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The goal of this study was to translate the Beliefs about Medicines Questionnaire – Specific (BMQ-Specific) for cholesterol-lowering drugs, into the Hungarian, Slovak, Czech and Polish languages and test their reliability with statistical methods. For this purpose, Cronbach’s alpha, confirmatory and exploratory factor analyses were conducted. The analyses included 235 Czech, 205 Hungarian, 200 Polish, and 200 Slovak respondents, all of whom were taking cholesterol-lowering drugs. The translations from English into the target languages were always done by two independent translators. As part of the validation process these translations were pilot tested and after the necessary alterations, they were translated back into English by a third translator. After the approval by the creator of the questionnaire, nationwide surveys were conducted in all four countries. The results of the confirmatory factor analysis were exceptionally good for the Czech and Slovak translations, while the Polish and Hungarian translations marginally crossed the predetermined thresholds. With the exception of a single Polish question, the results of the exploratory factor analysis were deemed acceptable. The translated versions of BMQ-Specific are reliable and valid tools to assess patients’ beliefs about medication, especially medication adherence among patients taking cholesterol-lowering medication. A comparison between the four countries with this questionnaire is now possible.
Klára Boruzs; Viktor Dombrádi; János Sándor; Gábor Bányai; Robert Horne; Klára Bíró; Attila Nagy. Cross-Cultural Adaptation and Lingual Validation of the Beliefs about Medicines Questionnaire (BMQ)-Specific for Cholesterol Lowering Drugs in the Visegrad Countries. International Journal of Environmental Research and Public Health 2020, 17, 7616 .
AMA StyleKlára Boruzs, Viktor Dombrádi, János Sándor, Gábor Bányai, Robert Horne, Klára Bíró, Attila Nagy. Cross-Cultural Adaptation and Lingual Validation of the Beliefs about Medicines Questionnaire (BMQ)-Specific for Cholesterol Lowering Drugs in the Visegrad Countries. International Journal of Environmental Research and Public Health. 2020; 17 (20):7616.
Chicago/Turabian StyleKlára Boruzs; Viktor Dombrádi; János Sándor; Gábor Bányai; Robert Horne; Klára Bíró; Attila Nagy. 2020. "Cross-Cultural Adaptation and Lingual Validation of the Beliefs about Medicines Questionnaire (BMQ)-Specific for Cholesterol Lowering Drugs in the Visegrad Countries." International Journal of Environmental Research and Public Health 17, no. 20: 7616.
Heavy metals can be released into all alcoholic beverages during production and storage. However, there is at least a theoretical risk that they could be present in higher, and potentially toxic, concentrations in those produced in the household and small-scale stills common in Central and Eastern Europe, which lack quality control and whose products are unrecorded by authorities. Yet, so far, few studies comparing concentrations of heavy metals in recorded and unrecorded spirits have been published. In this study we ask whether there is any difference between heavy metal concentrations in recorded and unrecorded spirits and, thus, the related health risk. The levels of heavy metals were determined in recorded (n = 97) and unrecorded (n = 100) spirits using inductively coupled plasma optical emission spectrometric analysis and applied to population-based risk assessments, considering average, regular and chronic heavy drinkers. Concentrations of Cu, Zn, and Sn were significantly higher in unrecorded spirits than those in their recorded counterparts and recorded spirits contained significantly higher levels of Fe, Mn, and Ni than unrecorded spirits. Combined exposure to heavy metals posed a potential health risk in chronic heavy drinkers consuming recorded spirits. However, when compared to the health risk arising from drinking large volumes of ethanol, the risk is negligible. Consequently, there are no grounds to worry about the adverse effects of heavy metals from spirits.
László Pál; Teuta Muhollari; Orsolya Bujdosó; Edina Baranyai; Attila Nagy; Ervin Árnyas; Róza Ádány; János Sándor; Martin McKee; Sándor Szűcs. Heavy metal contamination in recorded and unrecorded spirits. Should we worry? Regulatory Toxicology and Pharmacology 2020, 116, 104723 .
AMA StyleLászló Pál, Teuta Muhollari, Orsolya Bujdosó, Edina Baranyai, Attila Nagy, Ervin Árnyas, Róza Ádány, János Sándor, Martin McKee, Sándor Szűcs. Heavy metal contamination in recorded and unrecorded spirits. Should we worry? Regulatory Toxicology and Pharmacology. 2020; 116 ():104723.
Chicago/Turabian StyleLászló Pál; Teuta Muhollari; Orsolya Bujdosó; Edina Baranyai; Attila Nagy; Ervin Árnyas; Róza Ádány; János Sándor; Martin McKee; Sándor Szűcs. 2020. "Heavy metal contamination in recorded and unrecorded spirits. Should we worry?" Regulatory Toxicology and Pharmacology 116, no. : 104723.
Data mainly from one-off surveys clearly show that the health of Roma, the largest ethnic minority of Europe, is much worse than that of the general population. However, results from comprehensive exploratory studies are missing. The aim of our study was to create a complex database for comparative and association studies to better understand the background of the very unfavourable health of Roma, especially the high burden of cardiometabolic diseases. A three-pillar (questionnaire-based, physical and laboratory examinations) health survey was carried out on randomly selected samples of the Hungarian general (HG, n = 417) and Roma (HR, n = 415) populations, and a database consisting of more than half a million datapoints was created. Using selected data, the prevalence rates of metabolic syndrome (MetS) and of its components were determined, and to estimate the risk of insulin resistance (IR), surrogate measures (the homeostasis model assessment of insulin resistance index, quantitative insulin sensitivity check index, McAuley and TyG indices and the TG/HDL-C ratio) were calculated. Receiver operating characteristic curve analysis and Youden’s method were used to define the optimal cut-off values of each IR index. The prevalence of MetS was very high in both study populations (HG: 39.8%, HR: 44.0%) with no statistically significant difference between the two groups in females or males. The prevalence of MetS showed a very marked increase in the HR 35–49 years age group. Among surrogate measures, the TyG index showed the greatest power for predicting IR/MetS at a cut-off value of 4.69 (77% sensitivity, 84% specificity) and indicated a 42.3% (HG) and 40.5% (HR) prevalence of IR. The prevalence of MetS and IR is almost equally very unfavourable in both groups; thus, the factors underlying the high premature mortality burden of Roma should be further clarified by investigating the full spectrum of risk factors available in the database, with a special focus on the access of Roma people to preventive and curative health services.
