Trends in prevalence and risk factors of allergic rhinitis symptoms in primary schoolchildren six years apart in Budapest.

BACKGROUND: Few data are available concerning the time trends and risk factors associated with allergic rhinitis (AR) in schoolchildren in Hungary. METHODS: At an interval of six years, parents of 6-12-year-old children completed identical ISAAC-based and additional questionnaires related to possible risk factors. RESULTS: Response rate was 62.8% with 6335 questionnaires distributed in 2007, and 52.9% with 6441 questionnaires in 2013. The prevalence of current AR symptoms (subjects presenting clinical symptoms of AR in the past 12 months, but had yet to be diagnosed by physician) increased significantly from 14.9% to 23.5% (p<0.001). There was no significant change in the prevalence of physician-diagnosed AR (11.6-11.2%). In multivariate analysis, gender (OR 0.733; CI 0.642-0.931), a family history of atopy (OR 2.017; CI 1.669-2.436), frequent upper respiratory tract infections (OR 2.033; CI 1.659-2.492), long-lasting disease before the appearance of the allergy (OR 2.119; CI 1.311-3.428), feather bedding (OR 0.773; CI 0.599-0.996) and living in a green area (OR 1.367; CI 1.133-1.650) were found to be significant risk factors of cumulative AR in 2013. In both of the groups with (p<0.000) or without (p<0.003) AR the families with a history of atopy used feather bedding less frequently than families without atopy. CONCLUSION: Although the prevalence of physician-diagnosed AR has not shown significant changes during the studied interval, the significant increase of the current AR symptoms suggests growing prevalence of AR among children in Budapest. Our results revealed new aspects of bedding customs in atopic families.

A THz transparent 3D printed microfluidic cell for small angle x-ray scattering.

Excitation frequencies in the terahertz (THz) range are expected to lead to functionally relevant domain movements within the biological macromolecules such as proteins. The possibility of examining such movements in an aqueous environment is particularly valuable since here proteins are not deprived of any motional degrees of freedom. Small angle x-ray scattering (SAXS) is a powerful method to study the structure and domain movements of proteins in solution. Here, we present a microfluidic cell for SAXS experiments, which is also transparent for THz radiation. Specifically, cell dimensions and material were optimized for both radiation sources. In addition, the polystyrene cell can be 3D printed and easily assembled. We demonstrate the practicality of our design for SAXS measurements on several proteins in solution.

Structural phase transformations in annealed Pt/Mn/Fe trilayers.

Thermally-activated phase transitions in Pt/Mn/Fe thin films were investigated by a combination of x-ray diffraction, transmission electron microscopy, secondary neutral mass spectrometry depth profiling, atomic force microscopy, and magnetic properties measurements. Post-annealing was carried out in vacuum to different temperatures up to 620 °C. Initially, at temperatures between 280 °C-450 °C first L10-MnPt is formed at the Mn/Pt interface followed by the most likely formation of metastable bcc Fe3Pt, which gets transformed by further annealing to fcc Fe3Pt and eventually to chemically ordered L12-Fe3Pt. The final product after annealing at 620 °C consists of two interesting phases, which are relevant for spintronic applications, antiferromagnetic L10-MnPt with addition of Fe and ferromagnetic L12-Fe3Pt, consistent with the initial element composition.

In cellulo crystallization of Trypanosoma brucei IMP dehydrogenase enables the identification of genuine co-factors.

Sleeping sickness is a fatal disease caused by the protozoan parasite Trypanosoma brucei (Tb). Inosine-5'-monophosphate dehydrogenase (IMPDH) has been proposed as a potential drug target, since it maintains the balance between guanylate deoxynucleotide and ribonucleotide levels that is pivotal for the parasite. Here we report the structure of TbIMPDH at room temperature utilizing free-electron laser radiation on crystals grown in living insect cells. The 2.80 Å resolution structure reveals the presence of ATP and GMP at the canonical sites of the Bateman domains, the latter in a so far unknown coordination mode. Consistent with previously reported IMPDH complexes harboring guanosine nucleotides at the second canonical site, TbIMPDH forms a compact oligomer structure, supporting a nucleotide-controlled conformational switch that allosterically modulates the catalytic activity. The oligomeric TbIMPDH structure we present here reveals the potential of in cellulo crystallization to identify genuine allosteric co-factors from a natural reservoir of specific compounds.

Phase transformations in Pt/Fe bilayers during post annealing probed by resistometry.

