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Objetivos: Identificar putativas variantes funcionales en los genes CYP11A1 y CYP17A1 asociadas a efectos musculoesqueléticos (pérdida acelerada de la masa ósea y artralgias) derivados del tratamiento con inhibidores de la aromatasa (IA). Material y métodos: La cohorte B-ABLE es un estudio prospectivo de mujeres postmenopáusicas con cáncer de mama en tratamiento con IA. La densidad mineral ósea en columna lumbar y cuello femoral se midió mediante densitometría, y el dolor articular mediante escala analógica visual. A partir de polimorfismos de cambio de un nucleótido (SNPs) en los genes CYP11A1 (rs4077581, rs11632698 y rs900798) y CYP17A1 (rs4919686, rs4919683, rs4919687, rs3781287, rs10786712, rs6163, rs743572), asociados previamente con eventos musculoesqueléticos, se construyeron los haplotipos para cada paciente de la cohorte, y se seleccionaron aquellos que mostraron mayor diferencia fenotípica (p

Objetivos: El objetivo del estudio fue analizar los cambios en la densidad mineral ósea (DMO) a lo largo del tratamiento con inhibidores de aromatasa (IA) en la práctica clínica y evaluar la asociación entre el gen CYP11A1 y la variación de DMO al final del tratamiento. Material y métodos: La cohorte B-ABLE es un estudio prospectivo de mujeres postmenopáusicas con cáncer de mama, en tratamiento con IA. Se analizó la variación de DMO durante todo el tratamiento con IA, así como las diferencias entre las pacientes tratadas y no-tratadas previamente con tamoxifeno (TMX). Tres polimorfismos (rs4077581, rs11632698 y rs900798) del gen CYP11A1, fueron genotipados para su asociación con la variación de DMO. Resultados: Las pacientes tratadas con TMX mostraron pérdidas más aceleradas de DMO que las no tratadas previamente con TMX (60% menos en columna y 46% en fémur a los 2 años y 70% menos en columna y 63% en fémur a los 3 años). No obstante, al final del tratamiento no se detectaron diferencias significativas en la pérdida de DMO entre ambos grupos de pacientes. Los 3 polimorfismos del gen CYP11A1 resultaron significativamente asociados a la variación de DMO en fémur al final del tratamiento. Conclusiones: La DMO disminuyó de forma más acelerada en las pacientes con tratamiento previo con TMX que en las que solo recibieron AI, a pesar de que no se detectaron diferencias significativas al final de tratamiento. Polimorfismos en el gen CYP11A1 están relacionados con la variación de la DMO en respuesta al tratamiento con IA.

Objectives: The aim of this study was to analyze bone mineral density (BMD) changes throughout aromatase inhibitor (AI) treatment in clinical cases and also consider its association with the CYP11A1 gene and the BMD variation after treatment. Material and methods: The B-ABLE cohort is a prospective study of postmenopausal women with breast cancer, in AI treatment. BMD variation was analyzed during AI treatment, as well as the differences those patients who were treated and not treated previously with tamoxifen (TMX). Three polymorphisms (rs4077581, rs11632698 and rs900798) of the CYP11A1 gene were genotyped for their association with BMD variation. Results: TMX-treated patients presented more rapid BMD loss than those who did not undergo prior TMX treatment (60% less in spine and 46% in femur at 2 years and 70% less in the spine and 63% in the femur at 3 years). However, no significant BMD loss was detected after treatment in either group. The 3 CYP11A1 gene polymorphisms were significantly associated with BMD variation in the femur at the end of the treatment. Conclusions: BMD was reduced more rapidly in patients with prior TMX treatment than in those who only received AI, although no significant differences were detected after treatment. The 3 CYP11A1 gene polymorphisms were associated with BMD variation in response to AI treatment. [ABSTRACT FROM AUTHOR]

