LAM Extra for General Practicioners

[Health behaviour and cancer screening ]


DECEMBER 05, 2014

LAM Extra for General Practicioners - 2014;6(05)

[The purpose of the paper is to find out: what influences the participation in cancer screening. For answer, concepts such as health, health consciousness, health culture, health behaviour have been taken into account, and the factors that have an influence on the health behaviour considered. It concludes that the participation in screening makes a part of the health behaviour which is a mandatory task for the health education to include screening into the health message. ]



Further articles in this publication

LAM Extra for General Practicioners

[Parkinson’s disease from the perspective of general practice]

KOVÁCS Norbert

[Due to the recent developments in medicine, Parkinson’s disease became a relatively well-treatable condition. Recently the working abilities and the health-related quality of life of our patients dramatically improved by the application of optimal pharmacological and functional neurosurgical treatment options. Despite of these good progresses, the curative treatment option is still warranted. The aim of this review article is to present those pharmacological, neurosurgical and other treatments, which can improve the condition and quality of life of the patients. We also discuss the major concerns important for general practitioners including the assessment of driving abilities.]

LAM Extra for General Practicioners

[Polyneuropathy as a first sign of microscopic polyangiitis]

ZÖLD Éva, HORVÁTH Ildikó Fanny, TARJÁN Péter, BARTA Zsolt, ZEHER Margit

[INTRODUCTION - Microscopic polyangiitis (MPA) is a systemic autoimmun disease characterized by necrotizing small vasculitis. MPA belongs to the ANCA-associated vasculitides. The disease can affect many of the body’s organ systems. Major organs involved are kidneys, skin, peripheral nerves and lungs. In addition, generalized symptoms such as fever and weight loss are very common. CASE REPORT - In January 2013 a 56-year old woman presented with weight loss, lower leg numbness, walking difficulty and petechiae on the lower legs. One month later, laboratory examinations showed progressive kidney dysfunction, anemia, hypersedimentation and elevated C reactive protein level, but further tests and investigations for potential bacterial infection and tumors were all negative. In sum, clinical signs and symptoms suggested systemic vasculitis, which was proved by the kidney biopsy and ENG examination. From these findings, microscopic polyangiitis was diagnosed with polyneuropathy and glomerulonephritis. The patient was a Hepatitis B (HBV) virus carrier, which can be provoking factor for vasculitis. Corticosteroid and six treatment cycles of intravenous pulse cyclophosphamide were performed for induction of remission. After treatment her symptoms improved and kidney function was normalized. Antiviral treatment was started because of HBV reactivation in October 2013. As a new manifestation of MPA, pulmonary symptoms were appeared in November 2013 and the patient was treated with synchronization of plasmapheresis and pulse cyclophosphamide with good clinical effectivity. Now, she is treated with methotrexate as immunosuppressive treatment and control examinations indicate the remission of the disease with proper renal function. CONCLUSION - We draw attention to a rare case of vasculitis and underline the importance of both the early diagnosis and the early and effective immunosuppressive therapy. Peripheral neuropathy may occur as a result of having systemic vasculitis. Nevertheless, the exploration and elimination of provoking factors are also must be part of the management and the regular follow-up is essential to recognize the disease relapses, thus avoid permanent organ damage.]

LAM Extra for General Practicioners

[The prevalence of musculoskeletal symptoms among ambulance personnel in a national subsample]

PÉK Emese, BÁNFAI Bálint, DEUTSCH Krisztina, JEGES Sára, BETLEHEM József

[BACKGROUND - The ambulance workers face a lot of mental stress and physical demands in their everyday life. The physical demands can be originated from caring heavy equipment and moving patients. The poor mental health can strengthen physical problems, too. In this study our aim was to detect and compare the musculoskeletal status of ambulance personnel in two regions of Hungary. SAMPLE AND METHODS - On a voluntary base a cross-sectional anonymous, standardized self-fill-in questionnaire (Nordic Musculoskeletal Questionnaire) was used with additional items. All ambulance personnel over 18 years old were involved in the study who worked in direct patient care either in the North-Hungarian or in the West-Hungarian Region of the country. RESULTS - In the regional representative sample N=810 workers answered our questions. Out of them 587 persons (72.5%) reported about some musculoskeletal problem during his lifespan. Most of them suffered from lower back pain (448 persons, 55%), back pain (318 persons, 39%), neck pain (250 persons, 30.9%). Parallel with the aging and with the time spent working for the ambulance service more and more overall discomfort can be detected (p=0.013; p=0.020). Having a second job affected the level and frequency of discomfort negatively (p=0.005). CONCLUSIONS - More than 70% of the ambulance workers experienced musculoskeletal problem during his emergency workers carrier which may worsen the quality of his work and his personal life. To handle the situation primary prevention, screening and possibilities for recreation should be forced among ambulance workers. ]

