Gut microbiome composition: link between sports performance and protein absorption?

BACKGROUND: Sufficient protein intake is essential for adequate physical condition and athletic performance. However, numerous factors can influence the absorption of consumed protein, including timing, type of protein intake, and gut microbiota. In the present study, elite male water polo players consumed a plant-based, vegan protein supplement with (n = 10) or without (n = 10) pre- and probiotics daily during the 31-day study period. METHODS: We determined the anthropometric characteristics and body composition, dietary habits, gut microbiota composition, and blood parameters of the players at the beginning and at the end of the study. Body composition parameters were analyzed using the InBody 970 bioimpedance analyzer. Gut microbiome composition was determined from stool samples by metagenome sequencing. Paired and unpaired t-tests were used to determine differences between body composition and blood parameters within the groups and between the two groups at the two different sampling times. The Wilcoxon test was used to determine the change in bacterial composition during the study. Correlations between changes in body composition, blood parameters, and taxonomic groups were analyzed using a linear correlation calculation. RESULTS: Skeletal muscle mass (p < 0.001), body cell mass (p = 0.002), arm circumference (p = 0.003), and protein mass (p < 0.001) increased, while body fat mass (p = 0.004) decreased significantly in the intervention group which consumed pre- and probiotics in addition to protein supplement. Activated acetate (reductive TCA cycle I) and propionate (pyruvate fermentation to propanoate I) pathways correlated positively with increased skeletal muscle mass (p < 0.01 and p < 0.05), and the relative abundance of butyrate-producing species showed a significant positive correlation with changes in body fat mass in the intervention group (p < 0.05). These correlations were not observed in the control group without the intake of pre- and probiotics. CONCLUSIONS: The composition of the gut microbiota may influence protein absorption and therefore body composition and consequently physical condition and sports performance.

Factors Modulating Fallow Period of Aerosol-Generating Dental Procedures in a Clinical Setting.

The COVID-19 pandemic has resulted in amended regulations and guidelines governing the practice of dentistry and dental hygiene to ensure the protection of both patients and clinicians from transmission of the SARS-CoV-2 virus. These guidelines include changes in personal protective equipment and, under some guidelines, the institution of a fallow period after any aerosol-generating procedure (AGP). This study aimed to investigate the effect of both ventilation and 4-handed dentistry in clinical practice with patients undergoing supportive periodontal therapy (SPT) by air polishing, ultrasonic and hand instrumentation in a closed operatory. We studied 34 patients during SPT using either 2- or 4-handed dentistry in an operatory with either 0 or 20 additional air changes/h (ACH). Under clinical conditions, 20 additional ACH are adequate to eliminate aerosols produced during an SPT and before the cessation of the AGP. The presence of an assistant had no significant effect on the time needed for aerosol particles to return to baseline values following the AGP. This study supports the efficacy of 20 additional ACH during the process of AGP, but does not support the need for an extended fallow period or 4-handed dentistry to provide additional high-volume evacuation throughout the procedure.

Hungarian male water polo players' body composition can predict specific playing positions and highlight different nutritional needs for optimal sports performance.

BACKGROUND: Water polo is unique among aquatic-and generally other-sports as it includes cyclic elements typical in swimming and acyclic elements occurring mainly in ball games. Moreover, water polo demands high level of technical and tactical skills. Players need an optimal nutritional and physical condition to achieve high athletic performance, which is to a great extend influenced by nutritional habits. We aim to highlight possible shortfalls in players' nutritional intake in relation to positions played within the team. METHODS: In the present study, we determined the anthropometric and body composition characteristics, dietary habits and laboratory parameters of elite adult male water polo players (n = 19) before the start of the championship and at the end of the regular season, which meant a 4-month intervention period. Analyses of body composition characteristics and nutritional habits were performed using bioimpedance analyzer InBody 770 and a 3-day nutrition diary, respectively. Paired-sample t-test were used to determine the differences between the variables measured before and after the championship. Correlations between the anthropometric and body composition characteristics and different serum parameters were analyzed using linear correlation calculation. K-mean cluster analysis was performed using the anthropometric and body composition characteristics of the athletes. RESULTS: Based on anthropometric and body composition characteristics, players can be divided into two significantly different clusters that shows an association with specific playing positions. Cluster I included goalkeepers and wing players, while defenders, centers, and shooters belonged to Cluster II. We observed significant differences in the physical composition and slight but not significant differences in nutritional habits of the clusters. Cluster I players were 5 cm shorter on average, while their mean body weight, skeletal muscle mass and body fat mass data were lower by 19 kg, 7 kg, and 7 kg, respectively. We studied the correlation between initial anthropometric and body composition parameters and the changes in laboratory parameters before and after the regular season. As a result, we detected numerous significant differences between the two clusters, such as the changes in glucose and magnesium levels, which showed a strong correlation with several body composition parameters in cluster II, but did not in cluster I. CONCLUSIONS: Cluster differences between anthropometric and body compositional characteristics, and the changes in laboratory parameters can help to develop position-specific training and nutritional recommendations in the future. Therefore, the results may be applicable in sport sciences for elite athletes and sports coaches.

