[Modern views of fever management - about the FeverFriendTM program]. / A láz kezelésének modern szemléletérol a LázBarátTM program elso eredményeinek fényében.

INTRODUCTION: A wealth of physiological, pathophysiological and clinical evidence of the beneficial effects of childhood fever exists already. Nevertheless, the public perception of fever has become persistently negative. Sociological research attributes this to a number of factors: unjustified fear, help-seeking behaviour, complex behavioural patterns of symptom avoidance and comfort-seeking. One of the keys to this change in attitudes, in the light of recent research, is linked to changes in the awareness and understanding of health among health professionals and lay people. The role of the young generation using media is crucial. OBJECTIVE: To establish a long-term research project to reduce the use of medication (antipyretics and antibiotics) and the number of medical consultations and to improve attitudes towards fever, using media-based e-health tools. METHOD: An observational, adaptive, prospective cohort study was conducted. The intervention under study is a publicly available application and linked knowledge base. We collect self-reported data from caregivers. The application takes these into account and provides a decision-supporting condition classification based on a differential diagnosis algorithm. RESULTS: 1) The parameters, primary and secondary criteria to be captured in the application as well as the data collection and data processing methodology for the assessment were defined by 100% consensus of the expert partners in a Delphi process. 2) Based on the available national and international guidelines, the above parameters were used to create the condition assessment, decision aid algorithm, which can be a starting point for machine learning in the long term. 3) We evaluated baseline data on demographics, febrile events and antipyretic use from 01/11/2020 to 15/06/2022. CONCLUSION: The FeverFriendTM project can contribute to reduce the burden of medicalisation and care burden on the existing healthcare system through evidence-based modern fever management in the care of children and adults with fever. The impact of the FeverFriendTM program on target behavioural change needs to be further investigated through data analysis. Orv Hetil. 2023; 164(5): 179-185.

Gut dysbiosis and serotonin: intestinal 5-HT as a ubiquitous membrane permeability regulator in host tissues, organs, and the brain.

The microbiota and microbiome and disruption of the gut-brain axis were linked to various metabolic, immunological, physiological, neurodevelopmental, and neuropsychiatric diseases. After a brief review of the relevant literature, we present our hypothesis that intestinal serotonin, produced by intestinal enterochromaffin cells, picked up and stored by circulating platelets, participates and has an important role in the regulation of membrane permeability in the intestine, brain, and other organs. In addition, intestinal serotonin may act as a hormone-like continuous regulatory signal for the whole body, including the brain. This regulatory signal function is mediated by platelets and is primarily dependent on and reflects the intestine's actual health condition. This hypothesis may partially explain why gut dysbiosis could be linked to various human pathological conditions as well as neurodevelopmental and neuropsychiatric disorders.

[Maxillary sinusitis as a diagnostical adverse finding of the dental cone-beam computed tomography study]. / Sinusitis maxillaris mint a fogászati cone-beam komputertomográfiás vizsgálat melléklelete.

INTRODUCTION: Cone-beam computed tomography is a frequently used diagnostical method in the head and neck region. The thickening of the maxillary sinus mucosa is often observed in these images. AIM: Determining the prevalence of teeth and roots that can be identified as cause of maxillary odontogenic sinusitis, and recording the average observed mucosa thickening on these images. METHOD: The scans that give the base of the study have been performed by the Department of Dentistry of Medical University of Pécs between 2015-2016. The size of the voxels had been varied between 0.25 and 0.4 mm and the size of the image had been set up to 15×12 cm. The acquisition time had been set up to 27 seconds. RESULTS: 170 cases of the 260 revised records fulfilled the initial criterion conditions. The average mucosa thickness was 8.8 mm. During the present study, the upper first molars palatal and the second molars mesiobuccal roots were mainly associated with maxillary odontogenic sinusitis. CONCLUSION: Whether in the case of chronic maxillary sinusitis that is not or only temporarily responsive to conventional therapy, may it be justifiable to provide dental consultation and cone-beam computed tomography to exclude the dental origin of sinusitis. Orv Hetil. 2017; 158(44): 1747-1753.

Betamethasone augments the antifungal effect of menadione--towards a novel anti-Candida albicans combination therapy.

