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Hypertension and nephrology

FEBRUARY 20, 2019

[Carvedilol in chronic kidney disease]

CSIKY Botond

[Chronic kidney disease (CKD) is endemic affecting 850 million people worldwide. Adequate antihypertensive treatment slows the progression of the kidney disease and also decreases the mortality of this population. Because of the comorbidities and the high cardiovascular risk beta-blockers have to be administered frequently in these patients. Carvedilol is a 3rd generation non-selective beta-blocker with alpha- 1 receptor blocking and antioxidant properties. It is metabolically neutral, it does not increase the risk of new onset diabetes and it does not increase the patients’ body weight. In some animal models of CKD and in several human CKD studies carvedilol has shown to have nephroprotective properties and it also decreased the cardiovascular risk in combination therapies.]

Lege Artis Medicinae

OCTOBER 20, 2018

[Gene modified T cells against cancer]

SZÖŐR Árpád

[Chimeric antigen receptor modified (CAR) T cells are hailed as a revolutionary breakthrough in the field of oncology. CAR T cells were first applied, with outstanding success, in the treatment of various leukaemias, yielding unprecedented antitumor activity and long periods of disease free survival. Following the success of CAR T cell therapy in leukaemias, solid tumors should now be targeted. These are more complex targets, therefore CAR T cell therapy needs to be further optimized for this purpose. Also, some unfortunate side effects, including the potentially deadly global inflammation called cytokine storm have to be minimized and possibly even eradicated. The next decade will be an exciting time to define whether this therapy which is yet exclusively used for cancer patients is also successful in the treatment of other diseases. In a recent study, T cells reengineered with CAR derived chimeric autoantibody receptors (CAAR) efficiently prevented disease progression in pre-clinical animal models simulating the serious autoimmune disorder, pemphigus vulgaris. Therapy was based on CAAR constructs which have the unique ability to selectively recognize and eliminate the B-cell clones secreting autoantibodies against a self-protein, thus playing a key role in disease pathogenesis and progression. In this review, we would like to give an overview about the history of the CAR T-cell concept, summarize briefly the currently running clinical trials, and discuss the challenges and future prospects of CAR T-cell therapy.]

Lege Artis Medicinae

JANUARY 20, 2019

[Animal-assisted therapies for the treatment of elderly dementia ]

SOMOGYI Szilvia

[The therapeutic value of the relationship between humans and animals should be considered in the cases of patients suffering from dementia with the onset in old age. This paper provides an overview of the animal assisted interventions in dementia. Reviews emphasize the positive effects of pet-keeping on mental and physical quality of life. However, it can also have adverse effects unless the pet is selected with caution. Regular animal assisted therapies within institutional framework provide a valuable potential programme for the patients in care. Articles published so far depict the physiological, social and psychological output variables of animal assisted therapies. The enhancement of social behavior is considered to be a specific factor of animal assisted therapies. Among the physiological symptoms the enhanced physical activity, the decrease of stress response and sympathic activation have been highlighted. Among the psychological functions reduction of state anxiety, mood lift and the reduction of negative emotions such as isolation and abandonment should be underlined. Acknowledging the available results, it seems that cognitive efficacy is less impacted directly by animal assisted therapies. However, promising results have been acquired in the alleviation of the behavioural and psychological symptoms related to dementia ]

Hypertension and nephrology

JUNE 20, 2019

[Experimental models of renal fibrosis]

KÖKÉNY Gábor

[The high incidence of chronic kidney diseases and, regardless of the etiology, their progression to renal fibrosis with end-stage renal failure rise the urgent need to reveal the pathomechanisms. As the disease leads to complex changes in the body, it is essential to use in vivo model systems for these investigations. Animal experiments choosing the appropriate model system helps to develop more sensitive early diagnostic markers and new therapeutic approaches. Several animal experimental model descriptions can be found in the literature, which mimic specific or more general human diseases in order to help the better understanding of the pathomechanisms. Using these model systems, we are able to analyze the detailed pathophysiology of glomerulonephritis, tubulointerstitial fibrosis, glomerular scarring or generalized renal fibrosis. The most commonly used model systems for renal fibrosis are presented and discussed.]

