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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
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DOI
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2.

001-es BibID:BIBFORM092841
035-os BibID:(cikkazonosító)615177
Első szerző:Árokszállási Tamás (neurológus)
Cím:Prognostic value of various hemostasis parameters and neurophysiological examinations in spontaneous intracerebral hemorrhage : the IRONHEART study protocol / Tamás Árokszállási, Máté Héja, Zsuzsa Bagoly, Kitti Bernadett Kovács, Rita Kálmándi, Ferenc Sarkady, Judit Tóth, Klára Fekete, István Fekete, Laszlo Csiba
Dátum:2021
ISSN:1664-2295
Megjegyzések:Rationale: Stroke is the leading cause of death in all developed countries. In Hungary, more than 10000 patients die annually due to cerebrovascular diseases according to the WHO Mortality Database. 10-15 % of these patients suffer non-traumatic intracerebral hemorrhage (ICH). ICH results in a higher rate of mortality as compared to ischemic stroke and outcomes are difficult to predict. In the GINOP IRONHEART study, we aim to test various hemostasis parameters and clinical neurophysiological examinations in evaluating outcome in intracerebral haemorrhage. Methods: In this prospective, observational study, we plan to enroll consecutive patients with non-traumatic spontaneous intracerebral hemorrhage admitted to a single Stroke Center (Department of Neurology, University of Debrecen, Hungary). The protocol of the GINOP IRONHEART study includes the investigation of detailed clinical, laboratory investigations, and various neurophysiological examiniations. Stroke severity is quantified based on the National Institutes of Health Stroke Scale (NIHSS) on admisson and day 7, 14, 90 after the onset of stroke. Cranial CT is performed on admission, day 14, and 90 to estimate the ICH volume. Modified Rankin Score (mRS) is used for evaluating the long-term outcome (90 days post-event). Blood is drawn immediately on admission for specific hemostasis tests. Digital and quantitative EEG techniques and motor evoked potential (MEP) are performed to evaluate the prognosis of cerebral hemorrhage on admission (within 24-28h), immediately before discharge (??10?14 days later), and 3 months after the event. Outcomes: The following outcomes are investigated: 1/ Mortality by day 14 and day 90 2/ Long-term outcome at 90 days post-event: mRS 0-1 is defined as favorable long-term outcome. Discussion: If associations between outcomes and the investigated parameters (hemostasis and neurophysiological examinations) are confirmed, results might aid prognosis assessment in this subtype of stroke with particularly high mortality. Improving clinical grading systems on ICH severity and outcomes by including the investigated parameters could help to better guide the management of these patients in the future.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Frontiers in Neurology. - 12 (2021), p. 1-6. -
További szerzők:Héja Máté (1991-) (általános orvos) Bagoly Zsuzsa (1978-) (orvos) Kovács Kitti Bernadett (1985-) (neurológus) Orbán-Kálmándi Rita Angéla (1993-) (klinikai laboratóriumi kutató) Sarkady Ferenc (1982-) (laboratóriumi analitikus) Tóth Judit (1964-) (radiológus) Fekete Klára (1978-) (neurológus) Fekete István (1951-) (neurológus, pszichiáter) Csiba László (1952-) (neurológus, pszichiáter)
Pályázati támogatás:GINOP-2.3.2-15-2016-00043
GINOP
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
DOI
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3.

