[The biological basis of screening: natural history of malignous tumours]
DÖBRŐSSY Lajos, KOVÁCS Attila, BUDAI András
NOVEMBER 22, 2012
Lege Artis Medicinae - 2012;22(10-11)
DÖBRŐSSY Lajos, KOVÁCS Attila, BUDAI András
NOVEMBER 22, 2012
Lege Artis Medicinae - 2012;22(10-11)
[The development of malignous tumours is a prolonged, multistage process. The onset of clinical symptoms and subjective complaints is preceded by the preclinical detectable phase, during which the tumour does not cause any symptoms but it has some signs and can be detected by screening. Information on the tumour’s natural history is of practical importance for choosing the screening strategy. When evaluating screening results, the various biases related to biological reasons need to be taken into consideration.]
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Lege Artis Medicinae
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Lege Artis Medicinae
Clinical Neuroscience
[In the “Three Generations for Health” programme, general practitioners were responsible for screening for dementia in their practices using mini-COG and Mini Mental State Examination. The aim was to present the screening results of those included, their assessment by the doctor and the further fate of the patients. After mini-COG test, MMSE test was performed in case of suspected dementia. The examiner categorized the result as abnormal or no abnormal, recorded the referral, and recorded the data in an online interface. Our study is a cross-sectional study; the evolution and distribution of the parameters described in the objectives are described with raw case numbers and proportions. Patients aged 55 years and over were recruited consecutively. Only those cases (29 730) where mini-COG and MMSE test results were available, their assessment by the physician, and referral data to specialist care were analyzed. The Mini-COG test revealed that 64% of the subjects were suspected of cognitive decline. Misclassification occurred in 13 015 cases, with 21% of the Mini-Cog test scores matching cognitive decline and 21% of lesions considered abnormal by GPs. The MMSE test raised the suspicion of dementia in 34% of the sample (10 174 people), with 4 262 (42%) of the participating GPs considering the result abnormal. 11% (2095 people) of people with abnormal Mini-Cog test scores and 17% (1709 people) of people with suspected dementia based on MMSE test scores were referred to specialist care. Our study assessed the practice of detecting cognitive decline in primary health care. The tools adopted for screening for dementia were used by practices, but the assessment of results and referral of suspected cases of dementia to specialist care were below the expected level. There is a need to improve primary care providers’ knowledge of dementia detection and treatment and to strengthen links with specialist care.]
Hypertension and nephrology
[Cardiovascular (CV) diseases are not only the leading causes of mortality in Hungary, but also the mortality rate is excessively high compared with the average of European Union, so screening programs identifying subjects with elevated blood pressure (BP) is of utmost importance. May Measurement Month (MMM) is an annual global initiative which began in 2017 aimed at raising awareness of high BP. Hungary, through the Hungarian Society of Hypertension has joined the campaign of MMM from the beginning. The results of years 2017 and 2019 are presented in this paper. ]
Hypertension and nephrology
[Using our mobile public health screening system, we examined the changes in systolic blood pressure averages and systolic pressure distribution between 2010 and 2018 by analyzing the data of 72,857 women (mean age 42.3±13.9 years) and 61,563 mén (mean age 42.2±13.9 years) in three consecutive time periods. The SBP averages have been gradually and significantly decreased since 2010 in all age groups. The parametric and non-parametric characteristics of the systolic distribution curves alsó showed a favorable change during the indicated period. The observed changes may indicate that the primary and secondary prevention, as well as the treatment of hypertension and the physician-patient cooperation in Hungarywere successful in the indicated period.]
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[The „Comprehensive Health Screening of Hungary 2010-2020” have finished the 5th jubilee season. Int he past five year the program was working succesfully as a model for the primer and secondary prevention. The results of comprehensive screening have shown caracteristic picture about the health of population, and many people received education, informations about health protection, prevention and healthy lifestyle. More than 900 places, 7 millions of filled risk queries, 112 000 people’s comprehensive screening and 250 000 counsellings are the summary of activities. Some 200 000 people received the information pack. Significant is the familiar occurence of tumors and cardiovascular diseases, that means 20% of prevalence in test subjects. We are obese, smokers, physically inactive, our health behavior is poor. The improvement of the populational health care activity is among the strategical plans of health politics, and it is badly needed based on the results of MÁESZ Program.]
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[According to both international and national studies the point prevalence of diagnosed major depression requiring treatment is 6-10 percent in general practice. As untreated depression is the most important risk factor for suicide, early detection and effective management of depression (especially depression which predisposes sui-cide) are critical in prevention. According to international and national studies the re-cognition of major depression in primary care significantly contributes to the decline of suicide mortality. In our article we present two short questionnaires used for re-cognising depression and acute suicide risk and we describe their use in family/ general practice. We aim to raise awareness of the need of a systematic, nationwide sui-cide prevention programme which is supported on government level as well. ]
Population-based stroke screening days in the 12th district of Budapest in 2011 and 2016 - What have and what have not changed?
Public health prevention in Hungary II.: established methods, adequate information, real screening results „Comprehensive Health Screening of Hungary 2010-2020” - four-year results
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