Positive effect of colors and art in patient rooms on patient recovery after total hip or knee arthroplasty : A randomized controlled trial.

BACKGROUND: Environmental stimuli and well-being are considered to be significant factors in patients' rehabilitation. The aim of this study was to describe the effect of colors and art in hospital rooms on patients' recovery after total hip or knee arthroplasty. METHODS: We performed a prospective randomized, controlled study including 80 patients. The intervention group was randomized to colored patient rooms while the control group received medical care in conventional patient rooms. Data were collected preoperatively and postoperatively (3 and 6 days after operation). We measured mood, anxiety and depression, quality of life (QOL) and pain. RESULTS: Significantly better QOL summary scores were measured in the intervention group (6 days postoperative) compared to the control group (physical component summary score 37.1 ± 5.0 vs. 34.1 ± 6.7; p = 0.029 and mental component summary score 51.6 ± 6.6 vs. 47.2 ± 8.4; p = 0.015). Postoperatively, we found decreased total mood scores in both groups showing better results for the intervention group without significant differences (p = 0.353; p = 0.711). CONCLUSION: The use of colors in hospital rooms is an effective intervention to improve well-being and to enhance faster rehabilitation. We could demonstrate a positive effect of colors on patients' postoperative QOL.

Cognitive Gain or Handicap: Magical Ideation and Self-Absorption in Clinical and Non-clinical Participants.

Background: This study aimed to examine magical ideation and absorption traits across non-clinical and clinical groups to determine their potential adaptive and maladaptive functions. Method: We enrolled 760 healthy participants from neighboring communities (female = 53.2%). Moreover, we recruited 318 patients (female = 66.5%), which included 25, 183, and 110 patients with schizophrenia spectrum disorders, anxiety disorders, and mood disorders, respectively. Potentially adaptive and maladaptive sociocognitive functions were measured to determine the role of magical ideation and self-absorption in patients with psychiatric disorders. Results: The degree of magical ideation and absorption gradually increased in the following order: anxiety disorders, mood disorders, and schizophrenia spectrum disorders. Furthermore, enhanced self-absorption-related enhanced consciousness traits were essential indicators of the presence of self-integration weakness in patients with schizophrenia spectrum disorders. Conclusion: Magical ideation and psychological absorption may be considered as mental model construction functions, which result in both gains and handicaps in social adaptation.

Malnutrition as predictor of poor outcome after total hip arthroplasty.

INTRODUCTION: The aim of this study was to assess the prevalence of protein energy malnutrition (PEM) and correlation with poor post-operative outcome in the elderly undergoing primary total hip arthroplasty (THA). HYPOTHESIS: Patients with PEM would have inferior post-operative outcome after THA. MATERIALS AND METHOD: We retrospectively evaluated the nutritional status of 220 hospitalized patients undergoing THA, 65 years and older. PEM was assessed using serum albumin and total lymphocyte count (TLC). Studied outcome parameters were length of pre-operative and post-operative stay, complications up to six months after surgery and 12-month mortality. Clinical and demographic data were retrieved from medical records from the hospital database. RESULTS: The prevalence of PEM among patients undergoing THA was 12.3% (27/220). Patients with PEM were significantly older (mean age 81.3 ± 7.0, p < 0.001), had a lower BMI (24.7 ± 4.1 kg/m 2, p = 0.022), and showed more comorbid conditions (mean CCI 2.8 ± 2.0, p = 0.002) compared with well-nourished patients (age 75.6 ± 6.2, BMI 26.8 ± 4.3 kg/m 2, CCI: 1.7 ± 1.7). Length of pre-operative stay differed significantly (p < 0.001) between PEM (median 7, range 1-36 days) and non PEM (median 1, range 1-22 days). In the PEM group, 12 (44.4%) patients had post-operative complications within six months after OP and 15 (7.8%) patients in the non PEM group (HR = 6.3, 95% CI 1.7-23.1). CONCLUSION: We observed a higher post-operative complication rate for malnourished patients undergoing elective THA. These results underline the importance of pre-operative nutritional assessment in the elderly. Therefore, serum albumin and TLC are valuable clinical markers of PEM and the post-operative outcome.

Is there any difference between the findings of Clock Drawing Tests if the clocks show different times?

