Quantitative determination of isoflavonoids in Ononis species by UPLC-UV-DAD.

INTRODUCTION: The root of the Ononis species has been used internally and externally in ethnomedicine for centuries and contains biologically valuable isoflavonoid compounds. Therefore, it is important to obtain quantitative information about the isoflavonoid profile of these plants. OBJECTIVES: In this article we aimed to develop an optimised sample preparation protocol alongside a validated method for the quantitative measurement of isoflavones, isoflavanones and pterocarpans in the form of glucosides and aglycones, in order to compare the specialised metabolites of Ononis spinosa L. and O. arvensis L. MATERIAL AND METHODS: Quantitative determination was carried out by the means of ultra-performance liquid chromatography coupled with ultraviolet diode-array detection (UPLC-UV-DAD). RESULTS: An optimised sample preparation method was developed to transform malonyl glucosides to their glucosidic forms. Chromatographic methods were created for the baseline separation of isoflavones, isoflavanones and pterocarpans alongside with their glucosides. Altogether 12 compounds were evaluated quantitatively in samples of O. spinosa and O. arvensis. CONCLUSION: As a result, no characteristic change could be observed between the two species regarding their isoflavonoid pattern.

Aerobic exercise training and vascular function with ageing in healthy men and women.

Cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality in both men and women in developed societies. Age is the greatest risk factor for CVD due largely to adverse changes to arteries that include stiffening of the large elastic arteries (aortic and carotid arteries) and endothelial dysfunction. Vascular ageing is driven by oxidative stress, which reduces nitric oxide (NO) bioavailability and stimulates changes in the extracellular matrix. In women, reductions in circulating oestrogens with menopause interact with ageing processes to induce vascular dysfunction. Regular aerobic exercise is the most evidence-based strategy for reducing CVD risk with ageing in both men and women. Much of this cardiovascular-protective effect of aerobic exercise is likely due to its vascular health-enhancing influence. Large elastic artery stiffening with advancing age is attenuated in healthy adults engaged in aerobic exercise training, and aerobic exercise interventions improve arterial stiffness in previously sedentary middle-aged and older men and postmenopausal women. Regular aerobic exercise also enhances endothelial function with ageing in men (by reducing oxidative stress and preserving NO bioavailability), but not consistently in oestrogen-deficient postmenopausal women. In postmenopausal women, treatment with oestradiol appears to restore the ability of aerobic exercise to improve NO-mediated endothelial function by reducing oxidative stress. Several research gaps exist in our understanding of potential sex differences in the vascular adaptations to regular aerobic exercise. More information is needed on the factors that are responsible for sex differences, including the role of circulating oestrogens in transducing the aerobic exercise training 'stimulus'.

[Improvement in the glycaemic control of patients after switching from human insulin to insulin glargine-based basal-bolus regimen]. / Humán inzulinról glargininzulin-alapú bázis-bolus kezelésre váltott betegek glykaemiás állapotának javulása a váltás után.

INTRODUCTION: The effectiveness of human and analogue insulins is similar but the latter have more advantageous pharmacokinetic features, leading to an improvement in hypoglycaemia and come closer to achieving the physiologic insulin profile. AIM: To demonstrate that switching from a human basal-bolus insulin treatment to an insulin glargine-based basal-bolus regimen can achieve a better glycaemic control. METHOD: This 3-month prospective, non-interventional study, including a 12-month retrospective data collection phase, enrolled patients who were switched to the insulin glargine- - 100 U/mL - based basal-bolus treatment at the time of enrolment if they were inadequately controlled and had at least one additional HbA1c result in the 12 months before the switch. Of 1513 patients 1181 had the data that were needed for the efficacy analysis. RESULTS: The mean age of the efficacy population was 58.3 years and 48.1% were male. Their mean HbA1c levels remained unchanged in the year before the switch: it was 8.8 ± 1.4% at 12 months prior to the switch and 8.8 ± 1.2% at the switch, but decreased significantly to 7.7 ± 1.0% (p<0.001) after 3 months. Between the baseline and 3 months, the fasting blood glucose and the postprandial blood glucose improved significantly (from 10.0 ± 3.2 mmol/L to 7.4 ± 1.9 mmol/L, p<0.001 and from 11.1 ± 2.8 mmol/L to 8.8 ± 1.7 mmol/L, p<0.001, respectively). Insulin doses were increased both before and after the switch. CONCLUSIONS: Switch to an insulin glargine-based basal-bolus regimen could achieve a significant improvement in the glycaemic control in patients who were inadequately controlled prior to the switch. Orv Hetil. 2018; 159(29): 1201-1207.

