Lege Artis Medicinae

[Parliamentary debate on healthcare]

NAGY András László

MAY 01, 2000

Lege Artis Medicinae - 2000;10(05)

[On the proposal of the MSZP, the National Assembly organized a health debate day entitled Reform or Rhetoric. Árpád Gógl began his 40-minute introduction by criticizing the health policy of the Horn-Kuncze government. He stated that the Bokros package had shattered some elements of Hungarian health care: dentistry, sports health care, the sanatorium system, and in 1995 the expenditure had been halved from the 1990s.]



Further articles in this publication

Lege Artis Medicinae

[ Excerpts from publications of Hungarian authors published in foreign journals]

Lege Artis Medicinae

[Aspirin therapy in diabetes mellitus]

ÁBEL Tatjána

[Patients with diabetes mellitus have an increased risk of cardiovascular events and this risk is often present in the prediabetic phase of the type 2 diabetes. Diabetic patients have altered platelet function, including increased production of thombox ane resulting in increased platelet aggregation. This effect is reversed by aspirin within few days after beginning treatment with 75 mg aspirin daily. These findings of primary and secondary prevention trials in men and women with dia betes mellitus support the view that low-dose aspirin therapy should be used as secondary prevention when not contraindicated, and it should also be used as primary prevention in patients who are at high risk for cardiovascular events. ]

Lege Artis Medicinae

[The role of apoptosis in human diseases]


[Apoptosis and mitosis control the homeostasis of various cell populations. Several diseases are characterised by too much or to small amount of apoptosis. Carcinogenesis itself is connected with a decrease in apoptotic activity and malignant neoplasms are also known to show low apoptotic index. However, each type of malignant tumors should be viewed as a distinct entity, regarding the capacity for the induction of apoptosis especially. The role of apoptosis in the pathogenesis and progression of autoimmune, infectious, neurodegenerative diseases and alterations in the liver, kidney, lung and heart is also discussed, with special emphasis on therapeutic possibilities influencing the imbalance of apoptosis. ]

Lege Artis Medicinae



[In spite of our increasing knowledge about the pathomechanism, clinical classification and therapy of gout as well as the improving care of gouty patients, many problems of the field are unsettled. Among others, the atypical character of female gout, its more frequent occurrence in elderly women, the often aggressive character of the cyclosporin-induced gout belongs to the unanswered questions. Understanding the role of crystals covered by proteins (mostly IgG) in the induction of inflammation was of great importance, however, the changing character of inflammation caused by intraarticular MNU-crystal deposition is still a challenging problem. It is well known, that not all gouty patients are middle aged males, the number of young, drug-resistant gouty males having extensive tophi is increasing. Although the relationship between hyperuricemia and gout was clarified in many respect, it would be important to understand why chronic hyperuricemia is not associated regularly with gout and why gout can develop in patients without high serum uric acid levels. We learned finally, that early diagnosis and adequate treatment of gouty attacks and the therapy resulting in the decrease of high level of serum uric acid are prerequisites for slowing down the progres sion of the gout and for the prevention of its complications. ]

Lege Artis Medicinae



[The Reiter-syndrome is the complex of sterile arthritis, urethritis and conjunctivitis and involvement of other organs (skin, mucosal membranes, cardiac conducting system) following bacterial enteric or urogenital infec tion. Systemic signs can also occur with polyarthritis. This syndrome belongs to the reactive arthritis group. In each year there are 30 40 new cases among 100 000 citizens. The disease can occur at any age, but most of the patients are 20-40 years old. It is the patient's genetic background and the type of invading microbes that play a leading role in the pathomechanism of the disease. The exact pathomechanism is yet unknown, therefore our treatment is symptomatic. It is advised to immobilize the involved joint and aspirate the excess fluid and to take non-steroidal antiinflammatory drugs. The patient's medical history is most important to diagnose the disease, because laboratory tests may show signs of inflammation, the serology can only prove antecedent infection, viable organism can not be cultured from the involved organs and the imaging procedures and histology shows non-specific inflammation only. The importance of diagnostic procedures is to exclude the presence of other diseases. Other causes of monarticular inflammation (infection, crystal induced arthritis, sarcoid arthritis) and rheumatic fever should be excluded. The disease lasts for 3-6 months. 2 to 18% of the patients develop chronic arthritis and 12 to 26% of the patients develop ankylosing spondylitis. ]

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Cholinesterase inhibitors and memantine for the treatment of Alzheimer and non-Alzheimer dementias


In aging societies, the morbidity and mortality of dementia is increasing at a significant rate, thereby imposing burden on healthcare, economy and the society as well. Patients’ and caregivers’ quality of life and life expectancy are greatly determined by the early diagnosis and the initiation of available symptomatic treatments. Cholinesterase inhibitors and memantine have been the cornerstones of Alzheimer’s therapy for approximately two decades and over the years, more and more experience has been gained on their use in non-Alzheimer’s dementias too. The aim of our work was to provide a comprehensive summary about the use of cholinesterase inhibitors and memantine for the treatment of Alzheimer’s and non-Alzheimers’s dementias.

