Lege Artis Medicinae

[Possibilites for the prevention of heart failure - an internist’s take]

KIS János Tibor1

APRIL 20, 2016

Lege Artis Medicinae - 2016;26(04)

[Because of the high prevalence of heart failure in the general population, its prevention and treatment should be part of every clinicians’ knowledge base. The author summarizes lifestyle and dietary advices, as well as general medication considerations that might have a preventive effect on the development or progression of heart failure. ]

AFFILIATIONS

  1. Budai Irgalmasrendi Kórház, Belgyógyászati Osztály

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[MC world - a board game of medical communication]

KOLLÁR János

[In 2015 in the Institute of Behavioral Sciences of Semmelweis University a board game named MC World (Medical Communi­ca­tion World) was designed to further student learning in the field of medical communication by gamifying the learning material. 29 Hungarian and 28 foreign students were participating in a study where the acceptance of the game and its attitude change effect regarding medical communication were tested. The participants evaluated statements in connection with the game on a 5 point Likert-type scale. The survey responses suggest that both the Hungarian and the foreign medical students considered the application of the game in education as a practical and successful initiation. It draws the attention to better utilization of gamification as an educational facilitator and as a positive opinion forming opportunity.]

Lege Artis Medicinae

[Life in the Balance]

KÖVES Péter

Lege Artis Medicinae

[Unusual treatmeant of an unusual patient]

FARKAS Marianne

Lege Artis Medicinae

[Kindly Simulate Madness, Young Lady! ]

FALVAY Dóra

Lege Artis Medicinae

[Medicus imperitus. The inception of physician liability in classical Roman law]

PÉTER Orsolya Márta

[In an era where the number of medical liability suits is permanently increasing, it might be interesting - in Hungary as well -, and also useful to detect and analyse the roots of such liability in Continental/Euro­pean law. In classical Roman law - that also gives the basis for European ius commune - , we cannot encounter uniform and general norms governing medical liability. The reasons of such hiatus are inherent in the peculiar casuistic method of Roman law, as jurists focused on providing a proper solution for a specific case, and not on developing general and abstract behavioural norms. In addition to the foregoing, the legal status of physicians and their patients was heterogeneous: many doctors were foreign slaves who, if lucky, obtained freedom and Roman citizenship, or settled down in Rome as foreign citizens. The form of their professional liability was also determined by the legal status of their patients: if an untrained or careless physician tried to cure a slave owned by a Roman citizen and failed, the owner could sue the doctor for damaging his property. As far as free patients are concerned, we cannot formulate any unequivocal statements regarding medical liability and malpractice; however, the few available sources clearly prove that a physician who had wilfully caused harm to his free patient resulting in death was severely punished in ancient Rome.]

All articles in the issue

Related contents

LAM KID

[Vitamin D treatment: hormone therapy for patients who need it or simply a supplementation for everyone?]

SPEER Gábor

[Various medical associations issue different recommendations for the prevention and treatment of vitamin D deficiency. These significant differences are partly explained by the different definition of normal vitamin D level and the use of completely different mathematical models to predict the increase in vitamin D level as a response to therapy. According to the Institute of Medicine (IOM), the target vitamin D level is 20 ng/ml, whereas the Endocrine Society (ES) recommends 30 ng/m as the miminum target value. According to the ES, a 1 ng/ml increase of vitamin D level can be reached by a daily intake of 100 NE, while the IOM recommends 3.6 ng/ml. Moreover, the IOM states that the effect of therapy on serum level is nonlinear. These differences show that the ES and IOM have different views on the risk of adverse effects. The IOM recommends 400 IU vitamin D daily for children younger than 1 year, 800 IU for those above 70 years and 600 IU/per day for everyone else. The ES recommend 400-1000 IU daily for all infants and 1500- 2000 IU for adults. Screening, however, is not recommended by either society. To decrease uncertainty concerning the side effects of higher-dose vitamin D treatment, it is important to understand, use and support the function of the pharmacovigilance system of the pharmaceutical industry that manufactures and markets various (prescription, over-the-counter) preparations. This is what the author aims to highlight in the second part of this article. Using this system, both the doctor and the patient can help support and accept the justification of higher-dose vitamin D therapy.]

