33 research outputs found
Szájegészség által meghatározott életminőség: két rövid magyar ohip változat kifejlesztése és értékelése = Oral health related quality of life: development and evaluation of two abbreviated Hungarian OHIP versions
A tanulmány cĂ©lja az volt, hogy pszichometriai Ă©rtĂ©kelĂ©st adjon a szájegĂ©szsĂ©gi hatás profil (OHIP) magyar változatának (OHIP-H) kĂ©t rövid változatárĂłl (OHIP-H14 Ă©s OHIP-H5), fogászati betegekbĹ‘l Ă©s lakossági csoportokbĂłl kĂ©pzett mintákon. Az 53 kĂ©rdĂ©ses magyar OHIP változatbĂłl kĂ©t rövid kĂ©rdĂ©scsoportot választottunk ki, a 14 kĂ©rdĂ©ses angol Ă©s az 5 kĂ©rdĂ©ses nĂ©met változat alapján. A formai validitást 112 páciensnĂ©l teszteltĂĽk. ElĹ‘zetesen feltĂ©telezett összefĂĽggĂ©st vizsgáltunk az OHIP összesĂtett pontszám Ă©s a saját Ă©rtĂ©kelĂ©sű szájegĂ©szsĂ©g, valamint a szájállapotot felmĂ©rĹ‘ adatok között. A mĂ©rĹ‘eszköz stabilitását 19 állkapocs izĂĽleti (TMI) rendellenessĂ©ggel jelentkezĹ‘ páciensen ellenĹ‘riztĂĽk. Az ismĂ©telt tesztbĹ‘l számolt megbĂzhatĂłságot 42 foghiányos egyĂ©nen ellenĹ‘riztĂĽk, kĂ©t hetes követĂ©si idĹ‘szakot engedve kĂ©t vizsgálat között. A belsĹ‘ konzisztenciát 200, a lakosságbĂłl random mĂłdon választott egyĂ©nnĂ©l ellenĹ‘riztĂĽk. A kĂ©t rövid mĂ©rĹ‘eszköz összesĂtett pontszámai, valamint az önĂ©rtĂ©kelt szájegĂ©szsĂ©g Ă©s hatfĂ©le szájállapot közötti összefĂĽggĂ©s az eszköz formai validitását bizonyĂtja. Az Ă©rzĂ©kenysĂ©g megfelelĹ‘ volt az OHIP-H14-nĂ©l, ahol az átlag OHIP Ă©rtĂ©k a kezelĂ©s hatására 10,9-rĹ‘l 6,6-ra változott (a kĂĽlönbsĂ©g statisztikailag szignifikáns), azonban az OHIP-H5-nĂ©l nem, mert az átlagĂ©rtĂ©k változása nem volt szignifikáns. Az elfogadhatĂł megbĂzhatĂłságot a csoporton belĂĽli korreláciĂłs egyĂĽtthatĂł (ICC) 0,87/0,86 (ismĂ©telt teszt megbĂzhatĂłság) Ă©s a belsĹ‘ konzisztenciát mutatĂł 0,88–0,66 közötti Cronbach-alfa Ă©rtĂ©ke támasztja alá. MegállapĂthatĂł, hogy az OHIP-H14 a megfelelĹ‘ elkĂĽlönĂtĹ‘ Ă©s Ă©rtĂ©kelĹ‘ pszichometriás tulajdonságai miatt alkalmas a szájegĂ©szsĂ©g által meghatározott Ă©letminĹ‘sĂ©g keresztmetszeti Ă©s longitudinális vizsgálataira. Az OHIP-H5 kisebb Ă©rzĂ©kenysĂ©get mutatott.
