Role of oral health in heart and vascular health: A population-based study.

BACKGROUND AND AIM: Conditions such as hypertension, cardiovascular diseases, and hypercholesterolemia, are a major public health challenge. This study investigates the influence of oral health indicators, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on their prevalence in Hungary, considering socioeconomic, demographic, and lifestyle factors. MATERIALS AND METHODS: Data from the 2019 Hungarian European Health Interview Survey with 5,603 participants informed this analysis. Data were accessed from the records maintained by the Department of Health Informatics at the University of Debrecen between September and November 2023. Variable selection employed elastic net regularization and k-fold cross-validation, leading to high-performing predictors for weighted multiple logistic regression models. Sensitivity analysis confirmed the findings' validity. RESULTS: Significant links were found between poor oral health and chronic cardiac conditions. Multiple teeth extractions increased hypertension risk (OR = 1.67, 95% CI: [1.01-2.77]); dental prosthetics had an OR of 1.45 [1.20-1.75]. Gum bleeding was associated with higher cardiovascular disease (OR = 1.69 [1.30-2.21]) and hypercholesterolemia risks (OR = 1.40 [1.09-1.81]). CONCLUSIONS: Oral health improvement may reduce the risk of cardiac conditions. This underscores oral health's role in multidisciplinary disease management.

Oral health's role in diabetes risk: a cross-sectional study with sociodemographic and lifestyle insights.

Introduction: Diabetes, a key chronic non-communicable disease, poses a substantial public health burden. The role of oral health as a determinant in the epidemiology of diabetes mellitus, particularly in the Central Eastern European region, remains underexplored. This research aims to examine the impact of specific oral health parameters, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on diabetes prevalence. Additionally, it seeks to clarify the moderating effects of socio-demographic and lifestyle variables on this relationship. Materials and methods: Data were extracted from the 2014 and 2019 datasets of the Hungarian European Health Interview Survey, comprising a combined nationally representative sample of 11,429 participants. Descriptive statistics were presented as weighted proportions and unweighted counts, and weighted Pearson's chi-squared tests were employed for assessing associations and goodness-of-fit. Significant predictors were integrated into weighted multiple logistic regression models for analysis. Sensitivity analysis was then conducted to confirm the robustness of the findings. Results: The study identified 'Bad' self-perceived oral health as a diabetes risk (OR=1.35; 95% CI: [1.04-1.75]), with filled teeth being protective (0.65 [0.51-0.84]). Subgroup analysis revealed higher diabetes odds among individuals with primary education (1.41 [1.02-1.96]) and rural residents with tooth loss from decay (3.54 [1.36-9.19]). The bootstrap analysis with 1,000 iterations reaffirmed the model's stability and predictive accuracy for diabetes. Discussion: Enhanced oral health is associated with lower risk factors for diabetes. This research highlights the importance of including oral health measures in comprehensive diabetes management approaches.

Association Between Influenza Vaccine Uptake and Health Awareness: A Cross-Sectional Questionnaire-Based Study Among Medical Students and Healthcare Workers in Northern Vietnam.

BACKGROUND Seasonal influenza poses a significant global health concern. Despite the proven effectiveness of the influenza vaccine, its uptake remains low in Vietnam. This study aimed to assess the knowledge, attitudes, and practices of medical students and healthcare workers on influenza vaccine uptake in northern Vietnam. MATERIAL AND METHODS A cross-sectional survey was conducted among 585 participants from northern Vietnam institutions through an anonymous online survey via Google form from June to August 2022. The cut-off for a high level of knowledge and a positive attitude was set at 70% for each variable. Bivariate analysis was conducted to establish associations. Multiple binary logistic regression models were used to identify factors associated with knowledge, attitude, and practice. RESULTS Among the participants, 463 (79.15%) were women, 354 (60.51%) were below 25 years old, 426 (72.82%) were of "Kinh" ethnicity, and 454 (77.61%) were single. Only 237 (40.51%) were vaccinated. Good knowledge and attitude were reported by 36.58% and 42.39% of the participants, respectively. Having a high level of knowledge was found positively associated with having a positive attitude (odds ratio 2.11 [1.48-3.01]). Kinh ethnicity was positively associated with knowledge (1.67 [1.12-2.49]) and attitude (1.97 [1.32-2.94]). Female participants displayed a more positive attitude (2.08 [1.33-3.25]). Several factors influenced the uptake, such as being single (2.07 [1.19-3.59]), being a medical doctor (2.34 [1.09-5.06]), and being advised by a healthcare provider (2.96 [2.00-4.37]). CONCLUSIONS A noticeable gap in knowledge and attitude related to influenza vaccine uptake was found among the target population. Tailored interventions are necessary to improve vaccination coverage.

