TY - JOUR AU - Szegedi, István AU - Szabó, Dániel András AU - Emri, Miklós AU - Béresova, Mónika AU - Nagy, Mariann AU - Molnár, Sarolta AU - Nagy, Attila AU - Berényi, Ervin AU - Oláh, László AU - Csiba, László TI - Comparison of pre-mortem 2D-3D ultrasound examination to post-mortem micro-CT of carotid arteries – first experiences JF - IDEGGYOGYASZATI SZEMLE / CLINICAL NEUROSCIENCE J2 - IDEGGYOGY SZEMLE VL - 77 PY - 2024 IS - 1-2 SP - 13 EP - 20 PG - 8 SN - 0019-1442 DO - 10.18071/isz.77.0013 UR - https://m2.mtmt.hu/api/publication/34569182 ID - 34569182 AB - Background and purpose – A prerequisite for the treatment of carotid atherosclerosis is the accurate measurement of the stenosis, that is most commonly evaluated by duplex ultrasonography. In this study, we aimed to verify the reliability of 2D and 3D ultrasonography, comparing the data to results of postmortem micro-CT examination. Methods – Neurological patients with any life-threatening, presumably fatal neurological disease were enrolled. Ultrasound examinations were performed with a Philips Epiq 5G machine, using a VL13-5 broadband linear volume array transducer. Plaque length, diameter and vessel area reduction (stenosis) were calculated using the 2D images. Finally, the stenosis was reassessed using automatized, 3D application as well. After the death of the patient, autopsy was performed, during which the previously examined carotid artery was removed. The samples were examined with micro-CT. Similar to the ultrasound examination, plaque length, diameter and vessel area reduction (stenosis) were determined. Results – Ten vessels of seven patients were eligible for complex comparison. Plaque diameter and length measured by CT did not correlate with the ultrasound data. CT-measured axial plaque and vessel areas showed no correlation with ultrasound results either. While determining the strength of correlation between stenoses measured by the different modalities, significant correlation was found between the results measured by ultrasound (2D) and CT (Pearson r: 0.902, P<0.001). Conclusion – Three-dimensional ultrasound analysis is a spectacular method for examining carotid plaques, as it can assist in a more detailed evaluation of the plaque morphology and composition, thereby identifying plaques with a particularly high risk of stroke. Micro-CT is an excellent tool for the exact determination of calcified plaque areas, but ultrasound images are not suitable yet for such a precise examination due to acoustic shadowing and artifacts. LA - English DB - MTMT ER - TY - JOUR AU - Szegedi, István AU - Potvorszki, Fanni AU - Mészáros, Zsófia Réka AU - Daniel, Cecilia AU - Csiba, László AU - Oláh, László TI - Role of carotid duplex in the assessment of carotid artery restenosis after endarterectomy or stenting JF - FRONTIERS IN NEUROLOGY J2 - FRONT NEUR VL - 14 PY - 2023 IS - 1 SP - 14 SN - 1664-2295 DO - 10.3389/fneur.2023.1226220 UR - https://m2.mtmt.hu/api/publication/34493937 ID - 34493937 LA - English DB - MTMT ER - TY - JOUR AU - Varga , Eszter AU - Battamir, Ulambayar AU - Szegedi, István AU - Hudák, Lilla AU - Kovács, Nóra AU - Nagy, Attila Csaba TI - Seasonal patterns in the epidemiology of Bell's palsy in Hungary JF - FRONTIERS IN NEUROLOGY J2 - FRONT NEUR VL - 14 PY - 2023 SP - 1 EP - 6 PG - 6 SN - 1664-2295 DO - 10.3389/fneur.2023.1188137 UR - https://m2.mtmt.hu/api/publication/34048303 ID - 34048303 LA - English DB - MTMT ER - TY - JOUR AU - Sadeghi, Farzaneh AU - Sarkady, Ferenc AU - Zsóri, Katalin S AU - Szegedi, István AU - Orbán-Kálmándi, Rita Angéla AU - Székely, Edina G AU - Vasas, Nikolett AU - Berényi, Ervin AU - Csiba, László AU - Bagoly, Zsuzsa AU - Shemirani, Amir Houshang TI - High Neutrophil-Lymphocyte Ratio and Low Lymphocyte-Monocyte Ratio Combination after Thrombolysis Is a Potential Predictor of Poor Functional Outcome of Acute Ischemic Stroke. JF - JOURNAL OF PERSONALIZED MEDICINE J2 - J PERS MED VL - 12 PY - 2022 IS - 8 SN - 2075-4426 DO - 10.3390/jpm12081221 UR - https://m2.mtmt.hu/api/publication/33060167 ID - 33060167 AB - (1) Background: Ischemic stroke is one of the leading causes of death and disability. An inflammatory response is observed in multiple stages of cerebral ischemia, particularly in the acute phase. Recent publications revealed that the neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) may be used to predict long-term prognosis in acute ischemic stroke (AIS) after