Lege Artis Medicinae

[Two yes, one no; Amendment against over-education]

KRASZNAI Éva

SEPTEMBER 29, 1993

Lege Artis Medicinae - 1993;3(09)

[Gyula Kincses, MDF MEP, has tabled several amendments to the recently adopted Education Act. As a doctor and a key figure in the management of the health sector, he tabled a number of health-related motions in the House of Representatives. He did not dispute the intention of the draft law to give preference to training in general and to set the resources in proportion to the number of students. ]

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[Ceftazidime - over ten years in the clinical practice]

SZALKA András, PRINZ Gyula

[This review discusses the principal features of ceftazidime based on the ten years experience since the introduction of the drug in the clinical practice: its broad antibacterial spectrum including Pseudomonas aeruginosa, favourable pharmacokinetics, wide range of indications, excellent clinical efficacy using empiric treatment or elective therapy and safety profile. ]

Lege Artis Medicinae

[What to expect of PTCA today?]

MAJOR László, MOLNÁR Ferenc, BERENTEY Ernő, KÉKES Ede

[This article is a review of the changing indications for percutaneous coronary angioplasty during the last decade. The role of revascularisation and especially of PTCA in the treatment of coronary heart disease is explained. Coronarography is the most important morphol gic diagnostic tool for coronary artery disease. The importance of the topic of this article is enhanced by the position of Hungary at the top of morbidity and mortality statistics, and by the infrequency of revascularisation procedures, especially PTCA. PTCA proved to be a real alternative to a surgical procedure in about half of the patients indicated for revascularisation. PTCA is less invasive, requires less time for recovery and is less expensive compared to bypass surgery. This article should draw attention of the family practitioner to the importance of this method. ]

Lege Artis Medicinae

[Myocardial contrast echocardiography]

TEMESVÁRI András, LENGYEL Mária, PAOLO Voci

[Symptoms of ischemic heart disease will occur when myocardial perfusion diminishes below a critical level. Coronarography will disclose the anatomic stenoses, but there is no direct correlation between the grade of stenosis and the change of myocardial perfusion. Myocardial contrast echocardiography is a new technique to analyze the myocardial perfusion. The contrast agent contains micro bubbles which have nearly the same dimensions as red blood cells. The microbubbles increase the „whiteness" of the perfused myocardium during the echocardiographic examinations. The change in „whiteness" of the myocardium correlates with myocardial perfusion. Intracoronary injections delineate the perfusion area of the coronary artery, and Thus the coronary flow reserve and the collateral flow area can be measured. The cardioplegia fluid distribution and the graft perfusion area are examined intraoperatively. Bedside myocardial perfusion studies will be possible through the transpulmonary passage of intravenously injected contrast agents. Myocardial contrast echocardiography can be applied both in the diagnosis and treatment of ischemic heart disease.]

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[Randomised assessment of (the effect of) digoxin on inhibition of the angiotensin-converting enzyme study]

MATOS Lajos

[Circulatory failure worsened to the point of discontinuation in 23 patients in the diuretic + ACE inhibitor + placebo only group, compared to only four patients in the digoxin group (p<0.001). The relative odds of worsening circulatory failure with placebo compared with digoxin was 5.9. All measured parameters of functional capacity (maximal exercise capacity, submaximal exercise capacity, NYHA grade) worsened with digoxin withdrawal. Similarly, quality of life (p=0.04), ejection fraction (p=0.001), heart rate (p<0.001) and body weight (p<0.001) decreased with digoxin instead of placebo.]

Lege Artis Medicinae

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SZABÓ István, CSABAY László, NÉMET János, PAPP Zoltán

[The circulatory changes and the characteristics of blood flow in certain uterine vessels can be detected by transvaginal color Doppler in early pregnancy. The uterine circulation of 53 patients with normal intrauterine pregnancies at 4–14 weeks of gestation and 104 non pregnant patients were investigated. The main uterine artery, arcuated and spiral arteries were demonstrated by color Doppler in all patients in early pregnancy and characteristic flow velocity waveforms were obtained in 94% of the cases. The impedance to flow in the main uterine artery was significantly lower and the mean velocity was significantly higher in early pregnancy than in non pregnant patients. The indices of impedance to flow decreased with gestation in the uterine branches and there was a progressive fall in these indices from the uterine artery to the spiral arteries. Mean blood velocity in the uterine artery increased with gestation. The hemodynamical changes which are proportional to gestation age give an indirect evidence of the adequate maternal blood supply for the growing embryo.]

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