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1.
Orv Hetil ; 160(34): 1335-1339, 2019 Aug.
Artigo em Húngaro | MEDLINE | ID: mdl-31423830

RESUMO

Introduction: Uveitis is characterized by inflammation of the middle layer of the eye. Its overall incidence is low. Autoimmune diseases and infections are the most common underlying diseases. Out of the autoimmune diseases, juvenile idiopathic arthritis is associated most frequently with uveitis. The topical ophthalmological treatment may fail in a significant proportion of the patients and immunomodulatory therapy may be required. Aim and method: In a retrospective study, data of 33 children diagnosed and treated with uveitis at the Department of Pediatrics and Ophthalmology, University of Pécs during the last 5 years were collected and analyzed. Results: The mean age of the patients was 9.3 (0.3-17.8) years. Boys and girls were equally affected with an exception of patients with juvenile idiopathic arthritis where female predominance was found. An underlying disease could be identified in 60% of the cases (20/33). Uveitis was associated in 12 patients with juvenile idiopathic arthritis, in 2 patients with Behcet's disease and in a single case with inflammatory bowel disease. Infections have been proven in 5 patients. The autoimmune diseases caused an eye inflammation typically in anterior localization, in contrast to the infections that resulted in posterior uveitis. The majority of the patients required systemic treatment. 3 of them received systemic corticosteroid and 18 patients methotrexate as disease-modifying antirheumatic drug. 13 children with severe disease activity required biological therapy (adalimumab injection). Remission could be achieved in 1.45 (0.75-2.5) months. Conclusion: Pediatric uveitis is of great importance. Early diagnosis, adequate therapy and follow-up require multidisciplinary cooperation. Orv Hetil. 2019; 160(34): 1335-1339.


Assuntos
Adalimumab/uso terapêutico , Artrite Juvenil/complicações , Terapia Biológica , Fatores Imunológicos/uso terapêutico , Imunomodulação , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Adolescente , Antirreumáticos/uso terapêutico , Artrite Juvenil/tratamento farmacológico , Criança , Pré-Escolar , Feminino , Glucocorticoides/uso terapêutico , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Uveíte/complicações , Uveíte/etiologia
2.
Orv Hetil ; 160(32): 1270-1278, 2019 Aug.
Artigo em Húngaro | MEDLINE | ID: mdl-31387373

RESUMO

Introduction: During recent decades, the perinatal mortality of extremely low-birth weight infants has decreased. An important task is to recognize complications of prematurity. Aim: We made an attempt to explore the relationship between complications of prematurity and neonatal hyperglycemia. Method: From 1 January 2014 to 31 December 2017, 188 infants with birth weight below 1000 g were admitted. For each infant, the frequencies of hyperglycemia (blood glucose >8.5 mmol/l), retinopathy of prematurity, intraventricular hemorrhage, and bronchopulmonary dysplasia were determined. Animal studies were performed in Sprague Dawley rats. Hyperglycemia was achieved by intraperitoneal injection of streptozotocin (100 mg/kg). On the 7th day of life, aorta sections were prepared and stained with hematoxylin eosin. Wall thickness was measured using QCapture Pro 7 image analysis software. Results: The mean ± SD gestational age and birth weight were 27.1 ± 2.2 weeks and 814.9 ± 151.9 g; 33 infants (17.5%) died. Hyperglycemia was confirmed in 62 cases (32.9%), and insulin treatment was given to 43 infants (22.8%). The gestational age and birth weight of the hyperglycemic infants were significantly lower (p<0.001), the incidence of severe retinopathy (p = 0.012) and the mortality of insulin-treated patients were higher (p = 0.02) than in normoglycemic infants. Among survivors (n = 155), we found by logistic regression analysis that hyperglycemia was a risk factor for severe retinopathy (p<0.001). In the rat model, neonatal hyperglycemia caused significant thickening of the aortic wall. Conclusion: Our studies indicate that hyperglycemia is common in extremely low birth-weight infants. Monitoring of these infants for retinopathy of prematurity, kidney dysfunction, and hypertension is recommended. Orv Hetil. 2019; 160(32): 1270-1278.


