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Lege Artis Medicinae

MARCH 10, 2020

[Summary data of Hungary's comprehensive health screening program (MAESZ) 2010-2019]

BARNA István, KÉKES Ede, HALMY Eszter, BALOGH Zoltán, KUBÁNYI Jolán, SZŐTS Gábor, NÉMETH János, PÉCSVÁRADY Zsolt, MAJOROS Attila, DAIKI Tenno, ERDEI Ottilia, DANKOVICS Gergely

[The comprehensive screening program of Hun­gary (MAESZ) 2010-2020-2030 is a unique initiative in Hungary and worldwide too. This largest humanitarian program provides by the latest technology free scree­ning tests for all residents in Hungary. The program developed by 76 pro­fessional organizations offers 38 scree­ning tests to every participants free of charge, in a special designed screening truck. Screening program performed by MAESZ includes cardiovascular, ophthalmologic, dermatologic, gynecologic, and neurologic investigations, lab tests, audiometry, blood pressure and arterial stiffness measurements, and venous Doppler ultrasound examinations. More­over, screening tests for lactose intolerance, colon malignancy, inflammatory bowel disease, reflux disease, urine incontinency, prostatic cancer and physical activity level were evaluated. Starting 2020, a dental screening station will be added to the mobile unit for early detection of oral cancers. Beyond screening tests, special attention is paid to assess health threatening risk factors, such as smoking, alcohol con­sumption, physical inactivity, un­healthy nutrition, and obesity. The program demonstrates the key elements of first aid from reanimation to bandage of burns in cooperation with professional and civil organisations. Furthermore, during the waiting time, participants get lifestyle recommendations and a health booklet with a bar code enabling the immediate computer analysis of test outcomes. Since the 2018/2019 school year the official prevention program for children entitled “Travel around the Empire of Health” was started. During its 10 years, the MAESZ performed 7 million free of charge screening tests on 1,886 scenes, enrolled 560,000 participants, invested 16,000 hours for prevention, handed out 1,200,000 health booklets and 391,000 prevention info packages to thousands of fami­lies. More than 20,000 health professionals (GPs, nurses, dietetics, health development agents, public health government officials, Accident Prevention Committee of National Police Headquarters, General Directorate of Social Affairs and Child Protection and non-governmental organizations) have been participated. The program designed to improve social health aims to help more and more Hun­garian citizens to be informed about their health status and to reminds them of the importance of prevention. ]

Lege Artis Medicinae

MARCH 10, 2020

[Nutritional status, realizing sarcopenia and the importance of prehabilitation in surgical departments]

CSIBA Borbála, NAGY Ákos, LUKOVICH Péter, BAROK Bianka

[INTRODUCTION - Malnutrition can significantly influence the surgery’s outcomes. Currently, patients risk grouping is based on the body mass index (BMI), and the preparation for surgery is concerned only as nut­rients administration. PATIENTS AND METHODS - The Nutrition Support Team established in our Department is assessing first the patients’ nutritional status (BMI, MUST), sarcopenia (skinfold measure, handgrip strength) and fitness status (6 min step test, sit to stand test). Risk group patients were suggested nutrients and physiotherapy prior to the surgical operation. In order to follow up our patients we created an online interface and repeated the tests immediately before the operation. RESULTS - 135 cancer patients (76 male and 59 female) were operated. Their average age was 69.6 years. 33 patients had weight loss before the first consultation (average=8.7 kg). Their average BMI was 26.3. 21 patients had gained weight in the last 6 months (average=7.8 kg). Patients with left descending colon, liver - and also pancreatic tumors had overweight BMI values while the rest of pa­tients ill with right colon and stomach neo­plasm had normal weight. Those patients who we enrolled to the online system had better results at the second assessment. CONCLUSIONS - According to our survey, most of the patients had overweight BMI values but had sarcopenia based on anthropometric tests. Therefore, the importance of in time recognized and preoperatively started nutritional therapy must be coupled with the parallel applied physiotherapy. ]

