Pub Date : 2018-12-01DOI: 10.2478/orvtudert-2018-0015
Balla Árpád, Pelok Benedek-György
Abstract We present the life, career and memory of Pápai Páriz Ferenc (1649, Dés - 1716, Nagyenyed), professor and rector of the Protestant College of Nagyenyed, the famous Transylvanian humanist, medical doctor, poet, philosopher, church historian, heraldist. He studied in Dés (now Dej, Romania), Gyulafehérvár (now Alba Iulia, Romania), Kolozsvár (now Cluj-Napoca, Romania), Marosvásárhely (now Târgu-Mureş, Romania) and Nagyenyed (now Aiud, Romania). In the spring of 1672 he set off from Nagyenyed for a pedestrian trip abroad. He admired the Treasury in Dresden, and attended medical studies in Leipzig and Heidelberg. He completed his medical studies in Basel. In 1674 he became doctor medicus and was elected member of the board of the medical faculty. He returned to Nagyenyed in 1675. Between 1676 and 1690 he is the physician of the court of the Transylvanian princely couple. In 1678 he got a department in the College of Nagyenyed, extended in 1680 with Greek, physics, natural sciences and medical knowledge departments. Between 1681 and 1715 he was the rector of the College. Above all he cherished peace. He was a versatile writer. His medical book written in Hungarian, the PAX CORPORIS, i.e. “the peace of the body” was printed and published at Kolozsvár in 1690. This was dedicated to the target community: “for the benefit of the stupid poor”, it substituted the physician in the family. The rules of a healthy lifestyle were formulated also. The popularity of the book was proved by those eleven editions we know about. Another great work was the Hungarian-Latin, Latin-Hungarian dictionary (Lőcse, now Levoca, Slovakia, 1708). His memory is kept by a bust and plate in the courtyard of the Protestant College of Nagyenyed. The Hungarian postal service (Magyar Posta) released a stamp on his 350th anniversary. His life, work and importance were appreciated by a number of authors across centuries. An internet search on the terms “Pápai” + “Páriz” + “Ferenc” returns an important number of hits. Many foundations and associations are dedicated to his memory.
{"title":"To the memory of Pápai Páriz Ferenc. The „Pax Corporis”, a home medical book for people","authors":"Balla Árpád, Pelok Benedek-György","doi":"10.2478/orvtudert-2018-0015","DOIUrl":"https://doi.org/10.2478/orvtudert-2018-0015","url":null,"abstract":"Abstract We present the life, career and memory of Pápai Páriz Ferenc (1649, Dés - 1716, Nagyenyed), professor and rector of the Protestant College of Nagyenyed, the famous Transylvanian humanist, medical doctor, poet, philosopher, church historian, heraldist. He studied in Dés (now Dej, Romania), Gyulafehérvár (now Alba Iulia, Romania), Kolozsvár (now Cluj-Napoca, Romania), Marosvásárhely (now Târgu-Mureş, Romania) and Nagyenyed (now Aiud, Romania). In the spring of 1672 he set off from Nagyenyed for a pedestrian trip abroad. He admired the Treasury in Dresden, and attended medical studies in Leipzig and Heidelberg. He completed his medical studies in Basel. In 1674 he became doctor medicus and was elected member of the board of the medical faculty. He returned to Nagyenyed in 1675. Between 1676 and 1690 he is the physician of the court of the Transylvanian princely couple. In 1678 he got a department in the College of Nagyenyed, extended in 1680 with Greek, physics, natural sciences and medical knowledge departments. Between 1681 and 1715 he was the rector of the College. Above all he cherished peace. He was a versatile writer. His medical book written in Hungarian, the PAX CORPORIS, i.e. “the peace of the body” was printed and published at Kolozsvár in 1690. This was dedicated to the target community: “for the benefit of the stupid poor”, it substituted the physician in the family. The rules of a healthy lifestyle were formulated also. The popularity of the book was proved by those eleven editions we know about. Another great work was the Hungarian-Latin, Latin-Hungarian dictionary (Lőcse, now Levoca, Slovakia, 1708). His memory is kept by a bust and plate in the courtyard of the Protestant College of Nagyenyed. The Hungarian postal service (Magyar Posta) released a stamp on his 350th anniversary. His life, work and importance were appreciated by a number of authors across centuries. An internet search on the terms “Pápai” + “Páriz” + “Ferenc” returns an important number of hits. Many foundations and associations are dedicated to his memory.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"198 Pt 2 1","pages":"119 - 124"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79670946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.2478/orvtudert-2018-0018
K. Mihály, G. Árpád
Abstract Professor Károly Than was a very talented, widely travelled teacher, intuitive researcher, efficient organizer and public personality. His importance is beyond dispute in the development of Hungarian chemistry. Professor Béla Lengyel and other prominent individuals continued his scientific activity. Lot of honors, paintings, medals and reliefs also justify appreciation of his merits.
