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Király E, Szőllősi GJ, Jenei Z, Kárpáti I. Association between physical activity and quality of life in haemodialysed and peritoneal dialyzed patients in Hungary. Ren Fail 2024; 46:2324079. [PMID: 38425087 PMCID: PMC10911098 DOI: 10.1080/0886022x.2024.2324079] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Patients with end-stage kidney disease (ESKD) receiving peritoneal dialysis (PD) or haemodyalisis (PD) appear to be less physically active than healthy persons, a situation that could lead to reductions in quality of life. The aim of the present study was to assess and compare physical activity and health-related quality of life in renal patients on HD and PD programs. METHODS In May 2020, 130 patients (106 HD and 24 PD) were enrolled in a study of chronic dialysis programs. All participants received a questionnaire containing information on demographics, treatment, and co-morbidities. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) short form, and quality of life was measured using the Kidney Disease Quality of Life-Short Form 12 (KDQOL-SF-12) questionnaire comprising mental (MCS) and physical components (PCS). Non-parametric statistical tests were executed with 0.05 as the level of significance. RESULTS The physical activity of patients treated in both HD and PD programs could be considered as low, without a statistically significant difference between the two modalities. For the quality of life measures, we found a significant (p = .004) difference regarding Physical Component Summary (PCS) scores, with higher PCS scores in patients treated in the PD programme compared to HD. Furthermore, higher physical activity levels were associated with better quality of life parameters in both groups. CONCLUSION This study confirms the importance of physical activity among dialysis patients with ESKD, suggesting that greater activity could be associated with a better quality of life.
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Affiliation(s)
- Enikő Király
- Department of Medical Rehabilitation and Physical Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Gergő József Szőllősi
- Coordination Center for Research in Social Sciences, Faculty of Economics and Business, University of Debrecen, Debrecen, Hungary
| | - Zoltán Jenei
- Department of Medical Rehabilitation and Physical Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - István Kárpáti
- Department of Nephrology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Radó SI, Molnár M, Széll R, Szőllősi GJ, Törő V, Shehab B, Manios Y, Anastasiou C, Iotova V, Tsochev K, Chakarova N, Giménez-Legarre N, Miguel Berges ML, Schwarz PEH, Rurik I, Sárváry A. Association between Screen Time and Sociodemographic Factors, Physical Activity, and BMI among Children in Six European Countries (Feel4Diabetes): A Cross-Sectional Study. Children (Basel) 2024; 11:458. [PMID: 38671675 PMCID: PMC11049295 DOI: 10.3390/children11040458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/19/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Screen time among children in most European countries is notably high and is influenced by various sociodemographic and other factors. Our study aimed to explore the associations between parents' sociodemographic characteristics, socioeconomic status, body mass index (BMI), physical activity, risk status for type 2 diabetes, and their children's BMI, physical activity, and screen time. The data were sourced from the 2016 Feel4Diabetes study, involving 12,280 parents and 12,211 children aged 6-9 years (average age 8.21 years) in a cross-sectional study design. We used a logistic regression model to identify potential factors associated with children's screen time. The results showed that mothers with tertiary education (OR = 0.64; 95%CI = 0.49-0.82; p < 0.001), the middle age group (45-54 years) (OR = 0.81 95%CI = 0.66-0.98; p = 0.033), and families with higher incomes (middle-OR = 0.85; 95%CI = 0.75-0.97; p = 0.014; high-OR = 0.8; 95%CI = 0.69-0.93; p = 0.003) were associated with a decreased chance of children spending more than 2 h/day in front of the screen. In contrast, maternal overweight/obesity (OR = 1.15; 95%CI = 1.03-1.29; p = 0.013) and lower physical activity in children were linked to an increased likelihood of more than 2 h of screen time per day. Our findings suggest that targeted interventions should be developed to mitigate excessive screen time, particularly focusing on low-income families and mothers with low educational levels.
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Affiliation(s)
- Sándor Istvánné Radó
- Department of Nursing and Midwifery, Faculty of Health Sciences, University of Debrecen, 4400 Nyíregyháza, Hungary; (S.I.R.); (V.T.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary;
| | - Mónika Molnár
- Department of Integrative Health Sciences, Faculty of Health Sciences, University of Debrecen, 4400 Nyíregyháza, Hungary; (M.M.); (R.S.)
| | - Róbert Széll
- Department of Integrative Health Sciences, Faculty of Health Sciences, University of Debrecen, 4400 Nyíregyháza, Hungary; (M.M.); (R.S.)
| | - Gergő József Szőllősi
- Coordination Center of Social Sciences, Faculty of Economy, University of Debrecen, 4032 Debrecen, Hungary;
| | - Viktória Törő
- Department of Nursing and Midwifery, Faculty of Health Sciences, University of Debrecen, 4400 Nyíregyháza, Hungary; (S.I.R.); (V.T.)
| | - Bashar Shehab
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary;
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 176 76 Athens, Greece; (Y.M.); (C.A.)
| | - Costas Anastasiou
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 176 76 Athens, Greece; (Y.M.); (C.A.)
| | - Violeta Iotova
- Department of Pediatrics and Medical Genetics, Medical University of Varna, 9002 Varna, Bulgaria; (V.I.); (K.T.)
| | - Kaloyan Tsochev
- Department of Pediatrics and Medical Genetics, Medical University of Varna, 9002 Varna, Bulgaria; (V.I.); (K.T.)
| | - Nevena Chakarova
- Department of Endocrinology, Medical University of Sofia, 1431 Sofia, Bulgaria;
| | - Natalia Giménez-Legarre
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain; (N.G.-L.); (M.L.M.B.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud, Carlos III, 28029 Madrid, Spain
| | - Maria Luisa Miguel Berges
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain; (N.G.-L.); (M.L.M.B.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud, Carlos III, 28029 Madrid, Spain
| | - Peter E. H. Schwarz
- International Diabetes Federation, Medical Faculty Carl Gustav Carus, Technical University of Dresden, 01069 Dresden, Germany;
| | - Imre Rurik
- Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Attila Sárváry
- Department of Integrative Health Sciences, Faculty of Health Sciences, University of Debrecen, 4400 Nyíregyháza, Hungary; (M.M.); (R.S.)
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Szőllősi GJ, Pataki J, Virágh A, Bányai G, Boruzs K, Bíró K, Dombrádi V. Influenza Vaccination Coverage among People with Self-Reported Cardiovascular Diseases-Findings from the Hungarian Implementation of the European Health Interview Survey. Vaccines (Basel) 2024; 12:360. [PMID: 38675742 PMCID: PMC11054540 DOI: 10.3390/vaccines12040360] [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: 02/27/2024] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Worldwide, cardiovascular diseases are the leading cause of mortality. This has significant implications for public health. Influenza, a common infectious disease, poses an increased risk for individuals with chronic conditions, such as cardiovascular diseases. However, little is known about influenza vaccination coverage in this group. This study utilized data from the Hungarian implementation of the European Health Interview Survey to assess influenza vaccination coverage and its determinants among cardiovascular respondents from 2009 to 2019. The findings reveal a downward trend in the vaccination rates over the years (from 24% to 21%), despite the availability of free vaccination in Hungary for this high-risk population. The main factors influencing low influenza vaccine uptake were identified, as follows: young age, a lower level of education, good self-perceived health status, smoking, a lower frequency of medical visits, and not suffering from respiratory diseases. Addressing these disparities necessitates targeted vaccination strategies supported by enhanced education, better access to healthcare services, and the promotion of preventive healthcare measures. Improving vaccination coverage among patients with cardiovascular diseases is imperative for reducing influenza-related morbidity and mortality. This highlights the importance of comprehensive public health interventions and healthcare provider engagement in promoting vaccination among groups at increased risk.
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Affiliation(s)
- Gergő József Szőllősi
- Coordination Center for Research in Social Sciences, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary
| | - Jenifer Pataki
- Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (J.P.); (A.V.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Anett Virágh
- Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (J.P.); (A.V.)
| | - Gábor Bányai
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (K.B.); (K.B.)
| | - Klára Boruzs
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (K.B.); (K.B.)
| | - Klára Bíró
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (K.B.); (K.B.)
| | - Viktor Dombrádi
- Patient Safety Department, Health Services Management Training Centre, Faculty of Health and Public Administration, Semmelweis University, 1085 Budapest, Hungary;
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Gyöngyösi H, Szőllősi GJ, Csenteri O, Jancsó Z, Móczár C, Torzsa P, Andréka P, Vajer P, Nemcsik J. Differences between SCORE, Framingham Risk Score, and Estimated Pulse Wave Velocity-Based Vascular Age Calculation Methods Based on Data from the Three Generations Health Program in Hungary. J Clin Med 2023; 13:205. [PMID: 38202212 PMCID: PMC10779891 DOI: 10.3390/jcm13010205] [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: 11/17/2023] [Revised: 12/28/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
Early vascular ageing contributes to cardiovascular (CV) morbidity and mortality. There are different possibilities to calculate vascular age including methods based on CV risk scores, but different methods might identify different subjects with early vascular ageing. We aimed to compare SCORE and Framingham Risk Score (FRS)-based vascular age calculation methods on subjects that were involved in a national screening program in Hungary. We also aimed to compare the distribution of subjects identified with early vascular ageing based on estimated pulse wave velocity (ePWV). The Three Generations for Health program focuses on the development of primary health care in Hungary. One of the key elements of the program is the identification of risk factors of CV diseases. Vascular ages based on the SCORE and FRS were calculated based on previous publications and were compared with chronological age and with each other in the total population and in patients with hypertension or diabetes. ePWV was calculated based on a method published previously. Supernormal, normal, and early vascular ageing were defined as <10%, 10-90%, and >90% ePWV values for the participants. In total, 99,231 subjects were involved in the study, and among them, 49,191 patients had hypertension (HT) and 15,921 patients had diabetes (DM). The chronological age of the total population was 54.0 (48.0-60.0) years, while the SCORE and FRS vascular ages were 59.0 (51.0-66.0) and 64.0 (51-80) years, respectively. In the HT patients, the chronological, SCORE, and FRS vascular ages were 57.0 (51.0-62.0), 63.0 (56.0-68.0), and 79.0 (64.0-80.0) years, respectively. In the DM patients, the chronological, SCORE, and FRS vascular ages were 58.0 (52.0-62.0), 63.0 (56.0-68.0), and 80.0 (76.0-80.0) years, respectively. Based on ePWV, the FRS identified patients with an elevated vascular age with high sensitivity (97.3%), while in the case of the SCORE, the sensitivity was much lower (13.3%). In conclusion, different vascular age calculation methods can provide different vascular age results in a population-based cohort. The importance of this finding for the implementation in CV preventive strategies requires further studies.
