BackgroundDespite their worldwide popularity the question of using non-conventional treatments is a source of controversy among medical professionals. Although these methods may have potential benefits it presents a problem when patients use non-conventional treatments in the perioperative period without informing their attending physician about it and this may cause adverse events and complications. To prevent this, physicians need to have a profound knowledge about non-conventional treatments.MethodsAn anonymous questionnaire was distributed among surgeons and anaesthesiologists working in Hungarian university clinics and in selected city or county hospitals. Questionnaires were distributed by post, online or in person. Altogether 258 questionnaires were received from 22 clinical and hospital departments.ResultsAnaesthesiologists and surgeons use reflexology, Traditional Chinese Medicine, herbal medicine and manual therapy most frequently in their clinical practice. Traditional Chinese Medicine was considered to be the most scientifically sound method, while homeopathy was perceived as the least well-grounded method. Neural therapy was the least well-known method among our subjects.Among the subjects of our survey only 3.1 % of perioperative care physicians had some qualifications in non-conventional medicine, 12.4 % considered themselves to be well-informed in this topic and 48.4 % would like to study some complementary method. Women were significantly more interested in alternative treatments than men, p = 0.001427; OR: 2.2765. Anaesthesiologists would be significantly more willing to learn non-conventional methods than surgeons. 86.4 % of the participants thought that non-conventional treatments should be evaluated from the point of view of evidence. Both surgeons and anaesthesiologists accept the application of integrative medicine and they also approve of the idea of teaching these methods at universities.ConclusionsAccording to perioperative care physicians, non-conventional methods should be evaluated based on evidence. They also expressed a willingness to learn about those treatments that meet the criteria of evidence and apply these in their clinical practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-016-1426-0) contains supplementary material, which is available to authorized users.

MTA-NAP B Molekuláris Neuroendokrinológiai kutatócsoport, PécsBevezetés: A nem konvencionális gyógymódok egyre emelkedő használata miatt tudnunk kell ezek igénybevételéről a perioperatív ellátás során is. Célkitűzés: A szerzők felmérték az elektív műtétre váró betegek viszonyulását a termé-szetgyógyászati módszerekhez, valamint ezek esetleges igénybevételét és az ezt befolyásoló tényezőket. Módszer: Anonim, kérdőíves felmérést végeztek a Semmelweis Egyetem, I. Sebészeti Klinikán 2014. július és 2016. április között. Eredmények: Az 519 kitöltő (21%-os válaszadás) 63,6%-a érdeklődött a nem konvencionális gyógymódok iránt. Természetgyógyászati gyógymódot a válaszadók 26,8%-a vett már igénybe: e csoportban szignifikánsan több volt a nő (p = 0,022; OR: 1,066-2,3635), a diplomás (p = 0,000315; OR: 1,3915-3,1132), a 40-49 éves (p = 0,012419; OR: 1,1451-3,2405) és a hormonális betegségben szenvedő (p = 0,039482; OR: 1,0186-5,7242). Élet-tartam-prevalenciát tekintve a hagyományos kínai orvoslás (8,9%), az alternatív mozgás-és masszázsterápia (7,5%), illetve a homeopátia (7,3%) voltak a legnépszerűbb gyógymódok. Mindössze a betegek 12,9%-a számolt be e mód-szerek használatáról kezelőorvosának. Következtetés: A sebészeti betegek érdeklődőek a természetgyógyászattal kapcsolatban, és negyedük igénybe vesz ilyen gyógymódokat, akár a perioperatív időszakban is.

Background Postoperative pulmonary complications (PPCs) are important contributors to mortality and morbidity after surgery. The available predicting models are useful in preoperative risk assessment, but there is a need for validated tools for the early postoperative period as well. Lung ultrasound is becoming popular in intensive and perioperative care and there is a growing interest to evaluate its role in the detection of postoperative pulmonary pathologies. Objectives We aimed to identify characteristics with the potential of recognizing patients at risk by comparing the lung ultrasound scores (LUS) of patients with/without PPC in a 24-h postoperative timeframe. Methods Observational study at a university clinic. We recruited ASA 2–3 patients undergoing elective major abdominal surgery under general anaesthesia. LUS was assessed preoperatively, and also 1 and 24 h after surgery. Baseline and operative characteristics were also collected. A one-week follow up identified PPC+ and PPC- patients. Significantly differing LUS values underwent ROC analysis. A multi-variate logistic regression analysis with forward stepwise model building was performed to find independent predictors of PPCs. Results Out of the 77 recruited patients, 67 were included in the study. We evaluated 18 patients in the PPC+ and 49 in the PPC- group. Mean ages were 68.4 ± 10.2 and 66.4 ± 9.6 years, respectively (p = 0.4829). Patients conforming to ASA 3 class were significantly more represented in the PPC+ group (66.7 and 26.5%; p = 0.0026). LUS at baseline and in the postoperative hour were similar in both populations. The median LUS at 0 h was 1.5 (IQR 1–2) and 1 (IQR 0–2; p = 0.4625) in the PPC+ and PPC- groups, respectively. In the first postoperative hour, both groups had a marked increase, resulting in scores of 6.5 (IQR 3–9) and 5 (IQR 3–7; p = 0.1925). However, in the 24th hour, median LUS were significantly higher in the PPC+ group (6; IQR 6–10 vs 3; IQR 2–4; p < 0.0001) and it was an independent risk factor (OR = 2.6448 CI95% 1.5555–4.4971; p = 0.0003). ROC analysis identified the optimal cut-off at 5 points with high sensitivity (0.9444) and good specificity (0.7755). Conclusion Postoperative LUS at 24 h can identify patients at risk of or in an early phase of PPCs.

