A renin-angiotenzin rendszer szerepe a csontátépülés szabályozásában = The role of the renin-angiotensin system in the regulation of bone-remodelling

Számos humorális faktor veszt részt a csontszöveti remodelling szabályozásában. Feltételeztük, hogy a szöveti renin-angiotenzin rendszer (RAS) és a transforming growth factor (TGF)-beta is hatással van az osteoblastok funkciójára. In vitro vizsgáltuk MC3T3-E1 osteoblastok proliferációját és differenciálódását TGF-beta vagy angiotenzin II (Ang II) kezelés hatására. Eredményeink szerint a TGF-beta fokozza az immediate-early gén c-fos expresszióját és az osteoblastok proliferációját, ezzel szemben az gátolja az osteogen differenciációt. Továbbá az Ang II gátolja a proliferációt, de nem befolyásolja az osteogen markerek expresszióját. Az osteogen remodelling befolyásolása az endogén RAS aktivitáson és TGF-beta szintézisen keresztül ígéretes terápiás lehetőségeket kínál. További kutatásokat igényel a fenti jelenségek mögött húzódó intracelluláris események feltárása. | Several humoral factors are known to play role in the regulation of bone remodelling. It is conceivable that local renin-angiotensin system (RAS) and transforming growth factor (TGF)-beta have an impact on osteoblast function. We analysed proliferation and differentiation of MC3T3-E1 osteoblast treated with TGF-beta or angiotensin II (Ang II) in vitro. Our results show that TGF-beta increased the expression of c-fos an immediate early gene and subsequently the proliferation of osteoblasts. On the contrary TGF-beta inhibited the osteogenic differentiation. Moreover angiotensin II inhibited osteoblast proliferation and did not influence differentiation. Regulation of osteogenic remodelling via controlling endogenic RAS activity and TGF-beta synthesis would be an intriguing new therapeutic opportunity. Further investigation is required to clarify the intracellular event leading to these phenomena

Tracking movement of body-mounted markers through opaque orthotics

It is very important in marker-based motion capture systems that cameras can follow markers attached to anatomical points without any obstruction. Based on marker positions the computer program can reconstruct movement of the body’s biomechanical model by calculating typical distances, angles and trajectories.Analysis becomes complicated when the person wears a rigid and opaque orthotic device (e.g. a plastic corset), through which cameras can not see markers attached to the body surface. We had to find a marker attachment method, so that infrared motion capture cameras can follow movement of markers attached to certain anatomical points on scoliosis patients wearing their corsets, when analyzing the effects of corsets on posture and movement.Infrared cameras in the Gait Analysis Laboratory of Semmelweis University’s Department of Orthopedics can not „see through” polyethylene corsets. Markers have to be attached directly to the body surface, because a corset is a rigid body, therefore it moves differently, than the human body under it. Multiple considerations have to be made, when choosing markers. There is limited room between body and corset, markers can not affect wearer’s movement and can not cause discomfort. The chosen method uses magnets attached to the skin with medical tape. Size and properties of magnets were verified by simulation. Infrared cameras can follow the painted magnet counterparts on the outer surface of the corset.Magnets attached to the corset’s outer surface follow the movement of magnets taped to the body, so cameras can follow movement of anatomical points under the opaque corset, without the need of providing direct visibility by destructing corset material. Holes larger than the size of markers would be required, to avoid the shading effects of the corset resulting from body-corset and body-camera distance and angle.According to measurement results of patients with and without corsets, magnetic markers sufficiently follow the body’s movement under the corset. In the meantime with markers attached immovably to the corset’s outer surface, movement of the corset as a rigid body can be tracked, as well.The presented method allows further detailed investigation, concerning the movement altering effects of not just corsets, but other orthotics, too. DOI: 10.17489/biohun/2013/1/1

