196 research outputs found
Is supplementary feeding essential for red deer (Cervus elaphus) in Hungary?
Practical deer management requires understandingthe relationship between the quantity
and quality of the available food and resource use by deer in the habitat. Although red deer
(Cervus elaphus) primarily forages on woody plant species from the shrub layer, supplementation
by non-browse food is very common among game managers. Provision of extra food in addition \ud
to the natural supply has significant costs. Consequently, it is important to know how essential
this feeding may be for populations of game like red deer. In our study area we determined the
consumption by red deer of two feed types (maize silage and apple pomace which is the residue
from pressing apples) commonly offered at feeding plots in Hungary during the winter.
Additionally, we assessed the minimum distance for these feeders to have an attractive effect. We
used microhistological analysis of faeces and rumen content and macroscopic observation of
markers mixed into the food. Based on our analyses, 20 to 90% of the red deer (depending on the
date and method of investigation) had eaten the supplemental food. However, the proportion of
supplementary food in the red deer droppings collected in the immediate surroundings of the
feeding plots was always very low (<10%). The detected range of effect of the feeding plots (the
distance from which deer came to the feeder) was typically around 1.7 km, but no more than 3.2
km. All this indicates that only a part of the red deer population visits the feeding plots, and from
short distances from the forest. Thus, our data strongly suggests that supplementary food did not
necessarily play an important role in the diet of the red deer individuals regularly visiting these
sites. Managers considering supplementary feeding should evaluate the quality of the forest area
because the natural food supply can greatly influence the use of the feeding plots
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Systems evaluation of the Guatemalan eye care project – Enfoque Ixcan : barriers and avenues for providing eye care services to rural Guatemala
This thesis evaluates the programs, activities, and relationships of Enfoque Ixcan, a non-profit eye care project providing services to a rural area of Guatemala.
I conducted ethnographic interviews with key stakeholders of the organization and carried out participant observation in the Ixcan region of Guatemala in February 2006. The research focused on gaining an overall understanding of the structure and function of the organization. The objective of this study was to determine avenues to build a stronger and more sustainable eye care program through the evaluation of the organization.
Three themes emerged from the research: 1) obstacles of geography, 2) need for education and 3) the effects of transition on the Ixcan and Enfoque Ixcan. Recommendations were made to the organization in conclusion of this research and included such suggestions as: 1) increase communication with the current health facilitator and work to hire a part-time eye health promoter in order to increase care and lessen the demands placed on the health facilitator, 2) identify and build “social capital” resources to increase organizational learning, 3) continue to clarify information in writing in order to overcome misunderstandings that have occurred in the past, 4) build financial stability as a means of creating a stronger and more sustainable organization
Diagnosis of Epstein-Barr and cytomegalovirus infections using decision trees: an effective way to avoid antibiotic overuse in paediatric tonsillopharyngitis
Coincidence of bft and cfiA genes in a multi-resistant clinical isolate of Bacteroides fragilis
Valós idejű polimeráz láncreakció alkalmazása cytomegalovirus-fertőzés és -reaktiváció nyomon követésére malignus hematológiai betegségek kemoterápiás kezelése során és autológ őssejt-transzplantációt követően | Monitoring cytomegalovirus infection and reactivation using quantitative real-time polymerase chain reaction in patients with haematological malignancies during chemotherapy and after autologous stem cell transplantation
Absztrakt
Bevezetés: A hematológiai betegek kemo-immun terápiás kezelése
és az őssejt-transzplantáció során fellépő fertőzéses komplikációk egyikét
képezi a cytomegalovirus-infekció és -reaktiváció. Célkitűzés:
A szerzők célja a cytomegalovirus-fertőzés és -reaktiváció követése kvantitatív
valós idejű polimeráz láncreakció módszerével. Módszer: A
szerzők intézetében 2012–2014 között kezelt 96 beteg dokumentációját elemezték
retrospektív vizsgálatban. A betegeket az alapbetegség szerint csoportosították
(lymphoproliferativ betegségek, akut leukaemiák), valamint megkülönböztették
aszerint, hogy történt-e autológ őssejt-transzplantáció vagy sem.
