[Current issues in the peripartum management of diabetic women from the perspective of an internist-diabetologist]
KERÉNYI Zsuzsanna1
KERÉNYI Zsuzsanna1
Szöveg nagyítása:
[In pregnancy complicated with diabetes, treatment of hyperglycaemia is of fundamental importance during delivery in order to improve the outcome parameters of both the mother and the neonate. This is particularly important in the case of mothers with type 1 diabetes and of all mothers who require insulin treatment during their pregnancy. The use of antenatal steroids for women at risk of pre-term birth further complicates the treatment of hyperglycaemia in the period immediately before delivery and requires the appropriate change of insulin therapy. The requirement of nil per os in the delivery period necessitates proper fluid, glucose and insulin treatment in the pre-delivery hours. After surgical delivery the patients may also need infusion treatment until the first meal. As there is no unified guideline for the peripartum management of diabetes, the author reviews the international literature on the internal medicine issues concerning the peripartum treatment of pregnant women with diabetes. This study reviews the characteristics of insulin treatment of women with various types of diabetes before, during and directly after delivery. It presents a dosing schedule for women who needed an antenatal steroid treatment in the period before delivery due to premature birth for the purpose of lung maturation. The study also addresses the application and programming of peripartum blood glucose tests, continuous interstitial glucose monitoring (CGM) and insulin pump treatment (CSII).]
Lege Artis Medicinae
[The Covid-19 pandemic has swept across the world, causing a never seen burden on our health care systems and challenging biomedical research to give appropriate answers to the epidemic. Modern, one-particle biophysical methods ensure special insight to the characteristics of the cause of the epidemic, the SARS-CoV-2. The virus carries a crown-like layer of spike proteins, which plays a fundamental role in the process of infection. The topography structure and mechanical characteristics of native virions have been determined by atomic force microscopy. Spike proteins form a dynamic surface due to their flexibility and motility. Virions are surprisingly resistant to mechanical compression, and their structure is able to recover after mechanical perturbation. The global structure of the virus is resistant to heat effect, but spike proteins dissociate from the surface with higher temperatures. The mechanical and dynamic characteristics of SARS-CoV-2 contribute to its virulence. The applied one-particle biophysical methods play an important role in understanding and fighting with the more common virus infections. ]
Lege Artis Medicinae
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Lege Artis Medicinae
[Hypertension prevalence and cardiovascular risk gradually with age. However this aging process seems to take a more rapid course in some individuals, as reflected in the Early Vascular Aging (EVA) syndrome. Age and high blood pressure are the two main determinants of arterial stiffness which is the core of EVA: the impaired elasticity of the media layer of large elastic arteries (mainly the aorta), a process that can be measured by pulse wave velocity. In elderly hypertensives, large arteries stiffen and systolic and pulse pressures increase, due to wave reflections. Arterial stiffness has predictive value for future CV e.g. events, coronary artery disease, stroke, and vascular dementia and even all-cause mortality. The concepts of EVA (Early Vascular Aging) and SUPERNOVA (Supernormal Vascular Aging, the opposite phenotype of EVA) help to understand why early target-organ damages develop in some individuals and why others remain much more “younger” than their chronologic age. New drugs are being developed to treat EVA when lifestyle intervention and conventional risk factor controlling drugs are not enough.]
Lege Artis Medicinae
[Lower extremity arterial disease, in addition to the worsening life quality due to the concerning complaints and the rist of amputation, entails high risk of cardiovascular morbidity and mortality. The prevalence of this disease in the Hungarian population is close to 600 000 people, based on an extrapolation of the international epidemiological data. In the recent years two target studies started (i) to analyse the performance of screening for lower extremity arterial disease in a representative hypertensive population (ÉRV Program), and (ii) to analyse the data of patients in the whole Hungarian health insurance population with lower extremity amputation or revascularization (HUNVASCDATA study). The present review summarizes the outcomes of these two studies. Data analysis on national sample bears high importance, since any improvement in vascular care in Hungary rests entirely on this information. ]
Lege Artis Medicinae
[In Hungary the training and output requirements of faculty of general medicine determine the required knowledge, skills and abilities, i.e. competences of graduated medical doctors. On the one hand, we examined how the teachers ponder the weight of competences established for medical education in the training and output requirements, on the other hand to what extent they mediate these during their teaching activity. The field research by self-developed questionnaires was carried out in four Hungarian medical schools in the fall semester 2017. For evaluation we used gap analysis, Wilcoxon signed-rank test and factor analysis. The questionnaire was sent to all lecturers (n=1790) of the four medical schools and 439 of them filled it out (24.5%). Results of the research show that the lecturers do not mediate any competence in their teaching practice in such an extent, as important as they consider it is (except one). There are statistically proved negative gaps between the extent of importance and mediation – to a different extent per competence. The examined competences can be grouped in well identifiable factors, which corresponds to the three-circle model accepted in the international literature. Results of the research underline, that beside the core competences of medical knowledge, there are further developmental opportunities in the medical education, the importance of which was ensured by the lecturers as well. In addition to the realization of lacks and needs the development of lecturers’ skills as well as pedagogical and didactical knowledge are inevitable for the implementation. ]
Clinical Neuroscience
Stigma is a widespread phenomenon in Parkinson’s disease (PD) and has been shown to affect the quality of life of individuals. This study aims to assess the level of stigma and identify the factors contributing to stigma in patients with PD in Turkey. A total of 142 patients diagno¬sed with PD between June 2022 and March 2023 were included in the study. Sociodemographic data were collected using a sociodemographic information form.
