Az anyák és az újszülöttek megmentője, akire mindig büszkék leszünk: Semmelweis Ignác (1818–1865). Aki legyőzte a kórt, de nem győzte meg a kort, az orvostudományok és a sebészet doktora, szülészmester, a Pesti Királyi Magyar Tudományegyetemen az elméleti és gyakorlati szülészet nyilvános, rendes tanára = The savior of mothers and newborns, whom we shall always be proud of: Ignác Semmelweis (1818–1865). One who defeated the disease, yet could not convince the people, Doctor of Medical Sciences and Surgery, Master of Obstetrics, Professor of Theoretical and Practical Obstetrics at the Pest Royal Hungarian University of Sciences

Absztrakt: Semmelweis kitartó kutatómunkája, a klinikai statisztikai adatok tudományos igényű analízise, az állatkísérletei meghozták gyümölcsüket, a rettegett gyermekágyi láz okának felismerését és megelőzési lehetőségét. „Nemcsak a gyermekágyi láz igazi okát fedezte fel, hanem megalkotta és bevezette a szülészeti gyakorlatban az antiszeptikus profilaxist, de ugyanakkor lerakta a mai sebészet alapját, az asepsist is, amelynek elve és gyakorlata így a gyermekágyi láz kóroktanának felfedezéséből alakult ki és Semmelweis zseniális elgondolásában gyökerezik. A bakteriológia felfedezései, Lister, Pasteur és Koch műve csak tudományos bizonyítékát adták Semmelweis intuitív megállapításainak.” Semmelweis a klinikai kórélettani kutatások úttörője, akinek a kortársai támadásaitól elszenvedett, sokszor félreértéseken alapuló keserűségek jóvátételeként az utókor megadta és megadja a kijáró, méltó tiszteletet. Az anyák és csecsemők megmentője nemzetünk egyik büszkesége, mindnyájunk példaképe, akinek nemcsak hazánkban, de az egész világon elismerik munkásságát. Rövid, tragikus, de eredményes életének üzenete örök érvényű. Semmelweis Ignác alakját Chicagóban is megörökítették, a világ tizenkét leginnovatívabb orvosegészségügyi szakemberei között, Louis Pasteur és Wilhelm Conrad Röntgen szobrainak társaságában. Az utóbbi időben, különösen az angolszász területen új kifejezés, a „Semmelweis-reflex” jelent meg és kezdett terjedni. Ez nem orvosi jelenséget ír le, hanem annak kifejezője, amikor a szakemberek vagy a társadalom jelentős felismeréseket, felfedezéseket, tényeket automatikusan, vizsgálat és indoklás nélkül, szinte reflexszerűen elutasít. A jelenség ma sem ritka! Orv Hetil. 2018; 159(26): 1041–1054. | Abstract: Semmelweis finally achieved results from his persistent research work. Those being the scientific analysis of clinical statistical data and his animal experiments, which recognized the dreadful disease of puerperal fever and its prevention. “He not only discovered the real cause of puerperal fever but he also created antiseptic prophylaxis, which he introduced in obstetrics and laid the foundations of modern surgery (asepsis). The theory and practice of asepsis stemmed from the discovery of the etiology of puerperal fever and therefore originating from the genius idea of Semmelweis. The discoveries of bacteriology by Lister, Pasteur and Koch only provided a scientific proof of the intuitive statements of Semmelweis.” Semmelweis was a pioneer of clinical etiological research whose findings were aggressively disapproved by his colleagues due to earlier medical misunderstandings. Semmelweis is given due respect by posterity as a remuneration, to all the bitterness that he had suffered throughout his life. Semmelweis is considered the savior of mothers and infants. The Hungarian nation is very proud of him as he is one of our models whose oeuvre is acknowledged not only in Hungary but throughout the world. The message of his short, tragic yet effective life is eternal. The figure of Ignác Semmelweis is depicted as a statue and is placed in Chicago among the statues of the most innovative doctors and health care professionals of the world. The statue of Semmelweis is next to the statues of Louis Pasteur and Wilhelm Conrad Röntgen. “Semmelweis reflex” is a new expression which appeared and spread in English speaking countries. The word does not relate to a medical phenomenon but describes a social phenomenon when experts or the whole society automatically rejects discoveries and new recognitions without examination or justification. This phenomenon frequently occurs, even in our times. Orv Hetil. 2018; 159(26): 1041–1054

