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Hypertension and nephrology

JUNE 24, 2020

[Systolic and diastolic blood pressure by height, BMI, gender and age between 14 and 18 years of age]

SZABÓ László, SCHEURING Noémi, GÁCSI Erika, KORMOS-TASI Judit

[The aim of the screening program was to investigate blood pressure levels in different ages according to obesity. Blood pressure, heart rate, body composition, bodyweight, height and BMI were assessed. 2202 adolescent (1326 girls, 876 boys) participated in the screening program. The mean systolic blood pressure of all screened adolescents was 126.34 ± 12.55 mmHg. Boy/girl values were 131.87 ± 13.59/117.49 ± 5.69 mmHg, p < 0.001. The mean diastolic blood pressure of all screened adolescents was 71.86 ± 8.74 mmHg. Boy/girl values were 72.61 ± 9.17/66.69 ± 5.04 mmHg, p < 0.001. The 50%, 90%, 95%, and 99% thresholds and cases for systolic, diastolic blood pressure, and the BMI and BodyFluid thresholds, detailed for 14–18 year olds, girls and boys, are tabulated. Systolic blood pressure (SBP) was over 99% in 12 girls (14- year-olds), 39 (15), 42 (16), 33 (17), 5 (18) to height. SBP was over 99% in 17 boys (14-year-olds), 73 (15), 100 (16), 33 (17), 5 (18) to height. It is emphasized that systolic blood pressure (SBP) is > 99% in 12 girls (14 years), 39 (15), 42 (16), 33 (17), 5 (18) to body height. SBP > 99% for 17 boys (14 years), 73 (15), 100 (16), 33 (17), 5 (18) to body height. Elevated diastolic values were associated with elevated systolic values, but less occurred. The percentage of high blood pressure was more frequent among boys and girls who were in the overweight group (58.6% and 18.6%). Normal blood pressure is higher in overweight and obese adolescents and is a significant risk factor for developing high blood pressure in young adulthood.]

Lege Artis Medicinae

DECEMBER 10, 2019

[Risk assessment for child sexual abuse in the American legal practice]

KÓRÁSZ Krisztián

[The paper gives introspection into the child sexual abuse risk assessment practice in the USA by reviewing the literature. According to the definition of the World Health Organization, sexual assault is considered to be any act involving a child in a sexual activity if he or she can not be considered as prepared for the child's age or development. The author also makes an attempt to present some issues and pos­sible solutions regarding the current practice. ]

Clinical Neuroscience

SEPTEMBER 30, 2019

[The role of epigenetic regulations in early childhood diseases]

TORY Vera

[With the acceptance of “The developmental origins of health and disease” concept in the 1990s, it became clear that epigenetic inheritance, which do not involve changes in the DNA sequence has important role in the pathogenesis of diseases. Epigenetic regulation serves the adaptation to the changing environment and maintains the reproductive fitness even on the drawback of increased risk of diseases in later life. The role of epigenetic mechanisms in chronic non-communicable diseases has been well established. Recent studies have revealed that epigenetic changes have also causal role in certain pediatric diseases. The review evaluates the recent epigenetic findings in the pathomechanism of common pediatric diseases. The wide range and long-lasting duration of epigenetic regulations give importance to the subject. Methods are already available to evaluate a part of the epigenetic changes in the clinical practice, presently aiming primarily the estimation of the disease risk or definition of diagnosis. Furthermore, there are already available limited means to influence the epigenetic regulation. ]

Lege Artis Medicinae

MARCH 20, 2019

[Is it necessary? - Opinions and experiences about a first aid programme for children - pilot study]

BÁNFAI Bálint, PANDUR Attila, SCHISZLER Bence, RADNAI Balázs, BÁNFAI-CSONKA Henrietta, BETLEHEM József