Assessing the impact of sociodemographic and lifestyle factors on oral health: a cross-sectional study in the Hungarian population.

Introduction: Oral health, a critical aspect of overall well-being, is influenced by various sociodemographic and lifestyle factors, with poor oral health associated with systemic diseases and diminished quality of life. Methods: This cross-sectional study leverages data from the Hungarian European Health Interview Survey (EHIS) representative of the Hungarian population, to conduct a comprehensive examination of the intersection between these factors and oral health, aiming to identify potential risk factors and contribute to the development of targeted interventions. The research examined associations between sociodemographic/lifestyle factors and oral health. Statistical techniques included Pearson's Chi-square test, multivariate and ordinal logistic regression analyses. Weighting was applied to assure the representativeness of the population and enhance the validity of the survey results. Results: The study identifies gender, age, education, financial status, smoking, and self-perceived oral health as key factors influencing oral health outcomes. Notably, regular dental visits significantly reduced the risk of poor oral health and caries. Females, non-smokers, university graduates, high-income individuals, and those with good self-perceived health had fewer missing teeth and better self-perceived oral health. Teeth extractions due to decay, especially when not replaced, significantly increased the perception of poor oral health, while regular dental visits improved it. Discussion: The study highlights the need for personalized oral health interventions considering the different sociodemographic and lifestyle factors, along with promotion of healthy lifestyle, more frequent dental office visits and equitable dental care access. The findings offer the potential to inform regional oral health policies and prevention strategies, improving oral health and overall wellbeing.

Cardiovascular disease and risk factors in adults with diabetes mellitus in Hungary: a population-based study.

Introduction: Diabetes mellitus (DM) and cardiovascular disease (CVD) such as acute myocardial infarction, stroke, and coronary artery disease are highly prevalent conditions that are responsible for significant morbidity and mortality, particularly in Hungary. The conditions are attributed to identical risk factors, and individuals with DM are primarily susceptible to cardiovascular complications, which are the leading causes of death and disability in patients with DM. The objective of this study was to estimate the prevalence of CVD in individuals with DM and to investigate the association between potential risk factors and the presence of CVD among individuals with DM in a population-based sample. Methods: The study was based on data from three waves of the European Health Interview Surveys (EHIS) conducted in Hungary in 2009, 2014, and 2019. Results: The prevalence of CVD among patients with DM decreased during the study period and that socioeconomic factors, cardiometabolic risk factors including high blood pressure and high cholesterol, and depression are major contributors to CVD burden in patients with DM in Hungary. Discussion: Our findings suggest the importance of regular check-up for hypertension and hypercholesterolemia, better focus on socioeconomic status, as well as ongoing monitoring of mental health among patients with diabetes. Further research is needed to understand the potential causes behind the observed decrease in CVD prevalence.

Efficiency of Printed Patient Information Leaflets Written for Total Knee and Hip Arthroplasty Patients to Reduce Their Fear of Surgery.

