Lege Artis Medicinae

[Insulin dose titration in type 1 diabetes mellitus: A blessing or a curse?]

TAKÁCS Róbert

JUNE 15, 2012

Lege Artis Medicinae - 2012;22(05)

[INTRODUCTION - Knowing the pharmacokinetic properties of different insulins, useful treatment algorithms can be set up for the majority of our insulin-treated patients. When planning either a human or an analogue basal-bolus regimen, the first task is to determine the daily insulin requirement, followed by determination of the optimal rate of basal and bolus insulins. CASE REPORT - In a 33-year old, moderately obese man with type 1 diabetes who received 180 U daily insulin doses, accumulated hypoglycaemic episodes with neuroglycopenic symptoms occured. After cessation of the original insulin therapy and starting an analogue basal-bolus treatment regimen, both the carbohydrate metabolism and the overall quality of life of the patient have significantly improved. Optimal metabolic control was achieved by a basal insulin ratio above 50%. CONCLUSION - Using elements of the analogue basal-bolus regimen - one of the state-of-the-art forms of insulin treatment - at the appropriate dose and dose ratio, it is possible to comply with the therapeutic requirements of our age. However, if this weapon is used inappropriately, it might actually harm patients.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Quo vadis? Whose life is it anyway? EBM based health politics and health based politics]

KAPÓCS Gábor

Lege Artis Medicinae

[Liver diseases and diabetes mellitus]

WINKLER Gábor

[The liver plays a pivotal role in metabolism. Thus, it is hardly surprising that its acute and chronic diseases may be accompanied by multiple disturbances of the carbohydrate metabolism, and the development of diabetes mellitus - primarily of type 2 diabetes mellitus - may result in structural changes in the liver. This article overviews the main pathogenetic mechanisms of this bidirectional relationship, discusses special considerations of choosing the therapy and highlights special difficulties of the assessment of a diabetic metabolism.]

Lege Artis Medicinae

[Borderline and Stigmatisation An Interview with Éva Ratkóczi MD ]

NAGY Zsuzsanna

Lege Artis Medicinae

[The Ear Disease and Death of Heinrich Schliemann ]

GERLINGER Imre

Lege Artis Medicinae

[The role of vitamin D in gastrointestinal diseases]

ZÖLD Éva, BODOLAY Edit, ZEHER Zargit, BARTA Zsolt

[The amount of the fat-soluble vitamin D can be reduced by a number of chronic diseases or even obesity. On the other hand, vitamin D itself can also influence the development or course of these disorders. Some gastrointestinal diseases are known to cause vitamin D deficiency, but some observations and studies have also proved that certain gastrointestinal diseases occur more frequently in case of vitamin D deficiency. Moreover, in case of some intestinal tumours even “vitamin D sensitivity” can occur. Our aim is to introduce the relationship between vitamin D and gastrointestinal diseases, and to highlight the importance of vitamin D replacement in gastrointestinal diseases accompanied by vitamin D deficiency or vitamin D sensitivity.]

All articles in the issue

Related contents

Journal of Nursing Theory and Practice

[Assessing Quality of life of Women with Cervical Cancer After Treatment]

KOZMANN Krisztina, JÁNOSNÉ PÁNKI Roxána, FERENCZY Mónika, KOMLÓSI Kálmánné, KARÁCSONY Ilona

[To assess sexual function, functionality and quality of life in women with cervical cancer. Descriptive, cross-sectional, quantitative, non-random, purposive sampling of women (N=91) with FIGO stage I/II/III cervical cancer, more than 5 months after last treatment. The study used standard questionnaires with self-designed questions. Data were analysed using Microsoft Excel, descriptive and mathematical statistics (p<0.05). Completers who received radiotherapy scored significantly higher in functional status (p<0.05) and emotional function than those who did not receive radiotherapy (p<0.05). Completers with lower levels of emotional well-being were significantly more likely to have lower levels of sexual function and higher levels of gynaecological problems (p<0.05). Women affected by cervical cancer often experience somatic and psychological disturbances that reflect on quality of life associated with the disease and treatment.]

