Objectives: Early childhood caries (ECC) remains a significant global health issue. COVID-19 disrupted protective factors such as in-office parental support and routine dental screenings. This study investigates caries prevalence and severity in Hungarian toddlers (<3 years) born during the lockdown, compared with pre-pandemic data from 2019. Methods: A serial cross-sectional study was conducted through nursery-based dental screenings and a parental questionnaire. Key indices (caries prevalence; average number of decayed, missing, and filled tooth—dmf-t index; Significant Caries Index—SiC-index; and Restorative Index—RI) were calculated and analyzed in relation to parental education and knowledge of caries etiology. The results were compared to 2019 data. Results: A total of 636 children were examined; 274 (mean age: 29.37 ± 4.56 months) were part of the 2024 cohort. Caries prevalence decreased from 15.46% in 2019 to 13.87%. The mean dmf-t index also declined significantly (0.685 ± 2.20 vs. 0.383 ± 1.29; p = 0.025). Initial feeding practices, such as exclusive breastfeeding, were positively linked to later liquid intake habits (p < 0.01). Prenatal information did not affect caries rates or cariogenic liquid consumption. While parental education level was significantly related to caries prevalence and feeding practices in 2019, its influence was less marked in the 2024 cohort. Conclusions: ECC prevalence declined slightly among children born during the pandemic but remains high. Prenatal education did not promote healthier feeding-related oral health behaviors or outcomes. The reduced impact of parental education post-lockdown may suggest that heightened general health awareness during the pandemic lessened education-based disparities.

Background In a previous study, we found a possible connection between pre-vaccination CD3+CD56+ T cells and seroresponse to influenza vaccination in immunosuppressed patients. Decreased circulating CD3+CD56+ T cells have been described in severe COVID-19, but their role in vaccination is unknown. This study evaluated the humoral immune response after SARS-CoV-2 vaccination in children with cancer following two doses of the BNT162b2 mRNA vaccine. We investigated the relationship between cellular immunity (including CD3+CD56+ T cells) and the post-vaccination antibody response.Methods A multicenter, prospective cohort study was completed by recruiting patients receiving chemotherapy and healthy controls, who received two doses of the BNT162b2 mRNA vaccine. Flow cytometric analysis of peripheral blood lymphocyte subpopulations was performed before vaccination; serum anti-SARS-CoV-2 IgG was measured before vaccination and 21-28 days after the second vaccination. We evaluated the relationship between various cellular parameters before vaccination and antibody response.Results Serological response was assessed in 20 oncology patients and 13 healthy controls. The seroconversion rate was 55% among oncology patients and 92.3% among healthy controls (p = 0.023). Geometric mean fold increase (GMFI) of the titers was 6.69 and 41.64 (p = 0.011), respectively. Flow cytometric analysis revealed a significantly higher seroconversion rate in patients with higher baseline CD3+CD56+ T cell (p = 0.044) and CD56+ NK (p = 0.038) cell counts. Based on GMFI, we found a positive association between a greater antibody response and higher baseline CD4+ (p = 0.007), CD4+CD3+CD56+ (p = 0.019), and CD4+ MAIT (p = 0.010) cell counts, as well as a higher CD4/CD8 ratio (p = 0.029).Conclusion Our study suggests that an adequate humoral immune response can be induced by the SARS-CoV-2 mRNA vaccine in pediatric oncology patients. We explored for the first time the possible association between pre-vaccination T lymphocyte subpopulations (CD3+CD56+, CD56+ NK, CD4+, CD4+CD3+CD56+ cells) and the antibody response to the COVID-19 vaccine. We have similar observations as previously reported with influenza vaccination, suggesting that CD3+CD56+ T cells may be involved in the immune response to SARS-CoV-2 vaccines. We highlight the connection between pre-vaccination CD4+ MAIT cell populations and the antibody response.

