[The pathological processing of prostate biopsy and resection specimens]. / A prosztatabiopsziák és -reszekátumok patológiai feldolgozása.

Prostate cancer stands as the most prevalent malignant tumor among men; with its incidence increasing with advancing age. The spectrum of patient care options for this disease is broad, encompassing approaches such as "active surveillance," definitive radiation therapy, robot-assisted surgery, among others. These diverse modalities afford opportunities for cure or successful management in the majority of cases. It is paramount to underscore that optimal treatment hinges upon a multidisciplinary framework, wherein the coordinated efforts of allied healthcare professionals yield the highest standard of patient care. Hence, it is imperative for pathologists to keep abreast of contemporary processing and specimen collection protocols, as well as the potential necessity of supplementary investigations and their clinical significance. The latest Hungarian guideline on prostate cancer care features a dedicated chapter delineating the pivotal role and responsibilities of pathologists. Through this discourse, we aim to consolidate and disseminate pertinent insights, thereby fostering the continuing enhancement of pathologists' knowledge and elucidating the intricacies of histological processing to our clinical counterparts.

[County differences in incidence and mortality of malignant neoplasms in Hungary between 2005 and 2019]. / A rosszindulatú daganatos betegségek incidenciájának és mortalitásának vármegyénkénti különbségei Magyarországon 2005 és 2019 között.

The objective of our study was to map county differences in incidence and mortality by cancers and examine their changes over time. Based on the database of National Cancer Registry and Central Statistical Office, age-standardized incidence and mortality rates per 100,000 person-years were calculated for each county for 15 cancer types and 3 time periods. East-West divide was apparent in incidence and mortality of lung cancer, with larger weight in East (Borsod-Abaúj-Zemplén, Heves, Jász-Nagykun-Szolnok, Békés counties). Concentration of lip and oral cavity malignancies was identified in the northeastern periphery (Borsod-Abaúj-Zemplén, Szabolcs-Szatmár-Bereg counties). Breast cancer incidence was the highest in Budapest. As a conclusion, changes in cancer incidence and mortality over time were similar to developed countries; however, values were higher. Differences in spatial distribution follow territorial pattern of social deprivation, which correspond to higher prevalence of health risk factors. Our study contributes to planning of public health programs by pinpointing regional inequalities in different cancer types.

[The pitfalls of lung cancer coding practices based on the evaluation of the National Cancer Registry]. / A tüdorákhoz kötodo kódolási gyakorlat buktatói a Nemzeti Rákregiszter felmérése alapján.

The quality of input data determines the reliability of epidemiological assessments. Thus, the verification of cases reported to the National Cancer Registry is required. The objective of our study was evaluating the reliability of cases diagnosed by lung cancer, exploring the patterns of erroneous reports. The validation of the 11,750 lung cancer cases reported to the Cancer Registry in 2018 was performed with the involvement of the recording hospitals, analyzing the characteristics of reports by gender, age and attributes of the reporting institutions. 81.3 percent of the reported cases was confirmed, in 40.4 percent of the false reports, malignancy was not present at all. Among the erroneous cases women and the elderly age group were overrepresented. The highest deleted rate occurred in Borsod- Abaúj-Zemplén county. As a conclusion, there is a strong need for the improvement of the efficiency in encoding lung cancer. The most common errors: confusion of malignant-benign, cancerous-non-cancerous and primary-metastatic lesions. The reliability is not affected by the role of individual institutions in the hierarchy of health care. The availability of reliable epidemiological data is crucial in the fight against cancer, which requires broad professional cooperation.

[Examination of breast density in breast cancer discordant twin pairs]. / Emlodenzitás vizsgálata emlorákdiszkordáns ikerpárok esetében.

Previous twin studies show that genetic factors are responsible for 63% of the variability in breast density. We analyzed the mammographic images of 9 discordant twin pairs for breast cancer from the population-based Hungarian Twin Registry. We measured breast density using 3D Slicer software. Genetic variants predisposing to breast cancer were also examined. One of the examined twin pairs had a BRCA2 mutation in both members. There was no significant difference between the mean values of breast density in the tumor and non-tumor groups (p=0.323). In terms of parity and the presence of menopause, we found mostly no significant difference between the members of the twin pair. In our cohort of identical twins discordant for breast cancer, the average breast density showed no significant difference, which can be explained by the common genetic basis of breast cancer and breast density.

[Application of new imaging modalities for brachytherapy of cancer patients]. / Új képalkotó eljárások alkalmazása daganatos betegek brahiterápiájában.