X-ray diffraction (XRD), secondary neutral mass spectrometry (SNMS) depth profiling, and electrical resistivity measurements were used to follow the phase transformations in Pt/Fe bi-layered thin films during annealing. Initially, the electrical resistivity increases linearly with temperature up to 150 °C due to the contribution of phonon scattering of the metallic Pt and Fe bilayer. Further increase of the annealing temperature leads to a steeper linear increase, which is associated with the initial formation of the chemically disordered A1-phase followed by the formation of the chemically ordered L10-FePt phase, as confirmed by XRD and SNMS studies. Finally, at about 620 °C the single L10-FePt phase has formed throughout the film. Moreover, the electrical resistivity contains also the magnetic contribution to the total resistivity. In this case, the loss in magnetic order is indicated by a change in temperature dependence of the resistivity at about 310 °C, representing the Curie temperature of the initially formed A1-FePt alloy, while the finally formed L10-FePt alloy reveals a higher magnetic transition temperature of about 410 °C. In this study, it has been demonstrated that resistometry in combination with structural and chemical analysis provides valuable information on diffusion processes, structural phase formations and its stability range, as well as on the magnetic transition temperature.

Survivin in autoimmune diseases.

Survivin is a protein functionally important for cell division, apoptosis, and possibly, for micro-RNA biogenesis. It is an established marker of malignant cell transformation. In non-malignant conditions, the unique properties of survivin make it indispensable for homeostasis of the immune system. Indeed, it is required for the innate and adaptive immune responses, controlling differentiation and maintenance of CD4+ and CD8+ memory T-cells, and in B cell maturation. Recently, survivin has emerged as an important player in the pathogenesis of autoimmune diseases. Under the conditions of unreserved inflammation, survivin enhances antigen presentation, maintains persistence of autoreactive cells, and supports production of autoantibodies. In this context, survivin takes its place as a diagnostic and prognostic marker in rheumatoid arthritis, psoriasis, systemic sclerosis and pulmonary arterial hypertension, neuropathology and multiple sclerosis, inflammatory bowel diseases and oral lichen planus. In this review, we summarise the knowledge about non-malignant properties of survivin and focus on its engagement in cellular and molecular pathology of autoimmune diseases. The review highlights utility of survivin measures for clinical applications. It provides rational for the survivin inhibiting strategies and presents results of recent reports on survivin inhibition in modern therapies of cancers and autoimmune diseases.

Biodegradable airway stents in infants - Potential life-threatening pitfalls.

OBJECTIVE: The solution of severe tracheobronchial obstructions in early childhood means a great challenge. Biodegradable stents were intended to be a minimally invasive temporary solution which may decrease the number of interventions and limit the possible complications of stenting procedures. However, our first experiences have brought out a new, - especially in childhood - potentially life-threatening complication of this concept. METHODS: Five SX-ELLA biodegradable polydioxanone stents was applied in three patients because of severe tracheobronchial obstruction: congenital tracheomalacia (7 day-old), acquired tracheomalacia (10 month-old), and congenital trachea-bronchomalacia (10 month-old). RESULTS: The breathing of all children improved right after the procedure. We observed degradation of the stent from the 5th postoperative week which resulted in large intraluminar fragments causing significant airway obstruction: one patient died of severe pneumonia, the other baby required urgent bronchoscopy to remove the obstructing 'foreign body' from the trachea. In the third case repeated stent placements successfully maintained the tracheal lumen. CONCLUSIONS: Polydioxanone stents may offer an alternative to metallic or silastic stents for collapse or external compression of the trachea in children; however, large decaying fragments mean a potential risk especially in the small size pediatric airway. The fragmentation of the stent, which generally starts in the 4-6 postoperative weeks, may create large sharp pieces. These may be anchored to the mucosa and covered by crust leading to obstruction. As repeated interventions are required, we do not consider the application of biodegradable stents unambiguously advantageous.

Graphene oxide vs. reduced graphene oxide as carbon support in porphyrin peroxidase biomimetic nanomaterials.

The paper describes the preparation of supramolecular assemblies of tetrapyridylporphyrin (TPyP) and its metallic complexes with graphene oxide (GO) and thermally reduced graphene oxide (TRGO). The two carbon supports are introducing different characteristics in the absorption spectra of the investigated nanocomposites. Raman spectroscopy shows that the absorption of iron-tetrapyridylporphyrin is more efficient on GO than TRGO, suggesting that oxygen functionalities are involved in the non-covalent interaction between the iron-porphyrin and graphene. The biomimetic peroxidase activity is investigated and the two iron-containing composites exhibit a better catalytic activity than each component of the assembly, and their cobalt and manganese homologues, respectively. The main advantages of this work include the demonstration of graphene oxide as a very good support for graphene-based nanomaterials with peroxidase-like activity (K(M)=0.292 mM), the catalytic activity being observed even with very small amounts of porphyrins (the TPyP:graphene ratio=1:50). Its potential application in the detection of lipophilic antioxidants (vitamin E can be measured in the 10(-5)-10(-4) M range) is also shown.

Clinical experiences with the intramuscular injection of tiaprofenic acid in rheumatic diseases, with particular emphasis on time of onset and duration of the analgesic effect.