Background: Carcinogenic polycyclic aromatic hydrocarbons (PAHs), particularly benzo[a]pyrene (BaP) and the EFSA-recommended PAH4 index (benzo[a]pyrene, benzo[a]anthracene, benzo[b]fluoranthene, and chrysene), can accumulate in human breast milk following maternal exposure. Aim: This study aimed to determine BaP and PAH4 levels in breast milk samples of lactating mothers in Hungary and to evaluate demographic, lifestyle, dietary, and environmental predictors of these carcinogenic PAHs. Methods: Breast milk samples (n = 50) were analyzed using high-performance liquid chromatography with fluorescence detection (HPLC/FLD). Due to the right-skewed distribution of PAH concentrations, BaP and PAH4 values were log10-transformed before statistical analysis. Associations between log10-transformed PAH concentrations and maternal variables were assessed using t-tests, Pearson correlation, and multivariable linear regression. Results: BaP was detected in 32 of 50 samples (64%), whereas PAH4 was detectable in 44 of 50 samples (88%). Frequent milk consumption was independently associated with higher log10-transformed PAH4 concentrations in multivariable analysis. Samples collected during the heating season tended to show higher carcinogenic PAH levels compared to those obtained outside the heating period. Other demographic and lifestyle factors showed no consistent independent associations. Conclusions: Lifestyle and environmental factors, particularly dietary habits and seasonal exposure, contribute to carcinogenic PAH levels in breast milk among Hungarian mothers. Identifying modifiable determinants may support strategies to reduce infant exposure.

BACKGROUND:Modern higher education requires a redefinition of pedagogical objectives to meet the evolving cognitive and perceptual demands of contemporary students. One such emerging objective is the cultivation of visual perceptions. Generational differences suggest that current students possess distinct cognitive profiles and learning preferences compared to previous cohorts. These differences necessitate updated educational strategies that address the unique ways newer generations process and engage with information. METHOD:This longitudinal comparative study involved a 12-week developmental course, designed and led by a single art educator and implemented with dental student volunteers. The course integrated one phase focused on drawing and two phases involving wax carving, all structured around a self-assessment framework to encourage reflective practice. To evaluate changes in motor performance, the Purdue Pegboard Test was administered at two intervals: prior to and following the course. RESULTS:Participants demonstrated statistically significant improvements in motor performance across all academic levels. Notably, students who experienced educational disruption due to the COVID-19 pandemic exhibited greater gains, despite the lack of skill development traditionally expected within the dental curriculum. These findings suggest that the course provided compensatory cognitive and motor training during a period of limited practical instruction. CONCLUSION:The developmental course was associated with improvements in motor coordination and visual perception among student participants. The observed improvements, particularly in the context of pandemic-related educational challenges, underscore the value of integrating manual dexterity training into university curricula. This approach may address both generational learning differences and gaps in skill acquisition resulting from disrupted educational pathways.

BACKGROUND:Annual flu vaccination is recommended for children with rheumatic diseases. We investigated the cellular and humoral immune response and safety in pediatric patients that received inactivated influenza vaccines. METHODS:This is a comparative study of in 41 children with juvenile idiopathic arthritis (JIA) receiving influenza vaccination while being treated with methotrexate (MTX) or biological therapy. The influenza vaccination was administered as a single dose of trivalent influenza vaccine (TIV). Serological tests to monitor seroconversion and seroprotection were performed at baseline and at 4 as well as 12 weeks after vaccination. RESULTS:In all of the 41 children with JIA and the 22 healthy children seroconversion and seroprotection were observed for Influenza A. For Influenza B, no adequate seroconversion rates were not detected in any of the groups studied. No significant differences were observed in lymphocyte subpopulations when analysing time points and groups simultaneously. There were no relapses or cases of influenza infection after the vaccination. Our findings do not suggest non-specific immune activation following vaccination based on the distribution and quantity of the lymphocyte subsets that were investigated. CONCLUSION:The present study demonstrates adequate seroprotection rates against influenza A in immunosuppressed children with JIA. The trivalent vaccine had good immunogenicity and was safe to use in both JIA treatment groups.

