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Összefoglaló. A Helicobacter pylori továbbra is a világ legelterjedtebb fertőzése: prevalenciája a fejlődő országokban 70–80%, a fejlett országokban csökkenő tendenciát mutat. A dél-magyarországi véradókban a prevalencia 32%-ra csökkent. A migráció a befogadó ország számára a fertőzés fokozott kockázatával jár. A szövettani diagnózisban az immunhisztokémiai vizsgálat pontosabb a hagyományos Giemsa-festésnél. A mesterséges intelligencia érzékenysége a hagyományos endoszkópiáéval összehasonlítva 87%, pontossága 86%. Az újgenerációs szekvenálással lehetséges egy biopsziás mintából több antibiotikumérzékenység meghatározása. A Helicobacter pylori kezelésének európai regisztere kimutatta, hogy 2013 és 2018 között a bizmutalapú négyes vagy a 14 napos egyidejű négyes kezelések hatásosabbak, mint a hagyományos hármas kezelés, de elterjedésük igen lassú folyamat, jelentős földrajzi különbségekkel. Az új típusú koronavírus (SARS-CoV-2) felléphet Helicobacter pylori fertőzésben is, egymás kóros hatását felerősítve. A diagnosztikai módszerek korlátozottak. Protonpumpagátlók szedése növeli a COVID–19-fertőzés kockázatát és annak súlyos kimenetelét. Előzetesen ismert peptikus fekély, vérzés, illetve antikoguláns kezelés előtt az eradikáció a vírusos fertőzés lezajlása után indokolt. A probiotikumoknak az eradikációra gyakorolt hatásáról 20, közepes minőségű metaanalízis született, így a konszenzusokban foglalt álláspontok sem egyértelműek: a jövőben ezt tisztázni kell. Orv Hetil. 2021; 162(32): 1275–1282. Summary. Helicobacter pylori is still the most widespread infection in the world: its overall prevalence is 70–80% in developing regions, but fortunately it is decreasing in the Western world. The prevalence in blood donors from South-Eastern Hungary decreased from 63% in the 1990’s to 32% in 2019. Migration constitutes an increased risk of infection for the destination countries. Immunohistochemistry has proven to be more accurate in histological diagnosis than the conventional Giemsa stain. The sensitivity and accuracy of artificial intelligence as compared to videoendoscopy were 87% and 86%, respectively. The European Register on the management of Helicobacter pylori infection revealed that concomitant quadruple and 14-day bismuth-based therapies are more efficient than triple combinations, although their incorporation in practice is a long-lasting process, with large geographical variations. The novel type of coronavirus (SARS-CoV-2) can also occur in Helicobacter pylori-infected patients, mutually enhancing their pathogenetic effects. Diagnostic possibilities are limited in this setting. The use of proton pump inhibitors increases the risk of viral infection and the severity of the disease. Eradication treatment seems justified in patients with previously known peptic ulcers or gastrointestinal bleeding, or before starting anticoagulant treatment, but must be postponed after resolution of viral infection. The effect of probiotics on eradication was addressed by 20, medium-to-low quality meta-analyses and so, the recommendations of the guidelines are equivocal, which must be clarified in the future with higher quality studies. Orv Hetil. 2021; 162(32): 1275–1282.

Összefoglaló. Bevezetés: Magyarországon a KSH szerint több mint 1 millió ismert cukorbeteg él. A diabetes karbantartásához elengedhetetlen a betegek tudásának, készségeinek és önhatékonyságának növelése és fenntartása. A legelterjedtebb diabetes-betegségismeretteszt a 23 kérdéses Michigan Diabetes Knowledge Test. Első 14 tétele általános tudást mér, például az ételek tápanyagtartalmával és a vércukorszint-változás okaival kapcsolatban. További 9 kérdése az inzulinhasználatról szól. Célkitűzés: Célunk ennek a tesztnek a magyar nyelvű validálása, valamint összefüggéseinek vizsgálata szociodemográfiai és betegségváltozókkal. Módszer: Keresztmetszeti kérdőíves kutatásunkban a tesztcsomagot 129, inzulint használó, 2-es típusú diabeteses beteg töltötte ki (84 nő, átlagéletkor: 59,67; szórás: 12,6) elsősorban online, betegszervezeteken keresztül. Eredmények: A betegségismeret-teszt belső konzisztenciája 0,603, ami elfogadható érték. A 23 kérdés helyes kitöltési arányának átlaga 81,66%, ami az amerikai arányokhoz hasonló, más kutatások speciális csoportjaihoz képest azonban kifejezetten magas érték. A válaszadók a ketoacidosis fogalmát, az egyes ételek tápanyag-összetevőit és az elfogyasztott ételek vércukorszintre gyakorolt hatását illető kérdésekre tudták a választ a legkevésbé. A magyar teszt a szakirodalomnak megfelelő gyenge, negatív irányú összefüggésben áll az életkorral, és pozitív a kapcsolata az inzulinhasználat hosszával, valamint a napi vércukorszintmérés és inzulinbeadás számával. A betegségismeretet függetlenül egyedül a napi vércukorszintmérés mennyisége jósolta meg. A teszt konvergens validitását mutatja gyenge, de szignifikáns összefüggése az egészségértést mérő Brief Health Literacy Screening kérdésekkel. Következtetés: A magyar nyelvű Diabetes Betegségismeret Teszt alkalmas a diabetesszel élők tudásszintjének felmérésére. Mintánkban a betegségismeret magas szintje az inzulint használók megfelelő edukációjával függhet össze. Ugyanakkor eredményeink felhívják a figyelmet a betegek diétával kapcsolatos magasabb szintű tudásának szükségességére. Orv Hetil. 2021; 162(22): 870–877. Summary. Introduction: According to the Hungarian Central Statistical Office, more than 1 million diabetic patients live in Hungary. It is essential to enhance and sustain the knowledge, skills and self-efficacy of patients. The most widely used measurement of illness knowledge is the 23-item Michigan Diabetes Knowledge Test (DKT). Its first 14 items measure general knowledge: the nutritional value of food, and causes of change in blood glucose level. Its further 9 items are about insulin usage. Objective: To examine the reliability and the validity of the Hungarian version of DKT2 as well as its association with sociodemographic and illness-related variables. Methods: In our cross-sectional quantitative study, 129 patients (84 women, mean age: 59.67; SD = 12.6) diagnosed with type 2 diabetes mellitus using insulin therapy filled in a questionnaire online. Results: The α coefficient for the test is 0.603, which is acceptable. The mean of the correct answer rate is 81.66%, which resembles the American results, but it is higher than that of other specific groups. Problem areas for our patients included interpreting ketoacidosis, the nutritional value of foods and the effect of foods on blood glucose level. The score of the Hungarian test – in accordance with the literature – correlates negatively with age, positively with the year of insulin-usage and with the number of daily insulin intake and of blood glucose measurement. Illness knowledge was independently predicted only by the number of daily blood glucose measurement. The convergent validity of the Hungarian test is supported by its weak but significant association with Brief Health Literacy Screen questions. Conclusion: The Hungarian DKT2 properly measures the illness knowledge of diabetic patients. Their high level of knowledge can be traced back to the speciality of the subjects as well as to the overall education of insulin users. Nevertheless, our results draw attention to the necessity of enhancing the level of dietetic knowledge of patients. Orv Hetil. 2020; 162(22): 870–877.

