Birthweight trends and their explanatory factors in Hungary between 1999 and 2018: an analysis of the Hungarian Tauffer registry.

BACKGROUND: The increasing birthweight trend stopped and even reversed in several high income countries in the last 20 years, however the reason for these changes is not well characterized. We aimed to describe birthweight trends of term deliveries in Hungary between 1999 and 2018 and to investigate potential maternal and foetal variables that could drive these changes. METHODS: We analysed data from the Hungarian Tauffer registry, a compulsory anonymized data collection of each delivery. We included all singleton term deliveries in 1999-2018 (n = 1,591,932). We modelled birthweight trends separately in 1999-2008 and 2008-2018 in hierarchical multiple linear regression models adjusted for calendar year, newborn sex, maternal age, gestational age at delivery, and other important determinants. RESULTS: Median birthweights increased from 3250/3400 g (girl/boy) to 3300/3440 g from 1999 to 2008 and decreased to 3260/3400 g in 2018. When we adjusted for gestational age at delivery the increase in the first period became more pronounced (5.4 g/year). During the second period, similar adjustment substantially decreased the rate of decline from 2.5 to 1.4 g/year. Further adjustment for maternal age halved the rate of increase to 2.4 g/year in the first period. During the second period, adjustment for maternal age had little effect on the estimate. CONCLUSIONS: Our findings of an increasing birthweight trend (mostly related to the aging of the mothers) in 1999-2008 may forecast an increased risk of cardiometabolic diseases in offsprings born in this period. In contrast, the decreasing birthweight trends after 2008 may reflect some beneficial effects on perinatal morbidity. However, the long-term effect cannot be predicted, as the trend is mostly explained by the shorter pregnancies.

Birthweights showed an increase followed by a decrease in several high income countries in the last 20 years, however the reasons for these changes is not well described. Thus, we aimed to investigate birthweight trends and their potential explanatory factors in Hungary between 1999 and 2018. We used registry data of all deliveries from Hungary in 1999­2018 (n = 1 591 932). Birthweights increased from 3250/3400 g (girl/boy) to 3300/3440 g from 1999 to 2008 and decreased to 3260/3400 g until 2018. Maternal age explained approximately half of increase in the first period, while a substantial part of the decrease in the second period was explained by the presence of shorter pregnancies. The increasing birthweights in 1999­2008 may forecast an increased risk of cardiometabolic diseases in offsprings born in this period. In contrast, the decreasing birthweight trends after 2008 may reflect some beneficial effects on perinatal morbidity. However, its long-term consequences cannot be predicted, as the trend is mostly explained by the shorter pregnancies.

Carbon nanotubes exert basic excitatory enhancement in rat brain slices.

Carbon nanotubes are promising new tools in biomedicine but they may have yet some unknown influences on the organism. In the present study, the acute effect of solubilized, multi-walled carbon nanotubes (MWCNTs) on basic neuronal functions was examined. Rat brain slices were treated in vitro with nanotube-containing colloid solutions at concentrations of 100-800 µg/ml and evoked field potentials were recorded from the somatosensory cortex and hippocampus. Basic excitability of the treated slices was characterized by the amplitude of field excitatory postsynaptic potentials (fEPSPs) and population spikes. Experimental results indicated significantly higher excitability of treated samples than that of controls. Multiple components in evoked potentials were observed, which is in accordance with the increased excitability of investigated brain areas. Tests of short- and long-term plasticity were also performed, which revealed no difference between control and treated slices. Experimental results suggest an interaction between nanotubes and brain tissue. MWCNTs seem to act on the basic membrane potential of neurons by changing membrane properties or via a mechanism linked to voltage-gated ion channels, rather than influencing specific synaptic transmission. Further investigation is needed to clarify the nature of interactions between nanotubes and brain tissue.

Pregnancy outcomes of women with untreated 'mild' gestational diabetes (gestational diabetes by the WHO 2013 but not by the WHO-1999 diagnostic criteria) - A population-based cohort study.

