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Lege Artis Medicinae

AUGUST 30, 2018

[The Galilei of Bertolt Brecht and László Németh]

KELEMEN Gábor, ERDŐS Márta

[The trial of Galileo, who abjured his scientific convictions in the face of the Inquisitions was the most persistent and disturbing artistic theme of both Bertolt Brecht’s and Németh Laszlo’s writing careers. All three of them attended medical school. Galileo and Brecht never graduated whilst Németh’s medical work was subordinated to the art which became his vocation. The authors examine the genesis of Brecht’s and Németh’s dramas on Galileo, the possible effect of their medical studies or practice and their illnesses on their plays, and compare the work of the artists. This paper shows the process of their evaluating and re-evaluating their works and their struggle for further development of their artistic vision. Brecht’s and Németh's dramas, together with their formations and effects, can illuminate our understanding of the historically changing perpectivity of the scientific and artistic truth. ]

Clinical Neuroscience

JANUARY 30, 2018

[The facets of creativity in the light of bipolar mood alterations]

SZAKÁCS Réka

[The link between creativity, as the highest expression form of human achievement, and bipolar disorder came into focus of scientific investigations and research. Accomplished writers, composers and visual artists show a substantially higher rate of affective disorders, prodominantly bipolar mood disorders, comparing to the general population. Then again, patients afflicted with bipolar II subtype (hypomania and depression), as well as persons presenting the mildest form of bipolar mood swings (cyclothymia) possess higher creative skills. It evokes therefore that certain forms and mood states of bipolar disorder, notably hypomania might convey cognitive, emotional/affective, and motivational benefits to creativity. The aim of this paper is to display expression forms of creativity (writing, visual art, scientific work) as well as productivity (literary and scientific work output, number of artworks and exhibitions, awards) in the light of clinically diagnosed mood states at an eminent creative individual, treated for bipolar II disorder. Analysing the affective states, we found a striking relation between hypomanic episodes and visual artistic creativity and achievement, as well as scientific performance, whereas mild-moderate depressed mood promoted literary work. Severe depression and mixed states were not associated with creative activities, and intriguingly, long-term stabilised euthymic mood, exempted from marked affective lability, is disadvantageous regarding creativity. It seems, thereby, that mood functions as a sluice of creativity. Nevertheless, it is likely that there is a complex interaction between bipolar mood disorder spectrum and psychological factors promoting creativity, influenced also by individual variability due to medication, comorbid conditions, and course of disorder.]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2016

[The patients with sensory system impairment in peritoneal dialysis]

VARGANÉ SZABÓ Tünde, KERESZTESI Sándor

[The sensory system is responsible for perceiving information, which enables us to connect with the outside world. Its impairment could limit an individual’s chances to an equal role in society. Introduction of a special training programme that provides equal opportunities for patients with disabilities to participate in the peritoneal dialysis (PD) programme. In visually impaired patients training was not based on the visual teaching aids but on verbal communication (constant repetition, questioning). In patients with hearing loss visualisation and dexterity are in focus. Speech impediment, a condition often coexisting with hearing loss, made communication more difficult; therefore the training is built on writing, articulation and sign language. By acquiring the theoretical and technical bases of PD treatment, our patients is able to complete safe solution exchanges in their own homes. Once self-care treatment commenced, their nursing continued on an individual basis. Self-care treatment of PD patients with sensory impairment requires prudence, adequate training and aftercare; however according to our experience it does not necessarily imply a higher occurrence rate of complications. ]

Clinical Neuroscience

JULY 30, 2016

[The effect of anesthesia on cognitive functions]

BOCSKAI Tímea, KARÁDI Kázmér, BURIÁN András, KOVÁCS Norbert, BOGÁR Lajos, LUJBER László

