Stress Responses Among Individuals with Spiritual Struggles in Hungary: An Experimental Study.

Individuals with a Religious or Spiritual Problem (RSP), as defined in the DSM-5, experience distress associated with faith-related moral dilemmas, existential meaning, and transpersonal attitudes toward other people. It is unclear whether a RSP reflects a generally heightened stress reactivity or whether the stress response is confined to religious and spiritual contexts. To elucidate this issue, we measured behavioral and physiological responses during social-evaluative stress (public speaking-Trier Social Stress Test) and in religious/spiritual contexts (Bible reading and listening to sacred music) in 35 individuals with RSP and 35 matched participants. We found no stress reduction in the religious/spiritual context in RSP, as indicated by increased heart rate, saliva cortisol, and relatively higher left than right frontal activity. Religious stimuli evoked physiological stress responses in RSP. Contrary to the physiological parameters, participants with RSP reported less anxiety in the religious/spiritual context. Religious individuals with and without RSP showed similar stress responses during public speaking. Religious individuals without RSP displayed reduced stress responses in the religious/spiritual context. These results indicate that specific physiological distress in religious/spiritual contexts should be considered in the psychological care of RSP.

Tuberculosis in prehistory in Eastern Central Europe (Hungary) - Chronological and geographical distribution.

Tuberculosis (TB) has long been a major scourge of humankind. Paleopathological and paleomicrobiological studies have revealed the past presence of the disease on a large spatial and temporal scale. The antiquity of the disease has extensively been studied in the Carpathian Basin, given its dynamic population and cultural changes since prehistory. These studies, however, have mainly focused on the populations living during the Common Era. The aim of this paper is to present the published and the recently discovered cases of prehistoric TB, from the Neolithic (6000-4500/4400 BCE) to the Bronze Age (2600/2500-800 BCE) Central Carpathian Basin (Hungary). We summarize 18 published cases and present new cases dating to the Neolithic period and introduce 3 newly discovered Bronze Age cases of TB. Despite extensive research, TB has not yet been identified from the Copper and Iron Ages in the Carpathian Basin. Considering the state of TB research, and supplemented by our prehistoric dataset, the spatio-temporal pattern of the disease can be further elucidated, thus advancing future molecular and paleopathological studies. Our dataset offers comprehensive spatial and temporal information on the spread of the disease in the Carpathian Basin, along with a detailed biological profile of the demonstrated cases and extensive paleopathological descriptions of the observed lesions, complemented by photographic evidence. This invaluable resource paves the way for enhanced understanding and progress in the field.

[Burnout syndrome among Hungarian midwives in 2014 and 2022]. / Kiégésszindróma a magyar szülésznok körében 2014-ben és 2022-ben.

INTRODUCTION: The healthcare sector is the most studied area of burnout, as the mental health of healthcare workers has a significant impact on the mental health of the people they care for. OBJECTIVE: The aim of our study was to investigate whether there have been changes in the dimensions of burnout among midwives, and how the relationships between burnout and the individual factors and working conditions that influence it have evolved, using national data from 2014 and 2022. METHOD: An anonymous, voluntary, questionnaire-based survey of midwives working exclusively in maternity units was conducted using the Maslach Burnout Inventory questionnaire, which measures burnout, and questions on respondents' demographic characteristics and working conditions. Multivariate ordinal logistic regression was used to explore associations between burnout and respondent characteristics, and associations were characterized by odds ratios. RESULTS: Among the dimensions of burnout, no change in depersonalization was observed in 2022, but both emotional exhaustion and personal ineffectiveness were significantly more common in 2022 than in 2014. Responses from 224 midwives in 2014 and 152 midwives in 2022 were analyzed. Looking at the influencing factors, higher levels of burnout in 2014 were significantly associated with poorer perceived health, lack of a partner, smoking, shorter time in healthcare, having a job in a larger city, feeling overworked and dissatisfied. In 2022, on the other hand, younger age, smoking, shorter time in healthcare, feeling overworked, dissatisfied and unvalued were associated with higher levels of burnout. Looking at the combined effect of these factors, willingness to attend a health promotion lecture and having a second job also showed a significant effect on burnout in 2022. DISCUSSION: The authors discuss the change in burnout among midwives and the possible reasons for the correlations shown. CONCLUSION: The results of the first study on burnout among midwives in Hungary show that improving the working conditions of midwives is essential for the functioning of family-friendly midwifery. In addition, to prevent burnout, more emphasis should be placed on the prevention of the risk factors identified in the study in education and training. Orv Hetil. 2023; 164(40): 1592-1599.

Interdisciplinary Analyses of Bronze Age Communities from Western Hungary Reveal Complex Population Histories.

