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Bevezetés: Napjaink erőteljes tendenciája nemcsak Magyarországon, hanem a világ szinte minden részén az individualizmus felerősödése, a klasszikus nukleáris családi rendszerekkel szembeni negatív attitűdök felerősödése. Meggyőződésünk azonban, hogy a családok szétesése mind az egyén, mind a társadalom számára romboló. Számtalan kutatás tanúskodik arról, hogy a családi rendszerek, tartós párkapcsolat nemcsak mentális, hanem szomatikus preventív kapacitással rendelkezik, így a család a társadalmi tőke egyik alapvető forrása is. Célkitűzés: A szocializáció, a társas kompetenciák kialakulásának, fejlődésének alapvető színtere a család. E mellett meghatározó helyszín az oktatási rendszer. Az egészségügyi dolgozók a későbbiekben kiemelt szereppel bírnak a családdal kapcsolatos viszonyrendszerek formálásában. Célunk volt ezért egy egészségügyi képzést folytató intézményben a párkapcsolati, családon belüli szociális és mentálhigiénés kompetenciák fejlesztését szolgáló kurrikulum kidolgozása, bevezetése és a több éven keresztül zajló oktatásával szerzett tapasztalatok bemutatása. Módszertan: Két féléves, heti egy óra időtartamú, kezdetekben szabadon választható, majd a nép-egészségtan tantárgy megfelelő fejezeteibe integrált tantárgy tematikáját, óravázlatait dolgoztuk ki. A tárgy oktatása 2012 óta rendszeresen zajlik, az első félévben frontális előadás, majd a második félévben kiscsoportos tréningek formájában. A tárgyat a karon tanuló minden hallgató hallgatta. Az oktatással, hallgatói elégedettséggel kapcsolatos visszajelzéseket kérdőíves felméréssel vizsgáltuk. Eredmények: A visszajelzések egyértelműen igazolták a tárgy létjogosultságát az oktatási rendszerünkben. A hallgatók több mint fele úgy látja, hogy a hallottak alapvetően befolyásolták, pozitívan változtatták a témával kapcsolatos készségeiket. Következtetések: Összességében, az elmúlt néhány év tapasztalata alapján az a meggyőződésünk, hogy az egyetemista korú fiatalok rendkívül nyitottak a párkapcsolatot, a házasságot érintő kérdések feldolgozására, megvitatására. Leendő egészségügyi szakemberekként is – a személyes pozitív szemléletformáláson túl – jól hasznosíthatják az elsajátított, megerősített kompetenciáikat, készségeiket a családok mentális életminőségének javításában. Ezáltal úgy véljük, hogy képzésünk is hozzájárul a család mint társadalmi tőke lehetőségeinek szélesebb körű kiaknázásához. Egészségfejlesztés, LIX. évfolyam, 2018. 2. különszám 6 Introduction: Today's powerful tendency is, not only in Hungary, but in almost all parts of the world, to intensify individualism, and opposing attitudes towards classical, nuclear family-systems. We are convinced, however, that disintegration of families is destructive both for individuals and the society. Numerous research show that family-systems, long-term relationships have not only mental, but somatic preventive capacity, therefore, family is one of the basic sources of social capital. Objective: Families are essential settings for socialization and the development of social competencies. In addition, the educational system has fundamental role in this process. Later on, healthcare workers have a prominent role in forming family-related relationships. Therefore, our goal was to develop and implement a curriculum in a health care educational establishment to strengthen social and mental health competencies in partnerships, relationships. Our further aim was to summarize our experiences of several years of education. Methodology: Initially we designed an optional course-unit (two terms per year, 14 contact hours per terms). Later it was integrated into the relevant chapters of the Public Health course. We prepared the whole documentation of the of course-unit and learning subjects. The subject has been running continuously since 2012 (a frontal lecture is performed regularly in the first half of the year and then in the form of small group training in the second semester). Feedback on education and student satisfaction was examined by questionnaire surveys. Results: The feedback has clearly demonstrated the importance of the subject in our education system. More than half of students found that the acquired knowledge has fundamentally influenced, positively changed their competencies in this subject. Conclusions: Overall, based on our experience of the last few years, we are convinced that young university students have an extremely open mind on discussing issues related to relationships and marriage. As healthcare professionals, beyond developing positive personal attitudes, they can make good use of their acquired, strengthened competencies and skills in improving the quality of mental health of families. Thus, we believe that our training also contributes to the wider exploitation of families as a part of social capital., Egészségfejlesztés folyóirat, Évf. 59, Szám 5 (2018)

