Lege Artis Medicinae

[Recovering from Dependency ]

RÁCZ József1

SEPTEMBER 10, 2019

Lege Artis Medicinae - 2019;29(08-09)

AFFILIATIONS

  1. Eötvös Loránd Tudományegyetem, Pedagógiai és Pszichológiai Kar, Pszichológiai Intézet, Tanácsadás Pszichológiája Tanszék

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Further articles in this publication

Lege Artis Medicinae

[Path of life in the society with a diagnosis of a psychiatric disease ]

BÁNYAI Borbála, LÉGMÁN Anna

[INTRODUCTION - The aim of our study is to show how people can live with a diagnosis of a psychiatric disease, a schizophrenia diagnosis in Hungary. METHODOLOGY - We made 25 narrative life story interviews with Hungarian people diagnosed with mental illnesses. We examined what the main obstacles and supporting factors may be in the life stories regarding the independent lifestyle and participation in community. RESULTS - According to the interviewees the main obstacles are their states or diseases, the stigmas after their diagnoses, the function of the psychiatric care system and the lack of self-reliance following the patient role. They mentioned the family and their own motivations as supporting factors. CONCLUSION - The examination of the institutional functions can reveal what the supporting factors may be which can facilitate the social participation of people diagnosed with mental illnesses on the level of the system. ]

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[An Acknowledgment for Building the Future ]

KUN J. Viktória

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[The Peeping Painter, or an Earned Military Cross ]

GEREVICH József

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[Scientific Superstitions Regarding the Female Body ]

MAGYAR László András

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[What may hurt the patient’s leg? Lower extremity ischaemia]

FENDRIK Krisztina, BIRÓ Katalin, KOLTAI Katalin, ENDREI Dóra, TÓTH Kálmán, KÉSMÁRKY Gábor

[Peripheral artery disease (PAD) is of high prevalence, and one of the most common clinical manifestations of the atherosclerosis beside ischaemic heart disease and cerebrovascular disease. PAD should be considered as a systemic disease, PAD patients have two times higher ten-year cardiovascular mortality than the normal population. For these reasons, the early recognition of the disease, the appropriate secondary preventive medical and non-medical therapy are of great importance. Risk stratification, proper physical examination, ankle pressure, ankle-brachial index, toe pressure, transcutaneous partial tissue oxygen pressure measurement and duplex ultrasound are the cornerstones to an early diagnosis. This summary aims at calling attention to the fact that lower extremity pain can not only be caused by musculo­sceletal diseases but limb and/or life-threatening limb ischaemia can be revealed in the background. ]

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Clinical Neuroscience

The evaluation of the relationship between risk factors and prognosis in intracerebral hemorrhage patients

SONGUL Senadim, MURAT Cabalar, VILDAN Yayla, ANIL Bulut

Objective - Patients were assessed in terms of risk factors, hematoma size and localization, the effects of spontaneous intracerebral hemorrhage (ICH) on mortality and morbidity, and post-stroke depression. Materials and methods - The present study evaluated the demographic data, risk factors, and neurological examinations of 216 ICH patients. The diagnosis, volume, localization, and ventricular extension of the hematomas were determined using computed tomography scans. The mortality rate through the first 30 days was evaluated using ICH score and ICH grading scale. The Modified Rankin Scale (mRS) was used to determine the dependency status and functional recovery of each patient, and the Hamilton Depression Rating Scale was administered to assess the psychosocial status of each patient. Results - The mean age of the patients was 65.3±14.5 years. The most common locations of the ICH lesions were as follows: lobar (28.3%), thalamus (26.4%), basal ganglia (24.0%), cerebellum (13.9%), and brainstem (7.4%). The average hematoma volume was 15.8±23.8 cm3; a ventricular extension of the hemorrhage developed in 34.4% of the patients, a midline shift in 28.7%, and perihematomal edema, as the most frequently occurring complication, in 27.8%. Over the 6-month follow-up period, 57.9% of patients showed a poor prognosis (mRS: ≥3), while 42.1% showed a good prognosis (mRS: <3). The mortality rate over the first 30 days was significantly higher in patients with a low Glasgow Coma Scale (GCS) score at admission, a large hematoma volume, and ventricular extension of the hemorrhage (p=0.0001). In the poor prognosis group, the presence of moderate depression (39.13%) was significantly higher than in the good prognosis group (p=0.0001). Conclusion - Determination and evaluation of the factors that could influence the prognosis and mortality of patients with ICH is crucial for the achievement of more effective patient management and improved quality of life.

