Early and Menopausal Weight Gain and its Relationship with the Development of Diabetes and Hypertension.

Background: Previous research has revealed a clear relationship between weight gain of persons and their metabolic diseases developing later. These studies have covered only short periods lasting 4-8 years.Our goal was to collect decades' old and often life-long anthropometric data and correlate the figures with the presence of hypertension and diabetes or both. Methods: A retrospective international study was planned and organized to compare self-recorded data of lifelong weight gain among 60-70-year-old patients, analyze their correlation with metabolic diseases they developed, with special attention to women's weight gain around pregnancy, delivery and menopause in primary care settings in Germany, Hungary, Italy, Slovakia and the Ukraine. Results: Of the recruited 815 participants, 319 men and 496 women presented all the required data. Diabetics of both genders had the highest baseline weight at 20 years of age. The weight and BMI of the whole study population increased steadily until their seventies, but to a lesser extent after their fifties. Compared to the control group, changes over decades were the greatest among diabetics and also greater among patients with hypertension. Weight increase in the first decades (20-30-year-old men and 30-40-year-old women) was a significant risk factor for the development of diabetes (OR=1.044; p=0.002; 95% CI: 1.01-1.07). Among patients with diabetes and hypertension, both diagnoses were set up earlier than among those with a single morbidity.Among females, weight increase around pregnancy and menopause correlated significantly with higher odds for the diagnoses of diabetes and/or hypertension, irrespective of the number of children. Conclusions: During their decade-long relationship with their patients, family physicians are expected to identify the higher weight gain of their patients, especially among younger generation and intervene, if necessary.

Nationwide screening program for breast and cervical cancers in Hungary: special challenges, outcomes, and the role of the primary care provider.

INTRODUCTION: Breast and cervical cancers are both common malignancies in Hungarian women. The aim of this study was to evaluate the impact of nationwide screening programs on the incidence and mortality of breast and cervical cancers and to assess the role of primary care providers in this context. MATERIALS AND METHODS: Published records from 2000-2011 on breast and cervical cancer screening activities in Hungary were reviewed. Previously unpublished data from the Hungarian National Cancer Registry were also included in this review. Hungarian outcomes were compared to international results. RESULTS: A nationwide screening program for breast cancer was established in Hungary in 2001. A similar program for cervical cancer was subsequently initiated in 2003. As of 2009, 50% of the population at risk took advantage of breast cancer screening, while the exact participation rate for cervical cancer screening could not be established due to deficiencies of reporting by private gynecologists. The Health Visitors Cervical Screening Program, a new initiative within the context of the nationwide cervical screening program, based on involvement of local primary care providers, had encouraging results which substantially raised participation rates. However, deficiencies were identified regarding flow of information between service providers, patients, and family physicians. There was a slight reduction in the incidence of breast cancer and a more pronounced reduction in the incidence of cervical cancer, as well as a reduction in mortality for both breast and cervical cancers associated with these screening initiatives. CONCLUSION: The inclusion of primary care providers may benefit nationwide screening programs by raising participation rates in the target population.

Life-long weight change can predict metabolic diseases. Retrospective primary care study on the weight gain differences between elderly patients with diabetes and hypertension.

BACKGROUND: Patients with diabetes and hypertension represent a large proportion of primary care patients. Evaluation of their parameters usually requires medical setting, body weight and height can be measured by the patients themselves and this is often the case. The aim of this retrospective study is to analyse and to compare the life-long data on weight and BMI of patients with diabetes and hypertension and those without these pathologic conditions. PATIENTS: Eventually selected 759 patients (337 men, 422 women) between 60 and 70 years of age in different primary care settings were involved. METHODS: Retrospective and recent self-recorded data on weight and height in every decade since the age of 20 years in both genders were collected. These were compared to the control group of persons free from diabetes and hypertension. RESULTS: The current body weight and BMI were significantly higher in all groups than at 20 years and less than their maximal values. Patients with diabetes started at higher weights and their greatest gain was observed between 20-30 years in men and between 30-40 years in women, and in the last decade prior to diagnosis in both genders. Weight gain in the control group was steady at a lower rate. CONCLUSIONS: Higher increases in body weight in the early youth decades were related to elevated hazard ratios for diabetes in men and for hypertension in women. More research with standardized methodology is needed to explore this relationship better: meanwhile more contribution is expected from primary care physicians in the weight management of their younger patients.

