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.]

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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]

SZENDE Béla

[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

[Gout]

MITUSZOVA Mila

[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

[Reiter-syndrome]

GÉHER Pál

[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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