A személyi állomány és a fogvatartottak egészségügyi ellátásának biztosítása, a védekezés egészségügyi megszervezése a koronavírus-járvány alatt

The coronavirus pandemic meant an unexpected challenge both for the world and for the health care system of the Hungarian Prison Service. Based on study of the legal environment and the knowledge gained about the virus, it was necessary to rewrite the operation of the Hungarian Prison Service in order to preserve the health of the prison staff and the prisoners in the best way and to the greatest extent. Substantial measures had to be taken to reduce the risk of transmission of the infection by both staff members and new detainees significantly, and to prevent the spread of the pandemic within the institutions effectively, while maintaining lawfulness and safety of detention. A transformation of the prison service supply system had to be organized to ensure the rapid investigation of suspected infections and to grant adequate health care for all sick inmates quickly. The paper presents the legal environment of the prison service health care system, the most important characteristics of the SARS-CoV-2 virus causing the pandemic, and the health and epidemiological measures taken in order to maintain control and defence. I will present methods used to control the epidemic in the prisons, the strict rules that were applied for prisoners as a closed community and the measures taken to support prison staff and to protect their health.A koronavírus-járvány váratlan kihívásként érte úgy a világot, mint a magyar büntetés-végrehajtási szervezet egészségügyi ellátórendszerét. A jogi környezet áttanulmányozása, valamint a vírusról szerzett ismeretek alapján kellett úgy átgondolni a büntetés-végrehajtási szervezet eddigi működését, hogy az a személyi állomány és fogvatartottak egészségének megőrzését a legjobban és a legnagyobb mértékben szolgálja. Olyan érdemi intézkedéseket kellett meghozni, melyek jelentősen csökkentik mind a személyi állomány, mind az új befogadott fogvatartottak részéről a fertőzés intézetben történő terjesztésének kockázatát, valamint a belső kontaktusok számának csökkentésével a járvány intézeten belüli elterjedését is hatékonyan akadályozzák a fogvatartás jogszerűsége és biztonsága fenntartása mellett. Meg kellett szervezni a büntetés-végrehajtási ellátórendszer olyan átalakítását, ami biztosította a fertőzésgyanús esetek gyors kivizsgálásának lehetőségét, valamint minden beteg fogvatartott számára lehetővé tette a megfelelő egészségügyi ellátáshoz jutás gyors lehetőségét. A tanulmány a büntetés-végrehajtás egészségügyi ellátórendszerének jogi környezetét, a járványt okozó SARS-CoV-2-vírus legfontosabb tulajdonságait, valamint a védekezés érdekében meghozott egészségügyi, járványügyi intézkedéseket mutatja be. Ismertetésre kerülnek a büntetés-végrehajtási intézetekben és intézményekben a járvány megfékezése érdekében alkalmazott módszerek, a fogvatartotti állományra – mint zárt közösségre – vonatkozó szigorú szabályok, valamint a személyi állomány támogatására és egészségének védelme érdekében hozott intézkedések

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

Mammalian Target of Rapamycin (mTOR) Activity Dependent Phospho-Protein Expression in Childhood Acute Lymphoblastic Leukemia (ALL)

Modern treatment strategies have improved the prognosis of childhood ALL; however, treatment still fails in 25–30% of patients. Further improvement of treatment may depend on the development of targeted therapies. mTOR kinase, a central mediator of several signaling pathways, has recently attracted remarkable attention as a potential target in pediatric ALL. However, limited data exists about the activity of mTOR. In the present study, the amount of mTOR activity dependent phospho-proteins was characterized by ELISA in human leukemia cell lines and in lymphoblasts from childhood ALL patients (n = 49). Expression was measured before and during chemotherapy and at relapses. Leukemia cell lines exhibited increased mTOR activity, indicated by phospho-S6 ribosomal protein (p-S6) and phosphorylated eukaryotic initiation factor 4E binding protein (p-4EBP1). Elevated p-4EBP1 protein levels were detected in ALL samples at diagnosis; efficacy of chemotherapy was followed by the decrease of mTOR activity dependent protein phosphorylation. Optical density (OD) for p-4EBP1 (ELISA) was significantly higher in patients with poor prognosis at diagnosis, and in the samples of relapsed patients. Our results suggest that measuring mTOR activity related phospho-proteins such as p-4EBP1 by ELISA may help to identify patients with poor prognosis before treatment, and to detect early relapses. Determining mTOR activity in leukemic cells may also be a useful tool for selecting patients who may benefit from future mTOR inhibitor treatments

