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Abonyi-Tóth Z, Rokszin G, Fábián I, Kiss Z, Jermendy G, Kempler P, Lengyel C, Wittmann I, Molnár GA, Sütő G. Incident Cancer Risk in Patients with Incident Type 2 Diabetes Mellitus in Hungary (Part 1). Cancers (Basel) 2024; 16:1745. [PMID: 38730697 PMCID: PMC11083545 DOI: 10.3390/cancers16091745] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/26/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
(1) Background: Patients with type 2 diabetes mellitus (T2DM) are at higher risk of cancer but how these two diseases associate is still debated. The goal of this study was the assessment of the overall incidence of cancer among patients with newly diagnosed T2DM in Hungary. (2) Methods: A nationwide, retrospective, longitudinal study was performed using a Hungarian database. After exclusion of cases of age < 18 years, with gestational diabetes, with polycystic ovary syndrome, and with type 1 and prevalent type 2 diabetes mellitus, the incident T2DM (approx. 50,000 cases yearly) and for comparison, the diabetes-free Hungarian adult population (approx. 7,000,000 cases yearly) was included in the study. The primary endpoints were the overall and site-specific incidence and annual percentage change of the incidence of cancer in both populations. (3) Results: The overall incidence of cancer in patients amounted to 29.4/1000 and 6.6/1000 with or without T2DM, respectively, and the OR (95%CI) of cancer of the T2DM group was 4.32 (4.14-4.53), p < 0.0001. The risk of having cancer was age dependent. The incidence of cancer was declining in the non-diabetic but was unchanged in the T2DM population. The average lag time of diagnosing cancer after the detection of T2DM was 3.86 months. (4) Conclusions: Incident T2DM is associated with a significantly higher overall risk of incident cancer, with a reverse correlation of age. Newly registered T2DM patients were suggested to be screened for cancer within 6 months.
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Affiliation(s)
- Zsolt Abonyi-Tóth
- RxTarget Ltd., 5000 Szolnok, Hungary; (Z.A.-T.); (G.R.); (I.F.)
- Department of Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - György Rokszin
- RxTarget Ltd., 5000 Szolnok, Hungary; (Z.A.-T.); (G.R.); (I.F.)
| | - Ibolya Fábián
- RxTarget Ltd., 5000 Szolnok, Hungary; (Z.A.-T.); (G.R.); (I.F.)
- Department of Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - Zoltán Kiss
- Second Department of Medicine and Nephrology-Diabetes Centre, University of Pécs Medical School, 7624 Pécs, Hungary; (Z.K.); (G.A.M.); (G.S.)
| | - György Jermendy
- Department of Internal Medicine, Bajcsy-Zsilinszky Hospital, 1106 Budapest, Hungary;
| | - Péter Kempler
- Department of Medicine and Oncology, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary;
| | - Csaba Lengyel
- Department of Internal Medicine, University of Szeged, 6720 Szeged, Hungary;
| | - István Wittmann
- Second Department of Medicine and Nephrology-Diabetes Centre, University of Pécs Medical School, 7624 Pécs, Hungary; (Z.K.); (G.A.M.); (G.S.)
| | - Gergő A. Molnár
- Second Department of Medicine and Nephrology-Diabetes Centre, University of Pécs Medical School, 7624 Pécs, Hungary; (Z.K.); (G.A.M.); (G.S.)
| | - Gábor Sütő
- Second Department of Medicine and Nephrology-Diabetes Centre, University of Pécs Medical School, 7624 Pécs, Hungary; (Z.K.); (G.A.M.); (G.S.)
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Lázár Z, Horváth A, Kiss-Dala S, Abonyi-Tóth Z, Csoma B, Kontz K, Tamási L, Müller V. Assessment of bronchodilator responsiveness to salbutamol or ipratropium using different criteria in treatment-naïve patients with asthma and COPD. Eur Clin Respir J 2024; 11:2328434. [PMID: 38529514 PMCID: PMC10962294 DOI: 10.1080/20018525.2024.2328434] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/06/2024] [Indexed: 03/27/2024] Open
Abstract
Background The criteria for significant bronchodilator responsiveness (BDR) were published in 2005 by the European Respiratory Society/American Thoracic Society, which were revised in 2021, however, data on the agreement between these two recommendations in untreated patients with airflow limitation are missing. Aims We aimed to study BDR to salbutamol (SABA) or ipratropium bromide (SAMA) in patients with suspected bronchial asthma or COPD at initial clinical presentation using the 2005 and 2021 criteria and explore clinical factors associated with BDR+. Methods Symptomatic, treatment-naïve patients with expiratory airflow limitation (n = 105, 57 men, age (mean ± standard deviation): 65 ± 10 years) underwent BDR testing with 400 mcg salbutamol (day 1) or 80 mcg ipratropium bromide (day 2) and BDR was measured after 15 and 30 minutes. Clinical factors with risk for BDR+ were assessed with binomial logistic regression analysis. Results We found a good agreement between the number of 2005-BDR+ and 2021-BDR+ patients at 15 and 30 minutes post-salbutamol and post-ipratropium (88.6-94.8%). More patients showed BDR+ after 30 minutes than following 15 minutes using either criterion. When results at 30 minutes are considered, the number of patients with 2005-BDR+ (82%) was higher than that of 2021-BDR+ (75%), with the proportion of SAMA+ patients being higher than that of SABA+ (2005: 70% vs. 49%, Fisher exact p < 0.01; 2021: 64% vs. 41%, p = 0.001). 2005-BDR+ and 2021-BDR+ to SABA were associated with decreasing pre-BD FEV1% predicted and the presence of cough. More patients with asthma were in the SABA+ group compared to the SAMA+ group (2005: 71% vs. 53%, Fischer exact p = 0.04; 2021: 77% vs. 52%, p = 0.02). Conclusions Fewer patients show BDR+ according to the 2021 criteria in comparison with the 2005 recommendations, and protocols for BDR testing may consider the assessment of response to both SABA and SAMA after 30 minutes.
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Affiliation(s)
- Zsófia Lázár
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Alpár Horváth
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
- Medical Department, Chiesi Hungary Ltd., Budapest, Hungary
| | | | | | - Balázs Csoma
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Katalin Kontz
- Health and Social Public Benefit Nonprofit Ltd., Dunakeszi, Hungary
| | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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Vass-Bognár B, Khol JL, Baumgartner W, Fornyos K, Papp M, Abonyi-Tóth Z, Bakony M, Jurkovich V. Investigating the Prevalence of Paratuberculosis in Hungarian Large-Scale Dairy Herds and the Success of Control Measures over Four Years. Animals (Basel) 2024; 14:151. [PMID: 38200881 PMCID: PMC10778156 DOI: 10.3390/ani14010151] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/23/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
Paratuberculosis (PTB) is a severe, slow-developing, untreatable disease of ruminants. Worldwide, the disease affects more than 50% of herds in the dairy industry, and causes substantial economic losses for dairy producers. Diagnostic tests show limited sensitivity, especially in the early stages of the disease. Our study aimed to investigate the seroprevalence of Mycobacterium avium ssp. paratuberculosis (MAP) in large-scale dairy herds in Hungary, in association with the self-reported presence or absence of screening and intervention measures against MAP transmission. We processed data from 42 large-scale Holstein Friesian farms in Hungary between 1 January 2018 and 31 December 2021. An average of 32,009 (min.: 31,702; max.: 32,207) animals were blood sampled yearly (127,372 in total during the four years), corresponding to 15% of the Hungarian dairy cattle population. All female cattle older than 2 years were blood sampled on the farms enroled in the study. The samples were tested using a commercial ELISA (IDEXX paratuberculosis screening Ab test). Farm managers were interviewed about their on-farm diagnostic and intervention approaches using a uniform questionnaire, including questions on the level of awareness, frequency of ELISA and PCR testing, and their strategies for culling adult animals and reducing transmission to newborn calves. By comparing the annual rate of change in seroprevalence and the amount of change observed during the four-year period, we concluded that test-and-cull strategies implemented in parallel with newborn calf management that aimed at preventing MAP transmission were superior to test-and-cull strategies alone; moreover, fortifying culling decision making via additional ELISA and PCR tests is superior to using a single ELISA result. For farms that carried out a complex program with both "test-and-cull" and proper newborn calf management, there was a proportional reduction in apparent seroprevalence at an average of 22.8% per year. Fifteen of the sampled farms had no measures in place to control paratuberculosis. On these farms, the seroprevalence increased by 12.1% per year on average.
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Affiliation(s)
- Barbara Vass-Bognár
- Department of Animal Hygiene, Herd Health and Mobile Clinic, University of Veterinary Medicine, H-1078 Budapest, Hungary;
| | - Johannes Lorenz Khol
- University Clinic for Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Walter Baumgartner
- University Clinic for Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, 1210 Vienna, Austria
| | | | - Melitta Papp
- Eurofins Vetcontrol Ltd., H-1211 Budapest, Hungary
| | - Zsolt Abonyi-Tóth
- Department of Biostatistics, University of Veterinary Medicine, H-1078 Budapest, Hungary
| | - Mikolt Bakony
- Centre for Translational Medicine, Semmelweis University, H-1085 Budapest, Hungary;
| | - Viktor Jurkovich
- Department of Animal Hygiene, Herd Health and Mobile Clinic, University of Veterinary Medicine, H-1078 Budapest, Hungary;
- Centre for Animal Welfare, University of Veterinary Medicine, H-1078 Budapest, Hungary
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Lehel J, Magyar M, Palotás P, Abonyi-Tóth Z, Bartha A, Budai P. To Eat or Not to Eat?-Food Safety Aspects of Essential Metals in Seafood. Foods 2023; 12:4082. [PMID: 38002139 PMCID: PMC10670376 DOI: 10.3390/foods12224082] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
The popularity of seafoods is high due to their superb dietary properties and healthy composition. However, it is crucial to understand whether they adequately contribute to our essential nutritional needs. Small amounts of essential metals are indispensable in the human body to proper physiological functioning; their deficiency can manifest in various sets of symptoms that can only be eliminated with their intake during treatment or nutrition. However, the excessive consumption of metals can induce undesirable effects, or even toxicosis. Shellfish, oyster, and squid samples were collected directly from a fish market. After sample preparation, the concentration of essential metals (cobalt, chromium, copper, manganese, molybdenum, nickel, and zinc) was detected by Inductively Coupled Plasma Optical Emission Spectrometry. The results were analyzed statistically using ANOVA and two-sample t-tests. The average concentration of the investigated essential elements and the calculated burden based on the consumption were below the Recommended Dietary Allowances and Tolerable Upper Intake Levels. Based on these results, the trace element contents of the investigated seafoods do not cover the necessary recommended daily intake of them, but their consumption poses no health hazard due to their low levels.
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Affiliation(s)
- József Lehel
- Department of Food Hygiene, University of Veterinary Medicine Budapest, István u. 2., 1078 Budapest, Hungary;
- National Laboratory for Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine Budapest, István u. 2, 1078 Budapest, Hungary
| | - Márta Magyar
- Department of Food Hygiene, University of Veterinary Medicine Budapest, István u. 2., 1078 Budapest, Hungary;
| | - Péter Palotás
- The Fishmarket Fish Trading Company, Törökbálinti u. 23, 2040 Budaörs, Hungary;
| | - Zsolt Abonyi-Tóth
- Department of Biomathematics and Informatics, University of Veterinary Medicine Budapest, István u. 2., 1078 Budapest, Hungary;
| | - András Bartha
- Department of Animal Hygiene, Herd Health and Mobile Clinic, University of Veterinary Medicine Budapest, István u. 2., 1078 Budapest, Hungary;
| | - Péter Budai
- Institute of Plant Protection, Hungarian University of Agriculture and Life Sciences, Georgikon Campus, Deák F. u. 16, 8360 Keszthely, Hungary
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Kiss Z, Gálffy G, Müller V, Moldvay J, Sárosi V, Pápai-Székely Z, Csada E, Kerpel-Fronius A, Király Z, Szász Z, Hódi G, Polányi Z, Kovács K, Karamousouli E, Knollmajer K, Szabó TG, Berta A, Vokó Z, Rokszin G, Abonyi-Tóth Z, Barcza Z, Tamási L, Bogos K. Significant changes in advanced lung cancer survival during the past decade in Hungary: impact of modern immunotherapy and the COVID-19 pandemic. Front Oncol 2023; 13:1207295. [PMID: 37860193 PMCID: PMC10584310 DOI: 10.3389/fonc.2023.1207295] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/14/2023] [Indexed: 10/21/2023] Open
Abstract
Objective The approval of immunotherapy (I-O) for the treatment of late-stage non-small cell lung cancer (NSCLC) opened new perspectives in improving survival outcomes. However, survival data have not yet been provided from the period of the Covid-19 pandemic. The aims of our study were to assess and compare survival outcomes of patients with advanced LC receiving systemic anticancer treatment (SACT) before and after the approval of immunotherapy in Hungary, and to examine the impact of pandemic on survival outcomes using data from the Hungarian National Health Insurance Fund (NHIF) database. Methods This retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with advanced stage lung cancer (LC) (ICD-10 C34) between 1 January 2011 and 31 December 2021 and received SACT treatment without LC-related surgery. Survival rates were evaluated by year of diagnosis, sex, age, and LC histology. Results In total, 35,416 patients were newly diagnosed with advanced LC and received SACT during the study period (mean age at diagnosis: 62.1-66.3 years). In patients with non-squamous cell carcinoma, 3-year survival was significantly higher among those diagnosed in 2019 vs. 2011-2012 (28.7% [95% CI: 26.4%-30.9%] vs. 14.45% [95% CI: 13.21%-15.69%], respectively). In patients with squamous cell carcinoma, 3-year survival rates were 22.3% (95% CI: 19.4%-25.2%) and 13.37% (95% CI: 11.8%-15.0%) in 2019 and 2011-2012, respectively, the change was statistically significant. Compared to 2011-2012, the hazard ratio of survival change for non-squamous cell carcinoma patients was 0.91, 0.82, and 0.62 in 2015-2016, 2017-2018, and 2019, respectively (p<0.001 for all cases). In the squamous cell carcinoma group, corresponding hazard ratios were 0.93, 0.87, and 0.78, respectively (p<0.001 for all cases). Survival improvements remained significant in both patient populations during the Covid-19 pandemic (2020-2021). No significant improvements were found in the survival of patients with small cell carcinoma. Platinum-based chemotherapy was the most common first-line treatment in all diagnostic periods, however, the proportion of patients receiving first- or second-line immunotherapy significantly increased during the study period. Conclusion 3-year survival rates of NSCLC almost doubled among patients with non-squamous cell carcinoma and significantly improved at squamous cell carcinoma over the past decade in Hungary. Improvements could potentially be attributable by the introduction of immunotherapy and were not offset by the Covid-19 pandemic.