The most frequently used standard treatment for hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer patients consists of a CDK4/6 inhibitor (abemaciclib, ribociclib, or palbociclib) combined with endocrine therapy. Despite CDK4/6 inhibitors being part of routine care in the last few years, new adverse events continue to be reported. Here, we report two cases of palinopsia, a rare neurological visual disturbance that refers to the persistence or recurrence of a visual image after the removal of visual stimuli in patients treated with ribociclib and letrozole. Neuro-ophthalmological assessments and brain MRIs did not find any organic cause. However, palinopsia was related in a time- and dose-dependent manner to the intake of ribociclib. Following a one-level dose reduction of ribociclib, palinopsia was mild and well tolerated. Both patients continued the treatment with ribociclib, with one of them for almost 2 years. Based on the identification of two cases in our hospital in a short period of time, it is tempting to suggest that ribociclib-related palinopsias may not be uncommon. We propose that physicians should be aware of this ribociclib-associated adverse event. Patients presenting this symptom should undergo a routine workup (neuro-ophthalmological assessment and brain MRI) and, if negative, be reassured of its relation with ribociclib as well as the safety of continuing on this drug., Competing Interests: The authors declare that the research was conducted in absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Martos, Saint-Gerons, Masfarre, Castro-Henriques, Martinez-Garcia, Servitja and Albanell.)

Background: Neoadjuvant therapy, particularly the combination of chemotherapy and immunotherapy, has become standard in treating locally advanced non-small cell lung cancer (NSCLC). While this approach improves pathologic responses, its effect on postoperative outcomes following robotic-assisted thoracic surgery (RATS) is not fully characterized. Objective: This study aimed to evaluate the impact of neoadjuvant therapy on postoperative outcomes in patients undergoing RATS for NSCLC, focusing on operative time, conversion rates to open surgery, and postoperative complications. Methods: A retrospective cohort analysis was performed on patients who underwent RATS for NSCLC between February 2019 and August 2024. Propensity score matching was utilized to balance preoperative characteristics between the groups. The primary outcomes compared were operative time, conversion rates to open surgery, and postoperative complications, with statistical significance defined as p < 0.05. Results: A total of 253 patients were included in the analysis, of whom 23 received neoadjuvant therapy (either chemotherapy or chemoimmunotherapy) and 230 did not. The neoadjuvant group had significantly longer operative times (250 min vs. 221 min, p = 0.001) but there were no significant differences in conversion rates to open surgery (8.7% vs. 3.9%, p = 0.5). However, the neoadjuvant group showed a higher incidence of prolonged air leaks (>5 days) (39.13% vs. 35.21%, p < 0.001). Other parameters, such as hospital stay and chest drainage duration, showed no statistically significant differences between the groups ( p = 0.860 and p = 0.760, respectively). Conclusions: These findings support the feasibility of robotic-assisted thoracic surgery following neoadjuvant therapy in NSCLC, suggesting that this approach may be safely integrated into clinical practice for selected patients. Further studies are needed to define patient selection criteria and optimize postoperative management, potentially guiding personalized treatment strategies in complex cases.

Objectives: We aimed to explore healthcare students' intercultural sensitivity profiles and their relationship with empathy to develop effective education methods that promote non-discriminatory patient care., Methods: We conducted a cross-sectional questionnaire study, involving a total of 508 international (n= 100) and local (n= 408) healthcare students in Hungary by convenience sampling. The survey included demographics, the Intercultural Sensitivity Scale, and the Interpersonal Reactivity Index. We applied latent profile analysis to identify distinct sensitivity profiles and used multinomial logistic regression to estimate the predictive power of several background variables on profile group membership., Results: A four-profile solution emerged: "Interculturally average" (n= 241), "Interculturally uncertain" (n= 76), "Interculturally sensitive" (n= 132), and "Interculturally refusing" (n= 54). The model (R 2 = 0.123; p= 0.001) revealed that psychology major tended to predict "uncertain" group membership (OR= 0.56, p= 0.08) and higher personal distress was a significant predictor of this group (OR=1.11, p= 0.002). Male gender (OR= 3.03, p= 0.001), medicine major (OR= 5.49, p= 0.01), lower perspective-taking (OR= 0.91, p= 0.007) and higher personal distress (OR= 1.09, p= 0.028) were identified as predictors of "refusing" group membership, compared to the "average" group., Conclusions: By exploring the ways students experience intercultural situations, a more personalized medical education can be developed with a special focus on vulnerable subgroups. For the "uncertain" group, the focus should be more on developing confidence, and intercultural experiences, whereas in the "refusing" group on strengthening empathy. In general, it can be useful to create mixed-gender, multidisciplinary, and intercultural learning environments.

