Lege Artis Medicinae

[The Peeping Painter, or an Earned Military Cross ]

GEREVICH József

SEPTEMBER 10, 2019

Lege Artis Medicinae - 2019;29(08-09)

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Lege Artis Medicinae

[Anti-allergic agents and ICAM-1-antibodies for the control of upper respiratory infections]

SZABADKA Hajnalka

[Rhinoviruses are responsible for more than 50 percent of upper respiratory infections. It is well-established that the „Intercellular Adhesion Molecule 1” (ICAM-1) plays a crucial role in the adhesion of rhinoviruses and the relevant secondary bacterial pathogen Haemophilus influenzae to the epithelial cells of the respiratory tract. Both rhinoviruses and H. influenzae enhance the expression of ICAM-1 promoting their own attachment and mutually promoting that of the associated pathogen. It was experimentally shown that anti-ICAM-1 antibodies will inhibit infection by both rhinoviruses and H. influenzae. Since some anti-allergic agents - desloratadine and levocetirizine - also inhibit the expression of ICAM-1, their use may be beneficial in controlling some respiratory infections ]

Lege Artis Medicinae

[An Acknowledgment for Building the Future ]

KUN J. Viktória

Lege Artis Medicinae

[Path of life in the society with a diagnosis of a psychiatric disease ]

BÁNYAI Borbála, LÉGMÁN Anna

[INTRODUCTION - The aim of our study is to show how people can live with a diagnosis of a psychiatric disease, a schizophrenia diagnosis in Hungary. METHODOLOGY - We made 25 narrative life story interviews with Hungarian people diagnosed with mental illnesses. We examined what the main obstacles and supporting factors may be in the life stories regarding the independent lifestyle and participation in community. RESULTS - According to the interviewees the main obstacles are their states or diseases, the stigmas after their diagnoses, the function of the psychiatric care system and the lack of self-reliance following the patient role. They mentioned the family and their own motivations as supporting factors. CONCLUSION - The examination of the institutional functions can reveal what the supporting factors may be which can facilitate the social participation of people diagnosed with mental illnesses on the level of the system. ]

Lege Artis Medicinae

[Recovering from Dependency ]

RÁCZ József

Lege Artis Medicinae

[The health economic ISSUES of geriatric care in Hungary]

NÉMETH Bertalan

[INTRODUCTION - In Hungary, the ageing of the population is a major challenge for the healthcare system (and for the social care). Due to the complexity of treatment of the elderly, geriatric care needs to have a special integrative approach, in order to function effectively. METHODS - We analysed the data that was made publicly available by the Hungarian Payer, together with domestic and international publications, to provide suggestions regarding geriatric care. RESULTS - Based on public data, the utilization of geriatric healthcare services is low, and major differences could be observed within different areas of the country. Within outpatient care, geriatric care shows a decreasing trend. DISCUSSION - It is complicated to navigate through the services provided by the Hungarian healthcare system, while international examples show that additional health gain can be realized with geriatric care. The role of geriatric care needs to be increased within the Hungarian healthcare system, together with addressing the shortage of experts, and clarification of the relations and coordination amongst macro-level systems, and different healthcare professions.]

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Clinical Neuroscience

[Advanced Parkinson’s disease characteristics in clinical practice: Results from the OBSERVE-PD study and sub-analysis of the Hungarian data]

TAKÁTS Annamária, ASCHERMANN Zsuzsanna, VÉCSEI László, KLIVÉNYI Péter, DÉZSI Lívia, ZÁDORI Dénes, VALIKOVICS Attila, VARANNAI Lajos, ONUK Koray, KINCZEL Beatrix, KOVÁCS Norbert

[The majority of patients with advanced Parkinson’s disease are treated at specialized movement disorder centers. Currently, there is no clear consensus on how to define the stages of Parkinson’s disease; the proportion of Parkinson’s patients with advanced Parkinson’s disease, the referral process, and the clinical features used to characterize advanced Parkinson’s disease are not well delineated. The primary objective of this observational study was to evaluate the proportion of Parkinson’s patients identified as advanced patients according to physician’s judgment in all participating movement disorder centers across the study. Here we evaluate the Hungarian subset of the participating patients. The study was conducted in a cross-sectional, non-interventional, multi-country, multi-center format in 18 countries. Data were collected during a single patient visit. Current Parkinson’s disease status was assessed with Unified Parkinson’s Disease Rating Scale (UPDRS) parts II, III, IV, and V (modified Hoehn and Yahr staging). Non-motor symptoms were assessed using the PD Non-motor Symptoms Scale (NMSS); quality of life was assessed with the PD 8-item Quality-of-Life Questionnaire (PDQ-8). Parkinson’s disease was classified as advanced versus non-advanced based on physician assessment and on questions developed by the Delphi method. Overall, 2627 patients with Parkinson’s disease from 126 sites were documented. In Hungary, 100 patients with Parkinson’s disease were documented in four movement disorder centers, and, according to the physician assessment, 50% of these patients had advanced Parkinson’s disease. Their mean scores showed significantly higher impairment in those with, versus without advanced Parkinson’s disease: UPDRS II (14.1 vs. 9.2), UPDRS IV Q32 (1.1 vs. 0.0) and Q39 (1.1 vs. 0.5), UPDRS V (2.8 vs. 2.0) and PDQ-8 (29.1 vs. 18.9). Physicians in Hungarian movement disorder centers assessed that half of the Parkinson’s patients had advanced disease, with worse motor and non-motor symptom severity and worse QoL than those without advanced Parkinson’s disease. Despite being classified as eligible for invasive/device-aided treatment, that treatment had not been initiated in 25% of these patients.]

