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1.
Ideggyogy Sz ; 74(3-4): 87-98, 2021 Mar 30.
Artículo en Húngaro | MEDLINE | ID: mdl-33938670

RESUMEN

Background and purpose: The revised Adult Attachment Scale (AAS) developed by N. L. Collins is a widely used questionnaire to measure adult attachment. However, its psychometric properties have not been investigated in Hungary. We aimed to confirm the key psychometric properties of the Hungarian version of the AAS focusing on reliability indices on a population that consis-ted of depressed and non-depressed young adults. Methods: The AAS is a self-report questionnaire, in which two different dimensional evaluating systems are possible: the original (close, depend, and anxiety) and the alternative scoring system (anxiety, avoidance). Our study population consisted of young adults with a history of major depression (n = 264, median age = 25.7 years) and their never-depressed biological siblings (n = 244, median age = 24.0). Results: The internal consistency of close, anxiety, and avoidance scales were satisfactory (Cronbach-α >0.7). The consistency of the depend scale was slightly lower than expected (Cronbach-α = 0.62). Test-retest reliability was good for all of the scales, it ranged from 0.73 to 0.78 after 14 months of follow-up period. The scale showed good discrimination as tested by the differences of close and anxiety attachment dimensions between the groups (p<0.01). More-over, we were able to differentiate the currently dep-res-sed subjects based on these attachment dimensions. Explo-ra-tory and confirmatory factor analyses were conducted, and a bifactor solution proved optimal model fit. Conclusion: The three dimensions of the AAS has not been confirmed. However, the close and anxiety scales of AAS were found to be adequate. Our results also indicate that attachment features correlate with major depressive episodes in adulthood.


Asunto(s)
Trastorno Depresivo Mayor , Adulto , Análisis Factorial , Humanos , Hungría , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Adulto Joven
2.
Ideggyogy Sz ; 74(3-4): 79-86, 2021 Mar 30.
Artículo en Húngaro | MEDLINE | ID: mdl-33938671

RESUMEN

Background and purpose: Background - Spinal muscular atrophy (SMA) is an autosomal recessive, progressive neuromuscular disorder resulting in a loss of lower motoneurons. Recently, new disease-modifying treatments (two drugs for splicing modification of SMN2 and one for SMN1 gene replacement) have become available. Purpose - The new drugs change the progression of SMA with neonatal and childhood onset. Increasing amount of data are available about the effects of these drugs in adult patients with SMA. In this article, we summarize the available data of new SMA therapies in adult patients. Methods: Methods - Members of the Executive Committee of the Hungarian Clinical Neurogenetic Society surveyed the literature for palliative treatments, randomized controlled trials, and retrospective and prospective studies using disease modifying therapies in adult patients with SMA. Patients - We evaluated the outcomes of studies focused on treatments of adult patients mainly with SMA II and III. Results: In this paper, we present our consensus statement in nine points covering palliative care, technical, medical and safety considerations, patient selection, and long-term monitoring of adult patients with SMA. Conclusion: This consensus statement aims to support the most efficient management of adult patients with SMA, and provides information about treatment efficacy and safety to be considered during personalized therapy. It also highlights open questions needed to be answered in future. Using this recommendation in clinical practice can result in optimization of therapy.


Asunto(s)
Atrofia Muscular Espinal , Adulto , Niño , Consenso , Humanos , Hungría , Atrofia Muscular Espinal/genética , Atrofia Muscular Espinal/terapia , Estudios Prospectivos , Estudios Retrospectivos
3.
Orv Hetil ; 162(16): 602-607, 2021 04 07.
Artículo en Húngaro | MEDLINE | ID: mdl-33830937

RESUMEN

Összefoglaló. Újabb megfigyelések szerint a SARS-CoV-2-fertozést követoen gyermekekben a paediatric inflammatory multisystem syndrome (PIMS) elnevezésu, sokkállapottal szövodött Kawasaki-megbetegedéshez hasonlító, többszervi elégtelenségnek megfelelo tünetegyüttes alakulhat ki. A gyermekek többségében ilyenkor a direkt víruskimutatás már sikertelen, azonban a SARS-CoV-2 ellen képzodött antitest igazolhatja a diagnózist. Dolgozatunk célja az egyik elso hazai eset ismertetése. Egy 15 éves fiú került gyermek intenzív osztályos felvételre több napon át észlelt magas láz, kesztyu-, zokniszeru exanthema, conjunctivitis, többszervi elégtelenség, szeptikus sokk tüneteivel, akut gyulladásra utaló laboratóriumi eltérésekkel és diffúz hasi panaszokkal. Felvételét megelozoen néhány héttel SARS-CoV-2-fertozésen esett át. Felvételekor a direkt víruskimutatás sikertelen volt, ám a SARS-CoV-2 elleni antitest vizsgálata pozitív lett. Komplex intenzív terápia mellett állapota stabilizálódott. Az irodalmi ajánlásoknak megfeleloen immunglobulin-, acetilszalicilsav- és szteroidkezelésben részesítettük, melynek hatására állapota maradványtünetek nélkül rendezodött. A növekvo esetszámú gyermekkori SARS-CoV-2-fertozés mellett egyre gyakrabban várható a SARS-CoV-2-fertozést követo, a Kawasaki-betegség tüneteire emlékezteto PIMS kialakulása. Gyermekekben súlyos szeptikus állapot és többszervi elégtelenség esetén gondolni kell a PIMS lehetoségére, mely esetenként intenzív osztályos ellátást és célzott terápiát igényel. Legjobb tudomásunk szerint a leírásra került beteg a Magyarországon diagnosztizált egyik legkorábbi eset. Orv Hetil. 2021; 162(16): 602-607. Summary. Recently following SARS-CoV-2 infection, a new, multisystem disease (paediatric inflammatory multisystem syndrome, PIMS) with fever was recognized in children with shock and multiorgan failure. On of the first Hungarian cases will be described. A 15-year-old boy was admitted to the Paediatric Intensive Care Unit with persistent high fever, diffuse abdominal pain, septic shock, multiple organ failure, gloves- and socks-shaped cutan exanthema, conjunctivitis and laboratory signs of inflammation. Some weeks preceding his admission, symptoms of mild SARS-CoV-2 infection were revealed. At admission, the SARS-CoV-2 PCR and antigen tests were negative, however, the presence of IgG antibody was shown. Following complex supportive intensive care along with internationally recommended immunoglobulin, aspirin and steroid treatment, the patient was completely cured without any sequalae. In children after SARS-CoV-2 infection, PIMS could occur mimicking Kawasaki syndrome. At this time, in children virus PCR or antigen tests are usually negative already, but the presence of SARS-CoV-2 antibody could prove the preceding disease. Due to the increasing number of SARS-CoV-2 infections, the occurrence of post-SARS-CoV-2 PIMS in childhood is expected to increase. For paediatric patients, in case of severe septic state and multiple organ failure, PIMS should be also considered, which may require intensive care and targeted therapy. As far as we know, the described case is one of the earliest cases of PIMS in Hungary. Orv Hetil. 2021; 162(16): 602-607.