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KÉKES Ede, BARNA István, DAIKI Tenno, DANKOVICS Gergely, KISS István

[The clinical significance of serum uric acid markedly increased in the last years, especially in the civilized countries, but the abnormal serum uric acid level shows a significantly strong increasing tendency worldwide. The high level of uric acid is an integral part of metabolic syndrome. Today we recognized the important role of xanthine oxidase in the clinical practice for developing of oxidative stress in some tissues and organs. In 2011 during the Hungarian Health Care Screening Program we analyzed the prevalence of metabolic factors in 18 886 subjects. In the present publication we have dealt with uric acid and calculated the occurrence of abnormal values in percentage of the observed population. We found abnormal values in 12.3% of women (over 350 µmol/l) and 16.5% of men (over 400 µmol/l). The average values were higher in hypertensive subjects against normotensive ones in both gender. There was a close correlation among the metabolic components and the elevated uric acid level. The screening had given a possibility for detecting hidden gout and some other diseases, where the elevated uric acid level is specific of the clinical entity.]

Lege Artis Medicinae


ÚJSZÁSZY László, SIMON László, HORVÁTH Gábor, TAM Beatrix

[The frequency of colorectal cancer is increasing all over the world. It is the second most frequent oncological disease leading to death in both sexes in Hungary. The main part of colorectal cancer develope after the age of 50. In case of patients having higher risk we have to calculate with the earlier appearance of the tumour and detectable molecular genetic disorders. The development of colorectal cancer needs a long time. Before the appearance of the cancer, precancerous processes (adenomas, polyps) can be detected in the large intestine. The development of colorectal cancer can be prevented by the removal of the adenomas (polypectomy). There are many different and efficient methods to detect the precancerous and early disorders. For increasing the compliance to screening programs the common efforts of the society, the National Health Care Services and medical doctors are necessary. The education of the population and the medical services would also be helpful. The colorectal cancer screening programs are costeffective and supported by the different health services independently from the type of the insurance. Screening the patients having higher risk is one of most important task. In these cases the use of colonoscopy is the most frequent method for the screening and follow up as well.]

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[The importance of patient education and ILCO clubs in the rehabilitation of stoma patients]


[Aim of the study: The author aims to reveal and propose a solution for the flaws in the education of stoma patients, especially with regard to patient education at the Department of Surgery in Szeged. She examined the opinions, attitudes and knowledge of stoma patients regarding patient information, rehabilitation, and the extent to which they participated in the self-help groups. Methodology and sample: In the course of the quantitative descriptive research a questionnaire-based survey was conducted among the stoma patients treated and cared for at the institute (N=96). The data was processed using mathematical statistical methods. Results: 83% of the patients received lifestyle information at the institute, which helped them to accept their illness, and 99% of them were taught about stoma care at the clinic. The patients that participated in the training course, with the assistance of the stomal therapy nurse, were better able to accept their disease. The proportion of those participating in the self-help group was 51%, despite the fact that 65% of those asked regarded the ILCO club as useful. Conclusions: The provision of lifestyle information and the development of patient education at the department have an important role, because the majority of the patients express no demand for club membership. The author also takes the opportunity to highlight the importance of a holistic and multidisciplinary approach to the nursing of stoma patients. ]

Journal of Nursing Theory and Practice

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


[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. ]

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[From healthcare accross health affair to „whole-ness” affair ]


[The present healthcare system is mainly disease-centered. There is an increased need in a health model, that considerates the human being, his or her health, health status, their effects on every day life activities, on filling of his or her social tasks, takes into account the influential role of physical, social, economical factors and personal characteristics as well. A such of kind health model should be developed, that considerates the whole human being, the completness of his or her health affairs, and simultaneously is a part of a „whole-ness” affair-, human-centered system, taking into account physical, social, economical and political factors at the same time.]