Róza Ádány; Péter Pikó; Szilvia Fiatal; Zsigmond Kósa; János Sándor; Éva Bíró; Karolina Kósa; György Paragh; Éva Bácsné Bába; Ilona Veres-Balajti; Klára Bíró; Orsolya Varga; Margit Balázs. Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey. International Journal of Environmental Research and Public Health 2020, 17, 4833 .
AMA StyleRóza Ádány, Péter Pikó, Szilvia Fiatal, Zsigmond Kósa, János Sándor, Éva Bíró, Karolina Kósa, György Paragh, Éva Bácsné Bába, Ilona Veres-Balajti, Klára Bíró, Orsolya Varga, Margit Balázs. Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey. International Journal of Environmental Research and Public Health. 2020; 17 (13):4833.
Chicago/Turabian StyleRóza Ádány; Péter Pikó; Szilvia Fiatal; Zsigmond Kósa; János Sándor; Éva Bíró; Karolina Kósa; György Paragh; Éva Bácsné Bába; Ilona Veres-Balajti; Klára Bíró; Orsolya Varga; Margit Balázs. 2020. "Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey." International Journal of Environmental Research and Public Health 17, no. 13: 4833.
Background Improvement of preventive services for adults can be achieved by opportunistic or organised methods in primary care. The unexploited opportunities of these approaches were estimated by our investigation. Methods Data from the Hungarian implementation of European Health Interview Surveys in 2009 (N = 4709) and 2014 (N = 5352) were analysed. Proportion of subjects used interventions in target group (screening for hypertension and diabetes mellitus, and influenza vaccination) within a year were calculated. Taking into consideration recommendations for the frequency of intervention, numbers of missed interventions among patients visited a general practitioner in a year and among patients did not visit a general practitioner in a year were calculated in order to describe missed opportunities that could be utilised by opportunistic or organised approaches. Numbers of missed interventions were estimated for the entire population of the country and for an average-sized general medical practice. Results Implementation ratio were 66.8% for blood pressure measurement among subjects above 40 years and free of diagnosed hypertension; 63.5% for checking blood glucose among adults above 45 and overweighed and free of diagnosed diabetes mellitus; and 19.1% for vaccination against seasonal influenza. There were 4.1 million interventions implemented a year in Hungary, most of the (3.8 million) among adults visited general practitioner in a year. The number of missed interventions was 4.5 million a year; mostly (3.4 million) among persons visited general practitioner in a year. For Hungary, the opportunistic and organised missed opportunities were estimated to be 561,098, and 1,150,321 for hypertension screening; 363,270, and 227,543 for diabetes mellitus screening; 2,784,072, and 380,033 for influenza vaccination among the < 60 years old high risk subjects, and 3,029,700 and 494,150 for influenza vaccination among more than 60 years old adults, respectively. By implementing all missed services, the workload in an average-sized general medical practice would be increased by 12–13 opportunistic and 4–5 organised interventions a week. Conclusions The studied interventions are much less used than recommended. The opportunistic missed opportunities is prevailing for influenza vaccination, and the organised one is for hypertension screening. The two approaches have similar significance for diabetes mellitus screening.
János Sándor; Ildikó Tokaji; Nouh Harsha; Magor Papp; Róza Ádány; Árpád Czifra. Organised and opportunistic prevention in primary health care: estimation of missed opportunities by population based health interview surveys in Hungary. BMC Family Practice 2020, 21, 1 -12.
AMA StyleJános Sándor, Ildikó Tokaji, Nouh Harsha, Magor Papp, Róza Ádány, Árpád Czifra. Organised and opportunistic prevention in primary health care: estimation of missed opportunities by population based health interview surveys in Hungary. BMC Family Practice. 2020; 21 (1):1-12.
Chicago/Turabian StyleJános Sándor; Ildikó Tokaji; Nouh Harsha; Magor Papp; Róza Ádány; Árpád Czifra. 2020. "Organised and opportunistic prevention in primary health care: estimation of missed opportunities by population based health interview surveys in Hungary." BMC Family Practice 21, no. 1: 1-12.
Investigations on the impact of genetic factors on the development of obesity have been limited regarding the Roma population—the largest and most vulnerable ethnic minority in Europe of Asian origin. Genetic variants identified from genetic association studies are primarily from European populations. With that in mind, we investigated the applicability of data on selected obesity-related single nucleotide polymorphisms (SNPs), obtained from the Hungarian general (HG) population of European origin, on the Hungarian Roma (HR) population. Twenty preselected SNPs in susceptible alleles, known to be significantly associated with obesity-related phenotypes, were used to estimate the effect of these SNPs on body mass index (BMI) and waist circumference (WC) in HG (N = 1783) and HR (N = 1225) populations. Single SNP associations were tested using linear and logistic regression models, adjusted for known covariates. Out of 20 SNPs, four located in FTO (rs1121980, rs1558902, rs9939609, and rs9941349) showed strong association with BMI and WC as continuous variables in both samples. Computations based on Adult Treatment Panel III (ATPIII) and the International Diabetes Federation’s (IDF) European and Asian criteria showed rs9941349 in FTO to be associated only with WC among both populations, and two SNPs (rs2867125, rs6548238) in TMEM18 associated with WC only in HG population. A substantial difference (both in direction and effect size) was observed only in the case of rs1801282 in PPARγ on WC as a continuous outcome. Findings suggest that genetic risk scores based on counting SNPs with relatively high effect sizes, defined based on populations with European ancestry, can sufficiently allow estimation of genetic susceptibility for Roma. Further studies are needed to clarify the role of SNP(s) with protective effect(s).
Erand Llanaj; Péter Pikó; Károly Nagy; Gábor Rácz; Sándor János; Zsigmond Kósa; Szilvia Fiatal; Róza Ádány. Applicability of Obesity-Related SNPs and Their Effect Size Measures Defined on Populations with European Ancestry for Genetic Risk Estimation among Roma. Genes 2020, 11, 516 .
