Lege Artis Medicinae

[The Curative Tokaji ]

MAGYAR László András1

MARCH 20, 2015

Lege Artis Medicinae - 2015;25(03)

AFFILIATIONS

  1. Semmelweis Orvostörténeti Múzeum, Könyvtár és Levéltár

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Further articles in this publication

Lege Artis Medicinae

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

KEGYE Adrienne, ZANA Ágnes, RÉVAY Edit, HEGEDÛS Katalin

[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.]

Lege Artis Medicinae

[Protection of gastrointestinal system in cardiovascular diseases]

FARSANG Csaba, TULASSAY Zsolt

[Cardiovascular preventive drugs (nonsteroidal antiinflammatory drugs, aspirin, inhibitors of platelet aggregation, anticoagulants) are among the most frequently used medicines all over the world. Gastrointestinal (GI) complications (hemorrhage, ulceration, perphoration) are among the most frequent side effects of these drugs, however, differences in their pharmacodynamics properties and other pleiotropic effects may substantially modify these unwanted events. Authors, based on international and Hungarian guidelines, summarize the most important data for GI protection, focusing on the use of H-2 receptor blockers and proton pump inhibitors.]

Lege Artis Medicinae

[Holistic Approach in Ancient Egypt ]

ANDRÁSSY Gábor, KULCSÁR Emese, MAGYAR Erzsébet, FRECSKA Ede

Lege Artis Medicinae

[The role of hypoxia in tissue regeneration and in development of amplified aggressive fenotypes in malignant cancer]

HUNYADI János

[Several diseases are accompanied by hypoxic stress; elimination of it is an important physiological process. Our body provides a protective function which delays damage and destruction by hypoxia. In case of necrosis, it provides the mop up of the damaged area. This security system starts the regeneration in cells of the hypoxic zone which surrounds the necrotic area, resulting in the survival of the cells in hypoxic environment and ensuring the handling of the necrosis. The key molecules of the system are the hypoxia-induced factor molecules. The review discusses the physiological role of tissue hypoxia and normoxia and its effects on tissue regeneration. The physiological system triggered by the hypoxia-induced factor plays an important role in embryonic development, in wound healing and in numerous diseases (eg. myocardial infarction, stroke, vaculities, etc). Unfortunately, this system also plays a key role in several malignant tumors by rising the development of cells with increased aggressive fenotypes as well. The physiological process of regeneration starts in the hypoxic tumor cells aided by the hypoxia-induced factor system. The process results in neovascularization, and in the case of tissue damage, in the mop up of the necrotic tissue and in the restoration of tissue oxygenisation. However, after the formation of the new vascular network, tumor cells accustomed to hypoxia will not die but keep their original uncontrolled proliferation and anaerobic nature. Moreover the malignant nature of the cells will be increased by the genetic changes generated by the system of hypoxia- induced factors. The role of the hypoxia-induced factor system in tumor progression is discussed by the example of one of the most malignant tumors, malignant melanoma.]

Lege Artis Medicinae

[Experiences with fix combination of amlodipin-atorvastatin according to the ESH/ESC hypertension recommendation 2013]

NAGY Gergő

[BACKGROUND - Hypertension is a widespread disease in Hungary and worldwide as well. Combination products containing more effective agents in one pill have an increasing role in the treatment strategy. One of the most often used products is Amlator, in which the advantageous features of amlodipine and atorvastatin are combined. METHOD - During my investigation I treated a patient with just diagnosed hypertension, prescribing Amlator 20/5 pill once a day. Blood pressure measurements were registered at home in a blood pressure diary. After two months laboratory and ABPM measurements were administered again. Gathered data was compared and changes were analysed. RESULTS - During the first ABPM measurement the mean blood pressure was 150/90 mmHg. Laboratory measurements showed a moderate increase in cholesterol level (6.1 mmol/l), lipid values were in the normal range (LDL 3.0 mmol/l, HDL 2.61 mmol/l) and hypertriglyceridemia wasn’t observed either (0.97 mmol/l). The blood pressures measured at home showed a significant decrease using the prescribed medication. During the first month the average blood pressure was 133/80 mmHg. This shows an 11.3% decrease of the systolic value. At the second monthly inspection a decrease in the cholesterol level was noted (cholesterol 5.0 mmol/l, LDL 2.31 mmol/l, HDL 2.2 mmol/l, triglyceride 0.96 mmol/l). This is a 14.7% decrease. The second ABPM measurement showed a significant decrease in both the systolic and diastolic blood pressure values. The average blood pressure was 124/78 mmHg, which means a 17.3% decrease of the systolic value. CONCLUSION - Amlator proved to be an effective treatment of both hypertension and hypercholesterolemia.]

