Less invasive surfactant administration techniques, together with nasal continuous airway pressur... more Less invasive surfactant administration techniques, together with nasal continuous airway pressure (LISA-nCPAP) ventilation, an emerging noninvasive ventilation (NIV) technique in neonatology, are gaining more significance, even in extremely premature newborns (ELBW), under 27 weeks of gestational age. In this review, studies on LISA-nCPAP are compiled with an emphasis on short- and long-term morbidities associated with prematurity. Several perinatal preventative and therapeutic investigations are also discussed in order to start integrated therapies as numerous organ-saving techniques in addition to lung-protective ventilations. Two thirds of immature newborns can start their lives on NIV, and one third of them never need mechanical ventilation. With adjuvant intervention, these ratios are expected to be increased, resulting in better outcomes. Optimized cardiopulmonary transition, especially physiologic cord clamping, could have an additively beneficial effect on patient outcomes ...
Bevezetes: A vilagirodalomban 1989 ota szamolnak be olyan renopulmonalis szindromas betegekről, a... more Bevezetes: A vilagirodalomban 1989 ota szamolnak be olyan renopulmonalis szindromas betegekről, akiknel mind az antiglomerularis bazalmembran, mind az antineutrofil citoplazmatikus antitest kimutathato. Celkitűzes: A szerzők celja az volt, hogy az intezetukben előfordult „kettős pozitiv” eseteket felkutassak, adataikat feldolgozzak es osszehasonlitsak az irodalomban leirtakkal. Modszer: Az elmult 16 evben 87 antineutrofil citoplazmatikus antitest pozitiv vasculitises es 11 antiglomerularis bazalmembran antitest pozitiv beteget kezeltek, kozuluk negy betegben (36%) volt az antineutrofil citoplazmatikus antitest is kimutathato (ket antimieloperoxidaz-, ket antiproteinaz-3-pozitivitas). Eredmenyek: A csak antiglomerularis bazalmembran antitest pozitiv betegekkel szemben a kettős pozitiv betegekre magasabb atlageletkor (46 vs. 24 ev), a ferfi dominancia hianya (50% vs. 71%), megelőző extrarenalis tunetek gyakoribb jelenlete (50% vs. 0%), alacsonyabb antiglomerularis bazalmembran antites...
Hemodiafiltration (HDF) during chronic renal replacement therapy (RRT) is a relatively new practi... more Hemodiafiltration (HDF) during chronic renal replacement therapy (RRT) is a relatively new practice phenomenon, emerging over the last two decades. While the technological platforms utilized during chronic RRT are in many cases similar or effectively identical to conventional hemodialysis (HD), significant differences may emerge in daily practice. Several authors of this review moved practice site between the United States and the European Union and transitioned from an HD-based practice to predominantly HDF-practicing networks. In doing so, we became keenly aware of the potential pitfalls nephrologists may be facing during such transitions. This brief review is intended to provide a succinct overview of several practical concerns and complications nephrologists may encounter in daily practice of end-stage renal disease care, including but not limited to management of electrolytes, renal anemia and treatment goals and settings during HDF.
There's a fact, that Hungary has held the first places in suicidal statstics. The authors stu... more There's a fact, that Hungary has held the first places in suicidal statstics. The authors studied toxicological cases between 1989 and 1998 at the 1st Department of Medicine of the Medical and Health Science Centre, at the University of Debrecen, paying special attention to suicidal poisoning cases. 2% of the patient turnover accounted for acute poisoning cases, the number of which increased during the 10 years in question. 70% of the cases were of suicidal intentions, 20% were unintentional, these poisonings were not committed on purpose, while the proportion of iatrogenic intoxication cases was 10%. Amongst the failed suicide cases there was a higher proportion of women, whereas a higher percentage of men accounted for "successful" suicide cases. When examining auto-intoxication cases it turned out that the medicine most frequently used was meprobamate, besides benzodiazepines. Mortality rate was highest in the glutethimide intoxication cases. Most poisonings with su...
