Bethesda Gyermekkórház

With improvements in childhood cancer survival, attention has shifted toward health-related quality of life (HRQoL) and long-term treatment effects. This study aimed to validate the Hungarian version of the Minneapolis-Manchester Quality of Life Instrument – Adolescent Form (MMQL-AF) and explore factors associated with HRQoL among adolescents and young people with cancer. Ninety-two patients with cancer (46 receiving active treatment and 46 ≥ 1 year post-treatment) and 46 healthy controls completed the MMQL-AF. The MMQL-AF was translated into Hungarian in accordance with Beaton et al. and TARES (2024) guidelines. Reliability was assessed using Cronbach’s alpha and intra-class correlation coefficients (ICCs). Validity was evaluated by correlations with the Hungarian Pediatric Quality of Life Inventory (PedsQL 4.0) and by comparing scores across groups. Five items were removed during confirmatory factor analysis (CFA) to improve model fit. The MMQL-AF demonstrated acceptable reliability (Cronbach’s alpha 0.73–0.90; ICC 0.78–0.96; RMSEA = 0.062; 90% CI: 0.055–0.069; CFI = 0.828; TLI = 0.814; SRMR = 0.079; GFI = 0.962) and strong concurrent validity with PedsQL scores. Cancer patients reported significantly lower HRQoL than healthy peers (mean 3.58 vs. 3.81; mean difference 0.23; 95% CI: 0.05–0.41; p = 0.012). No significant difference emerged between patients on active treatment and patients off treatment. Patients with bone, soft-tissue, or central nervous system tumors reported worse outcomes (p = 0.015). Positive parental relationships were strongly associated with a better outlook (p < 0.001). The Hungarian MMQL-AF demonstrated acceptable reliability and validity for assessing HRQoL among adolescents and young people with cancer. Tumor type and family environment were associated with differences in the well-being of the patients. This instrument enables comprehensive HRQoL assessment in Hungarian pediatric oncology, supporting identification of at-risk groups and informing survivorship care strategies tailored to medical and psychosocial needs.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-33243-9.

Anthracycline-induced cardiotoxicity is a major concern in childhood cancer survivors. Detecting subclinical cardiac dysfunction early is critical, but the accuracy of current diagnostic tools is uncertain. We performed a systematic review and meta-analysis of studies evaluating the prognostic accuracy of echocardiography, serum biomarkers, microRNAs (miRNAs), and artificial intelligence (AI) models in predicting chemotherapy-induced cardiotoxicity in pediatric patients. Seventy-three studies were included in the qualitative synthesis, and ten in the meta-analysis. Quality was assessed using the QUAPAS tool (CRD42023485629). AI-based models showed the highest pooled predictive performance area under the curve (AUC)~0.80, despite significant heterogeneity (I² = 93%). Global longitudinal strain (GLS) had moderate accuracy (AUC~0.72). Cardiac biomarkers like troponin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) showed variable sensitivity and specificity, largely influenced by timing and thresholds. Preliminary evidence on miRNAs was promising but lacked standardization. Additional methods (e.g., cardiac MRI, cardiopulmonary exercise testing (CPET)) were excluded from meta-analysis due to methodological variability. No single modality reliably detects early cardiotoxicity. Promising tools like AI models and miRNAs need further validation. A multimodal diagnostic strategy combining imaging, biomarkers, and clinical data may be the most effective approach. Standardized definitions and protocols are urgently needed. Early detection of chemotherapy-induced cardiotoxicity in children remains unresolved. Multimodal assessment is most effective because no single test is sufficiently reliable. There are critical methodological gaps and heterogeneity that impede standardization in pediatric cardio-oncology. AI and microRNAs are promising but still unvalidated tools. The findings guide future clinical monitoring strategies and support standardized multimodal diagnostic algorithms.