Background: Patient education plays a key role in health care. In our study, we created a new information guide for patients waiting for total knee (TKA) or hip (THA) arthroplasty. The goal of our study was to create patient education material that would reduce patients' fear of surgery and improve their postoperative lifestyle. Methods: Patients in the intervention group (n = 44) received newly developed paper-based patient education material before surgery. The surgical fear questionnaire (SFQ) was used to assess fear reduction. A self-designed assessment questionnaire was used to measure the effectiveness of the leaflet among the intervention group patients. Results: The SFQ scores decreased significantly both in patients with TKA (median 37.50 IQR 30.00-40.00 vs. median 20.00 IQR 16.00-24.00) and THA (median 34.50 IQR 28.00-42.00 vs. median 20.00 IQR 16.00-22.00). A control group with TKA (median 37.50 IQR 30.00-40.00 vs. median 64.50 IQR 54.00-82.00) and THA (median 34.50 IQR 28.00-42.00 vs. median 73.00 IQR 56.00-81.00) was also included. An assessment of the content, usability, and clarity of the new leaflet showed that patients rated the new leaflet as almost entirely usable (median score 12.00-10.00). Conclusions: Our results suggest that new printed patient education material may reduce the fear of surgery.

Seasonal patterns in the epidemiology of Bell's palsy in Hungary.

Introduction: Epidemiological data on Bell's palsy are vital for elucidating disease prevalence and enhancing therapeutic options. Our objective was to explore the prevalence and possible risk factors associated with Bell's palsy recurrence in the Clinical Center of the University of Debrecen service area. Secondary data analysis was performed using hospital discharge data, including patient information and comorbidities. Methods: Data was obtained from the Clinical Center of the University of Debrecen, on Bell's palsy patients who were treated at the hospital between January 1, 2015 and December 31, 2021. Multiple logistic regression analysis was used to examine the factors associated with Bell's palsy recurrence. Results: Of the 613 patients analyzed, 5.87% had recurrent paralysis, and the median time interval between episodes was 315 days. Hypertension was significantly associated with Bell's palsy recurrence. Moreover, seasonal distribution analysis revealed that the number of Bell's palsy episodes was higher in colder seasons, with spring and winter having a significantly higher number of episodes than summer and autumn. Discussion: This study provides insights into the prevalence and associated risk factors of Bell's palsy recurrence, which could aid in its management and help reduce the long-term consequences of the disease. Further research is necessary to determine the precise mechanisms underlying these findings.

Hypercitrullination and anti-citrullinated protein antibodies in chronic apical periodontitis, a laboratory investigation. Does autoimmunity contribute to the pathogenesis?

AIM: The presence of Gram-negative anaerobic bacteria, in particular, Porphyromonas gingivalis (P. gingivalis) in periapical granulomas predicts the generation of citrullinated proteins in the lesion. Citrullination of proteins may lead to the formation of anti-citrullinated autoantibodies (ACPA-s) initiating the formation of an autoimmune loop which may contribute to the perpetuation of inflammatory reactions and tissue damage in chronic apical periodontitis. The objective of this study was to demonstrate the formation of citrullinated proteins in chronic apical periodontitis and whether they can act as autoantigens. METHODOLOGY: Twenty-five periapical granulomas (n = 25) were investigated in the study. Healthy periodontal tissue samples served as normal control tissue (n = 6). The peptidyl-citrulline level was determined with the dot blot method. ACPA levels were analysed using anti-citrullinated cyclic peptide (anti-CCP) EDIA kit. Differences between periapical granuloma and control samples were assessed using Mann-Whitney U tests. p Values <.05 were considered as statistically significant. RESULTS: Protein concentrations, peptidyl-citrulline levels and anti-CCP ratios were compared between periapical granuloma and healthy control groups. Multiple linear regression analysis revealed significant (p = .042) hypercitrullination in periapical granuloma samples. Moreover, there was a significant difference in the ACPA ratios between periapical granuloma (2.03 ± 0.30) and healthy control (0.63 ± 0.17) groups (p = .01). Seventeen of 25 periapical granuloma samples (17/25; 68%), whereas one out of six control samples (1/6; 17%) were shown to be positive for the presence of ACPA. CONCLUSIONS: This is the first study detecting the presence of citrullinated peptides and APCA in periapical granuloma, suggesting the contribution of autoimmune reactions in the pathogenesis and perpetuation of chronic apical periodontitis.

