Validation of the Hungarian version of the Prolapse and Incontinence Knowledge Questionnaire (PIKQ)

Objective

The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) is a self-administered, reliable and valid instrument which assess knowledge regarding urinary incontinence and pelvic organ prolapse. There is no validated Hungarian version of this questionnaire; therefore the aim of this study was to develop a reliable, valid and culturally sensitive Hungarian version of the PIKQ.

Study design

A cross-sectional study was conducted from March to October 2022 with a sample of 459 women. The PIKQ, which consists of the urinary incontinence and pelvic organ prolapse scales, was translated into Hungarian in accordance with international guidelines. The validity and reliability of the final version of the Hungarian PIKQ was evaluated using construct validity, comparison with known-groups, internal consistency and test-retest reliability.

Results

Regarding construct validity, all fit indices were found acceptable. Healthcare workers had significantly higher knowledge about urinary incontinence and pelvic organ prolapse (p < 0.001) compared to women who had not worked in a medical field. The Hungarian PIKQ had an adequate internal consistency with Cronbach alpha of 0.785 for the urinary incontinence scale and 0.826 for the pelvic organ prolapse scale. The correlation coeffcients between the test and retest was 0.931 for the urinary incontinence scale and 0.964 for the pelvic organ prolapse scale.

Conclusion

The Hungarian version of the PIKQ is a reliable and valid tool to measure the level of knowledge about urinary incontinence and pelvic organ prolapse among Hungarian speaking women.

Translation and Validation of the Premenstrual Assessment Form-Short Form Questionnaire in Hungarian

Introduction

Premenstrual symptoms, including premenstrual syndrome and its more severe form premenstrual dysphoric disorder, are a set of somatic and psychological symptoms that occur during the luteal phase of the menstrual cycle. Our research aimed to adapt the Hungarian version of the Premenstrual Assessment Form-Short Form (PAF-SF), a questionnaire suitable for assessing premenstrual symptoms, and to examine its reliability, validity, and applicability.

Methods

The questionnaire was validated according to Beaton's six-step guidelines. Our sample consisted of 198 menstruating women, 50 of whom completed the instrument for a second time to assess reliability. Descriptive statistics were calculated presenting mean (standard deviation), the internal consistency was measured by Cronbach's alpha value, the test-retest reliability using intraclass correlation coefficients, Spearman rank correlation was applied to test the criterion validity of the questionnaire, and discriminant validity was examined using the independent-sample t test using IBM SPSS 28.0 software. The structural validity was evaluated by confirmatory factor analysis (CFA) using IBM AMOS 29.0 software. The level of significance was set at p < 0.05.

Results

Our sample (average age 25.37 ± 4.80 years) scored 28.08 ± 9.49 points out of the maximum 60 points when filling out the PAF-SF questionnaire. The result of Cronbach's alpha calculation, which supports the reliability of the questionnaire, was 0.845. During the CFA, the three-factor structure (Affect, Water Retention, and Pain) was supported (root mean-square error approximation [RMSEA] = 0.054; Tucker-Lewis Index = 0.965; Comparative Fit Index = 0.976; χ2 = 48.642; df = 31; p = 0.023; χ2/df = 1.569).

Discussion

The PAF-SF questionnaire proved to be a reliable measuring tool for assessing premenstrual symptoms among women of reproductive age.

Effect of Resistance Exercise on Body Composition and Functional Capacity in Older Women with Sarcopenic Obesity-A Systematic Review with Narrative Synthesis

BACKGROUND

Resistance exercise has shown effectiveness in reducing various risk factors related to sarcopenic obesity (SO) compared to other types of exercise, e.g., aerobic exercise.

OBJECTIVE

This systematic review evaluates the effect of resistance exercise on body composition, muscular strength, and functional capacity among older women with sarcopenic obesity aged ≥ 60 years.

METHODS

This systematic review is registered on PROSPERO (registration No. CRD42023394603) and follows the PRISMA guidelines. The following electronic databases were used to search the literature: Pedro, Cochrane Central Register of Controlled Trials, Embase, PubMed, and Web of Science. We included only RCTs that investigated the effect of resistance exercise on body composition and functional capacity. Two independent reviewers conducted the process of study selection and data extraction.

RESULTS

The search strategy retrieved 687 results. One hundred and twenty-six records were deleted as duplicates. Consequently, 534 studies were excluded after the title/abstract assessment. After further detailed evaluation of twenty-seven full texts, seven RCTs were included; all the RCTs examined the isolated effect of resistance exercise in women with sarcopenic obesity. The included studies comprised 306 participants, with an average age of 64 to 72 years. We noticed a trend of improvement in the included studies among the intervention groups compared to the control groups among the different outcomes. The study protocol was inconsistent for the intervention settings, duration, and outcomes. Including a modest number of trials made it impossible to perform data meta-analysis.

CONCLUSIONS

Heterogeneity among studies regarding training protocols and the outcome measures reported limited robust conclusions. Still, resistance exercise intervention can improve body composition and functional capacity among elderly women with sarcopenic obesity.

Investigation of premenstrual syndrome in connection with physical activity, perceived stress level, and mental status-a cross-sectional study

Introduction

The premenstrual syndrome (PMS) is a critical factor in women's health, which, in addition to physical inactivity, can be influenced by the body mass index (BMI), stress, and mental state, among others. The study aimed to assess the severity of PMS symptoms among young women regarding physical inactivity, BMI, mental state, and perceived stress level.

Methods

A total of 198 female participants between the ages of 18-45 took part in a 6-month cross-sectional online questionnaire study. The average age of the participants was 25.37 ± 4.80 years. To assess physical activity, stress, mental state, and premenstrual symptoms, we employed standard questionnaires, including the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Perceived Stress Scale (PSS), the General Health Questionnaire-12 (GHQ-12), and the Premenstrual Assessment Form-Short Form (PAF-SF). The collected data were analyzed using IBM SPSS (Statistical Package for Social Sciences) version 28.0 software, with a significance level set at p < 0.05.

