Lege Artis Medicinae

[Stories of the Black Square ]

RÁCZ József

FEBRUARY 15, 2015

Lege Artis Medicinae - 2015;25(01-02)

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Lege Artis Medicinae

[A Painful Conversation of Statues ]

GEREVICH József

Lege Artis Medicinae

[Amlodipine/atorvastatin fix combination in type 2 diabetes mellitus]

BÓTYIK Balázs

[INTRODUCTION - Type 2 diabetes mellitus is known to represent a major cardiovascular risk. In type 2 diabetes, hypertension and dislipidemy are often also present, increasing the vascular risk. In this case the use of both antihypertensive and lipid lowering therapies is needed. In our CASE REPORT, we discuss the data of a 43 years old diabetic man with BMI: 29.4 kg/m2, waist circumference of 101 cm, who had recently diagnosed hypertension and was given single pill amlodipine/ atorvastatine in addition to his original ACEI therapy. At the initiation of the therapy the mean blood pressure - measured during ABPM was 149/91 ± 14.99 Hgmm, his total cholesterol: 4.18 mmol/l, HDL cholesterol: 0.82 mmol/l, LDL cholesterol: 2.41 mmol/l, and triglicerid: 4.09 mmol/l. Three months later the results were the following: mean blood pressure: 121.66/ 82.79 ± 8.21 Hgmm, total cholesterol: 3.47 mmol/l, HDL cholesterol: 1.08 mmol/l, LDL cholesterol: 1.98 mmol/l, triglicerid: 1.44 mmol/l. There were no side effects. Using the therapy among several other diabetic patients we observed similar efficacy and tolerability, and the adherence of the patients was perfect. DISCUSSION - In type 2 diabetes the use of the fix combination of amlodipin/atorvastatin in addition to previous ACEI therapy is effective, well tolerated, and the long term compliance proves to be good.]

Lege Artis Medicinae

[Physician and Science 2. The Science of Schizophrenia... But Which One? ]

BÁNFALVI Attila

Lege Artis Medicinae

[Bonferroni correction to adaptive clinical studies - Managing of multiplicity in clinical trials]

MOLNÁR D. László

Lege Artis Medicinae

[Alzheimer’s disease and arrhythmia: cause, effect, complication]

PETŐ Balázs, KOVÁCS Tibor

[Alzheimer’s disease (AD) is a new endemic of the 21st century which becomes the biggest health and social problem of the ageing societies in the next few decades. Vascular factors, such as cardiac arrhythmias, especially atrial fibrillation, play an important role in the pathogenesis of AD. Arrhythmias might develop as a consequence of AD, too, and they might be caused by the cholinergic medications used in the treatment of AD. In addition, AD has a major influence on the treatment of arrhythmias, especially atrial fibrillation. Because of these, AD and arrhythmias might accompany each other in the practice of several medical specialties; these interactions are reviewed in this paper. ]

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[Elements of health literacy among the Hungarian working population]

SZOBOTA Lívia, HIRDI Henriett Éva, BALOGH Zoltán

[Aim of the research: The authors’ objective was to reveal the state of health, lifestyle and health behaviour of economically active population. Research and sampling methods: The cross-sectional survey was conducted among white-collar workers in Hungary, selected using a random, sampling method. The data gathering took place using web-based, anonymous, self-completion questionnaire. The proprietary questionnaire used was based on the questionnaire used in the National Population Health Survey (OLEF) for the standard survey of health behaviour. The authors analysed the gathered data with Microsoft Excel 2010 software, using chi-square test and descriptive statistical method. They regarded the value of p <0,05 as significant. Results: The survey was completed by 735 workers (63% man, 37% woman). The average health value of workeres in the survey was 9.6 on a scale of ten grades. We separately analysed smoking habits and physical activity. Examining their state of health based on the psychosomatic symptoms scale, the respondents most frequently indicated back and lumbal pain, and sleep disorders. Conclusions: The results of survey revealed that the health condition of respondents is unsatisfying. Many white-collar workers are suffering from psychosomatic symptoms. On the whole it can be concluded that health behavior of workers needs to be changed. ]

Clinical Neuroscience

[Role of modified open-door laminoplasty in the treatment of multilevel cervical spinal stenosis: a retrospective analysis of 43 cases]

VITANOVICS Dusan, BÁRÁNY László, PAPP Zoltán, PADÁNYI Csaba, BALOGH Attila, BANCZEROWSKI Péter