[The value of early repeated N-terminal pro-B-type natriuretic peptide measurement in acute heart failure]. / Az N-terminális pro-B natriureticus peptid mérésének korai ismétlése akut szívelégtelenség miatt hospitalizált betegeken.

INTRODUCTION: The determination of natriuretic peptide levels in patients hospitalized for suspected acute heart failure is important for the confirmation of the diagnosis and for the prognosis. Changes in natriuretic peptide levels in response to therapy have a strong prognostic value. AIM: To decide whether repeated natriuretic peptide measurements for acute heart failure show changes that could influence the diagnosis and/or the prognosis. METHOD: Prospective data collection was carried out of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels on admission and within 12 hours in patients hospitalized for acute heart failure. Only the data of those patients were analyzed whose symptoms started within 24 hours prior to admission and were due to acute heart failure. RESULTS: The 23 patients whose data we analyzed had an average age of 77.9 ± 8.3 years. Most of them had left ventricular systolic dysfunction with an average ejection fraction of 34.1 ± 3.9%. The time between the start of symptoms and the first measurement was 6.7 ± 2.2 hours, while the time until the repeated determination was 6.5 ± 2.2 hours after the first measurement. The median value of the NT-proBNP levels in the 6 hours control showed an increase from 5064 pg/mL to 8847 pg/mL (p<0.0005), which amounts to a 75 percent increase - mean hs-troponin T showed an increase from 46 ± 25 ng/L to 78 ± 51 ng/L (p<0.002). CONCLUSIONS: A significant increase in NT-proBNP levels is to be expected in early repeated measurement after hospital admission. This fact could have diagnostic and prognostic consequences if validated in a larger patient population. Orv Hetil. 2018; 159(25): 1009-1012.

[The prognostic role of extremely high levels of the B-type natriuretic prohormone with regard to the in-hospital mortality of patients hospitalized for heart failure]. / Extrém magas B típusú natriureticus prohormon prognosztikai szerepe a szívelégtelenség miatt kezelt betegek kórházi halálozására.

INTRODUCTION: Patients hospitalized for heart failure have a very high in-hospital as well as one-year mortality. Natriuretic peptides play both a diagnostic and a prognostic role in this disease. Changes of natriuretic peptide levels in response to therapy are a well-known prognostic marker. Regarding in-hospital mortality, however, little is known about the prognostic value of extremely high levels of natriuretic peptides measured on admission. AIM: To decide whether extremely high levels of B-type natriuretic peptide have a prognostic value with regard to in-hospital mortality. METHOD: NT-proBNP levels on admission and in-hospital mortality were extracted retrospectively from the data of patients treated with heart failure in the cardiology department of the Hospital of St. John of God in Budapest. We separately analyzed the data of patients hospitalized for heart failure in 2015 with extremely high initial NT-proBNP levels. The cut-off value in this regard was 10 000 ng/l. We also analyzed the comorbidities of these patients. RESULTS: The median NT-proBNP level of those patients who survived beyond the index hospital stay in the last 10 years was 4842 ng/l, whereas the median NT-proBNP level of those 182 patients who died during their hospital stay was 10 688 ng/l (p<0.001). In the year 2015, we treated 118 patients with an NT-proBNP level above 10 000 ng/l. Thirteen of these patients died, which means that their in-hospital mortality exceeded 10%. In comparison, the in-hospital mortality of all heart failure patients was 5.8%. The difference of median NT-proBNP levels of surviving versus deceased patients in this group with extremely high NT-proBNP levels was no longer significant (17 080 ng/l vs. 19 152 ng/l). CONCLUSIONS: Patients with an NT-proBNP level of >10 000 ng/l on admission have a significantly higher in-hospital mortality. The difference of NT-proBNP levels of surviving versus deceased patients in the group with admission NT-proBNP levels >10 000 ng/l is no longer significant. We could not identify any etiological factors that would explain these extremely high NT-proBNP levels or the excess in-hospital mortality. Orv Hetil. 2017; 158(20): 779-782.

Effects of laser treatment on the expression of cytosolic proteins in the synovium of patients with osteoarthritis.