Results

During the analysis, we observed a significant relationship (p = 0.020) between regular exercise and the severity of PMS symptoms, as well as between mental state and PMS symptoms (p < 0.001). Furthermore, our findings revealed a significant negative correlation between regular physical activity and perceived stress levels (r = -0.179; p = 0.012), as well as between regular exercise and the participants' mental state (r = -0.157; p = 0.027). Additionally, we identified a significant difference (p < 0.001) among the six subgroups formed based on the PAF-SF and average PSS questionnaire results. Moreover, a significant difference was observed between the PAF-SF case and control groups in terms of BMI averages (p = 0.019).

Discussion

The research findings indicate that the severity of PMS symptoms is influenced by regular physical activity, mental state, and stress.

Effectiveness of exercise interventions on fall prevention in ambulatory community-dwelling older adults: a systematic review with narrative synthesis

Objective

To present a systematic review of randomized controlled trials which summarizes the effects of community-based resistance, balance, and multi-component exercise interventions on the parameters of functional ability (e.g., lower extremities muscle strength, balance performance and mobility).

Methods

This PROSPERO-registered systematic review (registration no. CRD42023434808) followed the PRISMA guidelines. Literature search was conducted in Cochrane, Embase, Ovid Medline, PEDro, Pubmed, Science Direct, Scopus and Web of Science. We included RCTs that investigated the following interventions: lower extremity strengthening, balance and multi-component exercise interventions on ambulatory community-dwelling adults aged ≥65 years.

Results

Lower extremity strengthening exercises revealed significant effects on the strength of lower extremity, balance outcomes and mobility. Balance exercises reduce the rate of injurious falls, improve static, dynamic and reactive balance, lower extremity strength as well as mobility. Multi-component exercise training reduces medically-attended injurious falls and fallers, incidence of falls, fall-related emergency department visits as well as improves mobility, balance, and lower extremity strength.

Conclusion

Physical exercises are effective in improving the components of balance, lower extremity strength, mobility, and reducing falls and fall-related injuries. Further research on fall prevention in low-income countries as well as for older adults in vulnerable context is needed.

Hungarian Women's Health Care Seeking Behavior and Knowledge of Urinary Incontinence and Pelvic Organ Prolapse: A Cross-sectional Study

IMPORTANCE

Adequate knowledge about pelvic floor disorders could lead to increased health care-seeking behavior, improved symptoms, and quality of life.

OBJECTIVES

The aims of the present study were to evaluate Hungarian women's knowledge about pelvic floor disorders and to assess health care-seeking behavior.

STUDY DESIGN

We conducted a cross-sectional survey from March to October 2022 using self-administered questionnaires. The Prolapse and Incontinence Knowledge Questionnaire was used to assess Hungarian women's knowledge about pelvic floor disorders. The International Consultation of Incontinence Questionnaire-Short Form was used to gather information about the symptoms of urinary incontinence.

RESULTS

Five hundred ninety-six women were included in the study. Urinary incontinence knowledge was deemed proficient in 27.7% of participants, while pelvic organ prolapse knowledge was deemed proficient in 40.4% of participants. Greater urinary incontinence knowledge was significantly associated (P < 0.001) with higher level of education (P = 0.016), work in a medical field (P < 0.001), and ever practiced pelvic floor muscle training (P < 0.001), whereas greater pelvic organ prolapse knowledge was significantly associated (P < 0.001) with higher level of education (P = 0.032), work in a medical field (P < 0.001), ever practiced pelvic floor muscle training (P = 0.017), and ever had pelvic organ prolapse (P = 0.022). Of the 248 participants who reported a history of urinary incontinence, only 42 (16.93%) women sought care. Care seeking was higher among women who were more knowledgeable about urinary incontinence and among women with more severe symptoms.

CONCLUSIONS

Hungarian women had limited knowledge about urinary incontinence and pelvic organ prolapse. Health care seeking among women with urinary incontinence was low.

[Hungarian adaptation and validation of the Osteoporosis Questionnaire (OPQ)]

INTRODUCTION

Osteoporosis affects one in three women and one in five men over the age of 50. We do not have an osteoporosis-related knowledge questionnaire over the age of 50, which is considered strong evidence in the prevention and treatment of the disease.

OBJECTIVE

Aim of the study was to validate the Hungarian form of the Osteoporosis Questionnaire in Hungarian-speaking women over the age of 50.

METHOD

The questionnaire was validated into Hungarian according to Beaton's six-step method. Our sample consisted of 326 women. During our statistical analysis, we calculated descriptive statistics, difference tests, Cronbach's alpha value, and Spearman's correlation coefficient for test-retest and for external validity. Quality of life and physical activity were examined to support the external validity.

RESULTS

Our sample (63.08 ± 9.36 years) scored 8.76 ± 6.94 points on the questionnaire. Cronbach's alpha value was 0.89. For the test-retest, Spearman's correlation coefficient showed a value of p≥0.25 for all the questions. Significant correlations were found between knowledge and age (R = 0.37; p<0.001) and years of using hormone replacement therapy (R = 0.34; p = 0.02). The correlation analysis showed significant (p<0.001) correlation between knowledge and all sub-dimensions of quality of life. Significant correlation was found between transport movement (p<0.001; R = 0.21), intensive (p<0.001; R = 0.354), moderate recreational activity (p<0.001; R = 0.348), total moderate (p = 0.041; R = 0.125) total intense movements (p = 0.018; R = 0.145) and knowledge.

DISCUSSION

The Hungarian questionnaire was validated in accordance with international practice.