AMA StyleErand Llanaj, Péter Pikó, Károly Nagy, Gábor Rácz, Sándor János, Zsigmond Kósa, Szilvia Fiatal, Róza Ádány. Applicability of Obesity-Related SNPs and Their Effect Size Measures Defined on Populations with European Ancestry for Genetic Risk Estimation among Roma. Genes. 2020; 11 (5):516.
Chicago/Turabian StyleErand Llanaj; Péter Pikó; Károly Nagy; Gábor Rácz; Sándor János; Zsigmond Kósa; Szilvia Fiatal; Róza Ádány. 2020. "Applicability of Obesity-Related SNPs and Their Effect Size Measures Defined on Populations with European Ancestry for Genetic Risk Estimation among Roma." Genes 11, no. 5: 516.
The importance of puberty on later health status and behavior is indisputable, which also means that it is worth making intervention efforts during this period of life. However, whether better health-related knowledge is correlated with favorable health behavior in adolescents is an important, still unanswered question. Our objective was to examine this relationship. The participants were ninth-grade secondary school students. Data were collected using anonymous, self-administered questionnaires. The knowledge-related questions were compiled by the authors, while the questions concerning eating habits, physical activity, demographic and socioeconomic data were taken from the Health Behavior in School-Aged Children survey. The relationship between knowledge and behavior was investigated with structural equation modeling adjusted for gender, age, and socioeconomic status. The results demonstrated a good fit to the data, but better knowledge was not related to behavior in our sample. This finding suggests that adolescents’ health behavior is highly influenced by the living context; therefore, appropriate knowledge is necessary but not sufficient to improve adolescents’ behavior. Hence, comprehensive health promotion programs could provide solutions for encouraging healthy behavior.
Gabriella Nagy-Pénzes; Ferenc Vincze; János Sándor; Éva Bíró. Does Better Health-Related Knowledge Predict Favorable Health Behavior in Adolescents? International Journal of Environmental Research and Public Health 2020, 17, 1680 .
AMA StyleGabriella Nagy-Pénzes, Ferenc Vincze, János Sándor, Éva Bíró. Does Better Health-Related Knowledge Predict Favorable Health Behavior in Adolescents? International Journal of Environmental Research and Public Health. 2020; 17 (5):1680.
Chicago/Turabian StyleGabriella Nagy-Pénzes; Ferenc Vincze; János Sándor; Éva Bíró. 2020. "Does Better Health-Related Knowledge Predict Favorable Health Behavior in Adolescents?" International Journal of Environmental Research and Public Health 17, no. 5: 1680.
Studies in the alcohol consumption area are mostly related to the (ab)use of alcohol in young people. However, today, a growing number of researchers are emphasizing the clinical and public health significance of alcohol consumption in the elderly. In the WHO reports, harmful alcohol consumption is responsible for 5.3% of the global burden of the disease. The aim of this study was to investigate the prevalence of alcohol consumption among men and women aged 55 and over in Serbia and Hungary, leveraging data from the 2013 Serbian National Health Survey and from the 2014 Hungarian National Health Survey. Respondents aged 55 and over were analysed based on logistic multivariate models. The prevalence of alcohol consumption was 41.5% and 62.5% in Serbia and Hungary, respectively. It was higher among men in both countries, but among women, it was significantly higher in Hungary than in Serbia. The statistically significant predictors affecting alcohol consumption in Serbia included age, education, well-being index, long-term disease and overall health status, with marital status being an additional factor among men. In Hungary, education and long-term disease affected alcohol consumption in both sexes, while age and employment were additional factors among women. In both countries for both sexes, younger age, more significantly than primary education and good health, was associated with a higher likelihood of alcohol consumption.
Natasa Mihailovic; Gergő József Szőllősi; Nemanja Rancic; Sándor János; Klára Boruzs; Attila Csaba Nagy; Yuriy Timofeyev; Viktorija Dragojevic-Simic; Marko Antunovic; Vladimir Reshetnikov; Róza Ádány; Mihajlo Jakovljevic. Alcohol Consumption among the Elderly Citizens in Hungary and Serbia—Comparative Assessment. International Journal of Environmental Research and Public Health 2020, 17, 1289 .
AMA StyleNatasa Mihailovic, Gergő József Szőllősi, Nemanja Rancic, Sándor János, Klára Boruzs, Attila Csaba Nagy, Yuriy Timofeyev, Viktorija Dragojevic-Simic, Marko Antunovic, Vladimir Reshetnikov, Róza Ádány, Mihajlo Jakovljevic. Alcohol Consumption among the Elderly Citizens in Hungary and Serbia—Comparative Assessment. International Journal of Environmental Research and Public Health. 2020; 17 (4):1289.
Chicago/Turabian StyleNatasa Mihailovic; Gergő József Szőllősi; Nemanja Rancic; Sándor János; Klára Boruzs; Attila Csaba Nagy; Yuriy Timofeyev; Viktorija Dragojevic-Simic; Marko Antunovic; Vladimir Reshetnikov; Róza Ádány; Mihajlo Jakovljevic. 2020. "Alcohol Consumption among the Elderly Citizens in Hungary and Serbia—Comparative Assessment." International Journal of Environmental Research and Public Health 17, no. 4: 1289.
Background: The triglycerides (TG) to high-density lipoprotein (HDL)-cholesterol (HDL-C) ratio (TG/HDL-C) is a well-known predictor for cardiovascular diseases (CVDs) with great heritability background. The cholesteryl ester transfer protein (CETP) and hepatic lipase (LIPC) gene affect TG/HDL-C ratio. This study aims to explore the association between haplotypes (H) in CETP (based on 5 single nucleotide polymorphisms (SNPs)) and LIPC (based on 6 SNPs) genes and the TG/HDL-C ratio and its components, among Roma and Hungarian general populations. Methods: The prevalence of haplotypes and their effect on HDL-C, TG and TG/HDL-C ratio were calculated in both populations and compared. Results: Ten haplotypes in CETP and 6 in LIPC gene were identified. Three haplotypes in CETP and 3 in LIPC have significant effect on HDL-C level, whereas two in CETP and 3 in LIPC on TG level. The H6 in CETP (β = 0.52, p = 0.015; odds ratio (OR) = 1.87, p = 0.009) and H5 in LIPC (β = 0.56, p < 0.001; OR = 1.51, p = 0.002) have a significant increasing effect on TG/HDL-C ratio and have shown higher prevalence among the Roma, as compared to Hungarian general population. The H2 in the CETP gene has a decreasing effect on the TG/HDL-C ratio (OR = 0.58, p = 0.019) and is significantly less frequent among the Roma. Conclusions: Accumulation of harmful haplotypes in CETP and LIPC genes might have a role in the elevated TG/HDL-C ratio in the Roma population, which contributes to a higher risk in the development of cardiovascular diseases.