AIMS: We compared pregnancy outcomes of untreated 'mild' GDM (GDM by WHO 2013 but not by WHO-1999) to normal glucose tolerant women (NGT). METHODS: In a universal screening program 4333 pregnant women had a 3-point 75 g OGTT in Hungary in 2009-2013. By WHO-2013 untreated NGT was diagnosed in n = 3303, 'mild' GDM in n = 336 cases. RESULTS: 'Mild' GDM women were older (mean difference, SE: 1.4, 0.3 yrs), had higher fasting (1.0, 0.02), 60-minute (1.0, 0.09), and 120-minute (0.4, 0.06 mmol/l) blood glucose, and blood pressure (2.6, 0.5/2.0, 0.5 mmHg). Weight gain was similar in both groups (-0.3, 0.3 kg). GDM newborns were heavier (142, 50 g) and were more frequently macrosomic (>4000 g, OR 1.85, 95 %CI 1.35-2.54). Hypertension during pregnancy was more prevalent in the GDM group (OR 1.55, 95 %CI 1.05-2.28), as well as induced (OR 1.38, 95 %CI 1.10-1.74) and instrumental delivery (OR 1.34, 95 %CI 1.07-1.68), and acute caesarean section (OR 1.32, 95 %CI 1.04-1.64). Most of these differences substantially attenuated or became non-significant after adjustment for pre-pregnancy BMI. CONCLUSIONS: Pregnancy outcomes of 'mild' GDM were worse compared to normal glucose tolerant women however these differences were explained by the pre-pregnancy BMI difference between groups.

Comparison of Efficacy and Safety of Commercially Available Fixed-Ratio Combinations of Insulin Degludec/Liraglutide and Insulin Glargine/Lixisenatide: A Network Meta-analysis.

OBJECTIVES: Our aim in this study was to compare the efficacy and safety of commercially available fixed-ratio combinations (FRCs) of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and basal insulins by a network meta-analysis of randomized controlled trials (RCTs) of people with type 2 diabetes. METHODS: We present a systematic review and network meta-analyses of RCTs of individuals with type 2 diabetes randomized to FRCs or to their components for ≥24 weeks. All reports were obtained from PubMed or ClinicalTrials.gov up to February 28, 2022. The primary outcome was glycated hemoglobin (A1C) level attained. Secondary outcomes included fasting plasma glucose, change in body weight, and incident hypoglycemia. Treatment effects were estimated as mean difference (MD) and standard error (SE), or as odds ratio (OR) with 95% confidence interval (CI) using the fixed combination of insulin glargine 100 IU/mL and lixisenatide (iGlarLixi) as reference. RESULTS: We included 29 RCTs from among the 1,404 articles identified. No direct comparisons between FRCs were found. After excluding some insulin-capped trials to reach model consistency, both FRCs were more efficacious regarding A1C than their components, but no difference between FRCs was found (MD, -0.10%; SE, 0.10%). The effect of the fixed combination of insulin degludec and liraglutide (IDegLira) (MD, -0.47 mmol/L; SE, 0.24 mmol/L) and basal insulins was similar to that of iGlarLixi (reference) on fasting glucose, whereas GLP-1RAs had lower efficacy than iGlarLixi. Weight gain was lower with GLP-1RAs and IDegLira (MD, -0.72 kg; SE, 0.32 kg) than with iGlarLixi (reference) and higher with basal insulins. Incident hypoglycemia (based on different definitions) was least frequent with GLP-1RAs, followed by IDegLira (OR, 0.78; 95% CI, 0.39 to 1.57), iGlarLixi (reference), and basal insulins. CONCLUSIONS: For A1C, both FRCs were more efficacious over their individual components, with similar efficacies of the 2 FRCs.

[Long term persistence of yellow fever neutralising antibodies in elderly persons]. / Persistance à long terme des anticorps neutralisants de la fièvre jaune chez les personnes âgées de 60 ans et plus.

