Journal of Nursing Theory and Practice

[Advanced, evidence-based care - The care of the mechanically ventillated patient]

FULLÉR Noémi, OLÁH András

JUNE 20, 2014

Journal of Nursing Theory and Practice - 2014;27(03)

[The care of the mechanically ventillated patient is a complex nursing duty what requires comprehensive knowledges from the professionals. The appearance of the nosocomial conditions, costs of the care and days of the care can be decreased by the proper evidence based nursing practice. Many research papers and guidelines were developed at the international literature regarding the mechanically ventillated patients but the well-founded books or studies are missing in Hungary. With this paper the aim is to emphasize the importance of the evidence based nursing practice part of the critically ill patients what is necesary for the eligible care and should be a part of a well-trained health care professional’s knowledge. ]



Further articles in this publication

Journal of Nursing Theory and Practice

[Assessing the knowledge of patients after cataract surgery]

MELEG Tiborné, BÍRÓ Gyöngyi, NÉMETH Anikó

[Aim of study: Examining the knowledge of patients about ophthalmic screenings, their disorder, the necessary lifestyle changes and on how to use eye drops properly. Sample and methods: This cross-sectional study was conducted at the ophthalmology department of the hospital in Kecskemét using a self-developed questionnaire. Inpatients were involved during the period from June to September in 2013. Results: The studied patient population knew the importance of ophthalmic screenings, but they had inappropriate information about the right way to use eye drops and about the nature of cataract and the operation. Although the majority of the responders were informed by an expert, they had much false information about the necessary lifestyle changes. Conclusions: One of the most important task of nurses working at ophthalmology departments is to correct the false beliefs of patients and to replace them with correct and clear information, especially about their disorder and lifestyle changes.]

Journal of Nursing Theory and Practice

[The decaying health status of nurses]


[Aim of the study: Investigating the changes in health status, medicine usage and frequency of taking sick-leaves among nurses. Sample and methods: Two cross-sectional studies were conducted in six Hungarian teaching hospitals in 2003 and in 2010 involving full time worker inpatient care nurses who were asked to complete a questionnaire developed by the researchers. Results: The self evaluated health status of nurses worsened since the first survey. Significantly more nurses suffered from chronic diseases and more of them are taking medicines regularly than in 2003. The biggest increment was measured in the rate of people with digestive and musculoskeletal disorders, with allergies, varicose veins and migraine. The number of days on sick-leave decreased significantly and there are more nurses who do not take sick-days when they are sick. Sleep disturbances, head and back aches also occur more often. Conclusions: Based on our data the nurse population is getting older and nurses suffer from numerous chronic diseases.]

Journal of Nursing Theory and Practice

[The nursing of history - the history of nursing]


[The purpose of nursing is always the same: to restore a patient’s health, and provide help during his or her illness. Findings demonstrate that nursing already had an important role thousands of years before Christ. Broken bones, healed skull trepanations and joint diseases can be discovered in early findings. Caring for injured members of the same species cannot be seen, but in the case of elephants and dolphins, who provide company to the suffering member. The rest of the animals simply let the injured die. The author reviews the history of this remarkable activity, and introducing it from the beginning to our days, with particular regard to the milestones in Hungary.]

Journal of Nursing Theory and Practice

[The trials and tribulations of district nurses past and present]

BAKONYI Zoltánné

[The author wishes to highlight, for healthcare management, the work of paramedical professionals active in this field. She draws attention to the still largely untapped reserves of specialist knowledge possessed by these health workers. She suggests a method by which the currently underrated field of nursing could receive greater recognition, both in terms of working conditions and professional status. In this way nurses could more effectively provide a higher standard of care to patients registered with their practice, in the case of both acute and chronic diseases. A further aim of the paper is to present the structure and operation of the nursing practices that she envisions.]

Journal of Nursing Theory and Practice

[Code of Ethics - Council of the Hungarian Health Care Professionals]

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Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

JARABIN András János, KLIVÉNYI Péter, TISZLAVICZ László, MOLNÁR Anna Fiona, GION Katalin, FÖLDESI Imre, KISS Geza Jozsef, ROVÓ László, BELLA Zsolt

Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

Hypertension and nephrology

[About the care of patients with hyperuricaemia and gout]

[This consensus document is intended to provide guidance for the effective and efficient treatment of asymptomatic individuals with high uric acid levels and gout patients.]

Clinical Neuroscience

[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]

Clinical Neuroscience

[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]

Hypertension and nephrology

[Association between cyclothymic affective temperament and hypertension]


[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.]