BACKGROUND: The Clock Drawing Test (CDT) is a widely-used, rapid assessment tool for the screening of cognitive decline though its evaluation and interpretation are still not uniform. The aim of present study was to investigate the difference in sensitivity and specificity of two types of CDTs and to compare the clinical benefits of quantitative and semiquantitative scoring systems. OBJECTIVE: To investigate the difference in sensitivity and specificity of two types of CDTs and to compare the clinical benefits of quantitative and semiquantitative scoring systems. METHODS: Six hundred and ninety-two participants with or without dementia completed 10-item CDTs in nursing homes in two counties in southern Hungary. The dementia was not further subclassified. The results of the two tests, CDT1 (representing five minutes to a quarter to four) and CDT2 (representing ten past five), were evaluated quantitatively and semiquantitatively. RESULTS: In the quantitative evaluation, the sensitivity and the specificity for the diagnosis of dementia at cut-off scores of 7 points were determined: 87.1% and 51.9%, respectively, for CDT1, and 81.7% and 57% for CDT2, respectively. The semiquantitative analysis revealed a sensitivity of 67.3% and a specificity of 65.3% for CDT1, and of 64.6% and 66.6% for CDT2, respectively. CONCLUSION: The results of CDT tests do not appear to depend on the positions of the clock hands and additionally suggest that the quantitative evaluation method is more sensitive than the semiquantitative method.

[The interpretation of attachment in the Szondi test and in the questionnaire processes of attachment theory]. / A kötodés értelmezése a Szondi-tesztben és a kötodéselmélet kérdoives eljárásaiban.

INTRODUCTION: [corrected] The Szondi-test is widely applied in clinical diagnostics in Hungary too, and the evidence resulting from the theory is that we can get information about attachment during its interpreting. Its validity is proven by empirical research and clinical experiences. By analyzing the modern attachment theory more thoroughly, it becomes clear in what ways the Szondi-test constellations regarding attachment are different from the classificationbased on questionnaires, allowing the discrete measurement of the attachment style. With the Szondi-test the classification to attachment style is more insecure, but if it is completed with exploration, it is more informative in vector C (vector of relation, attachment information), while short questionnaires make the classification to attachment style possible. METHODS: In our empirical analysis we represent the integration of the above mentioned clinical and theoretical experiences. In the present analysis we compare the vector C and S constellation of the two-profile Szondi-test of 80 persons with the dimensions of ECR-R questionnaire and with Collins and Read's questionnaire classification regarding attachment style. RESULTS: The statistical results refer to the fact that there is a legitimacy to compare questionnaire processes allowing the discrete classification of attachment and the Szondi-test's information content regarding attachment. With applying the methods together, we get a unique, complementary section of the information relating to attachment. CONCLUSION: Comparing the two methods (projective and questionnaire) establishes the need of theoretical integration as well. We also make an attempt to explain Fraley's evolutionary non-adaptivity of avoidant attachment, in the case of whose presence adaptivity of early attachment, counterbalancing the exploration and security need, and providing closeness--farness loses its balance.

Excess risk of diabetes in persons with hypertension.

PROBLEM: Persons with hypertension appear to be at increased risk of diabetes, an important predictor of cardiovascular disease. Whether, and to what extent, this risk may vary across subgroups defined on the basis of important clinical characteristics has not been well characterized. METHODS: Study population included members of Kaiser Permanente Northwest Region, a large health maintenance organization, aged > or = 35 years and free of diabetes in 1998. Persons in the study population were stratified based on whether or not they had hypertension, and onset of diabetes was ascertained over a 6-year period beginning January 1999. Excess risk of diabetes was characterized in terms of risk differences between persons with and without hypertension, and was estimated on an overall basis and for subgroups defined on the basis of age, sex, and body mass index (BMI). RESULTS: Study population totaled 104,368; 44% had hypertension. Relative risk (RR) of developing diabetes was 2.7 (95% CI: 2.6-2.8) for those with vs. without hypertension [21.0 (95% CI: 20.7-21.4) vs. 7.8 (95% CI: 7.6-8.0) per 1000 person-years, respectively]. Adjusted for age, sex, and BMI, RR of diabetes was 1.8 (95% CI: 1.7-1.9). With one exception (men, aged > or = 75 years), risk of diabetes was higher across all age and BMI strata for both men and women with vs. without hypertension; differences in risk were greatest among those with high BMI (> or = 35 kg/m(2)). Across BMI strata, RR of developing diabetes was generally higher at younger ages. CONCLUSION: All persons with hypertension, irrespective of age, sex, and BMI, are at elevated risk of developing diabetes. Men and women with hypertension who are overweight or obese are at substantially elevated risk of diabetes, regardless of age, and should be monitored especially closely for the development of this disease.

Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing histories.

OBJECTIVE: To describe characteristics of dosing history in patients prescribed a once a day antihypertensive medication. DESIGN: Longitudinal database study. SETTING: Clinical studies archived in database for 1989-2006. PARTICIPANTS: Patients who participated in the studies whose dosing histories were available through electronic monitoring. MAIN OUTCOME MEASURES: Persistence with prescribed antihypertensive treatment and execution of their once a day drug dosing regimens. RESULTS: The database contained dosing histories of 4783 patients with hypertension. The data came from 21 phase IV clinical studies, with lengths ranging from 30 to 330 days and involving 43 different antihypertensive drugs, including angiotensin II receptor blockers (n=2088), calcium channel blockers (n=937), angiotensin converting enzyme inhibitors (n=665), beta blockers (n=195), and diuretics (n=155). About half of the patients who were prescribed an antihypertensive drug had stopped taking it within one year. On any day, patients who were still engaged with the drug dosing regimen omitted about 10% of the scheduled doses: 42% of these omissions were of a single day's dose, whereas 43% were part of a sequence of several days (three or more days-that is, drug "holidays"). Almost half of the patients had at least one drug holiday a year. The likelihood that a patient would discontinue treatment early was inversely related to the quality of his or her daily execution of the dosing regimen. CONCLUSIONS: Early discontinuation of treatment and suboptimal daily execution of the prescribed regimens are the most common facets of poor adherence with once a day antihypertensive drug treatments. The shortfalls in drug exposure that these dosing errors create might be a common cause of low rates of blood pressure control and high variability in responses to prescribed antihypertensive drugs.

Effect of persistent use of antihypertensives on blood pressure goal attainment.

OBJECTIVE: Discontinuation rates with antihypertensive drugs in real life are high. The present study investigates the relationship between persistence with antihypertensive drugs (AHT) and blood pressure (BP) goal attainment in daily clinical practice. METHODS: In the PHARMO Record Linkage System, which includes drug dispensing and hospital records for > 2 million inhabitants in the Netherlands, new users of AHT > or = 18 years were identified for the period 1999-2004. Patients with elevated blood pressure (systolic BP > or = 140 and/or diastolic BP > or = 90 mmHg) within 6 months prior to onset of AHT treatment and a BP measurement within 6-12 months of treatment onset were included in the study cohort. Persistent AHT use was determined by summing the number of days of continuous treatment (gap between dispensings < 30 days) from start of treatment onwards. Patients with a BP below 140/90 mmHg at the first BP measurement within 6-12 months of treatment onset were defined as having attained goal. RESULTS: The study included 1271 patients with a mean systolic BP of 174 +/- 22 mmHg and a mean diastolic BP of 100 +/- 12 mmHg. Persistent AHT use was associated with a 40% increased chance of BP goal attainment (RR(adj) = 1.41; 95% CI: 1.08-1.85) after adjustment for gender, age, systolic blood pressure at start, and time to the BP measurement. CONCLUSION: Persistent use of AHT leads to increased blood pressure goal attainment in daily clinical practice.

Blood pressure control in patients initiating antihypertensive therapy.

BACKGROUND: Although information concerning the attainment of goal blood pressure for patients commencing antihypertensive therapy is available from controlled trials, no studies have examined this issue in the context of typical clinical practice. OBJECTIVE: To examine attainment of blood pressure control over time in patients initiating antihypertensive therapy in clinical practice. METHODS: Using an electronic medical records database, we identified all adults with systolic blood pressure (SBP)/diastolic blood pressure (DBP) of 140/90 mm Hg or higher who initiated antihypertensive drug therapy. Subjects were stratified into subgroups based on the presence of high-risk conditions or characteristics described by the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure in their seventh report as "compelling indications" (eg, diabetes) or "special situations" (eg, obesity). Blood pressure control was examined in terms of goal attainment and reductions in blood pressure using last available readings at days 90, 180, and 360, following therapy initiation. RESULTS: Among the 10,345 study subjects, 47% had compelling indications and 39% had special situations. In the former group, 62% (95% CI 61 to 64) of patients with Stage 1 hypertension (140-159/90-99 mm Hg) attained blood pressure less than 140/90 mm Hg by day 360; among those with Stage 2 hypertension (> or =160/100 mm Hg), the corresponding figure was 48% (95% CI 46 to 50). In the latter group, 64% (95% CI 61 to 66) and 55% (95% CI 53 to 57) of patients with Stage 1 and Stage 2 hypertension, respectively, attained blood pressure less than 140/90 mm Hg by day 360. Among those without high-risk conditions, these percentages were 63% (95% CI 59 to 67) and 55% (95% CI 52 to 59). Among patients with diabetes or chronic kidney disease, 25% (95% CI 24 to 26) attained blood pressure less than 130/80 mm Hg by day 360. CONCLUSIONS: Many patients starting antihypertensive therapy in clinical practice fail to achieve blood pressure control within the first year. Control is no better, and perhaps worse, among patients at highest risk of adverse outcomes.