Abstract: Introduction: The Pan-European Registry on Helicobacter pylori management was conceived in 2013 to monitor eradication practices in Europe for 10 years. Aim: To assess the efficacy of different eradication regimens in a single outpatient clinic of gastroenterology. Method: Between 2013 and 2019, 247 patients were registered in a prospective non-interventional study. The infection was diagnosed either by endoscopy, histology, rapid urease test or 13C-urea breath test. As first-line treatment, the patients received either a 7-day triple regimen (any of PPI + amoxicillin + clarithromycin or tinidazole), 10-day modified sequential treatment (PPI + amoxicillin for 5 days + tinidazole and levofloxacin for 5 days), 10-day quadruple concomitant treatment (PPI + amoxicillin + tetracycline or doxycycline + metronidazole or tinidazole) or bismuth-based quadruple treatment. Bismuth or non-bismuth based quadruple or alternative regimens were given as second- or third-line treatment. Results: The eradication rates on per protocol basis were: 82.7% (95% confidence interval: 68.1–97.4) (first-line regimens), 85.2% (75.4–94.9) (sequential treatment), 95.1% (89.6–100) (concomitant treatment) and 82.6% (69.7–95.9) (bismuth-based quadruple regimen). Second-line regimens achieved 65.2% (48.2–83.0) and third-line therapy 54.5% (19.4–86.6), respectively. Conclusion: The first-line concomitant regimen was superior to triple and not significantly better than the sequential or bismuth-based treatment. Second- and third-line regimens achieved largely suboptimal results. Orv Hetil. 2019; 160(47): 1856–1863.

Abstract: Introduction: The compromise effect is a well-known phenomenon in the world of marketing, but it is rarely examined in medical settings. In dental setting, the patient often has to make treatment-related decisions with price as the only available and comprehensible information to help informed choice. Aim: We sought to determine if the compromise effect plays a role in dental treatment choices, and if yes, how the effect is modified by factors such as perceived quality, professional jargon in the explanations, or the importance of keeping one’s own teeth intact. Method: 676 volunteers participated in this questionnaire-based study. The questionnaires were filled in anonymously. Altogether 8 versions of the same questionnaire were generated, in which the following information was given in varying combinations: the names of five different dental treatments from cheap to expensive, their possible prices, and additional information about the treatment. Statistical analysis: The significance of the relationship between the relative frequency of responses and the available additional information was determined by chi-square test and Fisher’s exact test. Results: The respondents did not approach dental treatment-related decisions on a heuristic basis by default, most probably because of their preconceptions and previous experiences in connection with dental treatments. Esthetics turned out to be of utmost importance and expectable lifespan was also information that significantly influenced the choices. Conclusion: Extra information can and does influence informed dental treatment choice on the patient side, provided it is offered in a clear, proper, and intelligible form, which points out the importance of professional communication. Orv Hetil. 2019; 160(38): 1503–1509.

Abstract: Introduction and aim: To assess the prevalence of lactase gene promoter C/T13910 phenotypes in patients with lactose intolerance symptoms and to analyze the birth-cohort phenomenon in lactose-intolerant patients. Method: 1266 patients consulted between 2010 and 2017 were enrolled. Five-year cohort periods of patients born before 1939 and after 1995 were defined and the prevalence of C/T13910 phenotypes was calculated. C/T13910 phenotypes were determined by polymerase chain reaction. Results: The prevalence of the CC phenotype was 43.1%, TC was detected in 44.3% and TT in 12.6% of the cases. The prevalence of the CC phenotype showed a non-linear incremental increase in females, from 9.13% in those born before 1939 to 37.7% in those born after 1995. Conclusion: The prevalence of CC phenotype raised incrementally in females, suggesting a gender/hormonal influence. Orv Hetil. 2019; 160(14): 549–554.

Összefoglaló. Bevezetés: Magyarországon a KSH szerint több mint 1 millió ismert cukorbeteg él. A diabetes karbantartásához elengedhetetlen a betegek tudásának, készségeinek és önhatékonyságának növelése és fenntartása. A legelterjedtebb diabetes-betegségismeretteszt a 23 kérdéses Michigan Diabetes Knowledge Test. Első 14 tétele általános tudást mér, például az ételek tápanyagtartalmával és a vércukorszint-változás okaival kapcsolatban. További 9 kérdése az inzulinhasználatról szól. Célkitűzés: Célunk ennek a tesztnek a magyar nyelvű validálása, valamint összefüggéseinek vizsgálata szociodemográfiai és betegségváltozókkal. Módszer: Keresztmetszeti kérdőíves kutatásunkban a tesztcsomagot 129, inzulint használó, 2-es típusú diabeteses beteg töltötte ki (84 nő, átlagéletkor: 59,67; szórás: 12,6) elsősorban online, betegszervezeteken keresztül. Eredmények: A betegségismeret-teszt belső konzisztenciája 0,603, ami elfogadható érték. A 23 kérdés helyes kitöltési arányának átlaga 81,66%, ami az amerikai arányokhoz hasonló, más kutatások speciális csoportjaihoz képest azonban kifejezetten magas érték. A válaszadók a ketoacidosis fogalmát, az egyes ételek tápanyag-összetevőit és az elfogyasztott ételek vércukorszintre gyakorolt hatását illető kérdésekre tudták a választ a legkevésbé. A magyar teszt a szakirodalomnak megfelelő gyenge, negatív irányú összefüggésben áll az életkorral, és pozitív a kapcsolata az inzulinhasználat hosszával, valamint a napi vércukorszintmérés és inzulinbeadás számával. A betegségismeretet függetlenül egyedül a napi vércukorszintmérés mennyisége jósolta meg. A teszt konvergens validitását mutatja gyenge, de szignifikáns összefüggése az egészségértést mérő Brief Health Literacy Screening kérdésekkel. Következtetés: A magyar nyelvű Diabetes Betegségismeret Teszt alkalmas a diabetesszel élők tudásszintjének felmérésére. Mintánkban a betegségismeret magas szintje az inzulint használók megfelelő edukációjával függhet össze. Ugyanakkor eredményeink felhívják a figyelmet a betegek diétával kapcsolatos magasabb szintű tudásának szükségességére. Orv Hetil. 2021; 162(22): 870-877.According to the Hungarian Central Statistical Office, more than 1 million diabetic patients live in Hungary. It is essential to enhance and sustain the knowledge, skills and self-efficacy of patients. The most widely used measurement of illness knowledge is the 23-item Michigan Diabetes Knowledge Test (DKT). Its first 14 items measure general knowledge: the nutritional value of food, and causes of change in blood glucose level. Its further 9 items are about insulin usage.To examine the reliability and the validity of the Hungarian version of DKT2 as well as its association with sociodemographic and illness-related variables.In our cross-sectional quantitative study, 129 patients (84 women, mean age: 59.67; SD = 12.6) diagnosed with type 2 diabetes mellitus using insulin therapy filled in a questionnaire online.The α coefficient for the test is 0.603, which is acceptable. The mean of the correct answer rate is 81.66%, which resembles the American results, but it is higher than that of other specific groups. Problem areas for our patients included interpreting ketoacidosis, the nutritional value of foods and the effect of foods on blood glucose level. The score of the Hungarian test - in accordance with the literature - correlates negatively with age, positively with the year of insulin-usage and with the number of daily insulin intake and of blood glucose measurement. Illness knowledge was independently predicted only by the number of daily blood glucose measurement. The convergent validity of the Hungarian test is supported by its weak but significant association with Brief Health Literacy Screen questions.The Hungarian DKT2 properly measures the illness knowledge of diabetic patients. Their high level of knowledge can be traced back to the speciality of the subjects as well as to the overall education of insulin users. Nevertheless, our results draw attention to the necessity of enhancing the level of dietetic knowledge of patients. Orv Hetil. 2020; 162(22): 870-877.

