Journal of Nursing Theory and Practice

[Summary Report of the 5th International FOHNEU Congress]

HIRDI Henriett Éva1,2,3, TÉGLÁSYNÉ Bácsi Mária4,2

OCTOBER 20, 2012

Journal of Nursing Theory and Practice - 2012;25(05)

AFFILIATIONS

  1. Foglalkozás-egészségügyi Ápolók Európai Szövetsége
  2. Magyar Egészségügyi Szakdolgozói Kamara
  3. Semmelweis Egyetem Doktori Iskola, Budapest
  4. Magyar Üzemegészségügyi Tudományos Társaság

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Further articles in this publication

Journal of Nursing Theory and Practice

[The opinions of paediatric nurses on cooperation with children and their parents in hospital; the factors affecting such cooperation]

MIKLÓSI Mónika, GALAMBOSI Elvira, PERCZEL FORINTOS Dóra

[Aim of the study: To explore pediatric staff nurses’ perception of collaboration with hospitalized children and their parents and to study underlying factors. Methodology and sample: In a prospective longitudinal design, parents of children admitted to hospital for planned surgical intervention (n=91) filled out a questionnaire packet before hospitalization assessing demographical and socio-economical characteristics, as well as mental health status of children and parents. Staff nurses were asked to estimate parents’ and children’s collaboration during hospitalization (n=131). Results: Nurses’ ratings about parents’ collaboration were higher than their ratings about children’s collaboration. Child’s gender, age, parent’s level of education, family characteristics and length of hospital stay had an impact on the perception of collaboration with parents. Child’s age and prosocial behavior were related to the perception of collaboration between nurses and children. Conclusions: Nurses’ perception of children’s and parents’ collaboration was related to demographical and socio-economical factors. Identifying these factors may help to promote partnership among nurses, parents and hospitalized children. ]

Journal of Nursing Theory and Practice

[Madeleine Leininger passed away]

PAPP Katalin

Journal of Nursing Theory and Practice

[Congratulations]

Journal of Nursing Theory and Practice

[Epidemic among health care providers: burnout]

IRINYI Tamás, NÉMETH Anikó

[Aims of the study: To track the changes since 2008 in the degree of burnout among health care workers in Csongrád County, and to examine its connections with the evaluation of own health, frequency of psychosomatic symptoms, the intent to leave the profession, and the measure of fear from becoming unemployed. Methodology and sample: 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: The number of burned-out health care workers increased since 2008. Burnout correlates with physical health (p<0.000), the intention to leave the profession (p<0.000), and the fear of losing the job (p<0.000). A significant increase could be observed by nurses starting their career. Conclusions: Burnout prevention trainings would be important also by career starters, which could also prevent profession leaving. ]

Journal of Nursing Theory and Practice

[A faraway land: nursing in a “small” Swedish hospital]

FUCHS Rita

[The author is currently working as a degree nurse in Örebro County, Sweden. In Sweden she has a greater degree of professional autonomy, which allows her to make use of all the theoretical knowledge and practical skills acquired at college. For performing certain tasks the doctor’s written authorisation is not required; nurses proceed in accordance with their competencies and the rules set out in the given protocol. She sets out to give an insight into the day-to-day work of nurses at her hospital, by describing the documents that are used, briefly outlining the training system, and the authority exercised by the nurses. Keywords: nurse, nursing training, nursing documentation, competency]

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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.

Clinical Neuroscience

Autonomic nervous system may be affected after carpal tunnel syndrome surgery: A possible mechanism for persistence of symptoms after surgery

ONDER Burcu, KELES Yavuz Betul

After carpal tunnel surgery, some patients report complaints such as edema, pain, and numbness. Purpose – The aim of this study was to evaluate autonomic nervous system function in patients with a history of carpal tunnel surgery using sympathetic skin response (SSR). Thirty three patients (55 ±10 years old) with a history of unilateral operation for carpal tunnel syndrome were included in the study. The SSR test was performed for both hands. Both upper extremities median and ulnar nerve conduction results were recorded. A reduced amplitude (p=0.006) and delayed latency (p<0.0001) were detected in the SSR test on the operated side compared to contralateral side. There was no correlation between SSR and carpal tunnel syndrome severity. Although complex regional pain syndrome does not develop in patients after carpal tunnel surgery, some of the complaints may be caused by effects on the autonomic nervous system.