Károly Than教授是一位非常有才华、游历广泛的教师、直观的研究者、高效的组织者和公众人物。他在匈牙利化学发展中的重要性是无可争议的。bsamla Lengyel教授和其他杰出人士继续他的科学活动。许多荣誉，绘画，奖章和浮雕也证明了他的功绩。
{"title":"Famous Hungarian chemists and pharmacists – modern chemistry founders: Károly Than","authors":"K. Mihály, G. Árpád","doi":"10.2478/orvtudert-2018-0018","DOIUrl":"https://doi.org/10.2478/orvtudert-2018-0018","url":null,"abstract":"Abstract Professor Károly Than was a very talented, widely travelled teacher, intuitive researcher, efficient organizer and public personality. His importance is beyond dispute in the development of Hungarian chemistry. Professor Béla Lengyel and other prominent individuals continued his scientific activity. Lot of honors, paintings, medals and reliefs also justify appreciation of his merits.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"16 1","pages":"125 - 130"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83467025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.2478/orvtudert-2018-0016
Csiba László
Abstract The imaging studies should be performed within 20 minutes after arrival and the door-to-needle time should be less than 60 minutes in more than 50 % of the patients. The time-windows and the outcome should be evaluated systematically. If the patient is suitable for intravenous (IV) thrombolysis within 3 hours (based on imaging) only the blood glucose measurement should precede the IV lysis. IV thrombolysis within 3 hours is recommended not only in case of severe stroke, but also in patients with severe isolated symptoms (e.g. aphasia or visual field defect) and in patients with improving paresis. The IV lysis should be considered both in patients on aspirin monotherapy or aspirin+clopidogrel therapy. The criteria for stroke cases between 3 to 4.5 hours became less exclusive: IV intervention can be considered in patients ≥80years, in patients with previous stroke and diabetes and also in patients with INR < 1.7. Mechanical thrombectomy (for interna or media occlusion) can be also considered within 4.5 hours after a non-successful intravenous thrombolysis. Other criteria for mechanical thrombectomy (interna or media occlusion) between 4.5 and 6 hours: NIHSS ≥ 6, ASPECTS score ≥ 6. For patients with interna or media occlusion between 6 and 16 hours, only mechanical thrombectomy could be recommended (by Solitaire or TREVO retriever), if the patient has large penumbra (confirmed by either perfusion CT or MRI and following the criteria of DAWN and DEFUSE-3 studies). Between 16 and 24 hours after stroke, a mechanical thrombectomy can be considered (selected by perfusion CT or MRI), if the patient fulfills DAWN criteria.
