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Artikel ; Online: Ágy melletti ultrahangvizsgálat az alapellátásban.

Xantus, Gábor / Peczelák, Patrícia / Hegyi, Krisztina / Kanizsai, Péter

2022 Band 163, Heft 52, Seite(n) 2067–2071

Abstract: It is hard to imagine a modern hospital ward without a mobile ultrasound, bedside (point-of-care) sonography (POCUS) is a technique of the 21st century, which in emergency medicine settings (for example during primary survey) might replace the ... ...

Titelübersetzung	Bedside ultrasound in adult primary care.
Abstract	It is hard to imagine a modern hospital ward without a mobile ultrasound, bedside (point-of-care) sonography (POCUS) is a technique of the 21st century, which in emergency medicine settings (for example during primary survey) might replace the stethoscope at times. In emergency medicine - which is the hospital discipline closest to primary care - bedside ultrasound is part of the routine care by now, and its use is based on evidences of thorough research. Given that the emergency outpatient population is getting closer to primary care patients both in presentation and demography, we believe that the current POCUS evidences are probably applicable to primary care as well. Based on the clinical experience gained in emergency medicine, we assume that bedside ultrasound may also be helpful in general practice reliably diagnosing certain, potentially life-threatening pathologies, reducing the length of time until definitive treatment, increasing the success rate of certain interventions, improving patients' experience, and potentially alleviating staff burnout. The present article summarizes experiences with bedside sonography in the Anglo-Saxon world and tries to find its place in the Hungarian primary care. The widespread use of bedside ultrasound, however, in the Hungarian general practice is still lagging due to numerous barriers, the most pressing of those are training, legal responsibility and financing. Regardless, we believe, that even in this early, unregulated phase, it is worth considering to introduce bedside ultrasound into daily primary care. Competent use, however, requires continuous practice; based on the average adult patient turnover in an urban Hungarian "adult only" surgery, it might take six months to gain the necessary skills to provide high level, safe patient care. Orv Hetil. 2022; 163(52): 2067-2071.
Sprache	Ungarisch
Erscheinungsdatum	2022-12-25
Erscheinungsland	Hungary
Dokumenttyp	English Abstract ; Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2022.32683
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Az e-cigarettázással összefüggésbe hozható tüdőbetegség.

Xantus, Gábor / Kanizsai, Péter

Orvosi hetilap

2020 Band 161, Heft 11, Seite(n) 413–418

Abstract: Over 1000 respiratory cases have been linked to vaping at the Centers for Disease Control and Prevention (Atlanta, GA, USA). So far at least 800 cases were confirmed as vaping-associated lung injuries (VALI) with 18 patients succumbing to the illness. To ...

Titelübersetzung	Vaping-associated lung injury.
Abstract	Over 1000 respiratory cases have been linked to vaping at the Centers for Disease Control and Prevention (Atlanta, GA, USA). So far at least 800 cases were confirmed as vaping-associated lung injuries (VALI) with 18 patients succumbing to the illness. To our present knowledge, vape fluids may contain certain compounds with toxic properties. It is not yet understood though what component or components are responsible for the cluster of cases. However, federal and state investigators are focusing on vape cartridges that likely contained cannabinoids as most patients vaped legal or illegal cannabinoids. Until recently, USA and UK public health authorities have welcomed vaping as a safer alternative to smoking. In countries where cannabis has been legalised, vaporizers became an increasingly popular form of administration, however, no human studies have been performed with vaporized cannabinoid oils, hence the safety of such device is unknown. A 2018 review concluded that although vaping might not necessarily be safe, it is still preferable for both patients and their environment to smoking cannabis. Since 2015, Hungarian, Australian and European scientific bodies have called for ban on the unregulated e-cigarettes, but encouraged future research to understand all aspects of vaping cannabinoids. Should vaping itself prove harmless, it might open new avenues for research and potential administration of medical cannabis, however, the contrary may cause landslide in the tobacco industry. Orv Hetil. 2020; 161(11): 413-418.
Mesh-Begriff(e)	Australia ; Cannabinoids/administration & dosage ; Cannabinoids/adverse effects ; Electronic Nicotine Delivery Systems ; Humans ; Lung Injury/chemically induced ; Marijuana Smoking ; Vaping/adverse effects
Chemische Substanzen	Cannabinoids
Sprache	Ungarisch
Erscheinungsdatum	2020-02-21
Erscheinungsland	Hungary
Dokumenttyp	Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2020.31671
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Az improvizációs tréningek lehetséges szerepe a kommunikáció optimalizálására a sürgősségi ellátásban.

