Semmelweis University Budapest Research Articles

Assessing well-being of university students and evaluation of its determinants

BackgroundOur study aimed to examine the well-being of students studying at the three (non-medical) faculties of Semmelweis University Budapest, to analyse the relationships between well-being, stress, emotional support, sleep patterns, sport, and further variables like smoking, consumption of sleeping pills, sedatives, psychoactive agents, energy drinks, and exam anxiety.MethodsIn our cross-sectional study, we asked 561 students of the Semmelweis University of Budapest; two internationally recognised instruments were used: the WHO-5 well-being index and the Perceived Stress Scale.ResultsThe mean WHO-5 well-being index was 42.62 ± 20.51 on a scale ranging from 0 to 100. We saw an inverse correlation between student well-being and years of study. The average anxiety level regarding oral exams and assessments was 7.63 ± SD = 2.04, while the mean level was lower concerning written exams and assessments 5.74 ± SD = 2.09. The result of a linear regression model indicates that the best level of explaining power by the regression model was with following variables combination: grade average + anxiety before written exam + academic year + stress.ConclusionOur data indicate that some students have poor or very poor well-being, which fluctuates over the study period. The worst state was found in the first and final academic year. The students’ well-being level is positively correlated with emotional support, physical activity, and quality of sleep and correlates negatively with anxiety before exams. Our results suggest that well-being could be improved when universities play an active role, supporting influential activities and offering help regarding coping with stress, like stress management, as well as by providing information on learning methods and techniques.

Evaluation of 3D visualization, planning and printing techniques in alveolar cleft repair, and their effect on patients' burden

BackgroundsThe aim of this study was to describe our auxiliary surgical techniques in alveolar cleft reconstruction and evaluate the patients burden after 3 years of surgical experience. MethodsAt the Cleft center, Semmelweis University Budapest, 28 patients underwent alveolar bone grafting between September 2017 and September 2020. We have used CBCT scans and computer software to perform 3D simulation of the alveolar defect and planning of patient- and defect specific grafts. An individual graft mold was designed for each alveolar defect and 3D printed for intra-operative use. During the surgical intervention, the mold was used to harvest the most appropriate amount and precise shape of graft material. We used cancellous iliac crest graft. After performing a descriptive statistical analysis of our patient group, we used a quality-of-life questionnaire to measure the patient's self-perception. ResultsIn all cases the treatment sequence could be applied, planning and surgery was successful and uneventful. Patients did not experience more pain, bleeding or any feeding impairment. No inflammatory or wound healing reactions were observed. There were no major adverse effects causing permanent problems. ConclusionsOur follow-up and patient satisfaction questionnaire showed that our treatment sequence with auxiliary techniques brought no further burden to the patients care and hospitalization, even though it is more complex. Efficacy of this treatment method and improvement in graft integration has yet to be determined.

Fully automatic segmentation of right and left ventricle on short-axis cardiac MRI images

Cardiac magnetic resonance imaging (CMR) is a widely used non-invasive imaging modality for evaluating cardiovascular diseases. CMR is the gold standard method for left and right ventricular functional assessment due to its ability to characterize myocardial structure and function and low intra- and inter-observer variability. However the post-processing segmentation during the functional evaluation is time-consuming and challenging. A fully automated segmentation method can assist the experts; therefore, they can do more efficient work. In this paper, a regression-based fully automated method is presented for the right- and left ventricle segmentation. For training and evaluation, our dataset contained MRI short-axis scans of 5570 patients, who underwent CMR examinations at Heart and Vascular Center, Semmelweis University Budapest. Our approach is novel and after training the state-of-the-art algorithm on our dataset, our algorithm proved to be superior on both of the ventricles. The evaluation metrics were the Dice index, Hausdorff distance and volume related parameters. We have achieved average Dice index for the left endocardium: 0.927, left epicardium: 0.940 and right endocardium: 0.873 on our dataset. We have also compared the performance of the algorithm to the human-level segmentation on both ventricles and it is similar to experienced readers for the left, and comparable for the right ventricle. We also evaluated the proposed algorithm on the ACDC dataset, which is publicly available, with and without transfer learning. The results on ACDC were also satisfying and similar to human observers. Our method is lightweight, fast to train and does not require more than 2 GB GPU memory for execution and training.

