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Abstract

Coronary angiography and intervention became an integral part of the modern cardiology. These invasive procedures beside their firmly established benefits also expose the patient to a hazard for access site complication, contrast material and radiation exposure. Transradial access significantly reduces the risk associated with the arterial puncture; however its effect regarding the radiation exposure is debated. Our aim was to review the aspects of transradial coronary intervention in the context of the radiation exposure. This review focuses on key aspects of feasibility and safety related to the access site choice and the learning curve.

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Acta Veterinaria Hungarica
Authors: M. Dobos-Kovács, E. Horváth, A. Farsang, Edith Nagy, Andrea Kovács, F. Szalai, and S. Bernáth

Haemorrhagic nephritis and enteritis of geese as a new disease was first described in Hungary in 1969. The authors identified the causative agent of the outbreaks occurring in 1969 as a polyomavirus by PCR in 2001. In order to study the pathogenesis of the virus, one-day-old goslings were infected with tissue homogenate that tested positive for polyomavirus by PCR. Morphological, light and transmission electron microscopic (TEM) examinations have revealed that goose haemorrhagic polyomavirus replicates in the endothelial cells of the blood vessels and capillaries of diseased birds. Infection causes damage and necrosis of the endothelial cells. The virus was not observed in the parenchymal cells. Oedema and haemorrhages found throughout the body may be due to the dysfunction or functional deficiency of endothelial cells damaged by the virus.

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We determined the effect of a school-based exercise training (ET) without dietary intervention, on body composition, fitness and cardiovascular risk in overweight/obese children. Subjects were 51 overweight/obese 6.5- to 12.5-year-old children (23 boys, 28 girls; BMI 25.6±4.3 kg/m 2 ), of whom 48 completed the program. Participants were enrolled in a 15-week aerobic training (three 60-minute sessions/week). Working heart rate was between 120–185 beats/minute. Participation rate was 87%. BMI, waist circumference, body composition (bioimpedance), aerobic capacity (treadmill), blood pressure, lipids and insulin sensitivity (HOMA) were assessed. Waist circumference (85.9±12.4 vs. 80.9±10.2 cm), muscle mass (32.4±6.2 vs. 33.7±6.1 kg), maximal oxygen consumption (37.0±3.9 vs. 42.6±11.2 ml/kg per minute), systolic blood pressure (113.3±11.2 vs. 106.7±11.6 mmHg) and LDL cholesterol (2.4±0.6 vs. 1.9±0.6 mM/l) improved significantly. Number of children with abdominal obesity (29 vs. 20), hypertension (10 vs. 5) and elevated triglyceride (18 vs. 14) also declined significantly over time. We concluded that as a result of high attendance and appropriate training program, cardiovascular fitness and abdominal obesity improved in overweight/obese children along with the improvement in metabolic risk factor profile.

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Abstract

Purpose

The purpose of the present cross-sectional study is to examine the degree of degenerative patho-anatomical changes in the thoracic vertebrae in asymptomatic adult patients.

Materials and Methods

A total of 150 adult patients were examined with computed tomography (CT) because of various health conditions (e.g., tumour risk). The images were revised with post-processing procedures to detect bony changes in the thoracic vertebrae. Three types of degenerations (osteophytes, arthrosis, and irregular endplates) were examined and graded using appropriate grading systems. Correlational investigations were carried out in relation to age, BMI, and degenerations. Moreover, to examine the value of the degenerations the frequencies of the grading categories were assessed in each segment.

Results

The total number of the patients included was 41, who had no trunk symptoms. We found no convincing correlations in terms of age, BMI, and degenerations, however, age and facet joint arthrosis showed a tentative association. The degree of the degenerations was the largest in the Th7-8, Th8-9, Th9-10 segments for osteophytes, in the Th4-5, Th5-6 for arthrosis, and in the Th8-9, Th9-10 for irregular endplates.

Conclusions

This study found that there are several progressive degenerative changes in the thoracic spine without any clinical symptoms. Accordingly, it can be advised that clinicians should avoid labelling the disorders and planning their treatment based on the results of diagnostic imaging only.