In this study, we report 21 ancient shotgun genomes from present-day Western Hungary, from previously understudied Late Copper Age Baden, and Bronze Age Somogyvár-Vinkovci, Kisapostag, and Encrusted Pottery archeological cultures (3,530-1,620 cal Bce). Our results indicate the presence of high steppe ancestry in the Somogyvár-Vinkovci culture. They were then replaced by the Kisapostag group, who exhibit an outstandingly high (up to ∼47%) Mesolithic hunter-gatherer ancestry, despite this component being thought to be highly diluted by the time of the Early Bronze Age. The Kisapostag population contributed the genetic basis for the succeeding community of the Encrusted Pottery culture. We also found an elevated hunter-gatherer component in a local Baden culture-associated individual, but no connections were proven to the Bronze Age individuals. The hunter-gatherer ancestry in Kisapostag is likely derived from two main sources, one from a Funnelbeaker or Globular Amphora culture-related population and one from a previously unrecognized source in Eastern Europe. We show that this ancestry not only appeared in various groups in Bronze Age Central Europe but also made contributions to Baltic populations. The social structure of Kisapostag and Encrusted Pottery cultures is patrilocal, similarly to most contemporaneous groups. Furthermore, we developed new methods and method standards for computational analyses of ancient DNA, implemented to our newly developed and freely available bioinformatic package. By analyzing clinical traits, we found carriers of aneuploidy and inheritable genetic diseases. Finally, based on genetic and anthropological data, we present here the first female facial reconstruction from the Bronze Age Carpathian Basin.

The effect of combined dietary supplementation of herbal additives on carcass traits, meat quality, immunity and cecal microbiota composition in Hungarian white geese.

The present study was performed to investigate the effects of dietary supplementation with herbal additives on meat quality, slaughter performance and the cecal microbial community in Hungarian white geese. A total of 60 newborn geese were assigned equally into the control group (CON) and the herbal complex supplemented group (HS). The dietary supplementations consisted of Compound Herbal Additive A (CHAA) including Pulsatilla, Gentian and Rhizoma coptidis, and Compound Herbal Additive B (CHAB) containing Codonopsis pilosula, Atractylodes, Poria cocos and Licorice. The geese in the HS group received a basal diet supplemented with 0.2% CHAA from day 0 to day 42 at the postnatal stage. Then from day 43 to day 70, the geese in HS group were provide a basal diet with 0.15% CHAB. The geese in the CON group were only provided with the basal diet. The results showed that the slaughter rate (SR), half chamber rates (HCR), eviscerated rate (ER) and breast muscle rate (BMR) in the HS group tended to increase slightly compared with the CON group (ns). In addition, the shear force, filtration rate and pH value of breast muscle and thigh muscle in the HS group were slightly enhanced compared to the CON group (ns). Significant increased levels in carbohydrate content, fat content and energy (P < 0.01) and significant decreased levels in cholesterol content (P < 0.01) were observed in the muscle of the HS group. The total amino acid (Glu, Lys, Thr and Asp) content in the muscle increased in HS group than in the CON group (P < 0.01). Dietary herb supplementations significantly increased the levels of IgG in serum (P < 0.05) on day 43 and higher levels of IgM, IgA and IgG (P < 0.01) were also observed in the HS group on day 70. Furthermore, 16S rRNA sequencing results indicated that herbal additives increased the growth of beneficial bacteria and inhibited the proliferation of harmful bacteria in the geese caecum. Altogether, these results offer crucial insights into the potential benefits of incorporating CHAA and CHAB into the diets of Hungarian white goose. The findings indicate that such supplementations could significantly improve meat quality, regulate the immune system and shape the intestinal microbiota composition.

[The institutional presence of music therapists in aphasia therapy in Hungary]. / Zeneterapeuták intézményi jelenléte a magyarországi aphasiaterápiában.

INTRODUCTION: Numerous international studies have reported on the relevance of music therapy for aphasia, but music-based therapy for the rehabilitation of acquired language and speech disorders is not common in the clinical practice of Hungary. OBJECTIVE: The aim of our study is to provide insights into the composition of professional teams involved in aphasia care in active neurology and stroke wards and rehabilitation departments in Hungarian hospitals, with a special focus on the presence of music therapists. We are looking for the answer to why the employment of music therapists in hospitals is so low in our country. METHOD: For our research, we selected the relevant institutions and departments from a list of hospitals on the website of the National Directorate General for Hospitals. Data were then collected from the websites of the hospital departments, supplemented or clarified with information from the head of department's physicians where necessary. RESULTS: None of the active neurology and stroke wards employ a music therapist. Two of the rehabilitation wards have a total of 4 music therapists. DISCUSSION: The low number of trained professionals in music therapy for aphasia is due to financial reasons, lack of professionals and lack of professional demand. CONCLUSION: Our research shows that music therapy is deeply underrepresented in the field of aphasia rehabilitation in Hungarian hospitals. The reasons for this are quite diverse and their elimination would require effective intervention in many areas. Orv Hetil. 2023; 164(19): 747-752.

