Lege Artis Medicinae - 2016;26(11-12)

Lege Artis Medicinae

DECEMBER 18, 2016

[The role of the family physician in the preparation for liver transplantation in Wilson’s disease]

FARKAS Anett, KALABAY László, MÁTHÉ Zoltán, MÁRKUS Bernadett, SZALAY Ferenc, VÖRÖS Krisztián, TORZSA Péter

[Wilson’s disease is an autosomal recessive disease with toxic copper accumulation caused by the mutation of the ATP7B gene in chromosome 13. The estimated prevalence of the disease is 2-3 / 100000. Early diagnosis is important because the treatment may stop the progression and could result regression or it can prevent the clinical manifestation of the disease. In our case study we describe how difficult could be to diagnose the disease, the role of the family physician in the preparation for liver transplantation and in the follow-up care. This case is an example demonstrating that Wilson's disease is often diagnosed only years after the appearance of the first symptom. We review the most important literature data on Wilson’s disease. ]

Lege Artis Medicinae

DECEMBER 18, 2016

[The cardiovascular risk of nonsteroidal antiinflammatory drugs]

AMBRUS Csaba, KISS István

[Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most common pain relief and anti-inflammatory medications all over the World, and many formulations are also available over-the-counter. Beyond the well-known gastrointestinal risks, emerging evidence supports increased incidence of cardiovascular events associated with the use of NSAIDs. This cardiovascular risk seems to be independent of the cyclooxygenase selectivity of these drugs. Distinct side effect profiles of various NSAIDs were summarized in a former issue of the Journal: LAM 2014;24(7): 327. In this paper, we aimed to summarize some of the yet unpublished results of a major research project of the European Medicines Agency (EMA), that was conducted in order to establish the relative risk of CV outcomes (myocardial infarction, ischaemic stroke and hospitalization for heart failure) associated with the use of various NSAIDs. In this epidemiological study, seven European healthcare databases on a source population of 35 million subjects were linked and analyzed. Most of the results are currently only available on the project homepage; however, analyses of heart failure data have already been published in a recent issue of The BMJ. ]

Lege Artis Medicinae

DECEMBER 18, 2016

[The role of spirituality in the twelve-step treatment model of addicts]

TREMKÓ Mariann, TÓTH András, MOLNÁR Rudolf, PETKE Zsolt

[First of all we shortly present the Minnesota model based on twelve-step programmes that could be implemented effectively in the recovery of addicts. The uniqueness of the model are the involvement of recovering helpers in the therapeutic work and the focus on spirituality. Our essay-like study aims to present the approach of Alcoholics Anonymous which forms the basis of the model, effectivity studies and the potential effect mechanisms through research data. We aim to define the phenomenon of spirituality from different aspects having regard to the preliminary psychological and psychotherapeutical contributions and provide some of our therapeutic tools. In the current study we picture the roles of the professional therapists and the voluntary recovering helpers in our programme. ]

Lege Artis Medicinae

DECEMBER 18, 2016

[Intravenous immunoglobulin immunotherapy in immune mediated habitual abortions]

FÜLÖP Vilmos, PETRÁNYI Győző

[INTRODUCTION - Based upon international and domestic research data authors summerize the humoral and cellular im­munregulatory disorders which can be found in the background of “immune me­diated abortions” (IMA). PATIENTS AND METHODS - Within the frame of a home research program a special examination protocol was elaborated in order to sepatare alloimmune habitual abortions from autoimmune and non immune backgrounds. After all other causes were excluded erythrocyte antibody inhibition assay (EAI) was used for measuring the serum level of FcgRII receptor blocking IgG antibody, because its lack an important diagnostic parameter. Among the cell mediated immunofuntional tests the mixed lymphocyte culture reaction (MLC) was the most useful. During the roughly last 16 years 67 out of 76 selected alloimmun IMA patients were administered Intratect IVIG treatment without any particular selection among them. IVIG treatment was first applied on the completed 5-6th week of pregnancy and doses of 0,3-0,4g/kg bodyweight per oc­casion were given 3 times with 3-week intervals. RESULTS - Altogether a significant rise in the serum level of blocking antibodies was shown after each IVIG treatment although a slight decrease was seen after every given dose. Of the 67 IMA patients 54 carried infants to term during the study period. In 4 cases of abortion no cause was identified with post hoc diagnosis. Thus the success rate of this type of IVIG therapy was 93.1% (58/54). Conclusion - In approprietly selected alloimmun IMA cases the IVIG generated immunoregulatory and antiimflammatory pathways may contribute to its net positive reproductive effect.]

Lege Artis Medicinae

DECEMBER 18, 2016

[Philosophical café as therapeutic community]

NEMES László

[In this paper we examine the very possibility of integrating philosophical discussion groups into the practice of community psychiatry as a kind of therapeutic community. We summarize the history of the café-philo movement, the conception, methods and goals of the philosophical café. I present a detailed report on the experiences about the philosophical cafés going on at the Awakenings Foundation on a weekly basis for two years. I suggest group philosophy discussion as a useful additional form of activities usual in psychiatric rehabilitation. ]

Lege Artis Medicinae

DECEMBER 18, 2016