{"title":"Advances in the treatment of acute ischemic stroke: the 2018 American Stroke Association recommendation","authors":"Csiba László","doi":"10.2478/orvtudert-2018-0016","DOIUrl":"https://doi.org/10.2478/orvtudert-2018-0016","url":null,"abstract":"Abstract The imaging studies should be performed within 20 minutes after arrival and the door-to-needle time should be less than 60 minutes in more than 50 % of the patients. The time-windows and the outcome should be evaluated systematically. If the patient is suitable for intravenous (IV) thrombolysis within 3 hours (based on imaging) only the blood glucose measurement should precede the IV lysis. IV thrombolysis within 3 hours is recommended not only in case of severe stroke, but also in patients with severe isolated symptoms (e.g. aphasia or visual field defect) and in patients with improving paresis. The IV lysis should be considered both in patients on aspirin monotherapy or aspirin+clopidogrel therapy. The criteria for stroke cases between 3 to 4.5 hours became less exclusive: IV intervention can be considered in patients ≥80years, in patients with previous stroke and diabetes and also in patients with INR < 1.7. Mechanical thrombectomy (for interna or media occlusion) can be also considered within 4.5 hours after a non-successful intravenous thrombolysis. Other criteria for mechanical thrombectomy (interna or media occlusion) between 4.5 and 6 hours: NIHSS ≥ 6, ASPECTS score ≥ 6. For patients with interna or media occlusion between 6 and 16 hours, only mechanical thrombectomy could be recommended (by Solitaire or TREVO retriever), if the patient has large penumbra (confirmed by either perfusion CT or MRI and following the criteria of DAWN and DEFUSE-3 studies). Between 16 and 24 hours after stroke, a mechanical thrombectomy can be considered (selected by perfusion CT or MRI), if the patient fulfills DAWN criteria.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"77 1","pages":"81 - 88"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83879778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.2478/orvtudert-2018-0019
Lészai Lehel, Túrós János Levente, Kiss Szilárd-Leó, Bereczky Lujza-Katalin, Nagy Katalin, S. Tamás, S. Béla
Abstract The shortening of the cervix, cervical incompetence or insufficiency that causes late miscarriage or preterm birth syndrome gives importance and clinical significance for the cervical cerclage or cervical stitch as treatment. Nowadays closure of the cervix with cerclage surgery is an effective way of preventing premature opening of the cervix, helping the pregnancy near due date, thus significantly reducing the risk of miscarriage and premature delivery. The retrospective longitudinal cohort study is based on an examination of 164 pregnant woman who underwent cervical cerclage surgery at Obstetrics and Gynecology Clinic nr. I Târgu-Mureș, between 2000-2017. The McDonald’s method was used in every case that we have studied. Cerclage surgery was performed in most cases in the second trimester. The results in the study reflect that in the majority of the cases, intervention is effective in preventing premature opening of the cervix. Most women are multipara and had multiple gestational pregnancy, which can also contribute to the weakening and early opening of the cervical closure system. In 66.5% of the cases, at least one abortion or miscarriage is present in the history of the disease, which may also lead to a weakening of the cervical closing function. Following cerclage surgery, 11.6% abortion and 88.4% in childbirth occurred, and in most cases, intervention can effectively prevent second trimester abortion while reducing the risk of premature birth (65, 8% had no premature birth in our study).
{"title":"The therapeutic effect of cervical cerclage in pregnancy with cervical incompetence","authors":"Lészai Lehel, Túrós János Levente, Kiss Szilárd-Leó, Bereczky Lujza-Katalin, Nagy Katalin, S. Tamás, S. Béla","doi":"10.2478/orvtudert-2018-0019","DOIUrl":"https://doi.org/10.2478/orvtudert-2018-0019","url":null,"abstract":"Abstract The shortening of the cervix, cervical incompetence or insufficiency that causes late miscarriage or preterm birth syndrome gives importance and clinical significance for the cervical cerclage or cervical stitch as treatment. Nowadays closure of the cervix with cerclage surgery is an effective way of preventing premature opening of the cervix, helping the pregnancy near due date, thus significantly reducing the risk of miscarriage and premature delivery. The retrospective longitudinal cohort study is based on an examination of 164 pregnant woman who underwent cervical cerclage surgery at Obstetrics and Gynecology Clinic nr. I Târgu-Mureș, between 2000-2017. The McDonald’s method was used in every case that we have studied. Cerclage surgery was performed in most cases in the second trimester. The results in the study reflect that in the majority of the cases, intervention is effective in preventing premature opening of the cervix. Most women are multipara and had multiple gestational pregnancy, which can also contribute to the weakening and early opening of the cervical closure system. In 66.5% of the cases, at least one abortion or miscarriage is present in the history of the disease, which may also lead to a weakening of the cervical closing function. Following cerclage surgery, 11.6% abortion and 88.4% in childbirth occurred, and in most cases, intervention can effectively prevent second trimester abortion while reducing the risk of premature birth (65, 8% had no premature birth in our study).","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"105 1","pages":"107 - 112"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78049402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.2478/orvtudert-2018-0017
Varga Réka-Izabella, Kovács Judit
Abstract Early recognition and intervention in sudden cardiac arrest is crucial for survival. The majority of these cases happen at the victims’ home or in public places, and the first person to act is usually a bystander. The purpose of this study was to assess and to compare bystander’s and third-year medical students’ (who attended first aid courses and training as first year students) knowledge about cardiopulmonary resuscitation in Tîrgu Mureş. Material and methods: We used a questionnaire, which included 28 questions and was filled in voluntarily by 335 people. We investigated previous cardiopulmonary resuscitation (CPR) experience, willingness to help in an emergency situation and basic knowledge about CPR techniques. Results: Only 15% of bystanders were trained in CPR. The majority (94%) of them knew when they have to resuscitate a person and the correct position the person be in. The location of chest compressions was known by 39% of bystanders and by 78% of third-year medical students, the exact rate of chest compressions by 14% of bystanders and by 66% of medical students. 49% of bystanders had driving license, and even though first aid training was required at driving school, their knowledge was barely better than those who did not have one. Conclusions: Bystander’s knowledge on cardiopulmonary resuscitation is generally poor. To improve it, CPR training courses are needed in the community.
