Assessing obsessive-compulsive symptoms in a subclinical and clinical sample: the development of the Hungarian version of the OCI-R.

OBJECTIVES: The prevalence of clinical obsessive-compulsive disorder (OCD) is around 1-2% in the population. Questionnaires, such as the OCI-R, are a useful tool in the diagnositc process. The purpose of this study was to develop the Hungarian version of the OCI-R, examine its validity and reliability, and its ability to differentiate between clinical and subclinical OCD. METHODS: Confirmatiory factor analysis was carried out on the subclinical sample (N = 4301). Reliability analysis was carried out on both samples, and Mann-Whitney tests were used to compare the two samples. RESULTS: The six-factor structure identical to the original was confirmed by confirmatory factor analysis. In the subclinical sample, all scales but Neutralizing had good reliability. Reliability analysis on the clinical sample (N = 26) showed good Cronbach's alpha values for all scales except for Hoarding. There were significant differences between the two groups on three scales: Neutralizing, Washing, and Obsessing, with the clinical group scoring significantly higher on these scales. The average score for Checking, Hoarding, and Ordering was higher in the subclinical sample, although the difference was not significant. CONCLUSION: The results highlight the advantages of symptom severity scales, such as the OCI-R, in the diagnostic process of obsessive-compulsive disorder. (Neuropsychopharmacol Hung 2024; 26(3): 144-152)

Canine companionship as a resilience factor: a quantitative inquiry into the impact of pet ownership on burnout mitigation among radiologists and radiographers.

Background: The demanding nature of diagnostic imaging, coupled with the increasing workload and exposure to high-stress scenarios, underscores the pressing concern of burnout among radiologists and radiographers in modern healthcare settings. The objective was to investigate the interplay between family characteristics, workplace characteristics, pet ownership, and the occurrence of burnout. Methods: An online, quantitative, cross-sectional study with a non-random, purposive sampling method was carried out among Hungarian radiologists and radiographers from 1st of September to 1st of November 2022. Results: We examined the results of 406 responses predominantly from females (79.8%, n = 324), including 70.7% radiographers (n = 287). Cronbach's alpha values for depersonalization (DP), emotional exhaustion (EE), and personal accomplishment (PA) were 0.74, 0.88, and 0.85, respectively. Average burnout scores were 8.35 (SD = 6.62) for DP, 26.26 (SD = 12.74) for EE, and 32.86 (SD = 9.52) for PA. DP demonstrated a balanced distribution (low: 35.7%, moderate: 27.3%, high: 36.9%). Conversely, EE and PA skewed towards high levels, with 52.5% (n = 213) and 49.5% (n = 201). Significant associations were found between gender and DP (p = 0.006), age (31-40 years) and DP/PA (p < 0.001; p = 0.004), absence of children and all burnout dimensions (p < 0.05), and pet ownership (p = 0.004) with lower EE, particularly for dog owners (p = 0.009). Occupation lacked a significant effect on burnout dimensions (p > 0.05). Employees without a second job had higher EE (p = 0.002) and lower PA (p = 0.008). Increasing healthcare experience correlated with decreased DP values (p = 0.001), while working over 40 h weekly negatively impacted all burnout dimensions (p ≤ 0.05). 15.5% (n = 63) exhibited signs of high burnout, with the age group 31-40 demonstrating the highest proportion (25.4%, n = 27) and significant associations with marital status, absence of children, pet ownership, private healthcare, 10-19 years in healthcare, and working over 40 h weekly. Conclusions: There is a pressing need for evidence-based strategies to alleviate burnout among radiologists and radiographers. There is a growing importance of recognizing the role of pets, especially dogs, as valuable companions for emotional support and stress relief. Implementing pet-friendly policies or therapy programs can contribute to a positive and supportive workplace, potentially mitigating burnout among essential frontline healthcare professionals.

Mortality in patients with major depressive disorder: A nationwide population-based cohort study with 11-year follow-up.