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Journal of Nursing Theory and Practice

[Associated factors of independency in older adults with cognitive impairment living in a long term care institute]

KOVÁCS Éva, JÓNÁSNÉ SZTRUHÁR Izabella, KARÓCZI Csilla Kata, VASS Zsolt, FARKAS Lilla

[Aim of the research: Functional independence determines the elderly’s health and quality of life. In them cross-sectional study the authors analysed the associations between functional abilities (balance, gait, functional mobility, cognitive abilities), age, BMI and comorbidities and independency in older adults with cognitive impairment. Research and sampling methods: 110 elderly people were measured. Self-sufficiency was measured by the Katz-index, balance, and gait by the Tinetti Test and functional mobility by the Timed Up and Go Test. Correlations between variables were analysed with the Spearman’s rank-order correlation. Results: There was strong association between balance (r=0,557), gait (r=0,515), functional mobility (r=-0,647), and independency. It means the better the balance, gait, and functional mobility is, the higher the independency is. There was weak association between age, BMI, cognitive abilities, comorbidities and independency. Conclusion: Results show that preserving of the functional independence in older adults with cognitive impairment is a multidisciplinary task: physiotherapists and nurses should work together to complete doctors’ curative work of chronic diseases.]

Clinical Oncology

[Current views on the male breast cancer]

BAKI Márta

[Breast cancer in men is a rare disease, and accounts for only 1% of all diagnosed breast cancers. Hungarian incidence by available data much higher. The greatest risk factor of male breast cancer the elevated estrogen concentration in the body. Genetic disorders, as a Klinefelter syndrome and estrogen exposures and other metabolic changes might cause the male breast cancer. Symptom duration is longer than female population and the male breast cancers diagnosed in older ages and advanced stages. Frequency of BRCA2 mutation is probably 10% among male patients. The most common type is invasive ductal carcinoma with estrogen and progesterone receptor positivity. Diagnostic, surgical, radiation procedures and chemotherapy probably same as female breast cancer. The guidelines recommend as in adjuvant and curative setting the tamoxifen and other selective estrogen receptor modulators treatment. By large nation based registry the survival rate is different from male and female breast cancers. New biomarkers, genetic changes are under investigation to understand munch better the male breast cancer.]

LAM Extra for General Practicioners

[Parkinson’s disease from the perspective of general practice]

KOVÁCS Norbert

[Due to the recent developments in medicine, Parkinson’s disease became a relatively well-treatable condition. Recently the working abilities and the health-related quality of life of our patients dramatically improved by the application of optimal pharmacological and functional neurosurgical treatment options. Despite of these good progresses, the curative treatment option is still warranted. The aim of this review article is to present those pharmacological, neurosurgical and other treatments, which can improve the condition and quality of life of the patients. We also discuss the major concerns important for general practitioners including the assessment of driving abilities.]

Lege Artis Medicinae

[MANAGEMENT OF CUTANEOUS MALIGNANT MELANOMAS]

OLÁH Judit

[Malignant melanoma, the disease originating from pigment cells of the skin, mucous membrane, eye and rarely from other tissues, shows increasing incidence in the Caucasian population. The Hungarian statistical data correspond with the data of other countries. In the early stages of malignant melanoma surgical removal of the tumor is often curative, but patients with disseminated tumors have a poor survival rate. Regrettably, in Hungary the majority of melanoma patients are diagnosed with advanced tumors, with nodal or systemic metastasis. Physicians working in other fields of medicine have a great responsibility in patient education and in early detection of susceptible pigmented lesions. Diagnosis and treatment of malignant melanoma requires an experienced dermatologist. The clinical diagnosis of melanoma is aided by several new techniques, like digital dermatoscopy. In recent years, surgical therapy of malignant melanoma has changed: today we routinely perform sentinel node biopsy. This type of surgical technique requires experience. In advanced disease the use of chemotherapy and immunotherapy requires onco-dermatological experience. Educating the public and physicians provides the basis for prevention. Survival rate is mainly dependent on the quality of primary care which determines survival rate, therefore it is essential that patients with melanomas are followed up in onco-dermatological centers.]

Lege Artis Medicinae

[The Curative Dream]

MAGYAR László András