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Affiliation(s)
- Zoltán Kiss
- MSD Pharma Hungary Ltd, Budapest, Hungary
- Second Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary
| | - Gabriella Gálffy
- Pulmonology Hospital Törökbálint, Department of Pulmonology, Törökbálin, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Judit Moldvay
- 1st Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
- 2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | | | - Zsolt Pápai-Székely
- Fejér County Szent György, University Teaching Hospital, Székesfehérvár, Hungary
| | - Edit Csada
- Csongrád-Csanád County Hospital for Chest Diseases, Deszk, Hungary
| | - Anna Kerpel-Fronius
- National Korányi Institute of Pulmonology, Department of Radiology, Budapest, Hungary
| | - Zsolt Király
- Veszprém County Pulmonary Hospital, Farkasgyepű, Hungary
| | - Zoltán Szász
- Department of Pulmonology, Petz Aladár University Teaching Hospital, Győr, Hungary
| | - Gábor Hódi
- MSD Pharma Hungary Ltd, Budapest, Hungary
| | | | | | | | | | | | | | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
- Syreon Research Institute, Budapest, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary
- Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary
| | | | - Lilla Tamási
- Pulmonology Hospital Törökbálint, Department of Pulmonology, Törökbálin, Hungary
| | - Krisztina Bogos
- National Korányi Institute of Pulmonology, Budapest, Hungary
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Tóth T, Tóth MT, Abonyi-Tóth Z, Silva V, Poeta P, Sipos M, Juhász A. Ultrasound examination of the teat parameters of mastitis and healed udder quarters. Vet Anim Sci 2023; 21:100296. [PMID: 37275241 PMCID: PMC10238760 DOI: 10.1016/j.vas.2023.100296] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 06/07/2023] Open
Abstract
A healthy udder is important for economical and hygienic milk production. In this study we determined the teat parameters, measured during milking, in the presence of mastitis and after its recovery. The length of the streak canal, the area of the teat end and the area of the pars papillaris of 52 Holstein-Friesian cows were examined by ultrasound before, immediately after, and two hours after milking. Pars papillaris size before milking was higher in the presence of disease (P = 0.011), but was larger before and two hours after milking (P = 0.047 and P = 0.024) with more severe mastitis. During mastitis and recovery, the dimensions of the streak canal (P=0.056-0.934) and teat end (P=0.156-0.420) did not differ from each other. The obtained results show that during mastitis, coagulated milk dilates the pars papillaris better (P=0.011) than the higher milk production of the cured cow. After more severe mastitis, regeneration of the pars papillaris as well as post-milking regeneration also takes place more slowly. The size and size changes of the streak canal and teat end are not affected by the presence or healing of the udder inflammation.
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Affiliation(s)
- Tamás Tóth
- Ruminant Health Service, Budapest H-1044, Hungary
| | | | - Zsolt Abonyi-Tóth
- Department of Biostatistics, University of Veterinary Science, Budapest H-1078, Hungary
| | - Vanessa Silva
- LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, Universidade Nova de Lisboa, Caparica 2829-516, Portugal
- CECAV—Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real 5000-801, Portugal
| | - Patricia Poeta
- LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, Universidade Nova de Lisboa, Caparica 2829-516, Portugal
- CECAV—Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real 5000-801, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real 5000-801, Portugal
| | | | - Alexandra Juhász
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
- Institute of Medical Microbiology, Semmelweis University, Budapest H-1089, Hungary
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Kovács G, Abonyi-Tóth Z, Fadgyas-Freyler P, Kaló Z. Incremental cost of premature birth - a public health care payer perspective from Hungary. BMC Health Serv Res 2023; 23:686. [PMID: 37353814 DOI: 10.1186/s12913-023-09697-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 06/13/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Preterm birth remains a significant burden to families, health systems and societies. The aim was to quantify the incremental prematurity-related public health expenditure in Hungary and to estimate the potential impact of a decrease in the prevalence of prematurity on the public payer's spending. METHODS Over a 6-year time horizon, public financing data of inpatient, outpatient and pharmaceutical care for children born at ≥ 25 weeks of gestation in 2009/2010 were retrieved from the Hungarian National Health Insurance Fund database. In descriptive analysis, the public payer's spending was given as cost/capita. The impact of a decrease in prematurity prevalence was specified as the total budget impact. An exchange rate of 294 Hungarian forint/Euro was applied. RESULTS A total of 93,124 children (including 8.6% who were premature babies) were included in the analysis. A strong negative relationship was shown between gestational age and per capita cost. The 6-year cost of care for the cohort born at 26 weeks of gestation (28,470 Euro per capita) was 24 times higher than that for the cohort born at 40 weeks. First-year inpatient spending accounted for the largest proportion of total health care spending across all gestational ages. All investigated prematurity complications (retinopathy of prematurity, necrotizing enterocolitis, bronchopulmonary dysplasia, intraventricular cerebral bleeding and leukomalacia) resulted in additional significant incremental spending. If 70% of pregnancies ending with preterm birth could be prolonged by 1 week, the savings would be almost 7.0 million Euros in the first 6 years of life. CONCLUSION This comprehensive analysis of prematurity-related health care spending confirmed that premature infants have much higher costs for care than those born at term in Hungary. These quantitative outcomes can provide essential inputs for the cost-effectiveness analysis of medical technologies and public health interventions that can decrease the prevalence of premature birth. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Gábor Kovács
- Doctoral School of Sociology, Eötvös Loránd University, Budapest, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - Zsolt Abonyi-Tóth
- University of Veterinary Medicine, Budapest, Hungary
- RxTarget Ltd, Budapest, Hungary
| | | | - Zoltán Kaló
- Syreon Research Institute, Budapest, Hungary.
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary.
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Horváth DG, Abonyi-Tóth Z, Papp M, Szász AM, Rümenapf T, Knecht C, Kreutzmann H, Ladinig A, Balka G. Quantitative Analysis of Inflammatory Uterine Lesions of Pregnant Gilts with Digital Image Analysis Following Experimental PRRSV-1 Infection. Animals (Basel) 2023; 13:ani13050830. [PMID: 36899686 PMCID: PMC10000175 DOI: 10.3390/ani13050830] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/09/2023] [Accepted: 02/21/2023] [Indexed: 03/02/2023] Open
Abstract
Reproductive disorders caused by porcine reproductive and respiratory syndrome virus-1 are not yet fully characterized. We report QuPath-based digital image analysis to count inflammatory cells in 141 routinely, and 35 CD163 immunohistochemically stained endometrial slides of vaccinated or unvaccinated pregnant gilts inoculated with a high or low virulent PRRSV-1 strain. To illustrate the superior statistical feasibility of the numerical data determined by digital cell counting, we defined the association between the number of these cells and endometrial, placental, and fetal features. There was strong concordance between the two manual scorers. Distributions of total cell counts and endometrial and placental qPCR results differed significantly between examiner1's endometritis grades. Total counts' distribution differed significantly between groups, except for the two unvaccinated. Higher vasculitis scores were associated with higher endometritis scores, and higher total cell counts were expected with high vasculitis/endometritis scores. Cell number thresholds of endometritis grades were determined. A significant correlation between fetal weights and total counts was shown in unvaccinated groups, and a significant positive correlation was found between these counts and endometrial qPCR results. We revealed significant negative correlations between CD163+ counts and qPCR results of the unvaccinated group infected with the highly virulent strain. Digital image analysis was efficiently applied to assess endometrial inflammation objectively.
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Affiliation(s)
- Dávid G. Horváth
- Department of Pathology, University of Veterinary Medicine, István u. 2, 1078 Budapest, Hungary
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine, István u. 2, 1078 Budapest, Hungary
| | - Zsolt Abonyi-Tóth
- Department of Biostatistics, University of Veterinary Medicine, István u. 2, 1078 Budapest, Hungary
| | - Márton Papp
- Centre for Bioinformatics, University of Veterinary Medicine, István u. 2, 1078 Budapest, Hungary
| | - Attila Marcell Szász
- Department of Internal Medicine and Oncology, Semmelweis University, Korányi Sándor u. 2/a, 1083 Budapest, Hungary
| | - Till Rümenapf
- Institute of Virology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - Christian Knecht
- University Clinic for Swine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - Heinrich Kreutzmann
- University Clinic for Swine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - Andrea Ladinig
- University Clinic for Swine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - Gyula Balka
- Department of Pathology, University of Veterinary Medicine, István u. 2, 1078 Budapest, Hungary
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine, István u. 2, 1078 Budapest, Hungary
- Correspondence:
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Lénárt Z, Bartha A, Abonyi-Tóth Z, Lehel J. Monitoring of metal content in the tissues of wild boar (Sus scrofa) and its food safety aspect. Environ Sci Pollut Res Int 2023; 30:15899-15910. [PMID: 36178655 PMCID: PMC9908636 DOI: 10.1007/s11356-022-23329-6] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
The study was performed on 10 female and 10 male wild boars (Sus scrofa) after shooting during the regular hunting season to investigate the concentration of metals in the muscle and fat tissue. The concentrations of essential and non-essential elements were determined (arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), manganese (Mn), mercury (Hg), and zinc (Zn)) using inductively coupled plasma optical emission spectrometry. The concentrations of As, Hg, and Cd were below the limit of detection (As, Hg: < 0.5 mg/kg, Cd: < 0.05 mg/kg) in every tissue sample of both sexes. The lead was detected as 0.36 ± 0.16 mg/kg and 0.22 ± 0.06 mg/kg in the muscle of females and males, respectively, showing a significant difference between the sexes (p = 0.0184). The measured concentration of Cr was 0.14 ± 0.08 mg/kg and 0.13 ± 0.06 mg/kg, and that of copper was 1.22 ± 0.14 mg/kg and 1.06 ± 0.16 mg/kg in the muscle of females and males, respectively. The same tendency was observed in the case of copper content of fat tissues (female: 0.13 ± 0.10 mg/kg; male: 0.13 ± 0.04 mg/kg; p = 0.2707). Manganese concentration of muscle was 0.45 ± 0.30 mg/kg (female) and 1.36 ± 0.96 mg/kg (male), and that of fat tissue was 0.32 ± 0.22 mg/kg (female) and 0.74 ± 0.75 mg/kg (male). The Zn was detected as 56.75 ± 7.86 mg/kg and 1.83 ± 0.76 mg/kg in the muscle and fat of females and 52.12 ± 11.51 mg/kg and 1.94 ± 0.57 mg/kg in males, respectively. Based on data, the consumption of fat and muscle tissues of the wild boars tested can be food toxicologically objectionable, mainly due to the lead content, and thus pose a risk to frequent consumers of this type of game meat.
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Affiliation(s)
- Zoltán Lénárt
- Department of Food Hygiene, University of Veterinary Medicine, István u. 2, 1078, Budapest, Hungary
| | - András Bartha
- Department of Animal Hygiene, Herd Health and Mobile Clinic, University of Veterinary Medicine, István u. 2, 1078, Budapest, Hungary
| | - Zsolt Abonyi-Tóth
- Department of Biomathematics and Informatics, University of Veterinary Medicine, István u. 2, 1078, Budapest, Hungary
| | - József Lehel
- Department of Food Hygiene, University of Veterinary Medicine, István u. 2, 1078, Budapest, Hungary.
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10
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Kiss Z, Bogos K, Tamási L, Ostoros G, Müller V, Bittner N, Sárosi V, Vastag A, Knollmajer K, Várnai M, Kovács K, Berta A, Köveskuti I, Karamousouli E, Rokszin G, Abonyi-Tóth Z, Barcza Z, Kenessey I, Weber A, Nagy P, Freyler-Fadgyas P, Szócska M, Szegner P, Hilbert L, Géczy GB, Surján G, Moldvay J, Vokó Z, Gálffy G, Polányi Z. Underlying reasons for post-mortem diagnosed lung cancer cases - A robust retrospective comparative study from Hungary (HULC study). Front Oncol 2022; 12:1032366. [PMID: 36505881 PMCID: PMC9732724 DOI: 10.3389/fonc.2022.1032366] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/24/2022] [Indexed: 11/27/2022] Open
Abstract
Objective The Hungarian Undiagnosed Lung Cancer (HULC) study aimed to explore the potential reasons for missed LC (lung cancer) diagnosis by comparing healthcare and socio-economic data among patients with post-mortem diagnosed LC with those who were diagnosed with LC during their lives. Methods This nationwide, retrospective study used the databases of the Hungarian Central Statistical Office (HCSO) and National Health Insurance Fund (NHIF) to identify patients who died between January 1, 2019 and December 31, 2019 and were diagnosed with lung cancer post-mortem (population A) or during their lifetime (population B). Patient characteristics, socio-economic factors, and healthcare resource utilization (HCRU) data were compared between the diagnosed and undiagnosed patient population. Results During the study period, 8,435 patients were identified from the HCSO database with LC as the cause of death, of whom 1,203 (14.24%) had no LC-related ICD (International Classification of Diseases) code records in the NHIF database during their lives (post-mortem diagnosed LC population). Post-mortem diagnosed LC patients were significantly older than patients diagnosed while still alive (mean age 71.20 vs. 68.69 years, p<0.001), with a more pronounced age difference among female patients (difference: 4.57 years, p<0.001), and had significantly fewer GP (General Practitioner) and specialist visits, X-ray and CT scans within 7 to 24 months and 6 months before death, although the differences in GP and specialist visits within 7-24 months did not seem clinically relevant. Patients diagnosed with LC while still alive were more likely to be married (47.62% vs. 33.49%), had higher educational attainment, and had more children, than patients diagnosed with LC post-mortem. Conclusions Post-mortem diagnosed lung cancer accounts for 14.24% of total lung cancer mortality in Hungary. This study provides valuable insights into patient characteristics, socio-economic factors, and HCRU data potentially associated with a high risk of lung cancer misdiagnosis.