BACKGROUND: Major depressive disorder (MDD) is a leading cause of disability and premature mortality. This study compared the overall survival (OS) between patients with MDD and non-MDD controls stratified by gender, age, and comorbidities. METHODS: This nationwide population-based cohort study utilized longitudinal patient data (01/01/2010 - 12/31/2020) from the Hungarian National Health Insurance Fund database, which contains healthcare service data for the Hungarian population. Patients with MDD were selected and matched 1:1 to those without MDD using exact matching. The rates of conversion from MDD to bipolar disorder (BD) or schizophrenia were also investigated. RESULTS: Overall, 471,773 patients were included in each of the matched MDD and non-MDD groups. Patients with MDD had significantly worse OS than non-MDD controls (hazard ratio [HR] = 1.50; 95% CI: 1.48-1.51; males HR = 1.69, 95% CI: 1.66-1.72; females HR = 1.40, 95% CI: 1.38-1.42). The estimated life expectancy of patients with MDD was 7.8 and 6.0 years less than that of controls aged 20 and 45 years, respectively. Adjusted analyses based on the presence of baseline comorbidities also showed that patients with MDD had worse survival than non-MDD controls (adjusted HR = 1.29, 95% CI: 1.28-1.31). After 11 years of follow-up, the cumulative conversions from MDD to BD and schizophrenia were 6.8 and 3.4%, respectively. Converted patients had significantly worse OS than non-converted patients. CONCLUSIONS: Compared with the non-MDD controls, a higher mortality rate in patients with MDD, especially in those with comorbidities and/or who have converted to BD or schizophrenia, suggests that early detection and personalized treatment of MDD may reduce the mortality in patients diagnosed with MDD.

Stability of Resistance of Maize to Ear Rots (Fusarium graminearum, F. verticillioides and Aspergillus flavus) and Their Resistance to Toxin Contamination and Conclusions for Variety Registration.

All major ear rots (F. graminearum, F. verticillioides, and Aspergillus flavus) and their toxins are present in maize of preharvest origin in Hungary. Resistance can be an important tool in reducing the infection and toxin contamination from these rots in maize. Previous results identified resistance differences in maize hybrids that were suitable for use in evaluating their risk from toxigenic fungi and their toxins. During the tests, two methodical improvements were achieved: the use of three isolates of the fungus secured and a more precise estimation of resistance to ear rots and their resistance to toxin accumulation or overproduction. The improvement in sampling and the tests of subsamples made the evaluation for the statistics much more exact. This way, we were able to reduce the Within value, providing a statistically more reliable method of evaluation. Earlier data had confirmed that toxin contamination could not be predicted well from visual ear rot severity data. Contradictory results for hybrid ranking were often identified between isolates. The resistance to disease and toxin contamination is not generally valid. The new suggested methodology compares the performance of hybrids in a large number of epidemic situations to identify adaptable hybrids that can respond to diverse conditions; therefore, the stability of resistance and toxin response is decisive information to evaluate risk analyses. The increased number of disease toxin data allowed for lower LSD 5% values for toxins, a much finer analysis of toxin overproduction and underproduction, and a wider database for stability analyses. This way, we obtained important additional separated information about resistance to accumulation of toxins and about maize resistance to these pathogens that is suitable to provide much more reliable testing than was possible until now. Globally, about 50-100 million metric tons can be saved by excluding susceptible hybrids from commercial production.

Road mortality of water snakes in light of landscape structure and traffic intensity in north-eastern Hungary.

Road mortality can be a serious threat to different animals, including snakes. However, mortality patterns can vary between species, intraspecific groups, locations and time. We compared the number of road-killed individuals (carcasses) of two semiaquatic water snakes (Natrix natrix and N. tessellata) on 58 km of road sections bordered by an active floodplain and a flood-protected former floodplain on one side and mountainous areas on the other in NE Hungary based on surveys conducted once every two weeks in three non-consecutive years. The results showed high road mortality of snakes, with a spring and an autumn peak corresponding to the times when snakes emerge from and return to hibernating sites. The results show that small-scale spatial differences in road mortality were mediated by landscape structure along the road, while the effects of traffic volume, flood regime and the age and sex of the individuals were negligible. For conservation, the study suggests that establishing culvert passages under the road and/or artificial hibernating sites on the floodplain-side of the roads in critical sections can be promising in reducing road-related mortality.

Factors Associated With Cervical Cancer Screening Attendance in Hungary Based on the European Health Interview Survey.