Assuntos
Diabetes Mellitus Experimental , Hiperglicemia , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Doenças do Prematuro , Retinopatia da Prematuridade/etiologia , Animais , Peso ao Nascer , Displasia Broncopulmonar/epidemiologia , Hemorragia Cerebral Intraventricular/epidemiologia , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/tratamento farmacológico , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Gravidez , Ratos , Ratos Sprague-Dawley , Retinopatia da Prematuridade/epidemiologia
3.
J Mol Neurosci ; 43(1): 51-7, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20521124

RESUMO

The retina is constantly exposed to ultraviolet (UV) light with different wavelengths, which may lead to chronic UV-induced retinal injury. In our previous studies, we have shown the protective effects of pituitary adenylate cyclase activating polypeptide (PACAP) in toxic and ischemic retinal injuries. The aim of the present study was to investigate the effects of PACAP in UV-A-induced retinal lesion. We used diffuse UV-A radiation (315-400 nm) to induce acute retinal damage over a short period of exposure. Using standard histological (morphological and morphometrical) analysis, we assessed the actions of intravitreal PACAP (100 pmol/5 µl) treatment on acute UV-A-induced retinal damage. We measured the thickness of nuclear and plexiform layers as well as the number of cells in the outer nuclear and inner nuclear layers and in the ganglion cell layer. Outer limiting membrane-inner limiting membrane distances in the cross-section of the retina were also examined. Our results show that UV-A light-induced retinal damage led to severe degeneration in the photoreceptor layer, and in the outer and inner nuclear layers. Alteration in the plexiform layers was also observed. We found that post-irradiation PACAP treatment significantly attenuated the UV-A-induced retinal damage. Our results provide the basis for future clinical application of PACAP treatment in retinal degeneration and may have clinical implications in several ophthalmic diseases.


Assuntos
Polipeptídeo Hipofisário Ativador de Adenilato Ciclase , Retina , Degeneração Retiniana/tratamento farmacológico , Degeneração Retiniana/etiologia , Raios Ultravioleta/efeitos adversos , Animais , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/farmacologia , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/uso terapêutico , Ratos , Ratos Wistar , Retina/efeitos dos fármacos , Retina/patologia , Retina/efeitos da radiação , Degeneração Retiniana/patologia
4.
Neonatology ; 95(4): 267-70, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-18984966

RESUMO

BACKGROUND: Hyperglycemia is a common complication of prematurity, which requires attention because of its high prevalence and multiple consequences. Serum fructosamine used in diabetic patients provides information about the average glucose concentration in the preceding period of 2-3 weeks. OBJECTIVE: We investigated the physiologic characteristics of a glycemic marker, fructosamine, in preterm and term neonates. We also studied its association with hyperglycemia and related morbidities of preterm infants. METHOD: Fructosamine levels of 22 extremely premature (gestational age, GA: 25.8 +/- 1.0 weeks), 36 moderately premature (GA: 29.8 +/- 1.3 weeks) and 26 term infants (GA: 39.1 +/- 1.3 weeks) were determined in the 1st week of life. Fructosamine assay was repeated in all preterm neonates in the 4th and 7th postnatal weeks. Hyperglycemic episodes and main morbidities of preterm infants were recorded and analyzed in association with fructosamine levels. RESULTS: Preterm infants had higher fructosamine levels after birth compared to term infants and a postnatal fall was observed. Serum fructosamine did not show association with the occurrence of hyperglycemia or its main morbidities in preterm infants. CONCLUSION: In the framework of our study, we could not confirm the usefulness of fructosamine determination in the glycemic control of preterm neonates during the perinatal period.


Assuntos
Frutosamina/sangue , Hiperglicemia/sangue , Hiperglicemia/diagnóstico , Recém-Nascido/sangue , Recém-Nascido Prematuro/sangue , Biomarcadores/sangue , Glicemia/metabolismo , Estudos de Casos e Controles , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Incidência , Masculino
5.
J Mol Neurosci ; 36(1-3): 321-9, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18421426

