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Lege Artis Medicinae

JUNE 20, 2016

[Organic and non-organic perspectives in feeding and eating disorders under three years of age]

SCHEURING Noémi, DANIS Ildikó, KAROLINY Anna, SZABÓ László

[Providing optimal nutrition to infants and toddlers is a critical issue for both parents and experts. Besides the quality and quantity of food, indications of feeding behaviour such as feeding method and acceptance by the child are also crucial when determining feeding issues. The development of self-feeding is a significant part of the healthy somatomental development of a toddler between the age of 0-3 years. Efficient treatment of infants and toddlers with feeding disorders is often challenging in clinical practice. These symptoms frequently appear together with additional behaviour disorders, therefore functional reasons have to be taken into consideration in such cases. Due to the complexity of manifestations, applying tools beyond me­dical competence and involvement of special related professions are necessary. The general diagnostic systems of BNO-10 (International Classification of Diseases) and DSM-V (Statistical Manual of Mental Disorders) which are also applied in our country cannot be used appropriately for clear classification of early childhood feeding disorders and for examination of their backgrounds. DC:0-3R (Diagnostic Classi­fication of Mental Health and Develop­men­tal Disorders of Infancy and Early Childhood- Zero to Three), generally used in Anglo-Saxon countries, can be considered as a complex diagnostic system. Using the DC:0-3R classification system (1), we will present six types of feeding disorders affecting children between the age of 0-36 months in which organic and functional origins have been examined as well. In our article we argue for the complex, psychosomatic interpretation and treatments of early childhood feeding disorders.]

Clinical Neuroscience

MAY 30, 2016

[Disease burden of Duchenne muscular dystrophy patients and their caregivers]

PÉNTEK Márta, HERCZEGFALVI Ágnes, MOLNÁR Mária Judit, SZŐNYI László Pál, KOSZTOLÁNYI György, PFLIEGLER György, MELEGH Béla, BONCZ Imre, BRODSZKY Valentin, BAJI Petra, SZEGEDI Márta, POGÁNY Gábor, GULÁCSI László

[Background and purpose - Data on the disease burden of Duchenne Muscular Dystrophy are scarce in Hungary. The aim of this study was to assess patients’ and their caregivers’ health related quality of life and healthcare utilisations. Methods - A cross sectional survey was performed as part of the European BURQOL-RD project. The EQ-5D-5L and Barthel Index questionnaires were applied, health care utilisations and patients’ informal carers were surveyed. Results - One symptomatic female carer, 50 children (boys 94%) and six adult patients (five males) participated in the study, the latter two subgroups were included in the analysis. The average age was 9.7 (SD=4.6) and 24.3 (SD=9.8) years, respectively. Median age at time of diagnosis was three years. The average EQ-5D score among children and adults was 0.198 (SD=0.417) and 0.244 (SD=0.322), respectively, the Barthel Index was 57.6 (SD=29.9) and 53.0 (SD=36.5). Score of satisfaction with healthcare (10-point Likert-scale) was mean 5.3 (SD=2.1) and 5.3 (SD=2.9). 15 children were hospitalised in the past 12 months for mean 12.9 (SD=24.5) days. Two patients received help from professional carer. 25 children (mean age 11.1, SD=4.4 years) were helped/supervisied by principal informal carer (parent) for mean 90.1 (SD=44.4) hours/week and further family members helped in 21 cases. Correlation between EQ-5D and Barthel Index was strong and significant (0.731; p<0.01) as well as with informal care time (-0.770; p<0.01), but correlation with satisfaction with health care was not significant (EQ-5D: 0.241; Barthel Index: 0.219; informal care: -0.142). Conclusion - Duchenne muscular dystrophy leads to a significant deterioration in the quality of life of patients. Parents play outstanding role in the care of affected children. This study is the first in the Central and Eastern European region that provides quality of life data in this rare disease for further health economic studies.]