{"title":"Evaluation of knowledge about cardiopulmonary resuscitation in Tîrgu Mures","authors":"Varga Réka-Izabella, Kovács Judit","doi":"10.2478/orvtudert-2018-0017","DOIUrl":"https://doi.org/10.2478/orvtudert-2018-0017","url":null,"abstract":"Abstract Early recognition and intervention in sudden cardiac arrest is crucial for survival. The majority of these cases happen at the victims’ home or in public places, and the first person to act is usually a bystander. The purpose of this study was to assess and to compare bystander’s and third-year medical students’ (who attended first aid courses and training as first year students) knowledge about cardiopulmonary resuscitation in Tîrgu Mureş. Material and methods: We used a questionnaire, which included 28 questions and was filled in voluntarily by 335 people. We investigated previous cardiopulmonary resuscitation (CPR) experience, willingness to help in an emergency situation and basic knowledge about CPR techniques. Results: Only 15% of bystanders were trained in CPR. The majority (94%) of them knew when they have to resuscitate a person and the correct position the person be in. The location of chest compressions was known by 39% of bystanders and by 78% of third-year medical students, the exact rate of chest compressions by 14% of bystanders and by 66% of medical students. 49% of bystanders had driving license, and even though first aid training was required at driving school, their knowledge was barely better than those who did not have one. Conclusions: Bystander’s knowledge on cardiopulmonary resuscitation is generally poor. To improve it, CPR training courses are needed in the community.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"39 1","pages":"113 - 118"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89473400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-01DOI: 10.2478/orvtudert-2018-0008
K. Loránd, S. Mónika
Abstract The internet is the most popular information source in our digital world. Studies confirm that numerous people are using the internet to look up health-related information. There is no information about this trend among the Transylvanian Hungarian population. Our purpose was to assess the role of the internet in answering health-related problems for young Hungarian Transylvanian people, and its impact. The participants (N=351) completed an online questionnaire with 28 items, which was available on Facebook, on the first page indicating their consent to a voluntary and anonymous survey. Our target was the generation below the age of 45. Descriptive, then comparative analysis was performed, based on gender and region of origin. 95.3% of the participants used the internet for finding health-related information, diagnosis, treatment or diet, without significant difference between subgroups, 70% at least once a month. Only 3.3% were instructed by their physician about the websites that provide health information, while 90% would require it. At least 64% of the respondents makes self-diagnosis at least sometimes, women more often, and nearly 25% frequently or always check the doctor’s opinion and/or the recommended treatment online. 40% of cases consider that their self-diagnosis was often the same as the physician’s final diagnosis, but only 33,2% agreed totally with their doctor. 47,4% of them were scared and/or became worried because of the information from the internet, especially women. Based on the above, it is clear that online health information overtakes the traditional doctor-centered health information and makes it necessary for us to change our perspective of digital healthcare.
