Különböző anyagokkal fedett, intraperitoneálisan beültetett polipropilén háló adhezió-gátló hatásának vizsgálata (állatkísérletes és klinikai vizsgálatok) = Evaluation of different physical barriers in prevention of adhesions to intraperitoneally placed polypropylene meshes (animal and clinical studies)

Vizsgáltuk a különböző anyagokkal fedett különböző fizikai tulajdonságú polipropilén háló viselkedését intraperitoneális helyzetben és megállapítottuk, hogy a szilikonnal történő fedés biztosítja a legmegbízhatóbb adhéziógátlást. Öt betegnél laparoszkópos hasfal rekonstrukció történt a fenti hálóval, szövődményt egyetlen esetben sem észleltünk. Az időközben kiadott EüM. rendelet megtiltotta a CE engedéllyel nem rendelkező termékek klinikai vizsgálatát, ezért azok folytatását felfüggesztettük és - az OTKA iroda előzetes hozzájárulása után - a CE engedély megszerzéséhez szükséges vizsgálatokkal folytattuk. 1. Implantációt követő helyi hatások (ISO 10993-6 1994): a szilikon fedés valóban hatékony adhézió gátló: három esetet kivéve, nem tapasztaltunk kitapadást és gyulladásos reakciót. 2. In vitro citotoxicitási teszt (ISO 10993-5 1992): A fibroblasztok a negatív kontrollhoz képest csak részben tapadtak a petricsésze alján rögzített szilikon fedett polipropilén hálóhoz. 3. Vérrel való kölcsönhatás vizsgálata (ISO 10993-10 1995): A szilikonnal fedett és nem fedett hálók abszorbanciájában nem találtunk szignifikáns különbséget. 4. VEGF és Ki-67 antitesttel végzett immunhisztológiai vizsgálatok: Valamennyi mintában jól detektálható a háló filamentumai körül kialakuló idegentest típusú, óriássejtes reakció. Az egy hetes mintákban a reaktív sejtek VEGF immunjelölődése gyengébb, mint a 3 hetesekben, ugyanakkor proliferációs aktivitásukban eltérés nem észlelhető (Ki-67 index). | Polypropylene meshes with different physical characteristics and covered with different barriers have been placed intraperitoneally. Based on biological behaviour and the tissue ingrowth silicone covered polypropylene mesh seems to be the best in adhesions prevention. Having the necessary permissions this mesh was used in a clinical trial and in five patients to perform laparoscopic hernia repair. There was no complications or other adverse events. This clinical tril was interupted because this mesh has no CE-mark and - after the permission of OTKA office -we continued our laboratory and animal work according to CE requirements. To gain the CE-mark we have investigated to local effect of mesh implantation (ISO 10993-6 1994), test for in vitro toxicity (ISO 10993-5 1992) and tests for interactions with blood (ISO 10993-10 1995) with results promoting the silicone covered polypropylene mes

Education of hand rubbing technique to prospective medical staff, employing UV-based digital imaging technology

The aim of this study was to objectively assess the hand hygiene performance of medical students. Hand rubbing technique was evaluated by employing innovative UV-light-based imaging technology, identifying patterns and trends in missed areas after applying WHO’s six-step protocol. This specially designed hand hygiene education and assessment program targeted 1,344 medical students at two distant sites in Central Europe. Students were introduced to a short video, presenting the basics of hand hygiene, and then received further demonstration from professional trainers, focusing on the correct execution of WHO’s six-step technique. To verify the acquired skill, participants rubbed their hands with UV-marked alcohol-based solution. Digital images of the hands were recorded under UV light, followed by computer evaluation and assessment. Immediate objective visual feedback was given to the participants showing missed areas on their hands. The statistical analysis of missed spots was based on retrospective expert-driven manual evaluation. Significant difference in rubbing quality was found between female and male participants [35.3% (CI 95%: 33–38%) versus 29.0% (CI 95%: 27–31%), p < 0.001], dominant and non-dominant hands [43.4% (CI 95%: 39–48%) versus 34.9% (CI 95%: 32–38%), p = 0.002], and various zones of the hands’ dorsal side. Based on the participants’ feedback and the evaluation of the infection control specialists, it can be stated that the identification of typically missed patterns and the instant visual feedback have a vital role in improving the hand hygiene technique of prospective medical staff

