Protein Expression of immune checkpoints STING and MHCII in small cell lung cancer.

BACKGROUND: SCLC is an aggressive malignancy where immunotherapies show limited efficacy. We aimed to characterize the SCLC microenvironment according to the expression patterns of SCLC subtype markers and novel immune checkpoints to identify therapeutic vulnerabilities. METHODS: We included SCLC tissue samples from 219 surgically resected, limited-stage patients in this cross-sectional study. We performed immunohistochemistry for STING and MHCII, as well as for the novel subtype markers (ASCL1, NEUROD1, POU2F3, YAP1). Moreover, we assessed CD45 + , CD8 + and CD68 + immune cell infiltration. RESULTS: 36% of SCLC tumors showed significant stromal or intraepithelial CD45 + immune cell infiltration. These patients exhibited significantly increased overall survival (OS) (vs. patients with immune-deserted tumors). High CD8 expression was associated with increased median OS. We found STING expression on cancer-associated fibroblasts in the stroma and on T-cells and macrophages in both tumorous and stromal compartments. STING expression positively correlated with immune cell infiltration. Increased STING-positivity in tumor nests was an independent favorable prognosticator for OS. ASCL1 was the most frequently expressed subtype-specific protein. Concomitant expression of three or four subtype-defining markers was seen in 13.8% of the included samples, whereas 24.1% of the cases were classified as quadruple negative tumors. YAP1 expression was associated with increased immune infiltrates. Tumor cell MHCII expression positively correlated with immune cell infiltration and with STING- and YAP1 expressions. CONCLUSIONS: STING and MHCII are expressed in SCLC. The majority of immune-infiltrated SCLCs exhibit increased STING expression. Immune infiltration and STING expression are prognostic in limited-stage SCLC, making STING a potential therapeutic target.

Efficacy and volume stability of a customized allogeneic bone block for the reconstruction of advanced alveolar ridge deficiencies at the anterior maxillary region: a retrospective radiographic evaluation.

OBJECTIVES: The aim of this retrospective case series was to evaluate the efficacy and volume stability of a customized allogeneic bone block (CABB) for the hard tissue reconstruction of severely atrophied anterior maxillary ridges. MATERIALS AND METHODS: Hard tissue alterations between baseline (T1), 2-month follow-up (T2), and 6-month follow-up (T3) cone-beam computed tomography scans were evaluated with semi-automatic segmentation. Following automatic spatial alignment of the datasets, 3D subtraction analysis was performed. The volume stability of the inserted allogeneic bone block was determined on the basis of the ratio of the T3 and T2 hard tissue volumes. RESULTS: The newly formed hard tissue volume at T2 averaged at of 0.75 cm3 ± 0.57 cm3, whereas at T3, an average of 0.52 cm3 ± 0.42 cm3 volumetric hard tissue gain could be detected. The T3/T2 ratio was found to be 67.83% ± 18.72% on average. The dice similarity coefficient between the T2 and T3 hard tissue models averaged at 0.73 ± 0.15. CONCLUSIONS: Cancellous CABBs are a reliable option for the reconstruction of severely atrophied alveolar ridges. The resorption rates of these grafts are similar to those found in the literature; however, with precise manufacturing and proper intraoperative flap management, the resorption rates may be reduced. CLINICAL RELEVANCE: With precise knowledge of the resorption patterns, the shape of blocks can be altered in the future to compensate for the volumetric loss.

Genetic Control of GCF Exudation: Innate Immunity Genes and Periodontitis Susceptibility.

