Lege Artis Medicinae

[Public health care prevention in Hungary: are we doing what we should?]

KISS István, DANKOVICS Gergely, BARNA István, DAIKI Tenno, KÉKES Ede

FEBRUARY 22, 2013

Lege Artis Medicinae - 2013;23(02)

[Primary prevention means health protection and disease prevention in the population, whereas secondary prevention includes early diagnosis and treatment to prevent the progression of diseases and the development of complications. Both ways of prevention are present in public health programs, but primary prevention measures are usually less substantial. METHODS - The “Comprehensive Health Protection Screening Program of Hungary 2010-2020” was organised in 2010 as part of the National Cardiovascular Program. In this program, a mobile screening station (set up on a truck) tours the country and provides a complex health status and risk assessment at village fairs as well as at offices. RESULTS - In the past three years, this station provided complex screening for 65267 individuals and lifestyle counseling and health education for 132964 people at 528 locations, touring 58807 km. The aim of the Program is to provide a comprehensive overview of the health status of the Hungarian population, and to make it possible to measure and record the long-term changes of the health status of the Hungarian population. Another goal is to inform those being screened about their health status and to highlight the importance of health protection and disease prevention. On the basis of the results, in the past three years the Program has been able to achieve its targets, which provides a good basis for its continuation.]



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[INTRODUCTION - Sulfonylureas have become sidelined as second-line preparations as their use has been associated with an increased occurrence of weight gain and hypoglykaemia. In the case reported, however, therapeutic goals have been achieved with the use of gliclazid. CASE REPORT - A 45-year-old man with type 2 diabetes mellitus was using a metformin XR preparation. His HbA1c level was high and his main complaint was distention. His abdominal complaint was also obstructing his diet. Because of the high HbA1c level and overweight I initiated incretin-mimetic treatment. Due to the worsening of abdominal complaints I replaced the treatment with gliclazid, after thoroughly informing the patient. With gliclazid treatment the patient's abdominal complaints subdued, he was able to maintain his diet, lost 14 kg in three months and the parameters of his carbohydrate metabolism normalised. CONCLUSION - In case of abdominal complaints, a repeated anamnesis of the diet can reveal metformin intolerance. In such cases, the use of gliclazid can lead to therapeutic success with no gastrointestinal adverse effects.]

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