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Clinical Oncology

SEPTEMBER 15, 2016

[Obesity and cancer]

VALTINYI Dorottya

[The role of obesity in the development of cancer is well-known from ages. However, these days we witness the explosion-like increase of obesity, globally, but mainly in the economically advanced population, and, which is even more alarming, among youngsters. The prognosis of the obesity-related cancer is rather poor, therefore, the prevention, including the screening, have outstanding importance. Unfortunately, the participation of the obes persons, especially obes women, in these programs is very low. The diagnostics and therapies should consider the special features of obesity, which are related to the magnitude, distribution, composition of fatty tissue connected to the changes in pharmacokinetics. Moreover, the problems might be complicated with obesity-associated non-tumorous severe diseases (e.g. cardiovascular, diabetes type 2).This review covers different aspects of obesity-cancer relationships, with an emphasis on everyday oncology.]

Journal of Nursing Theory and Practice

OCTOBER 30, 2016

[The analysis of influencing factors of population’s participation in colorectal screening programs]

HORVÁTHNÉ KÁNTOR Döniz Vivien

[Aim of the study: The aim of the study was to investigate the influencing factors of participation in screening programs in the population, and to make suggestions to improve the participation rate of these programs. Sample and method: The study was retrospective and not randomised. Self-administered questionnaire was applied among general practitioners’ patients in specific outpatient units of Győr (n=210). SPSS statistical program was used to analyse the data with descriptive and mathematical statistics. Results: 30 % of the sample was male and 70% was female. 50% of the respondents did not know the colorectal screening methods, and only 30% participated in one of them. The reasons of refusal to participate in a screening program were lack of symptoms and fear of the investigation. 94% of the respondents thought that they and other people in their environment could be motivated to participate in the colorectal screening programs. The most effective method was indicated as adequate information about the programs provided by GPs. Conclusions: Our results showed that the given population does not have enough information about colorectal cancer and its screening methods, and several misleading information exists among them, which is resulted in low participation rate of screening programs. ]

Lege Artis Medicinae

MARCH 20, 2017

[An analysis of the ankle-brachial index in patients with diabetes in general practice]

GALVÁCS Henrietta, HASITZ Ágnes, BALOGH Zoltán

[INTRODUCTION - Diabetic macroangiopathy is one of the most prevalent complications of chronic diabetes mellitus. In Hungary, diabetic foot diseases and atherosclerosis are the most common causes of lower limb amputations. In this paper, we aim to present the correlations between the ankle-brachial index in patients with diabetes mellitus, and risk factors such as HbA1c levels, smoking and gender, in order to prevent atherosclerosis and to facilitate its rapid diagnosis. PATIENTS AND METHODS - Ankle-brachial index (ABI) of diabetic patients was measured and statistically analysed. Our goal was to determine potential correlations between ABI and the three above mentioned risk factors. The study population consisted of patients with a known history of diabetes mellitus (n=65) who visited the general practitioner's office between July 2015 and September 2016. RESULTS - 47.69% of patients exhibited a pathological ankle-brachial index. The ankle-brachial index showed a statistically significant correlation with gender (p=0,054). There was no significant correlation between the ankle-brachial index and smoking (p=0.838) or between the ankle-brachial index and HbA1c levels (p=0.430). CONCLUSION - Our research suggests that primary care physicians should regularly assess the ankle-brachial index in diabetic patients as preclinical atherosclerosis is frequently present in this population. Regular screening can facilitate early diagnosis and reduce the risk of severe macrovascular complications.]

Clinical Neuroscience

MARCH 30, 2017

[A családorvosok alvási apnoéval kapcsolatos ismeretei és attitűdjei. Megvalósul-e az OSAS szűrése a járművezetők egészségi alkalmasságának vizsgálata során?]