Single protein nanocapsules (SPNs) means that each individual protein molecules are coated with a very thin polymer layer. The polymer chains which are porous enough to allow enzymatic functions are bound covalently to the protein molecule. According to our previous results the polymer layer can essentially stabilize different types of enzymes, e.g. its stability became to 50-70 times longer than that of the native ones. The heat stability (at 80 °C SPNs has activity after 24 hours) and the pH-stability (from pH = 1.5 to pH = 12.0) of the covered enzyme can essentially be improved comparing to the native enzymes. Our results show, that SPNs have a good features as drug carriers: acrylamide-bisacrylamide copolymer layer can carries bovine serum albumin molecules across the blood brain barrier in rat brain. We synthesized single haemoglobin nanocapsules with acrylamide-bisacrylamide copolymer on the surface of the molecules (PAAHgB) and their size, homogeneity, aggregation status, zeta potential were investigated compared with other nanomaterials.

An important obstacle to achieve optimal glycaemic control in diabetics on intensive insulin therapy is the frequent occurrence of insulin induced hypoglycaemic events. In healthy subjects and in diabetics without autonomic neuropathy hypoglycaemia activates the sympathetic nervous system, resulting in epinephrine and glucagon release. Both hormones increase hepatic glucose production and this counterregulatory response is of key importance of glucose homeostasis. Recent research shed light on the fact that antecedent hypoglycaemic episodes play pivotal role in hypoglycaemia associated autonomic failure (HAAF). In this condition the sympatho-adrenal response to decreased blood glucose level is blunted. The existence of HAAF clearly indicates that the nervous system contributes to glucose homeostasis in a substantial manner. This review outlines the mechanisms of both peripheral and central neuronal glucose sensing and of neural pathways involved in the counterregulatory response.

SUMMARY Aims: To evaluate motor performance and cardiorespiratory function in youths with type 1 diabetes in comparison with age-matched control group; and to analyse the influence of physical activity level, anthropometric and physical fitness parameters on long-term metabolic control. Methods: 106 youths with diabetes and 130 healthy youths aged 8-18 were assessed by the Eurofit Test Battery regarding motor performances, cardiorespiratory fitness (VO2max), skinfold thickness, and body mass index. Physical activity level was assessed through the use of questionnaires. Predictors of physical fitness and metabolic control were determined with regression analysis. Results: There were no differences either in body composition or in physical activity level, but younger girls with diabetes had impaired results in speed of upper limb movement, abdominal muscle strength, upper body strength, running speed and VO2max; older girls with diabetes had poor results in speed of upper limb movement, abdominal muscle strength, upper body strength and VO2max. Younger boys with diabetes had impaired results in speed of upper limb movement, flexibility, static strength of the hand and abdominal muscle strength; and older boys with diabetes had poor results in speed of upper limb movement, flexibility, abdominal muscle strength, upper body strength and VO2max. Older age, female gender, higher skinfold thickness, lower physical activity level and higher HbA1c were significant independent predictors of poorer VO2max. Better VO2max proved to be the single predictor of favourable HbA1c. Conclusions: Youths with diabetes have reduced fitness parameters. Efforts should be carried out to improve physical fitness as part of treatment and care of children and adolescents with type 1 diabetes.

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.

