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Hargittay C, Vörös K, Eőry A, Márkus B, Szabó G, Rihmer Z, Gonda X, Torzsa P. [The association between diabetes complications and symptoms of depression and anxiety]. Orv Hetil 2023; 164:79-87. [PMID: 36681997 DOI: 10.1556/650.2023.32676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/30/2022] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The bidirectional relationship between diabetes and depression results in severe disease burden. Co-occurring depression is associated with a higher rate of diabetes complications. These complications impair quality of life, however, their impact on depressive symptoms is controversial. OBJECTIVE In our cross-sectional study, we aimed to investigate whether the presence of diabetes complications is associated with depressive and anxiety symptoms among patients with type 2 diabetes in general practice. METHOD We obtained patient history, anthropometric, socioeconomic, laboratory parameters. For symptom assessment, the Beck Depression Inventory (BDI) and the Hamilton Anxiety Scale (HAM-A) were used. We collected data between September 2018 and February 2020. RESULTS We included 338 consecutive patients with type 2 diabetes. The mean age of the sample was 63.98 ± 11.51 (years ± SD), 61.2% of participants were female. We found significant univariate association between diabetes complications and older age, less physical activity, higher body mass index, insulin therapy, higher HbA1c, higher creatinine and carbamide concentrations, worse depressive and anxiety symptoms. In multivariate analysis, diabetes complications and certain socio-demographic factors (female gender, lower education, rural-dwelling) were the determinants of higher BDI and HAM-A scores. CONCLUSION Among primary care patients with type 2 diabetes, the prevalence of depressive and anxiety symptoms was higher and more severe in patients with diabetes complications. The recommended screening for affective disorders among patients with diabetes is especially justified if complications are present. Orv Hetil. 2023; 164(3): 79-87.
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Affiliation(s)
- Csenge Hargittay
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék 1428 Budapest, Pf. 2 Magyarország
| | - Krisztián Vörös
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék 1428 Budapest, Pf. 2 Magyarország
| | - Ajándék Eőry
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék 1428 Budapest, Pf. 2 Magyarország
| | - Bernadett Márkus
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék 1428 Budapest, Pf. 2 Magyarország
| | - Georgina Szabó
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Mentális Egészségtudományok Doktori Iskola Budapest Magyarország
| | - Zoltán Rihmer
- 3 Semmelweis Egyetem, Általános Orvostudományi Kar, Pszichiátriai és Pszichoterápiás Klinika és Országos Pszichiátriai és Addiktológiai Intézet Budapest Magyarország
| | - Xénia Gonda
- 3 Semmelweis Egyetem, Általános Orvostudományi Kar, Pszichiátriai és Pszichoterápiás Klinika és Országos Pszichiátriai és Addiktológiai Intézet Budapest Magyarország
| | - Péter Torzsa
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék 1428 Budapest, Pf. 2 Magyarország
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Vörös K, Márkus B, Atzél K, Szalay F, Gráf L, Németh D, Masszi T, Torzsa P, Kalabay L. Serum fetuin-A is decreased in cirrhotic patients with Wilson's disease. PLoS One 2023; 18:e0282801. [PMID: 36881584 PMCID: PMC9990947 DOI: 10.1371/journal.pone.0282801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/23/2023] [Indexed: 03/08/2023] Open
Abstract
INTRODUCTION Wilson's disease may lead to cirrhosis, but timely medical treatment could slow down its progression. Clinical markers helping early diagnosis are essential. Decreased fetuin-A concentration has been reported in cirrhosis of different etiologies. The aim of this study was to investigate whether decreased serum fetuin-A concentration could identify patients with Wilson's disease who developed cirrhosis. MATERIALS AND METHODS In this cross-sectional study we determined the serum fetuin-A concentration of 50 patients with Wilson's disease. We analyzed the data of patients with liver involvement, comparing cirrhotic and non-cirrhotic patients. RESULTS Among patients with liver involvement those with cirrhosis had significantly lower fetuin-A and albumin level, white blood cell and platelet count. Fetuin-A negatively correlated with disease duration, bilirubin level, positively with total protein and albumin concentration, but not with copper and ceruloplasmin concentrations or markers of systemic inflammation. In multivariate analysis with fetuin-A and the Nazer score or its parameters only fetuin-A was a significant determinant of having cirrhosis. In receiver operator curve analysis among patients with liver involvement the fetuin-A level of 523 μg/ml was associated with cirrhosis with 82% sensitivity and 87% specificity. The presence of the H1069Q mutation was not associated with alteration in fetuin-A concentration. CONCLUSIONS The serum concentration of fetuin-A is a sensitive marker of liver cirrhosis in Wilson's disease, independently of the H1069Q mutation, ceruloplasmin concentration or systemic inflammation.
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Affiliation(s)
- Krisztián Vörös
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
- * E-mail:
| | - Bernadett Márkus
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Klára Atzél
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Ferenc Szalay
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - László Gráf
- Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Dániel Németh
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Tamás Masszi
- Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - László Kalabay
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
- Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
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Hargittay C, Eöry A, Márkus B, Mohos A, Ferenci T, Vörös K, Rihmer Z, Gonda X, Torzsa P. Severity of depressive but not anxiety symptoms impacts glucose metabolism among patients with type 2 diabetes in primary care. Front Med (Lausanne) 2022; 9:944047. [PMID: 35966882 PMCID: PMC9366081 DOI: 10.3389/fmed.2022.944047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/04/2022] [Indexed: 11/21/2022] Open
Abstract
Background Data from primary care regarding the prevalence of symptoms of depression and anxiety, and their effect on glycemic control among people with diabetes is lacking in Hungary. The recently introduced Patient Health Record (PHR) requires family doctors to screen for depressive symptoms. Objectives We aimed to investigate the prevalence of depressive and anxiety symptoms among patients with type 2 diabetes in the general practice, and the relationship between these affective disorders and glycated hemoglobin (HbA1c) level. Methods We included 338 consecutive patients with type 2 diabetes from six primary care practices in this cross-sectional study. A self-administered questionnaire (patient history, anthropometric, socioeconomic, laboratory parameters), the Beck Depression Inventory (BDI) and the Hamilton Anxiety Scale (HAM-A) were used. Results The mean age of the sample was 64.0 ± 11.5 (years ± SD), 61% of participants were female. The prevalence of depressive symptoms was 21%, mainly moderate/severe symptoms (13%). Anxiety symptoms were more common (35%). We found significant univariate association between the depressive symptoms and HbA1c (p = 0.001), suicide attempt (p < 0.001), anxiety (p < 0.001), micro- and macrovascular complication (p = 0.028 and p < 0.001), education (p = 0.001) and place of residence (p = 0.002). In multivariate analysis, however, only BDI score had significant (p = 0.03191) association with glycemic control. Conclusion Among primary care patients with type 2 diabetes, the prevalence of depressive symptoms was less frequent than anxiety symptoms. More severe depressive symptoms were associated with worse glycemic control.