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Affiliation(s)
- Helga Gyöngyösi
- Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary; (H.G.); (C.M.); (P.T.)
| | - Gergő József Szőllősi
- Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary; (G.J.S.); (O.C.); (Z.J.); (P.A.)
- Coordination Center for Research in Social Sciences, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary
| | - Orsolya Csenteri
- Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary; (G.J.S.); (O.C.); (Z.J.); (P.A.)
| | - Zoltán Jancsó
- Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary; (G.J.S.); (O.C.); (Z.J.); (P.A.)
| | - Csaba Móczár
- Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary; (H.G.); (C.M.); (P.T.)
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary; (H.G.); (C.M.); (P.T.)
| | - Péter Andréka
- Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary; (G.J.S.); (O.C.); (Z.J.); (P.A.)
| | - Péter Vajer
- Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary; (G.J.S.); (O.C.); (Z.J.); (P.A.)
| | - János Nemcsik
- Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary; (H.G.); (C.M.); (P.T.)
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Mohos A, Szőllősi GJ, Kolozsvári LR, Rinfel J, Varga A, Kucsera MM, Hargittay C, Torzsa P. Rural family medicine as a career option among Hungarian medical students. Eur J Gen Pract 2023; 29:2174258. [PMID: 36794681 PMCID: PMC9937003 DOI: 10.1080/13814788.2023.2174258] [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] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The shortage of family physicians is a considerable challenge in Hungary. The number of vacant practices is increasing and the rural and deprived areas are more affected. OBJECTIVES This study aimed to investigate medical students' attitudes towards rural family medicine. METHODS The current study used a cross-sectional design with a self-administered questionnaire. Each of the four Hungarian medical universities was represented by their medical students from December 2019 to April 2020. RESULTS The response rate was 67.3% (n = 465/691). Only 5% of the participants plan to be a family doctor, 5% of the students plan to work in rural areas. On a 5-point Likert scale (1 = 'surely not', 5 = 'surely yes'), half of the participants answered 1 or 2 to choose rural medical work, while 17.5% answered 4 or 5. There was a significant relationship between rural working plans and rural origin (OR = 1.97; p = 0.024), and the plan to work in family practice (OR = 4.90; p < 0.001). CONCLUSION Family medicine is not a popular career option among Hungarian medical students and rural medical work is even less attractive. Medical students with a rural origin and an interest in family medicine are more likely to plan to work in rural areas. More objective information and experience need to be given to medical students about rural family medicine to increase the attractiveness of the speciality.
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Affiliation(s)
- András Mohos
- Albert Szent-Györgyi Medical School, Department of Family Medicine, University of Szeged, Szeged, Hungary,European Rural and Isolated Practitioners Association, Paris, France
| | | | - László Róbert Kolozsvári
- Department of Family Medicine and Occupational Health, University of Debrecen, Debrecen, Hungary
| | | | - Albert Varga
- Albert Szent-Györgyi Medical School, Department of Family Medicine, University of Szeged, Szeged, Hungary
| | - Maria Marko Kucsera
- Albert Szent-Gyögyi Medical School, Department of Public Health, University of Szeged, Szeged, Hungary
| | | | - Peter Torzsa
- Family Medicine, Semmelweiss University, Budapest, Hungary,CONTACT Peter Torzsa Family Medicine, Semmelweiss University, Budapest, Stáhly u. 7-9., Budapest, 1085Hungary
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Pataki J, Dombrádi V, Sárváry A, Szőllősi GJ. Breast cancer screening and its associating factors among hungarian women aged 45-65: a cross-sectional study based on the European health interview surveys from 2009 to 2019. BMC Public Health 2023; 23:1679. [PMID: 37653363 PMCID: PMC10472565 DOI: 10.1186/s12889-023-16608-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND In 2020, globally 685,000 people died, and 2.3 million women were diagnosed with breast cancer. The main cause of cancer deaths among women is breast cancer, which account for 15.5% of all cancer deaths. Most of these could have been avoided with timely diagnosis. The aim of our study was to determine the proportion of breast screening participation in Hungary, and to identify possible factors that may influence breast screening attendance. METHODS Our data were gathered from the cross-sectional European Health Interview Surveys conducted in Hungary in 2009, 2014, and 2019. In terms of categorical characteristics, Pearson's chi-square test was performed to evaluate the differences between people who have attended breast screening within two years and who have only attended more than two years ago. To determine the factors that may have an impact on the uptake of screening, generalized linear model with logit link function regarding binomial probability distribution was executed. RESULTS The responses of 2626 women between the age 45-65 were included in our study. In 2009 85% (n=741), in 2014 90% (n=851) and in 2019 87% (n=699) of the respondents claimed to have ever attended a breast screening in their life. In 2009 68% (n=594), in 2014 66% (n=630) and in 2019 64% (n=515) said that they have taken part in breast screening within two years (p=0.331). From 2014 to 2019 (AOR=0.72 [0.57-0.89]) the chance of attending breast screening was decreasing. We observed that both secondary (AOR=1.97 [1.60-2.44]) and tertiary educational level (AOR=2.23 [1.67-3.00]), higher perceived income (AOR=1.54 [1.25-1.90]), and more frequent meeting with the doctor (AOR=1.77 [1.39-2.27]) and with the specialist (AOR=1.88 [1.54-2.28]) appeared as protective factors of breast screening attendance. CONCLUSIONS Our results show that the lifetime prevalence of breast screening participation is high, however the recommended biennial rate is relatively low. To increase the participation rate, various initiatives would be needed, especially for women in identified risk groups, which are lower educational level, lower perceived income, and less frequent meeting with the doctor and with the specialist.
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Affiliation(s)
- Jenifer Pataki
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Viktor Dombrádi
- Health Services Management Training Centre, Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
| | - Attila Sárváry
- Department of Integrative Health Sciences, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Gergő József Szőllősi
- Coordination Center for Research in Social Sciences, Faculty of Economics and Business, University of Debrecen, Debrecen, Hungary
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Karácsony I, Bertókné Tamás R, Árváné Egri C, Fürtös VD, Szőllősi GJ, Surján O. [Summary of the Hungarian Mobile Health Screening Program data for 2021]. Orv Hetil 2023; 164:1070-1076. [PMID: 37422886 DOI: 10.1556/650.2023.32763] [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: 02/14/2023] [Accepted: 04/13/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION In Hungary, significant regional and social inequalities in health status exist. In addition, this is exacerbated by health care inequalities between West and East Hungary. OBJECTIVE The aim of our study was to summarize the results of the 2021 Hungarian Mobile Health Screening Program, in order to determine the rates of detected cases and to assess the health status differences between different regions. METHOD A cross-sectional retrospective study was executed to analyze the screening results (n = 5185) of the Hungarian Mobile Health Screening Program. RESULTS 9% of screening attendees had higher than normal blood glucose level, 25% had abnormal cholesterol levels and 20% had elevated blood pressure. Of those screened, 35% had a not-negative result at the neurological examination, 44% at the dermatological examination, 42% at the cardiological examination, 20% at the spirometry function test, and 4% at the ankle-brachial index measurement. Newly detected gynaecological problems affected 1 in 5 women (21%) and 3 women were diagnosed with malignant tumors. Of those attending oral screening (n = 1836), 90% were directed to different levels of the health care system. CONCLUSION The results of the Hungarian Mobile Health Screening Program have also demonstrated the health inequalities in our country. The data confirmed the need for the continuation of the Program under the current structure. The aim for the future screening period is to increase the attendance of several examinations and preventive/health promotion advices. Orv Hetil. 2023; 164(27): 1070-1076.