Self-rated health status and hygienic behaviour of pregnant women in Hungary during the pandemic.

OBJECTIVES: The aim of our research was to investigate the self-rated health status, health behaviour and hygiene habits of pregnant women, and to explore the influencing factors during the pandemic. METHODS: The sample included 1,200 pregnant women who gave birth in the most progressive institutions of the three examined counties in Hungary; 839 questionnaires were returned, based on which the willingness to answer can be said to be 69.9%. After data cleaning, 640 questionnaires were added to the database. Descriptive statistical analyses and correlation tests were performed, during which we used the Pearson's chi-square test and Fisher's exact test. RESULTS: Socio-demographic factors show a significant correlation with the perceived state of health and the degree of responsibility for health, however, the existence of a chronic disease does not affect either the self-assessed state of health or hygienic behaviour. Factors influencing hygienic behaviour include residence, education, assessed income, and gestational age. We found no correlation between health status and hygienic attitude. CONCLUSIONS: Our results draw attention to the fact that among pregnant women - especially pregnant women with low socioeconomic status - education about hygiene habits is of particular importance. Teamwork is needed in this area, which should start during the period of preparation for pregnancy, but at the latest in the early stages of pregnancy.

Nutrition habits and physical activity of disabled adolescents in Hungary.

OBJECTIVES: The overall aim of the research is to gain insight into the lifestyle and health behaviour of young people with disabilities aged 12-18 years, and to learn about the factors shaping their health. In this study, our aim was to investigate the eating habits and physical activity of adolescents with disabilities and the influencing factors. METHODS: The study's source population was young people aged 12-18 with disabilities in the Szabolcs-Szatmár-Bereg County. A total of 239 completed questionnaires were processed and analysed. Boys were overrepresented in the study. RESULTS: The results show that inadequate eating habits also exist in the population we studied, the consumption of certain foods correlates with the education level of parents. A more secure social background is a protective factor in terms of physical activity. The survey was made with the aim of intervention much needed. With precise knowledge of the health behaviour of the target group, our goal is to develop a complex intervention programme adapted to the needs of children with disabilities. CONCLUSION: The eating habits of adolescents with disabilities in the Szabolcs-Szatmár-Bereg County are unsatisfactory. Experience and results show that differentiated health promotion of young people with disabilities is necessary.

Influenza Vaccination Coverage and Its Predictors among Self-Reported Diabetic Patients-Findings from the Hungarian Implementation of the European Health Interview Survey.

In high-risk populations, such as the elderly or those with serious medical issues, for instance, people with cardiovascular diseases or diabetes, influenza can have devastating effects because it might contribute to severe complications or even death. This makes vaccination against influenza an essential component of public health. The primary objective of our research was to identify the characteristics that influenced whether an individual chose to become vaccinated against influenza, with an emphasis on whether they reported having diabetes. The data were obtained from the Hungarian implementation of the European Health Interview Surveys, which were conducted in 2009, 2014, and 2019. The total sample size was 15,874 people. To determine the variables that were related to vaccination, a multivariate logistic regression analysis that included interactions was performed. The overall vaccination coverage was 13% in 2009 and 12% in 2014 and 2019 among non-diabetic respondents; the coverage was 26% in 2009, 28% in 2014, and 25% in 2019 among diabetic respondents. Despite vaccination coverage in both groups being below the optimal level of 75%, we were able to identify factors influencing vaccination coverage. Among diabetic respondents, younger age, lower education level, sex, and co-morbidities were factors that influenced vaccination status. It is important for authorities managing healthcare and medical practitioners to be aware of the potential effects that influenza can have on diabetic patients; therefore, more efforts need to be made to increase the number of diabetic people receiving a vaccination against influenza.