Atopic dermatitis (AD) is a chronic, inflammatory skin disease that carries a significant psychological burden.1 Beyond the visible cutaneous symptoms, individuals with AD are associated with an increased risk of anxiety and depression.1 While standard treatments focus on alleviating the physical symptoms of AD, psychological stress and emotional factors play a significant role in triggering or worsening disease activity.2 However, add-on psychotherapeutic interventions remain underused in clinical practice. This implementation gap highlights the need for multidisciplinary care strategies that include psychological support. To address this, we conducted a systematic review and meta-analysis evaluating the impact of add-on psychotherapeutic interventions on disease severity and quality of life in adults with AD. We searched MEDLINE, EMBASE, and Cochrane CENTRAL on November 12, 2024, for interventional studies evaluating psychotherapy plus standard care for AD. A total of 6995 publications were screened by three independent reviewers. Sixteen clinical trials met the inclusion criteria for the systematic review (Table 1), five of which were eligible for meta-analysis (n = 335). Interventions included cognitive behavioural therapy, behavioural therapy, autogenic therapy, habit reversal, family constellation seminar, mindfulness, hypnotherapy, music therapy, stress management, and brief dynamic psychotherapy. The outcomes were the Eczema Area and Severity Index (EASI) and the Dermatology Life Quality Index (DLQI), assessing disease severity and quality of life, respectively. In the meta-analysis of five studies including 335 patients,3-7 psychotherapeutic interventions compared with standard dermatologic care led to a significant reduction of 3.92 points in EASI (N = 3, n = 126, 95% CI [−7.19, −0.66]) (Figure 1a) and 3.42 points in DLQI (N = 4, n = 315, 95% CI [−5.63, −1.20]) (Figure 1b). These reductions are not only statistically significant but also clinically meaningful. They correspond to a shift in disease severity from moderate to mild and a reduction in quality-of-life impact from moderate–very large to moderate-low across all add-on psychotherapy groups. The clinical impact of these findings is substantial; reduced disease severity may permit treatment de-escalation,8 while improved quality of life promotes patient adherence.9 Together, these can lead to better treatment outcomes and reduced healthcare costs.10 In addition, psychotherapeutic interventions may also help address significant psychological comorbidities associated with AD, such as depression, anxiety, and suicidal ideation, which are increasingly recognized in this population. Despite heterogeneity in intervention type, duration, delivery method, and outcome measures, the findings were directionally consistent. However, the limited number of studies and methodological issues reduce the certainty of the conclusions, warranting cautious interpretation. Our review focused exclusively on adult populations and excluded educational-only interventions, highlighting the direct impact of psychotherapy. It also included newer trials not covered by previous analyses and focused on validated outcomes widely used in clinical practice and research, enhancing the generalizability and translational relevance of our findings. The results suggest that psychotherapeutic interventions have the potential to transform the treatment of AD, particularly in patients with mild to moderate disease. Our findings therefore support its more precise recognition as a distinct psychotherapeutic intervention in official clinical guidelines and protocols. Additionally, future randomized clinical trials with robust methodology and validated outcome measures are needed to build on these findings by enrolling larger patient numbers to further establish the efficacy of add-on psychotherapy. Our results also suggested that psychotherapeutic interventions may have lasting benefits on disease severity and quality of life for up to 1 year, highlighting their potential to be used as part of a long-term management plan. Further research is also warranted in populations with severe AD to evaluate the applicability of psychotherapy in more complex diseases. Lastly, a comparison of the different psychotherapeutic modalities could help identify the most effective intervention for optimized psychotherapeutic care in adults with AD. None. None to declare. No ethical approval was required for this systematic review with meta-analysis. Not applicable. The data that support the findings of this study are available from the corresponding author upon reasonable request.

Kondisi gawat darurat tidak hanya terjadi di tempat-tempat yang ramai tetapi juga dalam lingkungan pemukiman warga atau perumahan warga. Misalnya, sedang makan tiba-tiba tersedak, atau kena luka bakar, dan kejang dirumah karena kondisi demam. Situasi-situasi tersebut perlu ditangai segera dalam hitungan menit bahkan detik sehingga perlu pengetahuan dan pelatihan secara praktis bagi setiap warga tentang pertolongan pertama pada kondisi gawat darurat pada lingkungan keluarga dan perumahan. Urgensi dari permasalahan kegawatdaruratan tersedak pada anak dapat menyebabkan kematian, sangat perlu untuk dilakukan edukasi terkait penanganan kegawatdaruratan tersedak pada anak dan kejang demam pada anak.. Masyarakat di Kampung Kayen, Wedomartani, Ngemplak, Sleman, belum memahami metode-metode penatalaksanaan kegawatdaruratan pada secara detail selain itu juga belum pernah ada pelatihan tentang penanganan kegawatdaruratan pada sehingga perlu dilakukan pelatihan dalam upaya meningkatnya kemandirian warga dalam penanganan kondisi kegawatdaruratan tesedak dan kejang. Kegiatan ini sebagai salah satu upaya penanganan dan mengurangi mortalitas kasus tersedak pada anak dan kejang demam pada anak. Kegiatan dilaksanakan meliputi pemberian edukasi tentang penatalaksanaan kejang dan tersedak untuk masyarakat umum. Kegiatan penyuluhan tentang penatalaksanaan kejang dan tersedak untuk diawali dengan pemberian pretest sebanyak 7 item pertanyaan (terlampir) untuk warga. Kegiatan pre-test dilakukan untuk melihat tingkat pengetahuan warga tentang penanganan kejang dan tersedak. Nilai rerata sebelum edukasi didapatkan skor 3,53 dan setelah edukasi didapatkan skor 5,19 dari total skor 7. Peningkatan nilai ini menunjukkan bahwa meningkatkan pemahaman warga setelah dilakukan edukasi penanganan kegawatan tersedak dan kejang dengan penyuluhan dan demonstrasi

