[The role of homocysteine and methylenetetrahydrofolate reductase, methionine synthase, methionine synthase reductase polymorphisms in the development of cardiovascular diseases and hypertension]. / A homocisztein és a metilén-tetrahidrofolát-reduktáz, metionin-szintáz, valamint a metionin-szintáz-reduktáz génpolimorfizmusok szerepe a cardiovascularis megbetegedésekben és a magas vérnyomás kialakulásában.

Cardiovascular diseases (CVDs) are the leading causes of death in the developed countries. Elevated homocysteine level is as an independent risk factor of CVDs. The C677T and A1298C variants of methylenetetrahydrofolate reductase gene (MTHFR) have been shown to influence folate and homocysteine metabolisms. However, the relationship between MTHFR polymorphisms and hyperhomocysteinemia has not been well established yet. The gene variants were also reported to be associated with CVDs. In addition, the C677T polymorphisms may play a role in the development of hypertension. Recent research evidence has suggested that MTHFR variants might be independently linked to CVDs and hypertension, because of the involvement of the MTHFR enzyme product (5-methyl-tetrahydrofolate /5-MTHF) in the regulation of endothelial functions. Further research is required to investigate the association between gene polymorphisms of folate-metabolizing enzymes and CVDs, and to identify the possible role of the relevant gene variants in the molecular pathogenesis of hyperhomocysteinemia.

Permanent stress may be the trigger of an acute myocardial infarction on the first work-day of the week.

Numerous studies have reported the weekly variation of an acute myocardial infarction. The Monday peek has been connected with higher rate of physical and mental, work-related stress. We wished to study the weekly variation of an acute myocardial infarction (AMI) in the group of workers and pensioners, and to find out whether National Holidays on the first day of the week could influence the weekly rhythm of an acute myocardial infarction. We carried out the retrospective analysis of patients admitted to Hungarian hospitals with the diagnose of an AMI (n=90,187) between 2002 and 2007. According to the morbidity data of an AMI, the weekly peek was detected on the first work-day of the week, showing a gradually decreasing tendency until the end of the week. Morbidity rates on Mondays being National Holidays were similar to the number of events on Saturdays and Sundays (Z=-24,431; p<0.001). There was a significant difference between the number of events on work-days and weekends (Z=-27,321; p<0.001). No marked difference was found between workers under the age of 65 and pensioners above the age of 65, or between the two sexes. The results of our study reveal that the occurrence of an AMI shows characteristic changes throughout the days of the week, and the first work-days of the week may be related to higher incidence of an acute myocardial infarction.

The time of sunrise and the number of hours with daylight may influence the diurnal rhythm of acute heart attack mortality.

We investigated whether the time of sunrise and the number of daylight hours have an effect on the seasonality, or the daily rhythm of heart attack mortality. We analyzed retrospectively data of patients admitted to hospitals with the diagnosis of heart attack (n=32,329) and patients who deceased of a heart attack (n=5142) between January 1, 2004 and December 31, 2005 in Hungary. Heart attack mortality was highest during winter, while lowest number of events was recorded during summer . The daily peak of diurnality was between 6:00 am and 12:00 pm (33.77%). A positive correlation was found between the time of sunrise, time of sunset and the mortality caused by myocardial infarction (p<0,01). In the analysis of the number of daylight hours and the heart attack mortality we found a negative correlation (r=-0.105, p<0.05). No significant difference was found between sexes and different age-groups in heart attack mortality. Our data suggest, that the occurrence and the mortality of heart attack may be related to the time of sunrise and the number of daylight hours.

The disease burden of colorectal cancer in Hungary.

The aim of the paper is to give an overview of the epidemiology, treatment pattern and quality, as well as policy issues and disease burden of colorectal cancer (CRC) in Hungary. Colorectal cancer is the second most common cause of cancer-related death in both males and females in Hungary. The Hungarian Cancer Registry collects data on the epidemiological characteristics of CRC. Two pilot programmes (1997/1998 and 2003/2004) were conducted for population-based screening of CRC using both immunological and guaiac faecal occult blood testing (FOBT). The National Health Insurance Fund Administration (NHIFA) spends altogether 38.9 million a year on the treatment of CRC. It is hoped that the introduction of an accepted and cost-effective screening programme for CRC can reduce the high CRC burden in Hungary.

Time of sunrise and hours with daylight may have an effect on the seasonality and diurnal variation of heart attack.

BACKGROUND: The time of onset of myocardial infarction shows seasonal and daily variation. We aimed to investigate whether the number of hours with daylight has an effect on the seasonal variation of heart attack, and whether the time of sunrise has an effect on the diurnal rhythm of myocardial infarction. METHODS: We carried out a retrospective database study covering all patients admitted to any acute care hospital with the diagnosis of myocardial infarction in Hungary between January 2004 and December 2005 (n = 32 329). Data were collected from the National Health Insurance Fund Administration (OEP) according to the International Classification of Diseases (ICD I21, I22) and National Meteorology Service (OMSZ). In case of patients who occurred in the database several times the events have been considered as a separate case. RESULTS: With consideration to seasonal variation, the peak period of heart attack was found in the spring, with the lowest number of events in the summer. The number of hours with daylight showed a weak negative correlation with the occurrence of myocardial infarction (r = -0.108, P < 0.05). With respect to diurnal variation, the peak period of daily events was between 6-12 in the morning (35.57%). We have found a positive correlation between the time of sunrise and sunset and the occurrence of myocardial infarction (P < 0.01). CONCLUSION: Based on our findings, the number of hours with daylight and the time of sunrise may be connected with the chances of having heart attack; however other factors, such as high blood pressure, diabetes or smoking may also have an influence.

