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Szívinfarktus miatt kezelt betegek ellátása Magyarország különböző régióiban és a betegek 10 éves túlélése

Management of patients treated for myocardial infarction in different regions of Hungary and patient survival for 10 years

Orvosi Hetilap
Authors: András Jánosi, Ferenc Péter Pach, Gergely Erdős, Kálmán Tóth, Péter Hári, Péter Ofner, and Péter Andréka

Összefoglaló. Előzmény: A szívinfarktus miatt kezelt betegek ellátásának regionális adataira és a betegek hosszú távú kórlefolyására vonatkozó hazai kutatás eddig nem történt. Célkitűzés: A vizsgálat célja a Magyar Infarktus Regiszter pilotidőszakában rögzített betegeknél az ellátás és a 10 éves túlélés elemzése a magyarországi nagyrégiókban. Módszer: A Magyar Infarktus Regiszter (későbbi neve: Nemzeti Szívinfarktus Regiszter) 2010. január 1. és 2013. december 31. között a centrumok önkéntes részvételével 23 142 beteg adatait rögzítette, akik írásban hozzájárultak egészségügyi és klinikai adataik kezeléséhez. Az adatgyűjtés a Kutatásetikai Bizottság engedélyével rendelkezett. A vizsgált populációban 12 104, ST-elevációval járó myocardialis infarctuson (STEMI) és 10 768, ST-elevációval nem járó myocardialis infarctuson (NSTEMI) átesett beteg szerepelt. A feldolgozott adatok 128 220 betegévre vonatkoznak, amelyeket nagyrégiók szerint (Nyugat-, Közép- és Kelet-Magyarország) hasonlítottunk össze. Eredmények: A STEMI-betegek 78,4%-ánál, az NSTEMI-betegek 51,6%-ánál történt katéteres érmegnyitás (PCI). NSTEMI esetén a Közép-Magyarország és Nyugat-Magyarország régiókban a beavatkozás gyakoribb volt, mint a Kelet-Magyarország régióban (p<0,01). Az utánkövetés során a PCI a Nyugat-Magyarország régióban, a revascularisatiós szívműtét (CABG) a Nyugat-Magyarország és a Kelet-Magyarország régióban szignifikánsan gyakoribb volt, mint a Közép-Magyarország régióban (p<0,01). A STEMI-betegek között a 10 év alatt a férfiak 49,2%-a, a nők 46,6%-a halt meg, az NSTEMI-csoportban 63%, illetve 57,6%. Az akut szakban elvégzett PCI mindkét betegcsoportban, nemben, az utánkövetés minden időpontjában és a vizsgált régiókban csökkentette a halálozást (p<0,01). A STEMI-betegek esetén a túlélés a régiók között nem különbözött (p = 0,72), míg az NSTEMI után a 10 éves túlélés a Nyugat-Magyarország régióban jobb volt (p<0,01). Következtetés: A magyarországi nagyrégiók között az infarktusos betegek ellátásában és prognózisában regionális különbségek vannak. Orv Hetil. 2021; 162(36): 1438–1450.

Summary. History: Regional data on patients’ care for myocardial infarction and the long-term follow up of patients have not yet been studied in Hungary. Objective: The study aims to analyze the care and 10-year survival of patients recorded during the Hungarian Myocardial Infarction Registry’s pilot period in large regions of Hungary. Method: Between Jan 1, 2010 and Dec 31, 2013, the Hungarian Myocardial Infarction Registry recorded data on 23 142 patients with voluntary participation. The Research Ethics Committee approved the program. The study included 12 104 patients with ST-elevation myocardial infarction (STEMI) and 10 768 patients with non-ST-elevation myocardial infarction (NSTEMI). The data processed refer to 128 220 patient years based on large regions (West, Central and East Hungary). Results: Percutaneous coronary intervention occurred in 78.4% of STEMI patients and 51.6% of NSTEMI patients. In the NSTEMI group, percutaneous coronary interventions (PCIs) in the Central-Hungary and West-Hungary regions were significantly more common than in the East-Hungary region (p<0.01). During follow-up, PCI in the West-Hungary region, revascularization surgery in the West-Hungary and East-Hungary regions were significantly more common than in the Central-Hungary region (p<0.01). Among STEMI patients, 49.2% of men and 46.6% of women died within 10 years, while in the NSTEMI group 63% and 57.6%, respectively. PCI reduced mortality in both patient groups, sex, at all times of follow-up and in the regions studied (p<0.01). As for STEMI patients, survival was similar in all regions (p = 0.72), while after NSTEMI, 10-year survival in the West-Hungary region was better (p<0.01). Conclusion: There are regional differences in the care and prognosis of patients with myocardial infarction. Orv Hetil. 2021; 162(36): 1438–1450.