[Background and purpose - Symptomatic degenerative multilevel cervical spinal stenosis - beside other methods - is often treated using the open-door laminoplasty. This procedure aims to decompress the spinal cord and preserve the stability of the cervical spine. The efficiency and safety of the method was proved by numerous Japanese and American studies, also the technique related complications are well known. We treated 43 patients with symptomatic multilevel cervical spine stenosis using the open-door laminoplasty as a surgical procedure of choice in the National Institute of Clinical Neurosciences between 2009 and 2012. In this article we analyse our results and the related literature is discussed. Methods - Symptomatic patients with a minimum of three-segment cervical spine stenosis and radiologically proved myelopathy or with electrophisiologically verified subclinical myelopathy were selected for laminoplasty. Patients in whom cervical kyphosis was present were operated on using laminectomy and posterior fusion. Postoperative control CT, MRI and/or X-ray images were made after the surgery and at six weeks, three, six and 12 months after the operation and in the same time neurological evaluation was performed. The modified Japanase Orthopaedic Association (mJOA) scale value was assigned to patients preoperatively, six weeks, three, six and 12 months after the operation. The statistical difference between the groups of data was tested by chi square test. Results - The average follow-up time was 27 months (minimum seven, maximum 42). According to the mJOA scale, 26 patient’s condition (61%) improved, in 13 cases (30%) remained unchanged, and in one case (2%) we detected neurological deterioration. We lost three patients during the follow up period. The median of mJOA preoperatively was 12 (minimum eight, maximum 18), while six week postoperative mJOA was 14 (minimum 10, maximum 17). Three, six and 12 months mean value of mJOA was 14 which shows that the improvement in patients’ condition remained stable at one year after surgery. The difference was statistically significant (p<0.05). The canal’s average anteroposterior diameter on CT was 8.29±0.92 mm at the level of C III, while after the operation we measured 15.16±1.02 mm; 7.54±0.62 mm at the level of C IV before, and 15.29±0.2 mm after; 9.05±0.48 mm at the level of C V before and 17.23±0.4 mm after the surgery. The differences proved to be significant (p=0.0001). Conclusion - According to our experiences the modified open-door laminoplasty is an efficient and safe method for the treatment of symptomatic multilevel cervical spinal stenosis.]

Journal of Nursing Theory and Practice

[Study based on special care needs of elderly people in Nursing Home run by Church ]

BADÓ Erika, BALOGH Zoltán

[Aims: The changes from the introduction of the care needs of elderly people in Nursing Home run by Church, set year 2011 against year 2016. Methods: The sample was taken from the residents of Filadelfia Integrated Social Institution in 2011 (N=118), in 2016 (N=122) and from the nurses who worked there in 2011 and also in 2016 (N==18). The survey was conducted through a self-constructed online questionnaire. The Nursing Documentation was reviewed during the document analysis. Data were analyzed with SPSS using Chi square and Fisher’s tests. Results: It can be concluded that the numbers of care needed people increased, like living with dementia (p=0,001), using catheter (p=0,001), handicapped (p=0,001), using long term painkillers (p=0,005). Fluctuation and the decrease of the numbers of professional stuff are typical. Conclusions: For the care needs of elderly people, higher level care is needed with professional stuff qualifications. ]

Journal of Nursing Theory and Practice

[Recognizing colorectal cancer, education of patients and preparing them for the stomal therapy]

TUSÓCZKI Evelin, NÉMETH Anikó

[Aim of the research: The study investigated the circumstances of the diagnosis of the disorder. The assessment of information given to patients, communication of the staff and the preparation for the stomal therapy was also part of the study. Research and sampling methods: A self-constructed questionnaire was administered during October and December of 2015. The inventory was uploaded to self-help sites for colorectal cancer patients and questionnaires were also handed out on surgical wards (N=114). Data were analysed with SPSS 22.0. Chi square, Mann-Whitney and Kruskal-Wallis tests were applied (p<0.05). Results: Colorectal cancer screening has never been attended by 81.6% of the responders. Constipation was a more frequent warning sign by women (p=0.045). The patients who received guidance from both doctors and nurses about oncology treatment were more satisfied with the information compared to those who only communicated with one person (p<0.001). The patients who could contact a stomal therapy nurse on-demand were able to handle their stomas autonomously (p=0.035). Conclusions: Information provided by more staff members help to dissolve anxiety. Contacting stomal therapy nurses on-demand should be preferred. ]

Hungarian Radiology

[The role of the mechanical lithotripsy for the treatment of ”difficult” common bile duct stones]

OROSZ Péter, NAGY György, SÜMEGI János, JUHÁSZ László

[INTRODUCTION - Present work aimed to identify some predictors of success or failure (gender, age, number and size of stones, presence of periampullary diverticula and jaundice) in mechanical lithotripsy. PATIENTS AND METHODS - 7998 endoscopic retrograde cholangio-pancreatographies, 2430 endoscopic sphincterotomies and 1205 bile duct stone extractions were performed between 1981 and 2000 years. In 159 patients - because of failure of standard techniques - mechanical lithotripsy was attempted for crushing of large bile duct stones. There were 39 men (mean age 70.5 years) and 120 women (mean age 67.7 years). 65 patients had single stone, 31 had 2 stones and 63 had multiple stones. 80 patients had larger stones than 20 mm in diameter. 23 patients had periampullary diverticula and 98 were jaundiced. Mechanical lithotripsy was accomplished with Olympus BML 2Q and BML 4Q intraendoscopic systems. When the first attempt failed, repeated treatment was performed or a Wilson-Cook extraendoscopic system was used. Data of predictors were processed using univariate analysis, Chi-square test and Fischer’s exact test. P<0.05 was regarded as statistically significant. RESULTS - Clearance of common bile duct was obtained in 130 patients (81.8%). Procedure related cholangitis occured in 16 patients. 8 pancreatitis developed, 7 of them subsided with conservative therapy, 1 of them required surgical treatment. On univariate analysis, the stone size was the only variable to differentiate the success from failure of procedure (p<0.05). Other variables had not any role in determining the outcome. CONCLUSION - Mechanical lithotripsy is a useful method with a high success rate and with an acceptable complication rate for treatment of ”difficult” bile duct stones. Stone size is the single outcome predictor.]