Chronic periodontitis is a bacterial infection associated with dentally adherent biofilm (plaque) accumulation and age-related comorbidities. The disease begins as an inflammatory exudate from gingival margins, gingival crevicular fluid (GCF) in response to biofilm lysine. After a week of experimental gingivitis (no oral hygiene), biofilm lysine concentration was linearly related to biofilm accumulation (plaque index) but to GCF as an arch-shaped double curve which separated 9 strong from 6 weak GCF responders (hosts). Host DNA was examined for single nucleotide polymorphisms (SNPs) of alleles reported in 7 periodontitis-associated genes. Across all 15 hosts, an adenine SNP (A) at IL1B-511 (rs16944), was significant for strong GCF (Fisher's exact test, p < 0.05), and a thymidine SNP (T) at IL1B+3954 (rs1143634) for weak GCF provided 2 hosts possessing IL6-1363(T), rs2069827, were included. The phenotype of IL1B+3954(T) was converted from weak to strong in one host, and of the non-T allele from strong to weak in the other (specific epistasis, Fisher's exact test, p < 0.01). Together with homozygous alternate or reference SNPs at IL10-1082 or CD14-260 in 4 hosts, all hosts were identified as strong or weak GCF responders. The GCF response is therefore a strong or weak genetic trait that indicates strong or weak innate immunity in EG and controllable or uncontrollable periodontal disease, dental implant survival and late-life comorbidities.

Antimicrobial efficacy of sodium hypochlorite and hyper-pure chlorine dioxide in the depth of dentin tubules in vitro.

OBJECTIVES: The study aimed to compare the antibacterial effect of a novel disinfectant, hyper-pure chlorine dioxide (hClO2) to sodium hypochlorite (NaOCl) in various depths of dentin tubules. MATERIALS AND METHODS: The distal root of the extracted lower molars was infected artificially with Enterococcus faecalis. The control group was rinsed with saline, and the test groups were irrigated with either 5% NaOCl or 0.12% hClO2. The longitudinally split teeth were stained by viability stain. The coronal third of the root was scanned with a confocal laser scanning microscope. The fluorescent intensities were measured, and the percentage of dead bacteria was calculated at depths up to 950 µm along the dentin tubules. The effect of penetration depth, irrigants, and their interaction on antimicrobial efficacy was determined by the linear mixed model. RESULTS: The percentage of dead bacteria was higher both in the NaOCl (45.1 ± 2.3%, p < 0.01) and in the hClO2 (44.6 ± 3.8%, p < 0.01) irrigant groups compared to saline (23 ± 4.5%); however, there was no difference between them. The percentage of killed bacteria was not correlated with the depths in any group (p = 0.633). CONCLUSIONS: Our results suggest that the functional penetration depth of NaOCl is at least 2-3 times more than published to date. There is no difference in disinfection effectiveness along the dentin tubules between NaOCl and hClO2 until at least the measured 950 µm. However, both were only able to eradicate the intratubular bacteria partially. CLINICAL RELEVANCE: Hyper-pure ClO2 could be used as an alternative or final adjuvant irrigant in endodontic treatment.

Level of advanced oxidation protein products is associated with subclinical atherosclerosis.

BACKGROUND: Oxidative stress is an important factor in the pathomechanism of atherosclerosis. Advanced oxidation protein products (AOPPs) are considered markers of oxidative stress. Thickening of the carotid intima-media layers indicates subclinical atherosclerosis and can be detected by carotid ultrasound. OBJECTIVE: Our aim was to examine the association between carotid intima-media thickness (CIMT) and the level of AOPPs. METHODS: Carotid duplex scans and measurements of AOPPs were performed on 476 participants of a cardiovascular population study. The presence of conventional cardiovascular risk factors was investigated with a questionnaire, physical examination, and laboratory tests. RESULTS: There was a positive correlation between maximum CIMT and the level of AOPPs only in the male population (r = 0.219, p = 0.033). Multivariate analysis has revealed that the association between AOPPs and mean or maximum CIMT was independent of cardiovascular risk factors (OR = 1.458, p = 0.004, and OR = 2.038, p < 0.001). CONCLUSIONS: Among males, the elevated level of AOPPs as a marker of oxidative stress may signal the existence of early atherosclerotic alterations.

Postural instability years after stroke.

