RESUMO
BACKGROUND: In the Eurotransplant, 12.6% of kidney transplantations are a repeat procedure. Third transplants are significantly more complex than first and second ones. We compared the results of first (PRT) versus third (TRT) transplantations. METHODS: Between 2011 and 2016, we performed 779 deceased donor adult kidney transplantations, 14.2% out of them were second, 2.6% (20) third, and 0.3% fourth. We compared the pre-, intra-, and postoperative data, kidney function, and survival rate. RESULTS: Recipients of TRT were younger (53.4 vs. 47.3 p = 0.02). HCV infection rate (20%, p = 0.00) is ten times higher. The operation time is longer (132 vs. 152 min, p = 0.02), and delayed graft function is much more frequent (22.4% vs. 60%, p = 0.00). Induction therapy was given to every TRT (7.9% vs.100%), but as a result, the rejection rate was the same (~ 15%). Hospital stay is a week longer. Patient's survival at 1, 3, and 5 years for PRT is 96.4%, 93.9%, and 91.2% and for TRT is 90%, 85%, and 78.4%, respectively (p = 0.023). TRT's odds ratio of fatal outcome is 4.35 (1.5-12.5). Graft survival at 1, 3, and 5 years for PRT is 93.1%, 91.4%, and 90.3% and for TRT is 75%, 75%, and 75%, respectively (p = 0.020). TRT's odds ratio of graft loss is 3.14 (1.1-8.9). Of PRT 85.76%, out of PRT 85.76%, while out of TRT 60% live with a functioning graft, p=0.00149. CONCLUSION: In a third transplant, both graft and patient survival are significantly inferior to primer ones. Careful selection is required to minimize the patient risk and graft loss.
Assuntos
Transplante de Rim , Adulto , Rejeição de Enxerto/epidemiologia , Sobrevivência de Enxerto , Humanos , Rim , Transplante de Rim/efeitos adversos , Pontuação de Propensão , Taxa de Sobrevida , Doadores de TecidosRESUMO
The purpose of this 30-day feeding study was to elucidate the changes, correlations, and mechanisms caused by the replacement of the starch content of the AIN-93G diet (St) with glucose (G), fructose (F) or lard (L) in body and organ weights, metabolic changes and caecal microbiota composition in rats (Wistar, SPF). The body weight gain of rats on the F diet was 12% less (P = 0.12) than in the St group. Rats on the L diet consumed 18.6% less feed, 31% more energy and gained 58.4% more than the animals on the St diet, indicating that, in addition to higher energy intake, better feed utilisation is a key factor in the obesogenic effect of diets of high nutrient and energy density. The G, F and L diets significantly increased the lipid content of the liver (St: 7.01 ± 1.48; G: 14.53 ± 8.77; F: 16.73 ± 8.77; L: 19.86 ± 4.92% of DM), suggesting that lipid accumulation in the liver is not a fructose-specific process. Relative to the St control, specific glucose effects were the decreasing serum glucagon (-41%) concentrations and glucagon/leptin ratio and the increasing serum leptin concentrations (+26%); specific fructose effects were the increased weights of the kidney, spleen, epididymal fat and the decreased weight of retroperitoneal fat and the lower immune response, as well as the increased insulin (+26%), glucagon (+26%) and decreased leptin (-25%) levels. This suggests a mild insulin resistance and catabolic metabolism in F rats. Specific lard effects were the decreased insulin (-9.14%) and increased glucagon (+40.44%) and leptin (+44.92%) levels. Relative to St, all diets increased the operational taxonomic units of the phylum Bacteroidetes. G and L decreased, while F increased the proportion of Firmicutes. F and L diets decreased the proportions of Actinobacteria, Proteobacteria and Verrucomicrobia. Correlation and centrality analyses were conducted to ascertain the positive and negative correlations and relative weights of the 32 parameters studied in the metabolic network. These correlations and the underlying potential mechanisms are discussed.