The fluorinated glucocorticoid betamethasone stimulated both the extracellular phospholipase production and hypha formation of the opportunistic human pathogen Candida albicans and also decreased the efficiency of the polyene antimycotics amphotericin B and nystatin against C. albicans in a dose-dependent manner. Importantly, betamethasone increased synergistically the anti-Candida activity of the oxidative stress generating agent menadione, which may be exploited in future combination therapies to prevent or cure C. albicans infections, in the field of dermatology.

Increased oxidative stress tolerance results in general stress tolerance in Candida albicans independently of stress-elicited morphological transitions.

A selection of tert-butylhydroperoxide (tBOOH)-tolerant Candida albicans mutants showed increased tolerances to 19 different stress conditions. These mutants are characterized by a constitutively upregulated antioxidative defense system and, therefore, adaptation to oxidative stress may play an important role in gaining general stress tolerance in C. albicans. Although C. albicans cells may undergo morphological transitions under various stress treatments, this ability shows considerable stress-specific and strain-specific variability and, hence, it is independent of mounting stress cross protections.

Study of amine composition of botrytized grape berries.

Aliphatic primary and biogenic amines of grape varieties from two vintages were studied. We established that appearance and/or increase of both primary aliphatic and biogenic amines is due to microbiota living in/on grape berries. Aszú, gray rotten grapes infected mainly with Botrytis cinerea, grape berries infected mainly with Penicillium species, and intact grape berries were compared on the basis of amine composition using t-test, analysis of variance, and multivariate statistical analysis (principal component analysis and linear discriminant analysis). The amine composition and amine content of Aszú grapes were significantly different (p < 0.05) from those of intact grapes despite the effect of the vineyards and the vintages. Grape samples coming from the same growing location, intact, Aszú grapes, and grape berries infected mainly with Penicillium species could be separated from each other with multivariate statistical analysis. We distinguished intact, Aszú (noble rotten), and gray rotten berries from each other as well. Evaluating amine values of grape samples independently of the place of origin, the Aszú and green rotten berries could not be differentiated. The varieties and vineyards have affected the amine composition of Aszú grapes, while these effects on intact grapes appeared only slightly.

Piracetam prevents cognitive decline in coronary artery bypass: a randomized trial versus placebo.

BACKGROUND: Coronary artery bypass grafting (CABG) can be associated with postoperative cognitive impairment and ischemic stroke. No effective treatment is currently available. The aim of this study was to evaluate the effectiveness of piracetam to treat the cognitive impairment after CABG in an investigator-initiated, double-blind, placebo-controlled, randomized clinical trial. METHODS: Patients undergoing CABG (n = 98) were randomized to placebo (n = 48) or piracetam (n = 50). Study drugs were administered intravenously (150 mg/kg daily; 300 mg/kg on the day of surgery) from the day before surgery to 6 days after surgery, then orally (12 g/day) up to 6 weeks after surgery. Cognitive function was assessed before surgery (baseline) and 6 weeks after surgery (outcome) by using a battery of 12 neuropsychologic tests. The Spielberger Anxiety Inventory and the Beck Depression Inventory were also administered. The combined score derived from the standardized neuropsychologic assessments was analyzed by using an analysis of covariance with baseline and education as covariates. RESULTS: Six weeks after surgery, the combined score indicated a statistically significant treatment effect in the per protocol population (1.848, p = 0.041) and a tendency towards statistical significance in the intent-to-treat population (1.624, p = 0.064) in the group treated with piracetam, but no statistically significant treatment effect was seen in the placebo. The state of anxiety measured by the Spielberger Anxiety Inventory was decreased in both groups (-9.27 and -6.37 in the placebo and piracetam groups, respectively). CONCLUSIONS: Six weeks after CABG, cognition was significantly improved in patients treated with piracetam. Additional trials are required to confirm these effects.

Protection of originality of Tokaji Aszú: amines and organic acids in botrytized wines by high-performance liquid chromatography.

Amine and organic acid composition of Aszú wines from the Tokaj region of Hungary, nonbotrytized Hungarian wines from different regions, and foreign botrytized wines were analyzed by high-performance liquid chromatography. Hungarian and foreign wines (36 Hungarian and seven foreign botrytized wines) were compared in different ways by calculation of ratios of given amine compounds, analyses of variance, principal component, and discriminant analysis. In wines, putrescine and in some samples 3-methyl-butylamine and/or phenyl ethylamine were found in remarkable concentrations, while in botrytized wines four other amines were verified in high concentration. Good separation between Aszú and foreign botrytized wines was found by calculation of the amine component's ratio. The first two principal components of the principal component analysis accounted for 77 and 84% of the total variance in the data of amines and acids, respectively. The component scores of samples grouped according to Aszú, foreign botrytized, and nonbotrytized wines. Linear discriminant analysis was used for differentiation of Aszú, foreign botrytized, and normal wines. Using nine amines and two acids as variables, the correct classification was 97.6%. On the basis of results, an objective evaluation method can be elaborated for quality control in order to protect the authenticity and origin of wine specialties made from botrytized grapes.

