Journal of Nursing Theory and Practice

[A poisonous heart killer]

RUTTKAY Bánk, CSIRIK Gyuláné

DECEMBER 30, 2016

Journal of Nursing Theory and Practice - 2016;29(06)

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Journal of Nursing Theory and Practice

[The problem-based learning benefits in nursing education]

POZSÁR Hajnalka

[Modern teaching in the schools of the XXI century is marked by terms of flexibility, innovation and requires the introduction of numerous innovations. Schools are required to modernize the curriculum and education technologies, and to leave the traditional teaching methods. Modern educational systems and teaching methods reflect the relevant didactic assumptions to improve the effectiveness of teaching. Emphasis will be put the changes that are designed to create independent and creative personalities. The attention in education is no longer a person who learn, rather the individual who is critical thinking, this is extremely important in the nursing profession. The nurse is the only profile of health workers trained in health care. They are a standalone members of the health team, in the area of its work with the necessary cooperation with other members of the health team. This paper analyzes the characteristics of modern educational systems and teaching methods to improve nurse education, especially problem-based learning and cooperative work, as an important segment in the nurse education. Analysing the modern educational systems, we expect results which will serve as a guide, how to change traditional „ex cathedra” teaching, to interactive and modern education.]

Journal of Nursing Theory and Practice

[The examination of the factors which are the underlying causes of the intrauterine fetal death]

ZUBOR Mónika, SZABÓ László, KARÁCSONY Ilona Hajnalka

[The aim of the study: Nowadays the most common obstetric complication is the stillbirth. The affected families suffer spiritually as well. The aim of our research was to identify those most common maternal factors which lead to the intrauterine death of the fetus. Material and methods: The retrospective research was carried out between January of 2007 and December of 2014 in Markusovszky Educational Hospital in Szombathely. During the non-random, targeted sampling, the research was carried out with the help of an essay which included the data of 50 people. Beside the descriptive statistics the authors also used Chi-squared test with the help of the Microsoft Excel program (p<0,05). Results: If we take into account the frequency of stillbirth, there is significant relationship between singular pregnancies and twin pregnancies (p<0,05). Among women from different ages there is a significant relationship between the frequency of endocrine diseases and stillbirth as well (p<0,05). According to the results the most common cause of the intrauterine death was hypoxia (32,6%). Conclusion:With the identification of high risk pregnancies at an early age and with the prevention the complications we could reduce the number of stillbirths.]

Journal of Nursing Theory and Practice

[Elements of health literacy among the Hungarian working population]

SZOBOTA Lívia, HIRDI Henriett Éva, BALOGH Zoltán

[Aim of the research: The authors’ objective was to reveal the state of health, lifestyle and health behaviour of economically active population. Research and sampling methods: The cross-sectional survey was conducted among white-collar workers in Hungary, selected using a random, sampling method. The data gathering took place using web-based, anonymous, self-completion questionnaire. The proprietary questionnaire used was based on the questionnaire used in the National Population Health Survey (OLEF) for the standard survey of health behaviour. The authors analysed the gathered data with Microsoft Excel 2010 software, using chi-square test and descriptive statistical method. They regarded the value of p <0,05 as significant. Results: The survey was completed by 735 workers (63% man, 37% woman). The average health value of workeres in the survey was 9.6 on a scale of ten grades. We separately analysed smoking habits and physical activity. Examining their state of health based on the psychosomatic symptoms scale, the respondents most frequently indicated back and lumbal pain, and sleep disorders. Conclusions: The results of survey revealed that the health condition of respondents is unsatisfying. Many white-collar workers are suffering from psychosomatic symptoms. On the whole it can be concluded that health behavior of workers needs to be changed. ]

Journal of Nursing Theory and Practice

[Dr. Mária Baloghy’s Memorial Exhibition]

HIRDI Henriett Éva

Journal of Nursing Theory and Practice

[The role of nurses in care of patients with Guillain- Barré syndrome]

ÁDÁM Éva

[The aim of study: development of nursing diagnoses that contribute to these patients’ quality of supply, and to work out a procedure for patients with Guillot-Barré syndrome, used by datas in the literature. Test method and sample: The test method is document analysis. I analyze and compare the literature da-tas, between 1 July 2007 and 31 October 2015, details of handled GBS patients suffering from neurologi-cal department. Following the presentation of GBS epidemiology, and anatomy background I present cli-nical symptoms of the disease, their justification, the opportunities to diagnosys, the treatment criterias, required in order to achieve quality patient care. Results: Treatment and Care of determining the recovery and rehabilitation of Guillain-Barré syndrome is concerned. The quality of care plays a key role in the patient’s quality of life regarding the future, which are summarized in a procedural order.]

