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Lege Artis Medicinae

AUGUST 30, 2018

[Feeding and eating in infancy and early childhood part II. - Breastfeeding, complementary feeding and weaning in the Large-sample of the “For Healthy Offspring” project]

NÉMETH Tünde, VÁRADY Erzsébet, DANIS Ildikó, SCHEURING Noémi, SZABÓ László

[INTRODUCTION - Complementary feed-ing is the transitional period from exclusive breastfeeding to family foods, while breastfeeding is continued. It should be started, when breastmilk itself no longer meets the infant’s nutritional requirements, ideally at the age of around 6 months. SUBJECTS AND METHODS - In the Healthy Offspring project self reported questionnaires were received from 1133 parents of 0-3 year old children. Comple­mentary feeding practices and issues of weaning were analyzed. RESULTS - In our sample complementary feeding was started at the age of 5.5±1.8 months. 6% of infants younger than 4 months and about two third of infants at the age between 4 and 6 months were started on complementary feeding. 32% of the 7-12 month old infants were continued on breastfeeding. The proportion of breastfed infants and young children in the 12-24 and 25-36 month age group was 24% and 5.5% respectively. The daily feeding frequency of breastfed infants was 6.7±1.6. The infants and young children, who were breastfed along with complementary feeding were feeding 5.6±1.5 times/day. After completed weaning the range of feeding frequency was limited to 4.9±0.9 occasions/day. 60.4% of mothers regarded their feeding style on demand, while 39.6% on set schedule. 16% of mothers reported that their child had feeding difficulties. CONCLUSIONS - Complementary feeding indicators should be part of infant feeding data collection, such as time of introduction of complementary food, feeding frequency, food consistency, energy density of food and safe preparation. Responsive feeding is part of responsive parenting and should be promoted, along with continuing breastfeeding at least till one year of age, and for as long as mother and infant wish to continue. ]

Journal of Nursing Theory and Practice

APRIL 30, 2018

[Quality of Life of Cancer Patients’]


[Aim of the study: This research is the part of an extended examination. It’s aim is to assess the cancer patients’ quality of life, how the diseas effects in the way of life, and also the psychologycal burden of the patients. Furthermore to assess the patient’s knowledge of their desease. Material and Methods: The research is descriptive, empirical, supplemenary, which in nurses and patients in oncology departments of Hondvéd Hospital in Budapest and Bács-Kiskun County Hospital in Kecskemét were attend. The method of the survey was an individual questionnaire. The evaulation of the results made with MS Excel and SPSS. The complete evaluable questionnaire’s rate is 74,9% (N=131). Results: the patients judge their own health and quality of life to low in a rate of 56,6%, and 75% of them stated that their way of life and their daily routin has changed in a significant extent. 50% of the responders described their actual emotional condition with a negative indicative, and also occur different psychic disfunctions amuong them. For example the depression in a rate of 17,5%, anxiety is in 18,5%, and reduced self-evaluation in 14,1%. A significant majority (76,3%) of respondents don’t possess the appropriate knowledge. Conclusions: The disease effect on cancer patients’ way of life and quality of life in a significant way. Patients are exposed to a significant psycholigycal burden. ]

Lege Artis Medicinae

JUNE 20, 2018

[Applying musical tools in healing children]


[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


SINKÓ Dániel

[Combining oncology with philosophy, as seemingly two different disciplines, is an exciting task but the question arises as to why this is necessary. For thousands of years philosophers have been trying to find answers to the basic questions of being-existence, reality, death, morality but from the twentieth century we see less and less the daily significance of these. Are not “questions of existence” important or are they no longer relevant? We would like to believe they are not but there are situations where suddenly our existence is threatened and all our already gained life experiences are proved to be a failure…]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2018

[The Importance of Teamwork and Patient Education in the Rehabilitation of Stroke Patients]

