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001-es BibID:BIBFORM109702
035-os BibID:(cikkazonosító)2238 (Scopus)85151612301 (WoS)000956763900001
Első szerző:Árokszállási Tamás (neurológus)
Cím:Elevated Blood Alcohol Concentration Is Associated with Improved Clinical Outcomes of Intravenous Thrombolysis Treatment in Acute Ischemic Stroke Patients : A Retrospective Study / Árokszállási Tamás, Balogh Eszter, Orbán-Kálmándi Rita, Pásztor Máté, Árokszállási Anita, Nagy Edit Boglárka, Belán Ivett, May Zsolt, Csépány Tünde, Csiba László, Bagoly Zsuzsa, Oláh László
Dátum:2023
ISSN:2077-0383
Megjegyzések:Background: Intravenous thrombolysis (IVT) improves acute ischemic stroke (AIS) outcomes, but with limited success. In addition, ethanol potentiates the effect of r-tPA in ischemia models. Methods: The effect of acute alcohol consumption on IVT outcomes was investigated in a retrospective cohort study. AIS patients with detectable blood alcohol concentration (BAC) during IVT were included (alcohol group; n = 60). For each case, 3 control subjects who underwent IVT but denied alcohol consumption were matched in terms of age, sex, affected brain area, and stroke severity. Outcomes were determined using the NIHSS at 7 days and the modified Rankin scale (mRS) at 90 days. Results: Patients were younger and had a less severe stroke than in a standard stroke study. Favorable long-term outcomes (mRS 0?2) occurred significantly more frequently in the alcohol group compared to controls (90% vs. 63%, p < 0.001). However, the rates of hemorrhagic transformation were similar. Multiple logistic regression models identified elevated BAC as a significant protective factor against unfavorable short-term (OR: 0.091, 95% CI: 0.036?0.227, p < 0.001) and long-term outcomes (OR: 0.182, 95% CI: 0.062?0.535, p = 0.002). In patients with BAC > 0.2%, significantly lower NIHSS was observed at 3 and 7 days after IVT vs. in those with 0.01?0.2% ethanol levels. Conclusion: Elevated BAC is associated with improved outcomes in IVT-treated AIS without affecting safety.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
stroke
observational study
thrombolysis
ethanol
outcomes
Megjelenés:Journal of Clinical Medicine. - 12 : 6 (2023), p. 1-13. -
További szerzők:Balogh Eszter (1991-) (neurológus) Orbán-Kálmándi Rita Angéla (1993-) (klinikai laboratóriumi kutató) Pásztor Máté Árokszállási Anita (1982-) (orvos) Nagy Edit Boglárka Belán Ivett May Zsolt Csépány Tünde (1956-) (neurológus, pszichiáter) Csiba László (1952-) (neurológus, pszichiáter) Bagoly Zsuzsa (1978-) (orvos) Oláh László (1967-) (neurológus)
Pályázati támogatás:Nemzeti Agykutatási Program (NAP) 2017-1.2.1-NKP-2017-00002
Egyéb
ELKH-DE Cerebrovascularis Kutatócsoport
MTA
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
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2.