Enhanced Oxidative DNA-Damage in Peritoneal Dialysis Patients via the TXNIP/TRX Axis.

Peritoneal dialysis (PD) is an effective method of renal replacement therapy, providing a high level of patient autonomy. Nevertheless, the long-term use of PD is limited due to deleterious effects of PD fluids to the structure and function of the peritoneal membrane leading to loss of dialysis efficacy. PD patients show excessive oxidative stress compared to controls or chronic kidney disease (CKD) patients not on dialysis. Therefore, defense systems against detrimental events play a pivotal role in the integrity of the peritoneal membrane. The thioredoxin-interacting-protein (TXNIP)/thioredoxin (TRX) system also plays a major role in maintaining the redox homeostasis. We hypothesized that the upregulation of TXNIP negatively influences TRX activity, resulting in enhanced oxidative DNA-damage in PD patients. Therefore, we collected plasma samples and human peritoneal biopsies of healthy controls and PD patients as well. Using ELISA-analysis and immunohistochemistry, we showed that PD patients had elevated TXNIP levels compared to healthy controls. Furthermore, we demonstrated that PD patients had a reduced TRX activity, thereby leading to increased oxidative DNA-damage. Hence, targeting the TXNIP/TRX system as well as the use of oxidative stress scavengers could become promising therapeutic approaches potentially applicable in clinical practice in order to sustain and improve peritoneal membrane function.

[Experiences with telepathology in northern Afghanistan : A 10-year success story]. / Erfahrungen mit Telepathologie in Nordafghanistan : Eine 10-jährige Erfolgsgeschichte.

Afghanistan is in a military conflict lasting more than 20 years and according to recent political development, in a downhill spiral towards a failed society. This scenario faces the question of the usefulness of international medical aid, especially morphological diagnostics in crisis situations. On the basis of ten years of experience from a telemedicine project, need, feasibility and results in Afghanistan will be discussed. General and country-specific problems and the sustainability of an international partnership are discussed. In summary our experience is: (1) Telemedicine is possible and necessary even in countries with high conflict potential. It is integrated into routine care by local medical care taker, (2) Accompanying video conferences are a significant improvement in telemedical diagnostics, (3) "High level" consultations can bridge the gap between sophisticated western diagnostics and medicine in the partner country in selected cases and (4) Scientific work is possible on the basis of the medical data collected on site and the image material generated.

Peritoneal Expression of SGLT-2, GLUT1, and GLUT3 in Peritoneal Dialysis Patients.

INTRODUCTION: In peritoneal dialysis (PD) patients, the peritoneal membrane is affected by glucose-based solutions used as peritoneal dialysate fluids. This exposure leads to changes of the membrane which may eventually culminate in fibrosis and method failure. In vitro or animal studies demonstrated that glucose transporters are upregulated upon exposure to these solutions. Expression studies of glucose transporters in human peritoneum have not been reported yet. METHODS: Expression of SGLT-2, GLUT1, and GLUT3 in human peritoneal biopsies was analyzed by real-time polymerase chain reaction and Western blot analysis. The localization of these glucose transporters in the peritoneum was evaluated by immunohistochemistry using a Histo-Score. RESULTS: Peritoneal biopsies of patients (healthy controls, uremic, PD, and encapsulating peritoneal sclerosis [EPS]) were analyzed. We found evidence of SGLT-2, GLUT1, and GLUT3 expression in the peritoneal membrane. Protein expression of SGLT-2 increases with PD duration and is significantly enhanced in EPS patients. All transporters were predominantly, but not exclusively, located adjacent to the vessel walls of the peritoneal membrane. CONCLUSION: Our study showed that SGLT-2, GLUT1, and GLUT3 were regularly expressed in the human peritoneum. SGLT-2 was particularly upregulated in PD patients with EPS, suggesting that this upregulation may be associated with pathological changes in the peritoneal membrane in this syndrome. Since preclinical studies in mice show that SGLT-2 inhibitors or downregulation of SGLT-2 ameliorated pathological changes in the peritoneum, SGLT-2 inhibitors may be potentially promising agents for therapy in PD patients that could reduce glucose absorption and delay functional deterioration of the peritoneal membrane in the long term.