BACKGROUND AND OBJECTIVE: Low level laser therapy (LLLT) has been developed for non-invasive treatment of joint diseases. We have previously shown that LLLT influenced synovial protein expression in rheumatoid arthritis (RA). The aim of this study was to assess the effects of laser irradiation on osteoarthritic (OA) synovial protein expression. STUDY DESIGN/MATERIALS AND METHODS: The synovial membrane samples removed from the knees of 6 OA patients were irradiated ex vivo using near infrared diode laser (807-811 nm; 25 J/cm(2) ). An untreated sample taken from the same patient served as control. Synovial protein separation and identification were performed by two-dimensional differential gel electrophoresis and mass spectrometry, respectively. RESULTS: Eleven proteins showing altered expression due to laser irradiation were identified. There were three patients whose tissue samples demonstrated a significant increase (P < 0.05) in mitochondrial heat shock 60 kD protein 1 variant 1. The expression of the other proteins (calpain small subunit 1, tubulin alpha-1C and beta 2, vimentin variant 3, annexin A1, annexin A5, cofilin 1, transgelin, and collagen type VI alpha 2 chain precursor) significantly decreased (P < 0.05) compared to the control samples. CONCLUSIONS: A single diode laser irradiation of the synovial samples of patients with osteoarthritis can statistically significantly alter the expression of some proteins in vitro. These findings provide some more evidence for biological efficacy of LLLT treatment, used for osteoarthritis.

[Special application of matrix-assisted laser desorption ionization time-of-flight mass spectrometry in clinical microbiological diagnostics]. / Mátrix-asszisztált lézer deszorpciós, ionizációs, repülési ido mérésén alapuló tömegspektrometria speciális alkalmazása a klinikai mikrobiológiai diagnosztika területén.

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry as a new possibility for rapid identification of bacteria and fungi revolutionized the clinical microbiological diagnostics. It has an extreme importance in the routine microbiological laboratories, as identification of the pathogenic species rapidly will influence antibiotic selection before the final determination of antibiotic resistance of the isolate. The classical methods for identification of bacteria or fungi, based on biochemical tests, are influenced by many environmental factors. The matrix-assisted laser desorption ionization time-of-flight mass spectrometry is a rapid method which is able to identify a great variety of the isolated bacteria and fungi based on the composition of conserved ribosomal proteins. Recently several other applications of the method have also been investigated such as direct identification of pathogens from the positive blood cultures. There are possibilities to identify bacteria from the urine samples in urinary tract infection or from other sterile body fluids. Using selective enrichment broth Salmonella sp from the stool samples can be identified more rapidly, too. The extended spectrum beta-lactamase or carbapenemase production of the isolated bacteria can be also detected by this method helping the antibiotic selection in some cases. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry based methods are suitable to investigate changes in deoxyribonucleic acid or ribonucleic acid, to carry out rapid antibiotic resistance determination or other proteomic analysis. The aim of this paper is to give an overview about present possibilities of using this technique in the clinical microbiological routine procedures.

In-situ investigation of the decomposition process in cold-rolled Nb53Ti47 alloy.

The multi-layer composite development primarily aims to develop and test the components of the next generation of hadron colliders (e.g., Large Hadron Collider - LHC) consisting of superconducting raw materials. Multilayer sheet is very similar to the commonly used NbTi wire products, a 2D version of the commercial wire. These composites consist of layers such as NbTi superconductor, Nb diffusion barrier (between NbTi and Cu) and Cu stabilizer. In ß-NbTi superconducting alloys, α-Ti precipitates are primary flux pinning centers that maintain stable superconductivity. A multi-step series of heat treatments and cold-forming processes can develop the flux pinning centers. Practically, this process means three heat treatments of constant period and temperature and drawing or rolling between the heat treatments. The study aimed to describe the behavior of the cold-rolled (ε = 3.35) Nb53Ti47w% alloys during isothermal heating at 673 K as a function of heating time. The processes during the aging were investigated by the in-situ XRD method in the heating chamber. The X-ray diffraction patterns were evaluated by Rietveld refinement. The thermally activated spinodal decomposition and precipitation processes were described based on the phases identified at the individual heat treatment steps and their lattice parameters. The in-situ study also revealed an increase in α-Ti precipitation with time and decomposition that co-occurs. This is the basic study that prepares the applicability of the alloy.

Characterisation of the complete chloroplast genome of Solanum tuberosum cv. White Lady.