The activity of the yellow fever virus is reemerging in areas without recent transmission history, such as northern Argentina and Paraguay, and persists in an epidemic mode in other countries in Africa and Latin America. Thus more and more travelers are at risk of being exposed to this disease. The population is becoming older, sometimes suffering from multiple pathologies. Moreover, the risk of serious adverse events associated with live-attenuated YF17D vaccine, such as multiple organ failure (YEL-AVD), reaches 1/50,000 vaccines in people over 65 versus 1/200,000 in the general population. We analyzed, in a retrospective study, the results of neutralizing antibody titers against yellow fever in people aged 60 and older, who had been previously vaccinated against yellow fever and had visited the International Vaccination Centre of the Institut Pasteur between January 2005 and February 2009. In this population of 84 persons (median age 69 years), the date of the last vaccination was always more than 10 years: it was precisely known in 68 subjects and alleged in 16 subjects. The median time since the previous vaccination was 14 years, with a maximum of 60 years. The indications of serology were: immunosuppressive therapy (19% of cases), cancer (32%), hemopathy (10.7%), HIV infection (3.6%), chronic hepatitis/chronic renal failure/dialysis (2.4%), autoimmune diseases (2.4%), and in 29.8% of cases, age alone was the indication of serology. The antibody titer was at a protective level in 95.2% of cases. The four individuals with negative serology had no formal documented proof of a previous vaccination against yellow fever. This serological study was able to show a persistent protective antibody titer, after a previous vaccination, even going back 60 years, allowing patients to travel in a yellow-fever endemic area despite a contraindication, and without requiring any vaccine booster.

Evaluation of critical design parameters for RT-qPCR-based analysis of multiple dUTPase isoform genes in mice.

The coupling of nucleotide biosynthesis and genome integrity plays an important role in ensuring faithful maintenance and transmission of genetic information. The enzyme dUTPase is a prime example of such coupling, as it generates dUMP for thymidylate biosynthesis and removes dUTP for synthesis of uracil-free DNA. Despite its significant role, the expression patterns of dUTPase isoforms in animals have not yet been described. Here, we developed a detailed optimization procedure for RT-qPCR-based isoform-specific analysis of dUTPase expression levels in various organs of adult mice. Primer design, optimal annealing temperature, and primer concentrations were specified for both nuclear and mitochondrial dUTPase isoforms, as well as two commonly used reference genes, GAPDH and PPIA. The linear range of the RNA concentration for the reverse transcription reaction was determined. The PCR efficiencies were calculated using serial dilutions of cDNA. Our data indicate that organs involved in lymphocyte production, as well as reproductive organs, are characterized by high levels of expression of the nuclear dUTPase isoform. On the other hand, we observed that expression of the mitochondrial dUTPase isoform is considerably increased in heart, kidney, and ovary. Despite the differences in expression levels among the various organs, we also found that the mitochondrial dUTPase isoform shows a much more uniform expression pattern as compared to the reference genes GAPDH and PPIA.

Regulation of cerebral endothelial cell morphology by extracellular calcium.

Cerebral endothelial cells interconnected by tight and adherens junctions constitute the structural basis of the blood-brain barrier. Extracellular calcium ions have been reported to play an important role in the formation and maintenance of the junctional complex. However, little is known about the action of calcium depletion on the structural characteristics of cerebral endothelial cells. Using atomic force microscopy we analyzed the effect of calcium depletion and readdition on the shape and size of living brain endothelial cells. It was found that the removal of extracellular calcium from confluent cell cultures induced the dissociation of the cells from each other accompanied by an increase in their height. After readdition of calcium a gradual recovery was observed until total confluency was regained. We have also demonstrated that Rho-kinase plays an important role in the calcium-depletion-induced disassembly of endothelial tight and adherens junctions. The Rho-kinase inhibitor Y27632 could prevent the morphological changes induced by a lack of calcium as well. Our results suggest that calcium depletion induces Rho-kinase-dependent cytoskeletal changes that may be partly responsible for the disassembly of the junctional complex.

Modification of multi-walled carbon nanotubes by Diels-Alder and Sandmeyer reactions.

Random (L) and aligned (A) multi-walled carbon nanotubes (MWNTs) were modified by Diels-Alder (DA) [4+2] cycloaddition, Sandmeyer (SM) reaction and by catalytic oxidation (OX). The properties of modified carbon nanotubes were studied by dispersability tests, elemental analysis, thermogravimetry/mass spectrometry, X-ray photoelectron spectroscopy, and NMR spectroscopy. The cycloaddition reaction could only be successfully performed with the L-MWNTs in molten and in solution state by using an aluminum chloride homogeneous catalyst. The efficiency and thermal stability of the solution phase cycloaddition were much higher than in the case of modification in the molten phase. The functionalization of both types of MWNTs by Sandmeyer reaction was carried out by copper(I) and iron(ll) ions that helped in the radical decomposition of diazonium salts. Successful functionalization of nanotubes is achieved by a long decomposition time of the thermally activated diazonium salts. To the contrary, in the case of radical decomposition of diazonium salts, the time is not a decisive parameter. The dispersability tests have proved the changes in the physical features of modified carbon nanotubes depending on the hydrophobic and hydrophilic character of the solvents. The presence of the modifying groups and their fragments from the functionalized MWNTs has been demonstrated by thermogravimetry/mass spectrometry (TG/MS). Relatively high concentration of sulfur atoms was detected by X-ray photoelectron spectroscopy in nanotubes modified by sulfur substituent groups. In the case of catalytic oxidation, the X-ray photoelectron spectroscopic signal of oxygen bound to nanotubes showed considerable change as compared to pristine nanotubes. Due to the high thermal stability of modified multi-walled carbon nanotubes, the functionalized derivatives are applicable in several industrial fields.