Background Children born with non-syndromic orofacial clefts are an at-risk population for neuropsychiatric disorders. In a previous study, we have observed a significantly higher proportion of previous psychiatric care, special education needs, and cognitive difficulties in children with cleft compared to their non-cleft controls. Our goal was to strengthen these observations by screening these children with a clinically well-established neuropsychiatric tool. Methods A follow-up study of our previous cohort was carried out in the Department of Pediatrics of the University of Pécs. The cohort included children with non.syndromic orofacial clefts and healthy controls. The M.I.N.I Kid semi-structured interview was used to screen for neuropsychiatric disorders. A parental questionnaire was used to collect demographicand clinical data. Chi2-test or Fischer's Exact test were used to analyze categorical data. Two-sided independent samples Student’s t-test were used for quantitative variables. Results The data of 32 non-syndromic cleft and 41 control participants were analyzed. Children with non-syndromic orofacial clefts represented a higher proportion of psychiatric diagnoses compared to their controls, significantly major depressive episode (12,5%), panic disorder (15,6%), and conduct disorder (9,4%). Subgroup analysis revealed higher proportions of diagnoses in children with complex (combined and/or bilateral) and left-sided clefts. Conclusions A higher proportion of neuropsychiatric diagnoses were observed in children with non-syndromic orofacial clefts compared to controls. Screening this population at an early age is an important part of their overall clinical care.

Background: Our knowledge about the attitudes of healthcare staff to palliative care in pediatric oncology is scarce. We aimed to assess their perceptions of palliative care in Hungary and find answers to the question of how to provide good palliative care for children. Method: Physicians (n = 30) and nurses (n = 43) working in the field of pediatric oncology (12 of them specialized in hospice care) were interviewed. Palliative care practice (communication, integration of palliative care, professionals’ feelings and attitudes, and opportunities for improvement) was assessed by semi-structured interviews evaluated in a mixed quantitative and qualitative way by narrative categorical content analysis and thematic analysis. Results: All providers displayed high negative emotions, positive evaluations, and used many active verbs. Nurses showed higher levels of denial, more self-references, and were more likely to highlight loss. Physicians emphasized the importance of communication regarding adequate or inadequate palliative care. Hospice specialists showed a higher passive verb rate, a lower self-reference, a lower need for psychological support, and a greater emphasis on teamwork and professional aspects. Conclusion: Our results show that nurses are more emotionally stressed than doctors in palliative care in pediatric oncology. To our knowledge, a study comparing doctors and nurses in this field has yet to be carried out. Our results suggest that pediatric oncological staff can positively evaluate a child’s palliative care despite the emotional strain. Regarding hospices, professional practice in palliative care may be a protective factor in reducing emotional distress and achieving professional well-being.

(1) The evidence is mounting that polycyclic aromatic hydrocarbons (PAHs) are a class of hazardous organic compounds with established carcinogenic and toxic properties. Humans may be exposed to PAHs through several different routes, including diet, inhalation, and dermal contact. There is also a possibility that they could transfer into breast milk following maternal exposure, which could potentially endanger breastfeeding infants. (2) The objective of this study was to ascertain the concentration of polycyclic aromatic hydrocarbons (PAHs) in breast milk samples from 50 Hungarian mothers, employing high-performance liquid chromatography with fluorescence detection (HPLC–FLD). An Incremental Life Risk Calculation (IRCL) model estimated the carcinogenic risk to infants. (3) Total PAH concentrations ranged from 0 to 78 ng/mL, with fluorene (5.3 ng/mL), phenanthrene (3.2 ng/mL), and pyrene (2.5 ng/mL) being the most abundant. PAHs were detected in 48 of the 50 samples, with phenanthrene present in 92% of samples. Dibenzo (a,h)anthracene was not detected. (4) According to the model measurements, most of the samples were within acceptable risk levels; however, 2 samples out of 50 posed a higher risk. Statistical analysis of questionnaires completed by the mothers indicated that factors such as diet, residence, and education may influence PAH levels in breast milk.

