Csaba Móczár - Academia.edu (original) (raw)

Papers by Csaba Móczár

Journal of Hypertension, Apr 1, 2021

Background: Previous research has revealed a clear relationship between weight gain of persons an... more Background: Previous research has revealed a clear relationship between weight gain of persons and their metabolic diseases developing later. These studies have covered only short periods lasting 4-8 years.Our goal was to collect decades' old and often life-long anthropometric data and correlate the figures with the presence of hypertension and diabetes or both. Methods: A retrospective international study was planned and organized to compare self-recorded data of lifelong weight gain among 60-70-year-old patients, analyze their correlation with metabolic diseases they developed, with special attention to women's weight gain around pregnancy, delivery and menopause in primary care settings in Germany, Hungary, Italy, Slovakia and the Ukraine. Results: Of the recruited 815 participants, 319 men and 496 women presented all the required data. Diabetics of both genders had the highest baseline weight at 20 years of age. The weight and BMI of the whole study population increased steadily until their seventies, but to a lesser extent after their fifties. Compared to the control group, changes over decades were the greatest among diabetics and also greater among patients with hypertension. Weight increase in the first decades (20-30-year-old men and 30-40-year-old women) was a significant risk factor for the development of diabetes (OR=1.044; p=0.002; 95% CI: 1.01-1.07). Among patients with diabetes and hypertension, both diagnoses were set up earlier than among those with a single morbidity.Among females, weight increase around pregnancy and menopause correlated significantly with higher odds for the diagnoses of diabetes and/or hypertension, irrespective of the number of children. Conclusions: During their decade-long relationship with their patients, family physicians are expected to identify the higher weight gain of their patients, especially among younger generation and intervene, if necessary.

Bevezetés: A szűréseken, köztük a mammográfiás szűrésen való részvétel aránya hazánkban igen alac... more Bevezetés: A szűréseken, köztük a mammográfiás szűrésen való részvétel aránya hazánkban igen alacsony. A megjelenési arány javítása terén az alapellátás szerkezeti átalakítása, a praxisközösségek kialakítása lényeges feladat. Célkitűzés: A szerzők munkájukban a praxisközösségek tagjaként a szűrést segítő prevenciós nővérek munkájának hatékonyságát vizsgálták a mammográfiás szűrések szervezésén keresztül. Módszer: Kecskeméten fokozatosan az összes felnőtt-háziorvosi praxisra kiterjesztve, meghatározott protokoll szerint, a prevenciós nővérek segítségével a háziorvosok nevében léptek kapcsolatba a mammográfiás szűrésen a bázisidőszakot megelőző két évben részt nem vett asszonyokkal. Eredmények: Az első szerző saját praxisában tartósan 60% feletti megjelenési arányt lehetett elérni a módszerrel. A második fázisban a programot öt praxisra kiterjesztve a két éven túl megjelentek 36,7%-át sikerült a mammográfiás szűrésbe ismételten bevonni. A harmadik fázisban, a város egészére kibővítve a programot, a két éven belül nem szűrt lakosság 16-20%-a jelent meg szűrésen, és a regionális mammográfiás központban 70% fölé emelkedett a terület átszűrtségének aránya. Következtetések: A program során igazolódott, hogy a praxisközösség tagjaként dolgozó prevenciós nővér hatékonyan tudja koordinálni a szűrési feladatokat a háziorvosok, a szűrőcentrumok és a páciensek között.

Hypertonia és nephrologia, 2014

Orvosi Hetilap, 2007

The obesity is an important risk factor of cardiovascular diseases. The change of life style play... more The obesity is an important risk factor of cardiovascular diseases. The change of life style plays very important role for management of overweight and obesity and related cardiovascular risk factors. Patients need to acquire and adopt these changes. The aim of this study was to screen practices for overweight and obese patients, to decrease their cardiovascular risk and prevent development of cardiovascular diseases. 2489 overweight patients have been screened from 29 general practices since April of 2001. The authors surveyed their characteristics of life style: eating and exercise habits, measure body mass index, waistline, rest blood pressure, heart rate and plasma glucose, total cholesterin, triglicerid, HDL after a 12-hour fasting. A team, which consisted of an internalist, a dietician and a physical instructor dealt with the patients. After ruling out secondary obesity the team tailored an individual life-style which focused on dietary interventions (low calorie diet) and inc...