CSATLÓS Dalma, FERENCI Tamás, KALABAY László, LÁSZLÓ Andrea, HARGITTAY Csenge, MÁRKUS Bernadett, SZAKÁCS ZOLTÁN, TORZSA Péter

[Objective - Obstructive sleep apnea syndrome (OSAS) without treatment can cause serious cardiovascular, cardiorespiratory, neurological and other complications. Family physicians have an important role in recognizing the disease. The aim of the study is to assess the knowledge and attitude of family physicians related to sleep apnea. Whether OSAS screening is realized during the general medical checkup for drivers. Methods - In the cross-sectional study we used a validated OSAKA questionnaire in mandatory continuous medical education courses, supplemented with four additional questions. Results - 116 family physicians and 103 family medicine residents filled out the questionnaire. Hungarian family physicians, especially male doctors lack the adequate knowledge of sleep apnea. The average score of female physicians was significantly higher than that of males (13.4±1.8 vs. 11.7±2.6, p=0.005). The more sprecializations the doctor has, the higher the score. Zero or one special examination holders reached 12.5±2.3 points, two special examination holders 12.7±2.2 points. three or four special examination holders reached 14.0±2.1 (p=0.05). Residents’ average score was 12.1±2.4 points, which is higher than that of family doctors (p=0.012). Female residents also had higher average points than male residents (12.6±2.0 vs. 11.3±2.7; p=0.008). The size, location and type of the practice or the doctor’s age did not show any statistically significant correlation with the number of points achieved. According to our regression analysis, corrected to variables in the model, we found correlation between gender and medical knowledge, but there was no correlation between age, number of specialities, body mass index and the theoretical knowledge of the doctors. In terms of attitude female GPs had higher average scores than male GPs (3.5±0.6 vs. 2.9±0.6, p<0.001). Despite the modification of the 13/1992 regulation only 39% of the practices carried out regularly the required OSAS screening as part of the medical examination for a driving licence. Conclusions - Despite the high prevalence and clinical importance of OSAS, GPs often do not recognize sleep apnea and they have difficulty in treating their patients for this problem.]

Lege Artis Medicinae

FEBRUARY 12, 2017

[Screening for depression and suicidal risk in family and general medical practice]

RIHMER Zoltán, SZILI Ilona, KALABAY László, TORZSA Péter

[According to both international and national studies the point prevalence of diagnosed major depression requiring treatment is 6-10 percent in general practice. As un­treated depression is the most important risk factor for suicide, early detection and effective management of depression (especially depression which predisposes sui-cide) are critical in prevention. According to international and national studies the re-cognition of major depression in primary care significantly contributes to the decline of suicide mortality. In our article we present two short questionnaires used for re-cognising depression and acute suicide risk and we describe their use in family/ general practice. We aim to raise awareness of the need of a systematic, nationwide sui-cide prevention programme which is supported on government level as well. ]

Lege Artis Medicinae

FEBRUARY 12, 2017

[Results of the Comprehensive Health Screening of Hungary (MÁESZ) in 2016 and comparative results of 2010-2016]

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

[In accordance with the Hungarian health strategy, the authors introduce the results of the „Comprehensive Health Screening of Hungary” (MÁESZ) as of 2016 and the comparative results of 2010-2016. It has been again found that the Hungarian population is at high medical risk from multiple perspectives. The program is supported by 68 professional-scientific societies as well as by various secretary of states and the ministry. So far it has accomplished the complex screening of 159 576 residents and informed 375 879 residents about the right lifestyle, the protection of health and prevention of diseases on the ground. ]

Clinical Oncology

DECEMBER 10, 2015

[Treatment of metastatic breast cancer – an update]

KOCSIS Judit, BÉRES Edit, HORVÁTH Zsolt

[Due to the effi cient screening and early detection most breast cancer cases are recognized today in early stage. Approximately 5% of newly detected cases have distant metastasis. In Hungary the situation is worse. Early stage disease will relapse in about 30%, mainly with distant metastasis. Metastatic breast cancer is incurable disease, except some rare, special cases. As systemic therapeutic options are developing rapidly, most breast cancer subtypes can be treated successfully and long term survival is not rare. Primary objective of the treatment is increasing overall survival and quality of life, by decreasing disease related symptoms. In this review we summarize the systemic therapeutic options of metastatic breast cancer according to the subtypes. It is recommended to use an individual treatment plan for every patient.]

