Lege Artis Medicinae

[THE RELATIONSHIP BETWEEN THE DEPRESSIVE MOOD OF PARENTS AND THE BEHAVIOURAL PROBLEMS OF THE CHILD]

HAJNAL Ágnes, SUSÁNSZKY Éva, SZÁNTÓ Zsuzsa, CSOBOTH Csilla

DECEMBER 20, 2004

Lege Artis Medicinae - 2004;14(12)

[INTRODUCTION - In this article we analyze the relationships between behavior problems of adolescents and depressed mood of their parents based on literature review and on our own questionnaire surveys. METHODS - We present the data from two surveys conducted among Hungarian adolescents. The first survey was conducted among 1604 young women students, aged of 15-19 years. The second survey included 502 high school students in Budapest. Both surveys were aimed at the lifestyle, health behavior, risk behavior, and emotional state, as well as the social-economic status and family background of the adolescents. Data of both surveys were analyzed using the SPSS 8.0 statistical program package. The association between the mood category of mothers and fathers and the risk factors and emotional state indicators of their children were tested with χ2 tests, as well as the indicators of students whose parents were not treated for depression. RESULTS - Data from both surveys suggest that there are close relationships between the negative mood states of the parents and the behavior problems of their children, especially between the mood of mothers and the behavioral and emotional state of daughters. CONCLUSIONS - Our research data call attention to the phenomenon that girls react explicitly and quite sensitively to the mood state of their mothers while the boys’ behavioral and emotional states are less responsive to their parents’ mood. On the other hand, boys react more intensively to the emotional instability of their fathers than to the instability of their mothers.]

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Lege Artis Medicinae

[LETHAL SEPTIC INFECTION IN RHEUMATOID ARTHRITIS]

BÉLY Miklós, APÁTHY Ágnes

[INTRODUCTION - The lethal septic infection was studied in a randomized (non-selected) autopsy population of 234 in-patients with rheumatoid arthritis. The patients died at the National Institute of Rheumatology between 1970 and 1999. PATIENTS AND METHOD - The aims of this study were to determine the prevalence of lethal septic infection with or without purulent arthritis in rheumatoid arthritis; the relationship between purulent arthritis and lethal septic infection; the clinically missed diagnosis of lethal septic infection and purulent arthritis; the influence of the main complications and associated diseases on lethal septic infection with and without purulent arthritis; the pathogens in lethal septic infection; and the clinico-laboratory parameters associated with lethal septic infection in rheumatoid arthritis. RESULTS - Lethal septic infection was found in 31 (13.24%) of 234 rheumatoid arthritis patients. Purulent arthritis complicated lethal septic infection in 15 (6.4%) of 31 patients. There was a significant association between lethal septic infection and purulent arthritis. Sepsis was detected clinically in 17 of 31 lethal cases and purulent arthritis was detected 9 of 15 septic infection complicated with suppurative articular processes. The coexistent complications (systemic vasculitis, AA amyloidosis), and associated diseases (tuberculosis with or without miliary dissemination, malignant tumors, diabetes mellitus) did not influence the prevalence of septic infection. The most frequent pathogenic agents were: Staphylococcus aureus, Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, Klebsiella species, Streptococcus species. The patients with septic infection had significantly lower levels of beta-globulin, and higher values of Waaler-Rose or latex fixation test in comparison to patients without septic infection or without complications. CONCLUSION - Lethal septic infection may exist in rheumatoid arthritis without the classical clinical symptoms of sepsis, and clinically latent suppurative processes may be found at autopsy. The missed clinical diagnosis of a fatal complication is explained by the weak immune response and atypical clinical symptoms of elderly patients mainly treated with steroids and immunosuppressive drugs.]

Lege Artis Medicinae

[A new medical field is born - The first world congress of immuno-genomics, Budapest]

PÓS Zoltán, WIENER Zoltán

Lege Artis Medicinae

[THE PRACTICE AND PROBLEMS OF EVIDENCED BASED DRUG TREATMENT]

KERPEL-FRONIUS Sándor

[The organization, the budget and the practical delivery of modern healthcare are all based upon the sum of available evidences. However, in the individualized drug therapeutic decisions beside the external evidences the personal experience of the treating physician as well as the preferences and expectations of the patients must be represented with equal emphasis. Without the interaction of these three modern, patient oriented medicine is not conceivable. Evidenced based drug application is primarily based upon the results of prospective, randomized, controlled clinical trials. The individual experiences and the systematic observations represent the lowest level of the evidence hierarchy. The results of the clinical studies are expressed as the absolute difference of the results of the treated and control groups and as relative values relating the outcome of the experimental group to the control, respectively. In practice the easily interpretable term "number needed to treat" is widely used. It shows how many patients have to be treated relative to the control group in order to observe the expected therapeutic outcome in one case. The wealth of evidences cannot be efficiently used without systematization in the daily practice. Therefore, the data collected from the independent publications containing the primary evidences are subjected to a joint statistical evaluation. Thereafter, the results are combined in systematic reviews by independent experts following thorough weighting without prejudice. Then short summaries, more easily and rapidly digested by practicing physicians are made according to the same principle. They are restricted to the presentation of the problem, the tabulation of the summarized data and the conclusion. It is expected that in the future systems combining the electronically stored patient's data with external evidences making possible the patient oriented presentation of the sum and hierarchy of evidences will be extensively used.]

