Peterfy Hospital

Budapest, Hungary

Peterfy Hospital

Budapest, Hungary
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Norgaard K.,Hvidovre University Hospital | Scaramuzza A.,Luigi Sacco Hospital | Bratina N.,University of Ljubljana | Lalic N.M.,University of Belgrade | And 7 more authors.
Diabetes Technology and Therapeutics | Year: 2013

Background: Sensor-augmented pump (SAP) therapy can improve glycemic control, compared with multiple daily insulin injections or with insulin pump therapy alone, without increasing the risk of hypoglycemia. Subjects and Methods: A 12-month observational study in patients with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII), upon the introduction of continuous glucose monitoring (CGM), was conducted in 15 countries (in Europe and in Israel) to document the real-life use of SAP and assess which variables are associated with improvement in type 1 diabetes management. Results: Data from 263 patients (38% male; mean age, 28.0±15.7 years [range, 1-69 years]; body mass index, 23.3±4.9 kg/m2; diabetes duration, 13.9±10.7 years; CSII duration, 2.6±3 years) were collected. Baseline mean glycated hemoglobin A1c (HbA1c) was 8.1±1.4%; 82% had suboptimal HbA1c (≥7%). The average sensor use for 12 months was 30% (range, 0-94%), and sensor use decreased with time (first 3 months, 37%; last 3 months, 27%). Factors associated with improvement in HbA1c after 12 months in patients with baseline HbA1c ≥7% were high baseline HbA1c (P<0.001), older age group (P<0.001), and more frequent sensor use (P=0.047). Significantly less hospitalization, increased treatment satisfaction, and reduced fear of hypoglycemia were reported after 12 months of SAP. Conclusions: This is the largest and longest multicenter prospective observational study providing real-life data on SAP. These results are consistent with those of controlled trials showing the effectiveness of CGM in pump users. © Mary Ann Liebert, Inc.


Ronaszki A.,Peterfy Hospital | Alings M.,Amphia Ziekenhuis Cardiologie | Egstrup K.,Forsknings Og Udviklingsafdeling | Gaciong Z.,Katedra i Klinika ChorobWewnetrznych i Nadcisnienia Tetniczego i Angiologii | And 9 more authors.
Europace | Year: 2011

Aim: AZD1305 is a combined ion channel blocker developed for the treatment of atrial fibrillation (AF). The aim of this study was to determine whether AZD1305 was effective in converting AF to sinus rhythm (SR). Methods and results: Patients with AF episodes of duration 3 h to 3 months were randomized in a 3:1 ratio to receive a maximum 30 min intravenous infusion of AZD1305 or matching placebo. The primary efficacy endpoint was the proportion of patients converting within 90 min of the start of infusion, after which patients who had not converted were to undergo direct current (DC) cardioversion. Four ascending AZD1305 dose groups were assigned sequentially, with dose rates of 50, 100, 130, and 180 mg/h.A total of 171 patients were randomized. Pharmacological conversion was achieved in 0 of 43 patients (0) in the placebo group, and in 2 of 26 (8; P 0.14 vs. placebo), 8 of 45 (18; P=0.006), 17 of 45 (38; P< 0.001), and 6 of 12 patients (50; P< 0.001) in AZD1305 dose groups 14, respectively. Maximum QTcF (QT interval corrected according to Fridericias formula) generally increased dose-dependently up to a plateau, although there was wide variation between patients. Two patients experienced torsade de pointes (TdP): one patient without symptoms in dose group 3, and one patient requiring DC defibrillation in dose group 4. Both patients recovered without sequelae. Conclusions: AZD1305 was effective in converting AF to SR, but was associated with QT prolongation and TdP. The benefitrisk profile was judged as unfavourable and the AZD1305 development programme was discontinued.Clinical trial registration: http://clinicaltrials.gov identifier NCT00915356. © 2011 The Author.


PubMed | Peterfy Hospital, Markusovszky Hospital, Janos Hospital, University of Szeged and 8 more.
Type: | Journal: Journal of Crohn's & colitis | Year: 2016

