[Host switching does not need any magic]
KOVÁCS Sándor
JULY 31, 2023
Lege Artis Medicinae - 2023;33(6-7)
KOVÁCS Sándor
JULY 31, 2023
Lege Artis Medicinae - 2023;33(6-7)
Szöveg nagyítása:
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Lege Artis Medicinae
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Lege Artis Medicinae
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Lege Artis Medicinae
[Both, mortality and morbidity of chronic heart failure are persistently high, thus its adequate disease management is of pre-eminent importance. For heart failure with reduced ejection fraction (HFrEF) numerous evidence are available to improve its prognosis, including reduction of mortality, sudden cardiac death, and hospitalizations. Large randomized clinical trials have been shown that angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin-receptor/neprilysin inhibitor (ARNI), B-blockers, mineralocotricoid receptor antagonists (MRAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) reduce both morbidity and mortality of HFrEF patients. Accordingly, the heart failure recommendation of the European Society of Cardiology (ESC) issued 2021, proposed the basic therapy for HFrEF in 4 pillars: ACEI/ARNI, BB, MRA and SGLT2 inhibitors.
Instead of the earlier approach of stepwise sequential therapy, the new recommendation advocates for simultaneous initiation of all four drug classes with rapid titration to the target dose. The STRONG-HF clinical trial aimed to compare the rapid titration with its conventional strategy. Concerning the primary composite endpoint of repeated heart failure in 180 days with rehospitalization and all-cause mortality compared with changes in quality of life and rehospitalization by heart failure as separate endpoints, the rapid titration was significantly more efficient solution.
When optimizing therapy, we have also to pay attention to the comorbidities of HFrEF patients, which may compromise the procedure of titration. The consensus document of the ESC Heart Failure Association recommends special patient profiling by comorbidities and specific hemodynamic parameters, followed by therapeutic recommendations on different patient profiles. Overall, SGLT2 inhibitors have the least limiting factors and contraindications, thus they can be used in all profiles without exception – as early as at initiating the therapy.]
Lege Artis Medicinae
[Type 2 diabetes mellitus, as well as depression and anxiety, are generally prevalent and often occur together. Their relationship is complex with impacts of common aetiological factors, such as genetic background, activation of the stress system and the sympathetic nervous system, dysfunction of the immune system and elevated inflammatory cytokines, changes in the central nervous system, as well as lifestyle and socioeconomic factors. On the other hand, their relationship of the three conditions are bidirectional: diabetes may increase the risk of developing depression and anxiety through the burden of disease and diabetic distress, as well as the negative impact of complications on quality of life, while depression and anxiety may lead to diabetes through their negative impact on self-care, and antidepressants used to treat depression may also affect glycaemic control. It is important to draw the attention of professionals to the interrelations of diabetes, depression and anxiety since by screening of mental symptoms there can be reduced the disease burden of comorbidities. ]
Lege Artis Medicinae
[2023-ban evidenciaként kell elfogadunk azt a tényt, hogy az emelkedett LDL-C okozó rizikótényezője az atheroscleroticus érbetegségeknek és a következményként fellépő érkatasztrófáknak (myocardialis infarktus, stroke, perifériás érelzáródás). Intenzív lipidterápiával, azaz intenzív dózisú statin (20–40 mg rosuvastatin vagy 40–80 mg atorvastatin) és ezetimib kombinációjának alkalmazásával 50% feletti mértékben csökkenthető az LDL-C-szint, és így a kezeltek nagy részénél elérhetőek lennének a hazai és a nemzetközi ajánlásokban szereplő LDL-C-célértékek. ]
Clinical Neuroscience
Atrial fibrilla- tion diagnosed after stroke (AFDAS) is a new term used for AF resulting from autonomic dysregulation. It is associated with a lower stroke recurrence compared to patients with known AF before a stroke (KAF). The aim of the study was to explore the characteristics and mortality rates in AFDAS patients. 134 ischemic stroke patients (66.1±14.2 years old, n=73 male) were consecutively included in the study.
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 dental hygiene of the elderly is showing a devastating picture worldwide. Among the reasons we can find: behavioural factors, medicines, different illnesses. The bad dental hygiene, which is called paradontitis, can be the reason of so many different illnesses. Tooth loss in old age and bad mouth hygiene is not a basic thing and it is not a natural occurence. By sustaining the appropriate dental hygiene and visiting the dentist frequently one can avoid these problems or can be managed in time. In this announcement, the reasons of the bad dental hygiene of the elderly, the possibilites of prevention and the steps of dental counseling are listed.]
Journal of Nursing Theory and Practice
[To assess lay parents’ knowledge and attitudes towards fever; to find out to what extent they know and use fever control recommendations for their children; to assess whether the perceptions of parents who manage their children’s fever independently have changed. And to put this snapshot into context, it summaries how the perception of fever has changed through history to the present day.
The cross-sectional study was conducted between November 12, 2022 and December 24, 2022 through self-constructed online questionnaire among non-medical parents.
Most parents are not even aware of the basic concepts. If they do not have to manage their own fever, but their child’s, they will begin to reduce the fever much sooner. 58% of those surveyed also use physical methods (compresses, cooling baths) in addition to medication. Many misconceptions about fever persist. There is an opinion among parents that it is better to consult a physician than to manage fever on your own.
Disseminating knowledge about fever and tackling misconceptions would be vital to reduce the burden of overused emergency care.]
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.
3.
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 ]