Eredmények: Lymphoproliferativ betegség miatt kezeltek 83
beteget, közülük 63 (76%) részesült autológ őssejt-transzplantációban. A 604
plazmamintából 46 mintában (7,6%) igazolódott valós idejű polimeráz
láncreakcióval cytomegalovirus-pozitivitás összesen 25 betegből (6 nem
transzplantált [18%], 19 transzplantált [30,2%]). A valós idejű polimeráz
láncreakcióval cytomegalovirus-pozitivitás kétszeres gyakorisággal fordult elő a
transzplantált betegcsoportban, azonban 68%-ukban a reaktiváció tünetmentes volt
és spontán oldódott. Következtetések: Rutinszerű
cytomegalovirus-monitorozás nem szükséges a fenti betegcsoportban, azonban jól
meghatározott betegcsoportban klinikai gyanú esetén elvégzett molekuláris teszt
lehetővé teszi a korai preemptív kezelést, ezáltal csökkentve a mortalitást.
Orv. Hetil., 2016, 157(35), 1403–1409.
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Abstract
Introduction: Because of the use of chemo-immunotherapeutic
drugs, cytomegalovirus infection is one of the most important infectious
complications among patients with haematological malignancies.
Aim: The aim of the authors was to detect cytomegalovirus
infection and reactivation using quantitative real-time polymerase chain
reaction. Method: Between 2012 and 2014, the authors
retrospectively analysed 96 patient’s medical history hospitalised in
haematology Unit. Patients were grouped on the basis of their underlying
diseases (lymphoprolipherative malignancies, acute leukaemias), and the
following groups were created: autologous stem cell transplanted and
non-transplanted groups. Results: Eighty-three patients were
treated with lymphoprolipherative disorders, and 63 (76%) of them underwent
autologous stem cell transplantation. Out of the 604 plasma specimens 46 (7.6%)
were positive for the cytomegalovirus desoxyribonucleic acid collected from 25
patients [6 non-transplanted (18%) and 19 from the transplanted group (30.2%)].
The frequency of cytomegalovirus positivity was doubled in the transplanted
patient group, however, reactivation was asymptomatic in 68% of the cases.
Conclusions: The routine use of cytomegalovirus monitoring
is not necessary in this patient group. In case of suspected cytomegalovirus
infection, molecular tests allow early preemptive antiviral therapy, which may
decrease the mortality attributed to cytomegalovirus infection. Orv. Hetil.,
2016, 157(35), 1403–1409
Lepedékes tonsilla gyermekkorban. Hogyan csökkenthető az indokolatlan antibiotikumfelhasználás? = Exudative tonsillitis in children How can we reduce the unnecessary antibiotic consumption?
Absztrakt:
Bevezetés: A lepedékkel, tüszőkkel fedett, gyulladt tonsilla
gyakori elváltozásnak számít a gyermekgyógyászatban. A tünet hátterében az
esetek nagyobb részében vírusfertőzés (Epstein–Barr-vírus [EBV], cytomegalovirus
[CMV], influenza, parainfluenza, adenovírus) áll; csak kisebb arányban
baktériumok, melyek közül az A-csoportú streptococcusok által okozott fertőzés
kiemelendő. A jelenlegi irányelvek alapján nem ajánlott rutinszerű, preventív
antibiotikumkezelés az A-csoportú streptococcusok által okozott szövődmények
megelőzésére. Célkitűzés: Célunk volt meghatározni, hogy a
lepedékes tonsillitis miatt felvett gyermekek esetén jelenthet-e
differenciáldiagnosztikai segítséget a laboratóriumi értékek változása a
felesleges antibiotikumhasználat elkerülésében. Módszer: A
vizsgálat során 133 beteg 135, exsudativ tonsillitis miatt történt
megjelenésének adatait elemeztük. A betegeket két csoportba osztottuk. Az 1.
csoportba kerültek azok a betegek, akiknél EBV vagy CMV kóroki szerepe volt
igazolható, míg a 2. csoportba azokat a betegeket soroltuk, akiknél szerológiai
módszerekkel nem volt igazolható vírusfertőzés. Eredmények: A
vizsgálati eredmények alapján 2016 és 2017 között az exsudativ tonsillitisek
többségénél (66/135, 48,8%) a CMV és az EBV kóroki szerepe volt igazolható
szerológiai módszerrel, míg Streptococcus pyogenes jelenléte
csak néhány esetben (3/65, 4,61%) volt kimutatható torokváladékból. A betegek
jelentős, 92%-a a fentiek ellenére antibiotikumkezelésben részesült.