Potato (Solanum tuberosum) is considered worldwide as one of the most important non-cereal food crops. As a result of its adaptability and worldwide production area, potato displays a vast phenotypical variability as well as genomic diversity. Chloroplast genomes have long been a core issue in plant molecular evolution and phylogenetic studies, and have an important role in revealing photosynthetic mechanisms, metabolic regulations and the adaptive evolution of plants. We sequenced the complete chloroplast genome of the Hungarian cultivar White Lady, which is 155 549 base pairs (bp) in length and is characterised by the typical quadripartite structure composed of a large- and small single-copy region (85 991 bp and 18 374 bp, respectively) interspersed by two identical inverted repeats (25 592 bp). The genome consists of 127 genes of which 82 are protein-coding, eight are ribosomal RNAs and 37 are transfer RNAs. The overall gene content and distribution of the genes on the White Lady chloroplast was the same as found in other potato chloroplasts. The alignment of S. tuberosum chloroplast genome sequences resulted in a highly resolved tree, with 10 out of the 13 nodes recovered having bootstrap values over 90%. By comparing the White Lady chloroplast genome with available S. tuberosum sequences we found that gene content and synteny are highly conserved. The new chloroplast sequence can support further studies of genetic diversity, resource conservation, evolution and applied agricultural research. The new sequence can support further potato genetic diversity and evolutionary studies, resource conservation, and also applied agricultural research.

Case-Study Investigation of Equine Maternity via PCR-RFLP: A Biochemistry Laboratory Experiment.

A simple and robust biochemistry laboratory experiment is described that uses restriction fragment length polymorphism (RFLP) of polymerase chain reaction (PCR) products to verify the identity of a potentially valuable horse. During the first laboratory period, students purify DNA from equine samples and amplify two loci of mitochondrial DNA. During the second laboratory period, students digest PCR products with restriction enzymes and analyze the fragment sizes through agarose gel electrophoresis. An optional step of validating DNA extracts through realtime PCR can expand the experiment to three weeks. This experiment, which has an engaging and versatile scenario, provides students with exposure to key principles and techniques of molecular biology, bioinformatics, and evolution in a forensic context.

[COVID-19 infections and effectiveness of the vaccination among healthcare workers]. / A COVID­19-fertozés és a védooltások hatásosságának vizsgálata egészségügyi dolgozókon.

INTRODUCTION: New variants of the SARS-CoV-2 coronavirus are constantly appearing, causing the COVID-19 pandemic. From November 2021, most infections were caused by the Omicron coronavirus variant. OBJECTIVE: The aim of this prospective observational cohort study was to estimate the incidence of COVID-19 infections in the high-risk healthcare workers after two BNT162b2 mRNA Pfizer-BioNTech vaccines and the subsequent booster vaccine, as well as the effectiveness, the safety and the humoral immune response of the vaccines. METHOD: We started the two Pfizer-BioNTech ((BNT162b29) vaccinations of healthcare workers of the Polyclinic of the Hospitaller Brothers of St. John between January 07 and March 08, 2021. The choice of the type and timing of the third booster vaccination was voluntary. The workers were followed up between January 07, 2021 and June 29, 2022. The infection rate, adverse events of the vaccination, risk factors to infection and the kinetics of anti-spike (S) antibody and anti-nucleocapsid (N) antibody serum level were evaluated. RESULTS: The data of 294 healthcare workers - 96 medical doctors, 127 nurses and 71 workers in hospital - who had at least three antibody level measurements were analyzed. The third booster vaccine was given to 280 workers, the distribution of the vaccines was the following: Pfizer-BioNTech (BNT162b29) vaccine (n = 210), Moderna COVID-19 (mRNA-1273) vaccine (n = 37), Sinopharm COVID-19 vaccine (n = 21), Janssen COVID-19 (n = 10), AstraZeneca (ChAdOx1 nCoV-19) vaccine (n = 2). Infection occurred in 121 cases (41%) during the observation period. The course of the COVID-19 infections was mostly mild (97%) and recovered within a week. During the observational period, 2 workers died: a 56-year-old woman died after two vaccinations for reason unrelated to COVID-19 infection, and a 58-year-old man died after the booster vaccination, following COVID-19 infection. The incidence of infection did not correlate with age, sex, comorbidities, smoking, occupation and BMI. The median titre of anti-S antibody serum level increased one month after the second vaccination of the basic immunization (1173.0 U/ml) and decreased slowly until the 8th month (678.5-625.8-538.0 U/ml) after the basic vaccination. One month after the booster vaccination, the median titre of anti-S antibody serum level increased significantly (16 535 U/ml), and showed a decreasing trend in the 3rd month after the booster vaccination (9697.7 U/ml). An exceptionally high S antibody serum level increasing after the basic (>10 000 U/mL) and booster (>60 000 U/m) vaccination showed a correlation with prior COVID-19 infection. The median cut-off index (COI) of anti-N antibody was not affected by vaccination, the increasing of the titre is related to the infection. CONCLUSION: The booster vaccination had less effect on the infection caused by Omicron variant, but the course of the infection was milder. Compared to the basic immunisation, the booster vaccination caused a significant increase in the S antibody level. An exceptionally high S antibody level correlated with prior COVID-19 infection. Orv Hetil. 2023; 164(5): 163-171.

Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in healthcare workers / A BNT162b2 mRNS-Pfizer-BioNTech-védooltás hatásosságának és immunogenitásának monitorozása egészségügyben dolgozókon.

Összefoglaló. Bevezetés: A SARS-CoV-2 koronavírus okozta COVID-19 általános egészségügyi és gazdasági krízist idézett elo. Célkituzés: A megfigyeléses vizsgálat célja a BNT162b2 mRNS-Pfizer-BioNTech-vakcina hatásosságának, biztonságosságának és immunogenitásának igazolása a Budai Irgalmasrendi Kórház dolgozóin. Módszer: A vakcina adása után elemeztük a COVID-19-fertozés elofordulását, az oltások utáni reakciókat, valamint a "spike" (S-) protein és a nukleokapszid (N)-protein elleni ellenanyag szintjének változását. Eredmények: A felmérésben részt vevo 295 dolgozó közül az oltást megelozoen 36 dolgozó esett át COVID-19-fertozésen (COVID-19-pozitív csoport). A második oltás után a megfigyelési idoszak három hónapjában COVID-19-fertozés nem alakult ki a felmérésben részt vevo oltott dolgozók körében. Az oltási reakciók enyhék voltak. A COVID-19-pozitív csoportban az N-antitestek medián küszöbértékindexe az elso vakcina után 4 héttel mérve szignifikánsan magasabb volt (28,37), mint a COVID-19-negatív (0,085) csoportban (p<0,0001). Az elso vakcina után 4 héttel az S-antitestek medián értéke (8015 U/ml) a COVID-19-pozitív csoportban szignifikánsan magasabb volt (p<0,0001), mint a COVID-19-negatív csoportban (23,18 U/ml). A COVID-19-negatív csoport S-antitest-középértéke a második vakcina után szignifikáns (p<0,0001), mintegy 500×-os emelkedést mutatott (23,18 U/ml rol 1173 U/ml-re). Egy vakcina hatásosságát a fertozések terjedésének megakadályozása igazolja. Következtetések: A második vakcina utáni megfigyelési idoszakban új COVID-19-fertozés nem volt az oltott dolgozók körében. A fertozésen át nem esett COVID-19-negatív egyének esetén az S-antitest emelkedése mérsékelt az elso oltás után, míg a második oltás után lényegesen emelkedik. A COVID-19-fertozésen átesett egyének csoportjában már az elso vakcina is jelentos S-antitest-termelodést vált ki. Orv Hetil. 2021; 162(39): 1551-1557. INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic caused global public health and economic crises. OBJECTIVE: The aim of this observation study was to estimate the effectiveness, safety and elicited immune response of the BNT162b2 mRNA Pfizer-BioNTech vaccine in healthcare workers of the Buda Hospital of the Hospitaller Order of St. John of God. METHOD: After vaccination, the infection rate, adverse events and the kinetics of anti-SARS-CoV-2 spike (S) protein and anti-SARS-CoV-2 nucleocapsid (N) protein antibodies were evaluated. RESULTS: Before vaccination, from the 295 healthcare workers 36 recovered from prior COVID-19 infection (COVID-19-positive group). After the second vaccination, there was no COVID-19 infection during the three-month follow-up period. The adverse events were mild. In the COVID-19-positive group, the median cut-off index of anti-N antibodies measured at 4 weeks after the first vaccination were significantly (p<0.0001) higher (28.37) than in the COVID-19-negative group (0.085). After the first vaccine, the median titer of anti-S antibodies was significantly higher (p<0.0001) in the COVID-19-positive group (8015 U/ml) compared to the COVID-19-negative group (23.18 U/ml). In the COVID-19-negative group, the median titer of anti-S antibodies increased significantly (p<0.0001) after the second vaccine (from 23.18 U/ml to 1173 U/ml), showing an increase of 500×. CONCLUSIONS: After the second vaccination, there was no COVID-19 infection during the follow-up. In the COVID-19-negative group, the anti-S antibody titer is moderate after the first vaccination and increases significantly after the second vaccine. In the COVID-19-positive group, the first vaccine induces significant anti-S antibody production. Orv Hetil. 2021; 162(39): 1551-1557.

