to a significant problem in the sector today, with the issue of human resources being pushed back, which is exacerbated by burnout syndrome. The aim of this questionnaire-based study was to examine the complex background of burnout among health care workers in the cities of Komló, Pécs and Kecskemét. Baseline demographic data were recorded. Burnout was assessed by the Maslach Burnout Inventory (MBI), and the intensity of dysfunctional attitudes were also studied. Depression was detected by the Beck Scale and social supports, and effort-reward dysbalance were also examined. Overall 411 employees participated in our study. Age group distribution was middle aged access, vast majority of the workers was between 36 and 55 years. Mean burnout scale was 58.6 (SD = 16.3), 63 workers had mild (14.2%), 356 had moderate (80.7%) and 22 had severe (5.1%) burnout. In a multivariate analysis the type of work (OR = 1.018), age (OR = 2.514), marital status (OR = 1.148), job type (OR = 1.246) the lack of social support (OR = 1.189) and allowance (OR = 9.719) were independently associated with burnout (p < 0.05 in all cases). There was a significant association among burnout, depression and dysfunctional attitudes. The vast majority of our social workers suffered from moderate and a small, but significant proportion suffered from severe burnout. Our work draws attention to the modifiable and unmodifiable risk factors of burnout in this population, which may help in the development of preventive strategies.]

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Surveillance and management of patients with tuberous sclerosis complex

FOGARASI András, GYORSOK Zsuzsanna, BODÓ Tímea

Tuberous sclerosis complex (TSC) is an autosomal dominant disease due to the uncontrolled differentiation, proliferation, and migration of cells in several organs. Clinical expression is highly variable, from mild skin findings and asymptomatic brain lesions to seizures, mental retardation, autism, and potentially fatal kidney, cardiac, or pulmonary disease. Aim of this paper is to summarize the diagnostic criteria, surveillance and therapeutic issues of this multisystemic disorder emphasizing the most important neurological consequences. Presenting the state-of-the-art management recommendations and comparing them with the local protocols, we hope that our review might help in the proper assessment of one of the most important single gene disorder.