Lege Artis Medicinae

[News]

JUNE 29, 1994

Lege Artis Medicinae - 1994;4(06)

[The 1st National AIDS Conference; Pharmaceutical production with international cooperation; The turbuhaler in Hungary; Markusovszky Memorial Medal for the President of the Chamber; IV. annual meeting of the Hungarian Psychiatric Society; Astra scholarship for gastroenterologists]

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Lege Artis Medicinae

[Embryonic diagnostic possibilities prior to implantation]

SZTANYIK László, URBANCSEK János, BÁRÁNDY Zsolt, TÓTH-PÁL Ernő, PAPP Zoltán

[A longlasting goal of the medical science has been the prevention of birth defects. Prenatal diagnosis, which is one of the most important subspecialities in modern obstetrics, has developed significantly in the last 10–20 years and has become a powerful tool in fulfiling this aim. The rapid development of the fields of molecular biology, genetics and assisted reproduction has ereated the possibility of introducing the new era of preimplantation genetic diagnosis. Preimplantation genetic diagnosis involves the genetic analyses of the fertilized pre-embryo, without changing its developmental capability or its original characteristics. The most well proven method is the biopsy and rapid genetic analysis by polymerase chain reaction and in situ hybridization of one or two cells removed from the in vitro fertilized pre-embryo. This technique can be used to determine the sex of the pre-embryo or to investigate specific genetic diseases. Numerous other methods have been tried, and the more successful ones are briefly discussed. ]

Lege Artis Medicinae

[Aspects of hormonal therapy in prostate cancer]

ROMICS Imre

[The author describes all of the hormonal therapeutic methods presently applied in Hungary and summarizes the recommended therapies for each stage of the disease. The therapeutic alternatives of three groups of patients are discussed. Evidence in the literature demonstrates the advantages of applying hormonal therapy, in cases of incidental prostate cancer found in tissues obtained by TURP, as opposed to the „wait and see" approach. Emphasis is placed upon the ad vantages of hormonal therapy prior to radical prostatectomy, chief among them being the decrease in volume of the prostate, which simplifies the operation. A promt and total androgenic block is the proper therapy for locally advanced prostate cancer or in metastatic prostate cancer.]

Lege Artis Medicinae

[Treatment of posttransplant polyglobulia with enalapril]

JÁRAY Jenő, HEMANGSHU Podder, HÍDVÉGI Márta, REMPORT Ádám, PERNER Ferenc

[Posttransplant polyglobulia is not a rare complication following kidney transplantation. Recently in some publications favourable experiences were reported with angiotensin converting enzyme inhibitors in the treatment of polyglobulia. Among 325 patients having kidneys transplanted by authors, polyglobulia was found in 52 patients (16%) after an average of 19,5 months (2,5– 44,2 months) following the operation. In 48 cases, 5 mg enalapril was given orally, independent of the body-weight, for the treatment of polyglobulia. Among them 12 patients – 2 for allergic skin-reactions and 10 for irregular medication – were rejected from the study. During the monthly follow-up of laboratory parameters (Hbg, serum creatinine, serum bilirubin, serum alcalic phosphatase) as well as in the blood pressure (systolic/diastolic) no substantial (significant) difference was found compared to the starting value in the treated 36 patients. The only essential change was the change in the haematocrit level: there was a significant decrease in the haematocrit level after two months from the starting time and this remained so during the investigation. From this study and follow up the authors recommend treating the poly globulia found after the kidney transplantations with enalapril in place of the bilateral nephrectomy used earlier. This treatment is more pleasant for the doctor and the patient.]

Lege Artis Medicinae

[IgE monoclonal gammopathy and amyloidosis]

JÁKÓ János, KASZÁS Ilona, GESZTESI Tamás

[ IgE myeloma is a very rare disease with only 38 cases reported in the world literature. The authors describe a case of IgE monoclonal gammopathy leading to primary amyloidosis and death in 5 months. This is the first reported IgE monoclonal gammopathy in Hungary. Diagnosis was based on the immunochemical analysis of the concentrated urine. Histologic analysis relevaled amyloidosis. Despite the fact that IgE myeloma is a rare entity, its clinical presentation is highly variable. This case of IgE myeloma presented itself clinically as amyloidosis. Free light chains could be detected from the patient's serum during the entire course of the clinically active disease. In contrast, heavy chains were not detectable, and therefore immunochemical analysis of the concentrated urine is recommended to help in establishing the diagnosis.]

Lege Artis Medicinae

[The relationship between premature mortality and marital status in hungary]

HAJDÚ Vargáné Piroska, BOJÁN Ferenc

[The relationship between mortality and the marital status of Hungarians aged 30–64 was analyzed for the period 1970–1990. The lowest mortality rate was found among married men and women, independent of age. The risk of mortality among unmarried men and women is greater in the age group 30–49 than in the age group 50–59. In both age groups the relative mortality risk of widowed and divorced men is higher than that of the corresponding women. As compared with the married population, the relative mortality risk of men and women who never married is less pronounced, especially in the age group 50– 59. From the late 1970s, the relative mortality risk of divorced men has increased to the greatest extent. As a consequence, in 1980s, the divorced men proved to be the group at greatest risk. ]

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Lege Artis Medicinae

[Education and psychological support of parents in cases of postnatally detected Down syndrome]

MÁTÉ Orsolya, KÍVÉS Zsuzsanna, OLÁH András, FULLÉR Noémi, PAKAI Annamária

[OBJECTIVE - Since the 60’s several publications dealt with the phenomenon how physicians inform parents of newborns about postnatal recognition of Down’s syndrome and the support they receive right after breaking the bad news. Howe - ver, the rest of these studies concentrated on surveying parental satisfaction, while relatively few international studies deal with the other side of the communicational situation, the opinion of the informer. Our study focused on the circumstances of parental information in Hungarian institutions of obstetrics in order to evaluate the possibilities for interventions. METHODS - The Down’s team operating at the University of Pécs Faculty of Health Sciences carried out a national survey in 2005 - an interview-based questionnaire filled by physicians of institutions of obstetrics - with the help of the National Register for Congenital Diseases of the National Centre for Epidemiology and Down’s Foun dation. RESULTS - The coverage of the survey reached 74%. Rest of the surveyed institutions did not have information protocol, however, 70% of them believes it would be necessary. Only 44% of the physicians received communication training and 81% of them believe they can manage communication, 33% have felt that the mother of a newborn with Down’s syndrome would expect special help that the institutions are unable to provide. CONCLUSION - There are serious problems with the circumstances of parental informing in Hungarian institutions of obstetrics. This situation would obviously require intervention. An aimed communicational training based on international experience and exploiting the openness of physicians, as well as the establishment of information protocol could be elements of such intervention.]