Comparative Health Behaviour of Young People with Disabilities in Hungary: A Cross-Sectional Study.

The health status of Hungary's population is unfavorable, with significant differences in health indicators not only compared to the EU15 but also to the Visegrad countries. Unfavorable health indicators can be disproportionate and particularly affect vulnerable groups, such as people with disabilities. In this study, we set out to compare the health behavior of disabled youth and youth with typical development in Hungary. We also aimed to compare the health behavior of adolescents in the Visegrad countries. The eating habits of both groups of young people we examined are unfavorable. Adolescents with disabilities experience a significantly higher rate of school stress than children with typical development in Hungary. The prevalence of somatic complaints and parameters of poor mental well-being are significantly higher in Hungary than in the other Visegrad countries. The results indicate that additional interventions are needed in Hungary and that differentiated, professional health promotion is needed for young people with disabilities. The researchers recommend extending the study to disabled adolescents living in Visegrad countries, on the basis of which an injury-specific health promotion methodology could be developed with international interprofessional cooperation.

[ECG pearl: Valsalva maneuver terminated ventricular tachycardia]. / EKG-gyöngyszem: Valsalva-manover terminálta kamrai tachycardia.

Összefoglaló. Egy 78 éves férfi széles-QRS-tachycardiás esetét mutatjuk be. A betegnél a pitvar-kamrai disszociáció igazolta a ritmuszavar kamrai eredetét, amelyet a Valsalva-manoverrel több alkalommal is átmenetileg meg lehetett szüntetni. A szerzok ismertetik a manover lehetséges patomechanizmusait, illetve felhívják a figyelmet arra, hogy a vagusmanoverre megszuno reguláris tachycardia nem jelent feltétlenül supraventricularis eredetet. Orv Hetil. 2021; 162(12): 468-470. Summary. A 78-year-old man is presented with wide QRS tachycardia (WQRST). The ventricular origin of WQRST was confirmed by atrioventricular dissociation. The Valsalva maneuver terminated the tachycardia repeatedly. The authors discuss the possible mechanisms of Valsalva maneuver in the arrhythmia termination. This case highlights that Valsalva maneuver or carotid massage terminated tachycardia are not necessarily supraventricular tachycardia. Orv Hetil. 2021; 162(12): 468-470.

[Role of implantable loop recorder in the clinical diagnosis of syncope: results of the introduction of an effective diagnostic tool]. / Az implantálható loop recorder szerepe a syncope diagnosztikájában: egy hatékony vizsgálati módszer bevezetésének eredményei.

INTRODUCTION: Extension of electrocardiographic monitoring via loop recorder implantation may increase the diagnostic yield of syncope work-up. AIM: In this retrospective observational study, the authors wanted to evaluate the diagnostic performance of implantable loop recorder in the everyday clinical practice. METHOD: The authors analyzed the electronically stored data of all patients who underwent loop recorder implantation between 2005 and 2014 in their cardiology department because of recurrent syncope of undetermined origin. RESULTS: There were 52 loop recorder implantations within the study period. During the 167 (± 136) days of monitoring, 36 (69.2%) diagnostic events occurred. In two-thirds of events, (46.2% of all monitored patients) a specific arrhythmia diagnosis was reached, allowing definitive treatment in these cases. In this selected population, there was no correlation between age, presence of known high-risk predictors, or accompanying trauma, and the mechanism of syncope. CONCLUSIONS: The high diagnostic rate of implantable loop recorder in the everyday clinical practice is in accordance with the findings in prospective clinical studies. This observation supports the early application of loop recorder in the diagnostic algorithm of syncope.

[Transient left ventricular dysfunction: special form of stress cardiomyopathy]. / Reverzibilis, stressz indukálta cardiomyopathiak.

INTRODUCTION: The phenomenon of stress induced left ventricular dysfunction has been long recognised. A special reversible form of it, characterized by left ventricular apical dilatation, is the so-called "tako-tsubo" or ampoule cardiomyopathy, based on its first description by Sato et al. in 1990. The tako-tsubo cardiomyopathy and stress cardiomyopathy are considered almost equivalent in the referring publications. METHODS: Retrospective analysis of patient data between 2002 and 2007: these patients suffered from transient left ventricular dysfunction and coronary artery disease and myocarditis were disclosed. RESULTS: 6 female patients between 55 and 80 years. In 5 of 6 cases the different forms of stress could be found before the patients were admitted to our department. CONCLUSIONS: The presented cases shed light to the fact that the apical dilatation of the left ventricle is only one of the possible presentations of stress induced cardiomyopathy. The main feature of this entity is not the tako-tsubo-like left ventricular dilatation, which is not always present, but the almost universal QT prolongation and negative T waves. These ECG features come a few days after the appearance of the reversible left ventricular dysfunction.

Switching beta-blocker therapy in chronic heart failure.

BACKGROUND: A beneficial effect on survival has been proven for the four long-acting beta-blockers. Such favorable results could not be obtained with short-acting beta-blockers. AIMS: to study the safety of switching from short-acting metoprolol to long-acting bisoprolol in patients with cardiac failure and postinfarction impaired left ventricular systolic function. METHODS AND RESULTS: 282 patients with NYHA classes I-III heart failure and/or postinfarction reduced left ventricular ejection fraction were enrolled in the study. Metoprolol tartarate was discontinued 12 h before the initiation of bisoprolol therapy. Dosages were as follows: 28.5% of the patients reached the 10 mg target dose, 21.5% received 7.5 mg, and 42.5% received 5 mg, while 7.5% stayed on the lowest 2.5 mg initial dose. Mean heart rate was 84 bpm before the switch; this dropped to 67 bpm with the above doses. CONCLUSION: The switch from non-recommended short-acting beta-blockers to long-acting beta-blockers may be carried out safely in stable heart failure patients. The significant reduction of the heart rate indicated that a more effective adrenergic blockage might be obtained with the switch, although physicians could titrate up to the target dose only in about one-third of the cases.