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Affiliation(s)
| | - Krisztina Bogos
- National Korányi Institute of Pulmonology, Directorate of Institution, Budapest, Hungary
| | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gyula Ostoros
- National Korányi Institute of Pulmonology, Directorate of Institution, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Nóra Bittner
- Department of Pulmonology, University of Debrecen, Debrecen, Hungary
| | | | | | | | | | | | | | | | | | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary
- University of Veterinary Medicine Budapest, Department of Biostatistics, Budapest, Hungary
| | - Zsófia Barcza
- Syntesia Medical Communications Ltd, Budapest, Hungary
| | - István Kenessey
- 1 Department of Pulmonology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - András Weber
- National Institute of Oncology, National Tumorbiology Laboratory project (NLP-17), Budapest, Hungary
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Péter Nagy
- National Institute of Oncology, National Tumorbiology Laboratory project (NLP-17), Budapest, Hungary
- Department of Anatomy and Histology, University of Veterinary Medicine, Budapest, Hungary
- Institute of Oncochemistry, University of Debrecen, Debrecen, Hungary
| | - Petra Freyler-Fadgyas
- National Health Insurance Fund, Department of Project Management and Data Services, Budapest, Hungary
| | - Miklós Szócska
- Institute of Digital Health Sciences, Semmelweis University, Budapest, Hungary
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Péter Szegner
- Institute of Digital Health Sciences, Semmelweis University, Budapest, Hungary
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Lászlóné Hilbert
- Hungarian Central Statistical Office, Department of Population Statistics, Budapest, Hungary
| | | | - György Surján
- Institute of Digital Health Sciences, Semmelweis University, Budapest, Hungary
| | - Judit Moldvay
- 2 Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Gabriella Gálffy
- Pulmonology Hospital Törökbálint, 6th Department, Törökbálint, Hungary
- Department of Thoracic Surgery, Semmelweis University, Budapest, Hungary
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11
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Jermendy G, Kiss Z, Rokszin G, Abonyi-Tóth Z, Lengyel C, Kempler P, Wittmann I. Changing Patterns of Antihyperglycaemic Treatment among Patients with Type 2 Diabetes in Hungary between 2015 and 2020-Nationwide Data from a Register-Based Analysis. Medicina (Kaunas) 2022; 58:medicina58101382. [PMID: 36295543 PMCID: PMC9612371 DOI: 10.3390/medicina58101382] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/17/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
Background and objectives: In the last couple of years, pharmacological management of patients with type 2 diabetes mellitus (T2DM) have been markedly renewed. The aim of this study was to analyse the changes in prescribing patterns of antidiabetic drugs for treating patients with T2DM in Hungary between 2015 and 2020. Material and Methods: In this retrospective, nationwide analysis, we used the central database of the National Health Insurance Fund. We present annual numbers and their proportion of T2DM patients with different treatment regimens. Results: In the period of 2015−2020, the number of incident cases decreased from 60,049 to 29,865, while prevalent cases increased from 682,274 to 752,367. Patients with metformin (MET) monotherapy had the highest prevalence (31% in 2020). Prevalence of insulin (INS) monotherapy continuously but slightly decreased from 29% to 27% while that of sulfonylurea (SU) monotherapy markedly decreased from 37% to 20%. Dipeptidyl peptidase (DPP-4) inhibitors remained popular in 2020 as monotherapy (5%), in dual combination with MET (12%) and in triple combination with MET and SU (5%). The prevalence of patients with sodium-glucose co-transporter-2 (SGLT-2) inhibitors increased from 1% to 4% in monotherapy, from <1% to 6% in dual combination with MET, and from <1% to 2% in triple oral combination with MET and SU or DPP-4-inhibitors. The prevalence of patients using glucagon-like peptide-1 receptor agonists (GLP-1-RAs) also increased but remained around 1−2% both in monotherapy and combinations. For initiating antihyperglycaemic treatment, MET monotherapy was the most frequently used regime in 2020 (50%), followed by monotherapy with SUs (16%) or INS (10%). After initial MET monotherapy, the incidence rates of patients with add-on GLP-1-RAs (2%, 3%, and 4%) and those of add-on SGLT-2 inhibitors (4%, 6%, and 8%) slowly increased in the subsequent 24, 48, and 72 months, respectively. Conclusions: In the period of 2015−2020, we documented important changes in trends of antihyperglycaemic therapeutic patterns in patients with T2DM which followed the new scientific recommendations but remained below our expectations regarding timing and magnitude. More efforts are warranted to implement new agents with cardiovascular/renal benefits into therapeutic management in time, in a much larger proportion of T2DM population, and without delay.
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Affiliation(s)
- György Jermendy
- Department of Internal Medicine, Bajcsy-Zsilinszky Teaching Hospital and Outpatient Clinic, Maglódi út 89-91, 1106 Budapest, Hungary
- Correspondence: ; Tel.: +36-20-9282445
| | - Zoltán Kiss
- Nephrology-Diabetes Center, 2nd Department of Internal Medicine, Faculty of Medicine, University of Pécs, Pacsirta út 1, 7624 Pécs, Hungary
| | - György Rokszin
- RxTarget Ltd., Bacsó Nándor utca 10, 5000 Szolnok, Hungary
| | | | - Csaba Lengyel
- Department of Internal Medicine, Faculty of Medicine, University of Szeged, Kálvária sgt. 57, 6725 Szeged, Hungary
| | - Péter Kempler
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Korányi Sándor út 2, 1082 Budapest, Hungary
| | - István Wittmann
- Nephrology-Diabetes Center, 2nd Department of Internal Medicine, Faculty of Medicine, University of Pécs, Pacsirta út 1, 7624 Pécs, Hungary
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12
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Kerek Á, Sasvári M, Jerzsele Á, Somogyi Z, Janovák L, Abonyi-Tóth Z, Dékány I. Photoreactive Coating Material as an Effective and Durable Antimicrobial Composite in Reducing Bacterial Load on Surfaces in Livestock. Biomedicines 2022; 10:biomedicines10092312. [PMID: 36140413 PMCID: PMC9496029 DOI: 10.3390/biomedicines10092312] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022] Open
Abstract
Titanium dioxide (TiO2) is a well-known photocatalytic compound that can be used to effectively reduce the presence of pathogens in human and animal hospitals via ROS release. The aim of this study was to investigate the efficacy of a polymer-based composite layer containing TiO2 and zinc oxide (ZnO) against Escherichia coli (E. coli) of animal origin. We showed that the photocatalyst coating caused a significant (p < 0.001) reduction in pathogen numbers compared to the control with an average reduction of 94% over 30 min. We used six light sources of different wattages (4 W, 7 W, 9 W, 12 W, 18 W, 36 W) at six distances (35 cm, 100 cm, 150 cm, 200 cm, 250 cm, 300 cm). Samples (n = 2160) were taken in the 36 settings and showed no significant difference in efficacy between light intensity and distance. We also investigated the influence of organic contaminant that resulted in lower activity as well as the effect of a water jet and a high-pressure device on the antibacterial activity. We found that the latter completely removed the coating from the surface, which significantly (p < 0.0001) reduced its antibacterial potential. As a conclusion, light intensity and distance does not reduce the efficacy of the polymer, but the presence of organic contaminants does.
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Affiliation(s)
- Ádám Kerek
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, István Street 2, H-1078 Budapest, Hungary
- Correspondence: (Á.K.); (I.D.)
| | - Mátyás Sasvári
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, István Street 2, H-1078 Budapest, Hungary
| | - Ákos Jerzsele
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, István Street 2, H-1078 Budapest, Hungary
| | - Zoltán Somogyi
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, István Street 2, H-1078 Budapest, Hungary
| | - László Janovák
- Department of Physical Chemistry and Materials Science, University of Szeged, Rerrich Béla tér 1, H-6720 Szeged, Hungary
| | - Zsolt Abonyi-Tóth
- Department of Biomathematics and Informatics, University of Veterinary Medicine, István Street 2, H-1078 Budapest, Hungary
| | - Imre Dékány
- Department of Physical Chemistry and Materials Science, University of Szeged, Rerrich Béla tér 1, H-6720 Szeged, Hungary
- Correspondence: (Á.K.); (I.D.)
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13
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Kiss Z, Bogos K, Tamási L, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Knollmajer K, Várnai M, Nagy B, Horváth K, Rokszin G, Abonyi-Tóth Z, Barcza Z, Moldvay J, Gálffy G, Vokó Z. Increase in the Length of Lung Cancer Patient Pathway Before First-Line Therapy: A 6-Year Nationwide Analysis From Hungary. Pathol Oncol Res 2021; 27:1610041. [PMID: 35002544 PMCID: PMC8734146 DOI: 10.3389/pore.2021.1610041] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/01/2021] [Indexed: 12/24/2022]
Abstract
Objective: This study aimed to examine the characteristics of the lung cancer (LC) patient pathway in Hungary during a 6-years period. Methods: This nationwide, retrospective study included patients newly diagnosed with LC (ICD-10 C34) between January 1, 2011, and December 31, 2016, using data from the National Health Insurance Fund (NHIF) of Hungary. The following patient pathway intervals were examined: system, diagnostic and treatment interval by age, gender, tumor type, study year and first-line LC therapy. Results: During the 6-years study period, 17,386 patients had at least one type of imaging (X-ray or CT/MRI) prior to diagnosis, and 12,063 had records of both X-ray and CT/MRI. The median system interval was 64.5 days, and it was 5 days longer among women, than in men (68.0 vs. 63.0 days). The median system interval was significantly longer in patients with adenocarcinoma compared to those with squamous cell carcinoma or small cell lung cancer (70.4 vs. 64.0 vs. 48.0 days, respectively). Patients who received surgery as first-line treatment had significantly longer median system intervals compared to those receiving chemotherapy (81.4 vs. 62.0 days). The median system interval significantly increased from 62.0 to 66.0 days during the 6-years study period. Conclusion: The LC patient pathway significantly increased in Hungary over the 6-years study period. There were no significant differences in the length of the whole LC patient pathway according to age, however, female sex, surgery as first-line treatment, and adenocarcinoma were associated with longer system intervals.
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Affiliation(s)
- Zoltan Kiss
- MSD Pharma Hungary Ltd., Budapest, Hungary
- *Correspondence: Zoltan Kiss,
| | - Krisztina Bogos
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gyula Ostoros
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Matrahaza Healthcare Center and University Teaching Hospital, Matrahaza, Hungary
| | - Nóra Bittner
- Department of Pulmonology, University of Debrecen, Debrecen, Hungary
| | | | | | | | | | | | | | - Balázs Nagy
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Krisztián Horváth
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary
- Department of Biomathematics and Computer Science, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Zsófia Barcza
- Syntesia Medical Communications Ltd., Budapest, Hungary
| | - Judit Moldvay
- 1st Department of Pulmonology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary
- 2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | | | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
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14
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Gálffy G, Vastag A, Bogos K, Kiss Z, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Polányi Z, Nagy-Erdei Z, Daniel A, Knollmajer K, Várnai M, Szegner P, Vokó Z, Nagy B, Horváth K, Rokszin G, Abonyi-Tóth Z, Pozsgai É, Barcza Z, Moldvay J, Tamási L. Significant Regional Differences in Lung Cancer Incidence in Hungary: Epidemiological Study Between 2011 and 2016. Pathol Oncol Res 2021; 27:1609916. [PMID: 34594159 PMCID: PMC8478017 DOI: 10.3389/pore.2021.1609916] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/27/2021] [Indexed: 12/09/2022]
Abstract
Objective: Hungary has one of the highest incidences and mortality rates of lung cancer (LC), therefore the objective of this study was to analyse and compare LC incidence and mortality rates between the main Hungarian regions. Methods: This nationwide, retrospective study used data from the National Health Insurance Fund and included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between Jan 1, 2011 and Dec 31, 2016. Age-standardized incidence and mortality rates were calculated and compared for the main regions. Results: The highest incidence rate in males was recorded in Northern Hungary (146.8/100,000 person-years [PY]), while the lowest rate was found in Western Transdanubia (94.7/100,000 PY in 2011). All rates showed a declining trend between 2011 and 2016, with the largest decrease in the Northern Great Plain (−20.0%; p = 0.008). LC incidence and mortality rates in women both showed a rising tendency in all regions of Hungary, reaching the highest in Central Hungary (59.86/100,000 PY in 2016). Lung cancer incidence and mortality rates in males correlated with the level of education and smoking prevalence (p = 0.006 and p = 0.01, respectively) in the regions. A correlation with GDP per capita and Health Development Index (HDI) index could also be observed in the Hungarian regions, although these associations were not statistically significant. No correlations could be detected between these parameters among females. Conclusion: This analysis revealed considerable differences in the epidemiology of LC between the 7 main Hungarian regions. LC incidence and mortality rates significantly correlated with smoking and certain socioeconomic factors in men, but not in women. Further research is needed to explain the regional differences.
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Affiliation(s)
- Gabriella Gálffy
- Department of Pulmonology, Pulmonology Hospital Törökbálint, Törökbálint, Hungary
| | | | - Krisztina Bogos
- Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | - Gyula Ostoros
- Department of Pulmonology, Pulmonology Hospital Törökbálint, Törökbálint, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Department of Pulmonology, Mátraháza Healthcare Center and University Teaching Hospital, Mátraháza, Hungary
| | - Nóra Bittner
- Pulmonology Clinic, University of Debrecen, Debrecen, Hungary
| | - Veronika Sárosi
- Department of Pulmonology, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | | | | | | | | | - Máté Várnai
- MSD Pharma Hungary Ltd, Budapest, Hungary.,Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Péter Szegner
- MSD Pharma Hungary Ltd, Budapest, Hungary.,Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Zoltán Vokó
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | - Balázs Nagy
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | - Krisztián Horváth
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary.,Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Éva Pozsgai
- Department of Primary Health Care, University of Pécs Medical School, Pécs, Hungary
| | - Zsófia Barcza
- Syntesia Medical Communications Ltd., Budapest, Hungary
| | - Judit Moldvay
- Department of Tumor Biology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary.,MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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15
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Boér K, Rubovszky G, Rokszin G, Abonyi-Tóth Z, Földesi C, Dank M. Demographic Characteristics and Treatment Patterns Among Patients Receiving Palbociclib for HR+/HER2- Advanced Breast Cancer: A Nationwide Real-World Experience. Onco Targets Ther 2021; 14:3971-3981. [PMID: 34234466 PMCID: PMC8257075 DOI: 10.2147/ott.s309862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/18/2021] [Accepted: 06/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background This nationwide retrospective study reports data on the real-world use of the selective cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor palbociclib in a large population of advanced breast cancer (ABC) patients during a 2-year period in Hungary. Methods All patients with ABC who received palbociclib between May 1, 2017 and June 30, 2019 were included in the analysis. Patient demographic and clinical characteristics, disease-related factors and treatment patterns were examined during the early access program and in the regular reimbursement period. Results Altogether, 962 patients were included (mean age: 60.6 years). A total of 399 patients (41%) were treated with palbociclib plus aromatase inhibitors (P+AI), and 563 patients (59%) received palbociclib and fulvestrant (P+F). The most commonly prescribed AI was letrozole (n=359; 90%). Of those with metastatic disease (n=733; 76%), 241 patients (33%) had visceral metastases and 449 (61%) had bone-only disease. The majority of patients (79%) received palbociclib as first- or second-line therapy for ABC. The starting dose of palbociclib was 125 mg in 98% of patients; dose reductions were required in 32% of patients receiving P+AI and 31% of those treated with P+F. At the time of data collection, palbociclib therapy was ongoing in 270 patients (68%) in the P+AI group and 245 patients (44%) in the P+F group. Conclusions This nationwide analysis is the first to provide insights into the real-world use of palbociclib in a large patient population from a Central-Eastern European country. The findings confirm the good tolerability of palbociclib with similar dose reduction rates to those reported from registration trials.
