Az Érsebészeti Regiszter működtetése során szerzett tapasztalatok

Randomized controlled trials provide the best evidence in clinical trials; however, they do have limitations. In order to evaluate the effectiveness of treatments, population based registries may also yield useful information about the actual practice and they may enable users to carry out a dynamic follow-up. To evaluate the outcome of vascular procedures, the Vascular Registry in Hungary has been established in 2002. This article presents the establishment and functioning of the Vascular Registry and provides information about scientific results obtained during the past years. The Vascular Registry is an internet based database with on-line input. The backup server is provided by the National Institute for Quality and Organizational Development in Healthcare and Medicines. The database collects data in three different fields: interventions for carotid artery, aneurysm (any type) and lower extremity vascular diseases. Twenty five vascular surgical units record interventions in the registry, which corresponds to two thirds of the whole activity. Since joining the Vascunet Group of the European Society for Vascular Surgery, the registry has contributed to several publications based on evaluation of a large common dataset in different fields of vascular surgery. A validation process has been recently performed which confirmed the internal and external validity of the database. The authors conclude that despite unsolved problems related to financing issues, the Vascular Registry has proved to be a useful tool during the past years. In order to take advantage of the registry to its fullest, measures should be taken to achieve a more complete data recording, increase publication activity on the national dataset, improve the flow of information during operation and develop a system of regular feedback. Orv. Hetil., 2014, 155(19), 755-760

The Tychonoff uniqueness theorem for the G-heat equation

In this paper, we obtain the Tychonoff uniqueness theorem for the G-heat equation

The association between overall health, psychological distress, and occupational heat stress among a large national cohort of 40,913 Thai workers

Background: Occupational heat stress is a well-known problem, particularly in tropical countries, affecting workers, health and well-being. There are very few recent studies that have reported on the effect of heat stress on mental health, or overall health in workers, although socioeconomic development and rapid urbanization in tropical developing countries like Thailand create working conditions in which heat stress is likely. Objective: This study is aimed at identifying the relationship between self-reported heat stress and psychological distress, and overall health status in Thai workers. Results: 18% of our large national cohort (>40,000 subjects) often works under heat stress conditions and males are exposed to heat stress more often than females. Furthermore, working under heat stress conditions is associated with both worse overall health and psychological distress (adjusted odds ratios ranging from 1.49 to 1.84). Conclusions: This association between occupational heat stress and worse health needs more public health attention and further development on occupational health interventions as climate change increases Thailand's temperatures

Impact of predicted precipitation scenarios on multitrophic interactions

1. Predicted changes in the frequency and intensity of extreme rainfall events in the UK have the potential to disrupt terrestrial ecosystem function. However, responses of different trophic levels to these changes in rainfall patterns, and the underlying mechanisms, are not well characterised. 2. This study aimed to investigate how changes in both the quantity and frequency of rainfall events will affect the outcome of interactions between plants, insect herbivores (above- and below- ground) and natural enemies. 3. Hordeum vulgare L. plants were grown in controlled conditions and in the field, and subjected to three precipitation scenarios: ambient (based on a local 10 year average rainfall); continuous drought (40% reduction compared to ambient); drought/ deluge (40% reduction compared to ambient at a reduced frequency). The effects of these watering regimes and wireworm (Agriotes species) root herbivory on the performance of the plants, aphid herbivores above-ground (Sitobion avenae, Metapolophium dirhodum and Rhopalosiphum padi), and natural enemies of aphids including ladybirds (Harmonia axyridis) were assessed from measurements of plant growth, insect abundance and mass, and assays of feeding behaviour. 4. Continuous drought decreased plant biomass, whereas reducing the frequency of watering events did not affect plant biomass but did alter plant chemical composition. In controlled conditions, continuous drought ameliorated the negative impact of wireworms on plant biomass. 5. Compared to the ambient treatment, aphid mass was increased by 15% when feeding on plants subjected to drought/ deluge; and ladybirds were 66% heavier when feeding on these aphids but this did not affect ladybird prey choice. In field conditions, wireworms feeding below-ground reduced the number of shoot-feeding aphids under ambient and continuous drought conditions but not under drought/ deluge. 6. Predicted changes in both the frequency and intensity of precipitation events under climate change have the potential to limit plant growth, but reduce wireworm herbivory, while simultaneously promoting above-ground aphid numbers and mass, with these effects transferring to the third trophic level. Understanding the effect of future changes in precipitation on species interactions is critical for determining their potential impact on ecosystem functioning and constructing accurate predictions under global change scenarios

The effectiveness of public health interventions to reduce the health impact of climate change:a systematic review of systematic reviews

Climate change is likely to be one of the most important threats to public health in the coming years. Yet despite the large number of papers considering the health impact of climate change, few have considered what public health interventions may be of most value in reducing the disease burden. We aimed to evaluate the effectiveness of public health interventions to reduce the disease burden of high priority climate sensitive diseases

Apparent Temperature and Cause-Specific Emergency Hospital Admissions in Greater Copenhagen, Denmark

One of the key climate change factors, temperature, has potentially grave implications for human health. We report the first attempt to investigate the association between the daily 3-hour maximum apparent temperature (Tappmax) and respiratory (RD), cardiovascular (CVD), and cerebrovascular (CBD) emergency hospital admissions in Copenhagen, controlling for air pollution. The study period covered 1 January 2002−31 December 2006, stratified in warm and cold periods. A case-crossover design was applied. Susceptibility (effect modification) by age, sex, and socio-economic status was investigated. For an IQR (8°C) increase in the 5-day cumulative average of Tappmax, a 7% (95% CI: 1%, 13%) increase in the RD admission rate was observed in the warm period whereas an inverse association was found with CVD (−8%, 95% CI: −13%, −4%), and none with CBD. There was no association between the 5-day cumulative average of Tappmax during the cold period and any of the cause-specific admissions, except in some susceptible groups: a negative association for RD in the oldest age group and a positive association for CVD in men and the second highest SES group. In conclusion, an increase in Tappmax is associated with a slight increase in RD and decrease in CVD admissions during the warmer months

National Assessment of Human Health Effects of Climate Change in Portugal: Approach and Key Findings

In this study we investigated the potential impact of climate change in Portugal on heat-related mortality, air pollution–related health effects, and selected vectorborne diseases. The assessment used climate scenarios from two regional climate models for a range of future time periods. The annual heat-related death rates in Lisbon may increase from between 5.4 and 6 per 100,000 in 1980–1998 to between 8.5 and 12.1 by the 2020s and to a maximum of 29.5 by the 2050s, if no adaptations occur. The projected warmer and more variable weather may result in better dispersion of nitrogen dioxide levels in winter, whereas the higher temperatures may reduce air quality during the warmer months by increasing tropospheric ozone levels. We estimated the future risk of zoonoses using ecologic scenarios to describe future changes in vectors and parasites. Malaria and schistosomiasis, which are currently not endemic in Portugal, are more sensitive to the introduction of infected vectors than to temperature changes. Higher temperatures may increase the transmission risk of zoonoses that are currently endemic to Portugal, such as leishmaniasis, Lyme disease, and Mediterranean spotted fever