Fekete, Judit Diána / Kanizsai, Péter László / Pótó, Zsuzsanna / Molnár, Gyula / Xantus, Gábor / Eklicsné Lepenye, Katalin

Orvosi hetilap

2023 Band 164, Heft 19, Seite(n) 739–746

Abstract: Introduction: One of the most common challenges in acute care is the time- and space-limited communication with patients, relatives and colleagues. There is ample evidence, however, that the quality of care, patient and staff satisfaction can be ... ...

Titelübersetzung	The potential role of improvisation training to optimize communication in emergency care.
Abstract	Introduction: One of the most common challenges in acute care is the time- and space-limited communication with patients, relatives and colleagues. There is ample evidence, however, that the quality of care, patient and staff satisfaction can be improved, measured and researched using simple communication tools (e.g., training). Objective: This improvement was what we focused on when carrying out voluntary participation surveys with the staff of the Department of Emergency Medicine of the Clinical Centre of the University of Pécs. Method: With the help of a trained psychologist-actor and a senior specialist in medical communication, we investigated the potential impact of applied improvisation on medical communication by testing the participants in various situations simulating communication challenges after having completed an improv-based communication training full of exercises, games and tasks. After warm-up games taken from improv, the participants completed pre-defined tasks and finished every session with discussion and self-reflective feedback. Questionnaire (Interpersonal Confidence Questionnaire - ICQ) was used to check the potentially positive impact of improvisation on emergency communication. Results: Our studies confirmed that the applied elements of medical improvisation, developing communication skills through play not only make participants more assertive and empathic, but also - after preparation - lead to a smoother and more effective exchange of information. Positive feedback from participants in the training sessions also confirms this. Discussion: Our aim is to develop an improvisation-based communication training focused specifically on acute care providers, which, based on our initial experience, could optimize communication with patients, relatives and also between professionals. Conclusion: Application of improvisational techniques in this segment of acute care studied by us might open new perspectives to improve communication. Orv Hetil. 2023; 164(19): 739-746.
Mesh-Begriff(e)	Humans ; Communication ; Emergency Medical Services ; Clinical Competence ; Surveys and Questionnaires
Sprache	Ungarisch
Erscheinungsdatum	2023-05-14
Erscheinungsland	Hungary
Dokumenttyp	English Abstract ; Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2023.32756
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Previously undiagnosed scoliosis presenting as pleuritic chest pain in the emergency department - a case series and a validating retrospective audit.

Xantus, Gabor / Burke, Derek / Kanizsai, Peter

BMC emergency medicine

2021 Band 21, Heft 1, Seite(n) 62

Abstract: Background: Chest pain is one of the commonest presenting complaints in urgent/emergency care, with a lifelong prevalence of up to 25% in the adult population. Pleuritic chest pain is a subset of high investigation burden because of a diverse range of ... ...