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Abstract

A sweeping micellar electrokinetic chromatography (sweeping-MEKC) method was developed for the determination of 1,7-naphthalenediol, 2,3-naphthalenediol, 1,5-naphthalenediol and 2,7-naphthalenediol in cosmetics. Several parameters affecting sweeping-MEKC method were studied systematically and the separation conditions were optimized as 20 mM NaH2PO4–110 mM SDS and 40% (v/v) MeOH (pH 2.4), with −22 kV applied voltage and UV detection at 230 nm. The sample matrix is 60 mmol L−1 NaH2PO4 and sample introduction was performed at 3 psi for 6 s. Separation of the four naphthalenediols was completed in less than 17 min. Limit of detection (LOD) and limit of quantitation (LOQ) are 0.0045∼0.0094 μg mL−1 and 0.015∼0.031 μg mL−1. Linear relationship (r 2 > 0.999) is satisfactory at the range of 0.1–10 μg mL−1. The developed method has been successfully applied to the determination of the four naphthalenediols in real cosmetic samples, with recoveries in foundation, sun cream and lotion in the range of 92.3%∼106.8% and relative standard deviation (RSD) less than 4.15%. A HPLC method described in the National Standards of the People’s Republic of China was carried out for the comparison with the proposed method. The results showed that the proposed sweeping-MEKC method has the advantages of fast, low cost with comparative sensitivity.

Open access
Acta Alimentaria
Authors: L. Červinka, P. Burg, I. Soural, V. Mašán, A. Čížková, J. Souček, V. Višacki, O. Ponjičan, and A. Sedlar

Abstract

Sauvignon Blanc represents an important grape variety. The wine made from this variety is known to have a wide range of aroma profiles from nettles to tropical fruits. Beside the raw material quality (grapes), the quality of wines can be fundamentally influenced by the technological conditions applied in the wine making process. Yeast and other microorganisms play a key role in the formation of metabolites during alcoholic fermentation. In this study, the effects of autochthonous or selected wine yeasts (Saccharomyces cerevisiae) and fermentation temperatures (15 °C and 19 °C) were tested on major monoterpenes contents of wines during the period 2016–2017. The obtained values show that the highest contents of linalool (24.36 μg L−1) and hotrienol (11.84 μg L−1) were determined in wine samples produced with active (selected) wine yeast at lower temperature. Sensory evaluation results indicated that monoterpenes can have a positive effect on the overall sensory quality of Sauvignon Blanc wines, despite the fact that their determined concentrations in the evaluated samples were not higher than their threshold values.

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Abstract

Gestation length (GL) data of dromedary camels were analysed for the period from 2007 to 2018. The database of the largest dairy camel herds (Dubai, United Arab Emirates) was used in this study. The data of 4,084 camels included in the assessment were classified into six ecotypes (Emirati, Emirati cross, Black, Pakistani, Saudi-Sudanese and Saudi cross). The aim of the study was to describe the heritability of GL of camels and the breeding value (BV) of sires for this trait. The genetic parameters of GL were estimated by the General Linear Model method and two Best Linear Unbiased Prediction (BLUP) animal models as well. The mean (±SE) of GL of camels was 384.3 ± 0.2 days. The direct heritability of GL (0.26 ± 0.06–0.36 ± 0.08) was higher than the maternal heritability (0.00 ± 0.05–0.13 ± 0.06) obtained. The maternal permanent environmental effect (0.15 ± 0.05) was similar to the results estimated previously in dromedary camel, but higher than the data reported by relevant sources in other species. Based on the results of this study it can be concluded that the GL of dromedary camels is a species-specific value similar to that in cattle, which is less affected by the maternal influence. Considerable differences (16 days) exist among male dromedaries in their BV for the GL trait.