Journal of Nursing Theory and Practice

AUGUST 30, 2019

[Dangerous beauty - Health risks of beauty salon workers ]

PÁLVÖLGYI Éva, HIRDI Henriett Éva

[The aim of the study: The aim was to assess the health status and working conditions of the beauty salon workers (hairdressers, barbers, beauticians, manicurists and pedicurists), and their knowledge regarding workplace risk factors. Methods: The survey was conducted in December 2018 - January 2019 through self-constructed online questionnaire among Hungarian beauty salon workers which covered socio-demographic data, workers’ health issues and occupational health issues. Data were analysed with SPSS 22.0. Results: The online questionnaire filled out by a total of 166 beauty salon workers. workers (165 women and 1 man). The respondents had an average age of 35.21 years. The average working hours of the workers was 8.88 hours. 33.73% of the sample did not visited the occupational health setting at all. It can conclude that all of the respondents have chronical disease. Conclusions: The research confirmed that the employees of the beauty industry are exposed to a lot of health damaging factors, which is primarily the permanent contamination with chemical substances. The test results prove, that more emphasis should be placed on prevention and appearance in occupational health tests, as well as order to the personal protective equipment to use for healthy and safe working.]

Journal of Nursing Theory and Practice

AUGUST 30, 2019

[How to break sensitive news in the Ophthalmology, specifically at diabetic retinopathy ]

TÓTH Lívia, BÁLINT Zsófia, MÁTÉ Orsolya

[The aim of the study: To investigate the circumstances of breaking bad news by health care professionals and the conditions of communication at the Ophthalmology Clinic of the University of Pécs, among diabetic retinopathy patients. Material and method: Quantitative and cross-sectional examination, February-December 2018. Statistical methods: descriptive and mathematical statistics (χ2-test), SPSSv22, (p<0,05). Results: Most of the examined medical professionals working at the clinic (20 persons/90.90%) can’t be supported by a protocol for breaking bad news, however, the need for a protocol is formulated as more than half of the respondents (11 persons/59.09%). Conclusions: Health care professionals would need to develop a protocol to break bad news in health care institutions, also in the Clinic of Ophthalmology, furthermore, attention should be paid to improving the circumstances during providing information to patients.]

Clinical Neuroscience

JANUARY 30, 2020

Review of electrode placement with the Slim Modiolar Electrode: identification and management

DIMAK Balazs, NAGY Roland, PERENYI Adam, JARABIN Andras Janos, SCHULCZ Rebeka, CSANÁDY Miklós, JÓRI József, ROVÓ László, KISS Geza Jozsef

Background - Several cochlear implant recipients experience functionality loss due to electrode array mal-positioning. The application of delicate perimodiolar electrodes has many electrophysiological advantages, however, these profiles may be more susceptible to tip fold-over. Purpose - The prompt realization of such complication following electrode insertion would be auspicious, thus the electrode could be possibly repositioned during the same surgical procedure. Methods - The authors present three tip fold-over cases, experienced throughout their work with Slim Modiolar Electrode implants. Implantations were performed through the round window approach, by a skilled surgeon. Standard intraoperative measurements (electric integrity, neural response telemetry, and electrical stapedial reflex threshold tests) were successfully completed. The electrode position was controlled by conventional radiography on the first postoperative day. Results - Tip fold-over was not tactilely sensated by the surgeon. Our subjects revealed normal intraoperative telemetry measurements, only the postoperative imaging showed the tip fold-over. Due to the emerging adverse perception of constant beeping noise, the device was replaced by a CI512 implant after 6 months in one case. In the two remaining cases, the electrode array was reloaded into a back-up sheath, and reinserted into the scala tympani successfully through an extended round window approach. Discussion - Future additional studies using the spread of excitation or electric field imaging may improve test reliability. As all of these measurements are still carried out following electrode insertion, real-time identification, unfortunately, remains questionable. Conclusion - Tip fold-over could be reliably identified by conventional X-ray imaging. By contrast, intraoperative electrophysiology was not sufficiently sensitive to reveal it.