Orvosi Hetilap, 2008

Using 30 years of cross-national data on the 15-year survival rates of men and women, this study ... more Using 30 years of cross-national data on the 15-year survival rates of men and women, this study sought to determine whether poor health care system performance or other risk factors, such as obesity or smoking, account for the lower relative gains in life expectancy in the United States compared with those of other industrialized countries. The researchers found that even though the U.S. has achieved gains in 15-year survival rates over three decades, life expectancy has declined relative to other wealthy nations, which have experienced even greater gains.

Lege Artis Medicinae

Az alapellátás átalakításának első lépéseként – a kompetenciák, az eszközpark, az alapellátás ál... more Az alapellátás átalakításának első lépéseként – a kompetenciák, az eszközpark, az alapellátás által nyújtott szolgáltatások bővítésének lehetőségét keresve – létrejöttek az első praxisközösségek. Ennek struktúrája már nem hasonlít a háziorvosi ellátási modell korábbi jellemzőire, az egymástól elszigetelten dolgozó, két-három orvoskollégából álló csapatra. Az új forma a közösségbe szerveződő praxisok hálózata. A hypertoniás beteg ellátása, gondozása tipikus területe a praxisközösségi munkának. A szerzők cikkükben a praxisközösségek szerepét igyekeznek bemutatni a hypertoniás betegek ellátása és gondozása során.

Experimental and Clinical Endocrinology & Diabetes, 2016

Wiener klinische Wochenschrift, 2013

Cardiovascular diseases are responsible for the majority of premature deaths in Hungary as well. ... more Cardiovascular diseases are responsible for the majority of premature deaths in Hungary as well. Most of them could be prevented with healthy lifestyle of patients and adequate drug prescription of primary care physicians. Earlier European surveys found wide differences between the practices and achievements of different countries in this field. The study was based on and designed according to the framework of previous European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) studies and aimed presenting Hungarian results and comparing with the achievements of other countries and previous Hungarian surveys. Among rural and urban settings, 679 patients under continuous care (236 diabetics, 218 with dyslipidaemia, and 225 with hypertension) were consecutively selected by 20 experienced general practitioners. The mean age of patients was 60.3 years (men) and 64.0 years (women). Among diabetics, less than 7 % of glycated hemoglobin (HbA 1 c) values were found in 42.5 % patients, while only 11.4 % patients had fasting plasma sugar less than 6.0 mmol/L. Of the patients treated for dyslipidaemia, the target level of triglyceride was reached by 40.6 %, recommended total cholesterol by 14.2 % and the HDL-cholesterol by 71.8 %. The therapeutic control of total and HDL-cholesterol was better in men, although women had better triglyceride values. The achievement among patients with hypertension was 42.0 %. Significantly higher blood pressure was measured by patients who were treated with not recommended combinations of antihypertensive medication. A remarkable improvement could be observed in Hungary in the field of secondary prevention. It was greater among patients with hypertension and dyslipidaemia and smaller in diabetes care. Compared to the results of published European surveys, Hungary occupies a good position, but further improvement is still required.

Orvosi Hetilap, 2012

The importance of primary care has already been recognized in the developed countries, where the ... more The importance of primary care has already been recognized in the developed countries, where the structure and function of primary care is very heterogeneous. In the QUALICOPC study, the costs, quality and equity of primary care systems will be compared in the 34 participating countries. Representative samples of primary care practices were recruited in Hungary. An evaluation with questionnaire was performed in 222 practices on the work circumstances, conditions, competency and financial initiatives. Ten patients in each practice were also questioned by independent fieldworkers. In this work, the methodology and Hungarian experience are described. The final results of the international evaluation will be analyzed and published later. It is expected that data obtained from the QUALICOPC study may prove to be useful in health service planning and may be shared with policy makers. Orv. Hetil., 2012, 153, 1396–1400.