Quantitative impact of direct, personal feedback on hand hygiene technique

This study investigated the effectiveness of targeting hand hygiene technique using a new training device that provides objective, personal and quantitative feedback. One hundred and thirty-six healthcare workers in three Hungarian hospitals participated in a repetitive hand hygiene technique assessment study. Ultraviolet (UV)-labelled hand rub was used at each event, and digital images of the hands were subsequently taken under UV light. Immediate objective visual feedback was given to participants, showing missed areas on their hands. The rate of inadequate hand rubbing reduced from 50% to 15% (P < 0.001). However, maintenance of this reduced rate is likely to require continuous use of the electronic equipment

A mozgató működésekért felelős gerincvelői neuronhálózatok morfológiai, fiziológiai vizsgálata és számítógépes szimulációja = Morphological, physiological investigations and computer simulation of spinal neuronal network involved in locomotion.

1. Fiziológiai kísérletekben jelentős különbségeket találtak propriospinalis axon - motoneuron (MN) kapcsolatokban a MN-ból elvezetett EPSP amplitúdójában a béka gerincvelőben. Modellkísérletekkel bizonyítottuk, hogy a kapcsolatok között mért eltéréseket több tényező magyarázhatja: a szinapszisok elhelyezkedése, a dendrit kitüremkedések, nem-lineáris PSP szummáció illetve a PSP-ok szómára érkezéséhez szükséges késési idők eltérései. 2. A Xenopus embrió úszómozgásáért felelős központi ritmusgeneráló hálózatában azt vizsgáltuk, hogyan vezethet egy rövid inger hosszú ideig tartó úszó mozgáshoz. Az utóagy-gerincvelő határának populációs modelljében azt találtuk, hogy az utóagyi neuronok közötti reciprok serkentő kapcsolatok felelősek lehetnek az említett jelenségért. Elképzelésünket a kísérletes eredmények megerősítik. 3. Patkány gerincvelőben vizsgáltuk a cink kolokalizációját gátló aminosavakkal. Eredményeink azt mutatták, hogy a gerincvelőben a cink tartalmú terminálisok elsősorban gátló karakterűek, amelyekben a GABA és glicin is megtalálható. 4. Újszülött patkány gerincvelőben elemeztük a commissuralis interneuronok (CIN) neurokémiai sajátságait és szinaptikus kapcsolatait. A jelölt CIN terminálisok több mint fele tartalmazott gátló aminosavat, míg a glutamátot tartalmazó terminálisok aránya 27% volt. A jelölt CIN terminálisok közvetlen kapcsolatot képeztek az ellenoldali motoneuronokkal és CIN-okkal. | 1. We investigated the postsynaptic factors that may contribute the high variability of synaptic efficacy in monosynaptically connected propriospinal axon-motoneuron pairs in the spinal cord of frog. We proved that differences in location of these synapses, dendritic protrusions, non-linear summation of PSPs, sizes of time windows for effective temporal summation and differences in delays of arrivals of PSPs to soma are all factors that may differentiate between high and low efficacy single fiber propriospinal connections found experimentally. 2. The central pattern generator for swimming in the Xenopus tadpole was investigated to find out how a brief stimulus can lead to prolonged swimming. By using large-scale population model of the hindbrain-spinal cord junction we found that reciprocal excitatory connections among hindbrain neurons may be responsible for this phenomenon. Our proposal has strong experimental support. 3. Colocalization of zinc with inhibitory neurotrasmitters was investigated in the rat spinal cord. 70% of zinc-containing terminals showed immunoreactivity for GABA and glycine. 4. In neonatal rats we investigated the axonal projection and neurotransmitter properties of spinal commissural interneurons (CIN). About half of the labelled CIN terminals contained GABA or glycine and one third proved to be excitatory. Many of CIN terminals made close appositions with motor neurons and also with CINs on the opposite side of the spinal cord