Lege Artis Medicinae

[The role of spirituality in the twelve-step treatment model of addicts]

TREMKÓ Mariann, TÓTH András, MOLNÁR Rudolf, PETKE Zsolt

[First of all we shortly present the Minnesota model based on twelve-step programmes that could be implemented effectively in the recovery of addicts. The uniqueness of the model are the involvement of recovering helpers in the therapeutic work and the focus on spirituality. Our essay-like study aims to present the approach of Alcoholics Anonymous which forms the basis of the model, effectivity studies and the potential effect mechanisms through research data. We aim to define the phenomenon of spirituality from different aspects having regard to the preliminary psychological and psychotherapeutical contributions and provide some of our therapeutic tools. In the current study we picture the roles of the professional therapists and the voluntary recovering helpers in our programme. ]

Hypertension and nephrology

[Practical questions of early diagnosis and prevention of cerebrovascular disease are highly important for all internists]

NAGY Judit, SZAPÁRY László, KOVÁCS Tibor, KÉSŐI István, TÓTH Péter, SÁGI Balázs, VAS Tibor, KOLLER Ákos, WITTMANN István, KISS István, KOMOLY Sámuel

[Stroke is the third most frequent cause of death and the most important cause of disability and dependency worldwide. There are marked differences in the incidence, prevalence and mortality between the populations of Eastern and Western Europe. In Hungary, between 1998-2003, the incidence of stroke was 1,5-2 times higher than in the Western part of the continent. The early recognition of signs and symptoms of TIA and stroke and the urgent transportation of the patient to neurology, preferably to the nearest stroke-center are the key points of successful treatment, reduction of consequences and increased survival. The “time is brain” concept means that the management of TIA/stroke patients should be considered as emergency. This review briefly summarizes the epidemiology, key elements of the etiology, risk factors, up-to-dated diagnosis, primary and secondary prevention and treatment of TIA/stroke to provide information regarding the development of this field targeting the optimal management of TIA/stroke patients.]

Lege Artis Medicinae

[POSTMENOPAUSAL HYPERTENSION]

SZÉKÁCS Béla

[Women with normal cycles on the average have lower blood pressure than age matched men. From the fifth decade of life increasing average blood pressure values of females reach or even exceed the levels of males. The frequency of hypertension among women in menopause and postmenopause is 3-4 times greater than in premenopause. This great difference can not be explained by the age dependent increase in blood pressure. There are several pathological components in the background of the elevation of blood pressure following the reduction and failure of female sex hormone production. Among these components are lifestyle changes, reduced physical activity, growing body weight, increased sympathetic activity, higher RAS (renin-angiotensin system) influence and increased salt dependence of blood pressure seem to be the dominant factors. Contrary to earlier suggestions recent clinical findings have proved that estrogen or combined hormone replacement therapy did not increase but rather slightly reduced the blood pressure in menopausal and postmenopausal hypertensive women. Therefore, hypertension itself should not be the contraindication against carefully managed hormone replacement therapy. The therapy is frequently used for preventing severe osteoporosis in spite of the disappointing cardiovascular results of the WHI and HERS trials. In the Joint National Committee 7 there are no special recommendations which would strictly prefer one or another antihypertensive agents in the pharmacological treatment of postmenopausal hypertension. However doctors are assisted in their individual therapeutical decisions by certain clinical and experimental findings which refer to higher sympathic activity, enhanced RAS influence and increased salt dependency in the pathomechanism of postmenopausal hypertension.]

Lege Artis Medicinae

[EYE DISORDERS ASSOCIATED WITH MUSCULOSKELETAL DISEASES]

VOGT Ferenc

[The diseases of connective tissue and musculoskeletal system frequently associated with typical eye disorders. These can either be mild, recovering fully after treatment or more serious with persisting symptoms and destructive changes resulting in permanent loss of sight Eye symptoms can occur in the following diseases: rheumatoid arthritis, juvenile chronic arthritis, neonatal onset multisystem disease, ankylosing spondylitis, seronegative spondarthrities, Reiter’s syndrome, Behçet’s syndrome, Lyme disease, systemic lupus erythematosus, scleroderma, polyarteritis nodosa, Wegener’s granulomatosis, giant cell arteritis, erythema nodosum, relapsing polychondritis, sarcoidosis, Marfan’s syndrome, osteogenesis imperfecta.]