Asunto(s)
Dolor Abdominal/etiología , Fiebre/etiología , Inmunoglobulina G/sangre , Síndrome de Respuesta Inflamatoria Sistémica , Adolescente , /virología , Conjuntivitis/virología , Exantema/virología , Hospitalización , Humanos , Hungría , Inflamación/virología , Unidades de Cuidado Intensivo Pediátrico , Masculino , Insuficiencia Multiorgánica/virología , Choque Séptico/virología , Síndrome de Respuesta Inflamatoria Sistémica/sangre , Síndrome de Respuesta Inflamatoria Sistémica/virología
4.
Cent Eur J Public Health ; 29(1): 62-67, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33831288

RESUMEN

OBJECTIVES: This article investigates how the numbers of registered addict patients have changed in the last three decades in Hungary and whether the predicted HIV epidemic among intravenous drug users has occurred. METHODS: Data were collected from the Annual Reports of the National Bureau of Statistics and National Epidemiological Centre as well as from the medical records of the author. RESULTS: The total number of registered alcoholics decreased by about 75% during the investigated period. This decrease was more pronounced among males than females. After initial increase, the number of registered drug addicts showed stagnation with an about 50% drop-out rate. Fortunately, the anticipated HIV epidemic did not manifest. The negative effect of a poor political action upon the number of client visits could, however, be documented. CONCLUSION: In conclusion, negative trends are seen in the Hungarian addiction care. Numerous variables may be taken into consideration as affecting factors, but it is not yet clear to what extent these negative factors are responsible for trends. These data, however, warrant further investigations.


Asunto(s)
Atención Ambulatoria , Femenino , Humanos , Hungría/epidemiología , Masculino
5.
Nat Commun ; 12(1): 2255, 2021 04 15.
Artículo en Inglés | MEDLINE | ID: mdl-33859206

RESUMEN

Clarithromycin is a macrolide antibiotic widely used for eradication of Helicobacter pylori infection, and thus resistance to this antibiotic is a major cause of treatment failure. Here, we present the results of a retrospective observational study of clarithromycin resistance (Cla-res) in 4744 H. pylori-infected patients from Central Hungary. We use immunohistochemistry and fluorescence in situ hybridization on fixed gastric tissue samples to determine H. pylori infection and to infer Cla-res status, respectively. We correlate this information with macrolide dispensing data for the same patients (available through a prescription database) and develop a mathematical model of the population dynamics of Cla-res H. pylori infections. Cla-res is found in 5.5% of macrolide-naive patients (primary Cla-res), with no significant sex difference. The model predicts that this primary Cla-res originates from transmission of resistant bacteria in 98.7% of cases, and derives from spontaneous mutations in the other 1.3%. We find an age-dependent preponderance of female patients among secondary (macrolide-exposed) clarithromycin-resistant infections, predominantly associated with prior use of macrolides for non-eradication purposes. Our results shed light into the sources of primary resistant cases, and indicate that the growth rate of Cla-res prevalence would likely decrease if macrolides were no longer used for purposes other than H. pylori eradication.


Asunto(s)
Antibacterianos/farmacología , Claritromicina/farmacología , Farmacorresistencia Bacteriana/efectos de los fármacos , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/efectos de los fármacos , Adulto , Factores de Edad , Anciano , Antibacterianos/uso terapéutico , Claritromicina/uso terapéutico , Femenino , Mucosa Gástrica/microbiología , Mucosa Gástrica/patología , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/transmisión , Helicobacter pylori/aislamiento & purificación , Humanos , Hungría/epidemiología , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Modelos Biológicos , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Adulto Joven
6.
Artículo en Inglés | MEDLINE | ID: mdl-33800049

RESUMEN

Burnout is an increasingly prevalent syndrome mainly involving those working in human services. Although it is categorized as an occupational phenomenon and not as a medical condition, it seems to be strongly associated with several diseases such as pain syndromes. However, no studies examined the association between neuropathic low back pain and burnout. This questionnaire-based study was carried out between April 2019 and March 2020 in three main sites among teachers, social workers and healthcare workers. Demographic criteria included age, gender, marital status, number of children, type of work, years spent with work, work schedule, legal relation, secondary employment. Included diseases were diabetes, hypertension, ischemic heart disease, generalized pain (pain involving more than one area of the body) and depression. Low back pain was assessed by the painDETECT questionnaire, burnout was measured with the Maslach Burnout Inventory (MBI) and depression was measured by the Beck Depression Inventory. Dysfunctional attitudes were also recorded. Overall, 1500 questionnaires were successfully delivered and 1141 responses received (response rate of 76%). Three hundred social workers, 399 teachers, 339 paramedics, 35 doctors and 68 medical attendants have completed our survey. In a multivariate analysis including of all factors (demographic criteria, burnout, depression, dysfunctional attitudes, comorbidity etc.) neuropathic low back pain was associated with age > 62 (OR = 3.981, p = 0.01), number of children ≥ 2 (OR = 2.638, p = 0.003), job type (being a social worker) (OR = 6.654, p < 0.001), burnout (OR = 2.577, p < 0.001), current depression (OR = 2.397, p < 0.001), and suffering from generalized pain (OR= 4.076, p < 0.001). This is the first study showing the association of burnout and neuropathic low back pain, which is the most common cause of disability. Based on our results neuropathic low back pain and burnout have similar risk factors and consequences which raises the possibility of similar pathophysiology.


Asunto(s)
Agotamiento Profesional , Dolor de la Región Lumbar , Agotamiento Profesional/epidemiología , Agotamiento Psicológico , Niño , Estudios Transversales , Humanos , Hungría/epidemiología , Dolor de la Región Lumbar/epidemiología , Encuestas y Cuestionarios
7.
Sensors (Basel) ; 21(7)2021 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-33801571

RESUMEN

Propolis contains many effective antifungal compounds that have not yet been identified and evaluated. In addition, distinguishing samples of propolis with high antifungal activity from less active ones would be beneficial for effective therapy. Propolis samples were collected from four different geographical regions in Hungary and used to prepare ethanol extracts for analysis. First, an antifungal susceptibility test was performed on Candida albicans. Then, gas chromatography-mass spectrometry (GC-MS) and an opto-electronic nose were applied for the classification of propolis samples. In three propolis samples, the IC50 was measured between 72 and 134 µg/mL, but it was not calculable in the fourth sample. GC-MS analysis of the four propolis samples identified several compounds belonging to the various chemical classes. In the antifungal samples, the relative concentration of 11,14-eicosadienoic acid was the highest. Based on the opto-electronic electronic nose measurements, 98.4% of the original grouped antifungal/non-antifungal cases were classified correctly. We identified several molecules from propolis with potential antifungal properties. In addition, this is the first report to demonstrate the usefulness of a portable opto-electronic nose to identify propolis samples with high antifungal activity. These results may contribute to the rapid and efficient selection of new fungicide-candidate molecules and effective propolis samples for treatment.