Lege Artis Medicinae

[BOUVERET’S SYNDROME]

KESZTHELYI László, FÓGEL Kristóf, VADINSZKY Péter, SÁVOLT Ákos, PŐCZE Balázs, BALOGH István

[INTRODUCTION - Gallstone ileus is a rare disorder among elderly population. The gallstone coming through a bilioenteral fistula into the gastrointestinal tract is stuck into the duodenal lumen causing ileus in approximately 0,5% of all cases. The syndrome is named after Bouveret, the first describer. CASE REPORT - Author present the case of 72 year old female patient with known cholelithiasis. Investigations proved existing cholelithiasis causing the patient abdominal pain one year before admission but she gave no consent to surgical intervention. An emergency admission to our department occurred after four days of abdominal pain and vomiting. The clinical status of the patient and abdominal X-ray examination suggested stomach evacuation disturbance. Double contrast barium swallow test and gastroscopy proved bowel obstruction caused by a gallstone. During surgery gastrotomy and the removal of gallstone was carried out. There were no postoperative complications and the patient was discharged home. CONCLUSION - Cholelithiasis should be resolved at any chosen time well before complications may occur. The simultaneous appearance of stomach evacuation problems and cholelithiasis should draw attention to this rare disease.]

Lege Artis Medicinae

[SEPSIS AS A NEW DISEASE - PROBLEMS IN HUNGARY]

LUDWIG Endre

[In our current understanding sepsis is a systemic inflammatory response syndrome to infections mediated by cytokines, an uncontrolled progression which may result in multiorgan failure and in the final stage septic shock. There are no pathognomic clinical signs or laboratory parameters in the early stage of sepsis and the diagnosis can be easily missed if the possibility is overlooked. One of the crucial points of therapy is early diagnosis: the mortality rate of severe sepsis is about 20% and that of septic shock is about 40-50%. The cornerstones of the therapy are the eradication of the focus of sepsis (surgical intervention and antimicrobial treatment), standard intensive care and the intervention in the pathophysiological process of sepsis. For successful treatment a multidisciplinary approach is required: only the early diagnosis and the teamwork of different specialists can decrease the mortality rate that is higher in Hungary than the international average.]

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Lege Artis Medicinae

[The significance of media literacy in adolescent smoking and drinking]

PIKÓ Bettina, BALÁZS Máté Ádám, PAGE M. Randy

[INTRODUCTION - Media exerts a strong socialization effect on adolescents who are particularly susceptible to different messages in this life period. In the present study, therefore, we focused on adolescents’ media literacy. METHODS - 546 adolescents from Makó (Southern Hungary) were studied, including 288 (52.7%) grade 8 (age 13-15 years) and 258 (47.3%) grade 12 (age 17-19 years) students; 49.5% of the participants were male and 50.5% female. The survey covered sociodemographic variables, lifetime and monthly prevalence of smoking and drinking, attitudes related to substance use and media literacy. For the study of media literacy, we adapted a Medica Literacy Scale containing 31 items. After performing factor analysis, factors of media literacy were analyzed by two-sample t-tests according to sociodemographic variables and behaviour. RESULTS - Our results show that factors of media literacy are well differentiated according to sociodemographic variables and even more according to smoking and drinking behaviour. Girls and younger adolescents (among who substance use is less frequent) are more likely to notice the hidden messages of substance use that are shown in advertisements and movies, and the representation of the interests of the tobacco and alcohol industry in the media. Nonsmokers and nondrinkers are a lot more aware of the manipulation effects of the media. CONCLUSIONS - Our results draw attention to the significance of media literacy in the prevention of adolescent smoking and drinking.]