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Affiliation(s)
- Csenge Hargittay
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Ajándék Eöry
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Bernadett Márkus
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - András Mohos
- Department of Family Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Tamás Ferenci
- Physiological Controls Research Center, Óbuda University John von Neumann Faculty of Informatics, Budapest, Hungary
- Department of Statistics, Corvinus University of Budapest, Budapest, Hungary
| | - Krisztián Vörös
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zoltán Rihmer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, Samara, Russia
- *Correspondence: Xenia Gonda,
| | - Péter Torzsa
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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Márkus B, Temesszentandrási G, Vörös K, Jakab L, Fekete B, Farkas H, Prohászka Z, Masszi T, Kalabay L. Serum fetuin-A level is independent of Helicobacter pylori postinfection status in systemic lupus erythematosus. Acta Microbiol Immunol Hung 2022. [PMID: 35446783 DOI: 10.1556/030.2022.01744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022]
Abstract
Helicobacter pylori is a common pathogen causing gastric inflammation and malignancy. Fetuin-A is a multifunctional protein that is involved in the regulation of calcification, insulin resistance and inflammation. Reports on serum levels of fetuin-A in acute H. pylori infection are contradictory. We intended to see whether H. pylori post-infection status has a long-term effect on serum fetuin-A levels in a well-characterized series of systemic lupus erythematosus cases. In this cross-sectional study 117 patients with systemic lupus erythematosus were enrolled. Helicobacter infection status and serum fetuin-A concentration were determined by ELISA and radial immunodiffusion, respectively. H. pylori positive patients had higher serum fetuin-A concentration than negative ones: 517 (456-603) vs. 476 (408-544) mg L-1, median (25-75% percentiles), P = 0.020. No other parameters differed between these groups. During univariate regression analysis fetuin-A levels were associated with Erythrocyte sedimentation rate (ESR), White blood cell count (WBC), C-reactive protein (CRP), serum total protein, albumin, and the SLEDAI index at the time of diagnosis but only serum albumin remained a significant determinant in multivariate regression study.
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Affiliation(s)
- Bernadett Márkus
- 1 Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | | | - Krisztián Vörös
- 1 Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - László Jakab
- 2 Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Béla Fekete
- 2 Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Henriette Farkas
- 2 Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
- 3 National Angioedema Center, Semmelweis University, Budapest, Hungary
| | - Zoltán Prohászka
- 2 Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
- 3 National Angioedema Center, Semmelweis University, Budapest, Hungary
| | - Tamás Masszi
- 2 Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - László Kalabay
- 1 Department of Family Medicine, Semmelweis University, Budapest, Hungary
- 2 Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
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Márkus B, Hargittay C, Iller B, Rinfel J, Bencsik P, Oláh I, Kalabay L, Vörös K. Validation of the revised Diabetes Self-Management Questionnaire (DSMQ-R) in the primary care setting. BMC Prim Care 2022. [PMCID: PMC8753895 DOI: 10.1186/s12875-021-01615-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background Available tools measuring self-management in diabetes are often improperly validated or do not correlate with glucose metabolism. The Diabetes Self-Management Questionnaire (DSMQ-R) is a valid tool, that showed strong relationship with glucose metabolism in tertiary care among people with mostly type 1 diabetes. Aim of the study To validate the translated DSMQ-R questionnaire in a Hungarian sample of people with predominantly type 2 diabetes in primary care. Methods We enrolled 492 adults from 38 practices in this cross-sectional cohort study, who filled out the self-administered questionnaire, consisting of DSMQ-R and the Summary of Diabetes Self-Care Activities (SDSCA) questionnaires. Family doctors provided clinical data. The translation process was performed in six steps, reaching the expert committee appraisal. The validity of the questionnaire was evaluated by assessing reliability and construct validity. Results Cronbach’s alpha showed the questionnaire to reach good reliability (α = 0.845), although subscales had lower alphas. Contrary to the SDSCA questionnaire, the DSMQ-R sum scale differed significantly between persons on target vs not on target (median (interquartile range): 7.23 (6.17–8.44) vs 6.91 (5.91–8.02), and the DSMQ-R sum scale correlated significantly with BMI, HbA1c and SDSCA sum scale. In multivariate analysis higher DSMQ-R scores were significant predictor of achieving glycemic target goal. Conclusion The Hungarian translation of the DSMQ-R is a comprehensible tool to assess self-management of persons with diabetes. The questionnaire is valid and reliable in family practice, although its association with achievement of diabetes HbA1c target is weaker in primary than in tertiary care.
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Hargittay C, Gonda X, Márkus B, Sipkovits Z, Vörös K, Kalabay L, Rihmer Z, Torzsa P. The relationship between anxiety and diabetes. Orv Hetil 2021; 162:1226-1232. [PMID: 34333455 DOI: 10.1556/650.2021.32169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/02/2021] [Indexed: 11/19/2022]
Abstract
Összefoglaló. A cukorbetegség és a depresszió kapcsolatáról számos tanulmány született. A szorongás és a diabetes közti összefüggést már kevesebben vizsgálták, pedig jelentős szerepük van a szorongásos kórképeknek is, hiszen nagyon gyakori a két betegség együttes előfordulása. A diabetes már önmagában is nagy betegségterhet jelent a betegek számára, a társuló pszichiátriai kórképek pedig tovább rontják a kezelés minőségét, ezért fontos a korai felismerésük és kezelésük. Jelen összefoglaló közleményünk célja a szorongásos kórképek és elsősorban a 2-es típusú cukorbetegség közti összefüggés feltárása. Több elmélet született a köztük lévő kapcsolat magyarázatára. Egyesek szerint szerepet játszhat benne a közös etiológiai háttér, mások szerint a cukorbetegség diagnózisa és a gondozásával kapcsolatos feladatok vezetnek szorongáshoz. Megint mások pedig ellentétes irányból vizsgálva a köztük lévő kapcsolatot, arra a megállapításra jutottak, hogy a szorongás különböző fiziológiai mechanizmusokon keresztül vezethet cukorbetegséghez. A szorongás és a diabetes közti kapcsolat irányától függetlenül javasolt a depresszió mellett a szorongásnak a szűrése és minél korábbi kezelése a cukorbetegek körében, így csökkennének a komorbiditásból származó szövődmények, a kezelési nehézségek, javulna a betegek életminősége és a terápiával való együttműködésük. Orv Hetil. 2021; 162(31): 1226-1232. Summary. The relationship between diabetes and depression has been evaluated in numerous studies. The association between diabetes and anxiety was less investigated, although the importance of anxiety disorders is underlined by its frequent co-occurrence with diabetes. Diabetes alone carries a significant disease burden for patients. Comorbidity with psychiatric disorders deteriorates the quality of care, therefore early treatment and diagnosis of these conditions are essential. The aim of the present review is to outline the relationship between anxiety and mainly type 2 diabetes. There are several theories to explain the relationship between them. Some researchers suggest that common etiological background may play a role in their co-occurrence, some believe that the diagnosis of diabetes and the burden of self-management lead to anxiety, while others - investigating the relationship from the opposite direction - suggest that anxiety leads to diabetes through physiological mechanisms. Independently of the direction of the relationship, screening for anxiety and timely treatment among diabetic patients may decrease the risk of complications, the difficulty in treatment arising from the co-occurrence of these two conditions and may improve patients' quality of life and adherence to therapy. Orv Hetil. 2021; 162(31): 1226-1232.
