Hypertension and nephrology

[Accredited Postgraduate Training]

DECEMBER 12, 2019

Hypertension and nephrology - 2019;23(06)

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Hypertension and nephrology

[Dystopic Kidney – Displacement of the Kidney]

DOLGOS Szilveszter, TÁRNOKI Ádám Domonkos, TÁRNOKI Dávid László

Hypertension and nephrology

[Hypertension and brain function. Correlation of high blood pressure and demencia in aging. Hypertension in young-middle adults - demencia in elderly]

SZÉKÁCS Béla, KÉKES Ede

[The cerebral vascular damage caused by hypertension is manifested primarily in cognitive dysfunction, which is caused by hypoperfusion of brain tissue, ischemic, or bleeding stroke, or white matte injury. Hypertension may not only result in cerebral damage to the vascular background - dementia -, but may also contribute to the development and progression of classical gene-related Alzheimer’s disease. Blood pressure gradually increases in the elderly and in the very elderly, and the frequency of hypertension-mostly as isolated systolic hypertension - is 50% to 70%. High blood pressure predominately, or in full, means not only an increase in the circulatory resistance of the small children, but also, as part of the aging of the body, the rigidity (stiffness) of the arteries. At the same time, the incidence of dementia, along with age, rises sharply - up to 20% in those over 65 years of age, and over 40% in 80-90 years of age. The relationship between high blood pressure and dementia from the young age to the very old age may change as a function of current age. In the very old age of life, the varying influence of other pathological factors other than hypertension is becoming more and more important in the deterioration of both the vascular structure and the brain function. In this late stage of life, the very advanced rate of aging and nutritive blood flow often require higher perfusion pressure, and the not enough thought-out blood pressure reduction can be more damaging than a protective effect on brain condition or function. SPRINT MIND - the Intense Blood Pressure Reduction - hasn’t resolved the question, and we can legally assume that the 130-140 Hgmm SBP. Is the most favorable for dementia. The value of DBP 70 Hgmm is definitely unfavorable.]

Hypertension and nephrology

[The effect of the β-blockers on left ventricular sytolic and diastolic function]

MOSER György

[The author surveys the pharmacodynamic effects, by which the β- blockers can exercise an influence on systolic and diastolic function. He points out, that the constituents of the effect can be separated only in didactic aspect, its worthwile to take the situation of their interdependence. Analyses the how the when and the wherefore the hemodynamic state determines the component of the complex mode of action that sets off. Deals with the problem, that what kind of effects are desired in certain clinical settings and which of those are deletorious. On emphasized he discusses the greatest danger of the β-blockade, the negative inotropic effect, and the mode of its offset or rather counteraction of its hemodinamic result.]

Hypertension and nephrology

[Risks Associated with the Use of Electronic Cigarette and Electronic Devices that Simulate Tobacco Smoking]

KÉKES Ede, VÁLYI Péter

Hypertension and nephrology

[Effects of Catheter Ablation or Antiarrhythmic Medicinal Treatment of Patients with Atrial Fibrillation on Mortality, Hemorrhage, the Frequency of Stroke and Sudden Cardiac Death: the CABANA Randomized Study Raising an Issue – Significance]

VÁRALLYAY Zoltán

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Relationship between Status Epilepticus Severity Score and etiology in adult NCSE patients

GENC Fatma, ERDAL Abidin, AKCA Gizem, KARACAY Ertan, GÖKSU Özaydın Eylem, KUTLU Gülnihal, GÖMCELI Bicer Yasemin

