@article{MTMT:34493390, title = {Gravity sedimentation reveals functionally and morphologically different platelets in human blood}, url = {https://m2.mtmt.hu/api/publication/34493390}, author = {Ezer, Erzsébet and Schrick, Diana Zsuzsanna and Tőkés-Füzesi, Margit and Papp, István and Réger, Barbara and Molnár, Abigél and Ábrahám, Hajnalka and Koller, Ákos and Hársfalvi, Jolán and Kellermayer, Miklós and Molnár, Tihamér}, doi = {10.1080/09537104.2023.2298341}, journal-iso = {PLATELETS}, journal = {PLATELETS}, volume = {35}, unique-id = {34493390}, issn = {0953-7104}, year = {2024}, eissn = {1369-1635}, orcid-numbers = {Koller, Ákos/0000-0003-3256-8701; Hársfalvi, Jolán/0000-0001-9940-4846; Kellermayer, Miklós/0000-0002-5553-6553} } @book{MTMT:34118867, title = {ANAESTHESIOLOGY AND INTENSIVE CARE THERAPY UNIVERSITY COURSE BOOK}, url = {https://m2.mtmt.hu/api/publication/34118867}, author = {Bátai, István and Bogár, Lajos and Csontos, Csaba and Ezer, Erzsébet and Molnár, Tihamér and Mühl, Diána and Almási, Róbert Gyula and Kövesi, Tamás and Márton, Sándor}, publisher = {Pécsi Tudományegyetem Általános Orvostudományi Kar}, unique-id = {34118867}, year = {2022}, orcid-numbers = {Almási, Róbert Gyula/0000-0002-1134-9932} } @article{MTMT:33195955, title = {Measurement invariance of six language versions of the post-traumatic stress disorder checklist for DSM-5 in civilians after traumatic brain injury}, url = {https://m2.mtmt.hu/api/publication/33195955}, author = {Bockhop, Fabian and Zeldovich, Marina and Cunitz, Katrin and Van Praag, Dominique and van der Vlegel, Marjolein and Beissbarth, Tim and Hagmayer, York and von Steinbuechel, Nicole}, doi = {10.1038/s41598-022-20170-2}, journal-iso = {SCI REP}, journal = {SCIENTIFIC REPORTS}, volume = {12}, unique-id = {33195955}, issn = {2045-2322}, abstract = {Traumatic brain injury (TBI) is frequently associated with neuropsychiatric impairments such as symptoms of post-traumatic stress disorder (PTSD), which can be screened using self-report instruments such as the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5). The current study aims to inspect the factorial validity and cross-linguistic equivalence of the PCL-5 in individuals after TBI with differential severity. Data for six language groups (n ≥ 200; Dutch, English, Finnish, Italian, Norwegian, Spanish) were extracted from the CENTER-TBI study database. Factorial validity of PTSD was evaluated using confirmatory factor analyses (CFA), and compared between four concurrent structural models. A multi-group CFA approach was utilized to investigate the measurement invariance (MI) of the PCL-5 across languages. All structural models showed satisfactory goodness-of-fit with small between-model variation. The original DSM-5 model for PTSD provided solid evidence of MI across the language groups. The current study underlines the validity of the clinical DSM-5 conceptualization of PTSD and demonstrates the comparability of PCL-5 symptom scores between language versions in individuals after TBI. Future studies should apply MI methods to other sociodemographic (e.g., age, gender) and injury-related (e.g., TBI severity) characteristics to improve the monitoring and clinical care of individuals suffering from PTSD symptoms after TBI.}, year = {2022}, eissn = {2045-2322}, orcid-numbers = {Barzó, Pál/0000-0001-8717-748X; Czeiter, Endre/0000-0002-9578-6944} } @article{MTMT:33163294, title = {Neurocognitive correlates of probable posttraumatic stress disorder following traumatic brain injury}, url = {https://m2.mtmt.hu/api/publication/33163294}, author = {Van Praag, Dominique L G and Wouters, Kristien and Van Den Eede, Filip and Wilson, Lindsay and Maas, Andrew I R}, doi = {10.1016/j.bas.2021.100854}, journal-iso = {BRAIN SPINE}, journal = {BRAIN AND SPINE}, volume = {2}, unique-id = {33163294}, issn = {2772-5294}, abstract = {Neurocognitive problems associated with posttraumatic stress disorder (PTSD) can interact with impairment resulting from traumatic brain injury (TBI).We aimed to identify neurocognitive problems associated with probable PTSD following TBI in a civilian sample.The study is part of the CENTER-TBI project (Collaborative European Neurotrauma Effectiveness Research) that aims to better characterize TBI. For this cross-sectional study, we included patients of all severities aged over 15, and a Glasgow Outcome Score Extended (GOSE) above 3. Participants were assessed at six months post-injury on the PTSD Checklist-5 (PCL-5), the Trail Making Test (TMT), the Rey Auditory Verbal Learning Test (RAVLT) and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Primary analysis was a complete case analysis. Regression analyses were performed to investigate the association between the PCL-5 and cognition.Of the 1134 participants included in the complete case analysis, 13.5% screened positive for PTSD. Probable PTSD was significantly associated with higher TMT-(B-A) (OR ​= ​1.35, 95% CI: 1.14-1.60, p ​< ​.001) and lower RAVLT-delayed recall scores (OR ​= ​0.74, 95% CI: 0.61-0.91, p ​= ​.004) after controlling for age, sex, psychiatric history, baseline Glasgow Coma Scale and education.Poorer performance on cognitive tests assessing task switching and, to a lesser extent, delayed verbal recall is associated with probable PTSD in civilians who have suffered TBI.