Andrea Horvath

Systematic review and meta-analysis of randomized controlled trials: Lactobacillus rhamnosus GG for abdominal pain-related functional gastrointestinal disorders in childhood

Background  A lack of reliable treatments for abdominal pain‐related functional gastrointestinal disorders prompts interest in new therapies.

Serum leptin, soluble leptin receptor, free leptin index and bone mineral density in patients with primary biliary cirrhosis

Background/aim The pathophysiology of osteoporosis in chronic liver diseases is unknown. Recent data suggest that serum leptin is associated with bone mineral density (BMD). In animal studies leptin was found to be a potent inhibitor of bone formation. We investigated the relationship between serum leptin levels, soluble leptin receptor (sOB-R), free leptin index (FLI) and BMD in patients with primary biliary cirrhosis (PBC). Patients and methods Ninety-four female patients with PBC were included in this study; 122 healthy women served as controls. Serum leptin levels were measured by radioimmunoassay, sOB-R by enzyme-linked immunosorbent assay. BMD was measured by dual energy X-ray absorptiometry in the lumbar spine and femoral neck. Results Serum leptin was significantly lower in patients with PBC compared with healthy controls. No difference was found between the body mass index (BMI) of patients and controls. There was a strong positive correlation between leptin and BMI. In PBC no association was found between leptin, sOB-R and liver function tests, histological stages or the presence of osteoporosis. Osteoporosis was present in 38 patients. A positive correlation was found between serum leptin and femoral neck z-score even after adjustment for BMI, whereas serum sOB-R correlated inversely with the serum leptin level. There was no difference in FLI between the subgroups of PBC patients according to the stages of the disease. Conclusions We found a lower serum leptin level and a higher sOB-R in patients with PBC, which could not be explained by the difference in BMI. As leptin was associated with BMD, it may be hypothesized that leptin is involved in the complex regulation of bone metabolism in PBC.

Probiotics, Prebiotics, and Dietary Fiber in the Management of Functional Gastrointestinal Disorders

At best, currently available therapies provide symptomatic relief from functional gastrointestinal disorders (FGD). No existing therapy, however, can influence the natural course of any of these disorders, prompting interest in new and safe treatment options. This paper summarizes the clinical evidence from randomized controlled trials (RCTs) and their meta-analyses of the effectiveness of probiotics, prebiotics, and dietary fiber in the treatment of FGD in the pediatric population. While it is too soon to recommend the routine use of any probiotics for treating FGD, some of these therapeutic options can provide a health benefit to patients, and therefore can be discussed with patients and/or caregivers. Lactobacillus reuteri DSM 17938 has consistently improved symptoms of infantile colic. The use of Lactobacillus GG moderately increased treatment success in children with abdominal pain-related FGD, particularly among children with irritable bowel syndrome. Also, data from one trial suggest that VSL#3 seems to be effective in ameliorating symptoms and improving the quality of life of children affected by irritable bowel syndrome. L. reuteri DSM 17938 may help infants with constipation. Limited evidence suggests that administration of a fiber supplement is more effective than placebo for the treatment of childhood constipation.

Rapid identification of pathogens in blood culture with fluorescent in situ hybridization (FISH)

Rapid identification of pathogens in bloodstream infections is of utmost importance to improve survival of septic patients. Fluorescent in situ hybridization (FISH) accelerates the identification of most frequent bacterial and yeast pathogens of sepsis. In this study, 210 positive blood cultures were tested with FISH method and the results were evaluated comparing to the traditional cultivation based results. Overall agreement between FISH and conventional identification was 91.4%, with better results for Gram-negative bacteria than for Gram-positives (100% and 89.5%, respectively). FISH results were obtained within 1 hour. FISH may serve as a useful tool to supplement traditional microbiological methods for rapid, provisional identification of sepsis pathogens.