[Aim of the study - General anesthetics, arterial hypotension and hypoxia developing during anesthesia may result in impaired memory and a decline in other abilities (such as attention, concentration, linguistic and writing abilities). Our aim was to detect changes in cognitive functions due to surgery and anesthesia with controlled arterial hypotension. Materials and methods - We studied combined and intravenous anesthesia detecting pre-and postoperative cognitive functions, intraoperative haemodynamic parameters, demographic data, other data of case history and surgical data. The Montreal Cognitive Assessment test was applied in the randomized, prospective study. The preoperative data served as basis for comparison. The second test was performed following surgery when patients were fully awake. Both groups included 30 patients. Results and conclusion - After both narcosis methods (postoperative second hour) cognitive functions were significantly deteriorated (p<0.05). Median MoCA before sevoflurane anesthesia was 24 points (interquartile range: 22-25), postoperative value was 20 (19-21) (p<0.05). Median MoCA before propofol anesthesia was 24 points (23-26), postoperative value was 20 (18-22) (p<0.01). Intraoperative arterial blood pressure, pulse rate and oxygen saturation values did not correlate with worsening of cognitive function (Pearson correlation coefficient values between -0.19 and 0.42). Execution is influenced by age (negative correlation) and education (positive correlation).]

Lege Artis Medicinae

APRIL 20, 2016

[Medicus imperitus. The inception of physician liability in classical Roman law]

PÉTER Orsolya Márta

[In an era where the number of medical liability suits is permanently increasing, it might be interesting - in Hungary as well -, and also useful to detect and analyse the roots of such liability in Continental/Euro­pean law. In classical Roman law - that also gives the basis for European ius commune - , we cannot encounter uniform and general norms governing medical liability. The reasons of such hiatus are inherent in the peculiar casuistic method of Roman law, as jurists focused on providing a proper solution for a specific case, and not on developing general and abstract behavioural norms. In addition to the foregoing, the legal status of physicians and their patients was heterogeneous: many doctors were foreign slaves who, if lucky, obtained freedom and Roman citizenship, or settled down in Rome as foreign citizens. The form of their professional liability was also determined by the legal status of their patients: if an untrained or careless physician tried to cure a slave owned by a Roman citizen and failed, the owner could sue the doctor for damaging his property. As far as free patients are concerned, we cannot formulate any unequivocal statements regarding medical liability and malpractice; however, the few available sources clearly prove that a physician who had wilfully caused harm to his free patient resulting in death was severely punished in ancient Rome.]

LAM Extra for General Practicioners

APRIL 20, 2014

[DOES THE VITAMIN K2 PLAY A ROLE IN THE PREVENTION OR TREATMENT OF OSTEOPOROSIS? - A SYSTEMATIC REVIEW]

SZILI Balázs, TAKÁCS István

[The physiological role of vitamin K in blood clotting and bone metabolism is well known. A number of articles have been published recently about the effects of vitamin K2 on bone. Non-professional media promotes vitamin K2 as a potent tool for the prevention and treatment of osteoporosis. Nevertheless vitamin K2 is not included in either Hungarian, or European, or Ameri - can guidelines as an anti-osteoporotic me - dication. Our aim was to review the literature and provide a systematic review on the role of vitamin K2 in the prevention and treatment of osteoporosis. We have searched articles on http://pubmed. org available on 14. February 2014. Our search terms were: („ vitamin K2” OR „ menaquinon” OR „ MK-7” OR „ menantrenon”) AND „ osteoporosis”. We have only reviewed original articles that discussed the relationship of vitamin K2 and osteoporosis, and had at least the abstract available in English. Of the 155 articles found, 135 had a relevant topic, 126 had at least the abstract in English. Of these, 73 were original articles, including 44 human studies (8 doubleblind, controlled, 26 open-label, controlled, 5 observational and 5 cross-sectional studies) and 29 animal or in vitro models. In the non-Asian population there is no evidence for fracture-preventing or BMD-increasing effect of vitamin K2 treatment. The currently recommended anti-osteoporotic medications are significantly more efficient compared with the BMD increase observed in some Asian studies.]

