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  • 1
    In: Sensors, MDPI AG, Vol. 21, No. 3 ( 2021-02-01), p. 969-
    Abstract: As demonstrated by earlier studies, pre-hospital triage with trans-telephonic electrocardiogram (TTECG) and direct referral for catheter therapy shows great value in the management of out-of-hospital chest pain emergencies. It does not only improve in-hospital mortality in ST-segment elevation myocardial infarction, but it has also been identified as an independent predictor of higher in-hospital survival rate. Since TTECG-facilitated triage shortens both transport time and percutaneous coronary intervention (PCI)-related procedural time intervals, it was hypothesized that even high-risk patients with acute coronary syndrome (ACS) and cardiogenic shock (CS) might also benefit from TTECG-based triage. Here, we decided to examine our database for new triage- and left ventricular (LV) function-related parameters that can influence in-hospital mortality in ACS complicated by CS. ACS patients were divided into two groups, namely, (1) hospital death patients (n = 77), and (2) hospital survivors (control, n = 210). Interestingly, TTECG-based consultation and triage of CS and ACS patients were confirmed as significant independent predictors of lower hospital mortality risk (odds ratio (OR) 0.40, confidence interval (CI) 0.21–0.76, p = 0.0049). Regarding LV function and blood chemistry, a good myocardial reperfusion after PCI (high area at risk (AAR) blush score/AAR LV segment number; OR 0.85, CI 0.78–0.98, p = 0.0178) and high glomerular filtration rate (GFR) value at the time of hospital admission (OR 0.97, CI 0.96–0.99, p = 0.0042) were the most crucial independent predictors of a decreased risk of in-hospital mortality in this model. At the same time, a prolonged time interval between symptom onset and hospital admission, successful resuscitation, and higher peak creatine kinase activity were the most important independent predictors for an increased risk of in-hospital mortality. In ACS patients with CS, (1) an early TTECG-based teleconsultation and triage, as well as (2) good myocardial perfusion after PCI and a high GFR value at the time of hospital admission, appear as major independent predictors of a lower in-hospital mortality rate.
    Type of Medium: Online Resource
    ISSN: 1424-8220
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2052857-7
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  • 2
    In: Neurobiology of Disease, Elsevier BV, Vol. 32, No. 2 ( 2008-11), p. 302-308
    Type of Medium: Online Resource
    ISSN: 0969-9961
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2008
    detail.hit.zdb_id: 1471408-5
    SSG: 12
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  • 3
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 158, No. 51 ( 2017-12), p. 2041-2047
    Abstract: Abstract: Introduction and aim: To implement lipiodol as a fiducial marker of the tumor bed for image-guided radiotherapy with simultaneous integrated boost technique as part of radiochemotherapy for muscle invasive bladder tumors. Method: Since April 2016, radiochemotherapy was performed in 3 male patients with muscle invasive, transitional cell bladder carcinoma. Prior to radiochemotherapy, tumor bed resection was performed for each patient, at the same time 10 ml of lipiodol solution was injected submucosally into the resection site, thus marking the tumor bed for escalated dose irradiation. During radiochemotherapy 51 Gy (1.7 Gy/die) to the pelvis, 57 Gy (1.9 Gy/die) to the whole bladder, and 63 Gy (2.1 Gy/die) to the lipiodol-labeled tumor bed was delivered with simultaneous integrated boost technique. The accuracy of the irradiation was controlled by daily kilovoltage CT. Early radiogenic urogenital and gastrointestinal side effects were recorded according to Radiation Therapy Oncology Group side-effects grading recommendation. Results: Substantial perioperative side effect or toxicity were not observed during and after the injection of lipiodol. The prescribed dose was successfully delivered in all patients. Radiotherapy duration was 6 weeks. The lipiodol-labeled tumor bed was clearly visible on daily kilovoltage cone beam CT. In one patient grade II cystitis and proctitis was observed, another patient experienced only grade I cystitis. These complaints improved with symptomatic medication. In the third patient no significant side effect occurred. Conclusions: The injection of lipiodol into the bladder wall is a safe technique, without any perioperative toxicity or complication. The tumor bed demarcated by lipiodol was visible both on treatment planning and kilovoltage CTs. The total treatment time was shortened by 4 days. The treatment was well tolerated, early side effects were moderate, or slight. Orv Hetil. 2017; 158(51): 2041–2047.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2017
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  • 4
    In: Life Sciences, Elsevier BV, Vol. 82, No. 17-18 ( 2008-4), p. 915-919
    Type of Medium: Online Resource
    ISSN: 0024-3205
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2008
    detail.hit.zdb_id: 2013911-1
    SSG: 12
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  • 5
    In: Journal of Personalized Medicine, MDPI AG, Vol. 12, No. 12 ( 2022-12-08), p. 2035-