An Exploratory Assessment of Factors with Which Influenza Vaccine Uptake Is Associated in Hungarian Adults 65 Years Old and Older: Findings from European Health Interview Surveys.

Influenza vaccination is an imperative public health task for elderly people due to a higher risk of developing more severe complications. The main aim of our study was to determine the influencing factors of being vaccinated against influenza among subjects aged 65 and above. Data were from the Hungarian implementations of the European Health Interview Survey 2009, 2014 and 2019 studies with a final sample size of 3355. A multivariate logistic regression model with interactions was used to identify the possible factors associated with vaccination. Approximately 32% of the participants were vaccinated for the most recent influenza season. The most important factors were identified that contributed to influenza vaccination among individuals, which were the following: educational attainment, having a partner, the annual frequency of specialist and doctor visits, and having comorbidities. Respondents who thought that they could do a lot for their health had higher odds of being immunized. Being obese seemed to be a risk factor. According to our findings, the current influenza vaccination coverage was considered as low in Hungary; hence, the implementation of minor reformulations in the field of health policy is suggested.

Efficacy of metacognitive training on symptom severity, neurocognition and social cognition in patients with schizophrenia: A single-blind randomized controlled trial.

Over the past decades, a number of complementary treatments for schizophrenia have emerged. One of these is metacognitive training (MCT), which combines the principles of cognitive-behavioral therapies, cognitive remediation, and psychoeducation into a hybrid approach placing emphasis on increasing metacognitive awareness. The aim of our study was to investigate the efficacy of MCT on symptom severity, and neurocognitive and social cognitive functioning in schizophrenia; also, attention was paid to the assessment of subjective acceptability. Forty-six patients diagnosed with schizophrenia were included in our single-blind randomized controlled trial, who were assigned to the intervention or control group. The intervention group was provided standard MCT, while the control group received treatment as usual. We assessed symptom severity and cognitive functions before and after the training, as well as after a 6-month follow-up period. Compared to the control group, the intervention group showed improvement in overall symptom severity, and positive and disorganized symptoms. Training participans showed further improvement at the follow-up assessment. Regarding neurocognitive functions, improvement in visuospatial functions was observed between pre- and post-intervention assessments compared to the control group. Patients showed excellent adherence, and evaluated the training as useful and interesting. In line with the results of previous studies, our results demonstrate the efficacy of MCT on symptom severity in schizophrenia. Improvements in cognitive functions that are closely related to the onset and prevalence of symptoms of schizophrenia were also found.

Effects of Classical Breathing Exercises on Posture, Spinal and Chest Mobility among Female University Students Compared to Currently Popular Training Programs.

Worldwide, university students' physical health and posture are declining due to a sedentary lifestyle. The aim of our study was to evaluate the effectiveness of physiotherapeutic breathing exercises on posture and spinal mobility among healthy female university students compared to other training methods. Sixty-one female students of the University of Debrecen were assigned to breathing exercise (BE; n = 15), yoga (Y; n = 16), Pilates (P; n = 15) programmes and interval-training (IT; n = 15). Each training session lasted one hour, performed twice a week for 7 weeks. Students were assessed using standardized clinical tests. All programmes resulted in significant improvement in chest expansion. Results of Schober's test showed substantial improvement using BE (p < 0.05), Y, P (p ≤ 0.01) programmes. Significant changes in occiput-to-wall distance (Y, P p ≤ 0.01) (BE p ≤ 0.001) were observed in three groups except the IT group. Fingertip-to-floor test (Y, P p < 0.05) results showed significant changes in two groups. The most outstanding effects on lateral flexion were achieved using BE (right, left p ≤ 0.001) programme. A comparison with results achieved using yoga and Pilates revealed that the physiotherapeutic breathing exercise programme is an equally effective method to significantly improve spinal mobility and correct postural problems in healthy young women.

Discrepancies between clinical and autopsy findings in patients who had an acute stroke.