Soft Tissue Wound Healing by Laser

Background: In 1967 a few years after the first working laser was invented, Endre Mester in Semmelweis University Budapest, Hungary wanted to find out if laser might cause cancer. He took some mice, shaved the hair off their backs, divided them into two groups and gave a laser treatment with a low powered ruby laser to one group. They did not get cancer and to his surprise the hair on the treated group grew back more quickly than the untreated group. That was how “laser biostimulation” effects were discovered. (Effect of laser on hair Growth of mice (in Hungarian). Mester, E. Szende, B. and Tota, J.G. (1967). Kiserl Orvostud 19. 628- 631). Purpose of the work: The effects of pulsed monochromatic light, with fixed pulsations and wavelengths, on the healing of pressure ulcers were evaluated in this prospective, randomized, controlled study. Method: A placebo-controlled, double-blind study using low energy photon therapy (LLLT) was performed in ten patients with bedsore on the back. Treatment was given three times a week for 10 weeks, using monochromatic (red) optical sources; diode 660nm (GaAl- 660). The patients who were randomized to placebo treatment received sham therapy from an identicalappearing light source from the same delivery system. Results: Ten patients with bedsore were randomized to receive LLLT or placebo therapy. At the conclusion of the study, the percentage of the initial ulcer area remaining unhealed in the LLLT and placebo groups was 24.4% and 84.7%, respectively (P = 0.0008). The decrease in ulcer area (compared to baseline) observed in the LLLT and placebo groups was 193.0 mm2 and 14.7 mm2, respectively (P = 0.0002). One patient dropped out of the study, complaining of lack of treatment efficacy; he was found to be randomized to the placebo group. There were no adverse effects. Conclusions: In this placebo-controlled, double-blind study LLLT was an effective modality for the treatment of bedsore which were resistant to conventional medical management. The results are encouraging as pulsed monochromatic light increased healing rate and shortened healing time. This will positively affect the quality of life in elderly patients with pressure ulcers.

Polymorphisms of xenobiotic metabolizing enzymes in bladder cancer patients of the Semmelweis University Budapest, Hungary

ABSTRACTPolymorphic xenobiotic metabolizing enzymes such as N-acetyltransferase 2 (NAT2) or glutathione S-transferase M1 (GSTM1) are known to modulate bladder cancer risk. As no apparent data were available from Hungary, a former member of the eastern European economic organization, a study was performed in Budapest. In total, 182 bladder cancer cases and 78 cancer-free controls were investigated by questionnaire. Genotypes of NAT2, GSTM1, GSTT1, rs1058396 and rs17674580 were determined by standard methods. Current smokers’ crude odds ratio (OR) (3.43) and former smokers crude OR (2.36) displayed a significantly increased bladder cancer risk. The risk rose by a factor of 1.56 per 10 pack years. Exposure to fumes was associated with an elevated bladder cancer risk (23% cases, 13% controls). Sixty-four % of the cases and 59% of controls were slow NAT2 acetylators. It was not possible to establish a particular impact of NAT2*6A and *7B genotypes (15 cases, 8%, 5 controls, 7%). GSTT1 exerted no marked influence on bladder cancer (negative 21% cases vs. 22% controls). The portion of GSTM1 negative bladder cancer patients was increased (63% cases vs. 54% controls). The SLC14A1 SNPs rs1058396[AG/GG] and the nearby rs17674580[CT/TT] occurred more frequently in cases (79% and 68%) than controls (77% and 55%). The portion of GSTM1 negative bladder cancer patients is comparable with portions reported from other industrialized areas like Lutherstadt Wittenberg/Germany (58%), Dortmund/Germany (70%), Brescia/Italy (66%) or an occupational case-control series in Germany (56%). Data indicate that GSTM1 is a susceptibility factor for environmentally triggered bladder cancer rather than for smoking-mediated bladder cancer.

Oral Mucosal Z-Plasty in Combination with Intravelar Veloplasty.

Summary:Our aim was to establish a reliable, functional surgical technique for soft palate closure. A step-by-step description of the operative procedure is presented. A cross-over procedure has been developed by combining the principles of a mucosal Z-plasty only on the oral side of the cleft palate, the intravelar veloplasty following Sommerlad’s principles and a straight line closure on the nasal side. In the last 2 years, 25 patients have undergone the operation at the Cleft Centre of the 1st Paediatric Department of the Semmelweis University Budapest, Hungary. In all cases the operative technique could be adapted, operations were uneventful and straightforward. This technique was appropriate to close all the soft palate clefts, even the wide ones. This procedure combines the advantages of both procedures and has shown very good early postoperative results.

