Risk of eating disorders in university students: an international study in Hungary, Poland and Ukraine.

OBJECTIVE: In this international study, the prevalence of Eating disorders (EDs) was determined among university students and identified associated demographic and behavioral factors predicting disorders using data from three European countries. METHODS: The survey was conducted in Hungary, Poland, and Ukraine in 2018. Registered full-time students completed an online anonymous questionnaire. Students provided data about socioeconomic characteristics, body mass index (BMI), EDs, physical fitness and sport practice, psychological distress (stress, anxiety, depression), life orientation, alcohol, tobacco, and cannabis use. Data were analyzed using SPSS 24.0 software. RESULTS: From the 1965 returned questionnaires 1950 were analyzed, because of the missing data (67.3% female, mean age of the total participant's 21.40 ± 3.83 years old). EDs were observed in 26.3% of students. In logistic regression, EDs were predicted by female sex, higher BMI, single marital status, elevated psychological distress and limited access to health care. CONCLUSION: EDs are relatively common in university students especially in females. Students with higher distress and BMI, limited access to health care and living without partner are at risk for EDs. This result highlights the need for a public health approach. Universities are the last chance where students can be screened in an organized setting and offer interventions early when treatment is likely to be most effective.

Physical activity and physical fitness as protective factors of adolescent health.

OBJECTIVE: This quantitative correlational design study aimed to examine the variation in adolescent health and lifestyle characteristics across self-reported physical activity (PA) and physical fitness (PF) levels. METHODS: Data were collected from 422 students (50.2% males) (16.33 SD = 1.66 y/o) attending a high school. An online questionnaire was used to gather data on the following characteristics: self-reported well-being, overall life satisfaction, depression (including self-harm and suicidal ideation), perceived health status, eating disorders, sleepiness, substance use (alcohol, tobacco and illicit drug use), body mass index, PA participation and PF levels. RESULTS: Of the participants, 42.4% reported at least 5 days of PA a week for 60 min per day. These high active individuals had significantly better well-being, health status, life satisfaction, PF and consumed fewer alcohol beverages. High PA and better PF inversely correlated with depression. CONCLUSIONS: It seems that high PA and better PF have a positive impact on adolescent perceived health, health-risk behaviors and mental health. Increased levels of PA can play a vital role in the primary care, prevention of health risks and in adolescent health promotion. Accordingly, educational institutions are an excellent setting to promote and provide sport facilities and encourage students to be more physically active.

[Neuroendocrine mechanisms controlling the development in puberty. A literature overview]. / A pubertas fejlodését szabályozó neuroendokrin mechanizmusok. Irodalmi áttekintés.

Puberty is the stage of development in human life, when the hypothalamus-hypophysis-gonad axis is re-activated after quiescence. Humanity has long been concerned with the idea of exogenous and endogenous factors and mechanisms that influence the temporal course of puberty neuroendocrine events. Recent discoveries have helped to understand the functioning of the neuroendocrine system. It has been clarified that kisspeptin plays a key role in puberty and regulation of fertility. However, in the function of the gonadotropin-releasing hormone (GnRH) pulse secretion, besides kisspeptin, neurokinin B, dynorphin neurons other positive and negative signals are involved, guiding the release of hormones of hypophysis gonadotropin. The knowledge of these nerves further enhanced the understanding of GnRH pulsation modulation by endocrine, metabolic and environmental impacts. The authors point out the risk of endocrine disruptors in the physiological course of puberty. The aim of the review is to provide a comprehensive picture of the research results of the physiology of kisspeptin, as the manipulation of kisspeptin signaling has the potential for novel therapies in patients with pathologically low or high luteinizing hormone (LH) pulsatility. Orv Hetil. 2018; 159(29): 1175-1182.

[Relationship of infant feeding on childhood obesity. A literature review]. / A csecsemokori táplálás összefüggése a gyermekkori elhízással. Irodalmi áttekintés.

The increasing frequency of childhood obesity is a serious public health concern. Today it is recognized that the infant feeding during critical periods of early human development ("the first 1000 days") can be a long-term impact for future health. Authors deal with with the infant period of the first 1000 days of life starting from the conception, based on literature review. Since 2010 a large number of publications have appeared in which the relationship between infant feeding, early weight gain and later obesity are investigated. The majority of studies have demonstrated, that breastfeeding has a marked effect on early growth and reduces the risk of obesity in the long-term. The health benefits of breastfeeding over infant formula feeding are accepted, however, the relationship between infant feeding and later obesity, there is no clear consensus in the literature. The authors investigated this contradiction reviewing the newly published articles over the last few years. In summary they established, that duration of breastfeeding for at least 4 months have an important role in lowering of childhood adiposity risk. The different or ambiguous statements in the relevant publications can be explained by the fact that the development and the prevention of obesity are multifactorial. Orv Hetil. 2017; 158(24): 938-943.

