Lege Artis Medicinae

[Errors of the Amended Version]

dr. KALÓ Zoltán

JANUARY 22, 2008

Lege Artis Medicinae - 2008;18(01)

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Lege Artis Medicinae

[“WHAT DO YOU THINK HAPPENS TO THOSE WHO RARELY GO OUTDOORS?”]

PLUHÁR F. Zsuzsanna, KOVÁCS Szilvia, PIKÓ Bettina, UZZOLI Annamária

[INTRODUCTION - The surrounding environment plays an important role in the development of psychosomatic symptoms. This study examines what children think of the consequences of not going outdoors for long periods. METHODS - Data were collected using the “draw-and-write” technique that besides the written answers allows children to express their thoughts in drawings. The questionnaire contained open-ended questions both on sociodemographic data and on the children’s notion of the relationship between environment and health or illness. Questionnaire submission was voluntary and anonymous. The study subjects were 9 to 11-year-old pupils (n=448, 44.6% boys, 55.4% girls) from six primary schools, two in Budapest, and one each in Pest, Jász-Nagykun-Szolnok, Csongrád and Békés counties. The primary schools were selected so as to represent various environmental locations, such as urban, town, suburban residential, area of blocks of flats. RESULTS - We found that all children agreed in that those who don't go outdoors for a long time will, in one way or another, get sick. Illnesses mentioned in the answers were classified in two categories, physical and mental. Physical health problems were further divided into four subcategories: symptoms (e.g., anaemia, pallor, fever, weak joints or bones); diseases; obesity; death. Mental health problems were divided into two subcategories: actual psychiatric diseases (e.g., depression) and symptoms, such as unhappiness, sadness, anger. CONCLUSIONS - We conclude that children in this study sample reckon the close connection between staying indoors for prolonged periods and the development of symptoms and disease.]

Lege Artis Medicinae

[Two Seconds]

dr. TAMÁS László

Lege Artis Medicinae

[Most recent data on drug-eluting stents]

FÜLÖP Gábor, BERTA Balázs, MERKELY Béla

Lege Artis Medicinae

[THE EPIDEMIOLOGY OF CEREBROVASCULAR DISEASES IN HUNGARY AFTER THE MILLENNIUM]

VOKÓ Zoltán, SZÉLES György, KARDOS László, NÉMETH Renáta, ÁDÁNY Róza

[INTRODUCTION - Here we present the descriptive epidemiology of stroke in Hungary including mortality, morbidity, functional limitation and inpatient care based on the most recent health statistical data. METHODS - Mortality data were analysed by direct and indirect standardisation, and geographical mapping based on empirical Bayesian smoothing. Morbidity data were obtained from the General Practitioners’ Morbidity Sentinel Station Program and the National Health Surveys. The latter also provided data on functional limitation. Data on inpatient service were taken from the European Hospital Morbidity Database of WHO. RESULTS - Hungarian stroke mortality continued to decrease in recent years, and the slope of the decrease was larger than in Western Europe. Stroke mortality was highest in the Northern- Hungarian Region, and in Somogy and Zala counties. The incidence of stroke was 1.5-2 times higher than in the developed countries in most age groups. Over 64 years of age, a decline of stroke incidence was observed, especially in men. In this age group approximately 10% of men and 7% of women had already had a stroke. Of these patients more than 10% needed assistance to get out of the bed, dress up, or eat. Hospitals reported more than 60 000 stroke cases in 2005. CONCLUSION - Despite the promising trends in stroke mortality and now also in morbidity, both indices are still rather high in Hungary compared to those in Western-Europe. The relatively favourable epidemiological changes, however, may be overridden by the increased stroke burden resulting from the aging of the population.]

Lege Artis Medicinae

[Liver transplantation in adulthood - For whom is it indicated and how they can get it in Hungary?]

GERLEI Zsuzsanna

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Validation of the Hungarian version of the Test Your Memory

KOLOZSVÁRI László Róbert, KOVÁCS Zoltán György, SZŐLLŐSI Gergő József, HARSÁNYI Szilvia, FRECSKA Ede, ÉGERHÁZI Anikó

Concerns regarding the projected prevalence of Alzheimer’s disease (AD) over the next several decades have stimulated a need for the detection of AD in its earliest stages. A self-administered cognitive test (Test Your Memory, TYM) is designed as a short, cognitive screening tool for the detection of AD. Our aim was to validate the Hungarian version of the Test Your Memory (TYM-HUN) test for the detection of AD. The TYM-HUN was applied in case of individuals aged 60 years or more, 50 patients with AD and 50 healthy controls were recruited into the study. We compared the diagnostic utility of the Hungarian version of the TYM in AD with that of the Mini-Mental State Examination (MMSE). The sensitivity and specificity of the TYM-HUN in the detection of Alzheimer’s disease were determined. The patients with AD scored an average of 15.5/30 on the MMSE and 20.3/50 on the TYM-HUN. The average score achieved by the members of the healthy control group was 27.3/30 on the MMSE and 42.7/50 on the TYM. The total TYM-HUN scores significantly correlated with the MMSE scores (Spearman’s rho, r=0.8830; p<0.001). Multivariate logistic regression model demonstrated that a one-point increase in the TYM score reduced the probability of having AD by 36%. The optimal cut-off score on the TYM-HUN was 35/36 along with 94% sensitivity and 94% specificity for the detection of AD. The TYM has a much wider scoring range than the MMSE and is also a suitable screening tool for memory problems, furthermore, it fulfils the requirements of being a short cognitive test for the non-specialists. The TYM-HUN is useful for the detection of Alzheimer’s disease and can be applied as a screening test in Hungarian memory clinics as well as in primary care settings.

