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Vincze M, Sikovanyecz J, Molnár A, Földesi I, Surányi A, Várbíró S, Németh G, Sikovanyecz J, Kozinszky Z. Predictive Capabilities of Human Leukocyte Antigen-G and Galectin-13 Levels in the Amniotic Fluid and Maternal Blood for the Pregnancy Outcome. Medicina (Kaunas) 2024; 60:85. [PMID: 38256346 PMCID: PMC10820789 DOI: 10.3390/medicina60010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/22/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Increasing evidence points to the significant role of the angiogenic factor levels in screening for pregnancy outcome. To examine the potential relationship between concentrations of placental protein 13 (PP13) and soluble human leukocyte antigen-G (sHLA-G) in maternal serum and amniotic fluid at 16-23 weeks of gestation and the sonographic features of pregnancy as well as pregnancy outcome. Materials and Methods: PP13 and sHLA-G in serum and amniotic fluid, fetal biometrical data, and placental volume and perfusion indices were determined in 71 euploid, singleton pregnancies. Results: The serum sHLA-G level exhibits a negative correlation with the serum PP13 level (r = -0.186, p < 0.001) and a positive correlation with the sHLA-G level in amniotic fluid (r = 0.662, p < 0.001). A significant correlation was found between serum sHLA-G level and placental volume (r = 0.142, p < 0.05) and between amniotic sHLA-G level and placental perfusion (r = -0.450, p < 0.001). A low amniotic PP13 level significantly predicted the birth weight (r = -0.102, p < 0.05), the duration of pregnancy (r = -0.155, p < 0.05), and the fetal abdominal circumference (r = -0.098, p < 0.05). Conclusions: PP13 assayed in amniotic fluid might be a potential marker of fetal growth, and sHLA-G can be an adjunct modality reflecting placental sonographic parameters.
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Affiliation(s)
- Márió Vincze
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - András Molnár
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Imre Földesi
- Department of Laboratory Medicine, University of Szeged, H-6720 Szeged, Hungary;
| | - Andrea Surányi
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Gábor Németh
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Zoltan Kozinszky
- Department of Obstetrics and Gynecology, Danderyd Hospital, 182 88 Stockholm, Sweden
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Horváth S, Nguyen Thuy HH, Eke Z, Németh G. Exploitation of the enantioselectivity space of coated amylose tris(3,5-dimethylphenylcarbamate) in mixtures of 2-propanol and acetonitrile. J Chromatogr A 2023; 1705:464161. [PMID: 37352691 DOI: 10.1016/j.chroma.2023.464161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/25/2023]
Abstract
Chiral stationary phases (CSPs) with coated amylose tris(3,5-dimethylphenylcarbamate) (ADMPC) selector have long been recognized for their excellent chiral recognition ability in liquid chromatography. The conformational versatility behind this feature is the source of their known hysteretic behavior, which has been previously observed in polar organic (PO) mode eluents containing 2-propanol (IPA). Mixtures of IPA and acetonitrile (MeCN), a typical PO mode eluent system, have not been examined in this aspect yet, even though hysteresis is promising for finding unique unexplored enantioselectivities. Not only was the hysteresis detectable on ADMPC using mixtures of IPA and MeCN, but it was the typical behavior in a diverse set of test compounds. The difference in the retention time of the same analyte under conditions which only differed in the eluent history on the column can go up to 20-fold. The assumed hindered conformational changes of the selector were reflected in retention drift at certain eluent compositions. On the two sides of the transitions, distinct, useful states of the selector were detected. A series of IPA - MeCN compositions with defined pretreatment was selected and recommended as an extension of the preliminary, first choice method screening set that used only alcohols. The incorporation of a solvent possessing substantially different characteristics enhances the potential in practical applications, while keeping the technical simplicity. Stability and robustness of the additional states of the CSP were characterized. The examined columns of different brands shared the observed behavior. Kinetic stability of a column state is adequate for successful application. The evaluated states of ADMPC provide multiple enantiorecognition potential by using mixtures of IPA and MeCN also considering the pretreatment of the column. Unprecedented double and triple elution order reversals along the composition range supported the versatility of the available states. Our findings further enhance the usefulness of ADMPC-containing CSPs. We provide instructions for the application of the widespread chiral selector in common eluent mixtures to avoid pitfalls regarding reproducibility and robustness.
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Affiliation(s)
- Simon Horváth
- Drug Substance Development Division, Egis Pharmaceuticals PLC, P.O. Box 100, Budapest H-1475, Hungary.
| | - Hong Ha Nguyen Thuy
- Drug Substance Development Division, Egis Pharmaceuticals PLC, P.O. Box 100, Budapest H-1475, Hungary
| | - Zsuzsanna Eke
- Joint Research and Training Laboratory on Separation Science, Eötvös Loránd University, Pázmány Péter stny. 1/A, Budapest H-1117, Hungary
| | - Gábor Németh
- Drug Substance Development Division, Egis Pharmaceuticals PLC, P.O. Box 100, Budapest H-1475, Hungary.
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Völgyesi P, Radnai M, Németh G, Boda K, Bernad E, Novák T. Maternal Periodontal Status as a Factor Influencing Obstetrical Outcomes. Medicina (Kaunas) 2023; 59:medicina59030621. [PMID: 36984622 PMCID: PMC10051501 DOI: 10.3390/medicina59030621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/09/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023]
Abstract
Background and Objectives: Preterm birth as a complex phenomenon is influenced by numerous endogenic and exogenic factors, although its exact cause often remains obscure. According to epidemiological studies, maternal periodontal diseases, in addition to affecting general health, can also cause adverse pregnancy outcomes. Nonetheless, the existing results in the literature regarding this topic remain controversial. Consequently, our study aimed to determine the connection between poor maternal periodontal status and neonatal birth weight. Materials and Methods: A total of 111 primigravida-primiparous pregnant, healthy women underwent a periodontal examination in the second trimester of their pregnancies. Probing depth (PD) and bleeding on probing (BOP) were determined, and based on these diagnostic measurements, the patients were divided into three subgroups according to their dental status: healthy (H, n = 17), gingivitis (G, n = 67), and periodontitis (P, n = 27). Results: Considering that poor maternal oral status is an influencing factor for obstetrical outcomes, the presence of PD and BOP (characterized by the sulcus bleeding index, SBI) was evaluated. In the case of P, defined as PD ≥ 4 mm in at least one site and BOP ≥ 50% of the teeth, a significant correlation between BOP and a low neonatal birth weight at delivery (p = 0.001) was found. An analysis of the relationship between SBI and gestational age (GA) at the time of the periodontal examination in the different dental status groups showed a significant correlation between these parameters in the G group (p = 0.04). Conclusions: Our results suggest that a worse periodontal status during pregnancy may negatively affect obstetrical outcomes, especially the prematurity rate and newborn weight. Therefore, the importance of periodontal screening to prevent these complications is undeniable.
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Affiliation(s)
- Petra Völgyesi
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Szeged, 6725 109 Szeged, Hungary
| | - Márta Radnai
- Department of Prosthodontics, Faculty of Medicine, University of Szeged, 6725 109 Szeged, Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Szeged, 6725 109 Szeged, Hungary
| | - Krisztina Boda
- Department of Medical Physics and Informatics, Faculty of Medicine, University of Szeged, 6725 109 Szeged, Hungary
| | - Elena Bernad
- Department of Obstetrics and Gynecology, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Clinic of Obstetrics and Gynecology, "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Center for Laparoscopy, Laparoscopic Surgery and In Vitro Fertilization, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Tibor Novák
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Szeged, 6725 109 Szeged, Hungary
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Surányi A, Németh G, Kozinszky Z. [Correlation between placental perfusion measured in the entire placenta versus assessed by sonobiopsy]. Orv Hetil 2023; 164:300-307. [PMID: 36842147 DOI: 10.1556/650.2023.32702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/15/2022] [Indexed: 02/27/2023]
Abstract
INTRODUCTION Placental perfusion can be evaluated using three-dimensional power-Doppler (3DPD) indices with sonobiopsy acquisition in a sphere or throughout the entire placenta. OBJECTIVE We aimed to explore the relation between these two measurement methods. METHOD A prospective cohort study was conducted among normal pregnant women recruited at 11 to 40 gestational weeks. Placental vascularization was evaluated using the 3DPD indices (vascularization index [VI]; flow index [FI]; vascularization flow index [VFI]) with the application of the sphere ultrasound technique or scanned from the entire placenta. RESULTS A total of 150 women were recruited at a mean gestational age of 20.8 ± 7.22 weeks. We observed that scanned 3DPD indices using sphere technique decrease by gestational age between 11 and 40 weeks, whereas whole placental volume scanning yielded stable, non-decreasing indices during gestation. The indices were correlated to each other at least moderately, irrespectively of the method of scanning (r≥0.30). LIMITATIONS As gestation advances, less and less placentas can be visualized in one sweep for a whole view and at late period of gestation only a minority of placentas can be visualized as a whole. CONCLUSION 3DPD indices acquired in a sphere of the placenta at umbilical cord insertion may reflect more to the decreasing vascularity of the exponentially growing placenta during gestation. Hence, sphere technique may have a greater screening opportunity in pathological pregnancies. Orv Hetil. 2023; 164(8): 300-307.
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Affiliation(s)
- Andrea Surányi
- 1 Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika Szeged, Semmelweis u. 1., 6725 Magyarország
| | - Gábor Németh
- 1 Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika Szeged, Semmelweis u. 1., 6725 Magyarország
| | - Zoltán Kozinszky
- 2 Danderydi Kórház, Szülészeti és Nőgyógyászati Osztály Stockholm Svédország
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Csoma D, Altorjay ÁT, Németh G, Nyári T, Surányi A. Panaszmentes várandósok artériás nyomásértéke a várandósság első és második trimeszterében. Orv Hetil 2022; 163:1721-1726. [DOI: 10.1556/650.2022.32604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/29/2022] [Indexed: 11/21/2022]
Abstract
Bevezetés: Várandósság során a keringési rendszer is segíti a
magzat fejlődését. Az artériás középnyomás és a centrális systolés vérnyomás
normálértéke a várandósság elején lecsökken, majd a terminus végére megközelíti
a várandósság előtti értéket. Célkitűzés: Tanulmányunk célja az
első és a második trimeszterben a magyar várandós nők körében a különböző
keringési paraméterek normálértékeinek referencia-adatbázisát létrehozni.
Módszer: A Szegedi Tudományegyetem Szülészeti és
Nőgyógyászati Klinikájának járóbeteg-ambulanciáján megjelent várandósok közül
185 egészséges, várandós nőt választottunk ki 2020 májusától augusztus végéig.
