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

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

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

DÉR Ilona

All articles in the issue

Related contents

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

Cholinesterase inhibitors and memantine for the treatment of Alzheimer and non-Alzheimer dementias

BALÁZS Nóra , BERECZKI Dániel, KOVÁCS Tibor

In aging societies, the morbidity and mortality of dementia is increasing at a significant rate, thereby imposing burden on healthcare, economy and the society as well. Patients’ and caregivers’ quality of life and life expectancy are greatly determined by the early diagnosis and the initiation of available symptomatic treatments. Cholinesterase inhibitors and memantine have been the cornerstones of Alzheimer’s therapy for approximately two decades and over the years, more and more experience has been gained on their use in non-Alzheimer’s dementias too. The aim of our work was to provide a comprehensive summary about the use of cholinesterase inhibitors and memantine for the treatment of Alzheimer’s and non-Alzheimers’s dementias.

Clinical Neuroscience

Atypical presentation of late-onset Sandhoff disease: a case report

SALAMON András , SZPISJAK László , ZÁDORI Dénes, LÉNÁRT István, MARÓTI Zoltán, KALMÁR Tibor , BRIERLEY M. H. Charlotte, DEEGAN B. Patrick , KLIVÉNYI Péter

Sandhoff disease is a rare type of hereditary (autosomal recessive) GM2-gangliosidosis, which is caused by mutation of the HEXB gene. Disruption of the β subunit of the hexosaminidase (Hex) enzyme affects the function of both the Hex-A and Hex-B isoforms. The severity and the age of onset of the disease (infantile or classic; juvenile; adult) depends on the residual activity of the enzyme. The late-onset form is characterized by diverse symptomatology, comprising motor neuron disease, ataxia, tremor, dystonia, psychiatric symptoms and neuropathy. A 36-year-old female patient has been presenting progressive, symmetrical lower limb weakness for 9 years. Detailed neurological examination revealed mild symmetrical weakness in the hip flexors without the involvement of other muscle groups. The patellar reflex was decreased on both sides. Laboratory tests showed no relevant alteration and routine electroencephalography and brain MRI were normal. Nerve conduction studies and electromyography revealed alterations corresponding to sensory neuropathy. Muscle biopsy demonstrated signs of mild neurogenic lesion. Her younger brother (32-year-old) was observed with similar symptoms. Detailed genetic study detected a known pathogenic missense mutation and a 15,088 base pair long known pathogenic deletion in the HEXB gene (NM_000521.4:c.1417G>A; NM_000521:c.-376-5836_669+1473del; double heterozygous state). Segregation analysis and hexosaminidase enzyme assay of the family further confirmed the diagnosis of late-onset Sandhoff disease. The purpose of this case report is to draw attention to the significance of late-onset Sandhoff disease amongst disorders presenting with proximal predominant symmetric lower limb muscle weakness in adulthood.

Lege Artis Medicinae

[A short chronicle of three decades ]

KAPRONCZAY Katalin

[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

Lege Artis Medicinae

[Second game, 37th move and Fourth game 78th move]

VOKÓ Zoltán

[What has Go to do with making clinical decisions? One of the greatest intellectual challenges of bedside medicine is making decisions under uncertainty. Besides the psychological traps of traditionally intuitive and heuristic medical decision making, lack of information, scarce resources and characteristics of doctor-patient relationship contribute equally to this uncertainty. Formal, mathematical model based analysis of decisions used widely in developing clinical guidelines and in health technology assessment provides a good tool in theoretical terms to avoid pitfalls of intuitive decision making. Nevertheless it can be hardly used in individual situations and most physicians dislike it as well. This method, however, has its own limitations, especially while tailoring individual decisions, under inclusion of potential lack of input data used for calculations, or its large imprecision, and the low capability of the current mathematical models to represent the full complexity and variability of processes in complex systems. Nevertheless, clinical decision support systems can be helpful in the individual decision making of physicians if they are well integrated in the health information systems, and do not break down the physicians’ autonomy of making decisions. Classical decision support systems are knowledge based and rely on system of rules and problem specific algorithms. They are utilized widely from health administration to image processing. The current information revolution created the so-called artificial intelligence by machine learning methods, i.e. machines can learn indeed. This new generation of artificial intelligence is not based on particular system of rules but on neuronal networks teaching themselves by huge databases and general learning algorithms. This type of artificial intelligence outperforms humans already in certain fields like chess, Go, or aerial combat. Its development is full of challenges and threats, while it presents a technological breakthrough, which cannot be stopped and will transform our world. Its development and application has already started also in the healthcare. Health professionals must participate in this development to steer it into the right direction. Lee Sedol, 18-times Go world champion retired three years after his historical defeat from AlphaGo artificial intelligence, be­cause “Even if I become the No. 1, there is an entity that cannot be defeated”. It is our great luck that we do not need to compete or defeat it, we must ensure instead that it would be safe and trustworthy, and in collaboration with humans this entity would make healthcare more effective and efficient. ]