Health care and social worker students' attitudes, knowledge and experience of complementary and alternative medicine and its differences between full-time and part-time students in Hungary

L

Hungarian health care students' choices between complementary and alternative medicine or conventional medicine: a cross-sectional survey

L

Az intracelluláris XIII-as faktor lehetséges szerepe a monocita/makrofág sejtvonalban = The possible role of Factor XIII in monocytes/macrophages

Ismert tény, hogy a véralvadás XIII-as faktorának A alegysége (FXIII-A) a monocita/makrofág sejtvonalban is szintetizálódik, de a sejtekből nem szekretálódik. A FXIII-A intracelluláris lokalizációja és szubsztrát profilja alapján feltehetően szerepet játszik intracelluláris folyamatokban is. Humán monocita kultúrákon, különböző aktiváló ágensek (interleukin 4, interferon gamma, Mycobacterium bovis) jelenlétében elvégzett vizsgálataink igazolták, hogy klaszikus és alternatív aktiváció során a FXIII-A gén expressziója (mRNS és fehérje szinten egyaránt) ellentétesen szabályozódik. A FXIII-A gén expressziójának jellemzése érdekében FXIII-A deficiens és egészséges egyének alternatív úton aktivált monocita-eredetű makrofágjainak expressziós profilját hasonlítottuk össze microarray vizsgálatokkal. Cytoscape/BiNGO and Ingenuity Pathways Analysis programokkal elvégeztük az eltérően expresszálódó gének funkcionális csoportosítását. Eredményeink igazolták, hogy a FXIII-A fontos szerepet játszik a makrofágok alternatív aktivációja során lejátszódó génexpressziós változásokban. A FXIII-A hiányában a legmarkánsabb génexpressziós eltérések az immunfunkciókban és a sebgyógyulásban szerepet játszó gének körében jelentkeznek. | It is known that Factor XIII subunit A of blood coagulation (FXIII-A) is synthesized but not secreted by the monocyte/macrophage cell line. On the basis of its intracellular localization and substrate-profile FXIII-A is thought to be involved in certain intracellular processes. Our study in long term culture of human monocytes during their differentiation into macrophages in the presence of activating agents (interleukin 4, interferon gamma, Mycobacterium bovis) inducing the classical and alternative activation pathways clearly showed that the expression of FXIII-A both at the mRNA as well as the protein level is inversely regulated during the two activation programmes. To characterize the effect of FXIII-A on gene expression microarray profiles of alternatively activated monocyte-derived macrophages of FXIII-A deficient patients and healthy controls were compared and functional clustering of the differently expressed genes was carried out by using Cytoscape/BiNGO and Ingenuity Pathways Analysis programs. Our results revealed that FXIII-A has important role(s) in mediating gene expression changes in macrophages during alternative activation. In the absence of FXIII-A, the most prominent differences are related to immune functions and to wound response

A magyarországi emlő- és méhnyakszűrés retrospektív vizsgálatának jellemzői a halálozási és megbetegedési adatok tükrében = Retrospective examination of the Hungarian breast and cervical cancer screening programmes according to mortality and morbidity data

Absztrakt: Bevezetés: A szervezett emlő- és méhnyakszűrés bevezetésére a népegészségügyi program keretében került sor Magyarországon. A program azt a célt tűzte ki, hogy 10 év alatt adott korcsoportban az emlőrák miatti halálozás 30%-kal, a méhnyakrák miatti halálozás 60%-kal csökkenjen 2012-ig. Célkitűzés: Kutatásunk célja az emlő- és méhnyakrák-mortalitási és -morbiditási adatok retrospektív elemzése, a bevezetett szűrővizsgálatok eredményességének vizsgálata volt. Módszer: Leíró statisztikai elemzést készítettünk a standardizált halálozási és megbetegedési adatokból 1980 és 2015 között, különös tekintettel a 2002–2012-es időszakra. Eredmények: A 45–64 éves nők emlőrák miatti halálozása 28,3%-kal, az emlőrák incidenciája 23,6%-kal csökkent, míg az in situ carcinoma incidenciája 242%-kal emelkedett 2002 és 2012 között. A 25–64 éves nők méhnyakrák miatti halálozása 25,5%-kal, a méhnyakrák incidenciája 21,2%-kal csökkent, míg az in situ carcinoma incidenciája 13,3%-kal növekedett a 2002–2012-es időszakban. Következtetés: Bár mind az emlőrák, mind a méhnyakrák miatti halálozás jelentősen csökkent Magyarországon, a halálozás csökkenése a méhnyakrák esetén jelentősen elmaradt a várt célértéktől. Orv Hetil. 2019; 160(49): 1948–1956. | Abstract: Introduction: The organized breast and cervical screening programs were implemented in the framework of public health program in Hungary in order to reduce breast cancer mortality by 30% and cervical cancer mortality by 60% in given age groups within 10 years by 2012. Aim: The aim of our study was to conduct a retrospective analysis of mortality and morbidity data and to evaluate the effectiveness of the implemented screening programs. Method: Descriptive statistical analysis was performed by age-standardized mortality and morbidity data between 1980 and 2015 with special regard to the period of 2002–2012. Results: Breast cancer mortality of women aged 45–64 reduced by 28.3%, the incidence reduced by 23.6% and the incidence of in situ carcinoma increased by 242% between 2002 and 2012. Cervical cancer mortality of women aged 25–64 years reduced by 25.5%, the incidence reduced by 21.2%, and the incidence of in situ carcinoma increased by 13.3% during 2002–2012. Conclusion: Although both breast cancer and cervical cancer mortality substantially decreased in Hungary, the decrease in cervical cancer did not reach the target value. Orv Hetil. 2019; 160(49): 1948–1956