Keringési és terhességi ultrahangvizsgálatok történtek. Validált TensioMed
Arteriograph 2020 műszerrel mértük a következő paramétereket: artériás
középnyomás, centrális systolés nyomás, a pulzushullám terjedési sebessége és a
boka-kar index a 12–21. hétig. Az ultrahangvizsgálatok Voluson 730 készülékkel
történtek. Eredmények: Eredményeink alapján látható, hogy az
artériás középnyomás és a centrális systolés vérnyomás értékei csökkentek a 12.
héttől a 15. hétig, és utána kezdtek el nőni a 21. hétig. A pulzushullám
terjedési sebessége és a boka-kar index esetében viszont nem volt szignifikáns
különbség a gestatiós hetekre vonatkoztatva. Megbeszélés: A 15.
gestatiós héten történő változás a keringési redisztribúciónak és szövettani
változásnak a következménye, amikor a chorion–placenta átalakulás végbemegy. Így
magas áramlású és alacsony ellenállású véráramlás jön létre. Összehasonlítva a
nem várandós állapotú nőknél mért referenciaértékekkel, azt mondhatjuk, hogy a
normáltartományon belül, de szignifikáns mértékben változnak az értékek.
Következtetés: A jövőben szeretnénk kiterjeszteni
vizsgálatainkat a harmadik trimeszterre is, valamint nemcsak egészséges
várandósokat, hanem magas vérnyomás kialakulására rizikós várandósokat is
bevonni a vizsgálatba. Ezáltal kívánunk létrehozni egy validált magyar
adatbázist, amely a terhességi magas vérnyomás kiszűrésében hasznos segédletté
válhatna a hazai várandósgondozási gyakorlatban. Orv Hetil. 2022; 163(43):
1721–1726.
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Affiliation(s)
- Dominika Csoma
- Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika Szeged, Semmelweis u. 1., 6720 Magyarország
| | - Ábel Tamás Altorjay
- Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika Szeged, Semmelweis u. 1., 6720 Magyarország
| | - Gábor Németh
- Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika Szeged, Semmelweis u. 1., 6720 Magyarország
| | - Tibor Nyári
- Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Orvosi Fizikai és Orvosi Informatikai Intézet Szeged Magyarország
| | - Andrea Surányi
- Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika Szeged, Semmelweis u. 1., 6720 Magyarország
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Karai A, Gyurkovits Z, Németh G, Orvos H, Paulik E. Adverse Maternal and Perinatal Outcome of Women Aged 40 Years or Over: A Retrospective Study. Int J Childbirth 2022. [DOI: 10.1891/ijc-2021-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDAdvanced maternal age is traditionally described to be 35 years of age or over. In recent years, new trends have suggested that it may be 40 years of age or over; this occurs in Hungary.AIMThe aim of this study was to determine the association between advanced maternal age and various adverse maternal and neonatal outcomes.METHODSA retrospective analysis was performed among women who delivered between 2015 and 2017. All women aged 40 years or over (cases) were involved into the analysis (n = 374). The controls (n = 378) were randomly selected from women aged 25 to 29 years who delivered during the same period considering the number of previous gestations and previous deliveries. The data collected from the medical records comprised the mothers’ demographic and obstetric characteristics and neonatal data. To assess the contribution of maternal age to various maternal and neonatal outcomes, multiple logistic regression analyses were used.RESULTSThe logistic regression analyses showed higher odds of gestational diabetes (AOR, adjusted odds ratio: 2.81), preeclampsia (AOR: 13.05), threatened preterm delivery (AOR: 3.62), and cesarean section (AOR: 3.31) in mothers of higher age. The odds of low birth weight (AOR: 2.56) and intensive care (AOR: 2.03) were significantly higher in older vs. younger mothers, while no significant associations were between maternal age and fetal macrosomia and congenital malformations.CONCLUSIONSConsidering our results, it is important to educate women about the consequences of delayed childbearing and the need of continuous observation within prenatal care.
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Polanek E, Karai A, Molnár R, Németh G, Orvos H, Balogh P, Paulik E. Association between sociodemographic, obstetric, and lifestyle factors among Hungarian pregnant women—A cross‐sectional study. J Obstet Gynaecol Res 2022; 48:2541-2551. [DOI: 10.1111/jog.15364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 03/29/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Evelin Polanek
- Department of Public Health University of Szeged Szeged Hungary
| | - Adrienn Karai
- Department of Pediatrics University of Szeged Szeged Hungary
| | - Regina Molnár
- Department of Public Health University of Szeged Szeged Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynecology University of Szeged Szeged Hungary
| | - Hajnalka Orvos
- Department of Obstetrics and Gynecology University of Szeged Szeged Hungary
| | - Péter Balogh
- Department of Sociology University of Szeged Szeged Hungary
| | - Edit Paulik
- Department of Public Health University of Szeged Szeged Hungary
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Falkai P, Dombi Z, Acsai K, Barabássy Á, Németh G. The efficacy of cariprazine in chronic schizophrenia – post hoc analyses of phase II/III clinical trials. Eur Psychiatry 2022. [PMCID: PMC9567052 DOI: 10.1192/j.eurpsy.2022.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Chronic schizophrenia patients are experiencing persistent and severe illness for more than 15-20 years and are usually suffering from long-term negative symptoms. Cariprazine, a novel D3-D2 partial agonist has been proven to be effective in the treatment of acute schizophrenia, however its ability to treat chronic patients has not been assessed yet. Objectives The primary aim of the present post-hoc analysis is to assess the efficacy of cariprazine in treating patients with chronic schizophrenia (late-stage and residual schizophrenia patients). Methods Data from 3 phase II/III 6-week, randomized, double-blind, placebo-controlled trials with similar design in patients with acute exacerbation of schizophrenia were pooled and patients with more than 15 years of schizophrenia were analysed (late-stage patients). Furthermore, schizophrenia patients experiencing predominantly negative symptoms from a 26-week, randomized, double-blind, active-controlled, fixed-flexible-dose trial with an ICD-10 code of F20.5 were analysed post-hoc (residual patients). Results Altogether, 414 late stage (286 cariprazine and 128 placebo) and 35 residual (23 cariprazine and 12 risperidone) patients were identified. The pooled analysis evaluating mean change from baseline to week 6 in the PANSS total score indicated statistically significant difference in favour of cariprazine in the late stage (LSMD -6.7, p<0.01) subpopulation compared to placebo. The mean change from baseline in patients with residual schizophrenia in the cariprazine arm was -9.6 on the PANSS-FSNS scale, while -7.9 in the risperidone arm. Conclusions Based on the results, it seems that cariprazine might be a good treatment option for patients with chronic schizophrenia. Nonetheless, further studies are needed to confirm this. Disclosure I am an employee of Gedeon Richter Plc.
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Németh G. From a Pathophysiological Concept to a New Drug. Eur Psychiatry 2022. [PMCID: PMC9566939 DOI: 10.1192/j.eurpsy.2022.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Although antipsychotics were discovered over fifty years ago, it took another decade until dopamine antagonism was demonstrated as central to their clinical effectiveness. Since accumulated evidence implicates the dopamine system in the pathophysiology of schizophrenia, all licensed first-line treatments operate primarily via antagonism of the dopamine D2 receptor. However, dopamine D2 receptor blockade does not effectively treat negative, cognitive and affective symptoms and, in a significant proportion of patients, it does not improve positive symptoms either. Therefore, additional neurochemical targets were considered. The “revised dopamine hypothesis” proposes that positive symptoms emerge due to hyperactive dopamine transmission in mesolimbic areas, while hypoactive dopamine transmission via the mesocortical pathway in the prefrontal cortex is linked to negative, cognitive, and partly affective symptoms. In this context, the role of D3 receptors were recognised. However, there is also evidence for the involvement of other neurotransmitter systems, suggesting that dopamine signalling relies on a suite of receptors that are thought to either facilitate or inhibit neurotransmitter activity through several interconnected neural circuits. Furthermore, there seem to be clusters of symptoms that cross the boundaries of disorders. Symptoms having similar pathophysiology at neurotransmitter level can be treated with the same drug or class of drugs. Thus, one particular drug might be effective in more than one indication. This lecture aims to illustrate the process of a new drug development by explaining how the underlying pathophysiology on receptor level impacts clinical studies and vice versa.
Disclosure
Employee of Gedeon Richter Plc.
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Mcintyre R, Dombi Z, Barabássy Á, Németh G. Cariprazine’s efficacy in treating affective symptoms – pooled data from schizophrenia and bipolar depression trials. Eur Psychiatry 2022. [PMCID: PMC9566323 DOI: 10.1192/j.eurpsy.2022.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Affective symptoms are a common feature of schizophrenia and define bipolar disorder. Alterations in dopamine neurotransmission and activity at D3-D2 receptors is associated with depressive symptoms providing the rationale for targeting D3-D2 receptors with partial agonists. Objectives The aim of the analysis herein is to examine and compare the efficacy of cariprazine in treating affective symptoms in both schizophrenia and bipolar depression. Methods Data from 3 schizophrenia [NCT00694707, NCT01104766, NCT01104779] and 3 bipolar I depression studies [NCT013896447, NCT02670538, NCT0267055] were pooled for the analyses. To investigate efficacy across individual affective symptoms, the Marder anxiety/depression and negative symptom items of the Positive and Negative Syndrome Scale (PANSS) and single items of the Montgomery-Asberg Depression Rating Scale (MADRS) were analysed. Improvement across affective symptoms was examined primarily evaluating least square mean differences (LSMDs) in comparison to placebo in mean change from baseline. Results The pooled ITT population was comprised of persons with schizophrenia (placebo=442, cariprazine=1024) and bipolar disorder (placebo=460, cariprazine=923). Cariprazine resulted in a significantly greater reduction when compared to placebo in three out of the four Marder anxiety/depression items; anxiety (p<0.01), tension (p<0.001) and depression (p<0.05). Similarly, cariprazine was significantly better than placebo in 9 out of the 10 MADRS individual items; apparent sadness (p<0.001), reported sadness (p<0.001), reduced sleep (p<0.05), reduced appetite (p<0.001), concentration difficulties (p<0.001), lassitude (p<0.001), inability to feel (p<0.001), pessimistic thoughts (p<0.01) and suicidal thoughts (p<0.05). Conclusions The results herein indicate that cariprazine treatment is significantly effective at treating affective symptoms in persons with both schizophrenia and bipolar I depression. Disclosure I am an employee of Gedeon Richter Plc.
