Lege Artis Medicinae

[Tracking the Forgotten Profession]

NAGY Zsuzsanna

AUGUST 20, 2010

Lege Artis Medicinae - 2010;20(08)

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[Variations to the Kreutzer Sonata – Leo Tolstoy Passed Away 100 Years Ago]

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[A chance to concretize the teratogenic risk: healthy babies born to mother with isotretinoin treatment during pregnancy]

TIMMERMANN Gábor, KONDÉR Béla, GIDAI János, CZEIZEL Endre

[The teratogenic risk means the probability of the occurrence of congenital abnormalities in fetuses after the exposure of teratogenic agents, mainly drugs during pregnancy. The recent highresolution ultrasound scanning may help us to concretize this teratogenic risk. The Genetic, Teratogenic and Family Planning Counseling Clinic of the authors in Budapest were visited by 10,557 couples or client between 1998 and 2007. Ten pregnant women visited this Clinic due to the isotretinoin (Roaccutan) treatment during pregnancy during the 10 years study period. At present Roaccutan is the most teratogenic drug among the medicinal products in Hungary because its teratogenic risk is 25% for a characteristic pattern of congenital abnormality syndrome including a/microtia, ventriculomegaly and contruncal cardiovascular malformation. These fetal defects are detectable by the high-resolution ultrasound scanning between 18th and 20th gestational week of pregnant women. Thus this examination was recommended for the 10 pregnant women with unintended use of isotretinoin (Roaccutan ) in early pregnancy. Six pregnant women followed our advice and the repeated ultrasound scanning was not able to detect the above-mentioned characteristic defects and all the 6 newborns were healthy after birth. In conclusion the recent highresolution ultrasound examination provides a chance for the diagnosis of certain fetal defect between 18th and 20th gestational week of pregnant women. The Hungarian law allows these pregnant women to decide the termination of pregnancy until 20th (24th) gestational week after the diagnosis of severe fetal defects. However, this approach can protect the life of the major part of fetuses in pregnant women at high risk.]

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[On the safety of angiotensin-receptor blockers - A new attack on this drug class]

FARSANG Csaba

[Up until now, angiotensin-receptor blockers have been considered to be the safest cardio-, cerebro-, reno- and vasculoprotective drugs. In a previous metaanalysis, ARBs were accused of increasing the risk of myocardial infarction, but a number of metaanalyses and randomised, controlled trials have disproved this hypothesis. In a recent metaanalysis, ARBs were associated with an increased risk of tumours. The author reviews this issue, discusses the flaws of the above metaanalysis and, on the basis of the most up-to-date data in the literature, expert opinions and official statements (FDA, EMA), concludes that members of this drug class should continue to be used according to their approved indications, which is supported by their cardio-, reno-, cerebro- and vasculoprotective effects demonstrated in a number of appropriate, large-scale clinical studies.]

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[We have read several publications of great authority on the neurological profession in the last two years in which were expressed assessments of the current situation combined with opinions about neurology and the necessity to reorganize neurological patient care. These articles took up the question of neurorehabilitation too. The authors, who on a daily basis, deal with the rehabilitation of people with disabilities as a consequence of neurological conditions, summarize some important definitions of rehabilitation medicine and the present system of neurological rehabilitation, as it is defined by the rehabilitation profession.]

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[Aim of the study: The authors studied the attitudes, regarding the future, of female students who had chosen a paramedical vocation. In the course of their work they assessed the students’ vision of the future, and obtained a detailed knowledge of their family and career plans, and the correlations between them. Methodology and sample: The quantitative sociological survey, based on a self-completion questionnaire, was conducted among 2nd, 3rd and 4th year student nurses, student midwifes and student health visitors at the Semmelweis University Faculty of Health Sciences. The results were analysed with the SPSS 19.0 program, using a descriptive statistical method. The proportion of useful responses to the questionnaire was 94.1% (N=257). Results: The students clearly prefer motherhood, but their vision of the future is uncertain. Achieving new and higher professional targets was considered important by 29.2% of the sample, and going to practice their studied profession by 54.5%. With regard to career plans, the authors found a statistically provable difference between the specialisations (p<0.001). Of the nursing students who responded, 82.6% wanted to attain middle-management status by the age of 40, while only 8.7% would also be happy to work as general staff. Conclusions: The female students at Semmelweis University are preparing both to have children and to practice their paramedical vocation. The responses given regarding their vision of the future could show that the reconciliation of these two future roles is already causing uncertainty. A higher proportion of the respondents would like to achieve middle-management status, which represents greater prestige for them. A positive shift in their vision of the future could help prevent career abandonment and emigration. ]

Lege Artis Medicinae

[Socialisation in the medical profession as reflected by students]

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[INTRODUCTION - This article analyses the socialisation in the medical profession using complex approach, and taking Merton’s definition as a starting point. METHODS - Qualitative sociological, semistructured deep-interview method. RESULTS - The motivation of medical students in choosing their profession have not changed in the past years. The socialisational phases can clearly be observed during their training, these can serve as a basis for empirical observations. The role of classes related to behavioural studies is significant, while the opinion of the students about the teaching methods is diverse. Taking a family member as a model or work experience gained in medical fields is an advantage in the socialisational process. Temporal or partial leaving of the profession are new phenomena. CONCLUSION - Considering the characteristics of qualitative observational methods, the results of the present analysis may serve as a starting point for further empirical observations based on a representative model.]

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