Introduction:The higher rate of neuropsychiatric disorders in individuals with non-syndromic orofacial clefts has been well documented by previous studies. Our goal was to identify children with non-syndromic orofacial clefts that are at risk for abnormal neurodevelopment by assessing their developmental history and present cognitive functioning. Materials and methods:A single-center, case-controlled study was carried out at the Department of Pediatrics of the University of Pécs in Hungary. The study consisted of three phases including questionnaires to collect retrospective clinical data and psychometric tools to assess IQ and executive functioning. Results:Forty children with non-syndromic oral clefts and 44 age-matched controls participated in the study. Apgar score at 5 min was lower for the cleft group, in addition to delays observed for potty-training and speech development. Psychiatric disorders were more common in the cleft group (15%) than in controls (4.5%), although not statistically significant with small effect size. The cleft group scored lower on the Continuous Performance Test. Subgroup analysis revealed significant associations between higher parental socio-economic status, academic, and cognitive performance in children with non-syndromic orofacial clefts. Analyzes additionally revealed significant associations between early speech and language interventions and higher scores on the Verbal Comprehension Index of the WISC-IV in these children. Discussion:Children with non-syndromic orofacial clefts seem to be at risk for deficits involving the attention domain of the executive system. These children additionally present with difficulties that affect cognitive and speech development. Children with non-syndromic orofacial clefts show significant skill development and present with similar cognitive strengths as their peers. Longitudinal studies with larger sample sizes are needed to provide more conclusive evidence on cognitive deficits in children with non-syndromic orofacial clefts at risk for neurodevelopmental difficulties.

The association of clinical variables with body mass index (BMI) and changes experienced during a gluten-free diet (GFD) in celiac disease (CD) is not well established. In this retrospective cohort study, we aimed to investigate factors aligned with baseline and a follow-up regarding BMI in CD cases diagnosed at the University of Pécs (Hungary). Data were collected regarding gender, age, clinical presentation, histology, serology, extraintestinal manifestations, and BMI upon diagnosis and during follow-up. To compare variables with baseline BMI and BMI changes in short-, intermediate-, and long-term periods, we applied univariate analyses. A total of 192 CD patients were included. Males had significantly higher mean BMI when compared with females at diagnosis (22.9 ± 4.1 vs. 21.4 ± 4.3 kg/m2, p = 0.041) and during follow-up (p = 0.031, p = 0.029, and p = 0.033 for short-, intermediate-, and long-term follow-ups, respectively). Non-classical CD patients experienced higher mean BMI at diagnosis (22.9 ± 4.0 vs. 20.7 ± 4.4 kg/m2, p < 0.001) and following long-term follow-up (24.5 ± 3.2 vs. 22.6 ± 3.4 kg/m2, p = 0.039) than classical patients. In conclusion, although the mean BMI remained in the normal range, it increased significantly during follow-up, even at the short-term follow-up. This change was characteristic for non-classical cases and males on the long-term follow-ups.

While the role of n-3 and n-6 long-chain polyunsaturated fatty acids (LCPUFAs) in the maturation of the infantile nervous system is extensively studied and relatively well-characterized, data on the potential developmental importance of the n-9 long-chain monounsaturated fatty acid (LCMUFA), nervonic acid (NA, C24:1n-9) are scarce and ambiguous. Therefore, the aim of the present study was to reanalyze our available data on the contribution of NA and its LCMUFA precursors, gondoic acid (C20:1n-9) and erucic acid (EA, C22:1n-9) to the fatty acid composition of human milk (HM) during the first month of lactation in mothers of both preterm (PT) and full-term (FT) infants. HM samples were obtained daily during the first week of lactation, and then on the 14th, 21st, and 28th days. Values of the LCMUFAs, C20:1n-9, EA, and NA were significantly higher in colostrum than in transient and mature HM. Consequently, there were highly significant inverse associations between LCMUFA values and the duration of lactation. Moreover, C20:1n-9, EA, and NA values were monotonously, considerably, and at many timepoints significantly higher in PT than in FT HM samples. By the 28th day of lactation, summarized LCMUFA values in PT HM samples declined to the level measured in FT HM samples on the first day of lactation; however, EA and NA values were still significantly higher in PT than in FT HM on the 28th day. Significantly higher availability of LCMUFAs in PT than in FT HM underpins the potential biological role of this hitherto somewhat neglected group of fatty acids.