Hypertension and nephrology

APRIL 10, 2016

[Blood pressures of adolescents at screening program in Budapest]

KORMOS-TASI Judit, GÁCSI Erika, SCHEURING Noémi, TÓTH Fanni, CZINNER Antal, SZABÓ László

[The Aim of the screening program was to investigate the blood pressure and the association with obesity, hypercholesterinaemia and increased body fluid in adolescents. Methods: A screening program was conducted during the period from April 2010 to May 2011.The screenings consisted of: blood pressure, heart rate, body composition determination, cholesterol, blood glucose, weight, height and BMI. Results: 2226 children fullfied all of the outlined criteria. Their range of age was between 14–18 years. The average systolic blood pressure was 126.34±12.55 Hgmm volt. At boys were higher 131.87±13.59 then at girls 117.49±5.69 Hgmm. The average diastolic blood pressure was 71.86±8.74 Hgmm. There were also higher at boys 72.61±9.17 then at girls 66.69±5.04 Hgmm. High systolic blood pressure (95%<) were 307/1326 cases at girls, and 403/876 cases at boys. High diastolic blood pressure were together with high systolic blood pressure, but less frequency. High diastolic blood pressure occurred at 85 girls and at 90 boys. Overweight and obes were 18.994% of girls and 15.26% of boys. The percentage of pathological high blood pressure was most frequent among boys and girls who are in the overweight group. The pathologically high level of body fat percentage appeared to be 12.98% among girls and 5.9% among boys. In elevated BMI groups the frequency of high body fat was 66% among girls and 81% among boys. The mean cholesterol was significantly higher in the overweight and obese group. Conclusions: Rates of hypertension and overweight and obesity are high in school children in Budapest, and increased bodyweight is a significant risk factor for hypertension. The results of the study will help to design preventive programmers.]

Lege Artis Medicinae

NOVEMBER 03, 2015

[Insulin pump therapy in type 1 diabetes in the light of efficacy, safety, and quality of life]

HIDVÉGI Tibor, SZEPESI Gábor, LUKÁCS Andrea, BARKAI László

[The level of glycaemic control necessary to achieve optimal outcomes in subjects with type 1 diabetes mellitus typically requires intensified insulin therapy using multiple daily injections or continuous subcutaneous insulin infusion (CSII). For CSII, the insulins of choice are the rapid-acting insulin analogues: insulin aspart, insulin lispro and insulin glulisine. The advantages of CSII over multiple daily injections in adult and paediatric populations with type 1 diabetes include superior glycaemic control, lower insulin requirements and better health-related quality of life/patient satisfaction. An association between CSII and reduced hypoglycaemic risk is more consistent in children/adolescents than in adults. The use of CSII is widely recommended in both adult and pediatric type 1 diabetes mellitus populations, but is limited in pregnant patients. The review also discusses the result of the “A non-interventional trial to observe the effect of the use of Accu Chek Combo device on quality of life and metabolic control“(COM-1101-HU 1.3).]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2015

[Value research of students in the patient care sector. Research carried out in a vocational secondary school]

KOVÁCSNÉ MELHER Marianna

[Aim of the study: Mapping out the value system, the professional motivation and the socio-cultural background of care provider students at the Zsuzsanna Kossuth Vocational Secondary School Sample and methods: Descriptive type research, number of elements 169 (n=169). The data was synthesized with Microsoft Office Excel 2007. Results: Taking into consideration the influence of the parents’ educational and professional background it can be stated that the parents’s influence gains control of their children’s school choice. In every analyzed group students are backed by strong family support. Regarding their career choice most students were motivated by the desire to help people. Graduate students demonstrate a more consistent career choice than younger students. The most important values of the care provider career proved to be: professional knowledge, know-how, responsibility and precision. An increase in career values related to age has not been demonstrated. Conclusions: It is very important to know the students’s value system because the values gained in the family and at school play a determining role in the care providers’s job. ]

Lege Artis Medicinae

JUNE 01, 2015

[Survey on the dietary habits of children between the age of 4-10]

KISS-TÓTH Bernadett, BÍRÓ Lajos

[INTRODUCTION - The prevalence of overweightness and obesity among children is increasing in Hungary, while the inadequate or excessive intake of some nutrients is also representative. Keeping these inappropriate lifestyle habits in adulthood could significantly worsen the health status of the rising generation. METHOD - The sample is representative for the 4-10 year old children of Budapest and Kecskemét city. The dietary assessment was executed, using the internationally accepted 3 day dietary record method. Body mass index was also calculated from the measured body weight and height, creating BMI categories according to the Cole methodology. RESULTS - The ratio of overweightness and obesity resulted in 21% (19% for the 4-6 year old, 24% for the 7-10 year old), while 13% of them belonged to the underweight category. The nutritional problems, identified by adults, like the excessive fat intake, its inappropriate composition, the high sodium-, low calcium- and vitamin D intake already appears in the early stages of life. CONCLUSION - The results prove, that the education for healthy nutrition among children is in high priority, in which all stakeholders, like the parents, the governmental and non-governmental organisations, the educational institutes as well as the food industry plays an important role. ]