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Affiliation(s)
- Katalin Boér
- Department of Medical Oncology, Szent Margit Hospital, Budapest, Hungary
| | - Gábor Rubovszky
- Chemotherapy Department B, National Institute of Oncology, Budapest, Hungary.,Department of Internal Medicine and Oncology, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary.,University of Veterinary Medicine, Budapest, Hungary
| | | | - Magdolna Dank
- Department of Internal Medicine and Oncology, Semmelweis University, Faculty of Medicine, Budapest, Hungary
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16
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Tamási L, Horváth K, Kiss Z, Bogos K, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Daniel A, Nagy B, Rokszin G, Abonyi-Tóth Z, Moldvay J, Vokó Z, Gálffy G. Age and Gender Specific Lung Cancer Incidence and Mortality in Hungary: Trends from 2011 Through 2016. Pathol Oncol Res 2021; 27:598862. [PMID: 34257553 PMCID: PMC8262188 DOI: 10.3389/pore.2021.598862] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/28/2021] [Indexed: 01/10/2023]
Abstract
Objective: No assessment was conducted describing the age and gender specific epidemiology of lung cancer (LC) prior to 2018 in Hungary, thus the objective of this study was to appraise the detailed epidemiology of lung cancer (ICD-10 C34) in Hungary based on a retrospective analysis of the National Health Insurance Fund database. Methods: This longitudinal study included patients aged ≥20 years with LC diagnosis (ICD-10 C34) between January 1, 2011 and December 31, 2016. Patients with different cancer-related codes 6 months before or 12 months after LC diagnosis or having any cancer treatment other than lung cancer protocols were excluded. Results: Lung cancer incidence and mortality increased with age, peaking in the 70–79 age group (375.0/100,000 person-years) among males, while at 60–69 age group for females (148.1/100,000 person-years). The male-to-female incidence rate ratio reached 2.46–3.01 (p < 0.0001) among the 70–79 age group. We found 2–11% decrease in male incidence rate at most age groups, while a significant 1–3% increase was observed in older females (>60) annually during the study period. Conclusion: This nationwide epidemiology study demonstrated that LC incidence and mortality in Hungary decreased in younger male and female population, however we found significant increase of incidence in older female population, similar to international trends. Incidence rates peaked in younger age-groups compared to Western countries, most likely due to higher smoking prevalence in these cohorts, while lower age LC incidence could be attributed to higher competing cardiovascular risk resulting in earlier mortality in smoking population.
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Affiliation(s)
- Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Krisztián Horváth
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | | | - Krisztina Bogos
- National Korányi Institute of Pulmonology, Department of Pulmonology, Budapest, Hungary
| | - Gyula Ostoros
- National Korányi Institute of Pulmonology, Department of Pulmonology, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Mátraháza Healthcare Center and University Teaching Hospital, Mátraháza, Hungary
| | - Nóra Bittner
- Pulmonology Clinic, University of Debrecen, Debrecen, Hungary
| | | | | | | | | | | | - Balázs Nagy
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary.,University of Veterinary Medicine, Budapest, Hungary
| | - Judit Moldvay
- Department of Tumor Biology, National Korányi Institute of Pulmonology - Semmelweis University, Budapest, Hungary.,2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Zoltán Vokó
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | - Gabriella Gálffy
- Department of Pulmonology, Semmelweis University, Budapest, Hungary.,Pulmonology Hospital, Törökbálint, Hungary
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17
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Bogos K, Kiss Z, Tamási L, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Daniel A, Vokó Z, Nagy B, Horváth K, Rokszin G, Abonyi-Tóth Z, Barcza Z, Gálffy G, Moldvay J. Improvement in Lung Cancer Survival: 6-Year Trends of Overall Survival at Hungarian Patients Diagnosed in 2011-2016. Pathol Oncol Res 2021; 27:603937. [PMID: 34257563 PMCID: PMC8262181 DOI: 10.3389/pore.2021.603937] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/24/2021] [Indexed: 12/25/2022]
Abstract
Objective: Lung cancer is one of the most common cancers worldwide and its survival is still poor. The objective of our study was to estimate long-term survival of Hungarian lung cancer patients at first time based on a nationwide review of the National Health Insurance Fund database. Methods: Our retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between January 1, 2011 and December 31, 2016. Survival rates were evaluated by year of diagnosis, patient gender and age, and morphology of lung cancer. Results: 41,854 newly diagnosed lung cancer patients were recorded. Mean age at diagnosis varied between 64.7 and 65.9 years during study period. One- and 5-year overall survival rates for the total population were 42.2 and 17.9%, respectively. Survival was statistically associated with gender, age and type of lung cancer. Female patients (n = 16,362) had 23% better survival (HR: 0.77, 95% confidence interval (CI): 0.75–0.79; p < 0.001) than males (n = 25,492). The highest survival rates were found in the 20–49 age cohort (5Y = 31.3%) and if the cancer type was adenocarcinoma (5Y = 20.5%). We measured 5.3% improvement (9.2% adjusted) in lung cancer survival comparing the period 2015–2016 to 2011–2012 (HR: 0.95 95% CI: 0.92–0.97; p = 0.003), the highest at females <60 year (0.86 (adjusted HR was 0.79), interaction analysis was significant for age and histology types. Conclusion: Our study provided long-term Lung cancer survival data in Hungary for the first time. We found a 5.3% improvement in 5-year survival in 4 years. Women and young patients had better survival. Survival rates were comparable to–and at the higher end of–rates registered in other East-Central European countries (7.7%–15.7%).
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Affiliation(s)
- Krisztina Bogos
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gyula Ostoros
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Matrahaza Healthcare Center and University Teaching Hospital, Matrahaza, Hungary
| | - Nóra Bittner
- Pulmonology Clinic University of Debrecen, Debrecen, Hungary
| | | | | | | | | | | | | | | | | | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd. Szolnok, Budapest, Hungary.,University of Veterinary Medicine Budapest, Budapest, Hungary
| | | | | | - Judit Moldvay
- Ist Department of Pulmonology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary.,2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
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18
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Bogos K, Kiss Z, Kerpel Fronius A, Temesi G, Elek J, Madurka I, Cselkó Z, Csányi P, Abonyi-Tóth Z, Rokszin G, Barcza Z, Moldvay J. Different Trends in Excess Mortality in a Central European Country Compared to Main European Regions in the Year of the COVID-19 Pandemic (2020): a Hungarian Analysis. Pathol Oncol Res 2021; 27:1609774. [PMID: 34257618 PMCID: PMC8262208 DOI: 10.3389/pore.2021.1609774] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/17/2021] [Indexed: 12/15/2022]
Abstract
Objective: This study examined cumulative excess mortality in European countries in the year of the Covid-19 pandemic and characterized the dynamics of the pandemic in different countries, focusing on Hungary and the Central and Eastern European region. Methods: Age-standardized cumulative excess mortality was calculated based on weekly mortality data from the EUROSTAT database, and was compared between 2020 and the 2016-2019 reference period in European countries. Results: Cumulate weekly excess mortality in Hungary was in the negative range until week 44. By week 52, it reached 9,998 excess deaths, corresponding to 7.73% cumulative excess mortality vs. 2016-2019 (p-value = 0.030 vs. 2016-2019). In Q1, only Spain and Italy reported excess mortality compared to the reference period. Significant increases in excess mortality were detected between weeks 13 and 26 in Spain, United Kingdom, Belgium, Netherland and Sweden. Romania and Portugal showed the largest increases in age-standardized cumulative excess mortality in the Q3. The majority of Central and Eastern European countries experienced an outstandingly high impact of the pandemic in Q4 in terms of excess deaths. Hungary ranked 11th in cumulative excess mortality based on the latest available data of from the EUROSTAT database. Conclusion: Hungary experienced a mortality deficit in the first half of 2020 compared to previous years, which was followed by an increase in mortality during the second wave of the COVID-19 pandemic, reaching 7.7% cumulative excess mortality by the end of 2020. The excess was lower than in neighboring countries with similar dynamics of the pandemic.
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Affiliation(s)
- Krisztina Bogos
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Zoltan Kiss
- 2nd Department of Medicine and Nephrological Center, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | | | | | - Jenő Elek
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Ildikó Madurka
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | - Péter Csányi
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | | | - Zsófia Barcza
- Syntesia Medical Communications Ltd., Budapest, Hungary
| | - Judit Moldvay
- 1st Department of Pulmonology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary
- 2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
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19
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Bogos K, Kiss Z, Gálffy G, Tamási L, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Vokó Z, Nagy B, Horváth K, Rokszin G, Abonyi-Tóth Z, Barcza Z, Moldvay J. Lung Cancer in Hungary. J Thorac Oncol 2021; 15:692-699. [PMID: 32340676 DOI: 10.1016/j.jtho.2019.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 11/02/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Krisztina Bogos
- IV. Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | | | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gyula Ostoros
- IV. Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Mátraháza Healthcare Center and University Teaching Hospital, Mátraháza, Hungary
| | - Nóra Bittner
- University of Debrecen, Pulmonology Clinic, Debrecen, Hungary
| | | | | | | | | | | | | | | | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary; University of Veterinary Medicine, Budapest, Hungary
| | | | - Judit Moldvay
- Department of Tumor Biology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary; MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
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20
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Bogos K, Kiss Z, Gálffy G, Tamási L, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Vokó Z, Nagy B, Rokszin G, Abonyi-Tóth Z, Moldvay J. [Novel approaches to the epidemiology of lung cancer in Hungary]. Magy Onkol 2020; 64:175-181. [PMID: 32966347] [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] [Received: 09/02/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
In the international publications, in the last decades, incidence and mortality of lung cancer was the highest in Hungary in the ranking of European countries and even worldwide, despite the fact that no lung cancer incidence data were reported from Hungary until 2019. In the studies published by our working group at the end of 2019 and in the first half of 2020, we were the first to publish Hungarian lung cancer incidence and mortality data based on research on the NEAK database. The results of this study showed a significant, 25-30% lower incidence of lung cancer in Hungary than the previously reported data. Based on these findings, it was determined that the previously reported Hungarian lung cancer incidence and mortality data can be compiled due to different methodological applications of inadequately calculated results, and Hungarian lung cancer incidence and mortality are equally high, but not higher than the average in Central European countries. In addition, a decrease in the incidence and mortality of male lung cancer was measured between 2011 and 2016, while increasing values were found for women.
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Affiliation(s)
| | | | | | - Lilla Tamási
- Pulmonológiai Klinika, Semmelweis Egyetem, Budapest, Hungary
| | - Gyula Ostoros
- Országos Korányi Pulmonológiai Intézet, Budapest, Hungary.
| | - Veronika Müller
- Pulmonológiai Klinika, Semmelweis Egyetem, Budapest, Hungary
| | | | - Nóra Bittner
- Tüdőgyógyászati Klinika, Debreceni Egyetem Klinikai Központ, Debrecen, Hungary
| | - Veronika Sárosi
- I. Sz. Belgyógyászati Klinika, Pécsi Egyetem Klinikai Központ, Pulmonológiai Tanszék, Pécs, Hungary
| | | | | | | | | | | | | | | | - Judit Moldvay
- Országos Korányi Pulmonológiai Intézet, Budapest, Hungary.
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21
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Barkai L, Kiss Z, Rokszin G, Abonyi-Tóth Z, Jermendy G, Wittmann I, Kempler P. Changes in the incidence and prevalence of type 1 and type 2 diabetes among 2 million children and adolescents in Hungary between 2001 and 2016 - a nationwide population-based study. Arch Med Sci 2020; 16:34-41. [PMID: 32051703 PMCID: PMC6963129 DOI: 10.5114/aoms.2019.88406] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 08/13/2019] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The aim of the present study was to assess changes in the incidence and prevalence of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in children and adolescents in Hungary during the period 2001 to 2016 in order to provide nationwide population-based epidemiology data on diabetes in youths aged 0-18 years. MATERIAL AND METHODS This was a retrospective cohort study of Hungarian children and adolescents aged 18 years or younger. Pharmacologically treated diabetes cases were obtained through a population-based registry of the Hungarian National Health Insurance Fund. Time series analysis was used to evaluate the changing patterns of the incidence and prevalence for type 1 and type 2 diabetes covering a 16-year period. RESULTS During the study period, 6,138 and 1,997 new T1DM and T2DM cases were observed, respectively. Newly diagnosed T2DM cases accounted for 24.5% of all incident diabetes cases. Incidence of T1DM increased from 16/100,000 to 23/100,000 (R 2 = 0.7681; p < 0.0001). The male-to-female ratio among newly diagnosed T1DM patients did not change over the study period. Prevalence of T1DM rose from 114/100,000 to 209/100,000 (R 2 = 0.9909; p < 0.0001). The prevalent T1DM cases showed significant male predominance in every year (p < 0.05). Incidence of T2DM decreased from 8/100,000 to 5/100,000 (R 2 = 0.4977; p < 0.0014). The overall prevalence of T2DM did not change significantly. Prevalent T2DM cases showed significant female predominance in every year (p < 0.0001). A significant decrease in male-to female ratio was observed among newly diagnosed T2DM cases over the study period (p < 0.0001). CONCLUSIONS According to these population-based Hungarian data of children and adolescents with diabetes, T1DM is still the most common form and its frequency continues to rise, affecting more males than females. A high proportion of patients have T2DM, affecting more females than males, but the occurrence of medically treated cases is not increasing. The decrease in male-to-female ratio in newly diagnosed T2DM cases needs further investigations.