Improved Healing after Non-Surgical Periodontal Therapy Is Associated with Higher Protein Intake in Patients Who Are Non-Smokers.

The aim of this study was to determine whether a relationship between periodontal healing and protein intake exists in patients undergoing non-surgical treatment for periodontitis. Dietary protein intake was assessed using the 2005 Block food frequency questionnaire in patients with chronic generalized periodontitis undergoing scaling and root planing (n = 63 for non-smokers, n = 22 for smokers). Protein intake was correlated to post-treatment probing depth using multiple linear regression. Non-smoking patients who consumed ≥1 g protein/kg body weight/day had fewer sites with probing depth ≥ 4 mm after scaling and root planing compared to patients with intakes <1 g protein/kg body weight/day (11 ± 2 versus 16 ± 2, p = 0.05). This relationship was strengthened after controlling for baseline probing depth, hygienist and time between treatment and follow-up (10 ± 2 versus 16 ± 1, p = 0.018) and further strengthened after controlling for potential confounders including age, sex, body mass index, flossing frequency, and bleeding on probing (8 ± 2 versus 18 ± 2, p < 0.001). No associations were seen in patients who smoked. Consuming ≥1 g protein/kg body weight/day was associated with reductions in periodontal disease burden following scaling and root planing in patients who were non-smokers. Further studies are needed to differentiate between animal and plant proteins.

Intervention with inulin prior to and during sanative therapy to further support periodontal health: study protocol for a randomized controlled trial.

BACKGROUND: Periodontal disease is a chronic state of inflammation that can destroy the supporting tissues around the teeth, leading to the resorption of alveolar bone. The initial strategy for treating periodontal disease is non-surgical sanative therapy (ST). Periodontal disease can also induce dysbiosis in the gut microbiota and contribute to low-grade systemic inflammation. Prebiotic fibers such as inulin can selectively alter the intestinal microbiota and support homeostasis by improving gut barrier functions and preventing inflammation. Providing an inulin supplement prior to and post-ST may influence periodontal health while providing insight into the complex relationship between periodontal disease and the gut microbiota. The primary objective is to determine if inulin is more effective than the placebo at improving clinical periodontal outcomes including probing depth (PD) and bleeding on probing (BOP). Secondary objectives include determining the effects of inulin supplementation pre- and post-ST on salivary markers of inflammation and periodontal-associated pathogens, as these outcomes reflect more rapid changes that can occur. METHODS: We will employ a single-center, randomized, double-blind, placebo-controlled study design and recruit and randomize 170 participants who are receiving ST to manage the periodontal disease to the intervention (inulin) or placebo (maltodextrin) group. A pilot study will be embedded within the randomized controlled trial using the first 48 participants to test the feasibility for the larger, powered trial. The intervention period will begin 4 weeks before ST through to their follow-up appointment at 10 weeks post-ST. Clinical outcomes of periodontal disease including the number of sites with PD ≥ 4 mm and the presence of BOP will be measured at baseline and post-ST. Salivary markers of inflammation, periodontal-associated pathogens, body mass index, and diet will be measured at baseline, pre-ST (after 4 weeks of intervention), and post-ST (after 14 weeks of intervention). DISCUSSION: We expect that inulin will enhance the positive effect of ST on the management of periodontal disease. The results of the study will provide guidance regarding the use of prebiotics prior to and as a supportive adjunct to ST for periodontal health. TRIAL REGISTRATION: ClinicalTrials.gov NCT04670133 . Registered on 17 December 2020.

The Importance of Clinical Data for the Diagnosis of Breast Tumours in North Afghanistan.