Abstract	Background: Chest pain is one of the commonest presenting complaints in urgent/emergency care, with a lifelong prevalence of up to 25% in the adult population. Pleuritic chest pain is a subset of high investigation burden because of a diverse range of possible causes varying from simple musculoskeletal conditions to pulmonary embolism. Case series: Among otherwise fit and healthy adult patients presenting in our emergency department with sudden onset of unilateral pleuritic chest pain, within 1 month we identified a cohort of five patients with pin-point tenderness in one specific costo-sternal joint often with referred pain to the back. All cases had apparent and, previously undiagnosed mild/moderate scoliosis. Methods: To confirm and validate the observed association between scoliosis and pleuritic chest pain, a retrospective audit was designed and performed using the hospital's electronic medical record system to reassess all consecutive adult chest pain patients. Results: The Odds Ratio for having chest pain with scoliosis was 30.8 [95%CI 1.71-553.37], twenty times higher than suggested by prevalence data. Discussion: In scoliosis the pathologic lateral curvature of the spine adversely affects the functional anatomy of both the spine and ribcage. In our hypothesis the chest wall asymmetry enables minor slip/subluxation of a rib either in the costo-sternal and/or costovertebral junction exerting direct pressure on the intercostal nerve causing pleuritic pain. Conclusion: Thorough physical examination of the anterior and posterior chest wall is key to identify underlying scoliosis in otherwise fit patients presenting with sudden onset of pleuritic pain. Incorporating assessment for scoliosis in the low-risk chest pain protocols/tools may help reducing the length of stay in the emergency department and, facilitate speedy but safe discharge with increased patient satisfaction.
Mesh-Begriff(e)	Adult ; Chest Pain/etiology ; Emergency Service, Hospital ; Humans ; Pleurisy/etiology ; Retrospective Studies ; Scoliosis/complications ; Scoliosis/diagnostic imaging
Sprache	Englisch
Erscheinungsdatum	2021-05-17
Erscheinungsland	England
Dokumenttyp	Case Reports ; Journal Article
ISSN	1471-227X
ISSN (online)	1471-227X
DOI	10.1186/s12873-021-00455-x
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: How to best handle vaccine decliners: scientific facts and psychological approach.

Xantus, Gabor Zoltan / Burke, Derek / Kanizsai, Peter

Postgraduate medical journal

2021 Band 98, Heft 1162, Seite(n) 626–632

Abstract: There is currently no curative drug therapy for COVID-19. The spread of the virus seems relentless despite the unprecedented epidemiological measures. Prevention remains the only feasible option to stop the pandemic; without population-level vaccination, ...

Abstract	There is currently no curative drug therapy for COVID-19. The spread of the virus seems relentless despite the unprecedented epidemiological measures. Prevention remains the only feasible option to stop the pandemic; without population-level vaccination, we are unlikely to regain the quality of social life and the unrestricted economy/commerce we enjoyed before. Anti-vaxxers and conspiracy theorists are seemingly oblivious to the detrimental effect of COVID-19 both at an individual and societal level. These groups have (and probably will) continue to attempt to undermine efforts to eradicate the virus despite the fact that the major reduction in morbidity/and mortality of infectious diseases of the past century was achieved through the development of vaccines and improved hygiene. Conspiracy theories are directly associated with reduced vaccine uptake and unfortunately neither anti-vaxxers nor vaccine hesitants cannot be persuaded (debunked) with logical arguments; hence, prescribers must not only be aware of the truth underlying the dense web of misinformation but must fully understand the psychological aspects as well to be able to efficiently counsel about the potential benefits and harms. Such knowledge is pivotal to help the lay public to make informed decisions about SARS CoV-2 in general and vaccination in particular; as the COVID-19 situation can probably be best controlled with mass inoculation and novel immune therapies. The lessons learnt regarding the importance of efficient communication and the adherence to the proven epidemiological measures hopefully would be leaving us better prepared for the future if challenged by novel communicable diseases of pandemic potential.
Mesh-Begriff(e)	COVID-19/prevention & control ; COVID-19 Vaccines ; Humans ; Pandemics/prevention & control ; SARS-CoV-2 ; Vaccines
Chemische Substanzen	COVID-19 Vaccines ; Vaccines
Sprache	Englisch
Erscheinungsdatum	2021-04-09
Erscheinungsland	England
Dokumenttyp	Journal Article ; Review
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2021-139835
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Patient satisfaction during the COVID-19 pandemic in an emergency department

Deák, András / Fusz, Katalin / Kanizsai, Péter

Orvosi hetilap

2020 Band 161, Heft 43, Seite(n) 1819–1823

Titelübersetzung	A COVID-19-járvány alatti betegelégedettség egy sürgősségi betegellátó osztályon.
Mesh-Begriff(e)	COVID-19 ; Coronavirus Infections/epidemiology ; Emergency Service, Hospital ; Humans ; Pandemics ; Patient Satisfaction ; Pneumonia, Viral/epidemiology
Schlagwörter	covid19
Sprache	Ungarisch
Erscheinungsdatum	2020-10-25
Erscheinungsland	Hungary
Dokumenttyp	Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2020.32037
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Actual questions about the electronic cigarette associated lung injury

Xantus, Gábor / Gyarmathy, V Anna / Kanizsai, Péter

Orvosi hetilap

2020 Band 161, Heft 31, Seite(n) 1281–1285

Abstract: The electronic cigarette and vaping associated lung injury (EVALI) syndrome was first described in the United States (US) and was presumably strongly associated with cannabinoid vaping and exposure to vitamin E acetate, an oily additive used to dilute/ ... ...