Journal of Nursing Theory and Practice

DECEMBER 30, 2014

[Disabled children in the family]

MÓRICZ Lászlóné

[Aim of the study: The arrival of a disabled child at the family is not a happy event at all. The whole life of the family would change and they must face lots of difficulties and impediments. Parents of disabled children become underprivileged financially and socially. They must continuously deal with the structural problems of the social system and the probability of out casting process which are the objects of this study. Sample and methods: Present case study is about a girl suffering from Mucopalysaccharidosis disease and her family. This descriptive study is based on observations, data collecting and analyzing and interviews with the mother. Results: This case is a perfect example to show the structural problems of the social system, which can be latent or not having received the necessary emphasis as most of the time only the parents concerned can see them so they remain unsolved. At the same time it causes great permanent changes having considerable effects on the life of the family. Conclusions: Solutions to the above mentioned problem can be the specialization of the education, the inspection of the nursing districts’ boundaries, the prevention of burning out syndrome of the helpers with proper trainings or if necessary, where there would be only one possible solution, the modification of the legislation.]

Hypertension and nephrology

APRIL 20, 2015

[Tubulointerstitial nephritis and uveitis syndrome]

BAJCSI Dóra, FEJES Imre, KEMÉNY Éva

[Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare and underdiagnosed oculorenal disorder that is characterized by the development of acute tubulointerstitial nephritis and uveitis. The median age of onset is 15 years, but it may occur at any age. There is a female predominance. Uveitis might occur before, after, and also concomitantly with tubulointerstitial nephritis. The symptoms are typically non-specific, including fever, loss of appetite, weight loss, nausea and vomiting, weakness, abdominal pain, arthralgias and myalgias. Laboratory findings reveal an acute impairment of renal function, anaemia and elevated inflammatory parameters. Urinary findings are consistent with tubulointerstitial nephritis including subnephrotic proteinuria, sterile leucocyturia, microhaematuria, and tubular dysfunction (e.g. normoglycemic glycosuria). The prognosis appears to be good, especially in children. Persistent renal dysfunction only develops in a small proportion of cases. In this paper, we present the case of a 39-year-old female patient with TINU syndrome, and review the literature.]

Journal of Nursing Theory and Practice

OCTOBER 30, 2014

[The malnutrition and the possibilities of its therapy in childhood]

GELENCSÉR Erzsébet

[Malnutrition is a very important clinical condition in pediatrics. However, undernutrition as negative impact on length hospital stay, risk of infection and health care costs. Moerver, it also effects the cognitive development of children. STONG is an easy-to use screening tool that can be recorded in a few minutes, and it does not require special knowledge measurement or follow-up. In Kaposi Mór Hospital (Kaposvár) the risk of malnutrition was assessed by STRONG nutritonal risk screening tool in 31 patient of child-gastroenterology ambulatory (02.01.2014-30.06.2014). In case of malnutrition counselling and use of special formulas are essential besides evaluating tehe cause of malnutrition.]

Journal of Nursing Theory and Practice

OCTOBER 30, 2014

[Application of „The Parental Belief Scale for Parents of Hospitalized Children” questionnaire in Hungarian language]

MIKLÓSI Mónika, PERCZEL FORINTOS Dóra

[Aim of the study: Beliefs about parental role and efficacy was shown to be important in adaptation to child’s hospitalization; there is a lack of adequate measure of this construct, however. Our aim was the evaluation of the Hungarian version of The Parental Belief Scale for Parents of Hospitalized Children (PBS; Melnyk, 1994) assessing parents’ beliefs about their ability to understand and predict their children’s behaviours and emotions, as well as to participate in their children’s care during hospitalization. Sample and methods: The Hungarian version of the PBS was evaluated using a back-translation process. One hundred parents of hospitalized children in Heim Pál Children’s Hospital, Department of Surgery and Traumatology fulfilled the measure along with questionnaires regarding demographics, general parental self-efficacy and state-anxiety. Results: The Hungarian version of the PBS showed excellent internal consistency (α=0,94), and good stability (r=0,85 p<0,001). A significant positive correlation of medium effect size was found between PBS scores and general parental self-efficacy (r=0,30 p=0,025). Parent’s state anxiety was significantly negatively related to their self-efficacy beliefs regarding hospital setting (r=-0,48 p<0,001). Conclusion: The Hungarian version of the PBS was shown to be a reliable and valid instrument for measuring efficacy-beliefs of parents of hospitalized children.]