Peter Piko; Szilvia Fiatal; Nardos Abebe Werissa; Bayu Begashaw Bekele; Gabor Racz; Zsigmond Kosa; Janos Sandor; Roza Adany. The Effect of Haplotypes in the CETP and LIPC Genes on the Triglycerides to HDL-C Ratio and Its Components in the Roma and Hungarian General Populations. Genes 2020, 11, 56 .
AMA StylePeter Piko, Szilvia Fiatal, Nardos Abebe Werissa, Bayu Begashaw Bekele, Gabor Racz, Zsigmond Kosa, Janos Sandor, Roza Adany. The Effect of Haplotypes in the CETP and LIPC Genes on the Triglycerides to HDL-C Ratio and Its Components in the Roma and Hungarian General Populations. Genes. 2020; 11 (1):56.
Chicago/Turabian StylePeter Piko; Szilvia Fiatal; Nardos Abebe Werissa; Bayu Begashaw Bekele; Gabor Racz; Zsigmond Kosa; Janos Sandor; Roza Adany. 2020. "The Effect of Haplotypes in the CETP and LIPC Genes on the Triglycerides to HDL-C Ratio and Its Components in the Roma and Hungarian General Populations." Genes 11, no. 1: 56.
Background: In a previous survey, an elevated fasting glucose level (FG) and/or known type 2 diabetes mellitus (T2DM) were significantly more frequent in the Roma population than in the Hungarian general population. We assessed whether the distribution of 16 single nucleotide polymorphisms (SNPs) with unequivocal effects on the development of T2DM contributes to this higher prevalence. Methods: Genetic risk scores, unweighted (GRS) and weighted (wGRS), were computed and compared between the study populations. Associations between GRSs and FG levels and T2DM status were investigated in separate and combined study populations. Results: The Hungarian general population carried a greater genetic risk for the development of T2DM (GRSGeneral = 15.38 ± 2.70 vs. GRSRoma = 14.80 ± 2.68, p < 0.001; wGRSGeneral = 1.41 ± 0.32 vs. wGRSRoma = 1.36 ± 0.31, p < 0.001). In the combined population models, GRSs and wGRSs showed significant associations with elevated FG (p < 0.001) and T2DM (p < 0.001) after adjusting for ethnicity, age, sex, body mass index (BMI), high-density Lipoprotein Cholesterol (HDL-C), and triglyceride (TG). In these models, the effect of ethnicity was relatively strong on both outcomes (FG levels: βethnicity = 0.918, p < 0.001; T2DM status: ORethnicity = 2.484, p < 0.001). Conclusions: The higher prevalence of elevated FG and/or T2DM among Roma does not seem to be directly linked to their increased genetic load but rather to their environmental/cultural attributes. Interventions targeting T2DM prevention among Roma should focus on harmful environmental exposures related to their unhealthy lifestyle.
Nardos Abebe Werissa; Peter Piko; Szilvia Fiatal; Zsigmond Kosa; Janos Sandor; Roza Adany. SNP-Based Genetic Risk Score Modeling Suggests No Increased Genetic Susceptibility of the Roma Population to Type 2 Diabetes Mellitus. Genes 2019, 10, 942 .
AMA StyleNardos Abebe Werissa, Peter Piko, Szilvia Fiatal, Zsigmond Kosa, Janos Sandor, Roza Adany. SNP-Based Genetic Risk Score Modeling Suggests No Increased Genetic Susceptibility of the Roma Population to Type 2 Diabetes Mellitus. Genes. 2019; 10 (11):942.
Chicago/Turabian StyleNardos Abebe Werissa; Peter Piko; Szilvia Fiatal; Zsigmond Kosa; Janos Sandor; Roza Adany. 2019. "SNP-Based Genetic Risk Score Modeling Suggests No Increased Genetic Susceptibility of the Roma Population to Type 2 Diabetes Mellitus." Genes 10, no. 11: 942.
Salivary IL-6 mRNA was previously identified as a promising biomarker of oral squamous cell carcinoma (OSCC). We performed a multi-center investigation covering all geographic areas of Hungary. Saliva from 95 patients with OSCC and 80 controls, all Caucasian, were collected together with demographic and clinicopathological data. Salivary IL-6 mRNA was quantified by real-time quantitative PCR. Salivary IL-6 protein concentration was measured by enzyme-linked immune-sorbent assay. IL-6 protein expression in tumor samples was investigated by immunohistochemistry. Normalized salivary IL-6 mRNA expression values were significantly higher (p < 0.001) in patients with OSCC (mean ± SE: 3.301 ± 0.885) vs. controls (mean ± SE: 0.037 ± 0.012). Differences remained significant regardless of tumor stage and grade. AUC of the ROC curve was 0.9379 (p < 0.001; 95% confidence interval: 0.8973–0.9795; sensitivity: 0.945; specificity: 0.819). Salivary IL-6 protein levels were significantly higher (p < 0.001) in patients (mean ± SE: 70.98 ± 14.06 pg/mL), than in controls (mean ± SE: 12.45 ± 3.29). Specificity and sensitivity of IL-6 protein were less favorable than that of IL-6 mRNA. Salivary IL-6 mRNA expression was significantly associated with age and dental status. IL-6 manifestation was detected in tumor cells and tumor-infiltrating leukocytes, suggesting the presence of a paracrine loop of stimulation. Salivary IL-6 mRNA is one of the best performing and clinically relevant biomarkers of OSCC.
Ildikó Judit Márton; József Horváth; Péter Lábiscsák; Bernadett Márkus; Balázs Dezső; Adrienn Szabó; Ildikó Tar; József Piffkó; Petra Jakus; József Barabás; Péter Barabás; Lajos Olasz; Zsanett Kövér; József Tőzsér; János Sándor; Éva Csősz; Beáta Scholtz; Csongor Kiss. Salivary IL-6 mRNA is a Robust Biomarker in Oral Squamous Cell Carcinoma. Journal of Clinical Medicine 2019, 8, 1958 .
