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001-es BibID:	BIBFORM029951
Első szerző:	Bereczki Dániel (neurológus)
Cím:	Mannitol use in acute stroke : case fatality at 30 days and 1 year / Bereczki D., Mihálka L., Szatmári S., Fekete K., Di Cesar D., Fülesdi B., Csiba L., Fekete I.
Dátum:	2003
ISSN:	0039-2499
Megjegyzések:	BACKGROUND AND PURPOSE: Mannitol is used worldwide to treat acute stroke, although its efficacy and safety have not been proven by randomized trials.METHODS:In a tricenter, prospective study, we analyzed the 30-day and 1-year case fatality with respect to mannitol treatment status in 805 patients consecutively admitted within 72 hours of stroke onset. Confounding factors were compared between treated and nontreated patients.RESULTS:Two thirds of the patients received intravenous mannitol as part of their routine treatment (mean dose, 47+/-22 g/d; mean duration, 6+/-3 days). The case fatality was 25% versus 16% (P=0.006) at 30 days and 38% versus 25% (P<0.001) at 1 year in the-mannitol treated and nontreated groups, respectively. Mannitol treatment effect was adjusted for age, stroke severity, fever in the first 3 days, and aspirin treatment (for ischemic strokes) in logistic regression models. Depending on the factors entered into the model, either no effect or harm could be attributed to mannitol. When the analysis was restricted to those admitted within 24 hours (n=568), case fatality differed significantly only at 1 year (35% in treated and 26% in nontreated patients, P=0.044). Although the prognostic scores of the Scandinavian Neurological Stroke Scale were similar in treated and nontreated patients, both in ischemic and hemorrhagic strokes, the patient groups differed in several factors that might also have influenced survival.CONCLUSIONS:Based on the results of this study, no recommendations can be made on the use of mannitol in acute stroke, and properly randomized, controlled trials should be performed to come to a final conclusion.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Stroke. - 34 : 7 (2003), p. 1730-1735. -
További szerzők:	Mihálka László (1950-) (neurológus) Szatmári Szabolcs (1960-) (neurológus) Fekete Klára (1978-) (neurológus) Di Cesar, D. Fülesdi Béla (1961-) (aneszteziológus) Csiba László (1952-) (neurológus, pszichiáter) Fekete István (1951-) (neurológus, pszichiáter)
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001-es BibID:	BIBFORM010568
Első szerző:	Bereczki Dániel (neurológus)
Cím:	The Debrecen Stroke Database : demographic characteristics, risk factors, stroke severity and outcome in 8088 consecutive hospitalised patients with acute cerebrovascular disease / Bereczki D., Mihalka L., Fekete I., Valikovics A., Csepany T., Fulesdi B., Bajko Z., Szekeres C., Fekete K., Csiba L.
Dátum:	2009
Megjegyzések:	High stroke mortality in central-eastern European countries might be due to higher stroke incidence, more severe strokes or less effective acute care than in countries with lower mortality rate. Hospital databases usually yield more detailed information on risk factors, stroke severity and short-term outcome than population-based registries. Patients and methods The Debrecen Stroke Database, data of 8088 consecutively hospitalised patients with acute cerebrovascular disease in a single stroke centre in East Hungary between October 1994 and December 2006, is analysed. Risk factors were recorded and stroke severity on admission was scored by the Mathew stroke scale. The modified Glasgow outcome scale was used to describe patient condition at discharge. Results Mean age was 68713 years, 11.4% had haemorrhagic stroke. The rate of hypertension on admission was 79% in men, and 84% in women, 40.3%of men and 19.8%of women were smokers, and 34% of all patients had a previous cerebrovascular disease in their history. Case fatality was 14.9%, and 43% had some disability at discharge. Outcome at discharge was worse with higher age, higher glucose, higher blood pressure, higher white cell count and erythrocyte sedimentation rate and more severe clinical signs on admission. In multivariate analysis admission blood pressure lost its significance in predicting outcome. Conclusions In this large Hungarian stroke unit database hypertension on admission, smoking and previous cerebrovascular disease were more frequent than in most western databases. These findings indicate major opportunities for more efficient stroke prevention in this and probably other eastern European countries.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban acute blood pressure cerebral haemorrhage epidemiology ischaemic stroke risk factors
