Lege Artis Medicinae

[Regime change?]

MAY 29, 1991

Lege Artis Medicinae - 1991;1(09-10)

[Finally, the first law of the comprehensive reform of the health care system, the Law on Public Health and Medical Services, has just been passed! Live long and fulfill the hopes of its creators! There must be tens of millions of us for whom this is a vital necessity.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Intendation: the principle hypothesis for conductive education]

HÁRI Mária

[The Conductive Education System has got special attention in the recent decade as an alternative form of integrating disabled persons to society (normalization). The primary goals of the system are costruction of an active life pattern, improvement of the cognitive functions and fulfilment of requirements of a complex and unified programme. This process is special in the (re)habilitation of the motor disabled. Instead of the sensomotoric teaching of orthofunction, its cognitive approach serves the learning of intendation and makes possible the development of orthofunctional spontaneity. Between 1968–88. 9772, 0–14 year old disabled children were registered, and 71% of them admitted. 80% of the younger age group, and 60% of the elder succeeded in integration. In the first half of 1989 80% of 268 children suffering mainly from cerebral palsy were admitted. The special formation of the groups, preparing for work and life, planning of the special education and running the program need well trained conductor staff. ]

Lege Artis Medicinae

[Diagnosis and treatment of neck pain]

BÁLINT Géza, SZEBENYI Béla, BÁLINT Péter

[Neck pain is a frequent syndrome; numerous diseases may stand in its background from a transient myalgia to vertebral malignoma. Thus its diagnostics has a great importance in the everyday practice of the general practicioners. After a short summary of the anatomic features and aetiopathogenesis, the article analizes the anamnesis and physical examination as well as the elements of radiology and laboratory tests. The most important characteristic features of the cervical syndromes, according to leading symptoms are summarized. ]

Lege Artis Medicinae

[Clinical aspects of congenital thrombophilia]

DOMJÁN Gyula, PÁL András, PETŐ Iván, SAS Géza

[In the recent decades the name ,,thrombophilia" has been accepted to denote the congenital, mostly inherited susceptibility to thromboses. The increased coagulability (hypercoagulation) is supposed to be the main cause of the evolution of congenital thrombophilia. Antithrombin III has an outstanding importance to neutralize the active factors developing in the course of the coagulative process, and heparin-cofactor 11 has become known recently. Protein C and protein S are also important regulators. The increased coagulability can be caused by congenital disturbances of the formation of fibrinogen and plasminogen and also by the decreased activity of the fibrinolytic system. Recently, we recognised several cases, where the cause of thrombophilia was simultaneous absence of two inhibitors of coagulation. We attach importance to those cases as well when the inherited defect of one inhibitor and a congenital metabolic disturbance occure together. The diagnosis of congenital thrombophilia needs a long series of laboratory tests. In the course of the treatment results can be expected from thrombolysis, probably from vascular surgical interventions and – in non recent cases – from anticoagulation. The substitution treatment is getting more important in these inhibitor deficiencies.]

Lege Artis Medicinae

[Predictive value of allergic rhinitis for bronchial asthma in childhood]

BITTERA István, GYURKOVITS Kálmán

[Asthmatic manifestations can be expected in 20 to 30% of children with allergic rhinitis. Risk factors were searched to predict later bronchial asthma in time. In a prospective study family history, clinical symptoms and laboratory signs, bronchial hyperreactivity (to histamine and to adenosine) and the lymphocyte beta-adrenergic receptor affinity and number were investigated. 31 of 40 patients responded with bronchoconstriction to histamin and 20 to adenosine. In 16 patients both provocation tests were positive. There was no significant difference in lymphocyte beta-adrenergic receptors between the patient group and the controls. It is suggested that children with allergic rhinitis who show bronchial hyperreactivity and a decreased number or affinity of lymphocyte beta-adrenergic receptors are more at risk to asthmatic manifestations. The risk is higher as the number of receptors decreases with age. The prognostic value of the above mentioned methods will be demonstrated by a subsequent retrospective study.]

Lege Artis Medicinae

[A consultation program for planning insulin therapy]

DEUTSCH Tibor, WÁGNER János, TAMÁS Gyula

[This paper describes a decision support system aimed to assist the day-to-day management of insulin treated diabetic patients based on blood glucose measurements. The therapeutic advices are generated by a multistep procedure involving qualitative reasoning to determine the direction of adjustments and numerical simulation of insulin effect on glycaemia to quantify the extent of control actions to achieve glucose control corresponding to the pre selected targets. The qualitative reasoning module uses meal time oriented glucose balances and distances from the glucose target values to guide the search for appropriate control actions. The simulation module contains a physiologically based glucose-insulin model which generates a 24 hour prediction of the patient's blood glucose profile based on these adjustments which allows the doctor to select the optimal control action from alternatives. The results of a preliminary study to compare the advices given by the system to that of an independent diabetologist are also presented for 11 patients.]

