A tüdőrák hazai epidemiológiai adatai új megközelítésben

In the international publications, in the last decades, incidence and mortality of lung cancer was the highest in Hungary in the ranking of European countries and even worldwide, despite the fact that no lung cancer incidence data were reported from Hungary until 2019. In the studies published by our working group at the end of 2019 and in the first half of 2020, we were the first to publish Hungarian lung cancer incidence and mortality data based on research on the NEAK database. The results of this study showed a significant, 25-30% lower incidence of lung cancer in Hungary than the previously reported data. Based on these findings, it was determined that the previously reported Hungarian lung cancer incidence and mortality data can be compiled due to different methodological applications of inadequately calculated results, and Hungarian lung cancer incidence and mortality are equally high, but not higher than the average in Central European countries. In addition, a decrease in the incidence and mortality of male lung cancer was measured between 2011 and 2016, while increasing values were found for women

Assessment of cervical spine involvement in rheumatoid arthritis patients in the era of biologics: a real-life, cross-sectional MRI study

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Ocularis syphilis

Bevezetés és célkitűzés: A syphiliseredetű uveitis szemészeti és általános tüneteinek ismertetése, a prognózis elemzése olyan esetek kapcsán, amelyekben az uveitis kivizsgálása során derült fény a syphilisre. Módszer: 2011 és 2019 között 14 uveitises beteg vizsgálata során derült fény syphilisre (13 férfi, 1 nő), a tünetek 25 szemen jelentkeztek. A betegek adatait retrospektíven elemeztük. Eredmények: A betegek átlagéletkora 46 év volt (23–72 év). A szemészeti diagnózis felállítását követően 2 beteg nem jelent meg a további bőrgyógyászati és szemészeti vizsgálaton, 1 beteget más intézetben kezeltek. A gondozott 11 betegnél a gyulladásban érintett szemeken az első alkalommal észlelt átlagolt látóélesség a jobb szemen 0,71 (0,001– 1,0), a bal szemen 0,53 (0,04–1,0) volt. A követési idő átlagosan 22 hónap (1–72) volt. A követési idő végén az át- lagolt látóélesség a jobb szemen 0,9 (0,15–1,0), a bal szemen 0,82 (0,08–1,0) volt. A leggyakoribb szemészeti ma- nifesztáció a hátsó uveitis volt, amely papillitis, chorioretinitis vagy kombinált formákban volt megfigyelhető, összesen 20 szemen. A neurosyphilis-protokoll alapján alkalmazott penicillinkezelés után a gyulladásos tünetek minden beteg- nél megszűntek, a követési idő végén a betegek többségénél a látóélesség teljes volt. A gyengébb látóélesség hátteré- ben látóideg-atrophia, illetve a macula károsodása állt. Következtetés: Eseteinkben a betegek főként középkorú férfiak voltak. Bár jellemző volt a hátsószegmentum-érintett- ség, megfelelő kezelés mellett a prognózis jónak volt mondható

Az elhízás mozgásszervi vonatkozásai: egy régi téma új megközelítésben = Musculoskeletal relevance of obesity: a new approach to an old topic

Absztrakt: A szerzők az elhízás mozgásszervi vonatkozásait új megközelítésben, elsősorban annak metabolikus hatásait kiemelve ismertetik. Az elhízással és különösen a metabolikus szindrómával járó biokémiai változások megváltoztatják a csont, az ízületi struktúrák és az izomzat működését. Ezek alapján szemléletváltozás szükséges bizonyos kórképekben az eddig kialakult nézetekben. A gyulladásos reumatológiai betegségek lefolyásának súlyosságában és az alkalmazott kezelések megválasztásában is figyelembe kell venni az elhízással járó anyagcsere-változásokat. A társuló komorbiditások miatt a személyre szabott kezelés fontossága kiemelt jelentőségű. Orv Hetil. 2019; 160(44): 1727–1734. | Abstract: Authors discuss the musculoskeletal aspects of obesity by applying a novel approach. Biochemical changes associated with obesity and especially metabolic syndrome, may have a great impact on the function of bones, joints and muscles. Therefore we need a new view and new strategies in rheumatic diseases. Obesity-associated metabolic changes should be considered during the progress of as well as the selection of treatment in inflammatory rheumatic diseases. Individualised treatment is necessary due to associated comorbidities as well. Orv Hetil. 2019; 160(44): 1727–1734

Real-world evidence on methotrexate-free subcutaneous tocilizumab therapy in patients with rheumatoid arthritis : 24-week data from the SIMPACT study

