Journal of Nursing Theory and Practice

[Research for Nurses 1. part: Research Design]

PAPP László

APRIL 30, 2013

Journal of Nursing Theory and Practice - 2013;26(02)

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Journal of Nursing Theory and Practice

[Complications of wearing contact lenses]

MÉSZÁROSNÉ PINTÉR Katalin

[Aim of the study: The author seeks to identify the reasons why contact lenses can cause wearers to develop inflammation of the cornea. She also examines whether the development of this severe condition can be avoided. Sample and method: The study was conducted among contact lens-wearing inpatients at the Ophthalmology Department of the Szent Pantaleon Hospital and Clinic. A questionnaire designed by the author, consisting of closed-ended questions, was distributed to 18 patients. Results: All 18 of the patients used soft, monthly-replacement contact lenses. Ten persons wore the lenses for two weeks longer, and five persons for one week longer than prescribed. Five persons neglected to wash their hands before inserting and removing the lenses. Five persons were not in the habit of cleaning contaminants from the lens, and seven persons did not use fresh storage solution every day. Four persons used tap water for the care of the lenses. Five persons did not remove the lenses at night, and four inserted the lenses into red, inflamed eyes. With the exception of one person they did not take a break from wearing the lenses, and three persons possessed spectacles. Fourteen persons were not satisfied with the information received from the optician. Conclusions: All of the changes were due to bacterial complications that were attributable to unsatisfactory cleaning of the contact lenses. ]

Journal of Nursing Theory and Practice

[Possible protective factors in the wound healing in light of survey]

PAKAI Annamária, TÓTH Marianna, VÁRADYNÉ HORVÁTH Ágnes, OLÁH András, HORVÁTH Örs Péter

[Purpose of the study: to investigate the correlation between the surgical procedure and the disorders of wound-healing, furthermore to examine the impact of the matter of suture on the incidence of wound healing problems. Methods and material: The survey was carried out at Surgical Clinic of the University of Pécs, among patients between 18 to 85 years who had been undergone an elective abdominal surgery between 2009-2010 (n=105). In the course of the document analysis the authors reviewed socio-demographic data and the preoperative and postoperative parameters. The authors applied descriptive statistics with SPSS 17 moreover two-sample t- test, khi square test and logistic regression (p<0,05). Results: The incidence of wound-healing disturbance is higher in the case of using draine, however it is lower if Triclosan suture is used (p<0,05). Conclusion: A number of Hungarian and international study reports that many factors can be responsible for surgical site infections. The results point out the significance of Evidence Based Nursing wound attendance in the context of team work. ]

Journal of Nursing Theory and Practice

[Does the fear of losing their jobs play any role in the everyday lives of health care workers?]

IRINYI Tamás, NÉMETH Anikó

[Aims: To assess the degree of fear from becoming unemployed among health care workers in Csongrád County, and the impact of this fear on physical and psychic health, or rather the intent to leave the profession. Methods: This is a cross-sectional study carried out through a self-designed self-report questionnaire sent to registered members of MESZK living in Csongrád County. Results: Those with worse psychosomatic status (p=0.003) and greater rate of burnout (p<0.000) are more afraid of losing their jobs. The fear has a great impact on the intent to leave the profession (p<0.000). Who are not afraid of becoming unemployed feel that they would be physically and psychically able to work in their profession till retirement. Conclusions: Fear is present in the everyday lives of health care workers, and affects their physical and psychic health. ]

Journal of Nursing Theory and Practice

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Journal of Nursing Theory and Practice

[Episiotomy practice in Hungary ]

SZÉNÁSI Rita, LIPIENNÉ KRÉMER Ibolya, MÉSZÁROS Judit

[Aim of the study: The aim of the research was to assess the ways in which pregnant women prepared for giving birth, and the alternative opportunities for labour and delivery, and to examine the attitudes of professionals and mothers to episiotomy. Sample and method: Participating in the first part of the study, a questionnaire-based survey with 35 questions, were women who underwent spontaneous vaginal labour in hospital after week 36 (643 persons). The data was processed in a descriptive statistical model with percentage distribution indicators. In the second part of the study, 314 spontaneous vaginal births that took place in a Budapest hospital between 1 January and 31 March 2011 were examined on the basis of the birth log, with the focus on episiotomy. Results: The results show that today the proportion of women who give birth with an episiotomy is still very high, and the incidence of intervention and tests in the course of labour is also high. The survey also revealed that episiotomies were carried out in fewer cases where the obstetrician was accompanied by a midwife. Conclusions: In comparison to past years there is a greater focus now on alternative obstetrician training and midwifery methods, and on perineal protection, but the use of these methods in everyday practice is still not sufficiently prevalent. It is essential to bring about a change in the professional attitudes of specialists to natural birth, which could promote a more humane standard of obstetric care.]

