Lege Artis Medicinae

[The 48. Congress of the Hungarian Society of Gastroenterology - 17-21. June 2006. Szeged]

IZBÉKI Ferenc

DECEMBER 16, 2006

Lege Artis Medicinae - 2006;16(12)

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Lege Artis Medicinae

[Chocolate]

MATOS Lajos, LENGYEL Margit

Lege Artis Medicinae

[EFFECTS OF VITAMIN D AND THE EFFICACY OF VARIOUS VITAMIN D PRODUCTS]

BORS Katalin

[An increasing number of studies suggests that the effects of vitamin D is not limited to the regulation of calcium homeostasis, but it is also involved in several other physiologic processes. Vitamin D receptors are present on the surface and in the nucleus of most cells. Vitamin D as a steroid hormone has genomic and non-genomic effects. Vitamin D deficiency is an important problem worldwide, and so is in Hungary. Vitamin D promotes bone formation and mineralization and decreases the rate of bone absorption. Its extraskeletal effects include antitumour, muscle strength increasing, antiinflammatory, blood pressure lowering and insulin secretion increasing activites.]

Lege Artis Medicinae

[I’ll Visit the Minister!]

dr. KRAMER Imre

Lege Artis Medicinae

[TREATMENT OF HYPERTENSION - RECOMMENDATIONS FOR THE PRACTICE]

PÁLL Dénes

[Hypertension is one of the most common diseases with a prevalence of over 25%. Despite of the availability of modern therapeutic options, the proportion of well-controlled patients is low. Before starting the treatment of patients with hypertension, it is essential to assess cardiovascular risk factors, co-morbidities and damages to target organs, in addition to repeated blood pressure measurements. The author first reviews the non-pharmacological treatment options of hypertension, then summarizes the most important characteristics of first-line antihypertensive agents (diuretics, beta-receptor blockers, calcium channel antagonists, angiotensin converting enzyme inhibitors, angiotensin receptor blockers). Considering the complex pathomechanism of essential hypertension, the author details the advantages and options of combined antihypertensive therapy, touching on the combinations recommended in special conditions. The metabolic effects and side-effects of antihypertensive agents, which have recently gained increased significance, are also discussed. Modern hypertension care is aimed at maximally decreasing cardiovascular morbidity and mortality, and improving the patient's quality of life. Maximum decrease of cardiovascular risk not only involves proper blood pressure control, but also aggressive fight against other risk factors (e.g., diabetes, dyslipidaemia, smoking) and treatment of target organ damages and comorbidities.]

Lege Artis Medicinae

[In the focus: malignant lung diseases]

MAGYAR Pál

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We aimed to analyze the clinical, laboratory and neuroimaging findings in patients with sporadic Creutzfeldt-Jakob disease (CJD) in a single center as well as to review other published cases in Turkey. Between January 1st, 2014 and June 31st, 2017, all CJD cases were evaluated based on clinical findings, differential diagnosis, the previous misdiagnosis, electroencephalography (EEG), cerebrospinal fluid and cranial magnetic resonance imaging (MRI) findings in our center. All published cases in Turkey between 2005-2018 were also reviewed. In a total of 13 patients, progressive cognitive decline was the most common presenting symptom. Two patients had a diagnosis of Heidenhain variant, 1 patient had a diagnosis of Oppenheimer-Brownell variant. Seven patients (53.3%) had been misdiagnosed with depression, vascular dementia, normal pressure hydrocephalus or encephalitis. Eleven patients (87%) had typical MRI findings but only 5 of these were present at baseline. Asymmetrical high signal abnormalities on MRI were observed in 4 patients. Five patients (45.4%) had periodic spike wave complexes on EEG, all appeared during the follow-up. There were 74 published cases in Turkey bet­ween 2005 and 2018, with various clinical presentations. CJD has a variety of clinical features in our patient series as well as in cases reported in Turkey. Although progressive cognitive decline is the most common presenting symptom, unusual manifestations in early stages of the disease might cause misdiagnosis. Variant forms should be kept in mind in patients with isolated visual or cerebellar symptoms. MRI and EEG should be repeated during follow-up period if the clinical suspicion still exists.

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Aim - The aim of this study was to evaluate the frequency and characteristics of attacks in patients with migraine, to determine the effects of anxiety or depressive symptoms, and to evaluate the marital relationships of patients with migraine. Method - Thirty patients who were admitted to the neurology outpatient clinic of our hospital between July 2018 and October 2018 and were diagnosed with migraine according to the 2013 International Headache Society (IHS) diagnostic criteria were included in this cross-sectional study. Age, sex, headache frequency and severity, depressive traits, marital satisfaction and anxiety status were examined. We used the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maudsley Marital Questionnaire (MMQ) and Visual Analogue Scale (VAS) for measuring relevant parameters. Results - The mean severity of migraine pain according to VAS scale was 6.93 ± 1.41 and the mean number of migraine attacks was 4.50 ± 4.24. The mean BDI score of the patients was 12.66 ± 8.98, the mean MMQ-M score was 19.80 ± 12.52, the mean MMQ-S score was 13.20 ± 9.53, the mean STAI-state score was 39.93 ± 10.87 and the mean STAI-trait score was 45.73 ± 8.96. No significant correlation was found between age, number of migraine attacks, migraine duration, migraine headache intensity, and BDI, STAI and MMQ scores (p>0.05). But there was a positive correlation between MMQ-S and scores obtained from the BDI and STAI-state scales (p<0.05). Conclusion - In this study more than half of the migraine patients had mild, moderate or severe depression. A positive correlation was found between sexual dissatisfaction and scale scores of depression and anxiety.

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[The real cost of caring for seriously ill patients - compassion fatigue or satisfaction]

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[The improvement of the Hungarian hospice network and the increasing number of people dealing with the seriously ill are reflected by the annual hospice reports (2001-2013). However these reports also draw the attention to the cumulating mental and spiritual burdens of carers which can lead to fatigue and burnout. On the base of practical experience we surveyed the mental and spiritual condition of the caregivers of seriously ill patients and also reviewed research findings and the professional literature on the exposure to imperilment. The grounds of professional literature’s research were the Hungarian and international databases. We favoured studies published in Hungarian or English between 2000 and 2014 primarily on carers working in palliative and hospice service. One of the main profits of reviewing the professional literature is getting more detailed information on the mental state of professional caregivers. Relatively new element in researches is studying the relation between burnout and compassion satisfaction and compassion fatigue. It includes studying of symptoms and coping strategies. These all enable a better understanding of causes and help us to support hospice carers with more effective methods to protect them from mental and spiritual exhaustion.]

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[The experience gained in teaching medical anthropology at Semmelweis University of Medicine is reported in the study. Very often medical anthropology is identified by the physical anthropology of “Dr. Bone”, although this discipline is a branch within cultural anthropology which deals with applied anthropology. During practices, students following their preclinical studies - that is already not lay but still not doing healing work - had to carry out fieldwork and participate as observants at a medical facility of their choice: inpatient, primary care clinic or alternative medical center/ clinic. The purpose of the field work was the examination and the analysis of the different healing systems, and of the doctorpatient relationship. During the nine years, more hundreds of fieldworks were made. In the study, we attempted to sum up these experiences for a better understanding of pluralism of the Hungarian medical system, the usability and eventual faults of different healing systems, and ultimately the effectiveness of the medical anthropology course.]