Lege Artis Medicinae

[Mazes and compass in prognostic value of cardiovascular risk factors]

KÉKES Ede, KISS István

MAY 20, 2017

Lege Artis Medicinae - 2017;27(04-05)

[The risk assessment of cardiovascular disease is dispensable in everyday practice, because this disease-group gives the high-est death rates all over the world - in developed countries, in Central European Region, including Hungary. Based on reliable surveys world side, we need in addition to coronary heart disease, stroke has been reckoned today to peripheral vascular disease, type-2 diabetes, and chronic kidney diseases as well. It seems useful to the new name i.e., atherosclerotic cardiovascular diseases. It stands as smoking, hypertension, dyslipidemia risk factors among this group of diseases in the background, but more and more importance is given to visceral obesity, physical inactivity, alcohol consumption and psycho-social status. It has to count with the fact that the individual factors together and appear further worsen to mortality rate. The greatest interference arises because the cardiovascular risk estimation proposed by embodiments of non-uniform principles. Undoubtedly, the resolution of ACC/AHA 2010 was the first correct compass, because the classification and utility values of the factors precisely regulated. But in addition, it is essential that in the risk assessment not only the “global estimation” (tables, other forms) will be conducted, but also other important parameters characterizing the extended factors (vascular structure, obesity, psycho-social status, etc.) - set schedule and regulations - acting on to be carried out. We presented in cardiovascular risk assessment methodology and the most profitable methods of estimation based on the preventive guidelines, extern opinions generally accepted now and own experiences. We propose to modify the risk assessment me-thod.]



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BÁN Attila

[Introduction - The doctor-patient relationship has always been an essential part of health care, however, in parallel with the integration infocommunication technologies in health care the doctor-patient communication is also transforming. Therefore, the aim of the study is to examine the effect of telemedicine on this relationship. Methods - During the study, we applied qualitative research methods and a total number of 58 semi-structured interviews (45 men, 13 women) were conducted among physicians having experience in telemedicine. The majority of the interviewees were radiologist, general practitioners, and internists. The interview questions concerned that what characterises the doctor-patient relationship in telemedicine. Results - The interviews pointed out that in teleradiology the doctor-patient relationship depersonalises and almost terminates. In this respect, the problem is often the incomplete clinical information about the patient. In turn, telemonitoring can bring a quality change in the doctor-patient communication and through remote contact the patients’ satisfaction, the sense of security, and the doctor-patient relationship will be further enhanced. Conclusions - In accordance with the academic literature - based on the research results - there is no clear evidence that telemedicine would affect doctor-patient communication only positively or only negatively. In some areas of telemedicine, this relationship is reducing (e.g. teleradiology) while in other areas it could be fur-ther strengthened (e.g. telemonitoring).]

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