A short Larsen score is effective when evaluating radiographs in early rheumatoid arthritis.

PURPOSE: To compare the efficacy of the short Larsen score (LS 12) based on analysis of 12 areas with the original Larsen score (LS 40), which includes 40 areas for assessing radiographic changes in rheumatoid arthritis. MATERIAL AND METHODS: The radiographs of the hands, wrists, and feet of 122 patients with early rheumatoid arthritis were evaluated by two radiologists using both the LS 40 and LS 12 methods. Cross-sectional analysis of radiographs of 122 patients and longitudinal analysis in 68 patients were performed. RESULTS: There was no significant difference between the mean LS 40 and mean LS 12 in the cross-sectional study. LS 12 correlated strongly (r=0.93, P<0.01) with LS 40 at the baseline, and the rate of progression was similar in both methods (r=0.89, P<0.01) in the longitudinal study. CONCLUSION: The short Larsen score was as efficient as the original method.

Selenium depletion in hemodialysis patients treated with polysulfone membranes.

BACKGROUND/AIMS: Epidemiological, animal and human studies have indicated that selenium deficiency is a risk factor for death from malignant diseases. The mechanisms that could modify selenium status may, therefore, be of particular interest in hemodialysis patients, considering their high cancer mortality rates. We aimed at evaluating the effect of hemodialysis with polysulfone membranes on selenium status. METHODS: Twenty- eight chronically dialyzed patients and 32 age-matched healthy controls were enrolled in the study. Serum and dialysis fluid selenium concentrations, serum total protein, and hemoglobin concentrations and serum glutathione peroxidase activity were determined before and after the hemodialysis procedure. RESULTS: The (mean +/- SD) serum selenium and total protein concentrations and glutathione peroxidase activities were significantly (p < 0.05) higher in healthy controls (75.9 +/- 8.3 microg/l, 78 +/- 6 g/l, and 23.8 +/- 4.8 mU/20 microl, respectively) than in the patients. There was no significant difference between serum selenium concentration before (63.6 +/- 11. 6 microg/l) and after (64.4 +/- 11.4 microg/l) hemodialysis sessions, although hemoglobin and total serum protein concentrations and serum glutathione peroxidase activities increased (from 98.5 +/- 1.3 to 114.8 +/- 1.5 g/l, from 64 +/- 8 to 71 +/- 9 g/l, and from 16.8 +/- 1.8 to 18.9 +/- 1.9 mU/20 microl, respectively) significantly (p < 0.05) during hemodialysis, indicating hemoconcentration. The selenium concentration doubled, and protein appeared in the dialysates during dialysis session. The correlation of the selenium concentrations with the protein concentrations in the dialysate is significant (p < 0.01) with a Spearman R value of 0.97. CONCLUSION: The results of the present study suggest that selenium is lost through the pores of polysulfone membranes during hemodialysis which is associated with their protein permeability.

[Plasma homocysteine concentration in healthy middle-aged men and its presumed association with cardiovascular mortality]. / Egészséges középkorú férfiak plazma homocystein koncentrációja és ennek feltételezett kapcsolata a szív- és érrendszeri halálozással.

It has recently become clear that hyperhomocysteinemia is an independent risk factor for vascular diseases. The plasma homocysteine concentrations of 71 healthy men (aged 40-49) living in Hungary were compared with those of randomly selected healthy age-matched men (n = 260) living in 11 different countries. The association between the mean plasma homocysteine concentration and reported cardiovascular mortality was analyzed in the respective countries. In Hungary the mean (+/- SD) plasma homocysteine concentration was 10.6 +/- 4.3 mumol/l. In the 11 other countries the mean (+/- SD) plasma homocysteine concentration ranged from 7.1 +/- 1.4 mumol/l (Schleiz, Germany, n = 20) to 10.7 +/- 2.1 mumol/l (Kuopio, Finland, n = 20). There was a significant correlation (r = 0.71, p < 0.005) between the plasma homocysteine concentration and male cardiovascular mortality in there countries. The strength of the correlation between the male plasma homocysteine concentration and cardiovascular mortality suggests that homocysteine may be an important factor in the variation of cardiovascular mortality between populations. The mean plasma homocysteine concentrations were the highest in the Hungarian (Budapest and Pest county) and the Finnish (Kuopio) groups but cardiovascular mortality is higher in Hungary than in Finland, referring to the pivotal role of other cardiovascular risk factors for the Hungarian population.

Enteral yeast-selenium supplementation in preterm infants.