Lege Artis Medicinae

[Cardiovascular diseaes and the kidney]

PRÉDA István

[From pathophysiological point of view, the kidney is an integral part of the cardiovascular system. Renal diseases adversely affect the cardiac functions, and disturbances of the cardiovascular system affect adversely renal functions, causing either the decrease of left ventricular functions or manifesting in overt chronic heart failure. Regarding the cardiac manifestations of renal diseases, characteristic features are the symptoms of left ventricular volume and pressure overload, the metabolic effects of the ”uremic toxins” and the frequent infections associated with dialysis and compromised immunologic state, the secunder hyperparathyreosis, as well as the associated conditions like hypertension, diabetes mellitus and coronary atherosclerosis. All these can be the explanation for the frequent cardiovascular death of chronic kidney disease patients. It also stresses the outstanding importance of the decrease of cardiovascular hazard of chronic renal disease patients. The strategy should comprise of an adequate antihypertensive treatment (ACE-inhibitor, AT-II blocking and calcium antagonist), strong antidiabetic control of diabetic patients and the adequate treatment of dyslipidaemia (if exists), as well as antithrombotic aspirin treatment.]

Lege Artis Medicinae

[POST-INFARCTION CARDIAC FAILURE]

TOMCSÁNYI János

[Recent advances in the care of acute myocardial infarction have resulted in more patients surviving myocardial infarction than earlier. However, heart failure is a common complication in these patients, which in turn is associated with substantial mortality, primarily due to a remodelling of the left ventricle that already starts in an early stage of the myocardial infarction. The aim of this review article is to present the pathomechanism of this remodelling and to discuss related therapeutic options. Current guidelines recommend the use of an angiotensin- converting enzyme inhibitor combined with or followed by an angiotensin receptor blocker, a beta-blocker, and an aldosterone antagonist in post-infarction patients with concomitant heart failure.]

Lege Artis Medicinae

[Apixaban: the newest oral anticoagulant in Hungary for the treatment of patients with atrial fibrillation]

BORBÉLY Attila, ÉDES István

[In the past few years a number of articles have been published on the new oral anticoagulants (Xa-factor inhibitors, thrombin inhibitors). These new agents are increasingly used in the daily clinical practice in Hungary. The new oral anticoagulants have been shown to be at least as effective in the prevention of stroke and systemic embolization related to non-valvular atrial fibrillation as K vitamin antagonists. Moreover, their use is safe, can be administered in a daily fixed dose and, even in case of long-term use, they do not require regular laboratory testing. This review aims to summarise the most important theoretical and practical information on the newest direct Xa-factor inhibitor agent apixaban from the perspective of a cardiologist.]

Journal of Nursing Theory and Practice

[Competencies of Community Nurses, Opportunities of Extensions in Adult General Practices of Cegléd .]

JÓZSA Edit

[Aims of the study: The local community nurses can use their present abilities between given conditions and how these abilities could be extended. Sample and methods: 137 evaluable questionnaires were returned from 14 family doctors’ patients and 12 questionnaires were from community nurses. The questionnaires consisted of open and closed questions. The data was processed by SPSS and Excel software. Statistics were made by descriptive statistic means and Fischer exact tests. Results: During my survey it turned out that patients don’t utilize basic adult health care means such as measuring blood pressure and blood-sugar and lab examinations. Conclusions: Most of the community nurses can’t utilize most of their abilities and knowledge. They don’t have the opportunity to perform health education or just to talk to the patients face-to-face. My thesis surfaces the fact that community workers and doctors should work coordinate. It’s not true in relation of all the general practitioners and nurses.]