Hypertension and nephrology

[Scientific Program]

OCTOBER 19, 2017

Hypertension and nephrology - 2017;21(02 klsz)

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Hypertension and nephrology

[Association between cyclothymic affective temperament and hypertension]

NEMCSIK János, BATTA Dóra, KŐRÖSI Beáta, RIHMER Zoltán

[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]

Clinical Neuroscience

[Decisional collisions between evidence and experience based medicine in care of people with epilepsy]

RAJNA Péter

[Background – Based on the literature and his long-term clinical practice the author stresses the main collisions of evidence and experience based medicine in the care of people with epilepsy. Purpose – To see, what are the professional decisions of high responsibility in the epilepsy-care, in whose the relevant clinical research is still lacking or does not give a satisfactory basis. Methods – Following the structure of the Hungarian Guideline the author points the critical situations and decisions. He explains also the causes of the dilemmas: the lack or uncertainty of evidences or the difficulty of scientific investigation of the situation. Results – There are some priorities of experience based medicine in the following areas: definition of epilepsy, classification of seizures, etiology – including genetic background –, role of precipitating and provoking factors. These are able to influence the complex diagnosis. In the pharmacotherapy the choice of the first drug and the optimal algorithm as well as the tasks during the care are also depends on personal experiences sometimes contradictory to the official recommendations. Same can occur in the choice of the non-pharmacological treatments and rehabilitation. Discussion and conclusion – Personal professional experiences (and interests of patients) must be obligatory accessories of evidence based attitude, but for achieving the optimal results, in some situations they replace the official recommendations. Therefore it is very important that the problematic patients do meet experts having necessary experiences and also professional responsibility to help in these decisions. ]

Journal of Nursing Theory and Practice

[Smoking habits and predicting factors of smoking cessation among health care workers ]

SZELKÓ Olajosné Katalin, SIKET Ujváriné Adrienn, SÁRVÁRY Attila, ZRÍNYI Miklós

[The aim of the study: The aims of the study were to determine the prevalence of smoking and identify factors that predict smoking cessation motivation among health workers. Material and method: Cross-sectional, self-reported survey filled out by all healthcare workers of Jósa András Teaching Hospital. Statistical analyses were performed by chi-square analysis and Mann-Whitney tests. Results: Of all responses (N =1561), 29.9% reported actively smoking, 52.0% smoked between 11-20 cigarettes a day. A total of 20.4% had tried to quit smoking before. Those who would not participate in a smoking cessation program outweighed those who favored participation (43.2% vs. 35.6%). Significant relationships were found between the technique of smoking cessation and intent to quit smoking (χ2 = 7,73; p = 0,02) and between smoking cessation and stress induced smoking habits (r = 0,1; p = 0,12). Those not wanting to quit smoking appraised smoking as a social link to others (Z = -2.34; p = 0,02). Conclusion: Besides putting a stronger emphasis on smoking cessation and on negative health effects of smoking, nurse managers should promote working environments where improvement in stress management and collegial relationships will minimize the need for smoke related groups.. ]

Clinical Neuroscience

[EVENT-RELATED EEG AND EVOKED POTENTIAL INVESTIGATIONS IN THE CLINICAL PRA]

RAJNA Péter, HIDASI Zoltán, WALDEMAR Szelenberger

[Considering the limits of the traditional EEG techniques the authors review the main methods and clinical importance of the event-related EEG investigations. According to methods, these can be classified into the spectral analysis of task-related, pre-task and post-task recordings as well as stimuluscontrolled measurements based on evoked potential techniques. The main results of clinical studies on the eventrelated EEG methods are summarized according to chief disease groups (Alzheimer’s disease, epilepsy, schizophrenia, Parkinson's disease, dyslexia, depression). The authors discuss the stimulus-dependent EEG discharges (P300, cognitive potential) in detail. They present the metaanalysis of 224 recent publications on human application of these methods. They analyze the involved scientific areas and the frequency by which these methods were applied in each. Following this, the results of 83 selected clinical studies are summarized. The frequency of the application of the various event-related EEG methods and the tested wave components and other parameters are listed. Finally a summary of the main clinical results is presented again by groups of diseases (schizophrenia, behavioral disorders, traumatic lesions, enuresis nocturna, depression, memory disturbance and dementia, drug effect). Finally, the potential perspectives and the limitations of the event-related EEG methods are briefly discussed.]

LAM KID

[Everyday decisions regarding osteoporosis treatment]

TAKÁCS István

[Efficient, new medicines as well as recent scientific results have substantially changed the options and daily practice of osteoporosis treatment. Besides the indicated duration of therapies, their indication has also changed in several key points, and the range of possibilities for switching therapies have expanded. Despite the availability of a steadily increasing number of data, large-scale studies do not always help making therapeutic decisions, so we have to rely on professional protocols and our own experience, as well as on logical thinking. Moreover, we also have to observe financial regulations. This summary is intended to serve as a guideline for the most important decision situations from the initiation of therapy until its cessation.]