Specialities

Infectology

Journal of Nursing Theory and Practice

AUGUST 30, 2020

[Beliefs and Misconceptions about Vaccination]

INHOFF Edina, GYERGYÁK Kinga, ILLYÉS-KOVÁCS Anita, LUKÁCS Erzsébet , TURCSÁN Judit

[Vaccination is one of the most effective public health interventions against infectious diseases, especially against vaccine-preventable paediatric diseases. However, there are parents either delaying or refusing recommended childhood vaccination due to the fear of a ‘link’ between vaccinations and autism or other diseases. Religious objection is often used as an excuse to avoid the vaccination. Opposition to vaccination dates back to the Victorian age. Since the 18th century, fear and controversy accompanied the introduction of every new vaccine. This has been compounded, in recent years, by a decreased trust in the vaccine manufacturing or distributing institutions. Although healthcare professionals are cited as the most influential source by parents and adult population on vaccine decision-making, mistrust of vaccinations is already occurs among health workers. It is important for health professionals to be well informed, to able to persuade parents and the targeted population to vaccine.]

Hypertension and nephrology

JUNE 24, 2021

[The main directions of treatment of obesity are described in VIII. Hungarian In the light of the Cardiovascular Consensus Conference]

SIMONYI Gábor, BEDROS J. Róbert

[The treatment of obesity is a complex process, the elements of which are lifestyle change (diet and exercise), psychic driving, medication and need in case of surgical treatment. The Hungarian Society of Obesitology and Movement Therapy the first half year of the weight loss program is low in carbs and elevated suggests a protein-rich diet. When designing physical activity, dynamic, aerobic (eg walking, walking, jogging, swimming, cycling, etc.) are recommended. In drug therapy, orlistat, naltrexone / bupropion, is fixed combination and liraglutide play a role. Bariatric surgery they are currently most effective in the short- and long-term treatment of obesity.]

Hypertension and nephrology

JUNE 24, 2021

[A new approach to renal osteodystrophy in the diagnosis and treatment of]

MÁCSAI Emília, SZLOVÁK Edina, DOLGOS Szilveszter

[Treatment of renal osteodystrophy (ROD) is one of the new osteoporosis recommendations requires a rethink of the current therapeutic approach. Addressing vitamin D deficiency and reducing quality of life deterioration caused by bone fractures it is also an important professional challenge in the renal insufficiency population. ROD is a classic nephrological treatment to improve the results of the newer molecular expected from better understanding of pathomechanisms and better imaging methods. Associated associations with vascular calcification are cardiovascular can help our efforts to prevent complications, a relationship with periodontal disease the importance of regular monitoring supports. In addition to phosphorus binders, vitamin D agonists and calcimimetics in the future is expected to be the resorption inhibitor denosumab, the bone-building processes supporting PTH analogues and the wider clinical use of romosozumab application.]

Hypertension and nephrology

JUNE 24, 2021

[Threshold for drug treatment of hypertension target values ​​in the most important therapeutic guidelines]

KÉKES Ede, VÁLYI Péter, NAGY Judit

[Start medication and choose the right target are crucial today - with the aging of the world’s population together - the occurrence of high blood pressure, which is clearly considered a public disease in order to curb it. This also means that the recommendations are justified age-disaggregated and segregated between 18 and 65 years old, the elderly and the very elderly hypertensives. In the latter, it is not just prevalence rate has increased significantly, but also to be reckoned with the incidence of cognitive dysfunction, physical inactivity and common comorbidities, and also with side effects due to polypragmatism. We show it with all this in mind recommendations for the most important guidelines for the treatment of hypertension - also the Hungarian Hypertension Society -, pointing to the corresponding / similar guidelines.]

Hypertension and nephrology

APRIL 29, 2021

[When should antihypertensive be taken: in the morning and/or evening? Chronopharmacotherapy of hypertension in practice]

SZAUDER Ipoly

[The circadian (24-hour) variability of blood pressure (BP) is influenced by constant and variable (external and internal) factors. With this in mind and by determining the type of hypertension with a 24-hour blood pressure monitoring (ABPM), individual chronopharmacological (chronopharmacotherapy) treatment can be planned. There are significant differences in the chronokinetics of antihypertensive drugs administered at different times. Their therapeutic range and efficacy depend significantly on their circadian timing. Although the most modern antihypertensives have a 24-hour effect, they are not able to lower blood pressure at all times. Morning intake of ACE inhibitors, ARB-s, alpha-blockers mainly affect the afternoon and early evening rise, while evening intake reduces nocturnal and morning rise. Calcium channel blockers, beta-blockers (except carvedilol and labetolol), do not affect the circadian blood pressure profile. Therefore, in nondipper hypertension or in the case of morning rise, the twice daily morning and evening administration is more effective than the single morning administration. (Usually a lower dose is sufficient in the evening.) Adequate control of nocturnal or morning blood pressure elevations can be achieved with medication taken in the evening. According to the relevant studies the conclusion is that there is no convincing evidence that the administration of BP-lowering drugs in the evening provides any significant advantage in terms of quality of BP control, prevention of target organ damage or reduction of cardiovascular events, so evening intake only is not recommended. In particular the administration of antihypertensive drugs at bedtime, especially in the case of elderly patients may cause excessive BP fall at night with increased risk of silent cerebral infarct and the myocardial ischemia in patients with coronary heart disease.]