Clinical Oncology

DECEMBER 10, 2018

[Gene-expression profiles in adjuvant treatment of early breast cancer]

PAJKOS Gábor

[Breast cancer is a heterogeneous disease with different subtypes having a distinct biological, molecular, and clinical course. Assessments of standard clinical and pathological features have traditionally been used to determine the use of adjuvant systemic therapy in early-stage breast cancer; however, the ability to identify those who will benefi t from adjuvant chemotherapy remains a challenge, leading to over treatment of some patients. Risk stratifi cation of patients with early stage breast cancer may support adjuvant chemotherapy decision-making. This review details the development and validation of seven multi-gene classifi ers, each of which claims to provide useful prognostic and possibly predictive information for early stage breast cancer patients. A careful assessment is presented of each test’s analytical validity, clinical validity, and clinical utility, as well as the quality of evidence supporting its use.]

Lege Artis Medicinae

DECEMBER 10, 2019

[Health risk awareness among healthcare professionals]

SZOBOTA Lívia, BALOGH Zoltán

[INTRODUCTION - The aim of our study was to assess how aware healthcare professionals are of the risks and dangers they are faced with while performing their jobs. MATERIAL AND METHOD - Data collection was done quantitatively with a survey filled out by the subjects themselves from among medical/healthcare professionals who are currently working multiple shifts or medical professionals who are in leadership positions and are currently continuing their higher education beside their employment. Data analysis was done with the help of Microsoft Excel and SPSS using the Pearson chi-squared test and the Mann Whitney test (p<0.05) as well as descriptive statistical methods. RESULTS - The 134 healthcare professionals taking part in the study were not fully aware of the health risks they are faced with. CONCLUSION - The people who provided answers were not clear on workplace dangers and risks. On the whole, it can be determined that the cooperation of occupational health and workplace safety is necessary in order to avoid damage to the health of healtcare professionals.]

Clinical Neuroscience

NOVEMBER 30, 2019

A clinical study of an online educational programme for chronic pain patients

GALAMBOS Wellingerné Krisztina, SZOK Délia, CSABAI Márta

Background - The research of alexithymia - the inability to express or understand emotions - has recently become of great importance in clinical practice, mainly in the field of doctor-patient and psychologist patient communication. Many studies have proven the correlation between alexithymia and the development of functional somatic symptoms, i.e. somatization. Purpose - The aim of this clinical study was to examine the emotion-recognition and emotion communication patterns of patients suffering from chronic pain (e.g., headache, low back pain, arthralgia, neuropathy). Moreover, the participants received access to the Hungarian adaptation of a new international online educational site (www.retrainpain.org) dealing with pain management. Methods - Data were collected from the Headache and Chronic Pain Outpatient Clinic, Department of Neurology, Faculty of Medicine, University of Szeged, Hungary (tertiary care - Group 1) and from a general practice in district 2, Budapest, Hungary (primary care - Group 2) from March, 2017 to April, 2018. Patients received a test package containing a pain-specific questionnaire, then the Difficulties in Emotion Regulation Scale (DERS), the Toronto Alexithymia Scale (TAS-20), and the shortened Hungarian version of the WHO-Well-being (WBI-5) had to be completed. After filling out the questionnaires, all patients got access to the Hungarian adaptation of the www.retrainpain.org website. Results - Altogether 92 patients participated in the study (Group 1 n=50; Group 2 n=42). Based on the TAS-20 re­sults, 35 patients reached a pathological score (≥60 points), which indicates the diagnosis of alexithymia. The mean TAS-score was lower in Group 2 (primary care) than in Group 1 (tertiary care) (p=0.003). The DERS disclosed pathological results in 19 cases (p=0.009). As regards the www.retrainpain.org chapters, we received feedback only from 25 out of 92 patients (27%) (Group 1 n=20; Group 2 n=5). Conclusions - Although the examined patients have been suffering from different chronic pain syndromes for years and 50% of them confirmed that symptoms placed at least moderate or heavy burden on their everyday life, the available educational programme was studied only by a smaller proportion of patients than expected. Additionally, those who surveyed the Hungarian adaptation of the www.retrainpain.org website were mainly patients from primary care (Group 2), in spite of the fact that patients from specialized medical care (Group 1) had worse subjective conditions. Our future objective is to extend our database with follow-up results and to improve patients’ response willingness.