[Comparison of clinical data of two autopsy series, 1938-1951 and 1990-2002, at the Debrecen University Department of Neurology]. / A klinikai paraméterek változásai 1938-1951 es 1990-2002 között, a Debreceni Idegklinika agyboncolási adatainak elemzése alapján.

BACKGROUND: The clinical parameters of autopsied brains in two periods (1938-1951 and 1990-2002) were analyzed and compared. METHODS: Gender distribution, age, clinical diagnosis, treatment length of 695 (1938-1951) and 1378 (1990-2002) autopsies of Department of Neurology, Debrecen, Hungary were investigated. RESULT: Between 1938-1951 mean 49.6 +/- 15.5 autopsies/year were performed while in the 1990-2002 the autopsies raised to 106 +/- 19.6 /year. In the first period almost all deceased patient has been autopsied, but the ratio decreased on 68.9% between 1990-2002. The average age of autopsied patients (39.1 +/- 2.9 years) almost doubled after 40 years (69.5 +/- 2.0 years). In the first period (1938-1951) the infectious and tumorous cases were most frequent (33.6% and 31.2%), while in the second one, the cerebrovascular diseases dominated (84.5%). There was no significant difference between the treatment lengths of two periods (18.1 and 14.5 days, respectively). CONCLUSIONS: While the absolute number of autopsies raised after 40 years, the ratio decreased at our department (from 100% to 68.9%), similarly to the worldwide trends. The significantly higher age of autopsied patients and the different spectrum of clinical diagnosis reflects the decrease of infectious diseases and increase of stroke frequency and the ageing of the Hungarian population. Authors sustain with literary data that autopsy should not be ignored, and are convinced, together with professor Mohr, that "autopsy is the ultimate audit of medicine, the yardstick of clinical care and research. To dispence with autopsy is an unfortunate trend that certainly endangers the value of clinical research."

Is community-based ecotourism a good use of biodiversity conservation funds?

Community-based ecotourism (CBET) has become a popular tool for biodiversity conservation, based on the principle that biodiversity must pay for itself by generating economic benefits, particularly for local people. There are many examples of projects that produce revenues for local communities and improve local attitudes towards conservation, but the contribution of CBET to conservation and local economic development is limited by factors such as the small areas and few people involved, limited earnings, weak linkages between biodiversity gains and commercial success, and the competitive and specialized nature of the tourism industry. Many CBET projects cited as success stories actually involve little change in existing local land and resource-use practices, provide only a modest supplement to local livelihoods, and remain dependent on external support for long periods, if not indefinitely. Investment in CBET might be justified in cases where such small changes and benefits can yield significant conservation and social benefits, although it must still be recognized as requiring a long term funding commitment. Here, I aim to identify conditions under which CBET is, and is not, likely to be effective, efficient and sustainable compared with alternative approaches for conserving biodiversity. I also highlight the need for better data and more rigorous analysis of both conservation and economic impacts.

Distribution of various peptides in citrus fruits (grapefruit, lemon, and orange).

Tissue- and species-specific peptides of the grapefruit have been investigated by SDS-PAGE and Western blot. Five peptides from the juice and one peptide from the peel were isolated by preparative gel electrophoresis. Polyclonal antibodies were developed against them in mice. It can be established that 82, 63, and 46 kDa peptides occurred exclusively in the samples prepared from the grapefruit and the lemon juice, whereas in the orange juice, only the 82 kDa peptide could be detected. The 31 kDa peptide is characteristic for the peel samples of grapefruit and lemon. The 210 kDa peptide did not show any specificity. A 117 kDa peptide appeared in the juice and peel of grapefruit and in the peel of lemon but not in the orange. From the data of this study, it is supposed that some of the polyclonal antibodies developed against characteristic juice and peel peptides can be used to test commercial grapefruit juice products for adulteration.