Asunto(s)
Própolis , Antifúngicos/farmacología , Hungría , Pruebas de Sensibilidad Microbiana , Odorantes
8.
Orv Hetil ; 162(17): 668-675, 2021 04 10.
Artículo en Húngaro | MEDLINE | ID: mdl-33838025

RESUMEN

Összefoglaló. Bevezetés: A stroke kezelésének lehetoségei az utóbbi években jelentosen megváltoztak: a thrombolysis után bevezetésre került a mechanikus thrombectomia, és a terápiás idoablak is jelentosen kitágult az utóbbi évek nagy multicentrikus tanulmányai alapján. Ezek a lehetoségek új igényeket fogalmaztak meg a képalkotó diagnosztikával szemben: az ischaemia okozta morfológiai elváltozások mellett az artériás és a kollaterális rendszer állapotát, valamint bizonyos esetekben az agy szöveti perfúzióját is szükséges meghatározni. Ezeket a komplex kiértékelési feladatokat ma már mesterségesintelligencia-algoritmusok támogathatják, melyek a kiértékelést pár perc alatt elvégezve segítenek a terápiás döntés kialakításában. Célkituzés: A Dél- és a Nyugat-dunántúli régióban hat intézmény részvételével egy dedikált stroke teleradiológiai hálózat kialakítása. Módszer: A stroke-CT-kiértékelo szoftver és a képkommunikáció integrációja, a vizsgálati protokollok technikai paramétereinek egységesítése, a kiértékelési eredmények teleradiológiai megjelenítése valósult meg a hálózat kialakítása során. Eredmények: A hálózat egységesítette nemcsak a stroke-CT-protokollok beállításait, de beutalási és értékelési szempontjait is. A stroke-CT-kiértékelések és a mechanikus thrombectomiák száma is emelkedett az elmúlt egy évben. Következtetés: A dedikált teleradiológiai stroke-hálózat segítségével optimalizálni kívánjuk a régió stroke-ellátását: egyrészt lehetoleg ne maradjanak ellátatlanul a thrombectomiából valószínuleg profitáló betegek, másrészt ne terheljük az ellátórendszert olyan esetekkel, melyekrol a teljes dokumentáció ismeretében derül ki, hogy nem javasolt a beavatkozás. Orv Hetil. 2021; 162(17): 668-675. INTRODUCTION: The possibilities of cerebral stroke management have changed substantially during the last few years. Following a few multicentric studies, mechanical thrombectomy became an established method besides thrombolysis. In addition, the therapeutic window for both methods is much wider now than before. These changes described above demanded more information of CT morphological changes due to ischemia, but the condition and functionality of the arterial and collateral system, and occasionally tissue perfusion performance should also be characterized. Recently, evaluation of different computer tomographic (CT) measurements can be done using artificial intelligence based methods, which perform data analysis in a few minutes. OBJECTIVE: To establish a dedicated stroke teleradiology network with artificial intelligence based image analysis in Western and Southern Transdanubia in Hungary that involves six partner institutes. METHOD: Integration of automated image analysis with teleradiology software was established, and the technical parameters of examination protocols were unified. Results of stroke CT image analysis became accessible through the teleradiology network. RESULTS: The daily use of integrated central image analysis and image communication had a positive impact on referrals and therapeutic evaluation of stroke cases. The number of image processing and mechanical thrombectomy increased during the last year. CONCLUSION: With the help of the dedicated teleradiology stroke network, we want to optimize the stroke care in the region: on the one hand, patients who are likely to benefit from thrombectomy should not be left unattended, on the other, the health care system should not be burdened with cases, when intervention is not recommended having the complete clinical data accessed. Orv Hetil. 2021; 162(17): 668-675.


Asunto(s)
Accidente Cerebrovascular , Telerradiología , Inteligencia Artificial , Humanos , Hungría , Derivación y Consulta , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/terapia
9.
Artículo en Inglés | MEDLINE | ID: mdl-33808833

RESUMEN

It is a matter of speculation whether the high prevalence of smoking among Hungarian Roma (HR) is related to genetic, gene-environmental interactions or cultural factors. Our aim is to compare the genetic susceptibility and possible effects of determinants associated with smoking behaviours in the Hungarian general (HG) and Roma populations. A complex health survey including three pillars (questionnaire, physical and laboratory examinations) was carried out (NHG = 412 and NHR = 402). Risk allele frequencies of ten single-nucleotide polymorphisms (SNPs) were compared, and their combined effect was estimated by computing unweighted and weighted genetic risk scores (GRS, wGRS). The effects of genetic and environmental factors were investigated in regression analyses after confounders were introduced. Socio-economic status (SES) was calculated based on the Kuppuswamy scale 2019. Risk allele frequencies of only four SNPs were found to be different between populations (p < 0.01). Median values of GRS did not differ, while the wGRS median was slightly higher among Roma individuals (5.2 vs. 4.9; p = 0.02). Roma individuals were more likely to be heavy smokers (ORmales = 2.05, 95% CI [1.47-2.86]; ORfemales = 1.89, 95% CI [1.58-2.25]. Smokers have lower SES compared to never smokers (SES ßHR = -0.039, p = 0.023; ßHG = -0.010, p = 0.049). An inverse relationship was found between SES and smoking behaviours (p < 0.0001) and was found to be a better predictor of smoking behaviours than genetic susceptibility. Our study findings suggest that the high prevalence of smoking behaviours and nicotine-dependence were not revealed to have a genetic susceptibility among HR individuals; therefore, the highest efforts should be focused on targeting SES-related factors in the Roma population. Strengths of the study: This is the first study carried out to investigate and detect the most relevant factors and the possible genetic background of the extremely high prevalence of smoking based in the Roma population. Limitations of the study: No standard instrument has been used to assess the intensity of addiction to nicotine. Because of some participants' unwillingness to define themselves as Roma, the overall HR population was not represented by the sample of this study.