CONCLUSION

The Hungarian version of the Osteoporosis Questionnaire is a reliable, adaptable questionnaire for measuring the osteoporosis-related knowledge of the Hungarian female population over 50. Orv Hetil. 2022; 163(51): 29-37.

A csípő-, valamint térdízületi arthrosisos betegek funkcióképességének és egészségi állapotának vizsgálata

Bevezetés: A csípő-, valamint térdízületi arthrosis gyakori megbetegedésnek számít. Számos terápiás lehetőség érhető el hazánkban. Célkitűzés: A komplex konzervatív gyógykezelés eredményességének vizsgálata csípő-, valamint térdízületi arthrosisos betegek esetén. Módszer: Saját készítésű kérdőív mellett alkalmaztuk a vizuális analóg skálát, a Functional Independence Measure, a Barthel-index, illetve az SF-36 kérdőíveket. Ezenkívül ízületi mozgástartományt mértünk. A vizsgálati csoport tagjai többféle fizioterápiás kezelést (gyógyvíz, gyógytorna, klasszikus svéd masszázs, Bemer-kezelés, pakolás, fizikoterápia) vettek igénybe. Eredmények: A vizuális analóg skála és a Barthel-index eredményei szignifikánsan változtak a két mérés között. A Functional Independence Measure esetén nem találtunk szignifikáns eltérést a két csoport adatainak értékelése során. Az egészségi állapot felmérésekor mind a fizikális egészség, mind a mentális egészség dimenziójában javulást figyelhettünk meg a vizsgálati csoportnál. Az ízületi mozgástartomány vizsgálata során a vizsgálati csoportnál a bal térd passzív extenziójának kivételével javulást figyelhettünk meg a résztvevők adatainak elemzésekor. Következtetés: A 3 hetes komplex konzervatív terápia megfelelő kezelési lehetőség lehet a funkcióképesség és az egészségi állapot javítására csípő-, valamint térdízületi arthrosis esetén. Orv Hetil. 2022; 163(48): 1917–1922.

Disease-Specific Knowledge, Physical Activity, and Physical Functioning Examination among Patients with Chronic Non-Specific Low Back Pain

Physical activity, physical functioning, and pain are some of the most critical factors of low back pain (LBP) treatment and prevention, but it was unknown that the back school program (BSP) influences the physical activity level of the patients with LBP. Data from 306 healthy patients and patients with chronic non-specific low back pain (cnsLBP) were used. We used the Global Physical Activity Questionnaire (GPAQ), the Low Back Pain Knowledge Questionnaire (LKQ), the visual analog scale, and the Roland-Morris Disability Questionnaire (RMDQ). The significance level was set at p < 0.05. The amount of sedentary time in cnsLBP patients enrolled in the BSP was significantly lower compared to the other two groups (p < 0.001). Significantly higher moderate-intensity activities, leisure time activities, and active transportation were observed in the cnsLBP patients enrolled in the BSP than in the other two groups (p < 0.001). RMDQ scores and the pain intensity of the cnsLBP patients enrolled in the BSP were significantly lower than in patients with LBP receiving only exercise therapy (p < 0.001). The physical activity level and low-back-pain-specific knowledge was significantly higher, while back-related disability and pain intensity were significantly lower among patients with low back pain syndrome who participated in a back school program.

Validation and translation of the Hungarian version of the Australian Pelvic Floor Questionnaire (APFQ-H)

INTRODUCTION AND HYPOTHESIS

The aims of the study were the translation, cultural adaptation, and validation of self-administered Australian Pelvic Floor Questionnaire (APFQ) on a Hungarian population.

METHODS

The validation was performed in 294 women over 18 who agreed to answer the Hungarian version of the APFQ. The validation of the questionnaire included evaluation of content/face validity, internal consistency, construct validity, test-retest reproducibility, discriminant validity and convergent validity.

RESULTS

Acceptable and good internal consistency was observed in all four dimensions [McDonald's ω (95% confidence interval) coefficients were > 0.7 for each dimension: bladder 0.888, bowel 0.790, prolapse 0.895 and sexual function 0.738]. Test-retest analyses revealed high reproducibility with intraclass correlation coefficients (bladder 0.83, bowel 0.92, prolapse 0.96 and sexual function 0.87). Prolapse symptom score correlated significantly with Pelvic Organ Prolapse Quantification (POP-Q), and bladder score correlated significantly with the results of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ UI SF) (convergent validity). Scores distinguished between patients with pelvic floor disorders and controls (high discriminant validity).

CONCLUSIONS

Hungarian version of the self-administered APFQ is a reliable and valid instrument for evaluating symptom severity and impact of pelvic floor dysfunction on the quality of life of Hungarian women.

Cross-sectional study of female pelvic floor dysfunction in a Hungarian population