BACKGROUND: This study was performed in knowledge of the increasing gap between breast disease treatment in countries with restricted resources and developed countries with increasingly sophisticated examination methods. METHODS: The authors present the analysis of a breast disease register consisting of diagnostic cases from Mazar e Sharif and Herat in 2018 and 2019. The study comprises a total of 567 cases, which were presented to experts via telemedicine for final diagnosis. 62 cases (10.9%) were excluded due to inacceptable data or insufficient image quality. These data provided by daily diagnostic classification were used for the built-up of a profile for each frequent breast disease and a breast cancer register. All images and cases were seen by at least 3 independent experts. The diagnoses were made in 60% of cases by cytology of fine needle aspiration and in 40% by histological images. RESULTS: For each entity of breast diseases (e.g., fibroadenoma), a profile of context variables was constructed allowing to assist medical decisions, as "wait and see," elective surgery or immediate surgical intervention with R0 (complete) resection. These "profiles" could be described for fibroadenoma, mastitis, galactocele, fibrous-cystic disease, and invasive breast cancer. CONCLUSIONS: The presented preliminary data set could serve as a cost-effective basis for a North Afghan breast cancer registry, with option to extent to a national model. These preliminary data are transformed in profiles of breast diseases, which are used by the local physicians in charge of breast disease patients. Each new case can be compared by the local treating physician with the profile of all preceded cases with the same diagnosis.

Extrusion-Printing of Multi-Channeled Two-Component Hydrogel Constructs from Gelatinous Peptides and Anhydride-Containing Oligomers.

The performance of artificial nerve guidance conduits (NGC) in peripheral nerve regeneration can be improved by providing structures with multiple small channels instead of a single wide lumen. 3D-printing is a strategy to access such multi-channeled structures in a defined and reproducible way. This study explores extrusion-based 3D-printing of two-component hydrogels from a single cartridge printhead into multi-channeled structures under aseptic conditions. The gels are based on a platform of synthetic, anhydride-containing oligomers for cross-linking of gelatinous peptides. Stable constructs with continuous small channels and a variety of footprints and sizes were successfully generated from formulations containing either an organic or inorganic gelation base. The adjustability of the system was investigated by varying the cross-linking oligomer and substituting the gelation bases controlling the cross-linking kinetics. Formulations with organic N­methyl-piperidin-3-ol and inorganic K2HPO4 yielded hydrogels with comparable properties after manual processing and extrusion-based 3D-printing. The slower reaction kinetics of formulations with K2HPO4 can be beneficial for extending the time frame for printing. The two-component hydrogels displayed both slow hydrolytic and activity-dependent enzymatic degradability. Together with satisfying in vitro cell proliferation data, these results indicate the suitability of our cross-linked hydrogels as multi-channeled NGC for enhanced peripheral nerve regeneration.

Regular maintenance appointments after non-surgical scaling and root planing support periodontal health in patients with or without dry mouth: A retrospective study.

OBJECTIVE: Non-surgical scaling and root planing (SRP), as an initial form of periodontal treatment, followed by ongoing periodontal maintenance appointments is necessary to manage periodontal disease and prevent tooth loss. Saliva also has an essential role in oral health though the relationship between low salivary flow and periodontal outcomes has not been extensively investigated. This study determined if patients with dry mouth have similar clinical outcomes as patients without dry mouth when receiving regular periodontal maintenance after SRP. MATERIALS AND METHODS: This is a retrospective study that investigated clinical periodontal outcomes in patients with (n = 34) or without (n = 85) dry mouth who had undergone SRP 1 to 5 years prior and had routine periodontal maintenance. The presence of dry mouth was established based on a patient's unstimulated salivary flow rate. RESULTS: Probing depth for both patients with or without dry mouth was similar between groups and maintained 1 to 5 years following initial SRP. Improved probing depth achieved post-SRP was sustained regardless of dry mouth status. CONCLUSION: Patients with or without dry mouth did not exhibit different probing depths.

Patients undergoing periodontal procedures commonly use dietary supplements: A consideration in the design of intervention trials.