Background: Inflammatory bowel disease (IBD) is a chronic condition that significantly affects patients' physical, mental, and social health, as well as their overall quality of life. Effective management of the disease demands self-management skills, enabling patients to navigate the daily challenges associated with IBD, such as unpredictable flare-ups, frequent hospitalization, severe symptoms, pain, and physical changes., Objectives: This study examines the motivational aspects of self-management for patients with IBD and focuses on the role of autonomy and directive support from healthcare professionals in enhancing their self-concordance and self-efficacy., Design: From November 2022 to February 2023, a cross-sectional questionnaire study was conducted at the IBD Center of Internal Medicine Clinic in Szeged, Hungary., Methods: A total of 374 adult patients with IBD completed the paper-pencil questionnaire, of whom 241 patients (64.4%) had Crohn's disease, and 133 patients (35.6%) had ulcerative colitis., Results: Based on the findings of the path analysis (χ 2 (8) = 18.914, p  = 0.01, comparative fit index = 0.935, TLI = 0.837, root mean squared error of approximation = 0.06), autonomy support positively predicted self-concordance (β = 0.48) and self-efficacy (β = 0.02), particularly during disease relapse. In addition, self-concordance and self-efficacy predicted more positive (βs = 0.28 and 0.35) and fewer negative emotional experiences (βs = -0.09 and -0.20). The model's associations varied between the relapse and remission groups, indicating distinct impacts on different states of the disease., Conclusion: Overall, autonomy support from healthcare professionals has been shown to enhance self-management in patients with IBD, particularly during disease relapse. Meanwhile, self-concordance and self-efficacy act as positive internal factors, thus reducing negative emotional experiences, especially during remission. In sum, this study underscores the need for further exploration of the motivational aspects of self-management and provides insights into developing interventions that promote the health behaviors of patients with IBD., Competing Interests: The authors declare that there is no conflict of interest., (© The Author(s), 2024.)

Objective: Our study focuses on the role of psychological states in the development of cardiovascular disease (CVD) and explores the potential of positive psychological factors in reducing CVD risk. While existing research has predominantly examined negative mental states and risk behavior, this longitudinal study takes a novel approach by investigating positive psychological wellbeing and its impact on sustained health behavior., Method: The research involved participants ( n = 502) with medium to high cardiovascular risk who underwent a comprehensive risk assessment in 2012, followed by written risk communication. Health behavior and psychological variables were measured in 2012 and 2019. A cross-lagged panel was employed to repeat measures of a cardiovascular health index with latent factors., Results: Results indicated an excellent fit for the model (RMSEA = 0.0644, CFI = 0.936, TLI = 0.921, SRMR = 0.050), with significant associations between the observed variables ( p < 0.05) and created latent factors. Furthermore, the model implied significant bivariate correlations ( p < 0.05) between latent constructs of sustained health behavior and positive psychological states in 2012 and 2019. A significant regression relationship between Health Awareness Index 2012 and 2019, between Psychological wellbeing in 2012 and 2019 (B = 1.103 p = 0.038), latent factors could be identified (B = 1.103 p = 0.038) using cross-lagged panel model. Results highlighted the importance of cardiovascular health awareness, subjective risk perception, and self-directed efforts in facilitating health behavior change., Conclusion: Relationships between psychological wellbeing and health awareness emphasize that positive experiences and reinforcement are crucial in sustaining optimal health behavior. Our findings offer a new perspective on cardiovascular risk screening and preventive interventions. Extending cardiovascular risk screening with psychological measures may broaden prevention opportunities by including psychological elements reinforcing positive psychological states. The findings suggest that an effective prevention program must consider stabilizing and maintaining positive psychological states to achieve lasting improvements in cardiovascular health., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ocsovszky, Ehrenberger, Berenyi, Assabiny, Otohal, Martos, Papp-Zipernovszky, Hegedus, Merkely, Csabai and Bagyura.)

