RESUMEN
Perinatal asphyxia (PA) poses a significant threat to multiple organs, particularly the kidneys. Diagnosing PA-associated kidney injury remains challenging, and treatment options are inadequate. Furthermore, there is a lack of long-term follow-up data regarding the renal implications of PA. In this study, 7-day-old male Wistar rats were exposed to PA using a gas mixture (4% O2; 20% CO2 in N2 for 15 min) to investigate molecular pathways linked to renal tubular damage, hypoxia, angiogenesis, heat shock response, inflammation, and fibrosis in the kidney. In a second experiment, adult rats with a history of PA were subjected to moderate renal ischemia-reperfusion (IR) injury to test the hypothesis that PA exacerbates renal susceptibility. Our results revealed an increased gene expression of renal injury markers (kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin), hypoxic and heat shock factors (hypoxia-inducible factor-1α, heat shock factor-1, and heat shock protein-27), proinflammatory cytokines (interleukin-1ß, interleukin-6, tumor necrosis factor-α, and monocyte chemoattractant protein-1), and fibrotic markers (transforming growth factor-ß, connective tissue growth factor, and fibronectin) promptly after PA. Moreover, a machine learning model was identified through random forest analysis, demonstrating an impressive classification accuracy (95.5%) for PA. Post-PA rats showed exacerbated functional decline and tubular injury and more intense hypoxic, heat shock, proinflammatory, and profibrotic response after renal IR injury compared with controls. In conclusion, PA leads to subclinical kidney injury, which may increase the susceptibility to subsequent renal damage later in life. In addition, the parameters identified through random forest analysis provide a robust foundation for future biomarker research in the context of PA.NEW & NOTEWORTHY This article demonstrates that perinatal asphyxia leads to subclinical kidney injury that permanently increases renal susceptibility to subsequent ischemic injury. We identified major molecular pathways involved in perinatal asphyxia-induced renal complications, highlighting potential targets of therapeutic approaches. In addition, random forest analysis revealed a model that classifies perinatal asphyxia with 95.5% accuracy that may provide a strong foundation for further biomarker research. These findings underscore the importance of multiorgan follow-up for perinatal asphyxia-affected patients.
Asunto(s)
Lesión Renal Aguda , Modelos Animales de Enfermedad , Riñón , Ratas Wistar , Daño por Reperfusión , Animales , Masculino , Lesión Renal Aguda/patología , Lesión Renal Aguda/metabolismo , Lesión Renal Aguda/etiología , Daño por Reperfusión/metabolismo , Daño por Reperfusión/patología , Riñón/patología , Riñón/metabolismo , Fibrosis , Asfixia Neonatal/metabolismo , Asfixia Neonatal/complicaciones , Asfixia Neonatal/patología , Animales Recién Nacidos , Ratas , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Subunidad alfa del Factor 1 Inducible por Hipoxia/genética , Citocinas/metabolismo , Factores de Edad , Mediadores de Inflamación/metabolismoRESUMEN
AIM: Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) is a modification of two-stage hepatectomy profitable for patients with inoperable hepatic tumors by standard techniques. Unfortunately, initially poor postoperative outcome was associated with ALPPS, in which mitochondrial dysfunction played an essential role. Inhibition of cyclophilins has been already proposed to be efficient as a mitochondrial therapy in liver diseases. To investigate the effect of Cyclophilin D (CypD) depletion on mitochondrial function, biogenesis and liver regeneration following ALPPS a CypD knockout (KO) mice model was created. METHODS: Male wild type (WT) (n = 30) and CypD KO (n = 30) mice underwent ALPPS procedure. Animals were terminated pre-operatively and 24, 48, 72 or 168 h after the operation. Mitochondrial functional studies and proteomic analysis were performed. Regeneration rate and mitotic activity were assessed. RESULTS: The CypD KO group displayed improved mitochondrial function, as both ATP production (P < 0.001) and oxygen consumption (P < 0.05) were increased compared to the WT group. The level of mitochondrial biogenesis coordinator peroxisome proliferator-activated receptor γ co-activator 1-α (PGC1-α) was also elevated in the CypD KO group (P < 0.001), which resulted in the induction of the mitochondrial oxidative phosphorylation system. Liver growth increased in the CypD KO group compared to the WT group (P < 0.001). CONCLUSIONS: Our study demonstrates the beneficial effect of CypD depletion on the mitochondrial vulnerability following ALPPS. Based on our results we propose that CypD inhibition should be further investigated as a possible mitochondrial therapy following ALPPS.