001-es BibID:bibEBI00026273
035-os BibID:(cikkazonosító)E3050 (WoS)000581708900001 (Scopus)85108175368
Első szerző:Bagoly Zsuzsa (orvos)
Cím:Uninterrupted Dabigatran Administration Provides Greater Inhibition against Intracardiac Activation of Hemostasis as Compared to Vitamin K Antagonists during Cryoballoon Catheter Ablation of Atrial Fibrillation / Zsuzsa Bagoly, Orsolya Hajas, Réka Urbancsek, Alexandra Kiss, Edit Fiak, Ferenc Sarkady, Noémi Klára Tóth, Rita Orbán-Kálmándi, Kitti Bernadett Kovács, László Nagy, Attila Nagy, János Kappelmayer, László Csiba, Zoltán Csanádi
Dátum:2020
ISSN:2077-0383
Megjegyzések:Background. Cerebral thromboembolism is a rare but feared complication of transcatheter ablation in patients with atrial fibrillation (AF). Here, we aimed to test which pre-procedural anticoagulation strategy results in less intracardiac activation of hemostasis during ablation. Patients and methods. In this observational study, 54 paroxysmal / persistent AF patients undergoing cryoballoon ablation were grouped according to their periprocedural anticoagulation strategy: no anticoagulation (oral anticoagulation (OAC) free; n = 24), uninterrupted vitamin K antagonists (VKA) ( n = 11), uninterrupted dabigatran ( n = 17). Blood was drawn from the left atrium before and immediately after the ablation procedure. Cryoablations were performed according to standard protocols, during which heparin was administered. Heparin-insensitive markers of hemostasis and endothelial damage were tested from intracardiac samples: D-dimer, quantitative fibrin monomer (FM), plasmin-antiplasmin complex (PAP), von Willebrand factor (VWF) antigen, chromogenic factor VIII (FVIII) activity. Results. D-dimer increased significantly in all groups post-ablation, with lowest levels in the dabigatran group (median [interquartile range]: 0.27 [0.36] vs. 1.09 [1.30] and 0.74 [0.26] mg / L in OAC free and uninterrupted VKA groups, respectively, p < 0.001 ). PAP levels were parallel to this observation. Post-ablation FM levels were elevated in OAC free ( 26.34 [30.04] mg / L ) and VKA groups (10.12 [16.01] mg / L), but remained below cut-o in all patients on dabigatran ( 3.98 [2.0] mg / L; p < 0.001). VWF antigen and FVIII activity increased similarly post-ablation in all groups, suggesting comparable procedure-related endothelial damage. Conclusion. Dabigatran provides greater inhibition against intracardiac activation of hemostasis as compared to VKAs during cryoballoon catheter ablation.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
atrial fibrillation
cryoballoon ablation;
dabigatran
vitamin K antagonists
Megjelenés:Journal of Clinical Medicine. - 9 : 9 (2020), p. 1-13. -
További szerzők:Hajas Orsolya (1987-) Urbancsek Réka (1991-) (általános orvos) Kiss Alexandra (1987-) (általános orvos) Fiák Edit Sarkady Ferenc (1982-) (laboratóriumi analitikus) Tóth Noémi Klára Orbán-Kálmándi Rita Angéla (1993-) (klinikai laboratóriumi kutató) Kovács Kitti Bernadett (1985-) (neurológus) Nagy László Tibor (1969-) (belgyógyász, kardiológus) Nagy Attila Csaba (1981-) (megelőző orvostan és népegészségtan szakorvos, epidemiológus) Kappelmayer János (1960-) (laboratóriumi szakorvos) Csiba László (1952-) (neurológus, pszichiáter) Csanádi Zoltán (1960-) (kardiológus)
Pályázati támogatás:GINOP-2.3.2-15-2016-00043
GINOP
MTA-DE
MTA
K109712
OTKA
K120042
OTKA
FK128582
OTKA
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:

3.

001-es BibID:BIBFORM088398
035-os BibID:(cikkazonosító)3137 (WoS)000586868500001 (Scopus)85102682323
Első szerző:Szegedi István (orvos)
Cím:Stroke as a Potential Complication of COVID-19-Associated Coagulopathy : a Narrative and Systematic Review of the Literature / István Szegedi, Rita Orbán-Kálmándi, László Csiba, Zsuzsa Bagoly
Dátum:2020
ISSN:2077-0383
Megjegyzések:Coronavirus disease 2019 (COVID-19) is the most overwhelming medical threat of the past few decades. The infection, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can cause serious illness leading to respiratory insufficiency, and, in severely ill patients, it can progress to multiple organ failure leading to death. It has been noted from the earliest reports that the disease influences the hemostasis system and a hallmark of severe infection is elevated D-dimer levels. The profound coagulation changes in COVID-19 seem to be linked to inflammation-related events and severe endothelial cell injury. Besides the high incidence of venous thromboembolic events in SARS-CoV-2 infections, arterial events, including cerebrovascular events, were found to be associated with the disease. In this review, we aimed to summarize the available literature on COVID-19-associated coagulopathy and thrombosis. Furthermore, we performed a systematic search of the literature to identify the characteristics of stroke in COVID-19. Our findings showed that acute ischemic stroke (AIS) is the most frequent type of stroke occurring in infected patients. In most cases, stroke was severe (median NIHSS:16) and most of the patients had one or more vascular risk factors. Laboratory findings in AIS patients were consistent with COVID-19-associated coagulopathy, and elevated D-dimer levels were the most common finding. The outcome was unfavorable in most cases, as a large proportion of the reported patients died or remained bedridden. Limited data are available as yet on outcomes after acute vascular interventions in COVID-19 patients. In the future, well-designed studies are needed to better understand the risk of stroke in COVID-19, to optimize treatment, and to improve stroke care.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
COVID-19
SARS-CoV-2
coagulopathy
stroke
thrombosis
Megjelenés:Journal of Clinical Medicine. - 9 : 10 (2020), p. 3137-3148. -
További szerzők:Orbán-Kálmándi Rita Angéla (1993-) (klinikai laboratóriumi kutató) Csiba László (1952-) (neurológus, pszichiáter) Bagoly Zsuzsa (1978-) (orvos)
Pályázati támogatás:GINOP-2.3.2-15-2016-00043
GINOP
MTA-DE
MTA
K120042
Egyéb
FK128582
Egyéb
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:
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