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Journal of Nursing Theory and Practice

AUGUST 30, 2019

[The effect of whole body electrostimulation for the pelvic floor muscles ]

ARANYNÉ Molnár Tímea, NAGY Edit, DOMJÁN Andrea, FEKETE Zoltán, SURÁNYI Andrea, BÓDIS József

[The aim of the study: Few studies research the effects of trunk stabilizer muscle strengthening on pelvic floor dysfunctions. We assessed a new core strengthening method on the pelvic floor muscles. Material and method: Female patient (70 years) with stressincontinence and low back pain received the Whole Body Electric Muscle Stimulation for 10 weeks (2x25 minutes/week). The EMG (for the conditioning ability of pelvic floor muscle such as maximal isometric contraction, dynamic endurance and relaxation values), urodynamic assessment, introitus and the transabdominal ultrasound were used before and after training. Results: The patient’s the stressincontinence, low back pain and the conditioning ability of pelvic floor muscles improved. The urodynamic and ultrasounds values showed improvement in functions of the bladder neck and deep abdominal muscle. Conclusion: This method would increase the trunk stabilization and pelvic floor muscle strength of the eldery age group, which might decrease the prevalence of urinary incontinence.]

Hypertension and nephrology

DECEMBER 10, 2018

[PAX2: lotium et visus sine pace]

VIOLETTA Antal, KERTI Andrea, JÁVORSZKY Eszter, MÁTTYUS István, REUSZ György, SZABÓ Attila, VÁRKONYI Ildikó, MAKA Erika, TORY Kálmán

[The autosomal dominant papillorenal syndrome results from primarily de novo mutations of PAX2. It encodes a transcription factor expressed in the kidney, urinary tract, nervous system, eye and the ear. Its haploinsufficiency causes primarily hypoplastic and hyperreflective kidney, or other forms of CAKUT. The clinical appearance may be dominated by nephrotic-range proteinuria with focal segmental glomerulosclerosis. The renal survival rate is highly variable: most of the recognized cases lead to ESRD during the first four decades of life. PAX2 mutations cause typical optic papillary alterations, most frequently papillary dysplasia. In contrast to the name of the syndrome, one fourth of the affected patients do not develop ocular involvement. Hearing impairment is associated in less than 10% of the patients. The affected members of the five families that we identified with PAX2 loss-of-function mutations, developed end-stage renal disease during the 2-4. decades of life.]

Journal of Nursing Theory and Practice

JUNE 30, 2018

[The importance of the hand hygiene compliance development in the light of prevention of nosocomial infections]

SAJTI Anikó, CSERNUS Mariann

[Good hand hygiene is the most effective means of preventing healthcare-associated infections, as contaminated hands are the greatest risk of spreading infections. It is critical that the infection control professionals emphasise the importance of good hand hygiene practices and help the health care professionals on the five steps of hand hygiene. The author presents in the case study that the numbers of positive urinary microbiological samples were decreased with systematic hand hygiene examination with direct methods and continuous feedback of experiences among the staff of the intensive care unit. For further development four sensory, alcoholic hand scrubbers with spraying automats were fitted by the management of the unit. Data obtained directly from observation further analysis is our goal a comprehensive study for the profession, which can serve as a positive example later to launch compliance development programs in other hospitals. ]

Clinical Oncology

DECEMBER 05, 2017

[Complex therapy of bladder cancer]

LANDHERR László

[Bladder cancer is the most common malignancy involving the urinary system. Urothelial (formerly called transitional cell) carcinoma is the predominant histologic type in the developed countries, where it accounts for approximately 90 percent of all bladder cancers. The optimal management of nonmuscle invasive urothelial cancer is highly important. For patients with muscle invasive cancer the gold standard treatment is the cystectomy. If the patient unable or unwilling to undergo radical cystectomy with urinary diversion, complete TURBT combined with radiation therapy plus chemotherapy may offer an alternative bladder-sparing approach. Patients with muscle invasive disease and regional lymph node metastasis limited to the pelvis (N1-N3), but without more distant lymph node or visceral metastasis may be treated with six cycles of cisplatin-based chemotherapy followed by cystectomy or a combined-modality approach. In metastatic cases the combination chemotherapy may prolong survival and often provides palliation of symptomatic disease. Checkpoint inhibition immunotherapy has substantial clinical activity in post-chemotherapy patients and is the preferred therapy for patients who have progressed after platinumbased therapy or is not suitable for them.]