AIM: To study the bioavailability of selenium enriched yeast in preterm infants living in a low selenium area (Hungary). METHODS: Thirty six preterm infants were randomly assigned to two groups at birth with respect to selenium supplementation. In the supplemented group (n = 18) infants received 4.8 mg of selenium enriched yeast containing 5 micrograms selenium daily. RESULTS: In the supplemented group the serum selenium concentration increased from 36.1 (+/- 12.8) micrograms/l to 43.5 (7.9) micrograms/l and in the non-supplemented group it decreased from 34.4 (20.4) micrograms/l to 26.1 (16.6) micrograms/l from birth in two weeks. No complications or side effects as a result of supplementation were observed. CONCLUSIONS: Selenium enriched yeast is a safe and an effective form of short term enteral selenium supplementation for preterm infants.

Randomized clinical trial of enteral yeast-selenium supplementation in preterm infants.

There are no data in the literature on effects of supplementing infants with yeast-selenium. We therefore studied the impact of selenium-enriched yeast on the serum selenium concentration of preterm infants living in a selenium-low area (Hungary). Twenty-eight preterm infants with a mean +/- SD birthweight of 962 +/- 129 g and a gestational age of 27 +/- 1 weeks were randomized into two groups at birth with respect to selenium supplementation. In the supplemental group (n = 14) infants received 4.8 mg yeast containing 5 microgram selenium daily with naso-gastric drip during the first 14 postnatal days. The nonsupplemented infants were used as a reference group. In the supplemented group the serum selenium concentration increased from 32.1 +/- 8.5 microgram/l to 41.5 +/- 6.5 microgram/l and in the nonsupplemented group it decreased from 25.9 +/ 6.8 microgram/l to 18.2 +/- 6.4 microgram/l within two weeks. The serum glutathione peroxidase activity increased from 2.97 +/- 0.73 U/20 microliter to 6.42 +/- 3.11 U/20 microliter in the supplemented group, and it did not change significantly (from 3.53 +/- 0.94 U/20 microliter to 3.85 +/- 0.95 U/20 microliter) in the nonsupplemented group. We did not observe any complications or side effects in connection with enteral yeast-selenium supplementation. It is concluded that selenium-enriched yeast is a safe and an effective form of short term enteral selenium supplementation for preterm infants.

Bioavailability of enteral yeast-selenium in preterm infants.

There is no data or literature on the effects of supplementing infants with yeast selenium, although its intestinal absorption and bioavailability are higher in adults compared with other selenium compounds. The aim of the present investigation was to study the impact of selenium enriched yeast on the serum selenium concentration of preterm infants living in a low selenium area (Hungary). Twenty-eight preterm infants with mean+/-SD birth weight of 962+/-129 g and gestational age 27+/-1 wk were randomized into two groups at birth with respect to selenium supplementation. In the supplemented group (n=14) infants received 4.8 mg yeast selenium containing 5 microg selenium daily via nasogastric drip during the first 14 postnatal days. The nonsupplemented infants were used as a reference group. In the supplemented group, the serum selenium concentration increased from 32.1+/-8.5 microg/L to 41.5+/-6.5 microg/L and in the nonsupplemented group it decreased from 25.9+/-6.8 microg/L to 18.2+/-6.4 microg/L from birth in two weeks time. Compared with previous studies, our results suggest that the bioavailability of selenium in the form of yeast selenium is higher than that of other selenium compounds used for preterm infants. We did not observe any complications or side-effects owing to enteral yeast selenium supplementation. We conclude that selenium enriched yeast is a safe and an effective form of short-term enteral selenium supplementation for infants.

[Endemic iodine deficiency in Hungary and possibilities of iodine substitution]. / Endémiás jódhiány és a jódpótlás lehetöségei Magyarországon.

Following a short historical review the authors summarize the latest results regarding domestic iodine supply. Iodine content in drinking waters, samples of mother's milk, urine and goiter screening data from all regions of Hungary unanimously verify that significant part of the population is deficient in iodine, yet supplementation of iodine is still even today an unsolved problem in our country. In the search for the reasons the authors review the theoretical possibilities of iodine supplementation by discussing advantages and disadvantages of the individual models. They establish that alimentary iodine supplementation in itself is not suitable due to both theoretical and practical reasons for the complete elimination of iodine deficiency, therefore they make recommendations to supplement iodine in other ways. They also discuss the effect of selenium deficiency on the metabolism of thyroid hormones. They call attention that domestic, endemic selenium deficiency may be related to the frequency of Hungarian occurrences of iodine deficiency disorders. The authors review the iodine deficiency disorders and their effects on the health of present and future generations. They compare the practical benefit and costs of iodine supplementation, and furthermore discuss in detail the possible side effects of iodine supplementation.