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Affiliation(s)
- Ilona Karácsony
- 1 Nemzeti Népegészségügyi Központ, Szűrésirányítási Főosztály Budapest Magyarország
- 3 Pécsi Tudományegyetem, Egészségtudományi Kar, Szombathelyi Képzési Központ Szombathely, Jókai u. 14., 9700 Magyarország
| | | | - Csilla Árváné Egri
- 1 Nemzeti Népegészségügyi Központ, Szűrésirányítási Főosztály Budapest Magyarország
| | | | - Gergő József Szőllősi
- 1 Nemzeti Népegészségügyi Központ, Szűrésirányítási Főosztály Budapest Magyarország
- 4 Debreceni Egyetem, Egészségtudományi Kar Debrecen Magyarország
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Szőllősi GJ, Csenteri O, Jancsó Z, Vajer P, Kardos L, Andréka P. Association Between Alcohol Consumption and Cardiovascular Risk Based on Data from the Three Generations for Health Program in Hungary. Med Sci Monit 2023; 29:e940327. [PMID: 37363885 DOI: 10.12659/msm.940327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Alcohol consumption has a significant effect on cardiovascular health, and risk factors, such as excessive alcohol use, should be avoided. Although alcohol consumption has decreased over the last decade in Hungary, it is still significantly higher than the average across the European Union. The objective of this study was to describe the patterns of alcohol use based on the Alcohol Use Disorders Identification Test (AUDIT), with a special focus on cardiovascular risk status (low, moderate, high, or very high). MATERIAL AND METHODS The Three Generations for Health program focuses on the development of primary health care in Hungary. One of the key elements of the program is the identification of risk factors of cardiovascular diseases. An ordinal multiple logistic regression analysis was performed with 10 categorical explanatory variables and the outcome was the categorical cardiovascular risk. RESULTS The database consisted of patients aged 40-65 years with a sample size of 11 348. A significant relationship was found between alcohol consumption and cardiovascular risk status; people with high-risk drinking patterns had higher a value of odds ratio (OR=1.306 [1.003-1.701]) for having a more serious cardiovascular status. According to multiple regression analysis, alcohol dependence was associated with cardiovascular risk. CONCLUSIONS From a public health perspective, the results highlight the importance of reducing alcohol consumption with the help of primary care and preventive services in countries with a high cardiovascular risk profile to reduce the cardiovascular disease-related burden.
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Affiliation(s)
- Gergő József Szőllősi
- Gottsegen National Cardiovascular Center, Budapest, Hungary
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | | | - Zoltán Jancsó
- Gottsegen National Cardiovascular Center, Budapest, Hungary
| | - Péter Vajer
- Gottsegen National Cardiovascular Center, Budapest, Hungary
| | - László Kardos
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Péter Andréka
- Gottsegen National Cardiovascular Center, Budapest, Hungary
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Szőllősi GJ, Minh NC, Pataki J, Santoso CM, Nagy AC, Kardos L. Influenza Vaccination Coverage and Its Predictors among Self-Reported Diabetic Patients-Findings from the Hungarian Implementation of the European Health Interview Survey. Int J Environ Res Public Health 2022; 19:16289. [PMID: 36498357 PMCID: PMC9736192 DOI: 10.3390/ijerph192316289] [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] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/27/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
In high-risk populations, such as the elderly or those with serious medical issues, for instance, people with cardiovascular diseases or diabetes, influenza can have devastating effects because it might contribute to severe complications or even death. This makes vaccination against influenza an essential component of public health. The primary objective of our research was to identify the characteristics that influenced whether an individual chose to become vaccinated against influenza, with an emphasis on whether they reported having diabetes. The data were obtained from the Hungarian implementation of the European Health Interview Surveys, which were conducted in 2009, 2014, and 2019. The total sample size was 15,874 people. To determine the variables that were related to vaccination, a multivariate logistic regression analysis that included interactions was performed. The overall vaccination coverage was 13% in 2009 and 12% in 2014 and 2019 among non-diabetic respondents; the coverage was 26% in 2009, 28% in 2014, and 25% in 2019 among diabetic respondents. Despite vaccination coverage in both groups being below the optimal level of 75%, we were able to identify factors influencing vaccination coverage. Among diabetic respondents, younger age, lower education level, sex, and co-morbidities were factors that influenced vaccination status. It is important for authorities managing healthcare and medical practitioners to be aware of the potential effects that influenza can have on diabetic patients; therefore, more efforts need to be made to increase the number of diabetic people receiving a vaccination against influenza.
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10
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Jancsó Z, Csenteri O, Szőllősi GJ, Vajer P, Andréka P. Cardiovascular risk management: the success of target level achievement in high- and very high-risk patients in Hungary. BMC Prim Care 2022; 23:305. [PMID: 36447162 PMCID: PMC9706967 DOI: 10.1186/s12875-022-01922-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/21/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The management of risk factors in patients with high cardiovascular risk and its effectiveness is of paramount importance. Over the last decade, several studies have examined the achievement of cardiovascular risk factors' target levels in Europe. In the present Hungarian study, we assessed the cardiovascular risk level of participants aged 40-65 years and the success of achieving risk factors' target levels in high- and very high-risk patients. We compared these results with the results of two similar European studies. METHODS We conducted a cross-sectional study involving 37,778 patients aged 40-65 years from Hungary between 2019 and 2020. Cardiovascular risk levels and target values were set according to the 2016 European Guideline. Target achievement was evaluated for body mass index, waist circumference, blood pressure, total, LDL, and HDL cholesterol, triglyceride, and HbA1c (in diabetics). RESULTS For 37,298 patients, all the data were available to determine their cardiovascular risk category. Of these, 23.1% had high and 31.4% had very high cardiovascular risk (men: 27.1 and 39.6%, women: 20.5 and 26.1%, respectively). Achievement of the LDL-C target of 1.8 mmol/l was only 8.0% among very high-risk patients, which was significantly lower than the European average (29%). Achievement of target blood pressure among high-risk patients was better than the European average (63.4% vs. 44.7%, respectively); however, achievement was slightly lower among very high-risk patients compared with the European average (49.4% vs. 58%, respectively). The proportion of patients with type 2 diabetes who achieved a HbA1c below 7% was 57.3% in the high-risk population and 53% in the very high-risk population, which was in line with the European average success rates (58.5 and 54%, respectively). Waist circumference (< 88 cm for women and < 102 cm for men) was achieved by 29.4% of patients in the very high-risk group in our survey, which was lower than the European average of 41%. CONCLUSIONS The success rate of cardiovascular risk management in Hungary is lower than the European average in several parameters. Furthermore, our data highlight the poor effectiveness of obesity management in Hungary. General practice partnerships may be important sites for positive change.
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Affiliation(s)
- Zoltán Jancsó
- Gottsegen National Cardiovascular Center, Haller u. 29, Budapest, 1096 Hungary
| | - Orsolya Csenteri
- Gottsegen National Cardiovascular Center, Haller u. 29, Budapest, 1096 Hungary
| | | | - Péter Vajer
- Gottsegen National Cardiovascular Center, Haller u. 29, Budapest, 1096 Hungary
| | - Péter Andréka
- Gottsegen National Cardiovascular Center, Haller u. 29, Budapest, 1096 Hungary
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11
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Nagy PF, Pócsi M, Fejes Z, Bidiga L, Szabó E, Balogh O, Szőllősi GJ, Nagy B, Nemes B. Investigation of Circulating MicroRNA Levels in Antibody-Mediated Rejection After Kidney Transplantation. Transplant Proc 2022; 54:2570-2577. [PMID: 36400592 DOI: 10.1016/j.transproceed.2022.10.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND One of the most important possible complications determining long-term graft survival after kidney transplant is antibody-mediated rejection (ABMR). The criterion standard approach to recognize ABMR is currently the kidney biopsy with histopathologic analysis. However, this test has limitations because of difficulties in timing of sampling, the evaluability of histology because of the questionable representativeness of specimens, and the limited number of this intervention. Hence, new reliable, noninvasive biomarkers are required to detect the development of ABMR in time. METHODS In this study, we analyzed the clinical data of 45 kidney transplant patients (mean age of 44.51 years, 20 male and 25 female subjects). These participants were recruited into 5 subcohorts based on their clinical status, histologic findings, and level of donor-specific anti-HLA antibodies. Circulating microRNAs (miR-21, miR-181b, miR-146a, miR-223, miR-155, miR-150) in plasma samples were quantified by quantitative polymerase chain reaction and their levels were correlated with the clinical characteristics in different subgroups. RESULTS The relative expression of plasma miR-155 (P = .0003), miR-223 (P = .0316), and miR-21 (P = .0147) were significantly higher in patients who had subsequent histology-approved ABMR with donor-specific anti-HLA antibody positivity (n = 10) than in the "triple negative" group (n = 21), and miR-155 showed the highest sensitivity (90%) and specificity (81%) to indicate ABMR development based on receiver operating characteristic analysis. CONCLUSIONS According to our preliminary data, plasma miR-155, miR-21, and miR-223 can indicate the development of ABMR after kidney transplant in correlation with classic clinical parameters. However, future studies with larger number of participants are necessary to further evaluate the diagnostic properties of blood miRNAs in prediction of this life-threatening condition.
