Lege Artis Medicinae

[Make music, doctors!]

BODA Domonkos

SEPTEMBER 01, 2000

Lege Artis Medicinae - 2000;10(09)

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Lege Artis Medicinae

[Bacteriophage therapy and prophylaxis; Renewal of earlier expectations]

MILCH Hedda

[Bacteriophages were discovered 84 years ago by the observation of a lysis of a bacterial culture. The aim of the earliest attempts was the therapeutic employment of bacteriophages. The experiments controlled unsatisfactorily, could not fulfill expecations and successful antibiotic testing resulted the rejection of bacteriophage therapy. Bacteriophages gained importance in biology in the 1950s, as model viruses in biological and genetic research. The decrease in the success of antibiotic therapy caused to renew efforts in experimental phage therapy. The author reviews the early studies carried out mainly on animals as well as human experiments with bacteriophages purified by genetic methods. According to the results, bacteriophage therapy may be effective under certain circumstances for the infections not treatable by antibiotics, and in the case of antiobiotic-susceptible bacteria it can supplement therapy.]

Lege Artis Medicinae

[Newly discovered molecules the chemokines]

KŐHIDAI László, DÉRFALVY Beáta

[Chemokine research in the last decade has provided new results in several areas of biomedicine. Investigation and characterization of chemokines resulted in better understanding and modeling complex pathophysiological and immunological processes. Chemokine research opened up entirely new aspects on the defense against pathogenic agents as well as on the processes of inflammation and angiogenesis. With the amount of clinical data growing steadily, it is clear that chemokines could play very important role not only in solving the problems of the oretical and experimental biology but also with their application in clinical diagnostics and therapy. ]

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Lege Artis Medicinae

[Effect of calcium channel blocking drugs on the periodontal status of hospitalised patients]

KEGLEVICH Tibor, ZSIDRÓ Emese, BENEDEK Erika, BARNA István, SZEGEDI Zsolt, SCHWAB E. Richárd, GERA István

[Ca2+-channel blockers play crucial role in the chronic treatment of hypertension and cardiac arrhythmia. One of the side effects of the chronic nifedipine treatment is gingival enlargement. The pathomechanism of this side effect is not fully understood. The main objective of the present study was to evaluate the potential role of different factors in the development and severity of gingival hyperplasia. The incidence and severity of gingival enlargement were examined around the six surfaces of all fully erupted teeth in 243 hospitalized patients with the modified Angelopoulus-Goaz Gingival Hyperplasia Index. 172 patients in the study group were on Ca2+ channel blockers for at least three months prior to the examination while 71 inpatients served as controls. Gingival hyperplasia occurred in 87% of the test group and in 53% of the control group. Severe gingival enlargement occurred in 35% in the test group and only in 2% of the control group. The age and gender of the patient, the daily dose of the medication, the duration of the administration of the drug showed no correlation with the extent and severity of gingival hyperplasia. Only oral hygiene showed statistically significant correlation with the severity of gingival enlargement. The only clinical parameter influencing the extent and severity of gingival enlargement associated with Ca2+-channel blocker drugs was the quality of oral hygiene. ]

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[Second game, 37th move and Fourth game 78th move]

VOKÓ Zoltán

[What has Go to do with making clinical decisions? One of the greatest intellectual challenges of bedside medicine is making decisions under uncertainty. Besides the psychological traps of traditionally intuitive and heuristic medical decision making, lack of information, scarce resources and characteristics of doctor-patient relationship contribute equally to this uncertainty. Formal, mathematical model based analysis of decisions used widely in developing clinical guidelines and in health technology assessment provides a good tool in theoretical terms to avoid pitfalls of intuitive decision making. Nevertheless it can be hardly used in individual situations and most physicians dislike it as well. This method, however, has its own limitations, especially while tailoring individual decisions, under inclusion of potential lack of input data used for calculations, or its large imprecision, and the low capability of the current mathematical models to represent the full complexity and variability of processes in complex systems. Nevertheless, clinical decision support systems can be helpful in the individual decision making of physicians if they are well integrated in the health information systems, and do not break down the physicians’ autonomy of making decisions. Classical decision support systems are knowledge based and rely on system of rules and problem specific algorithms. They are utilized widely from health administration to image processing. The current information revolution created the so-called artificial intelligence by machine learning methods, i.e. machines can learn indeed. This new generation of artificial intelligence is not based on particular system of rules but on neuronal networks teaching themselves by huge databases and general learning algorithms. This type of artificial intelligence outperforms humans already in certain fields like chess, Go, or aerial combat. Its development is full of challenges and threats, while it presents a technological breakthrough, which cannot be stopped and will transform our world. Its development and application has already started also in the healthcare. Health professionals must participate in this development to steer it into the right direction. Lee Sedol, 18-times Go world champion retired three years after his historical defeat from AlphaGo artificial intelligence, be­cause “Even if I become the No. 1, there is an entity that cannot be defeated”. It is our great luck that we do not need to compete or defeat it, we must ensure instead that it would be safe and trustworthy, and in collaboration with humans this entity would make healthcare more effective and efficient. ]

