Lege Artis Medicinae

[The concept of pre-embryo]

LAMPÉ László1

OCTOBER 30, 1991

Lege Artis Medicinae - 1991;1(16)

[With the practical application of new methods of human reproduction, a new name, a new concept for the initial stage of the development of the fertilised egg cell has become necessary. This is the period from the end of conception until the time when it has developed into a (single) biological individual without any doubt. In addition to the importance of the uniform use of nomenclature, there are two more important reasons for the definition. First and foremost, the fact that this period is a special and unique period of biological development in which the fate of the fertilised egg is very much in question and in which several alternatives are possible (1. below). ]


  1. egyetemi tanár Szülészeti és Nőgyógyászati Klinika Debrecen



Further articles in this publication

Lege Artis Medicinae

[Cardiac rehabilitation a review]

VICTOR Froelicher, CRES P. Miranda

[The questions of cardiac rehabilitation are reviewed evaluating own personal experiences and pertaining current literature. The authors touch upon the question of early mobilization, as well as supervised and non supervised exercise. The criteria for the implementation of coronary angiography and acute revascularization procedures in the early phase of myocardial infarction are established. They review the secondary prevention of myocardial infarction and the effects of rehabilitation training on the patients prognosis.]

Lege Artis Medicinae

[Problems of organ transplantation - donor care]


[The development of the definition of brain death which is fundamental in cadaver organ removal for transplantation purposes is reviewed. Brain stem death, an alternative term for brain death is based primarily on clinical findings namely the irreversible cessation of cephalic reflexes and spontaneous breathing. Hypothermia, metabolic and endocrine abnormalities, prolonged muscle relaxant, sedative or hypnotic drug action should be excluded. The early recognition of potential donor and the maintenance of basic life function at the Intensive Care Unit and the operating theater are essential for the good function of the transplanted organs. Normal homeostasis should be maintained by ensuring adequate fluid intake, good circulation and urine output. Brain death potential donors can exhibit persistent spinal reflexes and spontaneous movement wich may be erroneously interpreted as signs of life. The problem of the determination of brain death under 4 year of age is also discussed although law does not allow to use them as potentional donors in Hungary. ]

Lege Artis Medicinae

[A review of a three year period in general practice]


[The author summarizes his work as a general practicioner in a village of 2000 people. He aimed to construct racional conditions of health care using technical, educational and organizing tools. Patients are reported to be satisfied and positive tendencies appeared in medicamentum consumption, and the number of sick days decreared from 13 673 to 10 198 per year. Less consultations of specialists and ask for hospital admission war performed. Indispensability of computers in the management of general practice is stressed. ]

Lege Artis Medicinae

[Having got a district]


[A beginner young general practicioner summarizes the experiences of his first year of work. Complex preparation for this work at the university, and the build up of the new practice of basic health service is described. Care of hypertension and diabetes is detailed, as an example how important and difficult is to reorganise this part of the work. The first year of experience gives a good possibility to look over the lack of undergraduate teaching This type of data collection and critical analysis seems to be necessary for a better planning of the forthcoming medical work. ]

Lege Artis Medicinae

[Chlamydia Pneumoniae: a new respiratory disease]

MARTON Anna , FÓRIS Katalin, SZALKA András, KÁROLYI Alice

[Current knowledge of Chlamydia pneumoniae, a newly recognized Chlamydia species that causes acute respiratory infection is summarized. Microbiology, classification and the laboratory diagnosis of the organism are discussed. Serological studies in Hungary suggest that almost everyone is infected during lifetime and reinfection is common as well. The organism appears to spread from human to human. Tetracyclin or erythromycin is recommended for the treatment of the Chlamydia pneumoniae infection. ]

All articles in the issue

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Clinical Neuroscience

Evaluation of the effectiveness of transforaminal epidural steroid injection in far lateral lumbar disc herniations

EVRAN Sevket, KATAR Salim

Far lateral lumbar disc herniations (FLDH) consist approximately 0.7-12% of all lumbar disc herniations. Compared to the more common central and paramedian lumbar disc herniations, they cause more severe and persistent radicular pain due to direct compression of the nerve root and dorsal root ganglion. In patients who do not respond to conservative treatments such as medical treatment and physical therapy, and have not developed neurological deficits, it is difficult to decide on surgical treatment because of the nerve root damage and spinal instability risk due to disruption of facet joint integrity. In this study, we aimed to evaluate the effect of transforaminal epidural steroid injection (TFESI) on the improvement of both pain control and functional capacity in patients with FLDH. A total of 37 patients who had radicular pain caused by far lateral disc herniation which is visible in their lumbar magnetic resonance imaging (MRI) scan, had no neurological deficit and did not respond to conservative treatment, were included the study. TFESI was applied to patients by preganglionic approach. Pre-treatment Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores of the patients were compared with the 3rd week, 3rd month and 6th month scores after the procedure. The mean initial VAS score was 8.63 ± 0.55, while it was 3.84 ± 1.66, 5.09 ± 0.85, 4.56 ± 1.66 at the 3rd week, 3rd month and 6th month controls, respectively. This decrease in the VAS score was found statistically significant (p = 0.001). ODI score with baseline mean value of 52.38 ± 6.84 was found to be 18.56 ± 4.95 at the 3rd week, 37.41 ± 14.1 at the 3rd month and 34.88 ± 14.33 at the 6th month. This downtrend of pa­tient’s ODI scores was found statistically significant (p = 0.001). This study has demonstrated that TFESI is an effective method for gaining increased functional capacity and pain control in the treatment of patients who are not suitable for surgical treatment with radicular complaints due to far lateral lumbar disc hernia.

