Science News 9.

Investigation of the possible association between lithium levels in drinking water and suicide mortality in Hungary

Lithium (Li) has been part of the therapeutic armamentarium of psychiatry for decades, mainly used in the treatment of severe mood disorders, i.e. bipolar disorder and major depression. There is strong evidence that lithium, in addition to reducing the symptoms of mood disorders, provides a strong protective effect against suicidal behaviour in these patients. Li is also present in drinking water as a trace element, but typically in such low concentrations that we would need to consume tens of thousands of litres of tap water a day to consume the dose established for medical use. Nevertheless, a number of studies in different countries have shown that even the minimum amount of Li in drinking water can reduce the risk of suicide in the average population.

“In our study, we were the first to demonstrate that this effect can also be detected in our country (the study was conducted on aggregated data at the district level). According to the results, the suicide prevention effect of Li is mainly seen among males, which is probably due to the fact that they frequently choose more violent methods to commit suicides than females, and the anti-aggressive and anti-impulsive effect of Li is mainly able to prevent these deaths,” Dr. Péter Döme said in his summary.

Acute Pain Service in Hungarian hospitals

Pain after surgical interventions is a significant burden for both the patient and the healthcare system. After surgery, some patients experience moderate to severe pain, which can limit their ability to carry out daily activities and can cause anxiety, fear and depression, hindering the healing process. Multidisciplinary Acute Pain Services (APS) are a new form of care in hospitals that help to reduce the patient’s pain and treatment-related side-effects, improve patient safety and patient satisfaction. The research examined the availability and characteristics of APS in Hungary, their educational and quality activities and the barriers to their development.

“At present, only two hospitals have postoperative pain management teams, one made up of doctors and the other of healthcare professionals supervised by an anaesthetist. Their operations are in line with the literature. The need to set up these services is also recognized in hospitals that don’t have an APS. Lack of staff and funding were mentioned as the main obstacles to their establishment, but lack of motivation and initiative, and difficulties in cooperation between surgical specialties were also mentioned as important problems,” Dr Orsolya Lovasi wrote in her summary.

CAD-RADS may underestimate coronary plaque progression as detected by serial CT angiography

Coronary artery disease (CAD) is a chronic disease with dynamic temporal changes in plaque size and composition. Coronary computed tomography angiography (CTA) is a robust, non-invasive diagnostic test to characterize CAD. Coronary plaque progression is an independent predictor of cardiovascular events, but its definition is not uniform. Our aim was to determine plaque progression according to the different definitions currently used for the severity and extent of coronary artery disease. We also analysed which risk factors influence the progression of CAD. We enrolled 115 subsequent patients who underwent serial coronary computed tomography angiography at the Városmajor Heart and Vascular Center of Semmelweis University.

“Our results showed significantly different levels of progression using different definitions. It should be highlighted that the so-called CAD-RADS (coronary artery disease – reporting and data system) classification used in the clinic did not identify plaque progression in more than half of the cases, in contrast to other definitions. In addition, diabetes, smoking, male gender and age influenced the progression of coronary plaques significantly,” Dr. Borbála Vattay and Dr. Bálint Szilveszter summarized.

Association of Body Mass Index with clinical outcomes in patients with cystic fibrosis

The study investigates the link between body mass index (BMI) and various clinical outcomes in patients with cystic fibrosis.  Over the past two decades, life expectancy in this disease has increased significantly (currently 47 years in the US), giving way to phenomena that were not previously considered, such as obesity.

“The results suggest that a higher than normal BMI resulted better lung function (FEV1%) and more favourable exocrine and endocrine status in pancreatic function. The highly complex meta-analysis points to the need to replace the current nutritional recommendations (22 kg/m2 and 23 kg/m2) with a higher target BMI for patients with CF. Based on these results, a new therapeutic strategy is needed in the nutrition of patients, which could bring them significant health benefits,” Dr Andrea Párniczky and Dr Rita Nagy summarised.

The short summaries were made by the authors of the scientific publications.
Edited by Ádám Szabó, translation by Rita Kónya 
Photo illustrations: images from the publications