Assuntos
Frutose , Microbioma Gastrointestinal , Animais , Glicemia , Glucose , Insulina , Redes e Vias Metabólicas , Ratos , Ratos WistarRESUMO
The objective of this study was to investigate the effects of fulvic acid (FA) and humic acid (HA), the two main compounds of humic substances (HSs), on copper (Cu) and zinc (Zn) homeostasis. Seventy-two male Wistar rats were randomly divided into nine experimental groups. The control diet (AIN-93G formula) and the diets supplemented with 0.1%, 0.2%, 0.4% and 0.8% FA or HA were fed for 26 days. Cu and Zn concentrations of the large intestinal content (LIC), liver, kidney, femur and hair were determined. FA and HA did not influence significantly the Cu or Zn contents of the experimental diets, the rats' feed intake, weight gain and the feed to gain ratio. Both FA and HA decreased the Cu concentrations of the LIC significantly and in a dose-related manner; however the absorption-stimulating effect of HA was more pronounced. FA increased the Cu content of the liver, but neither FA nor HA had a dose-dependent effect on it. FA or HA supplementations had no significant effect on the Cu concentration of the kidney. At the concentrations used, dietary FA or HA supplementations are not promising growth promoters. FA influences the Cu homeostasis unlike HA, because FA not only stimulates Cu absorption, but the extra quantity of absorbed Cu is retained in the organism. The stimulatory effect of HA on Zn absorption may not be manifested in Cu and Zn homeostasis, because of the tight connection of these microelements to FA and HA, which prevents the transmission of Zn from the ZnHA complex to the organs. As regards the effect of FA and HA on Cu and Zn homeostasis, both FA and HA stimulated the absorption of these microelements, but only FA increased the retention of Cu (in the liver) and Zn (in the kidney).
Assuntos
Benzopiranos/farmacologia , Cobre/metabolismo , Homeostase/efeitos dos fármacos , Substâncias Húmicas , Zinco/metabolismo , Animais , Transporte Biológico , Osso e Ossos/química , Cobre/química , Relação Dose-Resposta a Droga , Conteúdo Gastrointestinal/química , Cabelo/química , Homeostase/fisiologia , Absorção Intestinal/efeitos dos fármacos , Intestino Grosso/química , Rim/química , Fígado/química , Masculino , Ratos , Organismos Livres de Patógenos Específicos , Zinco/químicaRESUMO
The deficit of mentalisation skills is a well-known phenomenon in schizophrenia. In our study, patients with schizophrenia underwent an 8-session training. The procedure was based on bibliotherapy, and we associated each basic emotion identified by Ekman with a short story that gave a striking description of that emotion. After we read the stories together, the participants were given a collection of face portrait photos and they were asked to pick the one that illustrated the emotional state of the characters. They were also asked to recall a personal memory when they felt the same way. We used the 'Reading the Mind in the Eyes' (RMET) test to assess the efficiency of our method. The one-sample t-test we performed to compare the pre- and post-training values detected a significant difference (p=0.000608<0.05). The control group of patients with schizophrenia who did not undergo the training presented no significant difference between the two RMET tests performed 2 weeks apart (p=0.467). However, the two-sample t-test performed on the individual changes in RMET results in the study and control groups did detect a significant difference (p=0.000786<0.005). Our results suggest that the mentalisation deficit of people suffering from schizophrenia can be decreased, therefore their communicative and adaptive skills can be developed or at least the deterioration of these skills can be slowed down.