Journal of Nursing Theory and Practice

[The Effect of Asthma Bronchiale on Everyday life Activities Among Adolescents]

RÁCZ Viktória Kinga, HEGEDŰS Bianka Ágnes , SZEBENI-KOVÁCS Gyula , FERENCZY Mónika

[The aim of this study is to assess the relationship between the physical activity of asthmatics, sleep disorders, the extent of asthma treatment, and to assess the quality of life in terms of physical activity. We conducted our quantitative, cross-sectional survey between 2020-2021. In a non-randomized, comfort sampling the target group was defined as adolescents aged between 14–18 years, their diagnosis of asthma bronchiale had to be for at least 1 year ago. The data were collected by a self-prepared questionnaire, the domains included: socio-demographic questions related to physical activites, symptoms, sleep disorders, severity of asthma. We used miniAQLQ to assess quality of life. The statistical analysis were performed by using Microsoft Excel 2016 and SPSS v 24 programs. Descriptive statistics (mean, standard deviation, minimum, maximum), two-sample t-test, Chi-square test were performed. The mean age of the respondents was 16±1.51, 38% were boys and 62% were girls (N=105). There was no significant difference between physical activity and the frequency of seizures and sleep disorders (p>0.05). There is a significant difference between the genders and the symptoms increasing with intense exercise (p=0.02). We found significant correlation between the active participations in physical education classes and the severity of the disease (p=0.021). There is a significant correlation between moderate-, social activities and physical activity (p<0.05). Appropriate health education, recommendation in career choices as well as in physical activities done by nurses may lead to decrease in the number of suffocation attacks in cases of adolescents suffering from asthma bronchiale.]

Clinical Neuroscience

[Disease burden of Duchenne muscular dystrophy patients and their caregivers]

PÉNTEK Márta, HERCZEGFALVI Ágnes, MOLNÁR Mária Judit, SZŐNYI László Pál, KOSZTOLÁNYI György, PFLIEGLER György, MELEGH Béla, BONCZ Imre, BRODSZKY Valentin, BAJI Petra, SZEGEDI Márta, POGÁNY Gábor, GULÁCSI László

[Background and purpose - Data on the disease burden of Duchenne Muscular Dystrophy are scarce in Hungary. The aim of this study was to assess patients’ and their caregivers’ health related quality of life and healthcare utilisations. Methods - A cross sectional survey was performed as part of the European BURQOL-RD project. The EQ-5D-5L and Barthel Index questionnaires were applied, health care utilisations and patients’ informal carers were surveyed. Results - One symptomatic female carer, 50 children (boys 94%) and six adult patients (five males) participated in the study, the latter two subgroups were included in the analysis. The average age was 9.7 (SD=4.6) and 24.3 (SD=9.8) years, respectively. Median age at time of diagnosis was three years. The average EQ-5D score among children and adults was 0.198 (SD=0.417) and 0.244 (SD=0.322), respectively, the Barthel Index was 57.6 (SD=29.9) and 53.0 (SD=36.5). Score of satisfaction with healthcare (10-point Likert-scale) was mean 5.3 (SD=2.1) and 5.3 (SD=2.9). 15 children were hospitalised in the past 12 months for mean 12.9 (SD=24.5) days. Two patients received help from professional carer. 25 children (mean age 11.1, SD=4.4 years) were helped/supervisied by principal informal carer (parent) for mean 90.1 (SD=44.4) hours/week and further family members helped in 21 cases. Correlation between EQ-5D and Barthel Index was strong and significant (0.731; p<0.01) as well as with informal care time (-0.770; p<0.01), but correlation with satisfaction with health care was not significant (EQ-5D: 0.241; Barthel Index: 0.219; informal care: -0.142). Conclusion - Duchenne muscular dystrophy leads to a significant deterioration in the quality of life of patients. Parents play outstanding role in the care of affected children. This study is the first in the Central and Eastern European region that provides quality of life data in this rare disease for further health economic studies.]