Asunto(s)
Predisposición Genética a la Enfermedad , Roma , Femenino , Humanos , Hungría , Masculino , Roma/genética , Fumar , Clase Social
10.
Wien Klin Wochenschr ; 133(Suppl 1): 1-21, 2021 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-33881635

RESUMEN

Pellagra is characterized by "dermatitis - diarrhea - dementia - death". Various causes were discussed over the course of two centuries. The initial presumption was that the sun caused changes in exposed areas of the body. The "Zeïsts" blamed the maize (corn), which forms the main constituent in the diet of poor peoples, for being an insufficient nutrient and thus causing the pellagra in such indigent populations. The "Toxikozeïsts", however, regarded toxins produced by innocuous bacteria and fungi in unripe or in ripe but badly stored maize or in maize flour or in poorly baked maize bread as the cause of pellagra. Pellagra as an allergic disease was also discussed. Self-experiments of Goldberger's group in 1916 and finally Elvehjem's detection of niacin deficiency in maize in 1937 solved the problem.In the Austrian empire and (from 1867 on) in the Austro-Hungarian monarchy, pellagra was diagnosed and combated in the provinces of Küstenland, Tirolia and Bukovina and in Hungary. Originally believing in the noxiousness of maize in the poor population, extensive measures were planned and partially executed. Primarily measures for providing salubrious maize products were planned for the population, such as public bakeries and eating houses, kilns and storage houses for maize. For the treatment of pellagra patients, so-called pellagrosaria and auxiliary hospitals were established and the number of general practitioners was increased. It was also important to educate the population about preventing pellagra by consuming proper food. Pellagra funds to sustain the measures were established. In the provinces, pellagra commissions, chaired by the governor and consisting of twelve experts of the relevant medical branches, were appointed as an advisory and expert body.


Asunto(s)
Pelagra , Austria , Diarrea , Humanos , Hungría , Pelagra/epidemiología , Pobreza
11.
Neuropsychopharmacol Hung ; 23(1): 184-207, 2021 Mar.
Artículo en Húngaro | MEDLINE | ID: mdl-33835041

RESUMEN

OBJECTIVES: This paper presents the methods and main methodological fi ndings of the third wave of data collection of the National Survey on Addiction Problems in Hungary (NSAPH). In addition to mapping the addiction problems of the Hungarian population and monitoring the general population addiction trends in Hungary, the research formulates objectives for the development of the methodology used in addiction research. The study presents the measurement tools used in the research, the sampling and data collection strategy, as well as the methodological results related to sample access and the reliability and validity of the applied measurement tools used. METHODS: The research was carried out on a nationally representative sample of the Hungarian adult population aged 16-64 yrs (gross sample 1800, net sample 1385 persons). The extent of the theoretical margin of error in the sample is ±2,6%, at a reliability level of 95%. Sample attrition was corrected by matrix weighting by layer categories. The research aimed at studying the different type substance use behaviours (smoking, alcohol use and other psychoactive substances) as well as several behavioural addictions (problematic internet use, problematic online gaming, problematic social media use, problematic gambling, exercise addictions, eating disorders, work addiction, compulsive buying, problematic mobile phone use). RESULTS: Based on the analysis of reliability and the extent of non-sampling errors within the context of the database we concluded that valid and reliable statements can be formulated on the basis of the research data regarding the current characteristics and patterns of the examined addiction behaviours. At the same time, in case of psychoactive substance use the observed trends of non-sampling errors indicate that the analysis of the changes requires outstanding attention whilst interpreting them; in some cases correction procedures might become necessary during estimating and interpreting the tendencies. This wave of the research was the first which examined the reliability and validity of prevalence data related to behavioural addictions. Based on this analysis it can be said that these data are less exposed to non-sampling errors than the ones related to substance use.


Asunto(s)
Conducta Adictiva , Juego de Azar , Adolescente , Adulto , Conducta Adictiva/epidemiología , Juego de Azar/epidemiología , Humanos , Hungría , Persona de Mediana Edad , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Adulto Joven
12.
Neuropsychopharmacol Hung ; 23(1): 221-231, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33835044

RESUMEN

OBJECTIVES: Patients' attitude towards treatment is one of the most signifi cant factors which has determining eff ect on suffi cient adherence. Data are lacking on Hungarian patients' attitude towards psychiatric treatment, however, high prevalence of suicide suggests that eff ectiveness of psychiatric treatments need to be improved. To pave the way for such studies, we performed the validation of the recently developed Patients' Health Belief Questionnaire on Psychiatric Treatment (PHBQPT) in a sample of Hungarian psychiatric patients. METHODS: We enrolled 188 Hungarian patients diagnosed with psychiatric disorders. The PHBQPT was translated into Hungarian by our group. Comparison of item and subscale mean scores with the original data are presented. Internal consistency, item-total and item-item correlations were calculated and factorial structure was analysed. RESULTS: Single item means, the highest item score and subscale mean scores were similar to data published in the original article. The factorial analysis confi rmed the validity of a fi ve-subscale structure in our sample. The eff ects of gender and age were not signifi cant on any of the subscales. CONCLUSIONS: The PHBQPT is a valid, reliable instrument with replicable psychometric properties. The Hungarian version is suitable for clinical practice and for further investigations on attitudes towards psychiatric treatment.


Asunto(s)
Trastornos Mentales , Humanos , Hungría , Trastornos Mentales/terapia , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
13.
Psychiatr Hung ; 36(2): 124-142, 2021.
Artículo en Húngaro | MEDLINE | ID: mdl-33870901

RESUMEN

INTRODUCTION: Even though mental disorders present significant health burden worldwide, most patients with mental disorders do not receive adequate healthcare. The possibility of telemental health service came into prominence in Hungary due to the restriciton of face-to-face doctor-patient meetings. The present review, based on the last 20 years' scientific literature, aims to summarize the feasability, efficacy and effectivity of telemedicine services in child and adolescent psychiatry. METHOD: A review by Gloff et al (17) summarized telepsychiatry service in children and adolescents before 2015. A literature search was generated in order to summarize current knowledge based on 3 international databases (Pubmed, Cochrane Database of Systematic Reviews és Web of Science) for scientific publi - cations after 2015. Search words were telemental health, children, adolescent, and telepsychiatry. RESULTS: International literature showed similar feasability, efficacy and effectivity of evidence based diagnostic and therapeutic methods in tele- child and adolescent psychiatry as in face-to-face services. CONCLUSION: The application of telemedicine in child and adolescent psychiatry is internationally accepted, feasible and effective. Its widespread use in Hungary would require a professional protocol which specifies the conditions and advices of telemental health services in this age group.


