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Biomedical subjects

G Jermendy

Publications and source records attributed to G Jermendy.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Study of the origin of hyperglycemia in acute myocardial infarct].

In order to clarify the origin of hyperglycaemia, blood glucose, glycated haemoglobin (GHb) and protein-corrected serum fructosamine (SFA) values were simultaneously determined at admission of 65 patients with acute myocardial infarction while oral glucose tolerance test was performed later at discharge. In 29 patients no alterations in carbohydrate metabolism were found (blood glucose: 5.2 +/- 0.1 mmol/l, GHb: 4.4 +/- 0.1%, SFA: 2.20 +/- 0.08 mmol/l) while in 9 patients diabetes was already recorded in the medical history (blood glucose: 11.5 +/- 1.1 mmol/l, GHb: 7.9 +/- 0.9%, SFA: 3.36 +/- 0.31 mmol/l, p < 0.001). Undiagnosed diabetes was documented in 8 patients (blood glucose: 11.8 +/- 1.3 mmol/l, GHb: 7.3 +/- 0.6%, SFA: 3.51 +/- 0.24 mmol/l) while stress-hyperglycaemia was found in 19 patients (blood glucose: 8.4 +/- 0.3 mmol/l, GHb: 4.5 +/- 0.1%, SFA: 2.55 +/- 0.17 mmol/l). Undiagnosed diabetes could be recorded in one seventh while stress-hyperglycaemia could be found in one third of non-diabetic patients with acute myocardial infarction. Due to overlapping values SFA is not suitable to distinguish between stress-hyperglycaemia and undiagnosed diabetes in patients with acute myocardial infarction.

Adult↗
PubMed1991

[Prospective study of cardiac autonomic neuropathy in diabetes mellitus].

For assessment of clinical and prognostic values of cardiac autonomic neuropathy, 53 patients with diabetes mellitus were followed-up for five years. Parasympathetic innervation was assessed by recording heart rate variability during deep breathing, Valsalva manoeuvre and lying-to-standing while sympathetic function was evaluated by measuring postural change in systolic blood pressure. During the follow-up period 1 of 23 diabetic patients died in group without signs of cardiac autonomic neuropathy whereas 2 of 13 diabetics and 10 of 17 diabetics deceased in groups with mild and definitive signs of cardiac autonomic neuropathy, respectively. At reinvestigation, the values of tests for parasympathetic impairment worsened or did not change significantly while improvement in these tests was only exceptionally observed in 40 diabetic patients. No significant change in values of test for sympathetic function was documented during the follow-up period suggesting that parasympathetic (vagal) impairment might precede the sympathetic dysfunction during development of autonomic neuropathy in diabetic patients. No correlation was observed between changes in cardiac autonomic neuropathy and alterations in distal somatic neuropathy (assessed by measurement of motor nerve conduction velocity in peroneal nerves) during the prospective study. Definitive cardiac autonomic neuropathy--as one of the late complications of diabetes mellitus--suggests poor prognosis in diabetic patients.

Adult↗
PubMed1991

Diabetes mellitus associated with late onset congenital adrenal hyperplasia: coincidence or causality?

Diabetes mellitus and late onset congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency were observed in two female siblings aged 51 and 60 years. Not only coincidence but also causality (hyperinsulinism, glucose intolerance due to hyperandrogenism) should be considered when explaining the association of diabetes mellitus with late onset congenital adrenal hyperplasia.

Adrenal Cortex Hormones↗
PubMed1991

Correlation between oesophageal dysmotility and cardiovascular autonomic dysfunction in diabetic patients without gastrointestinal symptoms of autonomic neuropathy.

The vagal function was assessed by oesophageal scintigraphy and cardiovascular autonomic function tests in 65 diabetic patients without gastrointestinal symptoms of autonomic neuropathy and in 20 control subjects. Oesophageal radioisotope transit time was abnormal in 32% of diabetics. Values of cardiovascular function tests were normal in 34% of diabetics while definitive and early signs of cardiac autonomic neuropathy were found in 34% and 32% of diabetics, respectively. The results of oesophageal scintigraphy and cardiovascular function tests were concordant only in 54% of diabetics. Simultaneous impairment of oesophageal motility and cardiovascular (vagal) reflexes could be frequently but not uniformly observed in diabetics. Thus, vagal innervation of different organs (oesophagus and heart) might be affected to different degrees in diabetic patients.

Diabetes Mellitus, Type 1↗
PubMed1991

Cardiac autonomic neuropathy and QT interval length. A follow-up study in diabetic patients.

