Nonactivated titanium-dioxide nanoparticles promote the growth of Chlamydia trachomatis and decrease the antimicrobial activity of silver nanoparticles.

AIMS: Chlamydia trachomatis and herpes simplex virus (HSV) are the most prevalent bacterial and viral sexually transmitted infections. Due to the chronic nature of their infections, they are able to interact with titanium-dioxide (TiO2 ) nanoparticles (NPs) applied as food additives or drug delivery vehicles. The aim of this study was to describe the interactions of these two prevalent pathogens with the TiO2 NPs. METHODS AND RESULTS: Chlamydia trachomatis and HSV-2 were treated with nonactivated TiO2 NPs, silver NPs and silver decorated TiO2 NPs before infection of HeLa and Vero cells. Their intracellular growth was monitored by quantitative PCR. Unexpectedly, the TiO2 NPs (100 µg ml-1 ) increased the growth of C. trachomatis by approximately fourfold, while the HSV-2 replication was not affected. Addition of TiO2 to silver NPs decreased their antimicrobial activity against C. trachomatis up to 27·92-fold. CONCLUSION: In summary, nonactivated TiO2 NPs could increase the replication of C. trachomatis and decrease the antimicrobial activity of silver NPs. SIGNIFICANCE AND IMPACT OF THE STUDY: The food industry or drug delivery use of TiO2 NPs could enhance the growth of certain intracellular pathogens and potentially worsen disease symptoms, a feature that should be further investigated.

Fungaemia caused by Candida pulcherrima.

Although neonatal bloodstream infections may be caused by a variety of fungi, invasive fungaemia due to Candida pulcherrima in a premature neonate has not been previously reported. We describe such a case in which antifungal susceptibility test data led to successful therapy. A colonized catheter used for parenteral nutrition is presumed to have been the main source of this persistent infection.

Epidemiological modelling of risk factors of human papilloma virus in women with positive cytology in the county of Csongrád.

This study was carried out to determine the prevalence and risk factors of genital HPV infection in women diagnosed with non-negative cytology in Southeastern Hungary. Cervical samples were collected for cytology and HPV testing from women seen at gynaecological outpatient clinics and diagnosed with non-negative cytology. The observed overall average HPV infection rate was found to be 61%. A smoking habit was the only risk factor in the logistic regression analysis that related significantly to exposure to HPV infection. Thus, prevention strategies should focus on the regular clinical cytological screening of HPV-infected patients and on the reduction of smoking.

Vulnerability and risk evaluation of agricultural nitrogen pollution for Hungary's main aquifer using DRASTIC and GLEAMS models.

In recent years, the significant improvement in point source depuration technologies has highlighted problems regarding, in particular, phosphorus and nitrogen pollution of surface and groundwater caused by agricultural non-point (diffuse) sources (NPS). Therefore, there is an urgent need to determine the relationship between agriculture and chemical and ecological water quality. This is a worldwide problem, but it is particularly relevant in countries, such as Hungary, that have recently become members of the European Community. The Italian Foreign Ministry has financed the PECO (Eastern Europe Countries Project) projects, amongst which is the project that led to the present paper, aimed at agricultural sustainability in Hungary, from the point of view of NPS. Specifically, the aim of the present work has been to study nitrates in Hungary's main aquifer. This study compares a model showing aquifer intrinsic vulnerability to pollution (using the DRASTIC parameter method; Aller et al. [Aller, L., Truman, B., Leher, J.H., Petty, R.J., 1986. DRASTIC: A Standardized System for Evaluating Ground Water Pollution Potential Using Hydrogeologic Settings. US NTIS, Springfield, VA.]) with a field-scale model (GLEAMS; Knisel [Knisel, W.G. (Ed.), 1993. GLEAMS--Groudwater Leaching Effects of Agricultural Management Systems, Version 3.10. University of Georgia, Coastal Plain Experimental Station, Tifton, GA.]) developed to evaluate the effects of agricultural management systems within and through the plant root zone. Specifically, GLEAMS calculates nitrate nitrogen lost by runoff, sediment and leachate. Groundwater monitoring probes were constructed for the project to measure: (i) nitrate content in monitored wells; (ii) tritium (3H) hydrogen radioisotope, as a tool to estimate the recharge conditions of the shallow groundwater; (iii) nitrogen isotope ratio delta15N, since nitrogen of organic and inorganic origin can easily be distinguished. The results obtained are satisfactory, above all regarding the DRASTIC evaluation method, which is shown to satisfactorily explain both low and high aquifer vulnerability, and furthermore proves to be a good tool for zoning hydrogeological regions in terms of natural system susceptibility to pollution. The GLEAMS model, however, proves not to be immediately usable for predictions, above all due to the difficulty in finding sufficient data for the input parameters. It remains a good tool, but only after an accurate validation, for decision support systems, in the specific case to integrate intrinsic vulnerability, from DRASTIC (or similar methods), with land use nitrate loads from GLEAMS, or similar methods. The PECO project has proved a positive experience to highlight the fundamental points of a decision support system, aimed to mitigate the nitrate risk for groundwater coming from Hungarian agricultural areas.