Assuntos
Biblioterapia , Emoções , Esquizofrenia , Psicologia do Esquizofrênico , Expressão Facial , Humanos , Individualidade , Esquizofrenia/terapiaRESUMO
The first lung transplantation in Hungary was performed on 12th of December, 2015. It was a joint effort of the National Institute of Oncology and the Semmelweis University. Hereby we summarise the results and experiences from the first three years. Until August, 2018, 55 lung transplantations were performed in Hungary. This was a retrospective analysis. All patients were listed according to the recommendation of the Lung Transplantation Committee. All implanted lungs have been procured from brain dead donors. Postoperative treatment and rehabilitation of the patients were continued at the Semmelweis University. Between 12. 12. 2015 and 31. 07. 2018, our team performed 76 organ retrievals: out of 45 Hungarian offers, 23 came from Eurotransplant countries and 8 outside of the Eurotransplant region. From these donations, 54 double and 1 single side transplantations were successfully performed. The surgical approach was single side thoracotomy (n = 1), bilateral thoracotomy (n = 1) and in the majority of the cases clamshell incision (n = 53). For the intraoperative veno-arterial extracorporeal membrane oxygenation support was used. The extracorporeal membrane oxygenation support had to be prolonged in 3 patients into the early postoperative period, two other recipients were bridged to transplant with extracorporeal membrane oxygenation. In the same time period, one combined lung-kidney transplantation was also performed. The distribution of recipients according to the underlying disease was: chronic obstructive pulmonary disease (n = 28); idiopathic pulmonary fibrosis (n = 8); cystic fibrosis (n = 12); primary pulmonary hypertension (n = 2); hystiocytosis-X (n = 1); bronchiectasis (n = 2); lymphangioleiomyomatosis (n = 1); and re-transplantation following bronchiolitis obliterans syndrome (n = 1), respectively. The mean age of recipients was 47.5 ± 15.18 years. The youngest recipient was 13 years old. We unfortunately lost 12 patients on our waiting list. The mean intensive care unit stay was 24.6 ± 18.18 days. Two patients were lost in the early postoperative phase. Tracheostomy was necessary in 13 cases due to the need of prolonged ventilation. 1-year survival of the recipients was 82.96% (until 31. 07. 2018). When looking at the first three years of the program, the case numbers elevated quickly throughout the years which is rather unique when compared to other centres in their starting period. Perioperative mortality and morbidity is comparable with high-volume lung transplantation centres. In the future we would like to increase the number of patients on the waiting list, thus increasing the total number of transplantations performed, and we are also planning to implement the use of the ex vivo lung perfusion system (EVLP) in our program. Orv Hetil. 2018; 159(46): 1859-1868.
Assuntos
Transplante de Pulmão/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Feminino , Humanos , Hipertensão Pulmonar/cirurgia , Masculino , Doença Pulmonar Obstrutiva Crônica/cirurgia , Taxa de SobrevidaRESUMO
The objective of this study was to investigate the effects of fulvic acid (FA) and humic acid (HA) as the two main compounds of humic substances, separately on Fe and Mn homeostasis. Seventy-two male Wistar rats were randomly divided into 9 experimental groups. The control diet (AIN-93G formula) and diets supplemented with 0.1%, 0.2%, 0.4% and 0.8% HA or FA were fed for 26 days. Fe and Mn concentrations of the large intestinal content, liver, kidney, femur and hair were determined. No significant differences were observed in the production parameters. The effects of FA and HA on iron homeostasis were significantly different. FA proved to be a good iron source, and slightly increased the iron content of liver and kidney, but - up to a dietary iron level of 52.7 mg/kg - it did not influence the efficiency of iron absorption. Above a dietary iron level of 52.7 mg/kg down-regulation of Fe absorption can be assumed. HA significantly stimulated the iron uptake and there was no down-regulation of Fe absorption up to 0.8% dietary HA supplementation level (61.5 mg Fe/kg diet). In the HA groups the iron content of the liver and kidney decreased significantly, suggesting that in spite of the better Fe absorption, the HA-Fe complex does not provide iron to the investigated organs. Neither FA nor HA supplementation influenced the Fe content of the femur and hair and slightly decreased the Mn concentration in the large intestinal content. This effect was significant (with a 22.7% Mn concentration decrease) only at the HA supplementation rate of 0.8%. Neither FA nor HA influenced significantly the Mn concentrations of the liver, kidney and femur. The Mn concentration of the hair in rats receiving FA- or HA-supplemented diets was higher than in the control rats; however, this result needs further confirmation.
