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.

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.

[Retrospective examination of the Hungarian breast and cervical cancer screening programmes according to mortality and morbidity data]. / A magyarországi emlo- és méhnyakszurés retrospektív vizsgálatának jellemzoi a halálozási és megbetegedési adatok tükrében.

Introduction: The organized breast and cervical screening programs were implemented in the framework of public health program in Hungary in order to reduce breast cancer mortality by 30% and cervical cancer mortality by 60% in given age groups within 10 years by 2012. Aim: The aim of our study was to conduct a retrospective analysis of mortality and morbidity data and to evaluate the effectiveness of the implemented screening programs. Method: Descriptive statistical analysis was performed by age-standardized mortality and morbidity data between 1980 and 2015 with special regard to the period of 2002-2012. Results: Breast cancer mortality of women aged 45-64 reduced by 28.3%, the incidence reduced by 23.6% and the incidence of in situ carcinoma increased by 242% between 2002 and 2012. Cervical cancer mortality of women aged 25-64 years reduced by 25.5%, the incidence reduced by 21.2%, and the incidence of in situ carcinoma increased by 13.3% during 2002-2012. Conclusion: Although both breast cancer and cervical cancer mortality substantially decreased in Hungary, the decrease in cervical cancer did not reach the target value. Orv Hetil. 2019; 160(49): 1948-1956.

Use of complementary and alternative medicine among breast cancer patients in Hungary: A descriptive study.

BACKGROUND AND PURPOSE: This study aimed to explore the prevalence of the use of complementary and alternative medicine (CAM) before diagnosis and during oncology therapy, and reveal the disclosure of CAM use among Hungarian breast cancer patients. MATERIALS AND METHODS: In a cross-sectional survey a self-administered questionnaire was used covering patients' demographics, oncology-related variables and various aspects of CAM use. Data were collected from 135 patients. Data analysis included descriptive analysis and Chi-square tests. RESULTS: The prevalence of CAM use was 52.6% before diagnosis while it was 84.4% during therapy. The most commonly used CAM practices before diagnosis and during therapy were vitamins/minerals (37%, 60%, respectively) and herbs (31.9%, 78.5%, respectively). The frequency of CAM use before diagnosis was higher among more educated patients (p < 0.001) and those living in cities (p = 0.001) while during therapy it was higher among patients with higher income (p = 0.020). Over 40% of the patients informed their physician about each CAM practice they used. CONCLUSION: Besides conventional medicine, CAM practices are also regarded as an important part of therapy by cancer patients. The higher frequency of CAM use during therapy and the relatively modest disclosure towards physicians indicate a greater need for patients' education regarding CAM practices.

Socioeconomic status, health related behaviour, and self-rated health of children living in Roma settlements in Hungary.

OBJECTIVE: The poor health of Roma is well documented, but there is only limited data regarding the health of Roma children. The aim of this study was to describe the socioeconomic status, health related behaviour, and health of children living in segregated Roma settlements, and to compare the data with that of non-Roma children. METHODS: In March-April of 2011, a cross-sectional questionnaire-based survey among 11-year-old (211 boys and 252 girls) and 13-year-old (205 boys and 247 girls) children living in Roma settlements was performed (response rate: 91.5%). These data were compared with data from the Health Behaviour in School-Aged Children (HBSC) survey carried out in 2009/2010. RESULTS: The parents of Roma children were substantially less educated and less likely to be actively employed, and Roma children reported lower material welfare than non-Roma ones. The prevalence of consuming sweets and soft drinks at least 5 times per week was 1.5-2 times higher among Roma children. The prevalence of regular intense physical activity was higher at the age of 13 years among Roma boys, while physical inactivity was substantially higher in both age groups among Roma girls. Almost one quarter of Roma children and approximately 14% of non-Roma children had tried smoking at the age of 11. More Roma boys tried alcohol at the age of 11 than non-Roma ones. One in ten Roma children was obese in both age groups. The self-rated health status of Roma children was worse than that of non-Roma children. CONCLUSIONS: Children living in Roma settlements reported poorer socioeconomic conditions, higher consumption of sweets and soft drinks, earlier smoking and alcohol initiation, and worse self-rated health, but with some exceptions do not differ in fruit or vegetable consumption and BMI from general child population. To promote health of children living in Roma settlements, a multi-sector approach, special health education, plus social and health promotion programmes are needed.

Method validation for the simultaneous determination of fecal sterols in surface waters by gas chromatography-mass spectrometry.