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The aim of this study was to evaluate the intercultural adaptation of two Hungarian short-forms of the Oral Health Impact Profile – OHIP-H14 and OHIP-H5 – on Hungarian population and dental patients. Following English and German methods for question selection, versions with 5 and 14 items were constructed using the complete Hungarian instrument with 53 questions. Construct validity was tested in 112 dental patients by examining a priori hypothesized associations of OHIP summary scores with self-reported oral health and six oral conditions estimated by respondents. Responsiveness of the instrument to change in oral health status was tested in 19 patients treated with temporomandibular disorder pain. To determine the reliability of OHIP scores, test-retest reliability was assessed in 42 prosthodontic patients using a time interval of two weeks. Internal consistency of OHIP scores was determined in 200 randomly selected general population subjects. Substantial associations between the two short-form summary scores, self reported oral health and six oral conditions supported the construct validity of the instruments. Responsiveness measures were on an acceptable level for the 14-item questionnaire where the mean OHIP-H14 scores changed from 10.9 (baseline) to 6.6 (follow-up) during treatment (statistically significant), but not for the OHIP-H5, where the mean score change was not significant. Reliability was acceptable for both instruments indicated by intraclass correlation coefficients of 0.87/0.86 (test-retest reliability), and Cronbach’s alphas of 0.88/0.66 (internal consistency). Sufficient discriminative and evaluative psychometric properties make OHIP-H14 suitable for assessment of oral health-related quality of life in cross-sectional and longitudinal studies. OHIP-H5 has marginal psychometric properties and is therefore less suitable for evaluative purposes
Molekuláris tĂ©nyezĹ‘k szerepe az inzulinrezisztencia–elhĂzás–2-es tĂpusĂş diabetes patogenetikai kapcsolatban = Molecular mechanisms of insulin resistance in obesity and type 2 diabetes mellitus
A zsĂrszövetben az inzulinreceptor jelátviteli folyamatait auto-, para- Ă©s endokrin hatásokkal szabályozĂł számos fehĂ©rje termelĹ‘dik Ă©s szekretálĂłdik. Ezek közĂĽl több, Ăgy a tumornekrĂłzis-faktor-α Ă©s szolĂşbilis receptor formái, az sTNFR1 Ă©s sTNFR2, a rezisztin, retinolkötĹ‘ fehĂ©rje-4, plazminogĂ©naktivátor-inhibitor, lipokain-1 gátolja az inzulin jelátviteli folyamatait Ă©s inzulinrezisztenciát okoz, elsĹ‘sorban a zsĂrszövetben, a májban, az izomszövetben, az agyban, az endothelsejtekben, valamint a hasnyálmirigy β-sejtjeiben. Más fehĂ©rjĂ©k, Ăgy az adiponektin, visfatin, vaspin, omentin, apelin Ă©s chemerin pedig javĂtják az inzulinreceptor jelátvitelĂ©t. Az összefoglalás áttekinti az inzulinreceptor jelátviteli folyamatainak fĹ‘bb rĂ©szleteit Ă©s kitĂ©r az elhĂzásban, valamint a 2-es tĂpusĂş cukorbetegsĂ©gben Ă©szlelhetĹ‘ inzulin- Ă©s citokinrezisztenciák patomechanizmusában a közelmĂşltban megismert molekuláris tĂ©nyezĹ‘kre (pĂ©ldául a suppressor of cytokine signaling fehĂ©rje család).
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Adipose tissue cells express and secrete numerous proteins influencing the signal transduction pathways of insulin receptor by auto-, para- and endocrine manner. Several cytokines, tumor necrosis factor-α and its soluble receptor forms, sTNFR1 and sTNFR2, resistin, retinol-binding protein 4, plasminogen activator inhibitor, lipocain 1 inhibit the signalization of insulin receptor causing insulin resistance in target tissues, mainly in adipose, liver and muscle, brain, endothelial as well as in pancreatic β-cells. However, many other proteins produced by the fat tissue, such as adiponectin, visfatin, vaspin, apelin, omentin and chemerin enhance the signal transmission of the receptor. Recently discovered common mechanisms leading to insulin and cytokine resistance in obesity and type 2 diabetes mellitus, e.g. protein family of suppressor of cytokine signaling (SOCS) are also discussed
Piaci viszonyok a foglalkozás-egészségügyben = Market Oriented Occupational Medicine
A szerzĹ‘k áttekintik a foglalkozás-egĂ©szsĂ©gĂĽgyi ellátás hazai törtĂ©netĂ©t Ă©s jelenlegi helyzetĂ©t, elemzik kapcsolatát a munkaĂĽgyi szervezetekkel. A rendszerváltozást követĹ‘ gazdasági átalakulásban a szocialista nagyĂĽzemek helyĂ©t több, de kevesebb dolgozĂłt foglalkoztatĂł vállalkozás vette át, Ăgy a munkáltatĂłknak már nincs saját ĂĽzemorvosuk, hanem szerzĹ‘dniĂĽk kell foglalkozás-egĂ©szsĂ©gĂĽgyi ellátásra engedĂ©lyt kapott szolgáltatĂłval, aki viszont több cĂ©g munkavállalĂłit látja el. A nagyĂĽzemekben korábban dolgozĂł ĂĽzemorvosok háziorvosi ellátást is nyĂşjtanak Ă©s a szakvizsgát tett háziorvosok is belĂ©ptek az ĂĽzemorvosi piacra. Ennek a piacnak a felosztása nĂ©ha etikátlan gazdasági versenyben törtĂ©nik, amit a nem kötelezĹ‘en elĹ‘Ărt tarifák Ă©s a kötelezĹ‘en elĹ‘Ărt, de csak rĂ©szlegesen ellenĹ‘rzött szerzĹ‘dĂ©skötĂ©s tesz lehetĹ‘vĂ©. A rendszer a hiányosságok javĂtásával jobbá tehetĹ‘, indokolatlannak tűnik felforgatása, baleset-biztosĂtási alapra helyezĂ©se, a szakmai feladatoknak az erre szakkĂ©pesĂtĂ©ssel nem rendelkezĹ‘knek valĂł átadása, nemzetközi kötelezettsĂ©gek felrĂşgása, ahogyan ez egyes publicitást kapott elkĂ©pzelĂ©sekbĹ‘l kiderĂĽlt. A foglalkozás-egĂ©szsĂ©gĂĽgyben folyĂł szakmai munka felĂĽgyeletĂ©t szĂĽksĂ©ges lenne ismĂ©t az egĂ©szsĂ©gĂĽgy felĂĽgyelete alá vonni, a teljesen más elveken működĹ‘ Ă©s más szempontokat figyelembe vevĹ‘ gazdasági tárca helyett.
