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001-es BibID:BIBFORM061605
Első szerző:Agarwal, Mohit
Cím:Severe Symptomatic Hypocalcemia after Denosumab Administration in an End-Stage Renal Disease Patient on Peritoneal Dialysis with Controlled Secondary Hyperparathyroidism / Mohit Agarwal, Éva Csongrádi, Christian A. Koch, Luis A. Juncos, Vonda Echols, Mihály Tapolyai, Tibor Fülöp
Dátum:2013
Megjegyzések:We report the 1st case of severe, symptomatic hypocalcemia after denosumab (RANKLinhibitor) treatment in a peritoneal dialysis patient with secondary hyperparathyroidismand osteoporosis. A 58-year-old Caucasian female has been receiving chronicambulatory peritoneal dialysis for four years secondary to polycystic kidney disease.Laboratory studies revealed: albumin-corrected calcium 9.0 mg/dL, phosphorus 5 mg/dL,alkaline phosphatase (ALP) 58 U/L [normal, 40-105], albumin 3.4 gm/dL [normal, 3.6-5.4]and intact parathyroid hormone (PTH) 315 pg/mL [normal, 40-72]. Marked osteoporosiswas noted on the DXA scan, preventing her from renal transplantation considerations.She had failed conventional medical treatment, including per os calcium, monthlyergocalciferol (50,000 units/month), activated vitamin-D analog (doxercalciferol) andrenal-failure adjusted alendronate (70 mg twice a month). She was started onsubcutaneous denosumab 60 mg every 6 months. After her first dose, she developed aprogressive drop of calcium, phosphorus, bicarbonate and magnesium, in spite ofmassive escalation of doxercalciferol and calcium supplementation. Hypocalcemianadired at 6.3 mg/dL with symptomatic tetany, requiring a brief hospitalizationapproximately 7 weeks after denosumab treatment. Her elevated PTH rose furthertransiently (647 pg/mL), along with ALP (123 U/L). Bone-mineral parameters normalizedapproximately 3 months after denosumab administration. The observed phenomenonresembled the phenotype of "hungry bone syndrome" observed after surgicalparathyroidectomy.Conclusion: Treatment decisions based on bone densitometry results alone are nottransposable between patients with or without end-stage renal disease. Denosumab maylead to critical hypocalcemia in dialysis patients and further aggravate existing secondaryhyperparathyroidism.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:British Journal of Medicine & Medical Research. - 3 : 4 (2013), p. 1398-1406. -
További szerzők:Csongrádi Éva (1969-) (szakorvos) Koch, Christian A. Juncos, Luis A. Echols, Vonda Tapolyai Mihály (1968-) (nefrológus) Fülöp Tibor (1957-) (kardiológus)
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2.

001-es BibID:BIBFORM061606
Első szerző:Avusula, Ramachandram (orvos)
Cím:Bacterial Peritonitis Following Esophagogastroduodenoscopy in a Patient on Peritoneal Dialysis / Ramachandram Avusula, Michael Shoemaker-Moyle, Minesh B. Pathak, Éva Csongrádi, Tibor Fülöp,
Dátum:2013
Megjegyzések:Aims: To recognize the importance of considering perforation of viscus in thedifferential of peritonitis after upper gastrointestinal endoscopy in peritoneal dialysispatients and to address the potential benefit of antibiotic prophylaxis in PD patientsundergoing upper GI procedures.Presentation of Case: We report the case of a 54-year-old African American femalewith end-stage renal disease on peritoneal dialysis presenting with generalizedabdominal pain, along with nausea and vomiting. Peritoneal fluid revealed a WBC countof 1,499/mm3. Two days earlier, she had undergone an esophagogastroduodenoscopywith biopsy. Broad spectrum antibiotics were started to treat possible peritonitis.Surgical exploration revealed no perforation but murky peritoneal fluid was noted andgram stain showed mixed flora (both gram negative and gram positive rods); however,blood and peritoneal fluid culture grew only Streptococcus pneumoniae.Discussion and Conclusion: An occult perforation, which may not be obvious to thenaked eye or signs of contrast extravasation can occur afteresophagogastroduodenoscopy with manipulations and can lead to peritonitis, especiallyin high-risk patients such as those with end-stage renal disease on peritoneal dialysis.To our knowledge, this is the first reported case of mixed peritonitis attributable tosuspected micro-perforation after esophagogastroduodenoscopy. Whether preprocedureantibiotics are warranted to decrease the occurrence of infectiouscomplications in PD patients undergoing upper gastrointestinal procedures remainsuncertain and not well studied. The prompt recognition of possible mixed bacterialinfection remains essential after these procedures.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:British Journal of Medicine & Medical Research. - 3 : 3 (2013), p. 784-789. -
További szerzők:Shoemaker-Moyle Michael (orvos) Pathak, Minesh B. (orvos) Csongrádi Éva (1969-) (szakorvos) Fülöp Tibor (1957-) (kardiológus)
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3.