[Metabolic complications of obesity during adolescence, particularly regarding elevated uric acid levels]. / Az elhízás anyagcsere-szövodményei serdülokorban, különös tekintettel az emelkedett húgysavszintek elofordulására.

INTRODUCTION: Obesity is a social problem worldwide that leads to several diseases, including metabolic syndrome, hypertension and cardiovascular diseases. It is known that hyperuricemia in adults may be associated with these disorders. AIM: The aim of the authors was to investigate the frequency of metabolic syndrome and hyperuricemia and their relationship among obese adolescents. METHOD: This was a cross-sectional study. The authors analysed the data of 162 overweight or obese adolescents (100 boys and 62 girls) who were previously investigated in a paediatric endocrinology consultation. Anthropometric and metabolic parameters were evaluated in all subjects. Healthy, age-matched, non obese girls (n = 20) and boys (n = 26) were used as controls. The age of overweight or obese boys was: 12 ± 2.1 and overweight or obese girls was 11 ± 2.5 years. In the control group the age of boys was 12.9 ± 2.5 years and the age of girls was 13.2 ± 1.6 years. Linear regression was used to evaluate associations between uric acid and clinical and laboratory findings associated with metabolic syndrome. RESULTS: Obese or overweight subjects had greater BMI SDS (boys, 3.4 ± 1.3 vs 0.05 ± 0.4 in controls, p<0.0001; girls, 3.75 ± 1.4 vs 0.72 ± 0.9 in controls, p = 0.0001), waist circumference (boys, 90.1 ± 9.2 vs 82.3 ± 6.4 cm in controls; girls, 90.2 ± 8.6 vs 78.1 ± 7.2 cm in controls, p<0.001), higher systolic blood pressure (boys, 125 ± 14.3 vs 118.2 ± 10.8 mmHg in controls, p = 0.02; girls, 125.8 ± 11.8 vs 119.8 ± 8.8 mmHg in controls, p<0.01), diastolic blood pressure (boys, 78.4 ± 9.1 vs 71.2 ± 8.0 mmHg in controls, p = 0.0003; girls, 76.45 ± 7.2 vs 73.2 ± 6.3 mmHg in controls, p = 0.0453). The prevalence of metabolic syndrome was 45/162 (27.8%) and the prevalence of hyperuricemia was 62/162 (38.3%). Of the 45 subjects with metabolic syndrome, 30 (66.7%) had hyperuricemia. CONCLUSIONS: It can be concluded that hyperuricemia is strongly associated with metabolic syndrome. The high concentration of uric acid predicts cardiovascular risk in adulthood. It is important for paediatricians to determine and assess uric acid levels in overweight or obese adolescents.

[Questions and dilemmas in the management of hypospadias]. / A hypospadiasis ellátásában felmerülo kérdések, dilemmák.

Hypospadias is the second most common congenital malformation in males. Etiology remains unknown in about 70% of the cases. Distal hypospadias is considered not only developmental abnormality of the urethra in males, but it may also constitute a mild form of sexual development disorder in 46,XY males. Most urologists and endocrinologists consider that it is necessary to perform a detailed investigation of children presenting with proximal hypospadias associated with a small phallus or poorly developed scrotum and undescended testes. Currently, there is no generally accepted recommendation for the preoperative evaluation of hypospadias and, therefore, masculinizing surgery without preoperative evaluation is performed in these children. The authors summarize the international literature data and their own experience for the assessment and management of hypospadias concerning questions and problems related to preoperative investigation, masculinizing surgery and additional surgery. A detailed algorithm is presented for preoperative evaluation of both proximal and distal hypospadias.

[Prevalence and possible causes of hypospadias]. / A hypospadiasis gyakorisága és lehetséges okai.

Hypospadias is the most common congenital malformation of the male external genitalia. After the heart and circulatory system, it is the second most common developmental disorder in males. It is due to a midline fusion defect of the male urethra, which results in a misplaced urethral meatus. Hypospadias may be distal, medial and proximal. It may occur as an isolated defect or it may develop together with other genital disorders (retention of testes in one or both sides, microphallus, bifid scrotum) or with malformation of other organs. In some cases syndromic forms may also occur. Genetic factors play a crucial role in the occurrence of early developmental defect, but endocrine and environmental factors may also be important in the aetiology of hypospadias. It may be associated with various sex and autosomal chromosomal abnormalities. Monogenic and chromosomal causes of hypospadias accounts for about in 30% of all cases, while genetic factors remain unknown in 70% of cases. The authors summarize the development of the male external genitalia, the prevalence and possible causes of hypospadias. They propose that better understanding of the pathogenesis of the disease may contribute to the prevention and decreased prevalence of the disease.

Flow cytometric analysis of the basophil cell activating impact of potential drug delivery nanoparticle-candidate.

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.

Factors influencing the diabetes-specific health-related quality of life in children and adolescents with type 1 diabetes mellitus.