The first case of human alveolar Echinococcosis in Hungary

Infection caused by Echinococcus multilocularis is a rare helminthiasis, human cases have not been diagnosed in Hungary until now. The endemic region is Central Europe; the occurrence of this infection has been reported from most of the neighbouring countries; however, E. multilocularis has been found in the red fox population in Hungary. Summarizing the recent knowledge concerning epidemiological, clinical patterns and therapeutic options, the authors describe the first Hungarian case of alveolar echinococcosis. In the presence of appropriate clinical findings, the possibility of this rare infection has to be considered in the differential diagnosis of infiltrative hepatic lesions.

Risk factors and prevalence of demodex mites in young adults

Demodex mites are ectoparasites often found in follicles of facial skin. Their role in human diseases is under investigation, and a growing number of studies indicated that they contribute to chronic inflammatory conditions of the skin, such as rosacea, blepharitis, otitis externa, alopecia and folliculitis. In our study we tested 96 healthy adults for the presence of Demodex mites. Risk factors influencing presence of mites and skin types of the tested individuals were evaluated. We found Demodex folliculorum or Demodex brevis in 17.7% of the samples, more frequently in males (21.9%) and in older adults (20%). Use of make-up seems to reduce the likelihood of Demodex carriage, while pet ownership, use of shared items and living in close contact with older adults had no significant influence of presence of mites. Demodex positive individuals described their skin to be drier, more prone to erythema, but less for folliculitis compared to Demodex negative subjects.

Transdermally administered proline–arginine-rich host defense peptides show systemic efficacy in a lethal mouse bacteremia model

Host defense peptides are preferably administered as topical therapeutic agents. We have investigated whether peptide A3-APO can enter the circulation when applied to the ear skin. Efficacy of peptide monotherapy as transdermal administration option was assessed in a systemic mouse Acinetobacter baumannii model. A3-APO reduced mortality and demonstrated a statistically significant reduction of blood bacterial counts, regardless whether it was administered prior or after bacterial challenge. The peptidic metabolite of A3-APO was efficacious when applied to the ear or tail.

New trends in the laboratory diagnostics of proteinuria and albuminuria

According to current clinical trials, albumin excretion is an early indicator of cardiovascular damage. While proteinuria is considered as a marker of kidney function, albuminuria indicates cardiovascular risk first of all. Sensitivity of the previous laboratory tests does not meet the clinical requirements, and the error of urine collection makes the results misleading. For that reason recent guidelines suggest to calculate albumin/creatinine (ACR) and protein/creatinine (PCR) measured from the first morning urine. For the clinical diagnosis of albuminuria the sensitive immunoturbidimetric assays are suggested. Albumin dipsticks are not recommended for the measurement of albuminuria. Wide-range urinary protein reagents are also available with high sensitivity, while serum reagents are not applicable (Biuret). The traceability of calibrator to a reference material is a critical requirement. Proteinuria and albuminuria of a patient should be monitored in the same laboratory, using a fixed method and cut-off value. Albumin/creatinine value should be reported together with gender-dependent reference range.Ujabb klinikai vizsgalatok szerint az albuminuria a cardiovascularis betegsegek korai markere. Mig a proteinuria elsősorban a vesefunkcio-romlas, az albuminuria a cardiovascularis riziko parametere. A regebbi laboratoriumi tesztek erzekenysege nem megfelelő, es a 24 oras vizeletgyűjtes pontatlansaga is sok bizonytalansagot okoz. Ezert a mai nemzetkozi iranyelvek 24 oras gyűjtes helyett a reggeli első vizeletből az albumin/kreatinin (ACR) es protein/kreatinin (PCR) meghatarozasat javasoljak. Klinikai laboratoriumok szamara javasolhatok az ujabb, nagy erzekenysegű immunkemiai vizeletalbumin-reagensek. Az albuminspecifi kus tesztcsikok az albuminuria fokanak meghatarozasara nem eleg erzekenyek. A vizeletfeherje-meghatarozashoz szinten leteznek nagy erzekenysegű, szeles meresi tartomanyu reagensek, igy erre nem alkalmazhatok a szerumfeherje-reagensek (peldaul Biuret). A modszervalasztas sarkalatos pontja, hogy a kalibrator nemzetkozi referensanyagra visszavezethető legyen. Mindezekből kovetkezik, hogy egy beteg ACR- vagy PCR-erteke az adott modszert es dontesi hatarerteket alkalmazo ugyanazon laboratoriumban kovethető jol. A laboratoriumi leleten az albumin/kreatinin referenciatartomanyat nemenkent kell megadni. Kulcsszavak: albuminuria, ACR, proteinuria, cardiovascularis betegseg, kreatinin New trends in the laboratory diagnostics of proteinuria and albuminuria According to current clinical trials, albumin excretion is an early indicator of cardiovascular damage. While proteinuria is considered as a marker of kidney function, albuminuria indicates cardiovascular risk fi rst of all. Sensitivity of the previous laboratory tests does not meet the clinical requirements, and the error of urine collection makes the results misleading. For that reason recent guidelines suggest to calculate albumin/creatinine (ACR) and protein/creatinine (PCR) measured from the fi rst morning urine. For the clinical diagnosis of albuminuria the sensitive immunoturbidimetric assays are suggested. Albumin dipsticks are not recommended for the measurement of albuminuria. Wide-range urinary protein reagents are also available with high sensitivity, while serum reagents are not applicable (Biuret). The traceability of calibrator to a reference material is a critical requirement. Proteinuria and albuminuria of a patient should be monitored in the same laboratory, using a fi xed method and cut-off value. Albumin/creatinine value should be reported together with gender-dependent reference range.