Renal transplantation (RTx) is the treatment of choice for end-stage renal failure, but these pat... more Renal transplantation (RTx) is the treatment of choice for end-stage renal failure, but these patients are increasingly older and have additional conditions leading to high mortality after RTx. The aim of our study was to validate a Spanish prognostic function that estimates survival in Hungarian renal transplant recipients. We estimated the 5-year survival of 339 patients who received a cadaver kidney between 1 January 1991 and 15 September 2004 at the Center of Transplantation, Medical and Health Science Centre, University of Debrecen, and who were followed up until death or 15 September 2009. To assess the calibration, we used the Hosmer-Lemeshow test to compare the observed and expected numbers of deaths in the deciles of the predicted 5-year risk of death. Additionally, we applied a smoother to obtain a nonparametric estimate of the 5-year cumulative incidence of death by robust locally weighted regression. To describe the discriminative power of the function, we calculated the area under the receiver operating characteristic (ROC) curve. The range of the estimated 5-year risk of death was 7%-100%. In the high-risk groups, the function severely overestimated the risk of death. The area under the ROC curve was 0.65 (95% confidence interval, 0.60-0.70). The poor performance of the prognostic function studied limits its clinical applicability.
Introduction: Patients with renopulmonary syndrome who have both anti-neutrophil cytoplasmic and ... more Introduction: Patients with renopulmonary syndrome who have both anti-neutrophil cytoplasmic and anti-glomerular basement membrane antibodies have been described since 1989. Aim: The aim of the authors was to analyse the data of “double positive” patients diagnosed in their department, and compare these with previous studies. Method: During the last 16 years, 87 anti-neutrophil cytoplasmic antibody positive and 11 anti-glomerular basement membrane antobody positive patients were diagnosed. Four patients with anti-glomerular basement membrane antibodies (36%) had detectable anti-neutrophil cytoplasmic antibodies, 2 patients were positive for anti-myeloperoxidase and 2 patients for anti-proteinase 3. Results: In comparison with patients having anti-glomerular basement membrane antibodies, the double-positive patients were characterized by older age (median of 46 vs. 24 years), lack of male dominance (50% vs. 71%), more frequent presence of previous extrarenal symptoms (50% vs. 0%), an...
Less invasive surfactant administration techniques, together with nasal continuous airway pressur... more Less invasive surfactant administration techniques, together with nasal continuous airway pressure (LISA-nCPAP) ventilation, an emerging noninvasive ventilation (NIV) technique in neonatology, are gaining more significance, even in extremely premature newborns (ELBW), under 27 weeks of gestational age. In this review, studies on LISA-nCPAP are compiled with an emphasis on short- and long-term morbidities associated with prematurity. Several perinatal preventative and therapeutic investigations are also discussed in order to start integrated therapies as numerous organ-saving techniques in addition to lung-protective ventilations. Two thirds of immature newborns can start their lives on NIV, and one third of them never need mechanical ventilation. With adjuvant intervention, these ratios are expected to be increased, resulting in better outcomes. Optimized cardiopulmonary transition, especially physiologic cord clamping, could have an additively beneficial effect on patient outcomes ...
Bevezetes: A vilagirodalomban 1989 ota szamolnak be olyan renopulmonalis szindromas betegekről, a... more Bevezetes: A vilagirodalomban 1989 ota szamolnak be olyan renopulmonalis szindromas betegekről, akiknel mind az antiglomerularis bazalmembran, mind az antineutrofil citoplazmatikus antitest kimutathato. Celkitűzes: A szerzők celja az volt, hogy az intezetukben előfordult „kettős pozitiv” eseteket felkutassak, adataikat feldolgozzak es osszehasonlitsak az irodalomban leirtakkal. Modszer: Az elmult 16 evben 87 antineutrofil citoplazmatikus antitest pozitiv vasculitises es 11 antiglomerularis bazalmembran antitest pozitiv beteget kezeltek, kozuluk negy betegben (36%) volt az antineutrofil citoplazmatikus antitest is kimutathato (ket antimieloperoxidaz-, ket antiproteinaz-3-pozitivitas). Eredmenyek: A csak antiglomerularis bazalmembran antitest pozitiv betegekkel szemben a kettős pozitiv betegekre magasabb atlageletkor (46 vs. 24 ev), a ferfi dominancia hianya (50% vs. 71%), megelőző extrarenalis tunetek gyakoribb jelenlete (50% vs. 0%), alacsonyabb antiglomerularis bazalmembran antites...