For evaluating the clinical significance of QT interval prolongation in diabetics with cardiac autonomic neuropathy (CAN), 53 diabetic patients were followed-up for 5 years or to death and the results of cardiovascular function tests as well as the values of QT intervals were repeatedly determined. At baseline investigation, the QTc intervals were significantly longer in diabetics with definitive (456 +/- 5 ms, mean +/- SEM, n = 17) than those with early (435 +/- 5 ms, n = 13, p less than 0.01) and without (413 +/- 4 ms, n = 23, p less than 0.001) signs of CAN or in controls (414 +/- 5 ms, n = 15, p less than 0.001). Thirteen patients died during the follow-up period (1 without, 2 with early and 10 with definitive signs of CAN) but QTc intervals did not differ significantly between patients with cardiac (456 +/- 9 ms, n = 8) and non-cardiac (459 +/- 15 ms, n = 5) causes of death. At reinvestigation of 40 patients, the severity of CAN worsened in 22 patients, remained unchanged in 15 patients and improved in 3 patients. Accordingly, the mean values of autonomic function tests decreased (beat-to-beat variation from 15 +/- 2 to 9 +/- 1 beats/min, p less than 0.01; 30:15 ratio from 1.19 +/- 0.03 to 1.09 +/- 0.02, p less than 0.01) while QTc interval increased (from 424 +/- 3 to 431 +/- 4 ms, p less than 0.01). It was concluded that CAN carries a poor prognosis in diabetic patients. Nevertheless, QTc interval prolongation could be evaluated as rather an additional sign of CAN than the only explanation for mechanism in the pathogenesis of sudden cardiac death in diabetic patients.

Adult↗
PubMed1990

[Correlations between cardiorespiratory reflex impairment and distal neuropathy in diabetics free of clinical symptoms of autonomic neuropathy].

Signs of autonomic cardiac neuropathy and its association with distal symmetrical polyneuropathy were investigated in adult diabetic patients free from clinical symptoms of autonomic neuropathy. Cardiorespiratory reflexes were assessed by non-invasive tests (deep-breathing, Valsalva manoeuvre and lying-to-standing) evaluating parasympathetic function of cardiac innervation. Measurement of motor nerve conduction velocity in both peroneal nerves and neurological physical examination were carried out for assessment of distal somatic neuropathy. Among 64 diabetics, definitive signs of cardiac autonomic neuropathy were found in 28 patients (44%), early signs of cardiac autonomic neuropathy were observed in 19 patients (30%) while no alterations were documented in 17 patients (26%). The values of motor nerve conduction velocity in peroneal nerves (41.8 +/- 0.7 m/s) were significantly (p less than 0.01) lower in patients with definitive cardiac autonomic neuropathy (n = 28) than those (45.8 +/- 1.1 m/s) of patients without any signs of cardiac autonomic neuropathy (n = 17). These latter values were, however, significantly (p less than 0.001) lower than those (53.7 +/- 0.7 m/s) of control subjects (n = 50). Abnormal results of non-invasive tests for autonomic neuropathy, i.e. alterations of cardiorespiratory reflexes indicating parasympathetic impairment in cardiac innervation could be often found in diabetics without clinical signs of autonomic neuropathy. These alterations could be frequently observed in diabetics with distal symmetrical neuropathy as well as in diabetic patients with one or more late specific complications.

Autonomic Nervous System Diseases↗
PubMed1990

Impairment of cardiorespiratory reflexes and its association with distal somatic neuropathy in diabetic patients free from clinical symptoms of autonomic neuropathy.

Signs of autonomic cardiac neuropathy and its association with distal somatic neuropathy were investigated in 36 type 1 and 28 type 2 diabetic patients free from clinical symptoms of autonomic neuropathy. Using bedside tests (deep-breathing, Valsalva manoeuvre and lying-to-standing) definitive cardiac autonomic neuropathy was found in 28 patients (44%), early cardiac autonomic neuropathy was observed in 19 patients (30%) while 17 patients (26%) showed no alterations. The values of motor nerve conduction velocity in peroneal nerves (41.8 +/- 0.7 m/s, mean +/- SEM) were significantly (p less than 0.01) lower in patients with definitive cardiac autonomic neuropathy than those (45.8 +/- 1.1 m/s) of patients without any signs of cardiac autonomic neuropathy. These latter values were, however, significantly (p less than 0.001) lower than those (53.7 +/- 0.7 m/s) of control subjects (n = 50). Signs of early or definitive cardiac autonomic neuropathy were recorded in 31 of 35 diabetic patients with distal somatic neuropathy assessed by measurement of motor nerve conduction velocity in peroneal nerves. It was concluded that abnormal results of noninvasive tests for autonomic neuropathy, i.e. alterations in cardiorespiratory reflexes indicating parasympathetic impairment of cardiac innervation could be often found in diabetic patients without clinical signs of autonomic neuropathy. These alterations could be frequently observed in diabetic patients with distal symmetrical somatic neuropathy.

Adult↗
PubMed1990

Left ventricular diastolic dysfunction in type 1 (insulin-dependent) diabetic patients during dynamic exercise.

