Lege Artis Medicinae

[On the draft budget of the social security funds for 1994]

GERENCSÉR László

DECEMBER 29, 1993

Lege Artis Medicinae - 1993;3(12)

[The use of public funds is planned in the general government balance. The general government balance is made up of four subsystems: - the central budget, - the budget of the earmarked public funds, - the budget of the local (regional or local) governments, - the budget of the social security system, which consists of two separate funds (pension and health insurance). The management of public finances is governed by the Public Finance Act, which requires each subsystem to prepare an annual budget. The budget appropriations include the cash requirements for the tasks to be performed by each subsystem and the expected revenue to be collected. It follows that behind the dry figures in the budgets are all the important context of the area concerned. The budgets of the subsystems of general government are approved and finalised by Parliament. In recent years, the budgets presented by the government have become law through the adoption of a number of amendments by Members of Parliament and committees.]

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[The significance of vasodilator drugs and angiotensin converting enzyme inhibitors in the treatment of congestive heart failure]

JÁNOSI András

[The significance of angiotensin converting enzyme inhibitors in the treatment of congestive heart failure is outlined. The results of multicenter, randomized trials are summarized confirming the beneficial effect on survival of vasodilator therapy and/or angiotensin converting enzyme inhibitors in the treatment of patients with congestive heart failure.]

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[Medical management of inland catastrophes]

FARKAS József

[The author details the medical consequences of disasters and mass casualty situations. The concept of disaster is definied and compared with that of mass accident. It is pointed out that in principle there are no essential differences between them since both disasters and mass accidents require the application of compromise medicine princliples at the site of the catastrophe and during the course of the hospital treatment. The main point of medical support at the site is the triage based on a numeric system of classification. In hospital treatment it is of great importance to adopt uniform (doctrinarian) principles and practice in order to prevent or decrease complications occurring in almost every extreme situation. Further co-operation of our medical organizations and development of common disaster plans may improve the effectiveness of coping with a possible emergency in our country.]

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[The value of colposcopical and cytological examination in the screening of cervical intraepithelial neoplasia]

PETE Imre, BŐSZE Péter, TÓTH Vera, LEHOCZKY Győző

[ From 1980 to 1991, 1379 women with abnormal colposcopic and/or cytologic findings were examined at the Department of Gynecological Oncology at the National Institute of Oncology, Budapest. The sensitivity and specificity of these screening tests were studied retrospectively. All women underwent either cervical excision or conisation. Cytological and colposcopical findings were compared with the histological findings. Sensitivity and specificity of cytology were 49% and 77%, retrospectively. The corresponding figures for colposcopy were 88% and 12%, and for cytology and colposcopy together, 96% and 14%. 1. The low sensitivity of cytology suggests that as many as 50% of CIN lesions will be missed if cytology alone is used for screening. This finding probably justifies our screening policy (i. e., colposcopy should be used as a primary tool). 2. We found 194 asymptomatic patients with carcinoma in situ, 40 with microinvasive and 8 with frank invasive carcinoma. This finding emphasizes the importance of cervical cancer screening. 3. To decrease the false positive and negative rates, the introduction of new scientific results into the every day screening practice is urgently needed. 4. Our data suggest the superiority of a colposcopical screening method to a cytological one; however histological examination must be done independently of a screening method if the suspicion of cervical dysplasia arises. ]

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[Digoxin 2 days a week; Can what is wrong be safe?]

[The last 20-25 years have seen significant advances in the use of medication. Blood levels of drugs can now be measured using available laboratory methods, and many effects can now be accurately measured in addition to general clinical monitoring. This has created the basis for the everyday use of pharmacokinetics and pharmacodynamics and a separate discipline, clinical pharmacology.]

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[Coronary Angioplasty Versus Excisional Atherectomy Trial]

MATOS Lajos

[Atherectomy reduced coronary stenosis 50% or more often (89%) than angioplasty (80%, p<0.001), and the acute increase in vessel diameter was more pronounced (p<0.001). Atherectomy was associated with more early complications (11%) than angioplasty (5%, p<0.001) and hospital costs were also higher ($11 904 vs $10 637, p<0.006). After six months, the restenosis rate was 50% for atherectomy and 57% for angioplasty (p<0.06). However, the probability of infarction or death at six months was higher in the group treated with atherectomy (86%) than after angioplasty (4,6%, p<0,007).]

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