Lege Artis Medicinae

[Second game, 37th move and Fourth game 78th move]

VOKÓ Zoltán

[What has Go to do with making clinical decisions? One of the greatest intellectual challenges of bedside medicine is making decisions under uncertainty. Besides the psychological traps of traditionally intuitive and heuristic medical decision making, lack of information, scarce resources and characteristics of doctor-patient relationship contribute equally to this uncertainty. Formal, mathematical model based analysis of decisions used widely in developing clinical guidelines and in health technology assessment provides a good tool in theoretical terms to avoid pitfalls of intuitive decision making. Nevertheless it can be hardly used in individual situations and most physicians dislike it as well. This method, however, has its own limitations, especially while tailoring individual decisions, under inclusion of potential lack of input data used for calculations, or its large imprecision, and the low capability of the current mathematical models to represent the full complexity and variability of processes in complex systems. Nevertheless, clinical decision support systems can be helpful in the individual decision making of physicians if they are well integrated in the health information systems, and do not break down the physicians’ autonomy of making decisions. Classical decision support systems are knowledge based and rely on system of rules and problem specific algorithms. They are utilized widely from health administration to image processing. The current information revolution created the so-called artificial intelligence by machine learning methods, i.e. machines can learn indeed. This new generation of artificial intelligence is not based on particular system of rules but on neuronal networks teaching themselves by huge databases and general learning algorithms. This type of artificial intelligence outperforms humans already in certain fields like chess, Go, or aerial combat. Its development is full of challenges and threats, while it presents a technological breakthrough, which cannot be stopped and will transform our world. Its development and application has already started also in the healthcare. Health professionals must participate in this development to steer it into the right direction. Lee Sedol, 18-times Go world champion retired three years after his historical defeat from AlphaGo artificial intelligence, be­cause “Even if I become the No. 1, there is an entity that cannot be defeated”. It is our great luck that we do not need to compete or defeat it, we must ensure instead that it would be safe and trustworthy, and in collaboration with humans this entity would make healthcare more effective and efficient. ]

Journal of Nursing Theory and Practice

[Operational Efficiency Investigation from APN Perioperative Perspective]


[In the healthcare system operating theatres have to put great emphasis on quality work, patient safety and efficiency as well, and to achieve this, optimal utilization of theatres is extremely important. The results of researches in this topic in Hungarian and international literature draw attention to a lot of aspects. The study of perioperative periods, and the evaluation of the analysed processes show that theatres could be operated more effectively. As a result of this, more operations could be carried out and waiting time would also reduce. In order to increase the efficiency of the processes, APNs can play a prominent role at several points. According to the experience, the number of people using health care and the number of people waiting for surgery is increasing, which is further increased by the development of the ongoing SARS-CoV-2 (COVID-19) epidemic. Thereby, patients are not satisfied with the service. The work of APNs would also help increasing the contentment of patients during the operation procedures. Taking advantage of the multifunctional role of the nurse due to her knowledge and training, she actively participates in the operation, in the smooth running of the scheduled daily surgical program and contributes to the reduction of the number of missed, planned surgeries.]

Journal of Nursing Theory and Practice

[Burnout and depression among healthcare nursing staff]


[The aim was to assess the levels of burnout and depressive symptoms among nursing staff members. We designed an online questionnaire for the present cross-sectional study, which was filled out by 10 285 participants between 01-27-2022 and 02-14-2022. The mean score of burnout showed a decrease compared to the score measured in 2021; however, the percent of nursing staff members suffering from burnout is still high (64.4%), from which 42% indicates severe burnout which would requires treatment. Concerning depressive symptoms, 57.8% of participants did not indicate the presence of depression, the rest presented different levels of depressive symptoms (6.8% showed severe depressive symptoms). Currently patients’ chance of recovery is under the expected level of what our healthcare system could provide, which is partially due to the affected mental state of healthcare nursing staff.]

Journal of Nursing Theory and Practice

[Use of the ankle-brachial index in occupational healthcare]

SZOBOTA Lívia, HIRDI Henriett Éva

[Elevated risk of fatal and non-fatal cardiovascular events is associated with high prevalence of peripheral arterial disease (PAD). Nurses working in occupational healthcare are ideally situated to identify individuals with undiagnosed PAD. The aim of the study: This study aimed to demonstrate that the ankle-brachial index (ABI) is a tool to be used by occupational health nurses in prevention of cardiovascular disease (CVD). A cross-sectional study was carried out with patients (N=638) from an occupational healthcare setting in 2021. The ABI was measured with an oscillometric blood pressure device. The measurements were analysed with the help of SPSS 22.0; descriptive statistics were calculated. A total of 638 patients were included. Mean age of the population studied was 46.5 ± 8.2 years; 38.4% were men and 61.6% were women. Mean ABI were 1.08 in right legs, 1.06 in left legs. Only 11 subjects (1.72%) had an ABI < 0.90. Occupational health nurses are able to identify key factors related to PAD, including use of the ABI, and to identify individuals with the disease. The determination of ABI using an oscillometric blood pressure device is feasible and easy to implement in occupational healthcare.]