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The prevalence of hepatitis C virus infection among patients on hemodialysis is about ten times higher than in the normal population. The infection can induce chronic glomerulonephritis, as an extrahepatic manifestation, which can lead to end-stage renal disease. However, in the majority of patients hepatitis C virus is acquired as a nosocomial infection during hemodialysis. Most of the infected patients have usually normal liver enzymes and need regular screening for hepatitis C antibody to detect the infection. Despite the normal liver enzymes, the liver disease may progress to cirrhosis. Some of the patients are on the renal transplantation waiting list. The immunosuppressive treatment after renal transplantation results in a significantly increased viral replication which might induce further progression of the liver disease. Interferon treatment given after transplantation can induce rejection and graft failure. Therefore the antiviral treatment should be administered during or before the hemodialysis period. Only limited data are available about the treatment of patients with impaired renal function. Alfa-interferon was used mostly in these patients. Due to its impaired renal clearance and higher serum concentration interferon seems to be more effective, but less tolerable in patients with end-stage renal disease than in other groups of patients. Ribavirin is also excreted exclusively by the kidney with anemia being even more pronounced in these patients, and as such is contraindicated in patients on hemodialysis. The pharmacokinetics of the pegylated interferon alfa-2a is very advantageous for patients with end-stage renal disease. The safety and efficacy of peginterferon alfa-2a is now being confirmed in many publications.

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Community Ecology
Authors: G. Bonanomi, G. Incerti, A. Stinca, F. Cartenì, F. Giannino, and S. Mazzoleni

Ring shaped patches of clonal plants fascinated plant ecologists since long time. In this work we review the reports on the occurrence of ring pattern in different environmental conditions, the growth forms of ring-forming plants, the mechanisms underlying ring formation, and the consequences for species diversity at community scale. Rings formed by 83 species of clonal vascular plants have been found in grasslands, deserts, bare substrates of lava flow, harvested peat lands, salt marshes, and sand dunes. Four causal hypotheses have been proposed for the emergence of ring patterns: i. occurrence of architectural constraints for ramets development; ii. induction by fire, drought, trampling or overgrazing; iii. nutrient and water depletion by competition inside the ring; and iv. onset of species-specific negative plant-soil feedback in the inner zone of the clone. Since almost all the available studies are observations of ring structure or modelling exercises, none of the putative mechanisms for ring formation emerged from the literature as either generally applicable or suitable for rejection. Therefore, long-term field experiments are needed to investigate the relative prevalence of different mechanisms in different environments. Ring formation bears important consequences at community scale, because ring forming plants often act as “nurses”, enhancing the recruitment and development of different plant species. In fact, ring establishment modifies above- and below-ground environmental conditions, providing specialized safe sites for beneficiaries in the inner zone of the clones. Such interspecific facilitation by ring forming plants, particularly in chronically stressed environments, contributes to increase plant species richness and can locally promote the successional dynamics.

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This paper aims to trace the cumulative trajectory of the 'Cultural Fever' that started in the early 1980s in China and to offer a cogent, broad analysis of it as a transitional phase of development into a new period of Chinese cultural history. Translation of massive writings of Western critical theories played a pivotal role in prompting the Great Cultural Discussion in China at the time. By and large, Chinese intellectuals were overwhelmingly responsive to Western critical theories, which seriously challenged the Chinese 'traditional' mode of creating and writing about literature, namely realism, or its variations: socialist realism and critical realism. Many literary critics and practitioners alike were eager to explore new approaches to literature in a bid to effect a radical cultural repositioning as well as to revitalize Chinese literary discourse. Nonetheless, the author questions the prevailing characterization of Chinese literary scholars and critics as submissive to this 'cultural invasion'. The borrowings are of a selective and eclectic nature and systematic introduction is rare, thereby leaving little chance of serious cultural colonization. This study brings together hitherto fairly fragmentary evidence of not only epistemological resistance but also of political resistance to Western critical theories, while conducing a careful investigation into the various forms and patterns of resistance that were motivated in substantially different ways. It can also be argued that resistance need not be viewed negatively, because it may mean critical acceptance and rational rejection of Western ideas. Meanwhile, resistance has undergone a traumatic but also exciting stage of development from nativity to maturity, from prejudice to rationalism. No reconstruction is possible unless it is based on some degree of resistance rather than indiscriminate acceptance.

