Lege Artis Medicinae

[Suggestive Communication in Medicine ]

BUDA Béla

JULY 20, 2012

Lege Artis Medicinae - 2012;22(06-07)

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Lege Artis Medicinae

[Idiopathic retroperitoneal fibrosis (Morbus Ormond) associated with severe cardiomyopathy in a young man: a case report]

KOVÁCS Erzsébet, ZEHER Margit, SZÁNTÓ János, PÁSZTOR Éva, TÓTH László, PFLIEGLER György

[INTRODUCTION - The cause of idiopathic retroperitoneal fibrosis is unknown, but probably involves a chronic, nonspecific, autoimmune inflammation. This rare disease mostly affects middle-aged or elderly people, it hardly ever occurs in young people. It causes obstruction of the urinary tract, postrenal insufficiency as well as functional disorder of vital organs in the retroperitoneum and its surrounding area. The diagnosis is based on diagnostic imaging and histological examinations. Surgical treatment of the urinary obstruction is only efficient in the long-term if combined with immunomodulatory treatment. CASE REPORT - A young, 34-year-old man who presented with oedema in his legs was diagnosed with retroperitoneal fibrosis. Autoimmune serology was negative. He needed temporary nephrostomy on the right side. Treatment with steroid and colchicine was initially successful. His severe cardiomyopathy improved gradually. No regression occurred with tamoxifen, so we started to administer azathioprine with methylprednisolone. The control abdominal CT showed stagnation of the process. CONCLUSIONS - Because of the rarity of this disease, no randomised controlled trials are available regarding its treatment. The aim of treatment is to eradicate the symptoms, solve the urinary obstruction, maintain renal function and prevent progression of the disease. Improvement may be achieved by corticosteroids, cyclophosphamide, azathioprine, leflunomide, mycophenolate mofetil and tamoxifen. To our knowledge, this case is unique as no similar case with severe cardiomyopathy and idiopathic retroperitoneal fibrosis has been reported in the literature previously.]

Lege Artis Medicinae

[A Winter in Mallorca – Chopin and George Sand ]

KÖVES Péter

Lege Artis Medicinae

[How to avoid hypoglycemia during insulin therapy of dialysed patients]

MÁCSAI Emília, VIZELINÉ S. Katalin, TÖLGYESI Katalin, BENKE Attila

Lege Artis Medicinae

[Saint Agatha’s Cult in Northern Italy ]

HORVÁTH Zoltán György

Lege Artis Medicinae

[Some psychological and system-oriented perspectives of modern eating disorders]

VARGA Márta, BABUSA Bernadett

[The newer types of eating disorders are less common in the therapeutic practice or they may appear as a secondary disorder. Therefore only a little we know about the psychological background of these disorders. There is only a few data in the literature about the relational of family characteristics of muscle dysmorphia, eating disorder bodybuilder type, Adonis complex or orthorexia nervosa. As the classical eating disorders, like anorexia and bulimia nervosa are in a strong relationship with the newer types of eating disorders, we can assume several family factors on the basis of the underlying common features. The problems of self-esteem, the self-developmental disorder, the perfectionism, the need for control, and the relationship to the obsessionality and compulsivity are common characteristics of these disorders.]

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Lege Artis Medicinae

[Health behavior of tattooed persons]