thrombolysis. To test whether there is a relationship between the combination of these parameters and long-term prognosis, we analyzed the NLR-LMR combination in AIS patients treated with intravenous recombinant tissue plasminogen activator (rtPA); (2) Methods: The study included 285 adults with a diagnosis of AIS and rtPA treatment within a 4.5 h time window. Blood samples were obtained at admission and 24 h after thrombolysis to calculate pre- and post-thrombolysis NLR and LMR. Clinical data, including NIHSS was registered on admission and day 1. The long-term outcome was defined 90 days post-event by the modified Rankin Scale (mRS). Therapy-associated intracranial hemorrhage (ICH) was classified according to ECASS II. Receiver operating characteristic curve (ROC) analysis was performed to determine optimal cutoffs of NLR and LMR as predictors of therapy outcomes; (3) Results: Patients were stratified by cutoffs of 5.73 for NLR and 2.08 for LMR. The multivariate logistic regression model, including all possible confounders, displayed no significant association between NLR or LMR with 3-months functional prognosis. The combination of high NLR-low LMR vs. low NRL-high LMR as obtained 24 h after thrombolysis was found to be an independent predictor of poor 3-months functional outcome (mRS ≥ 2; OR 3.407, 95% CI 1.449 to 8.011, p = 0.005). The proportion of patients between low NLR-high LMR and high NLR-low LMR groups from admission to day 1 showed no significant change in the good outcome group. On the other hand, in the poor outcome group (mRS ≥ 2), low NLR-high LMR and high NLR-low LMR groups displayed a significant shift in patient proportions from 67% and 21% at admission (p = 0.001) to 36% and 49% at 24 h after thrombolysis (p < 0.001), respectively; (4) Conclusions: Our study demonstrated for the first time that a high NLR-low LMR combination as observed at 24 h after thrombolysis can serve as an independent predictor of 3-months poor outcome in AIS patients. This simple and readily available data may help clinicians to improve the prognostic estimation of patients and may provide guidance in selecting patients for personalized and intensified care post-thrombolysis. LA - English DB - MTMT ER - TY - JOUR AU - Székely, Edina Gabriella AU - Orbán-Kálmándi, Rita Angéla AU - Szegedi, István AU - Katona, Éva AU - Baráth, Barbara AU - Czuriga-Kovács, Katalin Réka AU - Lóczi, Linda AU - Vasas, Nikolett AU - Fekete, István AU - Fekete, Klára AU - Berényi, Ervin AU - Oláh, László AU - Csiba, László AU - Bagoly, Zsuzsa TI - Low α2-Plasmin Inhibitor Antigen Levels on Admission Are Associated With More Severe Stroke and Unfavorable Outcomes in Acute Ischemic Stroke Patients Treated With Intravenous Thrombolysis. JF - FRONTIERS IN CARDIOVASCULAR MEDICINE J2 - FRONT CARDIOVASC MED VL - 9 PY - 2022 PG - 14 SN - 2297-055X DO - 10.3389/fcvm.2022.901286 UR - https://m2.mtmt.hu/api/publication/33060054 ID - 33060054 AB - Intravenous administration of recombinant tissue plasminogen activator (rt-PA) fails to succeed in a subset of acute ischemic stroke (AIS) patients, while in approximately 6-8% of cases intracerebral hemorrhage (ICH) occurs as side effect.Here, we aimed to investigate α2-plasmin inhibitor (α2-PI) levels during thrombolysis and to find out whether they predict therapy outcomes in AIS patients.In this prospective, observational study, blood samples of 421 AIS patients, all undergoing i.v. thrombolysis by rt-PA within 4.5 h of their symptom onset, were taken before and 24 h after thrombolysis. In a subset of patients (n = 131), blood was also obtained immediately post-lysis. α2-PI activity and antigen levels were measured by chromogenic assay and an in-house ELISA detecting all forms of α2-PI. α2-PI Arg6Trp polymorphism was identified in all patients. Stroke severity was determined by NIHSS on admission and day 7. Therapy-associated ICH was classified according to ECASSII. Long-term outcomes were defined at 3 months post-event by the modified Rankin Scale (mRS).Median α2-PI activity and antigen levels showed a significant drop immediately post-lysis and increased to subnormal levels at 24 h post-event. Admission α2-PI levels showed a significant negative stepwise association with stroke severity. Patients with favorable long-term outcomes (mRS 0-1) had significantly higher admission α2-PI antigen levels (median:61.6 [IQR:55.9-70.5] mg/L) as compared to patients with poor outcomes (mRS 2-5: