Lege Artis Medicinae

[Master surgeon Bertold's salary]

FORRAI Judit

JUNE 30, 1993

Lege Artis Medicinae - 1993;3(06)

[The healing of the sick was brought to our country by the monks, along with the Christian faith. The first physicians came from the Order of St Benedict, which had a rule for the care of the sick (Cura infirmorum). This monastic medicine! came from the West. The secular doctors appeared in our country around the reign of Béla III, and their skill was often rewarded by princely grants. This is evidenced by numerous surviving contracts of sale in which they are listed as buyers. ]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[The role of angiotenzin converting enzyme inhibitors in the treatment of hypertension]

FARSANG Csaba

[The role of the renin-angiotensin system in the regulation of blood pressure is outlined. The mechanism of action as well as the role of angiotensin converting enzyme inhibitors (ACEI) in the treatment of various forms (primary, secondary, uncomplicated, complicated) of hypertension is discussed. The individualized , stepped care" approach is detailed, therefore the advantages of the therapeutic combinations of ACEi-s are emphasized. Interactions with other antihypertensive agents and with other drugs are also described, and side effects are also briefly addressed]

Lege Artis Medicinae

[Postmenopausal hormone replacement therapy]

H S Jacobs, F E Loeffler

[Over the past year, a number of summary publications on postmenopausal hormone replacement therapy have been published in the UK (1-3). Therefore, in this review we focus on areas that, although often controversial, may be of interest to practitioners. We will discuss the effects of postmenopausal hormone therapy on the risk of ischaemic heart disease, osteoporosis and cancer and present some observations on the concept of oestrogen tachifilaxis and dependence. Our conclusions are summarised in our recommendations on hormone therapy in menopause.]

Lege Artis Medicinae

[Immunohistochemistry of atherosclerotic lesions]

ILLYÉS Gyula, KÁDÁR Anna

[Cellular interactions within the arterial wall are considered to be essential in the development and progression of atherosclerotic lesions. This paper is a review of the actual knowledge about the role of the macrophages in the process of atherogenesis. The cellular composition of atherosclerotic changes – aligned in a possible consecutive order in which they may progress – are presented and discussed from the author's own immunohistochemical investigation. 108 aortic specimens obtained at autopsy performed within 12 hours following death from young people (20–34 ages) were examined. The Factor VIII positive endothelial lining was well preserved, no desmin content could be demonstrated. In contrary the presence of vimentin was noted in almost all the cells of the aortic wall. The foam cells reacted with different anti-macrophage antibodies, and most of the non-reacting cells of the different lesions proved to be smooth muscle cells. A considerable part of the intimal cells showed HLA-DR positivity as well. The quantity of the T helper lymphocytes in the lesions did not bear any significance. There was relationship between clinical data and types of (early) atherosclerotic lesions in the aorta. It is suggested, that the atherogenetic process starts in the intima with the appearance of smooth muscle cells and an increase in the lipid content. Thereafter macrophages accumulate and lead to the development of foam cells and at the same time they cause tissue damages leading to further smooth muscle proliferation and to classic atherosclerotic changes within the arterial wall.]

Lege Artis Medicinae

[Genetic counselling service at the congenital diaphragmatic defect]

GÖRBE Éva, FEKETE Zoltán, JEAGER Judit, TÓTH-PÁL Ernő, PAPP Csaba

[Recurrence risk of congenital diaphragmatic defect in a genetic counselling service has been investigated. Based on the investigation of 78 cases the risk of recurrence proved not significant. The families who have already had a newborn with congenital diaphragmatic defect may be suggested to bear subsequent pregnancies with the support of genetic counselling and intermittent ultrasonography. ]

Lege Artis Medicinae

[Studies of left ventricular dysfunction]

MATOS Lajos

[510 patients (39.7%) in the placebo group and 452 patients (35.2%) in the enalapril group died. The reduction in cardiac mortality was mainly due to a reduction in progressive heart failure (placebo: 251, enalapril: 209; risk reduced by 22%). There was no appreciable reduction in mortality from arrhythmias without pump failure. However, fewer patients died or were hospitalised due to worsening of circulatory failure (placebo: 736, enalapril: 613; risk reduction 26%; p<0.001).]

All articles in the issue

Related contents

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.]