AMA StyleIldikó Judit Márton, József Horváth, Péter Lábiscsák, Bernadett Márkus, Balázs Dezső, Adrienn Szabó, Ildikó Tar, József Piffkó, Petra Jakus, József Barabás, Péter Barabás, Lajos Olasz, Zsanett Kövér, József Tőzsér, János Sándor, Éva Csősz, Beáta Scholtz, Csongor Kiss. Salivary IL-6 mRNA is a Robust Biomarker in Oral Squamous Cell Carcinoma. Journal of Clinical Medicine. 2019; 8 (11):1958.
Chicago/Turabian StyleIldikó Judit Márton; József Horváth; Péter Lábiscsák; Bernadett Márkus; Balázs Dezső; Adrienn Szabó; Ildikó Tar; József Piffkó; Petra Jakus; József Barabás; Péter Barabás; Lajos Olasz; Zsanett Kövér; József Tőzsér; János Sándor; Éva Csősz; Beáta Scholtz; Csongor Kiss. 2019. "Salivary IL-6 mRNA is a Robust Biomarker in Oral Squamous Cell Carcinoma." Journal of Clinical Medicine 8, no. 11: 1958.
Róza Ádány; János Sándor. Az északkelet-magyarországi telepszerű körülmények között élő cigány lakosság egészség-magatartása és egészségi állapota. Magyar Tudomány 2019, 1 .
AMA StyleRóza Ádány, János Sándor. Az északkelet-magyarországi telepszerű körülmények között élő cigány lakosság egészség-magatartása és egészségi állapota. Magyar Tudomány. 2019; ():1.
Chicago/Turabian StyleRóza Ádány; János Sándor. 2019. "Az északkelet-magyarországi telepszerű körülmények között élő cigány lakosság egészség-magatartása és egészségi állapota." Magyar Tudomány , no. : 1.
Background: Primary nonadherence to prescribed medications occurs when patients do not fill or dispense prescriptions written by healthcare providers. Although it has become an important public health issue in recent years, little is known about its frequency, causes, and consequences. Moreover, the pattern of risk factors shows remarkable variability across countries according to the published results. Our study aimed to assess primary nonadherence to medications prescribed by general practitioners (GPs) and its associated factors among adults in Hungary for the period of 2012–2015. Methods: Data on all general medical practices (GMPs) of the country were obtained from the National Health Insurance Fund and the Central Statistical Office. The ratio of the number of dispensed medications to the number of prescriptions written by a GP for adults was used to determine the medication adherence, which was aggregated for GMPs. The effect of GMP characteristics (list size, GP vacancy, patients’ education provided by a GMP, settlement type [urban or rural], and geographical location [by county] of the center) on adherence, standardized for patients’ age, sex, and eligibility for an exemption certificate, were investigated through generalized linear regression modeling. Results: A total of 281,315,386 prescriptions were dispensed out of 438,614,000 written by a GP. Overall, 64.1% of prescriptions were filled. According to the generalized linear regression coefficients, there was a negative association between standardized adherence and urban settlement type (b = -0.099, 95%CI = -0.103 to -0.094), higher level of education (b = -0.440, 95%CI = -0.468 to -0.413), and vacancy of the general practices (b = -0.193, 95%CI = -0.204 to -0.182). The larger GMP size proved to be a risk factor, and there was a significant geographical inequality for counties as well. Conclusions: More than one-third of the written prescriptions of GPs for adults in Hungary were not dispensed. This high level of nonadherence had great variability across GMPs, and can be explained by structural characteristics of GMPs, the socioeconomic status of patients provided, and the quality of cooperation between patients and GPs. Moreover, our findings suggest that the use of the dispensed-to-prescribed medication ratio in routine monitoring of primary health care could effectively support the necessary interventions.
Nouh Harsha; László Kőrösi; Anita Pálinkás; Klára Bíró; Klára Boruzs; Róza Ádány; János Sándor; Árpád Czifra. Determinants of Primary Nonadherence to Medications Prescribed by General Practitioners Among Adults in Hungary: Cross-Sectional Evaluation of Health Insurance Data. Frontiers in Pharmacology 2019, 10, 1 .
AMA StyleNouh Harsha, László Kőrösi, Anita Pálinkás, Klára Bíró, Klára Boruzs, Róza Ádány, János Sándor, Árpád Czifra. Determinants of Primary Nonadherence to Medications Prescribed by General Practitioners Among Adults in Hungary: Cross-Sectional Evaluation of Health Insurance Data. Frontiers in Pharmacology. 2019; 10 ():1.
Chicago/Turabian StyleNouh Harsha; László Kőrösi; Anita Pálinkás; Klára Bíró; Klára Boruzs; Róza Ádány; János Sándor; Árpád Czifra. 2019. "Determinants of Primary Nonadherence to Medications Prescribed by General Practitioners Among Adults in Hungary: Cross-Sectional Evaluation of Health Insurance Data." Frontiers in Pharmacology 10, no. : 1.
This study was part of monitoring an intervention aimed at developing a general practitioner cluster (GPC) model of primary healthcare (PHC) and testing its effectiveness in delivering preventive services integrated into the PHC system. The aim was to demonstrate whether GPC operation could increase the percentage of drugs actually dispensed. Using national reference data of the National Health Insurance Fund for each anatomical-therapeutic chemical classification ATC group of drugs, dispensed-to-prescribed ratios standardized (sDPR) for age, sex, and exemption certificate were calculated during the first quarter of 2012 (before-intervention) and the third quarter of 2015 (post-intervention). The after-to-before ratios of the sDPR as the relative dispensing ratio (RDR) were calculated to describe the impact of the intervention program. The general medication adherence increased significantly in the intervention area (RDR = 1.064; 95% confidence interval (CI): 1.054-1.073). The most significant changes were observed for cardiovascular system drugs (RDR = 1.062; 95% CI: 1.048-1.077) and for alimentary tract and metabolism-specific drugs (RDR = 1.072; 95% CI: 1.049-1.097). The integration of preventive services into a PHC without any specific medication adherence-increasing activities is beneficial for medication adherence, especially among patients with cardiovascular, alimentary tract, and metabolic disorders. Monitoring the percentage of drugs actually dispensed is a useful element of PHC-oriented intervention evaluation frames.
