Lege Artis Medicinae - 2017;27(10-12)

Lege Artis Medicinae

DECEMBER 15, 2017

[Feeding and eating in infancy and early childhood part I. - data on breastfeeding in the large-sample “For Healthy Offspring” project]

NÉMETH Tünde, VÁRADY Erzsébet, DANIS Ildikó, SCHEURING Noémi, SZABÓ László

[INTRODUCTION - Breastfeeding is the ideal and natural source of nutrition for infants, is associated with a reduced risk of many diseases in infants and mothers. It has a positive impact on the mother-infant relationship and also has considerable economic and environmental benefits. Subjects and methods - In the “For Healthy Offspring” Project parents of 1164, 0-3-year-old children completed a ques-tionnaire about breastfeeding and their feeding routine. The sample is not representative of the general population, but the sociodemographic and housing variables indicate an adequate spectrum. RESULTS - Breastfeeding was perceived by 60% of mothers enjoyable, while 20% of them had a negative experience with it. More than 50% of mothers had some breastfeeding difficulties, but it did not have a significant correlation with the negative perception of breastfeeding. The most common problem was the perception of inadequate milk supply. Among the studied variables maternal smoking, lower maternal education and the lack of antenatal breastfeeding education had the strongest correlation with the duration of breastfeeding. CONCLUSIONS - Adequate antenatal education on breastfeeding, proactive support of women and promptly attending their breastfeeding difficulties increases the duration of exclusive and any breastfeed-ing, helps mothers to reach their breastfeed-ing goals and to perceive breastfeeding enjoyable.]

Lege Artis Medicinae

DECEMBER 15, 2017

[Considerations for the design and evaluation of qualitative research]

ZÖRGŐ Szilvia

[Communication, opinions, and experiences signify a vital part of medical knowledge and researching these realms necessitates qualitative methods. Scientific rigor is an equally valid expectation for qualitative research, and many facets have been proposed in related discourse. Aside from demonstrating the relevance and clinical application of a qualitative initiative, paying heed to its level of transferability is also crucial. The credibility and dependability of the project are pivotal, which can be enhanced through transparency, confirmability, and consistency in procedures employed during the processes of planning, implementation, and analysis. Furt­hermore, continual reflexivity denotes a chief aspect of scientific rigor throughout every phase of research, inviting the researcher to take a critical stance concerning their own preconceptions, as well as their effect on the topic under scrutiny. Apart from methodology, quantitative and qualitative worldview may be very different, for example in the way they treat and interpret reality. We may consider the various paradigms and methods as complementary in the quest of furthering medical knowledge. In this methodological spectrum, each element bears its own limitations and possibilities, thus in order to select the most adequate tool, these must be weighed in light of the research question and objectives.]

Lege Artis Medicinae

DECEMBER 15, 2017

[Factors influencing anisocytosis among inpatients with chronic kidney disease]

MOLNÁR D. László, KISS István, SZAKONY Szilvia, AMBRUS Csaba

[The coefficient of variation of RDW (RDW-CV) is a predictor of mortality in several patient cohorts. RDW and other factors were analyzed in an earlier report as potential predictors of inpatient mortality. In this paper, determinants of RDW were examined in a sample of hospitalized patients with chronic kidney disease not yet on dialysis using both frequentist and bayesian ANCOVA models. For the non-informative Bayesian model no prior knowledge about the model parameters was assumed. For the informative Bayesian model prior knowledge from previous experience was applied. Calculations were performed in R with the faraway, car and MCMCPack programme packages. Male gender identity, higher mch and mcv were strongly associated with higher RDW. Blood glucose concentration, white blood cell count, blood hemoglobin concentration, platelet count, age and glomerular fil-tration rate showed inverse relationship with RDW levels. ]

Lege Artis Medicinae

DECEMBER 15, 2017

[What turns labour pain into suffering? The individual ways of coping]

RADOS Melinda, MÉSZÁROS Judit

[INTRODUCTION - Pain is not only a sensory experience, but includes emotional, motivational and cognitive dimensions, thus women’s perceptions of labour pain are largely influenced by individual attitudes. The distinction between pain and suffering sheds light on valuable information. Our aim was to study the relationship between women’s labour pain and their sense of suffering, and the effects of epidural analgesia on their judgements of pain, stress and satisfaction. SAMPLE AND METHOD - 342 women participated in our study. Their pain was assessed with the Numerical Rating Scale, sense of suffering with the shortened Perceived Stress Scale, which were followed by questions of epidural analgesia administration, its perceived effects and satisfaction. RESULTS - Women’s feelings of pain and sense of suffering show a strong positive correlation (R=0,283, p<0,001); but with the increase of these dimensions their satisfaction decreased (R=-0,162 and R= -0,444 respectively, p<0,001). The administration of epidural analgesia did not have a significant effect on their judgements of pain, stress and satisfaction. Perceived stress had the strongest determining influence on satisfaction (b=-0,534, p<0,001). CONCLUSIONS - According to our results on pain relief, we suggest the wider use of various non-pharmacological methods. Alleviation of maternal fear and suffering through non-judgemental, patient and supportive attitude of caregivers is of paramount importance.]

Lege Artis Medicinae

DECEMBER 15, 2017

[Long survival with multimodal therapy]

MÉSZÁROS Edina, LANDHERR László

[Breast cancer is the most frequently diagnosed cancer and leading cause of cancer death in women worldwide. Approxi­mately two-thirds of cases are potencially sensitive to endocrine therapy. Fulvestrant is a selective estrogen receptor downregulator indicated for the treatment of postmenopausal women with estrogen receptor positive, locally advanced or metastatic breast cancer for disease relapse on or after adjuvant antiestrogen therapy, or disease progression on therapy with antiestrogen. We are reporting here a nearly ten-years-long sucessful combination of multiple treatment lines of anti-estrogen treatment, chemotherapy and radiotherapy in a case of a patient with hormone receptor positive, HER2 negative breast cancer with pulmonary metastases.]

Lege Artis Medicinae

DECEMBER 15, 2017

[Differential diagnosis of anemia and abdominal pain - case report of a lead poisoned family]

NÉMETH Aliz, LISKA Zsófia, TÖRÖK Eszter, NÁDAI Mária, SCHANDL László, KIS János Tibor

[The authors describe a patient’s case, who was hospitalized with stomach pain. During the study of the patient, a microscopic examination of the blood vessel helped the diagnosis. Basophil eruptions of red blood cells raised the suspicion of lead poisoning, which was confirmed by a high lead level in the serum. The source of the lead poisoning was a lead covered jug, in which the family stored a homemade syrups that is popular among Hungarians. At several members of the family, who had been consumed the syrup, we measured high non-symptomatic lead levels. The patient and his family were successfully treated with a chelating therapy. The au-thors summarize the symptoms of lead poisoning through a case report. Call the attention that excessive lead exposure in Hungary is rarely recognized, and the symptoms are often misleading.]

Lege Artis Medicinae

DECEMBER 15, 2017