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Affiliation(s)
- Csenge Hargittay
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék, Budapest, Pf. 2, 1428
| | - Xénia Gonda
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Pszichiátriai és Pszichoterápiás Klinika és Országos Pszichiátriai és Addiktológiai Intézet, Budapest
| | - Bernadett Márkus
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék, Budapest, Pf. 2, 1428
| | - Zsófia Sipkovits
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék, Budapest, Pf. 2, 1428
| | - Krisztián Vörös
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék, Budapest, Pf. 2, 1428
| | - László Kalabay
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék, Budapest, Pf. 2, 1428
| | - Zoltán Rihmer
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Pszichiátriai és Pszichoterápiás Klinika és Országos Pszichiátriai és Addiktológiai Intézet, Budapest
| | - Péter Torzsa
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék, Budapest, Pf. 2, 1428
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Hargittay C, Márkus B, Vörös K, Tabák GÁ. [Co-occurrence of diabetes and depression, their potential bidirectional association and the significance of their screening]. Orv Hetil 2019; 160:807-814. [PMID: 31104498 DOI: 10.1556/650.2019.31400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Diabetes and depression are considered global epidemics. Both have multifactorial aetiologies, including external, environmental factors and internal factors in connection with physiological processes as well as genetic variants triggering disease onset. Although the co-occurrence of diabetes and depression is well described, the mechanisms underlying these diseases and their interactions are still not entirely revealed. The authors aimed to present known and potential explanations of the co-occurrence of these diseases and to highlight the importance of their timely diagnosis and effective treatment, as their co-occurrence may increase morbidity and mortality. Screening for depression among diabetes patients and for diabetes among patients with depression may decrease the incidence of complications and consequences of this comorbidity and may foster more effective treatment. General practitioners play a key role in the care of both diseases by providing timely diagnosis and adequate treatment potentially leading to a better quality of life, slower disease progression and decreased risk of complications. Orv Hetil. 2019; 160(21): 807-814.
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Affiliation(s)
- Csenge Hargittay
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Pf. 2, 1428
| | - Bernadett Márkus
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Pf. 2, 1428
| | - Krisztián Vörös
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Pf. 2, 1428
| | - Gy Ádám Tabák
- I. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
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Márkus B, Herszényi L, Matyasovszky M, Vörös K, Torzsa P, Rurik I, Tulassay Z, Kalabay L. The Diagnosis and Therapy of Helicobacter pylori Infection in Hungary: Comparison of Strategies Applied by Family Physicians and Internists. Dig Dis 2019; 37:434-443. [PMID: 31067529 DOI: 10.1159/000500243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/09/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND AIMS Most patients with Helicobacter pylori infection are consulted for the first time by family physicians. We aimed to survey the adherence to the newest guidelines of the management of H. pylori infection in the primary and secondary care settings in Hungary. METHODS From a total of 793 physicians, 94 trainees in family medicine, 334 family physicians without and 195 with board certification in internal medicine, 87 internists, 78 family paediatricians were invited to take part in the study. Diagnostic and therapeutic attitudes towards H. pylori infection were compared by a voluntary and anonymous questionnaire. RESULTS Participants test for H. pylori infection in 92.8% of cases with a family history of peptic ulcer or 76.9% of gastric cancer, 68.9% of dyspepsia and 49.9% of non-specific abdominal complaints, before initiation of non-steroidal anti-inflammatory drug (NSAID; 17.3%) and antiplatelet treatment (14.5%), respectively. They confirm the success of eradication therapy in 88.1% mainly by urea breath test. Most of them initiate eradication therapy by themselves and only 22.4% refer their patients to a gastroenterologist. Clarithromycin-based standard triple therapy is the most preferred (62.1%) and only 3.7% choose quadruple combination with bismuth as first-line and 48.1% as second-line therapy. We found significant differences between groups with respect to the physicians' own infection, localization of practice, and sources of information on H. pylori infection. Internists are more likely to clarify H. pylori status before the initiation of NSAID and antiplatelet therapies, initiate second-line therapies and use bismuth compared to the other groups. Family physicians with board certification in internal medicine are also prone to start eradication therapy and less prone to refer patients to a gastroenterologist. Family paediatricians prefer stool antigen determination, screen family members and prefer gastroenterologist consultation more often, and use bismuth less frequently than the other groups. Family physicians with previous infection check for H. pyloriinfection more frequently before the initiation of NSAID treatment and are more likely to use histology to detect H. pylori. Postgraduate trainings were the most popular source of information. CONCLUSION The adherence to the recent recommendations of current guidelines is moderate. There is a need to increase adherence to current recommendations by family physicians and internists.
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Affiliation(s)
- Bernadett Márkus
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - László Herszényi
- Department of Gastroenterology, Medical Centre, Hungarian Defence Forces, Budapest, Hungary,
| | | | - Krisztián Vörös
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Imre Rurik
- Department of Family Medicine and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Zsolt Tulassay
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - László Kalabay
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
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Márkus B, Veszeli N, Temesszentandrási G, Farkas H, Kalabay L. Serum fetuin-A, tumor necrosis factor alpha and C-reactive protein concentrations in patients with hereditary angioedema with C1-inhibitor deficiency. Orphanet J Rare Dis 2019; 14:67. [PMID: 30885236 PMCID: PMC6423823 DOI: 10.1186/s13023-019-0995-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/07/2019] [Indexed: 12/16/2022] Open
Abstract
Background and aims Hereditary angioedema with C1-inhibitor deficiency (C1-INH-HAE) is characterized by localized, non-pitting, and transient swelling of submucosal or subcutaneous region. Human fetuin-A is a multifunctional glycoprotein that belongs to the proteinase inhibitor cystatin superfamily and has structural similarities to the high molecular weight kininogen. Fetuin-A is also known a negative acute phase reactant with anti-inflammatory characteristics. In this study we aimed to determine serum fetuin-A, C-reactive protein (CRP) and tumor necrosis factor alpha (TNFα) concentrations in patients with C1-INH-HAE during symptom-free period and during attacks and compare them to those of healthy controls. Further we analyzed possible relationship among these parameters as well as D-dimer levels which was known as marker of HAE attacks. Patients and methods Serum samples of 25 C1-INH-HAE patients (8 men, 17 women, age: 33.1 ± 6.9 years, mean ± SD) were compared to 25 healthy controls (15 men, 10 women, age: 32.5 ± 7.8 years). Serum fetuin-A and TNFα concentrations were determined by ELISA, CRP and D-dimer by turbidimetry. Results Compared to healthy controls patients with C1-INH-HAE in the symptom-free period had significantly decreased serum fetuin-A 258 μg/ml (224–285) vs. 293 μg/ml (263–329), (median (25–75% percentiles, p = 0.035) and TNFα 2.53 ng/ml (1.70–2.83) vs. 3.47 ng/ml (2.92–4.18, p = 0.0008) concentrations. During HAE attacks fetuin-A levels increased from 258 (224–285) μg/ml to 287 (261–317) μg/ml (p = 0.021). TNFα and CRP levels did not change significantly. We found no significant correlation among fetuin-A CRP, TNFα and D-dimer levels in any of these three groups. Conclusions Patients with C1-INH-HAE have decreased serum fetuin-A concentrations during the symptom-free period. Given the anti-inflammatory properties of fetuin-A, the increase of its levels may contribute to the counter-regulation of edema formation during C1-INH-HAE attacks.
