Lege Artis Medicinae

[The vulnerable point]

KARDOS Piroska

APRIL 20, 2001

Lege Artis Medicinae - 2001;11(04)

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Lege Artis Medicinae

[Conclusions of a 1980 year long-term health care prognosis]

FORGÁCS Iván

Lege Artis Medicinae

[New oral antidiabetic agents - New aspects in the management of type 2 diabetes mellitus]

GERŐ László

[During the past years several new oral antidiabetic agents have become available and more new drugs of this type are expected to appear on the market. New products appeared in both groups of insulin sensitizers and insulin secretagogues. Modern insulin secretagogues are characterized by immediate and short action. As a consequence, insulin secretion will approach the physiological secretory pattern. The rapid, short-term insulin output prevents the abnormal increase of postprandial glucose level and - at the same time - the danger of late hypoglycemia will decrease. The combination of insulin sensitizers with the new insulin secretagogues provides the possibility to apply the basisbolus therapeutical principle to type 2 diabetic patients treated with oral agents.]

Lege Artis Medicinae

[Consensus or chaos?]

GRÉTSY Zsombor

Lege Artis Medicinae

[Postgraduate training for diabetologists - Report]

GYIMESI András

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[History of Doctors’ Circle]

KAPRONCZAY Károly

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Clinical Neuroscience

[The application of RBANS (Repeatable Battery for the Assessment of Neuropsychological Status) in neurocognitive testing of patients suffering from schizophrenia and dementia]

JUHÁSZ Levente Zsolt, KEMÉNY Katalin, LINKA Emese, SÁNTHA Judit, BARTKÓ György

[Introduction - The purpose of our study was to find out whether the Hungarian adaptation of the RBANS (Repeatable Battery for the Assessment of Neuropsychological Status), a brief neurocognitive screening test, is appropriate for the differentation of healthy and non-healthy subject groups, or for the detection of differences between the cognitive performance of patient groups. Patients and method - The test battery was administrated to 38 healthy subjects, 69 schizophrenic patients, and 18 patients suffering from dementia (10 probable Alzheimer-type and eight vascular dementia). Results - There was a significant decrease of performance in all patient groups compared to the healthy group. In the schizophrenic group, the test indicated a deterioration of functioning in all cognitive areas. The patient group with Alzheimer-type dementia performed only slightly better than the schizophrenic group, because the fall of performance was not significant only one of the cognitive areas (in the visuo-spatial tasks) when compared to the healthy group. There was no difference between the performance of patients with vascular dementia and that of healthy subjects in direct memory, verbal and visuo-spatial tasks. The test results indicated an even deterioration of cognitive areas in patients with Alzheimer-type dementia. As for the vascular dementia group, the most vulnerable area proved to be that of attention, while their verbal functions were relatively spared. The deterioration in other cognitive functions shown by schizophrenic subjects was more moderate, but still significant. A comparison of the RBANS scores of the schizophrenic patients in our study and the result of an American study was also carried out. The global indeces showed no difference; only the pattern of the sub-scales was a little different. Conclusion - The Hungarian version of the RBANS seems appropriate for the differentiation of healthy and deteriorated cognitive performance in a Hungarian patient population.]

Lege Artis Medicinae

[NON-INVASIVE CORONARY ANGIOGRAPHY BY MULTISLICE COMPUTED TOMOGRAPHY]

PRÉDA István, KERECSEN Gábor, MAUROVICH-HORVAT Pál

[This review summarizes the diagnostic spectrum, ways of application and methodological difficulties of multislice computed tomographic (MSCT) coronary angiography. The non-invasive assessment of cardiac and coronary anatomy is now possible with computed tomographic coronary angiography using the modern 16 to 64-slice technology. This technique finds its main use today in the screening of patients with moderate probability of having coronary artery disease (atypical chest pain). Its negative predictive value varies between 97% and 99%, thus, a negative result of this non-invasive outpatient procedure can reduce the possibility of coronary artery disease to the minimum. Other important diagnostic applications include the follow-up of patients with coronary artery bypass, accurate diagnosis of coronary artery anomalies, and the simultaneous examination of the heart and great vessels. The future development of the technique is directed to coronary plaque characterization, particularly the detection of vulnerable plaques. The radiation exposure is relatively low (7-13 mSv), comparable with that of invasive coronary angiography.]