HPLC Analysis of Polyphenols Derived from Hungarian Aszú from Tokaj Wine Region and Its Effect on Inflammation in an In Vitro Model System of Endothelial Cells.

Many studies have been published in recent years regarding the fact that moderate wine consumption, as a part of a balanced diet can have a beneficial effect on human health. The biologically active components of wine continue to be the subject of intense research today. In this study, the bioactive molecules of Hungarian aszú from the Tokaj wine region were analyzed using high-performance liquid chromatography (HPLC) and investigated in an in vitro model system of endothelial cells induced by bacterial-derived lipopolysaccharide. The HPLC measurements were performed on a reversed phased column with gradient elution. The non-cytotoxic concentration of the active substance was determined based on 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide (MTT)-, apoptosis, and necrosis assays. The antioxidant effect of the extract was determined by evaluating its ability to eliminate ROS. The expressions of the interleukin-(IL)1α, IL1-ß, IL-6, and IL-8 pro-inflammatory cytokines and nitric oxide synthase (eNOS) at the mRNA level were evaluated using a quantitative polymerase chain reaction (qPCR). We found that the lipopolysaccharides (LPS)-induced increases in the expressions of the investigated cytokines were significantly suppressed by Hungarian aszú extract, excluding IL-6. In our experimental setup, our treatment had a positive effect on the eNOS expression, which was impaired as a result of the inflammatory manipulation. In our experimental model, the Hungarian aszú extract decreased the LPS-induced increases in the expression of the investigated cytokines and eNOS at the mRNA level, which presumably had a positive effect on the endothelial dysfunction caused by inflammation due to its strong antioxidant and anti-inflammatory effects. Collectively, this research contributes to a more thorough understanding of the bioactive molecules of aszú from the Tokaj wine region.

Pregestational neurological disorders among women of childbearing age-Nationwide data from a 13-year period in Hungary.

OBJECTIVES: Comprehensive statistics evaluating pregnancies complicated by various medical conditions are desirable for the optimization of prenatal care and for improving maternal and fetal outcomes. The main objective of our study was to assess pregnancies during a 13-year study period with accompanying pregestational neurological disorders in medical history on a nationwide level. METHODS: In the framework of the NEUROHUN 2004-2017 project utilizing medical reports submitted for reimbursement purposes to the National Health Insurance Fund, we included women with at least one labor during 2004-2016 who had at least one pregestational diagnosis of a neurological disorder received within this time frame prior to their first pregnancy during the studied period. Three-digit codes from the 10th International Classification of Diseases (ICD) were used for the identification and classification of neurological and obstetrical conditions. RESULTS: Specific inclusion and exclusion criteria were employed during the study process. A total of 744 226 women have been identified with at least one delivery during the study period with 98 792 of them (13.3%) having at least one neurological diagnosis received during 2004-2016 before their first gestation in the time frame of the study. The vast majority of diagnosis codes were related to different types of headaches affecting 69 149 (9.3%) individuals. The most prevalent diagnoses following headaches were dizziness and giddiness (15 589 patients [2.1%]; nerve, nerve root and plexus disorders (10 375 patients [1.4%]); epileptic disorders (7028 patients [0.9%]); neurological diseases of vascular origin (6091 patients [0.8%]); other disorders of the nervous system (5358 patients [0.7%]); and demyelinating diseases of the central nervous system (2129 patients [0.3%]). The present findings of our study show high prevalence of pregestational neurological disorders, the dominance of headaches followed by the rather nonspecific diagnosis of dizziness and giddiness, the relevance of nerve, nerve root and plexus disorders and epilepsy, and the importance of cerebrovascular disorders among women of childbearing age. CONCLUSION: The present research findings can help healthcare professionals, researchers and decision makers in adopting specific health policy measures based on nationwide data and further aid the development of new diagnostic and therapeutic algorithms of various neurological manifestations concerning women of childbearing age.

Posture correction as part of holistic health promotion in Hungarian schools.

The primary prevention program of the Hungarian Spine Society was launched in 1995 with two goals: 1. to achieve that all school-children take part regularly in effective posture correcting exercises as part of physical education; and 2. to achieve daily physical education for all school-children. With appropriate governmental legislation and parliamentary decision both goals were integrated into the National Public Health Program in 2001 and 2003 and later in the national educational laws and documents. From 2011 and 2012 holistic health promotion in schools with the goal to reach all children became also prescription for all schools in Hungary. Public health institutions and actors still have to do much: they have to give continuous professional help to the physical education teachers in their posture correcting work and to all teachers in their daily health promoting tasks. The article presents the details of the special posture correcting exercises, their distribution and prospective controlled studies, their place in the national education, the present situation and the further tasks. The article is supplemented by a short report about daily physical education and holistic health promotion in schools: how the prescription was achieved, the essence and the follow up of it, and what are the tasks for the helping public health actors.

