[INTRODUCTION - At least 5-10% of the adult population is afraid of medical care. These fears may begin in preschool years. Therefore, the aim of our study was to assess the rates of medical fears among 5-6 year old children, and to prove that medical fears can be reduced by a health promotion program for children called “Teddy Bear Hospital” POPULATION AND METHODS - 248 children participated in the study (average age: 5.5 years, 45% girl, 55% boy). The “Teddy group” (129 children) took part in the Teddy Bear hospital program (Teddy group). The control group (119 children) did not take part in this program (control group). Questionnaires, including a Visual Analog Scale, a picture test, and drawing analyses were completed on two separate occasions three weeks apart difference. RESULTS - Fear of needles was the most frequent fear (59%) among the participating children, followed by the fear of medical environment (33%), the fear because of the lack of information (27%), the fear of doctors (20%), and the fear of pain (15%). On the basis of the picture test the fear of doctors significantly decreased in the Teddy group (from 18% to 7%) compared with the control group (from 10% to 11%, p<0.05). Drawing analyses also showed that children in the Teddy group had significantly lower levels of medical anxiety (29% and from 19.3 point to 17.6 point) than the control group (19% p<0.05 and from 18.8 point to 18,33 point p<0.05). On the drawings of the Teddy group we found significantly more new medical information (38%) compared with the control group (21%, p<0.05). CONCLUSIONS - Medical fears are frequently present among 5-6 year old children, therefore, their prevention is greatly needed. A potential way of the prevention is the “Teddy Bear Hospital” program, which efficiently reduces children's medical fears and anxiety.]

[Various medical associations issue different recommendations for the prevention and treatment of vitamin D deficiency. These significant differences are partly explained by the different definition of normal vitamin D level and the use of completely different mathematical models to predict the increase in vitamin D level as a response to therapy. According to the Institute of Medicine (IOM), the target vitamin D level is 20 ng/ml, whereas the Endocrine Society (ES) recommends 30 ng/m as the miminum target value. According to the ES, a 1 ng/ml increase of vitamin D level can be reached by a daily intake of 100 NE, while the IOM recommends 3.6 ng/ml. Moreover, the IOM states that the effect of therapy on serum level is nonlinear. These differences show that the ES and IOM have different views on the risk of adverse effects. The IOM recommends 400 IU vitamin D daily for children younger than 1 year, 800 IU for those above 70 years and 600 IU/per day for everyone else. The ES recommend 400-1000 IU daily for all infants and 1500- 2000 IU for adults. Screening, however, is not recommended by either society. To decrease uncertainty concerning the side effects of higher-dose vitamin D treatment, it is important to understand, use and support the function of the pharmacovigilance system of the pharmaceutical industry that manufactures and markets various (prescription, over-the-counter) preparations. This is what the author aims to highlight in the second part of this article. Using this system, both the doctor and the patient can help support and accept the justification of higher-dose vitamin D therapy.]

[In the past 10 years, a number of screening programs with various goals have been started in Hungary, with varying degrees of success. The „Comprehensive Health Screening of Hungary 2010-2020” program has been touring the country (with a screening truck), either joining organised events or as an independent screening, collaborating with local healthcare centers (primary care, occupational healthcare etc). The screening program has been conducted in a special truck, in which various examinations were performed in a set time. Those who participated in the screening received a prevention information pack (for studying and reading at home) and the official publication of the program (Health Book), in which the program and the screening results were described. In the past four years the screening truck has been to 725 places in Hungary and travelled 83,145 kilometers. 87,935 people have participated in comprehensive screening. 194,549 visitors received lifestyle counseling and 142,319 received Prevention Packs. In total 2,901,855 examinations have been performed, which required 6711 hours of work of 1132 healthcare professionals. 5,856,114 answers were given to queries of the survey related to the health status of the Hungarian population. The program has already overfulfiled its original goals to visit 1500 locations and perform 8 million examination during this period. It is of particular significance that the average age of participants was 40 years. As cardiovascular risk is still the leading health risk, screening for such risk factors has to be part of all general and complex screening programs. In this program, an increasing number of validated, rapid and effective risk-estimation tests were used. It is remarkable that 20% of the tests related to colorectal cancer risk has positive results. Also of importance are the test results for hearing loss (7% positive) and various degrees of visual impairment (over 50%). Both results have significant social and economical implications for both individuals and the society. Unfortunately, the general level of health consciousness is still low. This might be improved not only by the screening itself but the opportunity to inform the public and provide organised counselling and printed materials, for which the activity and expertise of professional healthcare worker is essential. ]

[Recent meta-analyses have indicated that patients with vascular disease demonstrated by laboratory tests to be aspirin or clopidogrel-resistant are at an increased risk of major vascular events. The suggested mechanisms of aspirin resistance include genetic polymorphism, alternative pathways of platelet activation, aspirin-insensitive thromboxane biosynthesis, drug interactions, or a low aspirin dose. Clopidogrel resistance is likely to develop as a result of a decreased bioavailability of the active metabolite, due to genetic variation or concomitant drug treatment. Additional work is required to improve and validate laboratory tests of platelet function, so that they may become useful tools for selection of the most appropriate antiplatelet therapy for an individual patient. Improvements in antiplatelet treatment strategies in the future should lead to a reduction in premature vascular events.]

[In the past few years a number of articles have been published on the new oral anticoagulants (Xa-factor inhibitors, thrombin inhibitors). These new agents are increasingly used in the daily clinical practice in Hungary. The new oral anticoagulants have been shown to be at least as effective in the prevention of stroke and systemic embolization related to non-valvular atrial fibrillation as K vitamin antagonists. Moreover, their use is safe, can be administered in a daily fixed dose and, even in case of long-term use, they do not require regular laboratory testing. This review aims to summarise the most important theoretical and practical information on the newest direct Xa-factor inhibitor agent apixaban from the perspective of a cardiologist.]