[The role of cognitive emotion regulation in disordered eating among chronically ill adolescents]

Bevezetés: A krónikus betegségek evészavartünetekkel való társulása fokozott figyelmet igényel a súlyos szövődmények lehetősége és a mortalitási rizikó növekedése miatt. Az evészavarok és a szubklinikai evészavarok maladaptív érzelemszabályozással járnak együtt, melyek kiváltó és fenntartó tényezői is lehetnek a betegségnek. Ismereteink szerint a gyulladásos bélbetegséggel és 1-es típusú diabetesszel élő serdülők kognitív érzelemszabályozásának szerepét az evészavartüneteikben ez idáig még nem vizsgálták. Célkitűzés: 14 és 18 év közötti serdülők körében elemeztük a kognitív érzelemszabályozás és az evészavartünetek kapcsolatát, különös tekintettel az 1-es típusú diabetesben és gyulladásos bélbetegségben érintett fiatalokra. Kutatásunk arra irányult, hogy krónikus betegek csoportjaiban kimutatható-e egyes kognitív érzelemszabályozó stratégiák szerepe az evészavartünetekben. Módszer: Vizsgálatunkban 300 serdülő töltötte ki tájékozott beleegyezés után a Kognitív Érzelemreguláció Kérdőívet és a Pszichopatológiai Tünetlista Gyermekek és Serdülők Számára kérdőívet. A négy vizsgálati csoportot 157, testileg egészséges serdülő, 51, gyulladásos bélbetegség diagnózisával élő serdülő, 61, 1-es típusú diabetes diagnózisú serdülő és 31, anorexia nervosa diagnózissal rendelkező serdülő alkotta. Eredmények: Vizsgálatunk eredményei alapján a gyulladásos bélbetegséggel élő fiatalok esetében a ruminatio és a pozitív átértékelés, az 1-es típusú diabetes diagnózisú serdülőknél pedig az önvád és a ruminatio közvetett úton szignifikáns kapcsolatban állt az evészavartünetekkel. Megbeszélés: Eredményeink arra utalnak, hogy a kognitív érzelemszabályozó stratégiák a vizsgált krónikus betegséggel élő serdülők körében indirekt módon kapcsolatban állnak az evészavartünetekkel. Az önvád és ruminatio negatív érzelemszabályozó stratégiák gyakoribb alkalmazása növeli az evészavartünetek előfordulását, ugyanakkor kisebb mértékű használatuk kevesebb evészavartünettel jár együtt. A pozitív átértékelés nagyobb mértékű alkalmazása kevesebb evészavartünettel jár együtt. Következtetés: A kognitív érzelemszabályozó stratégiák vizsgálatát és fejlesztését javasoljuk beépíteni a krónikus beteg serdülők komplex ellátásába. Orv Hetil. 2023; 164(48): 1895–1903.

Health-related productivity of the Hungarian population. A cross-sectional survey

INTRODUCTION

Health disorders may affect negatively work productivity of individuals, leading to absence from work (absenteeism) and/or decreased functioning in the workplace (presenteeism).

AIM

To assess the health-related work productivity of the adult population in Hungary by the Work Productivity and Activity Impairment questionnaire (WPAI).

METHOD

A cross-sectional survey was performed in 2019 involving a sample (n = 2023) representative for the adult population of Hungary. Socio-demographic characteristics were recorded. Health-related productivity of the participants was assessed by the WPAI questionnaire, health status was measured by the EQ-5D-3L measurement tool and the Minimum European Health Module (MEHM).

STATISTICAL ANALYSES

Descriptive statistics were performed, subgroups were compared by Mann-Whitney and Kruskal-Wallis tests. Spearman's rank correlation was applied to analyze the relationship between WPAI, age and EQ-5D-3L index score.

RESULTS

Among those in a paid job (n = 1194, 59%), altogether 70 respondents (6%) were absent from work during the week before the survey, which resulted in an average 1.9 (SD = 8.5) work hours loss per week. Presenteeism occurred in 166 (14%) cases. The average absenteeism was 3.6%, presenteeism was 4.4%, and activity impairment in the total sample was 9.5%. Absenteeism did not correlate with age and did not differ significantly across socio-demographic subgroups. Presenteeism was the highest among actively working retired people, disability pensioners and part-time employees. Presenteeism correlated moderately (r = -0.379), absenteeism weakly (r = -0.113) with EQ-5D-3L index. Correlation was significant between activity impairment and age (r = 0.412) as well as the EQ-5D-3L index score (r = -0.592). All WPAI items showed significant worsening across MEHM status levels.

CONCLUSION

This is the first study in Hungary to present population reference values with the WPAI. Productivity loss due to presenteeism deserves special attention from the employers as well as from decision makers in the labour, health and social sectors. Orv Hetil. 2020; 161(36): 1522-1533.

[Differencial diagnosis of the low alkaline phosphatase activities]

Laboratory diagnostics is especially important in the diagnosis of certain diseases. We compared manual measurements results to laboratory normal values. In some cases, these values depend on the gender and age as well. In the case of alkaline phosphatase, it is rarely considered that reference values change over life periods. Unfortunately, during the daily practice we do not always take into account of the changes with aging. This is especially true if the laboratory does not specify the age related normal values. Another problem that we mostly focus on the results exceeding the normal values, and do not pay enough attention to the low values. Of course, these results should be put in the context of the clinical picture and other diagnostic test results. We would like to draw attention to the measuring of alkaline phosphatase and the differential diagnosis for low serum activity. Orv Hetil. 2017; 158(26): 1003-1007.

[Sleep duration among school-age children in Hungary and Romania]

INTRODUCTION

Children's sleep duration is decreasing in the last decade. Despite of the well known negative consequences, there are no data on children's sleep duration in Hungary and Romania.

AIM

The aim of the authors was to assess sleep duration of school-age children in Hungary and Romania.

METHOD

A self-edited questionnaire was used for the study. 2446 children were enrolled. All elementary and secondary schools in a Hungarian city, and one elementary and secondary school in a Romanian city took part in the study.

RESULTS

Mean sleep duration was 8.3 ± 1.2 hours on weekdays. There was a significant difference between the two countries (Hungary vs. Romania, 8.5 ± 1.2 hours vs. 7.8 ± 0.9 hours, p = 0.001). Age correlated with sleep duration on weekdays (r= -0.605, p = 0.001), but not during weekend.

CONCLUSIONS

This is the first study on children's sleep duration in Hungary and Romania. The difference between countries may be due to the difference in mean age or cultural and/or geographical differences.

[The cortical collecting duct plays a pivotal role in the kidney's local renin-angiotensin system]

The renin-angiotensin system is one of the most important hormone systems in the body, and the regulations as well as the role in the juxtaglomerular apparatus are well known. The present review focuses on renin secretion in a recently described localization, the cortical collecting duct. The authors display it in parallel of the copying strategy of an adult and a developing kidney. Furthermore, based on different animal studies it highlights the local role of renin released from the collecting duct. In chronic angiotensin II-infused, 2-kidney, 1-clip hypertensive model as well as in diabetic rats the major source of (pro)renin is indeed the collecting duct. In this localization this hormone can reach both the systemic circulation and the interstitial renin-angiotensin system components including the newly described (pro)renin receptor, by which (pro)renin is able to locally activate pro-fibrotic intracellular signal pathways. Consequently, one can postulate that in the future renin may serve either as a new therapeutic target in nephropathy associated with both hypertension and diabetes or as an early diagnostic marker in chronic diseases leading to nephropathy.