Editorial introductions

Editorial introductions

Management of Prominent Premaxilla in Bilateral Cleft Lip and Alveolus

Our aim was to describe the early management protocol of the prominent premaxilla in bilateral cleft lip and alveolus and its rationale, as used in the Cleft Centre at the 1st Department of Pediatrics and at the Department of Pedodontics and Orthodontics at the Semmelweis University Budapest. The non-surgical and surgical procedures included lip taping, nasoalveolar molding, lip adhesion and definitive one-stage lip closure. With this treatment sequence, arch management was satisfactory and at the time of the definitive lip closure the position of the premaxilla did not interfere with adequate surgical repair.

The Development of Pharmaceutical Medicine in Hungary

The first Hungarian pharmaceutical companies were founded at the beginning of the twentieth century. The university pharmacological institutes and the pharmaceutical industry traditionally cooperated very closely in the discovery and clinical development of medicinal products. After World War II, the pharmaceutical companies were nationalized and their activities coordinated within the national economic plan. In accordance with this organization, clinical development was also centralized within a clinical pharmacological network. The network employed medical doctors working in different clinical departments who received additional training in clinical pharmacology, trial management, ethical, and regulatory principles. The scientific plan for drug evaluation was worked out jointly by industrial experts and the employees of the network. Currently, this organization may be described as a true pharmaceutical medicine network. The board examination in clinical pharmacology was introduced in 1979. Following political and economic changes in 1989, pharmaceutical companies regained their independence and considerably increased their medical units. A separate Clinical Trial Management Society was organized and became a member of the International Federation of Associations of Pharmaceutical Physicians and Pharmaceutical Medicine in 2004. The more than 300 active members with medical or life science training mainly work in pharmaceutical companies, contract research organizations, and the regulatory agency, performing all types of pharmaceutical medicine-related duties. To train future experts in pharmaceutical medicine, a course in clinical medicine development was initiated at the Semmelweis University Budapest in 2009. Within the European Innovative Medicine Initiative–PharmaTrain program, the course was further developed into a joint international educational network of universities working in the Central-East European and Mediterranean regions under the name of the ‘Cooperative European Medicine Development Course’.

The importance of IgM positivity in laboratory diagnosis of gestational and congenital syphilis

From January 1, 2009 through December 31, 2011, from 33,753 blood samples for syphilis screening, Treponema pallidum infections were confirmed in 241 pregnant women at the Department of Dermatology, Venerology, and Dermatooncology of Semmelweis University Budapest. In this period, four children born to inadequately or untreated women were confirmed to have connatal syphilis. The height of rapid plasma reagin (RPR) titer was measured to determine the stage of the infection and to examine the success of the antilues therapy. The diagnosis of maternal syphilis infection was confirmed with enzyme linked immunosorbent assay (ELISA), T. pallidum particle agglutination (TPPA), and IgG and IgM immunoblots. Maternal IgM immunoblot results identify mothers at risk of delivering babies with connatal syphilis better than the height of maternal RPR titer. The standard serological tests are less useful in newborns because of IgG transfer across the placenta. IgM test which depends on the infant's response has more specificity in diagnosing connatal syphilis.

597 Elevated Leukocyte Count Predicts Mortality in Infants with Neonatal Encephalopathy

Background and aims: An elevated peripheral leukocyte count has been associated with increased risk of neurological disability in asphyxiated term neonates. We aimed to examine the alternations in routine haematological indices in infants with severe asphyxia.Methods: 70 infants referred to the tertiary referral centre of Semmelweis University Budapest Ist Dept of Pediatrics with asphyxial encephalopathy and were randomized to either normothermia or hypothermia. Their serial full blood count parameters, clinical outcome and Bayleys assessments were evaluated.Results: There were 51 survivors and 19 nonsurvivors in this cohort. 60 infants received hypothermia therapy and the remainder were kept normothermic. There was a significant difference in the white cell count (WCC) in the first 8 hours of life between survivors and non-survivors (23+/-; 9 v 31+/-;11, respectively; p value=0.012). In addition the associated neutrophils were altered (Survivors:72+/-;12 v non-survivors:55+/-;5%). However CRP was not significantly different. Here was no correlation between Bayley score and initial WCC in surviving infants.Conclusions: Altered inflammatory markers may indicate infants at higher risk of death. Further exploration of early inflammatory markers may be useful in early decisions about the use of hypothermia.