Assuntos
Benzopiranos/farmacologia , Homeostase/efeitos dos fármacos , Substâncias Húmicas , Ferro/metabolismo , Manganês/metabolismo , Ração Animal/análise , Animais , Osso e Ossos/química , Dieta/veterinária , Conteúdo Gastrointestinal/química , Cabelo/química , Intestino Grosso/química , Ferro/química , Rim/química , Fígado/química , Masculino , Manganês/química , Distribuição Aleatória , Ratos , OligoelementosRESUMO
This study is part of the monograph entitled Scientific Elites and Politics (1945-1948) to be published soon. The relationships of political parties with several elite groups, such as groups of agronomic, human, economic, legal, technical and natural sciences, as well as the roles of these elites in scientific life, have been looked into and published in renowned periodicals. Using new sources, different specialist groups' and political powers' suggestions of reshaping medical education in 1947 and 1948, are presented. The medical elite's situation at universities and the Hungarian Academy of Sciences is also outlined. The study renders an account of the entire post-war medical elite. It will be stated who and based on what scientific achievement became member of the Hungarian Academy of Sciences, who was appointed to professor and who became a habilitated doctor. This study, which is a desideratum of research, may not only interest researchers but is aimed at a broader readership, including physicians. Orv. Hetil., 2017, 158(11), 432-437.
Assuntos
Academias e Institutos/história , Educação Médica/história , Medicina Interna/história , Inovação Organizacional , História do Século XX , Humanos , Hungria , Cultura OrganizacionalRESUMO
Although several authors have suggested that the labile fraction of soils could be a potential soil quality indicator, the possibilities and limitations of using the dissolved organic matter (DOM) fraction for this purpose have not yet been investigated. The objective of this study was to evaluate the hypothesis that DOM is an adequate indicator of soil quality. To test this, the soil quality indices (SQI) of 190 arable soils from a Hungarian dataset were estimated, and these values were compared to DOM parameters (DOC and SUVA254). A clear difference in soil quality was found between the soil types, with low soil quality for arenosols (average SQI 0.5) and significantly higher values for gleysols, vertisols, regosols, solonetzes and chernozems. The SQI-DOC relationship could be described by non-linear regression, while a linear connection was observed between SQI and SUVA. The regression equations obtained for the dataset showed only one relatively weak significant correlation between the variables, for DOC (R (2) = 0.157(***); n = 190), while non-significant relationships were found for the DOC and SUVA254 values. However, an envelope curve operated with the datasets showed the robust potential of DOC to indicate soil quality changes, with a high R (2) value for the envelope curve regression equation. The limitations to using the DOM fraction of soils as a quality indicator are due to the contradictory processes which take place in soils in many cases.
Assuntos
Compostos Orgânicos/análise , Solo/química , Agricultura , Hungria , Análise de RegressãoRESUMO
The objective of this study was designed to test whether supplementation of the diet with arginine (Arg) or glutamine (Gln) or their combination influences the production, organ weights and humoral immune response of broilers. A total of 432 one-day-old male Ross 308 broiler chickens were divided into 6 treatment groups: control, Arg-0.5%, Arg-1%, Gln-0.5%, Gln-1% and Arg-0.5%+Gln-0.5%. Drinking water and feed were provided ad libitum. On day 18 of the experiment 50% of chickens in each treatment group were immunised with bovine serum albumin. Ten and 21 days after immunisation blood samples were collected to determine the anti-albumin IgY titre, interleukin 6 (IL6) and interferon gamma (IFNG) and to measure the weight of the liver, spleen, bursa of Fabricius and thymus. Arg or Gln supplementation of the diets influenced neither the production nor the organ weights until 18 days of age. Between 18 and 39 days of age both Arg (0.5% and 1%) and Arg + Gln supplementation improved the feed conversion ratio (FCR) by 3.7%, 6.3% and 4.9%, respectively, while Gln-1% worsened it by 15%. Immunisation slightly (-0.79%) depressed the body weight gain of broilers fed the control diet, which was significantly improved by both Arg (0.5 or 1%) and Arg + Gln supplementation. Immunisation increased the weight of the spleen, bursa and thymus and decreased that of the liver. Supplementation with 1% Gln depressed (-5.13%) the body weight gain of the immunised chickens but strongly stimulated the immune response. Supplementations with Arg and Gln did not influence the IL6 and IFNG level of the blood; however, on day 10 after immunisation these two parameters showed a negative correlation with each other. Regarding production, organ weights and immunity, Arg supplementation should be recommended in the grower phase, while Gln supplementation can be useful in pullets raised for egg production, where a good immune response to vaccinations is an important factor.
