Hypertension and nephrology

[A Guidance to Authors]

OCTOBER 20, 2017

Hypertension and nephrology - 2017;21(05)

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Hypertension and nephrology

[Thoughts about the Jubilee Congress of the Hungarian Society for Hypertension and a Message to the Guardians...]

KISS István

Hypertension and nephrology

[ACEi or ARB? What are the results of the comparative analysis?]

BENCZÚR Béla

[Angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) are treatment options for patients with cardiovascular disease (CVD) or those with cardiovascular risk factors. The comparative efficacy and safety of ACEis and ARBs have been much debated. To compare the benefits of angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) in patients without heart failure a metaanalysis was carried out based on 254.301 subjects of 106 randomised trials. Meta-analysis included randomized trials of ACEis and ARBs compared with placebo or active controls and corroborated with head-to-head trials of ARBs vs ACEis. According to placebo controlled studies ACEis but not ARBs reduced all-cause mortality, cardiovascular mortality and MI. It seems that ACEis are more effective than ARBs. But this is only true if we take into account the trials before 2000. The analysis restricted to trials published after 2000 revealed similar outcomes with ACEis vs placebo and ARBs vs placebo. Head-to-head comparison trials of ARBs vs ACEis exhibited no difference in outcomes. The underlying causes and details are explained in this review.]

Hypertension and nephrology

[Therapy of isolated systolic hypertension III.]

FARSANG Csaba

[In the elderly and very elderly (˃80 yrs), a wealth of data from large clinical trials are available, showing the necessity of treatment mostly with drug combinations - fix-combinations are preferred for increasing the adherence/persistence to therapy. Using diuretics, ACE-inhibitors/ARBs with calcium antagonists, and in special cases diuretics and beta blockers are also suggested by recent European guidelines (ESH, HSH). The target is <140 mmHg, but in octogenarians <150 mmHg. Some studies are pressing for even lower SBP (to around 120 mm Hg), but it seems to be wise to balance advantages/disadvantages, so the optimal SBP may be around 130 mmHg.]

Hypertension and nephrology

[Report on the 25th Jubilee Congress of the Hungarian Society of Hypertension]

NEMCSIK János, JÁRAI Zoltán

Hypertension and nephrology

[Healthy Living Issues that Need to be “Clarified” – Results from the PURE Study]

VÁLYI Péter

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[Celiac disease - in its typical form - is a chronic immunemediated enteropathy with typical clinical symptoms that develops against gliadin content of cereal grains, and is often associated with other autoimmune diseases. In cases of atypical manifestation classic symptoms may be absent or mild, and extra-intestinal symptoms or associated syndromes dominate clinical picture. The authors present a longitudinal follow-up of such a case. A 63-years old woman was diagnosed with epilepsy at the age of 19, and with progressive limb ataxia at the age of 36, which was initially thought to be caused by cerebellar atrophy, later probably by stiff person syndrome. At the age 59, her diabetes mellitus manifested with type 2 diabetic phenotype, but based on GAD positivity later was reclassified as type 1 diabetes. Only the last check-up discovered the celiac disease, retrospectively explaining the entire disease course and neurological symptoms. By presenting this case, the authors would like to draw attention to the fact that one should think of the possibility of celiac disease when cerebellar ataxia, progressive neurological symptoms and diabetes are present at the same time. An early diagnosis may help to delay the progression of disease and help better treatment.]

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[The role of nurses and their tasks in early sepsis management]

VÁRADI Annamária, FEHÉR Gábor, FÖMÖTÖR Péter

[The Surviving Sepsis Guideline (SSG) is a document that proposed new solutions in the diagnostics and treatment of sepsis. The methods identified were the 100% oxygen therapy, fluid resuscitation, blood culture and microbiological analysis, empiric combination antibiotic therapy, lactate monitoring, comparison of PCT and CRP, and surgical opening. Using the above mentioned methods has proven to improve the quality of sepsis treatment and the safety of patients. Sepsis -6 protocol has been highlighted by the authors as a process that is easy to implement in terms of cost while remaining highly beneficial. This recommendation should also be well known for nurses that do not work in emergency units. This will help recognise sepsis at an early stage, and provide guideline in the analytical examination and the possibilities within the competence. ]

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[Aim of the study: To assess the willingness of students at the Faculty of Health Sciences of Semmelweis University, with respect to the preferred number of children and the planned date of the first birth. To gain an understanding of student attitudes in relation to motherhood and the role of the woman and the relevance of the traditional family model today. Further, to examine the differences in responses from students of the three specialist areas. Methodology and sample: The authors conducted the quantitative sociological survey, based on a self-completion questionnaire, among 2nd, 3rd and 4th year student nurses, student midwifes and student health visitors at the Semmelweis University Faculty of Health Sciences. The results were analysed with the SPSS 19.0 program, using a descriptive statistical method. The proportion of useful responses to the questionnaire was 94.1% (N=257). Results: The majority of the students planned to have children, at an average age of 26.5. The preferred number of children was two or three in most cases. The majority would like to start a family when married, and regard the daily caring for children as mainly the woman’s task, which shows support for the traditional family model. In their present/future circumstances, health visitors expressed a preference for motherhood in the highest numbers, and nurses in the lowest numbers (p=0.,012). Conclusions: The student nurses, midwives and health visitors at the Faculty of Health Sciences clearly plan to start families in the future. They have a traditional attitude towards the maternal role, but putting these ideas into practice is made more difficult by their paramedical vocation. Nurses and midwives, in particular, are in danger of a conflict of roles in their future lives, for reasons such as the shift working and secondary jobs. ]