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Vizsgálatunk célja pszichiáter szakorvosok drogfüggőség kezelésével kapcsolatos ismereteinek és véleményének, valamint a drogfüggők iránti attitűdjének feltárása volt. A vizsgálat során összesen 118 pszichiáter szakorvos megkérdezésére került sor, anonim önkitöltős kérdőív segítségével. A mintában a férfiak aránya 40%. Az átlagéletkor 44,4 év. A megkérdezett pszichiáter szakorvosok 67,5%-a nem szívesen vállal szenvedélybeteg pácienst, s amennyiben választási lehetősége van, akkor az alkoholbeteget részesíti előnyben (74,8%) a kábítószerfüggővel szemben. A szakorvosok túlnyomó többsége a drogfüggőség kezelését általánosságban nem pszichiátriai problémaként azonosította, így a detoxikálást inkább belgyógyászati-intenzív egységekre, míg a rehabilitációt pszichiátriai és szociális ellátást ötvöző intézményekre bízná. A drogbetegek elutasítása mellett jelentős hiányosságok voltak azonosíthatók a megkérdezett pszichiáterek addiktológiai ismereteiben. Jelen eredmények fényében indokoltnak tűnik a pszichiáter szakorvosok addiktológiai ismereteinek szélesítése, valamint a drogfüggő betegek irányába mutatott elutasító attitűd enyhítése, a drogfüggők elfogadottságának növelése.

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Plasma homocysteine and Cystatin C levels of 360 chronic haemodialysed patients were measured in fasting (191 men, mean age: 55.5 years; and 169 women, mean: 62.9 years). The patients were divided into subgroups: diabetes mellitus (34 men and 38 women 7 vs 8 IDDM). obliterative arteriosclerosis (68 men and 61 women), cardiovascular complications (75 men and 84 women) and stroke (16 men and 12 women), and after renal transplantation in chronic rejection (15 men and 5 female). Homocysteine was determined by IMx analyser from Abbott by FPIA method. Immunoturbidimetric method was used for quantification of Cystatin C (PETIA). The lowest Cystatin C concentration was found in diabetic patients (4.35±0.15 mg/l in men and 3.18±1.77 mg/l in women) and the highest one occurred in anuric and bilateral nephrectomised and transplanted chronic rejected patients (6.075 mg/l in men and 6.35 mg/l in women: p<0.001). The homocysteine levels (24.98±2.94mmol/l in men and 23.88±1.76mmol/l in women) exceeded the upper limit of reference range (<15.0mmol/l). There was a significant difference in favour of subgroup of cardiovascular (27.25mmol/l in men and 26.87mmol/1 in women) and stroke patients (27.16mmol/l in men and 30.76mmol/l in women p<0.001). Elevated levels were found in chronic rejected patients with accelerated arteriosclerotic events (25.94mmol/l in men and 27.43mmol/l in women). Good positive linear correlation was found between serum homocysteine and Cystatin C levels (r=0.2393 and 0.2252). The authors demonstrated hyperhomocysteinaemia associated with high Cystatin C concentration in four subgroups of haemodialysed patients (obliterative and accelerated arteriosclerosis. cardiovascular disease, and cerebrovascular complications and stroke).

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The Lisbon Treaty has sparked a new round of debate about the nature of membership in the European Union. Constitutional courts of Germany and the Czech Republic played a prominent role in this debate. Parts of their rulings were framed in the traditional vocabulary of ‘sovereignty’. In this paper, I proceed by showing heuristic limitations of the concept of ‘sovereignty’ in addressing the intricate issue of the EU membership. I will, first, argue that none of the aspects of sovereignty – neither international, nor domestic – is significantly affected by the membership in the Union. Moreover, the sovereignty lenses necessarily put emphasis on the question of the final authority, which legal pluralists rightly reject as misleading in the EU context. This rejection is a result of a genuine “heterarchical” relation between the EU and Member States. As a consequence, the EU membership can be more adequately reconstructed through the constitutional identity lenses. This is what both constitutional courts to a certain extent did in their Lisbon rulings. The German court, in addition, tried to determine the “core areas” of competences beyond which the constitutional identity of Germany as a member state can be compromised within the EU. In the last part of the paper, I will challenge this course of action by demonstrating that it is problematic on a number of accounts. In this respect, the Czech Constitutional Court’s (hereinafter: CCC) approach of refraining from determining in advance and in abstracto what might be the ultimate defining elements of the Czech constitutional identity seems to be more commendable.