A PACAP-38 citoprotektív és antiinflammatórikus hatásának vizsgálata vékonybél-autotranszplantációs modellben

Bevezetés: A vékonybél ischaemia-reperfusióval szembeni fokozott érzékenysége a szerv transzplantációjakor is jelen lévő probléma. Ismert a hypophysis adenilát-cikláz aktiváló polipeptid (PACAP) sejtvédő hatása. Munkánkban azt vizsgáltuk, hogy PACAP-38-at tartalmazó University of Wisconsin (UW) oldatban történő konzerválás hogyan befolyásolja a szöveti PACAP- és citokinszinteket. Anyag és módszer: Wistar-patkányokon (n = 56) vékonybél-autotranszplantációt végeztünk. A graftokat 4 °C-os UW oldatban tároltuk 1 (I. csoport), 3 (II.) és 6 órán (III.), illetve 100 μg PACAP-38-at tartalmazó UW oldatban 1 (IV.), 3 (V.) és 6 órán (VI.) át. A reperfusio 3 óra volt. Bélmintákból a PACAP-38- és PACAP-27-szinteket radioimmunassayjel határoztuk meg, míg a citokinexpressiót kemilumineszcens módszerrel és Luminex Multiplex Immunoassayjel mértük. Eredmények: A szöveti PACAP-38-szint a kontrollhoz (57,32 ± 3,5 fmol/mg) képest a konzerválás idejével csökkent, és 6 óra után szignifikáns volt (III.: 32,6 ± 3,9 fmol/mg, p < 0,05), míg a IV–VI. csoportoknál szignifikánsan nőtt. A PACAP-27 szöveti értéke is hasonló tendenciával változott. Az sICAM-1, L-selectin és a metalloproteáz-1 szöveti inhibitorának emelkedett expressióját mértük a III. csoportban, és jelentős csökkenés volt a VI. csoportban. Következtetés: UW oldathoz adott PACAP-38 növelte a szöveti PACAP-38- és PACAP-27-szinteket, és csökkentette a citokinexpressiót. Mindez a PACAP-38 citoprotektív és anti-inflammatórikus hatását jelzi bél-autotranszplantációs modellben

Effectiveness and Waning of Protection With Different SARS-CoV-2 Primary and Booster Vaccines During the Delta Pandemic Wave in 2021 in Hungary (HUN-VE 3 Study)

BackgroundIn late 2021, the pandemic wave was dominated by the Delta SARS-CoV-2 variant in Hungary. Booster vaccines were offered for the vulnerable population starting from August 2021.MethodsThe nationwide HUN-VE 3 study examined the effectiveness and durability of primary immunization and single booster vaccinations in the prevention of SARS-CoV-2 infection, Covid-19 related hospitalization and mortality during the Delta wave, compared to an unvaccinated control population without prior SARS-CoV-2 infection.ResultsThe study population included 8,087,988 individuals who were 18–100 years old at the beginning of the pandemic. During the Delta wave, after adjusting for age, sex, calendar day, and chronic diseases, vaccine effectiveness (VE) of primary vaccination against registered SARS-CoV-2 infection was between 11% to 77% and 18% to 79% 14–120 days after primary immunization in the 16–64 and 65–100 years age cohort respectively, while it decreased to close to zero in the younger age group and around 40% or somewhat less in the elderly after 6 months for almost all vaccine types. In the population aged 65–100 years, we found high, 88.1%–92.5% adjusted effectiveness against Covid-19 infection after the Pfizer-BioNTech, and 92.2%–95.6% after the Moderna booster dose, while Sinopharm and Janssen booster doses provided 26.5%–75.3% and 72.9%–100.0% adjusted VE, respectively. Adjusted VE against Covid-19 related hospitalization was high within 14–120 days for Pfizer-BioNTech: 76.6%, Moderna: 83.8%, Sputnik-V: 78.3%, AstraZeneca: 73.8%, while modest for Sinopharm: 45.7% and Janssen: 26.4%. The waning of protection against Covid-19 related hospitalization was modest and booster vaccination with mRNA vaccines or the Janssen vaccine increased adjusted VE up to almost 100%, while the Sinopharm booster dose proved to be less effective. VE against Covid-19 related death after primary immunization was high or moderate: for Pfizer-BioNTech: 81.5%, Moderna: 93.2%, Sputnik-V: 100.0%, AstraZeneca: 84.8%, Sinopharm: 58.6%, Janssen: 53.3%). VE against this outcome also showed a moderate decline over time, while booster vaccine types restored effectiveness up to almost 100%, except for the Sinopharm booster.ConclusionsThe HUN-VE 3 study demonstrated waning VE with all vaccine types for all examined outcomes during the Delta wave and confirmed the outstanding benefit of booster vaccination with the mRNA or Janssen vaccines, and this is the first study to provide clear and comparable effectiveness results for six different vaccine types after primary immunization against severe during the Delta pandemic wave