OBJECTIVES: According to international observations, the incidence of clinical autopsies is declining worldwide, plummeting below 5% in the USA and many European countries. It is an unfavourable trend as, in 7%-12% of cases, recent clinicopathological studies found discrepancies that might have changed the therapy or the outcome if known premortem. As previous large-scale observations have examined varied patient populations, we aimed to focus on the differences between the clinical and pathological diagnostic findings in only patients who had a stroke. MATERIAL AND METHODS: We assessed the postmortem non-neuropathological and neuropathological findings of 534 consecutive patients who had a stroke who passed away. Systemic neoplasms, pneumonias, thromboembolisms and haemorrhagic transformations revealed only by autopsy were considered severe abnormalities; in addition, benign abnormalities important from an educational or scientific point of view were also recorded. RESULTS: In 26 of the 534 cases (4.9%), the presence of systemic neoplasms had already been confirmed in the clinical stage; however, 8 (1.5%) malignant tumours were only detected during autopsy. Also, 80 (15%) thromboembolic events, 73 (13.6%) pneumonias and 66 (18%) haemorrhagic transformations were only diagnosed at autopsy. Longer hospital stay (from admission to death) resulted in fewer discrepancies between clinical and autopsy diagnosis of thromboembolic events and pneumonias (p<0.01). In 169 cases, benign findings were detected. CONCLUSIONS: While the type of acute stroke is reliably diagnosed with imaging techniques, postmortem autopsies are also important in patients who had a stroke as autopsies may reveal clinically silent diseases (eg, tumour), and contribute to knowing the actual incidence of stroke-related thromboembolic and pneumonia complications.

Regrouping scalets: Psychometric properties of the theory of mind picture stories task in a schizophrenic sample.

Theory of mind is one of the most intensively studied phenomena in the development of schizophrenic symptoms and impairments in social adjustment. Complex theory of mind processing requires both visual and verbal aspects of the social-perceptual and social-cognitive components of mind reading. Reliable assessment methods are considered essential for the proper conduct of research. The current study aims at investigating the psychometric properties of the Theory of Mind Picture Stories Task (ToM PST). Forty-seven patients with schizophrenia were enrolled in the study from three sites. Data from ToM PST were used for computing the consistency, reliability, and internal and construct validity of the test.Our preliminary findings showed less appropriate consistency. Therefore, we attempted to carry out structural changes on the task while preserving its scales and subscales, which measure crucial factors of ToM. The newly structured task has four scales. They show proper consistency (Sequencing: Cronbach's α = 0.70, Theory of a Single Person's Mind: α = 0.74, Switching Between Minds: α = 0.70, Comprehension of Misleading Behaviour: α = 0.67, Total: α = 0.80) with appropriate internal and construct validity, a moderate test-retest reliability over a four-month-course, and a proper inter-rater reliability.

Awareness Related to Cardiometabolic Diseases: A Cross-Sectional Study in Southern Vietnam.

BACKGROUND: the prevalence of cardiometabolic diseases (CMDs), such as type 2 diabetes mellitus (T2DM) and hypertension, is increasing rapidly in developing countries. This study aims to assess the awareness of CMD among a selected population in Vietnam. METHOD: a cross-sectional random sample of 402 Vietnamese citizens in two districts (Thu Duc and 12th district) in Ho Chi Minh City were interviewed. Data on knowledge, attitude, and preventive behavior (KAB) of the two conditions were collected through an interview-based questionnaire. RESULTS: the mean (± SD) age was 47.75 (± 15.61) years, and around 60.2% were female. Multiple logistic regression was performed to explore the association of sociodemographic factors, disease status, and awareness of the CMD. Females showed better awareness than males (OR = 3.89 (1.28-11.78)), and those with T2DM and hypertension had a significantly better awareness (OR = 8.33 (2.44-28.37)) than those without CMD. CONCLUSION: the awareness of CMD in our sample was poor. An extensive effort to increase awareness of CMD prevention is needed. Future studies and interventions can be developed more efficiently by targeting the right population.