BACKGROUND: Following a stroke, balance disturbances often persist despite full recovery of the paretic side. AIMS: The aims were to determine how long postural instability could be detected after stroke and the differences in post-stroke patients under and above 65 years of age. METHODS: Static and dynamic posturography (passing weights from hand to hand around the body) measurements were performed on 29 patients with stroke after 3 ± 2.4 years (≤65 years) and 4.7 ± 3.3 years. (> 65 years) compared with 38 controls. RESULTS: Only the pathway and the velocity assessed by dynamic posturography were significantly higher (p < 0.05) in the younger group of patients compared with the controls. The older group of patients had significantly elevated parameters measured by both static (p < 0.01) and dynamic posturography (p < 0.05). CONCLUSIONS: we conclude, using a sensitive and reproducible method to assess both static and dynamic adjustments to maintain balance, that postural instability is significantly greater in post-stroke patients than control subjects. This difference is demonstrable up to 4 years after stroke, despite full recovery of the affected side.

Effects of disinfection and sterilization on the dimensional changes and mechanical properties of 3D printed surgical guides for implant therapy - pilot study.

BACKGROUND: The purpose of this research was to investigate the effects of disinfection and three different sterilization methods on the dimensional changes and mechanical properties of three-dimensional (3D) printed surgical guide for implant therapy. The objective was to assess the effects of sterilization procedures in 3D printed drill guide templates with destructive and non-destructive material testing. METHODS: Fifteen identical drill guide templates were produced using a 3D printer. The surgical guides were classified into five groups: three controls, three disinfected (4% Gigasept®, 60 min), three plasma sterilized, three autoclave sterilized (+ 1 bar, 121 °C, 20 min), and three autoclave sterilized (+ 2 bar, 134 °C, 10 min). The templates were digitalized with a Steinbichler SCAN ST 3D scanner. Length was measured under an SZX16 stereomicroscope. A scanning electron microscope was used to study the surface morphology of the drill templates. The hardness, and flexural and compressive strength were measured to assess any changes in the physical characteristics of the material caused by sterilization. The drill guide templates were also examined with a Dage XiDAT 6600 X-ray. During the X-ray examinations, the following parameters were used: 100 kV voltage, 128 AVG averaging, 0.8 W power. One-way analysis of variance (ANOVA) was used to detect the difference between groups. RESULTS: Evaluation of the hardness measurements of the various specimens shows that the hardness of the material was not changed by the plasma sterilization (p = 0.0680), steam sterilization on 121 °C (p = 0.6033) or disinfection process (p = 0.1399). The statistical analysis revealed significant difference in hardness strength of the autoclave sterilized (134 °C) specimens (p = 0.0002). There was no significant difference between the goups regarding the scanning electron microscopic and stereomicroscopic examinations. There was no significant difference regarding the X-ray visibility of the templates to the effect of the disinfection (p = 0.7844), plasma sterilization (p = 0.4091) and steam sterilization on 121 °C (p = 0.9277) and steam sterilization on 131 °C (p = 0.093). The effect of the sterilization was the same in case of both flexural and compressive strength of the material. CONCLUSIONS: Our findings indicate that plasma sterilization and steam sterilization at 121 °C were both suitable for sterilizing the tested 3D printed surgical guides.

Functional characterization of collaterals in the human gingiva by laser speckle contrast imaging.

OBJECTIVE: The rate of blood flow between the various areas of the gingiva in resting position and under challenge is unknown. In this study, the LSCI method was used to map spatial and temporal changes in gingival blood flow after transient compression. METHODS: Horizontal, vertical, and papilla base compressions were applied on the attached gingiva in 21 healthy patients (13 women, 8 men). LSCI was used to determine dynamic changes in regional blood flow during a five-second occlusion interval and subsequent reperfusion for twenty minutes. RESULTS: Resting blood flow in the attached gingiva apical to the papillae was higher as compared to that in the midbuccal area of the teeth. During short-term horizontal compression, ischemia was greater coronal than apical to the occlusion line. Postocclusive hyperemia was observed not only in the regions affected by ischemia but encompassed a wider area. Hyperemic response was more pronounced and prolonged in male than in female patients. CONCLUSIONS: Blood flow in the attached gingiva shows spatial differences. Our findings corroborate the apicocoronal orientation of blood circulation. Periodontal and papillary collaterals may have little role in the blood supply of the adjacent attached gingiva under physiological conditions.

