[Colorectal cancer is one of the leading cancer-related death worldwide. The optimal treatment duration of metastatic colorectal cancer depends on the individual treatment aim and it should be decided by an onco-team and by the patient. In this review several actual issues will be discussed, like the optimal duration of therapy to reach the secondary resection, the accepted response rate and best treatment strategy in case of non-operable colorectal cancer. Furthermore, emphasis is given to the most useful endpoints to evaluate different therapeutic approaches.]

Objective - Patients were assessed in terms of risk factors, hematoma size and localization, the effects of spontaneous intracerebral hemorrhage (ICH) on mortality and morbidity, and post-stroke depression. Materials and methods - The present study evaluated the demographic data, risk factors, and neurological examinations of 216 ICH patients. The diagnosis, volume, localization, and ventricular extension of the hematomas were determined using computed tomography scans. The mortality rate through the first 30 days was evaluated using ICH score and ICH grading scale. The Modified Rankin Scale (mRS) was used to determine the dependency status and functional recovery of each patient, and the Hamilton Depression Rating Scale was administered to assess the psychosocial status of each patient. Results - The mean age of the patients was 65.3±14.5 years. The most common locations of the ICH lesions were as follows: lobar (28.3%), thalamus (26.4%), basal ganglia (24.0%), cerebellum (13.9%), and brainstem (7.4%). The average hematoma volume was 15.8±23.8 cm3; a ventricular extension of the hemorrhage developed in 34.4% of the patients, a midline shift in 28.7%, and perihematomal edema, as the most frequently occurring complication, in 27.8%. Over the 6-month follow-up period, 57.9% of patients showed a poor prognosis (mRS: ≥3), while 42.1% showed a good prognosis (mRS: <3). The mortality rate over the first 30 days was significantly higher in patients with a low Glasgow Coma Scale (GCS) score at admission, a large hematoma volume, and ventricular extension of the hemorrhage (p=0.0001). In the poor prognosis group, the presence of moderate depression (39.13%) was significantly higher than in the good prognosis group (p=0.0001). Conclusion - Determination and evaluation of the factors that could influence the prognosis and mortality of patients with ICH is crucial for the achievement of more effective patient management and improved quality of life.

[Mortality in epilepsy is 2-3 times higher than in the age- and sex-matched general population. It is the highest in young male epilepsy patients with generalised tonic-clonic seizures living in low socio-economical situation. The main factors of early mortality unrelated to seizures are the neurological conditions underlying epilepsy. Suicide is an important factor first of all in temporal lobe epilepsy. The group of mortality directly related to epilepsy is made up of the high-mortality grand mal status epilepticus rarely seen in treated epilepsy; the accidents related to seizures and sudden unexpected death (SUDEP). The reasons directly related to epilepsy make up about 40 per cent of epilepsy mortality. There is a 20-24-fold increase of the risk of sudden death in epilepsy compared to sudden death in the general population. The main risk of SUDEP is the “severity” of epilepsy signaled by generalized tonic-clonic seizures, resistance to antiepileptic drugs, polytherapy and frequent drug-modifications in adulthood epilepsy. Seizure-dependent autonomic changes as cardiac rhythm and breathing disturbances as well as some antiepileptic drugs and treatment modifications may contribute to the development of SUDEP. The data suggest that the main tools helping to decrease mortality in epilepsy nowadays are as follows: optimal seizure control, effective tratment of concomitant psychiatric conditions and monitoring for potentially dangerous heart dysrhythmias as well as respiration disorders.]

[According to The International Statistical Classification of Diseases and Related Health Problems (10th Revision, ICD 10; XIV), urogenital diseases resulted in an average 910 yearly deaths in Hungary from 2010 through 2014, less than 1% of the cumulative mortality rate. Out of all urogenital conditions, kidney and bladder diseases were the leading cause of death, accounting for nearly 85 percent of all deaths in the examined period. It should be noted that mortality due to urogenital cancers, renovascular hypertonia, diabetic nephropathy, congenital malformations and pathologies related to childbirth and pregnancy are excluded from consideration in the present review. As the Hungarian Central Statistical Office does not disclose the causes of death by age and gender at its county-level data, this paper reports gender-specific mortality rates. Due to the fact that the county-level mortality rate of urogenital diseases is low and the yearly standard deviation is high, the five-year overall mortality rate of 2010-2014 is presented. Hungarian counties differ greatly in terms of mortality from urogenital diseases. The number of deaths per 100 000 population ranges between 6.74 in Békés county and 16.38 in Fejér county. Counties within the same region may exhibit substantially different mortality rates. An overall 7.01 deaths per 100 000 population was reported in Győr-Moson-Sopron county, whereas among residents of the neighbouring Vas county the rate was reported as 14.73 per 100 000 population. The observed variations prevail even when standardised mortality rates are compared and thus the differences in the counties’ age distributions are accounted for. Regional differences become more apparent when only the deaths caused by kidney diseases are analysed out of all urogenital pathologies. In this case, two- or threefold differences are observed between the respective Hungarian counties. Major disparities are still present between counties within the same region. For example, the number of deaths per 100.000 population is 3.74 in Hajdú-Bihar county, and 8.04 in Jász-Nagykun-Szolnok county, respectively. The diagnosis frequency of kidney diseases has a strong positive correlation with case fatality, but it may not fully account for all regional variations in mortality rates. Regional characteristics of dialytic care and the accessibility of dialytic facilities is not related to patient mortality. ]

[The treatment of osteoporosis and its consequences place a significant burden on the health care of developed countries. Modern therapeutical approaches are able to efficiently decrease the risk of osteoporotic bone fractures. However, we do not know whether the interventions introduced in the past 15 years have significantly reduced the number of osteoporotic fractures in real life, and if they have, how cost-effective this effect was. To answer these questions, we have analysed data of the Hungarian National Insurance Company collected between 2004-2010. During these 7 years, the number of bone fractures among patients treated for osteoporosis continuously decreased. This was also observed in the incidence of hip fractures. Interestingly, the mortality of osteoporotic patients was significantly lower than that of the same age group in the average population. Besides the efficient treatment of osteoporosis, this finding is also due to the outstanding general care provided by the specialised osteoporosis centers of the country. As a consequence of the reduction in fractures, 3.4 billion HUF was saved per year by the insurance company, which is approximately equal to the 3.5 billion HUF spent on the reimbursement of medicines used for the treatment of osteoporosis, which means that the investments show a return. The calculation of the quality- adjusted life years, which is the internationally accepted method of the WHO for the study of cost-effectiveness, shows that the above results were achieved in a remarkably cost-efficient way. At the same time, it is noteworthy and calls for caution that the decrease in reimbursement by the insurance company in 2007 resulted in a 51% drop in the number of patients receiving treatment, which radically reduced the observed efficiency.]