Lege Artis Medicinae

[SCIENTIFIC BROWSING]

OCTOBER 20, 2001

Lege Artis Medicinae - 2001;11(10)

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Lege Artis Medicinae

[PEDIATRIC ONCOLOGY IN HUNGARY IN THE NEW MILLENNIUM]

SCHULER Dezső

[Pediatric malignancies are the most frequent causes of death among 1-15 year old children. These children are treated in 10 pediatric oncology centres in Hungary with therapy based on the same protocols. The author emphasises the importance of late side effects of the therapy, especially the cardiotoxicity, decreased fertility, secondary tumors and the neuropsychologic sequelae. In pediatric oncology, regular checkups of all affected children is the best way for secondary prevention. Molecular genetic studies and minimal residual disease prove to be valuable prognostic factors. New trends of therapy based on better knowledge of molecular biology and immunological characteristics of tumor cells are also mentioned.]

Lege Artis Medicinae

[Congress of the Hungarian Society on Thrombosis and Haemostasis Alsópáhok, September 2001]

KISS Róbert Gábor

Lege Artis Medicinae

[TRANSMYOCARDIAL LASER REVASCULARIZATION. FACTS AND QUESTIONS]

SZÉKELY László

[Transmyocardial laser revascularization (TMLR) is a relatively new technique for the treatment of patients with angina refractory to other medical interventions, such as CABG or PTCA. The laser drills channels through the myocardial wall into the cavity of the ventricle. While the mechanism of action is still debated, clinical data show incentive results suggesting favorable outcome for patients. In the article, the published clinical and experimental data relevant to theoretical mechanisms and clinical results are reviewed.]

Lege Artis Medicinae

[Epidemiology and Pathogenesis of Inflammatory Bowel Diseases]

KARLINGER Kinga, GYÖRKE Tamás, MAKÓ Ernő, MESTER Ádám, TARJÁN Zsolt

Lege Artis Medicinae

[The 2nd Congress of the Cardiovascular and Interventional Society, Hungary October 2001, Győr]

LÁZÁR István

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[Association between cyclothymic affective temperament and hypertension]

NEMCSIK János, BATTA Dóra, KŐRÖSI Beáta, RIHMER Zoltán

[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]

Clinical Neuroscience

[Decisional collisions between evidence and experience based medicine in care of people with epilepsy]

RAJNA Péter

[Background – Based on the literature and his long-term clinical practice the author stresses the main collisions of evidence and experience based medicine in the care of people with epilepsy. Purpose – To see, what are the professional decisions of high responsibility in the epilepsy-care, in whose the relevant clinical research is still lacking or does not give a satisfactory basis. Methods – Following the structure of the Hungarian Guideline the author points the critical situations and decisions. He explains also the causes of the dilemmas: the lack or uncertainty of evidences or the difficulty of scientific investigation of the situation. Results – There are some priorities of experience based medicine in the following areas: definition of epilepsy, classification of seizures, etiology – including genetic background –, role of precipitating and provoking factors. These are able to influence the complex diagnosis. In the pharmacotherapy the choice of the first drug and the optimal algorithm as well as the tasks during the care are also depends on personal experiences sometimes contradictory to the official recommendations. Same can occur in the choice of the non-pharmacological treatments and rehabilitation. Discussion and conclusion – Personal professional experiences (and interests of patients) must be obligatory accessories of evidence based attitude, but for achieving the optimal results, in some situations they replace the official recommendations. Therefore it is very important that the problematic patients do meet experts having necessary experiences and also professional responsibility to help in these decisions. ]

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WENINGER Csaba

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[“Yesterday no longer exists either…” - End-of-life ethical issues in the care of dementia patients]

HEGEDÛS Katalin

[The number of dementia patiens is rising. Most of them die in various institutions, often after many years of care. The long process of nursing and care entails particular ethical requirements that are built primarily on vulnerability, dignity, and dia-logue. The dialogue, however, is often absent from the care of dementia patients. Do we find - as physicians, patients, relatives - that specific time when the patients can still make decisions about end-of-life treatments in a good mental state? Most patients would like to participate in these decisions. Talking about these issues in the early stage of dementia may help in the great emotional burden of family members and caregivers. Therefore the ethical aim is the ad­vance care planning (ACP) of the end-of-life treatments. The study reviews the latest scientific results, with special regard to resources that may be helpful in the course of conversations between doctor and patient on end-of-life preferences, and in the preparation for decision making. ]

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[Scientific Program]