Lege Artis Medicinae

[Vision to be realised The harmony between solidarity and the insurance principle]

KRASZNAI Éva

APRIL 28, 1993

Lege Artis Medicinae - 1993;3(04)

[At the request of the Health Insurance Supervisory Commission, Deloitte and Touche and the consultancy Noble Lownds PX set up a working group of experts last July. It included health and medical experts, economists, lawyers, organisational and management experts, a mathematician, a sociologist and a political scientist. Their task was to develop a flexible organisational system for the management of the future local health insurance authority, based on an overview of the organisational, legal and financial conditions of the supervisory board. ]

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Lege Artis Medicinae

[Value of laboratory tests in alcohol abuse and alcoholic organ injuries]

NEMESÁNSZKY Elemér, JUHÁSZ Péter

[Alcohol has a toxic effect on the whole body. Alcohol abuse must be considered as one of the risk-factors to be able to challenge a broad spectrum of organ injuries. Chronic alcoholism, however, is a disease. In order to take preventive measures and to discover the early stages of organ damage caused by alcohol abuse, it is important to conduct those laboratory tests which can help to reveal the under Tyingetiology. With regular alcohol intake, the activity of serum enzymes (GGT, SGOT) and the SGOT/SGPT-index become elevated and the mean corpuscular volume of red cells (MCV) will increase. On the basis of their own experiences and supported by data found in the literature, the authors point out that regular alcohol intake cannot be proved by a single test. To enhance the specificity as well as the sensitivity of the laboratory tests, a combination of parameters must be obtained and tests should be repeated after a certain abstention period.]

Lege Artis Medicinae

[Alcohol induced specific cardiomyopathy]

TÁTRAI Tihamér

[Alcoholic cardiomyopathy represents a serious public health problem in Hungary. The author describes the diagnostic criteria and three clinical types: Vitamin B, deficiency, arrhythmic form and congestive alcoholic heart disease. The importance of arrhythmias is emphasized with regard to pathogenesis and clinical features. Non-invasive and invasive diagnostic methods are discussed. The latest therapeutic possibilities are discussed, but emphasis is placed on the importance of prevention.]

Lege Artis Medicinae

[The nomenclature of morphogenetic anomalies]

ÁDÁM Zsolt, PAPP Csaba, TÓTH-PÁL Ernő, PAPP Zoltán

[In spite of the unifying intentions on the nomenclature of congenital anomalies the problem is still considered to be unsolved internationally. Contradictions among each classifications are mainly based on the different viewpoints of practice and scientific researchers. The authors present here a proposition of nomenclature that fits the recommendations of the major international scientific committees but, as a synthesis, they are trying to give a role to etiopathogenesis as well as clinical presentation of congenital abnormalities in their classification. They intended to make this classification to give a proper nomenclature to everyday practice and scientific research work, too.]

Lege Artis Medicinae

[Position of the College of Respiratory Medicine on the care and screening of people with chronic pulmonary diseases]

[The Professional College, on the recommendation of the Epidemiology and Care Section of the Society of Lung Physicians, discussed the above topic at its meeting on 5 February 1993. After a lengthy discussion, and after the clash of opposing views, a compromise resolution was reached, summarised in the following points.]

Lege Artis Medicinae

[Pro-urokinase in myocardial infarction trial]

MATOS Lajos

[The patency of the vessel leading to infarction at 60 min was 71.8% in the rscu-PA group and 48% in the streptokinase-treated group (p < 0.001). At 90 min, the same values were 71.2% and 63.9%, respectively (p = 0.15). Between 24 and 36 h, reocclusion of the vessel occurred in 6/121 cases treated with rscu-PA and 5/114 cases treated with streptokinase. At the end of thrombolytic treatment, fibrinogen concentrations decreased to 0.44 g/l for rscu-PA injection and 0.17 g/l for streptokinase administration. The incidence of bleeding complications was significantly lower after rscu-PA treatment than after streptokinase (p<0.01).]

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We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

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Cases of inborn errors of metabolism diagnosed in children with autism

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Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

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[The role of sleep in the relational memory processes ]

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[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]