Inorganic Nitrite Supplementation Improves Endothelial Function With Aging: Translational Evidence for Suppression of Mitochondria-Derived Oxidative Stress.

[Figure: see text].

The role of microbiological examination in treating peritonsillar abscess based on the retrospective analysis of data from six years / A mikrobiológiai vizsgálatok szerepe a peritonsillaris tályog kezelésében hat év anyagának retrospektív elemzése alapján.

Összefoglaló. Bevezetés és célkituzés: A peritonsillaris tályog a leggyakoribb mély nyaki infekció. Olyan fül-orr-gégészeti kórkép, amely megfelelo kezelés nélkül életveszélyes szövodményekkel járhat. Dönto jelentoségu az empirikus antibiotikumválasztás, melyhez ismerni kell a leggyakoribb kórokozókat és a várható rezisztenciát. Módszerek: A 2012 és 2017 között peritonsillaris tályog miatt kezelt esetek retrospektív feldolgozását végeztük. Összesítettük a sebészi beavatkozás során vett minták aerob és anaerob irányú tenyésztési eredményeit, valamint az empirikusan választott antibiotikumokat. A rutinszeru mikrobiológiai tenyésztés alapján meghatároztuk a leggyakoribb kórokozókat. Az adatokat nemzetközi felmérések eredményeivel hasonlítottuk össze. Eredmények: A vizsgált 6 év során 217 esetben kezeltünk peritonsillaris tályogos beteget. A tenyésztési eredményeket csak 146 esetben tudtuk elemezni. Ebbol 47 esetben került sor Fusobacterium species (ebbol 25 esetben Fusobacterium necrophorum), 31 esetben Actinomyces species és 29 esetben Streptococcus pyogenes izolálására. Az esetek kétharmadában vegyes aerob/anaerob baktériumflórát izolált a laboratórium. Következtetés: A tályogok kezelésében önmagában a sebészi beavatkozás - az anaerob környezet megszüntetésével - jelentos klinikai javulást eredményez. A jól választott antibiotikum meggyorsíthatja a lefolyást, és csökkentheti az esetleges szövodményeket. Nagy jelentosége van a megfelelo mikrobiológiai mintavételnek, nem vagy nehezen gyógyuló esetekben ez teremtheti meg a célzott antibiotikumterápiára történo váltás lehetoségét. Felmérésünk alapján a peritonsillaris tályogok jelentos részét vegyes baktériumflóra okozza, így a szájüregi anaerob baktériumokra is ható amoxicillin-klavulánsav vagy antibiotikum kombinációjának (2. vagy 3. generációs cefalosporinok kombinálva klindamicinnel vagy metronidazollal) alkalmazása javasolt mint empirikus antibiotikumterápia. Orv Hetil. 2020; 161(44): 1877-1883. INTRODUCTION AND OBJECTIVE: Peritonsillar abscess is the most common deep neck infection. Without adequate treatment, this otolaryngological disease pattern can cause life-threatening complications. The empirical choice of antibiotics is crucial which requires knowledge of the most common pathogens and the potential resistance. METHODS: A retrospective analysis of cases treated for peritonsillar abscess was performed between 2012 and 2017. We summarized the aerobic and anaerobic culture results of the surgical samples and the empirically selected antibiotics. The most common pathogens were determined via routine microbiological culture tests. We compared our data with the results of international studies. RESULTS: During the 6-year study at our Clinic, 217 patients with peritonsillar abscess were treated. The microbiological tests were available for analysis in only 146 cases. In 47 cases, Fusobacterium species (including 25 cases with Fusobacterium necrophorum), in 31 cases Actinomyces species and in 29 cases Streptococcus pyogenes were isolated. In 2/3 of the patients, polymicrobial infection was detected. CONCLUSION: In the treatment of peritonsillar abscesses, surgical intervention can result in clinical improvement because of the elimination of the anaerobic milieu. A well-chosen antibiotic can accelerate the healing process and reduce the complication rate. Proper microbiological sampling is of great importance, and in cases of non-recovery or poor recovery, this may create the opportunity to switch for targeted antibiotic therapy. The results of this study show that polymicrobial flora is very important for the development of the peritonsillar abscess, thus the recommended antibiotic therapy is amoxicillin-clavulanic acid or 2nd/3rd generation cefalosporin combined with metronidazol or clindamycin. Orv Hetil. 2020; 161(44): 1877-1883.