[Association between the 5-HTTLPR polymorphism of the serotonin transporter gene and suicide: a case-control pilot study]. / A szerotonin transzporter gén 5-HTTLPR polimorfizmusa és az öngyilkosság összefüggése: eset-kontroll elrendezésu pilot vizsgálat.

OBJECTIVES: Besides psychological and social effects, biological, biochemical and genetic factors also play a role in the background of suicide. The aim is developing a complex model incorporating all the above factors so that suicide could be predicted and prevented in those at risk. Based on several studies 5-HTTLPR s allele frequency is increased in case of violent completed suicides. The aim of the present study was to validate this association in a sample of completed suicides. METHODS: During autopsy sample DNA samples were obtained for 5-HTTLPR genotyping from 200 subjects deceased due to suicide and 200 controls deceased due to other causes. Chi square tests and logistic regressions were performed according to additive, dominant and recessive models to analyse the possible association between 5-HTTLPR genotype distribution and suicide. RESULTS: Ratio of violent and non-violent suicides was 81% and 19% respectively. No significant difference was found in the distribution of 5-HTTLPR genotypes between the suicide and controls samples. No difference was found between violent and nonviolent suicides with respect to genotype distribution. A significant association was found between sl genotype and suicide at a younger age. CONCLUSIONS: Our pilot study did not support the supposed association between 5-HTTLPR and completed suicides or with violent completed suicides. However we found a significant association between sl genotype and suicide in young suicidals.

[Characteristics of clinical trials in Hungary based on the analysis of an international database]. / Magyar klinikai vizsgálatok sajátosságai egy nemzetközi adatbázis elemzése alapján.

Intorduction: The ClinicalTrials.gov website, which is operated by the US government, collects data about clinical trials. AIM: We have processed data related to Hungary by downloading from the website as XML files. METHOD: Most of the data describe trials performed after 2000, so we got an overview about the clinical research of the last 10 to 15 years. As the majority of the data fields are collected as free text, significant data cleaning was needed. RESULTS: The database contained 2863 trials related to Hungary from 189 settlements. Only 20 per cent of the actual research organizations could have been identified as many times only an "id" number or a general name was given, thus this information was anonymised in many cases. CONCLUSION: Besides the analysis of the information obtained from this database, our study points out the relevant issues that may influence the international view of the Hungarian clinical research. Orv. Hetil., 2017, 158(9), 345-351.

Antioxidant effect of the active metabolites of tibolone.

Certain steroidal compounds have an antioxidant effect in humans. Our aim was to test whether the synthetic steroid tibolone and its metabolites are also able to display such a property. For this, granulocytes from healthy men and women were incubated for two hours with different concentrations (10(-7), 10(-8), 10(-9 )M) of either estradiol, tibolone, 3α-hydroxytibolone, 3ß-hydroxytibolone, Δ(4)-tibolone, 3α-sulfated-tibolone, 3α-17ß-disulfated-tibolone, 3ß-sulfated-tibolone or 3ß-17ß-disulfated-tibolone. Superoxide anion generation of neutrophils was measured by photometry. Results of different steroids were given as percentages of their controls. A more simple superoxide generating system, the xanthine-xanthine oxidase reaction was also tested. We found that granulocyte superoxide production did not differ from the control using 10(-9 )M of steroids. Using 10(-8 )M concentration: estradiol (80.9 ± 2.5%); 3ß-sulfated-tibolone (83.3 ± 4.7%); 3ß-17ß-disulfated-tibolone (81.0 ± 4.2%) caused a significant decrease in superoxide production, compared to the control. In addition at 10(-7 )M, 3ß-hydroxytibolone and 3α-sulfated-tibolone also showed antioxidant effects. In the xanthine-xanthine oxidase system estradiol (67.4 ± 1.0%), 3α-sulfated-tibolone (85.8 ± 5.3%), 3α-17ß-disulfated-tibolone (71.9 ± 2.5%), 3ß-sulfated-tibolone (73.9 ± 5.0%), and 3ß-17ß-disulfated-tibolone (65.8 ± 3.4%) caused a significant decrease in superoxide production. Conclusively, although tibolone itself did not show significant antioxidant capacity, most of its active metabolites have antioxidant effects.