Determination of circular dichroism and ultraviolet spectral parameters of norgestimate- and other Delta(4)-3-ketosteroid oxime isomers via normal phase HPLC method.

The oxime formation reaction of therapeutical progestogen (levonorgestrel, levonorgestrel acetate, norethisterone), androgen (methyltestosterone, testosterone phenylpropionate) and anabolic (nortestosterone phenylpropionate) Delta(4)-3-ketosteroids has been investigated. The ketosteroid-hydroxylamine reaction was monitored by reversed phase HPLC system. It was established, that under the experimental conditions applied the oxime formation was complete within 2 h. The reaction leads to the formation of Z and E oxime isomers. The isomers of norgestimate (levonorgestrel 17-acetate oxime) and other Delta(4)-3-ketosteroid oximes have been separated by a new normal phase HPLC method. The identification (elution order assignation) and determination of the formation ratio of the isomers have been performed by 1H NMR spectroscopy on the basis of the chemical shift differences of 4-H signals. The on-line CD and UV spectra of the pure oxime isomers were recorded and then molar ellipticities and absorbances of the isomers were calculated in the wavelength range of 200-300 nm via parameter estimation method.

6-oxo-morphinane oximes: pharmacology, chemistry and analytical application.

The permanent therapeutic importance of morphine derivatives in pain treatment has inspired continual synthetic efforts to modify the rigid pentacyclic systems in search for new selective analgesic agents. As a result, several morphinane oximes have been synthesized recently, which have the additional advantage of possessing an oxime group that can provide a method for selective determination of opiate alkaloids in biological matrices. The oximes of hydrocodone and oxycodone have stronger analgesic effect than the parent ketones and they also proved to be effective in preventing the respiratory depressant and hypotensive actions of fentanyl. In this work a review is given on the present status of oxime pharmacology, chemistry and analysis and also the oxime and O-methyl oxime formation of 6-oxo-morphinanes with therapeutic interest (codeinone, oxycodone, hydrocodone and 14-OH-codeinone). The oxime formation was monitored by reversed-phase HPLC and the chromatographic properties of oxime isomers have been characterized. The assignation of the individual isomers isolated by preparative HPLC was performed by (1)H NMR spectroscopy based on the chemical shift differences of the 5-H signals. In this way the isomeric ratio in the oxime products could also be determined. It was found that in the case of Delta(7)-6-oxo-morphinanes, depending on the substituents, the formation of the Z-isomer highly dominates (73-96%) over that of the E-isomer. However, for the saturated 7,8-(dihydro) derivatives the E-isomer is definitely preferred (>98%). In conclusion of a survey on the theoretical background of oxime isomerism, the conformational differences between the saturated and unsaturated morphinane systems were found responsible for the different E/Z ratios. On the basis of the isomeric ratio and the on-line CD and UV spectra of the pure isomers, the molar ellipticities and absorbancies of the isomers were calculated by a parameter estimation method.

Determination of mercury in fish from rivers and lakes in Hungary by atomic absorption technique.

In 1975, in cooperation with 8 County Hygienic Stations, total mercury content in fish from rivers and lakes in Hungary was measured. The mercury content in fish muscle-tissue from 164 fish samples averaged 0.36 mg/kg. Average levels in different fish species ranged from 0.10 to 0.57 mg/kg. The amount of mercury in fish from rivers and lakes, with the exception of the Danube, was, in general, lower than the tolerance level (0.50 mg/kg) as adopted in many countries. Mercury levels in fish from Lake Balaton did not amount to more than 0.30 mg/kg. The circulating cold vapour atomic absorption method was used to determined the mercury content in the fish samples.