Hemodiafiltration (HDF) during chronic renal replacement therapy (RRT) is a relatively new practi... more Hemodiafiltration (HDF) during chronic renal replacement therapy (RRT) is a relatively new practice phenomenon, emerging over the last two decades. While the technological platforms utilized during chronic RRT are in many cases similar or effectively identical to conventional hemodialysis (HD), significant differences may emerge in daily practice. Several authors of this review moved practice site between the United States and the European Union and transitioned from an HD-based practice to predominantly HDF-practicing networks. In doing so, we became keenly aware of the potential pitfalls nephrologists may be facing during such transitions. This brief review is intended to provide a succinct overview of several practical concerns and complications nephrologists may encounter in daily practice of end-stage renal disease care, including but not limited to management of electrolytes, renal anemia and treatment goals and settings during HDF.
There's a fact, that Hungary has held the first places in suicidal statstics. The authors stu... more There's a fact, that Hungary has held the first places in suicidal statstics. The authors studied toxicological cases between 1989 and 1998 at the 1st Department of Medicine of the Medical and Health Science Centre, at the University of Debrecen, paying special attention to suicidal poisoning cases. 2% of the patient turnover accounted for acute poisoning cases, the number of which increased during the 10 years in question. 70% of the cases were of suicidal intentions, 20% were unintentional, these poisonings were not committed on purpose, while the proportion of iatrogenic intoxication cases was 10%. Amongst the failed suicide cases there was a higher proportion of women, whereas a higher percentage of men accounted for "successful" suicide cases. When examining auto-intoxication cases it turned out that the medicine most frequently used was meprobamate, besides benzodiazepines. Mortality rate was highest in the glutethimide intoxication cases. Most poisonings with su...
Renal transplantation (RTx) is the treatment of choice for end-stage renal failure, but these pat... more Renal transplantation (RTx) is the treatment of choice for end-stage renal failure, but these patients are increasingly older and have additional conditions leading to high mortality after RTx. The aim of our study was to validate a Spanish prognostic function that estimates survival in Hungarian renal transplant recipients. We estimated the 5-year survival of 339 patients who received a cadaver kidney between 1 January 1991 and 15 September 2004 at the Center of Transplantation, Medical and Health Science Centre, University of Debrecen, and who were followed up until death or 15 September 2009. To assess the calibration, we used the Hosmer-Lemeshow test to compare the observed and expected numbers of deaths in the deciles of the predicted 5-year risk of death. Additionally, we applied a smoother to obtain a nonparametric estimate of the 5-year cumulative incidence of death by robust locally weighted regression. To describe the discriminative power of the function, we calculated the area under the receiver operating characteristic (ROC) curve. The range of the estimated 5-year risk of death was 7%-100%. In the high-risk groups, the function severely overestimated the risk of death. The area under the ROC curve was 0.65 (95% confidence interval, 0.60-0.70). The poor performance of the prognostic function studied limits its clinical applicability.
Introduction: Patients with renopulmonary syndrome who have both anti-neutrophil cytoplasmic and ... more Introduction: Patients with renopulmonary syndrome who have both anti-neutrophil cytoplasmic and anti-glomerular basement membrane antibodies have been described since 1989. Aim: The aim of the authors was to analyse the data of “double positive” patients diagnosed in their department, and compare these with previous studies. Method: During the last 16 years, 87 anti-neutrophil cytoplasmic antibody positive and 11 anti-glomerular basement membrane antobody positive patients were diagnosed. Four patients with anti-glomerular basement membrane antibodies (36%) had detectable anti-neutrophil cytoplasmic antibodies, 2 patients were positive for anti-myeloperoxidase and 2 patients for anti-proteinase 3. Results: In comparison with patients having anti-glomerular basement membrane antibodies, the double-positive patients were characterized by older age (median of 46 vs. 24 years), lack of male dominance (50% vs. 71%), more frequent presence of previous extrarenal symptoms (50% vs. 0%), an...
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