Chlamydia trachomatis infections in eastern Europe: legal aspects, epidemiology, diagnosis, and treatment.

OBJECTIVES: Knowledge concerning genital Chlamydia trachomatis infections in eastern Europe is scarce. Data on the legal aspects, epidemiology, diagnosis, and treatment of the infection have never been collected, summarised, and presented to the international scientific community. The aim of this study was to present the current situation on the main aspects of chlamydial infections in the countries of eastern Europe. METHODS: Written questionnaires concerning legal aspects, epidemiology, diagnosis, and treatment of the infection were distributed among national STI operating administrators as well as researchers who had presented papers at earlier meetings of European chlamydia or STI societies. RESULTS: Most of the countries have not legalised reporting of chlamydial infections and in those who have done so, the quality of the reporting system is poor. Contact tracing is mostly done on a voluntary basis. Reported chlamydia incidence varies from 21 to 276 per 100000 inhabitants. The most commonly used diagnostic test remains the direct immunofluorescence test; however, some tendencies towards nucleic acid amplification are in evidence. Diagnostic services are paid for by the patient himself, while treatment in many countries is partially or completely covered by public insurance. CONCLUSIONS: This is the first report summarising data concerning the situation on C trachomatis infections in eastern Europe. The reporting system and diagnosis of C trachomatis infections remain suboptimal, which allows neither control of the epidemiological situation nor optimal treatment of the patients. The most urgent work currently necessary is the education of professionals and the general population.

[Unusual manifestations of Bartonella infections]. / Bartonella-infekciók szokatlan megjelenési formái.

The authors review the cases of two patients with an atypical form of cat scratch disease. The first case exhibited ileocoecal and hepatoportal lymphadenitis, and the second case the emerging symptoms of a non-specific granulomatous process in the middle third of the right forearm, which caused a differential-diagnostic problem. Establishment of a diagnosis was possible only on the basis of the disease process and the pathological, serological and histopathological pictures of the lymphatic glands after other causes of the lymphadenopathy had been excluded. Following two weeks of antibiotic treatment, the patients were free of complaints- and symptoms. Bartonella antibody tests were performed on 5 cats living in the neighbourhood of the patients with titer determinations too in 3 cases.

Screening for human papillomavirus infection in asymptomatic women in Hungary.

BACKGROUND: A multicentre epidemiological survey was carried out in order to determine the prevalence of, and risk factors for, persistent cervical human papillomavirus (HPV) infection in women in Hungary. METHODS AND RESULTS: A total of 728 women were examined for the prevalence of HPV. The estimated overall rate of HPV infection was 17%. In univariate analysis the strongest predictors were young age (< or =24 years), unmarried family status, smoking, a pathological Papanicolaou (Pap) smear, having a condyloma and previous gynaecological cancer in the family (age and marital status being the most important predictors). In multiple regression analysis, young age (< or =24 years)(odds ratio = 1.86, 95% confidence interval = 1.19-2.90, P < 0.01), smoking (1.78, 1.17-2.71, P < 0.05), an abnormal Pap smear (6.92, 2.68-17.84, P < 0.001), having a condyloma (4.22, 1.42-12.58, P < 0.01) and living in a region where the unemployment rate is relatively high (1.56, 1.24-2.82, P < 0.01) were associated risk factors for HPV infection. CONCLUSIONS: The prevalence of HPV infection in young women in Hungary is high. Screening for HPV is suggested only in women with an unfavourable gynaecological history who are < or =24 years old.