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Koványi-Lax G, Hargitai C, Ábrányi-Balogh P, Nagy T, Tóth G, Garádi Z, Németh G, Pandur A, Horváth S, Dancsó A, Simig G, Volk B. Experimental and computational study of BF 3-catalyzed transformations of ortho-(pivaloylaminomethyl)benzaldehydes: an unexpected difference from TFA catalysis. Org Biomol Chem 2022; 20:1933-1944. [PMID: 35170615 DOI: 10.1039/d1ob02308j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Previously, we have studied the trifluoroacetic acid (TFA)-catalyzed rearrangements of unsubstituted and alkoxy-substituted ortho-(pivaloylaminomethyl)benzaldehydes and revealed the formation of rearranged, regioisomeric aldehydes along with dimer-like products ("TFA dimers"). In the present study, related reactions of ortho-(pivaloylaminomethyl)benzaldehydes are described with the difference that boron trifluoride diethyl etherate (BF3·OEt2) is used as the catalyst. Although in these reactions the formation of the same "TFA dimers" can be observed after a couple of hours reaction time, during further stirring these are transformed into a new dimer-like keto compound ("BF3 dimer") that gradually becomes the main product. Apart from this, an oxoindene-type by-product is also formed. The new products are characterized by detailed NMR studies and two of them also by single-crystal X-ray diffraction. DFT calculations support the mechanism proposed for the transformations and explain the differences observed in the product distribution.
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Affiliation(s)
- Györgyi Koványi-Lax
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary.
| | - Csilla Hargitai
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary.
| | - Péter Ábrányi-Balogh
- Medicinal Chemistry Research Group, Research Centre for Natural Sciences, P.O. Box 286, H-1519 Budapest, Hungary
| | - Tamás Nagy
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary.
| | - Gábor Tóth
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary. .,Department of Inorganic and Analytical Chemistry, Budapest University of Technology and Economics, Szent Gellért tér 4, H-1111 Budapest, Hungary
| | - Zsófia Garádi
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary.
| | - Gábor Németh
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary.
| | - Angéla Pandur
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary.
| | - Simon Horváth
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary.
| | - András Dancsó
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary.
| | - Gyula Simig
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary.
| | - Balázs Volk
- Directorate of Drug Substance Development, Egis Pharmaceuticals Plc., P.O. Box 100, H-1475 Budapest, Hungary.
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András G, Németh G, Oláh CZ, Lénárt G, Drén Z, Papp M. The personalized Berger method is usable to solve the problem of tibial rotation. J Exp Orthop 2021; 8:116. [PMID: 34897564 PMCID: PMC8665959 DOI: 10.1186/s40634-021-00432-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/16/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose The revision of any total knee replacement is carried out in a significant number of cases, due to the excessive internal rotation of the tibial component. The goal was to develop a personalized method, using only the geometric parameters of the tibia, without the femoral guidelines, to calculate the postoperative rotational position of tibial component malrotation within a tolerable error threshold in every case. Methods Preoperative CT scans of eighty-five osteoarthritic knees were examined by three independent medical doctors twice over 7 weeks. The geometric centre of the tibia was produced by the ellipse annotation drawn 8 mm below the tibial plateau, the sagittal and frontal axes of the ellipse were transposed to the slice of the tibial tuberosity. With the usage of several guide lines, a right triangle was drawn within which the personalized Berger angle was calculated. Results A very good intra-observer (0.89-0.925) and inter-observer (0.874) intra-class correlation coefficient (ICC) was achieved. Even if the average of the personalized Berger values were similar to the original 18° (18.32° in our case), only 70.6% of the patients are between the clinically tolerable thresholds (12.2° and 23.8°). Conclusion The method, measured on the preoperative CT scans, is capable of calculating the required correction during the planning of revision arthroplasties which are necessary due to the tibial component malrotation. The personalized Berger angle isn’t altered during arthroplasty, this way it determines which one of the anterior reference points of the tibia (medial 1/3 or the tip of the tibial tuberosity, medial border or 1/6 or 1/3 or the centre of the patellar tendon) can be used during the positioning of the tibial component. Level of evidence Level II, Diagnostic Study (Methodological Study).
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Affiliation(s)
- Gömöri András
- Department of Traumatology, Semmelweis University - Medicine and Health Sciences, Borsod-Abaúj-Zemplén County Hospital, Üllői út 26., Budapest, 1085, Hungary.
| | - Gábor Németh
- Department of Ophthalmology, Borsod-Abaúj-Zemplén County Hospital, Szentpéteri kapu 72-76, Miskolc, 3526, Hungary
| | - Csaba Zsolt Oláh
- Department of Neurosurgery, Borsod-Abaúj-Zemplén County Hospital, Szentpéteri kapu 72-76, Miskolc, 3526, Hungary
| | - Gábor Lénárt
- Department of Radiology, Borsod-Abaúj-Zemplén County Hospital, Szentpéteri kapu 72-76, Miskolc, 3526, Hungary
| | - Zsanett Drén
- Department of Radiology, Borsod-Abaúj-Zemplén County Hospital, Szentpéteri kapu 72-76, Miskolc, 3526, Hungary
| | - Miklós Papp
- TritonLife Róbert Magánkórház, Department of Orthopaedics, Miskolci Egyetem, Egészségtudományi kar, Egyetemváros, Miskolc, 3515, Hungary
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Sikovanyecz J, Vincze M, Földesi I, Németh G, Kozinszky Z. Angiogenic factors measured in aspirated placental tissue between the 10 + 6 and 18 + 3 weeks of gestation. Reprod Biol 2021; 21:100572. [PMID: 34798517 DOI: 10.1016/j.repbio.2021.100572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 09/05/2021] [Accepted: 10/23/2021] [Indexed: 11/28/2022]
Abstract
This study was designed to determine the level of vascular endothelial growth factor-A (VEGF-A), basic fibroblast growth factor (bFGF) and endothelial nitric oxide synthase (eNOS) in chorionic villi during in first and second trimester, and their association with nuchal translucency (NT) measured by ultrasound. Seventy-five singleton healthy pregnancies with no detected congenital malformation were collected for NT measurements and chorionic villus sampling (CVS). Concentrations of angiogenic factors were assayed in chorionic villi sampled between 10 + 6 and 18 + 3 weeks of gestation. ENOS level was steady during this gestational period, while the concentrations of VEGF-A and bFGF significantly decreased. Placental concentrations of VEGF-A and bFGF correlated positively with each other (semi-partial correlation in multivariable linear regression (r): 0.90) and both correlated negatively with the eNOS level (r: -0.64 and r: -0.83, respectively). NT was positively correlated with eNOS concentration and negatively correlated with bFGF levels (r: 0.85 and r: -0.78, respectively). Inverse correlation was found between gestational age and VEGF-A and bFGF concentrations (r: -0.57 and r: 0.73, respectively). Alterations of angiogenic factors in chorionic villi might be an adjunct modality to NT and foetal growth as sonographic markers.
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Affiliation(s)
- János Sikovanyecz
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Centre, University of Szeged, Szeged, Hungary
| | - Márió Vincze
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Centre, University of Szeged, Szeged, Hungary
| | - Imre Földesi
- Department of Laboratory Medicine, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Centre, University of Szeged, Szeged, Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Centre, University of Szeged, Szeged, Hungary
| | - Zoltan Kozinszky
- Department of Obstetrics and Gynaecology, Danderyd Hospital, Stockholm, Sweden.
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Paulik E, Horváth E, Szabó A, Polanek E, Gyurkovits Z, Németh G, Orvos H. Vitamin D status and its influencing factors among pregnant women in Szeged, Hungary. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
During pregnancy vitamin D plays an important role in maternal and fetal immune regulation as well. The aim of our study was to evaluate vitamin D serum level and its influencing factors among pregnant women and their newborns.
Methods
A cross-sectional study was performed among women delivering at the Department of Obstetrics and Gynecology in 2019. Altogether 301 women were included into the study, who filled the questionnaire one or two days after delivery. Data collection was based on a self-administered questionnaire, health documentation, and maternal serum and infant cord-blood vitamin D laboratory tests. Vitamin D intake was evaluated by dietary and vitamin D containing dietary supplement intake. Statistical analyses (descriptive statistics, chi square, Pearson's correlation, Kruskal-Wallis test) were performed with the IBM SPSS 26.0 program. The study protocol was approved by the Research Ethics Committee of the University of Szeged (number: 4419). Written informed consent was obtained from each participant of the study.
Results
The average maternal age of the included women was 33.28 years. More than half of women did not eat sea fish during the pregnancy, 66.3% drank daily milk, 51.5% ate daily yoghurt, and 30.2% used daily margarine as a spread. During pregnancy 77.6% of included women took some kind of vitamin D containing dietary supplement with which their average daily vitamin-D supplementation was 17.19 microgram (SD = 22.45 microgram). The average serum vitamin D level was 52.81 nmol/L in mothers and 72.96 nmol/L in newborns' cord-blood. Only 12.1% of mothers, and 43.1% of their newborns reached the optimal (75 nmol/L) level.
Conclusions
Our results showed that dietary and supplementary vitamin-D intake are insufficient among pregnant women, and consequently vitamin D serum levels are also lower than the optimal among mothers and their newborns, consequently.
Grant support: University of Szeged, Faculty of Medicine, Hetényi Géza Grant
Key messages
Low vitamin D level is a global public health issue. Vitamin D supplementation during pregnancy is important to maintain the optimal vitamin D serum level.
