Lege Artis Medicinae

[The magician's party spell]

PELLEI Ilona

APRIL 27, 1994

Lege Artis Medicinae - 1994;4(04)

[Ethical dilemmas around the use of IVF]

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Lege Artis Medicinae

[Laboratory control of the oral anticoagulant therapy]

VAJDA Zoltán, PÁL András, SIKOS Zita, SAS Géza

[There are two basic requirements in the treatment and prophylaxis of thromboembo lic diseases by chronic anticoagulation with coumarin (Syncumar). The first is the preven tion of a new thrombosis while the second is the avoidance of concomitant bleeding complications. For this reason it is necessary to achieve an appropriate anticoagulation level which can be characterised by labora tory measurement of the prothrombin level. In this paper, the theoretical and practical as pects of the laboratory control of Syncumar treatment are reviewed. The most serious problem is that the prothrombin level (Quick time) determinations utilising thromboplastin preparations from different sources give diffe rent values in the same patient plasma, which makes comparison of data from different laboratories impossible. The paper gives a brief overview of the definition and practical use of the International Sensitivity Index (ISI), characterising the different thromboplastin preparations, and the International Normali sed Ratio (INR) which can be calculated on the basis of the ISI. In spite of unquestionable improvements, the uncertainty about instrument-thromboplastin-ISI relationships reduces confidence in the INR system, especially when differences in INR values have clinical significance. Efforts need to be directed toward providing local, laboratory/instrument specific ISI values. ]

Lege Artis Medicinae

[The clinical significance of amaurosis fugax]

HORVÁTH Sándor, SOMLAI Judit

[The symptoms of amaurosis fugax (transient monocular loss of vision) indicate not only atherosclerotic disease of the ocular or extra cranial cerebral vessels, but also that of the systemic circulation. The prognostic significance of amaurosis fugax developing after the age of 50-55 years is similar to that of transient ischaemic attack of the brain: it could be a harbinger of atherosclerotic disease of the extra- and intracranial brain vessels as well as the coronary arteries. According to the mortality data, patients presenting with symptoms suggestive of amaurosis fugax will die due to heart disease, primarily myocardial infarct. Diagnostic evaluation should include not only ophthalmological, but also neurological and cardiovascular in vestigation to verify carotid and coronary atherosclerosis. Therapy of the whole disease and not just the symptoms will influence life expectancy in patients with amaurosis fugax. ]

Lege Artis Medicinae

[Methylprednisolone pulse therapy in systemic lupus erythematosus]

GERGELY Péter

[The aim of this retrospective study was to assess the efficacy and safety of methylprednisolone pulse therapy. Thirty five patients with severe systemic lupus erythematosus (lupus nephritis, severe hemolysis and antiphospholipid syndrome with central nervous system involvement, arterial occlusion and thombocytopenia) were treated by pulse methylprednisolone, followed by long-term corticosteroid (and cyclophosphamide) therapy. Thirty four patients achieved remission, after a mean of 4.7 weeks, which lasted on average for > 2.7 years. Six patients presented with an exacerbation after 1-2.5 years. Twenty eight patients are still in remission. No side effects were observed during pulse therapy. Methylprednisolone bolus therapy is safe and effective in severe systemic lupus erythematosus, including cases of lupus nephritis and severe central nervous system manifestations, but an appropriate choice of long-term therapy is essential.]

Lege Artis Medicinae

[The value of immunoscintigraphy in patients with metastatic malignant melanoma]

PAPÓS Miklós, LÁNG Jenő, CSERNAY László, SZEKERES Lenke, KUBA Attila

[Immunoscintigraphy with 99MTc-labeled F(ab'),fragments of monoclonal antibody (reactive with a high molecular associated antigen) was performed in patients with malignant melanoma. 24 investigations on 23 patients were carried out. A total of 40 lesions in 23 patients were detected by chest radiography, ultrasound, CT, bone scintigraphy or histology. 24 of the 40 lesions (60%) were visualized by immunoscintigraphy. Following correction of the physiological liver background by digital subtraction, 3 liver metastases were localized. These results indicate that immunoscintigraphy with radiolabeled F(ab')2 fragments can provide clinically useful information. ]

Lege Artis Medicinae

[Methodological letter from the Public Health and Epidemiology Technical College on vegetarian and similar diets in crèches and educational establishments]

[The nutritional status of vegetarians is strongly influenced by the type of diet they eat. While semi-vegetarian and lacto-ovo-vegetarian diets can meet the nutrient needs of young children, provided they are carefully and professionally planned, strict vegetarian or macrobiotic diets may not meet the needs for some nutrients and may be deficient in both children and adults. ]

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[I got a letter]

KINCSES Gyula, FRENKL Róbert

[I love LAM, no secret. I love it because it is beautiful, I love it because it is worthy of the noblest of crafts, I love it because it is high quality, and I love it because it is well edited. Well edited because it has managed to find the right balance between professionalism and professional politics, and well edited because professional politics has remained professional politics and has resisted all the temptations of direct politics. It is a great thing that politics has been able to stay outside at this time, and that in the party-related writing it has managed to establish a ratio that is accepted by all, or at least not criticised. (This is no small achievement in the state of the media in this country...)]

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[Party fights - party faces]

NAGY András László

[Who would have thought, even a year ago, that months before the elections, a forum with the above title, attended by leading health politicians from the parliamentary parties and a spokesperson for the Republic Party, which is also a prestigious medical doctor, would end in disinterest. However, not only this event, but also the presentations on the situation and prospects of health insurance and health businesses, and the main event, the exhibition of medical instruments interest. ]

Lege Artis Medicinae

[Fine Art Column]

KESERŰ Katalin

["Not forced"; in Ferenc Banga's drawings, this is what is striking. Indeed, the line chosen is also ambiguous. For example, the waggon winding into the crescent of the moon (Force of the Spirit) links the magician with cosmic forces (one can think of mythology: Samson's tresses or the fairytale devil).]

Lege Artis Medicinae

[Champagne Party with a Student, or the “Expressionism” of Stroke ]

GEREVICH József

Lege Artis Medicinae

[Faces from the Parliament's Social Affairs, Family and Health Committee]

ANDRÁS László

[Péter Bod, coordinator of the expert group on social security reform, which works alongside the Commission. The correspondent, who regularly attends the meetings of the Parliament's specialised committee, has noticed, and consequently the reader of his reports may also have noticed, the increasingly frequent and increasingly outspoken expert, Péter Bod. I was unable to find out who he was, initially among the doctors working in the LAM editorial office, and then more widely. It became clear that he is not a health worker or a party politician. Who is he, then, who, with his well-argued, effective arguments, is increasingly swaying the Members of Parliament who decide with their votes, in other words, he is increasingly influencing the social security laws that are being drafted. ]