A magyarországi informatika történetének rövid vázlata

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Improper Supplementation Habits of Folic Acid Intake by Hungarian Pregnant Women: Improper Recommendations

Background: Neural tube defects (NTDs) are some of the most common congenital anomalies. Proper folic acid supplementation is a dominant risk factor, which has been shown to decrease the incidence of NTDs. In Canada, the incidence of neuroblastoma has presented a considerable decrease of 60% as a result of enrichment cereal grain flours with synthetic folic acid. The aim of this study was to investigate the effect of folic acid intake by pregnant women on the incidence of NTDs and neuroblastoma. Methods: Regular folic acid intake has been recommended to pregnant women in Hungary since the eighties of the last century by health visitors eventually raking effect as an official protocol which had been released in 1997. During 2001, 2002 and 2003. folic acid intake habits of pregnant women were evaluated by health visitors, proving to be successful in collecting data front 95.06% of the pregnant women. The incidence of NTDs has been registered by the Hungarian National Centre of Epidemiology, Department of Human Genetics and Teratology. The Pediatric Cancer Registry provided the incidence of neuroblastoma in children. Results: Consistent findings revealed a regular intake of supplementary folic acid products by 68.71% of the pregnant women. Out of these. 93.13% of pregnant women who were taking folic acid, started the supplementation after their 7 weeks of pregnancies, a time designated as the completion period of the development of the neural tube. The dose of folic acid supplementation was evaluated as less than 5 mg/day in 84.75% of the pregnant women. In Hungary, the incidence of NTDs has remained constant, while the incidence of neuroblastoma has shown constant slight increase in spite of the introduction of folic acid supplementation in 1997. Conclusions: Based on our experience, folic acid supplementation was initiated after the recognition of pregnancy and its application in a dose of lower than 5 mg/day neither decreased the incidence of NTDs nor did it have an effect on the neuroblastoma incidence. It is implicated that proper folic acid supplementation, which is started front the conception. can be achieved only with the enrichment of cereal grain flours

A Ewing-sarcomás betegek tünetmentes túlélési esélyeinek értékelése a Gyermekonkológiai Szekció eredményei alapján

Correlation between different prognostic factors and the overall survival of Ewing's sarcoma patients has been investigted. In this study data have been selected from the databank of Hungarian Pediatric Oncologist Section (1988-1999) (n=65). Whenever it was possible statistical analysis has been performed. Results: In our patients time interval from the primary symptoms to the diagnosis was 2-16 months. The average event-free survival in patients suffering from Ewing's sarcoma without metastasis is 0.39. Meanwhile, this value in patients with pulmonary or other metatasis is 0.24 (Kaplan-Meier analysis). Conclusion: Our results show a moderate difference between the Hungarian and the international event-free survival. Late detection is one of the answers of this discrepancy

A gyermekkori Ewing szarkómával szerzett magyarországi tapasztalataink

Magyarországon évente kb. 7-9 új Ewing szarkómás gyermeket diagnosztizálunk. Jelen munkánk célja az volt, hogy az Országos Gyermektumor Regiszter adatait felhasználva megvizsgáljuk a magyarországi Ewing szarkómás gyermekek prezentációs tüneteit, a klinikai paramétereket, a prognosztikai faktorokat, a terápiás és a túlélési eredményeket 1992 és 2002 közötti 11 éves periódusban. A fenti időszakban 88 új beteg került diagnosztizálásra, a fiú – leány arány 1,05 : 1 volt, az átlagéletkor 11 év 7 hónapnak bizonyult. A két leggyakoribb prezentációs tünet a lokális fájdalom és duzzanat voltak. 38 betegünkben hosszú csöves csontra lokalizálódott a megbetegedés, 29 gyermekben a Ewing szarkóma a csípő tájékról indult ki és 21 esetben valamely egyéb testtájékról. A betegeink közel egyharmadánál (29/88) már a diagnózis felállításakor áttétek voltak kimutathatóak. A fent nevezett időszakban három kemoterápiás protokollt alkalmaztunk Magyarországon: a CWS, az EICESS/CESS és 1999. decembere óta az Euro-EWING 99 protokollt. A 88 beteg 37,5%-nál (33/88) észleltünk recidívát átlagosan 22,4 hónappal a primer diagnózis felállítása után. A 88 betegből 45 jelenleg is él, az átlag követési idő 28,6 hónap. Az összes beteg 5-éves kumulatív túlélési valószínűsége 48,06±5,9%, a 10 éves 42,91±6,3%. A metasztázissal rendelkező betegek 5 és 8 éves túlélése 19,91±9,4%, a metasztázis nélküliek 5 éves túlélése 60,23±6,9%, míg a 10 éves 52,82±7,8%. A hazai eredmények megközelítik a nemzetközi adatokat, azonban törekednünk kell a diagnózis korai felállítására és ezáltal a kimondottan rossz prognózisú primer metasztatikus esetek számának csökkentésére. The number of newly diagnosed children in a year with Ewing’s sarcoma is 7-9 in Hungary. The aim of our study was to evaluate the presenting symptoms, clinical features, prognostic risk factors and treatment results of children’s Ewing’s sarcoma in Hungary using data from the National Childhood Cancer Registry in a 11 years-long period between 1992 and 2002. In this period, 88 new patients were diagnosed, the male-female ratio was 1,05:1 and the mean age was 11 years 7 months. The two most common presenting symptoms were local pain and swallowing. Tumor was located in the pelvis area in 29 patients, in the extremities in 38 and other sites in 21 cases. Almost one third of our patients (29/88) had metastasis at the time of the diagnosis. In this time period, three different protocols were used for treatment: CWS, EICESS/CESS and since December 1999 Euro-EWING 99. 37,5% of our patients (33/88) had relapse with a mean of 22,4 months after the diagnosis. 45 children are still alive, the median follow-up time is 28,6 months. The overall survival (OS) of all patients (n=88) was 48,06±5,9% at 5 years and 42,91±6,3% at 10 years. Patients with metastasis had OS 19,91±9,4% at 5 and at 8 years. The 5-year OS of children without metastasis was 60,23±6,9%, and 52,82±7,8% at 10 years. The Hungarian data are similar to international results, but we have to try to decrease the number of the primary metastatic cases with early diagnosis

