Hypertension and nephrology

[Scientific Program]

OCTOBER 01, 2019

Hypertension and nephrology - 2019;23(01 klsz)

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Lege Artis Medicinae

[THE EPIDEMIOLOGY OF CEREBROVASCULAR DISEASES IN HUNGARY AFTER THE MILLENNIUM]

VOKÓ Zoltán, SZÉLES György, KARDOS László, NÉMETH Renáta, ÁDÁNY Róza

[INTRODUCTION - Here we present the descriptive epidemiology of stroke in Hungary including mortality, morbidity, functional limitation and inpatient care based on the most recent health statistical data. METHODS - Mortality data were analysed by direct and indirect standardisation, and geographical mapping based on empirical Bayesian smoothing. Morbidity data were obtained from the General Practitioners’ Morbidity Sentinel Station Program and the National Health Surveys. The latter also provided data on functional limitation. Data on inpatient service were taken from the European Hospital Morbidity Database of WHO. RESULTS - Hungarian stroke mortality continued to decrease in recent years, and the slope of the decrease was larger than in Western Europe. Stroke mortality was highest in the Northern- Hungarian Region, and in Somogy and Zala counties. The incidence of stroke was 1.5-2 times higher than in the developed countries in most age groups. Over 64 years of age, a decline of stroke incidence was observed, especially in men. In this age group approximately 10% of men and 7% of women had already had a stroke. Of these patients more than 10% needed assistance to get out of the bed, dress up, or eat. Hospitals reported more than 60 000 stroke cases in 2005. CONCLUSION - Despite the promising trends in stroke mortality and now also in morbidity, both indices are still rather high in Hungary compared to those in Western-Europe. The relatively favourable epidemiological changes, however, may be overridden by the increased stroke burden resulting from the aging of the population.]

Journal of Nursing Theory and Practice

[The role of nurses in the early recognition and treatment of sepsis]

BABARCI Ágnes

[Aim of the study: The aim of the research was to gain a complex assessment of nurses’ skills related to sepsis. Sample and method: The survey was conducted at the University of Szeged, among nurses at four departments of the Anaesthesia and Intensive Care Institute, and at the Cardiac Surgery Post-operative Unit. The survey sample consisted of the specialist nurses at the aforementioned intensive-care departments. The nurses had to complete a questionnaire consisting of 37 questions, concerning the topics of sepsis, hand disinfection and continuous training. The answers were evaluated through a statistic analysis using the SPSS 21 program (Kruskal-Wallis test, binomial test, one-sample T-test and regression analysis), with a significance level of p =0.05. Results: Based on the results, 28.6% of the surveyed sample is capable of differentiating sepsis, severe sepsis and septic shock on the basis of the listed symptoms (p <0.001). The answers given to questions relating to the treatment and nursing of septic patients revealed that the level of knowledge is not satisfactory (p <0.001). No correlation could be demonstrated between the number of years spent working in the intensive-care department and the level of sepsis related knowledge (p =0.138). Conclusions: Based on the research results it can be concluded that there is a real need and demand for continuous training in relation to sepsis. ]

Clinical Neuroscience

[Tracing trace elements in mental functions]

JANKA Zoltán

[Trace elements are found in the living organism in small (trace) amounts and are mainly essential for living functions. Essential trace elements are in humans the chromium (Cr), cobalt (Co), copper (Cu), fluorine (F), iodine (I), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), and questionably the boron (B) and vanadium (V). According to the biopsychosocial concept, mental functions have biological underpinnings, therefore the impairment of certain neurochemical processes due to shortage of trace elements may have mental consequences. Scientific investigations indicate the putative role of trace element deficiency in psychiatric disorders such in depression (Zn, Cr, Se, Fe, Co, I), premenstrual dysphoria (Cr), schizophrenia (Zn, Se), cognitive deterioration/de­mentia (B, Zn, Fe, Mn, Co, V), mental retardation (I, Mo, Cu), binge-eating (Cr), autism (Zn, Mn, Cu, Co) and attention deficit hyperactivity disorder (Fe). At the same time, the excess quantity (chronic exposure, genetic error) of certain trace elements (Cu, Mn, Co, Cr, Fe, V) can also lead to mental disturbances (depression, anxiety, psychosis, cognitive dysfunction, insomnia). Lithium (Li), being efficacious in the treatment of bipolar mood disorder, is not declared officially as a trace element. Due to nutrition (drinking water, food) the serum Li level is about a thousand times less than that used in therapy. However, Li level in the red cells is lower as the membrane sodium-Li countertransport results in a Li efflux. Nevertheless, the possibility that Li is a trace element has emerged as studies indicate its potential efficacy in such a low concentration, since certain geographic regions show an inverse correlation between the Li level of drinking water and the suicide rate in that area. ]

