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Lege Artis Medicinae

SEPTEMBER 20, 2017

[Cardiovascular screening and risk stratification]

VÉRTES András

[Cardiovascular diseases are still leading cause of death in developed countries. A possible background, atherosclerosis, might appear even in childhood, and deteriorate during the years without any symptoms. The cardiovascular prevention is a complex activity, which can be observed in population or/and in individual level. The conventional screening means the assessment of higher cholesterol level, blood pressure or other risk factors in healthy population without symptoms. The point of clinical risk evaluation is to find patient with high cardiovascular risk and consequentially with the necessity of intensive preventive strategy. For the right cardiovascular screening and adequate evaluation of the risk, it is needed that the doctors who frequently meet with the population execute the above-mentioned risk assessment. Therefore doctors, nurses, and education for preventive aspect would is needed, as education is important to decrease cardiovascular mortality for those patients that were categorized as a high-risk group.]

Journal of Nursing Theory and Practice

APRIL 30, 2017

[An examination of knowledge about cervical cancer Roma women in Hungary]

BOGDÁNNÉ BASA Eszter, VAJDA Réka, VÁRADYNÉ HORVÁTH Ágnes, KARÁCSONY Ilona, PAKAI Annamária

[The aim of our study was to assess the main reasons for romany women to stay away from cervical cancer screening and knowledge about cervical cancer. Methods: We carried out a quantitative, cross-sectional study with non-probability convenience sampling in 2016. Our sample consists of romany women living in the agglomeration of Nagyatád, Hungary (N=126). In the questionnaire we measured reasons for non-attendance and knowledge. During statistical analysis we calculated descriptive statistics, χc2-test and t-test (p<0,05). Results: Mean age of responders is 37,45±12,05 years. 26,2% of women have not attended any kind of gynecological screening in their life. Mean age of women when they attended for screening for the first time was 24,05±8,96 years (n=91). Main score of the knowledge test is 31,4±3,93 points. According to knowledge level there is no connection between attendants and non-attendants(p>0,05). Conclusions: The lack of knowledge determines the participating willingness, to increase has been possible by organized knowledge transmitter performances.]

Clinical Neuroscience

SEPTEMBER 30, 2017

[Diabetes, dementia, depression, distress]

SZATMÁRI Szabolcs, ORBÁN-KIS Károly, MIHÁLY István, LÁZÁR Alpár Sándor

[The number of people living with diabetes continues to rise. Therefore neurologists or other health care practitioners may be increasingly faced with comorbid neuropsychiatric disorders commonly presented by diabetic patients. More recently there has been an increasing research interest not only in the interactions between diabetes and the nervous system, the fine structure and functional changes of the brain, but also in the cognitive aspects of antidiabetic treatments. Patients with both types of diabetes mellitus may show signs of cognitive decline, and depression. Comorbid insomnia, anxiety, and distress may also occur. The bi-directional relationships between all these phenomena as well as their connection with diabetes can lead to further health and quality of life deterioration. Therefore it is important that all practitioners involved in the care of diabetic patients recognize the presence of comorbid neuropsychiatric disturbances early on during the healthcare process. Identifying higher risk patients and early screening could improve the prognosis of diabetes and may prevent complications.]

Hypertension and nephrology

SEPTEMBER 10, 2017

[Sex-specific clinical and exercise based risk assessment of the total mortality risk]

KÉKES Ede

[In both sexes combining different types clinical questionnaire and results of exercise test in a point system can more reliably predict 10 years mortality or survival. The method in both sexes is reliably suitable for the screening of highly endangered individuals in everyday practice.]

Lege Artis Medicinae

JULY 20, 2017

[Relationship between adipokinome and lipid parameters in Hungarian obese patients]

LŐRINCZ Hajnalka

[Since the prevalence of obesity has been dramatically increasing worldwide, a better understanding of obesity-related comorbidities leading to carbohydrate and lipid metabolism disorders has become essential. As an active endocrine organ, white adipose tissue secretes adipokines with diverse biological functions. We have found strong correlations between serum chemerin level and atherogenic lipoprotein sub-fractions in obese non-diabetic patients. To better characterize obese patients with and without manifest insulin resistance, we plan to determine serum levels of novel adipokines (omentin-1, vaspin, visfatin, lipocalin-2 and plasminogen activator inhibitor-1) and various oxidative stress markers including paraoxonase-1 activity, tumor necrosis factor-alfa and interleukin-6 levels, as well as low- and high-density lipoprotein subfractions in them and compare their data with lean individuals. We plan to determine correlations between the levels of novel adipokines and oxidative stress markers and lipoprotein subfractions. Furthermore, based upon our previous observations, we plan to study the potential alterations in the adipokine profile and the ratios of lipoprotein subfractions during a 5-year follow-up in obese patients. Our expected results may help to characterize the involvement of the adipokine profile in the regulation of lipoprotein metabolism. Early screening and treatment of lipid abnormalities may help to reduce the risk of cardiovascular events in obesity. ]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2017

[Obstructive sleep apnea syndrome: how we screen and diagnose?]