Asunto(s)
Hepatectomía , Neoplasias Hepáticas , Regeneración Hepática , Mitocondrias Hepáticas , Peptidil-Prolil Isomerasa F , Animales , Peptidil-Prolil Isomerasa F/genética , Ciclofilinas/genética , Hepatectomía/métodos , Ligadura/métodos , Hígado/patología , Hígado/cirugía , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/cirugía , Regeneración Hepática/genética , Regeneración Hepática/fisiología , Masculino , Ratones , Mitocondrias Hepáticas/genética , Mitocondrias Hepáticas/metabolismo , Vena Porta/cirugía , ProteómicaRESUMEN
BACKGROUND: the role of bile acid (BA)-induced farnesoid X receptor (Fxr) signaling in liver regeneration following associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was investigated in a rat model. METHODS: Male Wistar rats underwent portal vein ligation (PVL) (n = 30) or ALPPS (n = 30). Animals were sacrificed pre-operatively and at 24, 48, 72, or 168 h after intervention. Regeneration rate, Ki67 index, hemodynamic changes in the hepatic circulation, and BA levels were assessed. Transcriptome analysis of molecular regulators involved in the Fxr signaling pathway, BA transport, and BA production was performed. RESULTS: ALLPS induced more extensive liver regeneration (p < 0.001) and elevation of systemic and portal BA levels (p < 0.05) than PVL. The mRNA levels of proteins participating in hepatic Fxr signaling were comparable between the intervention groups. More profound activation of the intestinal Fxr pathway was observed 24 h after ALPPS compared to PVL. CONCLUSION: Our study elaborates on a possible linkage between BA-induced Fxr signaling and accelerated liver regeneration induced by ALPPS in rats. ALPPS could trigger liver regeneration via intestinal Fxr signaling cascades instead of hepatic Fxr signaling, thereby deviating from the mechanism of BA-mediated regeneration following one-stage hepatectomy.
Asunto(s)
Hepatectomía , Regeneración Hepática , Animales , Humanos , Hígado/cirugía , Regeneración Hepática/fisiología , Masculino , Vena Porta/cirugía , Ratas , Ratas WistarRESUMEN
In an increasingly aging Western society, the treatment of the malignant diseases became the greatest challenge of medicine in the 21st century. Among these, pancreatic ductal adenocarcinoma (PDAC) is of particular interest which, in spite of modern oncology treatments, is a malignancy with an unfavorable prognosis. Underlying the poor survival rates, relatively late-stage recognition, limitations of surgical removal, and ineffective oncological treatments can be mentioned. Its importance is further enhanced by its growing incidence. As a consequence of these reasons, there is an increasing effort for the early detection of invasive tumors, the central part of which is the detection and clinical addressing of precancerous conditions in the pancreas. Of these, intraductal papillary mucinous neoplasia (IPMN) has a paramount importance. In this review, we present the latest evidence-based knowledge of the etiological factors, epidemiological features, pathomorphological manifestations, most up-to-date diagnosis and treatment of IPMN.
Asunto(s)
Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/terapiaRESUMEN
BACKGROUND: To identify the role of physical prehabilitation (PP) in liver regeneration, mitochondrial function, biogenesis, and inflammatory response was investigated after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in a rodent model. METHODS: Male Wistar rats (n = 60) underwent ALPPS. Animals were divided (n = 30) to the physical prehabilitation group (PP) and sedentary group (S). The animals were exsanguinated before (0 hour) and 24, 48, 72, or 168 hours after the operation. Regeneration rate and proliferation index were assessed. Mitochondrial function, biogenesis, and inflammatory response were evaluated. RESULTS: Regeneration rate and Ki67 index were significantly increased in the PP group compared to the S group (P < .001). Due to the changes in oxidative capacity and ATP production rate, the P/O ratio of PP group compared to the S group was significantly increased (P < .05). PP group was characterized by accelerated mitochondrial biogenesis and less intense inflammatory response compared to the S group. CONCLUSIONS: To our knowledge, this is the first demonstration of the beneficial effects of PP on liver regeneration, mitochondrial function, biogenesis, and the inflammatory response after ALPPS.