[INTRODUCTION - Starting first aid education in early childhood can be an effective method of knowledge transfer. AIM - Our aim was to examine first aid education related opinions of kindergarten- and primary school children, educators, and parents. MATERIALS AND METHODS - 871 people (children, educators, parents) were involved in our study. Opinions were measured with self-administered questionnaires, containing mainly open questions. RESULTS - General opinion of parents and educators on first aid education in childhood were mainly positive, but they also gave negative ones. The majority of participants had a positive opinion about our completed program. Based on the opinions of parents and educators first aid education is recommended by health care professionals. Opinions were independent from gender, age, lenght of time of working with children in all cases (p>0.05). CONCLUSIONS - General opinion of parents and educators was varied, but it was generally positive concerning our program. Based on this results opinions can be changed with concrete activities. ]

Clinical Neuroscience

NOVEMBER 30, 2018

Pulmonary physiotherapy and aerobic exercise programs can improve cognitive functions and functional ability

TEKESIN Aysel, TUNC Abdulkadir, GÜNGEN Dogan Belma, AVCI Nalan, BAKIS Muhammed, PERK Seyma

Objective - The increasing prevalence of dementia over the previous decades has been accompanied by numerous social and economic problems. The importance of exercise in the prevention of dementia coupled with the impact of aspiration pneumonia on the mortality and morbidity of dementia patients cannot be overstated. This study investigates the effects of pulmonary rehabilitation combined with aerobic stretching exercises on the cognitive function, life quality, effort capacity, and level of depression in patients with mild cognitive impairment (MCI) in the early stages of dementia. Methods - Sixty-nine patients with MCI diagnosis were routinely monitored, and six were excluded because they did not attend the follow-up appointments. The remaining 63 patients undertook pulmonary physiotherapy (PPT) and extremity exercises for six months. The mini-mental state examination (MMSE), six-minute walk test (6MWT), Nottingham health profile (NHP), and Beck depression inventory (BDI) scores were evaluated before and after exercise. Results - PPT plus extremity exercises appeared to significantly improve the MMSE scores and increase the 6MWT (p < 0.001) by an average of 25 m. No significant improvement was observed in the BDI and NHP scores. Conclusion - PPT and aerobic exercise positively affected the cognitive ability of MCI patients and improved their walking distance. These results underscore the importance of combining medical treatment with physical rehabilitation at the onset of dementia, a disease which exerts a significantly negative impact on the economy.

Lege Artis Medicinae

SEPTEMBER 20, 2018

[Multidisciplinarity and pulmonary hypertension in idiopathic pulmonary fibrosis]

BOHÁCS Anikó, KARLÓCAI Kristóf, KERPEL-FRONIUS Anna

[Idiopathic pulmonary fibrosis (IPF) is a subgroup of the fibrotising idiopathic interstitial pneumonias occuring primarily in older adults. It is characterised by progressive decline of lung function and is associated with high mortality. IPF is frequently associated with pulmonary hypertension (PH). PH has unfavourable impact on the prognosis of IPF. PH should be suspected in IPF patients presenting with dyspnoe, desaturation on exertion and disproportionately low diffusion capacity. Transthoracic echocardiography is used to screen for PH in IPF patients. Although right heart catheterization is the gold standard procedure for the diagnosis of PH, this is not regularly performed on IPF patients. Chest high resolution computer tomography (HRCT) is essential for the diagnosis of IPF. IPF is typically characterised by the presence of usual interstitial pneumonia (UIP) pattern on HRCT. Multidisciplinary discussion bet­ween experienced pulmonologists, radiologists, and pathologists is key in the early and accurate diagnosis of IPF. An important role of the interstitial lung disease-multidisciplinary team (ILD-MDT) is to determine whether other diagnostic examinations and surgical lung biopsy is needed, in an attempt to reduce unnecessary risk. ILD-MDT should propose the initiation of antifibrotic therapies that have the potential to reduce disease progression. All patients diagnosed with IPF, with no contraindications for lung transplantation, should be referred early to a transplant committee.]