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Affiliation(s)
| | - E Horváth
- Department of Public Health, University of Szeged, Szeged, Hungary
| | - A Szabó
- Department of Public Health, University of Szeged, Szeged, Hungary
| | - E Polanek
- Department of Public Health, University of Szeged, Szeged, Hungary
| | - Z Gyurkovits
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - G Németh
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - H Orvos
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
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Pap É, Nagy N, Farkas K, Németh G, Széll M. 177 Identification of putative genetic modifying factors that influence the development of Papillon-Lefévre or Haim-Munk syndrome phenotypes. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Nagy N, Pap ÉM, Farkas K, Németh G, Rajan N, Széll M. 176 Identification of putative phenotype-modifying genetic factors associated with phenotypic diversity in Brooke-Spiegler syndrome. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vincze MA, Németh G, Novák T. Laparoscopic management of adnexal torsion at 32th week of gestation. Orv Hetil 2021; 162:1418-1421. [PMID: 34460432 DOI: 10.1556/650.2021.32165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/18/2021] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Terhességben az élettani és anatómiai változások miatt bizonyos patológiás szervi eltérések nem specifikus tünettannal járhatnak. A várandósság alatt fellépő hasi panaszok esetén lényeges felállítani a gyors és pontos diagnózist, a minél korábbi adekvát terápia érdekében. A klinikai tünetek hátterében többek között állhatnak szülészeti betegségek, illetve appendicitis, megnagyobbodott ovariumcysta, nephrolithiasis vagy diverticulitis is. Esetismertetésünkben egy 32 hetes gravida ellátását prezentáljuk, aki jobb alhasi panaszok miatt jelentkezett a Szegedi Tudományegyetem Szülészeti és Nőgyógyászati Klinikáján. A magzati paraméterek megfelelőek voltak. A klinikai vizsgálatok appendicitis gyanúját vetették fel, mely miatt laparoszkópia történt. Torquálódott jobb oldali tuba uterina miatt jobb oldali salpingectomiát végeztünk, az appendix kóros elváltozása nem igazolódott. Magzati, illetve anyai szövődmény a posztoperatív szakban nem volt. A további terhesgondozás során szövődményt nem észleltünk, majd a betöltött 40. terhességi héten hüvelyi úton egészséges újszülött született. A méhfüggelék megcsavarodásának operatív megoldása laparoszkópos úton alkalmazható módszernek tekinthető terhességben is. Az adnexcsavarodás ritka sürgősségi nőgyógyászati kórképnek számít, bár szakirodalmi adatok alapján az adnexum torsiójának rizikója fokozott lehet a terhesség korai szakaszában, kiváltképp asszisztált reprodukciós technikák alkalmazása esetén. Várandósság alatt hirtelen jelentkező alhasi panaszok esetén az anamnesztikus adatok tükrében, a klinikai vizsgálatok során szükséges az adnextorsio lehetőségére is gondolni. Orv Hetil. 2021; 162(35): 1418-1421. Summary. Due to physiological and anatomical changes in pregnancy, certain pathological organ abnormalities may be associated with non-specific symptoms. In the case of abdominal complaints during pregnancy, it is important to make a quick and accurate diagnosis to apply an early adequate therapy. The cause of the clinical symptoms can be obstetrical diseases, appendicitis, large ovarial cyst, rarely nephrolithiasis or diverticulitis. Through our case study, we present the treatment of a 32-week gravida. Examination of the pregnant patient occured at the Department of Obstetrics and Gynecology of the University of Szeged due to right lower abdominal pain. The fetal parameters were satisfactory. We assumed appendicitis, so after proper preparation laparoscopy was performed. Salpingectomy was performed because of torqued right fallopian tube and no pathological changes were detected on the appendix. In the postoperative period, there were no fetal or maternal complications. During further care of pregnancy, there were no complications and a healthy newborn was born by vaginal delivery at the 40th week of gestation. The operative procedure of adnexal rotation by laparoscopy can be considered as an applicable method even in pregnancy. Adnexal torsion is a rare emergency gynecological disease, although literature data suggest an increased risk in early pregnancy, especially in the case of assisted reproductive technology. In the case of sudden abdominal pain during pregnancy, in the light of anamnestic data, it is recommended to consider the possibility of adnexal torsion, too. Orv Hetil. 2021; 162(35): 1418-1421.
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Affiliation(s)
- Márió Attila Vincze
- 1 Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika, Szeged, Semmelweis u. 1., 6725
| | - Gábor Németh
- 1 Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika, Szeged, Semmelweis u. 1., 6725
| | - Tibor Novák
- 1 Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika, Szeged, Semmelweis u. 1., 6725
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Abstract
OBJECTIVE To assess the effectiveness of early universal ultrasound (US) screening of developmental dysplasia of the hip (DDH). STUDY DESIGN A prospective study of universal hip screening of all mature neonates was conducted from 2012 to 2013, at the Department of Obstetrics and Gynaecology, University of Szeged; 1636 newborns (3272 hips) had clinical examinations and hip ultrasound by the Graf method within the1st 3 days of life. Prevalence of DDH, risk factors, sensitivity and specificity of clinical examinations were evaluated. RESULTS At the 1st US, 70 of the examined 3272 hips (2.14%) were found to be positive. According to Graf categories, the following distribution was observed: type II C, 21 hips (30.0%); D, 24 hips (34.28%); III, 24 hips (34.28%); IV, 1 hip (1.44%). Regarding the risk factors, female gender, breech presentation and positive family history proved to be significant. Interestingly, 28 (50.90%) of the 55 newborns with DDH had neither positive physical signs nor any risk factors, except being female. The physical examination was calculated for sensitivity (20.0%) and specificity (98.34%). CONCLUSIONS In our 1-year period study, 50.9% of the newborns with DDH had neither any positive physical signs nor any risk factors, except being a female. In contrast, early universal US screening of the hip facilitated to diagnose all cases with hip dysplasia. Hip sonography is an effective mode of prevention in orthopaedics, however further studies are needed to compare the rates of operative procedures in selective versus universal screening models.
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Affiliation(s)
- Zita Gyurkovits
- Department of Obstetrics and Gynaecology, University of Szeged, Hungary
| | - Gellért Sohár
- Department of Orthopaedics, University of Szeged, Hungary
| | - Anna Baricsa
- Department of Orthopaedics, University of Szeged, Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynaecology, University of Szeged, Hungary
| | - Hajnalka Orvos
- Department of Obstetrics and Gynaecology, University of Szeged, Hungary
| | - Beat Dubs
- Department of Obstetrics and Gynaecology, University of Szeged, Hungary
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Laszlovszky I, Dombi Z, Balogh Á, Barabássy Á, Vass G, Szatmári B, Németh G. The effect of cariprazine on patient engagement: Post-hoc analysis of a phase 3 study in patients with predominant negative symptoms of schizophrenia. Eur Psychiatry 2021. [PMCID: PMC9475933 DOI: 10.1192/j.eurpsy.2021.1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionMotivation deficit is a significant aspect of lack of improvement in patients with schizophrenia especially with predominant negative symptoms (PNS). Therefore, improvement depends not only on symptoms reduction and better social functioning but also on patient engagement which is a key but less investigated aspect of successful treatment.ObjectivesTo investigate and compare patient engagement in PNS patients after cariprazine and risperidone treatment characterized by the 11 items of the Positive and Negative Syndrome Scale (PANSS-11).MethodsIn this phase 3 study patients suffering from PNS of schizophrenia (PANSS-FSNS≥24) were randomized to 26 weeks of treatment with either cariprazine or risperidone (target dose 4.5 and 4 mg/day, respectively). To compare the effects of the two drugs on patient engagement the PANSS-11 scale was used. Change from baseline (CfB) on the selected items and PANSS-11 total score were analyzed using mixed model of repeated measures approach without correction for multiplicity.ResultsPANSS-11 total score mean CfB were -11.20 (SD=0.43) for cariprazine-, and -9.44 (SD=0.45) for risperidone-treated patients with a -1.79 (95% CI=-3.01, -0.56) mean difference (p=0.004) in favor of cariprazine. Most item differences were statistically significant (N1, N2, N3, N4, N5, G16) or numerically higher (N6, G7, G13) for cariprazine versus risperidone.ConclusionsCariprazine significantly improved patient engagement in patients with PNS of schizophrenia compared to risperidone based on the PANSS-11 post-hoc analysis. These results suggest that cariprazine treatment may improve not only the symptoms and everyday functioning of PNS patients but their engagement with life.Conflict of interestStudies were funded by Gedeon Richter Plc. and Allergan Plc (prior to its acquisition by AbbVie). Dr. Laszlovszky, Dombi, Balogh, Dr Barabassy, Dr Vass, Dr. Szatmári and Dr. Németh are employees of Gedeon Richter Plc.
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Dombi Z, Acsai K, Barabássy Á, Sebe B, Laszlovszky I, Vass G, Szatmári B, Patel M, Earley W, Németh G. Tolerability of cariprazine in the early stage of schizophrenia: A pooled, post-hoc analysis of 4 phase ii/iii double-blind placebo-controlled trials. Eur Psychiatry 2021. [PMCID: PMC9475661 DOI: 10.1192/j.eurpsy.2021.1400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction In the early stage of schizophrenia (first 5 years), the most important clinical target besides symptom control is relapse prevention as each relapse significantly decreases the possibility of preferable long-term outcomes. Early discontinuation of antipsychotic medication due to intolerable side-effects is one of the most common causes of relapse. Objectives This poster aims to present cariprazine’s tolerability in the early stage of schizophrenia. Methods Data from 4 randomized, double-blind, placebo-controlled trials (NCT00404573, NCT01104766, NCT01104779, NCT00694707) with similar design (1 week of wash out period, 6 weeks of treatment and 2-4 weeks of follow-up) were pooled. For the post-hoc analysis, patients with early stage of schizophrenia (defined as having a disease duration of less than 5 years) were extracted from the whole safety population, and approved doses of cariprazine (1.5-6.0 mg/day) were combined. Treatment-emergent adverse events (TEAEs) and discontinuation rates were analysed versus placebo. Results Overall, 169 placebo- (PBO) and 322 cariprazine-treated (CAR) patients were identified as having schizophrenia for less than 5 years. 67.7% cariprazine- and 56.2% placebo-treated patients reported at least one TEAE; most frequently insomnia (10.9 % CAR; 12.4% PBO), akathisia (9.6% CAR; 2.4% PBO) and extrapyramidal symptoms (9.3% CAR; 1.8% PBO). Discontinuation due to adverse events was reported in only 8.4% of cariprazine- and 14.8% of placebo-treated patients. Relapse occurred in 3.1% of cariprazine- and 5.3% of placebo-treated patients. Conclusions Cariprazine was generally well-tolerated in the early stage of schizophrenia; given the limitations of this analysis, additional research is warranted. Conflict of interest Studies were funded by Gedeon Richter Plc. and Allergan Plc (prior to its acquisition by AbbVie). Dombi, Acsai, Dr. Barabássy, Dr. Sebe, Dr. Laszlovszky, Dr Vass, Dr. Szatmári and Dr. Németh are employees of Gedeon Richter Plc., Dr. Earley and Dr. Patel a
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Vass G, Barabássy Á, Laszlovszky I, Sebe B, Dombi Z, Szatmári B, Németh G. Safety during polypharmacy: A post-hoc analysis examining the safety profile of cariprazine with other antipsychotics in the cross-titration phase. Eur Psychiatry 2021. [PMCID: PMC9476108 DOI: 10.1192/j.eurpsy.2021.1424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionAlthough monotherapy is preferable, in every day clinical practice polypharmacy is often unavoidable due to the need of treatment enhancement or cross-titration phases with shorter or longer overlaps of two or more drugs. However, administration of more than one drug treatment is often associated with more side effects.ObjectivesThe aim of the present post-hoc analysis was to examine treatment emergent adverse events (TEAEs) during co-administration of cariprazine with other antipsychotics.MethodsTreatment emergent adverse event data (TEAE) from a randomized, double-blind, parallel-group, active-controlled study (EudraCT Number: 2012-005485-36) in adult patients with schizophrenia having predominant negative symptoms was examined in the first two weeks of the double-blind treatment period, where gradual cross-titration occurred between cariprazine (3-6 mg/day) and other antipsychotics (including amisulpride, aripiprazole, fluphenazine, haloperidol, olanzapine, paliperidone, quetiapine, and sertindole). Thereafter, 24 weeks of cariprazine monotherapy followed.ResultsDuring the cross-titration period, 17.83% of patients experienced at least one TEAE. The TEAEs were in line with the well-established safety data: nausea (2.61%), insomnia (2.17%), headache (2.17%), akathisia (1.74%) and restlessness (1.3%) were the most common. Most events were mild in severity (66.1% mild, 32.2% moderate, 1.7% severe (insomnia)).ConclusionsWhile not definitive, and limited by small sample size, the co-administration of cariprazine with other antipsychotics did not show an unexpected safety profile or overlapping toxicities. This is an important finding, if intermittent or longer co-administration of other antipsychotics are unavoidable with cariprazine treatment.Conflict of interestStudies were funded by Gedeon Richter Plc. and Allergan Plc (prior to its acquisition by AbbVie). Dr Vass, Dr Barabássy, Dr Laszlovszky, Dr Sebe, Dombi, Dr Szatmári and Dr Németh are employees of Gedeon Richter Plc.