Possibility of bioimpedance-based nutritional status assessment in rehabilitation / A tápláltsági állapot bioimpedancia-alapú meghatározásának lehetosége a rehabilitációban

Introduction: We do not have a diagnostic method for malnutrition yet that can monitor the nutritional status of patients in rehabilitation institutions and its changes in an objective, accurate, reproducible way. Objective: The aim of this study was to determine the risk of malnutrition in patients at the National Institute for Medical Rehabilitation of Hungary completing with bioimpedance-based body composition in order to develop adequate nutrition therapy. Method: The Nutritional Risk Screening 2002 questionnaire was used. Body composition analysis was determined by the multifrequency bioimpedance-based seca mBCA 525 device. Results: The association between the risk of malnutrition measured by a validated screening method of 41 patients was weaker with fat-free mass index (r = -0.487, p = 0.001) and skeletal muscle mass (r = -0.476, p = 0.002) than with body mass index (r = -0.662, p<0.001). It was not correlated with fat mass. Strong correlations of body mass index with body composition were significantly weakened in the case of brain injuries. A strong correlation between skeletal muscle and fat mass was observed in all cases. Body mass index correlated with extracellular and total body water ratio only in the case of brain injuries. The extracellular and total body water ratio presented a strong correlation with the phase angle in each case (r = -0.711, p<0.001). Phase angle showed the strongest correlations with fat-free mass index (r = 0.638, p<0.001), skeletal muscle (r = 0.544, p<0.001) and fat mass (r = 0.588, p<0.001) in the case of brain-injured patients. Conclusion: Malnutrition screening tools are not sensitive enough for patient groups of rehabilitation institutions, and with body mass index, less risky patients can be screened out than with body composition analysis. Combining screening with bioimpedance-based body composition analysis is a suitable method for rehabilitation hospitals.

Hungarian consensus recommendation on the role of vitamin D in disease prevention and treatment / Magyarországi konszenzusajánlás a D-vitamin szerepérol a betegségek megelozésében és kezelésében

Nine Hungarian medical societies have developed a consensus recommendation on the preferred normal range of vitamin D, the dose of vitamin D supplementation and the method of administration. They summarized the clinical conditions and diseases the development of which may be associated with vitamin D deficiency (VDD). VDD is extremely common in Hungary, especially in late winter. The lower limit of the recommended normal range is 75 nmol/l, although the clinical significance of deficiency is evident mainly at values below 50 nmol/l, but since vitamin D supplementation at the recommended dose is safe, it is worthwhile for everyone to reduce the health risk associated with VDD. The aim of vitamin D supplementation is to prevent deficiency. The recommended normal range is 75­125 nmol/l, above which there is no clear benefit of vitamin D supplementation. To maintain the normal range, a daily intake of 2000 IU in adults is recommended during the UV-B radiation-free period. Vitamin D supplementation is also recommended for children during the same periods and conditions as for adults, but the dose varies with age. In adults, vitamin D3 supplementation at daily, weekly and monthly intervals is equally effective and safe. In severe deficiency, a loading dose is recommended, followed by maintenance supplementation. In addition to the wellknown skeletal, immunological and oncological effects of VDD, more and more data support unfavorable gyneco- logical and obstetric effects. The process of building the consensus has met the requirements of the latest Delphi criteria.

Prevalence of reflux-related symptoms in South-Hungarian blood donor volunteers.

BACKGROUND/AIM: Population-based studies on the prevalence of GERD-related symptoms are still missing in Eastern Europe, therefore, we aimed to obtain such data in South-East Hungarian subjects. METHODS: A total of 2,002 apparently healthy blood donor volunteers were consecutively enrolled and completed detailed questionnaires related to general factors, demographic data, socioeconomical factors, and the presence and frequency of typical and atypical GERD-related symptoms. RESULTS: Among 2,002 study participants, 56.5% were completely asymptomatic. The prevalence of typical GERD symptoms appearing at least monthly or weekly was 16.5% and 6.8%, respectively. Two-thirds (209/330) of the patients experienced at least monthly occurring typical GERD symptoms and also had associated atypical symptoms and this was even more pronounced when comparing subgroups with higher symptom frequencies. Significant correlations were found between monthly GERD-related complaints and height, body mass index (BMI), coffee consumption, and smoking. Positive family history was another significant factor in all the symptom-frequency categories. GERD-related symptom frequency showed a linear association with sex (R2 = 0.75, P = 0.0049). Typical and atypical GERD symptoms were significantly more common in those with chronic diseases than those without. Heartburn was observed in 12.5% and 4.4% (P<0.05) and acid regurgitation was seen in 6.9% and 1.8% (P<0.05), respectively. CONCLUSION: The prevalence of GERD-related symptoms in South Hungary was significantly lower than that in Western countries and was closer to Eastern values. The presence of mild, non-exclusionary chronic diseases significantly increased the prevalence of GERD-related symptoms, as well as positive family history of GERD, height, BMI, coffee consumption, and smoking.