    Abstract: Potential pitfalls of fractional flow reserve (FFR) measurements are well-known drawbacks of invasive physiology measurement, e.g., significant drift of the distal pressure trace may lead to the misclassification of stenoses. Thus, a simultaneous waveform analysis of the pressure traces may be of help in the quality control of these measurements by online detection of such artefacts as the drift or the wedging of the catheter. In the current study, we analysed the intracoronary pressure waveform with a dedicated program. In 130 patients, 232 FFR measurements were performed and derivative pressure curves were calculated. Local amplitude around the dicrotic notch was calculated from the distal intracoronary pressure traces (δdPn/dt). A unidimensional arterial network model of blood flow was employed to simulate the intracoronary pressure traces at different flow rates. There was a strong correlation between δdPn/dt values measured during hyperaemia and FFR (r = 0.88). Diagnostic performance of distal δdPn/dt ≤ 3.52 for the prediction of FFR ≤ 0.80 was 91%. The correlation between the pressure gradient and the corresponding δdPn/dt values obtained from all measurements independently of the physiological phase was also significant (r = 0.80). During simulation, the effect of flow rate on δdPn/dt further supported the close correlation between the pressure ratios and δdPn/dt. Discordance between the FFR and the δdPn/dt can be used as an indicator of possible technical problems of FFR measurements. Hence, an online calculation of the δdPn/dt may be helpful in avoiding some pitfalls of FFR evaluation.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662248-8
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  • 6
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2021-12-23)
    Abstract: Brachytherapy (BT) and external beam radiotherapy (EBRT) apply different dose rates, overall treatment times, energies and fractionation. However, the overall impact of these variables on the biological dose of blood is neglected. As the size of the irradiated volume influences the biological effect as well, we studied chromosome aberrations (CAs) as biodosimetric parameters, and explored the relationship of isodose surface volumes (ISVs: V 1% , V 1Gy , V 10% , V 10Gy , V 100% , V 150% ) and CAs of both irradiation modalities. We performed extended dicentrics assay of lymphocytes from 102 prostate radiotherapy patients three-monthly for a year. Aberration frequency was the highest after EBRT treatment. It increased after the therapy and did not decrease significantly during the first follow-up year. We showed that various types of CAs 9 months after LDR BT, 3 months after HDR BT and in a long time-range (even up to 1 year) after EBRT positively correlated with ISVs. Regression analysis confirmed these relationships in the case of HDR BT and EBRT. The observed differences in the time points and aberration types are discussed. The ISVs irradiated by EBRT showed stronger correlation and regression relationships with CAs than the ISVs of brachytherapy.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2615211-3
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  • 7
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 8 ( 2021-12-13)
    Abstract: Background: The morphology and functional severity of coronary stenosis show poor correlation. However, in clinical practice, the visual assessment of the invasive coronary angiography is still the most common means for evaluating coronary disease. The fractional flow reserve (FFR), the coronary flow reserve (CFR), and the resting full-cycle ratio (RFR) are established indices to determine the hemodynamic significance of a coronary stenosis. Design/Methods: The READY register (NCT04857762) is a prospective, multicentre register of patients who underwent invasive intracoronary FFR and RFR measurement. The main aim of the registry is to compare the visual estimate of coronary lesions and the functional severity of the stenosis assessed by FFR, as well as the RFR pullback. Characterizations of the coronary vessel for predominantly focal, diffuse, or mixed type disease according to visual vs. RFR pullback determination will be compared. The secondary endpoint of the study is a composite of major adverse cardiac events, including death, myocardial infarction, and repeat coronary revascularization at 1 year. These endpoints will be compared in patients with non-ischemic FFR in the subgroup of cases where the local pressure drop indicates a focal lesion according to the definition of ΔRFR & gt; 0.05 (for & lt;25 mm segment length) and in the subgroup without significant ΔRFR. In case of an FFR value above 0.80, an extended physiological analysis is planned to diagnose or exclude microvascular disease using the CFR/FFR index. This includes novel flow dynamic modeling for CFR calculation (CFR p−3D ). Conclusion: The READY register will define the effect of RFR measurement on visual estimation-based clinical decision-making. It can identify a prognostic value of ΔRFR during RFR pullback, and it would also explore the frequency of microvascular disease in the patient population with FFR & gt; 0.80. Clinical Trial Registration: ClinicalTrials.gov (NCT04857762).