Asunto(s)
Neoplasias Hepáticas , Regeneración Hepática , Ejercicio Preoperatorio , Animales , Hepatectomía , Humanos , Ligadura , Hígado/metabolismo , Hígado/cirugía , Neoplasias Hepáticas/cirugía , Masculino , Mitocondrias , Vena Porta/cirugía , Ratas , Ratas Wistar , RoedoresRESUMEN
Colorectal cancer is a major social and economic burden for developed countries. Our analysis aimed to evaluate the quality and performance indicators of colorectal cancer screening pilot program. The colon cancer screening pilot program was carried out in 2015 involving an average-risk population aged 50-69 in Csongrád county, Hungary. The analysis involved data from the Communication module of the Office of the National Chief Medical Officer. We recorded 21.1% invitation rate (22,130 persons), 51.2% attendance and 47.3% participation rates, with a higher female participation rate (p<0.001). Participation rate was far lower than the expected 65%. The rate of non-negative results (13.1%) exceeds the international reference rate. Participation rate on the colonoscopy screening (90.1%) reached the expected value. Compared to the number of actual colonoscopies performed, adenomas were found in 2.5% and malignant lesions in 0.3% of the cases. Our results highlight the deficiencies regarding the follow-up and data recording of screening results in the IT system as well as the lack of communication between the GP and the diagnostic laboratories.
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Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/normas , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Anciano , Colonoscopía , Femenino , Humanos , Hungría , Masculino , Persona de Mediana Edad , Proyectos PilotoRESUMEN
The aim of our analysis was the assessment of the qualitative and performance indicators of a pilot program for health visitors' cervical cancer screening. The analysis involved the data from the Communication module of the Office of the National Chief Medical Officer. In the examined period (October, 2013 - September, 2015) the participation indicators of women aged 25-65, the prevalence rates of human papillomavirus and the cervical intraepithelial neoplasia were determined. In the screening period, the call-in rate was 32.45% nationally, with the compliance of 8.26%. The occurrence of a positive result was 1.85% nationally, with the highest rate in Hajdú-Bihar county (7.24%). HPV infection was detected in 113 cases (0.45%) nationally, HPV prevalence was 37.44/100,000 persons. The willingness for participation among women was low concerning the indicators. Their raising should be an emphasized task for public health in favor of reducing mortality from morbidities.
Asunto(s)
Detección Precoz del Cáncer/métodos , Enfermeros de Salud Comunitaria/organización & administración , Infecciones por Papillomavirus/diagnóstico , Displasia del Cuello del Útero/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Hungría , Persona de Mediana Edad , Infecciones por Papillomavirus/epidemiología , Cooperación del Paciente/estadística & datos numéricos , Proyectos Piloto , Prevalencia , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa , Indicadores de Calidad de la Atención de Salud/organización & administración , Neoplasias del Cuello Uterino/epidemiología , Displasia del Cuello del Útero/epidemiologíaRESUMEN
INTRODUCTION: Within the tender (6.1.3.A-13/1-2013-0001) supported by the European Union, we wished to involve health visitors into the organized cervical cancer screening program. AIM: The aim of our survey was to assess the satisfaction of health visitors, instructors, and that of the teaching aids. Furthermore, we wished to assess whether the teaching materials met the expectations. METHOD: Satisfaction of the health visitors was assessed by a survey, in four groups of questions. These involved the assessment of the instructors, the teaching aids, evaluation of the further training day, and the compliance with the knowledge of training. Period for completion of the questionnaires lasted from October to December in 2014. We used descriptive statistics for data evaluation. RESULTS: Data of 2148 health visitors was evaluated. They rated the performance of gynecologist-obstetricians 4.65, that of health visitors 4.61, that of public health professionals 4.56, and that of IT specialists 4.52. 98% of the teaching aids were useful for them and the acquired knowledge was appropriate with their expectations. CONCLUSION: The health visitors were satisfied with the theoretical instruction within the pilot program. The professionally well prepared health visitors may contribute to the success of the cervical cancer screening program. Orv. Hetil, 2017, 158(12), 461-467.