Purpose - Nonconvulsive status epilepticus (NCSE) is a heterogeneous, severe neurological disorder of different etiologies. In this study, the outcomes of NCSE episodes was assessed in a large series of adult patients. Our objective was to evaluate relationship between Status Epilepticus Severity Score (STESS) and etiology and the role of etiological factors on predicting the outcomes. Method - In this retrospective study, the medical records of 95 patients over 18 years of age who were diagnosed with NCSE between June 2011 and December 2015 were reviewed. Their treatment and follow-up for NCSE was performed at the Epilepsy Unit in Department of Neurology, Antalya Research and Training Hospital. Etiological factors thought to be responsible for NCSE episodes as well as the prognostic data were retrieved. The etiological factors were classified into three groups as those with a known history of epilepsy (Group 1), primary neurological disorder (Group 2), or systemic/unknown etiology (Group 3). STESS was retrospectively applied to patients. Results - There were 95 participants, 59 of whom were female. Group 1, Group 2, and Group 3 consisted of 11 (7 female), 54 (33 female), and 30 (19 female) patients, respectively. Of the 18 total deaths, 12 occurred in Group 2, and 6 in Group 3. The negative predictive value for a STESS score of ≤ 2 was 93.88% (+LR 2.05 95% CI: 1.44-2.9 and -LR 0.3 95% CI 0.10-0.84 ) in the overall study group. While the corresponding values for Group 1 (patients with epilepsy), Group 2 (patients with primary neurological disorder), and group 3 (patients with systemic or unknown etiology) were 100%, 92.59% (+LR 2.06 95%CI: 1.32-3.21 and -LR 0.28 95% CI 0.08-1.02 ) 83.33% (+LR 1.14 95%CI: 0.59-2.9 and -LR 0.80 95% CI 0.23-2.73). Conclusions - This study included the one of the largest patients series ever reported in whom STESS, a clinical scoring system proposed for use in patients with status epilepticus, has been implemented. Although STESS appeared to be quite useful for predicting a favorable outcome in NCSE patients with epilepsy and primary neurological disorders, its predictive value in patients with systemic or unknown etiology was lower. Further prospective studies including larger NCSE samples are warranted.

Journal of Nursing Theory and Practice

[Nurses education project management tools to help introduce the practice of the administration of parenteral incretin mimetics]

DIHELNÉ TÓTH Tóth Anikó, SZABÓ Roberta

[Aim of the study: The goal of the authors was to further educate diabetes health care professionals and keep their knowledge up to date during the explosive development of diabetes science. The team members should be competent to administer modern therapies adapted to the patients’ satisfaction in order to improve the quality of life of the patients. Materials and methods: Diabetes education nurses team members were professionally educated in the administration of liraglutide therapy at Uzsoki Hospital, II. Department of Internal Medicine (N=20). The introduction of the new therapeutic steps of this treatment was carried out using project management techniques. The effectiveness of knowledge-education placement tests conducted by comparing. Results: After the introduction of planning and execution, it was found that the professionals mastered the education of liraglutide therapy. Included in the scope of the project, besides the educational training of the team was the introduction of the treatment stages in liraglutide therapy. In order to assess the level of the knowledge acquired among the team members, survey questions were evaluated. According to the results, it can be stated that trained team members learned the new skills in the field of educational modification. Conclusions: The most important question of patient management quality care is whether the patient is able to optimally manage his/her life independently. The continuous presence of an educator team - which is up to date in the rapid development of the clinical science of diabetology - is essential in the achievement of this goal. The supervisor of the department is responsible for the ongoing training and monitoring of educator nurses. ]

Hypertension and nephrology

[Report on the 7th National Psychonephrology and Rehabilitation Conference and the 4th National Psychosocial Resort Nurse Training in Gánt]

MUCSI István, POLNER Kálmán

Journal of Nursing Theory and Practice

[Evidence in the presentation of factors influencing the development of pressure ulcers]

CSERNUS Mariann

[The development and healing of pressure ulcers depends on a combination of several factors. The factors related to the patient (physical impacts, biological and psychosocial factors), as well as the influencing factors arising in relation to the lingering wound (e.g. the content, situation, size and blood supply of the sore, the condition of the wound bed, the presence of infection, the response to treatment) are all closely related to the patient’s general condition and the underlying disease. An important role is also played by the factors associated with the healthcare personnel (ability, professional qualifications, attitude), and the healthcare system (level of technical and economic advancement, preventive and wound care equipment, quality assurance, training). The author has set out to give a detailed description of these factors, supported by professional evidence. ]

Hypertension and nephrology

[Report of the 26th Postgraduate Training Congress of the Hungarian Society of Hypertension]

NEMCSIK János