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Objective: In developmental dysplasia of the hip (DDH), concentric reduction of dislocated hips cannot be achieved by closed reduction in many cases, and open reduction is required (‘failure of reduction’). The incidence of cases requiring open reduction and the significance of risk factors for unsuccessful reduction remain unclear. We investigated the overall rate and the risk factors for failed closed reduction in DDH. Methods: We followed the Cochrane recommendations in our systematic review and meta-analysis. We performed a systematic search in three medical databases to identify all studies reporting on pediatric patients with hip dislocation in DDH on 2 July 2022. Eligible studies reported on the rate of failure in children younger than 36 months. We calculated odds ratios (ORs) with 95% CIs from two-by-two tables (event rate in risk group, event rate in non-risk group). Results: We identified 13 316 studies and included 62 studies (5281 hips) for failure rate and 34 studies (3810 hips) for risk factor analysis. The overall rate of failure in closed reduction was 20%. The risk of failure of reduction increased with the grade of dislocation and was significantly higher for high dislocations (group 0–24: IHDI 4 vs IHDI 2 OR: 17.45, CI: 9.26–32.92; Tönnis 4 vs Tönnis 2 OR: 14.67, CI: 1.21–177.37; Graf IV vs Graf III OR: 3.4, CI: 2.27–5.09). Male gender was also a significant risk factor (OR: 2.27, CI: 1.13–4.56) in group 0–36. Conclusion: Higher grade dislocations and male gender are significant risk factors for failure of reduction in closed reduction in hip dislocation in DDH.

Abstract Amongst fishes, zebrafish (Danio rerio) has gained popularity as a model system over most other species and while their value as a model is well documented, their usefulness is limited in certain fields of research such as behavior. By embracing other, less conventional experimental organisms, opportunities arise to gain broader insights into evolution and development, as well as studying behavioral aspects not available in current popular model systems. The anabantoid paradise fish (Macropodus opercularis), an “air-breather” species has a highly complex behavioral repertoire and has been the subject of many ethological investigations but lacks genomic resources. Here we report the reference genome assembly of M. opercularis using long-read sequences at 150-fold coverage. The final assembly consisted of 483,077,705 base pairs (~483 Mb) on 152 contigs. Within the assembled genome we identified and annotated 20,157 protein coding genes and assigned ~90% of them to orthogroups.

The Bronze Age of Eurasia (around 3000-1000 BC) was a period of major cultural changes. However, there is debate about whether these changes resulted from the circulation of ideas or from human migrations, potentially also facilitating the spread of languages and certain phenotypic traits. We investigated this by using new, improved methods to sequence low-coverage genomes from 101 ancient humans from across Eurasia. We show that the Bronze Age was a highly dynamic period involving large-scale population migrations and replacements, responsible for shaping major parts of present-day demographic structure in both Europe and Asia. Our findings are consistent with the hypothesized spread of Indo-European languages during the Early Bronze Age. We also demonstrate that light skin pigmentation in Europeans was already present at high frequency in the Bronze Age, but not lactose tolerance, indicating a more recent onset of positive selection on lactose tolerance than previously thought.

We report the case of a woman in her 60s with confirmed multiple self-healing squamous epitheliomas (MSSE) Ferguson-Smith. After recurrences following surgery and radiotherapy, the patient was successfully treated with minimal surgical intervention combined with intralesional injections of triamcinolone acetate. The histological comparison between mature and regressed keratoacanthomas (KA) revealed an increased inflammatory infiltrate with numerous plasmacytoid dendritic cells in the regressed KA in comparison to the mature one, speaking in favor of an inflammation-mediated regression process. Corticosteroids injection in MSSE may have paradoxical effects with action on the proliferation phase rather than the inflammatory regression phase of the KA. Our case confirms previous reports showing that radiotherapy may exacerbate MSSE and should be avoided. Intralesional triamcinolone acetate injection is a safe and easy to use method also effective for multiple lesions. Our case underlines the difference between squamous cell carcinoma and KA, responding differently to therapies like imiquimod or radiotherapy.