RESUMO
This paper presents the principles and application of DNA based biological UV dosimeters, as developed by Research Group for Biophysics (RGB). These dosimeters are used for assessing the biological hazard of living systems on the Earth's surface and in different waters (rivers, lakes, seas, etc.). The UV dosimetry system has also been used in the space. In dosimeters a bacterial virus, bacteriophage T7 and polycrystalline uracil thin layers have been used as biological detectors. On the Earth's surface the UV radiation induces dimer formation in phage T7 and in the uracil detector, which was evaluated by loss of viability of the phage particles and by the decrease of the characteristic optical density (OD) of uracil thin layers. Recently the development of human space activities has also increased the need to measure the biological effect of extraterrestrial solar radiation, too. The evaluation of the space samples occurred on ground, thus only the starting and the final state were taken into account. A new improved, automated method is presented below which makes data collection more efficient and also makes the dynamics of the process observable.
Assuntos
Meio Ambiente Extraterreno , Bacteriófago T7/genética , Raios UltravioletaRESUMO
BACKGROUND: Fibromuscular dysplasia (FMD), a relatively frequent arterial deformity with an estimated prevalence of 2% to 6% has been sporadically reported during deceased donor kidney donations. Only 8 case reports are available in the previous literature. CASE PRESENTATION: In our work, implantation of 2 kidneys from the same deceased donor with macroscopically evident and later histologically confirmed FMD are presented, one of which ended up as acute arterial complication. Renal arteries were cut short to allow safe implantation, but arterial dissection and thrombosis led to graft loss in the early perioperative period in the latter case. CONCLUSIONS: Although resection of the arterial segments affected by FMD as a routine may allow implantation, macroscopically healthy-looking arteries might still be affected and thus carry elevated postoperative risk. The aim of our case report is to make proposal for an onsite diagnosis of FMD in case of clinical suspicion.
Assuntos
Dissecção Aórtica , Dissecção de Vasos Sanguíneos , Displasia Fibromuscular , Transplante de Rim , Trombose , Humanos , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/etiologia , Displasia Fibromuscular/complicações , Displasia Fibromuscular/diagnóstico , Transplante de Rim/efeitos adversos , Artéria Renal/patologia , Trombose/etiologia , Trombose/complicaçõesRESUMO
To provide a cost-efficient parentage testing kit for red deer (Cervus elaphus), a 63 SNP set has been developed from a high-density Illumina BovineHD BeadChip containing 777â¯962 SNPs after filtering of genotypes of 50 stags. The successful genotyping rate was 38.6â¯% on the chip. The ratio of polymorphic loci among effectively genotyped loci was 6.5â¯%. The selected 63 SNPs have been applied to 960 animals to perform parentage control. Thirty SNPs out of the 63 had worked on the OpenArray platform. Their combined value of the probability of identity and exclusion probability was 4.9 × 10 - 11 and 0.99803, respectively. A search for loci linked with antler quality was also performed on the genotypes of the above-mentioned stags. Association studies revealed 14 SNPs associated with antler quality, where low-quality antlers with short and thin main beam antlers had values from 1 to 2, while high-quality antlers with long and strong main beams had values between 4 and 5. The chance for a stag to be correctly identified as having high-value antlers is expected to be over 88â¯%.