Status Update and Interim Results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)

Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362. © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

Search for Physics beyond the Standard Model in Events with Overlapping Photons and Jets

Results are reported from a search for new particles that decay into a photon and two gluons, in events with jets. Novel jet substructure techniques are developed that allow photons to be identified in an environment densely populated with hadrons. The analyzed proton-proton collision data were collected by the CMS experiment at the LHC, in 2016 at root s = 13 TeV, and correspond to an integrated luminosity of 35.9 fb(-1). The spectra of total transverse hadronic energy of candidate events are examined for deviations from the standard model predictions. No statistically significant excess is observed over the expected background. The first cross section limits on new physics processes resulting in such events are set. The results are interpreted as upper limits on the rate of gluino pair production, utilizing a simplified stealth supersymmetry model. The excluded gluino masses extend up to 1.7 TeV, for a neutralino mass of 200 GeV and exceed previous mass constraints set by analyses targeting events with isolated photons.Peer reviewe

Calibration of the CMS hadron calorimeters using proton-proton collision data at root s=13 TeV

Methods are presented for calibrating the hadron calorimeter system of theCMSetector at the LHC. The hadron calorimeters of the CMS experiment are sampling calorimeters of brass and scintillator, and are in the form of one central detector and two endcaps. These calorimeters cover pseudorapidities vertical bar eta vertical bar ee data. The energy scale of the outer calorimeters has been determined with test beam data and is confirmed through data with high transverse momentum jets. In this paper, we present the details of the calibration methods and accuracy.Peer reviewe

Measurement of the Jet Mass Distribution and Top Quark Mass in Hadronic Decays of Boosted Top Quarks in pp Collisions at root s=13 TeV

A measurement is reported of the jet mass distribution in hadronic decays of boosted top quarks produced in pp collisions at root s = 13 TeV. The data were collected with the CMS detector at the LHC and correspond to an integrated luminosity of 35.9 fb(-1). The measurement is performed in the lepton + jets channel of t (t) over bar events, where the lepton is an electron or muon. The products of the hadronic top quark decay t -> bW -> bq (q) over bar' are reconstructed as a single jet with transverse momentum larger than 400 GeV. The t (t) over bar cross section as a function of the jet mass is unfolded at the particle level and used to extract a value of the top quark mass of 172.6 +/- 2.5 GeV. A novel jet reconstruction technique is used for the first time at the LHC, which improves the precision by a factor of 3 relative to an earlier measurement. This highlights the potential of measurements using boosted top quarks, where the new technique will enable future precision measurements.Peer reviewe

Search for top squark pair production in a final state with two tau leptons in proton-proton collisions at root s=13 TeV

A search for pair production of the supersymmetric partner of the top quark, the top squark, in proton-proton collision events at s = 13 TeV is presented in a final state containing hadronically decaying tau leptons and large missing transverse momentum. This final state is highly sensitive to high-tan beta or higgsino-like scenarios in which decays of electroweak gauginos to tau leptons are dominant. The search uses a data set corresponding to an integrated luminosity of 77.2 fb(-1), which was recorded with the CMS detector during 2016 and 2017. No significant excess is observed with respect to the background prediction. Exclusion limits at 95% confidence level are presented in the top squark and lightest neutralino mass plane within the framework of simplified models, in which top squark masses up to 1100 GeV are excluded for a nearly massless neutralino.Peer reviewe