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Pap ÉM, Farkas K, Széll M, Németh G, Rajan N, Nagy N. Identification of putative phenotype-modifying genetic factors associated with phenotypic diversity in Brooke-Spiegler syndrome. Exp Dermatol 2020; 29:1017-1020. [PMID: 32744342 DOI: 10.1111/exd.14161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/29/2020] [Accepted: 07/27/2020] [Indexed: 01/02/2023]
Abstract
Brooke-Spiegler syndrome (BSS, OMIM 605041) is a rare monogenic skin disease characterized by the development of skin appendage tumors caused by mutations in the cylindromatosis gene. We recently investigated a Hungarian and an Anglo-Saxon pedigrees affected by Brooke-Spiegler syndrome. Despite carrying the same disease-causing mutation (c.2806C>T, p.Arg936X) of the cylindromatosis (CYLD) gene, the affected family members of the two pedigrees exhibit striking differences in their phenotypes. To identify phenotype-modifying genetic factors, whole exome sequencing was performed and the data from the Hungarian and Anglo-Saxon BSS patients were compared. Three putative phenotype-modifying genetic variants were identified: the rs1053023 SNP of the signal transducer and activator of transcription 3 (STAT3) gene, the rs1131877 SNP of the tumor necrosis factor receptor-associated factor 3 (TRAF3) gene and the rs202122812 SNP of the neighbour of BRCA1 gene 1 (NBR1) gene. Our study contributes to the accumulating evidence for the clinical importance of phenotype-modifying genetic factors, which are potentially important for the elucidation of disease prognosis.
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Affiliation(s)
- Éva Melinda Pap
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - Katalin Farkas
- Department of Medical Genetics, University of Szeged, Szeged, Hungary
| | - Márta Széll
- Department of Medical Genetics, University of Szeged, Szeged, Hungary.,Dermatological Research Group of the Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - Neil Rajan
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Nikoletta Nagy
- Department of Medical Genetics, University of Szeged, Szeged, Hungary.,Dermatological Research Group of the Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
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Paulik E, Horváth E, Szabó A, Polanek E, Gyurkovits Z, Németh G, Orvos H. Health consciousness during pregnancy: the association between dietary supplementation and lifestyle. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Dietary supplements are recommended for pregnant women who cannot meet the daily dose through food intake, or who are at higher risk of deficiencies because of a substance abuse (e.g. smoking). Today, the preventive effect of folic acid (FoA) in the periconceptional period is evidence based, and there are studies about the positive effects of omega-3 fatty acids (n-3 FAs) during pregnancy. The aim of this study was to determine the association between FoA and n-3 FAs supplementation and health behavior - diet, physical activity, smoking - of pregnant women.
Methods
The cross-sectional study was conducted among women having their babies at the Department of Obstetrics and Gynecology (N = 1548). Data collection was based on self-administered questionnaire and health documentation. Uni- and multivariable logistic regression analyses were performed with IBM SPSS 26.0; the results are expressed in odds ratios (OR) and 95% confidence intervals (CI).
Results
Mean age of women was 31 years, most of them had university degree, nearly 90% of them lived in partnership. The prevalence of smoking during pregnancy was 6.5%, 39.8% did not consume fruits/vegetables daily, 58.5% ate fish less than weekly, 47.9% were physically inactive; 67.6% took FoA, and 30.6% n-3 FAs. FoA and n-3 FAs taking were more likely among those who ate fruits and vegetables every day (OR/CI: 1.30/1.01-1.66; 1.47/1.15-1.89) and among non-smokers (OR/CI: 1.73/1.06-2.83; 4.80/1.69-13.61), while FoA consumption associated with physical activity (OR/CI: 1.37/1.07-1.74) and n-3 FAs with fish consumption (OR/CI: 1.35/1.06-1.72).
Conclusions
Our results showed that a high proportion of pregnant women did not follow a healthy lifestyle, and the unhealthy behavior was significantly associated with the less frequent use of dietary supplementation. The results call the attention for the importance of counseling on healthy lifestyle and appropriate supplement use before and during pregnancy.
Key messages
Use of dietary supplementation is higher among pregnant women following a healthy way of lifestyle. The results reinforce the importance of lifestyle counseling during pregnant care.
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Affiliation(s)
- E Paulik
- Department of Public Health, University of Szeged, Szeged, Hungary
| | - E Horváth
- Department of Public Health, University of Szeged, Szeged, Hungary
| | - A Szabó
- Department of Public Health, University of Szeged, Szeged, Hungary
| | - E Polanek
- Department of Public Health, University of Szeged, Szeged, Hungary
| | - Z Gyurkovits
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - G Németh
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - H Orvos
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
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Horváth S, Eke Z, Németh G. Utilization of the hysteresis phenomenon for chiral high-performance liquid chromatographic method selection in polar organic mode. J Chromatogr A 2020; 1625:461280. [PMID: 32709331 DOI: 10.1016/j.chroma.2020.461280] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/12/2022]
Abstract
Polysaccharide-based chiral stationary phases (CSPs) are outstandingly suitable to play a key role in chiral HPLC method selection strategies, since they provide high success rates. One reason for this ability is that they adopt a diversity of higher order structures in various eluents, resulting in versatile chiral environments. A potential to extend this versatility further was expected and examined in the present study, based on the recently discovered hysteretic behavior of a widely used chiral selector (CS), amylose tris(3,5-dimethylphenylcarbamate). The hindered transitions of its structure, which are behind the history dependence of its separation ability, were used as a tool to identify distinct states of the chiral selector in order to exploit an extended selectivity space. The identification was carried out using a single diagnostic compound, as opposed to the common approach where testing a library of compounds is required. Eluent mixtures consisting of 2-propanol and either methanol or ethanol were scrutinized in terms of stability and robustness of the observed retentions. The solvent mixtures that were eligible for practical application in these respects were used to construct a screening sequence, including identical compositions combined with different column pretreatment. The gain achievable by using the proposed sequence was then evaluated using 15 enantiomer pairs with focus on resolution, enantiomer elution order and chemoselectivity.
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Affiliation(s)
- Simon Horváth
- György Hevesy Doctoral School of Chemistry, Eötvös Loránd University, Pázmány Péter stny. 1/A, H-1117 Budapest, Hungary; Drug Substance Development Division, Egis Pharmaceuticals PLC, P. O. Box 100, H-1475 Budapest, Hungary
| | - Zsuzsanna Eke
- Joint Research and Training Laboratory on Separation Science, Eötvös Loránd University, Pázmány Péter stny. 1/A, H-1117 Budapest, Hungary; Wessling International Research and Educational Center, Anonymus u. 6., H-1045 Budapest, Hungary
| | - Gábor Németh
- Drug Substance Development Division, Egis Pharmaceuticals PLC, P. O. Box 100, H-1475 Budapest, Hungary.
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Novák T, Németh G, Kozinszky Z, Urbán E, Gorzó I, Radnai M. Could Poor Periodontal Status be a Warning Sign for Worse Pregnancy Outcome? Oral Health Prev Dent 2020; 18:165-170. [PMID: 32238988 DOI: 10.3290/j.ohpd.a43356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The aim of the present study was to analyse the role of the main diagnostic signs of poor periodontal status, probing depth (PD) ≥4 mm and bleeding on probing (BOP) ≥50%, both simultaneously and individually in preterm birth (PB) and their effect on the birth weight (BW). Prematurity is a major health concern and it is the leading contributing factor to neonatal morbidity and mortality worldwide. Conflicting results exist on the relation between poor maternal, periodontal status and adverse pregnancy outcome, including preterm deliveries and low birth weight (LBW). MATERIALS AND METHODS Seventy-seven PBs and 165 deliveries at term were analysed out of 242 patients. The perinatal factors such as gestational age (GA) and BW were analysed by BOP, categorised as ≥50% (high BOP) vs <50% (non-high BOP) and PD ≥4 mm vs <4 mm, in combination or separately. RESULTS The obtained results suggest that maternal periodontal inflammation, represented particularly by BOP, might be a triggering factor and can be associated with PB and LBW. For women with high BOP the adjusted odds ratio (AOR) for LBW was 2.28-fold and they were likely to have PB, with a 2.02-fold higher rate. CONCLUSION An increasing tendency of BOP seemed to be associated with a tendency to PB and LBW. Further investigations are necessary to underline this relationship, but the role of good oral health status in general, and particularly in case of pregnancy, is unequivocal.
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Németh G, Debelle M, Laszlovszky I, Szalai E, Szatmári B, Harsányi J, Barabássy Á, Durgam S, Bitter I, Galderisi S. Monotherapy treatment with cariprazine for the treatment of predominant negative symptoms of patients with schizophrenia: A double-blind, active comparator-controlled trial. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
ObjectiveTo examine the effect of cariprazine, a dopamine D3/D2 receptor partial agonist with preferential binding to D3 receptors, on predominant negative symptoms of schizophrenia.MethodsSubjects with schizophrenia and PANSS factor score for negative symptoms (PANSS-FSNS) ≥ 24 and no pseudospecific factors (e.g. extrapyramidal symptoms, depression) were randomized to cariprazine 4.5 mg/d (dose range: 3-6 mg/d) or risperidone 4 mg/d (dose range: 3-6 mg/d) for 6 months.ResultsFour hundred and sixty-one patients were randomized 1:1 to double-blind risperidone (n = 231) or cariprazine (n = 230) treatment. Change from Baseline (CfB) at week 26 in the primary parameter, PANSS-FSNS, was larger in the cariprazine group than in the risperidone group (LSMD = −1.47; 95% CI: [−2.39, −0.53]; P = 0.002) significant from week 14 onwards. CfB at week 26 in the functional parameter, Personal and Social Performance (PSP) total score, showed similarly greater improvement with cariprazine than risperidone (LSMD = 4.63; 95% CI: [2.71, 6.56]; P < 0.001) significant from week 10 onward. Statistically significant differences in favor of cariprazine at week 26 were shown in the PSP areas of self-care, socially useful activities and personal and social relationships. Most patients tolerated the study treatment well, as reflected by low discontinuation rates due to adverse events (AEs). Adverse event profiles of cariprazine and risperidone were similar. The most common AEs during study treatment were insomnia (10.0%), and headache (10.4%), both in the risperidone group.Conclusion26-week cariprazine treatment, given as antipsychotic monotherapy, was significantly more effective on negative symptoms and on functioning than risperidone in patients with predominant negative symptoms of schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Pap ÉM, Farkas K, Tóth L, Fábos B, Széll M, Németh G, Nagy N. Identification of putative genetic modifying factors that influence the development of Papillon-Lefévre or Haim-Munk syndrome phenotypes. Clin Exp Dermatol 2020; 45:555-559. [PMID: 31925812 DOI: 10.1111/ced.14171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Papillon-Lefévre syndrome (PLS; OMIM 245000) and Haim-Munk syndrome (HMS; OMIM 245010), which are both characterized by palmoplantar hyperkeratosis and periodontitis, are phenotypic variants of the same disease caused by mutations of the cathepsin C (CTSC) gene. AIM To identify putative genetic modifying factors responsible for the differential development of the PLS or HMS phenotypes, we investigated two Hungarian patients with different phenotypic variants (PLS and HMS) but carrying the same homozygous nonsense CTSC mutation (c.748C/T; p.Arg250X). METHODS To gain insights into phenotype-modifying associations, whole exome sequencing (WES) was performed for both patients, and the results were compared to identify potentially relevant genetic modifying factors. RESULTS WES revealed two putative phenotype-modifying variants: (i) a missense mutation (rs34608771) of the SH2 domain containing 4A (SH2D4A) gene encoding an adaptor protein involved in intracellular signalling of cystatin F, a known inhibitor of the cathepsin protein, and (ii) a missense variant (rs55695858) of the odorant binding protein 2A (OBP2A) gene, influencing the function of the cathepsin protein through the glycosyltransferase 6 domain containing 1 (GLT6D1) protein. CONCLUSION Our study contributes to the accumulating evidence supporting the clinical importance of phenotype-modifying genetic factors, which have high potential to aid the elucidation of genotype-phenotype correlations and disease prognosis.
