Lege Artis Medicinae

[Rock Drawings, Shamans, Kings]

NAGY Gyula

OCTOBER 20, 2009

Lege Artis Medicinae - 2009;19(10)

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[Effect of beta blockers in hypertension, ischaemic heart disease, heart failure and metabolic syndrome]

BENCZÚR Béla

[Beta-blockers are among the most widely used drugs for the treatment of cardiovascular diseases. In the mid-90’s, these drugs were recommended as first-line therapies of hypertension. With the introduction of new drugs, the list of first-choice drugs has been extended. The results of recently published major hypertension trials, which compared conventional agents (beta blockers and/or diuretics) with newer agents (angiotensin converting enzyme inhibitors, Caantagonists, angiotensin receptor blockers), raised concerns regarding the role of beta blockers in cardiovascular primary prevention. Subsequently, a metaanalysis of 13 trials has shown that compared with other drug types, beta-blocker therapy is less beneficial in patients with hypertension who do not have heart disease. Nevertheless, in cardiovascular indications other than hypertension (acute myocardial infarction, heart failure and arrhythmias), betablockers retain their dominant position.]

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[Antibiotic treatment of intra-abdominal infections, focusing on secondary peritonitis]

PULAY István, KONKOLY THEGE Marianne

[The morbidity and lethality of intra-abdominal infections are still high. Their first-line therapies include surgical or image-guided interventions. Adjuvant therapy with a broad-spectrum antibiotic is crucial for the treatment of polymicrobial infections. As initiation of the therapy is urgent, the antibiotic must be chosen empirically. Pathogens of community-acquired and nosocomial intra-abdominal infections are greatly different. The type of microbes, the general status of the patients, and the severity of their disease determine the choice of antibiotic or antibiotic combination. Using an adequate initial antibiotic decreases postoperative mortality and morbidity. Emerging new pathogens and the resistance of known germs against multiple antibiotics complicates the selection of the antiinfective therapy. Tigecycline is a new tetracyclin-derivative that offers a novel therapeutic option owing to its broad spectrum and efficiency against “problematic bacteria”. The current guidelines facilitate the selection of an empirical therapy, but they do not replace the individualised therapeutic approach.]

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[Insulin pump therapy for type 1 diabetes mellitus]

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[Head and neck injury risks in heavy metal: head bangers stuck between rock and a hard bass]

BALLA Bernadett

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[Fear of medical care: epidemiology and prevention among 5-6 years old children]

PÓCS Dávid, SIKLÓSI Réka, NYÁRI Tibor, BARABÁS Katalin

[INTRODUCTION - At least 5-10% of the adult population is afraid of medical care. These fears may begin in preschool years. Therefore, the aim of our study was to assess the rates of medical fears among 5-6 year old children, and to prove that medical fears can be reduced by a health promotion program for children called “Teddy Bear Hospital” POPULATION AND METHODS - 248 children participated in the study (average age: 5.5 years, 45% girl, 55% boy). The “Teddy group” (129 children) took part in the Teddy Bear hospital program (Teddy group). The control group (119 children) did not take part in this program (control group). Questionnaires, including a Visual Analog Scale, a picture test, and drawing analyses were completed on two separate occasions three weeks apart difference. RESULTS - Fear of needles was the most frequent fear (59%) among the participating children, followed by the fear of medical environment (33%), the fear because of the lack of information (27%), the fear of doctors (20%), and the fear of pain (15%). On the basis of the picture test the fear of doctors significantly decreased in the Teddy group (from 18% to 7%) compared with the control group (from 10% to 11%, p<0.05). Drawing analyses also showed that children in the Teddy group had significantly lower levels of medical anxiety (29% and from 19.3 point to 17.6 point) than the control group (19% p<0.05 and from 18.8 point to 18,33 point p<0.05). On the drawings of the Teddy group we found significantly more new medical information (38%) compared with the control group (21%, p<0.05). CONCLUSIONS - Medical fears are frequently present among 5-6 year old children, therefore, their prevention is greatly needed. A potential way of the prevention is the “Teddy Bear Hospital” program, which efficiently reduces children's medical fears and anxiety.]

Lege Artis Medicinae

[“WHAT DO YOU THINK HAPPENS TO THOSE WHO RARELY GO OUTDOORS?”]

PLUHÁR F. Zsuzsanna, KOVÁCS Szilvia, PIKÓ Bettina, UZZOLI Annamária

[INTRODUCTION - The surrounding environment plays an important role in the development of psychosomatic symptoms. This study examines what children think of the consequences of not going outdoors for long periods. METHODS - Data were collected using the “draw-and-write” technique that besides the written answers allows children to express their thoughts in drawings. The questionnaire contained open-ended questions both on sociodemographic data and on the children’s notion of the relationship between environment and health or illness. Questionnaire submission was voluntary and anonymous. The study subjects were 9 to 11-year-old pupils (n=448, 44.6% boys, 55.4% girls) from six primary schools, two in Budapest, and one each in Pest, Jász-Nagykun-Szolnok, Csongrád and Békés counties. The primary schools were selected so as to represent various environmental locations, such as urban, town, suburban residential, area of blocks of flats. RESULTS - We found that all children agreed in that those who don't go outdoors for a long time will, in one way or another, get sick. Illnesses mentioned in the answers were classified in two categories, physical and mental. Physical health problems were further divided into four subcategories: symptoms (e.g., anaemia, pallor, fever, weak joints or bones); diseases; obesity; death. Mental health problems were divided into two subcategories: actual psychiatric diseases (e.g., depression) and symptoms, such as unhappiness, sadness, anger. CONCLUSIONS - We conclude that children in this study sample reckon the close connection between staying indoors for prolonged periods and the development of symptoms and disease.]