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Biomedical subjects

A Székely

Publications and source records attributed to A Székely.

At least 19 recordsLinked to original sources
PubMed2001

[Postoperative depression after open heart surgery].

Rehabilitation of the patients following open heart surgery is strongly influenced by the psychological conditions. Depression plays a crucial negative role in this process. Depression score was measured in patients taking part in the rehabilitation course of our institute last year (1998), 6 weeks after discharge from the hospital. Unfortunately preoperative score was not done. Beck Depression Inventory (BI) test was used. Following factors were investigated: age, gender, cross clamp and bypass time, type of anaesthesia (propofol, isoflurane or midazolam, all combined with fentanyl), ICU stay, hospital stay, hypotension, cardioversion during hospital stay and neurological disorders. Statistical analyses were performed with forward stepwise regression and ANOVA tests. 74 patients were investigated. BI score under 10 points is considered to be normal. Depression scores were significantly affected by the gender (females: r: 0.85, p = 0.005), and the ICU stay (r: 0.76, p = 0.007). Type of anaesthesia, age, hospital stay, and neurological disorders did not affected the depression score. Our results indicate, that females and patients with longer ICU stay require special attention during the perioperative period in psychological respect.

Aged↗
PubMed2001

[Successful new method for surgery of the postinfarctional left ventricular free wall rupture].

Authors discuss a history of a 78-years old male who suffered from left ventricular free wall rupture due to acute transmural myocardial infarction. Cardiac surgical intervention was carried out immediately after the ECHO examination which established the diagnosis. First time in Hungary authors used a sutureless technique to close the rupture and utilised double component glue and synthetic patch for this purpose. The patient had uneventful recovery and remained free of symptoms throughout his three months period of follow up. Current available data and knowledge are summarised about this life threatening disease.

Aged↗
PubMed2000

The role of the sand in chemical warfare agent exposure among Persian Gulf War veterans: Al Eskan disease and "dirty dust".

The purpose of this paper is to inquire into the relationship between Al Eskan disease and the probable exposure to chemical warfare agents by Persian Gulf War veterans. Al Eskan disease, first reported in 1991, compromises the body's immunological defense and is a result of the pathogenic properties of the extremely fine, dusty sand located in the central and eastern region of the Arabian peninsula. The disease manifests with localized expression of multisystem disorder. Signs and symptoms of Al Eskan disease have been termed by the news media "Persian Gulf syndrome." The dust becomes a warfare agent when toxic chemicals are microimpregnated into inert particles. The "dirty dust" concept, that the toxicity of an agent could be enhanced by absorption into inactive particles, dates from World War I. A growing body of evidence shows that coalition forces have encountered Iraqi chemical warfare in the theater of operation/Persian Gulf War to a much greater extent than early U.S. Department of Defense information had indicated. Veterans of that war were exposed to chemical warfare agents in the form of direct (deliberate) attacks by chemical weapons, such as missiles and mines, and indirect (accidental) contamination from demolished munition production plants and storage areas, or otherwise. We conclude that the microimpregnated sand particles in the theater of operation/Persian Gulf War depleted the immune system and simultaneously acted as vehicles for low-intensity exposure to chemical warfare agents and had a modifying-intensifying effect on the toxicity of exposed individuals. We recommend recognition of a new term, "dirty sand," as a subcategory of dirty dust/dusty chemical warfare agents. Our ongoing research efforts to investigate the health impact of chemical warfare agent exposure among Persian Gulf War veterans suggest that Al Eskan disease is a plausible and preeminent explanation for the preponderance of Persian Gulf War illnesses.

Chemical Warfare Agents↗
PubMed1999

[Primary reconstruction of the common truncus arteriosus in infants, using modified pulmonary homograft].