CZUPY Gábor, PONGÓ Gabriella, MIHÁLFFY Dávid, SUSÁNSZKY Éva

[INTRODUCTION - In post-modern societies tattoo has become decidedly fashionable as acceptance have replaced negative attitudes towards it. We assume that body decoration is a fashion-conscious behavior in the present Hungarian society and thus their lifestyle and risk behavior would not differ from the average of the Hungarian population; also, that there would be no gender differences in the motivations of having a tattoo nor in the messages communicated by tattoos. SAMPLE AND METHOD - Information on tattooed persons was collected on the Internet. The online questionnaire was completed by 508 persons. For processing the data we used the SPSS PC statistical software package. RESULTS - The majority of our sample was under 35 years of age. Respondents have an average of 5-7 tattoos. The most preferred body parts for tattooing are the arms and legs. The primary motivations for having a tattoo are self-expression and the need of commemorating emotions and events. There are significant differences between the characteristics of tattooing of men and women, however, these differences are not related to the social body. The eating habits of men and women are similar; the average number of meals per day is higher than three; the majority of the respondents eats healthy foods and chose their food consciously. They exercise 4-5 hours per week. The proportions of the overweight and the obese are far greater than the nationwide age averages. More than half of the respondents are active smokers. The estimated proportion of heavy drinkers is especially prominent among the tattooed women. SUMMARY - The motivational background and message communication support our assumptions that tattooing is fashion rather than a deviant behavior. The tattooed persons in our sample are health conscious regarding sports and exercise. Appearance has a great importance for them. On the other hand, above average use of legal addictive substances (alcohol) is characteristic among them.]

Clinical Neuroscience

A clinical study of an online educational programme for chronic pain patients

GALAMBOS Wellingerné Krisztina, SZOK Délia, CSABAI Márta

Background - The research of alexithymia - the inability to express or understand emotions - has recently become of great importance in clinical practice, mainly in the field of doctor-patient and psychologist patient communication. Many studies have proven the correlation between alexithymia and the development of functional somatic symptoms, i.e. somatization. Purpose - The aim of this clinical study was to examine the emotion-recognition and emotion communication patterns of patients suffering from chronic pain (e.g., headache, low back pain, arthralgia, neuropathy). Moreover, the participants received access to the Hungarian adaptation of a new international online educational site (www.retrainpain.org) dealing with pain management. Methods - Data were collected from the Headache and Chronic Pain Outpatient Clinic, Department of Neurology, Faculty of Medicine, University of Szeged, Hungary (tertiary care - Group 1) and from a general practice in district 2, Budapest, Hungary (primary care - Group 2) from March, 2017 to April, 2018. Patients received a test package containing a pain-specific questionnaire, then the Difficulties in Emotion Regulation Scale (DERS), the Toronto Alexithymia Scale (TAS-20), and the shortened Hungarian version of the WHO-Well-being (WBI-5) had to be completed. After filling out the questionnaires, all patients got access to the Hungarian adaptation of the www.retrainpain.org website. Results - Altogether 92 patients participated in the study (Group 1 n=50; Group 2 n=42). Based on the TAS-20 re­sults, 35 patients reached a pathological score (≥60 points), which indicates the diagnosis of alexithymia. The mean TAS-score was lower in Group 2 (primary care) than in Group 1 (tertiary care) (p=0.003). The DERS disclosed pathological results in 19 cases (p=0.009). As regards the www.retrainpain.org chapters, we received feedback only from 25 out of 92 patients (27%) (Group 1 n=20; Group 2 n=5). Conclusions - Although the examined patients have been suffering from different chronic pain syndromes for years and 50% of them confirmed that symptoms placed at least moderate or heavy burden on their everyday life, the available educational programme was studied only by a smaller proportion of patients than expected. Additionally, those who surveyed the Hungarian adaptation of the www.retrainpain.org website were mainly patients from primary care (Group 2), in spite of the fact that patients from specialized medical care (Group 1) had worse subjective conditions. Our future objective is to extend our database with follow-up results and to improve patients’ response willingness.

Lege Artis Medicinae

[From disease-centrism to P4 medicine - a route to a health system placing the human “wholeness” into the center]

dr. VÁLYI Péter

Lege Artis Medicinae

[Health or an Absence of Symptoms? – Or the Faces of Decontextualised Medicine ]

DARUKA István

Lege Artis Medicinae

[The Dramas of Becoming a Doctor A Novel Method in Teaching Doctor-Patient Communication]

CSÖRSZ Ilona, SZILI Katalin, CSABAI Márta