Journal of Nursing Theory and Practice

[Application of „The Parental Belief Scale for Parents of Hospitalized Children” questionnaire in Hungarian language]

MIKLÓSI Mónika, PERCZEL Forintos Dóra

[Aim of the study: Beliefs about parental role and efficacy was shown to be important in adaptation to child’s hospitalization; there is a lack of adequate measure of this construct, however. Our aim was the evaluation of the Hungarian version of The Parental Belief Scale for Parents of Hospitalized Children (PBS; Melnyk, 1994) assessing parents’ beliefs about their ability to understand and predict their children’s behaviours and emotions, as well as to participate in their children’s care during hospitalization. Sample and methods: The Hungarian version of the PBS was evaluated using a back-translation process. One hundred parents of hospitalized children in Heim Pál Children’s Hospital, Department of Surgery and Traumatology fulfilled the measure along with questionnaires regarding demographics, general parental self-efficacy and state-anxiety. Results: The Hungarian version of the PBS showed excellent internal consistency (α=0,94), and good stability (r=0,85 p<0,001). A significant positive correlation of medium effect size was found between PBS scores and general parental self-efficacy (r=0,30 p=0,025). Parent’s state anxiety was significantly negatively related to their self-efficacy beliefs regarding hospital setting (r=-0,48 p<0,001). Conclusion: The Hungarian version of the PBS was shown to be a reliable and valid instrument for measuring efficacy-beliefs of parents of hospitalized children.]

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[Errors and Mistakes Follow-up of a Symposium]

SZÁNTÓ Dezső

Clinical Neuroscience

[Guidelines for the treatment of traumatic brain injury - 2017]

BÜKI András, BARZÓ Pál, DEMETER Béla, KANIZSAI Péter, EZER Erzsébet, TÓTH Péter, HORVÁTH Péter, VARGA Csaba

[Traumatic brain injury (TBI) is recognized to be the main cause of death and disability in the first four decades representing a major socio-economical problem worldwide. Recent communications revealed a particularly worrying image about the quality of care for TBI in Hungary. For any improvement a systematic approach characterized by utilization of scientific evidence based guidelines forming the basis for close monitoring of the actual care are considered a prerequisite. In Hungary the first evidence based guidelines in the field of TBI have been issued by the National Society for Anesthesiology and Intensive Care more than two decades ago followed by joint guidelines of the Hungarian Neurosurgical Society and the Hungarian College of Neurosurgeons. These publications were primarily based on the work of the European Brain Injury Consortium as well as guidelines issued by the Brain Trauma Foundation. Recent renewal of the latter and a need to refresh the outdated national guidelines was met by a call from regulatory authorities to issue the updated version of the Hungarian TBI-guidelines. The present review is aimed to briefly summarize the most fundamental elements of the national head injury guidelines that would hopefully be officially issued in a far more detailed format soon.]

Clinical Neuroscience

[Validation of the Hungarian MDS-UPDRS: Why do we need a new Parkinson scale?]

HORVÁTH Krisztina, ASCHERMANN Zsuzsanna, ÁCS Péter, BOSNYÁK Edit, DELI Gabriella, PÁL Endre, KÉSMÁRKI Ildikó, HORVÁTH Réka, TAKÁCS Katalin, KOMOLY Sámuel, BOKOR Magdolna, RIGÓ Eszter, LAJTOS Júlia, ET al.

[Background - The Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) has been published in 2008 as the successor of the original UPDRS. The MDS-UPDRS organizing team developed guidelines for the development of official non- English translations consisting of four steps: translation/back-translation, cognitive pretesting, large field testing, and clinimetric analysis. The aim of this paper was to introduce the new MDS-UPDRS and its validation process into Hungarian. Methods - Two independent groups of neurologists translated the text of the MDS-UPDRS into Hungarian and subsequently back-translated into English. After the review of the back-translated English version by the MDS-UPDRS translation administration team, cognitive pretesting was conducted with ten patients. Based on the results of the initial cognitive pretesting, another round was conducted. For the large field testing phase, the Hungarian official working draft version of MDS-UPDRS was tested with 357 patients with Parkinson’s disease (PD). Confirmatory factor analyses (CFA) determined whether the factor structure for the English-language MDS-UPDRS could be confirmed in data collected using the Hungarian Official Draft Version. To become an official translation, the Comparative Fit Index (CFI) had to be ≥0.90 compared to the English-language version. Results - For all four parts of the Hungarian MDS-UPDRS, the CFI was ≥0.94. Conclusion - The overall factor structure of the Hungarian version was consistent with that of the English version based on the high CFIs for all the four parts of the MDSUPDRS in the CFA; therefore, this version was designated as the ‘OFFICIAL HUNGARIAN VERSION OF THE MDSUPDRS.’]