High prevalence of vitamin D insufficiency in community-dwelling postmenopausal Polish women

Introduction Inadequate vitamin D level is associated with altered bone turnover and bone loss, which increases the fracture risk. Aim To assess the seasonal prevalence of inadequate (insufficient or deficient) serum vitamin D levels in community-dwelling postmenopausal Polish women screened for osteoporosis. Material and methods A cross-sectional observational study based on the regional urban non-institutionalized sample (n = 107) of postmenopausal Caucasian women in the age range of 51-83 years, not taking any medication and free from any condition likely to affect vitamin D status or calcium/bone metabolism. The outcome measures were the mean 25-OH vitamin D level across all the seasons and the percentage of vitamin D deficiency and insufficiency and defined as < 20 ng/dl (50 nmol/l) and 20-30 ng/dl (50-75 nmol/l), respectively. Results No statistically significant difference has been found in the mean vitamin D level, regardless of the season (p = 0.4). The prevalence of vitamin D deficiency and insufficiency were in spring 54% and 32%, in summer 46% and 46%, in autumn 67% and 27%, and in winter 61% and 22%, respectively. Conclusions Vitamin D inadequacy is common in a sample of Polish community-dwelling postmenopausal women regardless of the season.

Epitaxial assembly dynamics of mutant amyloid β25-35_N27C fibrils explored with time-resolved scanning force microscopy.

Amyloid β25-35 (Aβ25-35) is a toxic fragment of Alzheimers beta peptide. We have previously shown that Aβ25-35 fibrils form a trigonally oriented network on mica by epitaxial growth mechanisms. Chemical reactivity can be furnished to the fibril by introducing a cysteine residue (Aβ25-35_N27C) while maintaining oriented assembly properties. Previously we have shown that fibril binding to mica is strongly influenced by KCl concentration. In the present work we explored the kinetics of epitaxial assembly of the mutant fibrils at different peptide and KCl concentrations by using in situ time-resolved AFM. We measured the length of Aβ25-35_N27C fibrils as a function of time. Increasing free peptide concentration enhanced fibril growth rate, and the critical peptide concentration of fibril assembly was 3.92μM. Increasing KCl concentration decreased the number of fibrils bound to the mica surface, and above 20mM KCl fibril formation was completely abolished even at high peptide concentrations. By modulating peptide and KCl concentrations in the optimal ranges established here the complexity of the Aβ25-35_N27C network can be finely tuned.