A testmozgás szerepe az egészségügyi dolgozók egészségfejlesztésében

Absztrakt Bevezetés: Az egészségügyben dolgozó orvosok, nővérek és egyéb szakemberek egészségi állapota a munkában töltött évekkel romlik, ami befolyást gyakorolhat az általuk végzett munka minőségére is. Az egészségügyi dolgozók egészségfejlesztése így nem csupán munkahelyi prevenciós programként, hanem az egészségügyi ellátás minőségét javító intézkedésként is felfogható. Célkitűzés: Egészségi alapállapot-felmérést követően intervenciós egészségfejlesztési program hatékonyságának mérése egészségügyi dolgozók körében. Módszer: A vizsgálat elején és végén kérdőíves és fizikaiállapot-felmérés történt. Az intervenciós csoport tagjai igénybe vehettek fitneszszolgáltatásokat, pszichológiai szakember segítségét, dietetikai tanácsadást és fogászati konzultációt. Eredmények: A 12 hónapon át tartó vizsgálat 79 dolgozó részvételével indult, akik maguk dönthették el, hogy intervenciós vagy kontrollcsoportba kerüljenek. A vizsgálat végén az intervenciós csoportban a haskörfogat szignifikáns csökkenését és a 12 perc alatt futott táv növekedését észlelték. Következtetések: Az eredmények igazolni látszanak az aktív életmóddal együtt járó rendszeres testmozgás kedvező hatását mind a fizikai teljesítőképesség növekedésében, mind pedig a testalkat változásában. Orv. Hetil., 2016, 157(39), 1563–1570. | Abstract Introduction: The health status of doctors, nurses and any other professionals working in the healthcare sector influences the quality of their work. Therefore, health promotion of healthcare workers is not only an occupational health program but it can be considered as an action towards improving the quality of care. Aim: The current study was designed to assess the efficacy of a health promotion intervention among healthcare workers after health status assessment. Method: Before and after the intervention a self-assessment questionnaire-based health survey and physical status examination were performed. Members of the intervention group were offered to use fitness facilities, professional psychological help, dietary counselling, and dental consultation. Results: The intervention program lasted for 12 months with the participation of 79 health care professionals (based on their decision being in the intervention or in the control group). Significant decrease was found in the abdominal perimeter in participants of the intervention group and they ran a longer distance on the 12 minute-long-run test at the end of the study. Conclusions: The positive effect of regular physical exercise as part of active lifestyle has been demonstrated not only in the increase of physical capacity, but in the change of body shape, as well. Orv. Hetil., 2016, 157(39), 1563–1570

Effect of school lockdown due to the COVID-19 pandemic on screen time among adolescents in Hungary: a longitudinal analysis

Introduction: Studies indicate that due to school lockdown during the Coronavirus Disease 2019 (COVID-19) pandemic, screen time increased more steeply than pre-pandemic years. The aim of our study was to examine changes in screen time and its components (screen time spent on videos, games, homework, and other activities) of adolescents affected by COVID-19 school closures compared to controls from pre-pandemic years and to assess the effect of family structure and family communication.// Methods: Two sets of ninth-grader boys and girls transitioning into 10th grade were included in the analysis. The ‘pre-COVID classes’ (controls) completed the baseline survey in February 2018 and the follow-up survey in March 2019. ‘COVID classes’ (cases) completed the baseline survey in February 2020 (1 month before the COVID-19-related school lockdowns) and the follow-up survey in March 2021. Linear mixed models stratified by sex were built to assess the change in screen time over one year adjusted for family structure and communication.// Results: Our study population consisted of 227 controls (128 girls, 99 boys) and 240 cases (118 girls, 122 boys). Without COVID-19, overall screen time did not change significantly for boys, but there was a decrease in screen time for gaming by 0.63 h, which was accompanied by an increase of 1.11 h in screen time for other activities (consisting mainly of social media and communication). Because of the pandemic, all components increased by 1.44–2.24 h in boys. Girls’ screen time and its components remained stable without school lockdown, while it increased for videos and homework by 1.66–2.10 h because of school lockdown. Living in a single-parent household was associated with higher, while better family communication resulted in lower screen time.// Discussion: Our results indicate that COVID-19-related school lockdowns modified the age-specific increase in screen time for boys and girls as well. This trend, however, may be counterbalanced by improving communication between family members

Gender Differences in Perceived Working Conditions of General Practitioners During the COVID-19 Pandemic-a Cross-Sectional Study.

BACKGROUND The ongoing COVID-19 pandemic has revealed gender-specific differences between general practitioners in adapting to the posed challenges. As primary care workforce is becoming increasingly female, in many countries, it is essential to take a closer look at gender-specific influences when the global health care system is confronted with a crisis. OBJECTIVE To explore gender-specific differences in the perceived working conditions and gender-specific differences in challenges facing GPs at the beginning of the COVID-19 pandemic in 2020. DESIGN Online survey in seven countries. PARTICIPANTS 2,602 GPs from seven countries (Austria, Australia, Switzerland, Germany, Hungary, Italy, Slovenia). Of the respondents, 44.4% (n = 1,155) were women. MAIN MEASURES Online survey. We focused on gender-specific differences in general practitioners' perceptions of working conditions at the beginning of the COVID-19 pandemic in 2020. KEY RESULTS Female GPs rated their skills and self-confidence significantly lower than male GPs (f: 7.1, 95%CI: 6.9-7.3 vs. m: 7.6, 95%CI 7.4-7.8; p < .001), and their perceived risk (concerned about becoming infected or infecting others) higher than men (f: 5.7, 95%CI: 5.4-6.0 vs. m: 5.1, 95%CI: 4.8-5.5; p = .011). Among female GPs, low self-confidence in the treatment of COVID-19 patients appear to be common. Results were similar in all of the participating countries. CONCLUSIONS Female and male GPs differed in terms of their self-confidence when dealing with COVID-19-related issues and their perceptions of the risks arising from the pandemic. To ensure optimal medical care, it is important that GPs realistically assess their own abilities and overall risk

