With the development of the paediatric oncohaematological care and improving healing results, the focus on survival with high quality of life increases. Some oncohaematological treatments have a high gonadotoxicity and can cause infertility, therefore the fertility preservation is gaining ground worldwide. Most of the fertility preservation procedures are not yet available in childhood in Hungary. One of the main fertility preservation methods is the ovarian cryopreservation followed by ovarian autotransplantation. The aim of this article is to introduce the first prepubertal ovarian cryopreservation procedure in Hungary. The procedure was a collaboration between the 2nd Department of Paediatrics and the Department of Obstetrics and Gynaecology of Semmelweis University. The patient treated with lymphoblastic granulomatosis was accepted for allogenic bone marrow transplantation, which conditional therapy has a very high gonadotoxic impact, with a consequential infertility. Also responding to the patient's family request, the oncoteam decided to carry out a fertility preservation procedure, an ovarian cryopreservation. With the necessary permits, we carried out the first laparoscopic ovarian removal for cryopreservation in a prepubertal girl at the 2nd Department of Paediatrics of Semmelweis University, resulting the tissue deep frozen at the Department of Obstetrics and Gynaecology of Semmelweis University. With the development of oncohaematological treatments, there is a growing need for fertility preservation methods. Most of these are already available for women, but not for the age group under eighteen. The presented ovarian cryopreservation method for the 13-year-old girl is the pioneer case in Hungary. In the future, the authors aim to create a national oncofertility network that can serve as a basis for the smoothest care of similar cases. Orv Hetil. 2023; 164(3): 104-109.
Fertility Preservation , Infertility , Neoplasms , Pregnancy , Female , Child , Humans , Adolescent , Hungary , Quality of Life , Ovary/transplantation , Cryopreservation/methods , Fertility Preservation/methods , Neoplasms/complications , Neoplasms/therapy
Background: Last year's epidemic experience proved that measurement of vaccine hesitancy is undeniably important. Existing methods for measuring this propensity are still either too specific, concerning a single vaccine, or only describe the general attitude towards vaccination. When a specific, but previously unknown infection and vaccine (such as SARS-CoV2) appear, these limitations are meaningful. Methods: Based on a method used to identify social prejudice, we created a new tool to assess vaccine hesitancy assessment and to study parental attitudes toward existing and non-existing ('Piresian') vaccines. After validating it with traditional tools for the measurement of vaccine hesitancy, we used the new tool for the demographic characterisation of different vaccine hesitant parent groups in Hungary. The data collected in 2017 on 430 parents, sorted by type of settlement and by geographic region, are representative of Hungarian households with children aged 0 to 18 years. Results: Our results show that attitudes towards a non-existing ('Piresian') vaccine have strong correlations with those towards existing vaccines (p < 0.001). No gender differences in vaccine hesitancy were found using either method. Notably, rejection was significantly higher among parents with low educational levels. Conclusion: The Piresian measurement of vaccine hesitancy offers a simple way to detect vaccine-hesitant groups, reliably quantitating vaccine hesitancy as measured for real vaccinations.
Összefoglaló. A gyermekkorban kialakuló Cushing-szindróma ritka betegség, a leggyakrabban exogén szteroidadás következményeként jelentkezik. A daganatos betegségek közül a hypophysis kortikotropint szekretáló adenomája, illetve a mellékvesekéreg-tumorok okoznak a leggyakrabban Cushing-szindrómát. Jelen tanulmányunkban egy Cushing-szindrómával diagnosztizált fiú esetét mutatjuk be. Az endokrinológiai kivizsgálás adrenokortikotropin (ACTH)-independens hypercortisolismust támasztott alá. A hasi MRI-felvételen egy éles határral rendelkezo, 3,5 cm nagyságú terime ábrázolódott a jobb mellékvese-régióban. A tumort parciális mellékvese-eltávolítás során távolították el. A szövettani elemzés mellékvesekéreg-adenomát igazolt. A gyermek klinikailag és laborértékei alapján gyógyultnak tekintheto. A Cushing-szindrómával kezelt betegek hosszú távú nyomon követése szükséges, melynek során szükség szerint biztosítani kell a glükokortikoidok és az egyéb szteroidhormonok megfelelo pótlását, a kialakult szövodmények kezelését, és adott esetben idoben fel kell ismerni a Cushing-szindróma késoi relapsusát is. Orv Hetil. 2022; 163(10): 407-412. Summary. Cushing's syndrome (CS) in children is a rare disease, most frequently caused by either an adrenal tumor or a corticotropin-secreting pituitary adenoma. Its early detection and effective treatment are highly important to avoid the short- and long-term consequences of hypercortisolism. We report a case of a child with Cushing's syndrome resulting from an adrenocortical adenoma. Endocrinological data revealed adrenocorticotropin (ACTH) independent hypercortisolism. MRI scan of the adrenal glands showed a single, well-encapsulated tumor on the right adrenal gland with a diameter of 3.5 cm. Adrenal gland sparing surgery was performed with total excision of the tumor. The histological analysis confirmed the diagnosis of adrenal adenoma. The child was cured clinically and biochemically. The long-term follow-up of patients treated for Cushing's syndrome should include the adequate replacement of glucocorticoids and other steroid hormones, treatment of osteoporosis and other pathologic effects of hypercortisolism and long-term screening for the relapse of Cushing's syndrome. Orv Hetil. 2022; 163(10): 407-412.