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Affiliation(s)
- Bernadett Márkus
- Department of Family Medicine, Semmelweis University, Budapest POB 2, Kútvölgyi str. 4, Budapest, H-1125, Hungary
| | - Nóra Veszeli
- Hungarian Angioedema Reference Center, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - György Temesszentandrási
- Hungarian Angioedema Reference Center, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Henriette Farkas
- Hungarian Angioedema Reference Center, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - László Kalabay
- Department of Family Medicine, Semmelweis University, Budapest POB 2, Kútvölgyi str. 4, Budapest, H-1125, Hungary. .,Semmelweis University, POB 2, Budapest, H-1428, Hungary.
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10
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Abstract
BACKGROUND Cardiovascular diseases are prominent cause of death. Lifestyle change is effective in decreasing mortality. Perception of patients' cardiovascular risk by physicians is a drive for following preventive recommendations. Whether the hazard perceived by patients influences their attitude towards lifestyle is uncertain. OBJECTIVE We hypothesized that high perceived risk would be associated with a stronger determination for lifestyle change, while incorrectly optimistic patients would be less motivated. METHODS Two hundred patients visiting their family physicians were asked to fill out a questionnaire about demographic, clinical and lifestyle characteristics, about their attitude towards lifestyle change and their estimation of their cardiovascular risk. Actual risk was estimated by family physicians based on the national guideline. RESULTS Questionnaires were completed by 80.5% (161/200) of patients approached. Patients underestimated their risk (P < 0.001), mainly because high-/very high-risk patients classified themselves into lower risk categories. The majority of patients were planning a lifestyle change, losing weight being the most popular goal. It was the priority even for some normal weight subjects and for smokers, too. Perceived risk played a marginal role as a determinant of lifestyle change. Underestimation of perceived risk had no effect on patients' motivation. Self-rated obesity was the predictor of three out of five means of change (weight loss, diet, physical activity). CONCLUSION Perceived cardiovascular risk and incorrect optimism about this hazard have minimal, if any, influence on attitude towards lifestyle change. Patients' motivation seems not to be primarily health related.
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Affiliation(s)
- Krisztián Vörös
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Bernadett Márkus
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Csenge Hargittay
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Orsolya Sisak
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - László Kalabay
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
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11
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Csősz É, Márkus B, Darula Z, Medzihradszky KF, Nemes J, Szabó E, Tőzsér J, Kiss C, Márton I. Salivary proteome profiling of oral squamous cell carcinoma in a Hungarian population. FEBS Open Bio 2018; 8:556-569. [PMID: 29632809 PMCID: PMC5881539 DOI: 10.1002/2211-5463.12391] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 12/23/2017] [Accepted: 01/15/2018] [Indexed: 12/13/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is the seventh most common malignancy and the ninth most frequent cause of cancer death in Europe. Within Europe, Hungary has one of the highest rates of OSCC incidence and mortality. Thus, there is an urgent need to improve early detection. Saliva, as a readily available body fluid, became an increasingly important substance for the detection of biomarkers for many diseases. Different research groups have identified salivary biomarkers specific for OSCC for different countries. In this study, saliva samples of Hungarian patients with OSCC were studied to discover disease‐specific and perhaps region‐specific biomarkers. LC‐mass spectrometry (MS)/MS analysis on a linear ion trap‐Orbitrap mass spectrometer was used for qualitative and quantitative salivary protein profiling. More than 500 proteins were identified from saliva by shotgun proteomics. The up‐ and downregulated proteins in the saliva of patients with OSCC highlighted the importance of protein–protein interaction networks involving the immune system and proteolysis in disease development. Two potential biomarkers from our shotgun analysis and a third candidate reported earlier by a Taiwanese group were further examined by ELISA on a larger reference set of samples. Resistin, a biomarker reported in Taiwan but not validated in our study, highlights the necessity of application of standardized analysis methods in different ethnic or geographical populations to identify biomarkers with sufficient specificity and sensitivity.
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Affiliation(s)
- Éva Csősz
- Proteomics Core Facility Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary.,Biomarker Research Group Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary
| | - Bernadett Márkus
- Proteomics Core Facility Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary.,Biomarker Research Group Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary
| | - Zsuzsanna Darula
- Laboratory of Proteomics Research Biological Research Centre of the Hungarian Academy of Sciences Szeged Hungary
| | - Katalin F Medzihradszky
- Laboratory of Proteomics Research Biological Research Centre of the Hungarian Academy of Sciences Szeged Hungary
| | - Judit Nemes
- Department of Pedodontics Faculty of Dentistry University of Debrecen Hungary
| | - Emese Szabó
- Proteomics Core Facility Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary.,Biomarker Research Group Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary
| | - József Tőzsér
- Proteomics Core Facility Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary.,Biomarker Research Group Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary
| | - Csongor Kiss
- Department of Pediatrics Faculty of Medicine University of Debrecen Hungary
| | - Ildikó Márton
- Department of Restorative Dentistry Faculty of Dentistry University of Debrecen Hungary
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12
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Abstract
INTRODUCTION The issue of gratuity is one of the most important health policy issues in Hungary. AIM The authors' aim is to investigate the attitude of Hungarian family medicine trainees towards gratitude payment. METHOD Quantitative, paper-based survey among trainees from four Departments of Family Medicine in Hungary (n = 152). RESULTS More than 50 percent of the residents do not approve of accepting gratitude money. Men (p<0.026), and graduating residents accept it significantly more often (p<0.036) while doctors with children tend to accept it more frequently (p<0.051). They think that the reason for this phenomenon is the lack of proper care (65%), vulnerability and the sense of real gratitude patients feel (52%). According to the participants, the least influencing factor was the low salary of physicians (14.4%). They believe that accepting gratuity is a corruption, and it's humiliating for doctors (80-80%). CONCLUSION Family medicine residents approve of gratitude money even less as compared to the results of previous studies, but related to other gratitude payment issues we have found similar opinions. Orv Hetil. 2017; 158(26): 1028-1035.