The history and the recent state of occupational medicine in Hungary, and its relation with governmental labor organizations are analyzed. In the past 20 years, large “socialist” factories were replaced by smaller companies employing fewer workers. They have been forced to establish contract with occupational health providers. Many of them offer primary care services, whereas family physicians having a board examination in occupational medicine are allowed to work in this field as well. The market of occupational medicine is less regulated, and ethical rules are not always considered. Undercutting prices is a common practice. The recent system could be improved by some regulations which should be respected. There is no reason to make rough changes establishing a new market for profit oriented insurance companies, and to allow employees and employers to work without specification neglecting international agreements. Occupational medicine should be supervised again by the health authorities instead of economists who have quite different, short-term priorities
Association of PPAR Alpha Intron 7 G/C, PPAR Gamma 2 Pro12Ala, and C161T Polymorphisms with Serum Fetuin-A Concentrations
BACKGROUND: Both peroxisome activator proteins (PPARs) and fetuin-A play a role in lipid and glucose metabolism. AIMS: We investigated whether PPARalpha intron 7 G2468/C and PPARgamma2 Pro12Ala and PPARgamma exon 6 C161T polymorphisms are associated with serum fetuin-A concentrations. PATIENTS AND METHODS: The PPARalpha intron 7 G/C polymorphism was studied in cohort 1 (79 reference individuals, 165 postinfarction patients). The two PPARgamma polymorphisms were investigated in cohort 2 (162 reference individuals, 165 postinfarction patients). Fetuin-A levels and PPAR polymorphisms were determined by radial immunodiffusion and polymerase chain reaction-restriction fragment length polymorphism techniques. RESULTS: The C allele variant of PPARalpha intron 7 G2467C was associated with higher fetuin-A levels (p = 0.018). Postinfarction status (p = 0.001), PPARalpha intron 7 GG/GC/CC genotypes (p = 0.032), and the C allele (p = 0.021) were the strongest determinants of fetuin-A concentration in a multiple regression model. Higher fetuin-A levels were associated with the Pro variant of PPARgamma2 (p = 0.047). Postinfarction status (p = 0.041) and BMI (p < 0.001) but not PPARgamma2 Pro were the strongest determinants of fetuin-A concentrations. PPARgamma exon 6 C161T genotypes were not associated with fetuin-A levels. CONCLUSIONS: Fetuin-A was determined mainly by the PPARalpha intron 7C allele and postinfarction status in cohort 1 and the BMI and postinfarction in cohort 2. The PPARalpha intron 7C and PPARgamma2 Pro variants are associated with fetuin-A levels
Peroxisoma proliferációt aktiváló receptorok (PPARalfa intron 7 2498 G/C, PPARgamma Pro12Ala és exon 6 C161T) génpolimorfizmusainak vizsgálata és összefüggésük a tumor necrosis factor (TNF)-alfa -238 G/A, -308 G/A promoter és a Toll-like receptor 4 (TLR) Asp299Gly és Thr399Ile polimorfizmusaival az inzulin-rezisztencia kialakulásának patomechanizmusában = Genetic polymorphisms of peroxisome activated receptors (PPARalpha intron 7 2498 G/C, PPARgamma Pro12Ala and exon 6 C161T) in association with TNF-alpha -238 G/A, -308 G/A promoter polymorphism and Toll-like receptor 4 (TLR) Asp299Gly and Thr399Ile poly