Significance of Off-hours in Centralized Primary Percutaneous Coronary Intervention Network

To analyze the efficacy of a regionally organized primary percutaneous coronary intervention (PCI) network at the Heart Center, Semmelweis University Budapest, part of the "Budapest model," and the factors that influence it. In order to investigate the differences between regular and off-hours patient care in a 24-hour myocardial infarction primary care system, we included 1890 consecutive, unselected patients with ST-segment elevation myocardial infarction and followed them until at least one year. The follow-up was complete for all participants. The difference between regular hours and off-hours mortality was not significant either after 30 days (8.6% vs 8.8%, respectively) or after 1 year (15.3% vs 14.7%, respectively). The rate of patients with re-infarction, frequency of re-intervention, and major adverse cardiac events, including death, re-infarction, re-intervention, and coronary artery bypass graft surgery, were similar in both patient groups. The time delay between the onset of chest pain and arrival to the clinic was 5.9+/-5.8 hours (mean+/- standard deviation) during regular hours and 5.2+/-4.6 hours during off-hours (P=0.235). Direct transport caused significant decrease in the 30-day and 1-year mortality independent of duty time (7.2% vs 9.9%, P=0.027; 12.6% vs 16.7%, P=0.028; respectively). Centralized primary PCI network of the "Budapest model" achieved the same level of patient care during both off-hours and regular hours.

Prevalence and distribution of permanent canine agenesis in dental paediatric and orthodontic patients in Hungary

Non-syndromic permanent canine agenesis, or combined with agenesis, or developmental absence of other tooth types, has occasionally been described in the literature, but isolated forms are rarely observed. The purpose of the present retrospective radiographic study was to provide data on the prevalence and distribution of permanent canine agenesis in the Hungarian population. Dental panoramic tomograms and the medical history data of 4417, 6- to 18-year-old children (average age 12 years, male-to-female ratio 1:1), who presented for treatment at the Department of Paediatric Dentistry and Orthodontics of the Semmelweis University Budapest, Hungary, were examined. Patients with systemic diseases were excluded. Chi-square and Fisher's tests were performed to determine statistical significance at a level of P < 0.05. Thirteen subjects had permanent canine agenesis. The overall prevalence was 0.29 per cent. The prevalence of permanent canine agenesis was 0.27 per cent in the maxilla and 0.09 per cent in the mandible (P < 0.01). The male-to-female ratio was 1:2.2. Dental anomalies associated with permanent canine agenesis were found: 11 patients had retention of the primary canines, 10 other types of agenesis of the permanent teeth, one a primary supernumerary tooth, one a supernumerary cusp, and nine occlusal disturbances.

Psychosomatic medicine and consultation-liaison psychiatry in Hungary

Psychosomatic medicine (PM) has a strong tradition inHungary—several leading figures of psychoanalysis wereof Hungarian descent. Franz Alexander (1891–1964) whowas a Hungarian-American psychoanalyst is consideredone of the founders of psychosomatic medicine. SandorFerenczi (1973–1933) was a close associate of Freud andhas been one of the founders of the “Budapest School ofPsychoanalysis.” Hans Selye (1907–1982) was alsoHungarian, born in Vienna in the Austro-HungarianMonarchy, and is perhaps best known for the generaladaptation syndrome and stress theory. His work isconsidered a central element of the theoretical foundationsof PM. Michael Balint (1896–1970) developed a group-model for family physicians based on psychoanalytictraditions in the 1950s, which has spread worldwide.In Hungary, a strong stream of psychosomatic researchfocused on psychophysiology (E. Grastyan, P. Molnar, M.S. Kopp), which is considered by many as the basic scienceof PM. Over the last decades, there has also been a strongemphasis on epidemiological research, studies on theeffects of chronic stress as well as on behavioralinterventions dealing with stress. We have to mentionhere large-scale population-based epidemiologic studiesfocusing on mental health issues and health behavior (M.S.Kopp, E. Szadoczky).After the political changes in Hungary in 1989, the 4medical schools in the country (Budapest, Szeged, Pecs,Debrecen) adapted the American model, and departmentsof behavioral sciences were established. According to thismodel, subjects relevant to the bio-psycho-social model ofmedicine are taught over several years in the graduatecurriculum. These areas include medical communication,medical sociology, medical anthropology, medical psychol-ogy, psychosomatic/behavioral medicine, and bioethics.Included also in the graduate curriculum at most uni-versities is the participation of medical students in “juniorBalint-groups.”The institutes/departments of behavioral sciences teachboth graduate and postgraduate courses as well as host PhDprograms. The largest in the country is the Institute ofBehavioral Sciences at the Semmelweis University Buda-pest (www.behsci.sote.hu), founded by Maria S. Kopp in1993. This department plays an important role in the areaof PM and Behavioral Sciences in Central and EasternEurope. The institute has published several textbooks forthe subdisciplines of these areas and has maintained a widerange of active international research and teachingcollaborations [1–5]. The institute also hosts severalprofessional societies and foundations in the area ofpsychophysiology and behavioral sciences, including theSelye Society (www.selyesociety.hu).These strong psychosomatic traditions have an importantimpact on many current activities in Consultation-LiaisonPsychiatry (CLP) in Hungary. Although CLP is an importantcomponent of the clinical workload of many colleagues whowork in general hospital psychiatric wards, the Hungarianliterature on CLP has been very scarce until recently. Thefirst review in the field was published by Furedi andMoussong-Kovacs [6], and subsequently textbook chaptersand original papers addressed practical [7] and researchtopics [8,9]. The most extensive study in CLP has beencarried out by Vincze et al. [10] in several hospital wardsacrossthecountrypointingoutthehighprevalenceofmentalhealth issues in the medically ill.