001-es BibID:BIBFORM083072
Első szerző:Csikai Enikő
Cím:Influence of angiotensin-converting enzyme inhibition on reversibility of alterations in arterial wall and cognitive performance associated with early hypertension : a follow-up study / Csikai Enikő, Andrejkovics Mónika, Balajthy-Hidegh Bernadett, Hofgárt Gergely, Kardos László, Diószegi Ágnes, Rostás Róbert, Czuriga-Kovács Katalin Réka, Csongrádi Éva, Csiba László
Dátum:2019
ISSN:0025-7974
Megjegyzések:The importance of optimal blood pressure control for preventing or reducing the impairment of vascular and cognitive functions is well known. However, the reversibility of early alterations in vascular and cognitive functions through antihypertensive agents is under-investigated. In this study, we evaluated the influence of 3 months of angiotensin-converting enzyme (ACE) inhibition treatment on the morphological and functional arterial wall and cognitive performance changes in 30 newly diagnosed primary hypertensive patients. Common carotid intima-media thickness (IMT) and brachial artery flow-mediated dilatation (FMD) were detected by ultrasonography. Arterial stiffness indicated by augmentation index (AIx) and pulse wave velocity (PWV) was assessed by arteriography. Cognitive functions were assessed by neuropsychological examination. The executive function overall score was significantly higher at 3-month follow-up than at baseline (median, 0.233 (IQR, 0.447) vs ?0.038 (0.936); P?=?.001). Three-month ACE inhibition did not produce significant improvement in IMT, FMD, AIx and PWV values. Significant negative associations were revealed between IMT and complex attention (r?=??0.598, P?=?.0008), executive function (r?=??0.617, P?=?.0005), and immediate memory (r?=??0.420, P?=?.026) overall scores at follow-up. AIx had significant negative correlations with complex attention (r?=??0.568, P?=?.001), executive function (r?=??0.374, P?=?.046), and immediate memory (r?=??0.507, P?=?.005). PWV correlated significantly and negatively with complex attention (r?=??0.490, P?=?.007). Timely and effective antihypertensive therapy with ACE inhibitors has significant beneficial effects on cognitive performance in as few as 3 months. Early ACE inhibition may have an important role in the reversal of initial impairments of cognitive function associated with hypertension-induced vascular alterations.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
arterial stiffness
carotid intima-media thickness
cognition
flow-mediated vasodilatation
hypertension
Megjelenés:Medicine. - 98 : 34 (2019), p. 1-9. -
További szerzők:Andrejkovics Mónika (1967-) (klinikai szakpszichológus, neuropszichológus, pszichoterapeuta) Balajthy-Hidegh Bernadett Hofgárt Gergely (1984-) (neurológus) Kardos László (1970-) (megelőző orvostan és népegészségtan szakorvos) Diószegi Ágnes (1987-) (belgyógyász) Rostás Róbert (1991-) (Orvos) Czuriga-Kovács Katalin Réka (1981-) (neurológus) Csongrádi Éva (1969-) (szakorvos) Csiba László (1952-) (neurológus, pszichiáter)
Pályázati támogatás:GINOP-2.3.2-15-2016-00048
GINOP
Gedeon Richter research grant 4700168520-KK/186/2016
Egyéb
NKFI K120042
Egyéb
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4.