Clinical Neuroscience

[The quality of life of the cluster headache patients during the active phase of the headache]

DIÓSSY Mária, BALOGH Eszter, MAGYAR Máté, GYÜRE Tamás, CSÉPÁNY Éva, BOZSIK György, ERTSEY Csaba

[Introduction - Cluster headache (CH), which affects 0.1% of the population, is one of the most painful human conditions: despite adequate treatment, the frequent and severe headaches cause a significant burden to the patients. According to a small number of previous studies, CH has a serious negative effect on the sufferers’ quality of life (QOL). In the current study, we set out to examine the quality of life of the CH patients attending our outpatient service between 2013 and 2016, using generic and headache-specific QOL instruments. Methods - A total of 42 CH patients (16 females and 26 males; mean age: 39.1±13.5 years) completed the SF-36 generic QOL questionnaire and the headache- specific CHQQ questionnaire (Comprehensive Headache- related Quality of life Questionnaire), during the active phase of their headache. Their data were compared to those of patients suffering from chronic tension type headache (CTH) and to data obtained from controls not suffering from significant forms of headache, using Kruskal-Wallis tests. Results - During the active phase of the CH, the patients’ generic QOL was significantly worse than that of normal controls in four of the 8 domains of the SF-36 instrument. Apart from a significantly worse result in the ‘Bodily pain’ SF-36 domain, there were no significant differences between the CH patients’ and the CTH patients’ results. All the dimensions and the total score of the headache-specific CHQQ instrument showed significantly worse QOL in the CH group than in the CTH group or in the control group. Conclusion - Cluster headache has a significant negative effect on the quality of life. The decrease of QOL experienced by the patients was better reflected by the headache-specific CHQQ instrument than by the generic SF-36 instrument. ]

Clinical Neuroscience

[The changes in quality of life after instrumented surgical fusion of degenerative spondylolisthesis]

SÁRÓ Enikő, MISIK Ferenc, BANCZEROWSKI Péter

[Objective - There is no internationally accepted guideline for treatment of spondylolisthesis in the literature, otherwise this degenerative disease has great social and economical impact. There is no hungarian study examining the efficacy of instrumented fusion procedure in surgical treatment of spondylolisthesis. In current study we examined the effectiveness of fusion technique focusing on the impact of quality of life. Methods - Between 1st January, 2011 and 30th June, 2012 we examined a group of patients - who were operated on by instrumented fusion technique because of spondylolisthesis -, in the National Institute of Clinical Neurosciences, using the Oswestry Low Back Disability Questionnaire. All patients were treated after ineffective conservative treatment. The question was wheather how has changed the patients’ quality of life after the operation. Paired-sample t-test was used in this study. Results - Eighty-eight of the 97 examined patients reported different levels of impovement in the postoperative period, two patient’s condition has not changed in spite of the surgery, seven patient’s condition showed progression in average one year after the surgery. The pain improved most significantly (55.5%) (p<0.0001). Using the 16 point borderline according to the Questionnaire (over moderate disability), significant improvement was detected in 50 patients (51.5%). Succesful surgical result - according to the quality of life - was seen in 77.41% of male and in 50.98% of female patients. According to the different age groups, 72.72% of the younger (before retirement), and 53.06% of the retired patients belonged to this group. At least 15 point improvement was detected 35.05% of the patients, the overall improvement was 10.5 point. Discussion - Our results proved effectiveness of instrumented surgical fusion procedure in the treatment of degenerative spondylolisthesis. According to our results the younger male population with significant symptoms is the group, where improvement in quality of life is more pronaunced after the surgical procedure. Conclusion - The instrumented fusion surgical technique provides successful clinical and surgical outcome in patients with degenerative spondylolisthesis. It could improve the quality of life. Althought multicentre follow-up studies are needed to determine the exact indication and optimal therapy.]