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Affiliation(s)
- László Barkai
- Institute of Theoretical Health Sciences, Faculty of Health Care, University of Miskolc, Miskolc, Hungary
- Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Zoltán Kiss
- 2 Department of Medicine and Nephrological Center, Medical Faculty, University of Pécs, Pécs, Hungary
| | | | | | | | - István Wittmann
- 2 Department of Medicine and Nephrological Center, Medical Faculty, University of Pécs, Pécs, Hungary
| | - Péter Kempler
- 1 Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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22
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Kiss Z, Rokszin G, Abonyi-Tóth Z, Jermendy G, Kempler P, Barkai L, Wittmann I. Young adult patients with type 1 diabetes have a higher risk of mortality than those of similar age with type 2 diabetes: A nationwide analysis in Hungary. Diabetes Metab Res Rev 2019; 35:e3190. [PMID: 31140677 DOI: 10.1002/dmrr.3190] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 04/11/2019] [Accepted: 05/22/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND There are few papers comparing complications of type 1 diabetes with those of a similarly young age with type 2 diabetes. The aim of our nationwide study was to compare the risks of mortality and morbidities between the two types of diabetes (age ≤ 40). METHODS We identified all young adult patients with type 1 diabetes who were recorded in the database of the Hungarian National Health Insurance Fund between 2001 and 2014 (n = 11 863) and compared them with a population of similar age with young adult type 2 diabetes (n = 47 931). The incidence of all-cause mortality, myocardial infarction, stroke, any type of cancer, diabetic ketoacidosis, and hypoglycemia was followed from the onset of diabetes to the date of death or end of study period. RESULTS The risks of all-cause mortality were significantly higher in patients with type 1 compared with patients with type 2 diabetes (hazard ratio, 95%CI; 2.17, 1.95-2.41; P < .0001). The risks of myocardial infarction (0.90, 0.71-1.13; P = 0.36) and stroke (1.06, 0.87-1.29; P = .582) were not significantly different in type 1 compared with type 2. In contrast, the risk of cancer (1.35, 1.15-1.59; P = .0003), dialysis (2.20, 1.76-2.75; P < .0001), hypoglycemia (7.70, 6.45-9.18; P < .0001), and ketoacidosis (22.12, 19.60-25.00; P < .0001) was higher among patients with type 1 compared with those with type 2 diabetes. CONCLUSIONS A comparatively higher incidence of diabetic ketoacidosis and hypoglycemia and higher risk of cancer and dialysis in patients with type 1 diabetes than in those with type 2 may play a role in the higher risk of mortality.
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Affiliation(s)
- Zoltán Kiss
- 2nd Department of Medicine and Nephrological Center, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary
- University of Veterinary Medicine, Budapest, Hungary
| | | | - Péter Kempler
- 1st Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - László Barkai
- Institute of Theoretical Health Sciences, Faculty of Health Care, University of Miskolc, Miskolc, Hungary
- Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
| | - István Wittmann
- 2nd Department of Medicine and Nephrological Center, Faculty of Medicine, University of Pécs, Pécs, Hungary
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23
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Bogos K, Kiss Z, Gálffy G, Tamási L, Ostoros G, Müller V, Urbán L, Bittner N, Sárosi V, Vastag A, Polányi Z, Nagy-Erdei Z, Vokó Z, Nagy B, Horváth K, Rokszin G, Abonyi-Tóth Z, Moldvay J. Revising Incidence and Mortality of Lung Cancer in Central Europe: An Epidemiology Review From Hungary. Front Oncol 2019; 9:1051. [PMID: 31709174 PMCID: PMC6819432 DOI: 10.3389/fonc.2019.01051] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 08/15/2019] [Accepted: 09/26/2019] [Indexed: 12/30/2022] Open
Abstract
Objective: While Hungary is often reported to have the highest incidence and mortality rates of lung cancer, until 2018 no nationwide epidemiology study was conducted to confirm these trends. The objective of this study was to estimate the occurrence of lung cancer in Hungary based on a retrospective review of the National Health Insurance Fund (NHIF) database. Methods: Our retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between 1 Jan 2011 and 31 Dec 2016. Age-standardized incidence and mortality rates were calculated using both the 1976 and 2013 European Standard Populations (ESP). Results: Between 2011 and 2016, 6,996 – 7,158 new lung cancer cases were recorded in the NHIF database annually, and 6,045 – 6,465 all-cause deaths occurred per year. Age-adjusted incidence rates were 115.7–101.6/100,000 person-years among men (ESP 1976: 84.7–72.6), showing a mean annual change of − 2.26% (p = 0.008). Incidence rates among women increased from 48.3 to 50.3/100,000 person-years (ESP 1976: 36.9–38.0), corresponding to a mean annual change of 1.23% (p = 0.028). Age-standardized mortality rates varied between 103.8 and 97.2/100,000 person-years (ESP 1976: 72.8–69.7) in men and between 38.3 and 42.7/100,000 person-years (ESP 1976: 27.8–29.3) in women. Conclusion: Age-standardized incidence and mortality rates of lung cancer in Hungary were found to be high compared to Western-European countries, but lower than those reported by previous publications. The incidence of lung cancer decreased in men, while there was an increase in incidence and mortality among female lung cancer patients.
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Affiliation(s)
- Krisztina Bogos
- Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | | | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gyula Ostoros
- Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Urbán
- Mátraháza Healthcare Center, University Teaching Hospital, Mátraháza, Hungary
| | - Nóra Bittner
- Pulmonology Clinic, University of Debrecen, Debrecen, Hungary
| | | | | | | | | | - Zoltán Vokó
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | - Balázs Nagy
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | - Krisztián Horváth
- Department of Health Policy and Health Economics, Eötvös Loránd University, Budapest, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary.,University of Veterinary Medicine, Budapest, Hungary
| | - Judit Moldvay
- Department of Tumor Biology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary.,2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
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24
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Jermendy G, Kiss Z, Rokszin G, Abonyi-Tóth Z, Wittmann I, Kempler P. Decreasing incidence of pharmacologically treated Type 2 diabetes in Hungary from 2001 to 2016: A nationwide cohort study. Diabetes Res Clin Pract 2019; 155:107788. [PMID: 31326457 DOI: 10.1016/j.diabres.2019.107788] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/17/2019] [Accepted: 07/08/2019] [Indexed: 11/19/2022]
Abstract
AIMS Incidence and prevalence of Type 2 diabetes mellitus (T2DM) vary in different regions. Long-term nationwide epidemiological data are useful to assess trends over time. The aim of the study was to analyze the epidemiological changes of pharmacologically treated T2DM among people aged over 18 years in Hungary between 2001 and 2016. METHODS Annual incidence, prevalence and all-cause mortality rate of pharmacologically treated T2DM patients were evaluated from 2001 to 2016 using the central database of the National Institute of Health Insurance Fund Management. Data were adjusted to age using the 2013 European Standard Population. RESULTS Incident rate of pharmacologically treated T2DM decreased from 931.6 cases/100,000 person-years to 350.7 cases/100,000 person-years resulting in a -62.4% change (annual average change: -6.46% [95% CI: -7.64%; -5.67%]) between 2001 and 2016. The prevalence rate continuously increased from 4949.9 cases/100,000 persons in 2001 to the highest rate (8135.0 cases/100,000 persons) in 2011, which plateaued during the next 3 years and slightly decreased thereafter. Standardized all-cause mortality rate in people with T2DM decreased between 2001 and 2016 by 11.9% (annual average change: -0.84% [95% CI: -1.22%; -0.39%]). CONCLUSIONS Despite a clearly decreasing incidence of pharmacologically treated T2DM in patients aged over 18 years, the prevalence rate increased from 2001 to 2011 followed by a 3-year-long plateau and a slight decrease thereafter. These long-term trends with the reduced mortality rate may indicate favorable effects of health promotional activities for preventing and treating T2DM.
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Affiliation(s)
- György Jermendy
- Bajcsy-Zsilinszky Hospital, Maglódi út 89-91, 1106 Budapest, Hungary.
| | - Zoltán Kiss
- University of Pécs, Faculty of Medicine, 2nd Department of Medicine and Nephrologica1 Center, Pacsirta út 1, 7624 Pécs, Hungary
| | - György Rokszin
- RxTarget Ltd., Bacsó Nándor út 10, 5000 Szolnok, Hungary.
| | | | - István Wittmann
- University of Pécs, Faculty of Medicine, 2nd Department of Medicine and Nephrologica1 Center, Pacsirta út 1, 7624 Pécs, Hungary.
| | - Péter Kempler
- Semmelweis University, Faculty of Medicine, 1st Department of Medicine, Korányi Sándor út 2, 1083 Budapest, Hungary.
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Tóth T, Abonyi-Tóth Z, Pajor F, Kocsis R, Juhász A, Tőzsér J, Póti P. Changes in the values of two ultrasound-examined teat parameters during the dry period in dairy cows. Acta Vet Hung 2019; 67:456-462. [PMID: 31549547 DOI: 10.1556/004.2019.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
The length of the streak canal and the area of the teat end were studied by ultrasound during the dry period in 40 Holstein-Friesian cows. In the first week, the values of these teat parameters decreased significantly (P < 0.05) and this did not change significantly until the middle of the dry period. In the last month of gestation, the length of the streak canal was significantly reduced (P < 0.05), while the area of the teat end did not decrease significantly (P > 0.05). At each of the five examination times, a very strong positive correlation (r = 0.85-0.94) was found between the two teat parameters. In healthy cows, the streak canal and the area of teat end, both of which are part of the udder's defence system, can regenerate sufficiently during the dry period, minimising the risk of contamination through the streak canal and the development of mastitis. If the regeneration of this defence system fails, the chances of infection through the streak canal increase.
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Affiliation(s)
- Tamás Tóth
- 1Animal Husbandry Institute, Szent István University, Páter K. u. 1, H-2100 Gödöllő, Hungary
| | - Zsolt Abonyi-Tóth
- 2Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - Ferenc Pajor
- 1Animal Husbandry Institute, Szent István University, Páter K. u. 1, H-2100 Gödöllő, Hungary
| | - Róbert Kocsis
- 3 Hungarian Milk Experimentation Institute, Mosonmagyaróvár, Hungary
| | - Alexandra Juhász
- 4Department of Parasitology and Zoology, University of Veterinary Medicine, Budapest, Hungary
| | - János Tőzsér
- 1Animal Husbandry Institute, Szent István University, Páter K. u. 1, H-2100 Gödöllő, Hungary
| | - Péter Póti
- 1Animal Husbandry Institute, Szent István University, Páter K. u. 1, H-2100 Gödöllő, Hungary
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Fodor I, Gábor G, Lang Z, Abonyi-Tóth Z, Ózsvári L. Relationship between reproductive management practices and fertility in primiparous and multiparous dairy cows. Can J Vet Res 2019; 83:218-227. [PMID: 31308594 PMCID: PMC6587879] [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] [Received: 07/09/2018] [Accepted: 10/26/2018] [Indexed: 06/10/2023]
Abstract
The aim of this study was to analyze the impact of reproductive management practices on fertility in primiparous and multiparous dairy cows and to identify the differences by parity. Data on reproductive performance and management of cows were gathered from 34 large commercial Holstein-Friesian dairy herds in Hungary. Individual data on 23 781 cows that calved in the studied herds in 2014 were collected from the national milk recording database and used to calculate the reproductive indices. Farm managers and veterinarians were interviewed in person from May 22 to November 6, 2015 using a questionnaire to collect information about reproductive management practices. The data were statistically analyzed by mixed-effects models. Our results showed that the use of a voluntary waiting period (VWP) was linked to a greater increase in calving-to-conception interval (CCI, P < 0.05) and a greater decline in the chance of pregnancy at 200 days in milk (P200, P < 0.001) in multiparous cows. Estrus synchronization was related to a larger reduction in days-to-first service (DFS, P < 0.001), breeding interval (IBI, P < 0.05), and CCI (P < 0.01) and a greater improvement in P200 (P < 0.001) in primiparous cows. Early pregnancy diagnosis and pregnancy recheck improved IBI (P < 0.01 for both practices), CCI (P < 0.01 and P < 0.001, respectively), and P200 (P < 0.001 for both practices) to a larger extent in primiparous than in multiparous cows. In conclusion, estrus synchronization, early pregnancy diagnosis, and pregnancy recheck led to a greater improvement in fertility in primiparous cows than in multiparous cows.
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Affiliation(s)
- István Fodor
- Department of Veterinary Forensics, Law and Economics (Fodor, Ózsvári) and Department of Biomathematics and Informatics (Lang, Abonyi-Tóth), University of Veterinary Medicine Budapest, István utca 2, H-1078 Budapest, Hungary; Research Institute for Animal Breeding, Nutrition and Meat Science, National Agricultural Research and Innovation Centre, Gesztenyés utca 1, H-2053 Herceghalom, Hungary (Gábor)
| | - György Gábor
- Department of Veterinary Forensics, Law and Economics (Fodor, Ózsvári) and Department of Biomathematics and Informatics (Lang, Abonyi-Tóth), University of Veterinary Medicine Budapest, István utca 2, H-1078 Budapest, Hungary; Research Institute for Animal Breeding, Nutrition and Meat Science, National Agricultural Research and Innovation Centre, Gesztenyés utca 1, H-2053 Herceghalom, Hungary (Gábor)
| | - Zsolt Lang
- Department of Veterinary Forensics, Law and Economics (Fodor, Ózsvári) and Department of Biomathematics and Informatics (Lang, Abonyi-Tóth), University of Veterinary Medicine Budapest, István utca 2, H-1078 Budapest, Hungary; Research Institute for Animal Breeding, Nutrition and Meat Science, National Agricultural Research and Innovation Centre, Gesztenyés utca 1, H-2053 Herceghalom, Hungary (Gábor)
| | - Zsolt Abonyi-Tóth
- Department of Veterinary Forensics, Law and Economics (Fodor, Ózsvári) and Department of Biomathematics and Informatics (Lang, Abonyi-Tóth), University of Veterinary Medicine Budapest, István utca 2, H-1078 Budapest, Hungary; Research Institute for Animal Breeding, Nutrition and Meat Science, National Agricultural Research and Innovation Centre, Gesztenyés utca 1, H-2053 Herceghalom, Hungary (Gábor)
| | - László Ózsvári
- Department of Veterinary Forensics, Law and Economics (Fodor, Ózsvári) and Department of Biomathematics and Informatics (Lang, Abonyi-Tóth), University of Veterinary Medicine Budapest, István utca 2, H-1078 Budapest, Hungary; Research Institute for Animal Breeding, Nutrition and Meat Science, National Agricultural Research and Innovation Centre, Gesztenyés utca 1, H-2053 Herceghalom, Hungary (Gábor)
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Kiss Z, Rokszin G, Abonyi-Tóth Z, Jermendy G, Kempler P, Wittmann I. Different Changes of Risks for Stroke and Myocardial Infarction in Patients With Type 2 Diabetes in Hungary Between the Two Periods of 2001-2004 and 2010-2013. Front Endocrinol (Lausanne) 2019; 10:170. [PMID: 30949133 PMCID: PMC6437040 DOI: 10.3389/fendo.2019.00170] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 02/28/2019] [Indexed: 01/09/2023] Open
Abstract
Objective: In recent decades several studies reported significant changes in the mortality and morbidity of patients with type 2 diabetes. In this Hungarian nationwide study, we assessed the changes of mortality and cardiovascular risks comparing a group of patient diagnosed during the two periods of 2001-2004 and 2010-2013. Research Design and Methods: We identified patients with type 2 diabetes recorded in the database of the Hungarian National Health Insurance Fund aiming to assess changes of risks for all-cause mortality, myocardial infarction, and stroke during the follow-up periods of 48 months. Results: We included 274,109 patients with newly diagnosed type 2 diabetes between 2001 and 2004, while only 152,678 in the 2010-2013 period. The risk of all-cause mortality at the beginning of the follow-up was not different comparing 2010-2013 to 2001-2004 (HR 1.03), and a mild but significant decrease could be detected (HR 0.87) after 48 months. A lower risk for myocardial infarction was documented in the second month after the diagnosis of diabetes (HR 0.67), which remained constant during the study period and almost the same after 48 months (HR 0.73). On the contrary, our study verified a slightly increased risk for stroke close to the diagnosis [HR 1.06 (1.00-1.13)] and a decreased one [HR 0.72 (0.69-0.79)] at the end of the study. Conclusions: An increased risk for stroke followed by a sharp decrease, and an unchanged risk for myocardial infarction in the Hungarian population with type 2 diabetes possibly resulted in a mild decrease of all-cause mortality between 2001 and 2013.