Open access

Abstract

Scarcity of the construction materials, peculiarly the natural river sand has become a serious threat in the construction industry. Though many researchers of developed and developing countries are trying to find alternative sources for the same, the complete replacement of the fine aggregate in concrete is crucial. Geopolymer sand developed from the Industrial waste (Ground granulated blast furnace slag - GGBS) is an effective alternative for the complete replacement of the natural sand. The GGBS based geopolymer sand (G-GFA) was tested for physical and chemical properties. Upon the successful achievement of the properties in par with the natural river sand, the fresh properties (fresh concrete density & slump) and hardened properties (compressive strength, tensile strength & flexural strength) of the concrete specimens developed with G-GFA were studied. The G-GFA is obtained by both air drying (AD-G-GFA) and oven drying (OD-F-GFA) after the dry mixing of the alkaline solution and GGBS for about 10 min. Thus, developed fine aggregates were studied separately for the fresh and hardened concrete to optimize the feasible one. Superplasticizer of 0.4% is included in the concrete mix to compensate the sightly hydrophilic nature of the fine aggregates produced. The mechanical properties of the concrete with G-GFA are observed to be more than 90% close to that of the concrete developed with natural river sand. Thus, both the fresh and mechanical properties of the G-GFA concrete specimens resulted in findings similar to those of the control specimen developed with natural river sand reflecting the plausibility of G-GFA as a complete replacement choice to the fine aggregate in the concrete industry. The flaky GGBS particles merge well with the alkaline solution at room temperature itself since the former gets dried at elevated temperatures. Thus, more feasible fresh concrete properties and mechanical properties were recorded for the AD-G-GFA than the OD-G-GFA.

Open access

The symbol S(X) denotes the hyperspace of finite unions of convergent sequences in a Hausdor˛ space X. This hyper-space is endowed with the Vietoris topology. First of all, we give a characterization of convergent sequence in S(X). Then we consider some cardinal invariants on S(X), and compare the character, the pseudocharacter, the sn-character, the so-character, the network weight and cs-network weight of S(X) with the corresponding cardinal function of X. Moreover, we consider rank k-diagonal on S(X), and give a space X with a rank 2-diagonal such that S(X) does not Gδ-diagonal. Further, we study the relations of some generalized metric properties of X and its hyperspace S(X). Finally, we pose some questions about the hyperspace S(X).

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Abstract

Although a number of studies have been conducted over the past decade to understand the factors influencing the willingness of producers to operate in a short supply chain (SSC), the intention to adapt can still be identified as an unexplored area. The main aim of the present study is to determine the extent to which Hungarian fresh sour cherry producers show a willingness to operate in a short supply chain and what investments they would make to do so. The sour cherry producers involved in the study clearly show a willingness to operate in a short supply chain. Some producers approach this in a “complex” manner, so they would even meet individual consumer needs and deliver orders to the consumer. Farmers opting for a “simpler” solution would prefer to sell their products to the consumer at their premises or at farmer’s markets. Further results support the fact that the more producers believe in the viability and future of SSCs and the higher their level of education is, the more willing they are to adapt in terms of resources or production processes in order to achieve complete transition. The results reflect the importance of examining the factors that determine farmers’ intentions to operate in the short supply chain, but it is also worthwhile and justified to explore how willing they are to “sacrifice” and invest in order to completely adapt.

Open access

Abstract

Background

Little is known on the abundance of the pathogens Bacillus anthracis and Burkholderia pseudomallei in environmental samples in Cameroon. Therefore, 100 respective samples were assessed in a proof-of-principle assessment.

Methods

DNA residuals from nucleic acid extractions of 100 environmental samples, which were collected between 2011 and 2013 in the Mapé Basin of Cameroon, were screened for B. anthracis and B. pseudomallei by real-time PCR. The samples comprised soil samples with water contact (n = 88), soil samples without water contact (n = 6), plant material with water contact (n = 3), water (n = 2), and soil from a hospital dressing room (n = 1).

Results

B. anthracis and B. pseudomallei were detected in none of the samples assessed.

Conclusion

The results indicate that at least a quantitatively overwhelming, ubiquitous occurrence of B. anthracis and B. pseudomallei in the environment in Cameroon is highly unlikely. However, the number and choice of the assessed samples limit the interpretability of the results.

Open access

Abstract

Napping is one of the rapid sensory profiling methods, which was established recently to meet the needs of sensory and consumer researchers. This approach provides a holistic evaluation of the tested sample through their positioning in a 2-dimensional space. The protocol of the analysis is somewhat different from the traditionally applied descriptive methods, like Quantitative Descriptive Analysis. In our review, we focus on the applicability of Napping in the field of fermented goods. The accompanying procedures are also investigated (typically Flash Profiling, CATA, and further methods), in order to understand how the combined datasets facilitate the understanding of the sensory characteristics of the products.

Open access