Lege Artis Medicinae

[The Family Tree of Franz Liszt ]

CZEIZEL Endre

NOVEMBER 20, 2011

Lege Artis Medicinae - 2011;21(11)

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Lege Artis Medicinae

[Account on the Symposium of Coenzyme Q10 Association - Balatonfüred, 1st October 2011]

LIPTÁK Judit

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[About the mortality rates of ischaemic heart disease]

MERKELY Béla, BECKER Dávid

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[50 years of tolperisone in clinical practice]

BÁLINT Géza

[Tolperisone is a centrally acting muscle relaxant that has both antispasticity and antispasmodic properties, but lacks the sedative effect of other muscle relaxants. In the past 50 years, millions of patients with spasticity due to neurological diseases and painful reflex muscle spasm have been treated with this drug. Although few welldesigned, double blind, controlled clinical trials have been published, the efficacy of tolperisone in the treatment of both spasticity and painful reflex muscle spasm is convincing. The tolerability and safety of the drug are well documented. In this respect, one of its greatest advantages is that it has no sedative effect, does not lengthen reaction time, and does not interfere with driving. Further, well-designed controlled trials are clearly required for widening the use of this excellent drug.]

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[Reality and Mystery – The Art of El Greco]

NAGY Zsuzsanna

Lege Artis Medicinae

[The role of metformin in the glucose-lowering therapy of patients with type 2 diabetes]

JERMENDY György

[Metformin is the oral antidiabetic drug of choice for patients with type 2 diabetes. Its effect is predominantly based on the reduction of insulin resistance by inhibiting hepatic glucose production. Metformin can be used as an initial oral antidiabetic drug at the start of, or in case of the failure of lifestyle modifications. Metformin is also used in dual or triple oral antidiabetic combinations, however, its use should not be suspended even if initiation of insulin therapy is indicated in patients with type 2 diabetes. Metformin does not increase bodyweight and the risk of hypoglycaemia, and recent data suggest that it decreases the risk of tumour development. Today, an extended- release (XR) formulation is also available besides the traditional one, which not only simplifies the treatment, but might also reduce the incidence of gastrointestinal adverse effects.]

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[Family planning in multiple sclerosis: conception, pregnancy, breastfeeding]

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[Family planning is an exceptionally important question in multiple sclerosis, as women of childbearing age are the ones most often affected. Although it is proven that pregnancy does not worsen the long-term prognosis of relapsing-remitting multiple sclerosis, many patients are still doubtful about having children. This question is further complicated by the fact that patients – and often even doctors – are not sufficiently informed about how the ever-increasing number of available disease-modifying treatments affect pregnancies. Breastfeeding is an even less clear topic. Patients usually look to their neurologists first for answers concerning these matters. It falls to the neurologist to rationally evaluate the risks and benefits of contraception, pregnancy, assisted reproduction, childbirth, breastfeeding and disease modifying treatments, to inform patients about these, and then together come to a decision about the best possible therapeutic approach, taking the patients’ individual family plans into consideration. Here we present a review of relevant literature adhering to international guidelines on the topics of conception, pregnancy and breastfeeding, with a special focus on the applicability of approved disease modifying treatments during pregnancy and breastfeeding. The goal of this article is to provide clinicians involved in the care of MS patients with up-to-date information that they can utilize in their day-to-day clinical practice. ]

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[The Prastige and Values of Nurses and Caregivers employed in the Social Service System]

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[Aim of the study: During the study my target was to identify the career motivations, prestige of caretakers and nurses working in the Gödöllő social services and get acquainted with the most important values in their life. Sample and methods: Descriptive type research, number of elements are 81 (n=81). Summarization of the data was executed by Microsoft Office Excel 2007. Results: The employees took part in the research considered their profession as relatively low prestigious, although they would choose again this profession if they could decide again. Supporting professionals consider health, family, friendship and affection as the most important value in their life. Conclusions: The nursesand caretakers interviewed by me consider their choice of career successful in spite of its low prestige and they like their profession. Recognition the values of the employees is an important objective, because the identified values determine the quality of the work they perform.]

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[Family medicine as a career. Medical students’ attitudes and vocational choice motivations]

MOHOS András, VARGA Albert, MARKÓ-KUCSERA Mária, KALABAY László, TORZSA Péter

[INTRODUCTION - The large number of vacant general practices is a burning issue in Hungary. The entering of new colleagues into the general practitioner speciality training does not pose a real solution to the human resources crisis in this field. Our aim is to assess medical students’ attitudes and knowledge about general practice. SAMPLE AND METHOD - Cross-sectional survey with self-completed questionnaires at the University of Szeged, with the participation of 94 fourth and fifth year medical students in 2016 and 78 first and fourth year medical students in 2017. RESULTS - In 2016 1% of students planned for sure, and 16% planned probably to work as a general practitioner in the future. In 2017 3.9% of first-year students planned definitely to be a general practitioner, and 15.4% planned that probably. Among fourth-year students 0% of students planned for sure, and 19.2% planned probably to work as a general practitioner in the future. Whatever the presence of family medicine in undergraduate training influenced the medical students’ opinion about the profession positively (0.4-1.3 on a scale based on the direction and strength of the effects of certain factors ranging from -5 to +5). Those who were interested in family medicine considered the situation of healthcare significantly worse (p=0.027), than those who were not interested. To make the profession more attractive the following factors may play the most important role: the more intense presentation (I: 37%) of general practice in undergraduate training, improving the prestige of family medicine (IV: 31%), high-quality work (IV: 39%). CONCLUSIONS - Few medical students plan to work as general practitioner in the future. The most effective way to raise interest in family medicine is to increase the students’ knowledge and awareness of this specialisation, and the more intensive presentation of family medicine in undergraduate training is a key issue.]

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[Obstructive sleep apnea syndrome: how we screen and diagnose?]

ANNUS János, CSATLÓS Dalma, SZAKÁCS ZOLTÁN

[The obstructive sleep apnea syndrome (OSAS) is known to cause obstructive apneas and hypopneas mostly with desaturations and/or arousals caused by repetitive collapse of the upper airway system during sleep. The disorder negatively affects sleep efficacy and daytime neurocognitive functions as well as increases cardiovascular risks. The typical clinical presentation is excessive daytime sleepiness and loud snoring interrupted by brief pauses of breathing. Its prevalence is 2-4% in the general population. It may be a causative factor in some disorders such as therapy resistant hypertension, nocturnal cardiac arrhythmias, stroke, cognitive decline or depression. Significance of the disorder is highlighted by the fact that its risk must be evaluated by the family doctors during the examination of medical suitability for driving licence in Hungary. ]

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[CARDIOMETABOLIC EFFECTS OF THE ANGIOTENSIN RECEPTOR BLOCKER TELMISARTAN]

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[Telmisartan, an angiotensin receptor blocker, is a potent antihypertensive drug. Similarly to other members of the drug family, it has cardio-, vasoand renoprotective properties; in addition, uniquely in the group, it stimulates the peroxisome proliferator activated receptor (PPAR) -γ. This partial agonist activity results in favourable effects mainly in carbohydrate metabolism and, to a lesser extent, in lipid metabolism. Based on this pharmacological profile, telmisartan seems to be especially useful in the treatment of hypertension associated with metabolic syndrome or type 2 diabetes.]