Rodent models of complement activation-related pseudoallergy: Inducers, symptoms, inhibitors and reaction mechanisms

Complement activation-related pseudoallergy (CARPA) is a hypersensitivity reaction to intravenous administration of nanoparticle-containing medicines (nanomedicines). This review focuses on CARPA in rodent models: rats, mice, guinea pigs and rabbits. Information on all aspects of hypersensitivity reactions caused by known complement activators (zymosan, cobra venom factor) and different nanomedicines (liposomes, other drug carrier nanocarriers) in these species has been compiled and analyzed, trying to highlight the similarities and differences. What is most common in all species' reactions to i.v. complement activators, liposomes and other nanoparticles is a dose-dependent hemodynamic and cardiopulmonary disturbance manifested in acute, reversible rise or fall of blood pressure and respiratory distress that can lead to shock. Other symptoms include heart rate changes, leukopenia followed by leukocytosis, thrombocytopenia, hemoconcentration due to fluid extravasation (rise of hematocrit) and rise of plasma thromboxane B2. The results of a recent rat study are detailed, which show that rats are 2-3 orders of magnitude less sensitive to liposome-induced CARPA than pigs or hypersensitive humans. It is concluded that CARPA can be studied in rodent models, but they do not necessarily mimic the human reactions in terms of symptom spectrum and sensitivity. © 2015 by De Gruyter

Cardiopulmonary and hemodynamic changes in complement activation-related pseudoallergy

Complement activation-related pseudoallergy (CARPA) is a frequent side effect of intravenous therapies with nanoparticle-containing drugs and biologicals that are recognized by the immune system as foreign. It is an acute infusion reaction dominated by cutaneous and hemodynamic changes, most significantly a cardiopulmonary distress involving major pulmonary hypertension, systemic hypotension and arrhythmias. Because CARPA is unpredictable by conventional allergy tests and it may be life threatening, it can represent a major barrier to the safe therapeutic application of many modern medicines, including liposomal drugs and monoclonal antibodies. This review summarizes and updates the facts and opens questions regarding this phenomenon, with particular focus on its porcine model

Dynamics of multiple sexual signals in relation to climatic conditions

Question: Can trait-specific phenotypic plasticity in response to annual environmental variation lead to changes in the strength of sexual selection through the relative expression of sexual ornaments at the population level? Data description: We recorded breeding dates and the sizes of white forehead and wing patches of male collared flycatchers (Ficedula albicollis) from 1998 to 2005 in a nestboxbreeding population in the Pilis Mountains, Hungary. As environmental predictors, we used the North Atlantic Oscillation (NAO) index and local weather data, classified as direct or indirect effects relative to the moult of the given ornament. Search method: First, we used general linear mixed models to assess environmental effects on the within-individual changes and absolute yearly sizes of forehead and wing patches. We then used similar models to determine whether the relative sizes of the two plumage traits at the population level varied among years. Finally, we used multiple regressions to establish if the relative yearly expression of an ornament affected standardized sexual selection gradients on this ornament in the given year. Conclusions: Within-individual changes in forehead and wing patch size were predicted by the climate of their moulting season (winter and summer, respectively). There was also an indirect effect of previous winter climate on changes in wing patch size. Environmental effects on the absolute expression of ornaments at the population level followed the within-individual patterns. The relative population-level expression of forehead and wing patches fluctuated significantly among years. Sexual selection on a given ornament increased with its relative expression in that year