Megjelenés:	International Journal of Stroke. - 4 : 5 (2009), p. 335-339. -
További szerzők:	Mihálka László (1950-) (neurológus) Fekete István (1951-) (neurológus, pszichiáter) Valikovics Attila Csépány Tünde (1956-) (neurológus, pszichiáter) Fülesdi Béla (1961-) (aneszteziológus) Bajkó Z. Szekeres C. Fekete Klára (1978-) (neurológus) Csiba László (1952-) (neurológus, pszichiáter)
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat DOI
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001-es BibID:	BIBFORM062625
Első szerző:	Nemes Réka (aneszteziológus, intenzív terápiás szakorvos)
Cím:	Assessment of severity and time course of critical illness neuropathy in septic patients : a prospective observational study / Nemes Réka, Fülep Zoltán, László István, Sárkány Péter, Fekete Klára, Mechler Ferenc, Fülesdi Béla
Dátum:	2015
ISSN:	0019-1442
Megjegyzések:	Objective ? In this prospective observational study we investigatedelectrophysiological alterations in the early phase ofcritical illness and correlated electrophysiological findingswith the clinical picture and outcome.Methods ? We enrolled 21 critically ill surgical patientshaving ?12 Acute Physiology and Chronic Health Evaluation(APACHE) II scores on admission. Routine non-invasive bilateralelectroneurography (ENG) examination of median andulnar nerves was done on five consecutive days starting intwo days after admission. Then weekly follow-up was performed.Motor and sensory nerve conduction indices werecalculated and correlated with APACHE II and SimplifiedAcute Physiology Score II severity scores.Results ? On the first examination 18/21 patients had>20% reduction in the motor and sensory nerve conductionindices. Severity score systems showed significant negativecorrelation with the daily change of CMAP and SNAP amplitudesand calculated nerve conduction indices (Spearman'scorrelation, p<0,001). Mortality was higher in the patientswith worse admission ENG and/or stagnant electrophysiologicalstatus or declining tendency in the first week.Conclusions ? Electrophysiological alterations appearedsoon after the development of critical illness. Early phasealterations showed a strong correlation with patients' generalcondition and more severe electrophysiological alterationspredisposed to higher mortality. In several cases early alterationsproved to be reversible.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény hazai lapban folyóiratcikk critical illness polyneuropathy electroneurography sepsis
Megjelenés:	Ideggyógyászati Szemle. - 68 : 1-2 (2015), p. 30-36. -
További szerzők:	Fülep Zoltán (aneszteziológus) László István (1978-) (aneszteziológus) Sárkány Péter (1966-) (aneszteziológus) Fekete Klára (1978-) (neurológus) Mechler Ferenc (1933-) (neurológus) Fülesdi Béla (1961-) (aneszteziológus)
Internet cím:	Szerző által megadott URL Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM062623
Első szerző:	Nemes Réka (aneszteziológus, intenzív terápiás szakorvos)
Cím:	Critical illness associated neuromuscular disorders : keep them in mind / Réka Nemes, Levente Molnár, Zoltán Fülep, Klára Fekete, Mariann Berhés, Béla Fülesdi
Dátum:	2014
ISSN:	0019-1442
Megjegyzések:	Neuromuscular disorders complicating sepsis and critical illnessare not new and scarce phenomena yet they receive littleattention in daily clinical practice. Critical illness polyneuropathyand myopathy affect nearly half of the patients withsepsis. The difficult weaning from the ventilator, the prolongedintensive care unit and hospital stay, the larger complicationand mortality rate these disorders predispose to,put a large burden on the patient and the health care system.The aim of this review is to give an insight into the pathophysiologicalbackground, diagnostic possibilities andpotential preventive and therapeutic measures in connectionwith these disorders to draw attention to their significanceand underline the importance of preventive approach.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény hazai lapban critical illness polyneuropathy critical illness myopathy sepsis pathophysiology physiotherapy
Megjelenés:	Ideggyógyászati Szemle. - 67 : 1-2 (2014), p. 1-12. -
További szerzők:	Molnár Levente Fülep Zoltán (aneszteziológus) Fekete Klára (1978-) (neurológus) Berhés Mariann (1975-) (orvos) Fülesdi Béla (1961-) (aneszteziológus)
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