Clinical Neuroscience

JANUARY 30, 2016

[A visual based proto-consciousness model of human thinking]

SZŐKE Henrik, HEGYI Gabriella, CSÁSZÁR Noémi, VAS József Pál, KAPÓCS Gábor, BÓKKON István

[Background and objectives – Here we present our results of many years of research on the visual (pictorial) representation model expanded with some new ideas in a simplified form. Our goal is to make available our new pictorial model for a broader scientific community and to point to its possible importance in the future. Method – Own scientific publications, selective literature analysis and preliminary experiments. Results – Our several scientific publications and preliminary experiments were presented outlining our new molecular visual representation model as brain might be able to generate internal images by regulated biophotons in early V1 retinotopic visual regions. We also proposed that some of symptoms and characteristics of autism and savantism may suggest that visual (pictorial) thinking might be a possible cognitive model in the case of healthy people as well. Our model can present a uniform molecular basis for many visual related phenomena. Conclusions – It is possible that a so-called visual proto-consciousness might be developed in evolution, which is directly related to the retinotopic visual areas, and which has a different cognitive ability from verbal abilities. If our model can be exactly proved it presents a common molecular basis for various visual phenomena such as visual perception and imagination, phosphenes ect. and might open new ways in several fields of science such as visual prosthesis for the blind, artificial intelligence, visual neuroscience, cognitive and autism research.]

Journal of Nursing Theory and Practice

OCTOBER 30, 2019

Use of Imogene King’s Nursing Model in the Care for a Patient with Heart Arrhythmias

CLOUBOVÁ Ivana, BULAVA Alan

Objectives: To discover the benefits of implementation of Imogene King’s nursing model into nursing care in a patient with arrhythmias. To find out how these patients are limited in saturation of their own needs and what are the most severe limitations for patients with arrhythmias. Material and methods: Qualitative research using semi-structured interviews. The interview with patients with arrhythmia was conducted in accordance with the structure of King’s nursing model. Results: The research group consisted of 20 respondents; 13 men and seven women. All respondents expressed satisfaction with their cooperation with staff. The respondents described a change in the subjectively perceived state, the psychic state, and emotions. Conclusions: Assessment of the subjectively perceived quality of life of patients with arrhythmias using the King’s interaction model allows nurses to see the patient from the holistic point of view and plan and provide individualized care.

Lege Artis Medicinae

JULY 20, 2019

[Empirical examination of the persistence value among the students studying health-care at the beginning of student professionalization]

DINYÁNÉ Szabó Mariann, PUSZTAI Gabriella

[INTRODUCTION – Students in healthcare studies can help maintain the mental base and maintain their health if the lecturers know the degree of student persistence. When entering higher education, it is possible to measure the pre-university experience. Persistence determines the student's relationship to learning and can be a predictor of learning success. PARTICIPANTS AND METHODS – A questionnaire study (N = 200) of the 1st year student (N = 200) of the Health Care Organization (BSc) of the University of Debrecen and Semmelweis University. For the continuous Persistence Variable a descriptive statistical method was used, an independent two-sample t-test was used for comparison between groups, and Hedges-g was used to express the effect size. We used the GLM (General Linear Model) model for fitting the persistence model. By means of factor analysis, we constructed factors from the significant predictor variables of the GLM model, which helped us assessing students' chances of learning. To quantify the strength of evidence against null hypothesis P < 0.05 (5% significance) was chosen as a standard level for concluding that there is evidence against the hypothesis tested. Statistical analysis was performed with IBM SPSS Statistics 24.0 (SPSS, Chicago, IL). RESULTS – The persistence factor loadings can be divided into three types: high, medium and low. High persistence rearranges student preferences, low interest persistence, minimal interest in academic engagement. In the case of middle-ranking people, the importance of volunteering (life-experience) and friendship is paramount. CONCLUSIONS – The results indicate that at the beginning of the student life there is a willingness, diligence, acceptance of academic values, interest or lack of interest in future success studies. During the stu­dies, these features can be monitored and the necessary interventions can be made in time.]