Screening for Chlamydia trachomatis in asymptomatic women in Hungary. An epidemiological and cost-effectiveness analysis.

BACKGROUND: A multicenter survey was carried out in order to determine the prevalence and risk factors for Chlamydia trachomatis infection in the population of asymptomatic women in Hungary. Results were used to carry out a cost-effectiveness analysis of screening for chlamydial infection in women with asymptomatic genital infections. METHODS: The non-amplified nucleic acid hybridization method (PACE 2 Gen-Probe) was used to diagnose C. trachomatis and Bayes' theorem was applied to assess the prevalence of the infection. Multiple logistic regression analysis was performed to differentiate the risk factors for chlamydial infections. RESULTS: According to the test, the prevalence of Chlamydia trachomatis among 1300 pregnant women was 4.5%. The sensitivity and specificity of the test are estimated to be 70% and 99%, respectively. After Bayes' correction, the overall estimated prevalence of chlamydial infection was 5.1%. There were significant differences in proportions of chlamydial infection in different regions, and also in different age groups and different family status groups. The highest rate was for women aged below 20 years: 16.9%. Cost-effectiveness analysis, with associated sensitivity analysis was carried out for women aged below 20 years. Three screening strategies were compared: using the ELISA method, using amplified Gen-Probe method and no screening. The amplified Gen-Probe method was best provided, the infection prevalence exceeded 16.7%, the PID rate exceeded 24% and the probability of tubal infertility in untreated women exceeded 25%. CONCLUSION: We conclude that screening with amplified Gen-Probe assays (followed by treatment of positive patients) is the preferred screening strategy for young women in Hungary.

The detection of hepatitis C virus in South Hungary.

BACKGROUND: More than 100 million people are infected with hepatitis C virus (HCV) worldwide. The prevalence of HCV infection varies from country to country and the natural history of hepatitis C infection is not well understood. OBJECTIVES: The prevalence of anti-HCV positive blood donors in South Hungary was determined. Potential risk factors of HCV transmission were investigated and compared to anti-HCV-negative blood donors. Furthermore, the rate of anti-HCV positivity in children who had received one or more blood transfusions prior to the implementation of anti-HCV blood donor screening was evaluated. STUDY DESIGN: A total of 45719 blood donors and 120 children were tested for the presence of anti-HCV antibodies by second- and third-generation enzyme immunoassays. Positive results were confirmed by a recombinant immunoblot assay. Data on potential sources of HCV transmission were obtained by interviews. RESULTS: Among blood donors, the rate of confirmed HCV antibody-positives was 0.4% (195 of 45719 donors). Previous surgery, transfusion, more than three pregnancies, and tattoos were significantly correlated with confirmed anti-HCV positivity. Two of 120 children (1.7%) were confirmed anti-HCV positives. In both of them, serum HCV RNA could be detected. CONCLUSIONS: The prevalence of anti-HCV positive blood donors in South Hungary is low. Nosocomial infections and tattooing were found to be the most important risk factors for transmission of HCV. Because of the low prevalence of anti-HCV positive blood donors, only a small number of children, who received blood transfusions prior to the implementation of anti-HCV blood donor screening, are infected with HCV.

Molecular genetic and traditional methods for detection of Mycobacterium tuberculosis complex (discrepancy analysis).

In the past six and half years, 862 different clinical samples [sputum, bronchoalveolar lavage, thorax puncture, cerebrospinal fluid and skin samples] were tested by Gen-probe amplified Mycobacterium tuberculosis direct test (MTD) or ligase chain reaction (LCR) or polymerase chain reaction (PCR). 239 parallel clinical samples were cultivated, and some samples were stained with Ziehl-Neelsen staining. 1-4 samples were tested per patient. 29 (12.13%) samples were positive and 177 (74.05%) samples were negative with both cultivation and molecular genetic methods. 2 (0.83%) samples were positive only on cultivation, and 31 (12.97%) samples were positive only with the molecular diagnostic methods. The differences are undoubtedly explained by the sensitivity of the molecular diagnostic methods.

[Potentials of screening for Chlamydia trachomatis in Hungary: cost-benefit analysis]. / A Chlamydia trachomatis-szúrés lehetósége Magyarországon--költség-haszon elemzés.