Abstract: Introduction: In a clinicopathological retrospective epidemiological study we investigated benign tumors and tumor-like lesions located in the orofacial region, diagnosed at the Universiy of Szeged, Department of Oral Medicine. Method: During a 54-year period (1960–2014), 14 661 biopsies were taken. The included subjects were 7491 patients diagnosed with benign tumors and tumor-like lesions. Results: The average age of patients was 55.3 years, 2823 (37.7%) patients were male and 4668 (62.3%) female. The male : female ratio was 1 : 1.65. Most of the patients included in the study were aged 51–60 (1280, 17.1%). The number of children was 1014 (13.6%) and the number of adults was 6477 (86.3%). The number of non-neoplasms was 6420 (85.7%), being significantly higher than the number of neoplasms (1071, 14.3%). Most of the lesions were of mesenchymal origin (5574, 77.4%); the number of lesions of non-mesenchymal origin was 982 (13.1%). The most prevalent type of lesions was traumatic fibroma (fibrosis): 1806 (32.4%). The most common lesion type in the group of lesions of infectious/inflammational origin was pyogenic granuloma, the number of which was 465 (8.3%). The most common cystic lesion was mucocele (805, 10.7%). Hemangioma was the most frequent lesion type among developmental anomalies with the number of 815 (14.6%). The most common location of the lesions was the lip in 2081 cases (27.8%), followed by the gingiva in 2024 cases (27.0%), bucca in 1069 cases (14.3%), tongue in 981 cases (13.1%), and the facial skin in 695 cases (9.3%). After taking biopsy, the majority of benign lesions were treated with cryo-, laser-, or combined (cryo and laser) surgery. Conclusion: The present computer-aided study showed that irritational fibroma was the most common orofacial benign tumor, and the lip was the most frequent location. The diagnostic classification and the methodology are considerably different in the majority of the studies, which may hinder the exact comparison with other surveys from different regions of the world. Orv Hetil. 2018; 159(37): 1516–1524.

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Abstract: Introduction: It is known that the quality of life (QoL) of patients surgically treated for head and neck cancer (HNC) is significantly enhanced by rehabilitation. It is also known that some of these patients will not quit smoking. Aim: To assess if smoking hampers rehabilitation-related QoL enhancement after surgery. Method: Applying the H&N 35 questionnaire of EORTC, we assessed the QoL of 38 smoking and non-smoking patients who underwent surgical therapy for HNC and subsequent rehabilitation. QoL was assessed after surgery (after the healing period) and 6 months after rehabilitation. Results: While the QoL enhancement of nonsmokers was significant in almost all aspects, that of smoking patients did not reach the level of significance on a number of scales. The results suggest that smoking does not hamper rehabilitation directly, rather, it prevents rehabilitation from exerting its beneficial effects through its own effects. Conclusions: Smoking is a factor that measurably acts against the efforts to enhance the QoL of the surgically treated HNC patient. Therefore, it is essential that emphasis is put on smoking cessation right from the cancer diagnosis also for this reason. Orv. Hetil., 2017, 158(5), 172–177.

Although fructose was discovered in 1794, it was realised in recent decades only that its malabsorption can lead to intestinal symptoms while its excessive consumption induces metabolic disturbances. Fructose is a monosaccharide found naturally in most fruits and vegetables. Dietary intake of fructose has gradually increased in the past decades, especially because of the consumption of high fructose corn syrup. With its 16.4 kg/year consumption, Hungary ranks secondly after the United States. Fructose is absorbed in the small intestine by facilitated transport mediated by glucose transporter proteins-2 and -5, and arrives in the liver cells. Here it is transformed enzymatically into fructose-1-phosphate and then, fructose-1,5-diphosphate, which splits further into glyceraldehyde and dihydroxyacetone-phosphate, entering the process of glycolysis, triglyceride and uric acid production. The prevalence of fructose intolerance varies strongly, depending on the method used. The leading symptoms of fructose intolerance are similar, but less severe than those of lactose intolerance. Multiple secondary symptoms can also occur. A symptom-based diagnosis of fructose intolerance is possible, but the gold standard is the H2 breath test, though this is less accurate than in lactose testing. Measuring fructosaemia is costly, cumbersome and not widely used. Fructose intolerance increases intestinal motility and sensitivity, promotes biofilm formation and contributes to the development of gastrooesophageal reflux. Long-term use of fructose fosters the development of dental caries and non-alcoholic steatohepatitis. Its role in carcinogenesis is presently investigated. The cornerstone of dietary management for fructose intolerance is the individual reduction of fructose intake and the FODMAP diet, led by a trained dietetician. The newly introduced xylose-isomerase is efficient in reducing the symptoms of fructose intolerance. Orv. Hetil., 2016, 157(43), 1708–1716.

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Extracellular vesicles are produced in all organisms. The most intensively investigated categories of extracellular vesicles include apoptotic bodies, microvesicles and exosomes. Among a very wide range of areas, their role has been confirmed in intercellular communication, immune response and angiogenesis (in both physiological and pathological conditions). Their alterations suggest the potential use of them as biomarkers. In this paper the authors give an insight into the research of extracellular vesicles in general, and then focus on published findings in hematological malignancies. Quantitative and qualitative changes of microvesicles and exosomes may have value in diagnostics, prognostics and minimal residual disease monitoring of hematological malignancies. The function of extracellular vesicles in downregulation of natural killer cells’ activity has been demonstrated in acute myeloid leukemia. In chronic lymphocytic leukemia, microvesicles seem to play a role in drug resistance. Orv. Hetil., 2016, 157(35), 1379–1384.