Asunto(s)
Psiquiatría Infantil , Trastornos Mentales , Servicios de Salud Mental , Telemedicina , Adolescente , Psiquiatría del Adolescente , Niño , Humanos , Hungría , Trastornos Mentales/diagnóstico , Trastornos Mentales/terapia
14.
Psychiatr Hung ; 36(2): 187-208, 2021.
Artículo en Húngaro | MEDLINE | ID: mdl-33870905

RESUMEN

INTRODUCTION: In Hungary, the use of music in rehabilitation is a scarcely researched area. In this study we aimed to examine the structure, purpose, and role of music activities conducted at the Department of Psychiatry, University of Szeged. We studied the rehabilitation programs of psychiatric patients and the role of music activities in healing and reintegration. All of this has been compared to the structure, timing and effectiveness of music therapy methods used worldwide. METHODS: The 10-person sample consisted of patients participating in the rehabilitation program of the department, who agreed to attend music sessions there over a two-week interval. During the first and last interventions, we mea - sured patient satisfaction with life, perceived social support, and levels of depression and trait anxiety. In addition, we measured changes in anxiety during a single music session, and a short structured interview was completed with each patient at the time of the last session. RESULTS: Our results show that patients' perceived social support increased (t[9]=-3,61, p< 0,01) during the intervention period - especially regarding the family dimension (t[9]=-2,57 , p=0,03). The level of anxiety decreased (t[9]=2,42, p=0,03), and the level of depression also showed a marginally significant decrease (t[9]=2,11, p= 0,06). No significant differences were found in the changes of life satisfaction and the immediate anxiety-relieving effect of music practice. The content of the interviews however confirmed that there is indeed an immediate anxiety-relieving effect of a single music session. DISCUSSION: To summarise the quantitative and qualitative data, it can be stated that the music activities of the department are several points in line with the international practice, and operate with low risk and high efficiency. The work done here has confirmed that music activities can be an effective method along with the clinical treatments and play an important role in the rehabilitation process.


Asunto(s)
Musicoterapia , Música , Rehabilitación Psiquiátrica , Ansiedad , Humanos , Hungría
15.
Orv Hetil ; 162(13): 488-496, 2021 03 28.
Artículo en Húngaro | MEDLINE | ID: mdl-33774599

RESUMEN

Összefoglaló. Bevezetés: Az elso szaruhártya-bank 1944-es alapítása óta jelentos változásokon ment át. A szaruhártya túlélését számos tényezo befolyásolja, így a tárolási mód, melynek a szövet lejárati ideje szerint rövid, közép és hosszú távú módszereit fejlesztették ki. Célkituzés: Retrospektív vizsgálatunk célja a 2008. január 1. és 2017. december 31. között perforáló és lamelláris keratoplasztika során felhasznált cadaverbol és multiorgan donorból származó szaruhártyák túlélésének vizsgálata volt a Semmelweis Egyetem Szemészeti Klinikáján. Módszer: Feljegyeztük a recipiens nemét, életkorát, a mutétet indikáló klinikai diagnózist, a mutét idopontját, a szövettani vizsgálat eredményét, valamint, hogy a beültetett szaruhártya cadaverbol vagy multiorgan donorból származott. Meghatároztuk, hogy a recipiens életkora korrelált-e a rekeratoplasztikáig eltelt idovel. Eredmények: 1451 szaruhártya-átültetés történt 1088 beteg (44,6% férfi) 1159 szemén (életkor 62,8 ± 18,5 év), melyek között 938 (64,6%) cadaver és 262 (18,0%) multiorgan donor került felhasználásra, 251 esetben (17,2%) nem állt rendelkezésre adat. A leggyakoribb primer diagnózis a szaruhártya-dekompenzáció volt (325 eset, 28%). A primer keratoplasztikák során felhasznált szaruhártyák 740 esetben (63,8%) cadaverbol, 212 esetben (18,2%) multiorgan donorból származtak, 207 esetben (17,8%) nem állt rendelkezésre adat. Elso rekeratoplasztika a primer keratoplasztikák közül 217 esetben (18,7%) történt. A leggyakoribb szövettani diagnózis az endothelsejt-degeneráció volt (130 esetben, 60,4%). 146 esetben (67,2%) korábban cadaver, 31 esetben (14,2%) multiorgan donor esetén került sor ismételt mutétre, 40 esetben (18,4%) nem állt rendelkezésre adat. Következtetés: Klinikánkon elsosorban cadaverbol származó donorok biztosítják a szaruhártya átültetésekhez szükséges szövetet. Cadaverbol vagy multiorgan donorból származó szaruhártyák esetén nem kerül gyakrabban sor rekeratoplasztikára. A szaruhártya-banki tevékenység további fejlesztésével növelheto a donorok túlélése hazánkban. Orv Hetil. 2021; 162(13): 488-496. INTRODUCTION: Corneal banking methods have been changing since the foundation of the first corneal bank in 1944. Corneal graft survival may be affected by several factors, among others the storage method, which may be short-, middle- and long-term storage. OBJECTIVE: To investigate corneal graft survival at the Department of Ophthalmology, Semmelweis University between 1 January 2008 and 31 December 2017, using cadaver and multiorgan donors for penetrating and lamellar keratoplasty, retrospectively. METHOD: Recipient sex, age, clinical diagnosis, date of surgery, histological examination results and origin of donors (cadaver or multiorgan donor) were recorded. Correlation between recipient age and time to repeat keratoplasty was also analyzed. RESULTS: There were 1451 keratoplasties in 1159 eyes (age 62.8 ± 18.5 years) of 1088 patients (44.6% male) using 938 (64.6%) cadaver and 262 (18.0%) multiorgan donors, data was not available in 251 (17.2%) cases. There was repeat keratoplasty in 217 patients (18.7% of first keratoplasties). The most common histological diagnosis was endothelial decompensation (130 cases, 60.4%) in these cases. In patients with a first repeat keratoplasty, in 146 cases (67.2%) the first donor originated from cadavers, in 31 cases (14.2%) from multiorgan donors and in 40 cases (18.4%) data were not available. CONCLUSION: Corneal donors mainly originate from cadavers at our Department. The necessity of repeat keratoplasties does not differ using cadaver or multiorgan donors. With further development of corneal banking, donor survival may be increased in Hungary. Orv Hetil. 2021; 162(13): 488-496.


Asunto(s)
Trasplante de Córnea , Supervivencia de Injerto , Adulto , Anciano , Anciano de 80 o más Años , Cadáver , Femenino , Humanos , Hungría , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Donantes de Tejidos/estadística & datos numéricos
16.
Orv Hetil ; 162(13): 504-513, 2021 03 28.
Artículo en Húngaro | MEDLINE | ID: mdl-33774601