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Affiliation(s)
- Péter Ferenc Nagy
- Institute of Surgery, Department of Organ Transplantation, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - Marianna Pócsi
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zsolt Fejes
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Bidiga
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Eszter Szabó
- Institute of Surgery, Department of Organ Transplantation, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Orsolya Balogh
- Institute of Surgery, Department of Organ Transplantation, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gergő József Szőllősi
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Béla Nagy
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Balázs Nemes
- Institute of Surgery, Department of Organ Transplantation, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Csizmadia Z, Ács P, Szőllősi GJ, Tóth B, Kerti M, Kovács A, Varga JT. Freedive Training Gives Additional Physiological Effect Compared to Pulmonary Rehabilitation in COPD. Int J Environ Res Public Health 2022; 19:11549. [PMID: 36141823 PMCID: PMC9517084 DOI: 10.3390/ijerph191811549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Pulmonary rehabilitation (PR) is beneficial for lung mechanics, chest kinematics, metabolism, and inspiratory and peripheral muscle function. Freediving training (FD) can be effective in sportsmen and can improve breath-holding time. AIMS We sought to determine the effectiveness of freediving training in the pulmonary rehabilitation of COPD patients. PATIENTS AND METHODS Twenty-three COPD patients (15 men and 8 women; median age 63 years; FEV1: 41% pred; BMI: 28 kg/m2) participated in the FD + PR group (3 weeks PR and 3 weeks FD + PR) and 46 patients with COPD (25 men and 21 women; median age 66 years; FEV1: 43% pred; BMI: 27 kg/m2) participated in an inpatient PR program (6 weeks). Patients performed comfort zone breath holding for 30 min/day. Patients increased their breath-holding time within their comfort zone for 30 min. We detected lung function, chest expansion (CWE), inspiratory muscle pressure (MIP), peripheral muscle function (GS), and exercise capacity (6MWD), and we included breath-holding time (BHT), quality of life score (COPD Assessment Test (CAT)), modified Medical Research Dyspnea Scale (mMRC) score, and the severity of the disease assessed by the BODE index (FEV1, BMI, 6MWD, and mMRC) and an alternative scale (FEV1, BMI, 6MWD, and CAT). RESULT There were significant differences in the characteristics of the two groups. Significant improvement was detected in all functional and quality of life parameters except lung function in both groups. Significantly higher improvement was detected in CWE, GS, 6MWD, BHT, CAT, mMRC, alternative scale, and MIP. The improvement in forced vital capacity (FVC) was not significant. There were no side effects of FD training. CONCLUSION The FD method can potentiate the effect of PR, improving not only BHT but also other parameters. TRIAL REGISTRATION ISRCTN ISRCTN13019180. Registered 19 December 2017.
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Affiliation(s)
- Zoltán Csizmadia
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
| | - Pongrác Ács
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
| | | | - Blanka Tóth
- Department of Pulmonary Rehabilitation, National Koranyi Institute of Pulmonology, 1122 Budapest, Hungary
| | - Mária Kerti
- Department of Pulmonary Rehabilitation, National Koranyi Institute of Pulmonology, 1122 Budapest, Hungary
| | - Antal Kovács
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
| | - János Tamás Varga
- Department of Pulmonology, Semmelweis University, 1083 Budapest, Hungary
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13
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Szőllősi GJ, Boruzs K, Karcagi-Kováts A, Kalas N, Bányai G, Bíró K. Investigation of the relationship between incidence of mental disorders and economic growth among the Visegrad countries. Front Public Health 2022; 10:982716. [PMID: 36159231 PMCID: PMC9490257 DOI: 10.3389/fpubh.2022.982716] [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: 06/30/2022] [Accepted: 08/18/2022] [Indexed: 01/25/2023] Open
Abstract
Prevention and care for mental disorders represent an important public health task in achieving global development goals. Proper access to adequate healthcare and social services is an important step related to care for mental disorders, which is presumably strongly related to economic growth. The main aim of the study was to investigate the relationship between the economic growth and the incidence of mental disorders in the V4 countries. An ecological correlation study was conducted regarding the four Visegrad countries. Indicators were derived from the World Health Organization (WHO) 'Health for All' (HFA) online database and Penn World Table version 10. The incidence of mental disorders increased in the V4 countries throughout the years between 2000-2018 except in Hungary, where a decreasing trend was observed. The prevalence of mental disorders increased in all countries as well, but it stagnated in Hungary. At the same time standardized death rate due to mental disorders increased in all Visegrad countries. According to the Hungarian data, while the prevalence of the disease did not change remarkably, the incidence decreased and the mortality increased as well as the prescription of drugs used in the treatment of mental disorders. This could indicate a serious hidden morbidity.
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Affiliation(s)
- Gergő József Szőllősi
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary,*Correspondence: Gergő József Szőllősi
| | - Klára Boruzs
- Faculty of Economics and Business, Institute of Health Economics and Management, University of Debrecen, Debrecen, Hungary
| | - Andrea Karcagi-Kováts
- Faculty of Economics and Business, Department of Environmental Economics, University of Debrecen, Debrecen, Hungary
| | - Nándor Kalas
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Gábor Bányai
- Faculty of Economics and Business, Institute of Health Economics and Management, University of Debrecen, Debrecen, Hungary
| | - Klára Bíró
- Faculty of Economics and Business, Institute of Health Economics and Management, University of Debrecen, Debrecen, Hungary
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14
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Szőllősi GJ, Minh NC, Santoso CMA, Zsuga J, Nagy AC, Kardos L. An Exploratory Assessment of Factors with Which Influenza Vaccine Uptake Is Associated in Hungarian Adults 65 Years Old and Older: Findings from European Health Interview Surveys. Int J Environ Res Public Health 2022; 19:ijerph19127545. [PMID: 35742792 PMCID: PMC9224319 DOI: 10.3390/ijerph19127545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/01/2023]
Abstract
Influenza vaccination is an imperative public health task for elderly people due to a higher risk of developing more severe complications. The main aim of our study was to determine the influencing factors of being vaccinated against influenza among subjects aged 65 and above. Data were from the Hungarian implementations of the European Health Interview Survey 2009, 2014 and 2019 studies with a final sample size of 3355. A multivariate logistic regression model with interactions was used to identify the possible factors associated with vaccination. Approximately 32% of the participants were vaccinated for the most recent influenza season. The most important factors were identified that contributed to influenza vaccination among individuals, which were the following: educational attainment, having a partner, the annual frequency of specialist and doctor visits, and having comorbidities. Respondents who thought that they could do a lot for their health had higher odds of being immunized. Being obese seemed to be a risk factor. According to our findings, the current influenza vaccination coverage was considered as low in Hungary; hence, the implementation of minor reformulations in the field of health policy is suggested.
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Affiliation(s)
- Gergő József Szőllősi
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary; (N.C.M.); (C.M.A.S.); (A.C.N.)
- Correspondence:
| | - Nguyen Chau Minh
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary; (N.C.M.); (C.M.A.S.); (A.C.N.)
| | - Cornelia Melinda Adi Santoso
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary; (N.C.M.); (C.M.A.S.); (A.C.N.)
| | - Judit Zsuga
- Department of Habilitational Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary;
| | - Attila Csaba Nagy
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary; (N.C.M.); (C.M.A.S.); (A.C.N.)
| | - László Kardos
- Department of Biostatistics and Bioinformatics, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary;
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15
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Csuhai ÉA, Nagy AC, Szőllősi GJ, Veres-Balajti I. Impact Analysis of 20-Week Multimodal Progressive Functional-Proprioceptive Training among Sedentary Workers Affected by Non-Specific Low-Back Pain: An Interventional Cohort Study. Int J Environ Res Public Health 2021; 18:ijerph182010592. [PMID: 34682338 PMCID: PMC8535833 DOI: 10.3390/ijerph182010592] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 11/17/2022]
Abstract
According to the latest data published by the WHO, 1.71 billion people suffer from musculoskeletal disorders and 568 million are affected by back pain, making these the most significant occupational health problems. The aim of this study was to analyze the effects of a newly developed Multimodal Workplace Training Program implemented among young sedentary employees in order to treat and prevent these problems. The 20-week Training Program was conducted at the National Instruments Corporations’ Hungarian subsidiary in Debrecen between January and June, 2019. Pre- and post-intervention questionnaires were used to assess subjective parameters. Baseline and follow-up physical examinations were performed using the SpinalMouse, Y-Balance, Sit and Reach, Prone and Side Plank, Timed Abdominal Curl, and Biering-Sorensen tests. The results for 76 subjects were eligible for statistical analysis. Our Training Program was effective in several aspects, including a reduction in musculoskeletal symptoms and improvements in posture (p < 0.001), in dynamic (p < 0.01) and static-isometric (p < 0.001) core strength, in flexibility (p < 0.001), in spinal inclination in the sagittal (p < 0.001) and frontal (p < 0.01) plane, and in balance and coordination (p < 0.05). The Multimodal Progressive Functional–Proprioceptive Training was highly effective, and the application of such a complex training program can be recommended in workplace settings.
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Affiliation(s)
- Éva Anett Csuhai
- Department of Physiotherapy, Faculty of Public Health, University of Debrecen, 26 Kassai Str., 4028 Debrecen, Hungary;
- Correspondence: ; Tel.: +36-52-512-732 (ext. 77144)
| | - Attila Csaba Nagy
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 26 Kassai Str., 4028 Debrecen, Hungary; (A.C.N.); (G.J.S.)
| | - Gergő József Szőllősi
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 26 Kassai Str., 4028 Debrecen, Hungary; (A.C.N.); (G.J.S.)