Development of autonomous vehicles (AVs) is growing in a rapid rate, however, the most dominant barriers in their adoption seem to be rather psychological than technical. The present online survey study aimed to investigate which demographical and personality dimensions predict attitudes towards AVs on a Hungarian sample (N = 328). Data was collected by convenience and snowball sampling. Three-level hierarchical regression models were applied: in the first level, demographical variables, then general personality traits and third, attitude-like personality factors were entered. We demonstrated that the predictive effect of age, gender and education disappeared when personality dimensions were included into the models. Importantly, more positive general attitudes towards technology and higher optimism regarding innovations predicted eagerness to adopt AVs. On the other hand, individuals with more negative attitudes and higher dependence on technology as well as those with lower level of Sensory Sensation Seeking and higher level of Conscientiousness were more concerned about AVs. Our results suggest that AV acceptance cannot be regarded as a one-dimensional construct and that certain personality traits might be stronger predictors of AV acceptance than demographical factors., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Volosin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Lesbian, gay, bisexual, and transgender individuals ( hereafter people with minoritized sexual orientation and/or gender identities) have limited legal rights and access to resources because of their marginalized status in society. These limitations are associated with notable health disparities and increase experiences of minority stress. For those in a romantic relationship, being able to communicate and cope with one's partner-dyadic coping-can help buffer stress' deleterious effects on well-being. Given the promise of understanding how dyadic coping can mitigate experiences of sexual minority stress, the Dyadic Coping Inventory-Sexual Minority Stress (DCI-SMS) was recently created and validated with those living in the United States to assess how partners cope with sexual minority stress. Answering a global call to expand psychological science beyond a U.S. centric perspective, the purpose of this study was to validate the DCI-SMS in German and Italian using samples from Austria, Germany, Switzerland, and Italy, respectively. Confirmatory factor analysis results, along with tests of convergent and discriminant validity, and measurement invariance, suggest that the DCI-SMS is a valid measure of stress communication and dyadic coping behaviors for those in a same-gender relationship in the countries sampled. Important future directions include examining its efficacy in other countries, such as those with more adverse sociopolitical climates for people with minoritized sexual orientation and/or gender identities in a same-gender relationship. Limitations and future directions for research and clinical practice are presented. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: For breast cancer patients, the partner's support for personal projects can serve as a means of adaptation. We aimed to investigate the associations between the intimate partner's personal project support and women's well-being., Methods: A sample of 274 Hungarian women (breast cancer patients n = 137, control n = 137) took part in the study. Expected and actually received autonomy-, directive- and emotional project support was assessed by the procedure of Personal Project Assessment. Well-being was measured by the Relationship Assessment Scale and the Rosenberg Self-Esteem Scale. For investigating the associations between project support and well-being in a multivariate way, structural equation modelling was used., Results: Except for autonomy support, participants expected more support than they received. A path model indicated multiple associations between types of project support and relationship satisfaction and self-esteem. The partner's emotional project support was predictive of women's relationship satisfaction and self-esteem, while directive support was predictive of self-esteem only. The associations showed similar patterns in the subgroups of patients with breast cancer and control., Conclusions: Our results highlight the importance of involving women's subjective perspectives regarding the partner's project support while also have implications for praxis. Teaching women how to communicate their needs to their partner effectively (whether it is the need for autonomy or directive guidance) can help close the gap between expected and received support, which may in turn enhance relationship satisfaction and self-esteem., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Introduction: Inflammatory bowel diseases, including Crohn's disease, have a significant impact on patients' lifestyle, requiring lifelong attention to health behavior., Objective: The aim of our study was to investigate health-related goals, emotions related to health goals, the use of infocommunication tools and their associations., Method: 79 patients with Crohn's disease (59.5% female, mean age 40.7 years, SD = 11.89) participated in the study. They answered demographic and health behaviour questions and completed the Personal Health Plans Questionnaire, which assessed their personal health goals, positive and negative emotions about health goal(s), support for personal health goals from their physician, negative and positive effects (barriers/support) of achieving health goals, and digital technology and internet use., Results: 70% of patients had at least 1 health goal. The health goals were classified into four categories: physical activity (43.6%), stress management (25.4%), nutrition (18%) and smoking cessation (7%). 71% of participants experienced at least average levels of positive emotions related to the health goal, but about 50% also experienced negative emotions. 51% of those with a health goal regularly use the internet and apps on smartphones. Infocommunication device use showed a medium-strength correlation with perceived health goal-related barrier/support (ρ = 0.55, p<0.01), support from the person's doctor (ρ = 0.45, p<0.05) and physical activity (ρ = 0.40, p<0.01)., Discussion: More than two-thirds of patients had a health goal; most of the goals were related to health behaviours that are also relevant to Crohn's disease, but few had healthy eating and smoking cessation as health goals. Half of those with a health goal regularly use the internet and apps on smartphones. Among health behaviours, physical activity was associated with infocommunication device use., Conclusion: It is recommended to investigate patients' health goals and infocommunication device use in the care of patients with Crohn's disease. This would allow the development of specific interventions to improve their health behaviour, which could increase the quality of life and disease prognosis. Orv Hetil. 2023; 164(28): 1102-1110.