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Affiliation(s)
- Zsuzsa Győrffy
- Magatartástudományi Intézet, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Nagyvárad tér 4., 1089
| | - László Kalabay
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - András Mohos
- Családorvosi Intézet és Rendelő, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged
| | - Bernadett Márkus
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Anna Nánási
- Családorvosi és Foglalkozás-egészségügyi Tanszék, Debreceni Egyetem, Népegészségügyi Kar Debrecen
| | - József Rinfel
- Alapellátási Intézet, Pécsi Tudományegyetem, Orvostudományi Kar Pécs
| | - Edmond Girasek
- Egészségügyi Menedzserképző Központ, Semmelweis Egyetem, Egészségügyi Közszolgálati Kar Budapest
| | - Péter Torzsa
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
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13
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Torzsa P, Csatlós D, Eőry A, Hargittay C, Horváth F, László A, Márkus B, Mohos A, Kalabay L, Győrffy Z. [Opinions of Hungarian family physicians and residents on vocation and informal payment]. Orv Hetil 2017; 157:1438-44. [PMID: 27596511 DOI: 10.1556/650.2016.30539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The changing of the family medicine can be observed in the New Millennium. Migration, the aging of the healers and informal payment are crucial to the human resource crisis of the health sector. AIM The aim of this study was to investigate the family physicians' and residents' opinions about the vocation and informal payment. METHOD Exploratory, quantitative study was carried out among family physicians (n = 363) and family physician residents (n = 180). The central questions of the study were the vocation, the income and the informal payment. RESULTS The most decisive factors of the carrier choice were altruism, service and responsibility. Residents were significantly rejective (19.7% vs. 38.3%, p<0.001) about informal payment. They would accept smaller amounts of informal payment (14.3% vs. 8.9%, p<0.034), and would spend it on praxis development (1.4% vs.9.4% p<0.023). CONCLUSIONS The attitudes of family physicians and residents are the same in case of the vocation, but on the issue of informal payment, the two generations have different opinions. Orv. Hetil., 2016, 157(36), 1438-1444.
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Affiliation(s)
- Péter Torzsa
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Kútvölgyi út 4., 1125
| | - Dalma Csatlós
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Kútvölgyi út 4., 1125
| | - Ajándék Eőry
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Kútvölgyi út 4., 1125
| | - Csenge Hargittay
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Kútvölgyi út 4., 1125
| | - Ferenc Horváth
- Népegészségtani Intézet, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Andrea László
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Kútvölgyi út 4., 1125
| | - Bernadett Márkus
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Kútvölgyi út 4., 1125
| | - András Mohos
- Családorvosi Intézet és Rendelő, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged
| | - László Kalabay
- Családorvosi Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Kútvölgyi út 4., 1125
| | - Zsuzsa Győrffy
- Magatartástudományi Intézet, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
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14
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Márkus B, Pató Z, Sarang Z, Albert R, Tőzsér J, Petrovski G, Csősz É. The proteomic profile of a mouse model of proliferative vitreoretinopathy. FEBS Open Bio 2017; 7:1166-1177. [PMID: 28781956 PMCID: PMC5537063 DOI: 10.1002/2211-5463.12252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/02/2017] [Accepted: 05/27/2017] [Indexed: 11/24/2022] Open
Abstract
Proliferative vitreoretinopathy (PVR) develops as a complication of retinal detachment surgery and represents a devastating condition leading to serious vision loss. A good animal model that permits extensive functional studies and drug testing is crucial in finding better therapeutic modalities for PVR. A previously established mouse model, using dispase injection, was analyzed from the proteomic point of view, examining global protein profile changes by 2D electrophoresis, image analysis and HPLC–tandem mass spectrometry‐based protein identification. The easy applicability of the mouse model was used to study the role of transglutaminase 2 (TG2) in PVR formation by proteomic examination of dispase‐induced TG2 knockout vitreous samples. Our data demonstrate that, despite the altered appearance of crystallin proteins, the lack of TG2 did not prevent the development of PVR.
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Affiliation(s)
- Bernadett Márkus
- Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary
| | - Zsuzsanna Pató
- Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary
| | - Zsolt Sarang
- Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary
| | - Réka Albert
- Department of Ophthalmology Faculty of Medicine University of Szeged Hungary
| | - József Tőzsér
- Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary
| | - Goran Petrovski
- Department of Ophthalmology Faculty of Medicine University of Szeged Hungary.,Department of Ophthalmology Oslo University Hospital and University of Oslo Norway
| | - Éva Csősz
- Department of Biochemistry and Molecular Biology Faculty of Medicine University of Debrecen Hungary
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15
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Csősz É, Lábiscsák P, Kalló G, Márkus B, Emri M, Szabó A, Tar I, Tőzsér J, Kiss C, Márton I. Proteomics investigation of OSCC-specific salivary biomarkers in a Hungarian population highlights the importance of identification of population-tailored biomarkers. PLoS One 2017; 12:e0177282. [PMID: 28545132 PMCID: PMC5436697 DOI: 10.1371/journal.pone.0177282] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 04/01/2017] [Indexed: 12/19/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) accounting for about 90% of malignant oral lesions is the 6th most common malignancy worldwide. Diagnostic delay may contribute to dismal survival rate therefore, there is a need for developing specific and sensitive biomarkers to improve early detection. Hungarian population occupies the top places of statistics regarding OSCC incidence and mortality figures therefore, we aimed at finding potential salivary protein biomarkers suitable for the Hungarian population. In this study we investigated 14 proteins which were previously reported as significantly elevated in saliva of patients with OSCC. In case of IL-1α, IL-1β, IL-6, IL-8, TNF-α and VEGF a Luminex-based multiplex kit was utilized and the salivary concentrations were determined. In case of catalase, profilin-1, S100A9, CD59, galectin-3-bindig protein, CD44, thioredoxin and keratin-19, SRM-based targeted proteomic method was developed and the relative amount of the proteins was determined in the saliva of patients with OSCC and controls. After several rounds of optimization and using stable isotope-containing peptides, we developed an SRM-based method for rapid salivary protein detection. The validation of the selected potential biomarkers by ELISA revealed salivary protein S100A9 and IL-6 as useful protein biomarkers for OSCC detection improving the diagnostic accuracy for OSCC in the Hungarian population.A noninvasive diagnostic method to detect biomarkers useful for the early diagnosis of OSCC was developed. This can be an attractive strategy in screening saliva samples collected in a nation-wide multi-centric study in order to decrease morbidity, mortality, to enhance survival rate and to improve quality of life. The heterogeneity of protein biomarkers found in different ethnic groups presented in the literature highlights the importance of identification of population-tailored protein biomarkers.
