Lege Artis Medicinae

[William Waldegrave on science policy]


APRIL 28, 1993

Lege Artis Medicinae - 1993;3(04)

[William Waldegrave has been in charge of science since the last elections. He is currently preparing a discussion paper on science, which will be published next spring. Richard Smith spoke to him about his new job, his ideas on science and his plans for the material. ]



Further articles in this publication

Lege Artis Medicinae

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


[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]


[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).]

All articles in the issue

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Clinical Neuroscience

[Mentalizing deficit among patients with traumatic brain injury ]

TAMÁS Viktória, BÜKI András, HEROLD Róbert

[Mentalization or theory of mind as an aspect of our social cognition, is our ability to infer mental states of others (intentions, desires, thoughts, emotions) and to predict their behavior accordingly. This function significantly affects our participation and orientation in the social world and plays an important role in conversational situations, social interactions, social integ­ration and adaptation. The brain regions that serve as the basis for mind-reading function can be damaged as a consequence of traumatic brain injury, which frequently occurs among the younger population. Traumatic brain injury can cause focal or diffuse cerebral injuries, often leading to theory of mind deficit. In this topic such publications were researched that compared theory of mind ability between traumatic brain injury patients and control subjects (comparative case-control studies). We searched for the studies in the following internet based/online databases: PubMed, Web of Science, ScienceDirect, Google Scholar, APA PsycNET (PsycARTICLES) and EBSCO Host. The search was performed using the following key word combinations: theory of mind or mentalizing or social cognition AND traumatic brain injury or head/brain injury or diffuse axonal injury. Based on the results of the included and processed studies (21 pc), traumatic brain injury often leads to mentalization deficit with different severity. With this present review we aim to draw attention to the fact that the appearance and severity of mind reading dysfunction can considerably affect the outcome of the disease, the length of rehabilitation time and the prognosis of traumatic brain injury patients. Besides this, with this review, we aim to take sides in whether theory of mind ability is domain-specific or domian-general based on studies including traumatic brain injury patients.]

Clinical Neuroscience

[New, innovative prognosis calculator for patients with metastatic spinal tumors]


[The aim of our research was to create a scoring system that predicts prognosis and recommends therapeutic options for patients with metastatic spine tumor. Increasing oncological treatment opportunities and prolonged survival have led to a growing need to address clinical symptoms caused by meta­stases of the primary tumor. Spinal metastases can cause a significant reduction in quality of life due to the caused neurological deficits. A scoring system that predicts prognosis with sufficient accuracy could help us to achieve personalised treatment options. Methods – We performed a retrospective clinical research of data from patients over 18 years of age who underwent surgery due to symptomatic spinal metastasis at the National Institute of Mental Disorders, Neurology and Neurosurgery between 2008 and 2018. Data from 454 patients were analysed. Survival analysis (Kaplan-Meier, log-rank, Cox model) was performed, network science-based correlation analysis was used to select the proper prognostic factors of our scoring system, such that its C value (predictive ability index) was maximized. Multivariate Cox analysis resulted in the identification of 5 independent prognostic factors (primary tumour type, age, ambulatory status, internal organ metastases, serum protein level). Our system predicted with an average accuracy of 70.6% over the 10-year study period. Our large case series of surgical dataset of patients with symptomatic spinal metastasis was used to create a risk calculator system that can help in the choice of therapy. Our risk calculator is also available online at https://emk.semmelweis.hu/gerincmet.]

Clinical Neuroscience

[Health status and costs of ambulatory patients with multiple sclerosis in Hungary]

PÉNTEK Márta, GULÁCSI László, RÓZSA Csilla, SIMÓ Magdolna, ILJICSOV Anna, KOMOLY Sámuel, BRODSZKY Valentin

[Background and purpose - Data on disease burden of multiple sclerosis from Eastern-Central Europe are very limited. Our aim was to explore the quality of life, resource utilisation and costs of ambulating patients with multiple sclerosis in Hungary. Methods - Cross-sectional questionnaire survey was performed in two outpatient neurology centres in 2009. Clinical history, health care utilisation in the past 12 months were surveyed, the Expanded Disability Status Scale and the EQ-5D questionnaires were applied. Cost calculation was conducted from the societal perspective. Results - Sixty-eight patients (female 70.6%) aged 38.0 (SD 9.1) with disease duration of 7.8 (SD 6.7) years were involved. Fifty-five (80.9%) had relapsing-remitting form and 52 (76.5%) were taking immunomodulatory drug. The average scores were: Expanded Disability Status Scale 1.9 (SD 1.7), EQ-5D 0.67 (SD 0.28). Mean total cost amounted to 10 902 Euros/patient/year (direct medical 67%, direct nonmedical 13%, indirect costs 20%). Drugs, disability pension and informal care were the highest cost items. Costs of mild (Expanded Disability Status Scale 0-3.5) and moderate (Expanded Disability Status Scale 4.0-6.5) disease were 9 218 and 17 634 Euros/patient/year respectively (p<0.01), that is lower than results from Western European countries. Conclusion - Our study provides current inputs for policy making and contributes to understanding variation of costof- illness of multiple sclerosis in Europe.]

Clinical Neuroscience

[Before setout...]

Z. I.

[The first psychiatric and neurological journal in Hungary is now launched. The support of the Academy of Sciences and the Medical-Health Trade Union made it possible to make up for the omission made by the pseudo-scientific cultural policy of the reactionary period. It has already happened in the past that Hungarian medicine started to flourish. Developments in the fields of neurophysiology, neurology and psychiatry began in the second half of the last century, during which Hungarian researchers were connected to the leading medical discoveries of the time in the world.]

Clinical Neuroscience

Isocitrate dehydrogenase mutations in defining the biology of and supporting clinical decision making in glioblastoma


Background and purpose - Oncogenesis is related to a sequential accumulation of somatic mutations. Comprehensive characterizations of the genomic landscapes have been completed recently for several tumors, glioblastoma being among the first ones. Our own translational research studies have been focused on defining molecular subtypes of glioblastoma in the clinical setting because of an expected prognostic and therapeutic utility of the information. Somatic mutations in genes of the isocitrate dehydrogenase (IDH) enzyme family appear to be among the best-defined biomarkers that also influence tumor behavior and confer clinical utility. Methods - We have reviewed the literature including our own results to summarize basic science and clinical correlates of IDH mutations. Results - The surveyed data reveal genomic, transcriptomic, epigenomic and biochemical consequences of IDH mutations in the context of glioblastoma biology and phenotype. In addition, a few studies highlight the therapeutic potential of targeting IDH, although thus far all tests have only been conducted in the preclinical setting. Conclusions - Somatic mutations in isoforms of IDH genes represent important biomarkers that correlate with biochemical, biological and phenotypic features of glioblastoma, and may also facilitate the development of new therapeutic strategies complementing the currently available approved protocols.