Metagenomic analysis reveals mixed Mycobacterium tuberculosis infection in a 18th century Hungarian midwife.

The Vác Mummy Collection comprises 265 well documented mummified individuals from the late 16th to the early 18th century that were discovered in 1994 inside a crypt in Vác, Hungary. This collection offers a unique opportunity to study the relationship between humans and pathogens in the pre-antibiotic era, as previous studies have shown a high proportion of tuberculosis (TB) infections among the individuals. In this study, we recovered ancient DNA with shotgun sequencing from a rib bone sample of a 18th century midwife. This individual is part of the collection and shows clear skeletal changes that are associated with tuberculosis and syphilis. To provide molecular proof, we applied a metagenomic approach to screen for ancient pathogen DNA. While we were unsuccessful to recover any ancient Treponema pallidum DNA, we retrieved high coverage ancient TB DNA and identified a mixed infection with two distinct TB strains by detailed single-nucleotide polymorphism and phylogenetic analysis. Thereby, we have obtained comprehensive results demonstrating the long-time prevalence of mixed infections with the sublineages L4.1.2.1/Haarlem and L4.10/PGG3 within the local community in preindustrial Hungary and put them in context of sociohistorical factors.

Perceived usefulness of yoga to maintain well-being and in relation to COVID-19 cases among Hungarian yoga practitioners.

BACKGROUND: The present COVID-19 epidemic has had a considerable impact on the mental health of individuals worldwide. Research projects suggests potential benefits of yoga practice for prevention, or as medical supplementation in relation to the present pandemic. This study investigated the association between yoga and health status, and how the frequency of yoga practice affected the mental well-being (MWB) of the respondents. METHODS: Hungarian yoga practitioners (N.=379) aged 20 to 75 years (93.4% female) were asked about their personal health, perceived usefulness of yoga practice for COVID-19 cases and their MWB. Data were collected between April 17 and May 17, 2021. The measurement tool used was an online questionnaire including sociodemographic data, characteristics of yoga practice, COVID-19 and health related questions, and WHO Well-being Index (WBI-5). Associations were examined through ANOVA and χ2 tests. RESULTS: There was a significant difference among the yoga practice groups by weekly frequency (once a week, 2-3 times a week, 4-5 times a week, daily) on the total mean score of well-being (WBI-5), F (3, 373) =12.97, P<0.001, ηp2=0.094. The daily practice of yoga showed the highest MWB. CONCLUSIONS: According to our findings, it can be stated that regular yoga practice is associated with higher level of MWB which can be successful in dealing with COVID-19 issues such as stress and depression.

The position of Ephedrae herba in the Western medicine / Az Ephedrae herba helye a nyugati orvoslásban.

Összefoglaló. A Magyar és az Európai Hypertonia Társaság legújabb ajánlásában a gyógyszer okozta szekunder hypertoniák gyakoribb okai között szerepel az Ephedra - csikófark (kínai nevén Mahuang) fajok drogjának (Ephedrae herba) felhasználása is. Összefoglaló közleményünk célja az Ephedra nemzetségbe tartozó, a gyógyászatban is felhasznált, a VIII. Magyar Gyógyszerkönyvben és a Kínai Gyógyszerkönyvben szereplo hivatalos fajoknak a részletes bemutatása. Betekintést nyújtunk történetükbe, továbbá leírjuk a bennük található vegyületek farmakológiai tulajdonságait és azok hatásait. Ismertetjük elonyeiket, mellékhatásaikat és lehetséges gyógyszerkölcsönhatásaikat. Ezenkívül feltárjuk fogyasztó- és testsúlycsökkento szerként való használatukat, étrend-kiegészítoként történo alkalmazásuk betiltásának okát, valamint tárgyaljuk a doppinglistán való szereplésük magyarázatát is. Ezzel párhuzamosan kitérünk az Ephedra fajok orvosi gyakorlatban betöltött szerepére is: rendeltetésszeru használatuk során a fitoterápiában - foleg kombinációban alkalmazva - számos jótékony hatás érheto el, de fontos hangsúlyozni óvatos használatukat és felismerni lehetséges mellékhatásaikat. Orv Hetil. 2022; 163(9): 343-349. Summary. The Hungarian and the European Society of Hypertension guidelines mention Ephedrae herba, the drug of Ephedra species (in Chinese "Mahuang") as one of the causes of secondary hypertension. The aim of our summary is to characterize the Ephedra species used in medicine (based on the VIII. Hungarian and the Chinese Pharmacopoeia), describe their history and their components alongside with possible pharmacological effects, benefits, side-effects, and interactions with other drugs. We demonstrate the herb's history from being a popular weight-loss product to being prohibited as a dietary supplement and citing it in the World Anti-Doping Agency's list. At the same time, we explain the role of the Ephedra species in the everyday medical practice. It is important to know their benefits in detail as used in combination with other herbs in phytotherapy, and recognize their possible side effects. Orv Hetil. 2022; 163(9): 343-349.