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[Avoiding unlimited energy drink consumption is a matter of our heart]

DOJCSÁKNÉ Kiss-Tóth Éva

[Energy drinks have been gaining unbroken popularity, especially among youngsters and children since they were introduced to the market. Manufacturers promise to improve performance and stamina with consuming the products, classified as non-alcoholic soft drinks. In addition to the vitamins and plant extracts, they contain a significant amount of caffeine and other stimulants (taurine, guarana). Among the active ingredients, caffeine has an outstanding effect and thereby a danger, since its overconsumption – in addition to milder he­mo­dynamic changes – can cause severe cardio­vascular consequences, cardiac arrhythmias, ion channel diseases, increased blood coagulation, myocardial infarction or reduced cerebral blood flow in susceptible consumers. Many case studies have also reported serious cardiovascular attacks among young chronic energy drink consumers. Health impairments of excessive and long-term consumption of energy drinks have been studied increasingly, however there is limited and contradictory evidence on the safety of consumption and the effectiveness of performance enhancement. ]

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[Differential diagnosis and treatment of hyponatraemia]

NÉMETH Zsófia, DEÁK György

[Hyponatraemia (serum sodium concentration < 136 mmol/l) is the most frequent electrolyte abnormality that inceases the risk of both in-hospital, and outpatient mortality. Antidiuretic hormone action or low glomerular fitration rate or low excretable osmoles or their combination are involved in its pathogenesis. Differential diagnosis is based on medical and medication histories, serum- and urine osmolality and urine sodium concentration. Measurement of fractional excretions of urea and uric acid help identifying low effective circulting volume, renal hypoperfusion. Symptomatic hyponatraemia or an acute decrease of serum sodium concentration exceeding 10 mmol/l should be treated with 3% NaCl to avoid impending threat to life. The principles of the treatment of chronic hyponatraemia are restriction of water intake and elimination of etiologic factor(s) (eg. medications - most often thiazides). In case of contracted axtracellular volume, isotonic saline should be given. In case of euvolaemia, restriciton of water intake is fundamental. In case of expanded extracellular volume, (heart failure, liver cirrhosis, nephrosis), water and NaCl intake should be restricted along with aldosteron antagonist and loop diuretic therapy. In chronic hyponatraemia, the rise of serum sodium concentration should not exceed 10 mmol/l during the first 24 hours and 8 mmol/l/day thereafter. ]

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[Amlodipine/atorvastatin fix combination in general practice]

ÁBRAHÁM Erzsébet Judit

[In total 50 patients with hypertension and dyslipidaemia received combined antihypertensive and antilipid treatment. The main component of therapy was a fixed combination of amlodipine/ atorvastatin in different dose variations. The goal of the observation was to achieve optimal target blood pressure and lipid profile. During the six- month therapy, the baseline average blood pressure value was 161/90 mmHg and it decreased to 133/84 mmHg. The lipid profile also changed successfully. The average value of total cholesterol decreased from 5.9 mmol/l to 4.76 mmol/l. Over the six month period, amlodipine/ ator vastatin usage not only decreased the number of the heart and vascular system events, but increased the patients medicine compliance and therapy loyalty.]

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[PErindopril-Amlodipine Reducing Blood Pressure Level Trial - The PEARL Study]