Összefoglaló. Bevezetés és célkitűzés: A női kismedencei funkciózavarok változatos tünetekkel jelentkezhetnek, és jelentősen befolyásolják az érintettek életminőségét. Vizsgálatunk célja volt felmérni a medencefenék-diszfunkciós tüneteket és azok hatását az egyén életminőségére. Módszer: Vizsgálatunkba 203 nőt vontunk be. Az adatgyűjtést két kérdőív, egy általunk összeállított és az Australian Pelvic Floor Questionnaire segítségével végeztük. Az adatok statisztikai elemzéséhez SPSS 20.0 rendszert használtunk. Spearman-korrelációt, khi-négyzet-próbát, Mann-Whitney-féle U-tesztet, Kruskal-Wallis-próbát és többváltozós lineáris regressziót alkalmaztunk. A szignifikanciaszintet p≤0,05 határnál állapítottuk meg. Eredmények: A hólyagdiszfunkciók gyakorisága (56,2%) szignifikáns kapcsolatot mutatott az életkor növekedésével (p<0,001), az obesitassal (p<0,001), a szülésszámmal és -móddal (p<0,001; p<0,001), az episiotomiával (p<0,001) és a prolapsusműtétekkel (p = 0,010). A süllyedéses kismedencei kórképek gyakorisága (27,1%) szignifikáns kapcsolatot mutatott az életkor növekedésével (p = 0,002), a szülésszámmal és -móddal (p<0,001; p<0,001) és a korábbi episiotomiával (p<0,001). Az analis incontinentia gyakorisága (58,9%) a magasabb testtömegindexszel (p = 0,029) volt szignifikáns kapcsolatban. Szexuális diszfunkciót (53,2%) allergia és tüdőbetegségek (p = 0,048) jelenlétével kapcsolatban találtunk. A többes diszfunkció előfordulási gyakorisága az életkor növekedésével (p<0,001), az obesitassal (p = 0,043), a korábbi hysterectomiával (p = 0,046) és prolapsusműtétekkel (p<0,001) mutatott szignifikáns kapcsolatot. Minden diszfunkció esetén kimutatható volt az életminőség-romlás (hólyagfunkciók: p<0,001; bél- és székletürítési funkciók: p<0,001, hüvelyfali süllyedés: p<0,001, szexuális funkciók: p<0,001). Következtetés: Az általunk vizsgált női populációban nagy arányban találtunk kismedencei funkciózavarokat, melyek kedvezőtlen hatással voltak az érintettek életminőségére. Orv Hetil. 2021; 162(43): 1724-1731.

SUMMARY

INTRODUCTION AND OBJECTIVE

Pelvic floor dysfunction (PFD) can cause several complaints in women and has an adverse effect on the quality of life (Qol). The aim of our study was to evaluate the prevalence of pelvic floor dysfunction and its effect on Qol.

METHOD

203 women were included. We used two questionnaires, a self-constructed and the Australian Pelvic Floor Questionnaire. Statistical analysis was performed by SPSS 20.0. Spearman's correlation, chi-square, Mann-Whitney U, Kruskal-Wallis tests and multivariate linear regression were used. Statistical significance was set at p≤0.05.

RESULTS

There was a significant association between the prevalence of urinary incontinence (56.2%) and age (p<0.001), obesity (p<0.001), number and mode of deliveries (p<0.001; p<0.001), episiotomy (p<0.001) and pelvic organ prolapse (POP) surgery (p = 0.010); between the occurrence of POP (27.1%) and age (p = 0.002), the number and mode of deliveries (p<0.001; p<0.001) and episiotomy (p<0.001); between the prevalence of anal incontinence (58.9%) and obesity (p = 0.029); between sexual dysfunction (SD) (53.2%) and respiratory disease and allergy (p = 0.048). Multiple PFD was significantly associated with age (p<0.001), obesity (p = 0.043), hysterectomy (p = 0.046) and POP surgery (p = 0.010). There was a significant difference between women having more severe PFD than milder complaints regarding Qol (bladder p<0.001; bowel p<0.001; SD p<0.001 and POP p<0.001).

CONCLUSION

Pelvic floor dysfunction was common in our study population and had a great adverse effect on Qol. Orv Hetil. 2021; 162(43): 1724-1731.

The Hungarian adaptation and validation of the Osteoporosis Health Belief Scale

Összefoglaló. Bevezetés: A nemzetközi szakirodalomban számos betegséget illetően elérhető betegségspecifikus tudást és attitűdöt mérő kérdőív. Magyarországon az osteoporosis témakörében validált kérdőívek tárháza meglehetősen hiányos. Célkitűzés: Célunk volt a csontritkulás-specifikus magatartás és attitűd vizsgálatára alkalmas Osteoporosis Health Belief Scale (OHBS-) kérdőív magyar nyelvre történő validációja, melynek segítségével mérhetővé válna a magyar anyanyelvű nők csontritkulással kapcsolatos attitűdje. Módszer: A kérdőív magyar nyelvre validálása a 2000-ben megfogalmazott hatlépcsős irányelv szerint történt. A külső validitás vizsgálatához az Osteoporosis Knowledge Assessment Tool (OKAT-) kérdőívet használtuk. Mintánkat 600 fő alkotta; statisztikai számításaink során leíró statisztikát készítettünk, különbözőségi vizsgálatokat végeztünk, a belső konzisztencia vizsgálatára Cronbach-alfa-értéket számítottunk, a konvergens validitás és a teszt-reteszt mérések vizsgálatához Spearman-féle korrelációs koefficienst számítottunk. A kérdőív belső struktúrájának vizsgálatához faktorelemzést végeztünk. Ennek megfelelően Kaiser-Meyer-Olkin (KMO)-tesztet és Bartlett-próbát számítottunk. Eredmények: Mintánk (37,7 ± 13,15 életév) az OHBS (126,28 ± 14,85 pont) és az OKAT (8,78 ± 3,1) tekintetében egyaránt alacsony pontszámot ért el. A teljes kérdőívre kivetített Cronbach-alfa-érték 0,802 volt. A faktorelemzés (KMO = 0,886; Bartlett-próba p<0,001) 7 faktort különített el, melyek megfeleltethetők az eredeti faktoroknak. A teszt-reteszt során a Spearman-féle korrelációs koefficiens 0,921 és 1,000 közötti értéket mutatott. Az OKAT- és az OHBS-dimenziók összevetésekor számos szignifikáns kapcsolatot találtunk. Megbeszélés: A vizsgálati eredmények megfelelnek az eredeti kérdőív szerinti, továbbá a más nyelvre történt validálás során kapott eredményeknek. Következtetés: Eredményeink alapján a magyar nyelvű OHBS csontritkulás-specifikus attitűdöt és magatartást vizsgáló kérdőívet megbízható és valid kérdőívnek tartjuk. Orv Hetil. 2021; 162(37): 1494-1501.