Clinical Neuroscience

Evaluation of anxiety, depression and marital relationships in patients with migraine

DEMIR Fıgen Ulku, BOZKURT Oya

Aim - The aim of this study was to evaluate the frequency and characteristics of attacks in patients with migraine, to determine the effects of anxiety or depressive symptoms, and to evaluate the marital relationships of patients with migraine. Method - Thirty patients who were admitted to the neurology outpatient clinic of our hospital between July 2018 and October 2018 and were diagnosed with migraine according to the 2013 International Headache Society (IHS) diagnostic criteria were included in this cross-sectional study. Age, sex, headache frequency and severity, depressive traits, marital satisfaction and anxiety status were examined. We used the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maudsley Marital Questionnaire (MMQ) and Visual Analogue Scale (VAS) for measuring relevant parameters. Results - The mean severity of migraine pain according to VAS scale was 6.93 ± 1.41 and the mean number of migraine attacks was 4.50 ± 4.24. The mean BDI score of the patients was 12.66 ± 8.98, the mean MMQ-M score was 19.80 ± 12.52, the mean MMQ-S score was 13.20 ± 9.53, the mean STAI-state score was 39.93 ± 10.87 and the mean STAI-trait score was 45.73 ± 8.96. No significant correlation was found between age, number of migraine attacks, migraine duration, migraine headache intensity, and BDI, STAI and MMQ scores (p>0.05). But there was a positive correlation between MMQ-S and scores obtained from the BDI and STAI-state scales (p<0.05). Conclusion - In this study more than half of the migraine patients had mild, moderate or severe depression. A positive correlation was found between sexual dissatisfaction and scale scores of depression and anxiety.

Clinical Neuroscience

The prevalence of sarcopenia and dynapenia according to stage among Alzheimer-type dementia patients

YAZAR Tamer, YAZAR Olgun Hülya

Aim - In this study, the aim was to identify the prevalence of sarcopenia and dynapenia according to disease stage among Alzheimer-type dementia (AD) patients and collect data to suggest precautions related to reducing the disease load. Method - The study was completed with 127 patients separated into stages according to Clinical Dementia Rating Scale (CDR) criteria and 279 healthy volunteers aged 18-39 years and 70-80 years abiding by the exclusion criteria who agreed to participate in the research. Our prospective and cross-sectional study applied the CDR and mini mental test (MMSE) to patients with disorder in more than one cognitive area and possible AD diagnosis according to NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association) diagnostic criteria. The patient and control groups had skeletal muscle mass index (SMMI), muscle strength and physical performance assessed with sarcopenia diagnosis according to European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria. Results - In our study, in parallel with the increase in disease stage of AD patients, the prevalence of sarcopenia (led by severe sarcopenia) and dynapenia was higher compared to a control group of similar age. Conclusion - In chronic, progressive diseases, like AD, identification of changes in parameters, like muscle mass and strength and reductions in physical performance in the early period, is important for identification and to take precautions in the initial stages considering the limitations of the preventive effects of treatment applied after diagnosis of AD.

Journal of Nursing Theory and Practice

[Comparison of somatic and psychological health of health care workers in Csongrád County between the years of 2008 and 2012]

NÉMETH Anikó, IRINYI Tamás

[Aims of the study: To asses the changes in psychosomatic status, burn-out level and judgment of own health of health care workers in Csongrád County since 2008. Furthermore we investigated how much they intend to continue working in their current position judging from psychological and somatic point of view. Methodology and sample: Both cross-sectional studies were carried out by the means of self-designed self-report questionnaires sent to registered members of MESZK living in Csongrád County in 2008 and 2012. Results: The judgement of own health got worse since 2008, but in psychosomatic symptoms there was a non-signifi cant improvement. The incidence of headaches decreased signifi cantly. The points on the burn-out scale increased signifi cantly which implies worse psychological condition. Conclusions: The population of health care workers is aging and it is characterised by worsening psychological state.]

Journal of Nursing Theory and Practice

[Occurrences involving aggression among healthcare workers ]

IVÁNKA Tibor, IRINYI Tamás, RUDISCH Tibor

[Aim of the study: Evaluation of prevalence and manner of verbal and psychical aggression, as well as measuring its emotional impact on the healthcare workers. Sample and methods: A total of 453 healthcare workers were involved in a national cross-sectional study using self-administrative questionnaires. Data were analyzed by descriptive methods, Chi square and Wilcoxon test using SPSS 19. A p-value of <0, 05 was accepted as statistically significant. Results: 86,1% of the participating healthcare workers (n=453) have reported being subject of aggression (verbal and/or psychical) during their work. Of the participants’ sociodemographic parameters, age was found to be a significant factor in incidents involving aggression, which had a statistically significant negative emotional impact. It was also established, that those healthcare workers who have been subject to aggression received more support from their colleagues than from their institution after the incident. Conclusions: Occurrences involving aggression in healthcare is a common phenomenon. The authors’s results show that there is an urgent need to develop an aggression management programme for all healthcare workers since they can encounter aggressive patients on all fields of medicine. ]