The left ventricular diastolic and systolic functions were assessed in 27 strictly selected type 1 diabetic patients without overt heart disease and 50 age- and sex-matched control subjects. For evaluating left ventricular performance, complex mechanocardiography including digitized apexcardiography was used at rest and after symptom-limited, graded dynamic exercise. The values of diastolic/systolic time intervals and amplitude parameters did not differ significantly between the diabetic and control groups at rest. A longer value of corrected early apexcardiographic relaxation time (diabetics: 38.7 +/- 2.6 ms, controls: 17.3 +/- 2.1 ms, p less than 0.001) and a smaller normalized amplitude of relaxation (diabetics: 0.014 +/- 0.004 ms-1, controls: 0.056 +/- 0.006 ms-1, p less than 0.001) were observed after dynamic exercise suggesting disturbances of the early diastole in diabetic patients. No correlations could be found between the diastolic abnormalities and the diabetic control. Significant correlation was observed between the diastolic disorders and the duration of diabetes mellitus. Testing left ventricular performance by complex mechanocardiography including digitized apexcardiography after dynamic exercise in patients with type 1 diabetes might be useful for recognizing diastolic abnormalities even when no alterations could be identified at rest. Diastolic disorders could appear in diabetic patients without overt heart disease and clinical symptoms. Left ventricular systolic function might be normal, although exercise-induced alterations of diastolic function might already be present in type 1 diabetic patients.

Adolescent↗
PubMed1989

[Granulomatous dermatitis caused by surfen in diabetics treated with Insulin-depot-S-Richter].

Two cases of local cutaneous reaction in diabetics treated with Insulin-depot-S-Richter are reported. Intracutaneous test and histological examination revealed that the granulomatous inflammation of the skin was due to surfen. Insulin-depot-S-Richter was changed to insulin preparation free from surfen (Monotard MC, Novo) and no further local reactions could be observed in the same patients.

Delayed-Action Preparations↗
PubMed1988

Serum fructosamine (alkaline-reducing activity) for evaluation of glycemic control in diabetic patients.

The values of serum fructosamine were significantly higher in 75 diabetic patients than those of metabolically healthy controls. Significant correlation could be observed between the glycated hemoglobin and serum fructosamine values in diabetics. Furthermore, significant correlations were established between the serum fructosamine values and the mean blood glucose as well as the mean 24 hours urinary glucose values measured 10-14 days previously in diabetics. Glycated hemoglobin values should be measured in diabetics for long-term assessment of glycemic control while serum fructosamine values could be useful in clinical practice for assessment of overall glycemic control of the previous two weeks in diabetic patients. Not only long-term glycemic control but medium-term alterations in blood glucose concentrations could be evaluated by simultaneous measurements of glycated hemoglobin and serum fructosamine values in diabetics.

Adult↗
PubMed1988

Left ventricular diastolic function in diabetics.

Left ventricular diastolic function was studied in 29 young diabetic patients (aged from 14 to 44 years) without any clinical sign of heart disease. The metabolic state, the presence and the degree of microvascular and neuropathic complications have been established. Age and sex matched 32 healthy subjects served as controls. The parameters of left ventricular diastolic function were determined by means of phonomechanocardiography. By this method in diabetic patients impaired diastolic function of the left ventricle was found. This alteration could be best characterized by the values of normalized relaxation index referring to the isovolumetric relaxation of the left ventricle. A close correlation was found between the microvascular and neuropathic complications and the left ventricular diastolic dysfunction, while no correlation could be demonstrated between the metabolic state and the diastolic cardiac disorder.

Adult↗
PubMed1986

Circulating blood volumes in diabetic patients.

To examine the mechanism of cardiac dysfunction in diabetes, total circulating blood volume, cardiac and stroke volumes were measured by radioisotope method in 44 patients with type 1 and type 2 diabetes. Considerable difference in actually circulating blood volume could be demonstrated in diabetic patients, which seemed to be dependent on the control of the carbohydrate metabolism. The achievement of well controlled carbohydrate metabolism in diabetics has a great importance with special respect also to the blood volumes.

Adult↗
PubMed1986

Hepatic artery embolisation--new approach for treatment of malignant carcinoid syndrome.

A transcatheter embolisation was carried out for treatment of a patient suffering from hepatic metastases of a malignant carcinoid tumour. Recurrent and very severe carcinoid symptoms could be observed; a bronchial carcinoid supposingly the primary tumour without characteristic symptoms was removed six years before. The carcinoid symptoms became resistant to pharmacological agents and finally ended in life-threatening clinical complications. The transcatheter hepatic artery embolisation was successfully performed and repeated three months later. After embolisation relief of carcinoid symptom and a significant decrease in 5-hydroxyindole acetic acid (5-HIAA) urinary excretion lasting for eight months could be observed. There were no serious complications with adequate pharmacological cover, however, a transient fever, leucocytosis, abdominal pain and an increase in serum transaminase activities occurred after the procedure. The transcatheter hepatic artery embolisation should be a method of choice for treatment of patients with carcinoid metastases producing severe carcinoid symptoms resistant to pharmacological agents.

Carcinoid Tumor↗