HORVÁTH Orsolya, STERLIK Krisztina

[The aim of the study: Stroke is an increasing problem in public health. Every year in Hungary tens of thousands of people survive stroke and continue their life bearing all the negative consequences of this disease. Well organized and early rehabilitation treatment, based on the patients’ clinical condition, improves not only their life expectancy, but also quality of life and helps to restore the self- sufficient living as well. The majority of the stroke patients live with numerous of cerebrovascular risk factors, highlighting the special importance of personalized education to prevent the recurrent stroke. Material and Methods: The aim of our investigation was to examine the efficiency of the neuro-rehabilitation teamwork and personalized patient-education among stroke patients took part inpatient rehabilitation of the Teaching Hospital and Rehabilitation Center of Sopron (2016-2017). We measured the change in ability of self- sufficient living with the FIM scale and the Bartel index, while we analyzed the presence of the modifiable cerebrovascular risk-factors with the assistance of a questionnaire was completed by the patient or the relatives (2016-2017). Results: During our research we also evaluated the knowledge of patients about their condition. According to our results the modifiable risk-factors occured cumulatively among our patients and despite the education that stroke patients received during the acute period in the hospital, there still occured a general lack of knowledge regarding their disease. Conclusions: Based on our results the complex rehabilitation therapy started at its earliest possible following the acute period was the most successful method of treatment. During the acute period, the dissemination of written educational materials and information sheets help the recovery phase until the start of the complex rehabilitation therapy. ]

Clinical Neuroscience

MAY 30, 2018

Is stroke indeed a “Monday morning disease”?


Introduction - The therapeutic time window of acute stroke is short. Decision on the use of intravenous thrombolysis is based on well-defined criteria. Any delay in the transport to a designated stroke centre decreases the odds of therapeutic success. In Hungary, the admission rate of stroke patients peaks on Monday, the number gradually decreasing by the end of the week. This phenomenon has long been suggested to be due to the lack of emergency care approach. According to the literature, however, returning to work following a holiday is a risk factor for acute stroke. A similar phenomenon is well-known in veterinary medicine, a condition in horses referred to as ‘Monday morning disease’. In our study, we analysed the distribution of admissions due to acute stroke by the day of the week in 4 independent data sources. Patients and methods - The number of patients admitted to the Szent János Hospital, Budapest, Hungary with stroke and that of emergency ambulance transports in the whole city of Budapest due to acute stroke were analysed in the period between January 1 and March 31, 2009. The distribution of thrombolytic interventions reflecting hospitalizations for hyperacute stroke was analysed based on data of the Szent János Hospital in 2009-2012, and on national data from 2006-2012. Descriptive statistics was used to present the data. The variation between daily admission was compared by chi-square test. Results - The proportion of daily admission of stroke patients admitted to the Szent János Hospital was the highest at the beginning of the week (18% on Monday, and 21% on Tuesday) and the lowest on the weekend (9% and 9% on Saturday and Sunday, respectively). The distribution of ambulance transports in Budapest due to acute stroke tended to be similar (15% and 15% on Monday and Tuesday, whereas 13% and 12% on Saturday and Sunday, respectively) on different days of the week. No such Monday peak could be observed in a single centre regarding thrombolytic interventions: 18% and 19% of the total of 80 thrombolytic interventions in the Szent János Hospital were performed on Monday and Sunday, respectively. At the national level the higher Monday rate is obvious: during a 7-year period 16.0%, 12.7%, and 13.5% of all thrombolytic interventions in Hungary were performed on Monday, Saturday and Sunday, respectively. Conclusion - Monday preference of stroke is not exclusively caused by the lack of emergency care approach, and the phenomenon is not consistent at the individual hospital level in cases undergoing thrombolysis.

Clinical Neuroscience

MAY 30, 2018

[Assessment of health related quality of life among epileptic patients in the context of coping strategies and subjective disease perception]