Lege Artis Medicinae

MARCH 20, 2017

[Purple urine bag syndrome]

VANDRUS Boglárka, KALABAY László, HARGITTAY Csenge, MÁRKUS Bernadett, TAMÁS Ferenc, TORZSA Péter

[Purple discoloration of an urinary catheter bag is rare and might be alarming to both patients and physicians. Purple urine bag syndrome is associated with urinary tract infections occurring in catheterized patients, generally elderly females. The urine is usually alkaline. Usually Gram-negative bacteria are detected, and tryptophan metabolism is involved in the pathogenesis. We present a case of this rare and interesting phenomenon and discuss the underlying pathogenesis. ]

Clinical Oncology

DECEMBER 10, 2015

[Non surgical treatment of urinary bladder cancer]

PIKÓ Béla, LACZÓ Ibolya

[According to our present knowledge the surgical intervention in the treatment of bladder cancer is essential, but some non-surgical treatment methods play an indispensable role as well. Super- fi cial (non-muscle-invasive) form of bladder cancer can be treated by intravesical chemotherapy or BCG instillation, radiotherapy; the muscle-invasive forms of this tumour (≥pT2a) need neoadjuvant, adjuvant chemotherapy, radiotherapy or radio-chemotherapy. In case of metastatic disease (or locally advanced, recurrent disease) the treatment regimen consist of chemotherapy (given as fi rst line or second line), palliative radiotherapy, interventional methods, radio-isotope therapy and symptoms relief drugs. We present each of the therapeutic modalities and their indications category based on the ESMO and NCCN guidelines.]

Clinical Neuroscience

JANUARY 20, 2017

Combination of severe facial and cervical vascular malformation with obstructive sleep apnea syndrome: diagnostic and therapeutic approaches

FALUDI Béla, IMRE Marianna, BÜKI András, KOMOLY Sámuel, LUJBER László

The combination of obstructive sleep apnea syndrome and vascular malformation within the head and neck region is a rare condition, and interestingly, only a few cases have recently been published. Propagation of the vascular mass to the larynx and pharynx can cause breathing and swallowing difficulties. Due to these sypmtoms, examination and initiation of appropriate therapy for such patients are indeed challenging. We reviewed the literature available and present our case of a 64 year old woman emphasizing the complaints of sleep apnea syndrome and vascular malformation of the face and neck region. Polygraphic examination detected severe obstructive sleep apnea syndrome. The MR examination of the neck revealed extensive vascular mass narrowing the pharyngo-laryngeal region, thereby causing temporal bone destruction on the right side with intracranial propagation. ENT examination demonstrated significant narrowing of the pharyngeal lumen and the laryngeal aditus caused by multiple hemangiomas. CPAP titration showed the minimalization of the apnea-hypopnea index on the effective pressure level. Regular CPAP usage resulted in diminishing a majority of the patient’s complaints. Our examination clearly demonstrates, obstructive sleep apnea syndrome coupled with significantly obstructing vascular malformation in the head and neck region can be effectively treated safely with a CPAP device, if surgical therapy is not possible. We summarized our findings and the data available in the literature to set up recommendations for the appropriate examination and therapy (including mask fit, etc.) of vascular malformations and hemangiomas causing pharyngo-laryngeal obstruction.

Clinical Neuroscience

JULY 30, 2016

[Angioneuritic edema in ischaemic stroke patients treated with rt-PA]

LOVÁSZ Rita, SAS Attila, KOLLÁR Tibor, PETERCSÁK Edina, FEKETE István, BILINSZKI Erika, VALIKOVICS Attila

[Data of our 254 patients who were treated with rt-PA between 1st of Jan, 2011 and 31st of Dec, 2014 were processed. We focused on angioneurotic oedema as allergic complication of thrombolysis which caused life threatening respiratory obstruction in two cases. We describe these two patients’ history. Out of 254 patients six (2.3%) suffered angioneurotic edema caused respiratory obstruction in two (0.90%) cases. This occurrence is approximately 1.3-5.1% in literature. Five, out of six patients who suffered from angioneurotic oedema, had been treated with ACE inhibitors or ARB before. The role of ACE inhibitors is known in metabolism of bradykinin cascade. Plasmin which present during thrombolysis, precipitates biochemical mechanisms of this potential life threatening complication. Therefore rt-PA alone can be the cause of angioedema, but it can be more frequent together with ACE inhibitors therapy.]

Lege Artis Medicinae

MARCH 20, 2016

[Possibilites of modern, evidence based prevention of recurrent cystitis]

GANYECZ Máté, KÖVES Béla, TENKE Péter

[Recurrent cystitis is a very common disease in women; every second women experiences at least one episode of acute cystitis during their lifetime, and in 20% of the cases it develops to recurrent cystitis. The disease also has a significant negative impact on quality of life. In 60% percent of the cases mild-severe depression can be shown, which can be reduced by 30-40% with the properly chosen prophylaxis. Therefore the up-to-date knowledge of the evidence based recommendations on disease management is mandatory to all clinicans dealing with this patient group. In case of a recurrent urinary tract infection treatment of the actual episode is not enough. Rather, emphasis has to be placed on appropriate prevention strategy. Alway non-antimicrobial methods has to be preferred as first choice, antibiotic prophylaxis should be considered only when the non-antimicrobials have been unsuccessful. In this review the authors summarise the evidence based management options of recurrent urinary tract infections in detail, based on the guideline recommendations of the European Association of Urology. ]