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Affiliation(s)
- Éva Csősz
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, 1. Egyetem ter, Debrecen, Hungary
| | - Péter Lábiscsák
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, 1. Egyetem ter, Debrecen, Hungary
| | - Gergő Kalló
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, 1. Egyetem ter, Debrecen, Hungary
| | - Bernadett Márkus
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, 1. Egyetem ter, Debrecen, Hungary
| | - Miklós Emri
- Department of Medical Imaging, Faculty of Medicine, University of Debrecen, 1. Egyetem ter, Debrecen, Hungary
| | - Adrienn Szabó
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Debrecen, 1. Egyetem ter, Debrecen, Hungary
| | - Ildikó Tar
- Department of Periodontology, Faculty of Dentistry, University of Debrecen, 1. Egyetem ter, Debrecen, Hungary
| | - József Tőzsér
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, 1. Egyetem ter, Debrecen, Hungary
| | - Csongor Kiss
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 1. Egyetem ter, Debrecen, Hungary
| | - Ildikó Márton
- Department of Periodontology, Faculty of Dentistry, University of Debrecen, 1. Egyetem ter, Debrecen, Hungary
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16
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Csatlós D, Ferenci T, Kalabay L, László A, Hargittay C, Márkus B, Szakács Z, Torzsa P. [A családorvosok alvási apnoéval kapcsolatos ismeretei és attitűdjei. Megvalósul-e az OSAS szűrése a járművezetők egészségi alkalmasságának vizsgálata során?]. Ideggyogy Sz 2017; 70:105-113. [PMID: 29870615 DOI: 10.18071/isz.70.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background and purpose Obstructive sleep apnea syndrome (OSAS) without treatment can cause serious cardiovascular, cardiorespiratory, neurological and other complications. Family physicians have an important role in recognizing the disease. The aim of the study is to assess the knowledge and attitude of family physicians related to sleep apnea. Whether OSAS screening is realized during the general medical checkup for drivers. Methods In the cross-sectional study we used a validated OSAKA questionnaire in mandatory continuous medical education courses, supplemented with four additional questions. Results 116 family physicians and 103 family medicine residents filled out the questionnaire. Hungarian family physicians, especially male doctors lack the adequate knowledge of sleep apnea. The average score of female physicians was significantly higher than that of males (13.4±1.8 vs. 11.7±2.6, p=0.005). The more specializations the doctor has, the higher the score. Zero or one special examination holders reached 12.5±2.3 points, two special examination holders 12.7±2.2 points. three or four special examination holders reached 14.0±2.1 (p=0.05). Residents' average score was 12.1±2.4 points, which is higher than that of family doctors (p=0.012). Female residents also had higher average points than male residents (12.6±2.0 vs. 11.3±2.7; p=0.008). The size, location and type of the practice or the doctor's age did not show any statistically significant correlation with the number of points achieved. According to our regression analysis, corrected to variables in the model, we found correlation between gender and medical knowledge, but there was no correlation between age, number of specialities, body mass index and the theoretical knowledge of the doctors. In terms of attitude female GPs had higher average scores than male GPs (3.5±0.6 vs. 2.9±0.6, p<0.001). Despite the modification of the 13/1992 regulation only 39% of the practices carried out regularly the required OSAS screening as part of the medical examination for a driving licence. Conclusion Despite the high prevalence and clinical importance of OSAS, GPs often do not recognize sleep apnea and they have difficulty in treating their patients for this problem.
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Affiliation(s)
- Dalma Csatlós
- Semmelweis Egyetem, ÁOK, Családorvosi Tanszék, Budapest
| | - Tamás Ferenci
- Óbudai Egyetem, Neumann János Informatikai Kar, Élettani Szabályozások Csoport, Budapest
| | | | - Andrea László
- Semmelweis Egyetem, ÁOK, Családorvosi Tanszék, Budapest
| | | | | | | | - Péter Torzsa
- Semmelweis Egyetem, ÁOK, Családorvosi Tanszék, Budapest
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17
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Csősz É, Kalló G, Márkus B, Deák E, Csutak A, Tőzsér J. Quantitative body fluid proteomics in medicine - A focus on minimal invasiveness. J Proteomics 2016; 153:30-43. [PMID: 27542507 DOI: 10.1016/j.jprot.2016.08.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 07/27/2016] [Accepted: 08/08/2016] [Indexed: 01/07/2023]
Abstract
Identification of new biomarkers specific for various pathological conditions is an important field in medical sciences. Body fluids have emerging potential in biomarker studies especially those which are continuously available and can be collected by non-invasive means. Changes in the protein composition of body fluids such as tears, saliva, sweat, etc. may provide information on both local and systemic conditions of medical relevance. In this review, our aim is to discuss the quantitative proteomics techniques used in biomarker studies, and to present advances in quantitative body fluid proteomics of non-invasively collectable body fluids with relevance to biomarker identification. The advantages and limitations of the widely used quantitative proteomics techniques are also presented. Based on the reviewed literature, we suggest an ideal pipeline for body fluid analyses aiming at biomarkers discoveries: starting from identification of biomarker candidates by shotgun quantitative proteomics or protein arrays, through verification of potential biomarkers by targeted mass spectrometry, to the antibody-based validation of biomarkers. The importance of body fluids as a rich source of biomarkers is discussed. SIGNIFICANCE Quantitative proteomics is a challenging part of proteomics applications. The body fluids collected by non-invasive means have high relevance in medicine; they are good sources for biomarkers used in establishing the diagnosis, follow up of disease progression and predicting high risk groups. The review presents the most widely used quantitative proteomics techniques in body fluid analysis and lists the potential biomarkers identified in tears, saliva, sweat, nasal mucus and urine for local and systemic diseases.
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Affiliation(s)
- Éva Csősz
- Proteomics Core Facility, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Egyetem ter 1, 4032 Debrecen, Hungary
| | - Gergő Kalló
- Proteomics Core Facility, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Egyetem ter 1, 4032 Debrecen, Hungary
| | - Bernadett Márkus
- Proteomics Core Facility, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Egyetem ter 1, 4032 Debrecen, Hungary
| | - Eszter Deák
- Proteomics Core Facility, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Egyetem ter 1, 4032 Debrecen, Hungary; Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Egyetem ter 1, 4032 Debrecen, Hungary
| | - Adrienne Csutak
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Egyetem ter 1, 4032 Debrecen, Hungary
| | - József Tőzsér
- Proteomics Core Facility, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Egyetem ter 1, 4032 Debrecen, Hungary.