Asunto(s)
Detección Precoz del Cáncer/métodos , Conocimientos, Actitudes y Práctica en Salud , Neoplasias del Cuello Uterino/diagnóstico , Enfermería en Salud Comunitaria/educación , Unión Europea , Femenino , Humanos , Evaluación de Necesidades , Proyectos Piloto , Neoplasias del Cuello Uterino/psicologíaRESUMEN
BACKGROUND: Since 2012, Associated Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has been standing in the limelight of modern liver surgery and numerous questions have been raised regarding this novel approach. On the one hand, ALPPS has proved to be a valuable method in the treatment of hepatic tumors, while on the other hand, there are many controversies, such as high mortality and morbidity rates. Further surgical research is essential for a better understanding of underlying mechanisms and for enhancing patient safety. SUMMARY: Until recently, only 8 animal models have been created with the purpose to mimic ALPPS-induced liver regeneration. From these 7 are rodent (6 rat and 1 mouse) models, while only 1 is a large animal model, which uses pigs. In case of rodent models, portal flow deprivation of 75-90% is achieved via portal vein ligation leaving only the right (20-25%) or left median (10-15%) lobes portally perfused, while liver splitting in general is carried out positioned according to the falciform ligament. As for the swine model, the left lateral and medial lobes (70-75% of total liver volume) are portally ligated, and the right lateral lobe (accounting for 20-24% of the parenchyma) is partially resected in order to reach critical liver volume. Each model is capable of reproducing the accelerated liver regeneration seen in human cases. However, all species have significantly different liver anatomy compared with the human anatomic situation, making clinical translation somewhat difficult. Key Messages: Unfortunately, there are no perfect animal models available for ALPPS research. Small animal models are inexpensive and well suited for basic research, but may only provide limited translational potential to humans. Clinically large animal models may provide more relevant data, but currently no suitable one exists.
Asunto(s)
Hepatectomía/métodos , Modelos Animales , AnimalesRESUMEN
BACKGROUND: Selective portal vein ligation (PVL) is followed by ipsilateral atrophy and contralateral hypertrophy of the liver lobes. Although the atrophy-hypertrophy complex induced by PVL is a well-documented phenomenon, the effect of different degrees of extended portal vein occlusion on liver regeneration is not known. The aim of this study was to assess the effects of different degrees of portal occlusion on portal pressure and liver regeneration. MATERIALS AND METHODS: Male Wistar rats (n = 96; 220-250 g) were randomized into three groups and underwent 70%, 80%, or 90% portal vein ligation, respectively. The portal pressure was measured immediately and 24, 48, 72, 120, and 168 h after PVL (n = 6/group/time point). The hepatic lobes and the spleen were weighed, and liver regeneration ratio was calculated. Changes in liver histology and the mitotic activity were assessed on hematoxylin-eosin stained slides. RESULTS: Higher degree of portal occlusion triggered a stronger regenerative response (regeneration ratio of PVL 70%168h = 2.23 ± 0.13, PVL 80%168h = 3.11 ± 0.37, PVL 90%168h = 4.68 ± 0.48) PVL led to an immediate increase in portal pressure, the value of which changed proportionally to the mass of liver tissue deprived of portal perfusion (PVL 70%acute = 17 ± 2 mm Hg, PVL 80%acute = 19 ± 1 mm Hg, PVL 90%acute = 26 ± 4 mm Hg). Findings in histology showed necro-apoptotic lesions in the atrophic liver lobes and increased mitotic cell count in the hypertrophic lobes. The mitotic cell count of PVL 90% peaked earlier and at a significantly higher value than of PVL 70% and PVL 80% (PVL 9024h%: 96.0 ± 3.5 PVL 70%48h: 64.0 ± 2.1, PVL 80%48h: 56.3 ± 4.0). The mitotic index after 24 h showed a strong correlation with the acute portal hypertension. CONCLUSIONS: A higher degree of portal vein occlusion leads to a greater regenerative response, presumably triggered by the proportional increase in portal pressure, which supports the role of the so-called "blood-flow" theory of PVL-triggered liver regeneration.