Risk of recurrence in major craniospinal malformations between 1976 and 2005

Craniospinal malformations are among the commonest developmental disorders. Due to its incidence the knowledge of the risk of recurrence is very important not only for the geneticist but also for the married couples. In the period between January 1st, 1976 and December 31st, 2005, among the 75320 documented cases at the Genetic Counselling Units of the Departments of Obstetrics and Gynecology of the University of Debrecen and Semmelweis University Budapest, consultations were requested due to previous craniospinal malformations in the patients' history in 3030 cases (4.2%). This paper contains the most important informations about these cases of craniospinal malformations. The greatest risk of non-central nervous system developmental anomalies was associated with holoprosencephaly. In approximately two thirds of the cases (65.1%), the couples sought counselling because of malformation in a previous pregnancy. In these cases, the risk of recurrence was thought to be 5.2%, while in the case of two affected children this figure stood at 21.9%. When the risk of recurrence was analysed according to the various types, much lower figures (3.8%) were found for neural tube defects compared to other anomalies in this study. Analysing the values for the risk of recurrence in five-year periods, neural tube defects (particularly anencephaly and spina bifida) showed detectable decrease, which could be attributed to a widening use of folic acid supplementation around about the time of conception and during pregnancy.

Hepatocellular carcinoma with lymphoid stroma: ‘lymphoepithelioma‐like carcinoma’?

HistopathologyVolume 39, Issue 5 p. 540-540 Hepatocellular carcinoma with lymphoid stroma: ‘lymphoepithelioma-like carcinoma’? E Szekely, E Szekely 2nd Department of Pathology, Semmelweis University Budapest, H-1091 Ulloi Ut 93, HungarySearch for more papers by this author E Szekely, E Szekely 2nd Department of Pathology, Semmelweis University Budapest, H-1091 Ulloi Ut 93, HungarySearch for more papers by this author First published: 07 July 2008 https://doi.org/10.1111/j.1365-2559.2001.1301a.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume39, Issue5November 2001Pages 540-540 RelatedInformation

Mitobronitol: an alkylating agent that does not induce extra leukemia cases if applied as pulse therapy for polycythemia vera.

Annals of the New York Academy of SciencesVolume 459, Issue 1 p. 335-335 Mitobronitol: An Alkylating Agent That Does Not Induce Extra Leukemia Cases if Applied as Pulse Therapy for Polycythemia Vera E. KELEMEN, E. KELEMEN First Department of Medicine Semmelweis University Budapest, HungarySearch for more papers by this authorS. TURA, S. TURA Department of Hematology University of Bologna Bologna, ItalySearch for more papers by this author E. KELEMEN, E. KELEMEN First Department of Medicine Semmelweis University Budapest, HungarySearch for more papers by this authorS. TURA, S. TURA Department of Hematology University of Bologna Bologna, ItalySearch for more papers by this author First published: December 1985 https://doi.org/10.1111/j.1749-6632.1985.tb20842.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume459, Issue1Hematopoietic Cellular Proliferation: An International Conference in Honor of Eugene P. CronkiteDecember 1985Pages 335-335 RelatedInformation