| | - Ilona Veres-Balajti
- Department of Physiotherapy, Faculty of Public Health, University of Debrecen, 26 Kassai Str., 4028 Debrecen, Hungary;
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16
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Kolozsvári LR, Bérczes T, Hajdu A, Gesztelyi R, Tiba A, Varga I, Al-Tammemi AB, Szőllősi GJ, Harsányi S, Garbóczy S, Zsuga J. Predicting the epidemic curve of the coronavirus (SARS-CoV-2) disease (COVID-19) using artificial intelligence: An application on the first and second waves. Inform Med Unlocked 2021; 25:100691. [PMID: 34395821 PMCID: PMC8349399 DOI: 10.1016/j.imu.2021.100691] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/21/2021] [Accepted: 08/01/2021] [Indexed: 12/15/2022] Open
Abstract
Objectives The COVID-19 pandemic is considered a major threat to global public health. The aim of our study was to use the official epidemiological data to forecast the epidemic curves (daily new cases) of the COVID-19 using Artificial Intelligence (AI)-based Recurrent Neural Networks (RNNs), then to compare and validate the predicted models with the observed data. Methods We used publicly available datasets from the World Health Organization and Johns Hopkins University to create a training dataset, then we employed RNNs with gated recurring units (Long Short-Term Memory - LSTM units) to create two prediction models. Our proposed approach considers an ensemble-based system, which is realized by interconnecting several neural networks. To achieve the appropriate diversity, we froze some network layers that control the way how the model parameters are updated. In addition, we could provide country-specific predictions by transfer learning, and with extra feature injections from governmental constraints, better predictions in the longer term are achieved. We have calculated the Root Mean Squared Logarithmic Error (RMSLE), Root Mean Square Error (RMSE), and Mean Absolute Percentage Error (MAPE) to thoroughly compare our model predictions with the observed data. Results We reported the predicted curves for France, Germany, Hungary, Italy, Spain, the United Kingdom, and the United States of America. The result of our study underscores that the COVID-19 pandemic is a propagated source epidemic, therefore repeated peaks on the epidemic curve are to be anticipated. Besides, the errors between the predicted and validated data and trends seem to be low. Conclusion Our proposed model has shown satisfactory accuracy in predicting the new cases of COVID-19 in certain contexts. The influence of this pandemic is significant worldwide and has already impacted most life domains. Decision-makers must be aware, that even if strict public health measures are executed and sustained, future peaks of infections are possible. The AI-based models are useful tools for forecasting epidemics as these models can be recalculated according to the newly observed data to get a more precise forecasting.
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Affiliation(s)
- László Róbert Kolozsvári
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Tamás Bérczes
- Faculty of Informatics, University of Debrecen, Debrecen, Hungary
| | - András Hajdu
- Faculty of Informatics, University of Debrecen, Debrecen, Hungary
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Tiba
- Faculty of Informatics, University of Debrecen, Debrecen, Hungary
| | - Imre Varga
- Faculty of Informatics, University of Debrecen, Debrecen, Hungary
| | - Ala'a B Al-Tammemi
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Gergő József Szőllősi
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Szilvia Harsányi
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary.,Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Szabolcs Garbóczy
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary.,Department of Psychiatry, Kenézy Hospital, University of Debrecen, Debrecen, Hungary
| | - Judit Zsuga
- Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
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17
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Kolozsvári LR, Bérczes T, Hajdu A, Gesztelyi R, Tiba A, Varga I, Al-Tammemi AB, Szőllősi GJ, Harsányi S, Garbóczy S, Zsuga J. Predicting the epidemic curve of the coronavirus (SARS-CoV-2) disease (COVID-19) using artificial intelligence: An application on the first and second waves. Inform Med Unlocked 2021; 25:100691. [PMID: 34395821 DOI: 10.1101/2020.04.17.20069666] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/21/2021] [Accepted: 08/01/2021] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic is considered a major threat to global public health. The aim of our study was to use the official epidemiological data to forecast the epidemic curves (daily new cases) of the COVID-19 using Artificial Intelligence (AI)-based Recurrent Neural Networks (RNNs), then to compare and validate the predicted models with the observed data. METHODS We used publicly available datasets from the World Health Organization and Johns Hopkins University to create a training dataset, then we employed RNNs with gated recurring units (Long Short-Term Memory - LSTM units) to create two prediction models. Our proposed approach considers an ensemble-based system, which is realized by interconnecting several neural networks. To achieve the appropriate diversity, we froze some network layers that control the way how the model parameters are updated. In addition, we could provide country-specific predictions by transfer learning, and with extra feature injections from governmental constraints, better predictions in the longer term are achieved. We have calculated the Root Mean Squared Logarithmic Error (RMSLE), Root Mean Square Error (RMSE), and Mean Absolute Percentage Error (MAPE) to thoroughly compare our model predictions with the observed data. RESULTS We reported the predicted curves for France, Germany, Hungary, Italy, Spain, the United Kingdom, and the United States of America. The result of our study underscores that the COVID-19 pandemic is a propagated source epidemic, therefore repeated peaks on the epidemic curve are to be anticipated. Besides, the errors between the predicted and validated data and trends seem to be low. CONCLUSION Our proposed model has shown satisfactory accuracy in predicting the new cases of COVID-19 in certain contexts. The influence of this pandemic is significant worldwide and has already impacted most life domains. Decision-makers must be aware, that even if strict public health measures are executed and sustained, future peaks of infections are possible. The AI-based models are useful tools for forecasting epidemics as these models can be recalculated according to the newly observed data to get a more precise forecasting.
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Affiliation(s)
- László Róbert Kolozsvári
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Tamás Bérczes
- Faculty of Informatics, University of Debrecen, Debrecen, Hungary
| | - András Hajdu
- Faculty of Informatics, University of Debrecen, Debrecen, Hungary
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Tiba
- Faculty of Informatics, University of Debrecen, Debrecen, Hungary
| | - Imre Varga
- Faculty of Informatics, University of Debrecen, Debrecen, Hungary
| | - Ala'a B Al-Tammemi
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Gergő József Szőllősi
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Szilvia Harsányi
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Szabolcs Garbóczy
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- Department of Psychiatry, Kenézy Hospital, University of Debrecen, Debrecen, Hungary
| | - Judit Zsuga
- Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
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18
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Barth A, Szőllősi GJ, Nemes B. Experiences of a patient education program related to kidney transplantation in the Eastern Hungary region. Orv Hetil 2021; 162:1012-1021. [PMID: 34175834 DOI: 10.1556/650.2021.32266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/24/2021] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Bevezetés: A tudás mint potenciálisan módosítható faktor a megfelelő döntéshozatal előfeltétele. Célkitűzés: Kutatásunk során a krónikus vesebetegek körében vizsgáltuk az egyes vesepótló kezelési módokkal kapcsolatos ismereteket, elemeztük a tudást befolyásoló tényezőket, annak érdekében, hogy feltérképezzük a betegismeretek e területen megfigyelhető hiányosságait. Egyúttal tájékoztatást és ismeretterjesztést adtunk a vesetranszplantációval kapcsolatosan. Módszer: A betegek ismereteit befolyásoló tényezőket tíz magyarázó változóra korrigált többváltozós lineáris regresszióval értékeltük, melynél a függő változó a tudáspontszám volt. Követéses vizsgálatunk első adatfelvétele során az Eurotransplant-várólistán szereplő, vesetranszplantáció irányában kivizsgálás alatt álló, valamint a veseátültetést elutasító, 18 és 75 év közötti betegeket kerestük fel. Az első körös (alaptudásszintet rögzítő) adatfelvétel összesen 254, az ismeretátadás utáni második pedig 115 vesebeteg bevonásával valósult meg. Eredmények: Eredményeink alapján elmondható, hogy a felsőfokú (β = 1,502, p<0,001) és a középfokú (β = 2,346, p<0,001) iskolai végzettséggel rendelkező betegek egyaránt magasabb tudáspontszámot értek el az alacsonyabb iskolai végzettséggel rendelkezőkhöz képest. A korábban veseátültetésen már átesett betegek 2 ponttal magasabb pontszámot értek el a veseátültetésben még nem részesültekhez viszonyítva (β = 2,024, p<0,001). Szignifikánsan magasabb pontszámot értek el azok a betegek is, akik megfelelő egészségműveltségi szinttel rendelkeztek (β = 1,344, p<0,001). Eredményeink bizonyítják programunk hatékonyságát, mert a részt vevő vesebetegek szignifikánsan magasabb pontszámot értek el a tudásszintfelmérő teszten, több hónappal a betegedukációt követően is (p<0,001). Következtetés: Az általunk azonosított hiányosságok segíthetnek az egészségügyi szakemberek számára abban, hogy melyek azok a területek, amelyekre a betegoktatási és önmegvalósító programok során hangsúlyt kell fektetni a beteg-együttműködés és az eredmények javítása érdekében. Orv Hetil. 2021; 162(26): 1012-1021. SUMMARY INTRODUCTION Knowledge as a potentially modifiable factor is a prerequisite for appropriate decision making. OBJECTIVE In our study, we examined the knowledge level related to renal replacement therapies and its influencing factors among chronic kidney disease patients, in order to identify the patients' knowledge gaps. At the same time, we provided information, education on kidney transplantation. METHOD Factors influencing the patients' knowledge were evaluated using a multivariate linear regression adjusted for ten factors, where the dependent variable was the knowledge score. During the first data collection of our follow-up study, we contacted patients on the Eurotransplant waiting list, patients undergoing medical evaluation, and patients who refuse a kidney transplant, between 18 and 75 years old. A total of 254 patients were involved in the first round of data collection (recording the basic level of knowledge), and 115 in the second one (after the education). RESULTS Our results show that patients with both tertiary (β = 1.502, p<0.001) and secondary (β = 2.346, p<0.001) educational attainment achieved higher knowledge scores. Patients with previous kidney transplantation scored 2 points higher than those without (β = 2.024, p<0.001). Moreover, patients with adequate health literacy level achieved significantly higher knowledge scores (β = 1.344, p<0.001). Our results prove the effectiveness of our program since the participants achieved significantly higher scores on the knowledge test, even several months after the education (p<0.001). CONCLUSION The gaps we have identified can help the healthcare professionals which areas need to be focused in patient education and self-management programs in order to improve patient collaboration and outcomes. Orv Hetil. 2021; 162(26): 1012-1021.
