[Personalized medicine and healthcare: where are we now, where should we go?] / Személyre szabott orvoslás és egészségügy: hol tartunk, merre menjünk?

The authors of this manuscript are representatives of different subdisciplines of medicine, all of them are experienced researchers. As of their origin, they are practicing doctors from the primary care and from the clinical/hospital setting, diagnostics experts, researchers from healthcare management, health economics, representatives of patients' rights and patient organizations. They are all devoted to the implementation of personalized medicine and personalized healthcare in Hungary. The current manuscript - also meant to be a keynote message provoking further discussion in the medical community - is devoted to correcting for two false ideas. One is that personalized medicine is not yet ready for practical applications, it is merely a research area of futurologists. The other false idea is that only (or mainly) the lack of financial resources hinders the introduction of personalized healthcare in Hungary. Orv Hetil. 2023; 164(6): 202-209.

[Participation rate of diabetes patients in structured education programs and reasons for non-participation: A cross-sectional survey among patients with diabetes mellitus in Thuringia]. / Teilnahmerate von Diabetespatient*innen an einer strukturierten Schulung und Gründe für eine Nicht-Teilnahme: eine querschnittliche Befragung von Patient*innen mit Diabetes mellitus in Thüringen.

BACKGROUND AND AIM: Structured education programs for patients with diabetes mellitus are an important and effective component of therapy. The aim of this survey is to assess the rate of participation in education programs in selected practices in Thuringia. Furthermore, we intend to identify factors that influence participation in order to derive strategies to increase participation. METHODS: Survey of patients with diabetes in Thuringian general practices and a diabetology practice using a newly developed questionnaire regarding "patient characteristics", "diabetes characteristics", "DMP and education programs" as well as reasons for non-participation in education programs and the wishes of non-educated patients. Data were analyzed using binary logistic regression analysis and other descriptive statistics in SPSS (IBM). RESULTS: Of the 1,254 questionnaires sent out, 637 (51%) were returned. Participation rate in education programs was 68% (n=405). HbA1c > 7.5%, diabetes sequelae, DMP participation and the awareness of education programs were significantly associated with participation in education programs. Recommendation/invitation to education programs, complex treatment regimes, long diabetes duration and urban practice led to a significant increase in the odds of attending an education program. Non-educated patients subjectively mentioned lack of need for training, lack of information, logistical reasons, and lack of time as reasons for non-participation. They expressed the wish for more information and recommendations from their general practitioner, shorter duration of education programs and online offerings. DISCUSSION: The participation rate in education programs was in the range of the evaluation reports on DMP programs for diabetes. Lower participation rates in rural areas may be explained by the lower physician density and especially education program offers as well as the more difficult accessibility. The factors and reasons for non-participation underline the need for comprehensive care and the general practitioner's key role in motivating, coordinating and educating patients. CONCLUSION: General practitioners play a central role in the care of patients with diabetes, and there is a need for comprehensive care and education programs. Telemedicine and digital applications can complement DMP and education programs.

[Malignant arrhythmias caused by hyperkalemia: a new area of drug-induced electrolyte abnormalities]. / Hyperkalaemia okozta malignus ritmuszavarok: a gyógyszer indukálta elektrolitzavarok új korszaka.

INTRODUCTION: High dose of angiotensin converting enzyme inhibitor is indicated in the treatment of heart failure and it is part of the treatment in the patients suffering from diabetes mellitus and nephropathy. The patients with preexisting renal insufficiency could have slowly elevated serum potassium level treated by angiotensin converting enzyme inhibitor. PATIENTS: Seven acute admitted cases is presented with severe hyperkalaemia and life threatening arrhythmias caused by ACEI administration. Wide QRS accelerated rhythm was detected in two cases and bradyarrhythmias in five cases. Two patients died among the bradyarrhythmias. CONCLUSIONS: The authors call the attention of danger of high dose angiotensin converting enzyme inhibitor in patients with preexisting renal insufficiency and concomittant drugs elevating serum potassium level.