Copper(II) and nickel(II) ternary complexes of L-dopa and related compounds.

The stability constants of the mixed ligand complexes of L-dopa, L-tyrosine, L-phenylalanine, and dopamine with copper(II) and nickel(II) ions and with 2,2'-bipyridyl and 1,10-phenanthroline were determined pH-metrically at 25 degrees C and an ionic strength of 0.2 mol/dm3 (KCl). Spectral studies were made to establish the binding mode of the ambidentate L-dopa in the ternary complexes. In contrast with the aromatic (N,N) donor atoms, the (O,O) binding mode of L-dopa is particularly favored in its ternary systems with copper(II) and nickel(II); thus, even at physiological pH there is a very considerable formation of (O,O)-bound mixed ligand complexes containing a free amino acid side-chain. Numerous binary transition metal-L-dopa complexes and the ternary complexes formed with various B ligands have been evaluated from a coordination chemistry aspect, with regard to the possibility of their therapeutic application in the treatment of Parkinson disease.

Determination of enantiomeric purity by simultaneous dual circular dichroism and ultraviolet spectroscopy.

A method is described for the determination of enantiomeric composition. The ellipticity and absorbance of the sample are measured simultaneously by CD and UV spectroscopies, and the resulting G value is determined. G is an intensive physico-chemical parameter, a close derivative of anisotropy factor. Its magnitude is identical with opposite sign for enantiomers. The experimental G value is concentration-independent, as long as both absorption and ellipticity are linear functions of concentration. The analytical procedure introduced here is simple, rapid, and inexpensive, even though it includes calibration with standards of established enantiomeric composition. Provided the sample contains some UV-active contaminant(s), the method can be used after achiral chromatographic purification. By virtue, the method lacks several sources of error, arising normally from concentration inaccuracies. Applicability of the principles is tested by the example of phenylglycine and mandelic acid. Advantages of the method allowed the determination of phenylglycine enantiomer purity with an accuracy of 0.1%.

A review of the application of chiroptical methods to analytical chemistry.

The analytical applications of the two most important chiroptical methods, optical rotatory dispersions (ORD) and circular dichroism (CD), have been surveyed, emphasizing the methods corresponding to the profile of the Journal of Pharmaceutical and Biomedical Analysis. After a brief introduction of the ORD and CD methods, the advantages and drawbacks of the application of the two methods have been described, and compared, and the calibration of ORD and CD instruments have been given. The analytical applications have been divided as follows: the use of ORD and CD in identification studies, the direct determination of optically active substances, the determination of optically active compounds after chromophore group formation, determination of optically inactive substances via their products with optically active compounds. The difference chiroptical methods increasing the selectivity of measurements and the chiroptical titrations have been summarized. Stress has been laid on the applicability of selective chiroptical detectors (based on laser light, too) used in liquid chromatography and the future developments have been mentioned.

Comparison of some components of pigs kept in natural (free-range) and large-scale conditions.

A new pig genotype of Hungarian Large White (75%) × Mangalica (pig with curly bristles, 25%) was used in the experiments. The experimental group was kept in a farming system under strictly natural circumstances until a body weight of 120 kg was attained. Neither antibiotics nor yield-increasing hormones were given to this group. The control group was kept in the usual large-scale farming conditions until body weight of 120 kg was attained. In most cases, protein, zinc, and copper levels and, in some cases, iron levels were significantly higher in some major cuts (neck-end (Boston-butt), loin, ham) of the 'free-range' pigs (n = 12) in comparison with the control animals kept in large-scale farming conditions. There was, on average, 15% less cholesterol in the muscles and 30% less cholesterol in the liver and less linoleic acid in all tissues of 'free-range' pigs than in the control group. There was less fat, but the amount of thiamin and riboflavin in the liver of the naturally kept pigs was twice that in the controls. In respect of TBA-reactive compounds, there were no significant differences between the two groups, but superoxide dismutase (SOD) showed significantly higher activities in all cuts from pigs kept in a large-scale farming system. This may be the effect of a higher level of linoleic acid in the fat.

Deconvolution of composite chromatographic peaks by simultaneous dual detections.