[Relationship between selenium deficiency and high mortality and morbidity of cardiovascular diseases]. / A szelénhiány és a magas szív és érrendszeri mortalitás, morbiditás kapcsolata.

The authors consider the role of selenium deficiency to be of the utmost importance in the deteriorating health status of the Hungarian population. The pathophysiological processes occurring in selenium deficiency and possibly leading to cardio- and cerebrovascular diseases are discussed in detail. The results of human studies investigating the relationship between vascular diseases and selenium deficiency are summarized. It is concluded that selenium deficiency together with other harmful (prooxidant) effects may be responsible for the poor health status of the Hungarian population and therefore the importance of long term selenium supplementation in the prevention of such diseases is stressed.

[Complex study of selenium levels in healthy subjects in Hungary]. / Egészséges emberek szelénstátusának komplex vizsgálata Magyarországon.

Selenium supply of different populations might vary substantially according to the geographical location and eating habits. The authors pioneered in surveying the selenium supply of the Hungarian population in diverse parts of the country. The former was achieved by the study of multiple parameters characteristic of the human body's selenium status. Selenium levels were determined in sera of blood donors and in toe and fingernails of healthy village and city populations. Measurements in sera and in nails were performed by electrothermic atomic absorption spectroscopy and by flourimetric method, respectively. The average selenium concentration in sera was 0.70 micromol/liter, in fingernails was 0.61 mg/kg, in toenails it was 0.56 mg/kg. The average selenium concentration was significantly higher in the south-eastern and significantly lower in the south-western regions of the country compared to the northern countries. Similar regional differences could be observed in the average selenium content of both toe and fingernails. According to the findings, selenium deficiency could be verified even in the majority of persons with the highest selenium levels.

The human selenium status in Hungary.

The selenium concentration of foods and of human blood varies widely between geographical areas depending on the availability of soil Se for plants. The mean serum Se concentration in Europe has been found to vary between 0.80-1.50 mumol/l and the mean Se concentration of wheat between 0.02-0.11 mg/kg. We estimated by various markers the Se status of Hungarians on whom data is lacking. Serum samples (n = 238) from healthy blood donors, and toenails (n = 132) and fingernails (n = 211) from different apparently healthy individuals residing in both urban and rural areas were collected from four districts in Hungary. Wheat samples (n = 29) as grains were obtained directly from farms representing the same areas. Serum Se was determined by electrothermal AAS and the other samples by acid-digestion fluorimetry. The accuracy of the methods was verified by analyzing external reference samples. The mean (+/- SD) serum Se concentration was 0.70 +/- 0.12 mumol/l, ranging between 0.41-1.18 mumol/l. The mean serum Se levels 0.87 mumol/l was significantly (p < 0.001) higher in the East and lower in the South (0.60 mumol/l) compared to the northern area 0.70 mumol/l. The mean (+/- SD) toenail Se concentration was 0.56 +/- 0.18 mg/kg. The Se level in the East was significantly (p < 0.01) higher than the level in the North, 0.68 mg/kg vs. 0.54 mg/kg, respectively, and lowest in the southern area, 0.40 mg/kg. The same pattern applied to fingernails. Wheat Se ranged from 5 to 235 micrograms/kg, with the median 34 micrograms/kg. The lowest Se concentrations were generally found in the South.(ABSTRACT TRUNCATED AT 250 WORDS)

Selenium in Hungary. The rock-soil-human system.

Selenium (Se) status of Hungarian rock-soil systems has been poorly investigated. The goal of this study was to get general information on the main features of Se geochemistry, and to have a brief look into the human Se status in Hungary, developing an appropriate method for a forthcoming systematic regional investigation. A multistage program was applied: 1. stream sediment sampling; 2. investigation of rock-soil profiles typical in Hungary; and 3. extraction of mobile Se fractions from soils. Human serum samples from apparently healthy blood donors residing in both urban and rural areas were collected from three districts in Hungary. It was concluded that Hungarian rock-soil systems, especially the acid igneous rocks and the widely distributed young sediments (loess and sand formations) with most of the agricultural activity, are low in Se, and the mean serum Se level of the blood samples were also low.