AIMS:To assess changes in temporomandibular disorder (TMD) pain and multiple biobehavioral variables relevant to TMDs in response to an external stressor.METHODS:Self-reported data using online DC/TMD questionnaires were collected from volunteer dentistry graduate students. Data collection was performed on two occasions: during a non-exam period of the semester and during the subsequent exam period. Changes in the proportion of students with pain, differences in pain grade, and severity of biobehavioral status were measured and compared over the two periods. The association between severity of non-exam-period biobehavioral status and pain presence was also tested to assess whether biobehavioral variables can predict pain occurrence or persistence. Chi-square test, Wilcoxon signed-rank test, ANOVA, and Kruskal-Wallis tests were used for data analysis. P < .05 was considered significant.RESULTS:Of the 213 enrolled students, 102 remained after data reduction. In the non-exam period, the proportion of individuals with pain was 24.5%; in the exam period, the proportion was 54.9%, and more students had a higher pain grade. The severity of all biobehavioral variables was higher in the exam period, but there was no association between changes in the presence of pain and changes in biobehavioral variables. Higher anxiety and parafunction levels were found in those who reported pain on both occasions.CONCLUSION:Exam periods initiate readily measurable changes in the psychologic status of many students, as well as alterations in their temporomandibular pain. Higher levels of anxiety and oral behaviors during non-exam periods seem to be predictors for persisting pain.

Polycyclic aromatic hydrocarbons (PAHs) can be extremely hazardous to human health due to their carcinogenicity and toxicity. Following mother exposure, a part of PAHs might be transferred into breast milk, and PAH exposure may results in adverse effects in breastfeeding infants. Chrysene, benzo(a,h)anthracene, benzo(b)fluoranthene and benzo(a)pyrene (PAH4) are the most suitable indicators of PAHs in food. The aim of this work was to develop a sensitive and selective sample preparation method for the determination of PAH4 in breast milk using gas chromatography-mass spectrometry. The study compared different extraction methods of PAHs. The method was validated using parameters such as linearity, precision, accuracy, limit of detection (LOD) and limit of quantification (LOQ). The calibration curve was linear over the range of 0.5–50 ng/mL. The intra- and inter-day relative standard deviation values were less than 0.37%. The recovery values ranged between 99.97 and 99.99%. The LOD and LOQ values were found to be between 1.4 and 1.7 ng/mL and between 2.5 and 4 ng/mL, respectively.

Identification of HPV infection is usually performed on cytological specimens, despite the often transient virus types. HPV profile analysis of pathologically confirmed lesions can also be performed on formalin-fixed paraffin-embedded (FFPE) cone samples and should be taken as standard during follow-up. We compared HPV profiles of cytological and FFPE specimens of women diagnosed with HSIL. Archived PAP smears and FFPE cones from 49 patients were processed. For genotyping, the HPV Direct Flow CHIP test was used. All samples were positive. HPV profile agreement of the two sample types was 84.16–100%. Mono-infections occurred in 12.24% and 61.22% in PAP smears and FFPE specimens, respectively; while multi-infections were detected in 87.76% and 38.78%, respectively. The most abundant genotypes were HPVs 16, 31, and 51/33. Of all infections, 56.25% and 64.93% were caused by nonavalent vaccinated type (VT) HPVs; while 50.69% and 38.96% belonged to non-nonavalent VT HPVs, in PAP smears and FFPE specimens, respectively. Our results confirmed the importance of HPV genotyping of FFPE cone samples. We also confirmed a remarkable presence of non-vaccinated HPV types in HSIL cases indicating the importance of vaccine development.