In the Radiotherapy Centre of the National Institute of Oncology, Budapest, a 0.55 T MR scanner (MAGNETOM Free. Max) and a ring-like X-ray machine (ImagingRing) have been in operation since 2022. The MR scanner has a tunnel diameter of 80 cm, the X-ray machine has a ring diameter of 121 cm. The latter can also be used for cone-beam CT (CBCT) imaging. The MR scanner is mainly used for planning gynaecological brachytherapy (BT) treatments. Image distortions in MR imaging were investigated with a special grid phantom. After head and neck and breast implant, image quality of ImagingRing CBCT and planning CT was compared. The position of the radiation source was verified by radiographs taken during treatment. Despite the lower field strength, the image quality of the MR scanner was found to be adequate for treatment planning of gynaecological BT. Image distortions were found to be clinically negligible. On CBCT images obtained with ImagingRing, catheters could always be well identified, and anatomical organs were adequately visualized for head and neck treatments, but not for breast implants. The MR scanner is suitable for treatment planning for gynaecological BT due to its good image quality and low image distortion. The image quality of the ImagingRing is suitable for treatment planning for small body sizes, but not for larger sizes. The device can be used to in vivo check of the radiation source position during treatment.

Validation of the Hungarian version of the 6-item turnover intention scale among elderly care workers.

This research examines the psychometric characteristics and reliability of the 6-item turnover intention scale (TIS-6) by Bothma and Roodt (SA J Hum Resour Manag 11:a507, 2013) on a Hungarian sample. The internal validity of the TIS-6 was assessed using data from 269 Hungarian elderly care institution workers. Confirmatory factor analysis was performed to analyse the structural validity. Convergent and discriminant validity were examined with questions on job characteristics and using the Maslach Burnout Inventory and Effort-Reward Imbalance Scale. IBM SPSS 28.0 software was used for the statistical analysis, and the results were considered significant at p < 0.05. The internal consistency of the questionnaire's scale proved to be acceptable (α = 0.826). Convergent validity was confirmed by the relationships between the components of the questionnaire and burnout (rs = 0.512; p < 0.001; rs = 0.419; p < 0.001) and workplace stress (rs = 0.565; p < 0.001; rs = 0.310; p < 0.001). There were significant differences between the TIS-6 scores among the groups with different degrees of burnout (p < 0.001), which indicated adequate discriminant validity of the questionnaire. The structural validity of the questionnaire was acceptable, and the scale questions fit well. The Hungarian version of the TIS-6 scale is a valid and reliable tool for assessing turnover intention among elderly care institution workers in Hungary.

Impact of different obstetric interventions and types of delivery on breastfeeding: a nationwide cross-sectional survey of Hungarian women.

BACKGROUND: We assessed the effect of different obstetric interventions and types of delivery on breastfeeding. METHODS: A quantitative, cross-sectional study was carried out using an online questionnaire. Data collection was performed in 2021 in Hungary. We included biological mothers who had raised their at least 5-year-old child(ren) at home (N = 2,008). The questionnaire was completed anonymously and voluntarily. In addition to sociodemographic data (age, residence, marital status, education, occupation, income status, number of biological children, and anthropometric questions about the child and the mother), we asked about the interventions used during childbirth, and the different ways of infant feeding used. Statistical analysis was carried out using Microsoft Excel 365 and SPSS 25.0. Descriptive statistics, two-sample t tests, χ2 tests and ANOVA were used to analyse the relationship or differences between the variables (p < 0,05). RESULTS: We found that in deliveries where synthetic oxytocin was used for both induction and acceleration, there was a higher incidence of emergency cesarean section. However, the occurrence of vaginal deliveries was significantly higher in cases where oxytocin administration was solely for the purpose of accelerating labour (p < 0.001).Mothers who received synthetic oxytocin also received analgesics (p < 0.001). Women giving birth naturally who used oxytocin had a lower success of breastfeeding their newborn in the delivery room (p < 0.001). Children of mothers who received obstetric analgesia had a higher rate of complementary formula feeding (p < 0.001). Newborns born naturally had a higher rate of breastfeeding in the delivery room (p < 0.001) and less formula feeding in the hospital (p < 0.001). Infants who were breastfed in the delivery room were breastfed for longer periods (p < 0.001). Exclusive breastfeeding up to six months was longer for infants born naturally (p = 0.005), but there was no difference in the length of breastfeeding (p = 0.081). CONCLUSIONS: Obstetric interventions may increase the need for further interventions and have a negative impact on early or successful breastfeeding. TRIAL REGISTRATION: Not relevant.

