Lege Artis Medicinae

[The human face of mathematics – Talks]

ROSIVALL László

FEBRUARY 20, 2021

Lege Artis Medicinae - 2021;31(1-2)

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Lege Artis Medicinae

[Vaccines against COVID-19 pandemic]

FALUS András, SZEKANECZ Zoltán

[The rapidly spreading SARS-CoV2 respiratory virus has evoked an epidemic with serious aftermath around the world. In addition to the health effects, the global economic damage is actually unpredictable. At the same time, the pandemic has launched a series of unprecedented collaborative scientific research, including the development of vaccines. This study summarizes up-to-date information on vaccines, immune memory, and some emerging clinical effects.]

Lege Artis Medicinae

[Diagnosis and treatment of microvascular coronary heart disease. Specialities of conditions in Hungary]

SZAUDER Ipoly

[Invasive investigations show that in two-thirds of patients the myocardial ischaemia persists without obstructive coronary disease and any other heart conditions (INOCA). The underlying cause may be microvascular dysfunction (CMD) with consecutive microvascular coronary disease (MVD) and microvascular or epicardial vasospastic angina (MVA). The modern practice of clinical cardiology while using the developed non-invasive cardiac imaging permits exact measuring of the coronary flow with its characteristic indices. All of these improve the diagnosing of CMD-induced myocardial ischemia and provide opportunity to determine primary MVD cases. Since the recognition and treatment of MVD is significantly underrep­resented in the Hungarian medical care, the primary stable microvascular angina (MVA) is described in detail below with its modern invasive and non-invasive differential diagnosis and treatment, concerning especially its frequency provoked by high blood pressure and female coronary heart diseases. There are highlighted all recommended diagnostic procedures available under domestic conditions.]

Lege Artis Medicinae

[Chronic obstructive pulmonary disease and recommendations for treatment]

LOSONCZY György

[Chronic obstructive pulmonary disease (COPD) is prognosticated to become the 3rd most prevalent cause of early lethality. It’s main etiology is long-term smoking which induces chronic inflammation and obstruction of the airways as well as elastolysis of the pulmonary interstitium which lead to emphysema. Increased resistance of the intrathoracic airways and emphysema induce hyperinflation of the lung and chest which increases the work-load of the respi­ratory muscles. COPD patients are typically hypoxaemic and normocapnic. Finally, fatigue of the respiratory muscles cause the development of global respiratory failure (hypercapnia and severe hypoxaemia). Most effective intervention is smoking cessation. Maintanance treatment includes inhalational long-acting bronchodilators with or without inhalational corticosteroids. Acute exacerbation is treated with O2 supplementation, inhalational bronchodilators, systemic steroids and/or antiobiotics. Frequency and severity of acute exacerbations prognosticate shorter survival. In chronic respiratory failure long-term home O2 therapy can be provided.]

Lege Artis Medicinae

[Interrelations of social phobia, trait anxiety, perfectionism and psychological protective factors in a young female population: Cluster analysis]

DOBOS Bianka, PIKÓ Bettina

[Deterioration of social functions and quality of life and lower level of satisfaction with life are often joining to axiety disorders. Considering the higher prevalence rates across anxiety disorders for women, the aim of this study was to examine the relationship of social phobia with trait anxiety, perfectionism, use of pharmaceuticals, self-efficacy and life satisfaction in a group of young female participants. Online, self-administered questionnaire was used as a method of data collection at different social network sites. The sample consisted of young women aged between 14–35 years (N = 435, M = 27.3 years; SD = 5.9). The questionnaire con­tained items of socio-demographic variables, use of pharmaceuticals as well as mental background variables (Social Pho­bia In­ventory, State-Trait Anxiety In­ven­tory, Mul­ti­dimensional Perfectionism Scale, Ge­neral Perceived Self-Efficacy Scale, Sa­tis­faction with Life Scale). Besides correlation analysis, cluster analysis was conducted. rait anxiety shows strong correlation with social phobia, perfectionism and use of pharmaceuticals. After examining all variables three clusters were emerging: 1) high level of trait anxiety with social phobia, moderate perfectionism, low levels of self-effcacy and satisfaction with life; 2) trait anxiety below the average without social phobia, high self-efficacy and satisfaction with life; 3) trait anxiety above the average with moderate phobia, high perfectionism with high self-efficacy and moderate life satisfaction. Results of our study show that social phobia strongly interrelates not only with trait anxiety as a stable part of personality but with self-estimated lower well-being and lack of mental protective factors. ]

Lege Artis Medicinae

[Ibuprofen administration in mild COVID-19 cases]

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[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]

Lege Artis Medicinae

[History of vaccine production in Hungary ]