Introduction: Adult type hypolactasia is the most prevalent carbohydrate malabsorption. Aim: To assess the distribution of lactase gene C/T-13910 polymorphism and the accuracy and concordance of a genetic test and H2 breath test in the diagnosis of adult type hypolactasia. Method: 496 patients with symptoms of lactose intolerance were enrolled in a retrospective study who underwent genetic test using TaqMan polymerase chain reaction and H2 breath test. Results: The prevalence of C/T-13910 genotypes was: CC 48.1%, TC: 40.5%, and TT: 11.4%. When the genetic test was taken as reference, the sensitivity of the breath test was 84.3%, with a specificity of 95.7%, a positive predictive value of 96.7% and negative predictive value of 80.4%. Conversely, the accuracy of genetic test was: sensitivity 96.6%, specificity 80.4%, positive predictive value 84.3% and negative predictive value 95.7%. The concordance value between the two tests (kappa index) was 0.78. The results were discordant in 11.1% of the cases. Conclusions: In symptomatic patients, the lactase non-persistence genotype CC occurred in almost half of the patients. Both the genetic and the breath tests are sufficiently accurate, with good predictive value and they can be used to set up the diagnosis. Discordant results should be carefully interpreted. Orv. Hetil., 2016, 157(25), 1007–1112.

The author summarises the interrelations between lactose intolerance, calcium and vitamin D metabolism and osteoporosis. Lactose intolerance enhances the risk of forearm and hip fractures in some patients. Lactase gene genotype and fracture risk are related in some populations. Calcium and vitamin D supplementation increase bone mineral content and they are justified in children, during pregnancy and lactation, and in postmenopausal women. The intake of milk and milk products could increase the risk of ovarian carcinoma. CC genotype of the lactase gene increased the risk of colorectal carcinoma in Finns; no such effect was observed in British, Spanish and Italian patients. Even small quantities of lactose in drugs (10–750 mg) could elicit intolerance symptoms due to individual susceptibility. In spite of public knowledge and advertising, controlled studies did not prove the beneficial effect of either a lactose-free diet, enzyme supplementation or probiotics in an evidence-based manner. While accepted guidelines are lacking, a personalised therapy is mandatory. In spite of increasing public interest in lactose intolerance, many unknown factors must still be studied. Orv. Hetil., 2015, 156(43), 1741–1749.

In a clinicopathological retrospective epidemiological study we investigated benign tumors and tumor-like lesions located in the orofacial region, diagnosed at the Universiy of Szeged, Department of Oral Medicine.During a 54-year period (1960-2014), 14 661 biopsies were taken. The included subjects were 7491 patients diagnosed with benign tumors and tumor-like lesions.The average age of patients was 55.3 years, 2823 (37.7%) patients were male and 4668 (62.3%) female. The male : female ratio was 1 : 1.65. Most of the patients included in the study were aged 51-60 (1280, 17.1%). The number of children was 1014 (13.6%) and the number of adults was 6477 (86.3%). The number of non-neoplasms was 6420 (85.7%), being significantly higher than the number of neoplasms (1071, 14.3%). Most of the lesions were of mesenchymal origin (5574, 77.4%); the number of lesions of non-mesenchymal origin was 982 (13.1%). The most prevalent type of lesions was traumatic fibroma (fibrosis): 1806 (32.4%). The most common lesion type in the group of lesions of infectious/inflammational origin was pyogenic granuloma, the number of which was 465 (8.3%). The most common cystic lesion was mucocele (805, 10.7%). Hemangioma was the most frequent lesion type among developmental anomalies with the number of 815 (14.6%). The most common location of the lesions was the lip in 2081 cases (27.8%), followed by the gingiva in 2024 cases (27.0%), bucca in 1069 cases (14.3%), tongue in 981 cases (13.1%), and the facial skin in 695 cases (9.3%). After taking biopsy, the majority of benign lesions were treated with cryo-, laser-, or combined (cryo and laser) surgery.The present computer-aided study showed that irritational fibroma was the most common orofacial benign tumor, and the lip was the most frequent location. The diagnostic classification and the methodology are considerably different in the majority of the studies, which may hinder the exact comparison with other surveys from different regions of the world. Orv Hetil. 2018; 159(37): 1516-1524.Absztrakt: Bevezetés: Az 54 éves (1960–2014) retrospektív klinikopatológiai analízis a szegedi Fogászati és Szájsebészeti Klinika Orális Medicina Részlegén diagnosztizált jóindulatú orofacialis daganatok és daganatszerű elváltozások utánkövetéses epidemiológiai eredményeinek bemutatására irányult. Anyag és módszer: Összesen 14 661 biopszia történt, amelyek közül 7491 (51,09%) jóindulatú daganatos beteget vontunk be számítógépes vizsgálatunkba. Eredmények: A betegek átlagéletkora 55,3 év, a férfiak száma 2823 (37,7%), a nőké 4668 (62,3%) volt. A férfi : nő arány 1 : 1,65 volt. Az 51–60 éves korcsoportból emelhető ki a legtöbb, 1280 eset (17,1%), és ezen belül 1014 eset (13,6%) alakult ki gyermekkorban és 6477 eset (86,3%) felnőttkorban. Dominálóan több volt a nem neoplasma (6420, 85,7%), mint a neoplasma (1071, 14,3%), ezenfelül pedig több volt a mesenchymalis (5574, 74,4%), mint a nem mesenchymalis (982, 13,1%) daganat. A leggyakoribb daganattípus az irritációs fibroma volt (1806, 32,4%). A gyulladásos/fertőzéses csoportban a legtöbbször granuloma pyogenicumot (465, 8,3%) észleltünk. A cysták közül a mucokele (805, 10,7%), a fejlődési rendellenességek közül pedig a haemangioma (815, 14,6%) fordult elő a leggyakrabban. A daganatok lokalizációját tekintve a legtöbb esetet az ajkon (2081, 27,8%), a gingiván (2024, 27,0%), a buccán (1069, 14,3%), a nyelven (981, 13,1%) és az arcbőrön (695, 9,3%) regisztráltuk. Az orofacialis jóindulatú lágyrész-daganatok döntő többségét a biopsziavételt követően cryo- vagy lézer-, esetenként kombinált (cryo + lézer) kezelésben részesítettük. Következtetés: A jelen vizsgálatban a leggyakoribb jóindulatú tumor az irritációs fibroma volt, és a legtöbb elváltozás az alsó ajkakon fordult elő. A tanulmányok összehasonlító vizsgálatát megnehezítették a diagnosztikai klasszifikációban és a metodológiában alkalmazott különbözőségek, valamint a változó földrajzi és populációs eltérések. Orv Hetil. 2018; 159(37): 1516–1524.