001-es BibID:BIBFORM079827
035-os BibID:(cikkazonosító)AS24-060
Első szerző:Árokszállási Tamás (neurológus)
Cím:Hemostasis biomarkers in the prognosis of non-traumatic intracerebral hemorrhage / T. Arokszallasi, Z. Bagoly, K. Fekete, I. Fekete, I. Szegedi, M. Andrejkovics, J. Toth, L. Csiba
Dátum:2019
Megjegyzések:Background and Aims: Non-traumatic intracerebral hemorrhage (ICH) accounts for 10?15% of all strokes and results in higher rate of mortality as compared to ischemic strokes. In the IRONHEART study we aimed to find potential hemostasis biomarkers with prognostic value in patients with ICH. Methods: In this prospective, observational study, 183 acute stroke patients and 140 healthy controls were included. Patients were grouped: 51 primary ICH patients (PICH), 118 acute ischemic stroke patients who underwent thrombolysis without hemorrhagic events (AIS), 13 patients with AIS who suffered hemorrhagic complications after intravenous thrombolysis (AIS-ICH). On admission, CT angiography, detailed clinical and laboratory investigations were performed. The following hemostasis measurements were carried out from blood samples: hemostasis screening tests, von Willebrand factor (VWF) antigen, factor XIII (FXIII), plasminogen and a2 antiplasmin activity, D-dimer. Patients were followed for 90 days, long term outcomes were defined using the modified Rankin Scale. Results: VWF level was significantly higher in all patient groups as compared to controls. VWF levels were significantly higher in patients with worse long-term outcomes (mRS>3) in all patient cohorts. FXIII activity was significantly elevated in the PICH group as compared to controls and to both AIS groups. FXIII activity in the lowest quartile was associated with a significant risk of mortality in the PICH group (OR: 9.9; 95%CI:1.6- 61.6, p ? 0.015). Among fibrinolytic markers, only D-dimer showed association with worse long-term outcomes (mRS>3). Conclusions: VWF antigen, FXIII activity and D-dimer could serve as biomarkers of long-term outcomes in PICH patients.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
haemorrhage
Megjelenés:European Stroke Journal. - 4 : Suppl. 1 (2019), p. 449. -
További szerzők:Bagoly Zsuzsa (1978-) (orvos) Fekete Klára (1978-) (neurológus) Fekete István (1951-) (neurológus, pszichiáter) Szegedi István (1992-) (orvos) Andrejkovics Mónika (1967-) (klinikai szakpszichológus, neuropszichológus, pszichoterapeuta) Tóth J. Csiba László (1952-) (neurológus, pszichiáter)
Pályázati támogatás:GINOP-2.3.2-15-2016-00043
GINOP
NKFI-K120042
NKFI
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
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4.

001-es BibID:BIBFORM096522
035-os BibID:(cikkazonosító)757078 (WoS)000717640900001 (Scopus)85118804752
Első szerző:Fekete Klára (neurológus)
Cím:Neurophysiological examinations as adjunctive tool to imaging techniques in spontaneous intracerebral haemorrhage : IRONHEART study / Fekete Klára, Tóth Judit, Horváth László, Márton Sándor, Héja Máté, Csiba László, Árokszállási Tamás, Bagoly Zsuzsa, Sulina Dóra, Fekete István
Dátum:2021
ISSN:1664-2295
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Frontiers in Neurology. - 12 (2021), p. 1-15. -
További szerzők:Tóth Judit (1964-) (radiológus) Horváth László (1973-) (gyógyszerész) Márton Sándor (1965-) (matematikus) Héja Máté (1991-) (általános orvos) Csiba László (1952-) (neurológus, pszichiáter) Árokszállási Tamás (1988-) (neurológus) Bagoly Zsuzsa (1978-) (orvos) Sulina Dóra (PhD hallgató) Fekete István (1951-) (neurológus, pszichiáter)
Pályázati támogatás:K109712
OTKA
K120042
OTKA
FK128582
OTKA
GINOP-2.3.2-15-2016-00043
GINOP
Internet cím:DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:

5.

