| 1. |
- Bogner, Péter, et al.
(författare)
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Stroke-ellátást támogató teleradiológiai hálózat a Nyugat- és Dél-Dunántúlon : [Teleradiology-based stroke network in Western and Southern Transdanubia in Hungary]
- 2021
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Ingår i: Orvosi Hetilap. - : Akademiai Kiado Rt.. - 0030-6002 .- 1788-6120. ; 162:17, s. 668-675
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Tidskriftsartikel (refereegranskat)abstract
- Összefoglaló. Bevezetés: A stroke kezelésének lehetőségei az utóbbi években jelentősen megváltoztak: a thrombolysis után bevezetésre került a mechanikus thrombectomia, és a terápiás időablak is jelentősen kitágult az utóbbi évek nagy multicentrikus tanulmányai alapján. Ezek a lehetőségek új igényeket fogalmaztak meg a képalkotó diagnosztikával szemben: az ischaemia okozta morfológiai elváltozások mellett az artériás és a kollaterális rendszer állapotát, valamint bizonyos esetekben az agy szöveti perfúzióját is szükséges meghatározni. Ezeket a komplex kiértékelési feladatokat ma már mesterségesintelligencia-algoritmusok támogathatják, melyek a kiértékelést pár perc alatt elvégezve segítenek a terápiás döntés kialakításában. Célkitűzés: A Dél- és a Nyugat-dunántúli régióban hat intézmény részvételével egy dedikált stroke teleradiológiai hálózat kialakítása. Módszer: A stroke-CT-kiértékelő szoftver és a képkommunikáció integrációja, a vizsgálati protokollok technikai paramétereinek egységesítése, a kiértékelési eredmények teleradiológiai megjelenítése valósult meg a hálózat kialakítása során. Eredmények: A hálózat egységesítette nemcsak a stroke-CT-protokollok beállításait, de beutalási és értékelési szempontjait is. A stroke-CT-kiértékelések és a mechanikus thrombectomiák száma is emelkedett az elmúlt egy évben. Következtetés: A dedikált teleradiológiai stroke-hálózat segítségével optimalizálni kívánjuk a régió stroke-ellátását: egyrészt lehetőleg ne maradjanak ellátatlanul a thrombectomiából valószínűleg profitáló betegek, másrészt ne terheljük az ellátórendszert olyan esetekkel, melyekről a teljes dokumentáció ismeretében derül ki, hogy nem javasolt a beavatkozás.
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| 2. |
- Büki, Andras, 1966-, et al.
(författare)
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A koponyasérülés által kiváltott axonkárosodás és kezelésének lehetóségei : [Therapeutic possibilities in axonal injury caused by head trauma]
- 2002
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Ingår i: Orvosi Hetilap. - : Akademiai Kiado Rt.. - 0030-6002 .- 1788-6120. ; 143:10, s. 499-503
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Forskningsöversikt (refereegranskat)abstract
- Traumatic brain injury is putting an extreme burden on societies all over the world. While surgical and neuro-intensive treatment is traditionally aimed at space occupying or focal lesions, traumatic brain injury is frequently associated with diffuse axonal injury, which significantly contributes to its morbidity and mortality. Current taught appreciates that diffuse axonal injury is a progressive event gradually evolving from focal alterations in axolemmal permeability and the underlying axonal ultrastructure to axonal disconnection, a process amenable of therapeutic interventions. This review is primarily focusing on the clinical/neuroradiological manifestation and our contemporary knowledge of the pathobiology of traumatically evoked (diffuse-) axonal injury with particular emphasize on recent- to date, primarily experimental-therapeutic approaches that in the future might offer potential aid to the head injured.
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| 3. |
- Csenge, Szeverenyi, et al.
(författare)
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Az ortopédiai nagymǔtétek során alkalmazott terápiás szuggesztiók hatása a beteg gyógyulására
- 2018
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Ingår i: Orvosi Hetilap. - : Akademiai Kiado Zrt.. - 0030-6002 .- 1788-6120. ; 159:48, s. 2011-2020
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and aim: Hip and knee replacement surgery is very demanding for patients. Medication consumption is further increased by perioperative anxiety. Besides pain killer and anxiolytic medications, patients' recovery can be enhanced by applying therapeutic suggestions, which are easily applicable during the patient-physician communication. Method: In our prospective, randomized, controlled study we examined the effects of positive suggestions on patients undergoing hip or knee arthroplasty in spinal anaesthesia. Members of the suggestion group received the therapeutic suggestions during a pre-surgery physician visit, and by listening to an audio recording during surgery. Results: Compared to the control group (n = 50), in the suggestion group (n = 45) the need of medication (pain killer and adjuvant pain medication) during the surgery was lower (p = 0.037), the mean change from baseline in the well-being of the patients was better on the 2nd [1.31 (0.57; 2.04); p<0.001] and 4th [0.97 (0.23; 1.7); p = 0.011] postoperative day and less transfusion had to be administered (OR: 2.37; p = 0.004). However, there was no difference between the two groups in the postoperative need of medications, in the length of hospitalisation and in the frequency of complications. Conslusion: Our results indicate that the administration of therapeutic suggestions in the perioperative period may be beneficial for orthopaedic surgery patients.