Objectives: This study assessed the change in cervical cancer screening attendance across 10 years and identified the associated factors. Methods: Data from the European Health Interview Surveys in Hungary (2009, 2014, 2019) were analyzed with multivariate and multiple logistic regressions. Results: The analysis involved 4,850 participants, revealing a significant (p < 0.001) increase in screening attendance from 69% to 77% over 10 years. Factors significantly associated with higher attendance rates included a higher education level (tertiary level AOR = 2.51 [2.03-3.09]), being in a relationship (AOR = 1.59 [1.39-1.83]), the belief that one can do much for one's health (OR = 1.26 [1.05-1.52]), and the absence of chronic health problems (AOR = 1.56 [1.33-1.84]). Lower screening odds were significantly correlated with worse self-perceived health status (AOR = 0.65 [0.52-0.81]) and less frequent doctor (AOR = 0.64 [0.54-0.76]) and specialist visits (AOR = 0.46 [0.39-0.53]). Conclusion: Enhancing cervical cancer screening rates requires tailored public health strategies, particularly targeting individuals with lower education and poor health perceptions. Public health initiatives and enhanced collaboration among healthcare professionals are required to further increase participation rates, particularly among the identified groups.

Changing trends in injury patterns of undocumented migrants along the Hungarian-Serbian border from 2018 to 2022.

OBJECTIVE: The Traumatology Clinic of the University of Szeged is a level one Trauma center situated near the Hungarian - Serbian border, where a 4 m tall fence constructed in 2018 serves as a barricade leading to numerous trauma cases. The objective of this study is to characterize the epidemiology of injuries, challenges, and recent trends whilst treating these undocumented migrants in Hungary. MATERIALS AND METHODS: A national retrospective mono-centrical study was performed, examining 982 patients who were admitted to the emergency trauma center in the University of Szeged between January 2018 and December 2022, using data from our electronic administrative system (eMedSol). Factors such as basic epidemiology, country of origin, fractures- according to the AO classification- and its respective treatments, mechanism of injury, duration of stay, and costs were assessed to set as a basis for prediction using a regression model. RESULTS: A total of 982 patients from 2018 to 2022 were included in the study. Patterns of injury included calcaneal fractures in 2018 and 2019 whereas in 2021 and 2022 along with the exponential increase in patient number, bilateral calcaneal fractures, open and multi-fragmentary tibial fractures were also observed. Additionally, seasonal variations, favoring the months of September through November were observed. Treatment cost ratios, especially surgeries, have also been consistent with the pattern of proximalizing injuries; more proximal surgeries indicate higher surgical costs which is evidently visible in the significantly higher cost ratio dedicated to surgery in 2022. CONCLUSION: While migration seems to be a global problem affecting governments and citizens alike, rarely do we understand the direct consequences of illegal migration affecting healthcare services. Hungary in particular created a 4 m tall wall between Serbia in 2019 with means of preventing illegal migration, which in turn led to gradual and later an exponential increase in the number of injured patients particularly in the years 2021 and 2022. Undocumented migrant cases have increased exponentially between 2018 and 2022, with certain patterns seen not only in the injury types but also in seasonal variations and cost expectations. Injuries have been showing a trend of proximalization and have been of more serious quality, including bilateral and/or open injuries. Revisions after surgery were virtually impossible due to the discharging of patients back to border control after their definitive treatment. The need for adequate quality surgical care, manpower and financial aid should be considered.

Real-World Study of Ragweed Sublingual Immunotherapy in Hungary.

BACKGROUND: Ragweed (Ambrosia elatior) has become invasive in Europe, causing significant respiratory issues. Subcutaneous allergen immunotherapy (SCIT) has long been used to manage pollen allergies, but sublingual immunotherapy (SLIT) has gained interest. OBJECTIVE: This study aimed to evaluate the clinical benefits of ragweed SLIT under real-world in a cohort of Hungarian patients allergic to ragweed pollen. METHODS: We retrospectively reviewed the clinical records of 57 patients during the 2015 and 2016 ragweed pollen seasons. Patients were divided into two groups: Group 1 (n = 29), who had not received immunotherapy, and Group 2 (n = 28), who had previously undergone immunotherapy with another sublingual preparation. All patients were treated with Oraltek® ragweed for 4-6 months, initiating 2-4 months before the pollen season and rest of the period was 2 months of the 2016 pollen season. Symptom score (SS), medication score (MS), and combined symptom and medication score (CSMS) were evaluated intra- and intergroup. RESULTS: Pollen counts were consistent between 2015 and 2016. All patients showed significant improvement in SS, MS, and CSMS, with a large effect size (>0.8). Group 2 had significantly lower SS and CSMS in 2015 because of prior immunotherapy. By 2016, both groups exhibited marked improvements, with Group 1 showing a 75% improvement in CSMS. No local or systemic reactions were recorded, indicating a high safety profile. CONCLUSIONS: Ragweed SLIT significantly improved symptoms and reduced use of medication in patients allergic to ragweed pollen. The treatment was effective even in patients with previous immunotherapy, with a high benefit-risk ratio demonstrated by the absence of adverse reactions. These findings support the use of Oraltek SLIT for managing ragweed pollen allergy.

