Purpose .To review studies focusing on cilioretinal arteries (CLRA) in order to assess the overallprevalenceandestablishtheprevalenceofCLRAinaHungarianCaucasianpopulation.Methods #1 .Systematic literature review of published studies with at least 100 participants.Methods #2 .Non-mydriatic digital colour photographs were taken of 1000 consecutively enrolled healthy Caucasian young adult volunteers. Images were graded by two trained independent observers. Number and location of identified cilioretinal arteries were recorded and statistically analysed.Results #1 .Prevalence of CLRA ranges from 6.9% to 49.5%. Detection with fluorescein angiography yields the highest values followed by fundus photography and ophthalmoscopy. Unilateral presence of CLRA is between 70.30% and 93.65%, and temporal location is between 80.77% and 100%.Results #2.We found at least one CLRA in 36.5% of the participants and in 22.75% of all the examined eyes. Cilioretinal arteries (CLRA) were unilateral in 75.34% and bilateral in 24.66%. Of all the identified CLRA, 96.16% were originating from the temporal rim of the optic disc. We identified at least one temporal CLRA supplying the macula in 28% of the participants and 16.95% of the examined eyes. Conclusion .Prevalence of CLRA varies depending on identification method. Unilateral presence is unequivocally more frequent similarly to temporal location. From a risk of bias standpoint, high-quality studies are rare. Our data on the distribution pattern of CLRA are similar to that in the international literature. Based on our findings, we assume that slightly more than one-third of the Hungarian Caucasian population has a CLRA.

Anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis is a destructive small vessel vasculitis affecting multiple organs. Renal involvement often leads to end-stage renal disease and increases mortality. Prompt diagnosis and initiation of adequate immunosuppressive therapy are critical for the best patient and kidney outcomes. However, considerable heterogeneity in symptoms and severity across the patients frequently hinder the diagnosis and management. The objective of this review is to emphasize the heterogeneity of the ANCA-associated vasculitis, facilitate the recognition and give guidance to the therapeutical possibilities. We present epidemiologic and risk factors, pathogenesis, and provide comprehensive clinical features of the disease. This article also focuses on the currently available therapeutic options and emerging cellular and molecular targets for the management of systemic and especially renal disease. We conducted extensive literature research published on PubMed and Google Scholar. We systematically reviewed, analyzed, and assembled databases, covering a broad spectrum of aspects of the disease. We compared and summarized the recommendations of two recent guidelines on ANCA-associated vasculitis. The incidence of ANCA-associated vasculitis, hence glomerulonephritis shows a steady increase. Familiarity with the presenting symptoms and laboratory abnormalities are necessary for rapid diagnosis. Early initiation of treatment is the key aspect for favorable patient and renal outcomes. A better understanding of the pathogenesis constantly leads to more targeted and therefore more efficient and less toxic treatment.

Background Concomitant occurrence of anti-GBM disease and anti-PLA2R positive membranous nephropathy have been previously described. However, to the best of our knowledge, this is the first case report that documents the co-occurrence of the diseases proven by both serologic and histologic methods. Case presentation A 51-year-old woman presented to hospital with nausea, bilateral lower extremity edema, dyspnea, dark urine, and then anuria. Symptoms developed one month after an upper respiratory tract infection. Laboratory results showed acute kidney injury, and hypoalbuminemia. Immunologic examination revealed both anti-GBM and anti-PLA2R positivity. Kidney biopsy demonstrated the histological features of Goodpasture’s disease and anti-PLA2R positive membranous nephropathy. Steroid, cyclophosphamide, and plasmapheresis were commenced. Despite the combined immunosuppressive, the patient remained on renal replacement therapy. Conclusions Microbial kidney injury can trigger multiple autoimmune diseases. The simultaneous occurrence of anti-glomerular basement (anti-GBM) disease and membranous nephropathy is extremely rare. Delayed recognition leads to delayed treatment, causing worse renal and patient outcomes, as well as increased financial costs.

Systematic registration and examination of biopsy-related data in Central and Eastern Europe are scarce, while the health condition of the population is worse compared to other more developed countries. We aim to create a database and analyze the distribution and temporal variation of the renal biopsy diagnoses in Hungary, including the effect of the recent coronavirus pandemic. The diagnoses were standardized according to the recommendation of the European Renal Association. Native biopsy samples processed between January 1, 2006, and December 31, 2020, were analyzed. During the 15 years, 2140 native kidney biopsies were performed. The number of samples increased from 24.5 to 57.9 per million person-years and the median age from 37 to 51 years (p < 0.0001). The predominance of glomerular diseases was stable. The most frequent glomerulopathy was IgA nephropathy (21.5%), followed by focal segmental glomerulosclerosis (17.7%), and membranous nephropathy (15.7%). Trends showed the rise of ANCA-associated vasculitis. During the coronavirus pandemic, there was a decrease in the number of kidney biopsies and the proportion of membranous nephropathies. The diagnostic trends in our database showed increasing biopsy rates among the elderly and the growing frequencies of age-related diseases, which emphasizes the importance of altering medical focus according to demographic changes in this area.

Research purpose. The marketing and sales activity of a company can involve synergy, and coordinated operations can contribute to the success of the enterprise. However, the operations of the former departments often rely on individual successes, which boost conflicts of interest and hinder collaboration. The main aim of the research described in this paper is to explore the areas and focal points of collaboration and conflict in order to highlight the tools that can contribute to enhancing alignment and effectiveness. A further goal is to examine the relationship between marketing and sales and their appraisal of each other. Design/Methodology/Approach. The empirical research applied three qualitative focus group interviews among marketing and sales employees in different positions at multinational enterprises. Results are analyzed using grounded theory methodology. Findings. The research highlights the process interfaces between marketing and sales activities and results in the identification of the competence and attitude gaps in their cooperation. Marketing is an entire corporate function, although without knowledge of customers and markets and experience of sales it is unable to foster the innovation processes which, along with cost and time management, result in “efficient and effective corporate operations” as the core category of grounded theory. The outcomes presented here are novel in relation to how they highlight that collaboration should be grounded on clearly defined corporate targets and the engagement of employees with these, as well as supportive and reinforcing manager–subordinate relationships. However, the prioritization and appraisal of the departments of organizational units appears to be dependent on the position and information coverage of employees. Having more information increases the latter’s ability to better evaluate other fields of business. In addition to these issues, the explored discrepancies refer mainly to the information transfer process, suggesting that the external and internal accessibility and availability of information to departments is crucial. Information that is accompanied by accurate predictions about market demand and local needs adjustment enables successful innovation and helps create marketable, innovative, well-differentiated, high-quality, valuable products, the availability of (and customer responses to) which is required for the successful performance of a company. The former may be delivered through the contribution of both organizational units. Building and reinforcing human relationships can facilitate these processes. Originality/Value/Practical implications. In comparison to other research on this topic, the present study applies focus group interviews as a novel method to create a deeper and more thorough picture of the related processes. The model which emerges from the analysis of results highlights problems with practical management that can contribute to the development of a more efficient management system. Employees can be trained to decrease the identified discrepancies, while rewarding positive attitudes to collaboration contributes to their alignment.