[Big Data- challenges and risks]. / Big Data - kihívások és kockázatok.

The term "Big Data" is commonly used to describe the growing mass of information being created recently. New conclusions can be drawn and new services can be developed by the connection, processing and analysis of these information. This affects all aspects of life, including health and medicine. The authors review the application areas of Big Data, and present examples from health and other areas. However, there are several preconditions of the effective use of the opportunities: proper infrastructure, well defined regulatory environment with particular emphasis on data protection and privacy. These issues and the current actions for solution are also presented.

The effect of indomethacin, myeloperoxidase, and certain steroid hormones on bactericidal activity: an ex vivo and in vivo experimental study.

BACKGROUND: The role of myeloperoxidase (MPO) is essential in the killing of phagocytosed bacteria. Certain steroid hormones increase MPO plasma concentration. Our aim was to test the effect of MPO, its inhibitor indomethacin, and certain steroid hormones on bactericidal activity. METHODS: Human polymorphonuclear leukocytes (PMN) were incubated with opsonised Escherichia coli and either MPO, indomethacin, estradiol, or hydrocortisone. Intracellular killing capacity was evaluated with UV microscopy after treatment with fluorescent dye. Next, an in vivo experiment was performed with nine groups of rats: in the first phase of the study indomethacin treatment and Pasteurella multocida infection (Ii), indomethacin treatment without infection (I0), untreated control with infection (Mi) and untreated control without infection (M0); in the second phase of the study rats with infection and testosterone treatment (NT), castration, infection and testosterone treatment (CT), castration, infection and estradiol treatment (CE), non-castrated infected control (N0), and castrated infected control (C0). After treatment bacteria were reisolated from the liver and heart blood on agar plates, and laboratory parameters were analyzed. For the comparison of laboratory results ANOVA or Kruskal-Wallis test and LSD post hoc test was used. RESULTS: Indomethacin did not have a remarkable effect on the bacterial killing of PMNs, while the other compounds increased bacterial killing to various degrees. In the animal model indomethacin and infection caused a poor clinical state, a great number of reisolated bacteria, elevated white blood cell (WBC) count, decreased C-reactive protein (CRP) and serum albumin levels. Testosterone treatment resulted in less bacterial colony numbers in group NT, but not in group CT compared to respective controls (N0, C0). Estradiol treatment (CE) decreased colony numbers compared to control (C0). Hormone administration resulted in lower WBC counts, and in group CE, a decreased CRP. CONCLUSIONS: MPO, estradiol, and hydrocortisone improve bacterial killing activity of PMNs. Indomethacin treatment and castration weaken immune responses and clinical state of infected rats, while testosterone and estradiol have a beneficial effect.

Incidence and Mortality of Uveal Melanoma in Hungary: A Nationwide Study.

Uveal melanoma (UM) is the most common primary malignant ocular tumour in adults, although its epidemiology in Central and Eastern Europe is unclear. This study aimed to analyse the incidence and all-cause mortality of UM in Hungary. This nationwide, retrospective, longitudinal study used data from the National Health Insurance Fund and included patients aged ≥18 years who were newly diagnosed with UM (ICD-10 C69.3 or C69.4) between 1 January 2012 and 31 December 2021. Age-standardised incidence and all-cause mortality rates were calculated using European Standard Population data from 2013. We identified 88 and 70 new patients with UM in 2012 and 2021, respectively, showing an almost stable trend. Age-standardised incidence rates varied between 6.40 and 10.96/1,000,000 person-years (PYs) during the analysed period. The highest age-standardised incidence was detected among men (13.38/1,000,000 PYs) in 2015. All-cause mortality decreased from 4.72/1,000,000 PYs to 0.79/1,000,000 PYs between 2012 and 2021. In conclusion, the UM incidence rate in Hungary is comparable to European incidence rates. The incidence did not markedly change, whereas all-cause mortality decreased during the study period, but this decline could not be attributed to improved treatment modalities for primary tumours and metastatic UM.

