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Journal of Nursing Theory and Practice

JUNE 30, 2019

[Understanding the past may help to shape the future (’Medical tasks, delegation and nursing’ - the past, present and the way forward)]

SÖVÉNYI Ferencné

[The history of nursing in Hungary has an aspect that has often been addressed but never looked into to the required depth and detail. This aspect concerns the regulation by law of certain specific relations between medicine and nursing from the mid-twentieth century to date. This issue has now come to the fore due partly to amendments to the legal framework and partly to changes in nursing education. ]

Lege Artis Medicinae

DECEMBER 10, 2019

[Family medicine as a career. Medical students’ attitudes and vocational choice motivations]

MOHOS András, VARGA Albert, MARKÓ-KUCSERA Mária, KALABAY László, TORZSA Péter

[INTRODUCTION - The large number of vacant general practices is a burning issue in Hungary. The entering of new colleagues into the general practitioner speciality training does not pose a real solution to the human resources crisis in this field. Our aim is to assess medical students’ attitudes and knowledge about general practice. SAMPLE AND METHOD - Cross-sectional survey with self-completed questionnaires at the University of Szeged, with the participation of 94 fourth and fifth year medical students in 2016 and 78 first and fourth year medical students in 2017. RESULTS - In 2016 1% of students planned for sure, and 16% planned probably to work as a general practitioner in the future. In 2017 3.9% of first-year students planned definitely to be a general practitioner, and 15.4% planned that probably. Among fourth-year students 0% of students planned for sure, and 19.2% planned probably to work as a general practitioner in the future. Whatever the presence of family medicine in undergraduate training influenced the medical students’ opinion about the profession positively (0.4-1.3 on a scale based on the direction and strength of the effects of certain factors ranging from -5 to +5). Those who were interested in family medicine considered the situation of healthcare significantly worse (p=0.027), than those who were not interested. To make the profession more attractive the following factors may play the most important role: the more intense presentation (I: 37%) of general practice in undergraduate training, improving the prestige of family medicine (IV: 31%), high-quality work (IV: 39%). CONCLUSIONS - Few medical students plan to work as general practitioner in the future. The most effective way to raise interest in family medicine is to increase the students’ knowledge and awareness of this specialisation, and the more intensive presentation of family medicine in undergraduate training is a key issue.]

Hypertension and nephrology

DECEMBER 12, 2019

[Serotoninergic drugs for weight loss. A review of efficacy and cardiovascular safety of lorcaserin]

SIMONYI Gábor

[Complex therapy of obesity consist the medical treatment. Several weight lowering drugs are available in the United States, one of which is 5-HT2c agonist lorcaserin. After failures with former non-selective serotoninergic agents (fenfluramine, dexfenfluramine), there was great anticipation and more questions about the release of lorcaserin, which proved its effectiveness and safety in several phase 3 studies. Lorcaserin is a selective agonist of 5-HT2c receptors, therefore free form adverse effects of former non-selective serotoninergic drugs on valvulopathy or pulmonary hypertension. The results of the recently published CAMELLIATIMI 61 study confirmed the cardiovascular safety of lorcaserin.]

Lege Artis Medicinae

DECEMBER 10, 2019

[Explorative statistical analysis of numerous blood tests’ metabolic panel with rank-correlation ]

BRYS Zoltán, NAGY Erzsébet, MAGYAR Gábor, MOLNÁR D. László, KIS János Tibor

[INTRODUCTION AND AIM - During rou­tine blood panel testing, large amounts of bio­medical data are collected in Hungary and in all over the world. The aim of our - ethically approved - exploratory medical data analysis was to examine whether the analysis of correlations among several variables in a real-life, non-random blood panel data leads to meaningful results. DATA AND METHODS - In a retrospective study 2,292,199 anonymous routine blood panel data points were analyzed. Rank correlation was used between variables with more than 10,000 data points and strong (|ϱ|>0.5, p<0.001) relationships were visualized and interpreted. RESULTS - Similar laboratory values, effects of diseases affecting the same organ, as well as well-known medical interrelationships were shown between the examined laboratory parameter-pairs. DISCUSSION - Our exploratory data analysis shows that despite the non-random nature of the big blood panel sample, well-known medical correlations were very well detectable. Based on the results further re­search - with the inclusion of additional variables - seems reasonable and meaningful with due caution.]