A húgyhólyag-recidíva jellemzői felső üregrendszeri daganatos betegekben radikális ureteronephrectomia után

Bevezetés: Urothelium béleli a vesemedencét, a húgyvezetéket, a húgyhólyagot és a húgycső proximalis harmadát, így ezen területek bármelyikén kialakulhat átmeneti sejtes carcinoma. A felső üregrendszeri daganatok ritka elváltozások, jelentőségüket azonban az adja, hogy a húgyhólyagban gyakori a recidíva, mely kockázatának felmérésére a mai napig nem alakult ki egységesen elfogadott rizikóbecslés. Célkitűzés: A felső üregrendszeri daganatos betegek adatainak általános jellemzése, illetve a húgyhólyag-recidívára vonatkozó rizikóbecslés. Módszer: A 2005. január 1. és 2016. december 31. közötti időszakban a Semmelweis Egyetem Urológiai Klinikáján radikális ureteronephrectomiával kezelt betegek adatainak tanulmányozása, statisztikai elemzése. Eredmények: Átmeneti sejtes felső üregrendszeri daganat 135 betegnél igazolódott. A betegeket a műtéttől számítva átlagosan 32 hónapig (SD: 30,25) követték, ezalatt 31 betegnél (23%) találtak húgyhólyag-recidívát, átlagosan 19,6 hónap (SD: 29,7) után. Minél idősebb korban fedezték fel a betegnél a primer daganatot, annál hamarabb észleltek kiújulást a húgyhólyagban (p = 0,007). A diagnóziskor ismert magas vérnyomás esetén is szignifikánsan korábban tért vissza az elváltozás (p = 0,035). Következtetés: A vizsgálat eredményei alapján az idősebb és multimorbid betegek esetében a daganat hamarabb reci- divált a húgyhólyagban, ezért az ő figyelmüket különösen érdemes felhívni a rendszeres, cystoscopiát is magában foglaló ellenőrző vizsgálat fontosságára már a kezelés megkezdésekor

COVI-Prim international: Similarities and discrepancies in the way general practices from seven different countries coped with the COVID-19 pandemic.

OBJECTIVES General practitioners (GPs) are frequently patients' first point of contact with the healthcare system and play an important role in identifying, managing and monitoring cases. This study investigated the experiences of GPs from seven different countries in the early phases of the COVID-19 pandemic. DESIGN International cross-sectional online survey. SETTING General practitioners from Australia, Austria, Germany, Hungary, Italy, Slovenia and Switzerland. PARTICIPANTS Overall, 1,642 GPs completed the survey. MAIN OUTCOME MEASURES We focused on how well-prepared GPs were, their self-confidence and concerns, efforts to control the spread of the disease, patient contacts, information flow, testing procedures and protection of staff. RESULTS GPs gave high ratings to their self-confidence (7.3, 95% CI 7.1-7.5) and their efforts to control the spread of the disease (7.2, 95% CI 7.0-7.3). A decrease in the number of patient contacts (5.7, 95% CI 5.4-5.9), the perception of risk (5.3 95% CI 4.9-5.6), the provision of information to GPs (4.9, 95% CI 4.6-5.2), their testing of suspected cases (3.7, 95% CI 3.4-3.9) and their preparedness to face a pandemic (mean: 3.5; 95% CI 3.2-3.7) were rated as moderate. GPs gave low ratings to their ability to protect staff (2.2 95% CI 1.9-2.4). Differences were identified in all dimensions except protection of staff, which was consistently low in all surveyed GPs and countries. CONCLUSION Although GPs in the different countries were confronted with the same pandemic, its impact on specific aspects differed. This partly reflected differences in health care systems and experience of recent pandemics. However, it also showed that the development of structured care plans in case of future infectious diseases requires the early involvement of primary care representatives