The relevance of underdocumented languages in the lexical semantic studies The relevance of underdocumented languages in the lexical semantic studies The presentation is primarily examines questions of principle, which, of course, theoretical and practical background also serves the lessons of experience gained in the Heng-On (OTKA) project is due. This project aims to explore the lexical pathways of the Nganasan language and attempts to create a motivational Nganasan "profile" on the basis of relations between lexical items and formal cognitive motivations. The problem arises in that the newer theories on linguistics also impose new requirements regarding the investigated language: the investigation concentrates to the speaker, using language that accommodates the new meanings in the context of the current use of language occur. That is, any change in motivation can be described on the basis of statements placed in context. In case of living, accessible language competence it is clear, but what to do with the languages for which this is not, or only be limited to? How plausible are the findings that we do on a language which is very limited and the lack of competence? In the presentation, the Nganasan talu ’yesterday, tomorrow’ are presented through word meaning to cover some of the long reach: we do is relevant to lexical semantic typology framework based on what information is. Az előadás elsősorban elvi kérdéseket feszeget, amelyhez természetesen elméleti és gyakorlati háttér is szolgál: a tanulságok a HeNg-On (OTKA) projekt során szerzett tapasztalatoknak köszönhetők. E projekt célja, hogy a nganaszan nyelv lexikalizációs ösvényeinek feltárásával megpróbálja megalkotni a nganaszan motivációs „profilját” a lexikai egységek a formai és kognitív motivációk közötti kapcsolatai alapján. A probléma ott merül fel, hogy a nyelvtudományban megjelenő újabb elméletek új elvárásokat is támasztanak a vizsgált nyelvvel kapcsolatban: a vizsgálat központjában a beszélő, a nyelvhasználó áll, azaz az új jelentések az aktuális nyelvhasználat kontextusában alakulnak. Azaz bármiféle változást, annak motivációját a kontextusba helyezett megnyilatkozások alapján lehet leírni. Ez élő, elérhető kompetenciájú nyelvek esetében ugyan egyértelmű, de mit kezdjünk azokkal a nyelvekkel, amelyek esetében mindez nem, vagy csak korlátozottan tehető meg? Mennyire plauzibilisek azok megállapítások, amelyeket olyan nyelvről teszünk, ahol erősen korlátozott, hiányos a kompetenciánk? Az előadásban a nganaszan talu ’tegnap, holnap’ jelentésű szón keresztül mutatom be, hogy meddig érhet az a bizonyos takaró: milyen információk alapján tudunk releváns megállapításokat tenni szemantikai lexikális tipológiai keretben, és hol van az a pont, amikor már nem nyújtózhatunk tovább.

The human fetus can suffer several presumably painful interventions perinatally and even before, during its intrauterine life. In the past years, scientific dispute concerning the existence of fetal pain and the need for its relief has expanded, and a heated social, political, religious, moral and philosophical debate has arisen, focusing mainly on the suffering experienced by the fetus during artificial abortion. In our two connected papers, medical scientific knowledge regarding fetal pain in the literature is reviewed. In the first article published in Orvosi Hetilap volume 150, issue 11, we defined pain and the neuroanatomical structures participating in subjective pain perception, as well as the development of these structures. Then, the objective indicators of intrauterine stress response (such as fetal neuroendocrine, cardiovascular, reflex and behavioral reactions) evoked by noxious stimuli were discussed. The present second article gathers the evidence of long-term pathologic effects caused by early-experienced pain and stress in animal models and humans. Finally, the potentially pain-evoking pre- and perinatal interventions are evaluated, as well as the analgetic/anesthetic methods that can be applied to intrauterine fetuses in everyday obstetrical practice.

The human fetus can suffer several presumably painful interventions perinatally and even before, during its intrauterine life. In recent years, a scientific dispute has expanded, concerning the existence of fetal pain and the need for its relief, and a heated social, political, religious, moral and philosophical debate has arisen, focusing mainly on the suffering experienced by the fetus during artificial abortion. We review the medical scientific knowledge regarding fetal pain in the literature. The definition of pain and the neuroanatomical structures participating in subjective pain perception, followed by the development of the latter in the course of ontogeny is presented. The objective indicators of intrauterine stress response (such as fetal neuroendocrine, cardiovascular, reflex and behavioral reactions) evoked by noxious stimuli are discussed.

Hysterectomy is one of the most frequent surgical interventions. Both specialists and lay people are interested in the following question: what kind of late psychosexual consequences does hysterectomy have? In the past years many publications showed a new aspect of the effects of hysterectomy on sexual life. The results of these prospective, randomized studies show that the late psychosexual changes do not primarily depend on the surgical method (vaginal, abdominal total or subtotal hysterectomy). The most significant predictive factor is the quality of sexual relationship before the operation. In the light of the evidence of the latest research, women can be reassured about the fact that hysterectomy, performed due to a benign disease, usually ameliorates the function of the organs in the small pelvis, i.e. positive change in sexual life can be expected. On the basis of the observations, this statement is valid for 2 years after the intervention. To analyze the effects after this period, further long-term studies are required. In this literature review the authors present the most significant study results published in the recent past.

In case of genetic risk, parents are often faced with reproductive decisions affecting their life essentially, so it is advisable to pursue careful deliberation. For this reason, the genetic counselor is expected to help the counselee make well-informed and well-considered decisions, which requires the understanding of the patient as an individual. To reach emphatic understanding, physicians can use the results of the Gadamerian theory of interpretation that contains the idea -- as it has been summarized by V. Arnason -- that four aspects of openness are necessary to fully understand the other, such as openness to oneself, to the other, to the subject matter and to tradition. In our paper, we are applying the four-openness model of interpretation to genetic consultation, and we argue that during counseling double interpretation takes place: the physician interprets the patient, and the patient interprets the physician. Double interpretation leads to the clarification of those factors which influence the patient's decision-making: the counselor's attitude and prejudices, the counselee's values and needs, the medical, social, and moral implications of the genetic disease, and the social expectations. By adopting the theory of interpretation, counselors can also advance the provision of emotional support patients need in hard situations.