OBJECTIVE: Diet and dietary supplement use are associated with periodontal health while a cause and effect relationship is less clear. Although associations with specific nutrients and supplements suggest a potential benefit to healing of periodontal tissues after periodontal procedures, this study determined if patients undergoing periodontal surgery currently take dietary supplements to gage whether patients may accept use of such supplements as a potential intervention. MATERIALS AND METHODS: Patients who were undergoing implant placement or soft tissue graft surgery completed a questionnaire indicating any dietary supplements they consumed. Patient demographics, such as age, sex, and smoking status, were gathered from patients' charting records. RESULTS: Data on dietary supplement usage were collected from 221 patients. More than half (64.7%) the population surveyed reported using one or more dietary supplements. The most commonly used dietary supplements were vitamin D (31%), multivitamin (28%), and B-complex (17.2%). Females were more likely to be taking calcium, vitamin B12, and magnesium than males. Adults, aged 51 years and older, were more likely to be taking dietary supplements than their younger counterparts. They were also more likely to be taking four or more supplements than those under the age of 50 years. There was no association between supplement use and sex, but when the number of different supplements being used was assessed, females were more likely than males to be taking four or more different supplements. CONCLUSIONS: The majority of the study population is already taking dietary supplements as part of their routine. Based on this study, future studies to determine if supplement usage, potentially at levels higher than current levels of intake, can be used to maintain or promote periodontal health seem highly feasible.

Sustained Calcium(II)-Release to Impart Bioactivity in Hybrid Glass Scaffolds for Bone Tissue Engineering.

In this study, we integrated different calcium sources into sol-gel hybrid glass scaffolds with the aim of producing implants with long-lasting calcium release while maintaining mechanical strength of the implant. Calcium(II)-release was used to introduce bioactivity to the material and eventually support implant integration into a bone tissue defect. Tetraethyl orthosilicate (TEOS) derived silica sols were cross-linked with an ethoxysilylated 4-armed macromer, pentaerythritol ethoxylate and processed into macroporous scaffolds with defined pore structure by indirect rapid prototyping. Triethyl phosphate (TEP) was shown to function as silica sol solvent. In a first approach, we investigated the integration of 1 to 10% CaCl2 in order to test the hypothesis that small CaCl2 amounts can be physically entrapped and slowly released from hybrid glass scaffolds. With 5 and 10% CaCl2 we observed an extensive burst release, whereas slightly improved release profiles were found for lower Calcium(II) contents. In contrast, introduction of melt-derived bioactive 45S5 glass microparticles (BG-MP) into the hybrid glass scaffolds as another Calcium(II) source led to an approximately linear release of Calcium(II) in Tris(hydroxymethyl)aminomethane (TRIS) buffer over 12 weeks. pH increase caused by BG-MP could be controlled by their amount integrated into the scaffolds. Compression strength remained unchanged compared to scaffolds without BG-MP. In cell culture medium as well as in simulated body fluid, we observed a rapid formation of a carbonated hydroxyapatite layer on BG-MP containing scaffolds. However, this mineral layer consumed the released Calcium(II) ions and prevented an additional increase in Calcium(II) concentration in the cell culture medium. Cell culture studies on the different scaffolds with osteoblast-like SaOS-2 cells as well as bone marrow derived mesenchymal stem cells (hMSC) did not show any advantages concerning osteogenic differentiation due to the integration of BG-MP into the scaffolds. Nonetheless, via the formation of a hydroxyapatite layer and the ability to control the pH increase, we speculate that implant integration in vivo and bone regeneration may benefit from this concept.

Gene Expression Signatures of BRCAness and Tumor Inflammation Define Subgroups of Early-Stage Hormone Receptor-Positive Breast Cancer Patients.

PURPOSE: Patients with estrogen receptor- and/or progesterone receptor-positive, early breast cancer benefit from hormonal treatment, yet high global death burdens due to high prevalence and long-term recurrence risk call for biomarkers to guide additional treatment approaches. EXPERIMENTAL DESIGN: From a prospective, observational study of postmenopausal early breast cancer patients treated with tamoxifen or aromatase inhibitors, gene expression analyses of 612 tumors was performed using the NanoString Breast Cancer 360 panel to interrogate 23 breast cancer pathways. Candidate signatures associated with disease subtype and event-free survival (EFS) were obtained by cluster analysis, Cox modeling, and conditional inference trees, and were independently tested in 613 patients from BreastMark. Tumor-infiltrating lymphocytes (TIL) were assessed on tissue sections, and mutational burden was assessed in 36 tumors by whole-exome sequencing. RESULTS: PAM50-derived classification distinguished lower-risk (Luminal A) from higher-risk subtypes (Luminal B, P = 0.04; HER2, P = 0.006; Basal, P = 0.008). In higher-risk patients, shorter EFS was associated with low androgen receptor [HR = 3.61; 95% confidence interval (CI), 1.72-7.56; P = 0.001] or high BRCAness signature expression (HR = 3.58; 95% CI, 1.19-10.7; P = 0.023). BRCAness was independently confirmed as a predictor of shorter EFS (HR = 2.64; 95% CI, 1.31-5.34; P = 0.007). About 13%-15% of patients, enriched for high-grade, higher-risk subtypes (P ≤ 0.0001), had strong expression of the Tumor Inflammation Signature (TIS) suggestive of an inhibited antitumor immune response. TIS scores were strongly associated with TIL numbers (P < 1e-30) but not with tumor mutation status. CONCLUSIONS: BRCA-related DNA repair deficiency and suppressed tumor immune responses may be clinically relevant predictors of endocrine therapy complementing treatment options in subgroups of hormone-sensitive early breast cancer.