Hypertension and nephrology

[Results of the comprehensive health screening of Hungary (MÁESZ) in 2017 and comparative results of 2010-2017 specially to hypertension]

BARNA István, KÉKES Ede, DAIKI Tenno, DANKOVICS Gergely, KISS István, A MÁESZ Programbizottsága nevében

[The year 2017 saw the continuation of Hungary’s greatest and to date most comprehensive health screening program started in 2010. The examinations - among them coronary examinations - covered the fields of cardiology and hypertension, they took place in a specially furnished lorry. In the program we measured blood pressure, pulse rate, calculated cardiovascular risk, plasma cholesterol, glucose and uric acid levels. Whole body analysis started with measuring height, weight, abdominal circumference and waist/hip ratio defining target body weight. Following the measurement of body fat and muscle content we decided the surface volume of the abdominal fat and calculated body mass index. Participants and results of the examinations of the people who have presented themselves for the test since 2017 have been evaluated. In the Program a total (52.2%) women and (47.8%) men were tested at 204 locations. Upon data processing with the help of a query 21.9% of the participants reported suffering from hypertension. The screening truck has been to 1505 places is Hungary, and travelled 183,335 km, 135,879 people have participated in comprehensive screening. The average systolic blood pressure among women was in the normal range up to the age of 55 years. The diastolic blood pressure levels were in the normal range for both sexes (with the exception of the age group 46-55 of men where it exceeded the upper limit of the normal range by a minimal extent). Among men stage 1 hypertension was the most frequent status for all age groups; blood pressures above 140/90 were measured for 39% of subjects from age 18 onwards. Conclusions: Thanks to the vast information obtained through the program a comprehensive picture has been drawn about Hungary’s present health status not only on a regional or cross sectional level but as it was described in the program, too.]

Clinical Neuroscience

[Measuring of functional impairment of lumbal spine]

VALASEK Tamás, VARGA Péter Pál, KLEMENCSICS István, SZÖVÉRFI Zsolt, BOZSÓDI Árpád, ÉLTES Péter Endre, LAZÁRY Áron

[Background and purpose - The purpose of our study was to outline the Hungarian validation process of the Oswestry Disability Index, the Quebec Back Pain Disability Scale, the Roland-Morris Disability Questionnaire and the Core Outcome Measurement Index, as well as to draw up recommendations regarding their future applications. Methods - The Hungarian versions were brought to life after a cultural and linguistic adaptation. Next to the above-mentioned questionnaires, the questionnaire booklet used for validation also contained the WHOQoL-BREF general quality of life questionnaire and a pain measuring Visual Analog Scale. The data of low-back pain patients were registered twice in two weeks. We determined the internal homogeneity (Cronbach alpha), reproducibility, standard error of measurement and the minimal detectable change of the questionnaires. Patients were assigned into different two subgroups (surgical / non-surgical, with / without affection of nerve roots) and differences between the subgroups were examined with the help of the questionnaires. We determined the physical subscale of the WHOQoL-BREF and the correlation between the pain and the studied questionnaires. Results - The value of Cronbach alpha was between 0.85 and 0.95. All four questionnaires showed significant differences (p<0.001) between the subgroups. The correlation studies brought strong and significant results (p<0.001, r>0.5) in every case. The values of reproducibility were between 0.93-0.92. The results of standard measurement error: 4.8 (Oswestry), 5.2 (Quebec), 1.6 (Roland-Morris), 0.59 (Core Index). The minimal detectable change was 13; 14; 4, and 2 points, respectively. Conclusion - The Hungarian versions of all four questionnaires are valid. They can be applied with scientific certainty to measure low back pain patients. From the studied questionnaires, we especially recommend the wide-raging application of the Oswestry Disability Index and the Core Outcome Measurement Index based on their psychometric and application features. ]