The occurrence of acute myocardial infarction in relation to weather conditions.

The spatial and temporal changes of weather factors depend on geographical location, seasons and the time of the day. Our study examines the relationships of meteorological factors and the incidence of acute myocardial infarction (AMI). A retrospective analysis of patients diagnosed with AMI between 2000 and 2004 in Hungary (n = 81,956 patients) was carried out. Data were collected by the National Health Insurance Fund Administration (OEP) and the National Meteorology Service (OMSZ). A peak period of the occurrence of AMI was found during spring, while minimum number of events were recorded during summer. Significant difference was observed between the number of events each season (F = 34.741; p < 0.001; N = 81,956). A medium level negative correlation was found between the monthly average temperature and the occurrence of AMI (r = -0.404) during the period examined. A positive correlation was shown between front movements and the number of events per season (r = 0.053). Average barometric pressure changes, the number of front movements and the number of AMI events also showed a nearly similar seasonal deviation. Our findings show that certain meteorological factors may be related to the onset of AMI, however other factors also play an important role.

[The daily rhythm of heart attack morbidity and mortality may be influenced by the time of sunrise]. / A napkelte idopontja befolyásolhatja a szívinfarktus morbiditásának és mortalitásának diurnalis ritmusát.

UNLABELLED: The morbidity and mortality of a myocardial infarction show characteristic seasonal and diurnal changes that may be influenced by the time of sunrise and the number of hours with daylight during the day. AIM: We wish to study whether the time of sunrise and the number of hours with daylight influence the seasonality of heart attack morbidity and mortality, and whether these have an effect on the diurnal rhythm of a heart attack. METHODS: We have carried out the retrospective analysis of patients received at Hungarian hospitals with the diagnose of an acute heart attack ( n = 32,329) and those deceased due to a heart attack ( n = 5,142) between 2004 and 2005. Data were gained from the data-base of the National Health Insurance Fund according to the International Classification of Diseases. RESULTS: Positive correlation showed between the time of sunrise and both the incidence of an acute myocardial infarction and related mortality ( p < 0.01). Negative correlation has been found between the number of hours with daylight and the occurrence of an acute myocardial infarction ( r = -0.107, p < 0.05). Also, negative correlation has been found between the number of hours with daylight and the mortality of a myocardial infarction ( r = -0.105, p < 0.05). CONCLUSIONS: Based on our data, the time of sunrise and the number of hours with daylight may be related to the incidence of heart attack morbidity and mortality, however, other factors are assumed to take a role as well.

Seasonal variations in the occurrence of acute myocardial infarction in Hungary between 2000 and 2004.

BACKGROUND: The purpose of this study was to determine whether a weekly or seasonal variation could be observed in the onset of acute myocardial infarction (AMI). METHODS: A retrospective analysis of patients diagnosed with AMI between 2000 and 2004 in Hungary (n=81,215 patients) was carried out. Data were collected by the National Health Insurance Fund Administration (OEP). We calculated the number of AMI cases (incidence) per year, month, and per day in the course of a week with 95% confidence interval. Statistical analysis using one-way analysis of variance (ANOVA) was performed. RESULTS: A peak period of the occurrence of AMI was found during spring, while minimum number of events were recorded during summer. Significant difference was observed between the number of events each season (F=34.741; p<0.001). Between 2000 and 2004 the monthly occurrence of AMI was highest in March, May and October (F=11.658; p<0.001). The weekly peak period of AMI morbidity was found on the first day of the week, showing a gradually decreasing tendency all week-through, reaching its minimum incidence on Sunday (F=4.162; p<0.001). CONCLUSIONS: Results of our study reveal that the incidence of AMI shows a characteristic rhythm with respect to seasons and the days of the week, which should be considered in the development of preventive concepts.

[The effects of seasonal variations and weather conditions on the occurrence of heart attacks in Hungary between 2000-2004]. / Szezonális változások, valamint az idôjárás hatása a szívinfarktus gyakoriságára Magyarországon 2000-2004 között.

INTRODUCTION: The onset of acute myocardial infarct shows circadian and seasonal variations, that are influenced by sex, age and the changes of weather conditions as well. AIM: The purpose of our present study is to investigate whether a seasonal variation can be found in the onset of myocardial infarctions during the period under investigation, and whether certain meteorological factors (air temperature, atmospheric pressure, front movements) influence the incidence of myocardial infarction. METHODS: Retrospective analysis has been carried out on patients admitted because of acute myocardial infarct in Hungary between 2000 and 2004 ( n=81.956). Data have been taken from the database of the National Health Insurance Fund Administration based on the International Classification of Diseases (ICD). Weather related data were provided by the National Meteorology Service. RESULTS: Regarding seasonal distribution the peak incidence period of acute myocardial infarct was spring, whereas the lowest number of events was observed during the summer months. There was a marked difference in the number of events per season ( p<0.001). A medium level negative correlation was found between the monthly average temperature and the occurrence of heart attack ( r=-0.404) during the period examined. A positive correlation was shown between front movements and the of number of events per season ( r=0.053). CONCLUSION: Our findings show that certain meteorological factors may be related to the onset of acute myocardial infarct, however, a number of other factors may also play an important role.