Szív-elektrofiziológiai vizsgálatok és katéterablációk Magyarországon 2021 és 2024 között

A katéterablációs eljárások száma az elmúlt évtizedben jelentős növekedést mutatott Magyarországon, amelyet a technológiai innovációk, a klinikai tapasztalatok bővülése és az indikációs körök kiszélesedése eredményezett. Jelen elemzés célja a 2021–2024 közötti időszak adatainak áttekintése, különös figyelemmel az eljárások számának és arányának változásaira. Az adatok a Magyar Kardiológusok Társaságának Aritmia és Pacemaker munkacsoportja által koordinált, centrumok által önbevallással szolgáltatott jelentéseken alapulnak. Az eredmények szerint a katéter­ablációk száma 2014 és 2024 között több mint 50%-kal emelkedett, a pitvarfibrilláció- (PF-) ablációk száma pedig a 2,5-szeresére nőtt. Ezzel párhuzamosan csökkent a diagnosztikus elektrofiziológiai vizsgálatok aránya. Az elmúlt évek egyik legjelentősebb újdonsága a pulzusmező-abláció (PFA) bevezetése volt, amely 2024-ben már az összes PF miatt végzett katéterabláció 22%-át, a single-shot PF-ablációk 50%-át tette ki. A nemzetközi trendekkel összhangban ezen technika további térnyerése várható

The global, regional, and national burden of cancer, 1990-2023, with forecasts to 2050 : a systematic analysis for the Global Burden of Disease Study 2023

Cancer is a leading cause of death globally. Accurate cancer burden information is crucial for policy planning, but many countries do not have up-to-date cancer surveillance data. To inform global cancer-control efforts, we used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 framework to generate and analyse estimates of cancer burden for 47 cancer types or groupings by age, sex, and 204 countries and territories from 1990 to 2023, cancer burden attributable to selected risk factors from 1990 to 2023, and forecasted cancer burden up to 2050.Cancer estimation in GBD 2023 used data from population-based cancer registration systems, vital registration systems, and verbal autopsies. Cancer mortality was estimated using ensemble models, with incidence informed by mortality estimates and mortality-to-incidence ratios (MIRs). Prevalence estimates were generated from modelled survival estimates, then multiplied by disability weights to estimate years lived with disability (YLDs). Years of life lost (YLLs) were estimated by multiplying age-specific cancer deaths by the GBD standard life expectancy at the age of death. Disability-adjusted life-years (DALYs) were calculated as the sum of YLLs and YLDs. We used the GBD 2023 comparative risk assessment framework to estimate cancer burden attributable to 44 behavioural, environmental and occupational, and metabolic risk factors. To forecast cancer burden from 2024 to 2050, we used the GBD 2023 forecasting framework, which included forecasts of relevant risk factor exposures and used Socio-demographic Index as a covariate for forecasting the proportion of each cancer not affected by these risk factors. Progress towards the UN Sustainable Development Goal (SDG) target 3.4 aim to reduce non-communicable disease mortality by a third between 2015 and 2030 was estimated for cancer.In 2023, excluding non-melanoma skin cancers, there were 18·5 million (95% uncertainty interval 16·4 to 20·7) incident cases of cancer and 10·4 million (9·65 to 10·9) deaths, contributing to 271 million (255 to 285) DALYs globally. Of these, 57·9% (56·1 to 59·8) of incident cases and 65·8% (64·3 to 67·6) of cancer deaths occurred in low-income to upper-middle-income countries based on World Bank income group classifications. Cancer was the second leading cause of deaths globally in 2023 after cardiovascular diseases. There were 4·33 million (3·85 to 4·78) risk-attributable cancer deaths globally in 2023, comprising 41·7% (37·8 to 45·4) of all cancer deaths. Risk-attributable cancer deaths increased by 72·3% (57·1 to 86·8) from 1990 to 2023, whereas overall global cancer deaths increased by 74·3% (62·2 to 86·2) over the same period. The reference forecasts (the most likely future) estimate that in 2050 there will be 30·5 million (22·9 to 38·9) cases and 18·6 million (15·6 to 21·5) deaths from cancer globally, 60·7% (41·9 to 80·6) and 74·5% (50·1 to 104·2) increases from 2024, respectively. These forecasted increases in deaths are greater in low-income and middle-income countries (90·6% [61·0 to 127·0]) compared with high-income countries (42·8% [28·3 to 58·6]). Most of these increases are likely due to demographic changes, as age-standardised death rates are forecast to change by -5·6% (-12·8 to 4·6) between 2024 and 2050 globally. Between 2015 and 2030, the probability of dying due to cancer between the ages of 30 years and 70 years was forecasted to have a relative decrease of 6·5% (3·2 to 10·3).Cancer is a major contributor to global disease burden, with increasing numbers of cases and deaths forecasted up to 2050 and a disproportionate growth in burden in countries with scarce resources. The decline in age-standardised mortality rates from cancer is encouraging but insufficient to meet the SDG target set for 2030. Effectively and sustainably addressing cancer burden globally will require comprehensive national and international efforts that consider health systems and context in the development and implementation of cancer-control strategies across the continuum of prevention, diagnosis, and treatment.Gates Foundation, St Jude Children's Research Hospital, and St Baldrick's Foundation

