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- Author or Editor: A. Takács x
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Abstract
Anaplasma phagocytophilum is the causative agent of granulocytic anaplasmosis in humans, dogs, cats, horses and tick-borne fever in ruminants. In Europe, its main vector is the tick species Ixodes ricinus. In this study, spleen and liver samples, as well as ticks from 18 wild-living mammals (belonging to seven species) were analysed for the presence of A. phagocytophilum with molecular methods. The zoonotic ecotype-I of A. phagocytophilum was identified in a European wildcat (Felis silvestris) and its tick, a European pine marten (Martes martes) and a Eurasian red squirrel (Sciurus vulgaris). All PCR-positive samples were collected in 2019 and originated in the same geographic area. These results indicate that taxonomically diverse mammalian species can maintain the local enzootic cycle of the same genotype of A. phagocytophilum. To the best of our knowledge, this is the first report of the zoonotic variant of A. phagocytophilum in the wildcat and in the European pine marten in a broad geographical context, as well as in the red squirrel in Hungary. Since all these host species are well known for their urban and peri-urban presence, the results of this study verify their role in the synanthropic enzootic cycle of granulocytic anaplasmosis and tick-borne fever.
The significance of co-infections with novel hepatitis viruses Hepatitis G (GBV-C, HGV) and TT virus (TTV) in chronic hepatitis C is not clear. We determined the prevalence of HGV RNA and TTV DNA in chronic hepatitis C patients and in asymptomatic hepatitis C virus (HCV) carriers, and assessed the influence of these agents on the course of HCV infection. Seventy-seven patients with chronic hepatitis C - 50 of them treated with interferon (IFN) - and 33 HCV carriers with normal alanine aminotransferase have been investigated. Previous HBV infection was detected by testing serum HBsAg and aHBc. HGV RNA and TTV DNA were detected by PCR. In the healthy population, the prevalence of anti-HCV was 0.3%, HGV RNA 8.0% and TTV DNA 18.5%. In chronic hepatitis C HGV RNA occurred in 9.09% and TTV DNA in 40.25% of cases. In IFN-treated patients with sustained remission, the frequency of TTV was 20% vs. 45.7% found in non-responders. Among asymptomatic HCV-carriers, the prevalence of HGV RNA was 9.09% and TTV DNA 75.7%. Neither HGV RNA nor TTV DNA had apparent effect on the HCV infection. TTV was detected with the lowest frequency in persons with sustained remission due to IFN, suggesting antiviral effect of IFN on TTV.
Abstract
Cardiac electromechanical resynchronisation therapy (CRT) is an effective non-pharmacological treatment of patients suffering from drug refractory heart failure. However, approximately 20–30% of patients are non-responder. Cardiac magnetic resonance imaging (CMR) may play significant role in clarifying many questions in this patient population. Forty-five patients, suffering from severe drug refractory heart failure, underwent CMR before applying CRT. Left ventricular end-diastolic, end-systolic volumes, ejection fraction, myocardial mass, wall motion disturbances, localisation of non-viable myocardium were determined. Left ventricular dyssynchrony was determined by illustrating wall-time thickening in short-axis slices of left ventricle from basis to apex. CMR-proved underlying heart disease were postinfarction heart failure, dilated cardiomyopathy and non-compaction cardiomyopathy in 62, 27 and in 11%, respectively. Mean left ventricular ejection fraction was 24.5±10%, intraventricular dyssynchrony was 200±78 ms. In four patients, requiring surgical revascularisation after unsuccessful coronary sinus electrode implantation, optimal position for epicardial screw-in electrode was selected. According to the results of CMR, biventricular device was not implanted in 7 patients. During the follow-up of the 38 patients, 5 patients (13.16%) were non-responders, despite the approximately 22% non-responder ratio in our whole patient population treated by CRT but without performing previous CMR examination. In this patient population CMR may have a significant role in the selection of responder patient population.
Abstract
Introduction:The Natural Orifice Transluminal Endoscopic Surgery (NOTES) is an abdominal operation carried out with flexible endoscopic instruments and their advanced versions via natural orifices. The NOTES causes theoretically less pain, operative stress, shorter hospitalization, quicker recovery and it is scarless. The aim of this investigation was to evaluate the feasibility and safety of transgastric small bowel resection. Materials and methods: Seven domestic pigs were investigated and entered the study; body weight 25 kg in average. General anesthesia was performed. One trocar was used for laparoscopic observations during gastrotomy and transgastric penetration with the gastroscope, later for assistance with a grasper for manipulation of the bowel loops and for the application of the linear stapling device. Then the needle knife was used to complete a 1.5 cm long incision in the gastric wall. The gastroscope was advanced into the peritoneal cavity and a small bowel loop was identified and elevated with a flexible grasper. Through the second channel of the scope a coag grasper was used to dissect the mesentery. Then a linear stapler was inserted through the assisting trocar and the resection was performed. Afterwards the bowel ends were opened with the needle knife and the stapler was reinserted for a side-to-side anastomosis. The specimen was removed via the stomach. Gastric closure was completed by laparoscopic mini-instruments through the stapler-port. All special events and all problems were prospectively documented. Follow-up was performed over 2 weeks and body weight was recorded. Then a laparoscopy was performed to document adhesions or abscess formation. Finally the animals were sacrificed to evaluate further evidence of infection or adhesions. Results: The operations were carried without complications, there was no case of letal outcome. On the 12th day the abdominal laparoscopic revision was carried out, after the revision in one case adhesion could be detected, no other kinds of complications were noticed. Conclusion: According to our results, the transgastric small bowel resection is a safe procedure, but further special instruments are needed. These experimental procedures should be evaluated carefully and critically in clinical practice.