Background: Controlled randomised studies to prove improved cardiovascular stability and improved anaemia management during on-line haemodiafiltration (oHDF) are scarce. Methods: 70 patients were treated with both haemodialysis (HD) and oHDF in a cross-over design during 2 × 24 weeks at a dialysis dose of eKt/V≧1.2. Patients randomised into group A started on HD and switched over to oHDF, whereas patients in group B began with oHDF and were treated with HD afterwards. Intradialytic morbid events (IME), such as symptomatic hypotension or muscle cramps, were noted in case of appearance. Blood parameters reflecting anaemic status, phosphate status, lipid metabolism, oxidative stress, and accumulation of advanced glycation end products were recorded either monthly or at the end of each study phase. Results: The mean incidence of IME was 0.15 IME per treatment, and there was no statistical difference between oHDF and HD. A higher haematocrit (oHDF 31.5% vs. HD 30.5%, p < 0.01) at a lower erythropoietin dose (oHDF 4,913 vs. HD 5,492 IU/week, p = 0.02) was found during oHDF, when the sequence of HD and oHDF had not been taken into account. For the study groups, the results were less distinct: in group A, a higher haematocrit (HD 30.4% vs. oHDF 32.0%, p < 0.01) at a comparable erythropoietin dose (HD 5,421 vs. oHDF 5,187 IU/week, ns) was observed during oHDF, whereas in group B an identical haematocrit (oHDF 30.8% vs. HD 30.7%, ns) was achieved at a reduced erythropoietin dose (oHDF 4,622 vs. HD 5,568 IU/week, p < 0.01). During oHDF, lower levels of free and protein-bound pentosidine and of serum phosphate were found. Conclusion: In contrast to other studies, no benefit regarding cardiovascular stability for oHDF was found, but oHDF could well offer a potential benefit regarding anaemia correction, inflammation, oxidative stress, lipid profiles, and calcium-phosphate product.

INTRODUCTION Carbon nanotubes – as artificial nano-size ranged materials –have increasing role in the modern biomedical, diagnostic and therapeutic applications.There is a promising option for their use as more potential drug carriers. Despite the favourable properties, their impact (accumulation, elimination, etc.) on biological systems is largely unknown. The main limiting factor of medical use of nanomaterials in most cases is the potential hypersensitive side effect. It can develop in different route, but the activation of basophil granulocytes may play a central role in this process. OBJECTIVE Our aim was to test the direct activation ability of different, surface modified nanotubes on basophil granulocytes in vitro. In parallel we tested the effectiveness of BasoTest planned to use for this study. MATERIALS AND METHODS Using the blood samples of allergic and healthy volunteers we examined the basophil degranulation in the presence of nanotubes and the expression level changes of cell-surface CD63 on FACS Calibur instrument. Our results were compared to positive(fMLP, Mite, Grass) and negative control samples. RESULTS The test we have chosen proved to be sufficiently sensitive and specific for further study. Significant basophil activation was observed in the presence of carbon nanotubes in healthy persons and allergic patients, as well. The activating effect of nanotubes was more prevailed in allergic population. CONCLUSION Our experiments have proven the fact that nanotubes may play a role in the development of hypersensitive allergic reactions through their basophil granulocyte activator effect.

To evaluate motor performance and cardiorespiratory function in youths with type 1 diabetes in comparison with age-matched control groups and to analyze the influence of physical activity level, anthropometric and physical fitness parameters on long-term metabolic control.106 youths with diabetes and 130 healthy youths aged 8-18 were assessed by the Eurofit test regarding motor performances, cardiorespiratory fitness (VO2max), skinfold thickness, and body mass index. Physical activity level was assessed through the use of questionnaires. Predictors of physical fitness and metabolic control were determined with regression analysis.There were no differences either in body composition or in physical activity level, but younger girls with diabetes had impaired results in speed of upper limb movement, abdominal muscle strength, upper body strength, running speed, and VO2max ; older girls with diabetes had poor results in speed of upper limb movement, abdominal muscle strength, upper body strength and VO2max . Younger boys with diabetes had impaired results in speed of upper limb movement, flexibility, static strength of hand, and abdominal muscle strength; and older boys with diabetes had poor results in speed of upper limb movement, flexibility, abdominal muscle strength, upper body strength, and VO2max compared with control groups. Older age, female gender, lower physical activity level, and higher HbA1c were significant independent predictors of poorer VO2max. Better VO2max proved to be the single predictor of favorable HbA1c .Youths with diabetes have reduced fitness parameters. Efforts should be carried out to improve physical fitness as part of treatment and care of children and adolescents with type 1 diabetes.