A magyar vesepótló kezelések 2020. évi jelentése az ERA-EDTA Regiszternek = The 2020 Annual Report of Hungarian Kidney Replacement Therapiesto the ERA-EDTA Registry

A szerzők röviden ismertetik az ERA-EDTA (European Renal Association – European Dialysis and Transplantation Association) – ma csak ERA – Vesepótló Kezelések (Kidney Replacement Therapy – KRT) Regiszterének, illetve a hazai adatgyűjtések történetét. Ezt követően bemutatják a 2020. évre vonatkozó, krónikus vesebetegek (chronic kidney disease – CKD) KRT-incidens és prevalens betegszámait, amelyeket – több mint két évtized kihagyás után – ismét jelentettek az ERA központi KRT Regiszterébe. Az első napi incidens KRT-re kerülő CKD-betegek száma Magyarországon 2020-ban 197 fő/1 millió lakos volt, még a prevalens dialízisben kezelt és átültetett vesével élőké összesen 998/1 millió lakos volt. A jelentés aggregált betegszámokkal történt. A jövőbeli terv: áttérés az egyedi betegadatok szerinti regiszter kialakítására. The authors briefly describe the history of the ERA-EDTA (European Renal Association – European Dialysis and Transplantation Association – today ERA only) Kidney Replacement Therapy – KRT Registry and the history of domestic data collection. After that, the incidence and prevalence of KRT Registry of the ERA after a gap of more than two decades, will be presented. In 2020, the number of day 1 incident CKD patients receiving KRT was 197 per 1 million, while the total number of people living with dialysis and transplanted kidneys (prevalant patient on 31 of Dec) was 998 per 1 million inhabitants. The report was made with aggregated patient numbers. The future plan: transition to the creation of a register according to individual patient data

A relaxin hatása a progressziv vesefibrózisra Alb/relaxin transzgenikus egerekben = The effect of relaxin on progressive renal fibrosis in Alb/relaxin transgenic mice

FVB/N alb/relaxin transzgenikus egereket hoztunk létre, hogy megvizsgáljuk az emelkedett plazma relaxin szint hatását vesefibrózis progressziójára. Ezek a transzgenikus egerek kizárólag a májukban expresszálják a relaxin transzgént. 12 hónapos korukra glomeruláris fibrozist és intersticiális infiltrációt figyeltünk meg. A transzgenikus egerek veséjében fokozott fibronektin festést találtunk. Ahhoz, hogy relaxin és TGF-beta kettős transzgenikus hibrid egerekben vizsgáljuk a vesefibrózis progresszióját először vissza kellett keresztezni 15 generáción kersztül az inhomogén genetikai hátterű TGF-beta egereket a beltenyészett C57Bl6 háttérre. A homogén genetikai háttéren eltűnt az a kettős fenotipus, mely jellemzte a TGF-beta transzgenikus egereket. Az állatoknak azonos keringő TGF-beta plazma szintje volt, de a C57Bl6 háttéren csak a fibrózis enyhe formája alakult ki, bizonyítva ezzel a genetikai háttér fontosságát vesefibrózisban. | We have generated FVB/N alb/relaxin transgenic mice to investigate the effect of elevated plasma relaxin level on progression of renal fibrosis. These mice express the transgene exclusively in the liver. At 12 month of age they are characterized with mild glomerular fibrosis and intersticial infiltration. Also increased fibronectin is present in the kidney of transgenic mice. We wished to cross these mice to generate hybrid animals with the alb/TGF-beta1 transgenic mice which are characterized with progressive renal fibrosis. First we have backcrossed the alb/TGF-beta1 transgene to the C57Bl6 inbred strain for 13 generations and compared to C57Bl/6 x CBA F2 mice. As we expected the dual phenotype disappeared on the homogeneous background. The C57Bl6 alb/TGF-beta1 transgenic mice had similarly elevated plasma concentrations of TGF-beta1 than C57Bl/6 x CBA F2 mice, but they developed renal fibrosis of a moderate degree which emphasize the importance of genetic background on renal fibrosis