    Type of Medium: Online Resource
    ISSN: 2297-055X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2781496-8
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  • 8
    Online Resource
    Online Resource
    GeoScienceWorld ; 2015
    In:  GeoArabia Vol. 20, No. 4 ( 2015-10-01), p. 17-36
    In: GeoArabia, GeoScienceWorld, Vol. 20, No. 4 ( 2015-10-01), p. 17-36
    Abstract: A field survey was carried out in 2012 focusing on the tectonic position and the role of Upper Triassic (Upper Norian–Rhaetian) Avroman Formation outcrops located in the Zalm area of Iraq, close to the Iraq-Iran border. At this location, the Cretaceous chert-bearing strata of the Qulqula Formation are overlain by sheared mafic bodies, which are in turn topped by the cliffs of the megalodontaceae-bearing Upper Triassic Avroman Formation. Similarities in lithology, sequence and tectonics position, suggest that the Triassic section of the Bisotoun Unit from the Kermanshah Zone of Iran can be used as a tectonic analogue of the Avroman Formation. According to our model, both the Avroman and the Bisotoun units formed an intra-oceanic carbonate platform, built-up by a characteristic megalodontaceae-bearing carbonate platform assemblage during the Late Triassic. The Harsin oceanic basin, which separated the Avroman-Bisotoun Platform from the Arabian Platform, was characterised by deep-marine sedimentation, the remnants of which form the Qulqula Formation in Iraq, and the Radiolaritic Nappe and the Harsin Mélange in the Kermanshah Zone. This tectonic setting is not unique; numerous authors suggest the existence of an oceanic rim basin, separating carbonate platform units (e.g. Oman ‘exotics’) from the Arabian Platform. The age of the deformation could be Late Cretaceous (Maastrichtian), but using analogues from Iran, a Palaeogene deformation also seems possible. The Avroman Formation was interpreted to be a Dachstein-type sediment, similar to the well-studied Dachstein Formation of the Northern Calcareous Alps, Austria. Rock units, with similar lithology, or identical depositional environment and macroscopic fauna, were described by numerous authors along the Neo-Tethys suture zone from Austria to Japan, and from several tectonic units along the Panthalassa margin. The implication of this correlation is important for future studies: using well-described type localities of the marine units from the Northern Calcareous Alps as a reference, it is possible to significantly extend the available background knowledge, and to gain better insight into the Triassic regional depositional environment of the Middle East.
    Type of Medium: Online Resource
    ISSN: 1025-6059
    Language: English
    Publisher: GeoScienceWorld
    Publication Date: 2015
    detail.hit.zdb_id: 2961690-6
    SSG: 13
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  • 9
    Online Resource
    Online Resource
    Akademiai Kiado Zrt. ; 2015
    In:  Orvosi Hetilap Vol. 156, No. 44 ( 2015-11), p. 1778-1781
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 156, No. 44 ( 2015-11), p. 1778-1781
    Abstract: Introduction: Palliative treatment of malignant gastroduodenal obstructions with enteral stents is an effective and safe method, and a viable alternative to gastroenterostomy. Aim: The authors present the most common malignancies behind gastroduodenal obstructions, the aspects of stent selections, insertion techniques, technical and clinical success rates, and possible procedure-related complications. Method: Between 1 March, 2013 and 9 April, 2015 nineteen patients were treated with uncovered, self-expandable enteral stents. Out of the 19 patients, 6 were females and 13 males, with an average age of 67 years. Indications of stenting were peripyloric ventricular tumour in five cases, malignancies of the duodenum, gastroenteralis anastomosis, Vater papilla and gallbladder in one case respectively, pancreatic tumor in seven cases and bile duct malignancies in three cases. Results: The technical success rate of stent placement was 100%. The evaluation of clinical success was analised on the basis of the Gastric Outlet Obstruction Scoring System. Conclusions: The use of enteral stents in malignant gastroduodenal obstructions is a reliable and safe method, which promptly decreases symptoms of the patients and improves their quality of life. Orv. Hetil., 2015, 156(44), 1778–1781.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2015
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  • 10
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 161, No. 12 ( 2020-03), p. 468-473
    Abstract: Bevezetés: A laboratóriumi vizsgálatok iránti igény fokozódik, a prevenció, a pontosabb diagnosztika, a terápia indikálásának eldöntése, a terápia eredményességének monitorozása érdekében. Célkitűzés: Elemzésünk célja az Egészségbiztosítási Alap laboratóriumi előirányzatának egészség-gazdaságtani elemzése. Adatok és módszer: Elemzésünkhöz a Nemzeti Egészségbiztosítási Alapkezelő (NEAK) finanszírozási adatbázisát használtuk. Az elemzés a 2002 és 2018 közötti időszakot öleli fel. Vizsgáltuk a laboratóriumi előirányzat éves összegét, az esetszámokat és a beavatkozások számát, a különböző tula jdonviszonyú laboratóriumi szolgáltatók részesedését az egészségbiztosítási gyógyító-megelőző kasszából. Eredmények: A laboratóriumi vizsgálatok finanszírozására rendelkezésre álló forrás 2005 és 2015 között érdemben nem változott, az időszak jelentős részében a 21–22 milliárd Ft/év sávban mozgott. Mind az esetszámban, mind a beavatkozások számában látunk érdemi visszaesést 2006 és 2008 között. Az utóbbi években az esetszám évi 14–15 millió körül, míg a beavatkozások száma évi 180 millió körül állandósult. A forprofit vállalkozások részesedése az egészségbiztosítási forrásokból a 2010. évi 29,0%-ról 2018-ban 10,6%-ra csökkent, míg az állami intézmények részesedése a 2010. évi 27,1%-ról 2018-ban 78,7%-ra nőtt. Következtetés: A laboratóriumi aktivitás az elmúlt években stabilizálódott. A szakmai szabályok esetlegesen még szükséges pontosításával, a kódok karbantartásával a laboratóriumi ellátásokra fordított összegek tovább növelhetők a most már zömében köztulajdonban lévő laboratóriumi szolgáltatók irányában. Orv Hetil. 2020; 161(12): 468–473.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    Language: Unknown
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2020
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