Abstract
Objectives
Conditions that have similar initial presentations as sepsis may make early recognition of sepsis in an emergency room (ER) difficult. We investigated whether selected physiologic and metabolic parameters can be reliably used in the emergency department to differentiate sepsis from other disease states that mimic it, such as dehydration and stroke.
Methods
Loess regression on retrospective follow-up chart data of patients with sepsis-like symptoms (N = 664) aged 18+ in a large ER in Hungary was used to visualize/identify cutoff points for sepsis risk. A multivariate logistic regression model based on standard triage data was constructed with its corresponding receiver operating characteristic (ROC) curve and compared with another model constructed based on current sepsis guidelines.
Results
Age, bicarbonate, HR, lactate, pH, and body temperature had U, V, W, or reverse U-shaped associations with identifiable inflexion points, but the cutoff values we identified were slightly different from guideline cutoff values. In contrast to the guidelines, no inflexion points could be observed for the association of sepsis with SBP, DPB, MAP, and RR and therefore were treated as continuous variables. Compared to the guidelines-based model, the triage data-driven final model contained additional variables (age, pH, bicarbonate) and did not include lactate. The data-driven model identified about 85% of sepsis cases correctly, while the guidelines-based model identified only about 70% of sepsis cases correctly.
Conclusion
Our findings contribute to the growing body of evidence for the necessity of finding improved tools to identify sepsis at early time points, such as in the ER.
The aim of this study was to obtain prevalence estimates about the most important enteropathogenic bacteria: Lawsonia intracellularis, Brachyspira hyodysenteriae, Brachyspira pilosicoli, Salmonella enterica and Clostridium perfringens A and C in Hungarian farrow-to-finish pig herds. A total of 31 herds were selected, from where six pooled faecal samples, each containing three individual rectal faecal samples were collected from fattening pigs of 5–6 months of age. All 186 samples were examined by polymerase chain reaction (PCR) for the presence of the pathogens mentioned above. Lawsonia intracellularis was found in 29 herds (93.55%) and in 108 samples (58.06%); B. hyodysenteriae in 14 herds (45.16%) and in 23 samples (12.37%); B. pilosicoli in 19 herds (61.29%) and in 53 samples (28.49%); S. enterica in 17 herds (54.83%) and in 40 samples (21.50%). We detected the presence of C. perfringens A in 19 herds (61.29%) and in 46 samples (24.73%), while C. perfringens C was found in 8 herds (25.81%) and in 11 samples (5.91%). All examined herds were infected with one or more of these agents. Herds with diarrhoea in the mid-to late finishing phase had almost 10 times higher prevalence of B. hyodysenteriae than herds without such a history.
Abstract
Increased intra-abdominal pressure during laparoscopy leads to hypoxia due to reduced blood flow. Aim of our study was to investigate whether preconditioning can reduce this negative effect of the pneumoperitoneum. Fifty female Wistar rats were used, divided into 5 groups. I: Sham operation (Sham), II: conventional pneumoperitoneum (PP), III: transvaginal pneumoperitoneum (TV), IV: preconditioning for 2.5 minutes in two cycles (Pre 2.5), V: preconditioning for 5 minutes (Pre 5). Malondialdehyde (MDA), reduced glutathione (GSH), sulfhydrylgroup (SH-) concentrations, superoxide-dismutase (SOD) and mieloperoxidase (MPO) activity, and anti-apoptotic pathway marker p-AKT level and inflammatory cytokine TNF-α were measured. SOD activity and GSH concentration were decreased in PP and TV groups comparing to Sham and preconditioning groups. MPO activity was decreased also in PP and TV groups comparing to the Sham group but in the preconditioning groups it has remained high. MDA concentration in plasma was increased in PP and TV groups comparing to Sham and preconditioning groups. There was no difference in the case of blood MDA and SH-concentrations between groups. Anti-apoptotic pathway marker p-AKT level was decreased in the TV group comparing to the sham and preconditioning groups. TNF-α level was increased in TV and preconditioning groups compared to the sham group. According to the results preconditioning can reduce negative effects of pneumoperitoneum.
Kinetoplastids are flagellated protozoa, including principally free-living bodonids and exclusively parasitic trypanosomatids. In the most species-rich genus, Trypanosoma, more than thirty species were found to infect bats worldwide. Bat trypanosomes are also known to have played a significant role in the evolution of T. cruzi, a species with high veterinary medical significance. Although preliminary data attested the occurrence of bat trypanosomes in Hungary, these were never sought for with molecular methods. Therefore, amplification of an approx. 900-bp fragment of the 18S rRNA gene of kinetoplastids was attempted from 307 ixodid and 299 argasid ticks collected from bats, and from 207 cimicid bugs collected from or near bats in Hungary and Romania. Three samples, one per each bat ectoparasite group, were PCR positive. Sequencing revealed the presence of DNA from free-living bodonids (Bodo saltans and neobodonids), but no trypanosomes were detected. The most likely source of bodonid DNA detected here in engorged bat ectoparasites is the blood of their bat hosts. However, how bodonids were acquired by bats, can only be speculated. Bats are known to drink from freshwater bodies, i.e. the natural habitats of B. saltans and related species, allowing bats to ingest bodonids. Consequently, these results suggest that at least the DNA of bodonids might pass through the alimentary mucosa of bats into their circulation. The above findings highlight the importance of studying bats and other mammals for the occurrence of bodonids in their blood and excreta, with potential relevance to the evolution of free-living kinetoplastids towards parasitism.