Nouh Harsha; Magor Papp; László Kőrösi; Árpád Czifra; Róza Ádány; János Sándor. Enhancing Primary Adherence to Prescribed Medications through an Organized Health Status Assessment-Based Extension of Primary Healthcare Services. International Journal of Environmental Research and Public Health 2019, 16, 3797 .
AMA StyleNouh Harsha, Magor Papp, László Kőrösi, Árpád Czifra, Róza Ádány, János Sándor. Enhancing Primary Adherence to Prescribed Medications through an Organized Health Status Assessment-Based Extension of Primary Healthcare Services. International Journal of Environmental Research and Public Health. 2019; 16 (20):3797.
Chicago/Turabian StyleNouh Harsha; Magor Papp; László Kőrösi; Árpád Czifra; Róza Ádány; János Sándor. 2019. "Enhancing Primary Adherence to Prescribed Medications through an Organized Health Status Assessment-Based Extension of Primary Healthcare Services." International Journal of Environmental Research and Public Health 16, no. 20: 3797.
Orsolya Bujdosó; László Pál; Attila Nagy; Ervin Árnyas; Róza Ádány; János Sándor; Martin McKee; Sándor Szűcs. Can be the health risk from consumption of unrecorded fruit spirits containing alcohols other than ethanol ruled out? Regulatory Toxicology and Pharmacology 2019, 107, 104431 .
AMA StyleOrsolya Bujdosó, László Pál, Attila Nagy, Ervin Árnyas, Róza Ádány, János Sándor, Martin McKee, Sándor Szűcs. Can be the health risk from consumption of unrecorded fruit spirits containing alcohols other than ethanol ruled out? Regulatory Toxicology and Pharmacology. 2019; 107 ():104431.
Chicago/Turabian StyleOrsolya Bujdosó; László Pál; Attila Nagy; Ervin Árnyas; Róza Ádány; János Sándor; Martin McKee; Sándor Szűcs. 2019. "Can be the health risk from consumption of unrecorded fruit spirits containing alcohols other than ethanol ruled out?" Regulatory Toxicology and Pharmacology 107, no. : 104431.
The lack of recommended design for Roma health-monitoring hinders the interventions to improve the health status of this ethnic minority. We aim to describe the riskiness of Roma ethnicity using census-derived data and to demonstrate the value of census for monitoring the Roma to non-Roma gap. This study investigated the self-declared occurrence of at least one chronic disease and the existence of activity limitations among subjects with chronic disease by the database of the 2011 Hungarian Census. Risks were assessed by odds ratios (OR) and 95% confidence intervals (95% CI) from logistic regression analyses controlled for sociodemographic factors. Roma ethnicity is a risk factor for chronic diseases (OR = 1.17; 95% CI: 1.16–1.18) and for activity limitation in everyday life activities (OR = 1.20; 95% CI: 1.17–1.23), learning-working (OR = 1.24; 95% CI: 1.21–1.27), family life (OR = 1.22; 95% CI: 1.16–1.28), and transport (OR = 1.03; 95% CI: 1.01–1.06). The population-level impact of Roma ethnicity was 0.39% (95% CI: 0.37–0.41) for chronic diseases and varied between 0 and 1.19% for activity limitations. Our investigations demonstrated that (1) the Roma ethnicity is a distinct risk factor with significant population level impact for chronic disease occurrence accompanied with prognosis worsening influence, and that (2) the census can improve the Roma health-monitoring system, primarily by assessing the population level impact.
Ferenc Vincze; Anett Földvári; Anita Pálinkás; Valéria Sipos; Eszter Anna Janka; Róza Ádány; János Sándor. Prevalence of Chronic Diseases and Activity-Limiting Disability among Roma and Non-Roma People: A Cross-Sectional, Census-Based Investigation. International Journal of Environmental Research and Public Health 2019, 16, 3620 .
AMA StyleFerenc Vincze, Anett Földvári, Anita Pálinkás, Valéria Sipos, Eszter Anna Janka, Róza Ádány, János Sándor. Prevalence of Chronic Diseases and Activity-Limiting Disability among Roma and Non-Roma People: A Cross-Sectional, Census-Based Investigation. International Journal of Environmental Research and Public Health. 2019; 16 (19):3620.
Chicago/Turabian StyleFerenc Vincze; Anett Földvári; Anita Pálinkás; Valéria Sipos; Eszter Anna Janka; Róza Ádány; János Sándor. 2019. "Prevalence of Chronic Diseases and Activity-Limiting Disability among Roma and Non-Roma People: A Cross-Sectional, Census-Based Investigation." International Journal of Environmental Research and Public Health 16, no. 19: 3620.
Introduction: The indicator-based performance monitoring and pay-for-performance system for Hungarian primary care was established in 2009, covering the whole country. It is based on a stable legal system and well operating information technology. Although, the health insurance system is able to facilitate the performance improvement only by the financing for general medical practices, the many times modified present system does not take into consideration (apart from the geographical location of practices) factors which determine the performance but cannot be influenced by general practitioners. Aim: The study aimed at renewing the indicator set and evaluation methodology in order to enable the monitoring to evaluate the performance of general medical practices independent of their structural characteristics. Method: Each adult care specific primary care performance indicator from June 2016 covering the whole country has been investigated. Indicators adjusted for structural practice characteristics (age and gender of patients; relative education of people provided; settlement type and county of the practice) have been computed. The difference between adjusted indicators and national reference values has been evaluated by statistical testing. Appropriateness of the present monitoring and financing system has been investigated by comparing the practice level presently applied and adjusted indicators to outline the opportunities to develop the present system. Results: The present monitoring allocates 34.46% of pay-for-performance resources for improving the performance of practices. The majority of resources supports the conservation of performance. Furthermore, the present system is not able to identify each practice with better than reference performance, withholding amount corresponding to 8.83% of pay-for-performance resources. If this financing were restricted to practices with significantly better than reference performance, the maximum of the financing a month in a practice would increase from 176 042 HUF (551 EURO) to 406 604 HUF (1274 EURO). Conclusion: Completing the performance monitoring system operated at present by the National Health Insurance Fund of Hungary with indicators adjusted for structural characteristics of the general medical practices, the resource allocation effectiveness could be improved. Orv Hetil. 2019; 160(39): 1542–1553.