RESUMEN

Összefoglaló. Bevezetés: A tumorsebészetben a malnutritio független rizikófaktor. A kockázatcsökkentés egyik fontos eleme a perioperatív tápláltsági állapot felmérésén alapuló klinikai táplálás. Az irodalomban jól dokumentált az idoben végzett rizikószurés fontossága, de ennek módja, különösen hazai környezetben, kidolgozatlanabb. Célkituzés: A malnutritio szempontjából esendobb csoportot alkotó onkológiai sebészeti betegek azonosíthatóságának igazolása, a szurési metódus vizsgálata. Módszer: 2016. október és 2018. november között öt kórcsoportban (emlo, máj, pancreas, mellkas, gyomor-bél rendszer) az igazolt vagy gyanított malignitás, illetve gyulladásos bélbetegség miatt mutétre váró betegeket telemedicina-módszerrel kerestük fel. A rizikócsoportokat (nincs rizikó - alultápláltság valószínusítheto - súlyos alultápláltság) a sebész és dietetikus által közösen vezetett 'Nutritional Risk Score 2002' (NRS 2002) szuro pontrendszerrel állapítottuk meg. Az NRS 2002 pontértékeket a posztoperatív lefolyással vetettük össze (kórházi tartózkodás, 30 napon belüli szövodmények Clavien-Dindo szerinti osztályozása). Prospektív vizsgálatunkban 1556 beteg szerepel. Eredmények: Az emlosebészeti betegek (n = 314) 95,2%-a rizikómentes. A májreszekcióra várók (n = 79) 43%-a valószínuleg vagy biztosan alultáplált. A hasnyálmirigymutétre elojegyzett betegek (n = 122) 81,2%-a emelt rizikójú. A kuratív célú pancreasreszekción átesett betegek pontértéke alacsonyabb, mint a palliatív mutétben részesüloké (p>0,05). A tüdoreszekcióra váró (n = 219) betegeknél 40,7% került emelt rizikócsoportba. Az emelkedett NRS 2002 érték magasabb szövodményaránnyal járt (p<0,05). Béltraktust érinto mutétek (n = 822) esetén a betegek 71,2%-a valószínuleg vagy biztosan súlyosan alultáplált. Az elorehaladott tumorok és a szövodmények egyaránt eros összefüggést mutattak az NRS 2002 értékkel (p<0,01). Következtetés: Az NRS 2002 szuromódszer prediktív értékkel bír mind a tumorstádium, mind a szövodmények tekintetében. Módszerünkkel idoben felismerheto a fokozott rizikót jelento betegcsoport, így a pontérték alapján célzott mesterséges táplálás tervezheto. Orv Hetil. 2021; 162(13): 504-513. INTRODUCTION: Malnutrition is an independent risk factor in oncologic surgery. Perioperative screening and aimed clinical nutrition are key elements in risk reduction. The importance of timely screening has been well published, but its method is underdeveloped, especially in Hungary. OBJECTIVE: Evaluation of a malnutrition screening method to identify patients at risk in oncologic surgery. METHOD: Patients were enrolled from October 2016 to November 2018 in five groups (breast, liver, pancreas, thoracic and gastrointestinal surgery). All patients awaiting surgery for suspected or proven malignancy or for inflammatory bowel disease were screened preoperatively via telephone (telemedicine). Probability for malnutrition (no risk - suspicion for malnutrition - severe malnutrition) was jointly assessed by surgeon and dietitian using Nutritional Risk Score 2002 (NRS 2002). Screening results were compared to the postoperative course (including length of stay and 30-day morbidity/mortality using Clavien-Dindo classification). A total of 1556 patients were identified prospectively. RESULTS: 95.2% of breast surgery patients (n = 314) were not at risk. Malnutrition was suspected or detected in 43% of patients awaiting liver resection (n = 79). Increased risk is present in 81.2% of pancreatic surgery cases (n = 122). Pancreas resections with curative intent were associated with lower scores than in palliative operations (p>0.05). 40.7% of the 219 patients scheduled for lung resection had increased malnutrition risk. Higher NRS 2002 resulted in increased morbidity rate (p<0.05). Surgery on the intestines was performed on 822 cases. 71.2% of them had suspected or severe malnutrition. Presence of advanced cancer and complication rate showed strong relations with increased NRS 2002 (p<0.01). CONCLUSION: Screening with NRS 2002 has predictive value on both tumor stage and complications. Our method is sound to identify patients at malnutrition risk in time, and thus an aimed clinical nutrition therapy can be planned. Orv Hetil. 2021; 162(13): 504-513.


Asunto(s)
Desnutrición , Tamizaje Masivo , Neoplasias , Atención Perioperativa , Femenino , Humanos , Hungría , Desnutrición/diagnóstico , Tamizaje Masivo/métodos , Neoplasias/cirugía , Valor Predictivo de las Pruebas , Factores de Riesgo
17.
Orv Hetil ; 162(162 Suppl 1): 14-21, 2021 03 28.
Artículo en Húngaro | MEDLINE | ID: mdl-33774604

RESUMEN

Összefoglaló. Bevezetés: Magyarországon a vastag- és a végbéldaganat mindkét nem esetében a harmadik leggyakoribb daganatos megbetegedés és a második leggyakoribb halálok. Célkituzés: Elemzésünk célja volt a vastag- és végbéldaganat okozta éves epidemiológiai és egészségbiztosítási betegségteher meghatározása Magyarországon. Adatok és módszerek: Az adatok a Nemzeti Egészségbiztosítási Alapkezelo (NEAK) finanszírozási adatbázisából származnak, és a 2018. évet fedik le. A daganat típusait a Betegségek Nemzetközi Osztályozása (BNO, 10. revízió) szerinti C18-as, C19-es, C20-as, C21-es, D010-D014-es és D12-es kóddal azonosítottuk. Meghatároztuk az éves betegszámokat korcsoportos és nemek szerinti bontásban, a prevalenciát 100 000 lakosra, az éves egészségbiztosítási kiadásokat valamennyi ellátási formára és daganattípusra vonatkozóan. Eredmények: A vastag- és végbéldaganatok kezelésére a NEAK 21,7 milliárd Ft-ot (80,2 millió USD; 68,0 millió EUR) költött 2018-ban. A költségek 58,0%-át az aktívfekvobeteg-szakellátás költségei teszik ki. Az összköltségek megoszlása szerint a legmagasabb költségek a férfiaknál (4,98 milliárd Ft) és a noknél (3,25 milliárd Ft) is a 65-74 éves korcsoportban figyelhetok meg. A legnagyobb betegszámot a járóbeteg-szakellátás esetében találtuk: 88 134 fo, ezt a háziorvosi ellátás (55 324 fo) és a CT, MRI (28 426 fo) követte. A vastagbél rosszindulatú daganata esetében az egy betegre jutó aktívfekvobeteg-kassza alapján az éves egészségbiztosítási kiadás 1,206 millió Ft (4463 USD/3782 EUR) volt a férfiak és 1,260 millió Ft (4661 USD/3950 EUR) a nok esetében. Következtetés: Hazánkban az aktívfekvobeteg-szakellátás bizonyult a fo költségtényezonek, mely magában foglalja az onkoterápiás gyógyszeres költségeket is. Orv Hetil. 2021; 162(Suppl 1): 14-21. INTRODUCTION: Colorectal cancer is the third most common type of cancer and the second most common cause of mortality in Hungary in both sexes. OBJECTIVE: The aim of our study was to determine the annual epidemiological disease burden and health insurance cost of colorectal cancer in Hungary. DATA AND METHODS: Data were derived from the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for the year 2018. Types of cancer were identified with the following codes of the International Classification of Diseases, 10th revision: C18, C19, C20, C21, D010-D014, D12. The data analysed included annual patient numbers according to age groups and sex, prevalence of care utilisation per 100 000 population, and annual health insurance costs for all types of care and all cancer types. RESULTS: In 2018, NHIFA spent 21.7 billion HUF (80.2 million USD, 68.0 million EUR) on the treatment of colorectal cancer. 58.0% of the costs was spent on acute inpatient care. Regarding total costs, the highest costs were found in the 65-74 age group in both men (4.98 billion HUF) and women (3.25 billion HUF). The highest patient numbers were in outpatient care: 88 134 patients, general practice care (55 324 patients) and CT, MRI (28 426 patients). The annual health care treatment cost per patient was 1.206 million HUF (4463 USD/3782 EUR) in men and 1.260 million HUF (4661 USD/3950 EUR) in women. CONCLUSION: Acute inpatient care, including the costs of oncotherapeutic pharmaceuticals, was found to be the major cost driver in Hungary. Orv Hetil. 2021; 162(Suppl 1): 14-21.