Titelübersetzung	Égető kérdések. Merre tartunk az e-cigarettázással összefüggésbe hozható tüdőbetegséggel?
Abstract	The electronic cigarette and vaping associated lung injury (EVALI) syndrome was first described in the United States (US) and was presumably strongly associated with cannabinoid vaping and exposure to vitamin E acetate, an oily additive used to dilute/cut cannabinoids vape liquids. As the case numbers were relatively low (epidemiologically) and the available data was inconsistent, several assumptions were made to explain the phenomenon. The lack of standardization of sampling, the self-reported, inhomogeneous user habits, the huge number of potential etiologies, and certain trade/legal loopholes (such as online distribution, black market penetration, or the inefficient regulatory control regarding the quantity and/or quality of ingredients/cutting agents) might question the validity of the data and the consequent conclusions. Furthermore, an interesting but by no means negligible question is the fact why no EVALI cases have been registered outside the US when electronic cigarettes and vapes have become increasingly popular worldwide. The present review seeks to answer whether vitamin E acetate is indeed the cause of this complex syndrome, what potentially non-healthcare related factors might have contributed to the rapid increase and decline in EVALI cases, and last but not least the minimum standards of safe vaping (as potential for drug delivery route for cannbinoids). Orv Hetil. 2020; 161(31): 1281-1285.
Mesh-Begriff(e)	Cannabinoids/administration & dosage ; Cannabinoids/adverse effects ; Electronic Nicotine Delivery Systems ; Humans ; Lung Injury/chemically induced ; Self Report ; United States ; Vaping/adverse effects ; Vitamin E
Chemische Substanzen	Cannabinoids ; Vitamin E (1406-18-4)
Sprache	Ungarisch
Erscheinungsdatum	2020-08-04
Erscheinungsland	Hungary
Dokumenttyp	Journal Article ; Review
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2020.31840
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Mortality benefit of crystalloids administered in 1-6 hours in septic adults in the ED: systematic review with narrative synthesis.

Xantus, Gabor Zoltan / Allen, Penny / Norman, Sharon / Kanizsai, Peter Laszlo

Emergency medicine journal : EMJ

2021 Band 38, Heft 6, Seite(n) 430–438

Abstract: Background: Based on the 2018 update of the Surviving Sepsis Campaign, the Committee for Quality Improvement of the NHSs of England recommended the instigation of the elements of the 'Sepsis-6 bundle' within 1 hour to adult patients screened positive ... ...

Abstract	Background: Based on the 2018 update of the Surviving Sepsis Campaign, the Committee for Quality Improvement of the NHSs of England recommended the instigation of the elements of the 'Sepsis-6 bundle' within 1 hour to adult patients screened positive for sepsis. This bundle includes a bolus infusion of 30 mL/kg crystalloids in the ED. Besides the UK, both in the USA and Australia, compliance with similar 1-hour targets became an important quality indicator. However, the supporting evidence may neither be contemporaneous nor necessarily valid for emergency medicine settings. Method: A systematic review was designed and registered at PROSPERO to assess available emergency medicine/prehospital evidence published between 2012 and 2020, investigating the clinical benefits associated with a bolus infusion of a minimum 30 mL/kg crystalloids within 1 hour to adult patients screened positive for sepsis. Due to the small number of papers that addressed this volume of fluids in 1 hour, we expanded the search to include studies looking at 1-6 hours. Results: Seven full-text articles were identified, which investigated various aspects of the fluid resuscitation in adult sepsis. However, none answered completely to the original research question aimed to determine either the effect of time-to-crystalloids or the optimal fluid volume of resuscitation. Our findings demonstrated that in the USA/UK/Australia/Canada, adult ED septic patients receive 23-43 mL/kg of crystalloids during the first 6 hours of resuscitation without significant differences either in mortality or in adverse effects. Conclusion: This systematic review did not find high-quality evidence supporting the administration of 30 mL/kg crystalloid bolus to adult septic patients within 1 hour of presentation in the ED. Future research must investigate both the benefits and the potential harms of the recommended intervention.
Mesh-Begriff(e)	Adult ; Crystalloid Solutions/administration & dosage ; Fluid Therapy ; Humans ; Sepsis/mortality ; Sepsis/therapy ; Time-to-Treatment
Chemische Substanzen	Crystalloid Solutions
Sprache	Englisch
Erscheinungsdatum	2021-04-15
Erscheinungsland	England
Dokumenttyp	Journal Article ; Systematic Review
ZDB-ID	2040124-3
ISSN	1472-0213 ; 1472-0205
ISSN (online)	1472-0213
ISSN	1472-0205
DOI	10.1136/emermed-2020-210298
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Antibiotics administered within 1 hour to adult emergency department patients screened positive for sepsis: a systematic review.