Truncus arteriosus communis (TAC) is a complex heart disease, it presents 1% of the congenital heart defects. A 7 weeks old infant with cardiac failure was operated on with TAC. The bicuspidized (14 mm diameter) pulmonary homograft valved conduit was used to reconstruct the right ventricular outflow tract (RVOT). The sternum closure was delayed. The important points of the indications for the surgical management of TAC: 1. Management or prevention of the pulmonary hypertensive crisis. 2. Patient's age. 3. Reconstruction of the RVOT (choices: homograft, dacron valve conduit, autologous pericardial valve conduit, porcine aortic root, direct anastomosis of the pulmonary trunc to the right ventricle). The surgical management is based on the optimal combination of these three important points. This is the first successfully performed primary surgical repair of an infant with TAC using modified pulmonary homograft in Hungary.

Echocardiography↗
PubMed1998

Clinical observations with long-term atrial pacing.

Atrial pacing (AP), despite its beneficial hemodynamic and antiarrhythmic effect, is still an underused mode of stimulation. The main purpose of this study was to evaluate the long-term results of AP. Sixty four patients (pts) with sinus node disease (28 male and 36 female: mean age 54.2; range: 44-88 years), 3.2% of the total implantation at our clinic were treated with AP between 1982-96. Criteria for atrial pacing were: no AV block in the history, no AV-block during carotid sinus massage, Wenckebach point > 130/min, left atrium < 50 mm, left ventricular EF > 40%. The indication for pacing was predominant sinus bradycardia (SB) in 34 pts and tachycardia-bradycardia syndrome (TBS) in 30 pts. Pts with TBS were on antiarrhythmic treatment, while most pts with SB received no antiarrhythmic drugs. All the pts were checked up at every 3-6 month. Sixty-two pts were followed for 3-154 (mean: 67) months, two pts were lost for follow-up. Repeated lead dislodgment occurred in two pts, which made a pacing mode change necessary. Four pts died during the follow-up period for non-cardiac reasons. At the end of the follow-up period the data of 60 pts were available for evaluation (33 pts with SB, 27 pts with TBS). All the pts with SB were in sinus rhythm, and no patient developed AV block by the end of the follow-up period. Seven out of 27 pts with TBS developed chronic atrial fibrillation, 3 out of them suffered a cerebral embolism; the remaining 20 pts were in sinus rhythm, and the number of paroxysmal attacks decreased significantly, which improved their quality of life significantly. Three pts in this group developed a temporary complete AV block, which regressed with decreasing the dosage of antiarrhythmic drugs. Atrial pacing is proved to be a safe and reliable treatment for sick sinus syndrome. Proper patient selection is crucial in preventing the development of AV conduction disturbance. Atrial stimulation had a satisfactory long-term antiarrhythmic effect in pts with sick sinus syndrome (SSS).

Anti-Arrhythmia Agents↗
PubMed1997

[Endoscopic ligation of bleeding esophageal varices].

Endoscopic variceal ligation (EVL) is a new method for treating oesophageal varices, which was developed to reduce the high complication rate seen with endoscopic sclerotherapy. This technique consists of mechanical occlusion and thrombosis applying small elastic bands around the variceal channels in the distal oesophagus. We report 39 patients treated with EVL during the period from April 1995 to December 1996. The average age of patients was 50.1 years, 33 men, 6 women. Portal hypertension was caused by alcoholic liver disease in 36 patients. Seven patients died within 1 month. Varices were eradicated in 28 patients. Variceal eradication required an average of 3, 4 sessions. Active bleeding was controlled by EVL in 11 patients out of 12. Recurrent bleeding occurred in 14 out of 39 patients (35%). One oesophageal perforation occurred in connection with overtube placement. There were no other major complications. In conclusion EVL is an effective treatment for bleeding oesophageal varices.

Endoscopy↗
PubMed1997

Transfusion of platelet-rich plasma from the organ donor during cardiac transplantation.