The effect of discontinuation of antihypertensives on the risk of acute myocardial infarction and stroke.

OBJECTIVE: Adherence to antihypertensive drug treatment is suboptimal. The present study investigates the effect of early treatment discontinuation with antihypertensive drugs on the risk of acute myocardial infarction (AMI) or stroke in daily clinical practice. METHODS: In the PHARMO Record Linkage System, which includes all records of drug dispensings and hospitalisations for > or = 2 million subjects in the Netherlands, new users of antihypertensive (AHT) drugs > or = 18 years of age were studied during the period 1 January 1993 - 1 October 2002 to determine the risk of AMI or stroke related to persistence with AHT. Patients were initially followed for 2 years to determine persistence with AHT, and then for a further 2 years or until the first hospital admission for AMI or stroke, death, or end of the study period. Patients using AHT for secondary prevention of cardiovascular disease were excluded from the study cohort. RESULTS: The study cohort included 77 193 AHT users. The percentage of non-persistent patients was 55% at 2 years, with the lowest non-persistence rates for angiotensin-receptor blockers (ARBs) and ACE-inhibitors (40%) and the highest rates for beta-blockers, calcium-channel blockers (CCBs) and diuretics (54-61%). Non-persistent AHT use was associated with a 15% increased risk of AMI (RR 1.15; 95% CI 1.00-1.33) and a 28% increased risk of stroke (RR 1.28; 95% CI 1.15-1.45). CONCLUSIONS: The results of this study show that in daily clinical practice early discontinuation of antihypertensive drug treatment in primary prevention increases the risk of subsequent AMI or stroke.

Risk factors of cognitive decline in residential care in Hungary.

OBJECTIVE: The incidence of dementia is known to vary between nations due to population specific interactions of genetic and epigenetic risk factors. Since this type of data was missing from the Central-Eastern part of Europe, especially from Hungary, an ongoing prospective multicentre study was initiated 3 years ago to determine the impact of some well-known social and biological dementia risk factors and the prevalences and conversion rates of dementia and depression syndromes. METHODS: As part of this work, the effects of age, gender, education, smoking and alcohol consumption were investigated in residental homes-based cohort of more than 2,100 elderly. RESULTS: Forty-eight percent of the entire population showed clinical signs of cognitive decline. Eighteen percent, 22%, 16% and 10% were classified as mild cognitive impairment, mild, moderate and severe stages of cognitive decline, respectively. Considered individually, all the examined dementia risk factors were significantly related to the presence of the cognitive decline. Age, female gender and regular drinking increased the risk, while smoking, higher level of education and occasional or former history of alcohol consumption were protective factors. The male gender associated regular alcohol consumption represented the strongest risk, especially with low education levels. When the different severity subgroups were compared, similar risk tendencies have been observed, but the most robust effects were associated with the most severe stages. CONCLUSIONS: The well-known dementia risk and protective factors are confirmed in our study. Taking these variables into consideration, the Hungarian cohort is similar to other ethnic groups in Europe.

Higher persistence with valsartan compared with enalapril in daily practice.

