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Journal of Nursing Theory and Practice

OCTOBER 30, 2017

[Importance of the Hyponatraemia in the Emergency Care]

PÓHR Kitti, KÖCSE Tamás, MESTERHÁZI András, BIERER Gábor, KARAMÁNNÉ Pakai Annamária

[The aim of the study: Hyponatraemia is the most common electrolyte abnormality in hospitalized patients. Certain drugs (eg, diuretics, antidepressants, and antiepileptics) have been implicated as established causes of either asymptomatic or symptomatic hyponatraemia. Studies proved correlation between hyponatremia and hospital mortality. Hyponatraemia remains asymptomatic in most cases, but if left untreated, it can cause life-threatening situations. Our aim was to examine the frequency of hyponatraemia in our hospital and its impact on the emergency care. Methods: A total of 75 patients were enrolled in the study with purposive sampling. We used descriptive and mathematical statistics with SPSS 22.0 software package for processing non-parametric statistical data. Results: Patients transferred by ambulance or arriving at the ER department came with dizziness, vomiting / diarrhea symptoms. Admission causes, were characteristic symptoms of hyponatraemia as well as non-specific neurological symptoms (headache, dizziness, confusion, unconsciousness) were found (n = 29). In addition, a common complaint of vomiting / diarrhea (n = 12), abdominal pain (n = 10). In particular, the complaint leading to a significant proportion of patients with hyponatraemia was not typical, but it was kind of trauma (n = 12). Nearly half of the patients (n = 36) were revenant. The most common diagnosis was hypertension (34%). 52% were taking medication that typically cause hyponatraemia. There were significant increase in the incidence of hyponatraemia in cases where the patient was taking diuretics. Conclusions: The diagnosis of hyponatraemia is based on the recording history, physical examination, and laboratory tests. Preventive approach would reduce the number of hospital stays due to hyponatraemia, and this may indeed improve patients’ life expectancy. The disease itself is easily remedied, it can cause critical condition due to disregard.]

Clinical Neuroscience

JANUARY 30, 2018

Electroclinical and prognostic characteristics of epilepsy patients with photosensitivity

YAZAR Olgun Hülya, GUL Gunay, YAZAR Tamer, EREN Fulya, KUSCU Yandım Demet, KIRBAS Dursun

Background - Epilepsy with photosensitivity (PSE) is one of the reflex epilepsy types with pathophysiology still unexplained. In our study we aimed to evaluate the clinical, electroencephalogram (EEG) and prognosis of patients with PSE diagnosis. Method - A total of 44 patients with PSE diagnosis according to international classification were included in this retrospective and cross-sectional study. The age, gender, syndrome, clinical and EEG characteristics of patients, and treatment response were investigated. Results - The mean age was 22.09±6.49 years for 28 females and 16 males included in the study. Of patients, 17 had idiopathic photosensitive occipital lobe epilepsy (IPOLE), 11 had juvenile myoclonic epilepsy (JME), 11 had other PSE and 5 had juvenile absence epilepsy (JAE), with the most common visual trigger factors television and sunlight. In terms of seizure type, the most common was generalized tonic clonic seizure (GTCS), with myoclonus, absence and other seizure types observed. There was family history present in 17 patients and valproic acid was most commonly used for treatment. Conclusion - As noted in the literature, our data show that PSE has defined age group and clinical presentation, good prognosis but requires correct choice of medication for treatment. It is thought that good description of these epilepsy types will reduce misdiagnosis and mistreatment rates.

Clinical Neuroscience

JANUARY 30, 2018

[The facets of creativity in the light of bipolar mood alterations]

SZAKÁCS Réka

[The link between creativity, as the highest expression form of human achievement, and bipolar disorder came into focus of scientific investigations and research. Accomplished writers, composers and visual artists show a substantially higher rate of affective disorders, prodominantly bipolar mood disorders, comparing to the general population. Then again, patients afflicted with bipolar II subtype (hypomania and depression), as well as persons presenting the mildest form of bipolar mood swings (cyclothymia) possess higher creative skills. It evokes therefore that certain forms and mood states of bipolar disorder, notably hypomania might convey cognitive, emotional/affective, and motivational benefits to creativity. The aim of this paper is to display expression forms of creativity (writing, visual art, scientific work) as well as productivity (literary and scientific work output, number of artworks and exhibitions, awards) in the light of clinically diagnosed mood states at an eminent creative individual, treated for bipolar II disorder. Analysing the affective states, we found a striking relation between hypomanic episodes and visual artistic creativity and achievement, as well as scientific performance, whereas mild-moderate depressed mood promoted literary work. Severe depression and mixed states were not associated with creative activities, and intriguingly, long-term stabilised euthymic mood, exempted from marked affective lability, is disadvantageous regarding creativity. It seems, thereby, that mood functions as a sluice of creativity. Nevertheless, it is likely that there is a complex interaction between bipolar mood disorder spectrum and psychological factors promoting creativity, influenced also by individual variability due to medication, comorbid conditions, and course of disorder.]

Hypertension and nephrology

DECEMBER 10, 2017

[Novelties in treatment of hypertension in pregnancy]

ALFÖLDI Sándor

[Hypertensive disorders represent the most common and dangerous medical disorder in pregnancy. Furthermore, its prevalence is rising. According the recent studies the initiation of antihypertensive treatment should be withhold in mild chronic hypertension (140-159/90-109 mmHg) in pregnancy, excepting associated subclinical hypertensive organ damage or hypertensive complications because of risk of compromising uteroplacental perfusion and fatal circulation. In preeclampsia, however, early antihypertensive treatment is necessary for the prevention of maternal cerebrovascular events.]