STUDY OBJECTIVE: To evaluate whether transfusion of platelet-rich plasma from the organ donor during cardiac transplantation can influence the amount of the needed homologous blood products. DESIGN: Randomized, controlled study. SETTING: University hospital. PATIENTS: 16 ASA physical status III patients undergoing orthotopic cardiac transplantation. INTERVENTIONS: Eight patients received donor plasma, while another 8 patients served as a control group. Blood from the organ donor was acquired during cardiac explantation. Thereafter platelet-rich plasma was separated by plasmapheresis (2400 turns per minute). The plasma was then transfused to the organ recipient at the end of the cardiac transplantation. The control group received a similar amount of albumin 5%. MEASUREMENTS AND MAIN RESULTS: In the patients who received donor plasma, the platelet count increased significantly from 98,000 +/- 49,000 mm-3 to 123,000 +/- 55,000 mm-3, the postoperative requirement of packed red blood cells (PRBCs) was 5.8 +/- 4.5 units, which was significantly lower as compared to the control group (10.8 +/- 5.9 units). CONCLUSIONS: Transfusion of platelet-rich plasma from the organ donor to the recipient was confirmed to be feasible, the number of postoperatively transfused PRBCs was reduced.

Blood Transfusion↗
PubMed1995

[Hand and arm vibration syndrome caused by mechanical screw driver].

Authors performed angiological, neurological and radiological examination of 17 persons working with power screw-drivers. Vibration measurement of the tools was made too. 10 patients had symptoms and signs corresponding to the hand-arm vibration syndrome. The vibration of some tools exceeded the maximal allowable acceleration level according to ISO 5349. On the ground of the results authors conclude that some power screw-drivers can cause hand-arm vibration syndrome. The importance of choosing of the right tools and the significance of the periodical examinations are underlined in the prevention of the damages.

Adult↗
PubMed1995

[Vibration-induced Raynaud phenomenon caused by an electric hedge trimmer].

Authors observed Raynaud's phenomenon verified by cold-provocation test and measuring finger systolic blood pressure on a man working with bush cutter equipment installed on a tractor. Vibration measurements showed acceleration superior to maximal allowable level. Other causes of a secondary Raynaud's phenomenon were excluded by means of detailed internal examination. On the ground of the exposure data and lack of other ethiological factors the authors think that the patient had vibration-induced Raynaud's phenomenon. For prevention they proposed the diminishing of the daily exposure time and periodical medical examinations. They want to draw the attention for this sort of exposure.

Adult↗
PubMed1994

[Experience with long-term atrial pacing].

The aim of this study was to evaluate the long term results of atrial pacing. There were 27 atrial pacemaker implantations and 26 out of them were followed for an average of 47, 04 months. Lead dislodgement occurred in two cases, which made necessary a ventricular pacing. Three other patients developed chronic atrial fibrillation. The late results of the remaining 21 patients were very good. No AV-block occurred during the follow-up period. The atrial pacing in selected patients is safe and reliable, and financial restraints makes it advantageous for economic reason.

Aged↗
PubMed1994

[Amiodarone-induced hyperthyroidism causing progression of arrhythmia].

A case of a 38-year-old male with supraventricular paroxysmal tachycardia existing for more than a decade is reported. He has received amiodarone in a daily dose of 800 mg for three years and the tachycardia returned in 1992. New antiarrhythmic drugs were added but no beneficial effect has been achieved and moreover, a case of ventricular fibrillation occurred. The 12-lead ECG performed during tachycardia and the electrophysiological study showed orthodromic AV reentry tachycardia. Laboratory tests performed proved hyperthyreotic state. Attacks of paroxysmal tachycardia were returned and aggravated by the hyperthyreosis induced by amiodarone. Finally, antiarrhythmic drugs were discontinued and methimazol was introduced. Gradually, the patient become asymptomatic within two months. The most important conclusion of the case reported, that the amiodarone induced hyperthyreosis can be subclinical or obscure. Consequently, a regular control of serum thyreoid hormone levels at least twice a year on patients with long term amiodarone administration should be advised.

Adult↗
PubMed1994

The combined cardiovascular effect of alcohol and noise in rats.

