BOHÁCS Anikó, KARLÓCAI Kristóf, KERPEL-FRONIUS Anna
SEPTEMBER 20, 2018
Lege Artis Medicinae - 2018;28(08-09)
[Idiopathic pulmonary fibrosis (IPF) is a subgroup of the fibrotising idiopathic interstitial pneumonias occuring primarily in older adults. It is characterised by progressive decline of lung function and is associated with high mortality. IPF is frequently associated with pulmonary hypertension (PH). PH has unfavourable impact on the prognosis of IPF. PH should be suspected in IPF patients presenting with dyspnoe, desaturation on exertion and disproportionately low diffusion capacity. Transthoracic echocardiography is used to screen for PH in IPF patients. Although right heart catheterization is the gold standard procedure for the diagnosis of PH, this is not regularly performed on IPF patients. Chest high resolution computer tomography (HRCT) is essential for the diagnosis of IPF. IPF is typically characterised by the presence of usual interstitial pneumonia (UIP) pattern on HRCT. Multidisciplinary discussion between experienced pulmonologists, radiologists, and pathologists is key in the early and accurate diagnosis of IPF. An important role of the interstitial lung disease-multidisciplinary team (ILD-MDT) is to determine whether other diagnostic examinations and surgical lung biopsy is needed, in an attempt to reduce unnecessary risk. ILD-MDT should propose the initiation of antifibrotic therapies that have the potential to reduce disease progression. All patients diagnosed with IPF, with no contraindications for lung transplantation, should be referred early to a transplant committee.]
Lege Artis Medicinae
Lege Artis Medicinae
[The paper reflects upon the process in which physician assisted suicide, as it is traditionally called, is being reinterpreted. First, changes in word usage shall be demonstrated by examples taken form the relevant US laws and statements of prestigious US organisations. Then the interpretive possibilities of suicide, as it is traditionally called, and their consequencies are discussed. In this context the present state of art of the Hungarian criminal law is briefly presented. Finally some remarks on the normative element of the practice are made. ]
Lege Artis Medicinae
Lege Artis Medicinae
[INTRODUCTION - In the severe forms of anorexia nervosa hospitalization may be required, and the somatic treatment is provided in a department of internal medicine. In such cases, collaboration between internist and psychiatrist is essential. Psychological support is necessary even in the period of nutritional rehabilitation. This can be applied in the framework of consultation-liaison psychiatry. After the initial weight gain providing psychotherapy in an outpatient setting is fundamental. In the case of anorexic patients who maintain a close relationship with the family, family therapy is the most effective treatment. CASE REPORT - A 26-year old female patient with anorexia was hospitalized in a department of internal medicine after an extreme emaciation, her body mass index was 11.6. During this period there was a psychiatric consultation involving the fa-ther of the patient as well. Her body weight increased, and outpatient family therapy was initiated. Fifteen family sessions were conducted in nine months, with special focus on the separation-individuation process. At the end of the therapy a full remission could be observed, with a normal body weight, and her periods returned. After a four-month follow-up her state was stable, and she got married. CONCLUSION - Interdisciplinary collaboration can be cardinal when somatic and psychological disorders are interwoven. The role of family therapy is crucial in those cases where emotional separation from the family of origin is difficult, even if the patient does not live with the parents any longer. ]
Lege Artis Medicinae
Clinical Oncology
[The interstitial lung diseases (ILD) are a heterogeneous group of disorders that are classifi ed together because of similar clinical, radiographic or pathologic manifestation. The diffuse interstitial lung diseases are divided into those that are associated with known causes and that are idiopathic. The treatment choices and prognosis vary among the different causes and types of ILD, so the early and correct diagnosis is important. In oncology ILD could be a rather severe adverse effect of treatment with radiationor chemotherapy.]
Lege Artis Medicinae
[During the last decade lung transplantation became an accepted treatment option for endstage lung disease of different origin. Technical problems of the early period have been solved completely during the course of time and the operation has found its place as a routine procedure. The shortage of donor lungs has stimulated the development of new operative techniques. Parallel to achievements in surgical treatment, significant progress in immunosuppressive therapy was obtained. Long-term survival following lung transplantation however remains limited by the onset of bronchiolitis obliterans syndrome. Since Vienna serves as a leading centre for lung transplantation in Middle-Europe, between 05/03/1996 and 17/01/2003 21 Hungarian patients underwent lung transplantation here. In close co-operation with the Vienna Lung Transplant Group, the Hungarian specialists prepare for introduction of lung transplantation in Hungary.]
Hypertension and nephrology
[This consensus document is intended to provide guidance for the effective and efficient treatment of asymptomatic individuals with high uric acid levels and gout patients.]
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Clinical Neuroscience
Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease2.
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Hypertension and nephrology
[Treatment and care of hypertensive patients during and after the Covid-19 pandemic. Possibilities and effectiveness of telemedicine]4.
Hypertension and nephrology
[Post-career development of cardiometabolic changes and hypertension in competitive athletes]5.
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