Inflammatory bowel diseases (IBD) are chronic gastrointestinal conditions that significantly impact patients' quality of life. Previous research indicates that patients with IBD have a higher prevalence of anxiety compared to the general population and other chronic diseases. This pilot study aimed to investigate the relationships between goal integration, positive and negative emotions, goal self-efficacy, and trait anxiety as the outcome variable, focusing on patients' self-management strategies. Drawing from the Self-Concordance Model (SCM) of Self-Determination Theory (SDT), the study explored how goal integration is associated with more fulfilling and enjoyable experiences and fewer negative emotions, ultimately improving psychological well-being. Health-related goals were evaluated using the Personal Project Analysis technique, while the State-Trait Anxiety Inventory was utilized to measure general anxiety levels. Among the 141 participants with inflammatory bowel disease, 96 reported having health-related goals. Of these, 66 were female (68.75%), and 30 were male participants (31.25%). Path analysis revealed a moderate negative association between self-concordance (SC) and negative emotions, which, in turn, predicted higher levels of trait anxiety. Furthermore, the alternative model tested indicated that trait anxiety predicted a lower level of self-concordance. Setting well-integrated health goals involves an internal capacity, enabling patients to experience less negative emotions during self-management activities. Anxiety can hinder individuals from accessing their inner needs, resulting in less self-concordant aspirations and more negative emotions. These findings may contribute to developing prevention and intervention programs to enhance IBD patients' adherence to lifestyle changes, ultimately improving their overall well-being., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Horvát, Dávid, Sallay, Rafael, Njers, Orbán, Molnár, Csabai and Martos.)

Goal pursuit shapes people' everyday experiences and is deeply embedded within close relationships. Several studies have shown that goal support from romantic partners facilitates goal progress, and individual goal progress contributes to wellbeing. However, few pieces of research have examined the whole process, how efficient goal coordination in a romantic relationship contributes to life satisfaction through goal progress. In these studies, short time frames were used and only one aspect of goal coordination was examined. To generate more complex, long-term understanding we collected data from 148 married or cohabitating Hungarian heterosexual couples (mean age 39.71 ± 10.40 and 38.57 ± 10.00 years for men and women, respectively) in a two-wave longitudinal study with a year-long time window. Both partners individually completed an adapted version of the Personal Project Assessment and evaluated four chosen projects associated with project coordination (emotional support, communication, and cooperation) at baseline, and project attainment (progress, success, satisfaction) in the follow up. Life satisfaction was assessed during both waves. Results from the actor-partner interdependence mediation modeling revealed complete mediation, where project coordination increased project attainment one year later, and consequently associated with higher life satisfaction for both partners. The direct effect between project coordination and life satisfaction remained nonsignificant. This association indicates that for long-term life satisfaction, it is crucial to experience better goal outcomes as the result of the couple's collaborative effort., Competing Interests: Conflicts of InterestThe authors have no relevant financial or non-financial interests to disclose., (© The Author(s) 2023.)