NAGY Viktor, LANTOS Éva, HABONY Norbert

[Background and aims - In order to reach target blood pressure values more successfully and to achieve better therapeutic compliance, concomitant use of more antihypertensive agents with different mechanisms of action has gained much attention recently. In the PEARL study we investigated the antihypertensive effect of fixed dose combinations of perindopril and amlodipine (5/5, 5/10, 10/5, 10/10 mg Covercard) by measuring blood pressure values in the doctor’s office and with a 24-hour ambulatory blood pressure monitor (ABPM) in outpatients with primary, grade 1 or 2 hypertension, whose target values could not be reached with prior treatment. We also assessed changes of metabolic parameters and how patients felt themselves throughout the study. Patients and methods - In this open-label, multicentre, non-interventional, observational, 3 month long study we evaluated the data of 10 335 patients (5 483 female, 4 852 male, mean age: 61.0±12.4 years, waist circumference 99.0±13.8 cm). The mean duration of hypertension was 9.5±7.7 years. After signing the informed consent form, patients attended three visits (inclusion, months 1 and 3), and they were asked to fill in the data sheets (visit 1: gender, age, waist circumference, blood pressure and heart rate measured at the doctor’s office, duration of hypertension, risk factors, complications, accompanying diseases, previous antihypertensive treatments, complaints), laboratory blood tests and ABPM were optionally performed; visits 2 and 3: blood pressure and heart rate measured at the doctor’s office, adverse events, patient’s evaluation about the way they felt themselves, treatment, optionally performed laboratory blood tests and ABPM. Patients were asked to take perindopril-amlodipine fixed combination tablets in the mornings; the dose was increased if no normalization of blood pressure was observed. Data were analyzed with a one-sample t-test. The consistency of the different frequency distributions was tested with a Chi-square test. The two-sided level of significance was set at 5%. Results - All the parameters sensitive to treatment efficacy (blood pressure values measured on-site and with ABPM) were significantly improved with perindopril-amlodipine fixed combination treatment. Blood pressure measured at the doctor’s office reduced from 158/93 mmHg to 132/80 mmHg, while 24-hour mean blood pressure reduced from 145/84 mmHg to 128/76 mmHg (p<0.001), the diurnal index sensitive to blood pressure variability did not change and a dipper curve was observed throughout the study. Target blood pressure (<140/90 mmHg) was reached by 75.5 % of the patients. The mean dosage at the end of the study was 8 mg perindopril and 7.3 mg amlodipine. The results were consistent across subgroups of different previously received treatments and cardiovascular risks. Regarding laboratory findings, the reduction of total cholesterol from 5.67 to 5.21 mmol/L and that of LDL cholesterol from 3.18 to 2.83 mmol/L (p<0.001 for both) were of clinical importance. Eighty-five percent of the patients evaluated the way they felt themselves as excellent or improved. No serious adverse events were reported. Conclusion - Perindopril-amlodipine fixed combination can be administered effectively and safely to a large population of hypertensive patients who do not reach target blood pressure values.]

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[THE COMPLEX EFFECT OF TREATMENT TARGETING THE OESTROGEN RECEPTORS IN POSTMENOPAUSAL WOMEN]

TAKÁCS István, LAKATOS Péter

[Hormone depletion after menopause results in the dramatic increase of the incidence of a number of diseases. It should seem reasonable to substitute female hormones to prevent or treat these disorders. However, hormone replacement therapy has not fulfilled the expectations in its current form. While the first large, prospective, randomized, controlled primary prevention trial showed a beneficial effect of hormone replacement on bone fracture and colorectal cancer, the incidence of cardiovascular diseases and breast cancer increased. The overall effect of treatment was assessed by the so called global index. Based on the global index, the overall health risk exceeded benefits from 5 years use of combined oestrogen plus progestin among healthy postmenopausal women. In another study, oestrogen alone did not affect the incidence of coronary heart disease or colorectal cancer, neither was the increase in breast cancer rate significant. Similarly to combination therapy, the beneficial effect on bone fracture rate and the adverse effect on the incidence of cerebrovascular events have remained. Overall, oestrogen monotherapy had no effect on the global index. There is not enough data available yet to draw a conclusion on the overall effect of fitooestrogens that also target oestrogen receptors and tibolon, a steroid hormone with tissue-specific effects. Raloxifene, a selective oestrogen receptor modulator considerably decreases the rate of vertebral fractures. In a study it also decreased the number of peripheral fractures in a subgroup of patients with severe vertebral fractures. It reduced the rate of cardiovascular and cerebrovascular events in patients at increased cardiovascular risk. The incidence of breast cancer dropped both in the original 4-year study period and in its 4-year extension. Based on the beneficial change of the global index, it is only raloxifen that can currently be recommended for the complex treatment of postmenopausal women.]