Lege Artis Medicinae

[Hospitals in Ancient Rome ]

KRUTSAY Miklós

SEPTEMBER 20, 2017

Lege Artis Medicinae - 2017;27(08-09)

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Lege Artis Medicinae

[Cardiovascular screening and risk stratification]

VÉRTES András

[Cardiovascular diseases are still leading cause of death in developed countries. A possible background, atherosclerosis, might appear even in childhood, and deteriorate during the years without any symptoms. The cardiovascular prevention is a complex activity, which can be observed in population or/and in individual level. The conventional screening means the assessment of higher cholesterol level, blood pressure or other risk factors in healthy population without symptoms. The point of clinical risk evaluation is to find patient with high cardiovascular risk and consequentially with the necessity of intensive preventive strategy. For the right cardiovascular screening and adequate evaluation of the risk, it is needed that the doctors who frequently meet with the population execute the above-mentioned risk assessment. Therefore doctors, nurses, and education for preventive aspect would is needed, as education is important to decrease cardiovascular mortality for those patients that were categorized as a high-risk group.]

Lege Artis Medicinae

[The László Romics Award – to Boost the Young An Interview with Professor István Karádi ]

KUN J. Viktória

Lege Artis Medicinae

[Effective fulvestrant treatment of indolent breast cancer in a patient with low compliance - a case report]

HÓDI Veronika

[In the explosive development of treatment of oncological patients, there are still patients who are not always cooperative even in their own treatment. The case report exemplifies that even in this case the endocrine treatment has its place in the hormone receptor positive breast cancer. ]

Lege Artis Medicinae

[Love or Thirst for Revenge or Forgiving – Flowing Melodies, a Virtuoso Play A Concert-like Performance of Bellini’s Last Opera in Budapest and in Pécs ]

WINKLER Gábor

Lege Artis Medicinae

[Advance directive]

KŐMÜVES Sándor

[In the first step the work defines the institution of advance directive, places advance directive in the context of advance care planning, and demonstrates the advantages of advance care planning. Then the forms of the advance directive are presented and related Hungarian health care sections are interepreted in the context of these back-ground conditions. In the third step decision making capacity is defined, its standards are set out, the role of substituted decision maker is delineated. In the fourth step accumulated experience with living will is demonstrated and the possible alternatives concerning the future of living will are provided: the elimination of the living will part of the institution from health care or its continued application after substantial revision. METHODS - Analytic presentation after systematic review of the literature on the topic. RESULTS - Significant experience has been accumulated since the implementation of advance directive. In light of experience two attitudes have been chrystallized regarding the future of the institution: one takes the side of the elimination of the living will part of the institution from health care, the other recommends its revised application. CONCLUSION - The American and Hungarian experiences with advance directive recommend the review of the Hungarian institution of advance directive. ]

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[Nursing care workers to assess job skills calicivirus caused by the accumulation of tasks required hospital infections]

KASZONYINÉ ENGI Erika

[Introduction: Author presents the results of surveys of knowledge-prepared nurses’ll need to Calicivirus infections at hospitals accumulation, which was conducted in 7 (a mix of invasive and non-invasive track) ward nurses skilled and unskilled workers. Aim of research: to find out which questions need to put the emphasis on nurses hospital hygiene education to subjects of age, prevention and early detection of infections from spreading which is an important part of the hospital wards enteric outbreaks may occur. Research and sampling methods: The research used an anonymous questionnaire method. The survey was conducted between January 04 2016 and whether 29 or not. The target population for the selection of the author of the favored classes of patient care, on which the last 6 years due to Calicivirus outbreak occurred, which was reported in the NNSR database. Results: 158 nurses participated. The obtained results show that nurses have the knowledge and experience to an infection caused by a Calicivirus, but there are also gaps in knowledge, particularly in the event of hospital infections overlapping actions to be taken to curb the epidemic. Conclusion: Keep the enteric infections also with regard to the knowledge acquired basic education level, especially since the hospital departments favor the spread of these infections are due to sanitary facilities shared by the patient’s condition resulting from lower personal hygiene and multi-bed wards. ]

Clinical Neuroscience

[Genetically determined neuromuscular disorders of some roma families living in Hungary (in English language)]

LÁSZLÓ Aranka, MAYER Péter, KÓBOR Jenõ, RÁCZ Katalin, TÁLOSI Gyula, ENDREFFY Emőke, HERCZEGFALVI Ágnes, HORTOBÁGYI Tibor, TISZLAVICZ László, BEREG Edit, KATONA Márta, SZABÓ János, KARCAGI Veronika

