Lege Artis Medicinae

[Migrating pulmonary infiltrates from the clinican's point of view]

TÓTH Krisztina, RUMSZAUER Ágnes, MESTER Judit

MAY 20, 2002

Lege Artis Medicinae - 2002;12(05)

[Authors define pulmonary migrating infiltrates based on four case reports of different etiologies: the concept refers to recurring pulmonary infiltrates appearing at separate localisations and at various times. Listed are those diseases and adverse factors where this phenomenon occurs with various prevalence. A diagnostic algorithm is suggested based on experience for similar cases starting with an accurate case history through non-invasive tests all the way to invasive diagnostics, including surgical intervention where needed. With full knowledge of the diagnosis adequate therapy can be started in time, which can save the patient from unnecessary and in many cases dangerous and incorrect treatment.]

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Lege Artis Medicinae

[Changing tendencies in retinal surgery]

MILIBÁK Tibor

[Retinal detachment, a disease caused by pathologic alteration of the vitreoretinal relationship, may decrease vision to blindness without treatment. Although some of the patients with retinal detachment become blind for the time being, last two decades produced significant improvement both in diagnosis and treatment. As a result of new surgical techniques we can perform successful surgery even in cases that were earlier inoperable. Recent methods are significantly less traumatic to the eye than they were 20 years ago. Dramatically reduced bedrest before and after surgery, regional or even topical anaesthesia instead of general anaesthesia, short term hospitalisation or one day surgery, short term restriction of physical activity after surgery are the most important consequences of the new wave of retinal detachment repair. According to recent recommendations of the prophylactic treatment of peripheral retinal lesions we treat only horse tears with sudden retinal complaints.]

Lege Artis Medicinae

[Thoughts on the mission of the LAM]

KAPÓCS Gábor

Lege Artis Medicinae

[Prevalence of subtreshold forms of psychiatric disorders in persons making suicide attempts in Hungary]

BALÁZS Judit, BITTER István, YVES Lecrubier, CSISZÉR Nóra, OSTORHARICS György

Lege Artis Medicinae

[ICD based data collection of sick-pay data in county Vas]

BONCZ Imre, FLAMIS László, GYŐRVÁRI Sándor

[INTRODUCTION - The analysis and evaluation of sick-pay data presents great challenge for a health insurance fund. It is very important to collect sick-pay data related to the medical diagnosis of the patients. DATA AND METHODS - The aim of the study is the analysis of sick-pay data in County Vas, Hungary. The new approach focuses on the ICD (International Classification of Diseases) based sick-pay reports which contains the cause of sicknesses according to ICD terms. The data was derived from 1998. RESULTS - During the period involved there were no significant change in the number of ICD codes used by the doctors. The cases shorter than 30 days account for 84,43 % of total cases, while they account for the 41,05 % of total disability to workdays. The most common ICD group measured by the number of cases is group Nr. X. (Diseases of the respiratory system), while most common as measured by the days spent on sick-pay is group Nr. XIII. (Diseases of the musculoskeletal system and connective tissue). Significant differences were found between men and women. Analysing the diagnosis within the main groups - ranked by the number of cases - the diseases of respiratory system and of the musculo-skeletal system are found in leading positions. Based on the number of sick-pay days the diseases of musculo-skeletal system are on the first place. CONCLUSIONS - Results of this analysis can provide valuable information for both the National Health Insurance Fund and the physicians and have contributed to the implementation of the national „Disability to work Monitoring System”.]

Lege Artis Medicinae

[How much does a deposit cost in a human umbilical cord blood bank?]

MASSZI Tamás

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A rare entity of acquired idiopathic generalised anhidrosis which has been successfully treated with pulse steroid therapy: Does the histopathology predict the treatment response?

ÖKTEM Özdemir Ece, ÇANKAYA Şeyda, UYKUR Burak Abdullah, ERDEN Simsek Nazan, YULUG Burak

Acquired idiopathic generalised anhidrosis is an uncommon sweating disorder characterized by loss of sweating in the absence of any neurologic, metabolic or sweat gland abnormalities. Although some possible immunological and structural mechanisms have been proposed for this rare entity, the definitive pathophysiology is still un­clear. Despite some successfully treated cases with systemic corticosteroid application, the dose and route of steroid application are controversial. Here, we present a 41-year-old man with lack of genera­lised sweating who has been successfully treated with high dose pulse intravenous prednisolone. We have discussed his clinical and histopathological findings as well as the treatment options in view of the current literature.

Lege Artis Medicinae

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Lege Artis Medicinae

[Fear of medical care: epidemiology and prevention among 5-6 years old children]

PÓCS Dávid, SIKLÓSI Réka, NYÁRI Tibor, BARABÁS Katalin

[INTRODUCTION - At least 5-10% of the adult population is afraid of medical care. These fears may begin in preschool years. Therefore, the aim of our study was to assess the rates of medical fears among 5-6 year old children, and to prove that medical fears can be reduced by a health promotion program for children called “Teddy Bear Hospital” POPULATION AND METHODS - 248 children participated in the study (average age: 5.5 years, 45% girl, 55% boy). The “Teddy group” (129 children) took part in the Teddy Bear hospital program (Teddy group). The control group (119 children) did not take part in this program (control group). Questionnaires, including a Visual Analog Scale, a picture test, and drawing analyses were completed on two separate occasions three weeks apart difference. RESULTS - Fear of needles was the most frequent fear (59%) among the participating children, followed by the fear of medical environment (33%), the fear because of the lack of information (27%), the fear of doctors (20%), and the fear of pain (15%). On the basis of the picture test the fear of doctors significantly decreased in the Teddy group (from 18% to 7%) compared with the control group (from 10% to 11%, p<0.05). Drawing analyses also showed that children in the Teddy group had significantly lower levels of medical anxiety (29% and from 19.3 point to 17.6 point) than the control group (19% p<0.05 and from 18.8 point to 18,33 point p<0.05). On the drawings of the Teddy group we found significantly more new medical information (38%) compared with the control group (21%, p<0.05). CONCLUSIONS - Medical fears are frequently present among 5-6 year old children, therefore, their prevention is greatly needed. A potential way of the prevention is the “Teddy Bear Hospital” program, which efficiently reduces children's medical fears and anxiety.]

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REISCH Róbert, RESCH Klaus, PERNECZKY Axel

[A preclinical cadaver study was performed to test a transendoscopic sonographic probe for neurosurgery. In 25 fresh post-mortem adult human cadaver with a total of 39 endo-sonographic dissections in the ventricular system were carried out. A sonograph with an outer diameter of 6 F was used and radial sonograms were made by a realtime image technique. First results showed precise imaging, comparable to a CT in a neighbouring area of 3 cm. In this publication, the authors describe the endo-neurosonographic anatomy of the ventricular system. The sonographic probe was advanced through the working canal of a ventriculoscope, then the endoscopic and sonographic imaging were compared. Results were documented by paralell sonographic and endoscopic photo and video recordings. Based on the authors experience, it is revealed that the additional sonographic view could also be used as a navigation tool.]