001-es BibID:BIBFORM061604
Első szerző:Csongrádi Éva (szakorvos)
Cím:The Efficacy of Intravenous versus Subcutaneous Recombinant Erythropoietin in Obese African-African Patients in a Southeast U.S. Dialysis Cohort / Éva Csongrádi, Michael Shoemaker-Moyle, Lajos Zsom, Catherine Wells, Zsolt Lengvárszky, Mihály Tapolyai, Tibor Fülöp
Dátum:2014
Megjegyzések:Aims: To correct renal anemia, subcutaneous (SC) route of recombinant humanerythropoietin (rhuEPO) administration has been associated with increased efficacy anddecreased dose requirements, when compared with intravenous (IV) route. The effect ofobesity as a potential modifier during rhuEPO administration has not been well explored.Study Design: Single-center, Longitudinal Cohort Study.Place and Duration of Study: University of Mississippi Medical Center OutpatientDialysis Unit, between February and November of 2009.Methodology: We performed IV to SC rhuEPO conversion for 86 in-center dialysispatients and, following a six-month equilibration period, we monitored outcomes over aperiod of three months. We obtained baseline demographic parameters, calculated BodyMass Index (BMI) and monitored iron saturation, ferritin, hemoglobin (Hgb) along withrhuEPO requirements. Patients were divided into 3 categories based on BMI [<25 (n=27),25-35 (n=38), >35 (n= 21) kg/m2]. Results are reported either as percents, means with SDor median with 25-75% interquartile range, as appropriate.Results: The cohort was all African-American, 48.8% male, aged 54.7 (13.3) years andBMI calculated at 29.9 (7.4) kg/m2. Baseline iron saturation was 24 (10.6)%, ferritinmeasured 641 (277) ng/mL. Hgb remained unchanged during the observation period:11.1 (1.3) vs. 11.2 (1.3) gm/dL. Initial rhuEPO weekly dose for the entire cohort was19,729 (17,448) Units/week (U/week); final dose 17,482 (14,860) U/week, with closecorrelation between initial and final doses (r: 0.653, P<0.0001). Weekly rhuEPO doseremained virtually unchanged in BMI categories 1 and 2 [13,927 (10,938) vs. 13,297(10,247) U/week; 20,684 (15,788) vs. 20,997 (17.917)] (P=NS for both) but decreased inthe category 3: 25,459 (24,403) vs. 16,444 (12,749) (P=0.081). However, BMI had noindependent effect in linear regression modeling with multiple covariates (age, BMI, ironsaturation, ferritin) included.Conclusion: Obesity may affect relative efficacy of rhuEPO conversion; additionalstudies may be needed.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:British Journal of Medicine & Medical Research. - 4 : 1 (2014), p. 184-193. -
További szerzők:Shoemaker-Moyle Michael (orvos) Zsom Lajos (1968-) (belgyógyász, nefrológus) Wells Catherine (tudományos segédmunkatárs) Lengvárszky Zsolt (matematikus informatikus) Tapolyai Mihály (1968-) (nefrológus) Fülöp Tibor (1957-) (kardiológus)
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5.

001-es BibID:BIBFORM010188
Első szerző:Káplár Miklós (belgyógyász, diabetológus)
Cím:Changes in cerebral blood flow detected by SPECT in type 1 and type 2 diabetic patients / Káplár Miklós, Paragh György, Erdei Annamária, Csongrádi Éva, Varga Éva, Garai Ildikó, Szabados Lajos, Galuska László, Varga József
Dátum:2009
ISSN:0161-5505 (Print)
Megjegyzések:Although macrovascular complications are typical for type 2 diabetes mellitus (T2DM), cerebral microvascular damage develops both in type 1 diabetes mellitus (T1DM) and T2DM. Color Doppler ultrasound is widely used for the examination of large- and medium-sized arteries, whereas SPECT and MRI are capable of identifying disturbances in the circulation of microvessels. Former studies using semiquantitative methods showed reduced reactivity and reserve capacity of cerebral vessels in both T1DM and T2DM patients. Our aim was to investigate whether there was any difference in the effects of the 2 types of diabetes mellitus on the global or regional cerebral blood flow, influenced by microvascular damage. METHODS: In our study, the circulation and reserve capacity of cerebral arteries was examined using (99m)Tc-hexamethylpropylene amine oxime SPECT. A total of 17 individuals with T1DM and 43 individuals with T2DM were involved in the study. RESULTS: Both basal and acetazolamide-challenged brain circulation were significantly lower in T2DM patients than in T1DM patients. We did not find a significant difference in the reserve capacity. However, the circulation of the frontal and occipital lobes changed differently in the 2 groups. The ratio of the circulation of the frontal and occipital lobes was significantly reduced both in basal and in acetazolamide-stimulated states in T2DM patients, independently of age (P < 0.0005 and P < 0.017), showing a greater relative decrease in the circulation of the frontal lobe in T2DM patients. CONCLUSION: There was a significant association between basal brain circulation and age, body mass index, and high-density lipoprotein (HDL), whereas acetazolamide-stimulated circulation showed a significant association with serum triglyceride and HDL.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
egyetemen (Magyarországon) készült közlemény
Megjelenés:Journal of Nuclear Medicine. - 50 : 12 (2009), p. 1993-1998. -
További szerzők:Paragh György (1953-) (belgyógyász) Erdei Annamária (1976-) (belgyógyász) Csongrádi Éva (1969-) (szakorvos) Varga Éva (1982-) (belgyógyász) Garai Ildikó (1966-) (radiológus) Szabados Lajos (1977-) (orvos) Galuska László (1946-) (belgyógyász, izotópdiagnoszta) Varga József (1955-) (fizikus)
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