Lege Artis Medicinae

[Tuberculosis surveillance epidemiological data from hungary in contrast of european trends]

VADÁSZ Imre1

DECEMBER 28, 1994

Lege Artis Medicinae - 1994;4(12)

[In the last fifteen years the favourable trends of tuberculosis epidemy has turned back in most European countries. This phenomenon and the vast migration of population provided the necessity, while the development in microbiology, immunology and informatics made possible to transform the previously successfull surveillance systems adopting new, up-to-date methods and technology. This has been performed in many Western and Middle European countries. The following facts has been established (1) The increasing of incidence is connected mainly to migration and HIV epidemy (2) New, exogeneus infections play major role in the pathogenesis of tuberculosis than it has been previously supposed (3) Microepidemics and polyresistent infections are the characteristic elements of epidemy. In the trends of tuberculosis epidemy in Hungary similar features can be recognized as in Western Europe (the increasing of incidence and its shift towards younger age groups etc.). To identify factors in the background of this phenomenon, following methods should be integrated into the surveillance system: (1) Centralized, individual, computer processed notification (2) Triple notification system (clinical, bacteriological, post mortem) (3) Compulsory screening of foreigners (4) Full scale sensitivity testing and adaptation of high technology microbiological methods (5) Intensive tracing of contacts and sources of infection. Preventive and therapeutical consequences: (1) Protection of health care staff (2) Isolation of infectious (mainly multidrug-resistant) cases (3) Wide scale application of fully supervised chemotherapy (4) Consistent performance of traditional patient care methods. Epidemiological and surveillance data from Western Europe and Hungary are reviewed to demonstrate the subject. ]

AFFILIATIONS

  1. Országos Korányi Tbc- és Pulmonológiai Intézet, Budapest

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Lege Artis Medicinae

[The first 15 years of the AIDS epidemic ]

FÖLDES István

[AIDS represents the most exciting infectious disease of the last 15 years. In addition to the fact that there are more than 4 million estimated AIDS patients and more than 16 million estimated HIV-infected individuals this can be explained by the peculiar features of the disease, including limited routes of infection, long latency period, a quasi 100% lethality, diversity of the clinical picture, difficulties in therapy and vaccination, the theoretically 100% possibility of prevention and the serious social problems associated with AIDS. After giving a short review of the development of our knowledge about AIDS, the author to explains the special features of AIDS mentioned above on the basis of the structure, regulation and replication cycle of the virus. The primary conclusion is that education and prevention should be stressed in the battle against AIDS.]

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[The role of transesophageal echocardiography in the investigation of stroke]

LENGYEL Mária

[Ischaemic infarction accounts for 85% of stroke aetiology (1). Approximately 60-70% of these are of cerebrovascular, i.e. carotid arteriosclerosis, origin (2). The proportion of cardiogenic embolism was previously estimated at 15% (1), but autopsy data suggest that embolism is the cause of half of fatal strokes (3). There are two reasons for this large discrepancy: 1) the intracardiac source is difficult to identify in vivo; 2) cardiogenic embolism has a more severe outcome than stroke of other origin. Probably both are true, but there is no doubt that before the introduction of transesophageal echocardiography (TE), the detection of intracardiac sources was rare and uncertain.]

Lege Artis Medicinae

[A multicentre, randomised, crossover, double-necked trial of contamination of conventional and bow-tie dressings in routine obstetric and gynaecological practice]

MARINKO M Biljan, CHARLES A Hart, DEBORAH Sunderland, PAUL R Manasse, CHARLES R Kingsland

[In the 19th century, the usual dress of doctors was a small bow tie tied in a flat knot "once round" in addition to a stiff standing collar (1). As fashions have changed, the wearing of bow ties has become less common and is now worn almost exclusively by a small minority of obstetricians, who often claim that they are more hygienic than the traditional tie in the delivery room, which is contaminated with blood and amniotic fluid. There is currently no evidence for this. We therefore examined the contamination of traditional and bow ties worn by obstetricians during a typical working week. ]

Lege Artis Medicinae

[Clinical and laboratory parameters in ulcerative colitis]

NAGY Ferenc, PAPÓS Miklós, CSERNAY László

[The clinical and laboratory parameters which correlate with the intensity of the inflammatory process in ulcerative colitis patients were analyzed in this study. The severity of the inflammatory process was assessed with leukocytescinti graphy by colorectal segments using a scoring method in 36 patients (group A). The sum of the segmental scores were considered to represent the intensity of the inflammatory process and were compared with clinical and laboratory parameters. From among the 36 patients, acute ulcerative colitis was established with biopsy in 30 cases. Two toxic patients were not tested and four patients had inactive disease. In 20 (16 acute, 4 inactive) of 36 patients, the intensity of the inflammatory process was assessed by segments with score values of biopsy samples and leukocyte scintigraphy (group B). The sum of the score values was used to determine the correlation of the two methods. The intensity of the inflammatory process assessed by scintigraphy showed a good correlation (r = 0.6564, p = 0.0016) with histological findings (group B), as well as with the ESR (r = 0.6398), serum fibrinogen (r = 0.5424), alfa2 globulin level (r = 0.4721), number of bloody stools (r = 0.4605), and the thrombocyte count (r = 0,4594) in group A. Five clinical and laboratory parameters proved to be suitable to assess the actual severity of the inflammatory process in ulcerative colitis. The values of the parameters may help to choose the right examination in new cases and to evaluate the efficacy of the therapy. ]

Lege Artis Medicinae

[Prenatal diagnosis of endocardial fibroelastosis]

KÁDÁR Krisztina, KIRÁLY László

[The authors report two cases of prenatally diagnosed endocardial fibroelastosis with echocardiography for the first time in Hungary. This disease is rare and usually fatal. Diagnoses were confirmed by autopsy and in one case by postnatal echocardiography as well. Principles for the diagnosis of endocardial fibroelastosis are discussed. Echocardiography makes possible the prenatal diagnosis of endocardial fibroelastosis and is recommended from the 18th week of pregnancy in high risk individuals.]

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