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Lege Artis Medicinae

MAY 20, 2019

[Perinatal faulty hormonal imprinting: early impact, late consequences]

CSABA György

[The description and basic study of hormonal imprinting were the first in the series of research, which led to the recognition of the role of perinatal chemical effects in the late (adult age) manifestation of some diseases and inclination to diseases. Today it is clear, that certain pathological states, as obesity or diabetes, hypo- or hyperactivity (autoimmunity and allergy) of immune system can be deduced to perinatal (hormonal or metabolic) imprinting. The perinatal hormonal (chemical) imprinting takes place at the first encounter between the developing hormone receptor and the target hormone which sets the binding capacity of the receptor for life. In the critical periods of ontogeny (in addition to the perinatal imprinting) it can be developed at weaning, in adolescence and in continuously dividing and differentiating cells during the whole life. It is provoked by considerable quantitative differences of the physiological hormone or the presence of strange target-hormone-like molecules. The faulty hormonal imprinting leads to the adult-age diseases at any time of life and is inherited epigenetically to the progeny generations. Faulty hormonal imprinting always could be present in earlier times however, at present, because of the erroneous multiplication of endocrine disruptors in the environment, nutrition and medicine, its importance is continuously growing. The effects of faulty hormonal imprinting seem to be dangerous however, it can be imagined in the far future also a positive effect by the transformation of the human endocrine system at an evolutionary route. In the metabolic or immunological imprinting as well, as in the DOHaD (Developmental Origins of Health and Disease) the foremost recognized hormonal (chemical) imprinting is materialized.]

Journal of Nursing Theory and Practice

OCTOBER 30, 2018

[Comparative analysis of job and life satisfaction among theatre nurses in Hungary and Germany]

MÁTÉ Szilvia, PHIL. TIGGES-LIMMER Katharina, PUSZTAFALVI Henriette

[The aim of the study: The objective of the study was to assess and compare job and life satisfaction affected by workplace problems, stress, rewards, success and social support. We analyzed the coping strategies applied by the employees to solves the above problems. Material and method: The anonymous data collection was carried out in October, 2015 by applying AVEM and an own-edited socio-demographic questionnaire among theatre nurses from Hungarian and German clinics. Results: The employees evaluated stressful situations and problems differently in the two groups examined. Job satisfaction was equally important for both groups, but it affected life satisfaction of the Hungarian employees to greater extent. The stress management of the Hungarian employees was more effective in spite of the fact that German nurses used more coping strategies. Social support had a positive effect on overcoming the workplace problems in both groups. Conclusions: Job satisfaction of the nurses has a beneficial effect on their life satisfaction. The ability to divide work and private life and stress management are different among the nurses. Job satisfaction can be improved by workplace health promotion programs.]

Journal of Nursing Theory and Practice

OCTOBER 30, 2018

[Influencing Factors of Parenting Sense of Competence - Focusing on Sense of Coherence]

CSIGÓ Luca, KARÁCSONY Ilona Hajnalka

[The aim of the study: Parenting sense of competence (PSOC) has major impact on children’s development. The aim of this study was to examine the influencing factors of the parenting sense of competence from the aspect of a Health Visitor, especially focusing on sense of coherence (SOC). Material and method: A quantitative, cross-sectional, online study was carried out in 2017. A non-random sampling was applied with 254 mothers, who cared healthy, 0-6-year-old children. A self-edited survey was used and we examined SOC by its standard scale (SOC-13). For the data analysis Chi2 probability was used (p<0,05). Results: The mean age of the mothers was 33 years, 47,8% had 2 children and almost 60%. were higher educated. The mean point of SOC was 58,49. Age and sense of coherence had major impact on PSOC (p<0,05). There was not correlation between the residence, the education level, the marital status and PSOC (p>0,05). However the judgement of the Heath Visitors was excellent, internet was the main source of information about childcare. At the same time, human resources were mostly used in practise. Conclusion: The sociodemographic factors had lower impact on PSOC but it had a strong rela­tion­ship with SOC. In case of a risk groups Health Visitor could be a resource, against physical and psychosocial stressors, and she also could help to develop the parenting sense of competence. The role of the professionals should be enhanced in the parents’ source of knowledge related to their children.]