001-es BibID:BIBFORM106027
035-os BibID:(cikkazonosító)912664 (scopus)85137215772 (wos)000882813200001
Első szerző:Lóczi Linda
Cím:Thrombin generation as a predictor of outcomes in patients with non-traumatic intracerebral hemorrhage / Lóczi Linda, Orbán-Kálmándi Rita, Árokszállási Tamás, Fekete István, Fekete Klára, Héja Máté, Tóth Judit, Csiba László, Bagoly Zsuzsa
Dátum:2022
ISSN:1664-2295
Megjegyzések:Background: Non-traumatic intracerebral hemorrhage (ICH) accounts for 10-15% of all strokes and leads to a higher rate of mortality as compared to ischemic strokes. We aimed to find out whether the thrombin generation assay (TGA) could predict outcomes in patients with ICH. Patients and methods: In this prospective, observational study, 87 consecutive patients with ICH and 164 healthy controls were included. Computed tomography (CT), detailed clinical investigation, and laboratory investigations were performed from patients on admission. TGA was performed using stored platelet poor plasma obtained on admission. Lag time, endogen thrombin potential (ETP), peak thrombin, and time to peak parameters were calculated. Short- and long-term outcomes of ICH were defined at 14 days and 3 months post-event according to the NIHSS and the modified Rankin Scale (mRS), respectively. Results: Peak thrombin was significantly higher in patients as compared to controls (397.2 ? 93.9 vs. 306 ? 85.3 nM, p < 0.0001). Lag time, ETP, and time to peak parameters showed a significant positive correlation with CRP in both groups. In patients with worse long-term functional outcomes, peak thrombin was significantly higher as compared to those with favorable outcomes [mRS 2-6 median: 402.5 (IQR:344.8-473.8) vs. mRS 0-1: 326.4 (294.2-416.1) nM, p = 0.0096]. Based on the statistically optimal threshold of 339.1 nM peak thrombin, the sensitivity and specificity of this parameter to determine mRS 2-6 as an outcome were 80.8 and 64.7%, respectively. In a binary logistic regression model including age, sex, BMI, smoking status, NIHSS on admission, D-dimer, and peak thrombin (>339.1 nM), only NIHSS and the peak thrombin parameters remained in the model as significant, independent predictors of poor outcome. Lag time and time to peak showed a modest, significant negative correlation with intracerebral bleeding volume on admission (r = -0.2603, p = 0.0231 and r = -0.3698, p = 0.0010, respectively). During the follow-up of patients, estimated hemorrhage volumes on day 90 showed significant positive association with the ETP and peak thrombin parameters (r = 0.3838, p = 0.0363 and r = 0.5383, p = 0.0021, respectively). Conclusion: In patients with ICH, TG was increased as compared to healthy controls, which might be explained by the presence of higher inflammatory parameters in patients. Peak thrombin measured on admission might be a useful tool to predict outcomes in patients with ICH.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Frontiers in Neurology. - 13 (2022), p. 1-12. -
További szerzők:Orbán-Kálmándi Rita Angéla (1993-) (klinikai laboratóriumi kutató) Árokszállási Tamás (1988-) (neurológus) Fekete István (1951-) (neurológus, pszichiáter) Fekete Klára (1978-) (neurológus) Héja Máté (1991-) (általános orvos) Tóth Judit (1964-) (radiológus) Csiba László (1952-) (neurológus, pszichiáter) Bagoly Zsuzsa (1978-) (orvos)
Pályázati támogatás:GINOP-2.3.2-15-2016-00043
GINOP
K120042
OTKA
FK128582
OTKA
ELKH-DE 332 Cerebrovascular and Neurodegenerative Research Group
Egyéb
ÚNKP 20-3-I-DE-220
Egyéb
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
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6.