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Affiliation(s)
- Zoltan Kiss
- Second Department of Medicine and Nephrological Center, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - György Jermendy
- Medical Department, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
| | - Péter Kempler
- First Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - István Wittmann
- Second Department of Medicine and Nephrological Center, Faculty of Medicine, University of Pécs, Pécs, Hungary
- *Correspondence: István Wittmann
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Jermendy G, Kiss Z, Rokszin G, Abonyi-Tóth Z, Wittmann I, Kempler P. Persistence to Treatment with Novel Antidiabetic Drugs (Dipeptidyl Peptidase-4 Inhibitors, Sodium-Glucose Co-Transporter-2 Inhibitors, and Glucagon-Like Peptide-1 Receptor Agonists) in People with Type 2 Diabetes: A Nationwide Cohort Study. Diabetes Ther 2018; 9:2133-2141. [PMID: 30120754 PMCID: PMC6167279 DOI: 10.1007/s13300-018-0483-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Adequate persistence to antidiabetic treatment is highly important to achieve proper glycemic control. In this study we evaluate the persistence to treatment with dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter-2 inhibitors, and glucagon-like peptide-1 receptor agonists in a nationwide cohort of patients with type 2 diabetes. METHODS Using a central database in Hungary, we analyzed the persistence to the treatment with dipeptidyl peptidase-4 inhibitors (n = 59,900), sodium-glucose co-transporter-2 inhibitors (n = 26,052), and glucagon-like peptide-1 receptor agonists (n = 17,332) at treatment intensification between 2014 and 2016. We also compared the persistence of dipeptidyl peptidase-4 inhibitors (n = 9163) and sodium-glucose co-transporter-2 inhibitors (n = 1257) in initial therapy to that of metformin (n = 79,305) or sulfonylureas (n = 29,057). The rates of persistence to treatment and risk of non-persistence are reported. RESULTS The persistence rates of dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter-2 inhibitors, and glucagon-like peptide-1 receptor agonists at treatment intensification were 69.6%, 67.8%, and 66.3% at year 1 which decreased to 57.3%, 56.8%, and 52.1% by year 2, respectively. The risk of non-persistence was higher by 6.6% (95% CI 3.6-9.6) for sodium-glucose co-transporter-2 inhibitors and by 8.3% (95% CI 5.0-11.5) for glucagon-like peptide-1 receptor agonists as compared to dipeptidyl peptidase-4 inhibitors. Novel oral antidiabetic drugs in fixed versus free add-on combinations with metformin had higher persistence. The persistence to treatment with novel oral antidiabetic drugs in initial therapy was better (dipeptidyl peptidase-4 inhibitors, 59.6% and 47.6%; sodium-glucose co-transporter-2 inhibitors, 61.9% and 47.0%) than that of initial monotherapy with metformin (47.0% and 39.1%) or sulfonylureas (52.4% and 41.8%) at years 1 and 2, respectively. CONCLUSION Analysis of persistence of treatment with novel glucose-lowering medications revealed differences between drug classes, favoring dipeptidyl peptidase-4 inhibitors vs. sodium-glucose co-transporter-2 inhibitors and glucagon-like peptide-1 receptor agonists. Persistence data of novel antihyperglycemic agents may be useful for guiding the decision at initiation of antidiabetic treatment. FUNDING Hungarian Diabetes Association. Plain language summary available for this article.
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Affiliation(s)
- György Jermendy
- Bajcsy-Zsilinszky Hospital, Maglódi út 89-91, 1106, Budapest, Hungary.
| | - Zoltán Kiss
- Faculty of Medicine, 2nd Department of Medicine and Nephrological Center, University of Pécs, Pacsirta út 1, 7624, Pécs, Hungary
| | - György Rokszin
- RxTarget Ltd, Bacsó Nándor út 10, 5000, Szolnok, Hungary
| | | | - István Wittmann
- Faculty of Medicine, 2nd Department of Medicine and Nephrological Center, University of Pécs, Pacsirta út 1, 7624, Pécs, Hungary
| | - Péter Kempler
- Faculty of Medicine, 1st Department of Medicine, Semmelweis University, Korányi Sándor út 2, 1083, Budapest, Hungary
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Kiss Z, Rokszin G, Abonyi-Tóth Z, Jermendy G, Kempler P, Aradi D, Wittmann I. Dissimilar impact of type 2 diabetes on cardiovascular outcomes according to age categories: a nationwide population study from Hungary. Cardiovasc Diabetol 2018; 17:107. [PMID: 30053870 PMCID: PMC6062985 DOI: 10.1186/s12933-018-0751-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/23/2018] [Indexed: 12/21/2022] Open
Abstract
Background The excess risks of mortality and cardiovascular morbidity among patients with type 2 diabetes mellitus (T2DM) is well known. In this nationwide study, we assessed risks of mortality and cardiovascular events comparing patients with T2DM and matched controls. Methods We identified patients with T2DM in a retrospective cohort study using the database of the National Health Insurance Fund between 1 January 2010 and 31 December, 2013. Controls were randomly included and matched according to age, gender, and zip code of residence. Patients were divided into subgroups according to age decades for outcome analyses. Results During the mean follow-up period of 2.3 years, 152,678 patients with T2DM and 305,356 matched controls were included. Patients with T2DM showed significantly higher risk for all-cause mortality (HR 1.26, 95% CI 1.22–1.29, p < 0.0001), myocardial infarction (HR 1.81, 95% CI 1.69–1.94, p < 0.0001) and stroke (HR 1.40, 95% CI 1.35–1.46, p < 0.0001) compared to matched controls. The higher risk associated with T2DM for mortality, myocardial infarction and stroke differed significantly between age groups (pinteraction < 0.05 for all outcomes) with significantly higher risk observed in younger patients. Conclusions The risk of cardiovascular outcomes and all-cause mortality is significantly higher in patients with T2DM. Notably, the relative hazard increases with decreasing age suggesting that younger patients with T2DM should receive more attention for cardiovascular prevention.
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Affiliation(s)
- Zoltán Kiss
- 2nd Department of Medicine and Nephrological Center, Faculty of Medicine, University of Pécs, Pacsirta str. 1, Pecs, 7624, Hungary
| | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd., Szolnok, Hungary.,University of Veterinary Medicine, Budapest, Hungary
| | | | - Péter Kempler
- I. Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Dániel Aradi
- Heart Centre Balatonfüred and Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
| | - István Wittmann
- 2nd Department of Medicine and Nephrological Center, Faculty of Medicine, University of Pécs, Pacsirta str. 1, Pecs, 7624, Hungary.
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Keller SR, Abonyi-Tóth Z, Sprenger N, Austin SC, Wichert BAC, Liesegang A, Oei CHY, Balogh O, Reichler IM. Effect of metoclopramide treatment of bitches during the first week of lactation on serum prolactin concentration, milk composition, and milk yield and on weight gain of their puppies. Am J Vet Res 2018; 79:233-241. [DOI: 10.2460/ajvr.79.2.233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Jermendy G, Kiss Z, Rokszin G, Abonyi-Tóth Z, Wittmann I, Kempler P. A 2-es típusú diabetes antihyperglykaemiás kezelésének alakulása Magyarországon 2001–2014 között – az Országos Egészségbiztosítási Pénztár adatbázis-elemzésének eredményei. Orv Hetil 2017; 158:770-778. [DOI: 10.1556/650.2017.30769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract: In the last couple of years, significant developments in antidiabetic treatment have influenced the pharmacological treatment of type 2 diabetes mellitus (T2DM). The aim of this study was to analyze the changes in prescribing patterns of glucose-lowering drugs for T2DM patients in Hungary between 2001 and 2014. The number of patients with newly diagnosed T2DM decreased from 75,700 (2001) to 33,700 (2014), while prevalent T2DM cases continuously increased and plateaued in 2014 with a number of registered patients of 727,000. Sulfonylurea-monotherapy decreased from 64% to 35% while metformin-monotherapy increased from 19% to 42% in this period. The most frequently used drug at first treatment initiation was metformin (66%) and sulfonylurea (16%) as monotherapy in 2014. DPP4-inhibitors were newly administered in 20,362 cases while GLP1-mimetics were newly used by 4,996 patients in 2014. Five years later after initiating sulfonylurea therapy between 2010 and 2014, metformin was more frequently used as second drug (39%) than sulfonylurea in patients with previous metformin treatment (22.9%). The prescribing patterns of glucose-lowering drugs have changed over time in accordance with new guidelines. Further changes in prescribing habits can be expected in the near future. Orv Hetil. 2017; 158(20): 770–778.
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Affiliation(s)
| | - Zoltán Kiss
- II. Belgyógyászati Klinika és Nephrológiai Centrum, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs
| | | | | | - István Wittmann
- II. Belgyógyászati Klinika és Nephrológiai Centrum, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs
| | - Péter Kempler
- I. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
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Reinitz LZ, Bajzik G, Garamvölgyi R, Benedek B, Petneházy Ö, Lassó A, Abonyi-Tóth Z, Lőrincz B, Sótonyi P. Linear relationship found by magnetic resonance imaging between cerebrospinal fluid volume and body weight in dogs. Acta Vet Hung 2017; 65:1-12. [PMID: 28244335 DOI: 10.1556/004.2017.001] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Despite numerous studies on cerebrospinal fluid (CSF) and its importance during hydrocephalus or myelography, no reliable values exist about its overall volume in dogs. In this study, our aim was to measure the intracranial (IC) volume of CSF in dogs and assess its possible relationship with body size and the symmetry of the lateral ventricles. We ran a 3D magnetic resonance imaging (MRI) sequence on the central nervous system of 12 healthy, male mongrel dogs between 3-5 years of age and 7.5-35.0 kg body weight. A validated semiautomatic segmentation protocol was implemented to segment the CSF and measure its volume. Values for the volume of the ventricular compartment were between 0.97 and 2.94 ml, with 62.1 ± 11.7% in the lateral ventricles, 17.6 ± 4.9% in the third ventricle, 4.9 ± 1.6% in the aqueductus mesencephali and 15.5 ± 6.6% in the fourth ventricle. In 11 cases a significant asymmetry was found between the lateral ventricles. The results suggest that it may be normal for a dog to have one of the lateral ventricles 1.5 times larger than the other. The correlation between body weight and CSF volume was linear, indicating that the current dosage protocols for myelography, based on a hypothetical proportional relationship with body weight, may have to be revised.
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Affiliation(s)
- László Z. Reinitz
- 1Department of Anatomy and Histology, University of Veterinary Medicine, István u. 2, H-1078 Budapest, Hungary
| | - Gábor Bajzik
- 2Institute of Diagnostic Imaging and Radiation Oncology, Kaposvár University, Kaposvár, Hungary
| | - Rita Garamvölgyi
- 2Institute of Diagnostic Imaging and Radiation Oncology, Kaposvár University, Kaposvár, Hungary
| | - Bianka Benedek
- 1Department of Anatomy and Histology, University of Veterinary Medicine, István u. 2, H-1078 Budapest, Hungary
| | - Örs Petneházy
- 2Institute of Diagnostic Imaging and Radiation Oncology, Kaposvár University, Kaposvár, Hungary
| | - András Lassó
- 3School of Computing, Queen’s University, Kingston, Canada
| | - Zsolt Abonyi-Tóth
- 4Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - Borbála Lőrincz
- 2Institute of Diagnostic Imaging and Radiation Oncology, Kaposvár University, Kaposvár, Hungary
| | - Péter Sótonyi
- 1Department of Anatomy and Histology, University of Veterinary Medicine, István u. 2, H-1078 Budapest, Hungary
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Végh Á, Abonyi-Tóth Z, Rafai P. Effect of current intensity and duration on the effectiveness of head-only electrical stunning in pigs under commercial conditions. Acta Vet Hung 2017; 65:13-28. [PMID: 28244337 DOI: 10.1556/004.2017.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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
After head-only electrical stunning of pigs sequential animal-based measurements were carried out right after stunning as well as before and after bleeding in order to analyse how unconsciousness is achieved and maintained in relation to recorded and calculated technical parameters such as electric current intensity, electric work, duration of stunning, and stun-to-bloodletting period. The measurements were performed at three different slaughterhouses on 9 different days under routine slaughtering conditions. The data of 405 pigs were analysed. The effectiveness of stunning was measured by the number of parameters at two (adequate and acceptable) levels. Current intensity had a predominant effect on the effectiveness of stunning and on the maintenance of unconsciousness. The duration of stunning played a role only as part of the electric work, which manifested itself in the maintenance of unconsciousness. Stunning proved acceptable in 99% of the cases, provided that the minimum current intensity of 1.02 Amp was secured. In 99% of the cases unconsciousness could be maintained at an acceptable level beyond bloodletting when the electric work was at least 8,089.38 Joules. Recovery of consciousness depends on the stun-to-stick period: the best time of bloodletting is less than 32 seconds from the end of stunning.