[The Hungarian adaptation of the Mental Health Quality of Life Questionnaire (MHQoL)]. / A Mentális Egészséggel Összefüggo Életminoség Kérdoív (MHQoL) magyar adaptációjának bemutatása.

Our study presents the Hungarian adaptation of the Mental Health Quality of Life Questionnaire (MHQoL). BACKGROUND: In recent decades, there has been a shift in the field of healthcare, with a notable change in the ultimate goal of health interventions. Rather than merely reducing symptoms and prolonging life, the objective of health interventions is now to improve quality of life. A number of measures of quality of life have been developed, but the majority of these focus exclusively on physical health and do not fully cover the dimensions that are relevant to the quality of life of people with mental health problems. Van Krugten et al. have developed the Mental Health Quality of Life (MHQoL) questionnaire, which covers the seven most important dimensions of mental health-related quality of life. OBJECTIVES: Our research had the following two main aims. Firstly, it aimed to develop and test a Hungarian adaptation of the Mental Health Quality of Life (MHQoL) questionnaire. Secondly, it aimed to compare the results of healthy individuals and those with diagnosed psychiatric disorders. METHODS: A total of 189 individuals participated in the survey, with 157 classified as psychiatrically healthy and 32 diagnosed with a mental disorder, of which 20 were in acute psychiatric care and 12 were in outpatient care. The data were analysed using confirmatory factor analysis, reliability analysis and independent samples t-test. RESULTS: Our confirmatoriy factor analysis indicated that all items show a good fit with the model. The factor weights for each item were observed to range from 0.45 to 0.79. The Cronbach's α index obtained in our reliability analysis of the MHQoL demonstrated exceptional internal reliability: an index value of 0.81, with individual item- specific reliability coefficients ranging from 0.7 to 0.81. Independent samples t-tests were conducted to assess the statistical significance of differences in mean scores between respondents with and without a psychiatric diagnosis. The results indicated that there were significant differences in the means of the two groups for items pertaining to future vision, mood, relationships and physical health, as well as when comparing the mean scores of the MHQoL total score and the mean scores of psychological well-being. The majority of variables exhibited statistically significant differences from each other, with medium effect sizes. CONCLUSIONS: The results thus far indicate that the Hungarian version of the MHQoL is an effective instrument for differentiating between individuals with and without mental illness, based on psychometric indicators. Furthermore, it provides valuable insights into the domains in which psychiatric illnesses have the greatest impact on patients' quality of life. The objective of our future research is to further validate the MHQoL questionnaire in order to contribute to the concept of healthcare that focuses not only on eliminating symptoms but also on improving quality of life.

How much can we learn from each other? Polish and Hungarian good practices in financing ophthalmology care as a proposal for implementation in Ukraine.

OBJECTIVES: The article aims to compare payment schemes for cataract, glaucoma, vitrectomy, cornea transplantations, DME, and AMD across Hungary, Poland, and Ukraine, and to identify implementable practices in Ukraine within the context of ongoing healthcare reforms. METHODS: Researchers used mixed-method research-with legal documents and data analysis on utilisation of ophthalmology services between 2010 and 2019 and in-depth semi structured interviews with fifteen health experts from Hungary, Poland, and Ukraine. Interviewees, five from each country, were representatives from healthcare providers and payers with at least 10 years' experience in ophthalmology care and knowledge about financing schemes in each country of residence. RESULTS: We identified significant differences in healthcare delivery and financing of ophthalmology services between Hungary and Poland, despite both countries rely on Diagnosis-Related Group (DRG) based systems for hospital care. Good practices for financing specific eye treatments like cataract, glaucoma, age-related macular degeneration (AMD), diabetic macular edema (DME), cornea transplantations, and vitrectomy are identified. The financing scheme, including financial products and incentives, can influence the volume of treatments. Access to ophthalmic care is a key concern, with differences in treatment schemes between Hungary (ambulatory care) and Poland (hospital care), leading to higher costs and the need for centralization of complex procedures like cornea transplantations. CONCLUSIONS: The article highlights the importance of incentivizing quality improvements and removing financial barriers in Poland, while Hungary should focus on continuous monitoring of treatment methods and flexibility in reimbursement. For Ukraine, the research findings are significant due to ongoing healthcare reform, and the country seeks optimal practices while considering the experiences of other countries.

