Lege Artis Medicinae

[Resolution of the plenary meeting of the Scientific Council for Health of 21 October 1991]

JANUARY 01, 1991

Lege Artis Medicinae - 1991;1(01 KLSZ)

[The Plenary Session of the Scientific Council for Health has formulated the following opinion on the "Action Programme for the Renewal of our Health Care System" and the "Basic Concept of the Financing System of the Hungarian Health Care System".]



Further articles in this publication

Lege Artis Medicinae

[Dear Editorial Team!]


[We respectfully send you the position paper of the FAKOOSZ on the "Action Programme", which we have prepared at the request of Dr. István Mikola, State Secretary. We would ask you, if possible, to publish an extract of this document in your newspaper. Our association aims to formulate, coordinate, defend, represent and constantly assert the interests of district doctors working in villages in accordance with their specific living and working conditions. It operates independently of political parties, denominations, the medical trade union and the MOK. In addition to advocacy, we also provide charitable and economic services to our members, the profits from which are donated to the FAKOOSZ Foundation. Our membership is open to all doctors of Hungarian nationality working in the rural districts and municipalities attached to the town, as well as to doctors of non-Hungarian nationality who are resident in Hungary or have a residence permit. ]

Lege Artis Medicinae

[Summary of comments]

[The Ministry of Public Welfare has published a working paper entitled Action Programme for the Renewal of our Health System for discussion in the Medical Weekly and in the pages of Lege Artis Medicinae. The programme has received many comments, opinions and suggestions. In addition to our medical colleagues, economists, sociologists, churchmen, lawyers, entrepreneurs, health professionals, politicians and parliamentarians have also contributed. The majority of the 269 analytical reflections - just over 5,000 pages - were written by institutions, university clinics, hospital doctors' groups, district medical associations, scientific associations, bodies of interest representation bodies (Hungarian Medical Chamber, EDDSZ), the Health Science Council, health and social committees of local authorities, regional and expert working groups of social security institutions and many others. The reflections have been examined in detail by experts from the Ministry and members of the working committee that drew up the programme. They provided many good ideas and useful suggestions for the final version of the programme. We thank all those who took the trouble to contribute with constructive comments and good intentions to the design of the new health care system and the new way of working. The most representative comments are published as promised and a summary of the lessons learnt from the processing of the material is presented in a bundle.]

Lege Artis Medicinae

[Meeting of the International Social Security Association in Budapest]

[From 28 October to 1 November, the 239-member International Social Security Association (ISSA) Standing Committee on Health and Sickness Insurance held its twenty-fifth meeting in Budapest.Experts from 33 countries (nearly 100 participants) discussed the most topical issues of health care in their countries over five days.]

Lege Artis Medicinae

[Old and new pitfalls: comments on health care reform]


[The following is an extract from a forthcoming book, the manuscript of which closed at the beginning of September, so it does not respond to the Ministry of Public Welfare programme that has been published since then - although it is still relevant. ]

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Lege Artis Medicinae

[LAM 30: 1990–2020. Facing the mirror: Three decades of LAM, the Hungarian medicine and health care system]


Clinical Neuroscience

Comparison of direct costs of percutaneous full-endoscopic interlaminar lumbar discectomy and microdiscectomy: Results from Turkey

ÜNSAL Ünlü Ülkün, ŞENTÜRK Salim

Microdiscectomy (MD) is a stan­dard technique for the surgical treatment of lumbar disc herniation (LDH). Uniportal percutaneous full-endoscopic in­terlaminar lumbar discectomy (PELD) is another surgical op­tion that has become popular owing to reports of shorter hos­pitalization and earlier functional recovery. There are very few articles analyzing the total costs of these two techniques. The purpose of this study was to compare total hospital costs among microdiscectomy (MD) and uniportal percutaneous full-endoscopic interlaminar lumbar discectomy (PELD). Forty patients aged between 22-70 years who underwent PELD or MD with different anesthesia techniques were divided into four groups: (i) PELD-local anesthesia (PELD-Local) (n=10), (ii) PELD-general anesthesia (PELD-General) (n=10), (iii) MD-spinal anesthesia (MD-Spinal) (n=10), (iv) MD-general anesthesia (MD-General) (n=10). Health care costs were defined as the sum of direct costs. Data were then analyzed based on anesthetic modality to produce a direct cost evaluation. Direct costs were compared statistically between MD and PELD groups. The sum of total costs was $1,249.50 in the PELD-Local group, $1,741.50 in the PELD-General group, $2,015.60 in the MD-Spinal group, and $2,348.70 in the MD-General group. The sum of total costs was higher in the MD-Spinal and MD-General groups than in the PELD-Local and PELD-General groups. The costs of surgical operation, surgical equipment, anesthesia (anesthetist’s costs), hospital stay, anesthetic drugs and materials, laboratory wor­kup, nur­sing care, and postoperative me­dication diffe­red significantly among the two main groups (PELD-MD) (p<0.01). This study demonstrated that PELD is less costly than MD.

Clinical Neuroscience

[The connection between the socioeconomic status and stroke in Budapest]


[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]

Clinical Neuroscience

[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]

Lege Artis Medicinae

[Vaccines against COVID-19 pandemic]


[The rapidly spreading SARS-CoV2 respiratory virus has evoked an epidemic with serious aftermath around the world. In addition to the health effects, the global economic damage is actually unpredictable. At the same time, the pandemic has launched a series of unprecedented collaborative scientific research, including the development of vaccines. This study summarizes up-to-date information on vaccines, immune memory, and some emerging clinical effects.]