LAM KID

MARCH 30, 2014

[Does the vitamin K2 play a role in the prevention or treatment of osteoporosis? - a systematic review]

SZILI Balázs, TAKÁCS István

[The physiological role of vitamin K in blood clotting and bone metabolism is well known. A number of articles have been published recently about the effects of vitamin K2 on bone. Non-professional media promotes vitamin K2 as a potent tool for the prevention and treatment of osteoporosis. Nevertheless vitamin K2 is not included in either Hungarian, or European, or Ameri­can guidelines as an anti-osteoporotic me­dication. Our aim was to review the literature and provide a systematic review on the role of vitamin K2 in the prevention and treatment of osteoporosis. We have searched articles on http://pubmed.org available on 14. February 2014. Our search terms were: („vitamin K2” OR „menaquinon” OR „MK-7” OR „menantrenon”) AND „osteoporosis”. We have only reviewed original articles that discussed the relationship of vitamin K2 and osteoporosis, and had at least the abstract available in English. Of the 155 articles found, 135 had a relevant topic, 126 had at least the abstract in English. Of these, 73 were original articles, including 44 human studies (8 double-blind, controlled, 26 open-label, controlled, 5 observational and 5 cross-sectional studies) and 29 animal or in vitro models. In the non-Asian population there is no evidence for fracture-preventing or BMD-increasing effect of vitamin K2 treatment. The currently recommended anti-osteoporotic medications are significantly more efficient compared with the BMD increase observed in some Asian studies. ]

AUGUST 15, 2011

The Paracetamol (Acetaminophen) In Stroke?

Original abstract:High body temperature in the first 12-24 h after stroke onset is associated with poor functional outcome. The Paracetamol (Acetaminophen) In Stroke (PAIS) trial aimed to assess whether early treatment with paracetamol improves functional outcome in patients with acute stroke by reducing body temperature and preventing fever. METHODS: In a multicentre, randomised, double-blind, placebo-controlled trial, patients with ischaemic stroke or intracerebral haemorrhage and body temperature between 36 degrees C and 39 degrees C were randomly assigned treatment with paracetamol (6 g daily) or placebo within 12 h from symptom onset. Treatment allocation was based on a computer-generated list of random numbers with varying block size. The primary outcome was improvement beyond expectation on the modified Rankin scale at 3 months, according to the sliding dichotomy approach. This trial is registered, number ISRCTN74418480. FINDINGS: Between March, 2003, and May, 2008, 1400 patients were randomly allocated treatment. 260 (37%) of 697 patients receiving paracetamol and 232 (33%) of 703 receiving placebo improved beyond expectation (adjusted odds ratio [OR] 1.20, 95% CI 0.96-1.50). In a post-hoc analysis of patients with baseline body temperature 37-39 degrees C, treatment with paracetamol was associated with improved outcome (1.43, 1.02-1.97). There were 55 serious adverse events in the paracetamol group (8%) and 70 in the placebo group (10%). INTERPRETATION: These results do not support routine use of high-dose paracetamol in patients with acute stroke. Paracetamol might have a beneficial effect on functional outcome in patients admitted with a body temperature 37-39 degrees C, but this post-hoc finding needs further study. FUNDING: Netherlands Heart Foundation.

Clinical Neuroscience

MARCH 24, 2010

[Numbers, counting and calculating problems in view of cognitive neurology]

MÁRKUS Attila

[The ability to count and calculate is a human-specific skill comprised of understanding numeric values and categories and performing numerical operations; it is an acoustic-verbal symbolic activity that may be expressed in writing and understood by reading. The neuronal bases and precursors of cognitive systems have been supplied to mankind by the process of evolution. Abilities to create symbols (speech, visual letter and number symbols) must have played a decisive role in the emergence of man from the world of primates. Although counting and calculating problems are classified into numerous types, two main forms of dyscalculia have practical importance: the acquired one (the loss of learned knowledge) and the developmental one (the disturbance of the acquisition of arythmetical knowledge).]

AUGUST 15, 2011