Orvosi Hetilap (Orv Hetil )

Publisher: Springer Verlag


The journal publishes original and review papers in the fields of experimental and clinical medicine. It covers epidemiology, diagnostics, therapy and the prevention of human diseases as well as papers of medical history. This is the oldest, still in-prin

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  • Website
    Orvosi Hetilap / Hungarian Medical Journal website
  • Other titles
    Hungarian medical journal
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  • Document type
    Journal / Magazine / Newspaper

Publisher details

Springer Verlag

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    • Author's pre-print on pre-print servers such as arXiv.org
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    • Articles in some journals can be made Open Access on payment of additional charge
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    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: The authors present the internet based Hungarian Arthroplasty Registry that was introduced in 2007. All departments involved in prosthesis implantation in Hungary have already registered and, therefore, data entry is available. However, data entry is far from 100 percent. The fully completed registry would be very important in order to be recognised at international forums. Until now 51 387 cases have been entered into the database. The datasheets can be saved after completion, the data and the correlations can be analysed and graphically displayed. This is a good tool to have data on prosthesis survival, surgical interventions and complications. Orv. Hetil., 2014, 155(19), 761-763.
    Orvosi Hetilap 05/2014; 155(19):761-3.
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    ABSTRACT: Since more than 80 years, the Hungarian obstetric database, called Tauffer registry, shows the evolution as well as professional and organizational issues of the Hungarian obstetrics. The system, renewed in 1994, provides detailed on-line information about obstetric events in the website owned by the National Institute for Quality and Organizational Development in Healthcare and Medicines. Although a significant overlap between Tauffer registry and other databases exists, these databases improve the efficacy of Tauffer registry and they provide additional information on obstetric events. Tauffer registry is publicly available for anyone and its data can be used by professionals and professional managers. The author presents 3 examples to demonstrate the practical use of professional indicators obtained from Tauffer registry. Orv. Hetil., 2014, 155(19), 750-754.
    Orvosi Hetilap 05/2014; 155(19):750-4.
  • Orvosi Hetilap 05/2014; 155(20):793-5.
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    ABSTRACT: The antitumour effect of statins has already been proven in animal experiments and human cancer cell lines in several gastrointestinal cancers. The chemopreventive mechanism is not completely clarified but the enhancement of oxidative stress, increased autophagy, altered expression of pro- and antiproliferative proteins and their influence on intracellular signaling pathways may play a role. Randomized studies, however, failed to confirme the expected results obtained from experimental studies. The goal of this review is to summarize the data available in the literature regarding the chemopreventive effects of statins on several gastrointestinal cancers. Results of clinical trials suggest that 10-20 mg statin daily has no or minimal antitumour effect. Chemopreventive effect of hydrophilic statins could not be detected but it seems to be significant in the case of hydrophobic statins. There are only few data available on the long-term daily use of 30-40 mg statins. Further long-term evaluation of the effect of statins regarding gastrointestinal cancers is needed, and an analysis of compound- and dose-related subgroups would be beneficial. Chemoprevention with statins cannot yet be accepted as standard medical practice. Use of statins as chemopreventive agents cannot be a substitute for regular oncological screening or surveillance. Orv. Hetil., 2014, 155(18), 687-693.
    Orvosi Hetilap 05/2014; 155(18):687-93.
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    ABSTRACT: After the completion of the Human Genome Project, the era of providing personalized dietary advice based on an individual's genetic profile seemed near. Since then more than a decade has passed and the pace of development has been slower than expected. Genotyping single nucleotide polymorphisms which may determine susceptibility to multifactorial diseases is cheaper and more accessible than it was ten years ago. However, few of them are supported by such solid scientific evidence which would justify their use for personalized dietary advice. The future of genotype-based personalized nutrition depends on whether a sufficient amount of gene-diet-disease interactions are identified and scientifically confirmed. Orv. Hetil., 2014, 155(20), 771-777.
    Orvosi Hetilap 05/2014; 155(20):771-7.
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    ABSTRACT: 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.
    Orvosi Hetilap 05/2014; 155(19):755-60.
