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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)
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
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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)
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM068276
Első szerző:	Gharaibeh, Kamel A. (orvos)
Cím:	Pulmonary embolization with tunneled hemodialysis catheter-associated blood stream infection : the perils of systemic anticoagulation / Kamel A. Gharaibeh, Éva Csongrádi, Michael Shoemaker-Moyle, Anna Lerant, Mihály Tapolyai, Tibor Fülöp
Dátum:	2012
Megjegyzések:	A 35-year old African-American male withend-stage renal disease on hemodialysisthrough a tunneled dialysis catheter (TDC) presentedwith fever, diffuse aches and generalizeddistress. Blood cultures (BC) wereobtained and empirical broad-spectrum antibiotictherapy started. After urgent renal dialysis,TDC was pulled at the bedside. Chest computedtomography (CT) diagnosed pulmonaryembolism and systemic i.v. heparin was initiated.BC grew Gram positive cocci (methicillinsensitiveS. aureus) and cardiac echocardiogramconfirmed acute bacterial endocarditis.Due to declined mental status, CT imaging wasobtained revealing massive intracranial hemorrhageleading to the patient's death. Furtherchest CT review revealed only hemodynamicallynon-significant pulmonary emboli in somesegmental and subsegmental arteries.Pulmonary embolization may be an expectedoccurrence with removal of infected TDC; systemicanticoagulation may not be warranted insuch cases and may lead to catastrophicintracranial hemorrhage. This case draws ourattention to the perils of rigid adherence to protocoland the failure of considering the needs ofspecial patient cohorts and individualized care.
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Nephrology Reviews. - 4 : 2 (2012), p. 73-75. -
További szerzők:	Csongrádi Éva (1969-) (szakorvos) Shoemaker-Moyle Michael (orvos) Lerant, Anna (orvos) Tapolyai Mihály (1968-) (nefrológus) Fülöp Tibor (1957-) (kardiológus)
Internet cím:	DOI Intézményi repozitóriumban (DEA) tárolt változat
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