Asunto(s)
Regeneración Hepática/fisiología , Hígado/crecimiento & desarrollo , Vena Porta/cirugía , Animales , Ligadura , Masculino , Tamaño de los Órganos , Presión Portal , Vena Porta/fisiología , Distribución Aleatoria , Ratas , Ratas WistarRESUMEN
Theoretically, the cytology-based cervical screening is capable of early detection of precancerous epithelial lesions of cervix uteri and its cancer, and of early referral to treatment. In this way, screening can inmprove the quality of life of the patients and reduce mortality from the target disease. Unfortunately, this often remains unexploited, because there might be inequalities on both "supply" and "demand" side of screening. In addition to the geopolitical situation of a country, inequalities might result from differences in the health care systems, and heavy access to the screening services. On the other hand, the socioeconomic status, the health-conciousness of the target population, and their knowledge and information of the benefits and potential harms of screening examination might have a bearing on the acceptance or refusal of the offered screening. Efforts need to be made to increase the uptake of cervical screening programmes.
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Conducta de Elección , Detección Precoz del Cáncer/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Difusión de la Información , Tamizaje Masivo/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Toma de Decisiones , Europa (Continente)/epidemiología , Femenino , Promoción de la Salud/estadística & datos numéricos , Humanos , Difusión de la Información/métodos , Masculino , Neoplasias/mortalidad , Calidad de Vida , Factores Socioeconómicos , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/mortalidadRESUMEN
BACKGROUND: Ligation of a branch of the portal vein redirects portal blood to nonligated lobes resulting in lobar hypertrophy. Although the effect of portal vein ligation on liver volume is well documented, the parallel alterations in liver function are still the subject of controversy. Our aim was to assess the time-dependent reactions of regional hepatic function to portal vein ligation by selective biliary drainage. METHODS: Male Wistar rats (n = 44) underwent 80% portal vein ligation. Before the operation as well as 1, 2, 3, 5, and 7 d after circulation, morphology and function (laboratory blood test; hepatic bile flow; plasma disappearance rate of indocyanine green; and biliary indocyanine green excretion) of the liver were examined. RESULTS: Although portal vein ligation affected liver circulation and morphology to a great extent, serum albumin levels, bilirubin levels, and total hepatic bile flow did not change significantly after the operation. Nevertheless, plasma disappearance rate and biliary indocyanine green excretion indicated a temporary impairment of total liver function with the lowest value on the second day and normalization by the fifth day. Bile production and biliary indocyanine green excretion of ligated lobes decreased rapidly after the operation and remained persistently suppressed, whereas the secretory function of nonligated lobes--after a temporary decline--showed a greater increase than the weight of the lobes. CONCLUSIONS: Portal vein ligation induced temporary impairment of total liver function, followed by rapid recovery mainly by reason of increase in the function of nonligated lobes. Functional increase in nonligated lobes was more pronounced than suggested by the degree of volume gain.
Asunto(s)
Regeneración Hepática/fisiología , Vena Porta/cirugía , Animales , Bilis/metabolismo , Biomarcadores/metabolismo , Ligadura , Circulación Hepática , Pruebas de Función Hepática , Masculino , Distribución Aleatoria , Ratas , Ratas WistarRESUMEN
Following the recommendation of the Council of the European Union, almost all governments made a policy statement on the introduction of cytology-based cervical screening for the health care system. However, the status of implementation is uneven. In the majority of the developed countries an organised model of screening recommended by the relevant international professional organisations are in use, while occasional screening is applied in some other countries. Screening strategies (i.e. age range, screening intervals), coverage of the target population, and compliance rates vary significantly. The screening activities are in a planning phase is some less developed Central-Eastern and South European countries. In Hungary, the transition from the traditional "gynaecological cancer screening" into the recommended organised cervical screening is in progress; the active involvement of the district health visitors in the cervical screening would provide further improvement.
Asunto(s)
Detección Precoz del Cáncer , Tamizaje Masivo , Neoplasias del Cuello Uterino , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/normas , Detección Precoz del Cáncer/tendencias , Europa (Continente)/epidemiología , Unión Europea/estadística & datos numéricos , Femenino , Política de Salud , Humanos , Hungría/epidemiología , Tamizaje Masivo/métodos , Tamizaje Masivo/organización & administración , Tamizaje Masivo/normas , Tamizaje Masivo/tendencias , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & controlRESUMEN
Participation of the target population in coloretal screening is generally low. In addition to demographic and socio-economic factors, the health care system and- in particular - family doctors play an important role. Further, the rate of participation is influenced by psychological, cognitive and behavioural factors, too. The paper analyses factors related to colorectal screening behaviour and potential interventions designed to screening uptake.