Chronic myeloid leukemia is an incurable white blood cell disease with slow progression which affects myeloid stem cells. In the course of chromosome 22 shortening a fusion oncogene arises whose product, a Bcr-Abl oncoprotein, is a continuously expressed tyrosine kinase protein. Beside the opportunity of chemotherapy, stem cell therapy and interferon-a therapy, the application of tyrosine kinase inhibitors also became widespread in the treatment of the disease. Patients bearing the T315I point mutation, however, show resistance against all tyrosine kinase inhibitors, which can be managed by dose escalation or the combination of therapies. The discovery of RNA interference or gene silencing put the therapeutic opportunity of CML in new light. The in vitro application of anti-bcr-abl siRNA showed promising results in the causal treatment of the disease, feasible for identification of new genes associated to the disease, but we do not have sufficient evidence for the safety and efficacy of this method in human therapy.

A 2006. évi ajánlások szerint az alapellátásban is alkalmazni kell a szérumkreatininből képlettel számított glomerulus filtrációs rátát, amely segít a krónikus vesebetegség korai felismerésében. Emiatt előtérbe kerültek a Jaffe-féle kreatininmeghatározás korlátai, és az eredmények összevethetősége érdekében felmerült az igény a leggyakrabban használt Jaffe- és az újabb kreatininmeghatározások harmonizációjára. A kinetikus Jaffe-féle kreatininmeghatározás hátránya, hogy nem elég specifikus. Ezen javítottak az elmúlt évtizedben bevezetett enzimatikus, kompenzált Jaffe és nagyfelbontású folyadékkromatográfiás módszerek. Az újabb módszerekkel kapott kreatininértékek már pontosabbak, de alacsonyabb értékük miatt a korábbi formulákkal (4 változós Modification of Diet in Renal Disease-186, Cockcroft–Gault, kvadratikus) nem lehet belőlük glomerulus filtrációs rátát számítani, mert durván torzítanák azt. Az új kreatininmódszerek miatt a korábbi számítási mód, s így a krónikus vesebetegség stádiumának meghatározása is bizonytalanná vált. Emiatt 2006-ban módosították a 4-változós Modification of Diet in Renal Disease-186 formulát, és az új (izotópdilutiós tömegspektrometriás referenciamódszerre visszavezethető) kreatininhez csak az új 4 változós Modification of Diet in Renal Disease-175 képlet ajánlott. A szerzők összevetik a kreatininmódszerek diagnosztikai értékét és korlátait.

As the literature has only controversial data on the role of nonallergen-specific antibodies in atopic eczema dermatitis syndrome, the authors investigated the link between the occurrence of the antiphospholipid [anticardiolipin (ACL), anti-beta2-glycoprotein I] and allergen-specific immunoglobulin E (IgE) antibodies in 72 children with atopic eczema/dermatitis syndrome (AEDS).The measurement of antiphospholipid antibodies was carried out by enzyme-linked immunosorbent assay (ELISA), serum total IgE by nephelometry, and allergen-specific IgE by immunoblotting assay. The statistical analysis was carried out by Fisher's exact test and odds ratio was calculated.Thirteen of 72 children with AEDS (mean age 8.3 years) had elevated serum levels of ACL, and eight anti-beta2-glycoprotein I antibodies. The presence of allergen-specific IgE against inhalant allergens and nutritive allergens was among eight of 13 and three of eight in the cases with elevated ACL. The ratio of patients with highly increased severity scoring of atopic dermatitis (SCORAD) index (75) was significantly higher in the group with elevated (4/13) than in those with the normal ACL levels (2/59). There was a significant association between the appearance of mite (Dermatophagoides pteronyssinus, D. farinae)-specific IgE and ACL IgM antibodies (6/13).These findings show that there are significant linkage and association between the appearance of ACL IgM or the production of allergen-specific IgE against inhalant (mainly mite) allergens in children with atopic eczema/dermatitis syndrome.