Multiscale assessment of conservation management for Amorpha fruticosa invasion in a marsh meadow

This study examined the ecological impact of the invasive shrub Amorpha fruticosa in marsh meadows and assessed the effectiveness of combined conservation management practices, i.e., mowing and cattle grazing, in on restoring native vegetation. Conducted in the Mártély Landscape Protection Area (Hungary), the research used a multiscale approach to compare treated non-invaded and treated invaded wetland vegetation. Information theory-based diversity metrics were employed to evaluate the impact of A. fruticosa on structural complexity and species composition. Results revealed that although A. fruticosa can significantly altered plant community structure, the implemented management strategies effectively reduced its impact. The treated invaded vegetation exhibited diversity levels compareable to native marshland communities, suggesting that mowing and grazing contributed to decreasing A. fruticose dominance. However, in the absence of untreated control stands, this pattern must be interpreted cautiously, as the observed similarity could be conclusively attributed to the applied management alone. A slight, but non-significant shift in structural diversity was also observed, implying a residual effect of invasion. This study underscores the value of active, combined conservation strategies in maintaining biodiversity and ecosystem resilience in wetland habitats. The results contribute to broader discussions on invasive species control, emphasizing the role of traditional land-use practices in mitigating the ecological effects of biological invasions

Injekciós laryngoplastica alkalmazása féloldali hangajakbénulás esetén [Injection laryngoplasty for the treatment of unilateral vocal fold paralysis]

Az egyoldali hangajakbénulás hangképzésre és nyelésre gyakorolt hatásai az életminőség szignifikáns romlásához vezethetnek. A nervus laryngeus recurrens izolált sérülése az érintett oldali hangajak mozgáskorlátozottságával és jellemzően paramedián helyzetben történő rögzítettségével jár. A bénulás vezető tünete a hangteljesítmény csökkenése, ritkábban az aspiráció és a terhelésre jelentkező légzési nehezítettség. Az optimális terápiás metódus kiválasztása függ a hangajakbénulás etiológiájától, a hangajkak helyzetétől, a betegség prognózisától, a bénulás óta eltelt időtől, a páciens társbetegségeitől és motiváltságától is. A probléma megoldására több típusú fonokirurgiai módszer kínálkozik, amelyek közös célja a kóros pozíciójú, mozgásképtelen hangajak medializációja a fonációs zárás optimalizálása érdekében. A beavatkozások közül egyszerűségével és sokoldalúságával kiemelkedik az injekciós laryngoplastica, amely a bénult hangajak pozíciója mellett annak volumenét és ezzel párhuzamosan tömegét is képes korrigálni. A nemzetközi szakirodalom áttekintésével és saját tapasztalataink alapján bemutatjuk az eljárás alkalmazásának módszertanát, különös tekintettel a különböző műtéti technikákra és az injektálható anyagok típusaira. E tényezők optimális megválasztásával az injekciós laryngoplastica biztonságos, olcsó, relatíve könnyen elsajátítható, kedvező eredményeket nyújtó megoldás a különböző okok miatt kialakuló enyhe-közepes glotticus elégtelenség kezelésében. Orv Hetil. 2025; 166(26): 1017–1024. | The effects of unilateral vocal fold paralysis on voice production and swallowing can lead to a significant deterioration in the quality of life. Isolated injury to the recurrent laryngeal nerve results in limited movement of the affected vocal fold and its fixation in a paramedian position. The leading symptom of paralysis is decreased vocal performance, less commonly aspiration and difficulty breathing on exertion. The selection of the optimal therapeutic method depends on the etiology of vocal fold paralysis, the position of the vocal folds, the prognosis of the disease, the time elapsed since the paralysis, the patient’s comorbidities and motivation. Several types of phonosurgical methods are available to solve the problem, the common goal of which is the medialization of the abnormally positioned, immobile vocal fold in order to optimize phonatory closure. Among the interventions, injection laryngoplasty stands out with its simplicity and versatility, which can correct the position of the paralyzed vocal fold, as well as its volume and, at the same time, its mass. Based on a review of the international literature and our own experiences, we present the meth- odology for applying the procedure, with particular attention to the different surgical techniques and the types of injectable materials. With the optimal choice of these factors, injection laryngoplasty is a safe, inexpensive, relatively easy to learn, and favorable solution for the treatment of mild to moderate glottic insufficiency due to various causes