Groups of 20 CFY male rats were made to drink water containing 10% alcohol and 5% sugar or 5% sugar. Half of both groups (10-10 animals) were exposed to 95 dBAeq mixed industrial noise for 3 weeks, 6 hours daily. Haemodynamic measurements were carried out using isotope (57Co) labelled microspheres, which were repeated after the i.v. administration of 30 micrograms/kg/3 min noradrenaline, using a second isotope (113Sn). It was found, that alcohol decreased the cardiac fraction of the cardiac output, the nutritive blood flow of the myocardium and increased the vascular resistance of the adrenals. Noise decreased the lung fraction of the cardiac output and the hepatic blood flow. Interaction between noise and alcohol, inhibiting the effect of alcohol, was demonstrated on the intestinal blood flow, adrenal fraction of cardiac output and testicular vascular resistance. The haemodynamic effects of noradrenaline observed in the control were in several organs more or less modified in the animals treated with alcohol or noise or both. It was concluded that the exposures (alcohol, noise or both) modify the alpha-adrenergic effect of noradrenaline.

Adrenal Glands↗
PubMed1993

[Dual-chamber rate responsive cardiac pacing].

The authors describe in this report their first experience with the implantation of a rate responsive, dual chamber pacemaker. They emphasize the advantages of this type of pacemakers: the maintenance of AV-synchrony and the rate increase in response to exercise. Meanwhile they call attention on the complexity of the ECG interpretation.

Adult↗
PubMed1991

[ A case of successfully treated duodenal hemangioma].

In some cases the radical removal of gastrointestinal hemangiomas involves an excessive risk or too extensive operation. Consequently some other solution has to be applied. At our patient with duodenum haemangioma the combination of angiographic embolism and endoscopic sclerotization was successfully employed.

Adolescent↗
PubMed1991

[Vascular ring and pulmonary loop: experience with the surgical treatment].

Operation was carried out on 143 children (aged from 5 days to 16 years) for tracheobronchial obstruction caused by vascular rings. A double arch of the aorta was found in 50 patients, double arch of the aorta with atresia of the left arch--in 50 patients, right arch of the aorta with ligamentum arteriosum--in 30, left arch of the aorta with an aberrant right subclavian artery--in 10, and a pulmonary loop in 3 patients. Stridor was the main clinical manifestation of the vascular ring. The diagnosis was established by means of two-projection chest radiography and esophagography with a barium meal, bronchoscopy, and angiography. The surgical approach was gained through a posterolateral (left or right) thoracotomy. No deaths occurred during the operation. Two infants died in the postoperative period from a severe bacterial infection of the respiratory tract. On the basis of a rich clinical experience the authors came to the conclusion that the presence of a right aortic arch (except for cases with situs inversus) is always pathognomic because it either causes the appearance of a vascular ring without any intracardiac anomaly, or it may be combined with a congenital heart disease in which a vascular ring is usually not encountered (tetralogy of Fallot, truncus arteriosus communis, etc.). The authors never encountered atresia of a segment of the right aortic arch. The last-named was either patent or absent.

Abnormalities, Multiple↗
PubMed1990

[Implanting an atrial pacemaker].

Twelve single chamber atrial demand (AAI) pacemakers have been implanted for the control of the symptomatic sick sinus syndrome and hypersensitive carotis sinus syndrome at the Postgraduate Medical University during the last year. The patient selection was based upon the long-term monitoring and the electrophysiological studies. In the presence of the intact atrioventricular conduction the "pysiological" pacing has been maintained using "J" shaped endocavital atrial electrodes being connected with simple or multiprogrammable generators. Late AV block was not observed. Authors propose the spreading of AAI stimulation due to its hemodynamical advantages comparing with VVI pacing.

Aged↗
PubMed1989

[The effect of a fiber-rich diet on the postprandial blood sugar level in diabetics].

The effect on the postprandial blood sugar level of a müzli prepared from dry fruits and rough ground grain flakes of rich ballast material content has been examined in insulin non-dependent and dependent diabetic patients. In random order the patients consumed in the morning for 3 days test food of rich and for 3 days of poor roughage content. In insulin non-dependent patients the blood sugar concentration was significantly lower 1-2 hours following the meal than after the consumption of a traditional food of poor roughage content. No significant change of the blood sugar concentration was observed in insulin dependent diabetic patients. Food of rich roughage content is suitable for the moderation of the postprandial blood sugar peak in insulin non-dependent diabetes.

Blood Glucose↗