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Affiliation(s)
- Anita Barth
- 1 Debreceni Egyetem, Egészségügyi Kar, Egészségtudományi Intézet, Ápolástudományi Tanszék, Nyíregyháza, Sóstói út 2-4., 4400.,3 Debreceni Egyetem, Általános Orvostudományi Kar, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen
| | | | - Balázs Nemes
- 3 Debreceni Egyetem, Általános Orvostudományi Kar, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen
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Illésy L, Fedor R, Kovács DÁ, Kanyári Z, Zádori G, Szőllősi GJ, Kovács M, Flaskó T, Tóth J, Veisz R, Belán I, Nemes B. Surgical complications after kidney transplantation based on the Clavien classification, especially with regard to the types of ureteral anastomoses. Orv Hetil 2021; 162:1038-1051. [PMID: 34175833 DOI: 10.1556/650.2021.32278] [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: 04/08/2021] [Accepted: 05/11/2021] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Bevezetés: Veseátültetést követően a graft és a beteg túlélésére hatással lehetnek a posztoperatív intervenciót igénylő szövődmények. Fontos szempont a műtéttechnikai eredményesség monitorozása. Többek között az irodalomban számos lehetőség ismert a veseátültetés sarokpontjának számító ureteranastomosis elkészítésére is, de az éranastomosisok technikája szintén döntő lehet. Célkitűzés és módszer: Retrospektíven vizsgáltuk a 2010 és 2020 között végzett veseátültetéseket a Debreceni Egyetem Sebészeti Klinikáján. Célul tűztük ki a sebészeti szövődmények vizsgálatát, melyeket rendszereztünk, a módosított Clavien-féle beosztás alapján. A legnagyobb figyelmet az ureteranastomosisokra fordítottuk. Minden betegnél az adott kategóriában legsúlyosabb szövődményt vettük alapul a beosztáshoz. A minimális utánkövetési idő 1 év volt. Az adatokat az SPSS statisztikai program segítségével elemeztük. Eredmények: A vizsgált periódusban 406 veseátültetés történt, melyből 24,4% (n = 99) vesetranszplantáltnál alakult ki intervenciós (sebészeti, radiológiai, urológiai) szövődmény. A betegek átlagéletkora 49,5 ± 13,7 év, 60,8% férfi volt. A kumulatív mortalitás 10,1% volt. Grade 4-es szövődmény a betegek 6,9%-ánál (n = 28), Grade 3-as a 6,7%-ánál (n = 27), Grade 2-es a 3%-ánál (n = 12), Grade 1-es a 7,9%-ánál (n = 32) jelentkezett. A veseátültetés után 20,4%-ban (n = 83) alakult ki későn induló graftfunkció. Következtetés: A legenyhébb kategóriába (Grade 1.) került a legtöbb beteg, a szövődmények jelentős része sebészi, intervenciós radiológiai és urológiai közreműködéssel megoldható volt. Az ureteranastomosisok műtéti technikája és a releváns szövődmények kialakulása között nincs szignifikáns összefüggés. Megfelelő és időben alkalmazott korrekciós kezelés mellett a graft- és betegtúlélést nem rontja szignifikánsan az enyhe és középsúlyos (Grade 1-3.) szövődmények kialakulása. Orv Hetil. 2021; 162(26): 1038-1051. SUMMARY INTRODUCTION Complications associated with postoperative intervention may affect graft and patient survival after kidney transplantation. Monitoring the effectiveness of surgery is an important aspect. Ureter anastomosis can be the pivot of kidney transplant, the same as vascular anastomosis, so efficiency of the surgical technique is important to follow up. OBJECTIVE AND METHOD We retrospectively examined kidney transplants performed between 2010 and 2020 at the Department of Surgery of the University of Debrecen. Data were analyzed by the SPSS statistical program. We aimed to investigate surgical complications, which were systematized based on the modified Clavien classification. In one patient, the most severe complication was used as the basis for the schedule. The minimum follow-up time was 1 year. RESULTS 406 kidney transplants were performed in the examined period, of which 24.4% (n = 99) developed renal transplant complications (surgical, radiological, urological). The mean age of the patients was 49.5 ± 13.7 years, and 60.8% were male. The cumulative mortality was 10.1%. Grade 4 complication developed in 6.9% (n = 28) of the recipients, Grade 3 in 6.7% (n = 27), Grade 2 in 3% (n = 12), and Grade 1 in 7.9% (n = 32). 20.4% of the recipients had delayed graft function. CONCLUSION The Grade 1 group had the biggest case number, so a significant part of the complications could be solved with the help of interventional radiology and urologists. There is no significant association between the surgical technique of ureteral anastomoses and the development of related complications. With appropriate therapy, graft and patient survival are not significantly impaired by the development of Grade 1-3 complications. Orv Hetil. 2021; 162(26): 1038-1051.
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Affiliation(s)
- Lóránt Illésy
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen, Móricz Zs. körút 22., 4032
| | - Roland Fedor
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen, Móricz Zs. körút 22., 4032
| | - Dávid Ágoston Kovács
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen, Móricz Zs. körút 22., 4032
| | - Zsolt Kanyári
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen, Móricz Zs. körút 22., 4032
| | - Gergely Zádori
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen, Móricz Zs. körút 22., 4032
| | | | - Márton Kovács
- 3 Debreceni Egyetem, Általános Orvostudományi Kar, Általános Orvos Szak, Debrecen
| | - Tibor Flaskó
- 4 Debreceni Egyetem, Általános Orvostudományi Kar, Urológiai Tanszék, Debrecen
| | - Judit Tóth
- 5 Debreceni Egyetem, Általános Orvostudományi Kar, Orvosi Képalkotó Intézet, Debrecen
| | - Richárd Veisz
- 5 Debreceni Egyetem, Általános Orvostudományi Kar, Orvosi Képalkotó Intézet, Debrecen
| | - Ivett Belán
- 5 Debreceni Egyetem, Általános Orvostudományi Kar, Orvosi Képalkotó Intézet, Debrecen
| | - Balázs Nemes
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen, Móricz Zs. körút 22., 4032
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Daragó A, Schwegler G, Szabó E, Barkó D, P Szabó R, Nagy AC, Szőllősi GJ, Nemes B. Early postoperative effects of kidney transplantation on the cardiovascular system in our clinical practice. Orv Hetil 2021; 162:1052-1062. [PMID: 34175832 DOI: 10.1556/650.2021.32269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/11/2021] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Bevezetés: Mind a dializált, mind a veseátültetett betegek körében vezető haláloknak számít a cardiovascularis megbetegedés. E mögött főképp bal kamrai hypertrophia, volumenterheltség, következményes szívritmuszavar, szívbillentyű-elégtelenség, fokozott atherosclerosis állhat. Célkitűzés: Célunk a vesetranszplantáció hatásának vizsgálata a bal kamra pumpafunkciójára, a szívritmuszavarokat kiváltó és meghatározó tényezőkre és a vitiumokra nézve. Módszerek: A 2014. december 20. és 2018. június 21. közti időintervallumban, a Debreceni Egyetem Szervtranszplantációs Tanszékén felnőtt betegeken végzett veseátültetéseket vizsgáltuk retrospektív analízissel (n = 184). Vesetranszplantációt megelőzően, illetve azt követően 6 és 12 hónappal az echokardiográfiás, a laboratóriumi és a gyógyszeres terápiás értékeket tanulmányoztuk. A statisztikai elemzéseket khi-négyzet-próbával, Fisher-féle egzakt teszttel és Kruskal-Wallis-féle varianciaanalízissel (ANOVA) végeztük (szignifikancia: p<0,05). Eredmények: A bal kamra végsystolés tágassága az átültetés előtt 34,67 mm volt, míg a 6 hónapos eredmény 31,82 mm, a 12 hónapos 32,68 mm volt (p = 0,01). Átültetés előtt a stroke prevalenciája 7,87% volt, míg a beavatkozás után nem fordult elő szélütés (p<0,001). Transzplantáció hatására a bal pitvari átmérő (43,68 mm; 41,59 mm; 41,00 mm; p = 0,0417) és a káliumszint (4,98 mmol/l; 4,49 mmol/l; 4,49 mmol/l; p = 0,01) szignifikáns változást igazolt. Műtét előtt II. fokú mitralis regurgitatiót észleltünk 10,7%-nál, mely 4,3%-ra, majd 2,1%-ra csökkent (p = 0,03). Transzplantációt megelőzően a billentyűmeszesedés előfordulása diabetesesek között 45% (p = 0,20), 6 hónap múlva 46,7% (p = 0,018), 12 hónap múlva 60,0% (p = 0,024) volt. Következtetés: Transzplantáció után a bal pitvari átmérő, a végsystolés bal kamrai átmérő regrediál, csökken a pitvari ritmuszavarok kialakulásának gyakorisága. A mitralis regurgitatio közepesen súlyos fokainál szignifikáns javulást, a diabeteses populáción belül szignifikáns emelkedést tapasztaltunk a meszes billentyűk számát tekintve. Orv Hetil. 2021; 162(26): 1052-1062. SUMMARY INTRODUCTION Among the population suffering from end-stage renal failure and the population after kidney transplantation, the leading reason of death is cardiovascular triggered by left ventricular hypertrophy, volume overload, consecutive arrhythmias, valvular insufficiency and increased artherosclerosis. OBJECTIVE This study was aimed at examining the effect of kidney transplantation on pump function of the left ventricle, arrhythmic substrates and valvular heart diseases. METHODS At the Division of Organ Transplantation, University of Debrecen, we carried out a retrospective data analysis of adult patients (n = 184) who had kidney transplantation in the period between December 2014 and June 2018. Preoperatively and, then, postoperatively (at 6 and 12 months) we studied the echocardiographic parameters, the laboratory results. Statistical analyses were performed using the chi-square/Fisher's exact test and Kruskal-Wallis analysis of variance (ANOVA) test. The results were regarded significant if p<0.05 was found. RESULTS Preoperatively the end-systolic diameter of the left ventricle was 34.67 mm, whereas 6 and 12 months later these values were 31.82 mm and 32.68 mm (p = 0.01). The prevalence of stroke was 7.87% preoperatively; there was no stroke detected postoperatively (p<0.001). The impact of transplantation on the left atrial diameter (43.68 mm; 41.59 mm; 41.00 mm; p = 0.04) and seral potassium level (4.98 mmol/l; 4.49 mmol/l; 4.49 mmol/l; p<0.01) showed significant improvement. Before transplantation, grade 2 mitral regurgitation was observed in 10.7% of the patients, whereas it reduced to 4.3%, then to 2.1% 6 and 12 months postoperatively (p = 0.03). Preoperative valvular calcification was detected in 45% of the diabetic study population (p = 0.20), 6 and 12 months later, in 46.7% (p = 0.018) and 60.0% (p = 0.024). CONCLUSION After transplantation, the left atrial and the end-systolic diameter of the left ventricle regrediated, decreasing the frequency of arrhythmic episodes. The number of the middle grade mitral valve regurgitation decreased and the calcification among diabetic population increased significantly. Orv Hetil. 2021; 162(26): 1052-1062.