Következtetés: Retrospektív felmérésünk eredményei is
alátámasztották, hogy a klinikai tünetek és a fizikális status alapján nem
lehetséges a kóroki tényezőt megítélni, sőt a legtöbb esetben a kvalitatív
vérkép eltérései és a gyulladásos markerek – például a C-reaktív protein (CRP) –
emelkedése sem jelez egyértelműen bakteriális infekciót. Ellenben a
transzaminázértékek emelkedése magas pozitív prediktív értékkel utal
vírusfertőzésre, azon belül is a vizsgálat tárgyát képező CMV- és
EBV-infekcióra. A laborvizsgálatok ez irányú kiterjesztésével a felesleges
antibiotikumhasználat jelentősen csökkenthető. Orv Hetil. 2020; 161(2):
50–55.
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Abstract:
Introduction: Exudative tonsillitis is a common clinical picture
during childhood. The majority of these cases are caused by viruses
(Epstein–Barr virus [EBV], cytomegalovirus [CMV], influenza virus, parainfluenza
virus, and adenovirus), and only some infections are caused by bacteria, mainly
group A streptococci (GAS). On the basis of international guidelines, routine
use of early antibiotic treatment is not recommended in these cases, because it
seems not to prevent GAS-associated complications. Aim: Our aim
was to determine those laboratory results which are useful to distinguish
between bacterial and viral infections in children with exudative tonsillitis to
reduce antibiotic overuse. Method: In our study, we evaluated
135 clinical data from 133 children with exudative tonsillitis. Patients were
grouped according to the following criteria: the first group contained patients
with acute CMV or EBV infections, while in the second group, CMV or EBV
infections were not confirmed using serology. Results: On the
basis of our results, EBV or CMV infections (66/135, 48.8%) were serologically
confirmed in the majority of cases with exudative tonsillitis between 2016 and
2017, while the causative role of GAS was minimal in this patient group (3/65,
4.61%). In spite of this finding, the majority of patients (92%) were treated
with antibiotics. Conclusion: Our retrospective findings
confirmed that it is not possible to determine the causative agent of this
clinical picture on the basis of symptoms, and physical findings, moreover
laboratory results, such as high white blood cell count could not confirm
bacterial infection. At the same time, elevated transaminase levels may refer to
viral origin of infection, especially EBV or CMV with high predictive value; the
use of extended laboratory tests may reduce the unnecessary antibiotic
consumption. Orv Hetil. 2020; 161(2): 50–55
Emergence of Clostridium difficile Ribotype 027 in Korea
Background: Clostridium difficile infection (CDI) has markedly risen and is associated with hypervirulent ribotype 027 outbreaks in North America and Europe since 2003. The aims of this study were to determine the prevalence of ribotype 027 among C. difficile isolates in Korea, to characterize the ribotype 027 isolates, and to determine the clinical severity of CDI in patients infected with these isolates. Methods: A total of 1,251 isolates of C. difficile recovered from stool specimens of suspected CDI patients at two tertiary-care hospitals and one commercial laboratory between 2002 and 2009. Genes for toxin A (tcdA), toxin B (tcdB), and binary toxin (cdtA and cdtB) were detected by PCR. Mutation in the tcdC gene was detected by sequencing after PCR amplification. For molecular genotyping, we performed PCR-ribotyping, pulsed-field gel electrophoresis (PFGE), and multilocus variable-number tandem-repeat analysis (MLVA). Minimum inhibitory concentrations of moxifloxacin were determined using Etest strips (AB bioMerieux, Sweden). Results: We identified 7 isolates as ribotype 027. These isolates had the same tcdC mutation as the epidemic strain, and 6 of them were resistant to moxifloxacin. The isolates were categorized into 3 different PFGE types and 7 different MLVA types. All the 7 cases had occurred sporadically. Conclusions: C. difficile ribotype 027 is uncommon, but it has emerged in Korea. The spread of this ribotype should be closely monitored in order to avoid an outbreak of CDI in Korea.This study was supported by a faculty research grant from Yonsei University College of Medicine (grant 6-2008-0269). We thank Thomas V. Reily (University of Western Australia, Perth, WA, Australia) for providing reference strains and Myungsook Kim (Yonsei University Health System, Seoul, Korea), Kwangwoo Kim (Yonsei University Health System, Seoul, Korea), and Gwanghee Byun (Kyunghee University, Yongin, Korea) for laboratory assistance
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