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Journal of Nursing Theory and Practice

OCTOBER 30, 2019

[Multimorbidity among older people participating in geriatric exercise programme]

KOVÁCS Éva, VIRÁG Anikó, MÉSZÁROS Lászlóné, HARKÁNYI Izabella, SIMON András

[Objective: To determine the exercises and dosis of the effective and safe geriatric exercise programme it is essential to know that what kind of chronic diseases an elderly people suffer from. However, the old age is characterized by multimorbidity which means that the same person may have two or more chronic diseases at the same time. Methods: The aim of our study was to investigate the prevalence of chronic diseases associated with aged and multimorbidity among older people participating in geriatric exercise programme. Data were collected with self-administered questionnaire at sites of geriatric exercises programmes, Budapest. Results: Seventy one percent of the sample of 180 participantes (N=128) suffered from more than one chronic diseases. In our sample, the proportion of people with osteoporosis and obesity was significantly higher than the national average. At the same time, the prevalence of type 2 diabetes, lower limb joint disease, cerebrovascular accident and myocardial infarction was significantly lower than the national average. As regards to asthma and hypertension the proportions observed in our sample did not differ from the national average. Conclusions: In case of newcommer older people we need to pay more attention to the effects of chronic diseases associated with aging and of multimorbidity.]

Clinical Neuroscience

JANUARY 30, 2015

[Treatment of osteoporotic vertebral compression fracture with PMMA augmented pedicle screw fixation]

PADÁNYI Csaba, MISIK Ferenc, PAPP Zoltán, VITANOVICS Dusan, BALOGH Attila, VERES Róbert, LIPÓTH László, BANCZEROWSKI Péter

[Background - Over the last few decades many innovative operation technique were developed due to the increase of porotic vertebral fractures. These new techniques aim to reach the required stability of the vertebral column. In case of significant instability, spinal canal stenosis or neural compression, decompressive intervention may be necessary, which results in further weakening of the column of the spine, the minimal invasive percutan vertebroplasty is not an adequate method to reach the required stability, that is why insertion of complementary pedicular screws is needed. Considering the limited screw-fixing ability of the porotic bone structure, with this new technique we are able to reach the appropriate stability of cement-augmented pedicle screws by dosing cement carefully through the screws into the vertebral body. We used this technique in our Institute in case of 12 patients and followed up the required stability and the severity of complications. Methods - Fifteen vertebral compression fractures of 12 patients were treated in our Institute. Using the classification proposed by Genant et al. we found that the severity of the vertebral compression was grade 3 in case of 13, while grade 2 in case of two fractures. The average follow up time of the patients was 22 months (12-39), during this period X-ray, CT and clinical control examinations were taken. During the surgery the involved segments were localised by using X-ray and after the exploration the canulated screws were put through the pedicles of the spine and the vertebral body was filled through the transpedicular screws with bone cement. Depending on the grade of the spinal canal stenosis, we made the decompression, vertebroplasty or corpectomy of the fractured vertebral body, and the replacement of the body. Finally the concerned segments were fixed by titanium rods. Results - In all cases the stenosis of spinal canal was resolved and the bone cement injected into the corpus resulted in adequated stability of the spine. In case of six patients we observed cement extravasation without any clinical signs, and by one patient - as a serious complication - pulmonary embolism. Neurological progression or screw loosening were not detected during the follow up period. Part of the patients had residual disability after the surgery due to their older ages and the problem of their rehabilitation process. Conclusion - After the right consideration of indications, age, general health condition and the chance of successful rehabilitation, the technique appears to be safe for the patients. With the use of this surgical method, the stability of the spine can be improved compared to the preoperative condition, the spinal canal stenosis can be solved and the neural structures can be decompressed. The severity of complications can be reduced by a precise surgical technique and the careful use of the injected cement. The indication of the surgical method needs to be considered in the light of the expected outcome and the rehabilitation.]

LAM Extra for General Practicioners

SEPTEMBER 20, 2014

[ROLE OF PATIENT CLUBS IN SUCCESSFUL TREATMENT OF OSTEOPOROTIC PATIENTS]

SOMOGYI Péter, GAÁL János, SPEER Gábor

[The significance of osteoporosis is well known, however, the number of patients receiving treatment is only a small fraction of ideal. Besides, the fact that the population is uninformed, the difficulties of making an appointment with a specialist and the unsatisfactory communication of the doctor all play a part in the fact that a high proportion of patients receiving mediation give up treatment prematurely. The Inter - na tional Osteoporosis Foundation supports the establishment of public patient clubs with regular training courses and grants and by doing so it also acknowledges their importance in the prevention and treatment of osteoporosis. The publication, based on the questionnaire filled in by the members of the first Hungarian patient club, the Hungarian Society of Osteopo - rosis Patients in district 3rd, introduces the Hungarian results and points out how important patient clubs are in increasing the success of treatment and it also draws attention to the necessity of establishing further patient clubs in the future.]

LAM KID

SEPTEMBER 19, 2014

[Forgotten agent: raloxifene]

BENKŐ Ágota

[The largest group of the patients with osteoporosis is postmenopausal women characterized by a state of menopausal hormone deficiency which is results in accelerated bone loss. This increased bone resorption significantly elevates the risk of bone fractures including the most common type, i.e. vertebral fractures. In addition to the increased risk of fractures, estrogen deficiency affects other organs, thus, increasing the incidence of cardiovascular diseases, cancers, mood disorders and the symptoms of menopausal syndrome in women after menopause. In postmenopausal osteoporosis, the primary objective is to maintain the existing bone mass, a priority for the prevention and treatment of bone fractures. Hormone deficiency may be prevented by the administration of estrogen but the treatment may have adverse effects such as increased risk of endometrial cancer. An etiological therapy is desirable where the compound used for treatment exerts effects similar to that of estrogen to prevent postmenopausal bone loss as well as reduces the risk of cardiovascular disease without the stimulation of reproductive tissues.]

LAM KID

SEPTEMBER 19, 2014

[Role of patient clubs in successful treatment of osteoporotic patients]

SOMOGYI Péter, GAÁL János, SPEER Gábor

[The significance of osteoporosis is well known, however, the number of patients receiving treatment is only a small fraction of ideal. Besides, the fact that the population is uninformed, the difficulties of making an appointment with a specialist and the unsatisfactory communication of the doctor all play a part in the fact that a high proportion of patients receiving mediation give up treatment prematurely. The Inter - na tional Osteoporosis Foundation supports the establishment of public patient clubs with regular training courses and grants and by doing so it also acknowledges their importance in the prevention and treatment of osteoporosis. The publication, based on the questionnaire filled in by the members of the first Hungarian patient club, the Hungarian Society of Osteopo - rosis Patients in district 3rd, introduces the Hungarian results and points out how important patient clubs are in increasing the success of treatment and it also draws attention to the necessity of establishing further patient clubs in the future.]

Lege Artis Medicinae

JUNE 20, 2014

[The effect of biological therapy on generalised osteoporosis in patients with rheumatoid arthritis]

JUHÁSZ Péter

[In rheumatoid arthritis, the inflammation and damage of multiple joints can lead to generalised osteoporosis. This process is mostly mediaated by cells and cytokines that are also important for maintaining inflammation, by inhibiting bone formation as well as stimulating bone resorption. Data from the literature show that biological therapies that effectively decrease inflammation can also stimulate bone formation and inhibit bone resorption. This results in an increased bone density and bone protection, which is highly important to prevent subseqent fractures.]