Hypertension and nephrology

DECEMBER 10, 2017

[Place of rilmenidine therapy in reducing of sympathetic overactivity]

FINTA Ervin, KUN Edit, SIMONYI Gábor

[The sympathetic nervous system plays an important and widely investigated role in the pathogenesis of the hypertension and its concomitant diseases. Between the several types of antihypertensive drugs which can influence the sympathetic over activity, centrally acting agents, play an important role. Here some special aspects of the imidazoline I1 receptor agonist rilmenidine are reviewed.]

Clinical Neuroscience

NOVEMBER 30, 2017

[Alemtuzumab therapy 2017]

BIERNACKI Tamás, BENCSIK Krisztina, SANDI Dániel, VÉCSEI László

[Multiple sclerosis (MS) is a chronic, immune-mediated disease of the central nervous system comprising of inflammation, demyelinisation and neurodegeneration. The natural history of MS is heterogenous. Owing to the vast range and severity of the symptoms MS can cause the effect of the disease on one’s cognitive and physical status is unpredictable. According to the new, phenotype based classification two subgroups can be distinguished; relapsing-remitting (RR) and progressive MS. Relapsing-remitting MS can be further divided into active and inactive disease. The activity of the disease can be proven either clinically and/or by radiological means. A patient’s disease is considered inactive, if it fulfills the criteriae set in the “no evidence of disease activity-3” (NEDA-3) concept, meaning that no progression can be seen on the MRI scans, the patient is relapse free and there is no worsening on any disability scale. Nowadays a paradigm shift can be seen in the treatment of MS. The aim of this shift is to provide each and every patient with the most potent medication best suiting his/her illness as soon as possible. Alemtuzumab offers a great option as either a first line treatment or as escalation therapy for patients with a highly active disease. The efficacy of alemtuzumab was proven in two phase III trials (CARE-MS I, II), where it was compared to subcutaneous interferon b-1a, administered three times weekly. In both studies alemtuzumab was superior to subcutaneous interferon b-1a in terms of relapse rate reduction, in all scouted MRI parameters. In the CARE-MS II trial it was found superior in terms of progression slowing. In the studies’ first 2 years 32% and 39% of the alemtuzumab treated patients managed to achieve the NEDA-3 state (data from CARE-MS II and I respectively). At the end of the 4 year extension of both studies these numbers have increased to 60% and 55% respectively. The aim of our synopsis is to suggest neurologists an evidence based guideline, a therapeutic algorithm to be used when they give their MS patients the very best, personalised treatment, and also to appoint the recently introduced alemtuzumab to its proper place in the algorithm.]

Journal of Nursing Theory and Practice

APRIL 30, 2017

[Examination of cardio-vascular risk factors in the priority of atrial fibrillation]

BÉKEFI-MENG Zsuzsa, PAKAI Annamária, SZUNOMÁR Szilvia, VÁRADYNÉ HORVÁTH Ágnes

[Objectives: Stroke-prophylaxis is the biggest question regarding atrial fibrillation. Their aim is to examine the risk factors, successfulness of frequency control, and the effectiveness of anticoagulant therapy. Methods: This quantitative cross-sectional study used a non-randomized sampling method. Enrollment criteria: anticoa-gulant therapy, atrial fibrillation, age 20-90 years, NYHA stage II. Excursion criteria: patients having elective intervention that influences INR rates. Patient data was collected from the records of the University of Pécs, Cardiology Clinic between 01.01.2012-31.12. They used linear regression, T-test, χ2-test, variance analysis (ANOVA), SPSS 20.0. Results: Significant correlation between BMI values-, systolic blood pressure-, modified medication and its effect on frequency control-, correct anticoagulant therapy, INR parameters and the increased risk of thromboembolia in patients with atrial fibrillation. (p<0.05) Conclusion: Stratification of risk factors and individual optimisation of anticoagulant therapy is important for effective stroke prevention and increased survival rate.]

Hypertension and nephrology

SEPTEMBER 10, 2017

[A Study Investigating the Success of Factors that have an Impact the Effects of Antihypertensive Treatment (CONADPER-HU)]

KISS István, KERKOVITS Lóránt, ALFÖLDI Sándor, BALOGH Sándor, BARNA István, JÁRAI Zoltán, PAKSY András, SIMONYI Gábor, SZEGEDI János, KÉKES Ede

JUNE 20, 2017

Antihypertenive effect of rilmenidine. Evaluation of the Hungarian multicenter VERITAS study

FARSANG Csaba

The VERITAS study showed that in hypertensive patients the imidazoline I1 receptor agonist, rilmenidine significantly decreased the office blood pressure as well as the blood pressure measured by ambulatory blood pressure monitoring (ABPM). The white-coat reaction and left ventricular hyperthrophy (LVH) were also decreased. Ain a separate study involving hypertensive subjects rilmenidine significantly increased baroreflex sensitivity. This effect may contribute - mainly during daytime - to the antihypertensive effect.

Hypertension and nephrology

MAY 20, 2017

[Antihypertenive effect of rilmenidine. Evaluation of the Hungarian multicenter VERITAS study]

FARSANG Csaba

[The VERITAS study showed that in hypertensive patients the imidazoline I1 receptor agonist, rilmenidine significantly decreased the office blood pressure as well as the blood pressure measured by ambulatory blood pressure monitoring (ABPM). The white-coat reaction and left ventricular hyperthrophy (LVH) were also decreased. Ain a separate study involving hypertensive subjects rilmenidine significantly increased baroreflex sensitivity. This effect may contribute - mainly during daytime - to the antihypertensive effect.]