Journal of Nursing Theory and Practice

[Correlations Between Burnout and Socio-demographic and Workplace Related Factors Among Health-care Workers During The Covid-19 Pandemics]

NÉMETH Anikó, IRINYI Tamás

[The present study aimed to assess the level of burn-out among health-care workers in 2020 and its correlations with socio-demographic and workplace related factors. The cross-sectional study was conducted by the means of a self-constructed online survey in the beginning of 2021. The responses of 1965 people were analysed with the help of SPSS 23.0. Descriptive statistics, chi-square and Kruskal-Wallis probes were run (p<0.05). Severe burnout was present in 46.7% of the responders. Age, marital status, type of health-care provided and years spent in the health-care system didn’t show any correlation with burnout. Unsure vision, opinion about salary raise and uncertainty at the workplace influenced the level of burnout significantly (p<0.000). The mental health of health-care workers is in continuous decline, in which the COVID-19 pandemic might play a big role. People with worse mental health feel more uncertain regarding their future and job; this might make providing health-care more and more difficult.]

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[Non-pharmacological prevention and treatment for postoperative delirium in elderly patients with hip fracture - a systematic review]

VIDA Nóra, PAPP László

[Delirium is defined as a disturbance of consciousness and cognition that develops over a short period of time and fluctuates over time. During the last decade, the number of publications dealing with different aspects of delirium have been grown. The key points in most articles are pharmacological prevention and treatment, but because the rise of health care expenditures, all activities, which cost-effectively support the care process, is getting more and more important. The aim of the study: The aim of this research is to review the non-pharmacological prevention and treatment possibilities of delirium in elderly patients undergoing hip surgery. Systematic review, using articles published between 1999 and 2019 in PubMed and Wiley Online Libraries. Non-pharmacologic treatments significantly reduced the incidence (p=0.003–0.045) and duration (p=0.009–0.03) of delirium. The interventions also contributed to decrease the number of episodes (p=0.03), and to make the symptoms lighter. Early mobilisation and adequate fluid and electrolyte intake are key factors in reducing the incidence of delirium. Measuring oxygen saturation and support, appropriate nutrition, effective pain treatment, minimizing drug-interactions, maintaining good sleep and managing sensory dysfunctions have an effect on incidence, duration and severity of delirium.]

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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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[Family planning in multiple sclerosis: conception, pregnancy, breastfeeding]

RÓZSA Csilla

[Family planning is an exceptionally important question in multiple sclerosis, as women of childbearing age are the ones most often affected. Although it is proven that pregnancy does not worsen the long-term prognosis of relapsing-remitting multiple sclerosis, many patients are still doubtful about having children. This question is further complicated by the fact that patients – and often even doctors – are not sufficiently informed about how the ever-increasing number of available disease-modifying treatments affect pregnancies. Breastfeeding is an even less clear topic. Patients usually look to their neurologists first for answers concerning these matters. It falls to the neurologist to rationally evaluate the risks and benefits of contraception, pregnancy, assisted reproduction, childbirth, breastfeeding and disease modifying treatments, to inform patients about these, and then together come to a decision about the best possible therapeutic approach, taking the patients’ individual family plans into consideration. Here we present a review of relevant literature adhering to international guidelines on the topics of conception, pregnancy and breastfeeding, with a special focus on the applicability of approved disease modifying treatments during pregnancy and breastfeeding. The goal of this article is to provide clinicians involved in the care of MS patients with up-to-date information that they can utilize in their day-to-day clinical practice. ]