BackgroundThe popularity of non-conventional treatments, especially the consumption of herbs is showing an increasing tendency all over the world. The consumption of herbal medicines might cause several complications during perioperative care.MethodsThe survey was conducted at the First Department of Surgery of Semmelweis University and focused on the demographics of patients consuming herbal medicines who had undergone elective surgery between July 1st 2014 and February 28th 2015. A one-page questionnaire, that the patients filled in individually and anonymously, was used. The response rate was 17.3 %.ResultsOut of the 390 patients who filled in the questionnaire, 7.2 % (28 patients) used herbal medicines, 3.6 % (14 patients) of them two weeks prior to their hospitalization. The other 3.6 % (14 patients) took herbal medicines sometime in the past. The majority of those who have ever consumed herbs are women (18/28), have completed secondary or tertiary education (23/28), more than half of them suffer from tumorous diseases and only a quarter of them (7/28) informed their physician about their use of herbal medication of their own accord.ConclusionsAttention must be paid to the exploration of herb consumption habits of surgery patients during the preoperative examinations in order to avoid potential side effects, complications or drug interactions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-015-0890-2) contains supplementary material, which is available to authorized users.

Bevezetés: A nem-konvencionális gyógymódokat a betegek igénye tartja fenn, és alkalmazásuk gyakran rejtve marad a családorvosuk előtt. Célkitűzés: Felmérni a családorvosok véleményét a nem-konvencionális gyógymódokról, oktatá-sukról és integrációjuk lehetőségeiről. Módszer: Önkéntes, anonim kérdőíves felmérés a Semmelweis Egyetem Család-orvosi Tanszékének két továbbképző rendezvényén. Eredmények: A 194 háziorvos (39,8%-os válaszadási arány) 14%-a rendelkezett természetgyógyász végzettséggel és egynegyedük alkalmazott ilyen módszereket. A válaszadók 45%-a állította, ők vagy családtagjaik betegség esetén igénybe vesznek ilyen gyógymódokat. Döntő többségük (91,8%) tudni akart minden, a betegeik által igénybe vett módszerről, ugyanakkor 82,5%-uk nem tartotta magát elég tájéko-zottnak a nem-konvencionális gyógymódokkal kapcsolatban. Többségük (86%) szerint a nem-konvencionális gyógy-módokat oktatni kellene az egyetemen. A női nem, húsz évnél rövidebb praxisgyakorlat és a személyes tapasztalat növelte a tanulás iránti igény valószínűségét. Következtetések: A megkérdezett családorvosok jelentős része szeretne tudni a betegeik által alkalmazott nem-konvencionális gyógymódokról, szükségesnek látná ezek oktatását az egyetemen, és speciális csoportjuk szívesen képezné magát ezen a területen. Orv. Hetil., 2015, 156(28), 1133-1139. Kulcsszavak: nem-konvencionális gyógymódok, természetgyógyászat, családorvos, integratív orvoslás, felmérésComplementary and alternative medicine from the primary care physicians' viewpoint Introduction: The patients initiate the use of complementary and alternative medicine and this often remains hidden from their primary care physician. Aim: To explore general practitioners' knowledge and attitude towards complementary and alternative medicine, and study the need and appropriate forms of education, as well as ask their opinion on integration of alternative medicine into mainstream medicine. Method: A voluntary anonymous questionnaire was used on two conferences for general practitioners organized by the Family Medicine Department of Semmelweis University. Complementary and alternative medicine was defi ned by the defi nition of the Hungarian Academy of Sciences and certifi ed modalities were all listed. Results: 194 general practitioners answered the questionnaire (39.8% response rate). 14% of the responders had licence in at least one complementary and alternative medicine modalities, 45% used complementary and alternative medicine in their family in case of illnesses. It was the opinion of the majority (91.8%) that it was necessary to be familiar with every method used by their patients, however, 82.5% claimed not to have enough knowledge in complementary medicine. Graduate and postgraduate education in the fi eld was thought to be necessary by 86% of the responders; increased odds for commitment in personal education was found among female general practitioners, less than 20 years professional experience and personal experience of alternative medicine. Conclusions: These data suggest that gen...