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Introduction and Aim: In the case of primary school children in Budapest (n = 165), data on their social status and their previous knowledge on hand hygiene were elicited with the help of pre-knowledge questionnaires issued by students of higher education. The aim of the research was introducing a novel pedagogical procedure - application and optimization of peer education in the development of proper hand hygiene among primary school students., Method: The knowledge-based survey was conducted after four (n = 85) and eight hours of teaching (n = 36). In addition, the effectiveness of hand washing was tested immediately before (n = 166) and after the four (n = 74) and eight hours of teaching (n = 35) with Semmelweis Scanner after rubbing the hand with fluorescent cream., Results: Prior knowledge of hand hygiene significantly increased after the four-hour and eight-hour trainings. In the case of smaller children, the effect of the eight-hour training was more pronounced. Similar results were obtained with regards to the changes in the number of areas missed while rubbing the surface of the hand as a result of the teaching., Conclusion: Sociological surveys on hand hygiene knowledge and direct physical measurements indicate that training with appropriate pedagogical procedures is effective and contributes to the environmentally conscious hygiene culture of children aged 6 to 10. Orv Hetil. 2018; 159(12): 485-490.

Numbers of arteriovenous (AV) fistula creation increase worldwide. Hemodialysis is more effective, patients live longer, they need more access operation. The optimal strategy for the order and sequence of the different type and localization of AV fistulas remains obscure. Based on internationally acclaimed guidelines, autogenous access should be performed whenever possible and the first operation of choice is the radio-cephalic fistula at the wrist, the second type is the elbow fistula. The area between the standard exposures means also good access area and its usage is not emphasized properly. At our department the performance of autogenous fistulas have always been favoured. Beside the wrist radio-cephalic and elbow fistulas a significant number of autologous forearm AV fistulas has been operated. Our aim was to study the short and long term results of the autogenous forearm fistulas at atypical anatomic positions. We also examined whether the patency rate is affected by different variables as diabetes mellitus, acute or chronic operative situation, the indication of surgery, the quality of thrill at the end of shunt creation, the diameter and quality of the vein. Between 1997 and 2005 we performed 1018 AV shunts in an academic tertiary care center. 97 autologous antebrachial AV shunts were performed. The average follow up time was 31.3 months. The primary patency rate was 97%, 92% and 63% at the end of the first, second and sixth years, respectively. The patency rate was not significantly affected by any of the examined variables mentioned above. The patency rate of the autologous antebrachial AV shunt is comparable to the wrist and elbow fistulas, so our results support the practice of performing fistula at this atypical localization. More proximal autologous fistulas and prosthetic graft implantation could be postponed, this way valuable time could be saved for the uremic patients.