Helicobacter pylori – 2021

Összefoglaló. A Helicobacter pylori továbbra is a világ legelterjedtebb fertőzése: prevalenciája a fejlődő országokban 70–80%, a fejlett országokban csökkenő tendenciát mutat. A dél-magyarországi véradókban a prevalencia 32%-ra csökkent. A migráció a befogadó ország számára a fertőzés fokozott kockázatával jár. A szövettani diagnózisban az immunhisztokémiai vizsgálat pontosabb a hagyományos Giemsa-festésnél. A mesterséges intelligencia érzékenysége a hagyományos endoszkópiáéval összehasonlítva 87%, pontossága 86%. Az újgenerációs szekvenálással lehetséges egy biopsziás mintából több antibiotikumérzékenység meghatározása. A Helicobacter pylori kezelésének európai regisztere kimutatta, hogy 2013 és 2018 között a bizmutalapú négyes vagy a 14 napos egyidejű négyes kezelések hatásosabbak, mint a hagyományos hármas kezelés, de elterjedésük igen lassú folyamat, jelentős földrajzi különbségekkel. Az új típusú koronavírus (SARS-CoV-2) felléphet Helicobacter pylori fertőzésben is, egymás kóros hatását felerősítve. A diagnosztikai módszerek korlátozottak. Protonpumpagátlók szedése növeli a COVID–19-fertőzés kockázatát és annak súlyos kimenetelét. Előzetesen ismert peptikus fekély, vérzés, illetve antikoguláns kezelés előtt az eradikáció a vírusos fertőzés lezajlása után indokolt. A probiotikumoknak az eradikációra gyakorolt hatásáról 20, közepes minőségű metaanalízis született, így a konszenzusokban foglalt álláspontok sem egyértelműek: a jövőben ezt tisztázni kell. Orv Hetil. 2021; 162(32): 1275–1282. Summary. Helicobacter pylori is still the most widespread infection in the world: its overall prevalence is 70–80% in developing regions, but fortunately it is decreasing in the Western world. The prevalence in blood donors from South-Eastern Hungary decreased from 63% in the 1990’s to 32% in 2019. Migration constitutes an increased risk of infection for the destination countries. Immunohistochemistry has proven to be more accurate in histological diagnosis than the conventional Giemsa stain. The sensitivity and accuracy of artificial intelligence as compared to videoendoscopy were 87% and 86%, respectively. The European Register on the management of Helicobacter pylori infection revealed that concomitant quadruple and 14-day bismuth-based therapies are more efficient than triple combinations, although their incorporation in practice is a long-lasting process, with large geographical variations. The novel type of coronavirus (SARS-CoV-2) can also occur in Helicobacter pylori-infected patients, mutually enhancing their pathogenetic effects. Diagnostic possibilities are limited in this setting. The use of proton pump inhibitors increases the risk of viral infection and the severity of the disease. Eradication treatment seems justified in patients with previously known peptic ulcers or gastrointestinal bleeding, or before starting anticoagulant treatment, but must be postponed after resolution of viral infection. The effect of probiotics on eradication was addressed by 20, medium-to-low quality meta-analyses and so, the recommendations of the guidelines are equivocal, which must be clarified in the future with higher quality studies. Orv Hetil. 2021; 162(32): 1275–1282.

Analysis of COVID-19 cases in adult cystic fibrosis patients in Saint-Petersburg and the Leningrad region

March 11, 2020 WHO has declared the COVID-19 coronavirus pandemic. The European Society for Cystic Fibrosis (ECFS) has developed the ECFSCOVID- 19 surveillance program to collect information on the characteristics of COVID-19 in patients with cystic fibrosis (CF). CF centers in the Russian Federation also joined the ECFS study. The ECFS collected information only through national Registers. In our country, the national register of CF patients has existed since 2011, its data is included in the European Register. Тo analyze the prevalence and course of COVID-19 in adult CF patients in Saint-Petersburg and the Leningrad region.Methods. From 11.03.20 to 24.12.20, 10 cases of adult CF patients (4 women, 6 men) with COVID-19 were analyzed in Saint-Petersburg and the Leningrad region. At the beginning of the study, 56 adult CF patients lived in Saint-Petersburg and Leningrad Region. All patients were monitored remotely by telephone, in case of ARVI symptoms, disease exacerbation, a PCR smear was performed on SARS-CoV-2, therapy was prescribed remotely, and inpatient treatment was prescribed if indicated.Results. COVID-19 was diagnosed in 10 adult CF patients aged 21 to 43 years. Two patients (32-year-old male and 31-year-old female with severe mixed cystic fibrosis form) were hospitalized with polysegmental pneumonia. 8 people were treated on an outpatient basis. Only 1 outpatient patient aged 43 years had pronounced clinical manifestations of COVID-19, the condition was regarded as moderate, the remaining outpatient patients suffered from a mild ARI disease. All patients were treated with positive dynamics. During the period of this follow – up, 3 CF patients (2 men, 1 woman) died, the death cause was the respiratory failure progression. Clinical and radiological, repeated laboratory data for COVID-19 were not obtained. At the point of December 24, 2020 53 adult CF patients are alive.Conclusion. According to our data, the incidence of COVID-19 among adult CF patients in Saint-Petersburg and the Leningrad Region was 17.85%, which is a lower indicator than in the general population. The disease was rarely severe, and effective treatment was noted in outpatient settings. There were no deaths from COVID-19.