Perioperative attitudes of breast cancer patients towards the complementary and alternative medicine based on a survey conducted at the National Institute of Oncology in Hungary. / Emlorákban megbetegedett nok perioperatív viszonyulása a komplementer és alternatív medicinához az Országos Onkológiai Intézetben végzett felmérés alapján.

Összefoglaló. Bevezetés: A komplementer és alternatív medicina (KAM) egyre népszerubb a daganatos betegek körében világszerte. Az emlorákkal diagnosztizált nok 45%-a használ KAM-ot, a fiatalabb betegek 62,5%-a. Magyarországon eddig egyetlen tanulmány jelent meg a témában, mely szerint a magyar, emlodaganattal küzdo nok 84,4%-a használ valamilyen komplementer terápiát. Egyes KAM-modalitások alkalmazása a gyógyszerkölcsönhatások miatt kockázatot hordoz. Fontos megismernünk a magyar páciensek igényeit és szokásait a KAM-használattal kapcsolatban, mely ismeret a klinikai gyakorlatban közvetlenül hasznosítható. Célkituzés: Vizsgálatunk célja a magyar emlorákos nok körében felmérni a KAM alkalmazásának mértékét, megvizsgálni ennek okait és az ezzel összefüggo demográfiai, pszichológiai és klinikai faktorokat. Módszer: Kérdoíves vizsgálatunkat az Országos Onkológiai Intézet Emlo- és Lágyrészsebészeti Osztályán végeztük az osztályon bent fekvok körében (n = 146). Felmértük a szociodemográfiai adatokat, a KAM-használat jellemzoit, a KAM iránti attitudöt és az egészségkontroll-igényt. A kérdoív adatait klinikai adatokkal egészítettük ki. Eredmények: A válaszadók 36%-a felkeresett KAM-szolgáltatót, 71%-a használ KAM-készítményt, és 64%-a alkalmaz önsegíto gyakorlatot. Ezekrol a betegek többsége egészségügyi szakembertol tájékozódik. A mintában a holisztikus szemlélet, valamint a belso és a társas külso kontroll dominál. A KAM-szolgáltatókat felkeresoknek és a KAM-készítményt alkalmazóknak erosebb a belsokontroll-igényük. A KAM-szolgáltatást vagy önsegíto gyakorlatot alkalmazók kedvezobben ítélik meg saját egészségi állapotukat. Következtetés: A betegeknek a számukra fontos személyektol, elsosorban a kezeloszemélyzettol kapott információ dönto az egészségükkel kapcsolatos viselkedésben, közöttük a KAM-választásban. Fontos látnunk a páciensek nagyfokú bizalmát az egészségügyi szakemberek iránt és eros igényét a KAM-mal kapcsolatos információk megbeszélésére, valamint az egészségük iránt érzett felelosségvállalásra és a kezelésben való aktív részvételre. Orv Hetil. 2022; 163(9): 350-361. INTRODUCTION: The popularity of complementary and alternative medicine (CAM) is increasing among cancer patients worldwide. 45% of women diagnosed with breast cancer use CAM, 62.5% of younger patients do so. So far, only one study has been published in Hungary, according to which 84.4% of Hungarian women with breast cancer use some form of complementary medicine. The utilization of some CAM modalities carries risks due to drug interactions. It is important to get to know the needs and habits of Hungarian patients in relation to CAM, which knowledge can be directly used in clinical practice. OBJECTIVE: The aim of our study was to assess the extent of CAM utilization among Hungarian breast cancer patients, to examine the reasons behind this choice, and to see the relating/connecting demographic, psychological and clinical factors. METHOD: In a cross-sectional survey, a self-administered questionnaire was used among inpatients at the Department of Breast and Soft Tissue Surgery in the National Institute of Oncology (n = 146). We assessed socio-demographic data, characteristics of CAM use, attitudes toward CAM, and the need for health control. Clinical data were added to the questionnaire data. RESULTS: 36% of the respondents visited some CAM providers, 71% used CAM preparation and 64% utilized self-help practices. Most patients are informed about these by a healthcare professional. The holistic approach is dominant in the sample as well as internal and social external control. Visitors to CAM providers and CAM preparation users have a stronger need for internal control. Visitors to CAM providers and self-help practitioners judge their own health status more favorable. CONCLUSION: The information that patients receive from people who are important to them, especially the caregiver, is crucial in their health-related behavior, including the choice of CAM. It is important to see such a high level of patient trust in health professionals and a strong need to discuss information about CAM, as well as a sense of responsibility for their health and active participation in treatment. Orv Hetil. 2022; 163(9): 350-361.