ANNUS János, CSATLÓS Dalma, SZAKÁCS ZOLTÁN

[The obstructive sleep apnea syndrome (OSAS) is known to cause obstructive apneas and hypopneas mostly with desaturations and/or arousals caused by repetitive collapse of the upper airway system during sleep. The disorder negatively affects sleep efficacy and daytime neurocognitive functions as well as increases cardiovascular risks. The typical clinical presentation is excessive daytime sleepiness and loud snoring interrupted by brief pauses of breathing. Its prevalence is 2-4% in the general population. It may be a causative factor in some disorders such as therapy resistant hypertension, nocturnal cardiac arrhythmias, stroke, cognitive decline or depression. Significance of the disorder is highlighted by the fact that its risk must be evaluated by the family doctors during the examination of medical suitability for driving licence in Hungary. ]

Clinical Neuroscience

JULY 30, 2017

Validation of the Hungarian version of the Test Your Memory

KOLOZSVÁRI Róbert László, KOVÁCS György Zoltán, SZŐLLŐSI József Gergő, HARSÁNYI Szilvia, FRECSKA Ede, ÉGERHÁZI Anikó

Concerns regarding the projected prevalence of Alzheimer’s disease (AD) over the next several decades have stimulated a need for the detection of AD in its earliest stages. A self-administered cognitive test (Test Your Memory, TYM) is designed as a short, cognitive screening tool for the detection of AD. Our aim was to validate the Hungarian version of the Test Your Memory (TYM-HUN) test for the detection of AD. The TYM-HUN was applied in case of individuals aged 60 years or more, 50 patients with AD and 50 healthy controls were recruited into the study. We compared the diagnostic utility of the Hungarian version of the TYM in AD with that of the Mini-Mental State Examination (MMSE). The sensitivity and specificity of the TYM-HUN in the detection of Alzheimer’s disease were determined. The patients with AD scored an average of 15.5/30 on the MMSE and 20.3/50 on the TYM-HUN. The average score achieved by the members of the healthy control group was 27.3/30 on the MMSE and 42.7/50 on the TYM. The total TYM-HUN scores significantly correlated with the MMSE scores (Spearman’s rho, r=0.8830; p<0.001). Multivariate logistic regression model demonstrated that a one-point increase in the TYM score reduced the probability of having AD by 36%. The optimal cut-off score on the TYM-HUN was 35/36 along with 94% sensitivity and 94% specificity for the detection of AD. The TYM has a much wider scoring range than the MMSE and is also a suitable screening tool for memory problems, furthermore, it fulfils the requirements of being a short cognitive test for the non-specialists. The TYM-HUN is useful for the detection of Alzheimer’s disease and can be applied as a screening test in Hungarian memory clinics as well as in primary care settings.

Hypertension and nephrology

MAY 20, 2017

[Prevalence of isolated systolic hypertension in our country]

KÉKES Ede, BARNA István, DAIKI Tenno, DANKOVICS Gergely, KISS István

[Prevalence of hypertension over the age of 56 is increasing in size and a significant proportion (60-80%) of isolated systolic hypertension. Within the population screening in the older age groups - in the light of economic development - 25-40% of the prevalence. We have an opportunity to analyse the prevalence and specificity of isolated systolic hypertension from age 36 to age 10 years on the base of 7 years data of the MÁESZ (Comprehensive Health Protection Screening Program of Hungary 2010- 2020) survey. Between 56-65 years 23.27-24.23% (male/female) 66-75 years 34,89-33,15% and over 76 years 44.04-41.5% occurrence was found. Divergence of systolic and diastolic pressure has begun since 36 years. Pulse pressure was used to separate individuals with varying degree of vascular disorders.]

Clinical Neuroscience

MAY 30, 2017

Case report of a woman with anti amphiphysin positive stiff person syndrome

MANHALTER Nóra, GYÖRFI Orsolya, BOROS Erzsébet, BOKOR Magdolna, FAZEKAS Ferenc, DÉNES Zoltán, FABÓ Dániel, KAMONDI Anita, ERÕSS Loránd

Stiff person syndrome is a rare neuroimmunological disease, characterized by severe, involuntary stiffness with superimposed painful muscle spasms, which are worsened by external stimuli. The classical form is associated with high levels of antibodies against glutamic acid decarboxylase. One of the variant forms is associated with antibodies against amphiphysin. This entity is a paraneoplastic syndrome, caused primarily by breast cancer, secondarily by lung cancer. Symptomatic therapy of anti amphiphysin positive stiff person syndrome includes treatment with benzodiazepines and baclofen (including intrathecal baclofen therapy). The effect of immunological therapies is controversial. Treatment of the underlying cancer may be very effective. In this report, we describe a 68 year old female presenting with an unusally rapidly developing anti amphiphysin positive stiff person syndrome, which was associated with breast cancer. Her painful spasms abolished after intrathecal baclofen treatment was initiated. Her condition improved spontaneously and significantly after cancer treatment, which enabled to start her complex rehabilitation and the simultaneous dose reduction of the intrathecal baclofen. The bedridden patient improved to using a rollator walker and the baclofen pump could be removed 18 monthes after breast surgery. This highlights the importance of cancer screening and treatment in anti amphiphysin positive stiff person syndrome cases.