Short-term time-restricted feeding is safe and feasible in non-obese healthy midlife and older adults.

Chronic calorie restriction (CR) improves cardiovascular function and several other physiological markers of healthspan. However, CR is impractical in non-obese older humans due to potential loss of lean mass and bone density, poor adherence, and risk of malnutrition. Time-restricted feeding (TRF), which limits the daily feeding period without requiring a reduction in calorie intake, may be a promising alternative healthspan-extending strategy for midlife and older adults; however, there is limited evidence for its feasibility and efficacy in humans. We conducted a randomized, controlled pilot study to assess the safety, tolerability, and overall feasibility of short-term TRF (eating <8 h day-1 for 6 weeks) without weight loss in healthy non-obese midlife and older adults, while gaining initial insight into potential efficacy for improving cardiovascular function and other indicators of healthspan. TRF was safe and well-tolerated, associated with excellent adherence and reduced hunger, and did not influence lean mass, bone density, or nutrient intake. Cardiovascular function was not enhanced by short-term TRF in this healthy cohort, but functional (endurance) capacity and glucose tolerance were modestly improved. These results provide a foundation for conducting larger clinical studies of TRF in midlife and older adults, including trials with a longer treatment duration.

[Microbiological service for intensive care units in Hungary]. / Milyen mikrobiológiai laboratóriumi háttér áll rendelkezésre az intenzív betegellátást végzo osztályok számára?

For the effective treatment of patients with infectious diseases in intensive care units, reliable microbiological diagnoses and correct evaluations of results by expert infectious disease specialists/microbiologists are indispensable. A 97-question survey was conducted about the antibiotic policy, the available background of the microbiological diagnoses and the consultation possibilities in infectious diseases/microbiology at intensive care units in Hungary. Sixty-two percent (60/96) of questionnaires were returned. Of these units, 55% had a microbiological laboratory in-house. Microbiological reports usually serve as basis for the choice of antibiotic treatment. It is an undesirable practice that during working days and during week-ends the proportions of positive microbiological reports sent back to the wards within the optimal time are only 50% and <20%, respectively. Helpful opinion of an expert infectious disease specialist or microbiologist was available in >90% of the cases during working hours, while out of working hours the help of an infectious disease specialist and a microbiologist specialist was available in 70% and 55% of the cases, respectively. Almost half of the units requested the help of an infectious disease specialist whereas only one-third of them turned to a microbiologist. Accordingly, the background for microbiological laboratory diagnoses available for intensive care units is far from optimal in Hungary and is not adequately stipulated in their working conditions.

[Streptococcus mutans colonization on titanium surfaces treated with various fluoride-containing preventive solutions]. / A Streptococcus mutans kolonizációja különbözô fluoridot tartalmazó prevenciós oldatokkal kezelt titánfelszínen.

Fluoride is a reductive agent and may modify the oxide layer of titanium (Ti) in the transgingival region of dental implants. The low pH and the high fluoride concentration of prophylactic mouthwashes and gels (used in caries prevention) may play a role in this phenomenon. Our main goal was to examine whether changes on the surface structure of Ti caused by high fluoride concentration and acidic pH alter the adherence and the colonization of bacteria. Polished commercially pure Ti discs (CP grade 4, Camlog, Biotechnologies AG, Switzerland) were used in the study. Each sample was treated for 1 hour with one of the solutions: mouthwash containing 0.025% (250 ppm) fluoride, a gel containing 1.25% (12500 ppm) fluoride, and a solution of 1% NaF (3800 ppm fluoride), pH 4.5. The surface structure of the discs was analyzed by atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). The colonization of Streptococcus mutans was studied by scanning electron microscope (SEM) after a 5-day incubation period. The roughness of the treated sample surfaces (Ra), as revealed by AFM measurements, increased 1.3 times for the gel and the mouthwash, and approximately seven folds for the 1% NaF solution, as compared to the control surface. The high fluoride concentration and acidic pH of the gel and the 1% NaF solution resulted in a strong corrosion and a modification of the composition of the Ti surface. The XPS spectra showed the formation of a fluoride containing complex (Na2TiF6) bound strongly to the surface. A correlation was revealed between the roughness of the surface and thickness and maturity of the S. mutans bacterial colonies developed on the modified Ti surface. High fluoride concentration and acidic pH increased the roughness of the Ti surface. Bacterial biofilm colonization on this rough surface proved to be more mature. The amount of bacteria was increased due to the changes in the surface caused by fluoride treatment. The present study indicates that high fluoride concentration in an acidic pH environment may affect the development of a healthy transgingival epithelial junction on the Ti surface. This work was supported by the SIMI-NAS Project of the 5th FWP of the European Commission (Growth Program, GRD3-2001-61801), the Hungarian Ministry of Economy and the EC (GVOP-3.2.1.-2004-04-0408/3.0), the Hungarian Ministry of Health (ETT, 434/2006), and the Hungarian Scientific Research Fund (OTKA F-68440).