Journal of Nursing Theory and Practice

APRIL 30, 2016

[Recognizing colorectal cancer, education of patients and preparing them for the stomal therapy]

TUSÓCZKI Evelin, NÉMETH Anikó

[Aim of the research: The study investigated the circumstances of the diagnosis of the disorder. The assessment of information given to patients, communication of the staff and the preparation for the stomal therapy was also part of the study. Research and sampling methods: A self-constructed questionnaire was administered during October and December of 2015. The inventory was uploaded to self-help sites for colorectal cancer patients and questionnaires were also handed out on surgical wards (N=114). Data were analysed with SPSS 22.0. Chi square, Mann-Whitney and Kruskal-Wallis tests were applied (p<0.05). Results: Colorectal cancer screening has never been attended by 81.6% of the responders. Constipation was a more frequent warning sign by women (p=0.045). The patients who received guidance from both doctors and nurses about oncology treatment were more satisfied with the information compared to those who only communicated with one person (p<0.001). The patients who could contact a stomal therapy nurse on-demand were able to handle their stomas autonomously (p=0.035). Conclusions: Information provided by more staff members help to dissolve anxiety. Contacting stomal therapy nurses on-demand should be preferred. ]

Clinical Neuroscience

SEPTEMBER 30, 2016

[Eating disorders and pregnancy - a review of literature]

DUKAY-SZABÓ Szilvia, VARGA Márta, TÚRY Ferenc

[Eating disorders are psychosomatic disorders affecting primarily women, and influence reproductive functions as well. They have an impact on ovarial cyclem fertility, course of pregnancy, process of delivery, post partum period. Moreover, some data show that they can influence the adult health status. Extensive research from the last three decades call the attention to the fact that besides the classical eating disorders (anorexia nervosa and bulimia nervosa) the newer types (e.g., orthorexia nervosa), and subclinical disorders also occur in a subgroup of pregnant women. For this reason it is of key importance that the personnel working in the territory of obstetrics and gynecology have a solid knowledge about the symptoms, screening and therapeutical opportunities, and outcome of these disorders. The review summarizes the recent research data about the relationship of eating disorders and pregnancy.]

Clinical Neuroscience

SEPTEMBER 30, 2016

Cerebral vasomotor reactivity in fibromyalgia patients and its relationship to central neuropathic pain

GULER Sibel, KURTOGLU S. Hakan, KEHAYA Sezgin, PAMUK Nuri, CELIK Yahya

Background - Cerebral vasomotor reactivity, defined as the cerebral vasculature response to hypoxia, is not wellunderstood in fibromyalgia (FM) patients. This study investigated the difference in the cerebrovascular reactivity (i.e., responsiveness to hypercapnia was evaluated by use of breath- holding index) to the breath-holding index (BHI) between patients with fibromyalgia and a group of normal controls. Methods - The study included 40 FM patients and 40 healthy subjects. Cerebrovascular reactivity was evaluated using the BHI, which is a nonaggressive, well-tolerated, real-time, reproducible screening method to study cerebral haemodynamics. Insonation depth and basal velocity were symmetrical and not significantly different between the two groups (p>0.05). All patients completed the Revised Fibromyalgia Impact Questionnaire (FIQR), Hospital Anxiety and Depression Scale (HADS), visual analogue scale (VAS), and the somatization subscale of the SCL-90-R symptom checklist. Results - The BHI ranged from 0.30 to 2.20 (mean 1.11±0.45) in the FM patients and 1.10 to 2.80 (mean 1.90±0.35) in the control group (p<0.001). Disease duration and right BHIaverage and left BHIaverage values exhibited a significant negative correlation (r=-0.877; p<0.001, r=-0.842; p<0.001, respectively). As pain and fatigue scores increased, the right BHIaverage and left BHIaverage values decreased (r=-0.431; p=0.005, r=-0.544; p<0.001, r=-0.341; p=0.031, r=-0.644; p<0.001, respectively). Conclusions - BHI values showed that cerebrovascular reactivity in FM patients decreased in comparison to healthy individuals. BHI decreased as disease duration and severity increased. Cerebrovascular reactivity decreased in FM patients, and this phenomenon should be accepted as an abnormality. Additionally, this outcome may have been the result of a mechanism responsible for central neuropathic pain.