It is known that the quality of life (QoL) of patients surgically treated for head and neck cancer (HNC) is significantly enhanced by rehabilitation. It is also known that some of these patients will not quit smoking.To assess if smoking hampers rehabilitation-related QoL enhancement after surgery.Applying the HN 35 questionnaire of EORTC, we assessed the QoL of 38 smoking and non-smoking patients who underwent surgical therapy for HNC and subsequent rehabilitation. QoL was assessed after surgery (after the healing period) and 6 months after rehabilitation.While the QoL enhancement of nonsmokers was significant in almost all aspects, that of smoking patients did not reach the level of significance on a number of scales. The results suggest that smoking does not hamper rehabilitation directly, rather, it prevents rehabilitation from exerting its beneficial effects through its own effects.Smoking is a factor that measurably acts against the efforts to enhance the QoL of the surgically treated HNC patient. Therefore, it is essential that emphasis is put on smoking cessation right from the cancer diagnosis also for this reason. Orv. Hetil., 2017, 158(5), 172-177.

Although fructose was discovered in 1794, it was realised in recent decades only that its malabsorption can lead to intestinal symptoms while its excessive consumption induces metabolic disturbances. Fructose is a monosaccharide found naturally in most fruits and vegetables. Dietary intake of fructose has gradually increased in the past decades, especially because of the consumption of high fructose corn syrup. With its 16.4 kg/year consumption, Hungary ranks secondly after the United States. Fructose is absorbed in the small intestine by facilitated transport mediated by glucose transporter proteins-2 and -5, and arrives in the liver cells. Here it is transformed enzymatically into fructose-1-phosphate and then, fructose-1,5-diphosphate, which splits further into glyceraldehyde and dihydroxyacetone-phosphate, entering the process of glycolysis, triglyceride and uric acid production. The prevalence of fructose intolerance varies strongly, depending on the method used. The leading symptoms of fructose intolerance are similar, but less severe than those of lactose intolerance. Multiple secondary symptoms can also occur. A symptom-based diagnosis of fructose intolerance is possible, but the gold standard is the H

Tumor markers are gene products which signal the occurrence of tumors in different organs as well as their response to surgery and chemotherapy. The discovery of tumor markers occurred after the demonstration of tumor-specific transplantation antigens in chemically or virally induced tumors in syngenic rodents. The history of currently used tumor markers began in the 1940s, the first discovered being alpha-fetoprotein in 1956, followed by that of carcinoembryonic antigen in 1965. Since then the range of tumor markers has widened continously. Their chemical structure and genetics is now well known. Some may play part in tumor growth and development of metastases. The potential uses of tumor markers are general or high risk population screening, adjunct in diagnosis of cancer, preoperative indicator of tumor burden, indicator of therapeutic success, evidence of postoperative recurrences and use in tumor localization. However, there is no ideal tumor marker fulfilling all the criteria. Isotope-labeled anti-carcinoembryonic antigen antibodies and small molecular E-selectin inhibitors could play a role in the molecular radio- and chemotherapy of colon and pancreatic carcinomas. Orv. Hetil., 2013, 154, 810–819.

After a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. The indications of probiotic administration have been defined and extended in recent years. The author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. Probiotics are useful in preventing and treating diarrhoea caused by antibiotics and Clostridium difficile caused diarrhoea. In the treatment of Helicobacter pylori infection, preparations containing certain Lactobacillus,Bifidobacterium strains or Saccaromyces boulardii could enhance by 5–10% the rate of successful eradication and reduce the incidence and severity of the side effects. Some symptoms of irritable bowel syndrome and thus the quality of life can be improved by probiotics. Their beneficial effect in ulcerative colitis was proven, while in Crohn’s disease has not yet been defined. The use of probiotics is not included in guidelines, with the exception of the Maastricht IV/Florence consensus. For each disease it is advisable to use probiotics containing strains only with proven beneficial effect. The efficiency of preparations containing mixed strains has not yet been properly investigated. The author reviews the rare but potentially serious side effects of probiotics. In Hungary, there are many probiotic preparations available which can be purchased in pharmacies without prescription: their use is more empirical than evidence-based. The European Food Safety Authority has recently rejected claims for probiotics to be classed as medicines given the lack of convincing evidence on the effects of probiotics on human health and well-being. Clearly, further research is needed to collect evidence which could be incorporated into the international guidelines. Orv. Hetil., 2013, 154, 294–304.

Extracellular vesicles are produced in all organisms. The most intensively investigated categories of extracellular vesicles include apoptotic bodies, microvesicles and exosomes. Among a very wide range of areas, their role has been confirmed in intercellular communication, immune response and angiogenesis (in both physiological and pathological conditions). Their alterations suggest the potential use of them as biomarkers. In this paper the authors give an insight into the research of extracellular vesicles in general, and then focus on published findings in hematological malignancies. Quantitative and qualitative changes of microvesicles and exosomes may have value in diagnostics, prognostics and minimal residual disease monitoring of hematological malignancies. The function of extracellular vesicles in downregulation of natural killer cells' activity has been demonstrated in acute myeloid leukemia. In chronic lymphocytic leukemia, microvesicles seem to play a role in drug resistance. Orv. Hetil., 2016, 157(35), 1379-1384.

Adult type hypolactasia is the most prevalent carbohydrate malabsorption.To assess the distribution of lactase gene C/T-13910 polymorphism and the accuracy and concordance of a genetic test and H(2) breath test in the diagnosis of adult type hypolactasia.496 patients with symptoms of lactose intolerance were enrolled in a retrospective study who underwent genetic test using TaqMan polymerase chain reaction and H(2) breath test.The prevalence of C/T-13910 genotypes was: CC 48.1%, TC: 40.5%, and TT: 11.4%. When the genetic test was taken as reference, the sensitivity of the breath test was 84.3%, with a specificity of 95.7%, a positive predictive value of 96.7% and negative predictive value of 80.4%. Conversely, the accuracy of genetic test was: sensitivity 96.6%, specificity 80.4%, positive predictive value 84.3% and negative predictive value 95.7%. The concordance value between the two tests (kappa index) was 0.78. The results were discordant in 11.1% of the cases.In symptomatic patients, the lactase non-persistence genotype CC occurred in almost half of the patients. Both the genetic and the breath tests are sufficiently accurate, with good predictive value and they can be used to set up the diagnosis. Discordant results should be carefully interpreted.

Lactose intolerance is the most prevalent intestinal malabsorption disorder. After presentation of its history, the author describes the emergence of lactose intolerance during the evolution of species, and the biochemistry of lactose as well as features of human and bacterial lactase enzymes are then described. The unequal distribution of lactose intolerance in different continents and population is discussed, followed by presentation of past and present prevalence data in Hungary. Adult-type hypolactasia is caused by a polymorphism of the MCM6 gene located upstream from the lactase gene on the long arm of the chromosome 2. It can be determined with the polymerase chain reaction. The intestinal symptoms of lactose intolerance are well known, but its extra-intestinal manifestations are less recognised. Invasive diagnostic methods (determination of lactase activity from small intestinal biopsies, lactose tolerance test), are accurate, but have been replaced by the non-invasive methods; their gold standard is the H2 breath test. Genetic testing is being used more and more frequently in Hungary too, and, presumably, the methane breath test will be also available in the near future. Lactose intolerance can be accompanied by inflammatory bowel diseases, coeliac disease and irritable bowel syndrome; it could be established whether this association is causal or not in order to start a correct diet and therapy.