}, keywords = {STRESS; cognition; head injury; neuropsychology; posttraumatic stress disorder}, year = {2022}, orcid-numbers = {Barzó, Pál/0000-0001-8717-748X; Czeiter, Endre/0000-0002-9578-6944} } @article{MTMT:32899084, title = {Health care utilization and outcomes in older adults after Traumatic Brain Injury : A CENTER-TBI study}, url = {https://m2.mtmt.hu/api/publication/32899084}, author = {van der Vlegel, Marjolein and Mikolić, Ana and Lee, Hee Quentin and Kaplan, Z L Rana and Retel, Helmrich Isabel R A and van Veen, Ernest and Andelic, Nada and Steinbuechel, Nicole V and Plass, Anne Marie and Zeldovich, Marina and Wilson, Lindsay and Maas, Andrew I R and Haagsma, Juanita A and Polinder, Suzanne}, doi = {10.1016/j.injury.2022.05.009}, journal-iso = {INJURY}, journal = {INJURY: INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED}, volume = {53}, unique-id = {32899084}, issn = {0020-1383}, abstract = {The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in older adults who sustained a TBI.We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. In-hospital and post-hospital health care utilization and outcomes were described for patients aged ≥65 years. Ordinal and linear regression analyses were performed to identify determinants of the Glasgow Outcome Scale Extended (GOSE), health-related quality of life (HRQoL), and mental health symptoms six-months post-injury.Of 1254 older patients, 45% were admitted to an ICU with a mean length of stay of 9 days. Nearly 30% of the patients received inpatient rehabilitation. In total, 554/1254 older patients completed the six-month follow-up questionnaires. The mortality rate was 9% after mild and 60% after moderate/severe TBI, and full recovery based on GOSE was reported for 44% of patients after mild and 6% after moderate/severe TBI. Higher age and increased injury severity were primarily associated with functional impairment, while pre-injury systemic disease, psychiatric conditions and lower educational level were associated with functional impairment, lower generic and disease-specific HRQoL and mental health symptoms.The rate of impairment and disability following TBI in older adults is substantial, and poorer outcomes across domains are associated with worse preinjury health. Nonetheless, a considerable number of patients fully or partially returns to their preinjury functioning. There should not be pessimism about outcomes in older adults who survive.}, keywords = {OLDER ADULTS; traumatic brain injury; health-related quality of life; OUTCOMES; mental health; health care utilization}, year = {2022}, eissn = {1879-0267}, pages = {2774-2782}, orcid-numbers = {Barzó, Pál/0000-0001-8717-748X; Czeiter, Endre/0000-0002-9578-6944} } @article{MTMT:32843086, title = {General Anesthesia-Related Drop in Diastolic Blood Pressure May Impact the Long-Term Outcome in Stroke Patients Undergoing Thrombectomy}, url = {https://m2.mtmt.hu/api/publication/32843086}, author = {Abada, Alan and Csécsei, Péter and Ezer, Erzsébet and Lenzsér, Gábor and Hegyi, Péter and Szolics, Alex and Mérei, Ákos and Szentesi, Andrea Ildikó and Molnár, Tihamér}, doi = {10.3390/jcm11112997}, journal-iso = {J CLIN MED}, journal = {JOURNAL OF CLINICAL MEDICINE}, volume = {11}, unique-id = {32843086}, abstract = {Background: Several factors affect the efficacy of endovascular thrombectomy (EVT); however, the anesthesia-related factors have not been fully explored. We aimed to identify independent predictors of outcome by analyzing procedural factors based on a multicentric stroke registry. Methods: Data of consecutive patients with acute ischemic stroke (AIS) were extracted from the prospective STAY ALIVE stroke registry. Demographic, clinical, and periprocedural factors including hemodynamic values were analyzed in patients undergoing thrombectomy with either general anesthesia (GA) or conscious sedation (CS). Independent predictors of outcome both at 30 and 90 days based on the modified Rankin Scale (mRS: 0–2 as favorable outcome) were also explored. Results: A total of 199 patients (GA: 76 (38%) vs. CS: 117 (59%); in addition, six patients were converted from CS to GA) were included. The minimum value of systolic, diastolic, and mean arterial pressure was significantly lower in the GA compared to the CS group, and GA was associated with a longer onset to EVT time and a higher drop in all hemodynamic variables (all, p < 0.001). A higher drop in diastolic blood pressure (DBP) was even independently associated with a poor 90-day outcome (p = 0.024). Conclusion: A GA-related drop in DBP may independently predict a poor long-term outcome in stroke patients undergoing thrombectomy.