Gastroenterology

Journal of Nursing Theory and Practice

MAY 03, 2024

[Diabetes Mellitus and Oral Health]

TISCHLÉR Dóra, NÉMETH Anikó

[Diabetes affects the whole body, altering fundamental metabolic processes. The number of people with diabetes is gradually increasing, with a growing proportion of younger and younger people affected. While significant lifestyle changes are needed to manage diabetes, some form of medication is also essential. Often, only the importance of exercise and diet is brought to patients’ attention by professionals, overlooking the importance of oral prevention. A number of oral conditions (e.g. dry mouth, gingivitis) can occur in people with diabetes as a result of poor oral hygiene. It is important to raise awareness of these conditions and how to prevent them at all levels of healthcare.]

HUN 2024;37(2)

Lege Artis Medicinae

APRIL 30, 2024

[Menorrhagia associated with anticoagulant treatment  of young thromboembolic  female patients ]

SCHLAMMADINGER Ágota, RÁZSÓ Katalin, ILLÉS Árpád

[Venous thromboembolism can occur also at young age and needs long-term anticoagulant treatment in specific cases. How­ever, young women on anticoagulant therapy face special problems. One of the most common ones is an increasing and often heavy menstrual bleeding, which may re­sult in anaemia. All anticoagulants can provoke menorrhagia and according to the available evidence, it is mostly associated with administration of activated factor X-in­hibitors. Its management requires cooperation of gynaecologists and haematologists. Most cases are well controlled by adjusting the anticoagulant therapy, using hormonal therapy orally or via intrauterine device or administration of antifibrinolytic agents. However, some cases require surgical treatment. While caring for these pa­tients, it is essential to explore the problem by taking accurate history and adequate la­boratory tests, to modify the treatment and supplement the loss of iron alleviating this way the symptoms and improving the pa­tient’s quality of life as well. ]

HUN 2024;34(4)

Clinical Neuroscience

MARCH 30, 2024

[Thrombolysis treatment and multi- disciplinary management of central retinal artery occlusion in comparison with traditional ophthalmological treatment options ]

VAJDA Szilvia, GUNDA Bence, KNÉZY Krisztina, BARSI Péter, VARGA Csaba, MAUROVICH-HORVAT Pál, BERECZKI Dániel, NAGY Zoltán Zsolt

[The management of central retinal artery occlusion (CRAO) has long been conservative therapy with limited efficacy carried out in ophthalmology departments together with etiolo­gi­cal investigations lacking a standardised protocol. However, CRAO is analogous to ischemic central nervous system stroke and is associated with increased stroke risk, thus, systemic thrombolysis treatment and multidisciplinary management can be beneficial. Since May 2022, at Semmelweis University CRAO patients diagnosed within 4.5 hours are given intravenous thrombolysis therapy and undergo etiologic workup based on current stroke protocols. Here we report our experience with the multidisciplinary, protocol-based management of CRAO in comparison with former non-protocol based ophthalmological conservative treatment.

We reviewed CRAO patients’ data treated conservatively and with paracentesis within 6 hours at the Department of Ophthalmology between 2013 and 2022 including changes in visual acuity, neurolo­gical and cardiovascular findings compared to those in the thrombolysis project. 

Of the 78 patients receiving non-protocol care, visual improvement was seen in 37% with natural course, 47% with conservative treatment and 47% with paracentesis. Four patients had significant carotid stenosis (2 underwent endarterectomy), 1 carotid dissection, 6 cardioembolism and 1 giant cell arteritis. Of the 4 patients within 4,5 hours, 3 gave their consent to the clinical trial and were treated with thrombolysis and underwent a full etiological assessment. 
2 pa­tients had improved visual acuity, 2 pa­tients had significant carotid stenosis and underwent endarterectomy, 1 patient was started on anticoagulation for newly diagnosed atrial fibrillation.

CRAO patients presenting within 4,5 hours are rare and more patients are needed in our study to establish the efficacy of thrombolysis. However uniform protocollized evaluation helps identifying embolic sources thus, avoiding further and potentially more serious thromboembolic events.]

HUN 2024;77(3-4)

Clinical Neuroscience

MARCH 30, 2024

The effect of anesthetic blockade of greater occipital nerve during the withdrawal period of the medication overuse headache treatment

MIRAC Aysen UNSAL, TUGRUL AYDIN

Discontinuation of medication still remains a key element in the treatment of medication overuse headache (MOH), but there is no consensus on the withdrawal procedure. We aimed to share the promising results of anesthetic blockade of greater occipital nerve (GON), which can be an alternative to existing treatments during the early withdrawal period of MOH treatment.

ENG 2024;77(3-4)

Clinical Neuroscience

MARCH 30, 2024

Perineural 5% dextrose versus corticosteroid injection in non-surgical carpal tunnel syndrom treatment

OZGE OCEK, DERYA GUNER

We aimed to investigate the difference of clinical and electrophysiological improvement between perineural corticosteroid injection therapy and perineural 5% dextrose injection therapy in carpal tunnel syndrome. Total of 92 wrists that were diagnosed as mild-to-moderate idiopathic CTS and completed their follow-up were included in our study. The severity of pain, symptom severity and functional status were assessed by visual analog scale.

ENG 2024;77(3-4)

Clinical Neuroscience

MARCH 30, 2024

[Middle meningeal artery embolization to treat acute epidural haematoma, case report and literature review ]

OLÁH Benedek, OLÁH Csaba Zsolt

[The treatment of acute epidural haematoma is surgery as soon as possible, elimination of the source of bleeding and evacuation of the haematoma. In case of small epidural haematoma, strict neurological and radiological follow-up is necessary. In a significant percentage of cases, open surgery must also be performed within a few days. In case of small epidural haematomas, embolization of the middle meningeal artery is considered as an alternative solution. We review the literature on middle meningeal artery embolization and present our first treatment. Our case report is the first European report about an acute epidural haematoma which was treated by embolization of middle meningeal artery. Our case study is the first report in which a patient was treated with both open surgery and endovascular treatment for acute epidural haematoma within a year.]

HUN 2024;77(3-4)