Adrenal Gland Neoplasms , Adrenocortical Adenoma , Cushing Syndrome , Adrenal Glands , Adrenocortical Adenoma/complications , Adrenocortical Adenoma/diagnosis , Adrenocortical Adenoma/surgery , Child , Cushing Syndrome/diagnosis , Cushing Syndrome/etiology , Humans , Neoplasm Recurrence, Local
Összefoglaló. Bevezetés: A magyar felnott lakosság heterogén attitudje folytán az influenza elleni átoltottság elmarad az nemzetközi ajánlásoktól. A háziorvosok meggyozo potenciálja jelentos, ezért fontos szerepük van a felnott lakosság oltással kapcsolatos döntéseinek befolyásolásában. Célkituzés: Az influenza elleni oltásra vonatkozó támogató és akadályozó tényezok azonosítása felnott háziorvosok és a teljes lakosság és körében. Módszer: 1000 fo, a teljes felnott lakosságra reprezentatív alany, valamint 317 fo, felnott- és vegyes praxisban dolgozó háziorvosokra reprezentatív orvos megkérdezése önkitöltos online kérdoív segítségével. Eredmények: Az influenza elleni oltás lehetosége 93%-ban ismert a lakosság számára, 30% a leginkább a háziorvos tanácsát követné ebben a kérdésben. A háziorvosok jelentosen túlbecsülik az ellátott lakosság átoltottságát. Az oltást nem tervezok leggyakoribb indokai: nem tartják veszélyesnek az influenzát, bíznak a saját immunrendszerükben, tartanak az oltás mellékhatásaitól. Megbeszélés: Elenyészo az influenza elleni oltás lehetoségét mereven elutasítók aránya. A többség relatív indokok alapján tartja kevésbé fontosnak ezt a lehetoséget. A háziorvos hiteles szereplo a lakosság jelentos része számára. Következtetés: A háziorvos szerepe kulcsfontosságú a lakosság átoltottságának növelésében. Orv Hetil. 2021; 163(6): 222-228. INTRODUCTION: Compared to the international guidelines, the flu vaccination rate of the Hungarian adult population is not satisfactory due to its heterogeneous attitude towards vaccination. Based on previous results, the convincing potential of general practitioners seems to be significant, therefore they have an important role when influencing people's decision-making concerning this topic. OBJECTIVE: To identify drivers and barriers to flu vaccination among general practitioners and the whole population. METHOD: Adult subjects representing the whole general population (n = 1000), and a representative sample of general practitioners (n = 317) surveyed through online self-completed questionnaires. RESULTS: 93% of the adult population is aware of influenza vaccine's existence. 30% prefer to follow the general practitioner's advice on this topic. General practitioners significantly over-estimate the vaccination coverage of the population they serve. The most common reasons for not getting vaccinated against flu: not considering the influenza dangerous, trusting their own immune system, and being afraid of the side effects of the vaccine. CONCLUSION: The rate of hard refusal of influenza vaccination is negligible. The vast majority of the population consider this option less important for relative reasons. The general practitioner is an authentic actor for a large part of the population. Orv Hetil. 2022; 163(6): 222-228.
General Practitioners , Influenza, Human , Adult , Humans , Hungary , Influenza, Human/prevention & control , Surveys and Questionnaires , Vaccination
INTRODUCTION: Parental health literacy is an important factor of pediatric health. Although it is thorougly studied in other countries, neither proper definition, nor adequate tool for its measurement exists in Hungarian. AIM: The aim of this work was to define the dimensions of parental health literacy and to introduce a questionnaire for its measurement. METHOD: Opinions of parents, pediatric nurses and pediatricians on parental health literacy were used to establish the definition and basic components. Based on these and previously standardized tests a new questionnaire was developed. RESULTS: Four dimensions of parental health literacy were formulated such as knowledge, functional literacy, self-confidence and motivation. The new questionnaire assesses all four dimension through eight topics. CONCLUSIONS: This is the first culturally adapted definition and test of parental health literacy in Hungarian. With its application the efficacy of both primary care services and health education may be improved and the correlation between parental health literacy and pediatric health may be properly studied.
Health Knowledge, Attitudes, Practice , Health Literacy , Parents , Self Report , Adult , Antipyretics , Breast Feeding , Chronic Disease , Emergencies , Female , Health Education , Humans , Male , Office Visits , Oral Hygiene , Vaccination , Vitamins
