The authors carried out a coronary heart disease risk factor screening on 1240 people of two villages of Békés county, Hungary. The prevalence of coronary heart disease among the 969 people 35-70 years old was 12.0%, in the different age groups varied between 0.8 and 20.9%. This high prevalence could be explained by the high occurence of the different risk factors. The results of cholesterol levels were analysed according to that of Scandinavian Simvastatin Survival Study. From 35-70 years old screened people with coronary heart disease 77 had a cholesterol level between 5.5 and 8.0 mmol/l. In these patients with 20-40 mg daily dose of simvastatin during 5.4 years long treatment from 7 predicted coronary death 3, from 17 expected non fatal myocardial infarction 5, from 13 anticipated revascularisation procedures 5 would be preventable. The 5.4 years long treatment with 20 mg simvastatin calculated with the prices of July 1996 in Hungary would cost 292831 forints, from which 87847 has to be paid by the patient. If the decrease of hospitalization costs of the coronary heart disease patients treated with simvastatin is also taken into account, the drug treatment costs, according to the literature, could be reduced with additional 88%.
To identify and describe infant feeding policy documents in Hungary and compare them to the documents of other four European countries (England, Finland, Germany and Spain). The question was also addressed how the phenomenon of nutritional programming was represented in the documents.
Policy documents on infant feeding were identified and analyzed in the five European countries by using uniform methods for searching and coding.
Twenty-six documents were identified: 4 in England, 2 in Finland, 9 in Germany, 6 in Hungary and 5 in Spain. Altogether 203 statements linked to references were identified: benefits of breast-feeding in general (24%), protection against infections (32%), long-term advantages like the prevention of diabetes (31%) or allergy (12%). Considerable variations were found within and between countries in the evaluation of the duration and character of the positive effects. The majority of the statements in the Hungarian documents referred either to the role of breast-feeding in infection protection (n = 8), or to long-term protective effects (n = 13).
Policy documents in the study countries varied both in their extent and in the description of the long-term effects of infant nutrition. Majority of the documents failed to contain evidence based discussion of the phenomenon of early nutritional programming.
Control serum samples of young, healthy volunteers (N = 5) were compared with serum samples and laryngeal cancer extracts of patients (N = 12) with stage 3 and 4 cancers. Eight patients were primarily treated by total laryngectomy, 4 patient by palliative irradiation therapy (60 Gy). Ethanol (80%, pH 2) extracts of sera and cancer specimen were gel chromatographed, and the nominally 0.3-5 KDa molecular mass substances were further examined by analytical capillary isotachophoresis (ITP) (LKB. Sweden). Serum samples were also examined after surgery of irradiation therapy. Serum and tumor extracts of each laryngeal cancer patient contained a substance in the molecular mass range of 0.3-5 kDa. This was not detected in the serum of normal control subjects. The marker-candidate substance disappeared from the serum of four out of 8 laryngectomized patients who live tumor-free for years. Recurrence or lymph node metastasis developed in three of the remaining four patients who did not become free of the marker substance after laryngectomy. The concentration of the marker has been increased in the serum after palliative irradiation in all four patients. This marker substance is probably a product of tumor necrosis. The marker may adequately monitor the recurrence of tumor postoperatively of after irradiation therapy.
A fast development in therapy with insulin was observed after its discovery. Besides the widely used human regular insulin preparations, nowadays ultrashort and long-acting insulin analogues are also available for the patients. At present, the results of large clinical trials enable an evidence based diabetes care. It is well documented, that near-normoglycemia should be achieved by intensive conservative insulin treatment or pump therapy in type 1 diabetic patients. The beneficial effects of the good metabolic control could also be observed years later concerning late specific complications of diabetes. Similarly, as good as possible metabolic control should be aimed with antidiabetic treatment including insulin, if necessary, in type 2 diabetic patients. It is documented that the risk of cardiovascular complications is not increased in type 2 diabetic patients treated with insulin. Hypoglycemia and weight gain are the most important side effects of the insulin treatment. Recently, evidence based recommendations for treatment with ultrashort (insulin lispro, insulin aspart) and long-acting insulin analogues (glargine) can also be determined.