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| 4. |
- Csepregi, Gyula, et al.
(författare)
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Sülyos koponya-agy sérültek ellátása Magyarországon, 2002-ben : [Management of patients with severe head injury in Hungary, in 2002]
- 2007
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Ingår i: Orvosi Hetilap. - : Akademiai Kiado Rt.. - 0030-6002 .- 1788-6120. ; 148:17, s. 771-777
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Tidskriftsartikel (refereegranskat)abstract
- In Hungary, epidemiological and clinical data regarding brain injury were rather scarce. The Hungarian Society for Neurotrauma aimed to make a nation-wide study about the number and the mortality of patients with severe head trauma, the organization of management, the diagnostics and monitoring in use, and finally about the clinical practice of management. A national survey was carried out with questionnaires asking about data of 2001, and a prospective, three-month-long data collection based on case studies was also executed in 2002. The Hungarian National Ambulance and Emergency Service centralized information gathering on rescue, and transportation. To collect data of hospital care, a network of regional coordinators and hospital communicators was developed. The responders covered 76% of the hospital neurotrauma care in the country. The number of brain trauma patients was close to 14,000 per year: 71.3% mild, 19.4% moderate, and 9.4% severe trauma. According to prospective study the mortality of those patients who were admitted as severe head injury patients was 55% and the mortality of those who got into severe condition later was 35% during the acute care. These data showed much worse outcome than those published in Western European countries and North America. In the background the authors found communication disorder between prehospital and hospital care, extreme long time spent until the patients got to the first CT-exam and to the definitive care. The implementation of Hungarian and international head trauma guidelines did not spread widely.
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| 5. |
- Frida, Katona, et al.
(författare)
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A melanoma és az agyi áttétképzödés molekuláris háttere
- 2017
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Ingår i: Orvosi Hetilap. - : Akademiai Kiado Zrt.. - 0030-6002 .- 1788-6120. ; 158:28, s. 1083-1091
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Forskningsöversikt (refereegranskat)abstract
- Malignant melanoma is one of the most aggressive tumors which often gives metastasis to distant organs thereby limiting the chances of survival. Brain metastasis occurs in nearly half of the advanced tumors. In order to improve outcome early diagnosis is important. The discovery and better understanding of genetic and epigenetic changes is essential for developing new effective therapies, which can designate promising therapeutic targets. Melanoma most often is caused by gene mutations of the mitogen-activated protein kinase pathway, the phosphatidylinositol 3-kinase signaling pathway, and the cell cycle regulatory molecules, respectively. The molecular process of brain metastasis has not been fully elucidated. In our review we summarize the genetic alterations and molecular mechanisms playing a role in the development of melanoma and its brain metastasis.
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| 6. |
- Hejjel, L., et al.
(författare)
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Alternatives to heart transplantation
- 1997
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Ingår i: Orvosi Hetilap. - : Akademiai Kiado Rt.. - 0030-6002 .- 1788-6120. ; 138:18, s. 1107-1111
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Tidskriftsartikel (refereegranskat)
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| 7. |
- Janos, B, et al.
(författare)
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[Clinical and neuropathological characteristics of dementia with Lewy bodies]
- 2017
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Ingår i: Orvosi hetilap. - : Akademiai Kiado Zrt.. - 0030-6002 .- 1788-6120. ; 158:17, s. 643-652
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia. The accurate diagnosis is often possible only by neuropathological examination. The morphologic hallmarks are the presence of α-synuclein-rich Lewy bodies and Lewy neurites, identical to those seen in Parkinson’s disease (PD) and Parkinson’s disease dementia (PDD). Neurotransmitter deficits, synaptic and ubiquitin-proteasome system (UPS) dysfunction play major role in the pathomechanism. Characteristic symptoms are cognitive fluctuation, parkinsonism and visual hallucinations. Due to the often atypical clinical presentation novel imaging techniques and biomarkers could help the early diagnosis. Although curative treatment is not available, therapies can improve quality of life. Clinicopathological studies are important in exploring pathomechanisms, ensuring accurate diagnosis and identifying therapeutic targets. Orv Hetil. 2017; 158(17): 643–652.
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| 8. |
- Pilisi, Róbert, et al.