Szomatosztatin receptor, mint lehetséges differenciál diagnosztikai, prognosztikai és terápiás faktor a gyermekkori medulloblastomák esetében = Somatostatin receptor Acts as a Potential Differential Diagnostic, Prognostic and Therapeutic Factor in Patients Treated with Medulloblastoma

A gyermekkori agytumorok terápiás eredményei nem kielégítőek. Célunk a medulloblastoma sejtjein kimutatott somatostatin receptorok (SSTR2) expressiojának vizsgálata volt; diagnosztikai-, prognosztikai és terápiás alkalmazhatóságának tanulmányozása. Az általunk vizsgált 21 medulloblastomában a SSTR2 kimutatható volt és recidivában nem változott. Az SSTR2 receptort Octreoscan vizsgálattal mutattuk ki, mely medulloblastomán kívül más agytumoros betegek egy részében is pozitiv volt (56 vizsgálat), tehát nincs differenciáldiagnosztikai jelentősége. Az Octreoscan vizsgálat az MRI nagyobb felbontóképessége ellenére hasznosnak bizonyult a medulloblastoma recidivának korai diagnosztikájában, mivel néhány MRI-vel negatív esetben is mutatott ki tumorszövetet. Szövettenyészetben az octreotid antipoliferativ, mitózisgátló hatással bír 40 ?m-nál nagyobb dózisban; apoptoticus hatása nincsen. Az octreotid vincristinnel, cisplatinnal és etoposiddal nem mutatott synergismust. Medulloblastoma xenograftban az octreotid magasabb dózisa gátolta a xenograft növekedését, de hatása a kezelés után egy héttel megszűnt. Mellékhatást nem észleltünk. Új terápiás eljárást dolgoztunk ki medulloblastomás betegek kezelésére, mellyel a 2 éves követési idő után (28 beteg) az eredmények, mind az előző, mind az átlagos nemzetközi eredményekhez képest jelentősen javultak (össztúlélés 82%); a jó prognozisú csoportban eddig egy betegnél észleltünk recidivát. | The present results of the therapy in paediatric brain tumors are unfavorable. Our aim was the study of the somatostatin receptors in medulloblastoma; the examination of its diagnostic-, prognostic- and antitumor effect. The somatostatin receptor (SSTR2) was shown by octreotid scintigraphy in 21 children with medulloblastoma, however, it was positive in some other brain tumors too. Hence it has no differencial diagnostic value. Instead of the greater sensitivity of MRI the application of Octreoscan my be useful in the early detection of a relapse in medulloblastoma, because in some MRI negativ cases it detected tumor tissue. The somatostatin in a higher dose, than 40 ?g had antiproliferativ effect in tissue culture and showed no synergetic effect with vincristin, cisplatin and etoposid. In xenograft the higher dose of octreotid showed antitumor effect, which lasted one week long after the end of treatmen. No side effect was seen. We set up a new treatment protocol for the patients with medulloblastoma. After 2 years long follow up (28 patients) the results are significantly better (OS 82%), than our previous or the international data: only one patient relapsed in the group of low risk patients

Menthol can be safely applied to improve thermal perception during physical exercise : a meta-analysis of randomized controlled trials