Current and future burden of obesity in the Hungarian Roma population II. / Az elhízás jelenlegi és prognosztizált betegségterhe a magyarországi romák körében II.

INTRODUCTION: Population-specific obesity in different age groups and in the Roma population as well as the presence of noncommunicable diseases that are linked to obesity necessitate the development of ethnical-specific prevention and intervention programmes. AIM: Our goal is to model the effects on nutritional status of interventional programmes of different intensities carried out in various age groups of the Roma population. METHOD: We defined the effect of different public health interventions on the state of health of the Roma population by use of the Dynamic Modeling for Health Impact Assessment software. Two models of interventions were studied throughout our research: one that focuses on only one aspect of lifestyle changes; and one that includes radical prevention programmes that aim to change lifestyles as a whole and have an impact on nutritional status. RESULTS: Nearly 20% of Roma men and women are obese, and by 2070, one third of the Roma population will be overweight or obese without any public health intervention. Not even when the most efficient proceedings of the scientific literature are applied do prevention-intervention programmes of moderate-intensity offer a perceptible result about the incidence and prevalence of diseases linked to obesity. In the case of application of these programs, not more than a ten-person order of magnitude decrease can be achieved. This is not enough to prove a statistical detectability on the population level. Whereas, complex intervention programmes, based on a comprehensive transformation of lifestyle and food consumption patterns can present perceptible outcome primarily among the middle-aged and the elderly. CONCLUSION: The survey results direct attention to the fact that reducing the burden of disease in the Roma population caused by obesity is only to be achieved as a complex, all-councils act that requires resources much greater than what is available now. Orv Hetil. 2020; 161(27): 1137-1145.

Higher intakes of flavonoids are associated with lower salivary IL-1ß and maintenance of periodontal health 3-4 years after scaling and root planing.

AIMS: Higher intakes of fruits and vegetables, and vitamin C are associated with improved periodontal healing post-scaling and root planing (SRP). This study determined if this association was sustained at 3-4 years post-SRP, and if flavonoid intake is associated with periodontal health. Whether reduced probing depth (PD) is sustained and whether PD is correlated with salivary IL-1ß, IL-6 and CRP at 3-4 years post-SRP were also studied. MATERIALS AND METHODS: Clinical periodontal outcomes, dietary intakes and salivary markers of inflammation were measured in patients (n = 43, 23 females, 37-93 years) who had undergone SRP 3-4 years earlier and had been part of a periodontal maintenance programme. RESULTS: Flavonoid intake was inversely associated with PD (p = .042) and salivary IL-1ß concentration (p = .015) after adjustment for multiple confounders. When changes in PD were considered, the association of flavonoid intake with reduced PD became borderline significant (p = .051) but persisted for IL-1ß (p = .018). PD at 3-4 years and 2-4 months post-SRP was similar. There was a positive correlation between PD and salivary IL-1ß (p = .005) but not with salivary CRP and IL-6. CONCLUSION: Higher flavonoid intake is associated with lower IL-1ß. Also, regular supportive periodontal therapy maintained the improved PD at 3-4 years post-SRP regardless of smoking status.

Experience with telepathology in combination with diagnostic assistance systems in countries with restricted resources.

