[The majority of patients with advanced Parkinson’s disease are treated at specialized movement disorder centers. Currently, there is no clear consensus on how to define the stages of Parkinson’s disease; the proportion of Parkinson’s patients with advanced Parkinson’s disease, the referral process, and the clinical features used to characterize advanced Parkinson’s disease are not well delineated. The primary objective of this observational study was to evaluate the proportion of Parkinson’s patients identified as advanced patients according to physician’s judgment in all participating movement disorder centers across the study. Here we evaluate the Hungarian subset of the participating patients. The study was conducted in a cross-sectional, non-interventional, multi-country, multi-center format in 18 countries. Data were collected during a single patient visit. Current Parkinson’s disease status was assessed with Unified Parkinson’s Disease Rating Scale (UPDRS) parts II, III, IV, and V (modified Hoehn and Yahr staging). Non-motor symptoms were assessed using the PD Non-motor Symptoms Scale (NMSS); quality of life was assessed with the PD 8-item Quality-of-Life Questionnaire (PDQ-8). Parkinson’s disease was classified as advanced versus non-advanced based on physician assessment and on questions developed by the Delphi method. Overall, 2627 patients with Parkinson’s disease from 126 sites were documented. In Hungary, 100 patients with Parkinson’s disease were documented in four movement disorder centers, and, according to the physician assessment, 50% of these patients had advanced Parkinson’s disease. Their mean scores showed significantly higher impairment in those with, versus without advanced Parkinson’s disease: UPDRS II (14.1 vs. 9.2), UPDRS IV Q32 (1.1 vs. 0.0) and Q39 (1.1 vs. 0.5), UPDRS V (2.8 vs. 2.0) and PDQ-8 (29.1 vs. 18.9). Physicians in Hungarian movement disorder centers assessed that half of the Parkinson’s patients had advanced disease, with worse motor and non-motor symptom severity and worse QoL than those without advanced Parkinson’s disease. Despite being classified as eligible for invasive/device-aided treatment, that treatment had not been initiated in 25% of these patients.]

[Mycophenolate mofetil (MMF) has been used as an immunosuppressive agent in renal transplant recipients for more than two decades. The aim of the ORANGE study was to collect data with respect to the efficacy and safety of MMF containing immunosuppressive regimens during standard nephrology care in Hungarian clinical centres. Efficacy of the therapy was primarily evaluated via moni - toring of renal function based on glomerular filtration rate (GFR) values calculated on the basis of the MDRD-175 formula. A total number of 128 patients were en rolled in two clinical centres within the frames of an open-label, non-interventional study. During the course of the study, mean GFR values showed stable renal function between the 1st month (53.5±33.4 ml/min/1,73 m2) and the 12th month (58±16.3 ml/min/1,73 m2). Acute graft rejection occurred in 21 patients during the first month, further, 1-1 rejection was documented in the remaining period between 2-6 and 6-12 months after renal transplantation, respectively. The graft survival was 100% 1 month after renal transplantation, while this ratio was calculated to be 98.4% after 12 months.]

[Background and purposes - In advanced Parkinson’s disease, medically refractory motor fluctuation or medically resistant tremor considerably affects quality of life. However, these symptoms can be mostly successfully treated by deep brain stimulation. We analyzed the efficacy of bilateral subthalamic stimulation in our patients with Parkinson’s disease. Methods - We assessed the clinical data of ten patients who have been treated in the Department of Neurology, Semmelweis University and have been operated in the National Institute of Neurosciences between 2008 and 2011. The Hoehn-Yahr scale score, the Unified Parkinson’s Disease Rating Scale score and the Parkinson’s Disease Questionnaire 39, as well as the dose of antiparkinson medication were documented prior to and one year after surgery. Results - Patient condition improved according to the Hoehn-Yahr scale, approximately by two stages. The dose of antiparkinson medication could be reduced by 63.4% (p=0.005) post operation. Unified Parkinson’s Disease Rating Scale scores decreased by 70.9% (p=0.005). 12 hours after medication withdrawal, execution of daily activity improved by 57.1% (p<0.01) and motor functions developed by 79.1% (p<0.01). Duration of dyskinesias decreased by 62.5% (p=0.018), duration of akinesia diminished by 87.5% (p=0.005). Quality of life rose by 41.6% (p<0.01). Neuropsychological tests detected improvement in verbal memory. Conclusion - With deep brain stimulation, the dosage of antiparkinson medication could be significantly reduced, with considerable improvements in motor function and quality of life. Although the number of patients is still low, good results have been established by careful patient selection, precise neurosurgical procedure and by appropriate programming and patient care.]

[It is well known, that there is a difference between peripheral and central systolic and pulse pressure. As the pressure wave travels distally from the heart, there is a significant increase, which is called pressure amplification. Central blood pressure can be measured easily and non-invasively, and the result shows a positive correlation with cardiovascular end-points. Several antihypertensive drugs can differently decrease central and peripheral blood pressure. The effect of diuretics on central systolic and pulse pressure is neutral or negative. While traditional β-blockers (e.g. atenolol) have a definitive negative effect, nebivolol shows a positive one. The calcium antagonists tend to have a favorable effect, while the clear beneficial effect of the angiotensin converting enzime inhibitors is well documented. There are only few data on angiotensin receptor blockers, however, the results seem to be promising.]