Lege Artis Medicinae



DECEMBER 20, 2005

Lege Artis Medicinae - 2005;15(12)

[In this comprehensive study the worldwide medical and social consequences of aging population are analysed. The physiological changes, deteriorations in the elderly, the relation of nutritional habits and lifestyle are also discussed according to the results of major epidemiological studies. The nutrition related morbidities, including obesity, diabetes, cardiovascular diseases are analysed in detail. The most important observations of Europe-wide studies and the limited Hungarian epidemiological surveys are compared. The author also emphasizes the importance of medical support, health education and nutritional advices in different generations, especially in the elderly population.]



Further articles in this publication

Lege Artis Medicinae

[Pathology Records from the Rákosi Era]


Lege Artis Medicinae



[INTRODUCTION - Mondor’s disease is an uncommon disorder occuring mostly in middleaged women and characterized by superficial thrombophlebitis classically involving the thoraco- epigastric veins. Rarely, cases have been reported in atypical sites (upper arms, abdomen, groin and penis). CASE REPORT - This is the first case being published in the Hungarian literature. The young male patient's complaints were caused by penile vein thrombosis which was demonstrated on physical examination and Doppler ultrasonography. Since hereditary thrombophilia and malignancy has been ruled out, we assume that local trauma and venous stasis caused by previous abdominal surgery have been the etiological factors of the disease. CONCLUSION - We give a review of the literature and would like to draw the attention to this rare type of thrombosis, its risk factors and the difficulties of the therapy.]

Lege Artis Medicinae

[Regret is Forbidden!]

Lege Artis Medicinae



[The familial combined hyperlipidemia (FCH) is the most common form of heritable lipid disorder. The prevalence of FCH is 0.5 to 2.0% in the general population, and 15 to 20% in the survivors of myocardial infarction before the age of 60 years. Healthy people spend most part of their life in postprandial state, which is the sum of the 6-8 hours after each main meal spanning over 20 or 24 hour per day. After the ingestion of the fat rich meal the intestinal chylomicrons disturbs the balance of lipid metabolism. The disorder of the lipid transport does not always manifest itself in the fasting state when the lipid transport system is yet at poise. So, the measuring of fasting triglyceride does not reflect exactly the metabolic capacity and the true atherogen risk of the subject. The healthy FCH family members may have got abnormal higher and extended postprandial lipemia contrast of the normal fasting triglyceride levels. The distributions of PvuII and HindIII polymorphisms in FCH are different from normolipidemic controls. At the same time, there is significantly higher incidence of the apo e4 allele. The apo E4/3 genotypes have got higher and extended postprandial lipemia in FCH subjects. In the investigated international and Hungarian FCH groups have got the minor allele of apolipoprotein AV T/C polymorphism more frequently. The carrying status of the minor allele is accompanied with higher fasting lipid levels and associated with higher and extended postprandial lipemia. The Hungarian results suggest a decreased and extended catabolism of the remnants in FCH caused by apoAV T/C promoter variation that seems to have a more direct effect on the postprandial status than that of apoE 3/3-4/3 polymorphism. The knowledge of characteristics of postprandial lipemia influenced by the mutations of genes described by us are more useful as only the fasting triglyceride level and it is as effective as LDL- or HDL-cholesterol value in the measuring of prognosis of development of vascular disease with athero-thrombotic origin.]

Lege Artis Medicinae

[Medicinal Geography?]

GRÉTSY Zsombor

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Related contents

Clinical Neuroscience

Quality of life of patients with non-diabetic peripheral neuropathic pain; results from a cross-sectional survey in general practices in Hungary