Vaccination homophily in ego contact networks during the COVID-19 pandemic.

Vaccine hesitancy is an inevitable risk for societies as it contributes to outbreaks of diseases. Prior research suggests that vaccination decisions of individuals tend to spread within social networks, resulting in a tendency to vaccination homophily. The clustering of individuals resistant to vaccination can substantially make the threshold necessary to achieve herd immunity harder to reach. In this study, we examined the extent of vaccination homophily among social contacts and its association with vaccine uptake during the COVID-19 pandemic in Hungary using a contact diary approach in two cross-sectional surveys. The results indicate strong clustering among both vaccinated and unvaccinated groups. The most powerful predictor of vaccine uptake was the perceived vaccination rate within the egos' social contact network. Vaccination homophily and the role of the interpersonal contact network in vaccine uptake were particularly pronounced in the networks of close relationships, including family, kinship, and strong social ties of the ego. Our findings have important implications for understanding COVID-19 spread dynamics by showing that the strong clustering of unvaccinated individuals posed a great risk in preventing the spread of the disease.

Socioeconomic determinants and reasons for non-acceptance to vaccination recommendations during the 3rd - 5th waves of the COVID-19 pandemic in Hungary.

BACKGROUND: In Hungary, although six types of vaccines were widely available, the percentage of people receiving the primary series of COVID-19 vaccination remained below the EU average. This paper investigates the reasons for Hungary's lower vaccination coverage by exploring changing attitudes towards vaccination, socio-demographic determinants, and individual reasons for non-acceptance during the 3rd - 5th pandemic waves of COVID-19. METHODS: The study's empirical analysis is based on representative surveys conducted in Hungary between February 19, 2021, and June 30, 2022. The study used a total of 17 surveys, each with a sample size of at least 1000 respondents. Binomial logistic regression models were used to investigate which socio-demographic characteristics are most likely to influence vaccine hesitancy in Hungary. The study analysed 2506 open-ended responses to identify reasons for vaccine non-acceptance. The responses were categorised into four main categories and 13 sub-categories. RESULTS: Between the third and fifth wave of the pandemic, attitudes towards COVID-19 vaccination have significantly changed. Although the proportion of vaccinated individuals has increased steadily, the percentage of individuals who reported not accepting the vaccine has remained almost unchanged. Socio-demographic characteristics were an important determinant of the observed vaccine hesitancy, although they remained relatively stable over time. Individuals in younger age groups and those with lower socioeconomic status were more likely to decline vaccination, while those living in the capital city were the least likely. A significant reason behind vaccine refusal can undoubtedly be identified as lack of trust (specifically distrust in science), facing an information barrier and the perception of low personal risk. CONCLUSION: Although compulsory childhood vaccination coverage is particularly high in Hungary, voluntary adult vaccines, such as the influenza and COVID-19 vaccines, are less well accepted. Vaccine acceptance is heavily affected by the social-demographic characteristics of people. Mistrust and hesitancy about COVID-19 vaccines, if not well managed, can easily affect people's opinion and acceptance of other vaccines as well. Identifying and understanding the complexity of how vaccine hesitancy evolved during the pandemic can help to understand and halt the decline in both COVID-19 and general vaccine confidence by developing targeted public health programs to address these issues.

From invaders to residents: The golden jackal (Canis aureus) expansion in Hungary since the mid-1990s.

The golden jackal has rapidly expanded across Europe in recent decades and was one of the first to reappear in Hungary. Using hunting bag data from the National Game Management Database from 1995 to 2021, we examined the spatial expansion of the species and its population dynamics. Our findings reveal an exponential increase in the golden jackal population since the mid-1990s, with an average annual growth rate of 40% in the hunting bag and an occupancy of 86% of the country. The average speed of the range expansion was 536.9 km2 year-1 until 2007 and increased to an average of 5,289.1 km2 year-1 during the second part of the expansion process. The density of shot golden jackals also shows an increasing trend with a substantial presence of outliers, indicating that nearly 10% of the hunting bag demonstrates exceptionally high numbers, particularly in southwestern Hungary. The spread originated in the southwest and extended towards the northeast and northwest. However, the increase of the hunting bag slowed down and the expansion rate has decreased in the previous two years, leading us to anticipate that the golden jackal population will stabilize soon, as the expansion has reached its maximum in Hungary. This indicates that from the initial settlement to the stabilization of the population, the time span can be two to three decades.