Clinical Neuroscience

NOVEMBER 30, 2019

Vestibular evoked myogenic potential responses in Parkinson’s disease

CICEKLI Esen, TITIZ Pinar Ayse, TITIZ Ali, OZTEKIN Nese, MUJDECI Banu

Background - Our objectives were to determine the differences in the vestibular evoked myogenic potential (VEMP) responses in patients diagnosed with early staged idiopathic Parkinson’s disease (PD) compared to the normal population and evaluate the vestibular system disorder causing balance-posture disorders. Second aim of this study was to investigate caloric test responses particularly in early staged PD compared to normal popu­lation. Material and methods - Thirty patients (14 females and 16 males; mean age, 60.6 ± 13.1 years) diagnosed with idiopathic PD and 28 healthy subjects (20 males and 8 females; mean age, 59.1 ± 6.4 years) were included. The patient and control groups were subdivided according to their age, gender and the patient group was subdivided according to onset time of the Parkinson symptoms, Hoehn-Yahr staging. The subgroups were compared for VEMP and caloric test responses. Results - There were no significant differences between the study and control groups for right and left VEMP measurements. Patients over 60 years and under 60 years did not show significant differences in terms of right and left mean VEMP measurements. However, P1 amplitude was significantly lower in patients over 60 years old (P = .004). Gender, disease duration, BERG balance scale and Hoehn-Yahr stage had no effect on the VEMP amplitudes. There was no significant correlation with the side of Parkinsonian symptoms to the side of canal paresis (P = .566) and the side on which no VEMP response was obtained in caloric test. Conclusion - VEMP responses were not different between PD and healthy subjects. VEMP P1 amplitude was decreased with age in PD group. Canal paresis and symptoms side were not statistically correlated in caloric test.

Journal of Nursing Theory and Practice

APRIL 30, 2019

[A Systematic Review of nurses knowledge of Incontinence-Associated Dermatitis ]

KÓSZÓ Lilla, NAGY Erika, PAPP Anita Tímea

[Background: Due to the growing incidence of incontinence, Incontinence-Associated Dermatitis (IAD) is one of the most important health problems nowdays. The most significant challange is the differentiation of IAD and ulcer pressure. Missclassification in practice causes suboptimal prevention and therapy. Thus, in order to provide optimal care, nurses need to be able to properly differentiate between the two illnesses. Objectives: The airm of this analysis was to identify how nurses can classify IAD from ulcer pressure, and how differentiation could be taught to nurses. Method: A systematic review was done wih ’pressure ulcer and ’classification’ and ’nurse’ search words using 3 databases, the Pubmed (NLM), the Science Direct and the Web of Science as basic sources. We relied on articles that were published before September 2018. From the total of 1268 records 7 studies met all the inclusion and exclusion criterias and were chosen for analysis. Results: We counted weighted arithmetic from the results of the studies. In total 4062 nurses participated in the clinical trials. Their weighted mean score was 33,2%. 2132 nurses got some types of education, The weighted mean score of their pre-test was 37%, while their post-test reached 66%. Conclusion: Differentional diagnosis between pressure ulcers and IAD is complicated. However, studies all agree that education in this field produces good results.. ]