The author summarises the interrelations between lactose intolerance, calcium and vitamin D metabolism and osteoporosis. Lactose intolerance enhances the risk of forearm and hip fractures in some patients. Lactase gene genotype and fracture risk are related in some populations. Calcium and vitamin D supplementation increase bone mineral content and they are justified in children, during pregnancy and lactation, and in postmenopausal women. The intake of milk and milk products could increase the risk of ovarian carcinoma. CC genotype of the lactase gene increased the risk of colorectal carcinoma in Finns; no such effect was observed in British, Spanish and Italian patients. Even small quantities of lactose in drugs (10-750 mg) could elicit intolerance symptoms due to individual susceptibility. In spite of public knowledge and advertising, controlled studies did not prove the beneficial effect of either a lactose-free diet, enzyme supplementation or probiotics in an evidence-based manner. While accepted guidelines are lacking, a personalised therapy is mandatory. In spite of increasing public interest in lactose intolerance, many unknown factors must still be studied.

Helicobacter pylori, discovered 27 years ago, has remained the most prevalent infectious agent in the world. In the author's hypothesis, the increase of peptic ulcer prevalence in the 19-20th century could be attributable to the extended worldwide use of gastric tubes for secretory testing which led to the iatrogenic transmission of pathogenic strains. Helicobacter pylori outer membrane proteins (OMP), and duodenal ulcer promoting (dupA) proteins were identified as novel virulence factors, leading to the production of pro-inflammatory cytokines, which could be future targets of therapy. There is no ideal first-line eradication of the infection and according to expert's opinion, the efficiency of these regimens has fallen gradually in recent years to unacceptably low levels; however, in the author's opinion this is a multifactorial phenomenon which can not be generalized. As alternative drugs, the efficiency of levofloxacin, furazolidone and rifabutin has been proven by meta-analyses. Sequential and bismuth-free quadruple therapies, although highly efficient, are not yet used on a large scale. The recurrence of the infection is 2.27%/year in developed and of 13.0%/year in developing countries. Spontaneous eradication occurred in 8-20% of the children and 5-11% of adults. The prevalence of clarithromycin resistance is increasing worldwide. In Hungary, it has reached 10.9% in county cities, according to a national survey. In a district of Budapest called Ferencváros, the prevalence between 2005 and 2009 was 16-22%, with no increasing trend. The development of enzymatic inhibitors (urease, carbonic anhydrase and gamma-glutamyl transpeptidase), modified antibiotics and efflux pump inhibitors seem promising ways because these compounds do not lead to resistance; however, none have yet been used in humans.

Az Orvosi Hetilap 1948 és 1989 között az előző időszakhoz képest jelentősen több gasztroenterológiai tárgyú publikációt közölt. Az ismeretek elsősorban angol közvetítéssel kerültek a magyar szakirodalomba. Célkitűzés: Az Orvosi Hetilap ban 1989 és 2008 között megjelent gasztroenterológiai tárgyú publikációk kiértékelése. Módszer: A szerző manuális módszerrel áttekintette a folyóirat 1989 és 2008 közötti évfolyamait. A gasztroenterológiai tárgyú eredeti közleményeket, lapszemléket és könyvismertetéseket azonosította és azokból adatbázist készített. A publikációkat tematikai csoportokba sorolta és arányukat meghatározta. Az eredményeket összehasonlította az 1948 és 1989 közötti időszak publikációs tevékenységével. Részletesen áttekintette a laparoszkópos sebészet, a májátültetés és a genetikai ismeretek recepcióját az Orvosi Hetilap ban. Eredmények: 1989 és 2008 között az Orvosi Hetilap ban 2817 gasztroenterológiai tárgyú dolgozat jelent meg (1067 eredeti közlemény, 1698 folyóirat-referátum, 52 könyvismertetés), ez az összes közlemény 10,1%-a. Az előző korszakhoz képest a gasztroenterológiai tárgyú közlemények száma nem változott (p = 0,82), a folyóirat-referátumok (p = 0,006) és könyvismertetések száma jelentősen csökkent (p = 0,01). 2007-től megjelent az Orvosi Hetilap online változata és a Hungarian Medical Journal . A 1989 és 2008 között legtöbbet a máj (17,8%) és epeutak betegségeivel (4,31%), ezen belül a vírusos hepatitisekkel foglalkoztak (7,0%). Laparoszkópos sebészettel 27 (1,8%), májátültetéssel 39 (2,6%), genetikával 61 (4,0%) közlemény foglalkozott. Százharmincegy szakfolyóiratot szemléztek, a gasztroenterológiai tárgyú folyóirat-referátumok száma az előző időszakhoz képest csökkent (p = 0,006). A referátumok 65,4%-a magfolyóiratokban jelent meg. Az angol nyelvű lapok aránya 62,4%, a lapszemlék 31,5%-a német, 1,69%-a francia forrásból táplálkozik, tehát az angol dominancia erősödött. A könyvismertetések száma 211-ről 52-re csökkent (p = 0,01). A laparoszkópos sebészetben elsősorban a cholecystectomiával szerzett tapasztalatokat ismertették. A májátültetés kérdéskörének fő fóruma az Orvosi Hetilap volt. A 2000-es években az egyetemi centrumokban működő munkacsoportok ismertették az emésztőszervi betegségek genetikai kutatásait. Következtetés: Az utóbbi két évtizedben az Orvosi Hetilap sikerrel látta el hagyományos feladatát a hazai orvosok szakmai tájékoztatásában, emellett fontos szerepet vállalt a kortárs gasztroenterológia új vívmányainak (laparoszkópos sebészet, májátültetés, genetika) ismertetésében.