}, keywords = {Blood Pressure; anesthesia; ischemic stroke; outcome; endovascular treatment}, year = {2022}, eissn = {2077-0383}, orcid-numbers = {Hegyi, Péter/0000-0003-0399-7259; Szentesi, Andrea Ildikó/0000-0003-2097-6927} } @article{MTMT:32832892, title = {Circulating Microvesicles in Convalescent Ischemic Stroke Patients: A Contributor to High-On-Treatment Residual Platelet Reactivity?}, url = {https://m2.mtmt.hu/api/publication/32832892}, author = {Schrick, Diana Zsuzsanna and Molnár, Tihamér and Tőkés-Füzesi, Margit and Molnár, Abigél and Ezer, Erzsébet}, doi = {10.31083/j.fbl2705158}, journal-iso = {FRONT BIOSCI-LANDMARK}, journal = {FRONTIERS IN BIOSCIENCE-LANDMARK}, volume = {27}, unique-id = {32832892}, issn = {2768-6701}, abstract = {Exploration of novel and effective antiplatelet strategies for the secondary prevention of ischemic stroke is utmost. Some platelet derived microparticles (PMVs) in convalescent stroke subjects were found to be predictive for the next vascular event. Patients with high-on-treatment platelet reactivity (HTPR) had a significantly higher risk for ischemic stroke. Here, we aimed to explore associations among circulating microparticles and responsivness to antiplatelet (clopidogrel) therapy.A total of 18 patients on clopidogrel therapy due to secondary stroke prevention were rospectively recruited into this study. Twenty age-matched healthy subjects served as controls. Flow cytometric measurements of microparicles (MVs) and data analysis were performed on Beckman-Coulter FC-500 cytometer with CXP software. Besides, platelet aggregometry data were revealed. Both measurements were performed in whole blood and from the lower and upper blood fractions separated after 1-hour gravity sedimentation by the analogy with erythrocyte sedimentation rate.The total number of circulating MVs, and particularly the platelet derived CD42+ and PAC-1+ were significantly higher in post-stroke patients (p < 0.001). The platelet aggregation in the whole blood (area under the curve, AUC) showed a significant negative correlation with the total number of MPs in the lower blood sample after 1-hour gravity sedimentation (r = -0.650, p = 0.005). Next, we analyzed associations among MPs and aggregometry data obtained from clopidogrel responders and non-responders. Both, area under the curve (AUC) and velocity in the whole blood showed opposite correlation with the total number of MVs in the lower blood sample after 1-hour gravity sedimentation. Importantly, a significant negative correlation was observed for the velocity (r = -0.801, p = 0.005), but not for the AUC in responders. Platelet derived CD42+ and PAC-1+ MVs showed positive correlations with neutrophils in the lower blood sample (p = 0.008 and p = 0.006 respectively).Circulating MVs may allow to monitor the response to antiplatelet therapy in post-stroke patients. In addition, the link between platelet derived MVs and neutrophil granulocytes might become therapeutic targets in the future.}, keywords = {neutrophil; platelet; ischemic stroke; ANTIPLATELET THERAPY; Clopidogrel; MICROVESICLES}, year = {2022}, eissn = {2768-6698} } @article{MTMT:32668374, title = {Global Characterisation of Coagulopathy in Isolated Traumatic Brain Injury (iTBI) : A CENTER-TBI Analysis}, url = {https://m2.mtmt.hu/api/publication/32668374}, author = {Böhm, Julia K and Güting, Helge and Thorn, Sophie and Schäfer, Nadine and Rambach, Victoria and Schöchl, Herbert and Grottke, Oliver and Rossaint, Rolf and Stanworth, Simon and Curry, Nicola and Lefering, Rolf and Maegele, Marc}, doi = {10.1007/s12028-020-01151-7}, journal-iso = {NEUROCRIT CARE}, journal = {NEUROCRITICAL CARE}, volume = {35}, unique-id = {32668374}, issn = {1541-6933}, abstract = {Trauma-induced coagulopathy in patients with traumatic brain injury (TBI) is associated with high rates of complications, unfavourable outcomes and mortality. The mechanism of the development of TBI-associated coagulopathy is poorly understood.This analysis, embedded in the prospective, multi-centred, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, aimed