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Affiliation(s)
- Andrea Daragó
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Klinikai Központ, Kardiológiai Intézet, Kardiológiai Tanszék, Debrecen, Móricz Zs. krt. 22., 4032
| | - Gerda Schwegler
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Klinikai Központ, Kardiológiai Intézet, Kardiológiai Tanszék, Debrecen, Móricz Zs. krt. 22., 4032
| | - Eszter Szabó
- 2 Debreceni Egyetem, Általános Orvostudományi Kar, Klinikai Központ, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen
| | - Dorina Barkó
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Klinikai Központ, Kardiológiai Intézet, Kardiológiai Tanszék, Debrecen, Móricz Zs. krt. 22., 4032
| | - Réka P Szabó
- 2 Debreceni Egyetem, Általános Orvostudományi Kar, Klinikai Központ, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen
| | | | | | - Balázs Nemes
- 2 Debreceni Egyetem, Általános Orvostudományi Kar, Klinikai Központ, Sebészeti Intézet, Szervtranszplantációs Nem Önálló Tanszék, Debrecen
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Abstract
Kidney transplantation is the best available treatment choice for patients suffering from end-stage renal disease; however, not all patients with end-stage renal disease have equal access to it. The aim of the study was to measure the factors that may influence access to the kidney transplant waiting list in eastern Hungary. A total of 254 patients with renal failure between 18 and 75 years old from 8 dialysis centers participated in the study. The factors associated with access to the waiting list were identified by univariate descriptive analysis and multivariate logistic regression analysis where the outcome variable was placement on the kidney transplant waiting list. Our findings demonstrates that patients registered on the waiting list were younger (odds ratio [OR] = 0.96; 95% confidence interval [CI], 0.94-0.98), were male (OR = 0.54; 95% CI, 0.30-0.98), were economically active (OR = 0.53; 95% CI, 0.29-0.98), and had greater knowledge in the field (OR = 1.17; 95% CI, 1.03-1.33). Disparity in access to the kidney transplant waiting list in Hungary does exist.
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Affiliation(s)
- Anita Barth
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Department of Nursing Science, Faculty of Health, University of Debrecen, Nyiregyhaza, Hungary; Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary.
| | | | - Balázs Nemes
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Barth A, Szőllősi GJ, Nemes B. Measuring Patients' Level of Knowledge Regarding Kidney Transplantation in Eastern Hungary. Transplant Proc 2021; 53:1409-1413. [PMID: 33637324 DOI: 10.1016/j.transproceed.2021.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Adequate knowledge is needed to make the correct decision regarding kidney transplantation. The purpose of this study was to measure the demographic, sociologic, economic, and cultural factors that may influence patients' decision-making regarding kidney transplantation and to explore patients' knowledge of renal replacement therapies. A total of 254 end-stage renal disease patients (predialysis, peritoneal dialysis, and hemodialysis) from 8 dialysis centers in eastern Hungary participated in our study. We developed a questionnaire that measures patients' knowledge of renal replacement therapies and the role of sociodemographic, economic, and cultural factors that may influence their knowledge. Factors influencing the knowledge scores were evaluated using a multivariate linear regression adjusted for 8 factors. We found a significant correlation between education level and knowledge score, where patients with greater education (greater than high school: β = 3.003; P < .001; high school: β = 1.906; P < .001) achieved higher knowledge scores than those without. Moreover, patients with a previous kidney transplant (β = -2.111; P < .001) had greater knowledge in the field. Our study identified a risk group where targeted, personalized patient education is essential.
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Affiliation(s)
- Anita Barth
- Department of Nursing Science, Faculty of Health, University of Debrecen, Nyiregyhaza, Hungary; Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary; Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | | | - Balázs Nemes
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Garbóczy S, Magócs É, Szőllősi GJ, Harsányi S, Égerházi A, Kolozsvári LR. The use of the Hungarian Test Your Memory (TYM-HUN), MMSE, and ADAS-Cog tests for patients with mild cognitive impairment (MCI) in a Hungarian population: a cross-sectional study. BMC Psychiatry 2020; 20:571. [PMID: 33256672 PMCID: PMC7708165 DOI: 10.1186/s12888-020-02982-6] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 11/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) often presages the development of Alzheimer's disease (AD). Accurate and early identification of cognitive impairment will substantially reduce the burden on the family and alleviate the costs for the whole society. There is a need for testing methods that are easy to perform even in a general practitioner's office, inexpensive and non-invasive, which could help the early recognition of mental decline. We have selected the Test Your Memory (TYM), which has proven to be reliable for detecting AD and MCI in several countries. Our study was designed to test the usability of the Hungarian version of the TYM (TYM-HUN) comparing with the Mini-Mental State Examination (MMSE) and the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in MCI recognition in the Hungarian population. METHODS TYM test was translated and validated into Hungarian (TYM-HUN) in a previous study. The TYM-HUN test was used in conjunction with and compared with the MMSE and the ADAS-Cog. For our study, 50 subjects were selected: 25 MCI patients and 25 healthy controls (HC). Spearman's rank correlation was used to analyse the correlation between the scores of MMSE and ADAS-Cog with TYM-HUN and the receiver operating characteristic (ROC) curve was established. RESULTS MCI can be distinguished from normal aging using TYM-HUN. We established a 'cut-off' point of TYM-HUN (44/45points) where optimal sensitivity (80%) and specificity (96%) values were obtained to screen MCI. The total TYM-HUN scores significantly correlated with the MMSE scores (ρ = 0.626; p < 0.001) and ADAS-Cog scores (ρ = - 0.723; p < 0.001). CONCLUSIONS Our results showed that the TYM-HUN is a reliable, fast, self-administered questionnaire with the right low threshold regarding MCI and can be used for the early diagnosis of cognitive impairment.
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Affiliation(s)
- Szabolcs Garbóczy
- grid.7122.60000 0001 1088 8582Gyula Kenézy University Hospital, Department of Adult Psychiatry, University of Debrecen, Debrecen, Hungary
| | - Éva Magócs
- grid.7122.60000 0001 1088 8582Department of Psychiatry, Clinical Center, University of Debrecen, Debrecen, Hungary
| | - Gergő József Szőllősi
- grid.7122.60000 0001 1088 8582Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Postal Adress: Móricz Zs. krt. 22, Debrecen, 4032 Hungary
| | - Szilvia Harsányi
- grid.7122.60000 0001 1088 8582Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Anikó Égerházi
- grid.7122.60000 0001 1088 8582Department of Psychiatry, Clinical Center, University of Debrecen, Debrecen, Hungary
| | - László Róbert Kolozsvári
- Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Postal Adress: Móricz Zs. krt. 22, Debrecen, 4032, Hungary.
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Mihailovic N, Szőllősi GJ, Rancic N, János S, Boruzs K, Nagy AC, Timofeyev Y, Dragojevic-Simic V, Antunovic M, Reshetnikov V, Ádány R, Jakovljevic M. Alcohol Consumption among the Elderly Citizens in Hungary and Serbia-Comparative Assessment. Int J Environ Res Public Health 2020; 17:E1289. [PMID: 32079338 PMCID: PMC7068319 DOI: 10.3390/ijerph17041289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 01/25/2020] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 01/03/2023]
Abstract
Studies in the alcohol consumption area are mostly related to the (ab)use of alcohol in young people. However, today, a growing number of researchers are emphasizing the clinical and public health significance of alcohol consumption in the elderly. In the WHO reports, harmful alcohol consumption is responsible for 5.3% of the global burden of the disease. The aim of this study was to investigate the prevalence of alcohol consumption among men and women aged 55 and over in Serbia and Hungary, leveraging data from the 2013 Serbian National Health Survey and from the 2014 Hungarian National Health Survey. Respondents aged 55 and over were analysed based on logistic multivariate models. The prevalence of alcohol consumption was 41.5% and 62.5% in Serbia and Hungary, respectively. It was higher among men in both countries, but among women, it was significantly higher in Hungary than in Serbia. The statistically significant predictors affecting alcohol consumption in Serbia included age, education, well-being index, long-term disease and overall health status, with marital status being an additional factor among men. In Hungary, education and long-term disease affected alcohol consumption in both sexes, while age and employment were additional factors among women. In both countries for both sexes, younger age, more significantly than primary education and good health, was associated with a higher likelihood of alcohol consumption.