Acta Alimentaria, 2012

Obesity is an important risk factor of cardiovascular diseases. Dietary intervention combined wit... more Obesity is an important risk factor of cardiovascular diseases. Dietary intervention combined with life style changes were implemented in other countries and proved to be effective. Previously, there were no similar Hungarian experiences. The aim of our study was to screen overweight and obese patients in primary care settings, to involve them in an interventional program and to analyse the expected changes in the laboratory and anthropometric parameters. From 29 primary care practices, 2489 overweight or obese patients were recruited between April of 2004 and 2006. The characteristics of living circumstances, life style, eating and exercise habits were explored by questionnaire. Regular energy intake was counted and compared to estimated requirements. Metabolic and anthropometric parameters were measured. Experienced multidisciplinary staff was involved, including internist, family physicians, dietetitian, experienced nurses and physical instructors. The interventions were: dietary (recommendation of low calorie diet) and increasing physical activity. One year later the body mass index decreased significantly by 0.56 kg m-2 average and remained about the same by the end of the second year. There was only a small decrease in waist circumference. The rest systolic blood pressure decreased significantly on average 5.9 mmHg by the end of the first year, while decrease in resting diastolic blood pressure was less. All metabolic parameters, except HDL-cholesterol decreased significantly: total cholesterol: by 0.23 mmol l-1 , trigliceride: by 0.18 mmol l-1 , blood glucose: by 0.15 mmol l-1. Primary care intervention proved to be effective. Better outcomes would be expected, when more resources, more focus in the media, more support from health authorities and sufficient manpower was available.

A hipertóniabetegség társulása anyagcserezavarral, különösen a szénhidrátanyagcsere zavarával gya... more A hipertóniabetegség társulása anyagcserezavarral, különösen a szénhidrátanyagcsere zavarával gyakori a klinikai gyakorlatban. Az ateroszklerózis megelőzésének holisztikus szemlélete, a rizikófaktorok felmérése és egyidejű kezelése alapelv. Az antihipertenzív terápiának meg kell felelnie ennek az alapelvnek, amelyet nehezít a kombinációs kezelés szükségessége. A diuretikumok erőteljes és olcsó vérnyomáscsökkentő gyógyszerek, kihagyhatatlanok a mindennapi gyógyszeres palettából. A fenti elveket szem előtt tartva fontos, hogy az anyagcsere szempontjából semleges képviselőjüket, az indapamidot helyezzük előtérbe. A szerző a cikkben górcső alá veszi a diuretikumok csoportját a jelenleg rendelkezésre álló tanulmányok alapján, különösen kiemelve a gyógyszercsoport főbb képviselőinek anyagcserehatásait. When a diuretic is needed, choose indapamide for the sake of effective and metabolically inert lowering of blood pressure! The association of hypertension with metabolic imbalance, especially of carbohydrate metabolism, is common in clinical practice. The prevention of atherosclerosis, driven by the holistic approach, as well as the appraisal and simultaneous management of risk factors are fundamental requirements. Antihypertensive treatment should comply with the latter, but this often proves difficult owing to the need for combination therapy. Diuretics, these potent though inexpensive blood pressure lowering drugs are integral to the set of routinely used medicinal products. In observance of the foregoing, it is prudent to prefer their metabolically inert representative, indapamide. Based on relevant studies available currently, the author elaborates on the class of diuretics, with special emphasis on the metabolic effects of the prominent members of this group.

Primary Health Care Research & Development, 2021

Background: Preferences and wishes of patients is an important indicator of primary health care p... more Background: Preferences and wishes of patients is an important indicator of primary health care provision, although there are differences between national primary care systems. Aim: The aim of this paper is to describe and evaluate the preferences and values of Hungarian primary care (PC) patients before accessing and to analyse their experiences after attending PC services. Methods: In the Hungarian arm of the European QUALICOPC Study, in 2013–2014, information was collected with questionnaires; the Patient Values contained 19 and the Patient Experiences had 41 multiple-choice questions. Findings: The questionnaires were filled by 2149 (840 men, 1309 women) using PC services, aged 49.1 (SD ± 16.7) years, 73% of them having chronic morbidities. Women preferred to be accompanied and rated their own health better. Patients in the lowest educational category and women visited their GPs more often, and they are consulted more frequently by other doctors as well. Men, older and secondary...