INTRODUCTION: We describe the use of telepathology in countries with restricted resources using two diagnosis assistance systems (Isabel and Memem7) in addition to the diagnoses made by experts in pathology via the iPath-Network. METHODS: A total of 156 cases, largely from Afghanistan, were analysed; 18 cases had to be excluded because of poor image quality. RESULTS: Of the remaining 138 cases (100%), a responsible physician provided a tentative diagnosis for 61.6% of them. With a diagnosis from a consultant pathologist, it was then possible to make a definite diagnosis in 84.8% of cases on the basis of images taken from hematoxylin and eosin staining sections alone. The use of the diagnosis assistance systems resulted in an ordered list of differential diagnoses in 82.6% (IsabelHealth) and in 74.6% (Memem7) of cases, respectively. Adding morphological terminology reduced the list of possible diagnoses to 52.2% (72 cases, Memem7), but improved their quality. DISCUSSION: In summary, diagnosis assistance systems are promising approaches to provide physicians in countries with restricted resources with lists of probable differential diagnoses, thus increasing the plausibility of the diagnosis of the consultant pathologist.

[Current and future burden of obesity at the Hungarian Roma population I]. / Az elhízás jelenlegi és prognosztizált betegségterhe a magyarországi romák körében I.

Introduction: The Roma population rapidly gains in importance in the social structure of Hungary. An adverse consequence of the multiple disadvantageous position of this minority is the unhealthy nutrition, which leads to obesity and high prevalence of its co-diseases. Aim: Based on primer anthropometric data collection, we will determine the nutritional status of the Hungarian Roma population, then on the basis of official statistical data, an estimation and prognoses will be prepared on the disease burden of obesity according to genders and age. Method: A long-range forecast of the population size of the Roma minority's prognosis has been prepared on the basis of official statistics and time-series by Spectrum 5.0 demographic software. On this basis, applying the Dynamic Modeling for Health Impact Assessment software, we have prepared a forecast for the incidence and prevalence of the most important diseases attributable to obesity. Results: In the next decades, the number of the Roma population will be doubled, but there is a high level of uncertainty of different forecasts. The nutritional status of the Hungarian roma population is less favorable, than the indicators, characterizing the Hungarian population as a whole. In the next half a century, the prevalence of co-morbidities of obesity will be increasing from 6 thousand up to 26 thousand in the case of women, while in the case of men from nearly 6 thousand up to 17 thousand. Conclusions: The rapidly increasing number of the Roma population is an increasing challenge for the Hungarian healthcare system, which highlights the importance of evidence-based prevention and intervention programs. Orv Hetil. 2019; 160(28): 1097-1104.

The Fonthill Dental Surgery Complication Classification Scale.

Objectives: A lack of consensus on how to classify post-operative complications in dentistry limits the ability for comparison of outcomes among treatments and their primary providers. Therefore, the Fonthill Dental Surgery Complication Classification Scale has been proposed as a uniform reporting tool to allow for the standardized quality assessment of dental treatment. This instrument classifies negative outcomes arising after dental treatment and is based on the clinician and the clinician time required to resolve the complication in seven classes of increasing severity. Materials and Methods: The scale was evaluated in a cohort of 2,382 consecutive patients, of which 9% experienced a complication, the majority of which were Class I or Class II-resolved without intervention by the dental surgeon. Results: Four scenarios where interpretation of the scale was required are presented with an explanation of their complication class. Conclusions: This classification system will ultimately prove reliable in measuring clinician success rate and aiding in the decision-making process for patients, clinicians, and financial providers.

[Dirofilariasis in the head and neck region. Case report]. / A dirofilariosis ­ fonalféreg-fertozés ­ ritka esete fej-nyak sebészeti területen.

Dirofilariasis refers to an infection caused by a specific parasitic roundworm. Dirofilaria repens - transmitted by mosquito bites - accounts for most human cases. The parasite forms a subcutaneous mass called cutaneous dirofilariasis near the original site of intrusion. The incidence of human infections shows an increasing tendency. We report a case of a 35-year-old woman presenting with three-week history of a painful swelling in the temporal region. The initial diagnostic work-up revealed a roundworm embedded in the subcutaneous fat tissue and temporal muscle. Differential diagnosis included erysipelas, herpes zoster, temporal arteritis. The final diagnosis of helminthiasis was established by ultrasound examination. A multidisciplinary consultation including infectious diseases specialist suggested surgical removal of the lesion. The microbiological examination of the specimen confirmed the presence of a female Dirofilaria repens. Orv Hetil. 2018; 159(45): 1844-1847.