Összefoglaló. Bevezetés és célkitűzés: A 3 év alatti korcsoportban a súlyos kisgyermekkori fogszuvasodás (S-ECC) gyakoriságának vizsgálata és a kisgyermekes szülők szájegészséggel kapcsolatos ismereteinek felmérése. Módszer: Háromszázhatvankét, 36 hónapos vagy annál fiatalabb gyermek (átlagéletkor: 28,49 ± 5,25 hónap) fogászati szűrővizsgálatát végeztük el, és szüleik számára önkéntesen kitölthető kérdőívet állítottunk össze. A 306 kitöltött kérdőív eredményét a gyermekek fogászati statusával egyénenként összevetve statisztikai analízist végeztünk. Eredmények: A gyermekek fogászati szűrésekor 15,46% volt a cariesprevalencia: df-t-index = 0,685 ± 2,20; az általunk javasolt, az előtört fogak számával módosított df-t-index = 0,758 ± 2,42, SiC-index = 2,06 ± 3,33. A vizsgált populációban nem találtunk tömött vagy fogszuvasodás miatt eltávolított fogat. A korábban szájhigiénés tájékoztatásban részesült/nem részesült szülők gyermekeinél nem volt szignifikáns különbség a szuvas fogak számának (p = 0,196), a fogyasztott folyadék cukortartalmának (81,5%/71,5%) és a bevitel módjának (p = 0,453) tekintetében. A gyermeküket 6 hónapos korukig kizárólagosan anyatejjel tápláló édesanyák nagyobb eséllyel választották a vízzel történő itatást (75%/52%) pohárból (68,1%/28,8%) a későbbiekben. Az édesanya legmagasabb iskolai végzettsége kulcsszerepet játszik mind az anyatejes táplálás melletti elhivatottságban (felsőfok: 53,4%, középfok: 34,2%, alapfok: 37,5%), mind a cariesfrekvencia csökkentésében (p = 0,015). Következtetés: A szülői szájhigiénés prevenciós tájékoztatás jelenleg nem hatékony. Eredményeink alapján a fogászati szűrést 1 éves kor előtt meg kell kezdeni, amely a hatékony, rendszeres fogászati prevenciós tanácsadás lehetőségét is megteremtené. Szükségesnek látjuk a védőnők és a gyermekháziorvosok folyamatos továbbképzésében a kisgyermekkori fogszuvasodás alapismereteinek integrációját. Orv Hetil. 2021; 162(22): 861-869. SUMMARY: INTRODUCTION AND OBJECTIVE:To investigate the frequency of severe early childhood caries (S-ECC) under 3 years of age and to assess the oral health related knowledge of parents/guardians with preschool children. METHOD:362 children younger than 36 months (mean age: 28.49 ± 5.25 months) were screened and a voluntary questionnaire for their parents was compiled. Statistical analysis was carried out comparing the results of the 306 completed questionnaires with the dental status of the screened children. RESULTS:Caries prevalence in the examined population was 15.46%, df-t index = 0.685 ± 2.20, our suggested modified df-t index based on the number of erupted teeth = 0.758 ± 2.42, SiC-index = 2.06 ± 3.33. No filled or extracted tooth due to caries was found in the study group. There was no significant difference in the number of carious teeth (p = 0.196), consumption of sugar-containing drinks (81.5%/71.5%) and administration of drinks (p = 0.453) in the case of children whose parents had previously received/not received oral hygiene information. Mothers who exclusively breastfed until the age of 6 months were more likely to choose to offer water (75%/52%) from cup (68.1%/28.8%) later. The mother's highest level of education plays a key role in both the commitment to breastfeeding (tertiary: 53.4%, secondary: 34.2%, primary: 37.5%) and in reducing the incidence of caries (p = 0.015). CONCLUSION:Parental oral hygiene preventive instruction is currently ineffective. Based on our results, dental screening should be started before the age of 1 year, that would also provide an opportunity of effective, regular dental prevention counseling. There is a need for the integration of the basics of early childhood caries in the continuous professional training of district nurses and pediatricians. Orv Hetil. 2021; 162(22): 861-869.