Detailed Insights into the Relationship Between Three-Dimensional Speckle-Tracking Echocardiography-Derived Systolic Left Atrial Global Strains and Left Ventricular Volumes in Healthy Adults from the MAGYAR-Healthy Study

Background and Objectives: The complex relationship between three-dimensional (3D) speckle-tracking echocardiography (3DSTE)-derived left ventricular (LV) and left atrial (LA) volumes and functional properties has been demonstrated in recent studies. A better understanding of LV volumetric dependence on systolic peak LA (reservoir) strains in healthy circumstances could complete this knowledge. Therefore, 3DSTE was used for the simultaneous evaluation of these parameters in healthy adults, aiming to examine their complex relationship. Materials and Methods: The present study consisted of 165 healthy individuals with a mean age of 33.1 ± 12.3 years and 90 men. A complete two-dimensional echocardiography with Doppler with 3DSTE was performed in all the cases. Results: The peak LA global radial (GRS), longitudinal (GLS), and 3D (G3DS) strains were increased in the subjects with a mean LV end-diastolic volume (EDV) as compared to those cases with a lower-than-mean LV-EDV. In the cases with a higher-than-mean LV-EDV, no further increase in these peak global LA strains could be detected. The peak LA global circumferential and area strains showed a tendentious (non-significant) increase with an increasing LV-EDV. The peak LA global strains showed similar non-significant associations with the LV end-systolic volume (except the peak LA-G3DS, which proved to be significant). Conclusions: In healthy adults, the 3DSTE-derived peak LA-GRS and LA-G3DS are increased with a larger LV-EDV up to a point, beyond which a further increase cannot be seen, suggesting a working Frank–Starling mechanism in this context similar to that for LA volumes. Similar associations are present for the peak LA-GLS as well

The Transmission Mechanism of Monetary Policy and Central Bank Digital Currency: A New Monetary Order?

Over the last decade, monetary policy frameworks and instruments have undergone significant modifications. In this regard, Central Bank Digital Currency (CBDC) has emerged as a new money invention to offset the advancement of cryptocurrencies and maintain central ability to distribute cash as a common good. Thus, the purpose of this study is to examine how the adoption of CBDC can change monetary policy transmission mechanism. CBDC can disintermediate the conventional banking industry and produce inflationary pressure through the money supply unless central banks adopt suitable regulatory frameworks to facilitate a seamless transition. On the other hand, a well-structured CBDC can encourage increased financial inclusion, resulting in a favourable outcome on the interest rate pass-through of monetary policy. Meanwhile, since interest-bearing CBDC can affect bank reserves, deposit rates and lending policies, it can also have an impact on the credit channel