A Novel Method for the Evaluation of Bone Marrow Samples from Patients with Pediatric B-Cell Acute Lymphoblastic Leukemia-Multidimensional Flow Cytometry.

Multicolor flow cytometry (FC) evaluation has a key role in the diagnosis and prognostic stratification of ALL. Our aim was to create new analyzing protocols using multidimensional dot-plots. Seventy-two pediatric patients with ALL were included in this single-center study. Data of a normal BM sample and three BM samples of patients with BCP-ALL were merged, then all B cell populations of the four samples were presented in a single radar dot-plot, and those parameters and locations were selected in which the normal and pathological cell populations differed from each other the most. The integrated profile of immunophenotype resulted in a simple, rapid, and accurate method. There were no significant differences between the percentages of lymphoblasts in the detection of minimal residual disease (MRD) by multidimensional or conventional FC method (p = 0.903 at Day 15 and p = 0.155 at Day 33). Furthermore, we found associations between the position and the number of clusters of blast cells in the radar plots and cytogenetic properties (p = 0.002 and p < 0.0001 by the position and p = 0.02 by the number of subclones). FC analysis based on multidimensional dot-plots is not only a rapid, easy-to-use method, but can also provide additional information to screen cases which require detailed genetic examination.

Impact Analysis of 20-Week Multimodal Progressive Functional-Proprioceptive Training among Sedentary Workers Affected by Non-Specific Low-Back Pain: An Interventional Cohort Study.

According to the latest data published by the WHO, 1.71 billion people suffer from musculoskeletal disorders and 568 million are affected by back pain, making these the most significant occupational health problems. The aim of this study was to analyze the effects of a newly developed Multimodal Workplace Training Program implemented among young sedentary employees in order to treat and prevent these problems. The 20-week Training Program was conducted at the National Instruments Corporations' Hungarian subsidiary in Debrecen between January and June, 2019. Pre- and post-intervention questionnaires were used to assess subjective parameters. Baseline and follow-up physical examinations were performed using the SpinalMouse, Y-Balance, Sit and Reach, Prone and Side Plank, Timed Abdominal Curl, and Biering-Sorensen tests. The results for 76 subjects were eligible for statistical analysis. Our Training Program was effective in several aspects, including a reduction in musculoskeletal symptoms and improvements in posture (p < 0.001), in dynamic (p < 0.01) and static-isometric (p < 0.001) core strength, in flexibility (p < 0.001), in spinal inclination in the sagittal (p < 0.001) and frontal (p < 0.01) plane, and in balance and coordination (p < 0.05). The Multimodal Progressive Functional-Proprioceptive Training was highly effective, and the application of such a complex training program can be recommended in workplace settings.

Early postoperative effects of kidney transplantation on the cardiovascular system in our clinical practice / A vesetranszplantáció korai posztoperatív hatásai a szív- és érrendszeri betegségekre klinikai gyakorlatunkban.