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Affiliation(s)
- Ákos Végh
- 1 Alpha-Vet Animal Health Limited, Homoksor 7, H-8000 Székesfehérvár, Hungary
| | - Zsolt Abonyi-Tóth
- 2Department of Biomathematics and Informatics University of Veterinary Medicine,, Budapest, Hungary
| | - Pál Rafai
- 3Department of Animal Hygiene, Herd Health and Veterinary Ethology, University of Veterinary Medicine,, Budapest, Hungary
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Jermendy G, Kempler P, Abonyi-Tóth Z, Rokszin G, Wittmann I. [Changes in features of diabetes care in Hungary in the period of years 2001-2014. Aims and methods of the database analysis of the National Health Insurance Fund]. Orv Hetil 2017; 157:1259-65. [PMID: 27499284 DOI: 10.1556/650.2016.30519] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In the last couple of years, database analyses have become increasingly popular among clinical-epidemiological investigations. In Hungary, the National Health Insurance Fund serves as central database of all medical attendances in state departments and purchases of drug prescriptions in pharmacies. Data from in- and outpatient departments as well as those from pharmacies are regularly collected in this database which is public and accessible on request. The aim of this retrospective study was to investigate the database of the National Health Insurance Fund in order to analyze the diabetes-associated morbidity and mortality in the period of years 2001-2014. Moreover, data of therapeutic costs, features of hospitalizations and practice of antidiabetic treatment were examined. The authors report now on the method of the database analysis. It is to be hoped that the upcoming results of this investigation will add some new data to recent knowledge about diabetes care in Hungary. Orv. Hetil., 2016, 157(32), 1259-1265.
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Affiliation(s)
| | - Péter Kempler
- I. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | | | | | - István Wittmann
- II. Belgyógyászati Klinika és Nephrologiai Centrum, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs
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35
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Gábor G, Kastelic JP, Abonyi-Tóth Z, Gábor P, Endrődi T, Balogh OG. Pregnancy Loss in Dairy Cattle: Relationship of Ultrasound, Blood Pregnancy-Specific Protein B, Progesterone and Production Variables. Reprod Domest Anim 2016; 51:467-73. [DOI: 10.1111/rda.12703] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/10/2016] [Indexed: 11/28/2022]
Affiliation(s)
- G Gábor
- National Agricultural Research and Innovation Centre Research Institute for Animal Breeding, Nutrition and Meat Science; Herceghalom Hungary
| | - JP Kastelic
- Department of Production Animal Health; Faculty of Veterinary Medicine; University of Calgary; Calgary, Alberta Canada
| | - Z Abonyi-Tóth
- Faculty of Veterinary Science Szent Istvan University; Gödöllő Hungary
| | - P Gábor
- Androvet Kft.; Budapest Hungary
| | - T Endrődi
- Dennis Gábor Applied University; Budapest Hungary
| | - OG Balogh
- National Agricultural Research and Innovation Centre Research Institute for Animal Breeding, Nutrition and Meat Science; Herceghalom Hungary
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36
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Reinitz LZ, Bajzik G, Garamvölgyi R, Petneházy Ö, Lassó A, Abonyi-Tóth Z, Lőrincz B, Sótonyi P. COMPARISON BETWEEN MAGNETIC RESONANCE IMAGING ESTIMATES OF EXTRACRANIAL CEREBROSPINAL FLUID VOLUME AND PHYSICAL MEASUREMENTS IN HEALTHY DOGS. Vet Radiol Ultrasound 2015; 56:658-65. [PMID: 26311617 DOI: 10.1111/vru.12283] [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: 08/02/2014] [Accepted: 05/13/2015] [Indexed: 11/29/2022] Open
Abstract
Dosages for myelography procedures in dogs are based on a hypothetical proportional relationship between bodyweight and cerebrospinal fluid (CSF) volume. Anecdotal radiographic evidence and recent studies have challenged the existence of such a defined relationship in dogs. The objectives of this prospective cross-sectional study were to describe CSF volumes using magnetic resonance imaging (MRI) in a group of clinically healthy dogs, measure the accuracy of MRI CSF volumes, and compare MRI CSF volumes with dog physical measurements. A sampling perfection with application optimized contrast using different flip-angle evolution MRI examination of the central nervous system was carried out on 12 healthy, male mongrel dogs, aged between 3 and 5 years with a bodyweight range of 7.5-35.0 kg. The images were processed with image analysis freeware (3D Slicer) in order to calculate the volume of extracranial CSF. Cylindrical phantoms of known volume were included in scans and used to calculate accuracy of MRI volume estimates. The accuracy of MRI volume estimates was 99.8%. Extracranial compartment CSF volumes ranged from 20.21 to 44.06 ml. Overall volume of the extracranial CSF increased linearly with bodyweight, but the proportional volume (ml/bodyweight kilograms) of the extracranial CSF was inversely proportional to bodyweight. Relative ratios of volumes in the cervical, thoracic, and lumbosacral regions were constant. Findings indicated that the current standard method of using body weight to calculate dosages of myelographic contrast agents in dogs may need to be revised.
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Affiliation(s)
- László Z Reinitz
- Department of Anatomy and Histology, Faculty of Veterinary Science, Szent István University, Hungary
| | - Gábor Bajzik
- Institute of Diagnostic Imaging and Radiation Oncology, Kaposvár University, Hungary
| | - Rita Garamvölgyi
- Institute of Diagnostic Imaging and Radiation Oncology, Kaposvár University, Hungary
| | - Örs Petneházy
- Institute of Diagnostic Imaging and Radiation Oncology, Kaposvár University, Hungary
| | - András Lassó
- School of Computing, Queen's University, Kingston, Canada
| | - Zsolt Abonyi-Tóth
- Department of Biomathematics and Informatics, Faculty of Veterinary Science, Szent István University, Hungary
| | - Borbála Lőrincz
- Institute of Diagnostic Imaging and Radiation Oncology, Kaposvár University, Hungary
| | - Péter Sótonyi
- Department of Anatomy and Histology, Faculty of Veterinary Science, Szent István University, Hungary
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Abstract
Hungary is a world leader in lung cancer deaths, so it is of crucial importance that patients have access to modern treatments. The aim of our analysis was to explore how drug treatments are used in Hungary and how they are compatible with international practice. The inpatient and prescription database of the National Health Insurance Fund Administration of Hungary was used to study the frequency of certain chemotherapy protocols and duration of therapies during a 3-year period (2008–2010). During the study period, 12,326 lung cancer patients received first-line chemotherapy, a third of those (n=3,791) received second-line treatment, and a third of the latter (n=1,174) received third-line treatment. The average treatment duration was between 3 and 4 months. The first-line treatment of non-small-cell lung carcinoma mainly consisted of platinum treatment in combination with third-generation cytotoxic agents. A downward trend of gemcitabine, still the most common combination compound, was observed, in parallel with a significantly increased use of paclitaxel, and as a consequence carboplatin replaced cisplatin. Among the new agents, the use of pemetrexed and bevacizumab increased. Pemetrexed appeared mainly in second-line treatment, while erlotinib appeared also in second-line but mostly in third-line treatments. The first-line treatment of small-cell lung carcinoma consisted of a platinum–etoposide combination, while in the second-line setting topotecan was the most commonly used drug. According to our results, the chemotherapeutic combinations and sequencing are in accordance with international and national recommendations. Further detailed analysis of the available data may help to obtain a more accurate picture of the efficacy of lung cancer treatments as well.
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Affiliation(s)
- Judit Moldvay
- Department of Tumor Biology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary
| | | | | | - Lajos Katona
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Katalin Fábián
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Gábor Kovács
- National Korányi Institute of Pulmonology and Tuberculosis, Budapest, Hungary
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Inotai A, Abonyi-Tóth Z, Rokszin G, Vokó Z. Prognosis, Cost, and Occurrence of Colorectal, Lung, Breast, and Prostate Cancer in Hungary. Value Health Reg Issues 2015; 7:1-8. [PMID: 29698146 DOI: 10.1016/j.vhri.2015.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 10/29/2014] [Revised: 02/26/2015] [Accepted: 03/30/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is an increasing social debate on expenditures on the care of patients with malignant diseases, especially in Central Eastern European countries with limited health resources. OBJECTIVES The aim of this research was to estimate the epidemiological and quality measures and resource use indicators in Hungary in four malignant conditions (breast, colorectal, lung, and prostate cancer) from the National Health Insurance Fund (NHIF) database. METHODS Survival and cost analyses were performed on the NHIF database. Patient records containing the International Classification of Diseases (ICD) codes C50 (breast cancer), C18-C20 (colorectal cancer), C33-C34 (lung cancer), and C61 (prostate cancer) were considered eligible. Inclusion criteria were at least two consecutive ICD codes between 2000 and 2012, with a minimum of 30-day difference, or one ICD code, followed by patient death within 60 days. A total of 428,860 social insurance numbers met inclusion criteria. RESULTS The number of new cases was 6381 for breast cancer, 8457 for colorectal cancer, 8902 for lung cancer, and 3419 for prostate cancer. The probability of 5-year overall survival from the first diagnosis was 75.2%, 41.3%, 17.1%, and 62.1%, respectively. Median time from first diagnosis to treatment initiation was less than 1 month in all conditions except for lung cancer. The annual cost of treatment was €2585, €3165, €4157, and €2834, respectively. Cost figures were compared with hemophilia as benchmark (€8284). CONCLUSIONS The results indicated that the database of the Hungarian NHIF is suitable for real-world data analysis in the field of oncology and can support long-term evidence-based policymaking.
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Affiliation(s)
| | - Zsolt Abonyi-Tóth
- RxTarget Statistical Agency, Szolnok, Hungary; Department of Biomathematics and Informatics, Szent István University, Budapest, Hungary
| | | | - Zoltán Vokó
- Syreon Research Institute, Budapest, Hungary; Faculty of Social Sciences, Department of Health Policy and Health Economics, Institute of Economics, Eötvös Loránd University (ELTE), Budapest, Hungary
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Inotai A, Abonyi-Tóth Z, Rokszin G, Voko Z. Occurrence, Survival And Annual Cost of Colorectal-, Breast-, Prostate- and Lung Cancer in Hungary. Value Health 2014; 17:A553. [PMID: 27201806 DOI: 10.1016/j.jval.2014.08.1809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- A Inotai
- Syreon Research Institute, Budapest, Hungary
| | | | | | - Z Voko
- Syreon Research Institute, Budapest, Hungary
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Balogh O, Túry E, Abonyi-Tóth Z, Kastelic J, Gábor G. Macroscopic and histological characteristics of fluid-filled ovarian structures in dairy cows. Acta Vet Hung 2014; 62:215-32. [PMID: 24334085 DOI: 10.1556/avet.2013.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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
The primary objective of this study was to use macroscopic and histological features of corpora lutea with a cavity and anovulatory cystic ovarian structures, present in 90 pairs of abattoir-derived dairy cow ovaries, as the basis to clarify the nomenclature of ovarian structures. Excluding morphologically normal ovarian fol-licles (antrum < 2 cm, wall < 1 mm), there were 27 fluid-filled ovarian structures. Ovulatory structures > 16 mm in diameter were designated as Group A (cavity ≤ 10 mm and wall > 10 mm) or Group B (cavity > 10 mm and wall < 10 mm). The volume of luteal tissue was less (P < 0.05) in Group B than in Group A, whereas that of a solid corpus luteum (CL) was intermediate (least square means ± SEM: 72 ± 1.92, 11.22 ± 1.57 and 5.84 ± 1.92 cm3, respectively). There was a greater proportion (P < 0.05) of small luteal cells in Group B compared to a solid CL, whereas Group A was intermediate (58.6 ± 5.3, 37.4 ± 5.3 and 44.0 ± 4.4%, respectively). Connective tissue was thicker (P < 0.05) in Group B than in Group A (295.4 ± 46.9 vs. 153.9 ± 38.2 μm). Based on the above-mentioned characteristics and differences, Groups A and B were designated as a CL with a cavity and a cystic CL, respectively. Furthermore, there were three groups of anovulatory ovarian structures. Structures in Group C were termed persistent/anovulatory follicles (overall diameter and wall thickness ≤ 20 and 1-3 mm, respectively). Finally, Groups D and E were designated as a follicle-fibrous cyst and a follicle-luteinised cyst (based on histological structure) for anovulatory structures with an overall diameter and wall thickness of ≥ 20 and ≤ 3 mm, and ≥ 20 and ≥ 3 mm, respectively.
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Affiliation(s)
- Orsolya Balogh
- 1 Research Institute for Animal Breeding and Nutrition Gesztenyés u. 1 Herceghalom H-2053 Hungary
| | - Ernő Túry
- 2 Szent István University Department of Anatomy and Histology Budapest Hungary
| | - Zsolt Abonyi-Tóth
- 3 Szent István University Department of Biomathematics and Informatics, Faculty of Veterinary Science Budapest Hungary
| | - John Kastelic
- 3 Szent István University Department of Biomathematics and Informatics, Faculty of Veterinary Science Budapest Hungary
| | - György Gábor
- 1 Research Institute for Animal Breeding and Nutrition Gesztenyés u. 1 Herceghalom H-2053 Hungary
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Hatvani C, Balogh OG, Endrődi T, Abonyi-Tóth Z, Holló I, Kastelic JP, Gábor G. Estrus response and fertility after a single cloprostenol treatment in dairy cows with various ovarian structures. Can J Vet Res 2013; 77:218-220. [PMID: 24101799 PMCID: PMC3700448] [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] [Received: 02/06/2012] [Accepted: 07/30/2012] [Indexed: 06/02/2023]
Abstract
The objective of this study was to determine rates of estrus and conception in lactating multiparous Holstein cows given 500 μg of cloprostenol intramuscularly after detection of the following ≥ 60 d after parturition: a solid corpus luteum (CL), a CL with a nonechodense cavity ≤ 20 mm in diameter (CLcav), a luteal cyst (cavity > 20 mm in diameter and a luteinized wall > 3 mm in diameter), or a follicular cyst (cavity > 20 mm and a luteinized wall ≤ 3 mm in diameter). The estrus rates were 335/419 (80.0%), 183/223 (82.1%), 170/182 (93.4%), and 44/87 (50.6%), respectively (P < 0.0001), and the conception rates 30 to 36 d after insemination among the estrous cows with an apparently normal mucus discharge were 130/285 (45.6%), 44/141 (31.2%), 39/79 (49.4%), and 19/30 (63.3%), respectively (P < 0.002). Compared with a solid CL, a CLcav did not affect the estrus rate but significantly reduced the conception rate (P < 0.05), and the estrus rates were significantly higher and lower in cows with a luteal or follicular cyst, respectively (P < 0.05).
