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Concentrating on some important literary and theoretical works, this article examines how Hungarian identity has been given different meanings and various forms of expression over the past few centuries. Hungarian identity is an ever-changing concept and the question of belonging and what is Hungarian has been subject to numerous interpretations. Linked to periods of victory and prosperity, and their opposite, defeat, humiliation and poverty, as well as revolt, revolution, defiance, resignation and even silence, the alternating forms of national identity can all be found in literature. The fact that Hungarians have more than one text (the “Hymn,” the “Appeal” and, recently, the “Székely Hymn”) that assumes the status or quasi-status of a national anthem itself indicates the multiplicity of Hungarian identity. These texts have become part and parcel of national identity due to the frequency with which individuals encounter them from their early childhood on. This is coupled with a strong Hungarian literary canon, which also plays an essential role in identity building. In the absence of a solid literary canon, literary works are less significant in the identity structure of many other nations; in larger countries a diversity of texts are taught at school due to substantial regional differences. In contrast, the Hungarian school system has traditionally placed and still places emphasis on a stable and only slowly changing literary canon which, in turn, leads to a body of literature known to most members of society.

Introduction: Cytokeratin-18 (CK-18) is releasing into the blood during systemic cell death due to ischemia-reperfusion injury after cardiac arrest. Its caspase-cleaved form is specific to apoptosis. Previous investigations proved their prognostic value in different conditions. We firstly investigated the prognostic value of these markers after cardiac arrest. Method: Plasma samples of 40 resuscitated patients were collected 6, 24, and 72 hours after successful resuscitation to determine the marker concentrations. We investigated the association of the markers with the 30-day mortality, neurological outcome, circumstances of the cardiac arrest, laboratory and physical parameters. Results: Resuscitated patients had highly elevated CK-18 levels (3842 vs. 242; 559; 1644 ng/L) and decreased caspase-cleaved CK-18/CK-18 ratio (0.14 vs. 0.58; 0.22; 0.24) compared to healthy subjects, septic and postoperative patients suggesting severe grade of cell death, mainly necrosis. Neither the marker concentrations nor their kinetics showed difference between survivors and non-survivors. They did not show association with the length of the resuscitation, the initial rhythm or the neurological outcome either. CK-18 decreased in patients with good renal function in contrast to patients with renal failure. Significant negative correlation was observed between the 6-hour cytokeratin-18 and hemoglobin concentrations (r = -0.400, p<0.01), while the 30-day survival was associated with lower hemoglobin levels. Conclusion: Surprisingly the biomarkers did not show prognostic value among resuscitated population. The outcome is probably not determined by the complete cell damage, but the loss of a small group of cells with critical role and the reserve capacity of the patient. Orv Hetil. 2020; 161(1): 26-32.

Introduction: One of the most serious complications of liver cirrhosis is variceal bleeding. Early recognition of the oesophageal varices is of primary importance in the prevention of variceal bleeding. Endoscopy is the only means to directly visualize varices and measure their size, as one of the most important predictor of the risk of bleeding. During the course of cirrhosis repeated oesophago-gastro-bulboscopic examinations are recommended. As these interventions are expensive and often poorly accepted by patients who may refuse further follow-up, there is a need for non-invasive methods to predict the progression of portal hypertension as well as the presence and the size of oesophageal varices. After several combinations of biological and ultrasonographical parameters proposed for the detection of advanced fibrosis, it was suggested that liver stiffness measured by transient elastography, a novel non-invasive technology may reflect not only fibrosis and portal pressure but it may even predict the presence or absence of large oesophageal varices in patients with cirrhosis., Aim: The aim of the authors was to study the diagnostic accuracy of transient elastography using FibroScan for selecting patients who are at risk of bearing large (Paquet-grade ≥ II) oesophageal varices and high risk of bleeding., Method: The authors performed upper tract endoscopy and transient elastography in 74 patients with chronic liver disease (27 patients with chronic hepatitis and 47 patients with liver cirrhosis). The relationships between the presence of oesophageal varices (Paquet-grade 0-IV) and liver stiffness (kPa), as well as the hematological and biochemical laboratory parameters (prothrombine international normalized ratio, platelet count, aspartate aminotransferase, alanine aminotransferase, albumin, and aspartate aminotransferase/platelet ratio index) were investigated. The predictive role of liver stiffness for screening patients with varices and those who are at high risk of variceal bleeding was also analysed., Results: Liver stiffness values significantly correlated with the grade of oesophageal varices (Paquet-grade) (r = 0.67, p<0.0001). The liver stiffness value of 19.2 kPa was highly predictive for the presence of oesophageal varices (AUROC: 0.885, 95% CI: 0.81-0.96) and for the presence of high grade varices (P≥II) (AUROC: 0.850, 95% CI: 0.754-0.94). Using the cut-off value of 19.2 kPa, the sensitivity of transient elastography was 85%, specificity was 87%, positive predictive value was 85%, negative predictive value was 87% and validity was 86% for the detection of varices. Liver stiffness values less than 19.2 kPa were highly predicitive for the absence of large (P≥II) varices (sensitivity, 95%; specificity, 70%; positive predictive value, 54%; negative predictive value, 97%)., Conclusions: Transient elastography may help to screen patients who are at high risk of bearing large (P≥II) oesophageal varices which predict variceal bleeding and, therefore, need endoscopic screening. Lives stiffness values higher than 19.2 kPa indicate the need for oesophageal-gastro-bulboscopy, while liver stiffness values lower than 19.2 kPa make the presence of large oesophageal varices unlikely.

Authors treated and checked 474 patients with acute myocardial infarction (AMI) during 5 years. The occurrence of hypertension was 37.15% of the total number of patients but this rate was 51.37% for women patients. Obesity, hyperlipidaemia and diabetes mellitus were the most frequent of the risk factors on the patients with hypertension. Asthma cardiale and acute arrhythmias were slightly more frequent early complications and cardial decompensation was a slightly more frequent late complication. The number of myocardial reinfarctions was the same both in the case of hypertensive and normotensive patients under the circumstances of parallel normalization and keeping the tension and serum cholesterol on the normal level.