Biosimilar infliximab CT-P13 received European Medicines Agency (EMA) approval in June 2013 for all indications of the originator product. In the present study we aimed to evaluate the predictors of short- and medium-term clinical outcome in patients treated with the biosimilar infliximab at the participating IBD centres in Hungary.Demographic data were collected and a harmonized monitoring strategy was applied. Clinical and biochemical activity were evaluated at weeks 14, 30 and 54. Trough level (TL) and anti-drug antibody (ADA) concentration were measured by ELISA (LT-005, Theradiag, France) at baseline at 14, 30 and 54 weeks and in 2 centres at weeks 2 and 6.291 consecutive IBD patients (184 CD/107 UC) were included. In UC, TLs at week 2 were predicting both clinical response and remission at week 14 and 30 (clinical response/remission at week 14: AUC=0.81, p<0.001, cut-off: 11.5g/ml/AUC=0.79, p<0.001, cut-off: 15.3g/ml; clinical response/remission at week 30: AUC=0.79, p=0.002, cut-off:11.5 g/ml/AUC=0.74, p=0.006, cut-off: 14.5g/ml), while ADA positivity at week 14 was inversely associated with clinical response at week 30 (58.3%vs.84.8%,p=0.04). Previous anti-TNF exposure was inversely associated with short-term clinical remission (week 2: 18.8% vs. 47.8%, p=0.03, at week 6: 38.9% vs. 69.7%, p=0.013, at week 14: 37.5% vs. 2.5%, p=0.06). In CD, TLs at week 2 were predicting short term- (week 14 response/remission, AUCIn UC, early TLs were predictive for short-and medium term clinical efficacy, while in CD, week 2 TLs were associated only with short-term clinical outcomes.


Bodzay T.,Peterfy Hospital | Sztrinkai G.,Peterfy Hospital | Pajor S.,Peterfy Hospital | Ga T.,Semmelweis University | And 3 more authors.
Eklem Hastaliklari ve Cerrahisi | Year: 2014

Objectives: This study aims to investigate whether surgical treatment of pubic rami fractures increases the stability of the posterior pelvis. Material and methods: A finite element pelvic model with improved geometric and material characteristics was analyzed. By imitating a standing position, a type I Denis sacrum fracture and a unilateral pubis fracture, we measured the differences in tension and displacement. The posterior injury was treated with a direct plate synthesis or transsacral plate synthesis, while the pubis fracture was left without fixation or fixed with either a retrograde pubic screw or plate synthesis. Results: The operative fixation of pubic rami fractures decreased the movement in the fracture gap not only at the site of the pubis fracture, but also at the site of the fixed sacrum fracture. The plate synthesis provided greater stability of the anterior fracture than the retrograde screw. The tensions in the implants were below the allowed values. Conclusion: We concluded that surgically fixation of pubic fracture increases the stability of the operated posterior pelvis.


Sztrinkai G.,Peterfy Hospital | Bodzay T.,Peterfy Hospital | Pajor S.,Peterfy Hospital | Erdos P.,Budapest University of Technology and Economics | And 3 more authors.
Eklem Hastaliklari ve Cerrahisi | Year: 2014

Objectives: In this study, we aimed to create a realistic model which is suitable for computerized simulation of any kind of fractures and provides reliable results. Patients and methods: We used a plastic pelvic model to construct advanced specimens. The data were retrieved from the computed tomography scans of a healthy pelvis. A geometrically exact model by the means of three-dimensional scanning of the plastic pelvis was obtained. The material properties of the bony parts based on the data retrieved from the computed tomography scans were modified. The pelvis was divided into distinct segments and the proportion of the cortical and cancellous bone substance in each segment were determined to make the material properties accurate. In the validation of the pelvic model, a type C pelvic injury was simulated and the fracture of the sacrum and the symphyseolysis were stabilized with plates. These data were compared with those of previously performed cadaver experiments. Results: Based on the simulation performed on the new model, the shift values between the fragments of the broken sacrum approximated the reported values of our cadaver experiments and also arising strains remained in the tolerable interval. Conclusion: Our new finite element pelvic model represents the pelvis more accurately than the former one. As the validation of the model was successful, it is suitable for computerized simulation of any kind of fractures offering reliable results.


Hever N.V.,Corvinus University of Budapest | Pentek M.,Corvinus University of Budapest | Ballo A.,University of Pécs | Gulacsi L.,Corvinus University of Budapest | And 7 more authors.
Pathology and Oncology Research | Year: 2015

Health-related quality of life (HRQoL) is an important outcome in oncology care although an underexplored area in bladder cancer (BC). Our aims were to assess HRQoL of patients with BC, analyse relationships between diverse HRQoL measures and validate the Hungarian version of the Bladder Cancer Index (BCI) questionnaire. A cross-sectional survey was performed among patients with BC (N = 151). Validated Hungarian versions of the FACT-Bl, SF-36 and EQ-5D were applied and SF-6D was derived. Psychometric analysis of the Hungarian BCI was performed. Pearson correlations between the five measures were analysed. Deterioration in SF-36 Physical Functioning was detected among patients aged 45–64 years. The EQ-5D score did not differ significantly from the age-matched population norm. Correlations between the FACT-Bl, EQ-5D and SF-6D utility measures were strong (r > 0.6). Cronbach alpha coefficients of the Hungarian BCI ranged from 0.75 to 0.97 and factor analysis confirmed that data fit to the six predefined subdomains. Test-retest correlations (reliability, N = 50) ranged from 0.67 to 0.87 and interscale correlations between urinary, bowel and sexual BCI domains were weak or moderate (r = 0.29 to 0.49). Convergent validity revealed a stronger correlation with FACT-Bl (r = 0.126 to 0.719) than with generic health state scores (r = 0.096 to 0.584). Results of divergent validity of the Hungarian BCI by treatment groups by Kruskal Wallis test were promising although limited by low sample sizes in cystectomy subgroups. Generic health state measures have limited capacity to capture HRQoL impact of BC. Validity tests yielded favourable results for the Hungarian BCI. Mapping studies to estimate utility scores from FACT-Bl are encouraged but less recommendable with the BCI. © 2014, Arányi Lajos Foundation.


