Ca&Bone

[Gyakorlati szempontok az osteoporosisos beteg ellátásában 2008-ban]

JANUARY 22, 2008

Ca&Bone - 2008;11(01)

[2008;11(01)]

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[Stroke associated dysphagia can have serious consequences such as aspiration pneumonia. The Hungarian guideline on nutritional therapy for stroke patients recommends dysphagia assessment, as early screening can optimize disease outcome and hospital cost. Thus far, this may be the first study in Hungarian that has documented a systematic review about the available validated dysphagia assessments of acute stroke. Purpose – The aim of this study was to summarize the instrumentally validated bedside dysphagia screening tools for acute stroke patients, which were published in the last twenty years. Our objective was to describe the characteristics of the validation studies, examine their study design, and sample the sub-tests and the diagnostic accuracy of the assessments. A systematic research was carried out of the literature between 2001 and 2021 in eight scientific databases with search terms appropriate to our objectives. Subjects of the study – 652 articles were found and were reduced to eight. We made a comparative analysis of these. The GUSS test reached a high level of sensitivity compared to the others. In our study sample, the prevalence of instrumentally confirmed dysphagia among acute stroke patients was 56.1%. The focus and the composition of the analyzed studies differed and posed problems such as the ambiguity of the concept of dysphagia, the difference in outcome indicators, or the timing of screening. The GUSS test, which offers domestic management, is a suitable tool for the Hungarian clinical use.]

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[The coronavirus pandemic started at December 2019 from Wuhan. The rate of spread of the coronavirus epidemic has shocked the entire world, and the WHO declared it as a pandemic in March 2020. The first case in Hungary was confirmed in March 2020. The infection primarily damages the lungs but can also infect other organs. The relationship between coronavirus infection and the kidney is bidirectional. On the one hand, the infection can cause acute renal damage, and on the other hand, chronic kidney patients and patients receiving renal replacement therapy are at increased risk of infection due to their immune compromised status. Chronic kidney patients are three times more likely to have a severe Covid-19 infection than the general population. Among patients with severe Covid-19, the incidence of acute renal failure may exceed. Patients treated with the HD program have a higher risk of infection due to transportation and treatment in the common area. The mortality rate of Covid-19 infected patients receiving renal replacement therapy is 20-35% according to international data. Infections occured in all the dialysis centers of the B.Braun Avitum Dialysis Network during both the 2nd and 3rd wave of the epidemic. Epidemiological data confirm that preventive measures are of paramount importance in the field of prevention of infections and in the care of the pandemic. Effective prevention and patient care can only be ensured on the basis of correct epidemiological data. The management of the B.Braun Avitum Dialysis Network decided at the time of the outbreak in Hungary to establish an Operational Staff to perform tasks related to the epidemic. The tasks of the Operational Staff are the following: to ensure an effective, up-to-date connection with the dialysis centers, to update the epidemiological data, and to develop and operate an effective prevention program and action plan. To address the epidemic situation, complex measures were introduced in the Network regulated in a pandemic plan which was periodically reviewed. This document includes detailed hygiene regulations regarding patient transport, screening of dialysis center entrants, proper use of mask and personal protective equipment, hand hygiene, contact and respiratory isolation, rules of behavior, ordering a visitation ban, and regulation of cooperation with the hospital. ]

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