Introduction: During the last few years family centred obstetric practice became more widespread in Hungary as well. The opinion of the population, however, is hardly known., Objectives: The authors attempted to acquire a better knowledge of the expectations of the various population segments towards postpartum care., Methods: The opinion of 485 person was analyzed with a questionnaire survey. The questions asked about ideal visiting time at the postpartum ward, postpartum organisational structures and appropriate time for discharge., Results: The average age of the examined sample was 25.2 years; 32.4% were still students, 52.6% were state employees. A very early discharge (within 6-8 hours) was suggested only by 1.2% of the sample. The ratio of those who wanted to leave the hospital at less than 24 hours postpartum was only 7.8% as well. At the same time, only one third (35.9%) of the participants would like to be discharged after 4 days after delivery. 57.7% of the whole sample would prefer discharge between day 2 and 4 after delivery. The opinions about the time of discharge are independent from the size of the family, martial status, sex, education and monthly income of the interviewees. The patients' preferences concerning the appropriate time for discharge following an uncomplicated pregnancy and normal vaginal delivery is mainly influenced by the number of children (chi 2 = 62.260; df = 20; p = 0.000) and previous deliveries (chi 2 = 57.803; df = 20; p = 0.000). Early discharge was most commonly voted for by those who had no children or by those who had many., Conclusions: When organising postpartum care, the opinion and expectations of the population should be taken into account as well. Almost 62% of the sample had no children at the time of the interview. They will be in need of obstetric care in the future as well. Because of this, their opinion is especially important.

It is known that patients undergoing laparoscopic surgery can be discharged from hospital sooner and their reconvalescence is achieved faster than after laparotomy. Beside the medical judgement of the healing process it is also important to assess the length of time needed for the patients to feel themselves completely cured and be free of complaints. The data on the subjective judgement of the healing process provided by 335 patients who underwent laparoscopic surgery are analyzed retrospectively here. The aim of the study was to assess how anxiety as a personality trait might influence the healing process and also if there is any connection between anxiety, clinical diagnosis and laparoscopic findings. Anxiety was measured by Spielberger's State-Trait Anxiety Inventory (STAI). The estimated average healing time is 29.8 days (appr. 4 weeks), but patients with diagnostic and/or operative laparoscopy felt themselves free of complaints after 18.9 days (appr. 3 weeks) on the average. The duration of the healing process is independent of the laparoscopic findings and the type of procedure. There is a strong correlation between the anxiety level and the healing process. The average level of anxiety trait was 47.99 +/- 9.50. Anxiety level was the highest in the group of patients operated on for pelvic pain (mean = 51.21). There was no serious organic alteration in the small pelvis in 37% of the cases. One year after the operation 11.3% of the patients did not feel themselves cured and 17.6% had complaints. These data emphasize the role of anxiety and that of psychological factors in the etiopathogenesis and treatment of gynecologic diseases, especially in chronic pelvic pain and infertility or sterility.

Findings of the retrospective questionnaire survey with 45 mothers who experienced perinatal loss show fairly higher residual anxiety scores 1-2 years after the death than it can be experienced in the case of normal population. The results suggest that the Hungarian clinical practice hardly helps the mothers' requested grief work. More than the half of women satisfied with the support from the medical staff, but 17 mothers did not get any kind of advice with respect of the next pregnancy. Nineteen women saw her died baby, while this opportunity was not offered for the others. The risks from the strengthened self-accusation of the mothers and from the "replacement child" syndrome are argued as well.

The authors survey the literature of psychosomatic aspects of infertility, in-vitro-fertilization and embryo transfer. They emphasize the most important thesises of psychosocial and psychodynamical approaches. The changing of sexual and marital relationship of infertile couples are analysed as well. They call readers' attention to some critical points of doctor-patient and psychotherapeutical relationship.

In the period between 1973 and 1976, in order to prevent neonatal RDS, 24 insulin-dependent diabetic mothers were given Dexamethason before delivery. The treated group was compared with a control group comprising 26 women of the same gesational age, severity of diabetes and mode of delivery. Neonatal care was similar in both groups. In the group where steroid prophylaxis was applied, decrease of RDS morbidity and mortality was observed. The authors accentuate that Dexamethason given to the mother may have an unfavourable effect on carbohydrate metabolism. Therefore, it is recommended to perform 4-hour determinations of blood sugar, urinary sugar and acetone and accordingly, modification of therapy.

The authors give a report of a follow-up the anxiety of 363 couples whereby the husband decided to be present at the childbirth and took part in the childbirth preparation courses. The anxiety state and anxiety trait in men was found to be significantly lower than in women. The data of women were compared to a matched control group consisting of 135 pregnant women. In cases where the husband was present at childbirth the anxiety state and anxiety trait of the women was considerably lower than in the control group. The degree of anxiety was found independent of age, educational level, occupation but depended of parity. During the childbirth preparation the anxiety state of the husbands reduced considerably, whereas in the women the trend of increasing anxiety state could be prevented. In the group where the husband was present at childbirth the authors did not find any close relationship between the degree of anxiety and the examined obstetrical parameters (gestational age at labour, outcome and duration of labour, and the birth-weight.