Mata merupakan organ penting dalam kehidupan manusia namun sering diabaikan. World Health Organization menyebutkan bahwa 217 juta orang mempunyai gangguan penglihatan. Dalam rangka menjaga kesehatan mata masyarakat perlu dilakukan tindakan promotif dan preventif. Tindakan promotif yang dilakukan adalah dalam bentuk pendidikan kesehatan mata dengan diberikan penyuluhan dan tanya jawab tentang kesehatan mata. Tindakan preventif yang dilakukan adalah dengan pemeriksaan kesehatan mata pada warga. Masalah yang diidentifikasi pada warga di adalah warga belum mengetahui tentang kesehatan mata dan belum pernah ada kegiatan deteksi gangguan penglihatan atau pemeriksaan mata. Selama ini warga hanya mengeluh mata sering pedih dan berair saat melihat handphone terlalu lama, dan pandangan lama-lama tampak kabur. Tujuan kegiatan ini adalah memberikan edukasi tentang kesehatan mata dan melakukan deteksi dini gangguan penglihatan dengan bekerja sama dengan OPTIK ARSEN dengan alat yang disebut dengan refraktor. Kegiatan ini meliputi pemberian edukasi tentang kesehatan mata dan pemeriksaan kesehatan mata yang meliputi persiapan, pelaksanaan, dan penutupan. Hasil kegiatan ini adalah terdapat 10 warga miopi, 6 hipermetropi, dan 10 astigmatisme. Diantara jumlah tersebut ada 9 warga yang terdeteksi miopi sekaligus astigmatisme. Ada 3 warga yang masih normal hasil pemeriksaannya, yaitu pada kategori anak-anak. Setelah kegiatan edukasi dan pemeriksaan kesehatan selesai, dilakukan post-test. Hasilnya terdapat perbedaan rerata skor sebelum (5,7) dan setelah pemberian edukasi kesehatan mata (7,9), dengan selisih skor 2,2. Peningkatan nilai ini menunjukkan bahwa meningkatkan pemahaman warga setelah dilakukan edukasi kesehatan mata dengan penyuluhan dan pemeriksaan kesehatan mata.

Az els vilghbor utn megfigyelhet az a tendencia, hogy a hbor eltt meglv felekezeti konfliktusok nem olddtak fel a bajban val sszetarts s keresztyn

Background: One of the efforts funded by Dikti in implementing the Student Creativity Program in the field of entrepreneurship gave us the opportunity to produce a Dompet Mask (DOMAS) product made using modified patchwork waste and mica polyvinyl chloride plastic waste with a thickness of 0.4 mm. The tools and materials we use are very affordable during this COVID-19 pandemic. Objective: Provide quality Domas innovation, practical, and safety of the waste material. Providing business opportunities through student creativity programs. Marketing DOMAS offline and online throughout Indonesia by actively promoting and improving the quality of products handmade. Methods: The implementation of activities is carried out outside the network (offline) and within the network (online). The activity was carried out at the production house located at Jatisawit Housing, Sleman, Yogyakarta. The production period starts on 08/08/2021 until 12/09/2021. Product marketing online and offline. Result: The selling price per unit is Rp. 20,000. For five weeks producing 250 DOMAS. DOMAS sales resulted in a profit of Rp. 3,000,000 with a cost of Rp. 1,549,080, a profit of Rp. 418,200 was obtained. The number of DOMAS that have been sold is 150 units. The profit per DOMAS unit is IDR 2,788. The original price per wallet is Rp. 17,212. Conclusion: The "DOMAS" mask wallet is a new breakthrough in the era of the COVID-19 pandemic. DOMAS has the advantage of being able to store clean and dirty masks in one place. In addition to the unique and attractive design of the mask, the materials used are also environmentally friendly, made from plastic waste mica PVC and waste batik patchwork with the motifs of the diversity of the archipelago.

