Urban Integration of an Oldtown District At-Risk of Segregation in Dombóvár

The urban structure of Dombóvár has been transformed in recent centuries, and the protected buildings that once defined the town center, have been relegated to the periphery. Today, despite its rich architectural heritage, the Kakasdomb district is an area at risk of segregation. The key to the integration of the district into the existing urban tissue is the utilization of the protected buildings of the area including the former synagogue building. This paper examines the possibilities for the reuse of the synagogue based on the town development strategy and the perceptions of the remaining Jewish community, and the systematic modification of the settlement structure, together with the possibilities for the integration of the neighborhood

Steroid but not biological therapy elevates the risk of venous thromboembolic events in inflammatory bowel disease: a meta-analysis

Background and aim: Inflammatory bowel disease [IBD] is associated with 1.5- to 3-fold increased risk of venous thromboembolic events [VTE]. The aim of this study was to determine the risk of VTE in IBD as a complication of systemic corticosteroids and anti-tumor necrosis factor alpha [TNFalpha] therapies. Methods: A systematic review and meta-analysis was conducted, which conforms to the Preferred Reporting Items for Systematic Reviews and Meta-analyses [PRISMA] statement. PubMed, EMBASE, Cochrane Library, and Web of Science were searched for English-language studies published from inception inclusive 15 April 2017. The population-intervention-comparison-outcome [PICO] format and statistically the random-effects and fixed-effect models were used to compare VTE risk during steroid and anti-TNFalpha treatment. Quality of the included studies was assessed using the Newcastle-Ottawa scale. PROSPERO registration number is 42017070084. Results: We identified 817 records, of which eight observational studies, involving 58,518 IBD patients, were eligible for quantitative synthesis. In total, 3,260 thromboembolic events occurred. Systemic corticosteroids were associated with a significantly higher rate of VTE complication in IBD patients as compared to IBD patients without steroid medication [OR: 2.202; 95% CI: 1.698-2.856, p < 0.001]. In contrast, treatment with anti-TNFalpha agents resulted in a 5-fold decreased risk of VTE compared to steroid medication [OR: 0.267; 95% CI: 0.106-0.674, p = 0.005]. Conclusion: VTE risk should be carefully assessed and considered when deciding between anti-TNFalpha and steroids in the management of severe flare-ups. Thromboprophylaxis guidelines should be followed, no matter the therapy choice

Classical celiac disease is more frequent with a double dose of HLA-DQB1*02

Experimental data suggest that the HLA-DQ2 gene dose has a strong quantitative effect on clinical outcomes and severity of celiac disease (CD). We aimed to conduct a meta-analysis with systematic review to investigate the association between HLA-DQB1*02 gene doses and the characteristics of CD.We searched seven medical databases for studies discussing HLA-DQB1 gene dose in CD and various disease characteristics, such as clinical presentation, histology, age at diagnosis, and comorbidities. Odds ratios (OR, for categorical variables) and weighted mean differences (for age) were calculated to compare patients with a double dose of HLA-DQB1*02 versus those with single and zero doses. Heterogeneity was tested with I2-statistics and explored by study subgroups (children and adults).Twenty-four publications were eligible for meta-analysis. Classical CD was more frequent with a double versus single dose of the HLA-DQB1*02 allele (OR = 1.758, 95%CI: 1.148-2.692, I2 = 0.0%). In pediatric studies, gene dose effect was more prominent (OR = 2.082, 95%CI: 1.189-3.646, I2 = 0.0% and OR = 3.139, 95%CI: 1.142-8.630, I2 = 0.0% for the comparisons of double versus single and double versus zero dose, respectively). Atrophic histology was more prevalent with a double versus zero dose (OR = 2.626, CI: 1.060-6.505, I2 = 21.3%). We observed no gene dose effect regarding diarrhea, age at diagnosis, the severity of villous atrophy, and the association with type 1 diabetes mellitus.A double dose of HLA-DQB1*02 gene seems to predispose patients to developing classical CD and villous atrophy. Risk stratification by HLA-DQB1*02 gene dose requires further clarification due to the limited available evidence

Classical celiac disease is more frequent with a double dose of HLA-DQB1*02: A systematic review with meta-analysis.

Background and aimsExperimental data suggest that the HLA-DQ2 gene dose has a strong quantitative effect on clinical outcomes and severity of celiac disease (CD). We aimed to conduct a meta-analysis with systematic review to investigate the association between HLA-DQB1*02 gene doses and the characteristics of CD.MethodsWe searched seven medical databases for studies discussing HLA-DQB1 gene dose in CD and various disease characteristics, such as clinical presentation, histology, age at diagnosis, and comorbidities. Odds ratios (OR, for categorical variables) and weighted mean differences (for age) were calculated to compare patients with a double dose of HLA-DQB1*02 versus those with single and zero doses. Heterogeneity was tested with I2-statistics and explored by study subgroups (children and adults).ResultsTwenty-four publications were eligible for meta-analysis. Classical CD was more frequent with a double versus single dose of the HLA-DQB1*02 allele (OR = 1.758, 95%CI: 1.148-2.692, I2 = 0.0%). In pediatric studies, gene dose effect was more prominent (OR = 2.082, 95%CI: 1.189-3.646, I2 = 0.0% and OR = 3.139, 95%CI: 1.142-8.630, I2 = 0.0% for the comparisons of double versus single and double versus zero dose, respectively). Atrophic histology was more prevalent with a double versus zero dose (OR = 2.626, CI: 1.060-6.505, I2 = 21.3%). We observed no gene dose effect regarding diarrhea, age at diagnosis, the severity of villous atrophy, and the association with type 1 diabetes mellitus.ConclusionA double dose of HLA-DQB1*02 gene seems to predispose patients to developing classical CD and villous atrophy. Risk stratification by HLA-DQB1*02 gene dose requires further clarification due to the limited available evidence