Quality Assessment of Goldenrod, Milkweed and Multifloral Honeys Based on Botanical Origin, Antioxidant Capacity and Mineral Content.

The goal of the study was to evaluate the pollen spectrum, antioxidant capacity and mineral content of four Hungarian honey types, using multivariate statistical analysis. The light colored honeys were represented by milkweed honey and a multifloral (MF) honey with dominant pollen frequency of linden (MF-Tilia); the darker ones were goldenrod honey and a multifloral honey with Lamiaceae pollen majority (MF-Lamiaceae). The pollen spectrum of the samples was established with melissopalynological analysis. The absorbance of the honeys positively correlated with the antioxidant capacity determined with three of the used methods (TRC, TEAC, DPPH), but not with ORAC. The latter method correlated negatively also with other antioxidant methods and with most of the mineral values. MF-Tilia had high ORAC value, K and Na content. The MF-Lamiaceae had the highest K, Mg, P, S, Cu and Zn content, the last five elements showing strict correlation with the TRC method. The darker goldenrod honey had higher SET values and total mineral content, than the milkweed honey. The above character-sets facilitate identification of each honey type and serve as indicators of variety. The antioxidant levels and mineral content of honeys allowed their clear separation by principal component analysis (PCA).

Origin Identification of Hungarian Honey Using Melissopalynology, Physicochemical Analysis, and Near Infrared Spectroscopy.

The objective of the study was to check the authenticity of Hungarian honey using physicochemical analysis, near infrared spectroscopy, and melissopalynology. In the study, 87 samples from different botanical origins such as acacia, bastard indigo, rape, sunflower, linden, honeydew, milkweed, and sweet chestnut were collected. The samples were analyzed by physicochemical methods (pH, electrical conductivity, and moisture), melissopalynology (300 pollen grains counted), and near infrared spectroscopy (NIRS:740-1700 nm). During the evaluation of the data PCA-LDA models were built for the classification of different botanical and geographical origins, using the methods separately, and in combination (low-level data fusion). PC number optimization and external validation were applied for all the models. Botanical origin classification models were >90% and >55% accurate in the case of the pollen and NIR methods. Improved results were obtained with the combination of the physicochemical, melissopalynology, and NIRS techniques, which provided >99% and >81% accuracy for botanical and geographical origin classification models, respectively. The combination of these methods could be a promising tool for origin identification of honey.

Anti-inflammatory effect of lavender (Lavandula angustifolia Mill.) essential oil prepared during different plant phenophases on THP-1 macrophages.

BACKGROUND: Pseudomonas aeruginosa is the most common Gram-negative bacterium associated with nosocomial respiratory infections. Lavender essential oil is mainly used in aromatherapy, but it has several pharmacological and therapeutic properties. Furthermore, it possesses antifungal and antibacterial activities. The anti-inflammatory activity of essential oils may depend on the composition and the ratio of the compounds. The constitution of the essential oils extracted from the different stages of flowering period varies, which makes it plausible that the collection time of the flowers influences the anti-inflammatory effects. Different types of essential oils reduce inflammation acting similarly by modulating the activity and action of the NFκB signalling pathway, which is the major regulator of the transcription of pro-inflammatory cytokines. METHODS: Lavender essential oils were distilled from lavender plant cultivated in Hungary and the flowers were harvested at the beginning and at the end of flowering period. The experiments were carried out on THP-1 human monocyte/macrophage cell line as in vitro cell culture model for monitoring the effects of lavender essential oils and the main compound linalool on P. aeruginosa LPS stimulated inflammation. The mRNA and protein levels of four pro-inflammatory cytokines, IL-6, IL-1ß, IL-8 and TNFα were determined by Real Time PCR and ELISA measurements. The effects of essential oils were compared to the response to two NFκB inhibitors, luteolin and ACHP. RESULTS: Linalool and lavender essential oil extracted from plants at the beginning of flowering period were successful in decreasing pro-inflammatory cytokine production following LPS pretreatment. In case of IL-8 and IL-1ß lavender oil showed stronger effect compared to linalool and both of them acted similarly to NFκB inhibitors. Pretreatments with linalool and lavender essential oil/beginning of flowering period prevented pro-inflammatory cytokine production compared to LPS treatment alone. Although lavender essential oil/end of flowering period decreased IL-6, IL-1ß and IL-8 mRNA expression in case of LPS pretreatment, it was not capable to reduce cytokine secretion. CONCLUSION: Based on our results it has been proven that lavender essential oil extracted at the beginning of flowering period is a potent inhibitor of the synthesis of four pro-inflammatory cytokines IL-6, IL-8, IL-ß and TNFα of THP-1 cells. This supports the relevance of the collection of the lavender flowers from early blooming period for essential oil production and for the utilization as an anti-inflammatory treatment.