{"title":"Use of internet as source of medical information and its impact among young Transylvanian Hungarian people - a comparative study","authors":"K. Loránd, S. Mónika","doi":"10.2478/orvtudert-2018-0008","DOIUrl":"https://doi.org/10.2478/orvtudert-2018-0008","url":null,"abstract":"Abstract The internet is the most popular information source in our digital world. Studies confirm that numerous people are using the internet to look up health-related information. There is no information about this trend among the Transylvanian Hungarian population. Our purpose was to assess the role of the internet in answering health-related problems for young Hungarian Transylvanian people, and its impact. The participants (N=351) completed an online questionnaire with 28 items, which was available on Facebook, on the first page indicating their consent to a voluntary and anonymous survey. Our target was the generation below the age of 45. Descriptive, then comparative analysis was performed, based on gender and region of origin. 95.3% of the participants used the internet for finding health-related information, diagnosis, treatment or diet, without significant difference between subgroups, 70% at least once a month. Only 3.3% were instructed by their physician about the websites that provide health information, while 90% would require it. At least 64% of the respondents makes self-diagnosis at least sometimes, women more often, and nearly 25% frequently or always check the doctor’s opinion and/or the recommended treatment online. 40% of cases consider that their self-diagnosis was often the same as the physician’s final diagnosis, but only 33,2% agreed totally with their doctor. 47,4% of them were scared and/or became worried because of the information from the internet, especially women. Based on the above, it is clear that online health information overtakes the traditional doctor-centered health information and makes it necessary for us to change our perspective of digital healthcare.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"176 1","pages":"56 - 59"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77482407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-01DOI: 10.2478/orvtudert-2018-0004
Túrós János Levente, Kiss Szilárd-Leó, Bereczky Lujza-Katalin, B. Edina, Lészai Lehel, S. Tamás, Györfi Imola, S. Béla
Abstract Thrombophilia refers to a coagulation disorder that predisposes to thrombosis and thus increases the risk of thrombotic events. Both inherited and acquired thrombophilia are associated with vascular thrombosis and pregnancy-related complications, including infertility, recurrent miscarriage, and premature birth. Recently, thrombophilia has been increasingly encountered as an infertility factor, which gives the clinical relevance of the disease. The aim of the study was to investigate the prognostic role of thrombophilia in the treatment of infertility and the pregnancy of thrombophilic women during assisted reproduction procedures. Frequency of abortions increases and effectiveness of in vitro fertilization (IVF) decreases with age. Normal weight has a positive effect on assisted reproduction techniques (ART’s) outcome. Repeat IVF failure is more common in thrombophilia than in healthy women, and the “take home baby” ratio for IVF is 24%. Spontaneous abortion was most commonly observed in the PAI homozygous group followed by MTHFR homozygous mutation, MTHFR heterozygous mutation, and Factor V (Leiden) mutation. The most effective treatment was concomitant therapy with low molecular weight heparin and aspirin.
{"title":"The prognostic role of thrombophilia in the treatment of infertility","authors":"Túrós János Levente, Kiss Szilárd-Leó, Bereczky Lujza-Katalin, B. Edina, Lészai Lehel, S. Tamás, Györfi Imola, S. Béla","doi":"10.2478/orvtudert-2018-0004","DOIUrl":"https://doi.org/10.2478/orvtudert-2018-0004","url":null,"abstract":"Abstract Thrombophilia refers to a coagulation disorder that predisposes to thrombosis and thus increases the risk of thrombotic events. Both inherited and acquired thrombophilia are associated with vascular thrombosis and pregnancy-related complications, including infertility, recurrent miscarriage, and premature birth. Recently, thrombophilia has been increasingly encountered as an infertility factor, which gives the clinical relevance of the disease. The aim of the study was to investigate the prognostic role of thrombophilia in the treatment of infertility and the pregnancy of thrombophilic women during assisted reproduction procedures. Frequency of abortions increases and effectiveness of in vitro fertilization (IVF) decreases with age. Normal weight has a positive effect on assisted reproduction techniques (ART’s) outcome. Repeat IVF failure is more common in thrombophilia than in healthy women, and the “take home baby” ratio for IVF is 24%. Spontaneous abortion was most commonly observed in the PAI homozygous group followed by MTHFR homozygous mutation, MTHFR heterozygous mutation, and Factor V (Leiden) mutation. The most effective treatment was concomitant therapy with low molecular weight heparin and aspirin.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"40 1","pages":"42 - 49"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86161750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-01DOI: 10.2478/orvtudert-2018-0005