Diagnostic challenges in patients with Castleman disease, a single center experience from Hungary.

Castleman disease is a rare and atypical lymphoproliferative disorder characterized by diverse clinical manifestations. It has both unicentric and multicentric forms, the latter with further subdivisions, i.e., human herpesvirus 8-associated and idiopathic forms. The diagnosis of Castleman disease is often delayed, as it is rare, and because it shares clinical features with different autoimmune, inflammatory, and malignant lymphoproliferative disorders. The first-line treatment in unicentric form is mainly surgical, while in idiopathic Castleman disease, anti-interleukin-6 treatment is the therapy of choice. In virus-associated diseases, antiretroviral therapy and rituximab are recommended. In Hungary, only a few cases of Castleman disease have been published. This report presents our two decades of experience in the challenging diagnosis and management of this rare disorder, most properly underdiagnosed in Hungary. We provide insights into seven unicentric and five idiopathic multicentric Castleman disease cases, the latter ones especially highlighting the diagnostic and therapeutic challenges due to the variable and unique clinical features both of patients and diseases, e.g., bronchiolitis obliterans, stage IV diabetic renal failure, anti-HBc positivity, siltuximab treatment period, respectively.

Assessing disparities in health and living conditions: a comparative study of Hungarian-speaking Roma and non-Roma women across Hungary, Romania, and Slovakia.

Background: The Roma minority, Europe's largest ethnic minority, experiences significant disparities in living conditions and health outcomes compared to the non-Roma populations across the continent. Despite extensive documentation of the socio-economic challenges faced by the Roma, there is a notable lack of comparative research. Methods: This study aims to fill this gap by examining the differences in socio-economic characteristics, living conditions, and self-reported health status between Roma (R) and non-Roma (nR) women in in Hungary (HU), Romania (RO), and Slovakia (SK), providing a cross-country comparative analysis. Utilizing simple and multiple binary logistic models, our research analysed data collected from September 2020 to March 2022, involving 322 Roma and 294 non-Roma women in Hungary, 258 Roma and 183 non-Roma women in Romania, and 146 Roma and 163 non-Roma women in Slovakia. Results: Findings indicate significant associations between increased age (R:OR = 1.04[1.02,1.06], p < 0.001), (nR:OR = 1.04[1.02,1.05], p < 0.001) lower financial situation (R:OR = 2.05[1.01,4.18], p = 0.048) (nR:OR = 1.67[1.01,2.77], p = 0.047), and basic education level (R:OR = 3.60[1.29,10.08], p = 0.015) (nR:OR = 3.64[1.77,7.51], p < 0.001) with the likelihood of poor health status across both groups in Hungary. In Romania, increased age (OR = 1.04[1.02,1.06], p < 0.001) and basic education level (OR = 5.24[2.29,11.99], p < 0.001) were particularly predictive of poor health among non-Roma, while in Slovakia, age (OR = 1.05[1.02,1.07], p < 0.001) was a significant factor for Roma, and intermediate education level (OR = 2.68[1.16,6.20], p = 0.021) was for non-Roma. The study also found that a higher number of children (HU:OR = 1.35[1.12,1.63], p = 0.002), (RO:OR = 1.57[1.25,1.96], p < 0.001) and problems with housing comfort (RO:OR = 4.83[2.19,10.62], p = 0.015) and wall conditions (RO:OR = 2.81[1.22,6.46], p < 0.001) significantly impacted the health status of non-Roma women in Hungary and Romania. Conversely, an increase in household size was associated with a better health status among Roma women in Hungary (OR = 0.88[0.79,0.99]) and Slovakia (OR = 0.78[0.61,0.99]). Conclusion: By offering a novel comparative analysis, this study highlights the critical need for focused attention on the health disparities faced by Roma women, particularly those in a multiply disadvantaged situation due to their ethnic and socio-economic status.