Lege Artis Medicinae

[When “Hard” Science Softens Up...]

BÁNFALVI Attila

FEBRUARY 21, 2006

Lege Artis Medicinae - 2006;16(02)

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Lege Artis Medicinae

[THE GENETICS OF INFLAMMATORY BOWEL DISEASE]

LAKATOS Péter László, LAKATOS László

[The pathogenesis of inflammatory bowel disease is only partly understood; various environmental and host factors (e.g., genetic, epithelial, immune and non-immune) are involved. It is a multifactorial polygenic disease probably with genetic heterogeneity; some genes confer susceptibility to IBD in general, while others specifically increase the risk of ulcerative colitis or Crohn's disease or affect location (localized or extensive) and/or behaviour (e.g., mild, severe, aggressive). This review presents recent advances in the genetics of inflammatory bowel disease including chromosome segments newly recognized to be involved in inflammatory bowel disease as well as the role of NOD2/CARD15, SLC22A4/A5 and DLG5. The increasing genetic information provides, for the time being, a better understanding of the pathogenesis of the disease thus setting a basis for potential targets for therapeutic intervention. In the future, however, genetics may also help in refining the diagnosis or predicting disease course.]

Lege Artis Medicinae

[Navigare Necesse Est A Discussion with Béla Buda MD]

FERENCZI Andrea

Lege Artis Medicinae

[Nobel prize for medicine and physiology in 2005. - The Helicobacter pylori-story in Hungary]

RÁCZ István, SIMON László

Lege Artis Medicinae

[OVARIAN CHORIOCARCINOMA - A MOLECULAR PATHOLOGIC APPROACH TO DIFFERENTIAL DIAGNOSIS]

ERÉNYI Éva, SZIGETVÁRI Iván, ANDRIKOVICS Hajnalka, TORDAI Attila, URBÁN Márta, SIMON Károly

[INTRODUCTION - Gestational and non-gestational choriocarcinoma, the two types of choriocarcinoma with distinct aetiologies, cannot be differentiated by conventional histological or immunohistochemical methods. In certain cases the verification of the origin of the tumour by molecular biological techniques is essential for prognostic and therapeutic reasons. CASE REPORT - A 22-year-old woman presenting with acute abdominal pain was examined and operated on. During surgery a tumour was found in the right ovary. “Pure” choriocarcinoma was histologically diagnosed and gestational origin was supposed based on the distinct clinical features and histological picture. This was subsequently confirmed by molecular genetic testing. Parallel VNTR (variable number of tandem repeats) analysis by PCR of DNA from the tumour tissue and the patient's peripheral blood was performed. The pattern showed the presence of an allele presumed to be of paternal origin. (Blood sample from the father was not available.) One regimen of Vepesid, Cisplatina and Bleomycin was applied, and more than three years after the diagnosis the patient is free of disease. CONCLUSION - Multidisciplinary cooperation led to an accurate diagnosis and successful treatment. Non-radical surgery with the preservation of fertility followed by proper early chemotherapy provided excellent results.]

Lege Artis Medicinae

[Music Therapy in the Treatment of Patients with Alzheimer’s]

KOLLÁR János

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MAJOR János, RESS Katalin, HULESCH Bors, TÚRY Ferenc

[Burnout, a physical, emotional and spiritual exhaustion, is caused by chronic emotional stress, and is considered to be the end-state of a multistep process. It is most frequently observed among professionals who work with people and are faced with people's negative emotions every day. Apart from emotional stress, certain personality traits as well as high workload have also been linked to the development of burnout. Burnout symptoms include physical exhaustion (depleted energy, tiredness, illnesses), emotional exhaustion (hopelessness, depression, suicide), and spiritual exhaustion (pessimism, negative attitudes, dehumanization of patients). Approximately 20% of all medical practitioners in several European countries, as well as in the United States, have been demonstrated to show burnout symptoms. Its prevalence appears to be similar across countries, but shows differences according to medical specialty. Doctors mostly seeing patients with easily curable diseases or with good prognosis have a lower risk of burnout, whereas those seeing chronic or dying patients on a daily basis are at a much higher risk. The prevention is possible in a number of ways, such as ensuring proper work environment, providing personality development and soft skills trainings, and participation in clinical case study workshops. The Humania Professional Socialization Workshop was set up with prevention in mind at Semmelweis University in 2002 to formally provide medical students, as part of their vocational training, with skills and techniques that later will help them cope with hard emotional situations and thus reduce the risk of burnout.]

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[Non-invasive brain stimulation for relieving acute and chronic pain]

CSIFCSÁK Gábor, ANTAL Andrea

[Controlling pain has always been one of the biggest challenges of medical science. Despite pharmacological developments, still many patients suffer from long-lasting pain. During the last 40 years several surgical interventions have been used to modulate the activity of the central nervous system in order to control chronic, pharmacoresistant pain. Because such interventions may involve very serious adverse events, safer and at least equally efficient methods are still required. In the 90’s new techniques of non-invasive brain stimulation have been introduced that enable the facilitation or inhibition of distinct cortical areas. These methods are based on the electrical stimulation of brain structures and to date they have been successfully used to modulate perceptual, cognitive and motor functions in healthy subjects and various diseases as well. In this review we describe such techniques of non-invasive brain stimulation, namely repeated transcranial magnetic stimulation and transcranial direct current stimulation and review the current literature about their efficacy in controlling acute and chronic pain.]

Lege Artis Medicinae

[Genomics, the science of biological complexity]

FALUS ANDRÁS

Lege Artis Medicinae

[Changes of the evaulation of scientific publications and researchers based on Hungarian Science Bibliography]

MOLNÁR-TAGA Márta, KAPÓCS Gábor, KISS István

[Different science-metric indicators are great important in evaluating the work of scientists. The authors present the advantages and disadvantages of evaluation numbers which used in the national science in decades and describe in the last year introduced new evaluation criteria. In addition, they analyze and compare the current requirements of the Hungarian Science Bibliography (MTMT) and the Doctoral Schools of the four Hungarian Medical Sciences. Finally, they seek to find out what changes are to be expected later. ]