RESUMO
BACKGROUND: Hepatocellular carcinoma (HCC) is the leading primary liver tumor and a main indication for transplant. Transplant criteria are based on clinicopathologic features, meanwhile adequate downstaging and molecular mechanisms are getting more attention in evolving therapeutic algorithm of HCC. The aim of our study was to overview the results of the Hungarian Liver Transplant Program in the field of HCC and introduce new aspects of personalized treatment options. METHODS: We performed retrospective analysis of survival and tumor recurrence of HCC-associated liver transplant recipients between October 2013 and December 2020. Patients were categorized in Milan criteria (MC), beyond MC but within University of California, San Francisco (UCSF), and beyond UCSF criteria groups after pathologic examination of the explanted liver. Demographic data and preoperative locoregional treatments were assessed. RESULTS: A total of 529 primer liver transplants were performed, 88 because of HCC. A total of 87 patients had underlying cirrhosis because of hepatitis C (54%), alcohol-related liver disease (33.7%), hepatitis B (4.5%), or unknown etiology. A total of 55.6% of the patients had at least one locoregional treatment. A total of 67.4% of the patients were within MC, 5.6% were within UCSF criteria, and 27% were beyond UCSF criteria. The 1-, 3-, and 5-year survival rates were 80%, 79%, and 75%. The outcome was better in early-stage tumors, but the difference was not significant (P = .745) CONCLUSIONS: The favorable survival in our department legitimates the strict transplant criteria of HCC. Adequate locoregional therapy as downstaging can expand recipient pool. Molecular tumor profiling may lead to personalized treatment of HCC.
Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Transplante de Fígado , Humanos , Carcinoma Hepatocelular/cirurgia , Transplante de Fígado/efeitos adversos , Neoplasias Hepáticas/cirurgia , Estudos Retrospectivos , Recidiva Local de Neoplasia/etiologia , Resultado do Tratamento , Seleção de Pacientes , Taxa de SobrevidaRESUMO
Összefoglaló. Bevezetés: A májtranszplantációs program részeként 1995 óta létezik folyamatosan vezetett várólista Magyarországon. Célkituzés: A legfontosabb várólista-paraméterek megállapítása és nemzetközi összehasonlítása. Módszer: A szerzok az 1995. január 1. és 2019. december 31. között elso májátültetés céljából várólistára helyezett betegek adatait elemezték. Eredmények: Összesen 1722 beteget helyeztek várólistára, 1608 felnottet, 114 gyermeket. A férfiak aránya 51,2%, az átlagéletkor 45,6 év. Az évente regisztrált új jelöltek száma 25 év során közel az ötszörösére emelkedett. A listára helyezés leggyakoribb indikációja a víruseredetu cirrhosis volt (n = 451). Ezt követte a cholestaticus (n = 314) és az alkoholos májbetegség (n = 264). Rosszindulatú daganat, 82%-ban hepatocellularis carcinoma miatt 215 beteget regisztráltak. Krónikus betegségekben az átlagos Model for End-Stage Liver Disease pontszám a regisztráláskor 13,5 volt. A 2018. december 31-ig listára helyezettek (n = 1618) 61%-a részesült májátültetésben, 24%-a várakozás közben meghalt, 7%-a a mutétre alkalmatlanná vált. A mutét elotti medián várakozási ido 248 nap volt a krónikus és 2 nap az akut betegek listáján. A transzplantált tumoros betegek (n = 132) szignifikánsan rövidebb ideig vártak mutétre (medián 115,5 nap), mint a többi krónikus beteg (n = 803, medián 282 nap). Az Eurotransplanthoz való csatlakozás utáni idoszakban (2013. július 1. és 2018. december 31. között) a transzplantációs arány növekedett (67%), a várólista-halálozás (meghaltak + mutétre alkalmatlanná váltak) 24%-ra csökkent. Megbeszélés: A várólista folyamatos bovülése hozzájárult a hazai májátültetési program fejlodéséhez. A hazai várólista diagnózis szerinti összetétele a mások által közöltekkel nagyrészt egyezik. A transzplantáltak aránya a nemzetközi átlagnak megfelelo. A várólista-halálozás és a mutét elotti várakozási ido a magyarországinál alacsonyabb donációs aktivitású vagy jelentosen nagyobb várólistával rendelkezo országokéhoz hasonló. Következtetés: Várólista-paramétereink javításához a transzplantációk számának további növelése szükséges. Orv Hetil. 2022; 163(8): 301-311. INTRODUCTION: The Hungarian liver transplant program including waiting list started in 1995. OBJECTIVE: Evaluation of the wait-list parameters and comparing them with those in the literature. METHOD: Data of patients listed for primary liver transplantation between 1995 and 2019 were analyzed. RESULTS: A total of 1722 recipient candidates were registered on the liver transplant waiting list: 1608 adults (51.2% men) with mean age of 45.6 year and 114 patients aged <18 year. Virus-induced cirrhosis was the leading indication of listing (n = 451) and cholestatic liver diseases (n = 314) and alcoholic cirrhosis (n = 264) thereafter. The mean Model for End-Stage Liver Disease score was 13.5 for those with chronic disease. 