Composite chromatographic peaks are deconvoluted by a method that uses ratio formation from signals of simultaneous double detection. The method is generally suitable if two detector signals can simultaneously be acquired and their uses do not need any a priori assumption or mathematical shape analysis. A simple deduction makes the compound- and detector-specific intensive parameters explicit, which allows for the digital construction of directly invisible component peaks. The simultaneous double detection is shown to be superior to coupled detectors, sequentially fixed chromatograms, and subsequently synchronized peaks. The combination of circular dichroism and ultraviolet (UV) detection is shown to be especially advantageous in the analysis of enantiomers for which the other ratio-forming peak-deconvolution techniques have inherently been insensitive. The double chiroptical UV detection can be of further use to decompose overlapping peaks of nonenantiomeric compounds that are highly similar. The capacity of the method is exemplified by the analysis of morphine alkaloids, steroid oximes, and synthetic heterocycles.

Optical resolution of a series of potential cholecystokinin antagonist 4(3H)-quinazolone derivatives by chiral liquid chromatography on alpha1-acid glycoprotein stationary phase.

Optical resolution of the enantiomers of new 4(3H)-quinazolone derivatives is investigated using the alpha1-acid glycoprotein chiral stationary phase (Chiral-AGP). Stereoselective separation of the model compounds can be controlled by varying the pH and adding uncharged organic modifiers (acetonitrile and 2-propanol) to the mobile phase. For the majority of quinazolone derivatives, Chiral-AGP is proved to be an excellent enantioselector, because optimized chromatographic conditions allow for the baseline separation of the enantiomers. Separation factors between 1.19 and 1.85 are obtained. The effects of acetonitrile and 2-propanol on the chromatographic behavior of the model compounds are quite different because of their different hydrophobic- and hydrogen-bonding properties. The eluent pH and organic modifier concentration also contributes to the chiral recognition by altering the protein environment. The analysis of the experimental results leads to new information about the chromatographic mechanism on a Chiral-AGP surface.

The importance of quantitative electron microscopy in studying hypertrophic neuropathies. A comparison between a case of Déjérine Sottas disease (HMSN III) and a case of the hypertrophic form of Charcot-Marie-Tooth disease (HMSN I).

The electron microscopic features and quantitative morphometric data of the sural nerve in Déjérine-Sottas disease (HMSN III) and in the hypertrophic form of Charcot-Marie-Tooth disease (HMSN I) are reported. Both forms are characterized by onion bulb formations, but they differ in: a) increased incidence of mucoid connective tissue in DS disease; b) higher incidence of demyelination in DS disease; c) uniformly small size of the remaining myelinated fibers in DS disease; d) larger and more developed onion bulbs in DS disease; e) clusters of 2-4 myelinated fibers in the core of onion bulbs of CMT disease; f) peripheral concentric lamellae with the typical aspects of the denervation bands of the unmyelinated fiber type in the onion bulbs of the CMT disease; g) non-involvement of unmyelinated fibers in DS disease. These differences permit two types of onion bulbs to be distinguished, and suggest a different pathogenesis. Electron microscopy, coupled with quantitative determinations, permits a deeper insight into the formation modalities of onion bulbs and may help in the diagnosis of the different forms of hypertrophic neuropathies.

[Incidence of food allergy and zinc deficiency in children treated for atopic dermatitis]. / Etelallergia és cinkhiány elöfordulása atopiás dermatitis miatt ápolt gyermekbetegeinkben.

Among the 134 children who were admitted to hospital with atopic dermatitis, authors found 41, suffering from food allergy and 39, being hypozincaemic; the latter ones belonged to the group of patients with serious and extended ekzemic laesions. The lymphoblast transformation with aspecific mitogen in the blood of ten hypozincaemic patients with negative tuberculinplaster-reaction in 9 cases showed pathological decreased level, and after one month of zinc intake, 8 children's lymphoblast transformation became normal.

[The effect of soybean protein on lipids and trace elements in elderly hospitalized women]. / Szójafehérje hatása hospitalizált idös nök lipid és mikroelem statusára.

Institutionalized elderly women received 5 g/day soya supplementation for three months. After having finished the soya supplementation, serum cholesterol levels of hypercholesterolemic women decreased and serum zinc levels were lower in all examined persons, compared to the status of the initiation of dietetic intervention.