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Affiliation(s)
- É M Pap
- Department of Obstetrics and Gynecology Szeged, University of Szeged, Szeged, Hungary
| | - K Farkas
- Department of Medical Genetics, University of Szeged, Szeged, Hungary
| | - L Tóth
- Department of Medical Genetics, University of Szeged, Szeged, Hungary
| | - B Fábos
- Mór Kaposi Teaching Hospital, Kaposvár, Hungary
| | - M Széll
- Department of Medical Genetics, University of Szeged, Szeged, Hungary.,Dermatological Research Group of the Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
| | - G Németh
- Department of Obstetrics and Gynecology Szeged, University of Szeged, Szeged, Hungary
| | - N Nagy
- Department of Medical Genetics, University of Szeged, Szeged, Hungary.,Dermatological Research Group of the Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
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28
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Hegyi BE, Kozinszky Z, Badó A, Dombi E, Németh G, Pásztor N. Anxiety and depression symptoms in infertile men during their first infertility evaluation visit. J Psychosom Obstet Gynaecol 2019; 40:311-317. [PMID: 30624134 DOI: 10.1080/0167482x.2018.1515906] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective: To assess the psychological condition of men at the start of the infertility work-up. Methods: Men seeking an infertility evaluation for the first time were recruited. Depression and anxiety symptoms and subjective psychological burden were assessed with the Beck Depression Inventory (BDI), the Spielberger State-Trait Anxiety Inventory (STAI), and a visual analog scale (VAS). Results: Data from 113 patients were analyzed. The mean age of the patients was 33.3 (range: 23-54) years, whereas the mean duration of infertility was 16.3 (range: 0-96) months. Results from the BDI and STAI were 2.24 (SD: ±3.18) and 33.74 (SD: ±8.04). Mild depressive symptoms were found in 4.5% of patients, whereas anxiety reached an abnormal level in 4.9%. There were significant correlations between the results from the BDI score and the duration of infertility (p = .024), whereas the STAI and VAS scores showed no similar connection (p = .142 and p = .261, respectively). Among patients with infertility longer than 2 years, mild depressive symptoms occurred in 23.1%. Conclusion: Among men, the levels of depressive and anxiety symptoms were low at the start of the infertility work-up. Depressive symptom levels increased significantly with the duration of infertility, whereas anxiety levels and VAS scores did not demonstrate a similar correlation.
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Affiliation(s)
- Borbála Eszter Hegyi
- Department of Obstetrics and Gynecology, University of Szeged , Szeged , Hungary
| | - Zoltan Kozinszky
- Department of Obstetrics and Gynaecology, Blekinge Hospital, Landstinget Blekinge , Karlskrona , Sweden
| | - Attila Badó
- Department of Obstetrics and Gynecology, University of Szeged , Szeged , Hungary
| | - Edina Dombi
- Department of Obstetrics and Gynecology, University of Szeged , Szeged , Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynecology, University of Szeged , Szeged , Hungary
| | - Norbert Pásztor
- Department of Obstetrics and Gynecology, University of Szeged , Szeged , Hungary
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Abstract
INTRODUCTION The prevention of early sexual life and its unwanted consequences is a worldwide problem. National and international surveys have shown that adolescents have their first sexual intercourse at a younger age. AIM The study aimed to determine the way of sexual education of young people provided by physicians - general practitioners, paediatricians, obstetricians, gynaecologists etc. - in accordance with the results of a questionnaire-based study, the experiences gained during the interactive education and the suggestions of international guidelines dealing with sexual education. METHOD Self-administered questionnaire-based study was performed among 13-18-year-old girls attending primary or secondary school (N = 868) between 2009 and 2016. The sexual activity of adolescent girls, their knowledge related to contraception and sexually transmitted infectious diseases, gynaecological (e.g., cancer screening) experiences were measured before sexual education performed by a gynaecologist. RESULTS Every 4th girl had the first sexual act at the age of 14 or before, but at the same time their sexual knowledge was incomplete and there was a significant proportion of those who already have had sex but have never had a gynaecological examination. CONCLUSION The results highlighted the educational deficiencies of reproductive life, which is a complex task to solve, to address the changing approach of national healthcare and education systems, to adopt and follow scientific evidence-based guidelines. All health-care workers who are in contact with adolescents during their work must be involved in the sexual education. It is essential to continue incorporating sex education into education from early childhood to young adult age. Orv Hetil. 2019; 160(13): 494-501.
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Affiliation(s)
- Andrea Varga-Tóth
- Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged
| | - Gábor Németh
- Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged
| | - Edit Paulik
- Népegészségtani Intézet, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Dóm tér 10., 6720
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30
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Chakraborty P, Dugmonits KN, Végh AG, Hollandi R, Horváth P, Maléth J, Hegyi P, Németh G, Hermesz E. Failure in the compensatory mechanism in red blood cells due to sustained smoking during pregnancy. Chem Biol Interact 2019; 313:108821. [PMID: 31525342 DOI: 10.1016/j.cbi.2019.108821] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/28/2019] [Accepted: 09/12/2019] [Indexed: 12/27/2022]
Abstract
Decrease in the bioavailability of vasoactive nitric oxide (NO), derived from the endothelial nitric oxide synthase (NOS3), underlines vascular endothelial damage. Our expanding knowledge on mature red blood cells (RBCs) makes it supposable that RBCs might contribute to vascular function and integrity via their active NO synthetizing system (RBC-NOS3). This "rescue" mechanism of RBCs could be especially important during pregnancy with smoking habit, when smoking acts as an additional stressor and causes active change in the redox status. In this study RBC populations of 82 non-smoking (RBC-NS) and 75 smoking (RBC-S) pregnant women were examined. Morphological variants were followed by confocal microscopy and quantified by a microscopy based intelligent analysis software. Fluorescence activated cell sorting was used to examine the translational and posttranslational regulation of RBC-NOS, Arginase-1 and the formation of the major product of lipid peroxidation, 4-hydroxy-2-nonenal. To survey the rheological parameters of RBCs like elasticity and plasticity atomic force microscopy-based measurement was applied. Significant morphological and functional differences of RBCs were found between the non-smoking and smoking groups. The phenotypic variations in RBC-S population, even the characteristic biconcave disc-shaped cells, could be connected to impaired NOS3 activation and are compromised in their physiological properties. Membrane lipid studies reveal an elevated lipid oxidation state well paralleled with the changed elastic and plastic activities. These features can form a basic tool in the prenatal health screening conditions; hence the compensatory mechanism of RBC-S population completely fails to sense and rescue the acute oxidative stress conditions.
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Affiliation(s)
- Payal Chakraborty
- Department of Biochemistry and Molecular Biology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Krisztina N Dugmonits
- Department of Biochemistry and Molecular Biology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Attila G Végh
- Institute of Biophysics and Biological Research Centre, Hungarian Academy of Sciences, Szeged, Hungary
| | - Réka Hollandi
- Institute of Biochemistry, Biological Research Centre, Hungarian Academy of Sciences, Szeged, Hungary
| | - Péter Horváth
- Institute of Biochemistry, Biological Research Centre, Hungarian Academy of Sciences, Szeged, Hungary
| | - József Maléth
- First Department of Medicine, University of Szeged, Hungary; HAS-USZ Momentum Epithel Cell Signalling and Secretion Research Group, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Gábor Németh
- Department Obstetrics and Gynaecology Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Edit Hermesz
- Department of Biochemistry and Molecular Biology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary.
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Farkas K, Rajan N, Pap É, Széll M, Németh G, Nagy N. 305 Putative phenotype modifying genetic factors associated with phenotypic diversity in Brooke-Spiegler syndrome. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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32
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Szabó É, Koványi-Lax G, Szénási G, Dancsó A, Kiss L, Kormány R, Simig G, Németh G, Volk B. A novel tool for structure assignment of hydroxylated metabolites of (arylpiperazinylbutyl)oxindole derivatives based on relative HPLC retention times. J Pharm Biomed Anal 2019; 170:102-111. [PMID: 30909055 DOI: 10.1016/j.jpba.2019.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 03/04/2019] [Accepted: 03/09/2019] [Indexed: 10/27/2022]
Abstract
Incubation of oxindole derivatives containing an arylpiperazine pharmacophore in rat liver microsomes in vitro formed several metabolites hydroxylated at various positions of the aromatic rings of the oxindole carbocycle or the arylpiperazine moiety. In order to substitute the sites of metabolic attack on these positional isomers, the exact structure of the molecules had to be identified. As polarities of the compounds depend on the site of hydroxylation, we measured retention times of the metabolites using reversed-phase HPLC. It was noted that the relative retention times (RRT, the ratio of the retention time of the metabolite and the parent compound) fell into distinct narrow ranges for metabolites identified by MS spectra as positional isomers. These RRT ranges correlated with the positions of hydroxylation. The hypothesis was validated by synthesis of hydroxy compounds of known structure and by determination of their RRT values. Change in the chromatographic parameters such as column type, eluent, gradient time and temperature did not impede the identification of the sites of hydroxylation as the RRT pattern remained similar to the original one. The new empirical method proposed in our study can be used for tentative identification of hydroxy metabolites and orient the direction of efforts to synthesize metabolically stable compounds.
