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001-es BibID:	BIBFORM113079
035-os BibID:	(cikazonosító)1233229
Első szerző:	Héja Máté (általános orvos)
Cím:	Ethylene glycol intoxication presenting as a mimic of acute stroke : report of three cases / Máté Héja, László Oláh
Dátum:	2023
ISSN:	1664-2295
Megjegyzések:	Stroke is a major cause of death and disability presenting with acute focal neurological symptoms of vascular origin. Several other disorders may cause symptoms similar to a stroke, referred as stroke mimics. Misdiagnosis of stroke mimics may lead to potentially harmful treatments, including thrombolysis. Intoxication is a rare, but possible cause of stroke mimic. We present three cases of ethylene glycol poisoning presenting as acute stroke mimic within the time window of thrombolytic therapy. Two of three patients (54-year-old, male) had dysarthria, nystagmus and truncal ataxia on admission. The third patient with a history of chronic alcoholism was presented after an epileptic seizure with mixed aphasia and confusion. NCCT and CTA were negative in all 3 cases. As stroke could not be excluded in any of the patients, thrombolysis was performed. Some hours later agitation, somnolence and hyperventilation developed in 2 of 3 patients. One patient's consciousness deteriorated rapidly, he became comatose and tetraplegic. Blood gas analysis showed acidosis in 2 of 3 patients, and toxicological screening revealed ethylene-glycol intoxication in all 3 cases. Due to the appropriate treatment, 2 of 3 patients became symptom-free, however, one of the 3 patients died. Our cases show that ethylene glycol intoxication in its early phase may mimic acute stroke resulting in an unnecessary thrombolytic therapy. Symptoms not characteristic of a stroke, such as hyperventilation, agitation, and disturbance of consciousness, may appear later and warn of intoxication. The final diagnosis of ethylene-glycol intoxication can be established by a severe metabolic acidosis and toxicological screening. Close monitoring of symptoms might contribute to early recognition of ethylene-glycol intoxication and its effective treatment.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Frontiers in Neurology. - 2 (2023), p. 1-8. -
További szerzők:	Oláh László (1967-) (neurológus)
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM116493
035-os BibID:	(cikkazonosító)1226220 (scopus)85176564612 (WoS)001103983900001
Első szerző:	Szegedi István (orvos)
Cím:	Role of carotid duplex in the assessment of carotid artery restenosis after endarterectomy or stenting / Szegedi István, Potvorszki Fanni, Mészáros Zsófia Réka, Daniel Cecilia, Csiba László, Oláh László
Dátum:	2023
ISSN:	1664-2295
Megjegyzések:	Introduction: Redo carotid endarterectomy (CEA) and carotid stenting (CAS) are often performed when there is evidence of post-procedural restenosis. The incidence of restenosis after carotid reconstruction is not negligible, ranging from 5 to 33%. The diagnosis of significant internal carotid artery (ICA) restenosis is usually based on duplex ultrasound (US) criteria, mostly on peak-systolic flow velocity (PSV). However, there have been no generally accepted duplex US criteria for carotid restenosis after CAS or CEA. Methods: In this systematic review, the PubMed/ Medline and Scopus databases were screened to find trials that reported duplex US criteria for significant restenosis after CEA and/or CAS. Only those reports were analyzed in which the restenoses were also assessed by CT/MR or digital subtraction angiography as comparators for duplex US. Results: Fourteen studies met the predetermined search criteria and were included in this review. In most studies, PSV thresholds for significant in-stent ICA restenosis after CAS were higher than those for significant stenosis in non- procedurally treated (native) ICA. Many fewer studies investigated the US criteria for ICA restenosis after CEA. Despite the heterogeneous data, there is a consensus to use higher flow velocity thresholds for assessment of stenosis in stented ICA than in native ICA; however, there have been insufficient data about the flow velocity criteria for significant restenosis after CEA. Although the flow velocity thresholds for restenosis after CAS and CEA seem to be different, the large studies used the same duplex criteria to define restenosis after the two procedures. Moreover, different studies used different flow velocity thresholds to define ICA restenosis, leading to variable restenosis rates. Discussion: We conclude that (1) further examinations are warranted to determine appropriate duplex US criteria for restenosis after CAS and CEA, (2) single duplex US parameter cannot be used to reliably determine the degree of ICA restenosis, (3) inappropriate US criteria used in large studies may have led to false restenosis rates, and (4) studies are required to determine if there is a benefit from redo carotid artery procedure, such as redo-CEA or redo-CAS, starting with prospective risk stratification studies using current best practice non-invasive care alone.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk carotid artery stenting carotid endarterectomy carotid restenosis ultrasound systematic review
Megjelenés:	Frontiers in Neurology. - 14 (2023), p. 1-14. -
További szerzők:	Potvorszki Fanni Mészáros Zsófia Daniel Cecilia Csiba László (1952-) (neurológus, pszichiáter) Oláh László (1967-) (neurológus)
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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