Összefoglaló. Bevezetés: Mind a dializált, mind a veseátültetett betegek körében vezeto haláloknak számít a cardiovascularis megbetegedés. E mögött foképp bal kamrai hypertrophia, volumenterheltség, következményes szívritmuszavar, szívbillentyu-elégtelenség, fokozott atherosclerosis állhat. Célkituzés: Célunk a vesetranszplantáció hatásának vizsgálata a bal kamra pumpafunkciójára, a szívritmuszavarokat kiváltó és meghatározó tényezokre és a vitiumokra nézve. Módszerek: A 2014. december 20. és 2018. június 21. közti idointervallumban, a Debreceni Egyetem Szervtranszplantációs Tanszékén felnott betegeken végzett veseátültetéseket vizsgáltuk retrospektív analízissel (n = 184). Vesetranszplantációt megelozoen, illetve azt követoen 6 és 12 hónappal az echokardiográfiás, a laboratóriumi és a gyógyszeres terápiás értékeket tanulmányoztuk. A statisztikai elemzéseket khi-négyzet-próbával, Fisher-féle egzakt teszttel és Kruskal-Wallis-féle varianciaanalízissel (ANOVA) végeztük (szignifikancia: p<0,05). Eredmények: A bal kamra végsystolés tágassága az átültetés elott 34,67 mm volt, míg a 6 hónapos eredmény 31,82 mm, a 12 hónapos 32,68 mm volt (p = 0,01). Átültetés elott a stroke prevalenciája 7,87% volt, míg a beavatkozás után nem fordult elo szélütés (p<0,001). Transzplantáció hatására a bal pitvari átméro (43,68 mm; 41,59 mm; 41,00 mm; p = 0,0417) és a káliumszint (4,98 mmol/l; 4,49 mmol/l; 4,49 mmol/l; p = 0,01) szignifikáns változást igazolt. Mutét elott II. fokú mitralis regurgitatiót észleltünk 10,7%-nál, mely 4,3%-ra, majd 2,1%-ra csökkent (p = 0,03). Transzplantációt megelozoen a billentyumeszesedés elofordulása diabetesesek között 45% (p = 0,20), 6 hónap múlva 46,7% (p = 0,018), 12 hónap múlva 60,0% (p = 0,024) volt. Következtetés: Transzplantáció után a bal pitvari átméro, a végsystolés bal kamrai átméro regrediál, csökken a pitvari ritmuszavarok kialakulásának gyakorisága. A mitralis regurgitatio közepesen súlyos fokainál szignifikáns javulást, a diabeteses populáción belül szignifikáns emelkedést tapasztaltunk a meszes billentyuk számát tekintve. Orv Hetil. 2021; 162(26): 1052-1062. INTRODUCTION: Among the population suffering from end-stage renal failure and the population after kidney transplantation, the leading reason of death is cardiovascular triggered by left ventricular hypertrophy, volume overload, consecutive arrhythmias, valvular insufficiency and increased artherosclerosis. OBJECTIVE: This study was aimed at examining the effect of kidney transplantation on pump function of the left ventricle, arrhythmic substrates and valvular heart diseases. METHODS: At the Division of Organ Transplantation, University of Debrecen, we carried out a retrospective data analysis of adult patients (n = 184) who had kidney transplantation in the period between December 2014 and June 2018. Preoperatively and, then, postoperatively (at 6 and 12 months) we studied the echocardiographic parameters, the laboratory results. Statistical analyses were performed using the chi-square/Fisher's exact test and Kruskal-Wallis analysis of variance (ANOVA) test. The results were regarded significant if p<0.05 was found. RESULTS: Preoperatively the end-systolic diameter of the left ventricle was 34.67 mm, whereas 6 and 12 months later these values were 31.82 mm and 32.68 mm (p = 0.01). The prevalence of stroke was 7.87% preoperatively; there was no stroke detected postoperatively (p<0.001). The impact of transplantation on the left atrial diameter (43.68 mm; 41.59 mm; 41.00 mm; p = 0.04) and seral potassium level (4.98 mmol/l; 4.49 mmol/l; 4.49 mmol/l; p<0.01) showed significant improvement. Before transplantation, grade 2 mitral regurgitation was observed in 10.7% of the patients, whereas it reduced to 4.3%, then to 2.1% 6 and 12 months postoperatively (p = 0.03). Preoperative valvular calcification was detected in 45% of the diabetic study population (p = 0.20), 6 and 12 months later, in 46.7% (p = 0.018) and 60.0% (p = 0.024). CONCLUSION: After transplantation, the left atrial and the end-systolic diameter of the left ventricle regrediated, decreasing the frequency of arrhythmic episodes. The number of the middle grade mitral valve regurgitation decreased and the calcification among diabetic population increased significantly. Orv Hetil. 2021; 162(26): 1052-1062.