Clinical Neuroscience

[Is the implementation of Vojta therapy associated with faster gross motor development in children with cerebral palsy? ]


[Vojta therapy has been reported as clinically beneficial for strength, movement and gross motor activities in individual cases and is being included within the second of three levels of evidence in interventions for cerebral palsy. The goal of this study is to understand the effect of Vojta therapy on the gross motor function. Our clinical trial followed a one group, pre-post design to quantify rates of changes in GMFM-88 after a two-months period undergoing Vojta therapy. A total of 16 patients were recruited. Post-intervention acceleration rates of GMFM-88-items acquisition (0.005; p<0.001) and Locomotor Stages (1.063; p<0.0001) increased significatively following Vojta the­rapy intervention. In this study, Vojta therapy has shown to accelerate the acquisition of GMFM-88-items and Loco­motor Stages in children with cerebral palsy younger than 18 months. Because functional training was not utilised, and other non-Vojta therapy intervention did not influence the outcome, Vojta therapy seems to activate the postural control required to achieve uncompleted GMFM-88-items. ]

Lege Artis Medicinae

[Current issues in the peripartum management of diabetic women from the perspective of an internist-diabetologist]

KERÉNYI Zsuzsanna

[In pregnancy complicated with diabetes, treatment of hyperglycaemia is of fundamental importance during delivery in order to improve the outcome parameters of both the mother and the neonate. This is particularly important in the case of mothers with type 1 diabetes and of all mothers who require insulin treatment during their pregnancy. The use of antenatal steroids for women at risk of pre-term birth further complicates the treatment of hyperglycaemia in the period immediately before delivery and requires the appropriate change of insulin therapy. The requirement of nil per os in the delivery period necessitates proper fluid, glucose and insulin treatment in the pre-delivery hours. After surgical delivery the patients may also need infusion treatment until the first meal. As there is no unified guideline for the peripartum management of diabetes, the author re­views the international literature on the internal medicine issues concerning the peripartum treatment of pregnant women with diabetes. This study reviews the characteristics of insulin treatment of women with various types of diabetes before, du­ring and di­rect­ly after delivery. It presents a dosing schedule for women who needed an antenatal steroid treatment in the period before delivery due to premature birth for the purpose of lung maturation. The study also addresses the application and programming of pe­ripartum blood glucose tests, continuous interstitial glucose monitoring (CGM) and insulin pump treatment (CSII).]

Clinical Neuroscience

[Dysphagiafelmérések akut stroke-ban]

SZABÓ Pál Tamás, MÛHELYI Viktória, BÉRES-MOLNÁR Katalin Anna, KOVÁCS Andrea, BALOGH Zoltán, FOLYOVICH András

[Stroke associated dysphagia can have serious consequences such as aspiration pneumonia. The Hungarian guideline on nutritional therapy for stroke patients recommends dysphagia assessment, as early screening can optimize disease outcome and hospital cost. Thus far, this may be the first study in Hungarian that has documented a systematic review about the available validated dysphagia assessments of acute stroke. Purpose – The aim of this study was to summarize the instrumentally validated bedside dysphagia screening tools for acute stroke patients, which were published in the last twenty years. Our objective was to describe the characteristics of the validation studies, examine their study design, and sample the sub-tests and the diagnostic accuracy of the assessments. A systematic research was carried out of the literature between 2001 and 2021 in eight scientific databases with search terms appropriate to our objectives. Subjects of the study – 652 articles were found and were reduced to eight. We made a comparative analysis of these. The GUSS test reached a high level of sensitivity compared to the others. In our study sample, the prevalence of instrumentally confirmed dysphagia among acute stroke patients was 56.1%. The focus and the composition of the analyzed studies differed and posed problems such as the ambiguity of the concept of dysphagia, the difference in outcome indicators, or the timing of screening. The GUSS test, which offers domestic management, is a suitable tool for the Hungarian clinical use.]

Clinical Neuroscience

[Tracing trace elements in mental functions]

JANKA Zoltán

[Trace elements are found in the living organism in small (trace) amounts and are mainly essential for living functions. Essential trace elements are in humans the chromium (Cr), cobalt (Co), copper (Cu), fluorine (F), iodine (I), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), and questionably the boron (B) and vanadium (V). According to the biopsychosocial concept, mental functions have biological underpinnings, therefore the impairment of certain neurochemical processes due to shortage of trace elements may have mental consequences. Scientific investigations indicate the putative role of trace element deficiency in psychiatric disorders such in depression (Zn, Cr, Se, Fe, Co, I), premenstrual dysphoria (Cr), schizophrenia (Zn, Se), cognitive deterioration/de­mentia (B, Zn, Fe, Mn, Co, V), mental retardation (I, Mo, Cu), binge-eating (Cr), autism (Zn, Mn, Cu, Co) and attention deficit hyperactivity disorder (Fe). At the same time, the excess quantity (chronic exposure, genetic error) of certain trace elements (Cu, Mn, Co, Cr, Fe, V) can also lead to mental disturbances (depression, anxiety, psychosis, cognitive dysfunction, insomnia). Lithium (Li), being efficacious in the treatment of bipolar mood disorder, is not declared officially as a trace element. Due to nutrition (drinking water, food) the serum Li level is about a thousand times less than that used in therapy. However, Li level in the red cells is lower as the membrane sodium-Li countertransport results in a Li efflux. Nevertheless, the possibility that Li is a trace element has emerged as studies indicate its potential efficacy in such a low concentration, since certain geographic regions show an inverse correlation between the Li level of drinking water and the suicide rate in that area. ]