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001-es BibID:BIBFORM077742
Első szerző:Diószegi Ágnes (belgyógyász)
Cím:Analysis of the Correlation between Microvascular Involvement and Neuropathy in Association with Metabolic Disorders in Case of Diabetic Leg Syndrome / Ágnes Diószegi, Melinda Vass, Anna Flaskó, Kristóf Gál, Ferenc Mechler, Miklós Káplár, László Csiba, Pál Soltész
Dátum:2018
ISSN:2644-0393
Megjegyzések:Diabetic leg developing with vascular and neuropathic path mechanism is a late onset complication of diabetes mellitus. Connection and therapeutic manageability of the two mechanisms is in close correlation, but it is still an unsolved issue. In our study we performed complex examination of patients presenting with symptoms referring to polyneuropathy. With ENG analysis we determined the conduction velocity, amplitude and distal latencies. Examination of motor fibres was performed by stimulating the peroneal nerve, while sensory fibres were assessed through stimuli of the sural nerve and the peroneal nerve. Presence of macro vascular involvement was confirmed by ankle-brachial index test and by Duplex ultrasound. Microcirculation was assessed by laser-Doppler test, triggering the Venous-Arteriolar (VA) reflex. During the measurement we detected the metabolic status by monitoring cholesterol, triglyceride, LDL, HDL, A1C levels and parameters of renal function, which were then compared to the above specified factors. We performed our examinations in the age- and gender-specific control group. We examined 50 (34 males, 16 females) patients presenting with polyneuropathic complaints with average ages of 64, 62 years. Average duration of the disease being present was 15.38 years. Regarding the tests assessing microcirculation, when analysing the Venous-Arteriolar (VA) reflex within the control group, we detected significantly higher (78% vs. 31.8%; p=0.001) within the control group, we detected significantly higher (78% vs. 31.8%; p=0.001) decrease in conduction velocity, compared to the diabetic patient group. We discovered significant correlation between the level of A1C characterizing the glycaemic control, and the decreased VA reflex response referring to microcirculatory disorder resulting from a neurogenic damage (R=0.322; p=0.024). We also found a similar association between increased triglyceride level and these pathological reflex response (R=0.35; p=0.015). ENG confirmed the presence of peripheral polyneuropathy (in 40% very severe, mixed type sensory-motoric neuropathy with axonal dominance, in 48% moderately severe, mixed type sensory-motoric neuropathy, in 6% severe sensory-motoric neuropathy with demyelinising dominance, and in 6% of them sensory-motoric neuropathy) in all cases. On the other hand we have not found a significant correlation between neuropathy confirmed by the ENG examination and the severity of the microcirculation disorder. Our results suggest that among macroangiopathic involvement of a diabetic leg, type and severity of the presenting neuropathy, the metabolic status of the patient and the observed microcirculation disorder, the latter one, the VA reflex measured by laser-Doppler is suitable for complex characterization of neuropathic, microcirculatory and metabolic status.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Diabetes mellitus
Microcirculatory damage
Neuropathy
Megjelenés:Annals of atherosclerosis research. - 1 : 2 (2018), p. 1-6. -
További szerzők:Vass Melinda (1986-) (általános orvos) Flaskó Anna Gál Kristóf (1994-) (orvos) Mechler Ferenc (1933-) (neurológus) Káplár Miklós (1965-) (belgyógyász, diabetológus) Csiba László (1952-) (neurológus, pszichiáter) Soltész Pál (1961-) (belgyógyász, kardiológus)
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2.

001-es BibID:BIBFORM023401
Első szerző:Fülesdi Béla (aneszteziológus)
Cím:Cerebrovascular reactivity and reserve capacity in type II diabetes mellitus / Fülesdi B., Limburg M., Bereczki D., Káplár M., Molnár C., Kappelmayer J., Neuwirth G., Csiba L.