A PPARgamma Pro12 Ala polimorfizmus gyakorisága az infarktuson átesett betegek csoportjában 13,7 % (47/342, 3 homozygĂłta), a referens csoportban 11,7% (38/324, 3 homozygĂłta) volt. ElhĂzott gyermekeben az elĹ‘fordulás 14,5 % (23/158, 2 homozygĂłta) volt, felnĹ‘tt cukorbetegekben pedig 13,1 % (21/160). A PPARgamma C161T polimorfizmus gyakorisága az infarktuson átesett betegek között 11,1 % (38/342, 3 homozygĂłta), a referens csoportban 9,8 % (32/324, 3 homozygĂłta), az obes gyermek csoportban 10,7 % (17/158, 1 homozygĂłta), a felnĹ‘tt cukorbetegek csoportjában 11,2% (18/160, 1 homozygĂłta) volt. A PPARalpha L162V polimorfizmus gyakorisága a myocardiális nfarktuson átesett betegek csoportjában 16,95 % (58/342, 10 homozygĂłta), a referen csoportban 19,7 % (64/324, 11 homozygĂłta), az obes gyermekek csoportjában 21,8% (33/158, 4 homozygĂłtas), a felnĹ‘tt cukorbeteg csoportban 20 % (32/160, 3 homozygĂłta) volt. Az egyes csoportok között az allĂ©lek elĹ‘fordulása statisztikailag nem volt kĂĽlönbözĹ‘. Valamennyi vizsgált csoportban, a szĂvinfarktuson átesett, elhĂzott gyermek Ă©s felnĹ‘tt cukorbeteg csoportban emelkedett TNF-?, szolubilis TNF receptor 2, leptin, resisztin szinteket találtunk, az adiponectin Ă©s a ghrelin szintek pedig alacsonyabbak voltak a 12Ala allĂ©lt hordozĂłkban. | The frequency of the Pro12Ala polymorphis of the PPAR-gamma gene was 13,7 % (47/342, 3 homozygotes) in patients with myocardial infarction, 11,7% (38/324, 3 homozygotes) in the referent group, 14,5 % (23/158, 2 homozygotes) in the obese childrens' group, 13,1 % (21/160) in the adult diabetyc patients' group. Allelic frequency of the C161T polymorphism of PPAR-gamma gene was 11,1 % (38/342, 3 homozygotes) in the myocardial infarction group, 9,8 % (32/324, 3 homozygotes) in the referent group, 10,7 % (17/158, 1 homozygote) in the obese childrens' group, and 11,2% (18/160, 1 homozygote) in the adult diabetic patients' group. The allelic frequency of the L162V polymorphism of the PPAR-alpha gene was 16,95 % (58/342, 10 homozygotes) in the myocardial infarction group, 19,7 % (64/324, 11 homozygotes) in the referent group, 21,8% (33/158, 4 homozygotes) in the obese childrens' group, and 20 % (32/160, 3 homozygotes) in the adult diabetic patients group. There was no significant difference concverning the distribution of the mutant alleles among the different patient groups. Carriers of the Ala12 allelic variant of the PPAR-? gene had a higher body mass index, elevated serum TNF-?, TNF-receptor 2, fasting plasma insulin and C-peptide concentrations, higher, HOMA A index, as compared to the carriers of the Pro12 allelic variant
Human Fetuin-A Rs4918 Polymorphism and its Association with Obesity in Healthy Persons and in Patients with Myocardial Infarction in Two Hungarian Cohorts.