Recently many publications have appeared about the new DNA virus, called transfusion transmitted virus (TT virus), first described in 1997. These are mainly about the virus epidemiology, gene sequences and the distribution of different genotypes. In spite of the fact that the prevalence of this type of infection can reach 40 percent rate in polytransfused patients, such as in hemodialysis patients, the real pathogenetic effect of the virus has not yet been known.The aim of the authors was to examine the activation and distribution of mononuclear cells in peripheral blood and to analyse the possible changes in Th1/Th2 immune regulatory mechanism through the soluble and intracellular cytokine profile beside the biochemical parameters of hepatic lesions in TT virus positive (n = 32) and negative (n = 17) hemodialysed patients. Healthy blood donors were the control group (n = 20).Semi-nested PCR was used to detect the DNA of TT virus. For the surface antigen (CD3, CD4, CD8, CD19, CD56, CD3/HLA-DR, CD3/CD69) and intracellular cytokine analysis the authors applied flow cytometric method.The authors did not find any differences in the liver specific biochemical parameters between TT virus positive and negative hemodialysed and the healthy control group. The number of total T, T helper and total B cells were decreased. The percentage of CD8+, CD3+/HLA-DR+, CD3+/CD69+ and CD56+ cells were increased significantly in both hemodialysed population independently the presence or absence of TT virus. The soluble and intracellular cytokines showed significant growth of the Th1/Th2 cells ratio in hemodialysed patients, which has not been modified by the virus.From these results the authors assume that the TT virus does not cause any significant changes in the immune regulation, although it could play some role in the pathogenesis of hepatitis by local reaction.

Aim: We aimed to examine the distribution and activation of peripheral T cells in TTV positive (n = 32) and negative (n = 17) hemodialyzed patients. The control group (n = 20) consisted of healthy blood donors. Method: TTV-DNA was detected by seminested PCR. CD3, CD4, CD8, CD19, CD56, CD3/HLA-DR, CD3/CD69 and the Th1/Th2 ratio of T cells were analyzed by flow cytometry. Circulating IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-13, TNF-α, TGF-β levels were measured by ELISA in the sera. Results: There was no difference between the CD3, CD4, CD8 and CD19 values of HD subjects. In addition, the expression of both activation markers, HLA-DR and CD69, was significantly elevated in the TTV-positive and -negative HD groups compared to the controls, but not showing any difference from each other. The measurements of intracellular cytokines showed the enhanced occurrence of INF-γ + CD4 T cells, and decreased appearance of IL-4 + CD4 lymphocytes in the HD groups without any significant difference between the TTV virus positive and negative patients. In addition, HD also elevated the expression of IL-10 in CD4 and CD8 (Th2) cells. There were only two significant changes in the levels of circulating cytokines: (a) IL-2 increased; (b) IL-13 decreased in both groups of HD patients compared to the controls, independently of TTV positvity or negativity. Conclusions: We assume that transfusion-transmitted virus does not cause any specific change in the distribution and activation of lymphocytes in the peripheral blood of hemodialyzed patients. Hemodialysis itself, however, results in a significant activation of peripheral T cells with the domination of increased production of Th1 type cytokines, IFN-γ, IL-2, in contrast to the decreased synthesis of Th2 type cytokines, IL-4 and IL-13. Furthermore, the increased expression of IL-10 in the CD4 and CD8 cells of HD patients can be the sign of a contraregulatory Th2 activation as an answer on the Th1 effect.