[The authors surveyed the already known factors responsible for the osteoporotic bone fragility. Then the results of using modern imaging techniques (micro-CT, high-resolution peripheral computed quantitative tomograph - HR-pQCT) and advanced computer analytic methods (finite element analysis, FEA) are presented. These data - beyond the already known fracture risk factors (age, risk of falling, bone mineral density - BMD, and fine structure damage of trabecular bone) are stressing the importance of the (micro)damage of cortical bone as a fracture risk factor, which has been still underrated. The cortical thickening and increased porosity - verified on various population samples - are increasing the risk of fractures in certain subgroups of subjects having identical BMD values, even among those, who are considered only osteopenic by the earlier classification based on BMD values. Backed with modern software batteries, the new imaging techniques are expected to enter clinical application in the near future. Pharmacologic agents with stronger cortical effect are already available and research is continuing to find new drugs to use in the management of osteoporotic patients of high fracture risk.]

[The Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guideline update for Chronic Kidney Disease Mineral and Bone Disorder (CKD-MBD) was published in the summer of 2017 and has become a very important guidance of the complex therapy of patients with CKD. It is well known that, besides infections, cardiovascular diseases in close causal relationship with CKD-MBD are leading mortality factors of patients with CKD. Therefore the publication of the new international guideline is especially important. A Nationwide Professional Advisory Board summoned upon the initiative of the Hungarian team of Sanofi-Aventis had its assembly in September 2017 focusing on the current approaches of the therapy of calcium-phosphate metabolism in CKD patients in Hungary. Board members compared the differences between the 2009 and 2017 KDIGO guidelines and reviewed the 2011 Hungarian CKD-MBD recommendation and the relevant financing protocol. Board members assessed the applicability of the new guideline to current Hungarian practice. As compared to the previous 2009 guideline, although a number of issues were revised and modified in the light of new research and clinical results in the new 2017 guideline, most of the recommendations are still applicable tooure very day practice. It is a fundamental requirement to keep to the new guideline including the modified recommendations to optimize the long term life expectancy and quality of life of patients with CKD. The purpose of this article is to compare the 2009 and 2017 KDIGO guidelines in terms of calcium-phosphate metabolism and the treatment of hyperphosphataemia focusing on the new or modified guideline recommendations in order to assess the feasibility of their implementation in Hungarian practice. Based on available evidence and the new KDIGO guideline, board member sout lined the direction of changes of the Hungarian CKD-MBD protocol and the prescription rules of the related medications.]

[Authors conducted a comparative sociological, social-psychiatric survey in the summer of 2000 on a representative sample (1000- 1000 people) from counties with high and low suicide rates (Bács-Kiskun and Vas). They also studied the so-called "health-behaviour" of subjects since it was supposed that negation or refusal of medical help are forms of latent auto-agressivity, probably of common origin with "direct" self-harm (alcohol abuse, smoking, suicide), from deeper behavioural roots. The rates of morbidity and mortality of the two counties do not differ each other significantly with the exception of alcoholism. In spite of this facts, people living in the Great Hungarian Plain (Alföld) regard themselves in worse health condition than people in western countryside, presenting as patients in the health care system more frequently in the Alföld. Authors did not find any connection between the quality of health behaviour and the sharply divergent suicide rates of the two territories. Studying the two sample as a whole, they found marked problems in the field of health behaviour in both counties. They also stress that suicide and alcoholism in Hungary are very closely connected entities. Authors suggest that tasks for the public health service in this matter are significant.]

[Molecular genetics has become an indispensable diagnostic tool in a number of diseases. The most frequent thyroid tumours are associated with genetic alterations that might be used for diagnostic purpose in the future. Somatic mutations and rearrangements in BRAF, RAS family RET/PTC and PAX8/PPAR-gamma genes may occur in papillary and follicular thyroid carcinomas. Other mutations of the RET gene can be found in medullary carcinomas (in sporadic as well as hereditary types), whereas mutations of the genes TP53, RAS, and BRAF are associated with poorly differentiated and anaplastic carcinomas. At present, the most reliable diagnostic tool for the differential diagnosis of thyroid nodules is fine-needle aspiration cytology. However, the existing malignancy cannot be unequivocally proven in up to 10-40% of all samples. On the basis of previous results, genetic examination of fine needle aspiration samples from thyroid nodules can contribute to a more precise diagnosis and the timely removal of potentially malignant nodules.]

[INTRODUCTION - Haemangioma is the most common type of benign hepatic tumors. Haemangiomas are usually asymptomatic, except for those that exceed five centimeters in size and are called “giant” haemangiomas. Malignant transformation has not been noted and therefore only regular follow-up is recommended for smaller haemangiomas. Surgical intervention becomes necessary only if symptoms or complications occur. Nevertheless, atypical presentation can cause a significant differential diagnostic problem. CASE REPORT - The authors report the case of a 51-year old woman with a focal hepatic abnormality diagnosed during a routine abdominal ultrasound examination. Results of the subsequent computed tomography scan suggested a multiple hepatocellular carcinoma based on the morphological appearance. Following oncology consultation, she was admitted to our department for liver biopsy. Histology did not reveal any malignancy. This result together with the lack of symptoms and complaints and the normal laboratory test results shifted the likely diagnosis towards a benign haemangioma. Blood-pool scintigraphy confirmed this diagnosis. CONCLUSIONS - Haemangiomas are benign hepatic tumors. They are often diagnosed accidentally, by routine abdominal ultrasound examination. If an abdominal ultrasound raises suspicion of haemangioma, abdominal MRI scan or blood-pool scintigraphy is recommended to be performed in order to exclude malignancy for lesion sizes of <2 cm or >2 cm, respectively. The reported case is considered important because of the differential diagnostic problems the large size and the atypical presentation of the given haemangioma imposed. Ultrasound-guided liver biopsy via fine-needle aspiration has previously been contraindicated. This invasive procedure can be performed in patients with focal hepatic pathology if diagnosis cannot be established by non-invasive tests, especially if malignancy is suspected. It can be performed conditional on the localization of the tumor, the patient’s general condition, the laboratory results, and if there is a therapeutic consequence of the biopsy results.]