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001-es BibID:	BIBFORM061608
Első szerző:	Fülöp Tibor (kardiológus)
Cím:	The safety and efficacy of bedside removal of tunneled hemodialysis catheters by nephrology trainees / Fülöp Tibor, Tapolyai Mihály, Qureshi, Naseem A., Beemidi, Vikram R., Gharaibeh, Kamel A., Hamrahian, S. Mehrdad, Szarvas, Tibor, Kovesdy, Csaba P., Csongrádi, Éva
Dátum:	2013
ISSN:	0886-022X
Megjegyzések:	BACKGROUND:Some nephrologists remove tunneled hemodialysis catheters (TDC) at the bedside, but this practice has never been formally studied. Our hypothesis was that bedside removal of TDC is a safe and effective procedure affording prompt removal, including in cases of suspected infection.METHODS:We reviewed our consecutive 3-year experience (2007-2009) with bedside TDC removal at the University of Mississippi Renal Fellowship Program. Data were collected on multiple patients and procedure-related variables, success and complication rates. Association between clinical characteristics and biomarkers of inflammation and myocardial damage was examined using correlation coefficients.RESULTS:Of 55 inpatient TDC removals (90.9% from internal jugular location), 50 (90.9%) were completed without hands-on assistance from faculty. Indications at the time of removal included bacteremia, fever or clinical sepsis with hemodynamic instability or respiratory failure. All procedures were successful, with no cuff retention noted; one patient experienced prolonged bleeding which was controlled with local pressure. Peak C-reactive protein (available in 63.6% of cohort) was 12.9???8.4?mg/dL (reference range: <0.49) and median troponin-I (34% available) was 0.534?ng/mL (IQR 0.03-0.9) (reference range: <0.034) and they did not correlate with each other. Abnormal troponin-I was associated with proven bacteremia (p?<?0.05) but not with systolic and diastolic BP or clinical sepsis.CONCLUSION:Our results suggest that bedside removal of TDC remains a safe and effective procedure regardless of site or indications. Accordingly, TDC removal should be an integral part of competent Nephrology training.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Renal Failure. - 35 : 9 (2013), p. 1264-1268, -
További szerzők:	Tapolyai Mihály (1968-) (nefrológus) Qureshi, Naseem A. Beemidi, Vikram R. (orvos) Gharaibeh, Kamel A. (orvos) Hamrahian, S. Mehrdad (orvos) Szarvas Tibor (matematikus informatikus) Kovesdy Csaba P. (orvos) Csongrádi Éva (1969-) (szakorvos)
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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)
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001-es BibID:	BIBFORM061590
Első szerző:	Gharaibeh, Kamel A. (orvos)
Cím:	Desmopression is an effective adjunct treatment for reversing excessive hyponatremia overcorrection / Kamel A. Gharaibeh, Matthew J. Craig, Christian A. Koch, Anna A. Lerant, Tibor Fülöp, Éva Csongrádi
Dátum:	2013
ISSN:	2307-8960
Megjegyzések:	We report a case of a 50-year-old malnourished AfricanAmerican male with hiccups, nausea and vomiting whowas brought to the Emergency Department after repeatedseizures at home. Laboratory evaluations revealedsodium (Na+) 107 mmol/L, unmeasurably low potassium,chloride < 60 mmol/L, bicarbonate of 38 mmol/Land serum osmolality 217 mOsm/kg. Seizures werecontrolled with 3% saline ?. Once nausea was controlledwith iv antiemetics, he developed large volumefree water diuresis with 6 L of dilute urine in 8 h (urineosmolality 40-60 mOsm/kg) and serum sodium rapidlyrose to 126 mmol/L in 12 h. Both intravenous desmopressinand 5% dextrose in water was given to achievea concentrated urine and to temporarily reverse theCASE REPORTWorld J Clin Cases 2013 August 16; 1(5): 155-158ISSN 2307-8960 (online)? 2013 Baishideng. All rights reserved.Online Submissions: http://www.wjgnet.com/esps/wjcc@wjgnet.comdoi:10.12998/wjcc.v1.i5.155WJCC\|www.wjgnet.com 55 August 16, 2013\|Volume 1\|Issue 5\|World Journal ofW J C C Clinical Casesacute rise of sodium, respectively. Serum Na+ was graduallyre-corrected in 2-3 mmol/L daily increments from118 mmol/L until 130 mmol/L. Hypokalemia was slowlycorrected with resultant auto-correction of metabolicalkalosis. The patient discharged home with no neurologicsequaele on the 11th hospital day. In euvolemichyponatremic patients controlling nausea may contributeto unpredictable free water diuresis. The addition ofan antidiuretic hormone analog, such as desmopressincan limit urine output and prevent an unpredictable riseof the serum sodium.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Hyponatremia Hypokalemia Overcorrection Polyuria Antidiuretic hormone Vasopressin Desmopressin Osmotic demyelination syndrome Central pontine myelinolysis
Megjelenés:	World Journal of Clinical Cases. - 1 : 5 (2013), p. 155-158. -
További szerzők:	Craig, Matthew J. (orvos) Koch, Christian A. Lerant, Anna (orvos) Fülöp Tibor (1957-) (kardiológus) Csongrádi Éva (1969-) (szakorvos)
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001-es BibID:	BIBFORM061636
Első szerző:	Musa, Abdeen Farah
Cím:	Targeted parathyroid gland reduction and long-term metabolic control of tertiary hyperparathyroidism / Abdeen Farah Musa, David R. Clarke, Kamel A. Gharaibeh, Mihaly Tapolyai, Eva Csongradi, Karen T. Pitman, Tibor Fulop
Dátum:	2014
ISSN:	0272-6386
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idézhető absztrakt folyóiratcikk
Megjelenés:	American Journal of Kidney Diseases. - 63 : 5 (2014), p. A46. -
További szerzők:	Clarke, David R. Gharaibeh, Kamel A. (orvos) Tapolyai Mihály (1968-) (nefrológus) Csongrádi Éva (1969-) (szakorvos) Pitman, Karen T. (orvos) Fülöp Tibor (1957-) (kardiológus)
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