Asunto(s)
Neoplasias Colorrectales , Costo de Enfermedad , Neoplasias Colorrectales/economía , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/terapia , Femenino , Costos de la Atención en Salud/estadística & datos numéricos , Humanos , Hungría/epidemiología , Seguro de Salud/economía , Masculino
18.
Orv Hetil ; 162(162 Suppl 1): 22-29, 2021 03 28.
Artículo en Húngaro | MEDLINE | ID: mdl-33774605

RESUMEN

Összefoglaló. Bevezetés: A méhnyakdaganatok kérdése kiemelten fontos, megoldatlan népegészségügyi probléma. A betegség terhe magas, ami elsosorban az alacsony és közepes jövedelmu országokban éloknél jelentkezik. Célkituzés: Elemzésünk célja volt meghatározni a méhnyakdaganatok epidemiológiai és egészségbiztosítási betegségterhét Magyarországon a 2018-as évre vonatkoztatva. Adatok és módszerek: Elemzésünket a Nemzeti Egészségbiztosítási Alapkezelo (NEAK) finanszírozási adatbázisának 2018. évi adatai alapján végeztük az in situ (D06), a jóindulatú (D26.0) és a malignus (C53) méhnyakdaganatokra vonatkozóan. Az elemzés a NEAK által finanszírozott összes szolgáltatóra és ellátási formára kiterjed. Meghatároztuk az éves betegszámokat, a prevalenciát 100 000 lakosra, továbbá az éves egészségbiztosítási kiadásokat betegségcsoportonként és korcsoportos bontásban, valamennyi egészségbiztosítási ellátás tekintetében. Eredmények: A NEAK 2018-ban 1,276 milliárd Ft-ot (4,7 millió USD; 4,0 millió EUR) költött a méhnyakdaganatok kezelésére. A betegek és a finanszírozás dönto többsége a méhnyak rosszindulatú daganatához kapcsolható. A finanszírozásból a malignus méhnyakdaganatok részesedése 97%. Ellátási típusonként vizsgálva a legnagyobb kiadási tétel az aktívfekvobeteg-szakellátásban jelenik meg, éves szinten 763,9 millió Ft, ami az összköltség 59,9%-a. A 100 000 lakosra jutó prevalencia az aktívfekvobeteg-szakellátás igénybevételi adatai alapján 26/100 000 lakos. Következtetés: A méhnyakdaganatok kezelésének meghatározó költségeleme az aktívfekvobeteg-szakellátás. Hazánkban a szervezett méhnyakszurés korszerusítéseként az új szurési stratégiát megfelelo finanszírozási támogatással célszeru bevezetni, a szurovizsgálatoknak, a hozzájuk kapcsolódó további diagnosztikus kivizsgálásnak és terápiának a teljesítményvolumen-korlát alóli mentesítésével. Orv Hetil. 2021; 162(Suppl 1): 22-29. INTRODUCTION: Cervical cancer is a particularly important, unresolved public health problem. The burden of the disease is high, primarily in those living in low- and middle-income countries. OBJECTIVE: Our aim was to determine the annual epidemiological disease burden and health insurance cost of cervical cancer in Hungary in 2018. DATA AND METHODS: Our analysis was made according to the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for the year 2018, which covers all service providers and maintenance forms financed by NHIFA. We analysed the in situ (D06), the benignant (D26.0) and the malignant (C53) cervical tumours. The data analysed included annual patient numbers and prevalence of care utilisation per 100 000 population furthermore annual health insurance costs calculated for disease and age groups. RESULTS: In 2018, NHIFA spent 1.276 billion HUF (4.7 million USD, 4.0 million EUR) on the treatment of patients with cervical cancer. The majority of patients and funding can be linked to malignant cervical cancer (97%). Acute inpatient care was the major cost driver: 763.9 million HUF (59.9% of the total health insurance expenditures) annually. The prevalence is 26 per 100 000 population based on acute inpatient care data. CONCLUSION: Acute inpatient care was the major cost driver. In Hungary, as a modernization of organized cervical screening, it is appropriate to introduce a new screening strategy with appropriate financial support, by exempting screening tests, associated additional diagnostic testing, and therapy from the performance volume limit. Orv Hetil. 2021; 162(Suppl 1): 22-29.


Asunto(s)
Costo de Enfermedad , Neoplasias del Cuello Uterino , Femenino , Humanos , Hungría/epidemiología , Seguro de Salud/economía , Neoplasias del Cuello Uterino/economía , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/terapia
19.
Orv Hetil ; 162(162 Suppl 1): 30-37, 2021 03 28.
Artículo en Húngaro | MEDLINE | ID: mdl-33774606

