Lege Artis Medicinae

[The social security concept of the KDNP]

OCTOBER 30, 1991

Lege Artis Medicinae - 1991;1(16)

[It is in the fundamental interest of society that its members feel safe. The main task of social security is precisely to compensate for a certain proportion of the risks to which members of society are exposed, in line with changes in living standards, in order to create (maintain) social security, and to offset, absorb and absorb adverse social, economic and political effects. ]

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[The questions of cardiac rehabilitation are reviewed evaluating own personal experiences and pertaining current literature. The authors touch upon the question of early mobilization, as well as supervised and non supervised exercise. The criteria for the implementation of coronary angiography and acute revascularization procedures in the early phase of myocardial infarction are established. They review the secondary prevention of myocardial infarction and the effects of rehabilitation training on the patients prognosis.]

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[The development of the definition of brain death which is fundamental in cadaver organ removal for transplantation purposes is reviewed. Brain stem death, an alternative term for brain death is based primarily on clinical findings namely the irreversible cessation of cephalic reflexes and spontaneous breathing. Hypothermia, metabolic and endocrine abnormalities, prolonged muscle relaxant, sedative or hypnotic drug action should be excluded. The early recognition of potential donor and the maintenance of basic life function at the Intensive Care Unit and the operating theater are essential for the good function of the transplanted organs. Normal homeostasis should be maintained by ensuring adequate fluid intake, good circulation and urine output. Brain death potential donors can exhibit persistent spinal reflexes and spontaneous movement wich may be erroneously interpreted as signs of life. The problem of the determination of brain death under 4 year of age is also discussed although law does not allow to use them as potentional donors in Hungary. ]

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[The author summarizes his work as a general practicioner in a village of 2000 people. He aimed to construct racional conditions of health care using technical, educational and organizing tools. Patients are reported to be satisfied and positive tendencies appeared in medicamentum consumption, and the number of sick days decreared from 13 673 to 10 198 per year. Less consultations of specialists and ask for hospital admission war performed. Indispensability of computers in the management of general practice is stressed. ]

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[A beginner young general practicioner summarizes the experiences of his first year of work. Complex preparation for this work at the university, and the build up of the new practice of basic health service is described. Care of hypertension and diabetes is detailed, as an example how important and difficult is to reorganise this part of the work. The first year of experience gives a good possibility to look over the lack of undergraduate teaching This type of data collection and critical analysis seems to be necessary for a better planning of the forthcoming medical work. ]

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