Clinical Neuroscience
Natural disasters, such as earthquakes, frequently result in mood disorders among affected individuals. It is established that neuropathic pain arising from traumatic neuropathies is also linked to mood disorders. This study investigates the influence of neuropathic pain on the development of mood disorders in earthquake survivors with peripheral nerve injuries, following the earthquake centered in Kahramanmaraş on February 6, 2023.
Journal of Nursing Theory and Practice
[The independent living of older people, who form an increasing proportion of society, is fundamentally determined by falls and the fear of falling. Fear of falling becomes pathological when loss of self-confidence and experience of fear of falling become persistent. Consequently, physical activity of older people becomes also limited, which compromises their future functional abilities and increases the risk of institutionalisation. This narrative review discusses the terminology used in the literature, the prevalence of fear of falling, and the methods used to evaluate it. It also outlines how it can be prevented and how it can be reduced (or even eliminated) based on current research.]
Clinical Neuroscience
The aim of this study is to comprehensively determine the types of affected fibers in Parkinson’s disease (PD) patients by employing nerve conduction studies (NCS), sympathetic skin response (SSR) examinations, and current perception threshold (CPT) testing and to analyze the correlation between levodopa use and nerve involvement. This retrospective study included 36 clinically diagnosed PD patients who were recruited between January 2018 and April 2019.
Journal of Nursing Theory and Practice
[In the course of our research, we compared the pre-pregnancy test mass index of Hungarian women with the results of the National Nutrition and Nutritional Status Examinations.
Our cross-sectional study was conducted between 01.01.2020 and 01.08.2020. During the nonrandom, targeted, expert sample selection, the target group included pregnant women or mothers raising at least one minor child (N=1423). Exclusion criteria include the omission of mandatory questions. Our survey was done online, with a self-filled questionnaire, anonymously. In the questionnaire, we used sociodemographic, anthropometric, pregnancy and nutrition-related questions. The data were analyzed with IBM SPSS 25.0 statistical software, descriptive statistics and tables.
The normal BMI was typical only for those under 20 years of age (21 kg/m2). The largest proportion of people over 20 years of age were overweight (>25 kg/m2). Every fourth pregnant woman (43.4%) and every third mother (33%) reported that excess body weight does not bother them at all.
Based on the body mass index, Hungarian women are already overweight before pregnancy, which entails an increased health and financial burden.]
An update on approved and emerging drugs for the treatment of postpartum depression
Cognitive impairment in long-COVID
1.
Clinical Neuroscience
Is there any difference in mortality rates of atrial fibrillation detected before or after ischemic stroke?2.
Clinical Neuroscience
Factors influencing the level of stigma in Parkinson’s disease in western Turkey3.
Clinical Neuroscience
Neuropathic pain and mood disorders in earthquake survivors with peripheral nerve injuries4.
Journal of Nursing Theory and Practice
[Correlations of Sarcopenia, Frailty, Falls and Social Isolation – A Literature Review in the Light of Swedish Statistics]5.
Clinical Neuroscience
[Comparison of pain intensity measurements among patients with low-back pain]1.
Clinical Neuroscience Proceedings
[A Magyar Stroke Társaság XVIII. Kongresszusa és a Magyar Neuroszonológiai Társaság XV. Konferenciája. Absztraktfüzet]2.
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Journal of Nursing Theory and Practice
[A selection of the entries submitted to the literary contest "Honorable mission: the joys and challenges of our profession" ]4.
Journal of Nursing Theory and Practice
[End of Life and Palliative Care of Newborns in the Nursing Context]5.
Journal of Nursing Theory and Practice
[Aspects of Occupational Health Nursing for Incurable Patients ]
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