Fluoride prevention has a significant role in complex caries prevention, together with the appropriate diet and oral hygiene. The aim of the present review is--considering mainly the public health aspects--to give information on changes of the methods of fluoride prevention, and the changing views on pathomechanisms, as well as statements in the course of the last 50 years, based on present scientific evidence. The first great breakthrough in caries prevention was the introduction of water fluoridation between 1945-1950 in the USA and Canada. The measure was adopted in other countries and resulted in significant caries reduction. In the fifties and sixties fluoride tablets were widely used in many countries and brought good results, mainly in well-controlled smaller communities. Salt fluoridation has been initiated in Switzerland in 1955, and introduced in numerous countries in the eighties. The concept of a strong protective systemic effect of fluorides in the early eighties gave place to ideas on mainly topical effects, playing a decisive role in toothpastes, gels, acting topically on the enamel of the erupted teeth. Therefore many water fluoridation projects, mainly in Central- and Eastern Europe--where the prevalence of dental caries is still very high--were cancelled after 1990. Tablet fluoridation became questionable due to the fear of the possibility of dental fluorosis. Recent scientific views, however, confirmed a weak pre-, and peri-eruptive, as well as a strong posteruptive effect of systemically applied fluorides. In countries where caries prevalence is high, but the majority of the population cannot afford fluoridated toothpastes due to low socio-economic conditions, the introduction and extension of salt fluoridation to the whole population is well founded and recommended from a public health view.
Human alveolar echinococcosis, caused by the metacestode stage of Echinococcus multilocularis, is one of the most dangerous zoonoses in the temperate and arctic areas of northern hemisphere. The mortality of the disease exceeds 95% in untreated or inadequately treated patients. In the past three decades, the spread of this parasite was observed in Europe as a consequence of human interventions resulting in the population size increase of foxes. The authors demonstrated the presence of E. multilocularis in foxes in all northern counties of Hungary and the existence of hyperendemic regions in the Counties Nógrád and Gyor-Moson-Sopron. The aim of the present paper is to summarize the current knowledge on the life cycle and distribution of E. multilocularis, and the epidemiology, clinical features, diagnosis, treatment and control of human alveolar echinococcosis.
Malaria was an endemic disease in Hungary for many centuries. A country-wide survey of the epidemiologic situation on malaria started in the year of 1927. That was done by the Department of Parasitology of the Royal State Institute of Hygiene (presently: Johan Béla National Center for Epidemiology). The notification of malaria was made compulsory in 1930. Free of charge laboratory examination of the blood of persons suffering from malaria or suspected of an infection have been carried out. Anti-malarial drugs were also distributed free of charge, together with appropriate medical advise given at the anti-malarial sanitary stations. Between 1933 and 1943, the actual number of malaria cases was estimated as high as 10-100,000 per year. The major breakthrough came in 1949 by the organized antimalarial campaign applying DDT for mosquito eradication. The drastic reduction of the vectors resulted in the rapid decline of malaria cases. Since 1956, there have not been reported any indigenous case in Hungary. In 1963, Hungary entered on the Official Register of the WHO to the areas where malaria eradication has been achieved. During the period of 1963-2001, 169 Hungarians acquired the malaria in abroad and 263 foreigners infected in abroad were registered in Hungary. More than half of the cases (230) were caused by Plasmodium falciparum. Further 178 cases were caused by Plasmodium vivax and 24 cases by other Plasmodium species. During that period, 7 fatal cases were reported (Plasmodium falciparum). The expansion of migration (both the increase of the number of foreigners travelling into Hungary and of Hungarians travelling abroad) favours to the appearance of imported cases. Attention is called of all the persons travelling to malaria endemic countries to the importance of malaria prevention by the International Vaccination Stations located in the National Center for Epidemiology and in the Public Health Institutes of 19 counties and of Budapest. The Johan Béla National Center for Epidemiology issued a protocol in 2001, the title of which is: "Antimalarial defence". This helps the information activity of the International Vaccination Stations. To prevent malaria infections, systemic mosquito eradication is organized and supervised by the Office of the Chief Medical Officer at the touristically important areas in the summer season.