61% of 1618 patients listed before December 31, 2018 underwent liver transplantation and 31% were removed from the wait-list for death or clinical deterioration. After joining Eurotransplant (period of 01. 07. 2013-31. 12. 2018), the transplant rate was 67%, the waiting list removal due to death/too sick for operation decreased to 24%. The median waiting time till transplantation was 248 days for those on elective and 2 days on acute list. Patients grafted with malignancy (n = 132) waited significantly shorter time than those with chronic non-malignant liver disease (median 115.5 versus 282 days). DISCUSSION: The composition of our waiting list by primary liver disease was similar to that of countries with large burden of hepatitis C. Transplant rate was average, wait-list mortality and waiting time were in line with those observed in low-donation countries or in the case of large volume waiting list. CONCLUSION: Listing of increasing the number of patients contributed to evolution of our liver transplant program. To improve our parameters, increasing transplant activity is warranted. Orv Hetil. 2022; 163(8): 301-311.
Assuntos
Doença Hepática Terminal , Transplante de Fígado , Adulto , Idoso , Feminino , Humanos , Hungria , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Listas de EsperaRESUMO
The aim of this study was to assess the age-related effects of dietary electrolyte balance (DEB) on the performance, immune response (from day 0 to 42) and macromineral content of femur ash of broilers. The DEB values of the purchased commercial broiler diets were modified with the addition of NH4Cl or NaHCO3 to formulate the diets (DEB 325, 250, 175, 100, 25 and -50 mmol/kg) for this investigation. A total of 396 chickens were divided into 6 treatment groups and fed with the experimental diets for 6 weeks. During the first two weeks of life, DEB did not influence feed intake and body weight gain; however, by the 21st day of age DEB 175 and between 22 and 42 days of age DEB 250 mmol/kg gave significantly better results than the control. DEB did not affect the macromineral concentrations of bone ash. The immune response of broilers on low DEB (< 175 mmol/kg) was faster and more intensive than that of chickens on diets with medium or high DEB (> 175 mmol/kg). It can be concluded that the optimal DEB value required for the best body weight gain is significantly influenced by the age of broilers. Our results call attention to the discrepancy between the decreasing DEB level of commercial broiler diets and the age-related increase of 'electrolyte requirements' of broilers. It is also interesting that DEB may influence not only the performance but also the immune response of broilers.
Assuntos
Densidade Óssea/efeitos dos fármacos , Galinhas , Dieta/veterinária , Eletrólitos/farmacologia , Aumento de Peso/efeitos dos fármacos , Envelhecimento , Cloreto de Amônio/administração & dosagem , Cloreto de Amônio/farmacologia , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Relação Dose-Resposta a Droga , Eletrólitos/administração & dosagem , Masculino , Bicarbonato de Sódio/administração & dosagem , Bicarbonato de Sódio/farmacologiaRESUMO
Introduction: We would like to present the case of a young patient with acute stress disorder and recurrent nightmares following the psychological trauma caused by a severe road traffic accident. The comprehensive therapy carried out at the Department of Traumatology included medication, trauma processing and a psychological method whose aim is to cease the development of nightmares. Case Presentation: Psychiatric assessment and treatment was asked for a polytraumatised female patient at the Intensive Care Unit after she had undergone a neurosurgical intervention. Her medicinal treatment was continued at the Department of Traumatology. Besides the antidepressant venlafaxine she was treated in accordance with the EMDR protocol for acute stress disorder, and we also applied imagery rescripting to prevent her from having recurrent (daily) nightmares. As a result of the therapy, her symptoms were fast relieved, the nightmares stopped almost instantly, her mood improved, rumination and anxiety decreased significantly. Conclusions: In view of the fast and significant symptomatic improvement, we can expect that the EMDR therapy and its protocol for acute stress disorder have successfully reactivated information processing, and besides the subjective relief we have managed to prevent a mental crisis that could lead to a suicide risk as well as the development of post-traumatic stress disorder. We also hope that the improvement will be long-lasting.