Journal of Nursing Theory and Practice

AUGUST 30, 2018

[Career Model of Primary Care Workers]

HIRDI Henriett Éva, BALOGH Zoltán

[The aim of the study: To assess the working conditions and level of job satisfaction of health professionals in primary care, and to explore key elements for a succesful career model. Methods: The cross-sectional survey was conducted between 12 March 2018 and 06 April 2018 among health professionals working in primary care, selected using a random, sampling method. The data gathering took place using a web-based, anonymous, self-completion questionnaire. For data analysis they used SPSS version 25.0 with Chi square test (p<0,05). Results: The sample size of the research comprised of 3740 persons, the average age was 44.87 years. The heath professionals are generally satisfied with their work schedule (74.8%), but they expressed the least satisfaction (81.5%) with their financial compensation. According to these survey results, pay is significant. 96.2% of respondents would like to be compensated according to new government-regulated pay scales. Conclusions: It can be stated that increasing the job satisfaction of health professionals and to elaborate the career model of them would be of crucial importance. Key elements of a successful career model offers benefits that are essential for health professionals retention: direction and motivation. ]

Clinical Neuroscience

MARCH 30, 2020

Cyanocobalamin and cholecalciferol synergistically improve functional and histopathological nerve healing in experimental rat model

ALBAY Cem, ADANIR Oktay, AKKALP Kahraman Asli, DOGAN Burcu Vasfiye, GULAEC Akif Mehmet, BEYTEMUR Ozan

Introduction - Peripheral nerve injury (PNI) is a frequent problem among young adults. Hopefully, regeneration can occur in PNI unlike central nervous system. If nerve cut is complete, gold standard treatment is surgery, but incomplete cuts have been tried to be treated by medicines. The aim of the study was to evaluate and compare clinical and histopathological outcomes of independent treatment of each of Vitamin B12 (B12) and Vitamin D3 (D3) and their combination on sciatic nerve injury in an experimental rat model. Materials and methods - Experimental animal study was performed after the approval of BEH Ethics Committee No. 2015/10. 32 rats were grouped into four (n=8) according to treatment procedures, such as Group 1 (controls with no treatment), Group 2 (intraperitoneal 1 mg/kg/day B12), Group 3 (oral 3500 IU/kg/week D3), Group 4 (intraperitoneal 1 mg/kg/day B12+ oral 3500 IU/kg/week D3). Sciatic Functional Index (SFI) and histopathological analysis were performed. Results - SFIs of Group 2, 3, 4 were statistically significantly higher than controls. Group 2 and 3 were statistically not different, however Group 4 was statistically significantly higher than others according to SFI. Axonal degeneration (AD) in all treatment groups were statistically significantly lower than in Group 1. AD in Group 4 was significantly lower than in Group 2 and 3; there was no significant difference between Group 2 and 3. There was no significant difference between Group 1,2 and 3 in Axonolysis (A). But A of Group 4 was significantly very much lower than all others. Oedema- inflammation (OE-I) in all treatment groups were significantly lower than in Group 1; there was no significant difference between Group 2 and group 4. OE-I in Group 2 and 4 were significantly lower than in Group 3. There were no significant differences between Group 1, 2 and 3 in damage level scores; score of Group 4 was significantly lower than of Group 1. Conclusions - B12 and D3 were found effective with no statistically significant difference. But combined use of B12 and D3 improve nerve healing synergistically. We recommend combined use of B12 and D3 after PNI as soon as possible.

Hypertension and nephrology

SEPTEMBER 30, 2020

[Non-pharmacological treatment of hypertension and reducing cardiovascular risk in general practitioners’ clusters]

MOHOS András, KOZMA Anna, MARKÓ-KUCSERA Mária, MESTER Lajos

[Hypertension and cardiovascular diseases are major public health issues. In their treatment non-pharmacological methods have a role in every case either alone or as a complement. Patient adherence is a key factor. The role of primary care is very important in the management and with general practitioners’ cluster model and with the involvement of new primary care professionals (for example: dietetitian, physiotherapist) the opportunities are expanding. In the A GP Cluster and in the Marosmenti GP Cluster the analysis of the patients’ results who participated in an individual health status examination, in dietetic and in physiotherapy services. Assessing the professionals’ attitudes towards GP cluster model. In the A GP Cluster 2409 people, in the Marosmenti GP Cluster 1826 people participated in an individual health status examination. 14.6% and 19.9% of the participants were under the age of 18. 58.9% and 60.7% of the participants over the age of 18 were female. 1083 and 232 patients used physiotherapy services, 147 and 187 people used dietetic services. The age distribution of the individual health status examinations is correspond to the Hungarian age pyramid. In addition to the preventive approach came into view the community based local health care services. The GP cluster model was welcomed by the patients, the physiotherapy was more popular than dietetic among them. All professionals of the GP clusters had a positive opinion of the professional work done in the project. Conclusion: There is a demand both from the patients and the healthcare professionals for the GP cluster concept. The establishing of an appropriate monitoring system and creating long-term, sustainable operating conditions are essential for achieving lasting social health gains. ]