Untreated chlamydial infections of the genital tract may cause a wide range of serious complications, which could be prevented by screening. Cost-effectiveness analysis based on previously reported epidemiological study among pregnant women was carried out to develop and evaluate cost-effectiveness of age-based screening (women younger than 20 years old) for Chlamydia trachomatis in Hungary. Three kind of screening strategies were used: a) no screening, b) screening by using ELISA test and c) screening by amplified Gen-Probe diagnostic test. Young age and unmarried status were significant predictors of the chlamydial infection. Prevalence of chlamydial infection was 11.4% in the group of age younger then 20 years. Strategy b) was more cost-effective than neither testing nor treating. Strategy c) was less cost-effective than non screening, unless certain conditions were satisfied. If the cost of the diagnostic test were less or equal than 2,000 HUF or the prevalence of infection in women were greater than 17%, screening strategy c) would be more cost-effective than no screening. Although screening by using ELISA test was more cost-effective than screening by amplified Gen-Probe test, additionally 10,000 infected cases could be prevented using amplified Gen-Probe method for screening Chlamydia trachomatis.

[Regional epidemiologic examination of dental health status]. / A fogazat egészségi állapotának regionális epidemiológiai vizsgálata.

This study examined the oral status of the adult population in South-West Hungary using panoramic radiographs. The results indicate that in this population group 5.2% of the teeth were carious and 38.6% were missing, 3.87% were endodontically treated. Around the apices of the endodontically treated teeth in this survey in 40%, radiographic signs of periapical pathology were observed. Only 18% of the missing teeth had fixed prosthodontic restoration. The results are indicating a substantial future need for dental treatment.

Quinone reductase inhibitors block SAPK/JNK and NFkappaB pathways and potentiate apoptosis.

A variety of environmental stresses stimulate the mitogen-activated protein kinase/extracellular signal-regulated kinase (ERK) kinase (MEKK) > stress-activated protein kinase (SAPK)-ERK kinase (SEK) > SAPK/c-Jun NH(2)-terminal kinase (JNK) stress-activated protein kinase cascade and coordinately activate the transcription factor NFkappaB. Mechanisms of stress activation upstream of MEKK1 have not been precisely determined. Redox mechanisms involving sulfhydryls are likely because N-acetyl-cysteine at millimolar concentrations blocks stress signals. Because intracellular sulfhydryl concentrations can be regulated through redox cycling involving reactive quinones (1), we tested the ability of quinone reductase inhibitors to alter stress signaling. Several quinone reductases are inhibited by dicoumarol, a coumarin derivative. Dicoumarol prevented SAPK activation in vivo by chemical cell stressors and also prevented SAPK activation induced by expression of the tumor necrosis factor alpha (TNFalpha) receptor-associated protein TRAF2 but not by expression of truncated active MEKK1. Other coumarin derivatives failed to block SAPK activation, but other inhibitors of quinone reductases, particularly menadione, similarly blocked SAPK activation. Cells deficient in a major quinone reductase, NQO1, displayed hypersensitivity to dicoumarol stress inhibition, whereas SAPK in cells reconstituted with the NQO1 gene displayed relative dicoumarol resistance. Consistent with the proposed role of overlapping upstream signaling cascades in activation of NFkappaB, dicoumarol also blocked NFkappaB activation in primary macrophages stimulated with either lipopolysaccharide or TNFalpha. In addition, dicoumarol strongly potentiated TNFalpha-induced apoptosis in HeLa cells, probably by blocking the anti-apoptotic effect of NFkappaB. The ability of dicoumarol to simultaneously inhibit SAPK and NFkappaB activation and to potentiate apoptotic cell death suggests that SAPK is not an obligate participant in apoptosis. Dicoumarol, currently in clinical use as an oral anticoagulant, represents a potential therapeutic inhibitor of the SAPK and NFkappaB response.

Burden of human rotavirus-associated hospitalizations in three geographic regions of Hungary.

Data on hospital admissions and laboratory reports were used to estimate the number of hospitalizations of children aged 14 y or less in three geographic regions of Hungary due to group A rotavirus infection. Between January 1993 and December 1996, 9182 hospitalizations for gastroenteritis occurred, of which 1946 (21%) were associated with rotavirus infection. Most (90%) of the rotavirus detections were among children aged 4 y or less. By extrapolation, an estimated 5000 rotavirus-related hospitalizations (8.4/1000 children aged 4 y or less/y) occurred in Hungary during the study period. Marked seasonality of rotavirus infections was observed, with a peak of incidence from December to February. Rotaviruses with "long" RNA electropherotypes predominated each year, but in 1995/1996 20% of electropherotypes in the Budapest area were "short". Effective surveillance is required for all children hospitalized for diarrhoea as part of a rotavirus immunization program in Hungary.