Menthol is often used as a cold-mimicking substance to allegedly enhance performance during physical activity, however menthol-induced activation of cold-defence responses during exercise can intensify heat accumulation in the body. This meta-analysis aimed at studying the effects of menthol on thermal perception and thermophysiological homeostasis during exercise. PubMed, EMBASE, Cochrane Library, and Google Scholar databases were searched until May 2020. Menthol caused cooler thermal sensation by weighted mean difference (WMD) of - 1.65 (95% CI, - 2.96 to - 0.33) and tended to improve thermal comfort (WMD = 1.42; 95% CI, - 0.13 to 2.96) during physical exercise. However, there was no meaningful difference in sweat production (WMD = - 24.10 ml; 95% CI, - 139.59 to 91.39 ml), deep body temperature (WMD = 0.02 °C; 95% CI, - 0.11 to 0.15 °C), and heart rate (WMD = 2.67 bpm; 95% CI - 0.74 to 6.09 bpm) between the treatment groups. Menthol improved the performance time in certain subgroups, which are discussed. Our findings suggest that different factors, viz., external application, warmer environment, and higher body mass index can improve menthol's effects on endurance performance, however menthol does not compromise warmth-defence responses during exercise, thus it can be safely applied by athletes from the thermoregulation point of view

Az energetika biotelemetriás vizsgálata TRPV génhiányos és vad típusú egérben: testhőmérsékleti és aktivitási ritmusok változásai különböző tápláltsági és stressz állapotokban = Biotelemetric studies of energetics in TRPV knockout and wild type mice: modifications body temperature and activity rhythms under different feeding and stress situations

C57/BL egerek maghőmérsékletét és lokomotor aktivitását vizsgáltuk biotelemetriás módszerrel különböző környezeti hőmérsékleten. Normális és zsírdús táplálás hatásait követtük a napszaki hullámzásokra táplálás, több napos teljes éheztetés és újratáplálás ideje alatt, valamint ismételt laparotomiás beavatkozást követően is. Mindezen változások energetikai hátterének megismerése céljából releváns mediátorok, gátló anyagok centrális vagy perifériás infúzióját végeztük ALZET minipumpa segítségével. Szabadon mozgó egerek napszaki hőmérsékleti és aktivitási hullámzásának nagysága fokozódik teljes éhezés során és a maghőmérséklet 30 °C-ra való csökkenése jelzi a túlélhető éhezés végét az aktivitás fokozódása mellett. Újratápláláskor, hidegben, elhízásban, CNTF infúzió alatt és laparotomia után csökken a hullámzások amplitúdója. CNTF és CCK-8 icv infúziója lázat vált ki. Eredményeink több új információval szolgáltak a szabadon mozgó egerek normális és kóros energetikájának mechanizmusáról. | Changes of core temperature and locomotor activity were monitored in C57/BL mice under different thermal conditions by using a biotelemetric method. Effects of normal or fat-rich diet were observed on daily oscillatons during feeding, total fasting, re-feeding or on repeated laparotomy. To learn the energetic background of all these stimuli relevant meditors or blocker were infused either centrally or peripherally by using ALZET minipumps. Excursions of daily changes in core temperature and activity were found to be increased during total fasting with core temperature falling to about 30 °C as a sign of threshold of survivability with locomotor activity increasing progressively. Re-feeding, cold exposure, obesity, CNTF infusion or laparotomy led to reversible decreases of daily oscillations. Icv infusion of CNTF or CCK-8 induced fever. Our results furnished new information on the mechanisms of changes in energetics observed under normal and various types of pathological conditions in freely moving mice

Maternal overnutrition impairs offspring's insulin sensitivity: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to investigate the association between maternal overnutrition and offspring's insulin sensitivity-following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Studies published in English before April 22, 2019, were identified through searches of four medical databases. After selection, 15 studies aiming to explore the association between prepregnancy body mass index (ppBMI) or gestational weight gain (GWG) of non-diabetic mothers and their offspring's insulin sensitivity (fasting insulin or glucose level and Homeostatic Measurement Assessment for Insulin Resistance [HOMA-IR]) were included in the meta-analysis. Associations of ppBMI and GWG with offspring's insulin sensitivity were analysed by pooling regression coefficients or standardized differences in means with 95% confidence intervals (CIs). Maternal ppBMI showed significant positive correlations with the level of both fasting insulin and HOMA-IR in offspring (standardized regression coefficient for fasting insulin: 0.107, CI [0.053, 0.160], p < 0.001 and that for HOMA-IR: 0.063, CI [0.006, 0.121], p = 0.031). However, the result of the analysis on coefficients adjusted for offspring's actual anthropometry (BMI and adiposity) was not significant. Independent from ppBMI, GWG tended to show a positive correlation with insulin level, but not after adjustment for offspring's anthropometry. Offspring of mothers with excessive GWG showed significantly higher HOMA-IR than those of mothers with optimal GWG (p = 0.004). Our results demonstrate that both higher ppBMI and GWG increase the risk of offspring's insulin resistance, but the effect of ppBMI on insulin sensitivity in offspring may develop as consequence of their adiposity