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    ABSTRACT: Introduction: Liquid-based cervical cytology has been developed as an alternative for conventional Papanicolaou cervical cytology. Aim: The aim of this study was to determine the quality assurance of liquid-based cervical cytology. Method: 4573 cervical cytology smears were classified according to the Bethesda (2001) system. Human papilloma virus infection was detected and subtyped from reflex test using real-time polymerase chain reaction. Results: 4573 smears were classified according to the Bethesda (2001) system. Negative diagnosis was made in 2323 cases (50.8%), non neoplastic in 2017 cases (44.1%), and positive for intraepithelial lesions or malignancy in 233 cases (5.1%). Unsatisfactory smear for diagnosis was found in 43 cases (0.9%), low-grade squamous intraepithelial lesion in 87 cases (1.9%), high-grade squamous intraepithelial lesion in 24 cases (0.5%), and carcinoma in 23 cases (0.5%). Fifty-nine of the cases were histologically verified and 4 falsely negative cases were detected. The sensitivity, specificity and the positive predictive value were 93.2%, 100% and 100%, respectively. Compared to an identical time periods of the previous three years, the low- and high-grade squamous intraepithelial lesion increased from 0.82% to 2.51%. Eighty one human papilloma virus tests were performed with a positive predictive value of 99%. Conclusions: The auditing values of the liquid-bases cervical cytology results meet the proposed threshold values. Liquid-bases cervical cytology is an alternative cervical cytology and it seems to be significantly better than conventional Papanicolaou cervical cytology in all parameters. Orv. Hetil., 2014, 155(18), 708-714.
    Orvosi Hetilap 05/2014; 155(18):708-14.
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    ABSTRACT: Today, hypertension is considered endemic throughout the world. The number of individuals with high blood pressure and the increasing risk, morbidity and mortality caused by hypertension despite modern therapy do not decrease sufficiently. Hypertension has become a public health issue. Prevention and effective care require integrated datasets about many features, clinical presentation and therapy of patients with hypertension. The lack of this database in Hungary prompted the development of the registry which could help to provide population-based data for analysis. Data collection and processing was initiated by the Hungarian Society of Hypertension in 2002. Data recording into the Hungarian Hypertension Registry was performed four times (2002, 2005, 2007, 2011) and the registry currently contains data obtained from 108,473 patients. Analysis of these data indicates that 80% of the patients belong to the high or very high cardiovascular risk group. The registry provides data on cardiovascular risk of the hypertensive populations and the effectiveness of antihypertensive therapy in Hungary. Based on international experience and preliminary analysis of data from the Hungarian Hypertension Registry, establishment of hypertension registry may support the effectiveness of public health programs. A further step would be needed for proper data management control and the application of professional principles of evidence-based guidelines in the everyday practice. Orv. Hetil., 2014, 155(19), 764-768.
    Orvosi Hetilap 05/2014; 155(19):764-8.
  • Orvosi Hetilap 05/2014; 155(18):716-8.
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    ABSTRACT: Integrated health data management and disease registries which are able to support evidence-based decision making are of critical importance for health policy. Data provided by disease registries are used for the development of health strategy, planning of preventive activities, capacity-building in health care provision, improving health care quality, and planning clinical trials. Disease registries monitoring epidemiology, natural history of diseases, treatment outcomes and the detection of adverse reactions are requested not only by policy-makers, but public health authorities and health care providers, too. Registries for rare diseases are of critical importance for developing network between reference centres and developing and evaluating new drugs. Data and information need for decision-making in public services and the protection of health data of individuals require a careful balance that needs to be taken into account when considering disease registries. Orv. Hetil., 2014, 155(19), 729-731.
    Orvosi Hetilap 05/2014; 155(19):729-31.
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    ABSTRACT: Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5-25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703-707.
    Orvosi Hetilap 05/2014; 155(18):703-7.
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    ABSTRACT: Primary spinal tumors are rare diseases. Primary spinal tumor registry would be useful to help decision making in this complex field of spine surgery. In this article the authors present the latest findings from the Primary Spinal Tumor Registry at the National Centre for Spinal Disorders, Hungary. The registry is based on a novel database management software, the REDCap electronic data capture system. It contains data of 323 patients treated surgically during an 18-year period. Among the 126 malignant tumors, the most frequent was chordoma (61 cases). In the case of benign tumors schwannoma showed the largest prevalence (45 cases). The authors conclude that due to the rarity of the disease and the complexity of the management, multicenter, prospective registries are required to provide high level of evidence. The structure of the Primary Spinal Tumor Registry in the National Centre for Spinal Disorders in Hungary is optimal for user-friendly, fast and secure data collection providing a prospective database for scientific researches and clinical follow-up. Orv. Hetil., 2014, 155(19), 745-749.
    Orvosi Hetilap 05/2014; 155(19):745-9.
  • Orvosi Hetilap 05/2014; 155(19):727-8.
