Journal of Nursing Theory and Practice

[American Heroine of home care nursing and social care, Lillian D. Wald was born 150 years ago]

BALOGH Zoltán, BALOGH Ádám, MISI Adelina

APRIL 30, 2017

Journal of Nursing Theory and Practice - 2017;30(02)

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Journal of Nursing Theory and Practice

[Examination of cardio-vascular risk factors in the priority of atrial fibrillation]

BÉKEFI-MENG Zsuzsa, PAKAI Annamária, SZUNOMÁR Szilvia, VÁRADYNÉ HORVÁTH Ágnes

[Objectives: Stroke-prophylaxis is the biggest question regarding atrial fibrillation. Their aim is to examine the risk factors, successfulness of frequency control, and the effectiveness of anticoagulant therapy. Methods: This quantitative cross-sectional study used a non-randomized sampling method. Enrollment criteria: anticoa-gulant therapy, atrial fibrillation, age 20-90 years, NYHA stage II. Excursion criteria: patients having elective intervention that influences INR rates. Patient data was collected from the records of the University of Pécs, Cardiology Clinic between 01.01.2012-31.12. They used linear regression, T-test, χ2-test, variance analysis (ANOVA), SPSS 20.0. Results: Significant correlation between BMI values-, systolic blood pressure-, modified medication and its effect on frequency control-, correct anticoagulant therapy, INR parameters and the increased risk of thromboembolia in patients with atrial fibrillation. (p<0.05) Conclusion: Stratification of risk factors and individual optimisation of anticoagulant therapy is important for effective stroke prevention and increased survival rate.]

Journal of Nursing Theory and Practice

[An examination of knowledge about cervical cancer Roma women in Hungary]

BOGDÁNNÉ BASA Eszter, VAJDA Réka, VÁRADYNÉ HORVÁTH Ágnes, KARÁCSONY Ilona, PAKAI Annamária

[The aim of our study was to assess the main reasons for romany women to stay away from cervical cancer screening and knowledge about cervical cancer. Methods: We carried out a quantitative, cross-sectional study with non-probability convenience sampling in 2016. Our sample consists of romany women living in the agglomeration of Nagyatád, Hungary (N=126). In the questionnaire we measured reasons for non-attendance and knowledge. During statistical analysis we calculated descriptive statistics, χc2-test and t-test (p<0,05). Results: Mean age of responders is 37,45±12,05 years. 26,2% of women have not attended any kind of gynecological screening in their life. Mean age of women when they attended for screening for the first time was 24,05±8,96 years (n=91). Main score of the knowledge test is 31,4±3,93 points. According to knowledge level there is no connection between attendants and non-attendants(p>0,05). Conclusions: The lack of knowledge determines the participating willingness, to increase has been possible by organized knowledge transmitter performances.]

Journal of Nursing Theory and Practice

[Handling hazardous drugs during bladder instillation: epirubicin contamination with and without a closed system]

BOGNÁR Krisztina, ZRÍNYI Miklós, JUHÁSZ Ákos, BATKA Gábor

[The aim of the study: Assess epirubicin contamination during bladder instillation with or without the use of a closed system drug transfer device (CSTD). Material and Methods: Four hospital sites participated in an experimental wipe study (3 used, 1 did not use a CSTD [control]). Samples were frozen and transported to Germany for liquid chromatography analysis. Samples were taken from seven surfaces following drug reconstitution and patient administration. Group differences were analyzed by one way ANOVA. Results: There was a major difference in contamination between CSTD and non-CSTD use (F = 7,63; p < 0,001); the workflow without the use of a CSTD showed much greater amounts of epirubicin left behind. There wasn’t any difference in contamination across sites using a CSTD. Conclusions: Without a CSTD epirubicin contamination was high. The CSTD was shown to be effective to minimize the health risk of nurses. We recommend that CSTD be implemented in routine nursing practice.]

Journal of Nursing Theory and Practice

[Intermittent Clean Catheterisation (ICC)]

NYILASI Anikó

[In Hungary intermittent clean selfcatheterization is a method which has been used for a long time, but the intervention in pediatrics like the process, the short history of it, the method’s detailed description and the education of it is less known among nurses. ]

Journal of Nursing Theory and Practice

[Introduction of the Hungarian Hospice- Palliative Association]

LUKÁCS Miklós

[The Hungarian Hospice-Palliative Association was founded in 1995 and represents nearly a hundred national hospice organization. Our goal is to promote technical cooperation, development of end of life care to terminally ill patients, social awareness and volunteerism, social responsibility and promoting solidarity with the patients. This is accomplished by initial and continuing vocational training, organizing conferences, professional guidelines and the formulation of policies, research support and coordination of publications.]

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Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

Clinical Neuroscience

Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

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.

Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

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.]