All articles in the issue

Related contents

Lege Artis Medicinae

[A short chronicle of three decades ]

KAPRONCZAY Katalin

[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

Clinical Neuroscience

[Consensus statement of the Hungarian Clinical Neurogenic Society about the therapy of adult SMA patients]

BOCZÁN Judit, KLIVÉNYI Péter, KÁLMÁN Bernadette, SZÉLL Márta, KARCAGI Veronika, ZÁDORI Dénes, MOLNÁR Mária Judit

[Background – Spinal muscular atrophy (SMA) is an autosomal recessive, progressive neuromuscular disorder resulting in a loss of lower motoneurons. Recently, new disease-modifying treatments (two drugs for splicing modification of SMN2 and one for SMN1 gene replacement) have become available. Purpose – The new drugs change the progression of SMA with neonatal and childhood onset. Increasing amount of data are available about the effects of these drugs in adult patients with SMA. In this article, we summarize the available data of new SMA therapies in adult patients. Methods – Members of the Executive Committee of the Hungarian Clinical Neurogenetic Society surveyed the literature for palliative treatments, randomized controlled trials, and retrospective and prospective studies using disease modifying therapies in adult patients with SMA. Patients – We evaluated the outcomes of studies focused on treatments of adult patients mainly with SMA II and III. In this paper, we present our consensus statement in nine points covering palliative care, technical, medical and safety considerations, patient selection, and long-term monitoring of adult patients with SMA. This consensus statement aims to support the most efficient management of adult patients with SMA, and provides information about treatment efficacy and safety to be considered during personalized therapy. It also highlights open questions needed to be answered in future. Using this recommendation in clinical practice can result in optimization of therapy.]

Clinical Neuroscience

[Transcranial direct current stimulation in neuroscientific researches – pitfalls and solutions]

PESTHY Orsolya, JANACSEK Karolina, NÉMETH Dezső

[Transcranial direct current stimulation (tDCS) is a promising brain stimulation tool which is non-invasive, easy to use and relatively cheap. Since it can change brain activity in a temporal manner, it can contribute to both clinical practice and neuroscientific research. However, the effectiveness of tDCS has been questioned considering the lack of full understanding of its mechanism of action and the seemingly contradictory results. In this review, we aim to provide a summary of potential problems and possible solutions. Our main focus is on the inter-individual differences in the effect of tDCS which can explain the noisy data, thus, controlling for them is important in order to show reliable results. This review is hoped to contribute to maximizing the potential of tDCS by helping future researchers to design replicable studies.]

Clinical Neuroscience

[Personalised epilepsy treatment]

ALTMANN Anna

[Epilepsy is one of the most common chronic neurological disease in childhood. Patients with epilepsy – even with so-called benign epilepsy – need medication for years. During this time, children go through a very big change, not only gaining weight and height, but also changing hormonal and metabolic processes. Maturation processes in different brain areas also take place at different rates depending on age. All of these should be considered when preparing a therapeutic plan. In everyday practice after the diagnosis of epilepsy, the applied drug is most often selected based on the shape and type of seizure. However, a number of other factors need to be considered when designing a therapeutic strategy: 1. efficacy (form of epilepsy, type of seizure), 2. age, gender, 3. pharmacological properties of the drug, 4. adverse drug reaction profile, 5. lifestyle (community), figure (skinny, corpulent, obese), 6. other comorbidities (nutrition, behavioral and learning problems, circulatory disorders, kidney or liver disease), 7. expected interactions with other drugs already used, 8. genetics, 9. other aspects (drug registration and prescription rules). The purpose of this article is to help to decide which antiepileptic drugs are expected to have the least side effects in a particular child with different comorbidities and which medications should be avoided if possible.]

Lege Artis Medicinae

Psychoneuroimmunology and the embodied mind

SZABÓ Attila

One of the major philosophical aspirations in contemporary consciousness research is to find a framework of explanation that could successfully address the problem of mind-body relations. Descartes is often regarded as the father of dualism in modern philosophy of mind. Phenomenology and embodiment may dissolve the problem of dualism in the waters of the experiential features of the life-world and the subject. Recent findings in psychoneuroimmunology have shown that somato-psychic mechanisms exist through which bodily stimuli are translated into neuropsychological events resulting in alterations in certain behavioral patterns. These may as well include changes in the qualitative features of the lived body (Leib) resulting in an overall change in the subjective experience. The application of modern embodiment theories in life sciences has the potential to create a novel, fruitful and heuristic approach, which may help us unveil features of the “mind-body phenomenon” that have been hidden so far. In this paper, I will try to briefly outline a possible analytical framework on the grounds of classic - Husserlian and Merleau-Pontian - phenomenology and biomedical sciences.