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condition, unfortunately, it cannot be used in vivo in everyday clinical practice. Our understanding of the cellular changes in different diseases has revealed a need for new everyday clinical examination methods that can be used in vivo to asses cellular and subcellular changes in neural and other cells of the retina, such as blood cells flowing in healthy vessels or in vessels of neovascular origin. In addition to the currently used clinical examination methods, these imaging methods could help confirm or dismiss diagnoses, assess the severity of a condition, and monitor disease progression or remission. Orv Hetil. 2021; 162(22) 851-860.Összefoglaló. Az eltűnőepeút-szindróma ritka, rossz prognózisú kórkép. Az epeutak progresszív destrukciójával, az intrahepaticus epeutak eltűnésével jár, epepangáshoz, biliaris cirrhosishoz, végül májelégtelenséghez vezet. A háttérben álló kiváltó okok között infekciók, ischaemia, gyógyszermellékhatások, illetve daganatos megbetegedések szerepelhetnek. A malignitások közül a leggyakrabban a Hodgkin-lymphomához társult formájával találkozhatunk. Cikkünkben egy fiatal, Hodgkin-lymphomás betegünk esetét szeretnénk bemutatni, akinél az icterus hátterében eltűnőepeút-szindróma igazolódott, melyet egyéb okok kizárását követően szövettani mintavétellel igazoltunk. A két ciklus ABVD-protokoll szerinti kezelést követő PET/CT az alapbetegség tekintetében komplett metabolikus remissziót igazolt. A klinikai javuláshoz azonban hosszú hónapokra volt szükség. Végül az epeúteltűnés esetünkben reverzibilis folyamatnak bizonyult, az alapbetegség tekintetében a komplett metabolikus remisszió elérésével az epeút-károsodás megállítható volt. Orv Hetil. 2021; 162(22) 884-888. Summary. destruction and loss of the intrahepatic bile ducts leading to cholestatis, biliar chirrosis and finally liver failure. It has been described in different pathologic conditions including infections, ischemia, adverse drug reactions and malignancies. The Hodgkin's lymphoma-associated type occurs most frequently among the forms of the disease of malignant origin. In this report, we introduce the case of a 32-year-old male patient with Hodgkin's lymphoma, diagnosed with vanishing bile duct syndrome upon liver biopsy as a root cause behind his icterus. The PET/CT has proven complete metabolic remission after 2 cycles of ABVD chemoterapy. Clinical improvement, however, occurred only after several months. Finally the loss of bile ducts proved to be a reversible process, the complete metabolic remission of Hodgkin's lymphoma resulted in the regeneration of the bile ducts. Orv Hetil. 2021; 162(22) 884-888.

The relationship of depressive symptoms with kidney function remains poorly investigated. We aimed to evaluate the prospective association between depressive symptoms and rapid decline in kidney function in Chinese adults with normal kidney function.

A total of 4763 participants with eGFR≥60 ml/min per 1.73 m

at baseline were enrolled from the China Health and Retirement Longitudinal Study. Baseline depressive symptoms were determined using a ten-item Center for Epidemiologic Studies Depression scale with a cutoff score of greater than or equal to ten to define high depressive symptoms. The GFR was estimated by a combination of serum creatinine and cystatin C. The primary outcome was rapid decline in kidney function, defined as an annualized decline in eGFR of ≥5 ml/min per 1.73 m

. Secondary outcome was defined as an annualized decline in eGFR of ≥5 ml/min per 1.73 m

and to a level of <60 ml/min per 1.73 m

at the exit visit.

During a median follow-up of 4 years (interquartile range, 3.92-4.00pid kidney function decline among Chinese adults with normal kidney function.

High depressive symptoms were significantly associated with a higher risk of rapid kidney function decline among Chinese adults with normal kidney function.According to the biopsychosocial model, disease is the dysfunctional resultant of various fields of human function (biological, psychological, behavioral, socioeconomic). This article deals with the psycho-biological field of Psychosomatic research, namely, the effect of stress on the body. The human organism, in the prospect of evolution, has developed biological mechanisms for maintaining its homeostasis (ομοιόσταση), in its interchange with the stressor stimuli. This process is called allostasis. Selleck SAG agonist The response to mild - short-term stress induces activation of the hypothalamic - pituitary - adrenal axis, the sympathetic system and the immune system; a process that proves beneficial to the body. On the contrary, exposure to traumatic or chronic stress, with subsequent overactivation of the body's allostatic mechanisms, wears out its homeostatic ability and initiates pathophysiological mechanisms that pave the way for the development of physical and mental illness. The above procedure is called allostatic loadi, it has also emerged that the individual's personal characteristics judge the vulnerability to stress, too. Psychiatrists must insist on the scientific documentation of the biopsychosocial model, so that they can raise awareness amongst the medical community, aiming at a holistic care of the patients.Accessibility of patients to the health system as well as the system's rapid and effective response to patients' needs constitute basic quality indices of health services. Major parameter of accessibility is the required waiting time for a new patient to enter the health system. We present the results of the use of an organized system for the management of new requests for psychiatric treatment, which is based on the triage and evaluation of priorities. While taking into consideration the administrative distribution of the health services, our system intervenes in the waiting time by evaluating the requests in terms of medical and moral criteria, via gradual prioritization. Principal aim is waiting time reduction as well as the optimal response of our service to the needs of our patients. This perspective study was based on the new requests. The 1839 (100%) requests for first psychiatric evaluation at the outpatient clinic of Eginition University Hospital in 2019 were studied in relation to different parameters, as well as the efficacy of the system in terms of waiting-time management.

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