[The authors discuss the clinical and molecular genetic aspects of genetically determined neuromuscular disorders of some Roma families living in Hungary. Among the autosomal recessively inherited spinal muscular atrophic (SMA) group, 8 Caucasian children had the typical 7-8 exonal deletions of the SMA gene, but only 2 patients belonged to the Roma population. There was no difference in the molecular genetic findings among the Caucasian and the Roma SMA patients. All of them had 7- 8 exonal deletions of the SMA gene. We wanted to call attention to the founder mutation of the Roma population in 7 patients suffering from congenital myasthenia (CMS) from 3 Roma families. The 1267G deletion for CMS was detected by molecular genetic method. Clinical onset was pubertal and relatively slow progression of specific and phenotypic features for this founder mutation of acetyl-cholin receptor epsylon gene. In 2 patients (sister and brother) the sarcoglycanopathy 2C type C283Q mutation was proven in one Roma family suffering from limb-girdle muscular dystrophy (LGMD). Two out of the three facioscapular-humeral dystrophy (FSHD) Roma families carried 21.8 kb and 18.5 kb alleles in FSHD A1 gene (D4S139). In one family together with prenatal diagnosis founder mutation in FSHD A1 gene was detected, according to the autosomal dominant (AD) inheritence. In (F2) prenatal diagnosis was carried out, 18.5 kb/18.5 kb homozygosity was proven in the fetus, so the pregnancy was interrupted. In the CMS, LGMD and FSHD Roma patients ancient typical Roma founder mutations were found.]

Lege Artis Medicinae

[How Public Hospitals Developed, the Saint John Hospital ]

LUGOSI Lugo László, ZÖLDI Anna

Lege Artis Medicinae

[ELEVATED RESTING HEART RATE AND THE RISK OF CARDIOVASCULAR MORTALITY]

BORBOLA József

[In ancient times medical practitioners already knew that heart rate is a measure of the general condition of the soul and body. Worldwide epidemiologic studies in the past decades indicated that decreased resting heart rate, a parameter that can be simply measured, has a favourable direct effect on cardiovascular risk. This consistent beneficial risk-reducing effect can be clearly shown in the asymptomatic general population as well as in patients with hypertension, stable coronary artery disease, acute myocardial infarction and congestive heart failure irrespective of gender, age or ethnic origin. In the asymptomatic general population this beneficial effect is mainly due to reduced early coronary artery disease events and diminished risk of sudden cardiac death. Population studies have clearly shown that decreasing resting heart rate - either by physical exercise or medical treatment - improves cardiovascular survival, and decreases the overall and cardiovascular mortality. It seems reasonable to conclude that in modern pharmacotherapy of cardiovascular disease the use of selective heart rate lowering drugs that directly act on the pacemaker activity of the sinus node (If-channel blockers) are warranted.]

Clinical Neuroscience

Different work schedules of nurses in Hungary and their effects on health

FUSZ Katalin, TÓTH Ákos, VARGA Bernadett, ROZMANN Nóra, OLÁH András

Introduction - The shift work is burdensome for nurses and may lead to health problems. Aims - The purpose of the study was to examine the nursing shift system types and to analyse the effects on nutritional status, subjective state of physical and mental health in case of different shift schedules. Method - In the first phase of the research 326 nurses working in changing shifts filled out the Bergen Shift Work Questionnaire after adaptation into Hungarian. 518 nurses participated in our second study in hospitals of the South-Danubian Region, in clinics of University of Pécs and at trainings organized by the Faculty of Health Sciences of the University of Pécs. Results - Based on the psychometric characteristics of Bergen Shift Work Questionnaire technically it is suitable for the examination of sleeping disorders associated with shift work. Sleeping quality is worse in those working in irregular work shifts compared to those working in regular and flexible work schedules (p<0.001). The irregular work schedule is worse than the regular work schedule according to 76.6% of the nurses. According to 63.8% of the respondents the following regular work schedule is the best: after one 12-hour day shift one 12-hour night shift, followed by two days of rest. The average Body Mass Index (BMI) is 26.16 kg/m2. Since the nurses work in shift work 47.7% of them reported weight gain. Among the psychosomatic symptoms the most frequent is back pain (78.4%) related elevated BMI (p=0.013). The nurses’ sense of coherence on average is 61.76 points. In case of full-time employees the sense of coherence is better than those who work in shifts (t=2.933, p=0.004). The nurses working irregular shift work asses their health worst (mean rank: 166.61; p=0.019), and their sense of coherence is lower (p=0.04). Conclusion - The irregularity of work schedules is stressful for nurses. Due to the health of nurses it would be useful to establish the least exhausting work schedules.