Journal of Nursing Theory and Practice

OCTOBER 30, 2018

[Assessment of environmental health and knowledge of silicosis among dental technicians]

LÁNG Anett, HIRDI Henriett Éva

[The aim of the study: The aim was to assess the health status of the Hungarian dental technicians and their knowledge of silicosis diseases. Methods: The survey was conducted in December 2017 - January 2018 through self-constructed online questionnaire among dental laboratory technicians in Budapest. Data were analysed with SPSS 22.0. Results: The survey was completed by 157 dental technicians. The sample consisted 80 male and 77 women. The average age was 38. Technicians were working for 9.4 hours a day. About the self equipment most of the participants (94.3%) wear respiratory protective equipment during laboratory work but 5.1% of them do not feel that the use of masks is necessary in laboratory. 13.37% of the participants don’t know the symptoms of silicosis and other 39.47% of them don’t know the right answer. Conclusions: The research has shown that the work safety situation of dental technicians is extremely low and their access to occupational health care is limited. The test results also demonstrated the need for early transfer of basic knowledge about the silicosis disease (its way of preventing, symptom, diagnosis and consequences) among dental technicians. ]

Journal of Nursing Theory and Practice

DECEMBER 30, 2018

[Judgement of organ donations’ nursing-related problems by nurses in the light of a Hungarian survey ]

SZÉCSÉNYI Péter, RAJKI Veronika

[Aim of the study: The research aims to map the opinions of nurses working on transplantation wards about the preparedness of laic people in relation to the theme of organ donation. In addition, we wanted to examine whether nurses give preference to religious beliefs and ethical principles against legal regulation. We also wondered whether nurses working on transplantation wards would offer their own organs. Materials and methods: The descriptive study was conducted among transplant nurses in Budapest, Szeged and Pécs, using a self-constructed questionnaire. Our results were obtained using a Pearson’s Chi-square test (all statistically significant levels were set at P<0.05), as well as using the one sample t-test. Results: The total sample size was 37. According to nurses, the laic population does not have the sufficient knowledge about the current legal rules. Nurses are positively committed to offering their own organs for a possible donation. In relation to organ donation, nurses prefer the religious and ethical principles against legal rules. Conclusions: The laic population is not fully aware of organ donation, which puts the success of organ donation at risk. It would worth to involve transplant nurses into the education of the laic population to improve the general acceptance of organ donation who work in transplantation fields and who do donor care, so laics would be more accepting and less conflict would occur, supposedly more organ transplants would occur.]

Journal of Nursing Theory and Practice

DECEMBER 30, 2018

[Challanges in transcultural nursing in the clinical practice]

BRECZKÓ Simenászné Lilla, TÓTH Dihelné Anikó

[The aim of the authors is to call attention to the differences arising during nursing of patients of different culture. Regarding to the fact that in our healthcare system there are more and more patients with foreign customs, it is inevitable for the healthcare staff to acquire new knowledge and apply it during their work in an effective way. ]

Journal of Nursing Theory and Practice

OCTOBER 30, 2018

[Faces from the Hungarian Nursing Hall of Fame: the exemplary careers of two Hungarian recipients of the Florence Nightingale Medal Part 2]

SÖVÉNYI Ferencné, PERKÓ Magdolna, FEDINECZNÉ VITTAY Katalin, BOROS Károlyné

[This part of the series of articles on Hungarian recipients of the Florence Nightingale Medal is dedicated to the life and work of Ms Vera Józsefné Marosi. Two of the authors of the article had the privilege and honor not only to know Ms. Vera Marosi personally, but also to have been her students and co-workers at the Vocational Secondary School of Nursing, Postgraduate Medical School, Budapest. The other awardee whose life is presented is Ms. Anci Jánosné Faragó who was the last nurse in the Hungarian nursing community to be awarded the Medal in 2003. What connects the two outstanding nursing personalities is that both of them started out as teachers and educators and turned towards nursing spurred by historical circumstances, the cruelties of World War II and last but not least their humanity and desire to help others. ]

Lege Artis Medicinae

MARCH 20, 2019

[Long-term CPAP compliance among Sleep Apnea Patients at the Sleep Laboratory of the Hungarian Defense Forces Medical Center ]

DOMBOVÁRI Magdolna, BERNÁT István, TERRAY-HORVÁTH Attila, CSATLÓS Dalma, HARGITTAY Csenge, TORZSA Péter

[Obstructive sleep apnea syndrome (OSAS) is the most common sleep disorder, with a prevalence of 2-4% in the overall popula­tion. It is a risk factor for cardiovascular diseases and its daytime symptoms significantly impair the patients’ quality of life and increase the risk of work and road accidents. Its first-line treatment is the CPAP device (Continuous Positive Airway Pres­sure) the effectiveness of which is significantly determined by the compliance of the patient. Although the issue of compliance in such treatment is a very important factor, long-term studies including a large number of patients have not been published yet, and there are no known data about it in Hungary. OBJECTIVE - Examining the long-term compliance of CPAP among OSAS patients in a sleep laboratory in Hungary. METHOD - 3403 OSAS patients were selected for our study between January 1, 2007, and September 30, 2017. The diagnosis and titration of effective CPAP pressure were determined by polysomnography. Patients were controlled after 2 months of therapy and then every 6 and 12 months. During the care, their compliance value was determined by data downloaded from their device's memory card. RESULTS - The mean age (± SD) of patients was 59.0 (± 10.5) years, most of them were male, 2676 (78.6%), their average body mass index (BMI) was 32.6 (± 5.25) kg/m2, their average Epworth Sleepiness Scale score was 11.4 (± 5.0), their average Apnea-Hypopnoe index was 51.0 (± 19.5) events/hour. The average usage time of the CPAP device was 5.0 (± 1.9) hours. 72.3% of the patients used the device for over 4 hours and 27.7% used it for less than 4 hours. 34.7% of the patients used the device for more than 6 hours. The Epworth Sleepiness Score showed a significant and dose-dependent improvement over CPAP treatment, with a greater improvement among patients who used the machine for longer hours. The highest score improvement was achieved by users who used CPAP between 6-7 hours, averaging 7.3 (± 3.2) points (p <0.001). CONCLUSIONS - Our present study shows that high average compliance can be achie­ved among well-adjusted and well-maintained patients. ]