LAM KID

[Experiences from the dissection room. Quantitative and qualitative study among Hungarian medical students]

IMOLA Sándor, CSALA Irén, BIRKÁS Emma, GYŐRFFY Zsuzsa

[BACKGROUND - The anatomy and pathology are the most outstanding field of the medical curriculum. These subjects mean the first practical experiences of dissection. The international literatures results shows that experience of dissection are important stages of becoming physician, but not always problemless. METHODS - Quantative (n=733) and qualitative (n=45) exploratory research among Hungarian medical students. We tried to present the effects and experiences of dissection pratcise using both analytical methods. Validity of the research was greatly improved by using the two methods. RESULTS - 50% of medical students reported that they were affected by dissection practice. The female students and those in clinical training (III-VI.years) reported about negative effects significantly more frequently. The results of the qualitative survey verified that dissection practices have decisive effect during the training and coping with experiences was often difficult especially for females students. CONCLUSIONS - Our research confirmed the hypothesis of dissection experiences play outstanding role in becoming physician. The successful coping isn’t the repression or ignorance of emotion, but understanding and finding effective solutions strategies for the negative emotions of experiences. Managing these experiences are a crucial factor of latter wellbeing of physicians and decisive factor of doctors-patient relationship.]

Lege Artis Medicinae

[Relationship of adolescents’ eating behavior and motivations with self-control and risk perception]

SZABÓ Katalin, PIKÓ Bettina

[Obesity and related diseases caused by unhealthy eating form a serious public health problem already in youth. In terms of prevention, it is essential to explore adolescents’ eating behaviors and factors influencing their diet. Our study aimed to explore adolescents’ eating behaviors, its motivations and their relation to self-control and risk perception related to eating behavior. Participants were 374 high school students (48% males; mean age: 16 years, S.D.=1.5) from Szeged and Bu­da­pest. Self-administered questionnaire was used for data collection which assessed socio-demographics, eating behaviors, mo­ti­vation, eating behavior related risk perception and self-control. Using factor analysis, we categorized eating behaviors (“junk food/drink consumption”; “health-oriented nutrition”; and “snacking and habit-oriented nutrition”), and eating motivations (“social, emotional and external motives”; “traditions and internal motives”; and “health motives”). According to correlation analysis, self-control was positively related to health-oriented nutrition and health motives and negatively to junk food/drink consumption and social, emotional and external motives. These two latter factors were associated with an increased risk perception as well. Our results draw the attention to strengthen self-control and explore the role of risk perception and eating motivations in school health education programs. ]

Lege Artis Medicinae

[Experiences from the dissection room. Quantitative and qualitative study among Hungarian medical students]

IMOLA Sándor, CSALA Irén, BIRKÁS Emma, GYŐRFFY Zsuzsa

[BACKGROUND - The anatomy and pathology are the most outstanding field of the medical curriculum. These subjects mean the first practical experiences of dissection. The international literatures results shows that experience of dissection are important stages of becoming physician, but not always problemless. METHODS - Quantative (n=733) and qualitative (n=45) exploratory research among Hungarian medical students. We tried to present the effects and experiences of dissection pratcise using both analytical methods. Validity of the research was greatly improved by using the two methods. RESULTS - 50% of medical students reported that they were affected by dissection practice. The female students and those in clinical training (III-VI.years) reported about negative effects significantly more frequently. The results of the qualitative survey verified that dissection practices have decisive effect during the training and coping with experiences was often difficult especially for females students. CONCLUSIONS - Our research confirmed the hypothesis of dissection experiences play outstanding role in becoming physician. The successful coping isn’t the repression or ignorance of emotion, but understanding and finding effective solutions strategies for the negative emotions of experiences. Managing these experiences are a crucial factor of latter wellbeing of physicians and decisive factor of doctors-patient relationship.]

Lege Artis Medicinae

[What makes youth happy today? Relationships between religion, spirituality and mental well-being among high school students]

PIKÓ Bettina, KOVÁCS Eszter, KRISTON Pálma

[INTRODUCTION - Studies suggest that traditional religiosity is more and more neglected among adolescents, however, not implying to the lack of religiousness or spirituality. Religion/spirituality is still a significant protective factor. Therefore, the main goal of the present paper was to analyze indicators of mental well-being in a sample of high school students in light of religious/spiritual variables. METHODS - The data collection of the questionnaire survey (2010) was going on among 656 high school students in Sze­- ged (age range between 14-21 years, mean=16.5 years, S.D.=1.5 years of age, 49.1% of the sample was female). Depressive symptomatology, satisfaction with life and optimism were dependent variables and indicators of spirituality/religiosity were the independent ones. Beyond descriptive statistics, correlation and multiple regression analyses (stepwise method) were applied in the calculations. RESULTS - Our results show that for today’s youth happiness is primarily associated with their existential well-being: those who see a meaning in life, who have goals in life and believe that they are able to see through and understand life events, tend to be more satisfied with life, more optimistic and less depressed. Besides, spiritual belief may also contribute to life satisfaction whereas importance of religiosity may be a protective factor in the case of depression. CONCLUSIONS - Based on these results we may conclude that existential well-being (that is, finding a meaning in life) is a prominent spiritual variable. Data also suggest, however, that youth’s mental well-being only partially comes from religiosity, mostly it stems from other resources. More research is needed to detect this. All in all, as it appears that youth do need a belief in a meaning in life, similar to other age groups.]