Differences in weight gain in hypertensive and diabetic elderly patients primary care study.

BACKGROUND: Treatment and care of elderly patients with diabetes and hypertension means a hard task in primary care. Patients with these two components of metabolic syndrome are often overweight or obese. Although some parameters of metabolic syndrome are usually measured in a medical setting, checking body weight is usually done by the patients. AIM: The aim of this study is to analyse the patients' self-recorded data on weight and compare them according to hypertension and diabetes. PATIENTS AND METHODS: Five hundred and forty people (225 men and 315 women) between 60 and 75 years of age were eventually selected in primary care settings. Retrospective self-recorded data on recent weights and every decade since the age of 20, as well as the decade prior to diagnosis were collected. The data of patients with and without diabetes and/or hypertension were compared. RESULTS: The current mean body weight was significantly higher in all groups than at the age of 20. Compared with the control group, hypertensive men and women were approximately of the same weight in their twenties and, also, recently, but they gained more weight in the 4th and 5th decades of their life. Diabetics started at higher weights. The greatest weight gain was observed as follows: between 20-30 years and 30-40 years in men and women, respectively, as well as between 50-60 years of age and in the last decade prior to diagnosis in both genders. Weight gain in the control group was steady at a lower rate. CONCLUSIONS: Weight gain between 20-40 years of age could be an important factor in the aetiology of diabetes. Stable or at least limited weight gain may be a preventive factor. Considering the limitations of the study, further and decades long epidemiological evaluations are suggested in a larger study population.

Relations between anthropometric parameters and sexual activity of Hungarian men.

In the last decades, there were visible achievements in the evaluation of sexuality-related problems and issues regarding sexual life. However, there are limited reliable and comparable data on the average values of sexual activity and its relation to anthropometric parameters in different populations and age cohorts. This study tries to examine the association between anthropometric parameters and male sexual activity. A clinical population of 1146 male patients between 25 and 45 years of age attending an outpatient clinic of andrology in Budapest (Hungary) was examined and questioned in a medical setting. Age, body height, weight, body mass index (BMI) and self-reported sexual activity were the main outcome measures. The patients were allotted into age groups (25-29, 30-39 and 40-45 years), the youngest group showing the highest coital activity. Although obesity and overweight were present in 61% of the study population, no connections between BMI and sexual activity were apparent. Comparing less active persons with those reporting at least two intercourses per week, significant difference was found between body height groups. Men below 170 cm reported higher activity than men over 180 cm. Despite the fact that the prevalence of obesity among younger generations is increasing, it has had no visible influence on the sexual activity of this age cohort as yet. Our data suggest that sexual activity was not clearly related to other anthropometric parameters, and depends mainly on the characteristics of the population examined. There is a great need for large-scale studies worldwide on larger representative samples, using similar methods, to acquire reliable data from other nations and different age groups.

Primary care guidelines for geriatric assessment. A structured, comparative analysis.

A structured geriatric assessment (GA) improves the quality of health care; however, the quality of GA guidelines has hardly been investigated. Eight guidelines were identified by systematically searching guideline databases, web sites of guideline developers, and PubMed. The methodological quality was assessed by two appraisers using the German Guideline Evaluation Instrument (DELBI). Guideline content was extracted; organizational and medical recommendations were compared. The methodological appraisal revealed a broad range of quality. The domains "Scope and purpose" and "Clarity and presentation" showed good results. The domains "Applicability" and "Editorial independence" had results that were not as good. Medical recommendations agreed to a great extent. GA should be delivered continuously for all older people in their homes by one responsible assessor. In cooperation with relatives, patient-centered therapy goals should be defined. Differences were identified in profession, instruments, aims, and "tailoring." The quality of primary care guidelines for GA may be improved. Details of organization of a GA require further research.

Evaluation on lifestyle and nutrition among Hungarian elderly.

A cross-sectional study on nutritional habits and lifestyle on 250 elderly Hungarian people was performed. The education level, marital status, housing situation, the time for social and outdoor activities, smoking and drinking habits and the general health condition were evaluated.Some anthropometric parameters, the nutritional habits, daily meal patterns and food preference were also briefly analyzed. The overweight, lack of physical activity and unfavourable nutritional habits were the main observations on this population. These trends should be turned by stronger medical intervention based on primary care.