[Purpose – Psychosocial condition and life quality of epileptic patients are greatly determined by the existence of the disease-related comorbid disorders, like depression, anxiety, and the subjective disease perception, as well as the neuropsychological consequences of the seizures. (Whitehead et al. 2015; Goldstein et al. 2005). It has been examined in patients living with epilepsy how subjective disease perception and coping strategies influence life quality, comorbid depression and the condition of anxiety. Methods – Study patients were asked to fill in a self-completion questionnaire, which examined their psychosocial condition (HADS, Beck Depression Scale), life quality (Qolie-31), coping strategies (FKV-LIS), and subjective disease perception (IPQ-R), as well as sociodemographic and disease variables. The subjects of the study: the data of epileptic patients between the age of 18 to 70 was recorded. Patients were selected from the adult outpatients of a national centre, a regional hospital and two private health care centres located in Budapest. Results – Based on the multiple regression analysis. Beck’s depression (b coefficient=-0.351, t=-4.703, p<0.001**). Depressive coping strategy (FKV Dep) (b coefficient = -0.235, t=-3.123, p=0.002**). Subjective health perception (b coefficient =0.232. t=3.643, p<0.001**). Sex (women; b coefficient =-0.162, t=-3.008, p=0.003**). IPQ consequences (b coefficient =-0.161, t=-2.572, p=0.012*). Active coping strategy (FKV Act; b coefficient =0.146, t=2.572, p=0.012*). Type of seizure (b coefficient =-0.138, t=-2.527, p=0.013*), and Sleep quality (b coefficient =-0.125, t=-1.995, p=0.049) explain some 75.6% of the variance of life quality’s total score (model3: F=33.333, p<0.001**. adjusted R2=0.733). Conclusions – Among the factors of the subjective disease perception (IPQ-R), the physical, mental and social consequences play the most important role. Similarly, the impact of negative emotional representation, as well as the erratic nature of the seizures are decisive. Emotional representation, cyclicity and disease coherence have an important role in coping with disease-related negative emotions. ]

Clinical Neuroscience

MAY 30, 2018

[Pharmacological and nonpharmacological treatment of insomnias with regard to sleep medicine]


[Insomnia - one of the most prevalent sleep complain - has a great impact on the everyday life. Basically two different form of insomnia can be defined: the insomnia disorder and the co-morbid insomnias. To treat adequately determination of background pathology is essential, which is based on the help of Sleep Medicine Centers. According to the newest guidelines, the treatment of insomnia disorder is based on cognitive behavioural therapies followed by pharmaceutical intervention. In this review we provide the short description of cognitive behavioural therapies and basic principles of hypnotic drugs. Despite the availability of insomnia guidelines the huge variation of the insomnia medication can be seen in the daily practice. Due to the above mentioned reasons we summarize the good clinical practice of hypnotic drug administration for insomnia patients.]

Journal of Nursing Theory and Practice

DECEMBER 30, 2017

[Awareness of Risk Factors of Falling among the Elderly]


[The aim of the study: determining the risk groups of falling among the elderly and measuring the awareness of the elderly of the risk factors of falling. Methods: During the quantitative, cross-section examination, the population consisted of elderly people living in the region of Dél-Alföld (N=379). We used our own questionnaire beside using the STEADI questionnaire determining risk group of falling for data colletion purposes. During the statistical analysis, we used simple descriptive statistics but also used Khi2 and Mann-Whitney tests. Results: The average age of the examined population was 71,96+ 6,8 years old and 45 % of the interviewed person have reported experiencing falling. The risk factors of higher age (p=0.001), dizziness (p=0.021) and polypharmacy (p=0.001) was demonstrable among those who have fallen at least one time. 83% of the population was from a risk group exposed to falling. Respondents were able to better identify the effect of extrinsic factors on the risk of falling than the intrinsic risk factors. Also, those who have fallen before found that there is no significant preventive effect of the orderliness of their home (p=0.009) and the usage of walking assisting equipment (p=0.010). Conclusions: Falling of elderly people is an actual problem, therefore it is recommended to raise the awareness of the elderly of the risk factors of falling.]

Clinical Neuroscience

MARCH 30, 2018

[Changes of cognitive functions in healthy aging]


[Introduction - Mental health has crucial role in our life. Cognitive changes or decline can lead to many difficulties in daily routine of older people (e.g. organization of daily activities), which can, consequently, influence their well-being. Therefore it is an important question, which cognitive abilities are affected by age-related decline. Methods - In our study we aimed to investigate the changes of cognitive abilities in healthy older adults between 61 and 85 years of age compared to the performance of younger adults. Digit span, counting span, listening span, letter fluency, semantic fluency and action fluency tests were used to assess cognitive abilities, namely working memory and executive functions. Results - The results showed that younger adults performed significantly better in all tests than older adults. Importantly, the performance of older adults was better on tests requiring less complex mental computations (e.g. digit span test) than on more complex tests where both storing and mani-pulating information was required (e.g., counting span test). We also showed that within the older age group, cognitive functions’ decline was linearly associated with increasing age. Conclusion - The present study used several, well-established neuropsychological tests to map the changes of working memory and executive functions in healthy older adults between 61 and 85 years of age compared to younger adults. Our findings can contribute to the development of prevention programs aimed at improving the quality of life of older adults and preventing age-related cognitive decline.]