Journal of Nursing Theory and Practice

[Hungarian Cancer Society - Nursing Section]

APRIL 30, 2015

Journal of Nursing Theory and Practice - 2015;28(02)

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Journal of Nursing Theory and Practice

[The international practice and acceptation concept on Hungary of the Advanced Practice Nurse (APN) training on the MSc level]

OLÁH András, MÁTÉ Orsolya, BETLEHEM József, FULLÉR Noémi

[In Hungary it was a niche and a reasonable developement according to the international trends to start the BSc nursing programme in 1989 - then the MSc nursing programme in 2000 -. However the structure of the nursing specialities’ education was not reviewed with the increase of the level of nursing education, so all of the nursing specialities’ education happens under BSc level. Also did not happened the determination of the nursing competencies on each educational level. These causes just contribute to have decreased number of nursing students within the BSc programmes and the numbers of nurses who intent to leave the profession are also increased. Migration of nurses, increased costs of the health care system, aging society, lack of physicians and the special knowledge of nurses to use for diagnostical and therapeutical equipements are challanges too beside these problems regarding the nurses. However, international literature says that with the employment of well-educated BSc, MSc nurses with expanded competencies the the problem of the lack of the physicians, waiting times, costs of the care, patients’ mortality may be decreased, patient’s satisfaction increases and because of the expanded nursing competencies the migration and nurses intent to leave are decreased. That is why it is reasonable to create BSc/MSc nursing specialities and expand nursing competencies in Hungary as well according to the international trends. Authors of this paper draw up a possible recommendation for the Hungarian implementation.]

Journal of Nursing Theory and Practice

[The effect of work uncertainty on burnout and health of nurses]

NÉMETH Anikó, LANTOS Katalin, BÁRSONYNÉ KIS Klára

[Aim of the research: To measure how work uncertainty effects on burnout, psychosomatic symptoms and subjective health conditious. Research and sampling methods: In this cross-sectional study the authors have conducted a group of nurses (N=29) at Mátra Health Institute in 2013-2014. The survey was designed by the authors. Results: The burnout becomes higher as the uncertainty at the workplace rises (p=0,038; r=0,387). The degree of the burnout correlates with the subjective negative health status (p<0,001; r=-0,650) and with the appearance of psychosomatic symptoms (p=0,003; r=0,530). The most common psychosomatic symptoms are the backache and dorsal pain, weakness, weariness, headache and sleeping problems. Conclusions: The uncertainty influences only the degree of the burnout, and it had no any effect on other variables) ]

Journal of Nursing Theory and Practice

[An in-depth look at chest pain, for ambulance nurses]

MOSKOLA Vladimír, HORNYÁK István

[Ambulance nurses often deal with complaints of chest pain, both when working independently and when on call in an emergency ambulance or quick response vehicle. It is essential that they know as much as possible about any life-threatening symptoms, and are as up-to-date with the latest skills when attending patients. This also helps teamwork and efforts to ensure an improvement and the proper treatment of the patient’s condition (in the context of an ambulance nurse’s duties). This all requires a knowledge of differential diagnosis, which gives a broad outline of the diseases that could potentially underlie the chest pains suffered by a patient who calls an ambulance. The more in-depth theoretical knowledge also promotes an understanding of the importance of intervention by ambulance crew/doctors in the case of certain diseases, the importance of the time factor, and the reason for urgency even if the patient’s condition does not appear serious at first glance. In the light of these factors the authors have undertaken to provide readers with new, evidence-based knowledge.]

Journal of Nursing Theory and Practice

[The role of self-help groups in the treatment of alcoholism]

PRÍMA Erika

[Alcoholism is one of the best-known addictions. The results of both international and national surveys illustrate the health consequences of the excessive consumption of alcoholic beverages, and its link with alcoholic disease and the associated dangers, but we still find a high proportion of people who show unrestrained consumption. Is there a genuine desire to recover, is there motivation, and where should one look for help? Such assistance could take the form of a self-help group, where addicts who want to quit, those in the various stages of recovery, or those who have already recovered, can meet up. The aim is to achieve and maintain abstinence, and prevent a relapse. The author presents the process and benefits of self-help, from the perspective of addiction. Her study proves that the treatment of alcoholism requires a complex approach, and one in which we can ascribe a key role to self-help groups.]

Journal of Nursing Theory and Practice

[Intracystic brachytherapy of cystic brain tumors by image fusion method- intracavital beta irradiation of 90-Yttrium solution]

BALLÁNÉ PERDUK Anikó, JULOW Jenő

[Aim of the research: The authors aimed to gain acceptance, effectiveness testing and the timetable of the shrinking of the cysts for the treatment procedure of patients with cystic craniopharyngeoma. The procedure utilizes intracavitary beta irradiation by 90Y colloidal solution. Image fusion was used for the first time for the guidance and control of the intra cystic irradiation of brain tumors. The authors also examined the use of the image fusion for brachytherapy of brain tumors before, during, and months or even years after surgery and to patient follow up. Research and sampling methods: 130 craniopharyngeoma cyst was irradiated with the Yttrium-90 colloidal solution in 84 patients. The internal wall of the cyst were getting a load of 180-300 Gy. The volumes of the cysts were followed almost over 30 years by the control of CT-MRI image fusion. For the planning of the irradiation the authors developed their own software and BrainLab was used for the CT-MRI-PET image fusion. For the mathematical and statistical calculation Matlab and MedCalc soft wares were utilized. Results: The results were from 130, 90Y β stereotactic intracavitary irradiation of cystic craniopharyngiomas. As per cystic CRF volume the volume reduction exceeded 80 %. The mean survival rate following 90-Y irradiation was 7.5 years. Large-scale shrinkage of craniopharyngioma cysts were observed significantly, following 6 months. Conclusions: According to long term clinical experience the intracavitary 90 Yttrium brachytherapy is a relatively non-invasive and effective mode for the recurrent cystic craniopharyngeoma therapy. Procedures where isotope get implanted, qualify in all aspects of a minimally invasive therapy.]

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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.

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[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

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[Thiazide- or thiazide-like diuretics should be used in the treatment of patients with hypertension? Particularities of the situation in Hungary]

VÁLYI Péter

[Diuretics have remained the cornerstone of the antihypertensive treatment since their widespreading in the 1960s. According to the 2018 ESC/ESH Guidelines for the management of arterial hypertension, in the absence of evidence from direct comparator trials and recognizing that many of the approved single-pill combinations are based on hydrochlorothiazide, this drug and thiazide-like indapamide can be considered suitable antihypertensive agents. In the 2018 Hungarian guidelines indapamide is named as the most efficacious diuretic in the treatment of patients with hypertension. The aim of the publication is redefining thiazide- and thiazide-like diuretic use in the treatment of hypertensive patients, with particular attention to presently available hydrochlorothia­zide and indapamide, and their combination drugs in Hungary.]

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VASAS Lívia, GEGES József

[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]

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[LAM 30: 1990–2020. Facing the mirror: Three decades of LAM, the Hungarian medicine and health care system]

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