Clinical Neuroscience

MARCH 30, 2019

[Rehabilitation possibilities and results after neurosurgical intervention of brain tumors ]

DÉNES Zoltán, TARJÁNYI Szilvia, NAGY Helga

[Objectives - Authors examined the rehabilitation possi­bi­lities, necessities, and results of patients after operation with brain tumor, and report their experiences. Method - Retrospective, descriptive study at the Brain Injury Rehabilitation Unit, in National Institute for Medical Rehabilitation. Patients - Patients were admitted consecutively after rehabilitation consultation, from different hospitals, following surgical intervention of brain tumors, between 01 January 2001 and 31 December 2016. Patients participated in a postacute inpatient rehabilitation program, in multidisciplinary team-work, leaded by Physical and Rehabilitation Medicine specialist included the following activities: rehabilitation nursing, physical, occupational, speech, psychological and neuropsychological therapy. Results - At the rehabilitation unit, in the sixteen-year period 84 patients were treated after operation with brain tumor. Patients arrived at the unit after an average of 41 days to the time of the surgical intervention (range: 10-139 days), and the mean length of rehabilitation stay was 49 days (range: 2-193 days). The mean age of patients was 58 years (20-91), who were 34 men and 50 women. The main symptoms were hemiparesis (64), cognitive problems (26), dysphagia (23), aphasia (16), ataxia (15), tetraparesis (5), and paraparesis (1). The mean Barthel Index at the time of admission was 35 points, whereas this value was 75 points at discharge. After the inpatient rehabilitation, 73 patients improved functionally, the status of 9 patients did not show clinically relevant changes, and 2 patients deteriorated. During the rehabilitation 10 patients required urgent interhospital transfer to brain surgery units, 9 patients continued their oncological treatment, two patients continued rehabilitation treatment at another rehabilitation unit, and after rehabilitation 73 patients were discharged to their homes. Conclusions - Inpatient rehabilitation treatment could be necessary after operation of patients with brain tumor especially when functional disorders (disability) are present. Consultation is obligatory among the neurosurgeon, rehabilitation physician and the patient to set realistic rehabilitation goals and determine place and method of rehabilitation treatment, but even at malignancies cooperation with oncological specialist also needed. Authors’ experience shows benefits of multidisciplinary rehabilitation for patients after brain tumor surgery. ]

Clinical Neuroscience

JANUARY 30, 2019

Additional value of tau protein measurement in the diagnosis of Creutzfeldt-Jakob disease

CSEH Katalin Edina, VERES Gábor, DANICS Krisztina, SZALÁRDY Levente, NÁNÁSI Nikolett, KLIVÉNYI Péter, VÉCSEI László, ZÁDORI Dénes

Since the definite diagnosis of Creutzfeldt-Jakob disease (CJD) can currently only be provided by autopsy, there is a special need for fine diagnostic tools in live patients to achieve accurate diagnosis as early as possible. The aim of this study was to perform a preliminary retrospective analysis on the utility of the measurement of total Tau (tTau) and some other biomarkers from the cerebrospinal fluid (CSF) of patients with rapidly progressive dementia in the diagnostic work up of CJD. Beside the assessment of relevant clinical data and the findings of electroencephalography and brain magnetic resonance imaging, the presence of 14-3-3 protein and the levels of tTau were determined by Western blot technique and enzyme-linked immunosorbent assay from the CSF of 19 patients diagnosed with rapidly progressive dementia between the period of 2004-2017 at the Department of Neurology, University of Szeged. This preliminary study provided 100% sensitivity for 14-3-3, and interestingly, only 40% specificity to support the clinical diagnosis of CJD. Regarding tTau, the sensitivity values were calculated to be 100% or 83%, whereas the specificity values were 71% or 86%, depending on the applied cut-off levels. The poor specificity of 14-3-3 is not in line with literature data and may be the result of the small number of patients in the cohort with non-prion disease, predominantly consisting of disorders with considerable tissue damage, whereas tTau presented good sensitivity and specificity values. The combined application of these and novel chemical biomarkers may increase both sensitivity and specificity to a desired level.