Clinical Neuroscience

Extraskeletal, intradural, non-metastatic Ewing’s sarcoma. Case report

OTTÓFFY Gábor, KOMÁROMY Hedvig

Intracranial localization of Ewing’s sarcoma is considerably very rare. Herein, we present clinical and neuroimaging findings regarding a 4-year-old boy with intracranial Ewing’s sarcoma. He was born prematurely, suffered intraventricular haemorrhage, posthaemorrhagic hydrocephalus developed, and a ventriculoperitoneal shunt was inserted in the newborn period. The patient endured re­gular follow ups, no signs of shunt malfunction nor increased intracranial pressure were observed. The last neuroima­ging examination was performed at 8 months of age. Upon reaching the age of 4 years, repeated vomiting and focal seizures began, and symptoms of increased intracranial pressure were detected. A brain MRI depicted a left frontoparietal space-occupying lesion infiltrating the superior sagittal sinus. The patient underwent a craniotomy resulting in the total excision of the tumour. The histological examination of the tissue revealed a small round blue cell tumour. The diagnosis was confirmed by the detection of EWSR1 gene translocation with FISH (fluorescent in situ hybridization). No additional metastases were detected during the staging examinations. The patient was treated in accordance to the EuroEwing 99 protocol. Today, ten years onward, the patient is tumour and seizure free and has a reasonably high quality of life.

Clinical Neuroscience

[Zonisamide: one of the first-line antiepileptic drugs in focal epilepsy ]

JANSZKY József, HORVÁTH Réka, KOMOLY Sámuel

[Chronic administration of antiepileptic drugs without history of unprovoked epileptic seizures are not recommended for epilepsy prophylaxis. Conversely, if the patient suffered the first unprovoked seizure, then the presence of epileptiform discharges on the EEG, focal neurological signs, and the presence of epileptogenic lesion on the MRI are risk factors for a second seizure (such as for the development of epilepsy). Without these risk factors, the chance of a second seizure is about 25-30%, while the presence of these risk factors (for example signs of previous stroke, neurotrauma, or encephalitis on the MRI) can predict >70% seizure recurrence. Thus the International League Against Epilepsy (ILAE) re-defined the term ’epilepsy’ which can be diagnosed even after the first seizure, if the risk of seizure recurrence is high. According to this definition, we can start antiepileptic drug therapy after a single unprovoked seizure. There are four antiepileptic drugs which has the highest evidence (level „A”) as first-line initial monotherapy for treating newly diagnosed epilepsy. These are: carbamazepine, phenytoin, levetiracetam, and zonisamide (ZNS). The present review focuses on the ZNS. Beacuse ZNS can be administrated once a day, it is an optimal drug for maintaining patient’s compliance and for those patients who have a high risk for developing a non-compliance (for example teenagers and young adults). Due to the low interaction potential, ZNS treatment is safe and effective in treating epilepsy of elderly people. ZNS is an ideal drug in epilepsy accompanied by obesity, because ZNS has a weight loss effect, especially in obese patients.]

Clinical Neuroscience

Valproic acid associated pleuropericardial effusion: case report

DEMIR Figen Ulku

Introduction - Valproic acid is an effective antiepileptic and mood stabilizer used in the treatment of many neurological and psychiatric disorders. Although there are frequently seen side effects, effusions between layers of pleural and pericardial membranes are rare to be seen. Case - Pleuropericardial effusion was detected in a 23 years old woman who was under valproic acid treatment because of epileptic seizure. After 1 year of valproic acid treatment, patient complained of dyspnea. As all the researches intended on etiology were usual, valproic acid has been thought to be responsible for the matter. Control examination after 1.5 months regarding the end of treatment revealed complete recovery of pleuropericardial effusion. Discussion - Pleural and pericardial effusions are rarely seen complications related to the use of valproic acid. It must also be kept in mind that valproic acid causes a potential for such side effects which can be blamed etiologically when the other possibilities for patients are excluded.