Introduction: University students are exposed to psychological stress, which can be increased in exam period and, as a result, symptoms of anxiety and depression may develop in some. According to previous studies, psychological status as an etiologic factor may play a role in the development of temporomandibular disorders. However, the nature of this correlation has not been clearly demonstrated. Our aim was to investigate how the levels of anxiety and depression, incidence of symptoms of temporomandibular disorders and certain oral parafunctions change in exam period. We searched for possible relationship between these factors. Materials and method: Questionnaire-based data collection was performed among dental undergraduate students at set times in the semester, and in the exam period, using the Hungarian version of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Incidence of temporomandibular symptoms, level of anxiety and depression, presence of oral parafunctions and intensity of pain were compared over the two periods. Results: Anxiety and depression scores were significantly higher in the exam period than in the semester. All measured symptoms of temporomandibular disorders were more frequent and incidence of pain has doubled (from 25,4% to 52,5%). Pain intensity and levels of oral parafunctions were also significantly higher in the exam period. Among parafunctions, daytime bruxism showed the most prevalent increase. Discussion: Our results suggest that higher stress levels in exam periods increase the degree of anxiety and depression, which coincides with higher frequency and severity of symptoms of temporomandibular disorders. Although correlation between these two phenomena is difficult to prove, it is possible that higher stress-levels may contribute to the onset or aggravation of temporomandibular disorders. Bruxism is supposed to be a physical manifestation of psychological stress and therefore, it may play a role as a link between psychological conditions and temporomandibular symptoms.

Az egyetemi hallgatókat tanulmányaik során különböző pszichés stresszhatások érik, ezek vizsgaidőszakban fokozódhatnak, és hatásukra egyeseknél szorongásos és depressziós tünetek jelentkezhetnek. A temporomandibularis diszfunkció kialakulásában a beteg pszichés állapota mint etiológiai tényező gyakran kerül említésre a szakirodalomban, de az összefüggés jellege nem pontosan tisztázott. Kutatásunkban azt vizsgáltuk, hogy a vizsgaidőszakban megjelennek-e szorongásos vagy depressziós tünetek, illetve változik-e a fogorvostan-hallgatók tüneteinek mértéke, valaminta temporomandibularis diszfunkció tüneteinek és egyes orális parafunkcióknak a gyakorisága, és összefüggést kerestünk az egyes tényezők között. Kérdőíves adatgyűjtést végeztünk két időpontban: egyszer a szorgalmi-, és egyszera vizsgaidőszakban. A kérdőíveket a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) magyar változatából vettük. Összehasonlítottuk a temporomandibularis diszfunkció tüneteinek gyakoriságát, a szorongás és a depresszió mértékét, valamint az arcfájdalom intenzitásának különbségét a két időpontban. Eredményeink az mutatták, hogy a hallgatók szorongásos és depressziós tünetei szignifikánsan magasabb szintet értek el vizsgaidőszakban, mint szorgalmi időszakban. A temporomandibularis diszfunkció valamennyi vizsgált tünete szintén nagyobb gyakorisággal fordult elő vizsgaidőszakban. Ekkor a tünetek közül a fájdalom több mint kétszer annyi hallgatónál volt jelen, mint szorgalmi időszakban. A fájdalom intenzitása is szignifikánsan magasabb volt vizsgaidőszakban. A vizsgált orális parafunkciók mértékében is jelentős emelkedést találtunk. Eredményeink alapján feltételezhető, hogy vizsgaidőszakban a hallgatók fokozott stressz-szintje növeli a szorongásos és depressziós tünetek mértékét és ez egybeesik a temporomandibularis tüneteik nagyobb arányú és mértékű előfordulásával. A kettő közötti kapcsolat nem bizonyítható, de elképzelhető, hogy az emel-kedett stressz-szint is hozzájárul a temporomandibularis diszfunkció tüneteinek megjelenéséhez vagy fokozódásához.

Juvenile idiopathic arthritis (JIA) is an umbrella term for seven distinct chronic immune-mediated diseases. Disease-modifying anti-rheumatic drugs (DMARD) are used to treat the underlying joint inflammation as well as extra-articular manifestations. Immunosuppression is a considerable side effect of the drugs. The main goal of this study was to investigate the effect of different JIA therapies on leukocyte subpopulations, which play a role in immune-defense. Three study groups were established. The first group consisted of JIA patients treated with methotrexate solely, the second one received a combination of methotrexate (MTX) and adalimumab (ADA). The control group was made up of the patients' healthy siblings. A total of 63 children were recruited. Fourty-one children with JIA and 22 healthy controls were included in the study. The absolute number of CD3+ T-cells was significantly elevated in patients treated with biological therapy compared to healthy controls (p2 = 0.017). In contrast, the number of CD56+ natural killer cells was significantly lower in children receiving biological therapy in comparison with healthy donors (p2 = 0.039). A significant alteration was also demonstrated between patients treated with MTX and MTX/ADA group concerning CD 19+ B-cells (p3 = 0.042). This is the first study that demonstrates significant alterations in the number of B-cells and T-cells with a relative decrease of NK-cell ratios in JIA patients receiving different DMARD therapy. Clinical Trial Registration: NCT03833271. 21.01.2019.