SUMMARY

INTRODUCTION

In the international literature, several disease-specific questionnaires are available for many diseases. The opportunities of validated questionnaires are incomplete about osteoporosis in Hungarian language.

OBJECTIVE

The aim of the study was to validate the Osteoporosis Health Belief Scale (OHBS) into Hungarian that would make it possible to measure the osteoporosis-related attitude for Hungarian-speaking women.

METHOD

The questionnaire was validated into Hungarian according to the six-step guideline outlined in 2000. The Osteoporosis Knowledge Assessment Tool (OKAT) questionnaire was used to examine external validity. Our sample consisted of 600 women. We performed descriptive statistics; Cronbach's alpha value was calculated for internal consistency, we calculated Spearman's correlation coefficient to examine external validity. We carried out factor analysis (Kaiser-Meyer-Olkin [KMO] test, Bartlett test) to examine whether the new questionnaire is suitable for measurements in the given language the same way as the original questionnaire.

RESULTS

Our sample (37.7 ± 13.15 years of age) achieved low score for both OHBS (126.28 ± 14.85) and OKAT (8.78 ± 3.1). The Cronbach's alpha value was 0.802. Factor analysis (KMO = 0.886; Bartlett test p<0.001) identified 7 factors that can be similar to the original factors. During the test-retest, the Spearman correlation coefficient showed a value between 0.921 and 1.000. When comparing the OKAT and OHBS dimensions we found several significant relationships.

DISCUSSION

The results of the study are similar to the results of the original questionnaire validation as well as to other OHBS validation studies.

CONCLUSION

Based on the results, we consider that the Hungarian form of the OHBS is a reliable and valid questionnaire. Orv Hetil. 2021; 162(37): 1494-1501.

Assessment of health-related quality of life and patient's knowledge in chronic non-specific low back pain

Background

Chronic non-specific low back pain syndrome (cnsLBP) is a severe health problem in developed countries, which has an important effect on patients’ quality of life and is highly determined by socio-demographic factors and low back pain specific knowledge. We examined patients’ health-related quality of life according to the results of the Short Form Health Survey (SF-36), low back pain knowledge (LBPKQ) and the social determinants of the participants.

Methods

We carried out our research in the first half of 2015 in Southern Transdanubia, Hungary. The examination included 1155 respondents living with chronic non-specific low back pain. The confidence interval of 95% was used, and the level of.

significance was p < 0.05 using SPSS 22.0 software.

Results

The SF-36 questionnaire is suitable for the examination of patients’ health-related quality of life (Cronbach’s Alpha> 0.76), as the LBPKQ’s Cronbach’s Alpha was 0.726 also, which showed good validity. Longer-term disease meant a lower health-related quality of life (p < 0.05). A greater decrease of function (Roland Morris scores (RM)) accounts for a lower HRQoL and higher knowledge level. We found significant differences in LBPKQ scores according to sociodemographic parameters. The general health status was positively correlated with LBPKQ (p = 0.024) adjusted for demographic and pain and functional status.

Conclusion

The negative effect of the symptoms on patients’ quality of life is proved, which is determined by different socio-demographic parameters furthermore by knowledge. Above all could be useful information for professionals to adopt the right interventions.

Multicausal analysis on psychosocial and lifestyle factors among patients undergoing assisted reproductive therapy - with special regard to self-reported and objective measures of pre-treatment habitual physical activity

Background

National, regional and global trends in prevalence of infertility indicate its public health importance, however it effects various life dimensions of individuals and couples as well. Lifestyle habits may counteract with these factors. The aim of the study was the multicausal analysis of psychosocial and lifestyle factors undergoing assisted reproductive therapy (ART) with special regard to pre-treatment habitual physical activity (PA).

Methods

In a cross-sectional, observational cohort study on ART patients (N = 60, age 34.6 ± 5.2 years, BMI 24.2 ± 4.9 kg/m²) with follow up on outcome measures a detailed description was given on PA patterns (ActriGraph GT3X, GPAQ-H) and on general and infertility related distress (BDI-13, FPI).

Results

Respondents reported normal mood state (BDI-13) but moderately high infertility-related distress (FPI) in Social- and very high distress in Sexual Concern. It was revealed that time spent with recreational PA (RPA) could counteract with infertility-related distress (Social Concern R = -0.378, p = 0.013; Relationship Concern R = -0.365, p = 0.019).

In the presence of clinical pregnancy GPAQ-H RPA MET was significantly higher (p = 0.048), in the non-pregnant group cumulative values and work-related PA were higher. Correlations could be found between RPA time and the number of oocytes (R = 0.315, p = 0.045), matured oocytes (R = 0.339, p = 0.030) and embryos (R = 0.294, p = 0.062) by women who reached at least 150 min RPA (GPAQ-H). Multivariate linear regression revealed that the number of oocytes was positively influenced by the GPAQ-H recreation MET (R² = 0.367; F = 10.994, p = 0.004; B = 0.005, p = 0.004, B Constant = 4.604). Regarding the number of embryos (R² = 0.757, F = 17.692, p < 0.001, B Constant = 1.342) positive relationship was found with GPAQ-H RPA MET (B = 0.004, p < 0.001) and negative with BMI (B = -0.167, p = 0.038). It was disclosed (R² = 0.958, F = 408.479, p < 0.001) that higher Very Vigorous Activity (ActiGraph) was accompanied with higher hCG (B = 63.703, p ≤ 0.001). However, time spent with moderate PA (GPAQ-H) (B = 0.002, SE = 0.001, Wald = 3.944, p = 0.047, OR = 1.002) was significantly associated with live births.

Conclusions

Amount of PA alone did not have a positive effect on outcome of ART. Type and intensity seemed to be more significant. Existing differences in response to infertility due to recreational PA suggest the importance of the development of a specific intervention. The robust overestimation of PA in self-reports highlights the need to improve physical literacy of women undergoing ART.