This study aimed to investigate the association of the anthropometric, clinical variables and maximal oxygen uptake (Vo2max) with diabetes-specific health-related quality of life (HRQoL) in youths with type 1 diabetes mellitus (T1DM) and to find the predictors of HRQoL and blood glucose control. A total of 239 youths with diabetes (124 boys and 115 girls) were recruited from diabetes-based summer camps. HRQoL assessment was carried out with the Pediatric Quality of Life Inventory 3.0 Diabetes Module (Information Resources Centre, Mapi Research Trust, France); Vo2max was evaluated by conducting the 20-m shuttle run test. Higher Vo2max and the insulin pump therapy were significant predictors of the HRQoL in the multiple regression analysis; other clinical and anthropometric variables had no effect. The better blood glucose control was explained only by the higher Vo2max. The good cardiorespiratory fitness (expressed by Vo2max) has clinical and QoL benefits for paediatric patients with T1DM.

[Role of genetic and environmental factors in the development of polycystic ovary syndrome]. / Genetikai és környezeti tényezok hatása a polycystás ovarium szindróma kialakulására.

Polycystic ovary syndrome is the most common heterogeneous endocrine abnormality in women in the reproductive age. The syndrome remains an enigmatic disorder because the aetiology is still unclear. Familial aggreagation is relatively common among patients with polycystic ovary syndrome suggesting a significant genetic component, although the way of inheritance has not been established firmly. The authors review the relevant medical literature and suggest that genetic and environmental factors play a role in the development of polycystic ovary syndrome. To date, no gene has been identified that causes or contributes substantially to the development of a polycystic ovary syndrome phenotype. Polycystic ovarian syndrome is considered to be an oligogenic disorder in which the interaction of a number of genetic and environmental factors determines the heterogeneous clinical and biochemical phenotype. To summarize current evidence the authors conclude, that when we are able to identify and then modify environmental determinants, then we will be able to safeguard better the health of those patients who are predisposed to disease development due to genotype or previous environmental effects.

Benefits of continuous subcutaneous insulin infusion on quality of life.

PURPOSE: The aim of this study was to compare the general health-related quality of life (HRQoL), the metabolic control (HbA1c), the anthropometric measurement, and the cardiorespiratory fitness (expressed by VO2max) in youths with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) to those receiving multiple daily injections (MDI). We looked for factors influencing the HRQoL and metabolic control. METHODS: A total of 239 patients treated with CSII (51 girls and 53 boys) or MDI (64 girls and 71 boys) between ages 8 and 18 years were assessed with the Pediatric Quality of Life Inventory, Generic Core Scales, and Diabetes Module. VO2max was evaluated using the 20-meter shuttle run test. RESULTS: CSII group had significantly better HRQoL according to both child self-report and parent proxy-report. Youths with CSII reported better physical, emotional, and school-related functioning, and had less diabetes-related fear and symptoms than the MDI group. There were no significant differences in body mass index z-scores, insulin doses, HbA1c, and VO2max between the groups. HRQoL was predicted by the CSII therapy (ß = -0.220; p = .000) and the VO2max (ß = 0.386; p = .000), other clinical and anthropometric parameters had no effect; the HbA1c was predicted only by VO2max (ß = -0.353; p = .000). CONCLUSIONS: Diabetic youths treated with CSII therapy have better HRQoL than those treated with MDI. There are no differences between the investigated groups in anthropometric data, glycated hemoglobin, and physical fitness. Moreover, good physical fitness has an important role in achieving better metabolic control and HRQoL, which underlines the importance of regular aerobic exercise in the treatment and care of type 1 diabetes in childhood.

[New perspective in the treatment of chronic myeloid leukemia? gene silencing therapy]. / Új perspektíva a krónikus mieloid leukémia kezelésében? géncsendesítéses terápia.

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.

[Hungarian adaptation of the Pediatric Quality of Life Inventory™ 3.0 Diabetes Module]. / A Pediatric Quality of Life Inventory™ 3.0 Diabetes Moduljának magyarországi adaptálása.

UNLABELLED: Due to the lack of validated age- and disease-specific instruments, there are limited health-related quality of life measurements in type 1 diabetes youths in Hungary. OBJECTIVE: To culturally adapt the Pediatric Quality of Life Inventory™ 3.0 Diabetes Module. METHOD: Feasibility, internal consistency reliability, reproducibility, convergent, discriminant and concurrent validities were evaluated in 134 type 1 diabetes youths. RESULTS: Low scale-level mean percentage of missing item responses, minimal floor and moderate ceiling effects supported the feasibility. Cronbach α exceeded the internal consistency reliability standard of 0.70. Concordance between the children's and the parents' reports was strong. The instrument differentiated between the quality of life of patients having acceptable and poor metabolic control. Intercorrelations between the Generic Module and Diabetes Module had moderate to large effect sizes. CONCLUSIONS: The results demonstrate the feasibility, reliability and validity of the instrument, but further research should be carried out for generalization for Hungarian population.