median:59.7 [IQR:54.5-69.1] and mRS 6: median:56.0 [IQR:48.5-61.0] mg/L, p < 0.001). In a Kaplan-Meier survival analysis, patients with an α2-PI antigen in the highest quartile on admission showed significantly better long-term survival as compared to those with α2-PI antigen in the lowest quartile (HR: 4.54; 95%CI:1.92-10.8, p < 0.001); however, in a multivariate analysis, a low admission α2-PI antigen did not prove to be an independent risk factor of poor long-term outcomes. In patients with therapy-related ICH (n = 34), admission α2-PI antigen levels were significantly, but only marginally, lower as compared to those without hemorrhage.Low α2-PI antigen levels on admission were associated with more severe strokes and poor long-term outcomes in this cohort. Our results suggest that in case of more severe strokes, α2-PI may be involved in the limited efficacy of rt-PA thrombolysis. LA - English DB - MTMT ER - TY - JOUR AU - Kešnerová, Petra AU - Školoudík, David AU - Herzig, Roman AU - Netuka, David AU - Szegedi, István AU - Langová, Kateřina TI - Peripheral Vascular Resistance in Cerebral Arteries in Patients With Carotid Atherosclerosis – Substudy Results of the Atherosclerotic Plaque Characteristics Associated with a Progression Rate of the Plaque and a Risk of Stroke in Patients With the Carotid Bifurcation Plaque Study ( ANTIQUE ) JF - JOURNAL OF ULTRASOUND IN MEDICINE J2 - J ULTRAS MED VL - 41 PY - 2022 SP - 237 EP - 246 PG - 10 SN - 0278-4297 DO - 10.1002/jum.15703 UR - https://m2.mtmt.hu/api/publication/32021271 ID - 32021271 LA - English DB - MTMT ER - TY - JOUR AU - Szegedi, István AU - Orbán-Kálmándi, Rita Angéla AU - Nagy, Attila Csaba AU - Sarkady, F. AU - Vasas, Nikolett AU - Sik, M. AU - Lánczi, L.I. AU - Berényi, Ervin László AU - Oláh, László AU - Crisan, A. AU - Csiba, László AU - Bagoly, Zsuzsa TI - Decreased clot burden is associated with factor XIII Val34Leu polymorphism and better functional outcomes in acute ischemic stroke patients treated with intravenous thrombolysis JF - PLOS ONE J2 - PLOS ONE VL - 16 PY - 2021 IS - 7 PG - 16 SN - 1932-6203 DO - 10.1371/journal.pone.0254253 UR - https://m2.mtmt.hu/api/publication/32154649 ID - 32154649 N1 - Department of Neurology, Doctoral School of Neuroscience, University of Debrecen, Faculty of Medicine, Debrecen, Hungary Division of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary Department of Radiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary Department of Neurology, City Hospital of Odorheiu-Secuiesc, Odorheiu Secuiesc, Romania ELKH-DE Cerebrovascular and Neurodegenerative Research Group, Debrecen, Hungary Export Date: 24 August 2021 CODEN: POLNC Correspondence Address: Bagoly, Z.; Department of Neurology, Hungary; email: bagoly@med.unideb.hu LA - English DB - MTMT ER - TY - JOUR AU - Orbán-Kálmándi, Rita Angéla AU - Szegedi, István AU - Sarkady, Ferenc AU - Fekete, István AU - Fekete, Klára AU - Vasas, Nikolett AU - Berényi, Ervin László AU - Csiba, László AU - Bagoly, Zsuzsa TI - A modified in vitro clot lysis assay predicts outcomes and safety in acute ischemic stroke patients undergoing intravenous thrombolysis JF - SCIENTIFIC REPORTS J2 - SCI REP VL - 11 PY - 2021 IS - 1 PG - 14 SN - 2045-2322 DO - 10.1038/s41598-021-92041-1 UR - https://m2.mtmt.hu/api/publication/32073172 ID - 32073172 LA - English DB - MTMT ER - TY - JOUR AU - Kalmár, Péter János AU - Tárkányi, Gábor AU - Nagy, Csaba Balázs AU - Csécsei, Péter AU - Lenzsér, Gábor AU - Bosnyák, Edit AU - Karadi, Zsofia Nozomi AU - Annus, Ádám AU - Szegedi, István AU - Büki, András AU - Szapáry, László TI - Comparing Endovascular Treatment Methods in Acute Ischemic Stroke Due to Tandem Occlusion Focusing on Clinical Aspects JF - LIFE-BASEL J2 - LIFE-BASEL VL - 11 PY - 2021 IS - 5 PG - 10 SN - 2075-1729 DO - 10.3390/life11050458 UR - https://m2.mtmt.hu/api/publication/32029068 ID - 32029068 LA - English DB - MTMT ER - TY - JOUR AU - Bagoly, Zsuzsa AU - Baráth, Barbara AU - Orbán-Kálmándi, Rita Angéla AU - Szegedi, István AU - Kissné Bogáti, Réka AU - Sarkady, Ferenc AU - Csiba, László AU - Katona, Éva TI - Incorporation of alpha 2-Plasmin Inhibitor into Fibrin Clots and Its Association with the Clinical Outcome of Acute Ischemic Stroke Patients JF - BIOMOLECULES J2 - BIOMOLECULES VL - 11 PY - 2021 IS - 3 PG - 13 SN - 2218-273X DO - 10.3390/biom11030347 UR - https://m2.mtmt.hu/api/publication/31896152 ID - 31896152 LA - English DB - MTMT ER -