Scapular dyskinesis: the origo of shoulder lesions?

Összefoglaló. Bevezetés: A megváltozott statikus és/vagy dinamikus lapockapozíciót, azaz a scapuladyskinesist gyakran vonják párhuzamba a vállelváltozásokkal. Mindemellett a lapocka kinematikai eltérései nagy számban jelen lehetnek tünetmentes egyéneknél is, melegágyat biztosítva a későbbi vállelváltozások kialakulásának. Célkitűzés: Munkánk fő célja az volt, hogy felhívja a figyelmet ezen problémakör fontosságára, valamint hogy megvizsgálja a scapuladyskinesis előfordulásának gyakoriságát és körülményeit az átlagpopulációban. Módszer: Mintánk 70 főből állt (átlagéletkor: 22,17 ± 1,77 év). 67%-uk férfi, míg 33%-uk nő volt. A scapuladyskinesis fennállását McClure-féle 'Scapular Dyskinesis Test'-tel vizsgáltuk. A résztvevők vállfájdalmának intenzitását vizuális analóg skála segítségével, habituális testtartásukat fotogrammetriás módszerrel, főbb lapockastabilizáló izmaik izomerejét pedig Kendall-féle manuális izomerőtesztekkel mértük fel. Mindemellett felvettük antropometriai adataikat, valamint megkérdeztük, hogy milyen gyakran végeznek sporttevékenységet. Eredmények: A résztvevők 53%-ánál találtunk valamilyen fokú scapuladyskinesist. A habituális testtartást vizsgáló fotogrammetriás felmérés eredményei és a scapuladyskinesist mérő McClure-féle teszt eredményei között szignifikáns összefüggést találtunk (p = 0,01). A sportolási gyakoriság és a scapuladyskinesis előfordulása között jelentős összefüggést tapasztaltunk (p = 0,01). A fájdalom erőssége és a scapuladyskinesis előfordulása között szignifikáns volt az összefüggés (p = 0,03). A scapuladyskinesist mérő McClure-féle teszt és az azonos oldali felső végtagon izomerő-csökkenést mutató tesztek eredményei között szintén szignifikáns összefüggést tapasztaltunk (p = 0,01). Következtetés: Az elit sportolók mellett az átlagos populációban is jelentős mértékben jelen lehetnek a lapocka kinematikai eltérései. Mindez jelentős összefüggésben állhat az adott személy életmódjával és egészségmagatartásával, valamint kiemelt szerepet játszhat a krónikus vállfájdalom kialakulásában. Orv Hetil. 2021; 162(15): 587-594.

SUMMARY

INTRODUCTION

The altered static and/or dynamic scapular position, i. e., scapular dyskinesis, is often paralleled with shoulder pathologies. However, shoulder kinematic abnormalities may also be present in large numbers in asymptomatic individuals.

OBJECTIVE

The main goal of our work was to draw attention to the importance of scapular dyskinesis in shoulder pathologies.

METHOD

The final sample consisted of 70 people (average age: 22.17 ± 1.77 years), 67% of them was male and 33% female. The presence of scapular dyskinesis was assessed by McClure's Scapular Dyskinesis Test. Visual analog scale was used to examine the shoulder pain of the participants, photogrammetric method was used to document their habitual posture. Kendall's manual muscle testing methods were used to determine the muscle strength of the individual muscles of the shoulder girdle; we also recorded their anthropometric data and asked them about their sporting habits.

RESULTS

In 53% of the participants, some degree of scapular dyskinesis was found. We observed significant correlation between the sporting habits and scapular dyskinesis (p = 0.01). Significant correlation was observed between the posture and scapular dyskinesis (p = 0.01). Between the strength of pain and the dyskinesis, we found a significant correlation (p = 0.03). There was a significant correlation between the results of the McClure's test and the tests showing muscle strength loss around the scapula (p = 0.01).

CONCLUSION

In addition to elite athletes, scapular dyskinesis may also be significantly present in the average population and can play a key role in the development of shoulder pain. Orv Hetil. 2021; 162(15): 587-594.

Association with subjective measured physical activity (GPAQ) and quality of life (WHOQoL-BREF) of ageing adults in Hungary, a cross-sectional study

BACKGROUND

It is well known that physical activity (PA) has health benefits. This study aimed to examine physical activity carried out by the senior (over 50) participants and its relation to their quality of life (QoL).

METHODS

Surveillance of PA and QoL was measured by using questionnaires (GPAQ, WHOQoL-BREF) in this study. Descriptive data were presented as means and standard deviations (SD) for continuous variables and as percentages for categorical variables. Multivariate linear regression analysis was conducted. The significance level was set at p ≤ 0.05.

RESULTS

Overall, 250 participants were recruited, the mean age of the study population (n = 243) was 70.2 (SD 7.1) years. The results clearly showed that the Hungarian participants aged over 50 years were more likely to do PA if they had university degree and lower age (p ≤ 0.001) and used more active transportation (p = 0.035) if they had low education. The results of WHOQoL-BREF showed that the Hungarian individuals have better QoL if they have university degree (p ≤ 0.001) and lower age (p ≤ 0.001). Using multivariate linear regression analysis to examine the effect of PA patterns on QoL adjusted for demographic variables (age, education, BMI, place of living), the result showed significant correlation between WHOQoL-BREF dimensions and GPAQ (p ≤ 0.001).

CONCLUSION

Higher amount of PA among aging population can result in better QoL in all dimensions.

[Prevalence, potential risk factors and sequelae of diastasis recti abdominis]

INTRODUCTION

There is scant knowledge on diastasis recti which occurs mostly in 3rd trimester of pregnancy.