Dátum:1999
ISSN:1056-8727
Megjegyzések:The aim of the study was to test the hypothesis that cerebrovascular reserve capacity and cerebrovascular reactivity are impaired in patients suffering from non insulin-dependent diabetes mellitus. We also intended to investigate factors which may influence resting cerebral blood flow velocity and cerebrovascular reserve capacity. A total of 28 patients suffering from type II diabetes mellitus and 20 healthy control subjects were studied. Based on diabetes duration patients were divided into two groups: subjects with > 10 years and those with < or = 10 years disease duration. Middle cerebral artery mean blood flow velocities were measured at rest and after intravenous administration of 1g acetazolamide. Cerebrovascular reactivity and reserve capacity were calculated. Blood glucose, insulin, glycosylated hemoglobin, hemostatic factors (fibrinogen, alpha-2 macroglobulin and von Willebrand factor antigen) were determined. Cerebrovascular reactivity and reserve capacity values were compared between the two diabetic subgroups and controls. Correlations between laboratory parameters and cerebrovascular reserve were investigated by linear regression analysis. Resting cerebral blood flow velocity was similar in controls and in the two diabetic subgroups. Cerebrovascular reactivity was elevated for a shorter time in patients with > 10 years disease duration than in controls and short-term diabetic patients. Cerebrovascular reserve capacity was lower in the long-term diabetes group (means +/- SD: 39.6 +/- 20.7%) than in patients with < or = 10 years disease duration (63.3 +/- 17.4%, p < 0.02 after Bonferroni correction). Cerebrovascular reserve capacity was inversely related to the duration of the disease (R = 0.53, p < 0.003). None of the determined laboratory factors had any relation with resting cerebral blood flow and cerebrovascular reserve capacity. The vasodilatory ability of cerebral arterioles is diminished in long-standing type II diabetes mellitus.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
egyetemen (Magyarországon) készült közlemény
Megjelenés:Journal Of Diabetes And Its Complications. - 13 : 4 (1999), p. 191-199. -
További szerzők:Limburg, Martien Bereczki Dániel (1960-) (neurológus) Káplár Miklós (1965-) (belgyógyász, diabetológus) Molnár Csilla (1962-) (aneszteziológus) Kappelmayer János (1960-) (laboratóriumi szakorvos) Neuwirth Gyula Csiba László (1952-) (neurológus, pszichiáter)
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
DOI
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3.

001-es BibID:BIBFORM023979
Első szerző:Fülesdi Béla (aneszteziológus)
Cím:Cerebrovascularis reaktivitás nem inzulindependens diabetes mellitusban : előzetes eredmények / Fülesdi, B., Limburg, M., Molnár, Cs., Káplár, M., Bereczki, D., Neuwirth, Gy., Csiba, L.
Dátum:1998
Tárgyszavak:Orvostudományok Klinikai orvostudományok magyar nyelvű folyóiratközlemény hazai lapban
egyetemen (Magyarországon) készült közlemény
Megjelenés:Orvosi Hetilap. - 139 : 30 (1998), p. 1789-1792. -
További szerzők:Limburg, Martien Molnár Csilla (1962-) (aneszteziológus) Káplár Miklós (1965-) (belgyógyász, diabetológus) Bereczki Dániel (1960-) (neurológus) Neuwirth Gyula Csiba László (1952-) (neurológus, pszichiáter)
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
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4.

001-es BibID:BIBFORM023404
Első szerző:Hidasi Eszter (neurológus)
Cím:No correlation between impairment of cerebrovascular reserve capacity and electrophysiologically assessed severity of neuropathy in noninsulin-dependent diabetes mellitus / Hidasi E., Káplár M., Diószeghy P., Bereczki D., Csiba L., Limburg M., Fülesdi B.