RESUMO

Pituitary adenylate cyclase activating polypeptide (PACAP) is widely distributed in ocular tissues, including the lacrimal gland. PACAP has been shown to influence the activity of several exocrine glands, but its effects on the composition of the tear film are not known yet. Similarly, the presence of PACAP has already been shown in the inner ear, but it is not known whether PACAP influences the composition of the endolymph. The aim of the present study was to investigate whether systemic injection of PACAP has any modulatory effects on the protein composition of the tear film and endolymph using chip electrophoresis and mass spectrometry analysis. Tear and endolymph samples were collected from rats and chickens, respectively, at various time points after systemic injection of PACAP. Fluid samples were further processed for chip electrophoretic studies. No difference was found in the protein composition of the endolymph between control and PACAP-treated animals. In contrast, tear samples showed a marked difference after PACAP treatment. Proteins in the molecular range 50-70 kDa, which showed a different chip electropherogram profile in every PACAP-treated sample, were further analyzed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. PACAP treatment induced a repression in certain keratins, while others were induced after PACAP injection. Furthermore, PACAP treatment decreased aldehyde dehydrogenase expression. The present study provides a base for further studies on the in vivo effects of PACAP on the composition of tear film. These investigations may have important clinical relevance because of the noninvasive sample collection, the correlation between tear proteins and ocular diseases, and the possible presence of biomarkers for both ophthalmological and systemic pathological conditions.


Assuntos
Orelha Interna/efeitos dos fármacos , Endolinfa/química , Aparelho Lacrimal/efeitos dos fármacos , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/farmacologia , Proteínas/análise , Lágrimas/química , Animais , Galinhas , Dados de Sequência Molecular , Ratos , Ratos Wistar
6.
Graefes Arch Clin Exp Ophthalmol ; 246(1): 161-5, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17674019

RESUMO

PURPOSE: To identify the prognostic factors concerning the anatomy and visual acuity of eyes subject to trauma related posterior intraocular foreign body. PATIENTS AND METHODS: The records of 28 eyes of 27 patients who underwent pars plana vitrectomy and intraocular foreign body removal during a 5 year period were retrospectively reviewed. Ocular trauma score was calculated for each eye. RESULTS: The most common initial findings were corneal wound (68%), lens injury (50%), retinal lesion (50%), vitreous hemorrhage (25%), and endophthalmitis (14%). Multiple foreign body causing perforating injury with retained posterior segment foreign body occurred in 7% of the cases. The foreign body was found on the surface of the retina in 39% of the cases. Postoperative complications were retinal detachment (46%), proliferative vitreoretinopathy (25%), and phthysis (4%). No eye was enucleated and 1 eye (4%) lost light perception. The final best corrected visual acuity became better or equal to 0.5 Snellen E in 34% of the eyes. The mean follow-up was 19 months (1.5-60 months). CONCLUSIONS: Prognosis was significantly worse in cases with lower trauma score, initial visual acuity less than 0.1 Snellen E, large foreign body, upset of bacterial endophthalmitis, and with proliferative vitreo-retinopathy. Visual outcomes in our cases were better than estimated follow-up visual acuity based on ocular trauma score parameters.


Assuntos
Corpos Estranhos no Olho/diagnóstico , Ferimentos Oculares Penetrantes/diagnóstico , Retina/lesões , Adolescente , Adulto , Idoso , Lesões da Córnea , Endoftalmite/diagnóstico , Corpos Estranhos no Olho/classificação , Corpos Estranhos no Olho/cirurgia , Ferimentos Oculares Penetrantes/classificação , Ferimentos Oculares Penetrantes/cirurgia , Humanos , Cristalino/lesões , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índices de Gravidade do Trauma , Acuidade Visual , Vitrectomia , Hemorragia Vítrea/diagnóstico
7.
Orv Hetil ; 148(48): 2279-84, 2007 Dec 02.
Artigo em Húngaro | MEDLINE | ID: mdl-18039619

RESUMO

Extremely preterm infants [gestational age (GA) between 24-28 weeks] should be delivered optimally in an institute where neonatal intensive care unit (NICU) is available and their short- and long-term care is ensured. At the Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7499 infants were born between 1st of January, 2000 and 31st of December, 2004. During this period the rate of preterm deliveries was 20% (1499/7499). Among preterm infants the incidence of extremely preterm babies (GA 28 weeks or less) was 18% (272/1499), the rate of profoundly preterm infants (GA less than 25 weeks) was 3.2% (48/1499). Advancing with gestational age the survival rate is increasing. At the department, the rate of handicapped infants among extremely premature babies was 15.3%. The majority of the handicapped infants were profoundly preterm, meanwhile, more than 50% of infants born at the 26 gestational weeks were free of symptoms influencing social activities. It is important to stress the prognostic value of the screening for hearing loss (otoacoustic emission), visual problems, and intracranial bleeding for the early detection and cure of the possible complications of prematurity.