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A jelen írás arra keres választ, mi lehetett az oka annak, hogy Semmelweis egyszerűnek, logikusnak és praktikusnak tűnt felfedezését nem fogadta el kortársainak többsége, sőt még halála után is jó néhány éven át csak egyfajta óvatos elfogadás jellemezte azokat. Igyekeztünk mindent Semmelweis eredeti szavai alapján felidézni, részben az Orvosi Hetilapban 1858-ban megjelent magyar nyelvű cikksorozata alapján, részben az 1860-as év végén elkészült német nyelvű összefoglaló kötetét figyelembe véve. Semmelweis ugyan mindent megtett annak érdekében, hogy ok-okozati kapcsolatot bizonyítson a gyermekágyi láz kialakulása és az azt okozó, kézre tapadt fertőző anyagok között, mindez nem volt elegendő. A korszak elfogadott teóriája szerint a fertőzést a levegőben előforduló miazmák közvetítik, így ebbe az elméletbe nemigen fért bele a fertőző kéz okozta fertőzés teóriája. Arra a következtetésre jutunk, hogy Semmelweis ok-okozati láncolatából egy fontos láncszem kimaradt, mégpedig az általa jogosan feltételezett kórokozók szemmel láthatóvá tétele, azaz mikroszkóppal történő kimutatása. Erre végül is csak Semmelweis halála után két évvel került sor. Ha a neves magyar orvos egy kicsit jobban átgondolta volna a mikroszkopizálás lehetőségét, akkor módja nyílt volna arra, hogy az általa még Bécsben megismert s már ott mikroszkópos kísérleteket folytató – később Franciaországban élt – tudóssal, Gruby Dáviddal felvegye a kapcsolatot. Gruby az 1840-es és 1850-es években a mikroszkópos technika egyik jelentős úttörője volt, s különösen szövettani vizsgálatai nemzetközileg is ismertek voltak. Grubynak a semmelweisi kutatásokba történt esetleges meghívása talán megmenthette volna Semmelweiset a fölösleges kritikáktól és a cáfolatoktól (köztük Virchow kellemetlen elutasításaitól), s akkor ma őt emlegethetnénk az elsők között a patogén baktériumok felismerői sorában. A mikroszkóp használatának elmaradása volt Semmelweis tragédiájának legfőbb előidézője. Közben a pesti egyetemen is egyre többen kezdtek mikroszkópos megfigyelésekbe, de senki nem ajánlotta fel számára, hogy munkáját mikroszkópos vizsgálatokkal segítse. Az utókor végül is igyekezett őt rehabilitálni és a noninfekció elvének kimondójaként és megvalósítójaként a világon valaha élt 10 legnagyobb orvos sorába emelni, de mindez életében nem adatott meg számára. Orv Hetil. 2018; 159(26): 1055–1064.

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Acta Veterinaria Hungarica
Authors: Tadeja Pintar, A. Pleskovič, M. Alessiani, Francesca Abbiati, Aleksandra Milutinović, D. Petrovič, M. Pogačnik, and Ruda Zorc-Pleskovič

, immunosuppressive drugs and rejection on graft function after small bowel transplantation: a large-animal study. Transpl. Int. (Germany) 16 , 327–335. Zonta A. The influence of surgery

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networks and multilayer perceptrons for ovarian tumor classification with rejection. Artif. Intell. Med., 2003, 29 (1–2), 39–60. 9 King, R. D., Rowland, J., Oliver, S

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Acta Biologica Hungarica
Authors: Elizabeth C. Cropper, C. G. Evans, J. Jing, A. Klein, A. Proekt, A. Romero, and S. C. Rosen

distinguishes ingestion from rejection can be used to predict behavioral transitions in Aplysia. J Comp. Physiol. 172 , 17-32. In vivo buccal nerve activity that distinguishes ingestion from rejection can be used to predict behavioral

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