The aim of the SIMPACT study was to evaluate the efficacy and safety of MTX-free s.c. tocilizumab (TCZ) therapy in RA patients.SIMPACT was an open-label, non-controlled, non-randomized, non-interventional study, in which RA patients for whom the treating physicians ordered s.c. TCZ were observed during a 24-week treatment period in Hungarian centres. Although the use of MTX was avoided during the study period, other conventional synthetic DMARDs, oral CSs and NSAIDs were allowed. Study endpoints included the change in DAS28 and clinical activity index (CDAI) scores, the proportion of patients achieving remission in the whole population and in subgroups defined based on prior RA treatment history, and age, weight or biological sex post hoc. The extent of supplementary medication use was monitored.Three hundred and thirty-seven RA patients were enrolled in 18 study centres. TCZ therapy significantly decreased the disease activity measured by both DAS28 (P = 0.0001) and CDAI (P = 0.0001). Clinical response was more pronounced in biologic-naïve patients and was lower in patients >75 years of age. In the whole population, DAS28 ESR or CRP and CDAI remission rates were 70.10%, 78.95% and 33.59%, respectively. In patients <45 years of age, the CDAI remission rate doubled (67.86%). A significant decrease in the frequency of co-administered medication was reported, including oral CSs and DMARDs.Real-world clinical evidence on s.c. TCZ reported here is in line with the efficacy outcomes of randomized clinical trials. Subgroup analysis revealed that TCZ was more effective in biologic-naïve patients and in those <75 years old.ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT02402686

Revising Incidence and Mortality of Lung Cancer in Central Europe: An Epidemiology Review From Hungary

Objective: While Hungary is often reported to have the highest incidence and mortality rates of lung cancer, until 2018 no nationwide epidemiology study was conducted to confirm these trends. The objective of this study was to estimate the occurrence of lung cancer in Hungary based on a retrospective review of the National Health Insurance Fund (NHIF) database. Methods: Our retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between 1 Jan 2011 and 31 Dec 2016. Age-standardized incidence and mortality rates were calculated using both the 1976 and 2013 European Standard Populations (ESP). Results: Between 2011 and 2016, 6,996 - 7,158 new lung cancer cases were recorded in the NHIF database annually, and 6,045 - 6,465 all-cause deaths occurred per year. Age-adjusted incidence rates were 115.7-101.6/100,000 person-years among men (ESP 1976: 84.7-72.6), showing a mean annual change of - 2.26% (p = 0.008). Incidence rates among women increased from 48.3 to 50.3/100,000 person-years (ESP 1976: 36.9-38.0), corresponding to a mean annual change of 1.23% (p = 0.028). Age-standardized mortality rates varied between 103.8 and 97.2/100,000 person-years (ESP 1976: 72.8-69.7) in men and between 38.3 and 42.7/100,000 person-years (ESP 1976: 27.8-29.3) in women. Conclusion: Age-standardized incidence and mortality rates of lung cancer in Hungary were found to be high compared to Western-European countries, but lower than those reported by previous publications. The incidence of lung cancer decreased in men, while there was an increase in incidence and mortality among female lung cancer patients

Increased frequency of temporal acoustic window failure in rheumatoid arthritis: a manifestation of altered bone metabolism?

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Subjective well‑being in patients with pemphigus: a path analysis

Background Pemphigus is a chronic autoimmune blistering disease of the skin and mucosa severely impairing patients’ health-related quality of life (HRQoL). To date, no studies have measured subjective well-being in terms of life satisfaction in pemphigus. Our main objective was to evaluate satisfaction with life in patients with pemphigus, and to analyse its relationship with clinical severity and HRQoL. Methods A cross-sectional survey was carried out enrolling 77 patients with pemphigus. Subjective well-being was measured using the Satisfaction with Life Scale (SWLS). HRQoL was assessed by the Dermatology Life Quality Index (DLQI) and EQ-5D-5L. Disease severity was measured by Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). Results Mean ABSIS, DLQI, EQ-5D-5L and SWLS scores of patients were 11.7 (SD 17.3), 5.4 (6.8), 0.84 (0.22) and 4.76 (SD 1.52), respectively. The proportion of patients indicating extreme dissatisfaction, dissatisfaction, slightly below average in life satisfaction, average satisfaction, high satisfaction and very high satisfaction with life was 6 (7.8%), 5 (6.5%), 14 (18.2%), 16 (20.8%), 21 (27.3%) and 15 (19.5%), respectively. Life satisfaction was independent from age, gender, level of education and type of disease. A path analysis revealed that there was no direct relationship between ABSIS and SWLS (beta=−0.09; p=0.428); however, the following indirect path was confrmed: ABSIS→DLQI→EQ-5D-5L→SWLS. Conclusions Disease severity and HRQoL measures regularly used to assess patients’ health status may be complemented with a measure of subjective well-being, such as SWLS, to achieve a more holistic assessment of patients’ lives and optimise pemphigus care