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18
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Temesszentandrási G, Vörös K, Márkus B, Böröcz Z, Kaszás E, Prohászka Z, Falus A, Cseh K, Kalabay L. Human Fetuin-A Rs4918 Polymorphism and its Association with Obesity in Healthy Persons and in Patients with Myocardial Infarction in Two Hungarian Cohorts. Med Sci Monit 2016; 22:2742-50. [PMID: 27487851 PMCID: PMC4982529 DOI: 10.12659/msm.896232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Human fetuin A (AHSG) has been associated with the development of obesity, insulin resistance, type 2 diabetes mellitus, and atherosclerosis. Observations on the role of AHSG rs4918 single-nucleotide polymorphism are contradictory. We investigated the association between variants of rs4918 and parameters of obesity, lipid status, tumor necrosis factor-α (TNFα), adipokines (adiponectin, resistin, leptin), and insulin resistance in healthy persons and in patients with previous myocardial infarction. Material/Methods This was a cross-sectional study comprising cohort 1 (81 healthy individuals) and cohort 2 (157 patients with previous myocardial infarction). We used the allele-specific KASP genotyping assay to detect rs4918 polymorphism. Results In cohort 1, G-nucleotide carriers had significantly lower serum TNFα, adiponectin, and higher leptin concentrations than in non-G carriers. These differences, however, were not observed in cohort 2. In cohort 2, G-carriers had lower BMI and waist circumferences than in non-G carriers. The G allele was more frequent among lean than obese patients (RR=1.067, 95%CI=1.053–2.651, p=0.015). An association between BMI and rs4918 polymorphism was observed among patients without diabetes (CC/CG/GG genotypes: p=0.003, G vs. non-G allele: p=0.008) but not in diabetics. In addition, a strong linearity between BMI and the CC/CG/GG genotypes (association value: 4.416, p=0.036) and the frequency of the G allele (7.420, p=0.006) could be identified. In cohort 2, non-obese, non-diabetic G-carriers still had lower BMI and waist circumferences than in non-G carriers. Conclusions The rs4918 minor variant is associated with lower TNFα and adiponectin, higher leptin levels in healthy persons, and more favorable anthropomorphic parameters of obesity in cohort 2.
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Affiliation(s)
| | - Krisztián Vörös
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Bernadett Márkus
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Zoltán Böröcz
- 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Edit Kaszás
- Department of Internal Medicine, Károlyi Sándor Municipal Hospital, Budapest, Hungary
| | - Zoltán Prohászka
- 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - András Falus
- Department of Genetics and Immunology, and Cell Sciences, Semmelweis University, Budapest, Hungary
| | - Károly Cseh
- Department of Public Health, Semmelweis University, Budapest, Hungary
| | - László Kalabay
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
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Abstract
The Shouldice operation has been increasingly applied in our department since 1996. Between 1998-2000 its proportion has achieved 58% (Lichtenstein: 30%, laparoscopy: 2%, TEPP: 3%, other: 7%). A total of 343 patients have been operated on according to Shouldice. These patients were followed for 3-5 years in the mean. So far we observed 3 recurrences corresponding to a recurrence rate of 0.9%. The recurrence rate decreased compared to a historical control group from 10 to 0.9% using the Shouldice technique instead of Bassini. We conclude from this study that the surgeon must know several surgical techniques and choose the most applicable one during operation. The overwhelming majority of cases can be resolved by the Shouldice operation. For elderly patients, the Lichtenstein operation is an appropriate alternative. For cases with large defects of the posterior wall we can choose between Lichtenstein operation, the laparoscopic procedures and transinguinal preperitoneal mesh plasty.
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Affiliation(s)
- G Pintér
- Department of General, Angio- and Septic Surgery, Lajos Markusovszky County, Hungary
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Márkus B, Pintér G. [Partial versus total gastrectomy in the surgical treatment of stomach cancer]. Magy Seb 2001; 54:361-7. [PMID: 11816133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The authors discuss some aspects of radical gastrectomy. They analyse whether there is any progress in their results in the treatment of stomach cancer in the past 5 years. They describe some aspects of total gastrectomy with regards to the need for splenectomy. During 36 years (01.07.1952-30.06.1962 and 1974-1999) 1614 patients were treated for stomach cancer. In the last two 5 year long periods (1990-1994 and 1995-1999) the number of radical operations was 106 and 114. In the second period we used laparoscopic exploration in some patients. We carried out total gastrectomies with modern suturing devices (AutoSuture Premium Plus CEEA, Proximate ILS Straight Intraluminal Stapler Endo Surgery, TA Premium) without compromising the principles of radicality using Rochard-Aesculap retractor in most patients. We tried to avoid splenectomy when possible. In the past 5 years we carried out lymphadenectomy according to the Japanese classification, excising group I and II lymph nodes. The resectability rate rose in the last 6 years compared to the previous ten year period (55.3%, 36.1%, 48.4%, 64.3%). The ratio of total gastrectomies increased from 8.6% (10 out of 106 resections) to 42.9% (49 out of 114 resections) in the two 5 year periods. Mortality for partial and total gastrectomy were 4.6% (65/3) and 6.1% (49/3). They could preserve the spleen in 32.6% of the cases. We found that laparoscopic exploration rarely influenced the operation. Partial resection in intestinal type stomach cancer should be performed, if a margin of 6 cm can be achieved. If the patient is in good general health, total gastrectomy should be performed unless the size, type and lymph node involvement of the cancer indicated otherwise. We think that increased resectability is related to both increased capabilities and better diagnostic tools. It is important to preserve the spleen where oncology principals allow.
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Affiliation(s)
- B Márkus
- Vas Megye és Szombathely Megyei Jogú Város Markusovszky Kórháza, Egyetemi Oktatókórház, Altalános Sebészeti Osztály, 9700 Szombathely, Markusovszky u. 3
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Patai A, Jakab Z, Nádasi G, Márkus B, Döbrönte Z. [Efficiency of electro-hydrothermal coagulation in the management of non-variceal upper gastrointestinal bleeding]. Orv Hetil 1998; 139:2299-304. [PMID: 9789983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
UNLABELLED The data of 596 electro-hydrothermal coagulations in nonvariceal acute gastrointestinal bleeding were retrospectively evaluated and the results were compared to a previous period in which the endoscopic hemostasis was not regularly applied. Initial hemostasis was achieved in 96.1%, the rebleeding rate was 20.5%, perforation occurred in 0.5%. Comparing the two period the need of urgent surgery decreased from 9.2% to 3.4% (p < 0.05) and the mortality from 25.4% to 12% (p < 0.01). CONCLUSION The electro-hydro-thermal coagulation is a safe and effective method in the treatment of nonvariceal gastrointestinal bleeding.