(författare)
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A repetitív transcranialis mágnesesstimuláció szerepe a mentális zavarok,elsősorban a terápiarezisztens majordepresszív zavar kezelésében : [The role of repetitive transcranial magnetic stimulation in the treatment of mental disorders, especially in treatment-resistant major depressive disorder]
- 2020
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Ingår i: Orvosi Hetilap. - : Akademiai Kiado Rt.. - 0030-6002 .- 1788-6120. ; 161:1, s. 3-10
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Tidskriftsartikel (refereegranskat)abstract
- The rapidly evolving field of repetitive transcranial magnetic stimulation as a neuromodulational technique may mean a safe, alternative approach to the management of several mental disorders, especially treatment-resistant major depressive disorder. Our aim is to describe the current role of transcranial magnetic stimulation in research and routine clinical practice, based on the literature and clinical protocols. Since the discovery, that an outer magnetic source can depolarize neurons, both neurology and psychiatry seek the method's possible clinical utility. To date, in the field of psychiatry, the method is only approved in the treatment of major depressive disorder and obsessive-compulsive disorder, but research continues to find application in other mental disorders (schizophrenia, bipolar disorder), too. The next step in the evolution of repetitive transcranial magnetic stimulation is based on magnetic resonance guided, real-time navigation with the help of positioning algorithms. The so-called neuronavigational systems make precise aiming of neuronal circuits responsible for the development of depression, thus increasing the excitability of the left dorsolateral prefrontal cortex and decreasing it on the right hemisphere. The method has few contraindications, and the occurrence of side effects can be minimized by carefully selected patient population. For today, transcranial magnetic stimulation became an evidence-based, effective treatment for some mental disorders, especially treatment-resistant major depressive disorder. It is to be assumed that in the future neuronavigational neuromodulation techniques, including repetitive transcranial magnetic stimulation, will be widely used in the field of psychiatry and neurology. Magnetic stimulation is currently available in a number of centres in Hungary, but the financial approval and the implementation of this neuromodulation method for treating mental disorders in the everyday clinical practice are still in progress.
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| 9. |
- Piski, Zalán, et al.
(författare)
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Minimálisan invazív, endoszkóppal asszisztált, transcribriform reszekció a koponyaalap rosszindulatú daganatainak sebészetében : [Minimally invasive endoscopic transcribriform resection of malignant lesions of the skull base]
- 2019
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Ingår i: Orvosi Hetilap. - : Akademiai Kiado Rt.. - 0030-6002 .- 1788-6120. ; 160:40, s. 1584-1590
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Forskningsöversikt (refereegranskat)abstract
- Introduction: Malignant tumours of the sinonasal region - including those with invasion of the skull base - necessitate surgical resection. The majority of the cases give an opportunity to perform the procedure via minimally invasive, endoscopic approach, without external, craniofacial surgery.Aim: To assess our clinical experience in treating anterior skull base malignancies, performing minimally invasive endoscopic transcribriform resection.Method: Between February 2015 and July 2017, four male and one female patient underwent minimally invasive, endoscopic skull base procedure. The mean age was 64.6 years (59-70, median: 66). Every surgery was performed via transnasal, endoscopic transcribriform approach. In two cases Kadish C esthesioneuroblastomas, while in one case a T3N0 sinonasal non-differentiated carcinoma, a T1N0 intestinal type adenocarcinoma and a T4N0 squamous cell carcinoma was the indication of surgery, respectively.Results: The mean follow-up time was 22.8 months, between 14 and 46 months. Intraoperative complications did not occur during the procedures. Regarding the postoperative period, liquorrhoea and pneumocephalus occurred in one case. Complications were solved with lumbar drainage. During follow-up, neither residual nor recurrent tumour was observed in our patients.Conclusion: Endoscopic transcribriform resection of the skull base malignancies is a safe and viable alternative to the traditional open approach.
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| 10. |
- Szecsi, J, et al.
(författare)
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[Effect of acute aprotinin (Gordox) therapy on hemostasis in heart surgery patients, with special reference to hyperfibrinolysis] : [Article in Hungarian]
- 1990
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Ingår i: Orvosi Hetilap. - : Akademiai Kiado Rt.. - 0030-6002 .- 1788-6120. ; 131:51, s. 2809-2814
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Tidskriftsartikel (refereegranskat)abstract
- Authors have studied the effect of Gordox-therapy on haemostasis after open heart surgery in a prospective clinical trial. Thirty seven patients (pts) undergoing cardiac surgery due to their valve disease were randomly assigned either to control-group (20 pts) or to Gordox-group (17 pts). The patients in the Gordox group were given Gordox according the following scheme: 2 M IU within 20 min. after induction of anaesthesia followed by 0.5 M IU/hour infusion until the end of the operation. One M IU also was given into the oxygenator before starting the extracorporeal circulation. The postoperative chest tube drainage was less in Gordox-group (534 +/- 260 ml vs. 987 +/- 583 ml, p less than 0.005), and donor blood and fresh frozen plasma requirement was also lower in this group (534 +/- 633 ml vs. 935 +/- 718 ml p less than 0.05; 70 +/- 153 ml vs. 211 +/- 245 ml p less than 0.05, respectively). There was no significant difference between the two groups concerning the postoperative activated partial thromboplastin time, prothrombin time, thrombin time values. The authors could document significantly higher fibrinogen concentration and significantly lower fibrinolytic activity postoperatively in the Gordox-group (p less than 0.05). Gordox therapy has advantageous effect on haemostasis after open heart surgery which can be documented both by clinical and laboratory examination.
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