Bene L.,Peterfy Hospital | Falus A.,Semmelweis University | Falus A.,Hungarian Academy of Sciences | Baffy N.,Semmelweis University | Fulop A.K.,Semmelweis University
Pathology and Oncology Research | Year: 2011

The factors involved in the pathogenesis of Crohn's disease and ulcerative colitis, the two major types of inflammatory bowel disease (IBD) are summarized. Intestinal antigens composed of bacterial flora along with antigen presentation and impaired mucosal barrier have an important role in the initiation of IBD. The bacterial community may be modified by the use of antibiotics and probiotics. The dentritic cells recognize the antigens by cell surface Toll like receptor and the cytoplasmic CARD/NOD system. The balance between Th1/Th2/Th17 cell populations being the source of a variety of cytokines regulates the inflammatory mechanisms and the clearance of microbes. The intracellular killing and digestion, including autophagy, are important in the protection against microbes and their toxins. The homing process determines the location and distribution of the immune cells along the gut. All these players are potential targets of pharmacological manipulation of disease status. © 2011 Arányi Lajos Foundation.


PubMed | Peterfy Hospital
Type: Journal Article | Journal: Eklem hastaliklari ve cerrahisi = Joint diseases & related surgery | Year: 2014

This study aims to investigate whether surgical treatment of pubic rami fractures increases the stability of the posterior pelvis.A finite element pelvic model with improved geometric and material characteristics was analyzed. By imitating a standing position, a type I Denis sacrum fracture and a unilateral pubis fracture, we measured the differences in tension and displacement. The posterior injury was treated with a direct plate synthesis or transsacral plate synthesis, while the pubis fracture was left without fixation or fixed with either a retrograde pubic screw or plate synthesis.The operative fixation of pubic rami fractures decreased the movement in the fracture gap not only at the site of the pubis fracture, but also at the site of the fixed sacrum fracture. The plate synthesis provided greater stability of the anterior fracture than the retrograde screw. The tensions in the implants were below the allowed values.We concluded that surgically fixation of pubic fracture increases the stability of the operated posterior pelvis.


PubMed | Peterfy Hospital
Type: Journal Article | Journal: Clinical hemorheology and microcirculation | Year: 2012

The developing callus requires sufficient oxygen and substrate supply. Despite the importance of these processes, we have limited understanding of regulation of the callus microcirculation. We aimed to assess the role of vasoactive substances in the microcirculation of the callus in a gap osteotomy model in the rabbit detected by laser-Doppler flowmetry. The reactions were elicited with locally applied vasoactive substances: epinephrine (E), calcitonine-gene related protein (CGRP), substance P (SP), sodium nitroprusside (SNP) and Ebrantil (Ebr) on the 10th and 15th postoperative days. Changes of the circulatory parameters were compared to changes in the ipsilateral femoral bone marrow. Perfusion pressure, maximal change of the blood flow and 50% recovery time (50RT) of the flow reactions and peripheral micro vascular resistance (MVR) was calculated. Systemic blood pressure (BP) was measured directly with an arterial catheter. Reactive neurovascular structures, sensitive to neuropeptides and vasoactive substances, appear at a very early stage of callus formation. On the 10th postoperative day, 2/3 of the blood flow velocity of the intact tibia has already returned, and the values are higher on the 15th postoperative day than those of the intact tibia. The basal blood flow velocities (prior to administration of any substance) are significantly higher on the 15th postoperative day than on the 10th.


PubMed | Peterfy Hospital
Type: Journal Article | Journal: Eklem hastaliklari ve cerrahisi = Joint diseases & related surgery | Year: 2016

In this article, we report successful treatment of serious complications of replantation after traumatic mid-third femoral amputation. To the best of our knowledge, no similar case has been reported in the literature. A 38-year-old healthy male sustained a mid-third right traumatic femoral amputation. We performed replantation. Oliguria and anuria occurred and were treated successfully with hemofiltration and hemodialysis. Six years later, patient walked wearing orthopedic shoes and also protective sensibility recovered on the limb. Serious complications of proximal lower limb replantation can be treated successfully and the limb can be saved.

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