Acute effects of traditional and electronic cigarettes on palatal blood flow in smokers: A cross-over pilot study.

Background: Smoking is a significant health hazard and contributes to cardiovascular and pulmonary diseases. It can increase postoperative complications during oral and maxillofacial surgery due to its topical effect on the oral mucosa. New alternatives to traditional tobacco products are gaining popularity, in particular, electronic cigarettes. Objectives: This pilot study investigated the acute effects of nicotine-containing and nicotine-free electronic cigarettes on palatal blood flow (PBF), and compared their effects to traditional cigarettes. Materials and methods: 14 medically healthy volunteers (8 males, 6 females, age: 34.7 ± 7.0) were recruited for the study. All patients (N = 14) were requested to smoke nicotine-containing (ECN) and nicotine-free electronic cigarettes (EC0) and a mouthpiece (end of a traditional cigarette) as a control sham smoking blind test (BT). EC users did not smoke a traditional cigarette (TC), resulting in 10 people in the TC group. Palatal blood flow was measured by Laser Speckle Contrast Imager before, immediately after, and 15 min after the exposures. Exhaled carbon monoxide (eCO) and carboxyhemoglobin (COHb) were measured before and immediately after smoking with a piCO+ Smokerlyzer machine. Results: In all groups, no significant differences were observed in the changes of palatal blood flow between time points. Exhaled carbon monoxide and carboxyhemoglobin were significantly higher in the traditional cigarette (TC) group compared to the nicotine-containing electronic cigarette (ECN) and nicotine-free electronic cigarette (EC0) groups, both before and after the exposure (p < 0.05). Conclusion: Acute use of either traditional or electronic cigarettes may have minimal impact on palatal blood flow, but additional studies are required to clarify their impact on the mucosa.

Trueness of five different 3D printing systems including budget- and professional-grade printers: An In vitro study.

Problem: Several types of 3D printers with different techniques and prices are available on the market. However, results in the literature are inconsistent, and there is no comprehensive agreement on the accuracy of 3D printers of different price categories for dental applications. Aim: This study aimed to investigate the accuracy of five different 3D printing systems, including a comparison of budget- and higher-end 3D printing systems, according to a standardized production and evaluation protocol. Material and methods: A maxillary reference model with prepared teeth was created using 16 half-ball markers with a diameter of 1 mm to facilitate measurements. A reference file was fabricated using five different 3D printers. The printed models were scanned and superimposed onto the original standard tesselation language (.stl) file, and digital measurements were performed to assess the 3-dimensional and linear deviations between the reference and test models. Results: After examining the entire surface of the models, we found that 3D printers using Fused filament fabrication (FFF) technology -120.2 (20.3) µm create models with high trueness but high distortion. Distortions along the z-axis were found to be the highest with the stereolithography (SLA)-type 3D printer at -153.7 (38.7) µm. For the 4-unit FPD, we found 201.9 (41.8) µm deviation with the digital light processing (DLP) printer. The largest deviation (-265.1 (55.4) µm) between the second molars was observed for the DLP printer. Between the incisor and the second molar, the best results were produced by the FFF printer with -30.5 (76.7) µm. Conclusion: Budget-friendly 3D printers are comparable to professional-grade printers in terms of precision. In general, the cost of a printing system is not a reliable indicator of its level of accuracy.

Association of growth and differentiation factor-15 with coronary artery calcium score and ankle-brachial index in a middle-aged and elderly Caucasian population sample free of manifest cardiovascular disease.