Unusual portal reconstructions after liver transplantation: case report and review of literature

L

Veseérintettség májátültetés során

Introduction: In liver cirrhosis renal function decreases as well. Hepatorenal syndrome is the most frequent cause of the decrease, but primary kidney failure, diabetes mellitus and some diseases underlying endstage liver failure (such as hepatitis C virus infection) can also play an important role. In liver transplantation several further factors (total cross-clamping of vena cava inferior, polytransfusion, immunosuppression) impair the renal function, too. Aim: The aim of this study was to analyse the changes in kidney function during the first postoperative year after liver transplantation. Method: Retrospective data analysis was performed after primary liver transplantations (n = 319). Results: impaired preoperative renal function increased the devepolment of postoperative complications and the first year cumulative patient survival was significantly worse (91,7% vs 69,9%; p<0,001) in this group. If renal function of the patients increased above 60 ml/min/1,73 m2 after the first year, patient survival was better. Independently of the preoperative kidney function, 76% of the patients had impaired kidney function at the first postoperative year. In this group, de novo diabetes mellitus was more frequently diagnosed (22,5% vs 9,5%; p = 0,023). Conclusions: Selection of personalized immunosuppressive medication has a positive effect on renal function. Orv. Hetil., 2013, 154, 1018-1025

Hepatitis C-vírus-fertőzés kiújulása májátültetés után. Mi változott az elmúlt 10 évben?

Introduction: Management of hepatitis C virus recurrence is a challenge after liver transplantation. Aim: The aim of the authors was to analyse the outcome of liver transplantation performed in hepatitis C virus positive patients during the past ten years and to compare recent data with a previous report of the authors. Method: The authors retrospectively evaluated the data (donors, recipients, perioperative characteristics, patient and graft survival, serum titer of hepatitis C virus RNA, histology) of 409 patients who underwent liver transplantation between 2003 and 2012. Results: 156 patients were transplanted due to hepatitis C virus associated liver cirrhosis (38%). Worse outcome was observed in these patients in comparison to hepatitis C virus negative recipients. The cumulative patient survival rates at 1, 5, and 10 year were 80%, 61%, 51% in the hepatitis C virus positive group and 92%, 85%, 79% in the hepatitis C virus negative group, respectively (p<0.001). The cumulative graft survival rates at 1, 5 and 10 year were 79%, 59% and 50% in hepatitis C virus positive and 89%, 80% and 70% in hepatitis C virus negative patients (p<0.001). Hepatitis C virus recurrence was observed in the majority of the patients (132 patients, 85%), mainly within the first year (83%). The authors observed recurrence within 6 months in 71 patients (56%), and within 3 months in 26 patients (20%). The mean hepatitis C virus recurrence free survival was 243 days. Higher rate of de novo diabetes was detected in case of early recurrence. The cumulative patient survival rates at 1, 3, 5, 10 years were 98%, 89.5%, 81% and 65% when hepatitis C virus recurrence exceeded 3 months and 64%, 53%, 30.5% and 30.5% in patients with early recurrence (p<0.001). Conclusions: Poor outcome of liver transplantation in hepatitis C virus positive patients is still a challenge. Hepatitis C virus recurrence is observed earlier after liver transplantation in comparison with a previous report of the authors. De novo diabetes occurs more frequently in case of early recurrence. Despite an immediate start of antiviral treatment, early recurrence has a significant negative impact on the outcome of transplantation. Orv. Hetil., 2013, 154, 1058-1066