AIM

Our aim was to assign the prevalence of diastasis recti and the possible risk factors and to investigate its association with some chronical diseases, like low back pain and urinary incontinence.

METHOD

200 women's interrectus distance was measured who filled out a self-made diastasis recti questionnaire, the SF-36, Oswestry Disability Index and the International Consultation on Incontinence Modular Questionnaire - Urinary Incontinence Short Form questionnaires.

RESULTS

Prevalence of the condition was 46.5%. In case of risk factors, relationship between number of deliveries and interrectus distance was significant. We found a significant difference in quality of life, in presence of low back pain and urinary incontinence between the normal and the abnormal group.

CONCLUSIONS

In line with the literature we found, that diastasis recti can predispose on serious sequelae, hence on decreased quality of life. Orv. Hetil., 2017, 158(12), 454-460.

[Motivations for foreign employment and carrier change among Hungarian physiotherapists]

INTRODUCTION

An increasing motivation can be experienced among professional workers within the Hungarian healthcare system towards foreign employment or career change.

AIM

The aim of the authors was to assess Hungarian physiotherapists' migration and career changing behaviour and to understand the underlying factors.

METHOD

A national survey in Hungary from April to August, 2014 was performed. Only physiotherapists who practice in Hungary were included (n = 215).

RESULTS

The results suggest that age (p<0.05) and the rate of financial appreciation experienced in the workplace (p<0.01) significantly affect the appearance of migratory thoughts. Those physiotherapists who do not feel themselves financially appreciated, are 55 times more likely to search for employment outside the country's borders [OR = 55.28 CI (95%) = 18.85 to 161.12]. The most common causes for that are unfavourable financial (p<0.01) and moral recognition (p<0.01).

CONCLUSIONS

In order to prevent our already highly-qualified colleagues from leaving the country or from considering to leave the profession we should concentrate on increasing the financial and moral appreciation of the profession within the Hungarian healthcare system.

Towards understanding the influence of lipid metabolism on CD8 T cell biology (P1136)

A hallmark of the adaptive immune system is the ability of CD8 T cells to undergo rapid clonal expansion in response to antigenic stimulation. To meet the biosynthetic requirements of rapid growth and proliferation, effector T cells must reprogram their metabolism to provide essential macromolecules. We have previously shown that mitogen signaling induces a gene expression program that drives de novo cholesterol and fatty acid biosynthesis, however the molecular events linking antigen receptor signaling with lipid anabolism remain poorly understood. Herein, we demonstrate an essential role for sterol regulatory element binding proteins (SREBPs) in the acquisition of effector cell metabolism. Without SREBP signaling, CD8 T cells are unable to grow and acquire the effector cell metabolism program, resulting in attenuated clonal expansion during viral infection. In contrast, SREBPs are dispensable for homeostatic proliferation, demonstrating a context-specific requirement for SREBP signaling during effector T cell blastogenesis. Mechanistic studies indicate that SREBP activity is required to maintain a level of cellular cholesterol sufficient to permit rapid ER and cellular growth. Taken together, these studies provide novel insights into the molecular signals underlying the metabolic reprogramming of CD8 T cell during the transition from quiescence to activation, and demonstrate the importance of SREBPs in regulating a cholesterol metabolic checkpoint during blastogenesis.

Circadian regulation of electrolyte absorption in the rat colon

The intestinal transport of nutrients exhibits distinct diurnal rhythmicity, and the enterocytes harbor a circadian clock. However, temporal regulation of the genes involved in colonic ion transport, i.e., ion transporters and channels operating in absorption and secretion, remains poorly understood. To address this issue, we assessed the 24-h profiles of expression of genes encoding the sodium pump (subunits Atp1a1 and Atp1b1), channels (α-, β-, and γ-subunits of Enac and Cftr), transporters (Dra, Ae1, Nkcc1, Kcc1, and Nhe3), and the Na(+)/H(+) exchanger (NHE) regulatory factor (Nherf1) in rat colonic mucosa. Furthermore, we investigated temporal changes in the spatial localization of the clock genes Per1, Per2, and Bmal1 and the genes encoding ion transporters and channels along the crypt axis. In rats fed ad libitum, the expression of Atp1a1, γEnac, Dra, Ae1, Nhe3, and Nherf1 showed circadian variation with maximal expression at circadian time 12, i.e., at the beginning of the subjective night. The peak γEnac expression coincided with the rise in plasma aldosterone. Restricted feeding phase advanced the expression of Dra, Ae1, Nherf, and γEnac and decreased expression of Atp1a1. The genes Atp1b1, Cftr, αEnac, βEnac, Nkcc1, and Kcc1 did not show any diurnal variations in mRNA levels. A low-salt diet upregulated the expression of βEnac and γEnac during the subjective night but did not affect expression of αEnac. Similarly, colonic electrogenic Na(+) transport was much higher during the subjective night than the subjective day. These findings indicate that the transporters and channels operating in NaCl absorption undergo diurnal regulation and suggest a role of an intestinal clock in the coordination of colonic NaCl absorption.

The early effect of dextran sodium sulfate administration on carbachol-induced short-circuit current in distal and proximal colon during colitis development

Increased colonic Cl(-) secretion was supposed to be a causative factor of diarrhea in inflammatory bowel diseases. Surprisingly, hyporesponsiveness to Cl(-) secretagogues was later described in inflamed colon. Our aim was to evaluate changes in secretory responses to cholinergic agonist carbachol in distal and proximal colon during colitis development, regarding secretory activity of enteric nervous system (ENS) and prostaglandins. Increased responsiveness to carbachol was observed in both distal and proximal colon after 3 days of 2 % dextran sodium sulfate (DSS) administration. It was measured in the presence of mucosal Ba(2+) to emphasize Cl(-) secretion. The described increase was abolished by combined inhibitory effect of tetrodotoxin (TTX) and indomethacin. Indomethacin also significantly reduced TTX-sensitive current. On the 7th day of colitis development responsiveness to carbachol decreased in distal colon (compared to untreated mice), but did not change in proximal colon. TTX-sensitive current did not change during colitis development, but indomethacin-sensitive current was significantly increased the 7th day. Decreased and deformed current responses to serosal Ba(2+) were observed during colitis induction, but only in proximal colon. We conclude that besides inhibitory effect of DSS on distal colon responsiveness, there is an early stimulatory effect that manifests in both distal and proximal colon.