Background and purpose - There is a lack of data on the impact on health related quality of life of peripheral neuropathic pain in Hungary. The main aims of the study were to assess the health related quality of life of nondiabetic PeNP patients identified in general practices through screening, and to assess the relationship between condition specific pain scores and health state utilities. Methods - Non-diabetic patients aged ≥30 years were recruited in 10 general practices in Hungary. At first, patients filled in the PainDETECT Questionnaire (PD-Q) and those who have achieved ≥13 PD-Q score (unclear or possible neuropathic pain) were further assessed by the DN4 questionnaire. Patients with PD-Q score >18 or DN4 score ≥4 were considered to have PeNP and they completed the EQ-5D health questionnaire. Results - Among the 111 patients identified as non-diabetic PeNP patients the mean age was 62 (SD=14) years, 69% were women. Average EQ-5D score was 44% lower than the gender and age matched Hungarian norm (0.42 vs. 0.75, p<0.001) and it worsened with increasing pain intensity. The pain/discomfort and anxiety/depression were the most affected EQ-5D dimensions. Strong relationship was demonstrated between the PD-Q and EQ- 5D score. Most of the PeNP patients (86%) were undiagnosed. Conclusions - Non-diabetic PeNP pain has a huge negative impact on health related quality of life. Although PeNP is a serious chronic condition, the disease burden is seriously underestimated, both on the level of individuals and society, due to the fact that patients are rarely identified.

Hypertension and nephrology

[Dietary treatment of dialysis patients]


[Adequate nutritional indices and intake are the corner stone of long term success of renal replecement therapies (hemo- and peritoneal dialysis, transplantation) characterized by favourable survial rates and a good quality of life. There has been no major change in basic principles of nutritional prescription (protein, energy, fluid intake, restriction of sodium, potassium and phosphorous), increasing emphasis has been placed on the reduction of calcium load and ”native” vitamin-D therapy in these patients. Less avareness has been put however in the past ten years (according to recent metaanalyses) on the role and replacement of the full scale of vitamins, in spite of their occasionally altered metabolism and replacement-requirements in ESRD patients. Usually there is a need for their replacement, but some of them are represented in abundant, sometimes toxic amounts in commercially available multivitamin preparates. With in the scope of general aspects of nutrition in ESRD patients, the article gives a detalied overview of their multivitamin recommendations and alternatives of a specified substition.]

Hypertension and nephrology

[Therapy of isolated systolic hypertension III.]


[In the elderly and very elderly (˃80 yrs), a wealth of data from large clinical trials are available, showing the necessity of treatment mostly with drug combinations - fix-combinations are preferred for increasing the adherence/persistence to therapy. Using diuretics, ACE-inhibitors/ARBs with calcium antagonists, and in special cases diuretics and beta blockers are also suggested by recent European guidelines (ESH, HSH). The target is <140 mmHg, but in octogenarians <150 mmHg. Some studies are pressing for even lower SBP (to around 120 mm Hg), but it seems to be wise to balance advantages/disadvantages, so the optimal SBP may be around 130 mmHg.]

Journal of Nursing Theory and Practice

[Milestone in the Development of the Primary Health Care]

GUTÁSI Éva, TÓTH Baloghné Edit, LÁZÁR Marsiné Erika

[All health care systems in Europe face similar challenges. In Hungary the most important one is the emigration of health system workers and the increasing demand for care in ageing population. Key areas of the development of primary health care are prevention, public health and health promotion. In The Primary Care Development Model Program the single-handed general practices comprised of one GP, one nurse and one health visitor who were teamed up and formed the GP’s cluster employing various other health professionals (including community nurses). In the last 4 years the new primary care system became a reality for 40,000 inhabitants of four disadvantaged micro-regions of Hungary. The health status of more than 20.000 adults and 8000 children were assessed between 2013 and 2017 in the Modell Programme that uncovered a number of hidden diseases.]

Lege Artis Medicinae

[Working capacity assessment: a literature review]

MÁK Kornél, FEHÉR Gergely, GOMBOS Katalin, PUSCH Gabriella, KOLTAI Katalin, BANK Gyula, KÓSA Gábor, VARJASI Gábor, TIBOLD Antal

[INTRODUCTION - Although work capacity assessment (WCA) has high social and economical impacts, national medical standards are lacking in Hungary. AIM - The aim of our literature search based review was to gather evidence and international standards on WCA. RESULTS - There are different methods in WCA, from questionnaire forms to computer-based evalution, the latter seems to be the most effective. Apart from physical WCA, additional cardiovascular risk profile and psychoscocial evaluations are recommended. Despite of intesive research of the topic, evidence-based standards do not exist. CONCLUSION - There is an increasing demand on evidence-based WCA. ]