The efficacy of intramuscular tiaprofenic acid (TA) was investigated in 3 separate studies: a multicentre open study involving 487 patients with various rheumatic conditions: an open study of 31 patients with active osteoarthritis of the knee; and an open comparative study with ketoprofen involving 30 patients with acute gout. In each of the studies tiaprofenic acid was given at a dose of 200mg intramuscularly twice daily for 5 days. In addition to clinical efficacy and tolerance, the time of onset and duration of the analgesic effect were also assessed. Significant improvements in both pain intensity and inflammation were seen in 60 to 70% of all patients in the 3 studies (p less than 0.0001). Benefits from tiaprofenic acid injection were noted within 60 minutes by about 47% of the patients with acute gout and about 85% of the whole group of patients enrolled in the multicentre study. The analgesic effect lasted from 8 to 12 hours in about 52% of the latter patients, and the overall effect was assessed as either good, very good or excellent in 62.5 to 100% of patients. Results from the comparative study with ketoprofen in acute gout patients showed a better and faster beneficial effect in the group receiving tiaprofenic acid. Thus the intramuscular administration of tiaprofenic acid at a dose of 200mg twice daily for 5 days to 533 patients with different rheumatic conditions resulted in good analgesic and anti-inflammatory activities with a rapid and sustained effect, and was also well tolerated.

Dopamine/L-dopa ratio in cerebrospinal fluid of parkinsonian patients treated with L-dopa + benserazide.

The CSF dopamine/L-dopa ratio was examined in 14 parkinsonian and six control patients. In parkinsonian patients the dopamine/L-dopa ratio showed significant correlation with the severity of the disease, as characterized by Yahr's scale. These data suggest some correlation between the dopamine synthesizing capacity and the degree of disability.

Nosocomial Streptococcus pneumoniae infection causing children's acute otitis media.

Streptococcus pneumoniae is the most frequent pathogen in young children's acute otitis media. It also plays a significant role in nosocomial ear infection in children, while it causes pneumonia with or without bacteremia in hospitalized elderly people. Multiple antibiotic resistant strains are prevalent among S. pneumoniae isolates from the respiratory tract of hospitalized patients in Hungary. This fact makes therapeutic reconsiderations concerning the use of oral beta-lactams mandatory. In this retrospective study two nosocomial outbreaks caused by multiresistant S. pneumoniae in two pediatric hospitals are described. The patients admitted with a chronic underlying disease (milk intolerance and gastro-oesophageal reflux were predominant) or respiratory tract infection acquired acute otitis media. Therapy with oral beta-lactams (first and second generation cephalosporins and amoxicillin), macrolides and co-trimoxazole was ineffective in most of the cases or resulted in transient improvement. In some cases acute otitis media resolved with the improvement of the underlying condition, in two cases administration of cefotaxime resulted in recovery and in one case mastoidectomy became necessary.

A clinical trial of glycosaminoglycan-peptide complex ('Rumalon') in patients with osteoarthritis of the knee.

A clinical trial was undertaken in 50 patients with osteoarthritis of the knee to assess the therapeutic value of glycosaminoglycan-peptide complex in treatment. The first year consisted of a randomized, double-blind, placebo-controlled, parallel-group trial (25 patients in each group), after which all patients received active treatment for a further 2 years. Treatment consisted of three 8-week courses in the first year and 2 such courses per year in subsequent years, each consisting of 2 ml intramuscular injections given 3 times per week. Patients were permitted to continue taking anti-inflammatory drugs and to receive physiotherapy during the trial period. At the end of the first year of the trial (double-blind phase), there were no significant differences between the two treatment groups. However, after the second year, those patients who had received glycosaminoglycan-peptide complex for 2 years had significantly greater improvements in night pain and rest pain than did those who had received active treatment for only 1 year. At the end of 3 years (when half the patients had received active treatment for 2 years and half for 3 years), there were significant overall improvements in relation to rest pain, pain on walking and morning stiffness, but not in respect to night pain, pain on standing or climbing stairs. At the same time, improvements were seen in radiological severity of disease (assessed double-blind) in 16% of patients, with 'no change' in 74% and deterioration in 10%, these figures being considerably better than might be expected with conventional therapy. Glycosaminoglycan-peptide complex was extremely well tolerated.

L-deprenyl in the treatment of Parkinson's disease.

The experiences of a six years' follow-up study with L-Deprenyl are summarized. L-Deprenyl may be effective in influencing the very early Parkinsonian symptoms but usually levodopa derivates must be given in addition. In the course of substitution therapy L-Deprenyl successfully replaces about 30% of levodopa administered to optimally treated patients. Concerning the "on-off" phenomena L-Deprenyl seems to be beneficial in the mild forms of "end-of-dose deterioration".