Nyúl-Tóth Ádám, M. Ádám, Győri Fanni, Wilhelm Imola, I. Krizbai
Abstract Proper functioning of the nervous system is largely dependent on the precise regulation of the neuronal environment. By shielding the central nervous system (CNS) from potentially harmful substances, the blood-brain barrier (BBB) has an indispensable role in this process. The BBB is a specialized system of endothelial cells lining brain microvessels, which – supported by pericytes and glial cells – form a selective barrier between the blood and the neural tissue. Under abnormal conditions, permeability of the BBB may increase, which may either trigger or aggravate the disease. Since CNS disorders – at least in their initial phase – usually do not involve the whole brain and spinal cord, but are localized to a certain region, our aim was to understand whether the BBB is regionally heterogeneous at the molecular level. By using bioinformatics tools, we analyzed expression levels of genes specific to cerebral endothelial cells, pericytes or astrocytes in different brain territories. Our results revealed regional heterogeneities in the expression of BBB-associated genes in both human and mouse. Expression pattern of efflux transporters – which have a major role in blocking passage of therapeutic agents through the BBB – proved to be diverse both among brain regions and between mouse and human. Our results indicate that: (1) in silico database analyses are suitable for group-based studies on gene functions, overcoming the limitations of single-gene analyses; (2) high-throughput tests should always be validated using other methods; (3) when using animal models, inter-species differences have to be always considered; (4) when comparing different brain regions, the BBB is heterogeneous at the molecular level, and this might have clinical significance.
{"title":"Analysis of regional heterogeneities of the blood-brain barrier in humans and mice","authors":"Nyúl-Tóth Ádám, M. Ádám, Győri Fanni, Wilhelm Imola, I. Krizbai","doi":"10.2478/orvtudert-2018-0005","DOIUrl":"https://doi.org/10.2478/orvtudert-2018-0005","url":null,"abstract":"Abstract Proper functioning of the nervous system is largely dependent on the precise regulation of the neuronal environment. By shielding the central nervous system (CNS) from potentially harmful substances, the blood-brain barrier (BBB) has an indispensable role in this process. The BBB is a specialized system of endothelial cells lining brain microvessels, which – supported by pericytes and glial cells – form a selective barrier between the blood and the neural tissue. Under abnormal conditions, permeability of the BBB may increase, which may either trigger or aggravate the disease. Since CNS disorders – at least in their initial phase – usually do not involve the whole brain and spinal cord, but are localized to a certain region, our aim was to understand whether the BBB is regionally heterogeneous at the molecular level. By using bioinformatics tools, we analyzed expression levels of genes specific to cerebral endothelial cells, pericytes or astrocytes in different brain territories. Our results revealed regional heterogeneities in the expression of BBB-associated genes in both human and mouse. Expression pattern of efflux transporters – which have a major role in blocking passage of therapeutic agents through the BBB – proved to be diverse both among brain regions and between mouse and human. Our results indicate that: (1) in silico database analyses are suitable for group-based studies on gene functions, overcoming the limitations of single-gene analyses; (2) high-throughput tests should always be validated using other methods; (3) when using animal models, inter-species differences have to be always considered; (4) when comparing different brain regions, the BBB is heterogeneous at the molecular level, and this might have clinical significance.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"22 1","pages":"26 - 36"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78353302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-01DOI: 10.2478/orvtudert-2018-0003
Sóki József, és Székely Edit
Abstract The Bacteroides and Parabacteroides species are important obligate anaerobic bacteria that are significant constituents of normal flora (microbiota), and opportunistic pathogens with special biological background. They are highly resistant to antibiotics and monitoring their resistance levels is important for their empiric therapy. Several antibiotic resistance studies were conducted in the USA and Europe and we have data for the region involved in this study showing comparable trends. Multidrug-resistant strains are emerging among Bacteroides too, where the proper antibiotic tests and treatments may be life-saving.