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Affiliation(s)
- A Patai
- Vas Megyei Markusovszky Kórház, Szombathely, II. Belgyógyászati Osztály
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Rakos G, Márkus B, Széll K. Cholecystectomy through a mini laparotomy alongside laparoscopic technique. Acta Chir Hung 1997; 36:286-8. [PMID: 9408377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The authors present the surgical treatment of gallstones with special instruments and technique through a mini laparotomy, as developed in Kaposvár (Hungary). Despite the fact that the widespread use of laparoscopic cholecystectomy (LC) has succeeded over open cholecystectomy (OC), in their opinion, there are some instances where cholecystectomy through a mini laparotomy (MLC) would be advantageous. Last year (1996), in the authors' department, 32 MLCs were performed in addition to 72 OCs and 176 LCs. Due to unspecified techniques and differing criteria used to define MLC, it is difficult to find any data related to this subject in the literature available. In Hungary, there are two cities--Kaposvár and Szolnok--where only MLCs are performed for the surgical treatment of gallstones. Conversely, the University hospital of Szeged and the County hospital of Békéscsaba use all three procedures i.e. OC, LC and MLC; as is the case in the authors' hospital. In the article, the pros and cons of MLC are compared to those of LC. (The MLC being more cost effective, enables quick conversion to an OC if required, and provides the surgeon with a three dimensional picture, it is also suitable for the surgical treatment of common bile duct stones. However, it is cosmetically worse, obesity can cause technical difficulties, the incidence of hernia formation is higher, and wound healing is affected.) In the authors' opinion, it would be important to establish set criteria in order to screen patients that are unsuitable for LC, and they attempt to do so in this article.
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Affiliation(s)
- G Rakos
- Department of General Surgery, Markusovszky Hospital Vas County Szombathely, Hungary
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Nagy I, Nádasi G, Széll K, Márkus B. Thoracic and lumbar sympathectomy with the application of ROMICRO mini laparotomy set. Acta Chir Hung 1997; 36:246-7. [PMID: 9408361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The authors present the use of ROMICRO set (originally developed for mini laparotomy) for thoracic and lumbar sympathectomy. They review 3 thoracic and 2 lumbar sympathectomy operations that had good effects and uneventful recoveries. The advantage of the method is that no special instruments are needed and it can be done as a conventional operation.
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Affiliation(s)
- I Nagy
- Department of Surgery Markusovszky Hospital, Vas County, Szombathely, Hungary
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Jakab Z, Döbrönte Z, Márkus B, Brittig F, Pintér G. [Early stage gastric cancer in Vas County]. Orv Hetil 1995; 136:1249-52. [PMID: 7784046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
UNLABELLED Between 1983 and 1992, 44 patients with early gastric cancer underwent operative treatment. This group comprised 13.3 percent of all patients with gastric cancer operated on during this period. Every patient underwent oesophago-gastro-duodenoscopy before operation. The indication for surgery was histologically confirmed carcinoma in 37 patients, gastric haemorrhage in 2 patients and gastric ulcer unresponsive to medical treatment in 5 patients. The gastric carcinoma was limited to the mucosa in 28 cases and involved the submucosa in 16. Five patients, one with mucosal and four with submucosal early gastric cancer had regional metastatic lymph node involvement. Life-table calculated patient survival rate at 5 years, excluding the perioperative mortality, was 79.4 percent. CONCLUSIONS 1. The prevalence of early gastric cancer proved to be similar to previously published in West-Europe and United States. 2. If early gastric cancer is limited only to the mucosa, regional metastatic lymph node is relatively rare. 3. Gastrointestinal bleeding can be the first clinical sign of early gastric cancer. 4. Therapy resistant gastric ulcer requires surgery irrespective of the histological examination of the biopsy specimen.
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Affiliation(s)
- Z Jakab
- Vas Megyei Markusovszky Kórház, Szombathely, II. Belgyógyászati Osztály
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25
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Bebök Z, Márkus B, Németh P. Prognostic relevance of transforming growth factor alpha (TGF-alpha) and tumor necrosis factor alpha (TNF-alpha) detected in breast cancer tissues by immunohistochemistry. Breast Cancer Res Treat 1994; 29:229-35. [PMID: 8049457 DOI: 10.1007/bf00666476] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The function of different growth factors in the development and progression of malignant tumors and the role of cytotoxic cytokines in the host response generated against neoplasms have been recently studied. Anti-TGF-alpha and anti-TNF-alpha monoclonal antibody families have been developed and characterized previously by our laboratory. Libraries of anti-TGF-alpha and anti-TNF-alpha monoclonal antibodies were selected for equal immunoreactivity both in native (frozen) and in formaldehyde fixed, paraffin embedded histological sections. No differences were found between native and fixed samples demonstrated in 10 cases in the present prospective study. Retrospective investigation was performed in 35 histopathological specimens of breast cancer patients detailed clinically and observed during 5 years after the surgical treatment. Correlation between TGF-alpha and/or TNF-alpha expression and clinical staging--TNM score, lymph node metastasis, tumor recurrence and survival time--was analyzed. According to our present study, the TGF-alpha positive patients had worse clinical prognosis than the TNF-alpha positive and double positive cases during long term observation.
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Affiliation(s)
- Z Bebök
- University Medical School of Pécs, Immunological and Biotechnological Laboratory, Hungary
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26
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Márkus B, Kántor E, Pintér G, Brittig F, Padányi J, Kocsis E. [Adjuvant endocrine therapy--Zitazonium--in breast cancer]. Orv Hetil 1993; 134:457-60. [PMID: 8446415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The authors deal with the problems of adjuvant therapy of breast cancer. They administrated Zitazonium in those postmenopausal women who had had positive axillary lymph nodes. In the course of analyzing the results, they calculated survival and tumor free survival with "life-table" method, while they used log-rank probe and Mantel-Haenzel X2 probe for showing significance between the diagrams. The results were favourable, but no significant variance could be shown in the group treated with Zitazonium. If lymph nodes were proved to be negative the difference between the graphs were minimal. They refer to the question of steroid receptor determination and emphasize to take into account the biological markers when projecting adjuvant therapy.
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Affiliation(s)
- B Márkus
- Altalános Sebészeti Osztály, Vas megyei Markusovszky Kórház--Szombathely
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27
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Márkus B. [Experience of a study trip to the Surgical Clinic I. of the Vienna University School of Medicine]. Orv Hetil 1988; 129:2415. [PMID: 3186247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Márkus B, Németh L, Czóbel M. [Successful use of the Gore-tex vascular prosthesis]. Orv Hetil 1981; 122:2173-4. [PMID: 7301379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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29
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Németh L, Márkus B, Gaál P, Weigl M. [Care of vascular diseases in Vas County]. Orv Hetil 1978; 119:2027-30. [PMID: 673418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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