001-es BibID:BIBFORM092842
035-os BibID:(cikkazonosító)613441
Első szerző:Orbán-Kálmándi Rita Angéla (klinikai laboratóriumi kutató)
Cím:A Modified in vitro Clot Lysis Assay Predicts Outcomes in Non-traumatic Intracerebral Hemorrhage Stroke Patients : the IRONHEART Study / Rita Orbán-Kálmándi, Tamás Árokszállási, István Fekete, Klára Fekete, Máté Héja, Judit Tóth, Ferenc Sarkady, László Csiba, Zsuzsa Bagoly
Dátum:2021
ISSN:1664-2295 1664-2295
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Frontiers in Neurology. - 12 (2021), p. 1-11. -
További szerzők:Árokszállási Tamás (1988-) (neurológus) Fekete István (1951-) (neurológus, pszichiáter) Fekete Klára (1978-) (neurológus) Héja Máté (1991-) (általános orvos) Tóth Judit (1964-) (radiológus) Sarkady Ferenc (1982-) (laboratóriumi analitikus) Csiba László (1952-) (neurológus, pszichiáter) Bagoly Zsuzsa (1978-) (orvos)
Pályázati támogatás:GINOP-2.3.2-15-2016-00043
GINOP
Internet cím:DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:

7.

001-es BibID:BIBFORM079828
035-os BibID:(cikkazonosító)AS24-058
Első szerző:Szegedi István (orvos)
Cím:The association of plasminogen activator inhibitor-1 (pai-1) 4g/5g polymorphism with the risk and prognosis of intracerebral hemorrhage / I. Szegedi, T. Arokszallasi, I. Fekete, K. Fekete, A. Nagy, F. Sarkady, E. G. Székely, K. R. Czuriga-Kovacs, E. Berenyi, Z. Bagoly, L. Csiba
Dátum:2019
Megjegyzések:Background and Aims: Non-traumatic intracerebral hemorrhage accounts for 10?15% of all strokes, but has much higher mortality than acute ischemic stroke (AIS). Plasminogen activator inhibitor-1 (PAI-1) is a natural inhibitor of fibrinolysis that protects against bleeding. PAI-1 5G/ 5G genotype is associated with lower PAI-1 levels, thus we hypothesized that it could be associated with the risk and outcome of intracerebral hemorrhage. Methods: Three populations were included in the study: 51 patients with primary intracerebral haemorrhage (PICH), 13 patients with AIS who suffered hemorrhagic transformation after intravenous thrombolysis (AIS-ICH), and 118 AIS patients without hemorrhagic events (AIS). PAI-1 4G/5G polymorphism was determined in all patients. Clinical data was registered on admission and day 7 post-event. Short-term outcome was defined according to NIHSS change at 7 days. Long-term outcome was measured by the modified Rankin Scale at 3 months. Results: The presence of PAI-1 5G allele was significantly more frequent in the AIS-ICH group as compared to the AIS and PICH cohorts and a population control cohort. PAI-1 4G/5G polymorphism had no effect on stroke severity or short-term outcome in either groups. In a binary backward logistic regression model including age, gender, BMI, NIHSS on admission, hypertension, hyperlipidaemia it was revealed that PAI-1 5G/5G genotype confers an independent, significant risk for post-lysis intracranial hemorrhage (OR:4.75, 95%CI:1.18-19.06, p ? 0.028). PAI-1 4G/5G polymorphism had no influence on mortality and long-term outcome in the studied patient cohorts. Conclusions: PAI-1 5G/5G genotype confers an independent, significant risk for post-lysis intracerebral haemorrhage.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
haemorrhage
Megjelenés:European Stroke Journal. - 4 : Suppl. 1 (2019), p. 470. -
További szerzők:Árokszállási Tamás (1988-) (neurológus) Fekete István (1951-) (neurológus, pszichiáter) Fekete Klára (1978-) (neurológus) Nagy A. Sarkady Ferenc (1982-) (laboratóriumi analitikus) Székely Edina Gabriella Czuriga-Kovács Katalin Réka (1981-) (neurológus) Berényi Ervin (1964-) (radiológus) Bagoly Zsuzsa (1978-) (orvos) Csiba László (1952-) (neurológus, pszichiáter)
Pályázati támogatás:GINOP-2.3.2-15-2016-00043
GINOP
NKFI-K120042
NKFI
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
Borító:
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