Lege Artis Medicinae

[Detection of endemic MRSA colonisation in a retirement home]

STÁNITZ Éva, TOMPITY Tünde, UNGVÁRI Erika, PÁSZTI Judit

APRIL 20, 2013

Lege Artis Medicinae - 2013;23(03-04)

[Methycillin-resistant Staphylococcus aureus (MRSA) colonisation was proved in a retirement home. A resident of the social institution (a 83-year-old man) was hospitalised and was cared for in a ward where a patient positive for MRSA was treated. Screening tests of the above mentioned resident, one of his room-mates at the retirement home as well as three of the four nurses being on duty at the weekend when the man returned to the social institution from the hospital proved the presence of MRSA colonisation. The screening test, which had been extended to the whole staff due to epidemiological reasons and also because of their anxiety, revealed MRSA positivity in the throat and nasal mucus of a fourth nurse. We presumed that the patient released from the hospital had infected his roommate as well as the four nurses. In order to investigate the epidemiological correlations we requested the cultured strains to be typified. With the use of phage typification, three different types of MRSA strains were identified in the six persons positive for MRSA, and a further MRSA strain could not be typified with the basic phage sequence. We review some interventions with regard to the avoidance and prevention of methycillin- resistant Staphylococcus aureus infection, which we had the opportunity to order as well as implement at the retirement home. We raise some of the problems we encountered.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Beyond the wrinkles: botulinum toxin for the treatment of focal dystonia]

KOVÁCS Tibor

[Botulinum toxin (BTX) is used in various fields including biological warfare as well as cosmetic applications. However, its ability to block neuromuscular transmission provides a unique option for the therapy of diseases associated with increased muscle tension. BTX is effective in both striated and smooth muscles, which makes it applicable for a number of clinical purposes beyond its cosmetic use. Clinical applications include treatment of focal dystonias, the most common form of which is spastic torticollis (cervical dystonia) and blepharospasm. As BTX therapy is a safe, efficient and first-line treatment option in focal dystonias, the recognition of these diseases and their differential diagnosis might be important in almost all clinical fields, especially in ophthalmology, psychiatry, orthopedic surgery and rheumatology. The aim of this review is to present BTX therapy as a treatment option for these diseases.]

Lege Artis Medicinae

[Clinicoradiological consultation, it could be!]

ROMICS Imre

Lege Artis Medicinae

[A Kind but Sly Wizard – Ethical Musings upon Reading Irvin D. Yalom’s The Schopenhauer Cure ]

LŐRINCZ Jenő

Lege Artis Medicinae

[Apixaban: the newest oral anticoagulant in Hungary for the treatment of patients with atrial fibrillation]

BORBÉLY Attila, ÉDES István

[In the past few years a number of articles have been published on the new oral anticoagulants (Xa-factor inhibitors, thrombin inhibitors). These new agents are increasingly used in the daily clinical practice in Hungary. The new oral anticoagulants have been shown to be at least as effective in the prevention of stroke and systemic embolization related to non-valvular atrial fibrillation as K vitamin antagonists. Moreover, their use is safe, can be administered in a daily fixed dose and, even in case of long-term use, they do not require regular laboratory testing. This review aims to summarise the most important theoretical and practical information on the newest direct Xa-factor inhibitor agent apixaban from the perspective of a cardiologist.]

Lege Artis Medicinae

[Pro-Micro (Intracoronary Enalaprilat to Reduce Microvascular Damage During Percutaneous Coronary Intervention)]

MATOS Lajos

All articles in the issue

Related contents

Lege Artis Medicinae

[Changes in infectology over the past two decades]

SZALKA András

[Infectious diseases and various infections are the major causes of morbidity and mortality in developing as well as in industrialised countries. Despite the advances in the past decades in our understanding of microbes, efficient treatment of diseases and preventive approaches, more than 13 million people die every year due to infectious diseases. In the past two decades, more and more new pathogens and infections diseases have been emerging and old diseases that were almost forgotten have re-emerged. There are many new diseases for which we do not have or have hardly any efficient antimicrobial drugs and no efficient vaccines. Despite an increasing frequency of multi- and panresistant microbes, the development of new antibiotics to be used against these infections is unlikely to occur in the near future. The big pharmaceutical companies have stopped the research of antibiotics. In this situation, the only option we have is to use antibiotics rationally and to take prevention and control of infections seriously, both in the outpatient system and in hospitals. Preserving the effectiveness of currently used antibiotics is in everyone’s interest and is everyone’s responsibility.]