Anita Pálinkás; Nóra Kovács; Valéria Sipos; Ferenc Vincze; Magor Papp; Árpád Czifra; Róza Ádány; János Sándor. Az indikátoralapú teljesítményértékelésre épülő forráselosztás hatékonysága Magyarországon a felnőtteket ellátó háziorvosi praxisokban. Orvosi Hetilap 2019, 160, 1542 -1553.
AMA StyleAnita Pálinkás, Nóra Kovács, Valéria Sipos, Ferenc Vincze, Magor Papp, Árpád Czifra, Róza Ádány, János Sándor. Az indikátoralapú teljesítményértékelésre épülő forráselosztás hatékonysága Magyarországon a felnőtteket ellátó háziorvosi praxisokban. Orvosi Hetilap. 2019; 160 (39):1542-1553.
Chicago/Turabian StyleAnita Pálinkás; Nóra Kovács; Valéria Sipos; Ferenc Vincze; Magor Papp; Árpád Czifra; Róza Ádány; János Sándor. 2019. "Az indikátoralapú teljesítményértékelésre épülő forráselosztás hatékonysága Magyarországon a felnőtteket ellátó háziorvosi praxisokban." Orvosi Hetilap 160, no. 39: 1542-1553.
The performance of general practitioners (GPs) is frequently assessed without considering the factors causing variability among general medical practices (GMPs). Our cross-sectional national-based study was performed in Hungary to evaluate the influence of GMP characteristics on performance indicators. The relationship between patient's characteristics (age, gender, education) and GMP-specific parameters (practice size, vacancy of GP's position, settlement type, and county of GMP) and the quality of care was assessed by multilevel logistic regression models. The variations attributable to physicians were small (from 0.77% to 17.95%). The education of patients was associated with 10 performance indicators. Practicing in an urban settlement mostly increased the quality of care for hypertension and diabetes care related performance indicators, while the county was identified as one of the major determinants of variability among GPs' performance. Only a few indicators were affected by the vacancy and practice size. Thus, the observed variability in performance between GPs partially arose from demographic characteristics and education of patients, settlement type, and regional location of GMPs. Considering the real effect of these factors in evaluation would reflect better the personal performance of GPs.
Nóra Kovács; Anita Pálinkás; Valéria Sipos; Attila Nagy; Nouh Harsha; László Kőrösi; Magor Papp; Róza Ádány; Orsolya Varga; János Sándor. Factors Associated with Practice-Level Performance Indicators in Primary Health Care in Hungary: A Nationwide Cross-Sectional Study. International Journal of Environmental Research and Public Health 2019, 16, 3153 .
AMA StyleNóra Kovács, Anita Pálinkás, Valéria Sipos, Attila Nagy, Nouh Harsha, László Kőrösi, Magor Papp, Róza Ádány, Orsolya Varga, János Sándor. Factors Associated with Practice-Level Performance Indicators in Primary Health Care in Hungary: A Nationwide Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2019; 16 (17):3153.
Chicago/Turabian StyleNóra Kovács; Anita Pálinkás; Valéria Sipos; Attila Nagy; Nouh Harsha; László Kőrösi; Magor Papp; Róza Ádány; Orsolya Varga; János Sándor. 2019. "Factors Associated with Practice-Level Performance Indicators in Primary Health Care in Hungary: A Nationwide Cross-Sectional Study." International Journal of Environmental Research and Public Health 16, no. 17: 3153.
Alcohol-attributable mortality in certain countries of Central and Eastern Europe (CEE) remains higher than in their western neighbours. The effect of unrecorded alcohol consumption, including home-made fruit spirits have been suggested as an explanation. Besides ethanol, recorded and unrecorded spirits frequently contain other aliphatic alcohols (OAAs). Our aim was to ascertain whether there is any difference in the amounts of OAAs in recorded and unrecorded spirits, and thus the health risk associated with their consumption. The concentrations of ethanol and OAAs in recorded (n = 119) and unrecorded (n = 87) spirits were determined by gas chromatography and used in a Monte Carlo type probabilistic simulation to assess the risk based on average consumption level, consumption by drinkers only and chronic heavy drinkers. The concentrations of OAAs in unrecorded spirits were significantly higher [median: 9896.1 mg/L, interquartile range (IQR): 7898.3–12 634.6 mg/L] than those in their recorded (median: 975.6 mg/L, IQR: 136.9–4006.7 mg/L) counterparts. Besides ethanol methanol also posed a health risk at each consumption level. The risk associated with exposure to OAAs was higher only in chronic heavy drinkers consuming unrecorded spirits. These findings reinforce the importance of action to address the risks associated with consumption of recorded and unrecorded spirits.
Orsolya Bujdosó; László Pál; Attila Nagy; Ervin Árnyas; Róza Ádány; János Sándor; Martin McKee; Sándor Szűcs. Is there any difference between the health risk from consumption of recorded and unrecorded spirits containing alcohols other than ethanol? A population-based comparative risk assessment. Regulatory Toxicology and Pharmacology 2019, 106, 334 -345.
AMA StyleOrsolya Bujdosó, László Pál, Attila Nagy, Ervin Árnyas, Róza Ádány, János Sándor, Martin McKee, Sándor Szűcs. Is there any difference between the health risk from consumption of recorded and unrecorded spirits containing alcohols other than ethanol? A population-based comparative risk assessment. Regulatory Toxicology and Pharmacology. 2019; 106 ():334-345.
Chicago/Turabian StyleOrsolya Bujdosó; László Pál; Attila Nagy; Ervin Árnyas; Róza Ádány; János Sándor; Martin McKee; Sándor Szűcs. 2019. "Is there any difference between the health risk from consumption of recorded and unrecorded spirits containing alcohols other than ethanol? A population-based comparative risk assessment." Regulatory Toxicology and Pharmacology 106, no. : 334-345.
