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Hypertension and nephrology

OCTOBER 23, 2019

[Non-invasive evaluation of cardiovascular risk in pediatric chronic kidney disease patients]

BÁRCZI Adrienn, DÉGI Arianna Amália, KIS Éva, REUSZ György

[Cardiovascular diseases are the leading cause of mortality and morbidity in children with chronic kidney disease (CKD). Similar to adults, children with CKD experience a high burden of traditional and uremia-associated risk factors. Recent years, several studies were published in connection with cardiovascular risk factors, patomechanism, and early markers of cardiovascular diseases. Early signs of cardiomyopathy, such as left ventricular hypertrophy or dysfunction, and markers of atherosclerosis, such as increased intima-media thickness of the carotid artery or increased wall stiffness of the aorta are frequently present in early stages of CKD in children. As prevention is important in pediatrics, the evaluation of subtle changes of the cardiovascular system provide opportunity for early treatment and that enables children to develop normally and have a better long-term quality of life. Recently, newer non-invasive cardiovascular imaging modalities have been emerged to diagnose subclinical alterations of the heart and vessels in this specific population with kidney disease. In this review, we provide an overwiev of the emerging imaging techniques used to detect early subclinical organ damage in pediatric chronic kidney disease patients.]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2019

[Focus on quality of life: Reconstruction in Vascular Surgery ]

AGÓCS Gábor, VÁRADYNÉ HORVÁTH Ágnes, SZEBENI-KOVÁCS Gyula, ROZMANN Nóra, PAKAI Annamária

[The aims of the study: The aim of our research was to gain deeper insight into the quality of life of patients after reconstructive vascular surgery of the lower limb. Material and method: The Vascuqol questionnaire survey was performed at the PTE KK Vascular Surgery Clinic on the day before the surgery and 3-6 weeks after surgery (N=54). Statistical analysis was carried out with Microsoft Office Excel 2013. Results: In summary it can be stated that following surgical intervention the quality of life of patients significantly improved, this finding ephasises the importance of invasise therapy. As the extent of pain decreased after surgery, patients’ ability to walk started to improve, as well as their overall physical state and ability to carry out certain household activities. There was also an improvement in their social life, more time was spent with family and friends. Conclusions: Although the VascuQoL-25 questionaire is senstivie device to measure quality of life, it is difficult to apply in clinical practice beacause of its length.]

Lege Artis Medicinae

JULY 20, 2019

[Epidemiology, comorbidity, etiology of depression and cardiovascular diseases]

PÉTER László, RIHMER Zoltán

[Psychiatric problems are a common comorbid condition in patients with cardiovascular disease. Depression is a well-known risk factor for the development of cardiovascular disease and mortality too. Psychiatric and cardiovascular diseases are prevalent public health problems in the western world. Depression is associated with endo­thelial dysfunction and increased platelet aggregation, which may explain the consequent cardiovascular complications. Specific affective temperaments may be associated with special cardiovascular diseases. Antidepressant therapy does not only reduce depression but also cardiac mortality.]

Lege Artis Medicinae

JULY 20, 2019

[How many cardiovascular events can be avoided by a lipid lowering therapy based on preventive guidelines?]

MÁRK László

[The lipid lowering therapy became one of the most important elements in the cardiovascular prevention, yet it is not appropriately evaluated neither by the doctors, nor by the patients. The lipid goal attainment should to be improved according to Hungarian and international data. Using a recommendation guided lipid lowering therapy the most benefit can be expected in the patients at very high risk who alrea­dy had a cardiovascular event, where the LDL-cholesterol goal is 1.8 mmol/L. Calculating upon the data of 170000 patients of Cholesterol Treatment Trialists’ Collaboration a decrease of LDL-cholesterol level from 2.5 mmol/L to 1.8 in 100 patients in 10 years would avoid 3 myocardial infarctions, strokes or death, lowering that from 3.5 mmol/L to the goal would prevent these 3 events within 5 years. Using the traditional LDL-cholesterol lowering medication, high dose statin and ezetimibe, if the attitude of doctors and the compliance of patients would be ideal, the 1.8 mmol/L goal attainment rate would be over 80%. Unfortunately, up to now the reimbursed administration of ezetimibe in Hungary is still bound to a specialist’s recommendation, adding it to any dose of any statin an additional 20% LDL-cholesterol can be expected. The reimbursed administration of PCSK9-inhibitors is possible only based on a special request to National Health Insurance Fund. To achieve a better national cardiovascular morbidity and mortality the attitude of the doctors and the adherence of the patients to the lipid lowering therapy should be improved (it’s the goal of the present paper as well).]

Thrombosis management

APRIL 17, 2019

[Rivaroxaban with or without aspirin in stable cardiovascular disease ]

EIKELBOOM JW, CONNOLLY SJ, BOSCH J, DAGENAIS GR, HART RG, SHESTAKOVSKA O, DIAZ R, ALINGS M, LONN EM, ANAND SS, WIDIMSKY P, HORI M, AVEZUM A, PIEGAS LS, BRANCH KRH, PROBSTFIELD J, BHATT DL, ZHU J, LIANG Y, MAGGIONI AP, LOPEZ-JARAMILLO P, O’DONNELL M

Thrombosis management

APRIL 17, 2019

[Impact of polyvascular disease on patients with atrial fibrillation: Insights from ROCKET AF]

CHEN ST, HELLKAMP AS, BECKER RC, BERKOWITZ SD, BREITHARDT G, FOX KAA, HACKE W, HALPERIN JL, HANKEY GJ, MAHAFFEY KW, NESSEL CC, PICCINI JP, SINGER DE, PATEL MR.