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Affiliation(s)
- Éva Szabó
- Egis Pharmaceuticals Plc., Directorate of Drug Substance Development, P. O. Box 100, H-1475 Budapest, Hungary
| | - Györgyi Koványi-Lax
- Egis Pharmaceuticals Plc., Directorate of Drug Substance Development, P. O. Box 100, H-1475 Budapest, Hungary
| | - Gábor Szénási
- Institute of Pathophysiology, Semmelweis University, 4 Nagyvárad tér, H-1089 Budapest, Hungary
| | - András Dancsó
- Egis Pharmaceuticals Plc., Directorate of Drug Substance Development, P. O. Box 100, H-1475 Budapest, Hungary
| | - Loránd Kiss
- Institute of Pharmaceutical Chemistry, University of Szeged, 6 Eötvös utca, H-6720 Szeged, Hungary
| | - Róbert Kormány
- Egis Pharmaceuticals Plc., Directorate of Drug Substance Development, P. O. Box 100, H-1475 Budapest, Hungary
| | - Gyula Simig
- Egis Pharmaceuticals Plc., Directorate of Drug Substance Development, P. O. Box 100, H-1475 Budapest, Hungary
| | - Gábor Németh
- Egis Pharmaceuticals Plc., Directorate of Drug Substance Development, P. O. Box 100, H-1475 Budapest, Hungary.
| | - Balázs Volk
- Egis Pharmaceuticals Plc., Directorate of Drug Substance Development, P. O. Box 100, H-1475 Budapest, Hungary.
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Jakó M, Surányi A, Kaizer L, Németh G, Bártfai G. Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction. Med Princ Pract 2019; 28:101-108. [PMID: 30685759 PMCID: PMC6545914 DOI: 10.1159/000497240] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/27/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate the placental and umbilical cord histopathology in intrauterine growth restriction (IUGR) and their relation to second-trimester maternal hematological parameters. MATERIALS AND METHODS Patients were selected for the IUGR group based on estimated fetal weight below the 10th percentile. Patients were recruited into the control group randomly. Patients were followed up with ultrasound, and blood samples were taken between the 20th and 24th gestational weeks. After delivery and formalin fixation, weight and volume of the placenta were recorded and histologic samples were processed. RESULTS Maternal platelet count strongly correlates with placental weight (r = 0.766). On the other hand, neonatal weight correlates with placental volume (r = 0.572) rather than with placental weight (r = 0.469). Umbilical arterial lumen cross-sectional area correlates with birth weight (r = 0.338). CONCLUSIONS Maternal hematological parameters do not seem to affect neonatal outcome. Our main findings are the correlation of maternal platelet count with placental weight, the correlation of placental volume with birth weight being stronger than the correlation of placental weight with birth weight, and the correlation of umbilical artery lumen cross-sectional area with neonatal weight. Mild histopathologic alterations might occur in normal pregnancies; however, sufficient fetal nutrition can be maintained. This compensatory function of the placenta seems to be insufficient when two or more pathologies are present, which is characteristic for IUGR.
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Affiliation(s)
- Mária Jakó
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary,
| | - Andrea Surányi
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - László Kaizer
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - György Bártfai
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
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Affiliation(s)
- C Habl
- Gesundheit Österreich GmbH, Vienna, Austria
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Novák T, Radnai M, Kozinszky Z, Práger N, Hodoniczki L, Gorzó I, Németh G. [Effect of the treatment of periodontal disease on the outcome of pregnancy]. Orv Hetil 2018; 159:978-984. [PMID: 29888663 DOI: 10.1556/650.2018.31103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Correlations between periodontitis and its effects on the outcome of pregnancies are actually more focused topics. Maternal motivation for a good oral hygiene and preventive dental treatment must be highlighted tasks during pregnancy care. AIM The authors analysed the effect of the preventive dental treatment during pregnancy and its obstetrical effects. METHOD In a prospective randomised study, including pregnant women observed for threatening preterm deliveries, patients with dental examination (n = 71) were compared with patients undergoing dental treatment at the same time (n = 79). STATISTICAL ANALYSIS Univariate comparisons for categorical variables were assessed by χ2 tests and independent Student's t-tests for continuous variables. ORs were compared with Mantel-Haenszel tests. Multivariable logistic regression was performed to evaluate the factors determining the poor periodontal parameters and gingivitis separately. The two-tailed statistical significance level was set at 5%. RESULTS In the dental treatment group, the neonatal birth weight was significantly higher than in the non-treated group, in case of patients with periodontitis (2990 ± 582.3 g vs 2568.1 ± 699.1 g, p = 0.005). Also the average age at delivery was significantly higher in the treated vs non-treated groups (37.3 ± 1.9 vs 36.0 ± 2.9 weeks, p = 0.027), and the treatment had a beneficial effect on the prolongation of pregnancy, with a higher level of significance in the gingivitis group vs patients with periodontitis groups (p = 0.02 vs p = 0.043). CONCLUSIONS Dental treatment of expecting women has a beneficial effect on the prolongation of pregnancy by decreasing the rate of prematurity and perinatal complications. Orv Hetil. 2018; 159(24): 978-984.
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Affiliation(s)
- Tibor Novák
- Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem Szeged, Semmelweis u. 1., 6725
| | - Márta Radnai
- Fogorvostudományi Szak, Fogászati és Szájsebészeti Klinika, Fogpótlástani Tanszék, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs
| | | | - Nándor Práger
- Fogpótlástani Tanszék, Szegedi Tudományegyetem, Fogorvostudományi Kar Szeged
| | - László Hodoniczki
- Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem Szeged, Semmelweis u. 1., 6725
| | - István Gorzó
- Parodontológiai Tanszék, Szegedi Tudományegyetem, Fogorvostudományi Kar Szeged
| | - Gábor Németh
- Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem Szeged, Semmelweis u. 1., 6725
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Sepsey A, Németh DR, Németh G, Felinger A. Rate constant determination of interconverting enantiomers by chiral chromatography using a stochastic model. J Chromatogr A 2018; 1564:155-162. [DOI: 10.1016/j.chroma.2018.06.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/03/2018] [Accepted: 06/05/2018] [Indexed: 11/29/2022]
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Altorjay ÁT, Nyári T, Gyurkovits Z, Németh G, Surányi A. Evaluation of placental vascularization indices in monochorionic diamniotic and dichorionic diamniotic twin pregnancies. Eur J Obstet Gynecol Reprod Biol 2018; 228:225-231. [PMID: 30014928 DOI: 10.1016/j.ejogrb.2018.05.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 05/07/2018] [Accepted: 05/31/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We aimed to investigate and compare placental vascularization indices between monochorionic-diamniotic, dichorionic-diamniotic normal twin pregnancies, and normal singular pregnancies. We hypothesized that there is correlation between placental three-dimensional power Doppler vascularization indices and birth weight in case of twin pregnancies, and that normal singular pregnancies have higher placental vascularization indices than normal twin pregnancies. STUDY DESIGN Placental three-dimensional power Doppler vascularization indices, such as vascularization index, flow index, and vascularization-flow index were measured in monochorionic-diamniotic (N = 15) and dichorionic-diamniotic (N = 36) normal twin pregnancies, and in normal singular (N = 109) pregnancies. Correlations were analyzed between vascularization indices, and birth weight, APGAR score, umbilical pH, umbilical venous bicarbonate, lactate, and base excess. RESULTS Vascularization indices and birth weight were significantly (p < 0.01) higher in normal singular gestations (vascularization index = 10.36, flow index = 46.08, vascularization-flow index = 4.08, average birth weight = 3377 g at 38.2 weeks average gestational age) compared to monochorionic-diamniotic and dichorionic-diamniotic normal twin pregnancies. No significant differences were found in vascularization indices between monochorionic-diamniotic and dichorionic-diamniotic normal twins. There were no significant differences in APGAR score, umbilical pH, umbilical venous bicarbonate, lactate, and base excess between groups examined (p < 0.01). We found strong linear correlations between placental vascularization indices and birth weight in both twin groups. CONCLUSION Placental three-dimensional power Doppler vascularization indices seem appropriate for predicting birth weight in monochorionic-diamniotic and dichorionic-diamniotic normal twin pregnancies. Our pilot study revealed reference values for vascularization indices in case of twin pregnancies examined.
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Affiliation(s)
- Ábel Tamás Altorjay
- Szeged, Csongrád, Hungary; Department of Obstetrics and Gynecology, University of Szeged, Faculty of Medicine, Szeged, Hungary.
| | - Tibor Nyári
- Szeged, Csongrád, Hungary; Department of Medical Physics and Informatics, University of Szeged, Faculty of Medicine, Szeged, Hungary.
| | - Zita Gyurkovits
- Szeged, Csongrád, Hungary; Department of Obstetrics and Gynecology, University of Szeged, Faculty of Medicine, Szeged, Hungary
| | - Gábor Németh
- Szeged, Csongrád, Hungary; Department of Obstetrics and Gynecology, University of Szeged, Faculty of Medicine, Szeged, Hungary
| | - Andrea Surányi
- Szeged, Csongrád, Hungary; Department of Obstetrics and Gynecology, University of Szeged, Faculty of Medicine, Szeged, Hungary
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Fekete Z, Kőrösi S, Pajor L, Bajory Z, Németh G, Kozinszky Z. Does anchoring vaginal mesh increase the potential for correcting stress incontinence? BMC Urol 2018; 18:53. [PMID: 29855312 PMCID: PMC5984302 DOI: 10.1186/s12894-018-0363-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 05/11/2018] [Indexed: 11/22/2022] Open
Abstract
Background This study aims to explore the feasibility of anchoring a four-arm transvaginal mesh (TVM) to the mid-urethra to correct an anterior compartment POP–Quantification stage II–III (Q II–III) and concomitant genuine SUI. Methods We analysed clinical data from 248 patients with stage II–III anterior prolapse and concomitant SUI who had undergone surgery at a tertiary referral centre in Hungary between January 2008 and June 2010. One hundred and twenty-four women treated with anterior colporrhaphy and 62 patients implanted with a conventional permanent TVM were selected as historical matched controls. Sixty-two patients received a modified permanent TVM, where the mesh was fixed to the mid-urethra with two stitches for the purpose of potentially correcting SUI. Surgical complications were classified using the Clavien–Dindo (CD) classification system. Results The anti-SUI efficacy was minimally higher in the mTVM group than in the original TVM group (p = 0.44, 96.8% vs 91.9%, respectively), while prosthesis surgery was more effective than anterior colporrhaphy in improving the anterior compartment POP–Q status (96.8, 90.3% vs 64.5%, respectively). Anchoring the mesh did not increase the extrusion rate (p = 0.11). The de novo urge symptoms were not more prevalent among those who had received additional periurethral stitches (p = 1.00, 11.3% vs 12.9%). The incidence of reoperation observed in the mTVM group was non-significantly lower than that in the TVM group (p = 0.15, 6.5% vs 16.1%); however, the difference did not reach the level of significance. The early postoperative complication profile was more favourable among the mTVM patients (classified as CD I: 8.1%; CD II: 1.6%; and CD IIIb: 1.6%) as compared to the TVM group (p = 0.013). Conclusions The new, modified mesh surgery represents an effective procedure for prolapse and concomitant SUI with a decreased risk of short- and long-term complications.