The choice of the ideal anti-inflammatory drug.

The selection of the ideal anti-inflammatory drug is an important task bearing in mind some of the characteristics concerning its pharmacokinetics, mechanism of action, efficacy, tolerability, dosage, safety, presentation and route of administration, patient compliance and patient expectancy. The present paper deals with each of these topics, based on current knowledge of the different anti-inflammatory drugs and the more than 20 years experience in a great number of clinical trials with most of the best known non-hormonal anti-inflammatory compounds.

The cytologic identification and quantification of testicular cell subtypes. Reproducibility and relation to histologic findings in the diagnosis of male infertility.

In testicular imprint smears from 100 infertile men (both testicles), stained using the Pappenheim and Papanicolaou methods, the cell forms (light and dark spermatogonia, primary and secondary spermatocytes, spermatids, spermatozoa and Sertoli cells) were identified and quantified by the counting of 500 consecutive cells. Identification of the cell types, which are described and illustrated, was consistent and reproducible; the advantages of the different stainings in their analysis is documented. The cell counts were tested for reproducibility and compared to the histologic diagnoses and sperm counts. Statistical analysis showed the highest reproducibility for cells frequently encountered in smears (0.99 for Sertoli cells and 0.98 for spermatozoa) and the lowest but still satisfactory reproducibility for rare or arbitrarily defined cell forms (0.71 for dark spermatogonia and 0.76 for secondary spermatocytes). The high reproducibility of the smear quantification permits the introduction of a number of indices, defining clinically useful relations between cell types that are indicative of various types of infertility. The data obtained by cytologic quantification showed reasonably good correlation with the histologic diagnoses of desquamation and focal fibrosis and excellent correlation with Sertoli cells only, arrested spermatogenesis and complete fibrosis. The cytologic quantification of testicular smears adds considerable information to the diagnosis of impaired fertility and should be instituted in properly equipped centers.

Epipharyngeal teratoma in infancy.

Epipharyngeal teratomas are rare congenital lesions that often cause respiratory distress, stridor at birth. The management of such anomalies should include establishment of secure upper airways, radiographic exclusion of midline CNS malformations and early surgical excision to prevent malignant transformation, asphyxia or permanent facial distortion. The diagnosis of congenital stridor, dyspnea and rhinitis should be performed very carefully.

Transitory evoked otoacoustic emission (TEOAE) in a child with profound hearing loss.

The case of a 3-month-old, prematurely born boy with auditory brainstem response (ABR), verified profound hearing loss and normal transitory evoked otoacoustic emission is presented. Isolated retrocochlear deafness which did not influence TEOAE is hypothesised as a possible cause. The critical evaluation of results when using TEOAE as a screening method is suggested.

Effect of vitamin E-deficiency on the activity of some lysosomal and non-lysosomal proteases in rabbit muscles.

The activity of different cathepsins and neutral proteinases was measured in normal and vitamin E-deficient rabbit muscles using specific substrates. Among the changes of enzyme activities in dystrophy caused by vitamin E-deficiency the increase in the activity of cathepsin B is the most striking. The activity of cathepsin H, both in the fast and slow muscles and that of MMP-ase in the slow muscle remains practically unchanged. Activities of other proteases significantly increase. The change in the activity of proteolytic enzymes in striated muscle of vitamin E-deficient rabbits seems to be selective. As a rule the increase in the activity is higher in fast than in slow muscles.

Osteoarthritis--an inflammatory disease?

From a study of 160 cases of osteoarthritis (OA), including photographs from gross examination, arthroscopy, radionuclide scanning and histological preparations including crystal deposits from synovial fluid, it is concluded that OA may be regarded as an inflammatory condition for which the use of non-steroidal antiinflammatory drugs rather than pure analgesics should be encouraged.

[Objective audiologic assessment of children treated with amikacin]. / Amikacinnal kezelt gyermekek objektív audiológiai vizsgálata.

Hearing assessment of 14 children suffered from urinary tract infection and treated by amikacin is reported. The dosage of amikacin was 7.5 mg/kg/daily for 10 days and the serum level of amikacin not exceeded the 35 mcg/ml. The aim of the study was on the one hand to determine the hearing damaging side effect of amikacin and on the other to assess the usefulness of objective methods for detection of hearing loss in this population. Authors used for screening a transient otoacoustic emission (TEOAE) during and after (2-4 weeks) therapy. If subjective and objective (TEOAE) methods gave a good result, no further checkup has considered as necessary, but if there were no evoked emission, acoustic brainstem response audiometry has been carried out for verification. It result no hearing loss could be detected in the measured specimen. In conclusion it has been stated that by proper dosage and serum level screening amikacin may no lead to hearing loss in children, and objective methods are valuable for hearing screening and monitoring of such population of children.