Lege Artis Medicinae

[MARITAL STRESS, DEPRESSIVE SYMPTOMS AND CARDIOVASCULAR VULNERABILITY IN WOMEN]

BALOG Piroska, MÉSZÁROS Eszter

SEPTEMBER 20, 2005

Lege Artis Medicinae - 2005;15(08-09)

[INTRODUCTION - Marital stress and depression have proved to be independent biopsychosocial risk factors for cardiovascular disorders. At the same time their interaction increases cardiovascular vulnerability. The Stockholm Female Coronary Risk Study has shown that marital stress was statistically significantly associated with depressive symptoms, in both groups of healthy women and in patients, even after adjusting for age, educational level, menopausal status, body mass index, cigarette smoking, sedentary lifestyle and the severity of heart failure. METHODS - The aim of this study was to investigate the effect of marital stress on depressive symptoms and psychosocial vulnerability in women with coronary heart disease and in healthy women, cohabiting and currently working. Data were obtained from the Hungarostudy 2002, representing the Hungarian population over the age of 18, according to age, sex and county. RESULTS - The results have shown that an increase in marital stress contributes to an increase in psychosocial vulnerability (depression, anxiety, vital exhaustion, sleep complaints) in healthy women and in women with cardiovascular disorders as well. Higher depression has been related with higher marital stress as well. DISCUSSION - The relation between marital stress and depression seems to be independent from socio-cultural, economical differences: the same results have been found in Hungarian and Swedish women. This relation seems to be bidirectional: a bad marriage increases the prevalence rate of depressive symptoms and depression worsens marital quality. At the end we propose a conceptual framework for how marital stress and depression increases cardiovascular vulnerability in women, emphasizing circular causality.]

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Lege Artis Medicinae

[TRAVEL MEDICINE IN GP PRACTICE]

FELKAI Péter, KOVÁCS Erzsébet

[The authors describe the basic ideas of travel medicine, as a newly introduced interdiscipline of the medical science in Hungary. Recently, this segment is considered to be the part of Insurance Medicine, on the other hand the methods and the practice of the travel medicine is based on the other medical specialities’ knowledge. Due to the growing number of travellers in our country as well as the consequences of the joining Hungary to EU, travel medicine could play an important role in the improvement of the Hungarian travellers’ attitude to their health care status, the prevention against the emerged infectious diseases, and in the medical assistance for the international tourism. Travel medicine also a good guideline for the fit-for-travel considerations, made by the GPs. Hungary with its advantageous geographical position appears to be an excellent stopover for any medical evacuation from East European or other surrounding countries. That is why we would like to establish a first travel medicine facility in central Europe. It is expectable that the Hungarian travellers require more and more information regarding to their health care possibilities and prevention during their trip. The first authentic person is being asked by the patients’ are GPs. The GP’s tasks are: diagnosis and the treatment of travel related diseases, the pre-travel advices. All the mentioned factors are a new challenge for the GPs in Hungary.]

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[REHABILITATION OF HEARING IMPAIRMENTS WITH HEARING AIDS IN CHILDREN AND ADULTS - INDICATIONS, POSSIBILITIES, CARE]

REJTŐ Kálmán

[The early diagnosis of the different types of hearing impairments and the adequate surgical or conservative therapy have changed in the last decades. Up-to-date objective audiological methods (otoacustic emission, auditory brain stem potentials, audiotory steady state potentials) and genetic laboratory examinations help us in the diagnosis of the congenital hearing impairments. Formerly, only patients with the different diseases of the middle ear consisted into the group for surgical rehabilitation but recently this has been completed with middle ear implantation of different types as well. In cases of sensoryneural hearing impairments of severe degree cochlear implantation is now possible and in the case of severe impairments nerve VIII brain stem implantation can be performed. The high level of the technical development brought revolution in the rehabilitation with hearing aids as well. The new digital technology, the sizes of the hearing aids, good cosmetic and excellent functional results help the medicaltechnical team in the optimal fulfilment of the demands and expectations. In the process of the complex rehabilitation with hearing aids, the exact diagnosis, the fitting of the proper hearing aids with individual ear moulds, the teaching and training and the care of the patient will bring the expected result.]

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