Background: The importance of community health psychology in providing complex bio-psycho-social care is well documented. We present a mixed-method outcome-monitoring study of health psychology services in the public-health-focused Primary Health Care Development Model Program (2012-2017) in four disadvantaged micro-regions in northeast Hungary., Methods: Study 1 assessed the availability of the services using a sample of 17,003 respondents. Study 2 applied a follow-up design to measure the mental health outcomes of the health psychology services on a sample of 132 clients. In Study 3, we conducted focus-group interviews to assess clients' lived experiences., Results: More mental health issues and higher education predicted a higher probability of service use. Follow-up showed that individual and group-based psychological interventions resulted in less depression and (marginally) higher well-being. Thematic analysis of the focus-group interviews indicated that participants deemed topics such as psychoeducation, greater acceptance of psychological support, and heightened awareness of individual and community support important., Conclusions: The results of the monitoring study demonstrate the important role health psychology services can play in primary healthcare in disadvantaged regions in Hungary. Community health psychology can improve well-being, reduce inequality, raise the population's health awareness, and address unmet social needs in disadvantaged regions.

Introduction: Even though preventive measures have been taken to reduce cardiovascular risk, cardiovascular mortality is increasing. Cardiovascular screening can be a population strategy that contributes to the reduction of mortality over the long term when implemented in a systematic, protocol-based, expanded manner., Objective: In this study, we examine changes in participants' health behavior between 2012 and 2019 as a follow-up to the Budakalász Epidemiological Study (BEV)., Method: A cardiovascular health index was developed to enable effective follow-up. This study included subjects with medium and high cardiovascular risks who participated in the BEV complex cardiovascular risk assessment in 2012 (n = 502). Besides the basic data from the BEV baseline study (demographics, healthy lifestyle, risk behavior, diseases treated by medicine), the 2019 follow-up questionnaire included newly added psychological questionnaires (Perceived Stress, WHO Well-being, Beck Hopelessness Scale, Health-Related Social Support, ABCD Risk Questionnaire)., Results: All factors of the cardiovascular health index created in our analysis showed an improvement of over 70% between 2012 and 2019. 37.6% of the participants did something for their health, according to their confession, by 30.3%, BEV had a big or very big impact on their lives from the 2012 BEV test in the year after the test, and by 24.7%, BEV had and still has a big or very big impact on their lives. The improving health indices show a significant correlation with psychological factors. Psychological factors showed a positive correlation with well-being (tau&#95;b = 0.344) and a negative correlation with perceived stress (tau&#95;b = -0.225) and hopelessness (tau&#95;b = -0.206)., Conclusion: The participants in the study showed a significant change in health behavior seven years after the BEV cardiovascular risk assessment. A higher level of mental well-being is associated with improved values. By analyzing the impact of BEV on the health behavior change and the lifestyle, we can conclude that the cardiovascular risk assessment facilitates health behavior change. Orv Hetil. 2023; 164(4): 119-131.

In challenging times, home is frequently the primary basis of environmental self-regulation processes, individual and relational coping, and well-being. This study aimed to identify multiple types of security experiences at home during the first lockdown period of the COVID-19 pandemic. We used data from 757 Hungarian adults who completed the online, modified form of the Emotional Map of the Home Interview method in 2020 after the outbreak of the COVID-19 pandemic. Participants imagined their homes, chose the place of security in their homes and rated their personal experiences (i.e., experiences of agency, communion, self-recovery, and distress) related to these places. Latent profile analysis of personal experiences revealed four types of relational-environmental self-regulation in secure places: "security in active self-recovery," "security in detachment," "security in doing and feeling good enough," and "security in stress and compensation." Profile membership was predicted by age, gender, and indices of psychological support and well-being. Results suggest that finding psychological security in the home is a multifaceted phenomenon that may be partly affected by the perception of the broader social-ecological context. Identifying subpopulations vulnerable to the challenges of the pandemic may help researchers and practitioners provide better support in times of local and global crises.