BACKGROUND Human fetuin A (AHSG) has been associated with the development of obesity, insulin resistance, type 2 diabetes mellitus, and atherosclerosis. Observations on the role of AHSG rs4918 single-nucleotide polymorphism are contradictory. We investigated the association between variants of rs4918 and parameters of obesity, lipid status, tumor necrosis factor-alpha (TNFalpha), adipokines (adiponectin, resistin, leptin), and insulin resistance in healthy persons and in patients with previous myocardial infarction. MATERIAL AND METHODS This was a cross-sectional study comprising cohort 1 (81 healthy individuals) and cohort 2 (157 patients with previous myocardial infarction). We used the allele-specific KASP genotyping assay to detect rs4918 polymorphism. RESULTS In cohort 1, G-nucleotide carriers had significantly lower serum TNFalpha, adiponectin, and higher leptin concentrations than in non-G carriers. These differences, however, were not observed in cohort 2. In cohort 2, G-carriers had lower BMI and waist circumferences than in non-G carriers. The G allele was more frequent among lean than obese patients (RR=1.067, 95%CI=1.053-2.651, p=0.015). An association between BMI and rs4918 polymorphism was observed among patients without diabetes (CC/CG/GG genotypes: p=0.003, G vs. non-G allele: p=0.008) but not in diabetics. In addition, a strong linearity between BMI and the CC/CG/GG genotypes (association value: 4.416, p=0.036) and the frequency of the G allele (7.420, p=0.006) could be identified. In cohort 2, non-obese, non-diabetic G-carriers still had lower BMI and waist circumferences than in non-G carriers. CONCLUSIONS The rs4918 minor variant is associated with lower TNFalpha and adiponectin, higher leptin levels in healthy persons, and more favorable anthropomorphic parameters of obesity in cohort 2
Correlation of maternal serum fetuin/alpha2-HS-glycoprotein concentration with maternal insulin resistance and anthropometric parameters of neonates in normal pregnancy and gestational diabetes
OBJECTIVE: Human fetuin/alpha(2)-HS-glycoprotein (AHSG) is a 49 kDa serum and tissue protein which is a natural inhibitor of insulin receptor signaling. We investigated serum AHSG levels during pregnancy and whether the protein is involved in insulin resistance observed in healthy pregnant women and patients with gestational diabetes. DESIGN: One hundred and four healthy pregnant women and 23 of their neonates, 30 patients with gestational diabetes and their neonates and 30 healthy age-matched non-pregnant females as a control group were investigated in a case-control cross-sectional study. METHODS: Serum AHSG was determined by radial immunodiffusion. RESULTS: We observed an increase of serum AHSG concentration in the second and third trimesters. Gestational diabetes patients had significantly higher AHSG levels than healthy pregnant women and non-pregnant controls. There was a highly significant positive correlation between serum AHSG concentration and indirect parameters of insulin resistance, i.e. tumor necrosis factor-alpha (TNF-alpha), leptin, C-peptide and C-peptide/blood glucose ratio. There was also a negative correlation between maternal AHSG, TNF-alpha, leptin levels and head circumference, body length and body weight of newborns. CONCLUSION: AHSG, TNF-alpha and leptin may contribute to insulin resistance during normal pregnancy and gestational diabetes. AHSG along with these cytokines may also negatively regulate neonatal skeletal development
Cigarette, waterpipe and e-cigarette use among an international sample of medical students. Cross-sectional multicenter study in Germany and Hungary
BACKGROUND: Tobacco use is the leading preventable cause of death worldwide. Besides cigarette smoking, waterpipe and e-cigarettes are gaining popularity among young adults. Medical students' smoking behavior is of particular interest because of their impending role in health promotion as future physicians. Aim of our study is to examine the prevalence and predictors of cigarette, waterpipe and e-cigarette use and the association of tobacco use with self-reported health status in an international sample of medical students. METHODS: In a multicenter cross-sectional study data on different aspects of health behavior were collected from medical students of 65 nationalities using a self-administered questionnaire in Germany (Dresden, Munich) and Hungary (Budapest, Pecs). The survey was conducted among 1st, 3rd and 5th year students. To explore associations between smoking behavior and socio-cultural factors Pearson's chi(2)-tests and multivariate binary logistic regression analyses were performed. RESULTS: The largest subpopulations were formed by German (n = 1289), Hungarian (n = 1055) and Norwegian (n = 147) students. Mean age was 22.5 +/- 3.3 years. Females represented 61.6% of the sample. In the whole sample prevalence of cigarette smoking was 18.0% (95% CI 16.6-19.4%), prevalence of waterpipe use was 4.8% (95% CI 4.0-5.7%), that of e-cigarette 0.9% (95% CI 0.5-1.2%). More males (22.0%) than females (15.5%) reported cigarette smoking. The lowest prevalence of cigarette smoking was found among Norwegian students (6.2%). Cigarette smokers were older, waterpipe users were younger than non-users. E-cigarette use was not associated with age of the students. Religious involvement was protective only against cigarette smoking. Financial situation showed no association with any kind of tobacco consumption. Cigarette smokers and e-cigarette users were less likely to report very good or excellent health status. CONCLUSIONS: Cigarette smoking is still the most popular way of consuming tobacco, although alternative tobacco use is also prevalent among medical students. To further health consciousness, medical schools should pay more attention to students' health behavior, especially their smoking habits. Tobacco prevention and cessation programs for medical students should consider not only the health risks of cigarette smoking but the need to discourage other forms of tobacco use, such as waterpipe
Hogyan nyer alkalmazást a Büntetőtörvénykönyv általános része a kihágások tekintetében
INST: L_08