Introduction: During recent decades, the perinatal mortality of extremely low-birth weight infants has decreased. An important task is to recognize complications of prematurity. Aim: We made an attempt to explore the relationship between complications of prematurity and neonatal hyperglycemia. Method: From 1 January 2014 to 31 December 2017, 188 infants with birth weight below 1000 g were admitted. For each infant, the frequencies of hyperglycemia (blood glucose >8.5 mmol/l), retinopathy of prematurity, intraventricular hemorrhage, and bronchopulmonary dysplasia were determined. Animal studies were performed in Sprague Dawley rats. Hyperglycemia was achieved by intraperitoneal injection of streptozotocin (100 mg/kg). On the 7th day of life, aorta sections were prepared and stained with hematoxylin eosin. Wall thickness was measured using QCapture Pro 7 image analysis software. Results: The mean ± SD gestational age and birth weight were 27.1 ± 2.2 weeks and 814.9 ± 151.9 g; 33 infants (17.5%) died. Hyperglycemia was confirmed in 62 cases (32.9%), and insulin treatment was given to 43 infants (22.8%). The gestational age and birth weight of the hyperglycemic infants were significantly lower (p<0.001), the incidence of severe retinopathy (p = 0.012) and the mortality of insulin-treated patients were higher (p = 0.02) than in normoglycemic infants. Among survivors (n = 155), we found by logistic regression analysis that hyperglycemia was a risk factor for severe retinopathy (p<0.001). In the rat model, neonatal hyperglycemia caused significant thickening of the aortic wall. Conclusion: Our studies indicate that hyperglycemia is common in extremely low birth-weight infants. Monitoring of these infants for retinopathy of prematurity, kidney dysfunction, and hypertension is recommended. Orv Hetil. 2019; 160(32): 1270-1278.

Breast milk provides nutrition for infants and also contains a variety of bioactive factors that influence the development of the newborn. Human milk is a complex biological fluid that can be separated into different layers (water phase and lipid phase with its component water and lipid fractions). It can affect the developing human body along the whole length of the gastrointestinal tract, and through the circulation, its factors may reach every organ. In the present study, we analyzed milk samples collected monthly for 6 months from 16 mothers from the 4th week postpartum between 2014 and 2016 in Baranya County, Hungary. The 96 samples provided us information about the fluctuation of certain bioactive factors during the first 6 months of lactation. We investigated with Luminex technology the concentrations of several cytokines (CD40, Flt-3L), chemokines (MCP-1, RANTES, GRO, MIP-1ß, MDC, eotaxin, fractalkine), and epidermal growth factor (EGF). Paired t-tests and one-way ANOVA followed by Bonferroni post-hoc tests were used to compare the data. We detected the presence of each bioactive factor in every layer of the milk samples during the first 6 months of breastfeeding in widespread concentration ranges. In the case of GRO, MIP-1ß, MDC, Flt-3L, fractalkine, and eotaxin, the concentrations were constant during the first 6 months of lactation. The water phase of human milk contained higher factor concentrations compared to both fractions of the lipid phase for most factors (except eotaxin and MIP-1ß). The concentrations of CD40, EGF, MCP-1, and RANTES in the first 3 months were significantly different compared to the values detected between 4th and 6th months. In the water phase, the level of MCP-1 was significantly decreased, while all of the other factors increased during the 4th through 6th months. We found significantly higher EGF, GRO, and RANTES levels in the water fraction compared to the lipid fraction of the lipid phase. The novel findings of this investigation were the presence of Flt-3L and MDC in all layers of breast milk, and nearly all bioactive factors in the lipid phase. Due to their widespread physiological effects these factors may have an essential role in organogenesis.