Asunto(s)
Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/prevención & control , Detección Precoz del Cáncer , Medicina Familiar y Comunitaria/métodos , Conductas Relacionadas con la Salud , Educación en Salud , Tamizaje Masivo , Rol del Médico , Conducta de Elección , Colonoscopía , Neoplasias Colorrectales/epidemiología , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/psicología , Medicina Familiar y Comunitaria/normas , Humanos , Hungría/epidemiología , Difusión de la Información , Tamizaje Masivo/métodos , Tamizaje Masivo/psicología , Sangre Oculta , Atención Primaria de Salud/métodos , Factores SocioeconómicosRESUMEN
OBJECTIVES: In the early recognition of portal vein ligation (PVL) induced tumor progression, positron emission tomography and magnetic resonance imaging (PET/MRI) could improve diagnostic accuracy of conventionally used methods. It is unknown how PVL affects metabolic patterns of tumor free hepatic tissues. The aim of this preliminary study is to evaluate the effect of PVL on glucose metabolism, using PET/MRI imaging in healthy rat liver. MATERIALS AND METHODS: Male Wistar rats (n=30) underwent PVL. 2-deoxy-2-(18F)fluoro-D-glucose (FDG) PET/MRI imaging (nanoScan PET/MRI) and morphological/histological examination were performed before (Day 0) and 1, 2, 3, and 7 days after PVL. Dynamic PET data were collected and the standardized uptake values (SUV) for ligated and non-ligated liver lobes were calculated in relation to cardiac left ventricle (SUVVOI/SUVCLV) and mean liver SUV (SUVVOI/SUVLiver). RESULTS: PVL induced atrophy of ligated lobes, while non-ligated liver tissue showed compensatory hypertrophy. Dynamic PET scan revealed altered FDG kinetics in both ligated and non-ligated liver lobes. SUVVOI/SUVCLV significantly increased in both groups of lobes, with a maximal value at the 2nd postoperative day and returned near to the baseline 7 days after the ligation. After PVL, ligated liver lobes showed significantly higher tracer uptake compared to the non-ligated lobes (significantly higher SUVVOI/SUVLiver values were observed at postoperative day 1, 2 and 3). The homogenous tracer biodistribution observed before PVL reappeared by 7th postoperative day. CONCLUSION: The observed alterations in FDG uptake dynamics should be taken into account during the assessment of PET data until the PVL induced atrophic and regenerative processes are completed.
Asunto(s)
Ligadura/métodos , Hígado/metabolismo , Hígado/patología , Imagen por Resonancia Magnética , Imagen Multimodal , Vena Porta/cirugía , Tomografía de Emisión de Positrones , Animales , Atrofia , Fluorodesoxiglucosa F18 , Glucógeno/metabolismo , Salud , Ventrículos Cardíacos/diagnóstico por imagen , Hipertrofia , Hígado/diagnóstico por imagen , Masculino , Trazadores Radiactivos , Ratas , Ratas Wistar , Factores de Tiempo , Distribución TisularRESUMEN
INTRODUCTION: Organised, nationwide screening for breast cancer with mammography in the age group between 45 and 65 years with 2 years screening interval started in Hungary in January 2002. AIM: The aim of this study is to analyze the attendance rate of nationwide breast screening programme for the 2008-2009 years. METHOD: The data derive from the database of the National Health Insurance Fund Administration. The ratio of women in the age group 45-65 years was calculated having either a screening mammography or a diagnostic mammography in the 4th screening round of the programme. RESULTS: In the years 2000-2001, 7.6% of the women had an opportunistic screening mammography while in 2008-2009 31.2% of the target population had screening mammography within the organized programme. During the same periods 20.2% (2000-2001) and 20.4% (2008-2009) of women had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.6% (2000-2001) to 50.1% (2008-2009). The attendance rate failed to change between 2002 and 2009. CONCLUSIONS: In order to decrease the mortality due to breast cancer, the attendance rate of mammography screening programme should be increased. Orv. Hetil., 154(50), 1975-1983.