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Affiliation(s)
| | | | | | | | | | | | - György Gábor
- Address all correspondence to Dr. György Gábor; telephone/fax: +3623/319133; e-mail:
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Moldvay J, Rokszin G, Abonyi-Tóth Z, Katona L, Kovács G. [Analysis of drug therapy of lung cancer in Hungary]. Magy Onkol 2013; 57:33-38. [PMID: 23573520] [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] [Received: 12/01/2012] [Accepted: 12/20/2012] [Indexed: 06/02/2023]
Abstract
Hungary is a world leader in lung cancer deaths, so it is particularly important that patients could have access to modern treatments. The aim of our analysis was to find how drug treatments are used in Hungary and how they are compatible with international practice. The in-patient and prescription database of the National Health Insurance Fund for three years (2008-2010) was used to study the frequency of certain chemotherapy protocols, the duration of therapies, and the changes in the individual protocols and drugs used for lung cancer treatment (ICD: C33H0-C34) during the reviewed period. We did not differentiate between neoadjuvant and adjuvant treatment and therapy after progression. During the study period 12326 lung cancer patients received first-line chemotherapy, one third of those (n=3791) received second-line, and one third of those (n=1174) third-line treatment. The average treatment duration was between 3 and 4 months. The first-line treatment of NSCLC mainly consisted of platinum treatment in combination with third generation cytotoxic agents. A downward trend of gemcitabine, still the most common combination compound, was observed, in parallel with the increased use of paclitaxel, and as a consequence carboplatin replaced cisplatin. Among new agents the use of pemetrexed and bevacizumab has increased. Pemetrexed appeared mainly in second-line treatment, while erlotinib also in second, but mostly in third line. The first-line treatment of SCLC consisted of a platinum-etoposide combination, and in second-line setting topotecan was the most commonly used drug. According to our results the chemotherapeutic combinations and sequencing are in accordance with international and national recommendations. Further detailed analysis of the available data may help to obtain more accurate picture of the efficacy of lung cancer treatments as well.
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Affiliation(s)
- Judit Moldvay
- Pulmonológiai Klinika, Semmelweis Egyetem, Budapest, Hungary.
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Jermendy G, Wittmann I, Nagy L, Kiss Z, Rokszin G, Abonyi-Tóth Z, Katona L, Paragh G, Karádi I, Merkely B. Persistence of initial oral antidiabetic treatment in patients with type 2 diabetes mellitus. Med Sci Monit 2012; 18:CR72-77. [PMID: 22293880 PMCID: PMC3560582 DOI: 10.12659/msm.882459] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [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] [Indexed: 01/06/2023] Open
Abstract
Background Adequate persistence of oral antidiabetic treatment is highly important to achieve proper glycemic control in patients with type 2 diabetes. The aim of this study was to evaluate the persistence of initial treatment with metformin and/or sulphonylureas in patients with type 2 diabetes. Material/Methods The study was performed among diabetic patients (n=256,384) who were with newly prescribed oral antidiabetic drugs (metformin and/or sulphonylureas) between 2007 and 2009. For making comparison, patients with newly prescribed statin or clopidogrel therapy (with and without percutaneous coronary intervention) were investigated. The database of the Hungarian National Health Insurance Fund Administration was used. Results The 1-year persistence of initial treatment with metformin, sulphonylureas or metformin/sulphonylurea combination was 47.7%, 45.4% and 55.8%, respectively, which was significantly better than the persistence of statin therapy (26.3%) but worse than that of clopidogrel therapy in patients undergoing coronary intervention (73.2%). Within the sulphonylurea group there was a tendency of better persistence of treatment with the “modified-release” tablets at 12 months compared to the conventional sulphonylureas (47.8 vs. 42.2%). The persistence of therapy using metformin 1000 mg – 60 tablets was significantly better (60.4%) at 12 months than that of other forms of metformin therapy with lower doses and smaller boxes (with fewer tablets) analyzed together (47.7%). Conclusions The persistence of initial treatment with metformin and/or sulphonylureas is far from optimal. Better diabetic care and continuous patient education should be encouraged to achieve higher persistence of oral antidiabetic treatment in patients with type 2 diabetes.
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Affiliation(s)
- György Jermendy
- 3rd Department of Medicine, Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
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Abstract
To estimate the prevalence and incidence of atrial fibrillation in the entire population of Hungary. Methods: Analysis of the National Health Insurance Fund Administration database between 2007 and 2009 considering data from 2002. We assumed that patients with atrial fibrillation would turn to health care providers at least once either as outpatients or inpatients in a 5-year period. The National Health Insurance Patient Registry was used to assess the true number of patient visits. Results: The prevalence of atrial fibrillation in Hungary is between 2.37–2.67%. Each year, only about half of these patients seek medical advice. Conclusions: Our survey seems to be the first epidemiological study that aims at estimating the prevalence of atrial fibrillation in the total population of our country. Using a time frame of five to seven years, the prevalence of atrial fibrillation in the total population is significantly higher than it was estimated earlier. However, by using a mathematical model, an even higher prevalence rate of atrial fibrillation (2.95%) was calculated for the total population of Hungary. Orv. Hetil., 2012, 153, 339–342.
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Affiliation(s)
- János Tomcsányi
- Budai Irgalmasrendi Kórház Kardiológia Budapest Frankel Leó út 33–35. 1023
| | - Béla Bózsik
- Budai Irgalmasrendi Kórház Kardiológia Budapest Frankel Leó út 33–35. 1023
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Balogh O, Fébel H, Huszenicza G, Kulcsár M, Abonyi-Tóth Z, Endrődi T, Gábor G. Seasonal fertility differences in synchronised dairy cows: ultrasonic, metabolic and endocrine findings. Acta Vet Hung 2012; 60:131-43. [PMID: 22366138 DOI: 10.1556/avet.2012.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to identify relationships among seasonal differences of fertility, metabolic parameters and appearance of irregular luteal forms in high-yielding dairy cows. Holstein-Friesian cows were put on the Provsynch regimen in winter (n = 10) and in summer (n = 10). Blood sampling (starting 35 days post partum) and rectal ultrasound examinations (starting post insemination) were carried out once a week in each examination period. Metabolic [plasma nonesterified fatty acid (NEFA) and beta-hydroxybutyrate (BHB) levels, ferric reducing ability of plasma (FRAP) and serum beta-carotene] and endocrine parameters [plasma thyroxine (T4), triiodothyronine (T3), insulin-like growth factor (IGF-I) and insulin levels] were measured. In summer, two cows were excluded from the study because of metritis and none of the remaining animals became pregnant, but 6 of the 8 cows had irregular luteal forms (ILF) on their ovaries. In winter, one cow was excluded because of metritis and 6 of the 9 cows became pregnant, while 2 of the 3 open cows had irregular luteal forms. In summer the mean plasma NEFA and BHB concentrations were significantly higher, while serum carotene and plasma IGF-I concentrations were significantly lower than in winter. The high plasma NEFA concentration found in summer seemed to be in association with the lower body condition score (BCS) caused by depressed appetite. In conclusion, statistical analysis supports the hypothesis that increased plasma NEFA and BHB and decreased plasma IGF-I concentrations may result in reduced fertility in summer. These changes may be associated with the more frequent appearance of ILFs and probably have a negative effect on ovarian function and/or oocyte quality.
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Affiliation(s)
- Orsolya Balogh
- 1 Research Institute for Animal Breeding and Nutrition Gesztenyés u. 1 H-2053 Herceghalom Hungary
| | - Hedvig Fébel
- 1 Research Institute for Animal Breeding and Nutrition Gesztenyés u. 1 H-2053 Herceghalom Hungary
| | - Gyula Huszenicza
- 2 Szent István University Department and Clinic of Reproduction, Faculty of Veterinary Science Budapest Hungary
| | - Margit Kulcsár
- 2 Szent István University Department and Clinic of Reproduction, Faculty of Veterinary Science Budapest Hungary
| | - Zsolt Abonyi-Tóth
- 3 Szent István University Department of Biomathematics and Informatics, Faculty of Veterinary Science Budapest Hungary
| | | | - György Gábor
- 1 Research Institute for Animal Breeding and Nutrition Gesztenyés u. 1 H-2053 Herceghalom Hungary
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Pápa K, Máthé Á, Abonyi-Tóth Z, Sterczer Á, Psáder R, Hetyey C, Vajdovich P, Vörös K. Occurrence, clinical features and outcome of canine pancreatitis (80 cases). Acta Vet Hung 2011; 59:37-52. [PMID: 21354940 DOI: 10.1556/avet.59.2011.1.4] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Medical records of 80 dogs diagnosed with acute pancreatitis during a 4-year period were evaluated regarding history, breed predilection, clinical signs and additional examination findings. Cases were selected if compatible clinical symptoms, increased serum activity of amylase or lipase and morphologic evidence of pancreatitis by ultrasonography, laparotomy or necropsy were all present. Like in other studies, neutered dogs had an increased risk of developing acute pancreatitis. Although breed predilection was consistent with earlier reports, some notable differences were also observed. Apart from Dachshunds, Poodles, Cocker Spaniels and Fox Terriers, the sled dogs (Laikas, Alaskan Malamutes) also demonstrated a higher risk for pancreatitis according to our results. Concurrent diseases occurred in 56 dogs (70%), diabetes mellitus (n = 29, 36%) being the most common. Clinical signs of acute pancreatitis were similar to those observed in other studies. The study group represented a dog population with severe acute pancreatitis, having a relatively high mortality rate (40%) compared to data of the literature. Breed, age, gender, neutering and body condition had no significant association with the outcome. Hypothermia (p = 0.0413) and metabolic acidosis (p = 0.0063) correlated significantly with poor prognosis and may serve as valuable markers for severity assessment in canine acute pancreatitis.
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Affiliation(s)
- Kinga Pápa
- 1 Szent István University Department and Clinic of Internal Medicine P.O. Box 2 H-1400 Budapest Hungary
| | - Ákos Máthé
- 1 Szent István University Department and Clinic of Internal Medicine P.O. Box 2 H-1400 Budapest Hungary
| | - Zsolt Abonyi-Tóth
- 2 Szent István University Department of Biomathematics and Informatics, Faculty of Veterinary Science P.O. Box 2 H-1400 Budapest Hungary
| | - Ágnes Sterczer
- 1 Szent István University Department and Clinic of Internal Medicine P.O. Box 2 H-1400 Budapest Hungary
| | - Roland Psáder
- 1 Szent István University Department and Clinic of Internal Medicine P.O. Box 2 H-1400 Budapest Hungary
| | - Csaba Hetyey
- 1 Szent István University Department and Clinic of Internal Medicine P.O. Box 2 H-1400 Budapest Hungary
| | - Péter Vajdovich
- 1 Szent István University Department and Clinic of Internal Medicine P.O. Box 2 H-1400 Budapest Hungary
| | - Károly Vörös
- 1 Szent István University Department and Clinic of Internal Medicine P.O. Box 2 H-1400 Budapest Hungary
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Végh Á, Abonyi-Tóth Z, Rafai P. Verification of the technical parameters of head-only electrical stunning of pigs under commercial conditions. Acta Vet Hung 2010; 58:147-56. [PMID: 20460214 DOI: 10.1556/avet.58.2010.2.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The European Food Safety Authority recommends a minimum current of 1.3 Amps for the electrical head-only stunning of pigs. However, it is stated as well that 'the technical reference data for head-only electrical stunning of pigs such as 1.3 Amps are either rather old or worked out under experimental laboratory conditions'. This study was carried out to verify the electrical parameters of pig stunning under commercial conditions. Altogether 145 fattener pigs (body weight range: 30-150 kg, median 109 kg) were tested at four different private slaughterhouses in Hungary where head-only electrical stunners were used with different constant voltage settings. In each case the following data were recorded: individual liveweight (kg), current (A) and voltage (V) (measured with an individually developed analogue device placed in the circuit), current duration (s), effectiveness of stunning, grading of carcass. Correlations between these parameters and effectiveness were examined. Besides that, any correlation between the test parameters and impedance of head was examined. In 128 out of the 145 cases the stunning was effective (88.3%). Effectiveness was significantly related to current but not to other parameters such as voltage and duration of load. Impedance of head was not correlated with the size of the animal and the meat grading scores. Generally, it was concluded that the use of a single electrical parameter (e.g. a minimum current of 1.3 A) as a prerequisite of good stunning is not ideal.
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Affiliation(s)
- Ákos Végh
- 1 Fejér County Agricultural Office Food-chain Safety and Animal Health Directorate Csíkvári u. 15 H-8000 Székesfehérvár Hungary
| | - Zsolt Abonyi-Tóth
- 2 Szent István University Department of Biomathematics and Informatics Budapest Hungary
| | - Pál Rafai
- 3 Szent István University Department of Animal Hygiene, Herd Health and Veterinary Ethology, Faculty of Veterinary Science Budapest Hungary
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Benyeda Z, Mató T, Süveges T, Szabó É, Kardi V, Abonyi-Tóth Z, Rusvai M, Palya V. Comparison of the pathogenicity of QX-like, M41 and 793/B infectious bronchitis strains from different pathological conditions. Avian Pathol 2009; 38:449-56. [DOI: 10.1080/03079450903349196] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Reiczigel J, Abonyi-Tóth Z, Singer J. An exact confidence set for two binomial proportions and exact unconditional confidence intervals for the difference and ratio of proportions. Comput Stat Data Anal 2008. [DOI: 10.1016/j.csda.2008.04.032] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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50
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Gaál T, Halmay D, Kocsis R, Abonyi-Tóth Z. Evaluation of the effect of ketoprofen and carprofen on platelet function in dogs studied by PFA-100 point-of-care analyser. Acta Vet Hung 2007; 55:287-94. [PMID: 17867455 DOI: 10.1556/avet.55.2007.3.2] [Citation(s) in RCA: 9] [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: 11/19/2022]
Abstract
The effect of two nonsteroidal anti-inflammatory drugs (carprofen and ketoprofen) on platelet adhesion and aggregation functions was evaluated by the PFA-100 analyser (Dade-Behring, CA, U.S.A.) using its collagen-adenosine diphosphate (ADP) and collagen-epinephrine (EPI) cartridges. The function of platelets was evaluated in 55 healthy dogs, in 7 dogs treated with ketoprofen and in 31 dogs treated with carprofen in a therapeutic dose for minimum 5 days. The therapeutic doses of carprofen had no effect on the closure time of PFA-100 (which is the marker of platelet function) but ketoprofen caused a significant increase when using collagen-EPI stimulation The closure times for both the healthy (control) and the treated dogs using EPI cartridges were often longer than the upper default cut-off point (300 sec) of the device. The PFA-100 analyser with collagen-ADP cartridges could be a useful tool for veterinary applications including the evaluation of platelet aggregation in dogs treated with NSAIDs. The upper cut-off point of PFA-100 might be extended.
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Affiliation(s)
- T Gaál
- Department of Internal Medicine Faculty of Veterinary Science, Szent István University, H-1078 Budapest, István u. 2, Hungary.
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