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Affiliation(s)
- Natasa Mihailovic
- Institute of Public Health Kragujevac, Department of Biostatistics and Informatics, Nikole Pašića 1, 34000 Kragujevac, Serbia
| | - Gergő József Szőllősi
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, H-4002 Debrecen, Hungary
| | - Nemanja Rancic
- The Centre for Clinical Pharmacology, Medical Faculty, Military Medical Academy, University of Defence, Crnotravska 17, 11000 Belgrade, Serbia
| | - Sándor János
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, H-4002 Debrecen, Hungary
| | - Klára Boruzs
- Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, H-4002 Debrecen, Hungary
| | - Attila Csaba Nagy
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, H-4002 Debrecen, Hungary
| | - Yuriy Timofeyev
- National Research University Higher School of Economics, Shabolovka Ulitsa 26-28, 119049 Moscow, Russian
| | - Viktorija Dragojevic-Simic
- The Centre for Clinical Pharmacology, Medical Faculty, Military Medical Academy, University of Defence, Crnotravska 17, 11000 Belgrade, Serbia
| | - Marko Antunovic
- National Poison Control Center, Medical Faculty, Military Medical Academy, University of Defence, Crnotravska 17, 11000 Belgrade, Serbia
| | - Vladimir Reshetnikov
- N.A. Semashko Department of Public Health and Healthcare, I.M. Sechenov the First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Róza Ádány
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, H-4002 Debrecen, Hungary
| | - Mihajlo Jakovljevic
- N.A. Semashko Department of Public Health and Healthcare, I.M. Sechenov the First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- Department of Global Health Economics and Policy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Institute of Comparative Economic Studies, Hosei University, Tokyo 194-0298, Japan
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Biró B, Szabó RP, Illésy L, Balázsfalvi N, Szőllősi GJ, Baráth S, Hevessy Z, Nemes B. Regulatory T Cells in the Context of New-Onset Diabetes After Renal Transplant: A Single-Center Experience. Transplant Proc 2019; 51:1234-1238. [PMID: 31101204 DOI: 10.1016/j.transproceed.2019.03.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND New-onset diabetes mellitus after transplant (NODAT) is a well-known complication of renal transplant that severely affects graft and patient survival. It is necessary to explore further risk factors and reveal the underlying pathomechanism. METHODS Renal transplants performed between January 2010 and June 2018 were involved. Exclusion criteria were the recipient age younger than 18 years, follow-up period less than 6 months, and patients with diabetes at the time of transplant. Only primary kidney transplants were involved in our study, which totaled 223 cases. Besides donor and recipient demographic data, the type of immunosuppression, the average fasting glucose level, and T-subset profiles were compared. RESULTS Of 223 cases there were 33 patients (14.8%) with NODAT (17 female; mean age, 54.2 [SD, 10.3] years; mean body mass index [calculated as weight in kilograms divided by height in meters squared], 27.8 [SD, 5.1]; mean follow-up, 43.3 [SD, 25.5] months). The control group consisted of 190 patients. The average fasting blood glucose level was higher in the NODAT group vs the control group (P < .001). The average fasting blood glucose level above diabetic threshold (≥7 mmol/L) was in association with a 6-fold higher risk of NODAT (odds ratio, 5.86; 95% CI, 2.46-13.97; P < .001). Absolute value of CD4+CD25brightCD127dim regulatory T cells was lower in the NODAT group at the first month after transplant (P = .048) Immunosuppressive protocol and survival data did not differ. CONCLUSIONS Intensive management of the carbohydrate excursions during the early post-transplant period may decrease the incidence of NODAT. Further investigations will be required to decide whether the reduced CD4+CD25brightCD127dim/regulatory T-cell count contributes the development of NODAT.
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Affiliation(s)
- B Biró
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - R P Szabó
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - L Illésy
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - N Balázsfalvi
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - G J Szőllősi
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - S Baráth
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Z Hevessy
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - B Nemes
- Department of Transplantation, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Kolozsvári LR, Kónya J, Paget J, Schellevis FG, Sándor J, Szőllősi GJ, Harsányi S, Jancsó Z, Rurik I. Patient-related factors, antibiotic prescribing and antimicrobial resistance of the commensal Staphylococcus aureus and Streptococcus pneumoniae in a healthy population - Hungarian results of the APRES study. BMC Infect Dis 2019; 19:253. [PMID: 30866843 PMCID: PMC6415336 DOI: 10.1186/s12879-019-3889-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 06/26/2018] [Accepted: 03/07/2019] [Indexed: 11/10/2022] Open
Abstract
Background Antimicrobial resistance (AMR) is an increasing public health problem worldwide. We studied some patient-related factors that might influence the antimicrobial resistance. and whether the volume of antibiotic prescribing of the primary care physicians correlate with the antibiotic resistance rates of commensal nasal Staphylococcus aureus and Streptococcus pneumoniae. Methods The socio-demographic questionnaires, the antibiotic prescription and resistance data of commensal nasal S. aureus and S. pneumoniae were collected in the 20 participating Hungarian practices of the APRES study. Multivariate logistic regression analyses were performed on the patient-related data and the antimicrobial resistance of the S. aureus and S. pneumoniae on individual, patient level. Ecological analyses were performed with Spearman’s rank correlations at practice level, the analyses were performed in the whole sample (all practices) and in the cohorts of primary care practices taking care of adults (adult practices) or children (paediatric practices). Results According to the multivariate model, age of the patients significantly influenced the antimicrobial resistance of the S. aureus (OR = 0.42, p = 0.004) and S. pneumoniae (OR = 0.89, p < 0.001). Living with children significantly increased the AMR of the S. pneumoniae (OR = 1.23, p = 0.019). In the cohorts of adult or paediatric practices, neither the age nor other variables influenced the AMR of the S. aureus and S. pneumoniae. At practice level, the prescribed volume of penicillins significantly correlated with the resistance rates of the S. aureus isolates to penicillin (rho = 0.57, p = 0.008). The volume of prescribed macrolides, lincosamides showed positive significant correlations with the S. pneumoniae resistance rates to clarithromycin and/or clindamycin in all practices (rho = 0.76, p = 0.001) and in the adult practices (rho = 0.63, p = 0.021). Conclusions The age is an important influencing factor of antimicrobial resistance. The results also suggest that there may be an association between the antibiotic prescribing of the primary care providers and the antibiotic resistance of the commensal S. aureus and S. pneumoniae. The role of the primary care physicians in the appropriate antibiotic prescribing is very important to avoid the antibiotic resistance.
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Affiliation(s)
- László Róbert Kolozsvári
- Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
| | - József Kónya
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - John Paget
- NIVEL, The Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Francois G Schellevis
- NIVEL, The Netherlands Institute for Health Services Research, Utrecht, The Netherlands.,Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - János Sándor
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Gergő József Szőllősi
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Szilvia Harsányi
- Department of Health Systems Management, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Zoltán Jancsó
- Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Imre Rurik
- Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
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Kolozsvári LR, Kovács ZG, Szőllősi GJ, Harsányi S, Frecska E, Égerházi A. Validation of the Hungarian version of the Test Your Memory. Ideggyogy Sz 2019; 70:267-272. [PMID: 29870641 DOI: 10.18071/isz.70.0267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Concerns regarding the projected prevalence of Alzheimer's disease (AD) over the next several decades have stimulated a need for the detection of AD in its earliest stages. A self-administered cognitive test (Test Your Memory, TYM) is designed as a short, cognitive screening tool for the detection of AD. Our aim was to validate the Hungarian version of the Test Your Memory (TYM-HUN) test for the detection of AD. The TYM-HUN was applied in case of individuals aged 60 years or more, 50 patients with AD and 50 healthy controls were recruited into the study. We compared the diagnostic utility of the Hungarian version of the TYM in AD with that of the Mini-Mental State Examination (MMSE). The sensitivity and specificity of the TYM-HUN in the detection of Alzheimer's disease were determined. The patients with AD scored an average of 15.5/30 on the MMSE and 20.3/50 on the TYM-HUN. The average score achieved by the members of the healthy control group was 27.3/30 on the MMSE and 42.7/50 on the TYM. The total TYM-HUN scores significantly correlated with the MMSE scores (Spearman's rho, r=0.8830; p<0.001). Multivariate logistic regression model demonstrated that a one-point increase in the TYM score reduced the probability of having AD by 36%. The optimal cut-off score on the TYM-HUN was 35/36 along with 94% sensitivity and 94% specificity for the detection of AD. The TYM has a much wider scoring range than the MMSE and is also a suitable screening tool for memory problems, furthermore, it fulfils the requirements of being a short cognitive test for the non-specialists. The TYM-HUN is useful for the detection of Alzheimer's disease and can be applied as a screening test in Hungarian memory clinics as well as in primary care settings.
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Affiliation(s)
- László Róbert Kolozsvári
- Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Zoltán György Kovács
- Department of Psychiatry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gergő József Szőllősi
- Department of Preventive Medicine, Division of Biostatistics and Epidemiology, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Szilvia Harsányi
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Ede Frecska
- Department of Psychiatry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Anikó Égerházi
- Department of Psychiatry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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