Implementation of evidence-based health policy in the field of integrated care: A Ritka Betegségek Nemzeti Eroforrás Központjának tervezési folyamata / Bizonyítékokon alapuló egészségpolitikai döntéshozatal az integrált ellátásban: A Ritka Betegségek Nemzeti Eroforrás Központjának tervezési folyamata

Összefoglaló. Bevezetés: A ritka betegséggel élok ellátásában fontos elorelépések történtek az elmúlt években. Egy következo lépés lehetne hazánkban a Ritka Betegségek Nemzeti Eroforrás (Uni-Versum) Központjának (a továbbiakban: Központ) létrehozása, amely az egészségügyi, szociális és köznevelési szolgáltatásokat összehangolva és kiegészítve személyközpontú ellátást nyújtana a betegek és támogatóik részére. Célkituzés: Célunk az volt, hogy egy nemzetközi tudományos módszertan alapján javaslatokat tegyünk arra, hogy milyen eszközökkel lehet feloldani a Központ megvalósításának lehetséges korlátozó tényezoit. Módszer: A Központ megvalósíthatóságának értékelésére interdiszciplináris szakmai egyeztetést szerveztünk különbözo érintett érdekcsoportok részvételével, a SELFIE H2020 kutatási projekt által kidolgozott módszertan alapján. Az elozetesen rangsorolt legfontosabb korlátozó tényezokre lehetséges megoldási javaslatokat tettünk. Eredmények: A lehetséges korlátozó tényezoket a résztvevok relevánsnak tartották a Központ létrehozásával kapcsolatban, és ezekre összesen 17 olyan konkrét javaslat született, amelyben a résztvevok között egyetértés alakult ki. A javaslatok kiterjedtek az ellátás tartalmára, az alkalmazott technológiák támogató szerepére, a humáneroforrás-korlátok megoldására, a hatékony vezetés és szervezés kialakítására, az összetett finanszírozási struktúra kialakítására és a kutatási lehetoségek megteremtésére is. Megbeszélés: A Központ megvalósítása esetén a ritka betegséggel élok ellátása az egészségügyi, szociális és köznevelési tevékenységeket integráló megközelítés felé mozdulna el. A kutatás során megfogalmazott javaslatok hozzájárulhatnak a Központ létrehozásához, amennyiben megvan az ehhez szükséges szakpolitikai támogatás is. Ezen túlmutatóan, a leírt munkamódszer más integrált ellátási modellek bevezethetoségének elemzéséhez is mintaként szolgálhat. Következtetés: Összefoglalva megállapíthatjuk, hogy a Központ létrehozásához számos, elozetesen is látható korlátozó tényezot kell feloldani. Az érdekcsoportok közös javaslatai alapján kialakítható egy olyan muködési forma, amely az ellátórendszerek kiegészítésével és összehangolásával jelentos társadalmi értéktöbbletet eredményezhet. Orv Hetil. 2021; 162(45): 1818-1825. INTRODUCTION: In Hungary, significant achievements have been made in the care of patients with rare diseases in recent years. A next step could be the establishment of the National Resource Centre for Rare Diseases (hereinafter: Centre) to facilitate patient-centered complex care by the integration and supplementation of existing health, social and educational services. OBJECTIVE: This research aimed to develop recommendations based on international scientific methodology to overcome potential implementation barriers of the aforementioned Centre. METHOD: To evaluate the feasibility of the implementation, we organized an interdisciplinary workshop with representatives of different stakeholder groups, adopting the methodology developed in the SELFIE H2020 research project. During the workshop, we discussed the previously ranked, most significant implementation barriers and made recommendations for potential solutions. RESULTS: The potential implementation barriers were considered relevant by the participants and, reflecting on these barriers, altogether 17 recommendations were developed by consensus. These recommendations were related to the content of service delivery, use of supportive technologies, overcoming workforce issues, establishing effective leadership, implementing a complex financing structure and creating research opportunities. DISCUSSION: Implementation of the Centre would shift the care of rare diseases towards personalized and integrated health, social and educational services. Our recommendations will contribute to the establishment of the Centre, subject to positive policy decision. Furthermore, our methodological approach could support the feasibility assessment of future integrated care solutions and programs. CONCLUSION: Several predictable barriers must be overcome to establish the Centre. Recommendations developed by representatives of relevant stakeholders could support successful implementation and societal value generation. Orv Hetil. 2021; 162(45): 1818-1825.