Lege Artis Medicinae

[Philosophical café as therapeutic community]

NEMES László

DECEMBER 18, 2016

Lege Artis Medicinae - 2016;26(11-12)

[In this paper we examine the very possibility of integrating philosophical discussion groups into the practice of community psychiatry as a kind of therapeutic community. We summarize the history of the café-philo movement, the conception, methods and goals of the philosophical café. I present a detailed report on the experiences about the philosophical cafés going on at the Awakenings Foundation on a weekly basis for two years. I suggest group philosophy discussion as a useful additional form of activities usual in psychiatric rehabilitation. ]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Dual effect of rosuvastatin on glucose homeostasis through reduced insulin secretion and improved insulin sensitivity]

KAPÓCS Gábor

Lege Artis Medicinae

[Outrageous Nudity, or the Burden of Being Recognisable ]

GEREVICH József

Lege Artis Medicinae

[Handicap in Movie ]

LENGYEL Dávid

Lege Artis Medicinae

[The cardiovascular risk of nonsteroidal antiinflammatory drugs]

AMBRUS Csaba, KISS István

[Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most common pain relief and anti-inflammatory medications all over the World, and many formulations are also available over-the-counter. Beyond the well-known gastrointestinal risks, emerging evidence supports increased incidence of cardiovascular events associated with the use of NSAIDs. This cardiovascular risk seems to be independent of the cyclooxygenase selectivity of these drugs. Distinct side effect profiles of various NSAIDs were summarized in a former issue of the Journal: LAM 2014;24(7): 327. In this paper, we aimed to summarize some of the yet unpublished results of a major research project of the European Medicines Agency (EMA), that was conducted in order to establish the relative risk of CV outcomes (myocardial infarction, ischaemic stroke and hospitalization for heart failure) associated with the use of various NSAIDs. In this epidemiological study, seven European healthcare databases on a source population of 35 million subjects were linked and analyzed. Most of the results are currently only available on the project homepage; however, analyses of heart failure data have already been published in a recent issue of The BMJ. ]

Lege Artis Medicinae

[Intravenous immunoglobulin immunotherapy in immune mediated habitual abortions]

FÜLÖP Vilmos, PETRÁNYI Győző

[INTRODUCTION - Based upon international and domestic research data authors summerize the humoral and cellular im­munregulatory disorders which can be found in the background of “immune me­diated abortions” (IMA). PATIENTS AND METHODS - Within the frame of a home research program a special examination protocol was elaborated in order to sepatare alloimmune habitual abortions from autoimmune and non immune backgrounds. After all other causes were excluded erythrocyte antibody inhibition assay (EAI) was used for measuring the serum level of FcgRII receptor blocking IgG antibody, because its lack an important diagnostic parameter. Among the cell mediated immunofuntional tests the mixed lymphocyte culture reaction (MLC) was the most useful. During the roughly last 16 years 67 out of 76 selected alloimmun IMA patients were administered Intratect IVIG treatment without any particular selection among them. IVIG treatment was first applied on the completed 5-6th week of pregnancy and doses of 0,3-0,4g/kg bodyweight per oc­casion were given 3 times with 3-week intervals. RESULTS - Altogether a significant rise in the serum level of blocking antibodies was shown after each IVIG treatment although a slight decrease was seen after every given dose. Of the 67 IMA patients 54 carried infants to term during the study period. In 4 cases of abortion no cause was identified with post hoc diagnosis. Thus the success rate of this type of IVIG therapy was 93.1% (58/54). Conclusion - In approprietly selected alloimmun IMA cases the IVIG generated immunoregulatory and antiimflammatory pathways may contribute to its net positive reproductive effect.]

All articles in the issue

Related contents

Lege Artis Medicinae

[Community participation in sustainable development - in the wake of community medicine]

BRYS Zoltán, HARANGOZÓ Judit, SZARVAS Hajnalka

[Sustainable development aims to secure the living conditions of the next generations. Currently it fails to achieve its goal as the human destruction of ecosystem is accelerated. Institutions of the developed countries can not control the environmental crisis. The increased environmental degradation is caused by overconsumption, which is mainly driven by the widespread consumption-culture. Failure of institutional solutions drew the attention to the empowerment of communities. Aarhus Convention has legally empowered the local communities and various scientific fields examines community participation. Community Based Mental Health Services has gathered a significant knowledge about the psychosocial processes of community participation and about the participatory-culture. According to our assumption this knowledge can be used in the field of sustainable development. Besides the empowerment of the independent, local communities, concordance, affective experiencing diversity of the members, involvement of experiential experts are all important in the operation of self-organizing, responsible, local communities. We believe that the empowerment and support of eco-conscious communities is an important, new intervention in the field of sustainable development. ]