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Neuroscience highlights: Main cell types underlying memory and spatial navigation

KRABOTH Zoltán, KÁLMÁN Bernadette

Interest in the hippocampal formation and its role in navigation and memory arose in the second part of the 20th century, at least in part due to the curious case of Henry G. Molaison, who underwent brain surgery for intractable epilepsy. The temporal association observed between the removal of his entorhinal cortex along with a significant part of hippocampus and the developing severe memory deficit inspired scientists to focus on these regions. The subsequent discovery of the so-called place cells in the hippocampus launched the description of many other functional cell types and neuronal networks throughout the Papez-circuit that has a key role in memory processes and spatial information coding (speed, head direction, border, grid, object-vector etc). Each of these cell types has its own unique characteristics, and together they form the so-called “Brain GPS”. The aim of this short survey is to highlight for practicing neurologists the types of cells and neuronal networks that represent the anatomical substrates and physiological correlates of pathological entities affecting the limbic system, especially in the temporal lobe. For that purpose, we survey early discoveries along with the most relevant neuroscience observations from the recent literature. By this brief survey, we highlight main cell types in the hippocampal formation, and describe their roles in spatial navigation and memory processes. In recent decades, an array of new and functionally unique neuron types has been recognized in the hippocampal formation, but likely more remain to be discovered. For a better understanding of the heterogeneous presentations of neurological disorders affecting this anatomical region, insights into the constantly evolving neuroscience behind may be helpful. The public health consequences of diseases that affect memory and spatial navigation are high, and grow as the population ages, prompting scientist to focus on further exploring this brain region.

Clinical Neuroscience

Simultaneous subdural, subarachnoideal and intracerebral haemorrhage after rupture of a peripheral middle cerebral artery aneurysm

BÉRES-MOLNÁR Anna Katalin, FOLYOVICH András, SZLOBODA Péter, SZENDREY-KISS Zsolt, BERECZKI Dániel, BAKOS Mária, VÁRALLYAY György, SZABÓ Huba, NYÁRI István

The cause of intracerebral, subarachnoid and subdural haemorrhage is different, and the simultaneous appearance in the same case is extremely rare. We describe the case of a patient with a ruptured aneurysm on the distal segment of the middle cerebral artery, with a concomitant subdural and intracerebral haemorrhage, and a subsequent secondary brainstem (Duret) haemorrhage. The 59-year-old woman had hypertension and diabetes in her medical history. She experienced anomic aphasia and left-sided headache starting one day before admission. She had no trauma. A few minutes after admission she suddenly became comatose, her breathing became superficial. Non-contrast CT revealed left sided fronto-parietal subdural and subarachnoid and intracerebral haemorrhage, and bleeding was also observed in the right pontine region. The patient had leucocytosis and hyperglycemia but normal hemostasis. After the subdural haemorrhage had been evacuated, the patient was transferred to intensive care unit. Sepsis developed. Echocardiography did not detect endocarditis. Neurological status, vigilance gradually improved. The rehabilitation process was interrupted by epileptic status. Control CT and CT angiography proved an aneurysm in the peripheral part of the left middle cerebral artery, which was later clipped. Histolo­gical examination excluded mycotic etiology of the aneu­rysm and “normal aneurysm wall” was described. The brain stem haemorrhage – Duret bleeding – was presumably caused by a sudden increase in intracranial pressure due to the supratentorial space occupying process and consequential trans-tentorial herniation. This case is a rarity, as the patient not only survived, but lives an active life with some residual symptoms.

Hypertension and nephrology

[Association between cyclothymic affective temperament and hypertension]

NEMCSIK János, BATTA Dóra, KŐRÖSI Beáta, RIHMER Zoltán

[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.]

Clinical Neuroscience

[Interdisciplinary approach of vestibular system impairment]

PONGRÁCZ Endre

[In the first part of this review the definition of vertigo/dizziness was discussed. The major difference between the two signs is the exsistence of the direction, which is specific for vertigo. Dizziness is a frequent complaint in the clinical practice. Its frequency is increasing with advance of age, to intimate the play of declining cognitive process in the pathogenesis of its. The popular health significance of vertigo is in the rowing number of the patients. The onset of the most cases with acute vertigo appears between secundums and minutes so the patients will be provided in circumstances of emergency department. First of all three form schould be take into account: neuronitis vestibularis, benign paroxysmal positional vertigo and Meniere syndrome. Without tipical periferal signs of vertigo, central cause should be searched, principally stroke (lysis possibility). The differential diagnose of the different dizzeness/vertigo forms according to the elapsed time of the onset or congenital and acquired nystagmus was created in tables. The recommendations of the therapy of acute and chronic dizziness/ vertigo syndroms are, lack of results of evidence based trials doubtful. The more often used drugs based on clinical trials are discussed as vinpocetine, betahistine and piracetam. The in vitro and in vivo data suggest that the last molecule is eligible to use both in periferal and central type of vertigo syndroms.]

LAM KID

[New findings in the cortical bone biology and its role in bone fractures]

BALOGH Ádám, BHATTOA Harjit Pál

[The authors surveyed the already known factors responsible for the osteoporotic bone fragility. Then the results of using modern imaging techniques (micro-CT, high-resolution peripheral computed quantitative tomograph - HR-pQCT) and advanced computer analytic methods (finite element analysis, FEA) are presented. These data - beyond the already known fracture risk factors (age, risk of falling, bone mineral density - BMD, and fine structure damage of trabecular bone) are stressing the importance of the (micro)damage of cortical bone as a fracture risk factor, which has been still underrated. The cortical thickening and increased porosity - verified on various population samples - are increasing the risk of fractures in certain subgroups of subjects having identical BMD values, even among those, who are considered only osteopenic by the earlier classification based on BMD values. Backed with modern software batteries, the new imaging techniques are expected to enter clinical application in the near future. Pharmacologic agents with stronger cortical effect are already available and research is continuing to find new drugs to use in the management of osteoporotic patients of high fracture risk.]