ÓCSAI Lajos

[This study presents the complete history of the Hungarian vaccine production, partly in association with the process of fighting vaccine-preventable infectious diseases, and underlines the fact that every government actively contributed to the age-adjusted mandatory vaccination schedule of the past 140 years. It demonstrates the various achievements from the smallpox lymph production through the launch of diphtheria serum production at Phylaxia and the establishment of the National Public Health Institute (OKI) with its vaccine production and the later institutional transformation of OKI into Humán as economic corporation to its closure. Among all OKI’s vaccine production activities, this study focuses on the production of influenza vaccines, due to its international importance in the 1960s and 1970s. The vaccine production against diphtheria tetanus and pertussis stands out from Humán’s activities, and the tetanus component of this vaccine is still used in the products of a multinational vaccine manufacturer. ]

Clinical Neuroscience

Neuroscience highlights: The mirror inside our brain

KRABÓTH Zoltán, KÁLMÁN Bernadette

Over the second half of the 19th century, numerous theories arose concerning mechanisms involved in understanding of action, imitative learning, language development and theory of mind. These explorations gained new momentum with the discovery of the so called “mirror neurons”. Rizzolatti’s work inspired large groups of scientists seeking explanation in a new and hitherto unexplored area of how we perceive and understand the actions and intentions of others, how we learn through imitation to help our own survival, and what mechanisms have helped us to develop a unique human trait, language. Numerous studies have addressed these questions over the years, gathering information about mirror neurons themselves, their subtypes, the different brain areas involved in the mirror neuron system, their role in the above mentioned mechanisms, and the varying consequences of their dysfunction in human life. In this short review, we summarize the most important theories and discoveries that argue for the existence of the mirror neuron system, and its essential function in normal human life or some pathological conditions.

LAM KID

[Quality of life of patients with osteoporosis in Hungary]

VOKÓ Zoltán, INOTAI András, HORVÁTH CSABA, BORS Katalin, SPEER Gábor, KALÓ Zoltán

[AIM - The aim of our study was to estimate the loss of quality of life due to osteoporotic fractures. We performed a cross-sectional study including 840 patients in 21 centers that specialise in the care of patients with osteoporosis and in acute care of fractures. METHODS - Patients were selected randomly and stratified for the location of and time elapsed since the fracture. Quality of life (QoL) was assessed by the Qualeffo-41 and the EuroQol-5D questionnaires. RESULTS - Patients with morphometric fractures of more than one vertebra had the lowest median EQ-5D index value (0.59). Symptomatic vertebral, hip and arm fractures also considerably decreased QoL. Patients with morphometric fractures of more than one vertebra had the lowest total Qualeffo-41 score. When controlled for age and gender, patients with hip fracture or morphometric vertebral fracture had at least 0.2 less mean utility values than had osteoporotic patients without history of fracture. Patients with more than a oneyear history of hip fracture had QoL scores as low as had patients with an acute fracture. In case of wrist and arm fractures, the acute loss of QoL somewhat decreased with time. CONCLUSION - In conclusion, osteoporotic fractures, especially hip and vertebral fractures result in a significant loss of patients’ quality of life. Our results show that physicians need to pay a close attention to morphometric vertebral fractures, which contribute to a great loss of human capital.]

Clinical Neuroscience

[Symptomatic trigeminal autonomic cephalalgia without headache]

RÓZSA Anikó, KOVÁCS Krisztina, GUBA Katalin, GÁCS Gyula

[We report the case of a 60-year-old man who exhibited trigeminal autonomic symptoms on his right side (numbness of the face, reddening of the eye, nasal congestion) occurring several times a day, for a maximum of 60 se­conds, without any pain. The complaints were similar to trigeminal autonomic cephalalgia, just without any headache. Our 60-year-old male patient underwent a craniocervical MRI as part of his neurological workup, which revealed lesions indicative of demyelination. Further testing was guided (ophthalmological examination, VEP, CSF test) by the presumptive diagnosis of multiple sclerosis. It is likely that in his case the cause of these trigeminal and autonomic paroxysms is MS. Here we present an overview of the few cases we found in the literature, although we did not find any similar case reports. Perhaps the most interesting among these is one in which the author describes a family: a 54-year-old female exhibiting the autonomic characteristics of an episodic cluster headache, only without actual headache, her son, who had typical episodic cluster headaches with autonomic symptoms, and the woman’s father, whose short-term periorbital headaches were present without autonomic symptoms. We had not previously encountered a case of trigeminal autonomic cephalalgia without headache in our practice, nor have we had an MS patient exhibiting similar neurologic symptoms. The significance of our case lies in its uniqueness. ]