Clinical Neuroscience

[Are oppressive dreams indicators in bereavement?]

PUREBL György, PILLING János, KONKOLY THEGE Barna, BÓDIZS Róbert, KOPP Mária

[Objectives - It is widely believed that oppressive dreams are frequent in bereavement - despite the lack of scientific investigations of the subject. The aims of our study were the analysis of dream quality as well as the correlates of oppressive dreams in bereavement. Method - Participants with (N=473) and without bereavement were compared upon the database of a national representative study (Hungarostudy Epidemiological Panel Survey 2006, N=4329). Dream contents were assessed with the Dream Quality Questionnaire (DQQ). Depressive symptoms (BDI-S) and the presence anxiety were also investigated. Results - Oppressive dreams occurred significantly higher frequency in the first year of bereavement (men: F=17.525, p<0.001, women: F=8.291, p=0.004). Oppressive dreams were significantly associated with anxiety (F=37.089, p<0.001) and with depressive symptoms (F=50.562, p<0.001). Discussion - Oppressive dreams are significantly more frequent in the first year of bereavement, and may act as indicators of bereavement-linked mental health consequences like depression and anxiety. These are often masked by the symptoms of grief and therefore remain untreated. Our preliminary results could be a starting point for the development of further research aiming to clarify the relationship amongst dream contents, anxiety, and depression in bereavement.]

Lege Artis Medicinae

[How do physicians sleep and dream?]

SUSÁNSZKY Éva, SZÁNTÓ Zsuzsa

[INTRODUCTION - Satisfying sleep is especially important for physicians. Our study analyses physicians’ sleep and dream from the point of view of continuous nightand- day duty. SAMPLE AND METHOD - Questionnaires were completed by 125 physicians among whom the proportion of night shift taking and only day-time working persons was equal. The questionnaire contained the Athens Insomnia Scale and the Dream Quality Questionnaire as well as questions about demographical characteristics and work circumstances. RESULTS - Almost each doctor mentioned sleep problems, principally daytime sleepiness (78%) and sleep deprivation (70%). Long sleep latency is reported more often by women doctors; the frequency of night awakenings increases, while daytime sleepiness decreases by age. The feeling of performance-loss is more prevalent among night shift takers. Dream characteristics differ significantly neither along demographical characteristics nor by work shifts. CONCLUSION - Although sleep problems are more frequent among physicians when comparing to the Hungarian general population, the frequency of clinical level insomnia is not higher. On the other hand, physicians can recall their dreams more often (25% vs 7%) and the emotional load of their dreams influence their daytime mood more commonly.]

Lege Artis Medicinae

[CYCLIC RIFAXIMIN TREATMENT IN UNCOMPLICATED COLONIC DIVERTICULAR DISEASE - AN OPEN LABEL STUDY]

SIMON László, SALAMON Ágnes, FELFÖLDI Ferenc, TAM Beatrix, SÁNTA Judit, VADÁSZ Edit

[INTRODUCTION - Aquired diverticular disease of the colon is extremely common in developed countries. Poorly absorbing antibiotics may have beneficial effects on symptoms in long-term treatment. An open study was conducted to evaluate the efficiency of rifaximin in the prevention of complaints and recurrent diverticulitis. PATIENTS AND METHODS - Thirty consecutive patients with proven uncomplicated colonic diverticulosis were selected to receive rifaximin 200 mg bid for the first six days of every month, for six months. They were also advised to consume an high-fibre diet. Patients were reviewed on a monthly basis by clinical examinations; changes in symptom variables (lower abdominal pain, upper abdominal pain, bloating, tenesmus, diarrhoea, abdominal tenderness) were evaluated on a 10-point Visual Analogue Scale (VAS), and the presence of acute diverticulitis (abdominal mass, fever, US) was ruled out at every monthly visit. RESULTS - Twenty-nine of 30 patients completed the study. After six months of cyclic rifaximin treatment the global symptom score decreased in all patients compared to the baseline. Acute diverticulitis, other complications or side effects were not observed. CONCLUSIONS - In this open study cyclic administration of a relatively low dose of rifaximin in uncomplicated colonic diverticular disease resulted in the reduction of abdominal complaints and prevented recurrent diverticulitis. This effect might be explained by a reduced metabolic activity of intestinal bacterial flora.]