to characterise the coagulopathy of TBI. Emphasis was placed on the acute phase following TBI, primary on subgroups of patients with abnormal coagulation profile within 4 h of admission, and the impact of pre-injury anticoagulant and/or antiplatelet therapy. In order to minimise confounding factors, patients with isolated TBI (iTBI) (n = 598) were selected for this analysis.Haemostatic disorders were observed in approximately 20% of iTBI patients. In a subgroup analysis, patients with pre-injury anticoagulant and/or antiplatelet therapy had a twice exacerbated coagulation profile as likely as those without premedication. This was in turn associated with increased rates of mortality and unfavourable outcome post-injury. A multivariate analysis of iTBI patients without pre-injury anticoagulant therapy identified several independent risk factors for coagulopathy which were present at hospital admission. Glasgow Coma Scale (GCS) less than or equal to 8, base excess (BE) less than or equal to - 6, hypothermia and hypotension increased risk significantly.Consideration of these factors enables early prediction and risk stratification of acute coagulopathy after TBI, thus guiding clinical management.}, keywords = {Risk Factors; traumatic brain injury; coagulopathy; CENTER-TBI}, year = {2021}, eissn = {1556-0961}, pages = {184-196}, orcid-numbers = {Barzó, Pál/0000-0001-8717-748X; Czeiter, Endre/0000-0002-9578-6944} } @{MTMT:32502755, title = {Központi Idegrendszeri kórképek}, url = {https://m2.mtmt.hu/api/publication/32502755}, author = {Futó, Judit and Ezer, Erzsébet}, booktitle = {Aneszteziológia és intenzív terápia}, unique-id = {32502755}, year = {2021}, pages = {451-488} } @article{MTMT:32164324, title = {Primary versus early secondary referral to a specialized neurotrauma center in patients with moderate/severe traumatic brain injury : a CENTER TBI study}, url = {https://m2.mtmt.hu/api/publication/32164324}, author = {Sewalt, Charlie Aletta and Gravesteijn, Benjamin Yaël and Menon, David and Lingsma, Hester Floor and Maas, Andrew I R and Stocchetti, Nino and Venema, Esmee and Lecky, Fiona E}, doi = {10.1186/s13049-021-00930-1}, journal-iso = {SCAND J TRAUMA RESUS}, journal = {SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION AND EMERGENCY MEDICINE}, volume = {29}, unique-id = {32164324}, issn = {1757-7241}, abstract = {Prehospital care for patients with traumatic brain injury (TBI) varies with some emergency medical systems recommending direct transport of patients with moderate to severe TBI to hospitals with specialist neurotrauma care (SNCs). The aim of this study is to assess variation in levels of early secondary referral within European SNCs and to compare the outcomes of directly admitted and secondarily transferred patients.Patients with moderate and severe TBI (Glasgow Coma Scale < 13) from the prospective European CENTER-TBI study were included in this study. All participating hospitals were specialist neuroscience centers. First, adjusted between-country differences were analysed using random effects logistic regression where early secondary referral was the dependent variable, and a random intercept for country was included. Second, the adjusted effect of early secondary referral on survival to hospital discharge and functional outcome [6 months Glasgow Outcome Scale Extended (GOSE)] was estimated using logistic and ordinal mixed effects models, respectively.A total of 1347 moderate/severe TBI patients from 53 SNCs in 18 European countries were included. Of these 1347 patients, 195 (14.5%) were admitted after early secondary referral. Secondarily referred moderate/severe TBI patients presented more often with a CT abnormality: mass lesion (52% vs. 34%), midline shift (54% vs. 36%) and acute subdural hematoma (77% vs. 65%). After adjusting for case-mix, there was a large European variation in early secondary referral, with a median OR of 1.69 between countries. Early secondary referral was not associated with functional outcome (adjusted OR 1.07, 95% CI 0.78-1.69), nor with survival at discharge (1.05, 0.58-1.90).Across Europe, substantial practice variation exists in the proportion of secondarily referred TBI patients at SNCs that is not explained by case mix. Within SNCs early secondary referral does not seem to impact functional outcome and survival after stabilisation in a non-specialised hospital. Future research should identify which patients with TBI truly benefit from direct transportation.}, keywords = {transfer; traumatic brain injury; Referral; trauma system}, year = {2021}, eissn = {1757-7241}, orcid-numbers = {Barzó, Pál/0000-0001-8717-748X; Czeiter, Endre/0000-0002-9578-6944} }