Expression of gastrin/CCK-B receptors does not lead to a mitogenic response to gastrin in two colon cell lines

To clarify the impact of the classic gastrin/CCK-B receptor on the growth of benign and malignant colonic cells, two permanent cell lines expressing this receptor have been established. The conditionally immortalized nonmalignant colonic cell line YAMC and the colonic carcinoma cell line SW 403 were stably transfected with a plasmid encoding the gastrin/CCK-B receptor (GR), or with plasmid alone (V). Expression of the gastrin/CCK-B receptor in the transfected YAMC-GR and SW 403-GR cells was demonstrated by gastrin binding experiments. The YAMC-GR cell line did not respond mitogenically to pentagastrin or gastrin(17) in vitro and was not tumorigenic. The SW 403-GR cell line was stimulated by gastrin(17) in vitro, but the growth patterns of SW 403-GR and SW 403-V were the same in nude mice with cells injected either subcutaneously or into the spleen. These results provide further evidence that the gastrin/CCK-B receptor is not responsible for gastrin-stimulated growth in colonic tumors.

[Interindividual differences in priming and memory effects of threatening stimuli: effect of cognitive avoidance and vigilant anxiety coping]

This study examined the influence of dispositional coping strategies (cognitive avoidance, vigilance) on priming and memory effects of emotional stimuli. In the first phase of the study participants performed a lexical decision task that involved threat-related and neutral words. Subsequently, a previously unannounced recognition memory test for a subset of the words presented during the first phase was carried out. Repressers (i.e. individuals high in avoidance and low in vigilance) showed stronger emotional priming effects than nonavoiders. Repressers also showed a memory deficit for emotional relative to neutral words, whereas sensitizers (vigilance high, avoidance low) remembered emotional words comparatively well. Results raise the question of whether repressers' memory deficits for threat-related stimuli are actually based on a less differentiated network of emotional information, as assumed by recent theoretical accounts of individual differences in coping.

Sequences flanking the pentanucleotide T-antigen binding sites in the polyomavirus core origin help determine selectivity of DNA replication

Replication of the genomes of the polyomaviruses requires two virus-specified elements, the cis-acting origin of DNA replication, with its auxiliary DNA elements, and the trans-acting viral large tumor antigen (T antigen). Appropriate interactions between them initiate the assembly of a replication complex which, together with cellular proteins, is responsible for primer synthesis and DNA chain elongation. The organization of cis-acting elements within the origins of the polyomaviruses which replicate in mammalian cells is conserved; however, these origins are sufficiently distinct that the T antigen of one virus may function inefficiently or not at all to initiate replication at the origin of another virus. We have studied the basis for such replication selectivity between the murine polyomavirus T antigen and the primate lymphotropic polyomavirus origin. The murine polyomavirus T antigen is capable of carrying out the early steps of the assembly of an initiation complex at the lymphotropic papovavirus origin, including binding to and deformation of origin sequences in vitro. However, the T antigen inefficiently unwinds the origin, and unwinding is influenced by sequences flanking the T antigen pentanucleotide binding sites on the late side of the viral core origin. These same sequences contribute to the replication selectivity observed in vivo and in vitro, suggesting that the inefficient unwinding is the cause of the replication defect. These observations suggest a mechanism by which origins of DNA replication can evolve replication selectivity and by which the function of diverse cellular origins might be temporally activated during the S phase of the eukaryotic cell cycle.

Neuropeptide Y differentiates between exocytotic and nonexocytotic noradrenaline release in guinea-pig heart

The overflow of neuropeptide Y (NPY; radioimmunoassay), noradrenaline and dihydroxyphenylethylenglycol (DOPEG; high pressure liquid chromatography) from guinea-pig perfused hearts was investigated in relationship to exocytotic and nonexocytotic release mechanisms. Exocytotic release: Electrical stimulation of the left stellate ganglion (12 Hz; 1 min) evoked a calcium-dependent overflow of noradrenaline and NPY, that was accompanied by a minor and prolonged increase in DOPEG overflow. This increase in DOPEG overflow was attenuated by blockade of neuronal amine re-uptake. In the presence of calcium, a closely related co-release of noradrenaline and NPY was also observed during administration of veratridine (10 microM); it was completely prevented by tetrodotoxin (1 microM). Nonexocytotic release: In the absence of extracellular calcium, veratridine (30 microM) induced noradrenaline overflow only when combined with the reserpine-like agent Ro 4-1284 (10 microM). This overflow was accompanied by efflux of DOPEG, but not of NPY. Similarily, tyramine (1-100 microM) induced a calcium-independent concomitant overflow of both noradrenaline and DOPEG, but not of NPY. During anoxic and glucose-free perfusion a predominantly calcium-independent overflow of noradrenaline was observed; only in the presence of extracellular calcium was this overflow accompanied by a minor overflow of NPY. Noradrenaline overflow, induced by veratridine plus Ro 4-1284 (in the absence of calcium), by tyramine, or by anoxia, was suppressed by blockade of neuronal amine re-uptake, and was, therefore, mediated by reversed transmembrane amine transport by the neuronal uptake carrier. The results indicate that NPY is co-released with noradrenaline only during calcium-dependent exocytosis.(ABSTRACT TRUNCATED AT 250 WORDS)