Antimicrobial resistance (AMR) is an increasing public health problem worldwide. We studied some patient-related factors that might influence the antimicrobial resistance. and whether the volume of antibiotic prescribing of the primary care physicians correlate with the antibiotic resistance rates of commensal nasal Staphylococcus aureus and Streptococcus pneumoniae. The socio-demographic questionnaires, the antibiotic prescription and resistance data of commensal nasal S. aureus and S. pneumoniae were collected in the 20 participating Hungarian practices of the APRES study. Multivariate logistic regression analyses were performed on the patient-related data and the antimicrobial resistance of the S. aureus and S. pneumoniae on individual, patient level. Ecological analyses were performed with Spearman's rank correlations at practice level, the analyses were performed in the whole sample (all practices) and in the cohorts of primary care practices taking care of adults (adult practices) or children (paediatric practices). According to the multivariate model, age of the patients significantly influenced the antimicrobial resistance of the S. aureus (OR = 0.42, p = 0.004) and S. pneumoniae (OR = 0.89, p < 0.001). Living with children significantly increased the AMR of the S. pneumoniae (OR = 1.23, p = 0.019). In the cohorts of adult or paediatric practices, neither the age nor other variables influenced the AMR of the S. aureus and S. pneumoniae. At practice level, the prescribed volume of penicillins significantly correlated with the resistance rates of the S. aureus isolates to penicillin (rho = 0.57, p = 0.008). The volume of prescribed macrolides, lincosamides showed positive significant correlations with the S. pneumoniae resistance rates to clarithromycin and/or clindamycin in all practices (rho = 0.76, p = 0.001) and in the adult practices (rho = 0.63, p = 0.021). The age is an important influencing factor of antimicrobial resistance. The results also suggest that there may be an association between the antibiotic prescribing of the primary care providers and the antibiotic resistance of the commensal S. aureus and S. pneumoniae. The role of the primary care physicians in the appropriate antibiotic prescribing is very important to avoid the antibiotic resistance.
László Róbert Kolozsvári; József Kónya; John Paget; Francois G. Schellevis; János Sándor; Gergő József Szőllősi; Szilvia Harsányi; Zoltán Jancsó; Imre Rurik. Patient-related factors, antibiotic prescribing and antimicrobial resistance of the commensal Staphylococcus aureus and Streptococcus pneumoniae in a healthy population - Hungarian results of the APRES study. BMC Infectious Diseases 2019, 19, 253 .
AMA StyleLászló Róbert Kolozsvári, József Kónya, John Paget, Francois G. Schellevis, János Sándor, Gergő József Szőllősi, Szilvia Harsányi, Zoltán Jancsó, Imre Rurik. Patient-related factors, antibiotic prescribing and antimicrobial resistance of the commensal Staphylococcus aureus and Streptococcus pneumoniae in a healthy population - Hungarian results of the APRES study. BMC Infectious Diseases. 2019; 19 (1):253.
Chicago/Turabian StyleLászló Róbert Kolozsvári; József Kónya; John Paget; Francois G. Schellevis; János Sándor; Gergő József Szőllősi; Szilvia Harsányi; Zoltán Jancsó; Imre Rurik. 2019. "Patient-related factors, antibiotic prescribing and antimicrobial resistance of the commensal Staphylococcus aureus and Streptococcus pneumoniae in a healthy population - Hungarian results of the APRES study." BMC Infectious Diseases 19, no. 1: 253.
Due to the increasing trends of recent decades, diabetes prevalence has reached a frequency of 1/11 adults worldwide. However, this disadvantageous trend has not been accompanied by worsened outcome indicators; better short-term (e.g., HbA1c levels) and long-term [e.g., all-cause mortality among type 2 diabetes mellitus (T2DM) patients] outcomes can be observed globally. We aimed to describe changes in the effectiveness of type 2 diabetes mellitus care between 2008 and 2016 based on outcome indicators. The study is a secondary analysis of data from two previously performed surveys. Both surveys were conducted in the framework of the General Practitioners’ Morbidity Sentinel Stations Program (GPMSSP), which maintains a nationally representative registry of T2DM patients. The largest improvement was observed in achieving fasting blood glucose and HbA1c target values [OR = 0.67, 95% confidence interval (CI), 0.56–0.80 and OR = 0.58; 95% CI, 0.48–0.70, respectively]. Moderate improvement was detected by reaching body mass index (BMI), diastolic blood pressure and total cholesterol target values (OR = 0.78, 95% CI, 0.65–0.93; OR = 0.78, 95% CI, 0.65–0.94 and OR = 0.76, 95% CI, 0.63–0.92, respectively). Our study demonstrated that if standardized indicators are investigated in population-based samples, the effectiveness of T2DM care can be monitored by ad hoc surveys. The systematic application of this approach completed with the detailed documentation of the applied therapies could demonstrate the public health impact of certain modifications in T2DM care. An overall improvement in metabolic control (glycaemic control, lipid status and obesity) was observed, which was not accompanied by improved therapeutic target achievement for systolic blood pressure.
Attila Nagy; Nóra Kovács; Anita Pálinkás; Valéria Sipos; Ferenc Vincze; Gergő Szőllősi; Róza Ádány; Árpád Czifra; János Sándor. Improvement in Quality of Care for Patients with Type 2 Diabetes in Hungary Between 2008 and 2016: Results from Two Population-Based Representative Surveys. Diabetes Therapy 2019, 10, 757 -763.
AMA StyleAttila Nagy, Nóra Kovács, Anita Pálinkás, Valéria Sipos, Ferenc Vincze, Gergő Szőllősi, Róza Ádány, Árpád Czifra, János Sándor. Improvement in Quality of Care for Patients with Type 2 Diabetes in Hungary Between 2008 and 2016: Results from Two Population-Based Representative Surveys. Diabetes Therapy. 2019; 10 (2):757-763.
Chicago/Turabian StyleAttila Nagy; Nóra Kovács; Anita Pálinkás; Valéria Sipos; Ferenc Vincze; Gergő Szőllősi; Róza Ádány; Árpád Czifra; János Sándor. 2019. "Improvement in Quality of Care for Patients with Type 2 Diabetes in Hungary Between 2008 and 2016: Results from Two Population-Based Representative Surveys." Diabetes Therapy 10, no. 2: 757-763.