Lege Artis Medicinae

[The healer-doer sunglasses]

GYŐRY Hedvig

MAY 25, 1994

Lege Artis Medicinae - 1994;4(05)

[A long time ago, when gods still lived in the land of Egypt under the rule of the sun god Ra, his lovely daughter, the light of the sun's eye called Tefnut, moved to the land of Bugem in northern Nubia, where she lived her life in the form of a wild cat. But his father longed for him and entrusted Thoth, the god of wisdom, with the task of bringing him back to him.]

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Lege Artis Medicinae

[Tuberculosis an immunological perspective]

GERGELY Péter

[Tuberculosis is one of the most frequent infections in the world, with at least one third of the world's population carrying the pathogen. The number of active tuberculosis cases is increasing in the industrialized nations. The human immune system is unable to clear M. tuberculosis completely. The immune response in tuberculosis may be summarized as follows: M. tuberculosis is an intracellular pathogen living in the macrophages and evading the cell's effective antibacterial mechanisms. The defense against tuberculosis is a local event, resulting in a labile balance between host and parasite. Bacteria can survive in the tuberculotic granuloma and are prepared at any time to spread the organism in case of defective cell-mediated immunity. Activated macrophages play a pivotal role in the defence against Mycobacteria. The appropriate activation and cooperation of T cells is mandatory to mount a protective immune response. BCG vaccination is inefficient in protecting against adult tuberculosis but does protect newborns from disseminated tuberculosis. New vaccines or vaccination procedures are needed to develop a protective immunity against tuberculosis. ]

Lege Artis Medicinae

[Immunotherapy for tuberculosis clinical aspects of immunological research]

VADÁSZ Imre

[Efforts toward developing an immunotherapy for tuberculosis are based upon the knowledge of delayed hypersensitivity and cellular immunity. The aim of immunotherapy is to strengthen the cellular immunity, enabling the immune system to destroy those persistent bacteria which remain alive following chemotherapy. Chemotherapy combined with an appropriate dose (10%) of dead M. vaccae significantly improved the therapeutic results of tuberculosis patients and reduced their mortality in double blind controlled studies. A beneficial effect was also observed in the treatment of chronic, multidrug resistent cases and in HIV positive tuberculosis patients. The duration of chemotherapy can be considerably shortened when concurrent immuno therapy is utilized.]

Lege Artis Medicinae

[Color and pulsed doppler velocimetry of the uterine artery in the second part of the normal pregnancy]

SZABÓ István, PAULIN Ferenc, RINGÓ János Jun, NÉMETH Lajos, CSABAY László, PAPP Zoltán

[Color Doppler imaging allows accurate identification of the main uterine arteries, which reflect the sum of the resistance of the placental bed and are therefore more likely to provide an overall picture of placental perfusion. In a cross-sectional study of 231 healthy women with singleton pregnancies at 19–40 week's gestation, color Doppler imaging was used to identify the main uterine arteries for subsequent pulsed Doppler studies. Flow velocity waveforms were obtained and indices of impedance, peak systolic blood velocity and mean blood velocity were measured. Impedance to flow decreased, whereas blood velocity increased significantly with gestation. Furthermore, impedance to flow was lower and velocity higher in the placental uterine artery (closest to the main bulk of the placenta) than in the non-placental artery. The changes in the uterine blood flow during normal pregnancy provide indirect evidence for the increase of the maternal blood supply necessary for normal intrauterine development. Definition of the reference ranges of parameters used to characterize blood flow velocity wave forms has an importance in the investigation of complicated pregnancies. ]

Lege Artis Medicinae

[Correspondence]

FENYVESI Tamás

[On outpatient care from the perspective of the hospital outpatient clinic; The doctor's medicine; Renew or reassess; ]

Lege Artis Medicinae

[Epidemological findings of inflammatory bowel diseases in borsod county 1963-1992]

NAGY György, ÚJSZÁSZI László, JUHÁSZ László, MINIK Károly

[The epidemiologic data of inflammatory bowel diseases and the clinical aspects of ulcerative colitis and Crohn's disease were evaluated among the 800 000 inhabitants of Borsod County during three decades. Inflammatory bowel disease cases were continuously gathered from all the hospitals in the county. Patients were examined by standard diagnostic criteria. Consultative endoscopic advice, follow-up, and drugs prescription were provided on the wards. Patients' data were systematically registered and summarized. The following data were recorded: the patients' age, sex, ethnic group, urbanization; family prevalence, anatomical extension, type of course, severity of disease, and the occurance of malignant transformation. The authors registered 913 patients with inflammatory bowel disease, in the 10 hospitals of Borsod County between 1963 and 1992. 488 cases of ulcerative colitis were detected during the first twenty years, which is an incidence rate of 3.1/ 100,000 per year. The incidence during the third decade was 3.6/100,000 per year. 69 patients with Crohn's disease were examined during the first 20 years, and 78 in the third decade. The incidence of ileocolonal Crohn's disease increased from 0.43 to 1.00/100,000 per year. The authors didn't find a significant change in anatomical extension, severity or the clinical course of ulcerative colitis during the three decades. The increase of Crohn's diseases, and especially of isolated colonic types, may reflect improved diagnostic techniques. The incidence of inflammatory bowel disease increased among gypsies, but the incidence in that population was still only half of what was expected in the region. The authors found familial inflammatory bowel disease occurrence in 15 patients. Eight carcinomas were observed in the 766 ulcerative colitis patients, and 2 in the 147 Crohn's disease patients. ]

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[Who are the happy female physicians in Hungary?]

GYŐRFFY Zsuzsa

[BACKGROUND - The female Physicians’ well-being and happiness has become the latest researching field of the “Physicians studies”. In Hungary the researches haven't focused on this subject. Our aim was to examine the subjective well-being of the Hungarian female Physicians. METHODS - Representative, cross-sectional, quantitative survey on a representative sample of female Physicians (N=408). Modified version of WHO Well- Being Index was performed to measure of subjective Well-Being. RESULTS - We have found that the key to the Hungarian female Physicians’ wellbeing is the “time”. Significantly higher rate of well-being is associated with reduced work-hours (8 hour or less, p=0.000), and duty hours (p=0.042), having one hour free time daily (p=0.021) and they satisfied with the time of doctor-patient interaction (p=0.021). The higher rate of Well-Being scores haven't associated with age, marital status, number of children and the speciality. CONCLUSION - Similarly to the national trends, the Hungarian female Physicians' well-being is depending on the work and the satisfaction with work. The satisfied healer is the key of the health system therefore the future studies and the prevention and intervention have to focus on the Physicians’ well-being.]