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.]

Lege Artis Medicinae

NOVEMBER 15, 2019

[Neuropathic pain: spotligth on amitriptyline]

FEHÉR Gergely, POHL Marietta, KAPUS Krisztián, GOMBOS Katalin, PUSCH Gabriella, MÁK Kornél, KOLTAI Katalin, BANK Gyula, KÓSA Gábor, VARJASI Gábor, TIBOLD Antal

[The management of neuropathic pain is a challenge both for patients and medical professioners. A novel approach is recommended for its management based on the novel neurobiological results of pain research. Multidisciplinary teams and medical consensus are required due to the variety of symptoms and concomittant psychopathology. This approach allows us to avoid extensive diagnostic and trerapeutic workups and appropiate treatment for our patients. Most extensive evidence is available for pharmacological treatment, and currently recommended first-line treatments include antidepressants (tricyclic agents and serotonin-norepinephrine reuptake inhibitors) and anticonvulsants (gabapentin and pregabalin). The aim of our review was to collect articles focusing on the efficacy of the most widely available and cheapest tricyclic agent, amitriptyline in different neuropathic pain conditions. ]

Lege Artis Medicinae

NOVEMBER 15, 2019

[Specialists’ opinions about the introduction of colorectal cancer screening ]

MAGDA Lilla, TEREBESSY András

[ INTRODUCTION - The number of new cases of colorectal cancer is over 10 000 and there are around 5000 deaths per year in Hungary. A nationwide colon cancer screening program was launched in 2018. AIMS - Concerning the upcoming national screening, our aim was to explore attitudes, preferences and knowledge of specialists (family medicine, gastroenterology, surgery, oncology, pathology) who will be engaged in screening, diagnosis and treatment of colorectal cancer. METHOD - Before the start of the program we conducted semi-structured interviews with 20 representatives of specialties mentioned above. Interview-questions focused on knowledge (epidemiology, screening methods, program-related), preferences (screening method, protocol) and impact of the program on medical practice. Quan­ti­ta­tive and qualitative methods were used for analysis. RESULTS - Incidence of colon cancer was well known but its mortality in Hungary was underestimated. The public health significance of colorectal cancer scored 7 on a 10-point Likert scale and all participants agreed with introduction of the program. 12 people knew the chosen protocol (two-stage), only a single person mentioned one-stage (colonoscopy), and 7 had no information. 16 people prefer colonoscopy as the best screening method. 11 support two-stage protocol, 5 do not support but accept it, 4 would only accept the one-stage approach. 13 people think their duties will increase considerably. CONCLUSIONS - Our review partners consider colorectal screening in Hungary as an initiative to be supported. They expect increase of workload in their everyday medical practice and assume that the current endoscopic capacity will be overburdened. The majority prefers two-stage protocol because of cost-effectiveness while arguing that the colonoscopy has a bad reputation among the general population, nevertheless they consider colonoscopy as the best method of screening. ]

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.

Journal of Nursing Theory and Practice

APRIL 30, 2019

[Attendace of the wounded: A historical overview from antiquity to South Slavic war ]

HEGYI Péter hadnagy

[A series of care history reviews can be found in the journals. However, there have been few publications about the military aspect of the attendance of the wounded, so I found it important to show how it has changed, how it has developed, what has become a medical field nowadays and what its significance can be today. As a medical officer I would like to present the historic milestones of prehospital battlefield trauma from antiquity to Vietnam and South Slavic war. ]

Journal of Nursing Theory and Practice

APRIL 30, 2019

[What does a triage nurse do? ]

BALOGH Khernné Mariann

[Emergency patient care department problems have recently come to the fore, especially in terms of waiting times and triage activity. It is still not entirely clear to society what is the triage system is, what is it good for, and who is the person, who applies the classification of patients. There is countless conflicts and tensions in the process of health services due to lack of knowledge. In Hungary, emergency departments play a prominent role in healthcare. Increased patient flow is a global problem, and therefore a distinction should be made between the „door to physician time” of the patients. The so-called grading system (triage) has been developed for this purpose, during which an experienced qualified nurse will measure and assess the patient’s condition as quickly as possible on the basis of different criteria. In my communication, I present the triage activity, the use of the classification system, what the triage nurse is doing, by comparing two cases. ]