Characterization of “Mais delle Fiorine” (Zea mays L.) and nutritional, morphometric and genetic comparison with other maize landraces of Lombardy region (Northern Italy)

The loss of agrobiodiversity is a topic of global impact. On a local scale, Lombardy, in the Alpine macro-Region, has lost more than 78% of its plant agrobiodiversity. Only four maize (Zea mays L. subsp. mays) landraces of Lombardy are registered in the European Register of Conservation Varieties. However, there are other maize landraces in Lombardy such as “Mais delle Fiorine”, which was characterized from an agronomic, morphometric, nutritional and genetic point of view in this research and then compared with the four other landraces already registered (“Spinato di Gandino”, “Rostrato Rosso di Rovetta”, “Scagliolo di Carenno” and “Nero Spinoso”). “Mais delle Fiorine” resulted richer in starch (81% ± 1.6) and zinc (35.8 ± 9.1 mg Kg−1) and lower in phosphorus (3256.7 ± 204.2 mg Kg−1). The kernels in the five landraces also differ in the mean shape that is obovate without beak. A genetic distinction between “Mais delle Fiorine” and the other varieties was observed, and in particular compared to “Nero Spinoso”, while “Scagliolo di Carenno” and “Rostrato Rosso di Rovetta” showed great similarities. As regards agronomical trials, “Mais delle Fiorine” can grow from the Po Valley (90 m a.s.l.) to the mountain environments of the Seriana Valley (also over 900 m a.s.l.) without significant differences in grain yield. In addition, this landrace would seem able to tolerate environments where there is a greater probability of water stress.

The Academy of the European Federation of Clinical Chemistry and Laboratory Medicine and the European Register of Specialists in Laboratory Medicine: guide to the Academy and the Register, version 4 – 2020

The 4th version of the guide to the Register for European Specialists in Laboratory Medicine (EuSpLM) established by the European Communities Confederation of Clinical Chemistry and Laboratory Medicine describes the transfer of the register to the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) in 2016, the extension in 2018 of the Register beyond the European Union to Europe and the benefits of membership of the EFLM Academy to which the Register transferred on the Academy’s launch in 2019. The Academy offers EuSpLM registrants access to benefits that include reduced registration rates at selected conferences and free subscription to Clinical Chemistry and Laboratory Medicine. With effect from 2020 eligibility was extended to anyone with an interest in laboratory medicine. The updated guide describes the electronically driven processes for individual membership and block enrolment from national societies/organisations, and the stepping stones to recognition as an EuSpLM within the Academy. Whilst eligibility for recognition as an EuSpLM remains largely unchanged new expectations across Europe in education, training, professional regulation and qualifications are reflected in updated criteria. The continuing driver for establishing the Academy and growing the EFLM Register reflects the federation’s leadership role in the harmonisation of high quality education and training for those with an interest in laboratory medicine as well as ongoing initiatives to establish a Common Training Framework for Specialists in Laboratory Medicine under EU Directive 2013/55/EC (The Recognition of Professional Qualifications).

Mário de Andrade’s Antropofagia and Macunaíma as Anti-Imperial Scene of Writing

This chapter examines Mário’s own deployment of the cannibal allegory his novel, Macunaíma (1928), and then by offering a rereading of the relationship between a particular chapter of the novel, titled ‘Carta pras Icamiabas’ [‘Letter to the Icamiabas’] and the novel as a whole. This particular part of the novel stands out from the rest for a variety of reasons. Firstly, its prose, utilizing a Renaissance European register of written Portuguese, is markedly different from the rest of the novel’s use of a strategically colloquial speech – one that supposedly reflected the everyday speech of Brazilian non-elites. Equally relevant is the fact that it is the only part of the novel narrated by Macunaíma. The letter comes after he reaches São Paulo following his journey from the Amazon to the industrialized mega-city, and is addressed to the all-woman tribe, Icamiabas, detailing what he finds in São Paulo.