Growth and differentiation factor-15 (GDF-15) is a stress-associated cytokine of the transforming growth factor-ß superfamily. The inflammatory and angiogenic effects of GDF-15 in atherosclerosis are controversial, and its correlation with the long asymptomatic phase of the disease is not well understood. Coronary artery calcium score (CACS) and ankle-brachial index (ABI) are sensitive markers of subclinical atherosclerosis. To date, only a few studies have examined the impact of GDF-15 on coronary artery calcification, and the association between GDF-15 and ABI has not been evaluated. Therefore, we aimed to investigate the possible relationship between serum GDF-15 concentrations and CACS and ABI in a Caucasian population sample of middle-aged (35-65 years) and elderly (> 65 years) people. In addition to recording demographic and anthropometric characteristics, atherosclerotic risk factors, and laboratory tests including serum HDL-cholesterol, LDL-cholesterol, hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein, and N-terminal pro-B-type natriuretic peptide (NT-proBNP); GDF-15 level, cardiac computed tomography, and ABI measurements were also performed. A total of 269 asymptomatic individuals (men, n = 125; median age, 61.5 [IQR, 12.7] years) formed the basis of this study. Participants were divided into two groups according to their age (middle-aged, n = 175 and elderly, n = 94). Hypertension and diabetes mellitus were significantly more prevalent and CACS values and HbA1c, NT-proBNP, and GDF-15 levels were significantly higher (all p < 0.001) in the elderly group compared to the middle-aged group. Multivariate ridge regression analysis revealed a significant positive association between GDF-15 and CACS (middle-aged group: ß = 0.072, p = 0.333; elderly group: ß = 0.148, p = 0.003), and between GDF-15 and ABI (middle-aged group: ß = 0.062, p = 0.393; elderly group: ß = 0.088, p = 0.041) only in the elderly group. Our results show that GDF-15 is not only a useful biomarker of inflammation but can also predict early signs of asymptomatic atherosclerosis, especially in elderly people with chronic systemic inflammation associated with aging (inflammaging).

[Feasibility of tailored patient education]. / A személyre szabott betegoktatás lehetoségei.

Patient education has an important role in the prevention and therapy. It enables the delivery of necessary information, development of skills and motivations and supporting to cope with the disease. Although many information sources are available, it is still necessary to provide organized patient education. Tailored patient education was proved to be more effective than using general information materials. The proper use of information technology enables the widespread and cost-effective implementation of tailored patient education. The authors analyse the components necessary for development of such a system.

[Benefits and disadvantages of telemedicine]. / A telemedicina elonyei és hátrányai.

Telemedicine is used more and more frequently worldwide. It is increasingly popular in North America, Australia, South Africa, as well as the Scandinavian countries. However, it is not commonly used in Hungary despite various attempts, which is presumably due to earlier dismissive governmental attitude. In this paper the authors analyze ethical, legal and financial aspects of telemedicine from the viewpoints of physicians and patients, too. The results indicate that it cannot be clearly decided whether telemedicine is worth to apply at present. Further, introduction of telemedicine should be based on experience gained in local application.

[Short and long term prognosis of patients with myocardial infarction. Hungarian Myocardial Infarction Registry]. / Szívinfarktus miatt kezelt betegek korai és késoi prognózisa. Magyar Infarctus Regiszter Vizsgálat.

INTRODUCTION: Mortality data of patients with acute myocardial infarction are incomplete in Hungary. AIM: The aim of the authors was to analyse the data of 8582 myocardial infarction patients (4981 with ST-elevation myocardial infarction) registered in the Hungarian Myocardial Infarction Register in order to define the hospital, 30-day, and 1-year mortality. To evaluate the prehospital mortality of myocardial infarction, all myocardial infarction and sudden death were registered in five districts of Budapest. METHOD: Multivariate logistic regression was performed to define risk factors of mortality and the model were assessed using c statistics. RESULTS: The hospital, 30-day and 1-year mortality of patients with ST elevation myocardial infarction were 3.7%, 9.5% and 16.5%, respectively. In patients without ST elevation myocardial infarction these figures were 4%, 9.8% and 21.7%, respectively. The 1-year mortality of patients without ST elevation was higher than those of with ST elevation and the difference was statistically significant. Age, Killip class, diabetes mellitus, history of stroke and myocardial infarction were independent predictors of death. Coronary intervention improved the prognosis of patients with myocardial infarction significantly. CONCLUSIONS: The rate of pre-hospital mortality was considerably high; 72.5% of 30 day mortality occurred before admission to hospital.