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    ABSTRACT: The tendons of flexor digitorum profundus are most often interconnected and making them less able to move independently than the superfical tendons. The reason for this is the cross connective tissue-ligamentous connection between the tendons of the profundus. The recognition of this so called quadriga phenomenon is important in the clinical practice, when the presence of this syndrome hinders the strength and the movement of the tendons after the operative reconstruction. In his work the author describes the anatomical bases, the biomechanical relations and the clinical importance of the quadriga syndrome in the mirror of literature data. Orv. Hetil., 2014, 155(20), 778-782.
    Orvosi Hetilap 05/2014; 155(20):778-82.
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    ABSTRACT: National Childhood Cancer Registry has been operated since 1971 by the Hungarian Paediatric Oncology Network. This Registry collects data on epidemiology, treatment modalities and effectiveness, as well as late follow-up of childhood cancers. An internet-based paediatric cancer registration and communication system for the Hungarian Paediatric Oncology Network has been introduced in April, 2010. The National Childhood Cancer Registry contains data of all paediatric cancer patients (0-18 yrs) who have insurance covered by the Hungarian Social Security Card. Creation (1971) and operation of the National Childhood Cancer Registry have been very important steps in the field of childhood oncology to evaluate the efficiency of paediatric oncology treatments as well as maximize return on medical investment. Orv. Hetil., 2014, 155(19), 732-739.
    Orvosi Hetilap 05/2014; 155(19):732-9.
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    ABSTRACT: The authors delineate the circumstances of the creation of the National Myocardial Infarction Registry program. This web-based program started in January 1, 2010 as a "pilot" study with the voluntary participation of 12 centres. As a result of professional consensus, the number of participating institutions has continuously increased and, since March 1, 2013, data supply has become obligatory for hospitals treating patients with myocardial infarction. In December, 2013 a new modification of certain health and health insurance related acts such as Act XLVII/1997 regulated the operation of National Myocardial Infraction Registry. At present 65 institutions provide data regularly. The number of patients with myocardial infarction in the database was 24308 in January 1, 2014. The authors summarize the data which accumulated during almost four years of functioning of the National Myocardial Infarction Registry Program. The incidence of myocardial infarction was defined by reviewing the number of pre hospital and hospital cases in five districts of the capital and Szabolcs-Szatmár-Bereg County of Hungary. Reviewing the records patients with ST-elevation and non-ST-elevation myocardial infarction revealed that treatment of 91% of ST-elevation patients occurred in hospitals with cardiac catheterization laboratory, and 82% of patients had primary percutaneous coronary intervention. In-hospital, 30-day and 1-year mortality were defined for patients treated for both types of myocardial infarction. Based on national and international experience, the authors emphasize that professional characteristics of patient care can only be assessed using specific patient registries and these data are essential in the development of an efficient health-care system. Orv. Hetil., 2014, 155(19), 740-744.
    Orvosi Hetilap 05/2014; 155(19):740-4.
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    ABSTRACT: Introduction: Cardiac troponin T in renal failure is used for the assessment of cardiovascular risk and mortality. Elevated cardiac troponin T levels correlate with subclinical myocardial necrosis, coronary heart disease, several echocardiographic parameters, metastatic calcification, as well as the presence of diabetes and uremic toxins. Aim: The aim of the authors was to examine the impact of factors, mainly the independent effects of inflammatory laboratory parameters, which may influence hypersensitive troponin T levels in hemodialysed patient groups with and without diabetes. Method: Hemodialysed patient groups with (n = 44) and without diabetes (n = 76) were studied. Difference in serum hypersensitive troponin T values before and after dialysis were analysed by paired Wilcoxon test. Factors possibly affecting the level of hypersensitive troponin T (especially inflammatory markers) were evaluated by multiregression analysis. Results: Hypersensitive troponin T levels in patients without diabetes (p = 0.0003) and those with diabetes (p = 0.0032) significantly increased during hemodialysis. In patients without diabetes several factors had significant effect on hypersensitive troponin T including age (p = 0.025), duration of hemodialysis (p = 0.0002), presence of cardiovascular complications (p = 0.0002), high sensivivity C-reactive protein (p = 0.0021), white blood cell count (p = 0.038), and the monocyte ratio (p = 0.0202). However, in patients with diabetes only high sensivivity C-reactive protein (p = 0.0024) showed association with hypersensitive troponin T levels. Conclusions: In hemodyalised patients with and without diabetes the hypersensitive troponin T levels are differently influenced by clinical and inflammatory laboratory parameters, which should be taken into consideration during clinical judgement. Orv. Hetil., 2014, 155(16), 627-633.
    Orvosi Hetilap 04/2014; 155(16):627-33.