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Factors associated with postural control in nursing home residents

Oral presentation at the 13th Conference of the Hungarian Medical Association of America – Hungary Chapter (HMAA-HC) at 30–31 August 2019, in Balatonfüred, Hungary

Developments in Health Sciences
Authors: R.L. ErdŐs, I. Jónásné Sztruhár, A. Simon, and É. Kovács

Abstract

Purpose

Decline of the sensory and motor systems in older people negatively affects postural control. This increases the risk of falls, which is dangerous for older people in long-term care. Being aware of the quality of postural control and the factors affecting it among elderly people, is crucial in implementing an effective fall-prevention program. This study aimed to measure postural control and the demographic, health-related, and functional factors presumed to be correlated with it among nursing home residents. Another aim was to find valid screening tools based on these factors.

Materials and methods

Seventy one nursing home residents were included. Postural control was measured using the Berg Balance Scale. Grip strength, the 30-s chair stand test, and the Timed Up and Go test were used to measure global muscle strength, and functional mobility, respectively. The results of these functional tests were dichotomized using age-specific reference values.

Results

Postural control was significantly worse in those who did not reach the age-specific reference values in any of the three functional tests. Effect sizes were large for functional mobility and medium for muscle strength. Multimorbidity and gender had no effect on postural control in our sample.

Conclusions

Among nursing home residents, postural control is related to functional mobility and muscle strength. Thus, routine testing of these skills among elderly people is an important task of the physiotherapist.

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Purpose

Reduced functional mobility is a risk factor for falls. The Timed Up and Go test is a complex measurement tool for functional mobility. Our aims were to assess the functional mobility of: (a) community-living elderly who were participating in an exercise programme (n = 40; mean age = 73.7 years), (b) community-living elderly who were physically inactive (n = 40; mean age = 74.1 years), and (c) institutionalized elderly (n = 40; mean age = 73.5 years) and to compare the results with cut-off values for risk of fall.

Materials and methods

After measuring functional mobility, one-way independent ANOVAs and sample t-tests were used for analysis.

Results

The functional mobility of the active participants was better than that of the inactive (p < .001) and institutionalized participants (p < .001). There was no significant difference between the inactive and institutionalized participants (p = .990). The functional mobility of the active participants was better, whereas the functional mobility of the inactive participants was worse than the cut-off value of 13.5 s for risk of fall for community-living elderly. The functional mobility of the institutionalized participants did not differ from the 15-s reference value for predicting risk of fall.

Conclusion

The results indicate that regular physical activity has a positive effect on maintaining functional mobility among both community-living and institutionalized elderly individuals.

Open access
Acta Veterinaria Hungarica
Authors: Beáta Kovács, Mathilda Toussaint, E. Gruys, Ibolya Fábián, L. Szilágyi, J. Janan, and P. Rudas

Serum amyloid A (SAA) is of interest as the circulating precursor of amyloid A protein, the fibrillar component of AA (secondary) amyloid deposits, and also as an extremely sensitive and rapid major acute phase protein. Serum concentrations of acute phase proteins (APPs) provide valuable information about the diagnosis and prognosis of various diseases, and thus the relevance of APPs for monitoring the health status of domestic animals is widely accepted. More importantly, the measurement of SAA concentration assists in assessing the prognosis in secondary amyloidosis, which is a common disease of geese, affecting an increasing number of animals. In the present study we introduce a highly sensitive goose-specific ELISA method for measuring SAA concentration in goose serum or plasma samples. Samples were taken from geese of the Landes Grey and Hungarian White breeds, which were stimulated for an acute phase reaction by administration of a commercially available fowl cholera vaccine containing inactivated Pasteurella multocida . Strong and characteristically rapid acute phase responses were measured in both breeds, peaking at approximately 24 h after inoculation. The maximum SAA concentration was 1200 μg/ml. At 72 h post-inoculation, the concentrations returned to pre-inoculation values. There was significantly (p = 0.004) less intense response in the control groups; however, a very mild increase of SAA levels was detected due to the stress inevitably caused by the sampling procedure.

