Neurology

Lege Artis Medicinae

FEBRUARY 20, 2024

[Gynaecological hormone therapy and cardiovascular risk. Part 2: menopausal hormone therapy ]

LÁSZLÓ Ádám

[Concerning cardiovascular (CV) risk, be­side hormonal contraception, menopausal hormone therapy (MHT) has a pre-eminent clinical significance. If women start MHT younger than 60 years of age, or within 10 years after their menopausal transition, the risk of coronary diseases and mortality too decreases. Conventional oral MHT slightly increases the risk of venous thromboembolism (VTE) and stroke, while transdermal admission does not it. MHT initiated in wo­men above 60, raise the risk of cardiovascular (CV) diseases, thus it is useful to start MHT at the onset of menopause syndrome signs (primarily hot flashes), preferably at a younger age. Preventing serious late complications to start and continue MHT at least until natural menopause is essential in premature ovarian insufficiency and early menopause. Below, we summa­rize the CV implications of MHT and its al­ter­native treat­ment options.]

HUN 2024;34(1-2)

Journal of Nursing Theory and Practice

DECEMBER 18, 2023

[Analysis of the Quality of Life Patients With Huntington’s Disease and Their Families In Hungary]

SZALAI Klára Szilvia, MOLNÁR Mária Judit, MOLNÁR Viktor, ÁCS Andrea

[The aim of the research study was to get a better picture of the patient’s quality of life with Huntington’s disease and their caretaker’s. One of the main topics of the investigation was the family, because taking care of a Huntington’s patient can have a big impact on their lives. Our further concern was to introduce the concept for the families and test their open mindedness, if they would take assistance from nurse graduates to make the patient’s medical journey shorter and help with their everyday life challenges. 

The cross-sectional research was done by validated tests, as well as, self-made tests which contained socio-demographic data and questions regarding the disease. The trial took place at Semmelweis University, at the Institute of Genomic Medicine and Rare Disorders in collaboration with the patients and their families. 

According to the patients, their life quality is affected more physically than their mental health. The experiment showed that the disease has a big impact on the quality of life of the family members. The family members would be more open in regards to accepting help from advanced practice nurses. 

Huntington’s disease has a negative impact on the quality of life of the patients and their families. It would be adequate to study if the provided help of advanced practice nurses could improve their quality of life. ]

HUN 2023;36(6)

Lege Artis Medicinae

DECEMBER 19, 2023

[Gynaecological hormone therapy and the cardiovascular risk. Part 1: hormonal contraception]

LÁSZLÓ Ádám

[Preventing unwanted pregnancy, and in treating many gynaecological diseases, we use hormones produced by the ovaries, namely the follicle hormone and the corpus luteum hormone, or their synthetic versions. In terms of hormonal therapies, combined oral hormonal contraception and menopausal hormone therapy are of outstanding importance. Some pharmaceuticals do not increase the cardiovascular (CV) risk, while others do it by increasing the risk of coronary diseases (primarily myocardial infarction), venous thromboembolism, and ischaemic and haemorrhagic strokes respectively. This review of concerning literature summarized the cardiovascular impact of hormonal therapies in gynaecologic practice, in two parts. The first part discusses hormonal contraception, the second one the menopausal hormone therapy.
Combined hormonal contraceptives (COC) containing follicle hormone and progestogen significantly increase the risk of ve­nous thromboembolism (VTE), however without any major clinical significance. The higher risk perceived among smoking, overweight and older women is additionally burdened by COC. Nevertheless, products containing estetrol and progesterone-only-pills do not increase the CV risk. Using COC does not increase the risk of haemorrhagic stroke, but does it slightly that of ischaemic stroke and myocardial infarction. CV side effects of hormonal ACs are not significant from a clinical point of view and are far below the complications caused by un­wanted pregnancies due to the use of im­proper contraception. This study summarized the literature data on CV risk of hormonal contraceptives. ]

HUN 2023;33(12)

Lege Artis Medicinae

DECEMBER 19, 2023

[Female specific differences of ischemic stroke and cerebral venous thrombosis]

VASTAGH Ildikó, BERECZKI Dániel

[There are female-specific characteristics also in epidemiology, emerging risk factors, acute reperfusion therapy and out­come of cerebrovascular disorders. Among classical risk factors, as hypertension, atrial fibrillation, diabetes and obesity the risk of stroke is higher in females than males. Re­cognizing female specific risk factors is indispensable not only in therapeutic but also in preventive measures. Pregnancy and puerperium increase the prothrom­botic state which results in a significantly higher incidence of ischemic stroke and cerebral venous thrombosis respectively. The treatment of acute stroke in pregnancy and puerperium is a great challenge since the concerning guidelines providing hardly any conduct in such cases. After meno­pause, there is change in prevalence and severity of cardiovascular risk factors and as a result, the stroke incidence is higher among females than males over the age of 80. Additionally, there are evidence based sex differences in the stroke outcomes. This re­view aims to improve the stroke care quality by presenting characteristic sex differences in this summary. ]

HUN 2023;33(12)

Lege Artis Medicinae

DECEMBER 19, 2023

[Digitalization in healthcare: usage habits, attitudes and needs of patients and doctors over 65 concerning digital health in Hungary]

BOROS Julianna, GIRASEK Edmond, DÖBRÖSSY Bence, GYÔRFFY Zsuzsanna

[The development of digital health has accelerated significantly in recent years, but often the most vulnerable groups, including the elderly, are missing out on the most advanced digital technologies.

In our exploratory research, a national, representative questionnaire-ba­sed patient survey of the adult Hungarian population was conducted in autumn 2021 (N=1723), 428 respondents were aged 65+. Out of the 1576 GPs completing the online survey of doctors working in Hun­gary between July 2021 and May 2022, 435 were aged 65+. The data were analysed descriptively and by cluster analysis.

While the likelihood of patients using the internet decreases with age, doctors over 65 years of age are significant daily users (88.5%). More than a third of older doctors (37.2%) and half of younger doctors (50.3%) are more likely to support their patients’ use of the internet for health purposes. Educational attainment is a de­termining factor in patients’ use of digital technologies. Virtually all of the elderly who use the internet have heard of digital health solutions and nearly 70% have used at least one type of digital communication, administration or device solution.

Although elderly pa­tients are disadvantaged in their use of digital tools, their openness to the future is encouraging: 70% of them would like to try digital technologies. Older doctors are also open to new solutions, and although they are more cautious about the benefits of digital health, there is no age gap in terms of disadvantages.]

HUN 2023;33(12)

Lege Artis Medicinae

DECEMBER 19, 2023

[The role of brain neural networks in the developing dementia: our research methods from optogenetics to artificial intelligence]

HANGYA Balázs

[In the Laboratory of Systems Neuroscience of the Institute of Experimental Medicine, our main objective is the better understanding of the brain mechanisms of cognitive functions. We investigate the nervous system basis of learning, memory, attention and decision-making not only in normal conditions but also in pathological ones, especially concerning the neurodegenerative dementias such as Alzheimer’s and Parkinson’s dis­ease. 



Our main profile is conducting animal studies, but we carry out hu­man research too in collaboration with clinical partners. We analyse multichannel, i.e. multidimensional electrophysiological signals using both classical and modern statistical methods and new and powerful machine learning algorithms. 



This study presents the activity of our team, while focusing on artificial intelligence app­lications.

]

HUN 2023;33(12)