OBJECTIVE: To compare persistence with valsartan and enalapril in daily practice. METHODS: The PHARMO Record Linkage System includes various data registries including drug dispensing and hospitalizations for > or =2 million subjects in the Netherlands. Patients newly treated with valsartan or enalapril in the period of 1999-2002 were selected. Persistence was calculated by summing up the number of days of continuous treatment. Patients who remained on therapy with valsartan or enalapril for 12 or 24 months were defined as persistent at 1 or 2 years, respectively. RESULTS: 3364 patients received valsartan and 9103 patients received enalapril. About 62% of patients treated with valsartan and 55% of patients treated with enalapril remained on therapy at 12 months after the initial dispensing, while 48% of patients treated with valsartan and 43% of patients treated with enalapril were persistent at 24 months. Patients treated with valsartan were about 20% more likely to stay on treatment than patients treated with enalapril (1 year RR(adj): 1.23, 95% CI: 1.16-1.32; 2 years RR(adj): 1.16, 95% CI: 1.11-1.23). CONCLUSIONS: Real-life persistence is higher with valsartan than with enalapril. The results of this and other studies on persistence in daily practice should be taken into account when deciding upon drug treatment for hypertension.

[Addictive behaviors in a general hospital population from the viewpoint of consultation-liaison psychiatry]. / Addikciós sajátosságok általános kórházi populációban a konzultációs-kapcsolati pszichiátria szemszögéböl.

AIM: Based on a comprehensive survey among patients of general hospital departments, the data relating to addictive behaviours were analyzed in this publication. METHOD: A questionnaire screening was performed involving general, demographic questions, and psychiatric rating scales in 9 Hungarian general hospitals. Data provided by 2485 patients were included in the analysis. Alcohol consumption was evaluated using the CAGE questionnaire. RESULTS: The prevalence of smoking was 28.5% in the total population, and ranged between 14.5% and 37.3% in the different hospital departments. 25.4% of the patients are at risk of developing alcoholism, and 4.4% can be regarded to be alcohol dependent. These data correspond well with former results obtained from the general Hungarian population. The highest prevalences measured with the CAGE questionnaire were found in the departments of pulmonology, surgery, traumatology, and orthopedics. CONCLUSIONS: The data obtained in this study help determine the segments of health care that are mostly affected by addictive disorders from the perspective of consultation-liaison psychiatry.

Strategies to improve adherence with medications in chronic, 'silent' diseases representing high cardiovascular risk.

Given the burden of illness related to diabetes, hypertension and dyslipidemia, it is very important to achieve glycemic control, optimal blood pressure and low-density lipoprotein cholesterol (LDL-C) in order to avoid severe long-term complications. Patients' adherence with, and persistence to, the treatment regimen is a critical factor in achieving this goal. Medication taking behavior in these chronic, nonsymptomatic ('silent') diseases is generally low, although a wide range of results have been reported. The literature has shown that nonadherence to medications is a multidimensional phenomenon; relating factors can be grouped into the following categories: health system related, social/economic, condition-related, therapy-related and patient-related factors. Although several interventions exist to improve patients' medication-taking behavior, none appear to be clearly superior to others. The key steps to improve adherence are to identify individual barriers and to develop patient-specific self-management plans to overcome them (called 'patient-centric' approach). When developing intervention strategies one should always remember that 'one size does not fit all'. Well designed (but not randomized), observational studies (for example, patient registries) may be required with sufficient follow-up periods and multiple adherence measurements in order to advance the field.

CYP46 T/C polymorphism is not associated with Alzheimer's dementia in a population from Hungary.

Multiple genetic and environmental factors regulate the susceptibility to Alzheimer's disease (AD). Recently, several independent studies have reported that a locus on chromosome 14q32.1, where a gene encoding a cholesterol degrading enzyme of the brain, called 24-hydroxylase (CYP46A1) is located, has been linked with AD. The single nucleotide polymorphism (T/C) in intron 2 of CYP46 gene has been found to confer the risk for AD. The water soluble 24(S)-hydroxysterol is the product of the CYP46A1, and elevated plasma and cerebrospinal fluid hydroxysterol concentrations have been found in AD, reflecting increased brain cholesterol turnover or cellular degradation, due to the neurodegenerative process. A case-control study was performed on 125 AD and 102 age- and gender-matched control subjects (CNT) from Hungary, to test the association of CYP46 T/C and apolipoprotein E (ApoE) gene polymorphisms in AD. The frequency of the CYP46 C allele was similar (chi2=0.647, df=1, P=0.421, exact P=0.466, OR=0.845; 95% CI: 0.561-1.274) in both groups (CNT: 27%; 95% CI: 21.3-33.4; AD 30%; 95% CI: 25.0-36.3). The ApoE varepsilon4 allele was significantly over-represented (chi2=11.029, df=2, P=0.004) in the AD population (23.2%; 95% CI: 18.2-29.0) when compared with the CNT (11.3%; 95% CI: 7.4-16.6). The presence or absence of one or two CYP46C alleles together with the ApoE varepsilon4 allele did not increase the risk of AD (OR=3.492; 95% CI: 1.401-8.707; P<0.007 and OR=3.714; 95% CI: 1.549-8.908; P<0.003, respectively). Our results indicate that the intron 2 T/C polymorphism of CYP46 gene (neither alone, nor together with the varepsilon4 allele) does not increase the susceptibility to late-onset sporadic AD in the Hungarian population.