Dátum:2002
Megjegyzések:Microvascular abnormalities have an important role in the most frequent neurological complications of diabetes mellitus: neuropathy and cerebrovascular disorders. Severity of neuropathy as well as of cerebral microvascular damage can be quantitatively evaluated by instrumental methods like nerve conduction studies and transcranial Doppler. In the present study, we investigated whether a correlation exists between the severity of peripheral neuropathy and the impairment of cerebrovascular reserve capacity (CRC) in 20 patients with Type 2 diabetes mellitus. METHODS: CRC was measured by transcranial Doppler and defined as the maximal percentage increase in blood flow velocity in the middle cerebral artery within 20 min after an intravenous dose of 1000 mg of acetazolamide. Nerve conduction studies of the median, ulnar, peroneal, and sural nerves were performed. Severity of neuropathy was scored based on conduction velocities, amplitudes, and distal latencies. RESULTS: There was no correlation between the neuropathic score and CRC (R= .003, P= .99). Neither CRC nor the neuropathic score correlated significantly with age, duration of diabetes, and serum values of HbA(1c), glucose, insulin, von Willebrand factor, and alpha(2) - macroglobulin. Severity of neuropathy but not CRC correlated with microalbuminuria (R= .47, P= .038 and R= .14, P= .54). Improper treatment reflected by HbA(1c) >10% was associated with significantly more severe albuminuria, higher actual blood glucose level, higher von Willebrand factor activity, and marginally higher neuropathic score (21 vs. 13, P=.096), but was not associated with CRC (44% vs. 42%, P= .81). When duration of diabetes was dichotomized to 15 years and less or over 15 years, CRC was significantly smaller (35% vs. 50%, P= .036) and neuropathy was more severe in the subgroup with longer diabetes duration (19 vs. 11.5 points, P= .07). CONCLUSIONS: Although both CRC and peripheral nerve function are affected more severely in patients with long-lasting Type 2 diabetes mellitus, damage in the cerebrovascular system and in the long peripheral nerves occur independently. As in diabetes mellitus pathological changes in autonomic and large peripheral nerves develop simultaneously, decreased CRC in diabetic patients might be predominantly due to structural changes of resistance arteries or to metabolic than to neurogenic factors.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Journal of Diabetes and its Complications. - 16 : 3 (2002), p. 228-234. -
További szerzők:Káplár Miklós (1965-) (belgyógyász, diabetológus) Diószeghy Péter (1948-) (ideg- és elmeszakorvos) Bereczki Dániel (1960-) (neurológus) Csiba László (1952-) (neurológus, pszichiáter) Limburg, Martien Fülesdi Béla (1961-) (aneszteziológus)
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DOI
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5.

001-es BibID:BIBFORM031562
Első szerző:Szabó Katalin Judit (neurológus)
Cím:Újabb ismeretek a különböző vascularis kórképek megelőzésében, diagnosztikájában és terápiájában / Szabó Katalin Judit, Ádány Róza, Balla József, Balogh Zoltán, Édes István, Fekete István, Káplár Miklós, Mátyus János, Oláh László, Olvasztó Sándor, Paragh György, Páll Dénes, Pfliegler György, Vajda Gusztáv, Zeher Margit, Csiba László
Dátum:2012
Tárgyszavak:Orvostudományok Elméleti orvostudományok magyar nyelvű folyóiratközlemény hazai lapban
egyetemen (Magyarországon) készült közlemény
Megjelenés:Orvosi Hetilap. - 153 : 13 (2012), p. 483-498. -
További szerzők:Ádány Róza (1952-) (megelőző orvostan és népegészségtan szakorvos) Balla József (1959-) (belgyógyász, nephrológus) Balogh Zoltán (1965-) (belgyógyász, gasztroenterológus, diabetológus) Édes István (1952-) (kardiológus) Fekete István (1951-) (neurológus, pszichiáter) Káplár Miklós (1965-) (belgyógyász, diabetológus) Mátyus János (1957-) (belgyógyász, nephrológus) Oláh László (1967-) (neurológus) Olvasztó Sándor (1957-) (sebész) Paragh György (1953-) (belgyógyász) Páll Dénes (1967-) (belgyógyász, kardiológus) Pfliegler György (1949-) (belgyógyász, hematológus, labor szakorvos) Vajda Gusztáv (1956-) (kardiológus) Zeher Margit (1957-2018) (belgyógyász, allergológus és klinikai immunológus, reumatológus) Csiba László (1952-) (neurológus, pszichiáter)
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