Clinical Neuroscience

[Family planning in multiple sclerosis: conception, pregnancy, breastfeeding]

RÓZSA Csilla

[Family planning is an exceptionally important question in multiple sclerosis, as women of childbearing age are the ones most often affected. Although it is proven that pregnancy does not worsen the long-term prognosis of relapsing-remitting multiple sclerosis, many patients are still doubtful about having children. This question is further complicated by the fact that patients – and often even doctors – are not sufficiently informed about how the ever-increasing number of available disease-modifying treatments affect pregnancies. Breastfeeding is an even less clear topic. Patients usually look to their neurologists first for answers concerning these matters. It falls to the neurologist to rationally evaluate the risks and benefits of contraception, pregnancy, assisted reproduction, childbirth, breastfeeding and disease modifying treatments, to inform patients about these, and then together come to a decision about the best possible therapeutic approach, taking the patients’ individual family plans into consideration. Here we present a review of relevant literature adhering to international guidelines on the topics of conception, pregnancy and breastfeeding, with a special focus on the applicability of approved disease modifying treatments during pregnancy and breastfeeding. The goal of this article is to provide clinicians involved in the care of MS patients with up-to-date information that they can utilize in their day-to-day clinical practice. ]

Lege Artis Medicinae

[CARCINOID TUMORS]

RÁCZ Károly

[Carcinoid tumors are rare neoplasms: they are traditionally divided into three subgroups (foregut, midgut and hindgut tumors). Despite their neuroendocrine cell origin and the similarities in their histological structure, the molecular background, pathogenesis, clinical features, diagnostic and therapeutic procedures, as well as the prognosis of carcinoid tumors located at different sites may be highly variable. Although sensitive biochemical markers (serum chromogranin A concentration, urinary 5- hydroxyindoleacetic acid excretion) and localization methods (somatostatin receptor scintigraphy, positron emission tomography) are available, a considerable number of patients are only diagnosed at the late stages of the disease. When surgical cure is not obtainable such as in cases with advanced metastatic disease, surgical procedures to reduce tumoral tissue should be still considered. At present, the most effective drugs for the symptomatic treatment of carcinoid tumors are somatostatin analogues (octreotide, lanreotide). In addition to their beneficial effect on clinical symptoms they may stabilize tumor growth for many years and rarely, tumor regression is produced. Radioisotope-labelled somatostatin analogues are presently under clinical evaluation, which may offer new therapeutic means for patients with carcinoid tumors.]

Lege Artis Medicinae

[Perioperative management of patients with coronary stent undergoing noncardiac surgical procedures - Part II. - Algorythm of emergency and perioperative treatment decisions]

ZIMA Endre, MEZŐFI Miklós, BECKER Dávid, SZABÓ György, MERKELY Béla, PÉNZES István

[The aim of percutaneous coronary intervention (PCI) is to optimise coronary and cardial status, and thus improve short- and long-term outcomes. It is known from large Western databases that stent implantation is performed during 77-85% of coronary interventions, which means hundreds of thousands of patients with new stent every year. The majority of patients need to take dual platelet aggregation inhibitor, namely acetyilsalicylic acid and thienopyridin - most often clopidrogel - following stent implantation. It presents a major therapeutic dilemma when these patients need noncardiac surgery. First, the surgery should be performed with the least blood loss possible, which would be optimally achieved by suspension of the platelet aggregation inhibitor therapy that cannot be stopped during the critical period after stent implantation. Second, stent thrombosis should be avoided, which can only be achieved if platelet aggregation inhibitor therapy is continued. The aim of our paper is to summarise the current professional guidelines and the current risk estimation in the perioperative management of patients with coronary stent. In the second part of the article, we summarise the preoperative preparation of the patient, assessment of coronary status and cardial medication, and the optimal time and location of the surgery. We present the decision principles regarding the risks of perioperative bleeding and stent thrombosis, and the need to continue platelet aggregation inhibitor therapy.]