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Cerebral state monitor (CSM) is a recently developed anaesthesia depth monitor based on EEG measurement. Medline search confirmed that the accuracy of this monitor has already been compared with BIS monitoring; however, we did not find any studies comparing CSM monitor with AEP monitoring. Therefore, the aim of our study was to investigate the correlation between AAI using AEP monitor and CSI (cerebral state index) using CSM monitor. Methods: Prospective, observational study involving 39 ASA I–III patients undergoing lumbar discus hernia operation. Simultaneous registration of CSI and AAI was performed during general anaesthesia. The identical values were off-line analysed. Additionally in 20 patients parallel registration of CSI and AAI was undertaken while anaesthesia was guided based on routine clinical signs. Results: While analysing the data in the superficial, ideal and deep anaesthesia zones, we found that a relationship between CSI and AAI is weak. Our patients spent roughly the half of the clinical anaesthesia in the ideal zone based on the AAI index and less than 50% based on CSI. Almost one fifth of clinical anaesthesia based on AAI and nearly 40% based on CSI was spent in the deep anaesthesia zones. A superficial anaesthesia has been detected in 27% of time based on AAI and 17% based on CSI. Conclusions: CSI and AAI weakly correlated to each other. Depth of anaesthesia monitors may be useful in detecting patients who spend valuable time within the deep anaesthetic zone.

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Physiology International
Authors: Zs. Sári, T. Kovács, T. Csonka, M. Török, É. Sebő, J. Toth, D. Tóth, E. Mikó, B. Kiss, D. Szeőcs, K. Uray, Zs. Karányi, I. Kovács, G. Méhes, P. Árkosy, and P. Bai

Abstract

Breast cancer is characterized by oncobiosis, the abnormal composition of the microbiome in neoplastic diseases. The biosynthetic capacity of the oncobiotic flora in breast cancer is suppressed, as suggested by metagenomic studies. The microbiome synthesizes a set of cytostatic and antimetastatic metabolites that are downregulated in breast cancer, including cadaverine, a microbiome metabolite with cytostatic properties. We set out to assess how the protein expression of constitutive lysine decarboxylase (LdcC), a key enzyme for cadaverine production, changes in the feces of human breast cancer patients (n = 35). We found that the fecal expression of Escherichia coli LdcC is downregulated in lobular cases as compared to invasive carcinoma of no special type (NST) cases. Lobular breast carcinoma is characterized by low or absent expression of E-cadherin. Fecal E. coli LdcC protein expression is downregulated in E-cadherin negative breast cancer cases as compared to positive ones. Receiver operating characteristic (ROC) analysis of LdcC expression in lobular and NST cases revealed that fecal E. coli LdcC protein expression might have predictive values. These data suggest that the oncobiotic transformation of the microbiome indeed leads to the downregulation of the production of cytostatic and antimetastatic metabolites. In E-cadherin negative lobular carcinoma that has a higher potential for metastasis formation, the protein levels of enzymes producing antimetastatic metabolites are downregulated. This finding represents a new route that renders lobular cases permissive for metastasis formation. Furthermore, our findings underline the role of oncobiosis in regulating metastasis formation in breast cancer.

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Interventional Medicine and Applied Science
Authors: Zsolt Szelid, G. Kerecsen, P. Maurovich-Horvat, Á. Lux, E. Marosi, A. Kovács, R. G. Kiss, I. Préda, and B. Merkely

Abstract

Diagnostic accuracy of 64-slice CT angiography in the evaluation of in-stent restenosis is improved compared to previous CT methods. The image quality and exact diagnostic performance is, however, limited by several method, stent and patient-related factors. In this retrospective multicenter study the first results with dual source 64-slice scanner are presented in a Hungarian post PCI patient population (n=99). Radiation dose was 11.3±5.2 mSv (average±STD) using a helical scan. In 5.6% of all (n=142) examined stents clinicians were not able to give a final diagnosis using CT scan. This limitation showed correlation with the stent diameter. Nondiagnostic stents were smaller compared to the diagnostic stents (diameter 2.4±0.2 mm versus 3.2±0.5 mm, average±STD, respectively, P<0.01). Despite its high negative predictive value in the detection of restenosis, positive predictive value of CTA is lower, than that of invasive angiography. CT was not powerful enough in our study to distinguish vessel occlusion from severe restenosis. Heart rate was decreased by administration of intravenous metoprolol and in 75.8% of the patients scan was performed at a heart rate over 70 beats/minute, which did not have a significant influence on the diagnostic value.

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