The editions of Orvosi Hetilap published between 1857 and 1905 covered most of the contemporary aspects of digestive diseases. Most of knowledge was transferred from German, French and English literature. Aim: Evaluation of the papers dealing with the diseases of the gastrointestinal tract published in Orvosi Hetilap between 1905 and 1944. Method: The author manually reviewed the journal volumes published between 1905 and 1944. The original articles, journal and book reviews were identified and classified according to their subject and origin. The rate of publications of the editorial periods (1857 and 1904 vs 1905 and 1944) was statistically compared with that of certain historical periods (World Wars I and II, the years following the Trianon treaty). Results: Between 1905 and 1944, a total of 1101 original articles were publised about the diseases of the gastrointestinal tract, constituting 10.3% of the total publications. The rate of publications was decreased during World Wars I and II and the years following the Trianon treaty. The most studied diseases were that of the stomach and duodenum (21%), while hepatologic studies accounted for 16.4%. The proportion of basic science studies (anatomy, pathology, physiology) decreased to 3%. Endoscopy was studied in only 1.4% of the publications, while gastrointestinal radiology, as a newcomer, achieved a figure of 3.2%. 1695 publications were reviewed from 112 journals, constituting a significant increase as compared to the previous period. 74.6% of the reviews were published in 15 core journals. 57.1% of the journals were German, 19.6% were English/American and 16.9% French, showing the persistence of the major German influence. The number of book reviews slightly decreased from 116 to 95. Peptic ulcers were the most studied disease of the period and several alternative treatments were tried, all of which are now obsolate. Conclusion: The rate of gastroenterologic publications in Orvosi Hetilap increased considerably in 1905–1944, as compared to the prior period. The main sources of knowledge remained the German literature. Diseases of the stomach and duodenum, including peptic ulcers, were studied in most detail. The development of endoscopy was overshadowed by the emergence of radiology.

Az Orvosi Hetilap 1857–1905 kozott a gasztroenterologia legtobb korabeli kerdesevel foglakozott. Az ismeretek nemet, francia es angol kozvetitessel kerultek a magyar irodalomba. Celkitűzes: Az Orvosi Hetilap ban 1905–1944 kozott megjelent gasztroenterologiai targyu publikaciok kiertekelese. Modszer: A szerző manualis modszerrel attekintette a folyoirat 1905–1944 kozotti evfolyamait. A gasztroenterologiai targyu eredeti kozlemenyeket, lapszemleket es konyvismerteteseket azonositotta, es azokbol adatbazist keszitett. A publikaciokat tematikai csoportokba sorolta, es aranyukat meghatarozta. Az 1857–1904 es 1905–1944 kozti időszak es egyes tortenelmi korszakok (I. es II. vilaghaboru, trianoni korszak) publikacios tevekenyseget osszehasonlitotta. Eredmenyek: 1904–1944 kozott az Orvosi Hetilap ban 1101 gasztroenterologiai targyu kozlemeny jelent meg, amely az osszes eredeti kozlemeny 10,3%-a, jelentősen tobb az előző időszaknal. A kozlemenyek időrendi megjelenese egyenetlen, az I. es II. vilaghaboru eveiben, illetve a trianoni szerződes utani evekben lenyegesen csokkent. A gyomor es nyombel betegsegeivel a kozlemenyek 21%-a foglalkozik, a hepatologiai targyu kozlemenyek aranya 16,4%, az alaptudomanyoke (anatomiai, patologiai, elettani) 3%-ra csokkent. Endoszkopiaval 21 (1,4%), radiologiaval 48 (3,2%) kozlemeny foglakozott. 112 szakfolyoiratot szemleztek, a gasztroenterologiai targyu folyoirat-referatumok szama 1695, aranya 9,4%, az előző időszakhoz kepest jelentősen novekedett. A referatumok 74,6%-a magfolyoiratokban jelent meg. A nemet folyoiratok aranya 57,1%, a lapszemlek 19,6%-a angol nyelvű, 16,9%-a francia forrasbol taplalkozik. A konyvismertetesek szama 116-rol 95-re csokkent. A fekelybetegseg kezeleseben szamos alternativ, ma mar tulhaladott eljarast alkalmaztak. Megbeszeles: 1905–1944 kozott az eredeti gasztroenterologiai publikaciok szama jelentősen meghaladja az előző időszak teljesitmenyet. Az informaciok forrasa tovabbra is elsősorban a nemet szakirodalom. Az időszakban kiemelkedően a gyomor es nyombel betegsegeivel foglalkoztak a legtobbet; az endoszkopia a radiologia elterjedese miatt hatterbe szorult. | The editions of Orvosi Hetilap published between 1857 and 1905 covered most of the contemporary aspects of digestive diseases. Most of knowledge was transferred from German, French and English literature. Aim: Evaluation of the papers dealing with the diseases of the gastrointestinal tract published in Orvosi Hetilap between 1905 and 1944. Method: The author manually reviewed the journal volumes published between 1905 and 1944. The original articles, journal and book reviews were identified and classified according to their subject and origin. The rate of publications of the editorial periods (1857 and 1904 vs 1905 and 1944) was statistically compared with that of certain historical periods (World Wars I and II, the years following the Trianon treaty). Results: Between 1905 and 1944, a total of 1101 original articles were publised about the diseases of the gastrointestinal tract, constituting 10.3% of the total publications. The rate of publications was decreased during World Wars I and II and the years following the Trianon treaty. The most studied diseases were that of the stomach and duodenum (21%), while hepatologic studies accounted for 16.4%. The proportion of basic science studies (anatomy, pathology, physiology) decreased to 3%. Endoscopy was studied in only 1.4% of the publications, while gastrointestinal radiology, as a newcomer, achieved a figure of 3.2%. 1695 publications were reviewed from 112 journals, constituting a significant increase as compared to the previous period. 74.6% of the reviews were published in 15 core journals. 57.1% of the journals were German, 19.6% were English/American and 16.9% French, showing the persistence of the major German influence. The number of book reviews slightly decreased from 116 to 95. Peptic ulcers were the most studied disease of the period and several alternative treatments were tried, all of which are now obsolate. Conclusion: The rate of gastroenterologic publications in Orvosi Hetilap increased considerably in 1905–1944, as compared to the prior period. The main sources of knowledge remained the German literature. Diseases of the stomach and duodenum, including peptic ulcers, were studied in most detail. The development of endoscopy was overshadowed by the emergence of radiology.

The author summarizes the historical development of our knowledge about functional dyspepsia and overviews the so-called "road to Rome" process. Between 1988 and 2006, expert committees developed using the Delphi method subsequent classifications of functional gastrointestinal disorders (Rome I-III). The Rome III classification reassessed the diagnostic criteria for functional dyspepsia and distinguished new subgroups as the postprandial distress and epigastric pain syndrome. The rationale for the proposed new classification was based on the inadequacy of prior approaches such as the predominant symptom, the results of factor analyses in tertiary care and in the general population, clinical experience and new observations in the peer-reviewed literature. Epidemiologic data suggest that dyspeptic symptoms date back to the 1730s and their prevalence increased markedly subsequently, remaining the commonest diagnosis even in the endoscopic era. The current worldwide prevalence of functional dyspepsia is 7-45%, with large geographic variations. The role of Helicobacter pylori and Salmonella infection as etiologic factors is discussed. Amongst the pathophysiological features, the recent data on the role of phenotypic changes of acid secretion, alterations of fundic accommodation and antro-duodenal motility and gastric emptying, gastric hypersensitivity and hormonal disturbances are presented, but all these abnormalities are present only in a small part of the patients. The possible role of the polymorphism of alpha-adrenoceptor gene was also raised. The treatment of functional dyspepsia led to equivocal results and the high rate of placebo response makes difficult any interpretation. According to the recent meta-analyses, proton pump inhibitors and H 2 -histamine receptor blockers are superior to placebo. In spite of good results, cisapride was withdrawn in 2004. Eradication of Helicobacter pylori can induce sustained remission in a small but significant minority of patients. However, it might prevent further development of peptic ulcer and gastric carcinoma and from public health view, eradication of the infection must be performed by using a test-and-treat or test-and-scope strategy and the benefits and risks of this approach must be discussed with the patient. Each of the above treatments achieves transient symptomatic improvement only and follow-up of dyspeptic patients for 5-7 years showed the benign, but recurrent nature of the disease in 50% of the cases. The aim of the Rome III classification is the identification of pathophysiological changes associated with the new subgroups of functional dyspepsia which will permit their targeted pharmacologic treatment leading to better and cost-efficient results.

