Hypertension and nephrology

[From healthcare accross health affair to „whole-ness” affair ]


DECEMBER 10, 2017

Hypertension and nephrology - 2017;21(06)

[The present healthcare system is mainly disease-centered. There is an increased need in a health model, that considerates the human being, his or her health, health status, their effects on every day life activities, on filling of his or her social tasks, takes into account the influential role of physical, social, economical factors and personal characteristics as well. A such of kind health model should be developed, that considerates the whole human being, the completness of his or her health affairs, and simultaneously is a part of a „whole-ness” affair-, human-centered system, taking into account physical, social, economical and political factors at the same time.]



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Hypertension and nephrology

[A Letter to Our Readers]


Hypertension and nephrology

[Novelties in treatment of hypertension in pregnancy]


[Hypertensive disorders represent the most common and dangerous medical disorder in pregnancy. Furthermore, its prevalence is rising. According the recent studies the initiation of antihypertensive treatment should be withhold in mild chronic hypertension (140-159/90-109 mmHg) in pregnancy, excepting associated subclinical hypertensive organ damage or hypertensive complications because of risk of compromising uteroplacental perfusion and fatal circulation. In preeclampsia, however, early antihypertensive treatment is necessary for the prevention of maternal cerebrovascular events.]

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Hypertension and nephrology

[Strategies for increasing physical activity in chronic kidney insufficiency. Why to train in CKD?]

APOR Péter

[Chronic kidney patients are prone to lose their muscles, strength, their physical functioning and parallel to this the life expectancies are diminish. Physical training is a natural way to delaying these devastating processes in every grade of the illness. Centre-based or home, ambulant or dialysis-bound forms of programs are published – some of that recent information are summarized in this paper.]

Hypertension and nephrology

[Gout, hyperuricaemia and cardiovascular risk - Effects of allopurinol]


[Hyperuricemia has an increasing clinical relevance due to its pathomechanism and its presence and adverse effects on cardiovascular, metabolic and renal diseases today. Its presence is a world phenomenon and in our country, we have seen increasing incidence rates during the screening surveys in recent years. Convincing evidence suggests that the high uric acid values in cardiovascular and renal diseases is an independent risk factor for CV mortality and their clinical manifestations. Experimental and clinical evidences indicates that in addition to gout, all high uric acid levels should be considered to initiate the XO inhibitor allopurinol treatment. Recently, in some diseases, in the treatment of the underlying disease (especially elderly hypertension, ischemic heart disease, chronic heart failure, chronic kidney failure) is also considered as an adjunct therapy.]

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Clinical Neuroscience

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ÁDÁM Szilvia, CSERHÁTI Zoltán, MÉSZÁROS Veronika

[Background and purpose - Poor mental health among health care professionals may have a significant impact on public health. There is limited information about the prevalence and potential consequences of burnout and depression among nurses in Hungary. The objective of this study is to explore the relationship between burnout as well as depression and somatic symptoms as well as comorbidities among nurses in Hungary. Methods - Cross-sectional study with self-administered questionnaires among 1,713 nurses. Burnout and depression were assessed by the Maslach Burnout Inventory (MBIHSS) and the Shortened Beck Depression Questionnaire, respectively. Somatisation was measured by the Patient Health Questionnaire (PHQ-15). Correlates of burnout and depression were assessed by logistic and linear regression analyses. Results - The prevalence of depressive symptom and clinical depression was 35% and 13%, respectively. The prevalence of moderate and high level emotional exhaustion, depersonalisation, and decreased personal accomplishment was 44%, 36% and 74%, respectively. We identified burnout and depression as a predictor of high prevalence of subjective somatisation. Whilst burnout showed a strong association with increased prevalence of hypertension, depression predicted almost all examined diseases, in particular, cardiac and cerebrovascular diseases, as well as neoplasms. Conclusion - We found high prevalence of burnout and depression among nurses in Hungary. As depression has been shown to be associated with higher prevalence of comorbidities than burnout, its consequences may be more significant. Appropriate prevention, diagnosis, and adequate treatment of burnout and depression may decrease the prevalence of ensuing comorbidities.]

Clinical Neuroscience

[Health status and costs of ambulatory patients with multiple sclerosis in Hungary]

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[Background and purpose - Data on disease burden of multiple sclerosis from Eastern-Central Europe are very limited. Our aim was to explore the quality of life, resource utilisation and costs of ambulating patients with multiple sclerosis in Hungary. Methods - Cross-sectional questionnaire survey was performed in two outpatient neurology centres in 2009. Clinical history, health care utilisation in the past 12 months were surveyed, the Expanded Disability Status Scale and the EQ-5D questionnaires were applied. Cost calculation was conducted from the societal perspective. Results - Sixty-eight patients (female 70.6%) aged 38.0 (SD 9.1) with disease duration of 7.8 (SD 6.7) years were involved. Fifty-five (80.9%) had relapsing-remitting form and 52 (76.5%) were taking immunomodulatory drug. The average scores were: Expanded Disability Status Scale 1.9 (SD 1.7), EQ-5D 0.67 (SD 0.28). Mean total cost amounted to 10 902 Euros/patient/year (direct medical 67%, direct nonmedical 13%, indirect costs 20%). Drugs, disability pension and informal care were the highest cost items. Costs of mild (Expanded Disability Status Scale 0-3.5) and moderate (Expanded Disability Status Scale 4.0-6.5) disease were 9 218 and 17 634 Euros/patient/year respectively (p<0.01), that is lower than results from Western European countries. Conclusion - Our study provides current inputs for policy making and contributes to understanding variation of costof- illness of multiple sclerosis in Europe.]

Lege Artis Medicinae

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[Informing patients is still a concern for both patients and physi­cians. The §45/1 of the Act 1972 II. dealt the first time with general patient informa­tion. The right of patients to adequate information and the obligations of healthcare providers in order to enforce this right are enshrined in Articles 13 and §134-135 of the Act CLIV 1997 on Health. Under these laws, the patient is entitled to the full information provided to him/her in an indivi­dualized form. Regarding the content and scope of patient information, the main issue is its purpose. Thus the patient has to be placed in a position to assess the risk of the intervention and to make an informed decision about his/her own fate. A question­naire-based survey, which included 42 questions in five blocks, was conducted on a sample of 547 adults. As demonstrated, there was a strong correlation between patients’ under­standing of health and their need for information, and the content of doctor-patient interaction was not affected by how long the patient has been with his/her GP and the age of the doctor. The results showed that following the legal requirements for patient information and GP primary care during doctor-patient meetings is essential. It can be concluded that the number of individual doctor-patient appointments, their actual time and the number of patients appearing in the practice are not sufficient to ensure entirely the patient's general right to information.]

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Journal of Nursing Theory and Practice

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