ApoE -491A/T promoter polymorphism is not an independent risk factor, but associated with the epsilon4 allele in Hungarian Alzheimer's dementia population.

Apolipoprotein E gene (Apo(epsilon)) has three common alleles (epsilon2, epsilon3, and epsilon4), of which epsilon4 has been shown to be associated with an increased risk for Alzheimer's disease (AD). Possible additional genetic factors, like the -491A variant of ApoE promoter may modify the development of AD, independently of the ApoE allele status. The objective of this study was to investigate whether A/T allelic polymorphism at site-491 of the ApoE promoter is associated with AD in a Hungarian population. The genomic DNA isolated from peripheral blood lymphocytes of 52 late-onset AD and 53 control individuals was used as a template for the two examined polymorphisms and PCR assay was applied. The epsilon4 allele was significantly over-represented in the AD group (28%) as compared with the control population (7%). No significant differences have been found between the control and the AD populations regarding the occurrence of the promoter A allele frequencies (control: 77%, AD: 70%). However, the AA genotype was more frequent in the AD group (48%) than in the control (10%) when the presence of epsilon4 allele was also considered. It is unlikely therefore that the -491A variant of the ApoE promoter gene is an independent risk factor in the Hungarian AD population, but a linkage disequilibrium exists between the two examined mutations.

Regional cortical blood flow changes following sodium lactate infusion in Alzheimer's disease.

Bilateral temporoparietal hypoperfusion is a characteristic single photon emission computed tomography (SPECT) finding in Alzheimer's disease (AD). Lactate is a metabolic vasodilator and is known to provoke increased cerebral blood flow (CBF) in healthy adults. This work investigated whether lactate, which is present in high concentrations in AD cerebrospinal fluid, affects AD-specific perfusion abnormalities. Twenty mild-to-moderately demented AD probands participated in the self-controlled study. The regional CBF was examined utilizing (99m)Tc-HMPAO SPECT after sodium lactate infusion (0.5 M, 5 mL/kg body weight) and 0.9% NaCl infusion, one on each of two separate days. Despite the vasodilatator effects of sodium lactate, AD rCBF patterns did not show increase in temporo-parietal regions after its infusion. AD-specific bi-temporo-parietal reduction in CBF was accompanied by further hypoperfusion in the parieto-occipital areas after the sodium lactate infusion in seven patients, while no CBF changes were observed in the case of the remaining 13 probands. The pattern of the CBF abnormalities was not correlated with the apolipoprotein E genotype. The decreased vascular responsiveness to sodium lactate reflects disturbed vasoregulatory processes in AD and it is unlikely that lactate would have any relevance in the treatment of AD-related cerebral hypoperfusion, but could be used to improve the value of perfusion SPECT in the diagnosis of AD.

[Dysmenorrhea in adolescent girls]. / Dysmenorrhoea elofordulása serdülokorban.

INTRODUCTION: Dysmenorrhea is highly prevalent during adolescence but the incidence of this disease is very often underestimated. Depending on different measurement methods 20-90% of adolescent girls report dysmenorrhea. OBJECTIVES: This study examined the prevalence of dysmenorrhea among high-school female adolescent students in Eastern-Hungary. Early diagnosis and treatment of the possible pathological background is very important to prevent long term consequences. RESULTS: 2337 girls were interviewed in this study about their menstrual cycle. The overall prevalence of dysmenorrhea in this population was 79.2%. Altogether 67.0% described their pain and cramp as severe. 61.2% of the girls use some kind of medication due to dysmenorrhea. Despite these data only 1.2% of them had previous medical counseling because of their complains. CONCLUSIONS: It is important to screen female adolescents for dysmenorrhea and provide them with information on the disease and possible treatment options. Follow up of these adolescents is mandatory especially in cases not responding to standard medical treatment.