Assuntos
Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/epidemiologia , Idade Gestacional , Recém-Nascido Prematuro , Expectativa de Vida , Anormalidades Múltiplas/economia , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Humanos , Hungria/epidemiologia , Recém-Nascido , Hemorragias Intracranianas/diagnóstico , Hemorragias Intracranianas/epidemiologia , Masculino , Programas de Rastreamento/métodos , Emissões Otoacústicas Espontâneas , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia
8.
Orv Hetil ; 148(19): 897-905, 2007 May 13.
Artigo em Húngaro | MEDLINE | ID: mdl-17478405

RESUMO

UNLABELLED: Encephalopathy, recurrent occlusion of retinal arteries and hearing loss comprise the clinical picture of Susac's syndrome. The correct diagnosis is frequently missed because of incomplete clinical signs or negligence of previous symptoms. Early diagnosis and treatment can halt the progression and prevent permanent disability. METHODS: Here, we describe a Hungarian case and review the clinical characteristics, diagnostic procedures and current concepts of therapy. RESULTS: A 30-year-old female was admitted to our neurology department because of change in her personality, apathy, and difficulty in concentration. Brain MRI indicated multiple hyperintense T2-weighted lesions including cerebellum and corpus callosum. Protein content of the CSF was markedly elevated. The recurrent bilateral loss of vision and hearing along with migraine in her previous 2,5-year-long medical history suggested Susac's syndrome. Fundoscopy and fluorescein angiography indicated multiple occlusions of the retinal arteries, audiography revealed bilateral hearing loss. Systemic autoimmune and connective tissue diseases and thrombophilia were excluded. The markedly elevated protein in the cerebrospinal fluid supported Susac's syndrome. Chronic treatment with methylprednisolone resulted in remission of clinical signs. DISCUSSION: Consideration of multiple clinical signs is an important key to the diagnosis of rare clinical entities like Susac's syndrome.


Assuntos
Encefalopatias/diagnóstico , Perda Auditiva/diagnóstico , Oclusão da Artéria Retiniana/diagnóstico , Transtornos da Visão/diagnóstico , Adulto , Audiometria , Encefalopatias/patologia , Diagnóstico Diferencial , Feminino , Angiofluoresceinografia , Cefaleia/etiologia , Humanos , Hungria , Comunicação Interdisciplinar , Angiografia por Ressonância Magnética , Imagem por Ressonância Magnética , Oclusão da Artéria Retiniana/complicações , Síndrome , Transtornos da Visão/etiologia
9.
Biol Neonate ; 89(1): 56-9, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16155387

RESUMO

Retinopathy of prematurity (ROP) is a multifactorial vasoproliferative retinal disorder that increases in incidence with decreasing gestational age. Recently, an association between hyperglycemia and severe ROP was found in extremely low birth weight infants (ELBWI). The purpose of this study was to evaluate the possible relation between hyperglycemia and ROP at any stage in very low birth weight infants (VLBWI). We analyzed the data of 201 VLBWI. The incidence of ROP and hyperglycemia was detected and the chi2 test was applied to investigate the association between the two variables. The Clinical Risk Index for Babies (CRIB) score was attributed as a marker of illness severity. The incidence of ROP and hyperglycemia in VLBWI was 35.3 and 19.4%, respectively. ROP developed more frequently in hyperglycemic infants (p < 0.001). The gestational age, birth weight, and Apgar scores were significantly lower, the CRIB score was higher in ROP patients. In hyperglycemic ROP patients the CRIB score was significantly higher compared to euglycemic ROP patients (mean (SD) 8.1 (4.2) vs. 5.5 (3.3); p < 0.01). A logistic regression model revealed that gestational age (OR 0.59; 95% CI 0.46-0.76; p < 0.001) and hyperglycemia (OR 3.15; 95% CI 1.12-8.84; p < 0.05) are independent risk factors in ROP development. When ELBWI were analyzed separately, gestational age (OR 0.38; 95% CI 0.20-0.72; p < 0.01) and CRIB score (OR 1.58; 95% CI 1.02-2.45; p < 0.05) were found as significant contributors. Further studies are needed to elucidate the pathophysiological role of hyperglycemia in the development of vasoproliferative retinal disorder.