Biocompatibility study of poly(vinyl alcohol)-based electrospun scaffold for hernia repair

Abdominal hernia is a purely surgical disorder where due to a defect in the abdominal wall, tissues or organs can extrude out of the abdominal cavity. The only conclusive treatment is surgical making a mesh implantation indispensable. Tissue engineering is now a promising method for creating scaffolds that provide an adequate support for tissue ingrowth. Our purpose was to develop a non-adhesive hernia mesh, which could be used in the repair of abdominal wall hernias but concurrently a scaffold for abdominal tissue regeneration. Poly(vinyl alcohol) bulk hydrogels are promising materials in wound dressing hence, interest in electrospun poly(vinyl alcohol) meshes has emerged in the past few years for different biomedical applications. In the present paper, preparation of electrospun poly(vinyl alcohol) fiber membranes and their in vitro and in vivo behaviors were followed to study the adhesion, biocompatibility, and biodegradability of the meshes. Our results showed that the surface of PVA meshes does not favor cell adhesion in vitro. During the animal experiments, PVA meshes demonstrated good integration into the surrounding tissue with minimal inflammatory reaction and minimal adhesions to intra abdominal structures

Source analysis of the March 7, 2019 M-L=4.0 Somogyszob, Hungary earthquake sequence

Between February 16 and April 5, 2019, a series of earthquakes took place around the village of Somogyszob, Somogy county, Hungary. The mainshock occurred on March 7 with a local magnitude M-L=4.0 and epicentral intensity of 5 on the EMS scale. The main event was preceded by four foreshocks and followed by four aftershocks. The largest foreshock (M-L=2.6) was also felt with maximum intensity of 4 EMS. This earthquake sequence is the first remarkable one in the region that was recorded by a significant number of high-quality broadband digital seismographs. We have estimated the hypocenters of the 9 earthquakes using the hypoDD multiple-event location algorithm. The events occurred in a tight region around the mainshock at around 13-14 km depth. For the main event, we obtained an average moment magnitude of M-w=3.75, source radii of r(P)=509 m nd r(S)=400 m, and static stress drops of Delta sigma(P)=1.19x10(6) Pa and Delta sigma(S)=4.00x10(6) Pa from the analysis of displacement P- and S-wave spectra, respectively. The resulting spectral source parameters for the investigated events agree well with the results of earlier research. We have also shown that our recently developed probabilistic waveform inversion techniques applied in this study are suitable to retrieve the source mechanism for weak local earthquakes. We have successfully estimated the focal mechanism for the mainshock, a foreshock and an aftershock. Each earthquake was a thrust faulting event with a sub-horizontal P-axis pointing towards N-NE, coinciding with the general trend of the compressional stress field in the epicentral region