Data on protected plant species and the main characteristics of local landscape history and historical land-use patterns are presented for altogether 11 abandoned vineyards around Aszófő, Balatonudvari, Dörgicse, Örvényes, Pécsely and Vászoly villages (Central Transdanubia, Hungary). The main reasons for abandonment were the vine-pest epidemic and the nationalization, and later the conversion of previous garden plots to holiday sites. Built-up areas have increased during the past two years due to the covid-19 pandemic, which leads to the deterioration of previously re-vegetated grasslands. Succession is ongoing in every sample area. I found 32 protected plant species and present their localities on maps. After the evaluation of the list of vascular plants based on their social behavior types and ecological indicator values (SBT, Val, TB, WB, RB, NB, SB) I state that the current vegetation of the studied abandoned vine parcels refer to close-to-natural conditions. Their conservation value is emphasized by the fact that I found protected plants in every study area. However, several endangering factors threaten these parcels (except for one site), such as built-up, plowing, conversion to garden; as well as scrub encroachment and afforestation. I add suggestions for the conservation management o each studied parcel.

Introdução: O termo "epilepsias genéticas focais (idiopáticas) da infância" representa um espectro de síndromes epilépticas, que vão desde epilepsias autolimitadas com espículas centrotemporais (SeLECTS) até doenças neurológicas mais graves, como a encefalopatia epiléptica e do desenvolvimento com ativação de espícula-onda durante o sono.Embora a atividade interictal nessas doenças possa ter topografia semelhante no eletroencefalograma (EEG) de escalpo, diferentes distribuições de redes neuronais cerebrais poderiam justificar desfechos clínicos distintos.Objetivos: Investigar padrões de neuroimagem funcional associados às descargas epileptiformes interictais (DEIs) e sua associação com varáveis clínicas em crianças com SeLECTS.Métodos: Sete pacientes (três meninas e quatro meninos, de oito a 12 anos) com SeLECTS, foram submetidos a EEG e ressonância magnética funcional concomitantemente (EEG-RMf), além de acompanhamento clínico e avaliação neuropsicológica (Escala Wechsler de Inteligência para Crianças, WISC-IV).Todas as imagens foram adquiridas em um scanner de 3 Tesla e aparelho de EEG com 64 canais apropriado para RM.DEIs foram identificadas visualmente no traçado do EEG e utilizadas para definir alterações hemodinâmicas através do sinal dependente do nível de oxigênio sanguíneo (Blood Oxygen Level Dependent -BOLD) (SPM12, p<0,001, mínimo de 40 voxels contíguos).As imagens de RM e os traçados de EEG foram revisados por dois epileptologistas.Foram realizados mapas BOLD individuais, procurando "ativações" (BOLD positivo) ou "deativações" (BOLD negativo) relacionadas às DEIs, além de análises de grupos de acordo com idade, número total de crises, lateralidade, quociente de inteligência total e outros subtestes do WISC-IV.Os mapas BOLD foram, então, divididos em grupos de acordo com a distribuição típica (eletrodos C3, C4, C5 e C6) ou atípica (eletrodos T7, T8, P7, P8, P3, P4, O1, O2) das DEIs observadas ao EEG.Resultados: Total de 10 mapas BOLD de seis pacientes derivados de DEIs de diferentes distribuições foram analisados.Sinal BOLD positivo relacionado às DEIs foi observado principalmente nos lobos temporal mesial e occipital ipsilaterais e nos lobos occipital e parietal contralaterais, bem como no giro frontal superior.O sinal BOLD negativo foi observado principalmente nos lobos parietal, occipital e mesial temporal ipsilaterais e nos lobos parietais e giro frontal inferior contralaterais.Padrões distintos de resposta BOLD positivo foram observados para as DEIs de distribuição típica e atípica, com distribuição predominantemente central ipsi ou bilateral para as DEIs típicas e predominantemente em regiões têmporo-occipital, parietal superior e precuneus bilateral.Não foram encontradas diferenças entre os mapas BOLD relacionados às DEIs à direita e à esquerda nem na comparação dos grupos, como idade, sexo, número de crises ou aspectos cognitivos.Conclusões: DEIs estão relacionadas a padrão difuso de respostas BOLD positivo e negativo em crianças com SeLECTS.DEIs de distribuição típica ou atípica apresentam padrões distintos de ativação BOLD.É possível que DEIs de distribuição atípica tenham geradores distintos e distantes do sulco central.