[Detection of human papillomavirus infection by the nucleic acid hybridization method (a multicenter study)]. / Human papillomavírus-fertözés kimutatás nukleinsav hibridizációs módszerrel (multicentrikus tanulmány).

The human papillomaviruses (HPV) are regarded as one of the important agents of cervical carcinoma. A multicentre study was organized to determine the prevalence of HPV in the fertile female population in Hungary. Parallel with the clinical sample collection, a questionnaire interview was performed to acquire data on the life style, socioeconomic status, sexual practice, etc. 1200 women were examined colposcopically and cervix samples were collected for cytology and the detection of HPV DNA. 17.4% of the samples were HPV-infected. 3.9% of the patients had acquired low-risk, and 10.1% 10.2% high-risk HPV types; 3.4% of the women were at the same time infected with both low-risk and high-risk HPV types. Simultaneously performance of cytology and the HPV hybrid capture assay contribute to recognise and treat the precancerous status and risk factors.

Quinone reductase (NQO1), a sensitive redox indicator, is increased in Alzheimer's disease.

NAD(P)H:quinone oxidoreductase 1 (NQO1), a redox-regulated flavoenzyme, plays a central role in monitoring cellular redox state. NQO1 acts to protect against oxidative stress induced by a variety of metabolic situations, including metabolism of quinones and other xenobiotics, by: (i) functioning as a two electron donor to provide a shunt that competes with the formation of reactive oxygen species; (ii) maintaining reduced coenzyme Q; and (iii) regulating the stress activated kinase pathway. In Alzheimer's disease, while there is abundant evidence for the involvement of oxidative stress, the cause or the consequences are largely unresolved. We suspected that increased NQO1 could signal a major shift in redox balance in Alzheimer's disease and, in this study, found that NQO1 is localized not only to neurofibrillary tangles but also the cytoplasm of hippocampal neurons. By marked contrast, there is very little NQO1 in the same neuronal populations in young and age-matched controls. This novel association of NQO1 further buttresses the nexus of oxidative stress, via free radicals, with selective neuronal vulnerability and also supports a fundamental abnormality in redox balance in Alzheimer's disease.

Epidemiological study of Chlamydia trachomatis infection in pregnant women in Hungary.

A multicentre survey was carried out in order to determine the prevalence and risk factors of Chlamydia trachomatis infection in the pregnant population in Hungary. The nucleic acid hybridisation method (PACE 2 Gen-Probe) was applied for the examination of C trachomatis. The overall average prevalence of C trachomatis cases during an 18 month survey on 6161 pregnant women was 5.87%. There were significant differences in the proportions of chlamydial infection in the different survey centres, and also in the different age groups and the different family status groups. The perinatal mortality rate exhibited a significantly higher prevalence (8.52%) among C trachomatis positive than among negative patients (2.03%). In the anamnestic histories of C trachomatis infected patients, the frequency of premature uterine activity was 8.13%, in contrast with 5.18% in the non-infected group (p < 0.05). We suggest that all pregnant women be tested for C trachomatis infection.

The frequency and the role of Chlamydia trachomatis infection in premature labor.

OBJECTIVE: The importance of Chlamydia trachomatis (C. tr.) infection in the etiology of premature labor was examined in a prospective, representative, multicenter study. METHOD: Specimens were collected from 6161 subjects in seven centers and examined by the Gen-Probe method. RESULTS: The infection rate was 5.74%. There were no significant correlations between low birth weight, premature rupture of the membranes, dysmaturity and C. tr. infection. In cases of threatening premature labor, the infection rate was significantly higher in C. tr.-positive patients. In the event of combined low birth weight and perinatal death, the maternal C. tr. infection rate was significantly higher than in normal pregnancies. C. tr.-positive patients treated with roxithromycin had term deliveries. A correlation between poor social circumstances and a high C. tr. infection rate could be proved. CONCLUSION: Cases with a poor obstetric history and/or socially high-risk patients should be screened for C. tr. infection, and in positive cases treatment is recommended.