Assuntos
Hiperglicemia/complicações , Doenças do Prematuro , Recém-Nascido de muito Baixo Peso , Retinopatia da Prematuridade/complicações , Índice de Apgar , Peso ao Nascer , Idade Gestacional , Humanos , Hiperglicemia/epidemiologia , Recém-Nascido , Modelos Logísticos , Retinopatia da Prematuridade/epidemiologia
10.
Colloids Surf B Biointerfaces ; 45(3-4): 125-30, 2005 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-16199146

RESUMO

Implantation of artificial intraocular lenses into the eye during ophthalmic surgical procedures ensures an unliving surface on which bacterial pathogens may attach and form biofilms. Despite antibiotic treatment bacteria growing in biofilms might cause inflammation and serious complications. In this study the adhesive ability of 7 Staphylococcus aureus and 11 coagulase-negative Staphylococcus (CNS) strains to the surface of acrylic intraocular lenses had been examined by the ultrasonic method. In untreated cases adhesion of the S. aureus and CNS strains did not differ significantly. We could not demonstrate significant differences between the adhesive ability of the standard strains and the clinical isolates. In this study a single--60 min long--antibiotic (ciprofloxacin and tobramycin) treatment had been applied, that correlate well with the single or intermittant antibiotic prophylaxis of patients. Ciprofloxacin administration was able to reduce significantly the number of attached cells on the surface of acrylic lenses both in the case of S. aureus and CNS strains. Dependence of the effect from concentration could also be demonstrated. Tobramycin treatment was able to inhibit significantly the attachment of S. aureus cells. Despite the debate on antibiotic prophylaxis we presented in our experiments that a single antibiotic administration can decrease the attachment of bacterial cells to the surface of acrylic intraocular lenses, and might be effective in the prevention of postoperative endophthalmitis, that is a rare but serious complication of ophthalmic surgery.


Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Aderência Bacteriana/efeitos dos fármacos , Lentes Intraoculares , Bactérias/crescimento & desenvolvimento , Relação Dose-Resposta a Droga , Técnicas In Vitro , Lentes Intraoculares/microbiologia , Testes de Sensibilidade Microbiana , Propriedades de Superfície
11.
Orv Hetil ; 144(22): 1085-90, 2003 Jun 01.
Artigo em Húngaro | MEDLINE | ID: mdl-12847818

RESUMO

INTRODUCTION: Hemorheological factors are of significance in the determination of flow characteristics of blood and play an important role in the pathogenesis of cerebrovascular diseases. AIMS AND METHODS: In this study the changes of rheological factors--hematocrit (Hct), plasma fibrinogen concentration (PFC), whole blood (WBV) and plasma viscosity (PV), red blood cell aggregation (AI) and deformability and the association between these parameters and cardiovascular risk factors were investigated in 297 patients (173 males, 124 females, mean age: 60 11 years) with chronic phase (3 months after onset) ischemic cerebrovascular diseases, and in 68 healthy volunteers (30 males, 38 females, mean age: 36 6 years). RESULTS: All investigated hemorheological factors were significantly (p < 0.05-0.0001) elevated in cerebrovascular patients compared to normal controls, the rise in Hct, WBV and PV are some of the most prominent findings. In the group of hypertensive, hyperlipidemic patients, smokers and alcoholics Hct, PFC, WBV, PV and AI were significantly (p < 0.05-0.0001) higher compared to healthy controls, the same factors except plasma fibrinogen concentration showed association with diabetic history. Comparing cerebrovascular patients with or without risk factors, the most severe hemorheological deficit was observed in patients with hyperlipidemia and smoking habits. CONCLUSIONS: In this study the authors proved in chronic ischemic cerebrovascular patients that hemorheological abnormalities persist in most cases for a long time after an acute stroke, significant correlation could be seen between blood rheology and cardiovascular risk factors. Examination of rheological parameters can support to choose the optimal medical treatment in the secondary prevention of stroke, correction of hemorheological disturbances can reduce the risk of recurrent stroke.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Hemorreologia , Acidente Vascular Cerebral/prevenção & controle , Acidente Vascular Cerebral/fisiopatologia , Adulto , Idoso , Alcoolismo/complicações , Viscosidade Sanguínea , Doenças Cardiovasculares/sangue , Estudos de Casos e Controles , Transtornos Cerebrovasculares/fisiopatologia , Complicações do Diabetes , Agregação Eritrocítica , Deformação Eritrocítica , Feminino , Fibrinogênio/metabolismo , Hematócrito , Humanos , Hiperlipidemias/complicações , Masculino , Pessoa de Meia-Idade , Plasma , Fatores de Risco , Fumar/efeitos adversos , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/etiologia
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