Lege Artis Medicinae

[Defending the statins]

MÁRK László

[Taking into account the frequent occurrence of coronary heart disease and the mortality related to this, it is obvious that the primary and secondary prevention of cardiovascular events is nowadays a major challenge in medicine. The lipid lowering therapy has become the basic element of the prevention and the statins are first-choice drugs in this field. Despite the great amount of the evidences coming from studies based on the principles of the evidence based medicine, the statins are frequently in the crossfire of undeserved offensives. The unexplainable reluctance to statins is frequent not only among the misled patients but among doctors too. The attitude of the latter to the treatment determines the patients’ compliance. The change of this attitude is the aim of this paper. This potential change and the continuous education of the patients are the most common possibilities for the improvement of the bad statin persistence and adherence. ]

Lege Artis Medicinae

[Vitamin D treatment: hormone therapy for patients who need it or simply a supplementation for everyone?]

SPEER Gábor

[Various medical associations issue different recommendations for the prevention and treatment of vitamin D deficiency. These significant differences are partly explained by the different definition of normal vitamin D level and the use of completely different mathematical models to predict the increase in vitamin D level as a response to therapy. According to the Institute of Medicine (IOM), the target vitamin D level is 20 ng/ml, whereas the Endocrine Society (ES) recommends 30 ng/m as the miminum target value. According to the ES, a 1 ng/ml increase of vitamin D level can be reached by a daily intake of 100 NE, while the IOM recommends 3.6 ng/ml. Moreover, the IOM states that the effect of therapy on serum level is nonlinear. These differences show that the ES and IOM have different views on the risk of adverse effects. The IOM recommends 400 IU vitamin D daily for children younger than 1 year, 800 IU for those above 70 years and 600 IU/per day for everyone else. The ES recommend 400-1000 IU daily for all infants and 1500- 2000 IU for adults. Screening, however, is not recommended by either society. To decrease uncertainty concerning the side effects of higher-dose vitamin D treatment, it is important to understand, use and support the function of the pharmacovigilance system of the pharmaceutical industry that manufactures and markets various (prescription, over-the-counter) preparations. This is what the author aims to highlight in the second part of this article. Using this system, both the doctor and the patient can help support and accept the justification of higher-dose vitamin D therapy.]

Journal of Nursing Theory and Practice

[Competencies of Community Nurses, Opportunities of Extensions in Adult General Practices of Cegléd .]

JÓZSA Edit

[Aims of the study: The local community nurses can use their present abilities between given conditions and how these abilities could be extended. Sample and methods: 137 evaluable questionnaires were returned from 14 family doctors’ patients and 12 questionnaires were from community nurses. The questionnaires consisted of open and closed questions. The data was processed by SPSS and Excel software. Statistics were made by descriptive statistic means and Fischer exact tests. Results: During my survey it turned out that patients don’t utilize basic adult health care means such as measuring blood pressure and blood-sugar and lab examinations. Conclusions: Most of the community nurses can’t utilize most of their abilities and knowledge. They don’t have the opportunity to perform health education or just to talk to the patients face-to-face. My thesis surfaces the fact that community workers and doctors should work coordinate. It’s not true in relation of all the general practitioners and nurses.]

Clinical Neuroscience

[Questions of epileptogenesis and prevention in symptomatic epilepsies]

NIKL János

[Symptomatic epilepsies usually report themselves after a longer period of time after brain injury, after the so-called latent period. During this period progressive functional and structural changes occur which finally cause an increased excitatory condition. The process of epileptogenesis may be examined in animal models, such as in the kindling, status epilepticus, hypoxicischaemic models. Data gained from such sources support the hypothesis that the first injury results in a lower seizure threshold, but genetical and enviromental factors also contribute to the development of epilepsy and most probably further insults may be needed. The development of epilepsy can be traced back to several reasons. In spite of this, the latent period provides opportunity for the prevention of epilepsy or for the influence of epileptogenesis in such a manner that later treatment can become more succesful. Prevention should be an aim in clinical practice, as well. Medication used presently are more like to have anticonvulsive properties and their antiepileptogenic effect is questionable. Due to this fact, development of new drugs is necessary with new theoretical background. The most important influence on the incidence of epilepsy in recent years has been provided by the improvement in neonatal care. This highlights the fact that such optimal medical care should be provided in the acute period of brain injury which can terminate or lessen the risk of epilepsy.]