RESUMEN

Összefoglaló. Bevezetés: A rheumatoid arthritisszel kapcsolatos szolgáltatások igénybevétele nagy teher az egészségügyi rendszerek számára. Célkituzés: Elemzésünk célja volt a rheumatoid arthritis okozta éves epidemiológiai és egészségbiztosítási betegségteher meghatározása Magyarországon. Adatok és módszerek: Az elemzésben felhasznált adatok a Nemzeti Egészségbiztosítási Alapkezelo (NEAK) finanszírozási adatbázisából származnak, és a 2018. évet fedik le. Meghatároztuk az éves betegszámokat, a prevalenciát 100 000 lakosra, továbbá az éves egészségbiztosítási kiadásokat korcsoportos és nemenkénti bontásban valamennyi egészségbiztosítási ellátás tekintetében. A rheumatoid arthritis kórképet fodiagnózisként a Betegségek Nemzetközi Osztályozása (BNO, 10. revízió) szerinti M0690-es kóddal azonosítottuk. Eredmények: Meghatározó betegforgalmat a gyógyszerek ártámogatása esetében találtunk: 7015 férfi, 23 696 no, együtt 30 711 fo. A gyógyszer-ártámogatás betegforgalmi adatai alapján a 100 000 fore eso prevalencia férfiaknál 150,2 fo, noknél 464,0 fo, együtt 314,1 fo volt. A rheumatoid arthritis kezelésére a NEAK 1,64 milliárd Ft-ot (6,07 millió USD, illetve 5,14 millió EUR) költött 2018-ban. A kiadások 19,3%-a férfiaknál, míg 80,7%-a noknél jelenik meg. A gyógyszer-ártámogatás (az összes kiadás 42,8%-a), a járóbeteg-szakellátás (21,9%) és az aktívfekvobeteg-szakellátás (12,4%) voltak a meghatározó költségelemek. Az egy betegre jutó átlagos éves egészségbiztosítási kiadás 53 375 Ft (198 USD/167 EUR) volt. Következtetés: A gyógyszerek ártámogatása bizonyult a fo költségtényezonek. A rheumatoid arthritis elofordulási gyakorisága 3,1-szer magasabb a nok esetében a férfiakhoz képest. Orv Hetil. 2021; 162(Suppl 1): 30-37. INTRODUCTION: Utilisation of services related to the treatment of rheumatoid arthritis poses a great burden for healthcare systems. Objecive: Our aim was to determine the annual epidemiological disease burden and the health insurance treatment cost of rheumatoid arthritis in Hungary. DATA AND METHODS: Data were derived from the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary, for the year 2018. The data analysed included annual patient numbers and prevalence per 100 000 population and annual health insurance treatment costs calculated for age groups and sex according to all health insurance treatment categories. Patients with rheumatoid arthritis were identified as main diagnosis with the following code of the International Classification of Diseases, 10th revision: M0690. RESULTS: We found a significant patient turnover in pharmaceutical reimbursement: 7015 men, 23 696 women, in total 30 711 patients. Based on patient numbers in pharmaceuticals, prevalence for 100 000 population among men was 150.2 patients, among women 464.0, in total 314.1 patients. In 2018, NHIFA spent 1.64 billion HUF (6.07 million USD, 5.14 million EUR) on the treatment of patients with rheumatoid arthritis. 19.3% of the costs was spent on the treatment of male, 80.7% on female patients. Pharmaceuticals (42.8% of the total expenditures), outpatient care (21.9%) and acute inpatient care (12.4%) were the main cost drivers. Average annual health insurance treatment cost per patient was 53 375 HUF (198 USD/167 EUR). CONCLUSION: Pharmaceutical reimbursement was the major cost driver. The prevalence of rheumatoid arthritis was by 3.1 higher in women compared to men. Orv Hetil. 2021; 162(Suppl 1): 30-37.


Asunto(s)
Artritis Reumatoide , Costo de Enfermedad , Artritis Reumatoide/economía , Artritis Reumatoide/epidemiología , Artritis Reumatoide/terapia , Femenino , Humanos , Hungría/epidemiología , Seguro de Salud/economía , Masculino
20.
Orv Hetil ; 162(162 Suppl 1): 38-45, 2021 03 28.
Artículo en Húngaro | MEDLINE | ID: mdl-33774607

RESUMEN

Összefoglaló. Bevezetés: Az idegrendszeri károsodás az egyik leggyakrabban kialakuló komplikáció a cukorbetegek körében, mely az egyénnek és a finanszírozónak is jelentos terhet jelent. Célkituzés: Elemzésünk célja volt a diabeteses polyneuropathia okozta epidemiológiai és egészségbiztosítási betegségteher elemzése. Adatok és módszerek: Az adatok a Nemzeti Egészségbiztosítási Alapkezelo (NEAK) finanszírozási adatbázisából származnak, és a 2018. évet fedik le. Meghatároztuk az éves betegszámokat és a 100 000 lakosra jutó igénybevételi prevalenciát, továbbá az éves egészségbiztosítási kiadásokat korcsoportos és nemenkénti bontásban és ellátási típusonként. A vizsgált kórképet a Betegségek Nemzetközi Osztályozása (10. revízió) szerinti G6320-as kóddal azonosítottuk. Eredmények: A diabeteses polyneuropathia kezelésére a NEAK 6,63 milliárd Ft (24,52 millió USD; 20,78 millió EUR) egészségbiztosítási kiadást fordított 2018-ban. E költségek legnagyobb hányadát a gyógyszerek ártámogatása adta (78,29%). A teljes népességre számolt, 100 000 fore vetített prevalencia 862/100 000 fo volt a férfiak, 981/100 000 fo a nok esetében, együtt 924/100 000 fo a járóbeteg-szakellátásban. A 65-74 évesek jelentek meg a legnagyobb számban az egyes ellátási szinteken. A nemek eloszlása között a legtöbb vizsgált korcsoport tekintetében számottevo különbség nem tapasztalható, 65 év felett azonban már jóval magasabb a nok aránya. Következtetés: A betegség elofordulási gyakorisága a nok esetében 15,6%-kal magasabb. Idosebb korban jelentosen magasabb betegszámot figyeltünk meg. A neuropathiás szövodmények elkerülése érdekében a terápiás kezelésen túl a megelozésre is sokkal nagyobb figyelmet javasolunk fordítani. Orv Hetil. 2021; 162(Suppl 1): 38-45. INTRODUCTION: Neurological complications are the most common type of complications among type 2 diabetes mellitus patients, which put a heavy burden on both individuals and health insurance organizations. OBJECTIVE: The aim of our study was to determine the epidemiological and health insurance disease burden of non-insulin-dependent diabetes with neurological complications. DATA AND METHODS: Data were derived from the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for the year 2018. Data analysed included annual patient numbers and prevalence of care utilisation per 100 000 population according to age groups and sex. Patients were identified with the following code of the International Classification of Diseases, 10th revision: G6320. RESULTS: In 2018, NHIFA spent 6.63 billion HUF (24.52 million USD; 20.78 million EUR) on treating diabetic polyneuropathy. Reimbursement of pharmaceuticals was the main cost driver (78.29% of total expenditure). Based on patient numbers in outpatient care, prevalence in 100 000 population was 862 men, 981 women, together 924 people based on outpatient-care utilization. Most patients were aged between 65-74 years in all forms of care. Regarding sex, no significant differences were found among most age groups, however, the ratio of women tends to be higher above 65 years of age. CONCLUSION: Prevalence was found to be by 15.6% higher among women. Significantly higher patient numbers were found in old age. Besides therapeutic interventions, prevention should gain considerably more attention to avoid polyneuropathic complications. Orv Hetil. 2021; 162(Suppl 1): 38-45.


Asunto(s)
Costo de Enfermedad , Neuropatías Diabéticas , Anciano , Diabetes Mellitus Tipo 2/complicaciones , Neuropatías Diabéticas/economía , Neuropatías Diabéticas/epidemiología , Neuropatías Diabéticas/terapia , Femenino , Costos de la Atención en Salud/estadística & datos numéricos , Humanos , Hungría/epidemiología , Seguro de Salud/economía , Masculino
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