Journal of Nursing Theory and Practice

[“Entering the Forbidden Zone” – Career Orientation Open Day at the Toldy Ferenc Hospital and Patient Care Unit]

DÉR Ilona

DECEMBER 30, 2018

Journal of Nursing Theory and Practice - 2018;31(06)

COMMENTS

0 comments

Further articles in this publication

Journal of Nursing Theory and Practice

[Pulse Wave Velocity measurement among university students ]

KALMÁR Ágota, PÓSA Gabriella, FINTA Regina, NAGY Edit, SZILÁGYI Levente

[The aim of the study: The purpose of our investigation is to prove the favorable effect of regular physical activity on arteries. Material and method: 42 students (29 women; 13 men; age 24 ±2,71 years) volunteered for our research. Anthropometric data, segmental-, visceral body composition (TanitaSBCA) and arterial stiffness parameters (Arteriograph) were measured. Participants took part in an 8-week training. Interventional-group: started training during our research, control-group: doing sports constantly for years. Results: Compared to the age decadal artertial pulse wave velocity (PWVao) reference value both groups showed significant difference. PWVao significantly improved because of training by the interventional group (6,23±0,79; 5,87±0,59 p<0,01); while in the case of the control group there was no significant change (5,85±0,54; 5,87±0,63 p=0,80). The body composition data showed minimal correlation with PWVao. Conculsion: Regular training has favorable effect on one stiffness parameter of arteries. Already 8 weeks enough to reach significant change to reduce arterial stiffness and this condition can be maintained with long-term regular training.]

Journal of Nursing Theory and Practice

[Treatment and nursing of patients placed in prone position]

KISS Eszter

[Acute respiratory distress syndrome (ARDS) is a medical condition characterized by a high mortality rate. ARDS may be triggered by various pathologies such as sepsis and can have a significant impact on the overall outcome of primary disease. Prone positioning as a supportive strategy in the treatment of ARDS that has been investigated  since 1974. Lying face down has become more and more popular because it might have helped to improve oxygenisation in 70 percent of patients with ARDS. Occurence of ARDS did not change in the last 10 years in Europe and the syndrome is still associated with a quite high death rate between 40-50% despite of technologic and therapeutic improvement of last decades. It has already been investigated whether prone positioning may increase survival in patients with ARDS. However, approaches to the exact use of position are often occasional. Guideline development would be crucial to emphasize beneficial effect of prone positioning in patients suffering from ARDS and describe the process by which the manoeuvre may be performed. Primarily, it is substantial to improve oxygenation through the use of the prone position whilst promoting patient safety. Complications can be minimized by using a predefined strategy of placing patients in a prone position and a related checklist. ]

Journal of Nursing Theory and Practice

[Judgement of organ donations’ nursing-related problems by nurses in the light of a Hungarian survey ]

SZÉCSÉNYI Péter, RAJKI Veronika

[Aim of the study: The research aims to map the opinions of nurses working on transplantation wards about the preparedness of laic people in relation to the theme of organ donation. In addition, we wanted to examine whether nurses give preference to religious beliefs and ethical principles against legal regulation. We also wondered whether nurses working on transplantation wards would offer their own organs. Materials and methods: The descriptive study was conducted among transplant nurses in Budapest, Szeged and Pécs, using a self-constructed questionnaire. Our results were obtained using a Pearson’s Chi-square test (all statistically significant levels were set at P<0.05), as well as using the one sample t-test. Results: The total sample size was 37. According to nurses, the laic population does not have the sufficient knowledge about the current legal rules. Nurses are positively committed to offering their own organs for a possible donation. In relation to organ donation, nurses prefer the religious and ethical principles against legal rules. Conclusions: The laic population is not fully aware of organ donation, which puts the success of organ donation at risk. It would worth to involve transplant nurses into the education of the laic population to improve the general acceptance of organ donation who work in transplantation fields and who do donor care, so laics would be more accepting and less conflict would occur, supposedly more organ transplants would occur.]

Journal of Nursing Theory and Practice

[Challanges in transcultural nursing in the clinical practice]

BRECZKÓ Simenászné Lilla, TÓTH Dihelné Anikó

[The aim of the authors is to call attention to the differences arising during nursing of patients of different culture. Regarding to the fact that in our healthcare system there are more and more patients with foreign customs, it is inevitable for the healthcare staff to acquire new knowledge and apply it during their work in an effective way. ]

Journal of Nursing Theory and Practice

[Together with You for Others – a Report about the Chamber’s Campaign to Promote Healthcare Profession ]

BALOGH Zoltán, BABONITS Tamásné

All articles in the issue

Related contents

Clinical Neuroscience

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.]