Correlations between distal sensorimotor polyneuropathy and cardiovascular complications in diabetic patients in the North-Eastern region of Hungary.

Distal sensorimotor polyneuropathy (DSPN) is the earliest detectable and the most frequent microvascular complication in diabetes mellitus. Several studies have previously demonstrated correlations between cardiovascular risk factors in diabetic patients and independent risk factors for diabetic neuropathy. Our objective was to retrospectively analyze data from diabetic patients in the North-East region of Hungary who underwent neuropathy screening at the Diabetic Neuropathy Center, University of Debrecen, between 2017 and 2021. We aimed to investigate the correlations between cardiovascular risk factors and microvascular complications among patients with DSPN. The median age of the patients was 67 years, 59,6% were female, and 91,1% had type 2 diabetes. The prevalence of DSPN among the study subjects was 71.7%. A significantly longer duration of diabetes (p<0.01) was noted in patients with DSPN. Those with DSPN demonstrated a significantly higher HbA1c level (p<0.001) and a greater frequency of insulin use (p = 0.001). We observed a significantly elevated albumin/creatinine ratio (p<0.001) and a significantly lower eGFR (p<0.001) in patients with DSPN. Diabetic retinopathy exhibited a significantly higher prevalence in patients with DSPN (p<0.001). A higher prevalence of myocardial infarction (p<0.05), ischemic heart disease (p<0.001), peripheral arterial disease (p<0.05) and a history of atherosclerosis (p<0.05) was observed in patients with DSPN. In a multivariate logistic regression analysis, the following factors were independently associated with the presence of DSPN: higher HbA1c (OR:2.58, 95% CI:1.89-3.52, p<0.001), age (OR:1.03, 95% CI:1.01-1.05, p = 0.006), albumin/creatinine ratio above 3 mg/mmol (OR:1.23, 95% CI:1.06-1.45, p = 0.008), retinopathy (OR:6.06, 95% CI:1.33-27.53, p = 0.02), and composite cardiovascular endpoint (OR:1.95, 95% CI:1.19-3.19, p = 0.008). Our study revealed that age, elevated HbA1c levels, significant albuminuria, retinopathy, and cardiovascular complications may increase the risk of DSPN. Further investigation of these associations is necessary to understand the impact of patient characteristics during the treatment of diabetic neuropathy.

The leading role of personality in concerns about autonomous vehicles.

Development of autonomous vehicles (AVs) is growing in a rapid rate, however, the most dominant barriers in their adoption seem to be rather psychological than technical. The present online survey study aimed to investigate which demographical and personality dimensions predict attitudes towards AVs on a Hungarian sample (N = 328). Data was collected by convenience and snowball sampling. Three-level hierarchical regression models were applied: in the first level, demographical variables, then general personality traits and third, attitude-like personality factors were entered. We demonstrated that the predictive effect of age, gender and education disappeared when personality dimensions were included into the models. Importantly, more positive general attitudes towards technology and higher optimism regarding innovations predicted eagerness to adopt AVs. On the other hand, individuals with more negative attitudes and higher dependence on technology as well as those with lower level of Sensory Sensation Seeking and higher level of Conscientiousness were more concerned about AVs. Our results suggest that AV acceptance cannot be regarded as a one-dimensional construct and that certain personality traits might be stronger predictors of AV acceptance than demographical factors.

Mental health competencies are stronger determinants of well-being than mental disorder symptoms in both psychiatric and non-clinical samples.

The present study aimed to investigate whether the strength of mental health competencies and the severity of mental disorder symptoms, and their interaction, differ in the strength of their associations with several dimensions of well-being in Hungarian adult psychiatric and non-clinical samples. All respondent in the psychiatric sample (129 patients (44 male, 85 female)) and in the non-clinical community sample (253 adults (43 male, 210 female)) completed the Mental Health Test, six measures of well-being and mental health, and the Symptom Checklist-90-Revised. Including both mental health competencies and mental disorder symptoms in a regression model in both samples can predict patients' well-being even more accurately. Mental health competencies were positively related; mental disorder symptoms were negatively related to subjective well-being. In all models and in both samples, mental health competencies were found to be stronger determinants of well-being than mental disorder symptoms. The interaction of mental health competencies and mental disorder symptoms is no more predictive of well-being in either psychiatric or non-clinical samples than when the effects of each are considered separately. The assessment of mental health competencies has an important predictive value for well-being in the presence of psychopathological symptoms and/or mental disorders.