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Pub Date : 2018-07-01DOI: 10.2478/orvtudert-2018-0002
H. Adrienne, Papp Zsuzsanna Erzsébet
Abstract A broad spectrum of chemotherapy is being used in the therapy of childhood cancers, which may induce liver injury, impairing quality of life and efficacy of the treatment. History of, especially viral, liver diseases may increase toxicity. The aim of the paper is to assess the incidence, type and grade, predisposing factors and treatment options of drug-induced liver injury in children with malignant diseases under cytostatic therapy at the Hemato-Oncology Department of the Pediatric Clinic 2 from Targu-Mures, over a time period spanning from 2012 to 2017. The results of the study may serve as a foundation for such treatment strategies which would enable optimal outcomes with fewer cases of liver toxicity. During this period, we treated 26 patients with acute lymphoblastic leukemia (ALL), two patients with acute myeloblastic leukemia (AML), one patient with lymphoma and seven with solid tumors. We found liver toxicity in 77% of the patients treated for ALL, mainly during the maintenance therapy (65%) with oral 6-mercaptopurine and methotrexate. The most common clinical signs were anorexia, nausea, vomiting, abdominal pain and faltering weight gain. Cholestasis developed in two patients, while hepatocytolysis was the most common observed event (n = 24). Liver fibrosis, hypersplenism, portal hypertension and esophageal varices were found in two patients. One patient required endoscopic ligation of esophageal varices. Elevation of serum bilirubin appeared in two patients, while hypoproteinemia was observed in nine patients. None of the patients developed acute liver failure. We treated liver toxicity with hydration, alkalinization, i.v. Aspatofort, Aminosteril-N Hepa 8%, oral acetylcysteine, silymarin, ursodeoxycholic acid, Liv-52, Sargenor, and Essentiale forte. We found hepatotoxicity in 77% of the ALL patients undergoing chemotherapy, similar results have been published by other authors. Hepatotoxicity may develop through direct hepatic effects of cytostatics, or a preexisting liver disease impairs the metabolism and excretion of the drug, increasing its toxic effects. In our patients hepatotoxicity can be explained mainly by direct liver-injury, previous infections with hepatotropic viruses, such as cytomegalovirus, were detected only in three patients. Liver injury appeared in 77% of our ALL patients; 65% occurred during maintenance therapy with oral 6-mercaptopurine and methotrexate. Close followup of liver function during chemotherapy is mandatory for optimal results.
广泛的化疗方案正被用于儿童癌症的治疗，这可能会导致肝损伤，影响生活质量和治疗效果。肝脏疾病史，特别是病毒性肝病史，可增加毒性。本文的目的是评估2012年至2017年期间Targu-Mures儿科诊所2血液肿瘤科接受细胞抑制剂治疗的恶性疾病儿童药物性肝损伤的发生率、类型和分级、易感因素和治疗方案。该研究的结果可以作为这种治疗策略的基础，这将使更少的肝毒性病例获得最佳结果。在此期间，我们治疗了26例急性淋巴细胞白血病(ALL)， 2例急性髓母细胞白血病(AML)， 1例淋巴瘤和7例实体瘤。我们发现77%的ALL患者出现肝毒性，主要是在口服6-巯基嘌呤和甲氨蝶呤的维持治疗期间(65%)。最常见的临床症状是厌食、恶心、呕吐、腹痛和体重增加缓慢。2例患者出现胆汁淤积，而肝细胞溶解是最常见的观察事件(n = 24)。2例患者出现肝纤维化、脾功能亢进、门脉高压及食管静脉曲张。1例患者需要内镜结扎食管静脉曲张。2例患者出现血清胆红素升高，9例患者出现低蛋白血症。没有患者出现急性肝功能衰竭。我们用水合、碱化、静脉注射阿斯帕妥福、氨固醇- n - Hepa 8%、口服乙酰半胱氨酸、水水蓟素、熊去氧胆酸、Liv-52、Sargenor和Essentiale forte治疗肝毒性。我们发现77%接受化疗的ALL患者出现肝毒性，其他作者也发表了类似的结果。肝毒性可通过细胞抑制剂对肝脏的直接作用而发展，或先前存在的肝脏疾病损害药物的代谢和排泄，增加其毒性作用。在我们的患者中，肝毒性主要可以通过直接肝损伤来解释，既往感染嗜肝病毒，如巨细胞病毒，仅在3例患者中检测到。77%的ALL患者出现肝损伤;65%发生在口服6-巯基嘌呤和甲氨蝶呤维持治疗期间。在化疗期间密切随访肝功能是获得最佳结果的必要条件。
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