Clinical Neuroscience

Review of electrode placement with the Slim Modiolar Electrode: identification and management

DIMAK Balazs, NAGY Roland, PERENYI Adam, JARABIN Andras Janos, SCHULCZ Rebeka, CSANÁDY Miklós, JÓRI József, ROVÓ László, KISS Geza Jozsef

Background - Several cochlear implant recipients experience functionality loss due to electrode array mal-positioning. The application of delicate perimodiolar electrodes has many electrophysiological advantages, however, these profiles may be more susceptible to tip fold-over. Purpose - The prompt realization of such complication following electrode insertion would be auspicious, thus the electrode could be possibly repositioned during the same surgical procedure. Methods - The authors present three tip fold-over cases, experienced throughout their work with Slim Modiolar Electrode implants. Implantations were performed through the round window approach, by a skilled surgeon. Standard intraoperative measurements (electric integrity, neural response telemetry, and electrical stapedial reflex threshold tests) were successfully completed. The electrode position was controlled by conventional radiography on the first postoperative day. Results - Tip fold-over was not tactilely sensated by the surgeon. Our subjects revealed normal intraoperative telemetry measurements, only the postoperative imaging showed the tip fold-over. Due to the emerging adverse perception of constant beeping noise, the device was replaced by a CI512 implant after 6 months in one case. In the two remaining cases, the electrode array was reloaded into a back-up sheath, and reinserted into the scala tympani successfully through an extended round window approach. Discussion - Future additional studies using the spread of excitation or electric field imaging may improve test reliability. As all of these measurements are still carried out following electrode insertion, real-time identification, unfortunately, remains questionable. Conclusion - Tip fold-over could be reliably identified by conventional X-ray imaging. By contrast, intraoperative electrophysiology was not sufficiently sensitive to reveal it.

Clinical Neuroscience

Epidermoid tumours of the posterior fossa

K. Bálint, F. Slowik, M. Kordás, J. Juhász, J. Julow

In opposite of the benign biological behaviour of the posterior fossa epidermoids the operation of these tumours a great challenge for the surgeon both theoretical and surgical point of view. We analysed our 14 operated cases clinico pathologically in this retrospective study.

Clinical Neuroscience

[Neurophobia]

SZIRMAI Imre

[Neurophobia is the fear of neurological diseases. Its main symptom is that medical students and young doctors are not able to utilize their basic neurological knowledge at the bedside. According to statistics, every second student suffers from neurophobia. This attitude could explain why in the last two decades less and less young doctors wanted to become neurologist. Medical students complain that they receive no instructions, and are afraid of loosing their interest and of facing the failure of their competency. The hardship of neurology was explained by the insufficient knowledge of anatomy and the infrequent encounter with patients. Even general practitioners have anxiety about neurological patients. The loss of interest in neurosciences seems to associate with insensitivity of human-centered culture and corruption of empathic thinking. The burnout syndrome of medical doctors and students can be explained by stress, loss of respect, permanent competition, independency that interferes with responsibility, stiff hierarchy of medical society, fear of diagnostic failures and of economical difficulties. The scores of depression in female students were higher than in male. The idea of the “good neurologist” has been changed. The business oriented care, the shortage of time, and the financial restrictions corroded the conventional practice and ceased the vocational idealism. At present, personal teaching is going to transform into impersonal multimedia learning. Because of the drastic change of values, the age of inner-oriented professionals has terminated also in the medicine. Medical doctors follow even less the traditional troll of professional behavior, but according the social demands, they choose their specialization for subsistence. The highly esteemed social status of neurologists and psychiatrists is going to sink in Europe. To reduce neurophobia it would be desirable 1. to introduce neurology training in the early years of medical school; 2. to teach neurology in all semesters, 3. to assure the effective teaching of neuro-anatomy and physiology, 4. to organize more one-to-one teacher-student communication. In the United States, residents participate in teaching during their residency training. To master neurology dedicated teachers are necessary whom neurology residents ought to meet personally with optimal frequency. However, these requirements seem to fail because of the chiefly technical characters of the actual reforms.]

Clinical Neuroscience

[The efficacy of autologous free fat graft and Spongostan in preventing postmicrodiscectomy scar formation]

LAPIS István, HORVÁTH Gyõzõ

[Introduction - Postoperative scar formation has been implicated as one of the possible cause of persistent or recurrent pain after spine surgery. The efficacy of the autologous free fat graft and the Spongostan gel foam for the prevention of extradural adhesion after lumbar discectomy was investigated by the evaluation of postoperative neurological symptomps and visual analogue scale. Patients and methods - In the study 174 patients were involved, average 14.5 months after the intervention. Autologous free fat graft (group I) and Spongostan gel foam (group II) was used randomly by the operations. Patients were operated by the same surgeon, and they were investigated by another independent surgeon. Result - No significant difference was found between the two groups.]