Xantus, Gabor / Allen, Penny / Norman, Sharon / Kanizsai, Peter

European journal of emergency medicine : official journal of the European Society for Emergency Medicine

2019 Band 27, Heft 4, Seite(n) 260–267

Abstract: Objective: The 2018 Surviving Sepsis Campaign update recommended instigating the Sepsis-6 bundle within 1 h; however, the supporting evidence is weak. The objective was to systematically review the literature to determine whether there is mortality ... ...

Abstract	Objective: The 2018 Surviving Sepsis Campaign update recommended instigating the Sepsis-6 bundle within 1 h; however, the supporting evidence is weak. The objective was to systematically review the literature to determine whether there is mortality benefit (hospital or 28/30-day survival) associated with administration of antibiotics <1 h to adult emergency department (ED) patients screened positive for sepsis using systemic inflammatory response system criteria. Methods: A systematic review and meta-analysis were conducted. Embase, CINAHL, Medline, Pubmed, Cochrane Library and grey literature were searched for articles published between 2012 and 2019. Results: From 232 identified articles, seven met the inclusion criteria. Due to the small number of articles that fit the inclusion criteria and the considerable heterogeneity (I = 92.6%, P < 0.001), only the results of the systematic review are reported. Three of the seven studies demonstrated survival benefit for patients who screened positive for sepsis who were administered antibiotics ≤1 h after presentation to the ED. Four studies reported no statistically significant improvement in survival associated with administration of antibiotics within 1 h of ED presentation. Interestingly, two studies reported worse outcomes associated with early administration of antibiotics in patients with low acuity sepsis. Conclusion: There is equivocal evidence of in-hospital or 28/30-day survival benefit associated with antibiotics administered ≤1 h after presentation to the ED for patients who screened positive for sepsis. Further research is needed to identify the exact patient group, which would truly benefit from initiation of antibiotics <1 h after ED presentation.
Mesh-Begriff(e)	Adult ; Anti-Bacterial Agents/therapeutic use ; Emergency Service, Hospital ; Humans ; Sepsis/diagnosis ; Sepsis/drug therapy
Chemische Substanzen	Anti-Bacterial Agents
Sprache	Englisch
Erscheinungsdatum	2019-12-19
Erscheinungsland	England
Dokumenttyp	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1233544-7
ISSN	1473-5695 ; 0969-9546
ISSN (online)	1473-5695
ISSN	0969-9546
DOI	10.1097/MEJ.0000000000000654
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: The role of early intravenous crystalloid bolus in adult sepsis resuscitation in the emergency department

Xantus, Gábor / Penny, Allen / Norman, Sharon E / Kanizsai, Péter László

Orvosi hetilap

2020 Band 161, Heft 39, Seite(n) 1668–1674

Titelübersetzung	A korai krisztalloidbolus előnyei felnőtt szeptikus betegek sürgősségi kezelésében.
Mesh-Begriff(e)	Adult ; Crystalloid Solutions ; Emergency Service, Hospital ; Fluid Therapy ; Humans ; Resuscitation ; Sepsis/drug therapy
Chemische Substanzen	Crystalloid Solutions
Sprache	Ungarisch
Erscheinungsdatum	2020-09-25
Erscheinungsland	Hungary
Dokumenttyp	Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2020.31864
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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