The author reviews the main achievements in Helicobacter pylori research in the past 2 years. Of the more than 1000 microRNAs described thus far, sets of over- and underexpressed samples were identified that are associated with either gastric cancer or precancerous lesions, and some of them could be either markers or therapeutic targets in the near future. Meta-analyses involved 95 new publications: the association between infection and oesophageal, colorectal, pancreatic and liver carcinomas is supported by the increased odds ratios, but the results do not reach the strength seen in gastric carcinoma. Epstein-Barr virus is an emerging pathogen: 10% of gastric cancers are virus-associated; the prevalence of the virus in normal mucosa, chronic gastritis and peptic ulcer are currently being studied. Current Helicobacter pylori eradication regimens frequently achieve suboptimal results: a few optimisation methods are presented, although not all are supported by the meta-analyses. In 2013, the European Helicobacter Study Group proposed the development of a pan-European registry; data from 5792 patients registered so far indicated that many therapeutic regimens resulted in a low eradication rate. In 2013, the Healthy Stomach Initiative was started with the aim of supporting and disseminating research performed in the field of healthy and diseased stomachs.A szerző az utóbbi 2 év Helicobacter pylori-kutatás eredményeit tekinti át. A genetikusok több mint ezer mikro-RNS közül azonosítottak néhány csoportot, amelyek gyomorrákban vagy rákmegelőző állapotokban túl- vagy alulszabályozottak: ezek lehetnek a jövő markerei vagy terápiás célpontjai. A metaanalízisek 95 közleménnyel gazdagodtak: több dolgozatban kimutatták a Helicobacter pylori és a nyelőcső-, vastagbél-, hasnyálmirigy- és májrák asszociációját, bár a kapcsolat ezek egyikében sem olyan erős, mint a fertőzés és a gyomorrák kapcsolata. Az Epstein–Barr-vírus a gyomorrákok 10%-ában mutatható ki; a fertőzés gyakoriságát normális nyálkahártyában, krónikus gastritisben és peptikus fekélyben jelenleg kutatják. Az eradikációs kezelések eredményei gyakran elégtelenek: néhány módszer kerül bemutatásra, amelyekkel azokat optimalizálni lehet. 2013-ban az Európai Helicobacter Munkacsoport kezdeményezte egy páneurópai regiszter összeállítását: eddig 5792 beteg adatait regisztrálták, kimutatva, hogy több terápiás módszer nem elég hatékony. 2013-ban indult útjára az Egészséges Gyomor Kezdeményezés azzal a céllal, hogy az egészséges egyénekben és gyomorbetegségekben végzett kutatásokat világszerte támogassák, hogy azok mielőbb alkalmazásra kerüljenek. Orv. Hetil., 2015, 156(6), 203–210.

Tumor markers are gene products which signal the occurrence of tumors in different organs as well as their response to surgery and chemotherapy. The discovery of tumor markers occurred after the demonstration of tumor-specific transplantation antigens in chemically or virally induced tumors in syngenic rodents. The history of currently used tumor markers began in the 1940s, the first discovered being alpha-fetoprotein in 1956, followed by that of carcinoembryonic antigen in 1965. Since then the range of tumor markers has widened continously. Their chemical structure and genetics is now well known. Some may play part in tumor growth and development of metastases. The potential uses of tumor markers are general or high risk population screening, adjunct in diagnosis of cancer, preoperative indicator of tumor burden, indicator of therapeutic success, evidence of postoperative recurrences and use in tumor localization. However, there is no ideal tumor marker fulfilling all the criteria. Isotope-labeled anti-carcinoembryonic antigen antibodies and small molecular E-selectin inhibitors could play a role in the molecular radio- and chemotherapy of colon and pancreatic carcinomas.A tumormarkerek olyan géntermékek, amelyek az egyes szervekben kialakuló daganatok jelenlétét, illetve azok sebészeti/gyógyszeres kezelés utáni kórlefolyását jelzik. Felfedezésüket a syngen rágcsálókban kémiai vagy virális úton kiváltott daganatokban leírt tumorspecifikus antigénekből származtatják. A mai klinikai gyakorlatban használt tumorjelzők története az 1940-es években kezdődött: 1944-ben elsőként az alfa-foetoproteint, 1965-ben a karcinoembrionális antigént fedezték fel, azóta palettájuk egyre bővült. Ma már mindegyik pontos szerkezete és genetikája ismert. Egyeseknek funkciója lehet a daganatok növekedésében és a metasztázisok keletkezésében. A tumorjelzők meghatározása végezhető lakossági/kockázati csoportok szűrése céljából, a tumordiagnosztikában, a sebészeti és kemoterápiás kezelés eredményének kiértékelésében, a recidívák kimutatásában és a tumorlokalizációban, de ideális tumorjelző nincs. Izotópokkal jelzett anti-karcinoembrionális antigén ellenanyagnak és E-szelektin-gátló szereknek a jövőben szerepe lehet a vastagbél- és pancreasrák molekuláris sugár- és kemoterápiájában. Orv. Hetil., 2013, 154, 810–819.

MicroRNAs are major regulators of gene expression at the posttranscriptional level. Besides being detected intracellularly, microRNAs have been found in body fluids, as well. Circulating microRNAs may have hormone like features, since they might affect distant cells as mediators of intercellular communication. MicroRNAs occurring in serum, urine, stool and saliva can be exploited as biomarkers of several diseases, and intensive research efforts are being performed in this field. MicroRNAs are also found in breast milk, and it cannot be excluded that these may act on the baby as a form of inter-individual transfer of epigenetic information. The presence of food-derived microRNAs is even more astonishing, thus plant microRNAs have been detected in the circulation, and these could be functionally active in the human/animal organism. Based on these observations, microRNAs could be involved in the transfer of gene expressional/epigenetic information between different individuals, but also between different species, even cross-kingdom. This microRNA-mediated communication might alter our concepts on the functioning of nature and on the development of diseases, as well. Orv. Hetil., 2012, 153, 1647–1650.