Different expression pattern of flowering pathway genes contribute to male or female organ development during floral transition in the monoecious weed Ambrosia artemisiifolia L. (Asteraceae).

The highly allergenic and invasive weed Ambrosia artemisiifolia L. is a monoecius plant with separated male and female flowers. The genetic regulation of floral morphogenesis is a less understood field in the reproduction biology of this species. Therefore the objective of this work was to investigate the genetic control of sex determination during floral organogenesis. To this end, we performed a genome-wide transcriptional profiling of vegetative and generative tissues during the plant development comparing wild-growing and in vitro cultivated plants. RNA-seq on Illumina NextSeq 500 platform with an integrative bioinformatics analysis indicated differences in 80 floral gene expressions depending on photoperiodic and endogenous initial signals. Sex specificity of genes was validated based on RT-qPCR experiments. We found 11 and 16 uniquely expressed genes in female and male transcriptomes that were responsible particularly to maintain fertility and against abiotic stress. High gene expression of homologous such as FD, FT, TFL1 and CAL, SOC1, AP1 were characteristic to male and female floral meristems during organogenesis. Homologues transcripts of LFY and FLC were not found in the investigated generative and vegetative tissues. The repression of AP1 by TFL1 homolog was demonstrated in male flowers resulting exclusive expression of AP2 and PI that controlled stamen and carpel formation in the generative phase. Alterations of male and female floral meristem differentiation were demonstrated under photoperiodic and hormonal condition changes by applying in vitro treatments.

[Transient left ventricular dysfunction: special form of stress cardiomyopathy]. / Reverzibilis, stressz indukálta cardiomyopathiak.

INTRODUCTION: The phenomenon of stress induced left ventricular dysfunction has been long recognised. A special reversible form of it, characterized by left ventricular apical dilatation, is the so-called "tako-tsubo" or ampoule cardiomyopathy, based on its first description by Sato et al. in 1990. The tako-tsubo cardiomyopathy and stress cardiomyopathy are considered almost equivalent in the referring publications. METHODS: Retrospective analysis of patient data between 2002 and 2007: these patients suffered from transient left ventricular dysfunction and coronary artery disease and myocarditis were disclosed. RESULTS: 6 female patients between 55 and 80 years. In 5 of 6 cases the different forms of stress could be found before the patients were admitted to our department. CONCLUSIONS: The presented cases shed light to the fact that the apical dilatation of the left ventricle is only one of the possible presentations of stress induced cardiomyopathy. The main feature of this entity is not the tako-tsubo-like left ventricular dilatation, which is not always present, but the almost universal QT prolongation and negative T waves. These ECG features come a few days after the appearance of the reversible left ventricular dysfunction.

Pharmacokinetics and pharmacodynamics of levofloxacin in critically ill patients with ventilator-associated pneumonia.

The pharmacokinetics of levofloxacin and outcome of levofloxacin therapy in critically ill patients with ventilator-associated pneumonia (VAP) were assessed. Further theoretical considerations regarding the pharmacokinetic/pharmacodynamic (PK/PD) appropriateness of levofloxacin therapy were made. Twelve patients completed the study, all of whom were treated with a standard intravenous levofloxacin regimen (2x500 mg on Day 1, then 1x500 mg daily). The maximum free plasma levofloxacin concentration (fC(max,ss)) and the area under the free concentration-time curve (fAUC) were 8.13+/-1.64 mg/L and 49.63+/-15.60 mgh/L, respectively. Optimal PK/PD target parameters were achieved in 10 patients; clinical success was attained in 11 of the 12 patients who completed the study. Bacterial eradication was obtained in 9 of the 11 cases with microbiologically confirmed bacteriological aetiology. Intravenous levofloxacin therapy (500 mg/day) was proven to be an effective regimen in this limited number of patients with VAP. However, theoretical considerations based on PK/PD indices predict that, with the current susceptibility breakpoint of 2mg/L, even higher levofloxacin doses (e.g. 1000 mg) could result in treatment failures in infections caused by pathogens labelled as levofloxacin-susceptible in the microbiology report.