Lege Artis Medicinae

[SCIENTIFIC DIGEST]

NOVEMBER 19, 2006

Lege Artis Medicinae - 2006;16(11)

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Lege Artis Medicinae

[Autoimmune pancreatitis]

dr. JAKAB Lajos

Lege Artis Medicinae

[In Memoriam Sándor Gerő (1904-1992)]

dr. EMED Alexander

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[DREAM]

HALMOS Tamás

Lege Artis Medicinae

[THE PATHOPHYSIOLOGICAL IMPORTANCE OF FAT TISSUE - INTRAABDOMINAL OBESITY]

PARAGH György, KÖBLING Tamás

[Obesity affects a significant proportion of the population in Western countries. Metabolic changes that are associated with obesity lead to metabolic syndrome, a significant risk factor of cardiovascular mortality. Body mass index, which is used to describe the extent of obesity, is not suitable on its own to predict cardiovascular risk or assess metabolic changes, because it doesn't provide information on the distribution of accumulated fat within the body. Several studies have shown that it is the central/abdominal/visceral type of obesity that significantly increases cardiovascular morbidity and mortality. Visceral and subcutaneous fat tissue differ both in their function and the biological effects of adipocytokines secreted by them. Apart from the known effects of free fatty acids on insulin resistance and consequently to other metabolic parameters, adipocyte-derived adipokines have been shown to have a beneficial, antiatherosclerotic effect. In order to precisely estimate the obesity-related cardiovascular risk in everyday practice, not only body mass index, but waist circumference, a marker of visceral obesity, should also be measured.]

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[Management of Antibiotic Side Effects]

dr. HAMVAS József

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[Financial incentives for quality improvement]

BELICZA Éva, EVETOVITS Tamás

[Policy makers and payers of health care services devote increasing attention to improve quality of services by incentivising health care providers. These - so called - pay for performance (P4P) programmes have so far been introduced in few countries only and evidence on their effectiveness is still scarce. Therefore we do not know yet which instruments of these programmes are most effective and efficient in improving quality. The P4P systems implemented so far in primary care and in integrated delivery systems use indicators for measurement of performance and the basis for rewards. These indicators are mostly process indicators, but there are some outcome indicators as well. The desired quality improvement effects are most likely to be achieved with programmes that provide seizable financial rewards and cover the extra cost of quality improvement efforts as well. Administration of the programme has to be fully transparent and clear to all involved. It has to be based on scientific evidence and supported with sufficient dedicated funding. Conducting pilot studies is a precondition for large scale implementation.]

Lege Artis Medicinae

[Illness representation of patiens with migraine and tension headache]

AMANDA Illés, NAGY Beáta Erika

[It’s been proven by many scientific observation that patients describe their diseases both in progression and adaptation in a different manner even though having a similar origin. The reason behind is the various cognitive background. The investigation of this cognitive function may help us understand patients personal reactions better. In 2007 I investigated the effect of three factors (type, understanding and duration of the disease) on illness representation in patients suffering from headache. The patients included were the following three groups: having migraine with aura, migraine without aura and patients with tension headache. I was looking for correlations and differences in disease representations. For this investigation I have used illness representation questionnaires translated and adapted to Hungarian population. The data were obtained in the waiting hall of two headache centres in Debrecen. Although there were no significant correlations in most of the cases, certain tendencies were observed. Understanding of disease representation could be very useful tool in psychological support, psychotherapy for the patients and it could improve their quality of life.]