Lege Artis Medicinae

JUNE 20, 2018

[Applying musical tools in healing children]

KOLLÁR János

[The aim of the study is drawing the attention to the possibilities of applying musical tools in healing children. After doing research in main medical databases (PubMed, Web of Science, Medline) some research works were discovered and harmonized in which the researchers give proof of the effectiveness of music therapies implemented in therapeutic circumstances and by proper experts on medical fields. The study focuses on the following topics: applying music for reducing stress caused by medical interventions and hospitalization, treating speech disturbances, improving communication and social abilities of autistic children, improving capabilities of people suffering from visual and hearing impairment, providing help during anaesthesia, stimulating different parts of the brain in children suffering from PDOC (Prolonged Disorder of Consciousness), improving capabilities of children living with disabilities and helping creating harmonic relationship between children, their parents and the healing staff. ]

Lege Artis Medicinae

JUNE 20, 2018

[Diagnosis of interstitial lung diseases]

MÜLLER Veronika

[Recognition and diagnosis of interstitial lung diseases (ILD) is one of the most challenging tasks of respiratory medicine. In the wide range of different ILD-s idiopathic pulmonary fibrosis (IPF) is one of the most common. Improvements in the diagnosis made the recognition of IPF easier. Typical clinical features and usual interstitial pneumonia pattern on high resolution CT are now enough for the confident diagnosis of IPF in the multidisciplinary ILD-team discussions. Bronchoscopic cryobiopsy is a great achievement of histological sampling as this can give appropriate size tissue for histological analysis making surgical intervention rare. As IPF cannot be cured early diagnosis is crucial. Today available treatments can only slow down progression of the disease, so early stages and better clinical condition of the patients are essential for therapeutic success. Follow-up of IPF patients includes complex lung functional measurements in dedicated centers in Hungary. Former studies confirmed forced vital capacity (FVC) decline as an important measure of disease progression and mortality. Available IPF treatments decrease FVC decline and can prevent the mostly deadly acute exacerbations of the disease. Additionally palliative treatments including supplementary oxygen and in selected patients lung transplantation can be offered. This is the first of a series of three articles about IPF. ]

Clinical Oncology

DECEMBER 05, 2017

[Hematopoetic stem cell transplantation for pediatric non-hematological solid tumors]

HAUSER Péter, KRIVÁN Gergely

[High-dose chemotherapy followed by stem cell rescue or allogeneic stem cell transplantation in the treatment of solid tumor with non-hematologic origin applied for more than three decades. High-dose chemotherapy with stem cell rescue is the part of standard fi rst line therapy for several chemosensitive tumors with unfavorable outcome (neuroblastoma, Ewing-sarcoma, medulloblastoma), and also successfully applied in certain therapy-resistant or recurrent solid tumors (germ cell tumors, Wilmstumor). Allogeneic transplantation with reduced intensity conditioning is still not successful in terms of survival in pediatric solid tumors with non-hematological origin. In present paper results of autologus and allogeneic stem cell transplantation in different pediatric solid tumor are discussed.]

Lege Artis Medicinae

JANUARY 20, 2018

[Faces of dementia]

FULLAJTÁR Máté, HIDASI Zoltán

[Dementia is defined as a combination of symptoms or as a syndrome. In different types of dementia syndromes cognitive, behavioural and psychological symptoms can be distinguished according to clinical aspects. The prevalence of dementia increases continuously with age, causing significant challenges for the health care system of developed countries. Early diagnosis and early intervention by progression slowing therapy can be defined as goals in treating dementia. At the same time, the education and psy­chological support of the patients, their relatives and health care providers are also essential. A more accurate knowledge of the pathomechanisms behind the symptoms is ne­cessary in order to develop more effective therapies in the future. The authors review the most important types of mild cognitive impairment and dementia syndromes, their clinical and diagnostical criteria and therapeutic possibilities, focusing on early diagnosis and prevention.]