Asunto(s)
Neoplasias de la Mama , Mamografía , Neoplasias de la Mama/diagnóstico , Detección Precoz del Cáncer , Humanos , Tamizaje Masivo , Programas Nacionales de SaludRESUMEN
Organised, nationwide screening for breast cancer with mammography in the age group of 45-65 years with 2 years screening interval started in Hungary in January 2002. The aim of this study is to analyse the attendance rate of breast screening programme for the 2006/2007 years, including the analysis of the ratio of screening and diagnostic mammography examinations. The data derive from the financial database of the National Health Insurance Fund Administration (NHIFA) covering the 8 years period between 2000 and 2007. The ratio of women in the age group of 45-65 years was calculated having either a screening mammography or a diagnostic mammography. The analysis was carried out for the years 2000-2001 before and 2006-2007 after the implementation of nationwide organised programme. In the years 2000-2001 7.26% of the women aged 45-65 years had an opportunistic screening mammography while in 2006-2007 29.4% of the target population had screening mammography within the organised programme. During the same periods 19.8% (2000-2001) and 21.8% (2006-2007) of women aged 45-65 years had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.2% (2000-2001) to 49.7% (2006-2007). The attendance of the Hungarian organised breast cancer screening programme slightly declined in 2006-2007 compared to 2002-2003/2004-2005, and to achieve the expected results in mortality decrease a further improvement of the uptake is necessary.
Asunto(s)
Neoplasias de la Mama/prevención & control , Detección Precoz del Cáncer/estadística & datos numéricos , Mamografía/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Programas Nacionales de Salud/estadística & datos numéricos , Anciano , Neoplasias de la Mama/diagnóstico , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/tendencias , Femenino , Humanos , Hungría , Mamografía/tendencias , Tamizaje Masivo/métodos , Tamizaje Masivo/tendencias , Persona de Mediana Edad , Programas Nacionales de Salud/tendencias , Evaluación de Programas y Proyectos de SaludRESUMEN
The "gynecological screening" that is composed of complex gynecological examination including colposcopy and cytological examinations has traditionally been incorporated into the gynecological protocol and practice. Over the past few decades, unfortunately, this screening practice has entrenched in the mind both of the gynecological community and the general public. As a result, the government-supported, organized cervical screening program of the population has come to a standstill. In order to adjust the cervical screening practice to the international public health recommendations in which cytology is the only screening test applied, the authors decided to involve primary care nurses and health visitors in smear taking, and to refer those with abnormal findings to a gynecologist for further clinical examination.
Asunto(s)
Cuello del Útero/patología , Cuello del Útero/virología , Neoplasias de los Genitales Femeninos/diagnóstico , Ginecología , Tamizaje Masivo , Atención Primaria de Salud , Salud Pública , Alphapapillomavirus , Colposcopía , Conflicto Psicológico , Técnicas Citológicas , Femenino , Neoplasias de los Genitales Femeninos/epidemiología , Neoplasias de los Genitales Femeninos/prevención & control , Neoplasias de los Genitales Femeninos/virología , Ginecología/métodos , Ginecología/normas , Ginecología/tendencias , Humanos , Hungría/epidemiología , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Tamizaje Masivo/tendencias , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/diagnóstico , Atención Primaria de Salud/métodos , Atención Primaria de Salud/normas , Atención Primaria de Salud/tendencias , Salud Pública/métodos , Salud Pública/normas , Salud Pública/tendencias , Derivación y Consulta , Frotis VaginalRESUMEN
In Hungary, mortality rates from colorectal cancer are dramatically high, therefore the reduction by population screening as a public health measure is considered as one of the priorities of National Public Health Program. In the beginning, a human-specific immunological test was applied in the "model programs", as a screening tool, to detect the occult blood in the stool; compliance was 32% in average. However, the objectives of the model programs have not been achieved, because, among other reasons, a debate on the method of choice and the strategy to follow have divided the professional public opinion. In this study the debated issues are critically discussed, being convinced that, at present, population screening seems to be the most promising way to alleviate the burden of colorectal cancer.