RESUMO
Little data have been published on specific health indicators for Roma, especially on substance use and related problems, and to our knowledge no data are available for Roma adolescents. The objective was to assess substance use of Roma as compared with non-Roma adolescents. Prevalence of tobacco and illicit drug use, and alcohol intoxication were examined in 225 Roma and 182 non-Roma adolescents. Relationship between substance use and potential risk factors, and ethnicity, was investigated by logistic regression analyses. A matched sample of Roma and non-Roma subjects was also used for additional confirmatory conditional regression analyses. Results indicated a significant association between Roma ethnicity and higher lifetime prevalence of tobacco use, alcohol intoxication, and illicit drugs use. Roma girls as compared with non-Roma girls evidenced a disproportionately higher prevalence of smoking as compared with the difference between Roma and non-Roma boys. Chi square analyses showed for both Roma parents a higher level of tolerant attitude to smoking. The inequalities of the health status in substance use behaviors of the Roma versus non-Roma population, expressed in a more pronounced way in the female Roma population, emerge at an early age, based on our data; they are observable already in the early adolescent and adolescent age groups.
Assuntos
Roma (Grupo Étnico)/psicologia , Roma (Grupo Étnico)/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Comportamento do Adolescente/psicologia , Fatores Etários , Idade de Início , Intoxicação Alcoólica/epidemiologia , Intoxicação Alcoólica/psicologia , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Hungria/epidemiologia , Masculino , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , Prevalência , Fatores de Risco , Fatores Sexuais , Fumar/epidemiologia , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Introduction: The past decade has seen some major changes in the diagnostics of prostate cancer. Progress in MR imaging has allowed us to better visualise prostate cancer and thus perform targeted biopsies of tumour suspect lesions. mpMRI-ultrasound fusion-guided prostate biopsy is a precise and cost-effective method to diagnose prostate cancer. Objective: The purpose of this study was to summarise our results in mpMRI-ultrasound fusion biopsy between 2017 and 2019 and compare them with the findings in the current literature. Method: Between 2017 and 2019, fully 40, mpMRI-ultrasound fusion biopsies were performed transperineally using the BioJet fusion system at Semmelweis University Urology Clinic. The MRI evaluations were done in line with the PI-RADS v2 guidelines. It was analysed whether the PI-RADS score, the location of the tumour, lesion size, the signs of extraprostatic extension, PSA/PSAD density and prostate volume have an influence on the outcome of mpMRI-ultrasound fusion biopsy. Results: Prostate cancer was diagnosed in 80% of the cases during targeted biopsies. The detection rate was 91%, 85%, and 20% for PI-RADS 5, 4 and 3 lesions, respectively. The detection rate was significantly higher for lesions located at the peripheral zone compared to the ones in the transitional zone (khi2(1) = 6.555, p = 0.010, Fisher-exact p = 0.017, V = 0.355). Signs of extraprostatic extension and higher PSAD correlated with better detection rate (khi2(1)= 7.704, p = 0.006, Fisher-exact p = 0.004, V = 0.355; and 0.47 ± 0.50 ng/ml2 vs. 0.18 ± 0.17 ng/ml2; Z = 3.447, p<0.001, respectively). The size of the lesions did not influence the outcome. The analysis showed a significant correlation between large prostate volumes and negative biopsies (50.9 ± 18.8 ml vs. 119.6 ± 91.6 ml; Z= 3.505, p<0.001). Conclusions: The detection rate of prostate cancer with targeted biopsies was higher than the data found in the international literature. The PI-RADS score, the location of the tumour, MRI signs of extraprostatic extension, PSAD and prostate volume had an influence on the detection rate. Our findings may promote a better selection of the best candidates for targeted biopsies in the future.