Besides microbiological methods, fecal pollution of surface waters is estimated by gas chromatographic (GC) determination of sterols present in human and animal sewage effluents. The most frequently used biomarkers for the evaluation of contamination levels include coprostanol, cholesterol, dihydrocholesterol, stigmasterol, beta-sitosterol, and stigmastanol. Although several GC techniques are used to measure these compounds in aquatic systems, the analytical performance of GC-mass spectrometric (MS) determination of these sterols has not been systematically characterized. Therefore, the aim of this work is to validate a simple and rapid GC-MS method for the simultaneous analysis of six sterols, considering all parameters and requirements defined by Good Laboratory Practice. Following liquid-liquid extraction of spiked surface water samples, the extracts are silylated and analyzed by GC-MS. The method is evaluated for linearity and limits of detection and quantitation, as well as for precision, extraction efficiency, and stability. The assay is linear up to 160 ng; the limits of detection and quantitation are 5-10 ng and 20 ng, respectively. The within- and between-day precision ranged from 1% to 9% and 1% to 16%, respectively. The extraction efficiency was 65-80%. The stability studies indicate that the sterols in surface water samples begin to degrade after 24 h of refrigerated storage. However, three freeze/thaw cycles could be performed without their decomposition. The method is applied to the analysis of surface water and wastewater samples. The technical advantages make this GC-MS analysis suitable for routine environmental monitoring of fecal pollution in aquatic systems.

Possible role of factor XIII subunit A in Fcgamma and complement receptor-mediated phagocytosis.

Besides its traditional role in hemostasis, factor XIII subunit A (FXIII-A) is supposed to function as a cellular transglutaminase and to be involved in certain intracellular processes, including cytoskeletal remodeling. To investigate its intracellular role, the aim of the present study was to follow changes in FXIII-A production in combination with the receptor-mediated phagocytic activities of monocytes/macrophages and to examine the phagocytic functions of monocytes in patients with FXIII-A deficiency. Human blood monocytes were isolated from the buffy coats of healthy volunteers and cultured for 4 days. The FcgammaR-mediated phagocytosis of sensitized erythrocytes (EA) and the complement receptor (CR)-mediated phagocytosis of complement-coated yeast particles were studied during monocyte/macrophage differentiation. Changes in the gene expression of FXIII-A were detected by real-time quantitative RT-PCR. FXIII-A protein production was investigated with fluorescent image analysis at single cell level and Western immunoblot analysis. Both the FcgammaR and CR-mediated phagocytosis increased during culturing, which peaked on day 3. The phagocytic activity of the cells could be markedly inhibited with monodansylcadaverine, an inhibitor of the transglutaminase-induced crosslinking of proteins. The phagocytosis of EA, complement-coated and uncoated yeast particles was found to be strongly diminished in monocytes of FXIII-A deficient patients. The phagocytic functions of cultured cells showed a change in parallel with the alterations in FXIII-A mRNA expression, as well as with that in FXIII-A in protein synthesis detected by image and Western immunoblot analyses in concert. Our results suggest that FXIII-A plays a role in the Fcgamma and complement receptor-mediated phagocytic activities of monocytes/macrophages.

Simultaneous determination of styrene, toluene, and xylene metabolites in urine by gas chromatography/mass spectrometry.

Exposure to styrene, toluene, and xylene (STX) frequently occurs in various industrial settings leading to several adverse health effects. Therefore, the biological monitoring by determination of urinary mandelic acid (MA) and phenylglyoxylic acid (PGA), hippuric acid (HA), and 2-, 3-, and 4-methylhippuric acids (2-, 3-, and 4-MHAs), the metabolites of STX, is required or at least recommended in case of workers exposed by these agents. Considering the fact that co-exposure to STX frequently occurs, methods that have been described for the separate analysis of these compounds in urine samples cannot be used effectively for monitoring. Therefore, a reliable gas chromatographic/mass spectrometric (GC/MS) method was developed for the simultaneous identification and quantification of these metabolites. Following solid phase extraction of the urine samples, the extracts were silylated and analyzed by GC/MS using a HP-5MS capillary column. The method was evaluated for linearity, limits of detection and quantification, and specificity, as well as for precision, extraction efficiency, and stability at three different concentrations prepared in urine. The assay was linear up to 0.16 mg/ml for MA, and 0.32 mg/ml for PGA, HA, and 2-, 3- and 4-MHAs. The limits of detection and quantification of STX metabolites varied between 0.001 and 0.02 mg/ml, and from 0.01 to 0.04 mg/ml, respectively. The within-day and between-day precision, determined at low, medium, and high concentrations, ranged from 2 to 12% and 2 to 19%, respectively. The extraction efficiency was 70-80%. No degradation of the metabolites occurred in the urine samples under the possible working conditions. The method was applied for the analysis of the urine samples from exposed workers. The cost- and time-effectiveness, the technical advantages and validity parameters of this GC/MS analysis make it suitable for biological monitoring of mixed exposure to styrene, toluene and xylene.

Optimal flattening filter shape of a surface brachytherapy applicator.

As an alternative to standard treatment of superficial lesions with surgery and/or superficial/orthovoltage x-ray irradiation, radioactive moulds can be used. However, close proximity of the source to the treatment region leads to significant dose inhomogeneities in the tissue. Analytical and fast numerical methods have been developed that can calculate a corresponding flattening filter that evens out the dose distribution at the surface. Monte Carlo transport calculations were used to enable accurate treatment of the transport through the geometry. It was found that the use of pre-calculated transport parameters like dependence of the attenuation coefficient and scattering with depth is required for fast calculation of the flattening filter shape. Only 1-2 iterations were needed for a successful convergence to the filter shape that flattens out the dose distribution at the surface to within 1%. The developed methods are very general and could be applied with some minor modifications to other problems, where shaping of the irradiation field is required.