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Clinical Oncology

DECEMBER 10, 2018

[The use of NGS in oncology in diagnostic setting]

BECSÁGH Péter

[Today the information could be the basis of further development by collecting, saving, structuring and analyzing them. Inside the living organism and inside viruses the biochemical storage system was evolved. The linear coding inside macromolecular structures could create and store a series of building block combinations along the chain structure. Those chemical structures are the so called information coding macromolecules, for example, the polypeptides and nucleic acids. Analysis of the genetically coded functionalities of tumor cells has a great impact in the oncological setting. The connected functions of inherited or acquired alterations inside the tumor cell clones are the main contributors of tumor evolution and surviving, although provide a way to target possible mechanism and touch points. Today the oncodiagnostic use of next generation sequencing technology focus on tumor evolution and tumor surviving connected gene set analysis. This kind of gene panel analysis connected to NGS technology is enough enforced - enforced enough - to reach the diagnostic level, but one still need to take care about the quality and standardization to meet the IVD conditions.]

Clinical Oncology

SEPTEMBER 15, 2016

[Biomarkers - today and tomorrow]

KOPPER László

[Biomarkers (tumor markers in oncology) are able to make exact, objective and reproducible distinction between two groups. Biomarkers can serve different purposes, as to estimate the patient’s survival without treatment (prognostic marker), to select those patients who would respond optimally to treatment (predictive marker), to follow the patient in order to detect of a relapse (monitoring marker), helping identifi cation the tumor-type (diagnostic marker). The main task for a biomarker is to find the best treatment with less toxicity. The main enemy of biomarkers is the heterogeneity of the tumor, the continuous change in its geno- and phenotype, which can explain the low sensitivity and specifi city. More attention should be given to standardization and validity. It is highly possible, that biomarker-panel as well as marker-based clinical trials will be used in the near future.]

Hypertension and nephrology

DECEMBER 10, 2013

[Managing medical quality and patient safety in an international dialysis network]

TÖRÖK Marietta, OROSZ Attila, CHARLOTTA Wollheim, JÖRGEN Hegbrant

[A dialysis provider’s core activities include providing dialysis care with excellent quality, ensuring a low variability across the clinic network and ensuring strong focus on patient safety. In this article, we summarize the pertinent components of the quality assurance and safety program of the Diaverum Renal Services Group. Concerning medical performance, the key components of a successful quality program are setting treatment targets; implementing evidence- based guidelines and clinical protocols and revising targets, guidelines and clinical protocols based on sound scientific data. Consistently, regularly, prospectively and accurately collecting data from all clinics in the network; processing collected data to provide feedback to clinics in a timely manner. The key activities for ensuring patient safety include a standardized approach to education, i.e. a uniform education program including control of theoretical knowledge and clinical competencies; implementation of clinical policies and procedures in the organization in order to reduce variability and potential defects in clinic practice. We point out the importance of auditing clinical practice on a regular basis. By applying a standardized and systematic continuous quality improvement approach throughout the entire organization, it has been possible for Diaverum to progressively improve medical performance and ensure patient safety]

Clinical Neuroscience

JANUARY 20, 2009

[Measurement of mental fatigability by task related spectral EEG. A pilot study (in English language)]

RAJNA Péter, HIDASI Zoltán, PÁL Iván, CSIBRI Éva, VERES Judit, SZUROMI Bálint

[Background - Task related EEG spectra are promising markers of mental activity. But the cooperation of the patients necessary for the registration limits its application in the neuro-psychiatry. Methods - EEG difference spectra on counting (EDSC) - was developed to detect the effect of a short calculation task on the spectral EEG. The originality of the task situation is a continuous mental work in a very short period of time, while the level of task difficulty is adapted to the patient’s actual mental capacity. While the rest pre-task and the post task EEG sections were compared, the results show the mental “EEG fatigability” caused by the short intensive cognitive activity. The first preliminary results have been demonstrated by a comparative study of two healthy and three patient (probable Alzheimer disease, post-stroke state without mental deficit and mixed type of dementia) groups. Results - Similarly to the findings of other authors, in addition to the differences of the alpha band seen on the temporo-parieto-occipital regions, the frontal localization and the beta band seem to be prominent, too. Demented patients had stronger EEG reactions than post-stroke patients without mental deficits and healthy elder persons had more extensive changes than the younger ones. Conclusions - The test can be considered as indirect marker showing the different mental fatigability in diverse pathological conditions and during the aging process. Effect of therapeutic processes can also be followed based on “key-lock principle”. Standardization of the test is essential for the introduction of EDSC to the every-day routine of clinical neuropsychiatry.]

Ca&Bone

APRIL 20, 2002

[Epidemiologic features of nephrolithiasis in Hungary, based on morbidity data on hospitalized patients]

SILLER György, PÁLDY Anna, NÁDOR Gizella, VINCZE István, ZSÁMBIKINÉ Bakacs Márta, PINTÉR Alán, HORVÁTH CSABA

[AIM - To examine geographic, gender and age differences in the morbidity of nephrolithiasis (NL) in Hungary based on data from hospitalised NL cases. PATIENTS AND METHODS:The descriptive epidemiologic study involved settlements with 2,000 or more inhabitants and applied a spatial accumulation analysis to reveal any significant differences from the national average. Standardized morbidity ratios (SMRs) were calculated by indirect standardization and differences were tested by the c2 test. RESULTS - In the period between 1997 and 1999, a significant spatial accumulation of NL morbidity in the 0-100 year age group without stratification by gender was observed in Zala,Vas, Nógrád and Bács-Kiskun counties. The male:female ratio was 1:0.98.The highest morbidity surplus was found in the 35-64 age group, which in females extended into the over 65 year age group.There were 158.33 NL cases per 10,000 hospital discharges. CONCLUSION - Morbidity data of hospitalised NL patients show significant geographic differences. In contrast to literature data, no gender differences were found.The causes of the observed geographic, age and gender differences require further investigations.]