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Affiliation(s)
- Zoltán Fekete
- Department of Urology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary. .,Department of Obstetrics and Gynaecology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary.
| | - Szilvia Kőrösi
- Department of Obstetrics and Gynaecology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary
| | - László Pajor
- Department of Urology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary
| | - Zoltán Bajory
- Department of Urology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynaecology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary
| | - Zoltan Kozinszky
- Department of Obstetrics and Gynaecology, Blekinge Hospital, Karlskrona, Sweden
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Abstract
INTRODUCTION The prevalence of pelvic organ prolapse (POP) with aging is escalating alarmingly, and now becoming a growing epidemic among the elderly. Synthetic transvaginal mesh (TVM) has been employed with increasing popularity in the treatment of POP until the end of the last decade. After the U.S. Drug and Food Administration (FDA) warnings in the years 2008 and 2011, the number of vaginal mesh operations has decreased dramatically. AIM The aim of the study was to evaluate and compare the anti-POP effectivity, the anti-stress incontinence (anti-SUI) efficacy, and the late (36 months) post-operative complications of the anterior vaginoplasty and the TVM operations. METHOD We analysed the clinical data from 120 patients with stage II-III anterior prolapse and concomitant SUI who had undergone surgery at a tertiary referral centre in Hungary between January 2013 and January 2014. Sixty patients underwent Kelly-Stoeckel vaginoplasty and the other 60 cases had TVM operation. The surgical complications were classified using the Clavien-Dindo (CD) classification system. RESULTS The anti-POP (91.6% vs. 63.3%; p<0.001) and the anti-SUI efficacy (90% vs. 55%, p<0.001) were significantly higher in the TVM group than in the vaginoplasty group, while the overall extrusion rate was found 8.3% after a 3-year follow-up. The Clavien-Dindo score (CD) proved that the early post-operative complication profile was similar among the TVM patients as compared to the vaginoplasty group (p = 0.405). CONCLUSION Vaginal mesh surgery represents an effective procedure for prolapse and concomitant SUI with a decreased risk of short- and long-term complications. Orv Hetil. 2018; 159(10): 397-404.
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Affiliation(s)
- Zoltán Fekete
- Szent-Györgyi Albert Klinikai Központ, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Semmelweis u. 1., 6725
| | - Szilvia Körösi
- Szent-Györgyi Albert Klinikai Központ, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Semmelweis u. 1., 6725
| | - Gábor Németh
- Szent-Györgyi Albert Klinikai Központ, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Semmelweis u. 1., 6725
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Karai A, Gyurkovits Z, Nyári TA, Sári T, Németh G, Orvos H. Adverse perinatal outcome in teenage pregnancies: an analysis of a 5-year period in Southeastern Hungary. J Matern Fetal Neonatal Med 2018; 32:2376-2379. [PMID: 29409369 DOI: 10.1080/14767058.2018.1438393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To determine the risks of adverse perinatal outcomes of teenage mothers. MATERIAL AND METHODS A retrospective analysis was performed on teenage mothers (under 20 years of age) who delivered in the period of 2010-2014 at the Department of Obstetrics and Gynecology, University of Szeged (study group). All mothers who delivered in Hungary during the same period were studied as a control group. The following parameters were analyzed: demographic data of the mothers, maternal complications, perinatal outcome and congenital malformations of the newborns. The binominal test, Student's t-test and Poisson's regression were applied using STATA 9.0 (StataCorp, College Station, TX, USA) statistical software (p < .05 was considered to be statistically significant). RESULTS During this 5-year period, 12,845 births were recorded at the Department, of these 274 (2.1%) were teenage pregnancies with 275 newborns. The offsprings of teenage mothers had significantly lower mean birth weight (3110.2 ± 564.03 g versus 3247 g), higher rate of congenital malformations (8.0 versus 5.0%) and higher admission to neonatal intensive care unit (12.4 versus 8.0%) than the infants in the control group. CONCLUSIONS Younger maternal age was significantly associated with lower mean birth weight, higher risk of congenital malformations, and increased admission rate to neonatal intensive care unit.
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Affiliation(s)
- Adrienn Karai
- a Department of Pediatrics , University of Szeged , Szeged , Hungary
| | - Zita Gyurkovits
- b Department of Obstetrics and Gynecology , University of Szeged , Szeged , Hungary
| | - Tibor András Nyári
- c Department of Medical Physics and Informatics , University of Szeged , Szeged , Hungary
| | - Tamás Sári
- b Department of Obstetrics and Gynecology , University of Szeged , Szeged , Hungary
| | - Gábor Németh
- b Department of Obstetrics and Gynecology , University of Szeged , Szeged , Hungary
| | - Hajnalka Orvos
- b Department of Obstetrics and Gynecology , University of Szeged , Szeged , Hungary
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Hájsxár L, Németh G, Naszály A, Takácsi-Nagy L. Preparation of Cervix and Corpus Carcinoma Patient Records for Computer Evaluation. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1636616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Collection and presentation of data for retrospective computer evaluation of 5,279 cervix carcinoma and 1,366 corpus carcinoma cases treated at the Institute of Oncoradiology, Budapest from 1946 to 1972 is reported on. The work took two years and made the databank handling of the cases studied possible. Reorganization of the hospital patient recording system in compliance with the established coding principles and use of special record forms, on which entries can be directly coded, is recommended.
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Abstract
In certain regions of the world the enormous rate of population growth raises economic and public health concerns and widely accessible contraceptive methods would be desired. In contrast, in other countries the use of effective contraception is a question of individual preferences. Today, most of the reliable contraceptive methods are applied by women, while the options for male methods are quite limited. It is well known that significant portion of pregnancies are still unplanned and several data revealed men's willingness to take part in family planning. Based on these needs, remarkable efforts have been made to develop a suitable hormonal contraceptive agent for men. With the exogenous suppression of follicle stimulating hormone and luteinizing hormone secretion, the inhibition of the testicular testosterone production and the spermatogenesis can be achieved. In the beginning, testosterone-derivatives, or testosterone-progestin combinations were administered, later synthetic androgen agents were developed. Despite of these efforts, unfortunately, there is no safe, widely feasible male hormonal contraception to date, but in the future this goal can be achieved by solving the key hurdles. Orv Hetil. 2017; 158(46): 1819-1830.
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Affiliation(s)
- Norbert Pásztor
- Szent-Györgyi Albert Klinikai Központ, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Semmelweis u. 1., 6725
| | - Borbála Eszter Hegyi
- Klinikai Orvostudományok Doktori Iskola, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged
| | - Attila Badó
- Szent-Györgyi Albert Klinikai Központ, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Semmelweis u. 1., 6725
| | - Gábor Németh
- Szent-Györgyi Albert Klinikai Központ, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Semmelweis u. 1., 6725
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Tsorbatzoglou A, Módis L, Kertész K, Németh G, Berta A. Comparison of Divide and Conquer and Phaco-Chop Techniques during Fluid-Based Phacoemulsification. Eur J Ophthalmol 2018; 17:315-9. [PMID: 17534809 DOI: 10.1177/112067210701700306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine whether, similar to ultrasound phaco-emulsification, applied energy and surgery time decrease using phaco-chop nucleus fragmentation method compared to divide and conquer technique using the fluid-based system. METHODS This prospective, comparative, randomized clinical study included patients with cataract who were randomly assigned to use either standard divide and conquer technique (25 eyes of 25 patients, Group 1) or Nagahara phaco-chop maneuver (25 eyes of 25 patients, Group 2) during fluid-based phaco-emulsification. Surgical parameters were recorded and patients were examined 1 day, 10 days, and 1 month after surgery. Statistical analyses were performed using the paired test of Wilcoxon. RESULTS Fluid-based time, mean fluid-based magnitude, effective fluid-based time, and the number of pulses were significantly less using phaco-chop technique compared to divide and conquer method (p<0.001). Surgery time was similar using the two nucleofractis techniques (p=0.97). Visual acuities showed no statistical differences between the two groups (p>0.05). CONCLUSIONS Nuclear fragmentation can be performed with Nagahara phaco-chop technique using the fluid-based system as well. The applied fluid-based energy decreases compared to divide and conquer method. However, surgery time is not reduced due to the difficulties reaching the full occlusion necessary to hold the nucleus during the chop maneuver.
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Affiliation(s)
- A Tsorbatzoglou
- Department of Ophthalmology, Medical and Health Science Center, Univ of Debrecen, Debrecen, Hungary.
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Fekete Z, Surányi A, Rénes L, Németh G, Kozinszky Z. Efficacy of anchoring the four-arm transvaginal mesh to the mid-urethra vs original surgery as a surgical correction for stress urine incontinence in coexisting anterior vaginal prolapse grades II and III: study protocol for a randomized controlled trial. Trials 2017; 18:624. [PMID: 29282115 PMCID: PMC5746023 DOI: 10.1186/s13063-017-2314-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 10/31/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The prevalence of obesity with aging is escalating alarmingly; and pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are now becoming a growing epidemic among the elderly. Synthetic transvaginal mesh has been employed with increasing popularity in the treatment of POP and is usually highly effective in controlling the principal symptoms of prolapse. However, studies have reported that mesh operations provide fairly unfavorable SUI cure rates. Therefore, additional anti-incontinence surgical strategies are increasingly being scrutinized to achieve better postoperative continence without any significant side-effects for patients with both POP and SUI. We hypothesize that the modification with the fixing of the mesh to the mid-urethra is superior to the original transvaginal mesh operation (TVM) with regard to anti-incontinence. METHODS One hundred and thirty patients diagnosed with POP-Q II-III and concomitant SUI requiring surgical treatment will be included in this prospective, randomized, double-blind, controlled clinical trial. Patients will be randomly allocated to receive either original TVM (TVM group, n = 65) or modified TVM surgery (mTVM group, n = 65). As the primary outcome parameter, we will evaluate the objective SUI and POP cure rates. Secondary endpoints include postoperative morbidity as assessed with the International Urogynaecological Association classification and subjective prolapse and incontinence cure rates reported by questionnaires. DISCUSSION Recognizing the importance of an additional surgical procedure for anti-incontinence management, we aim to investigate whether a stabilizing suturing of the mesh to the mid-urethra delivers superior SUI correction compared to the original prosthesis surgery. TRIAL REGISTRATION ClinicalTrials.gov, NCT02935803. Registered on 20 May 2016.
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Affiliation(s)
- Zoltán Fekete
- Division of Urogynaecology, Department of Obstetrics and Gynaecology, University of Szeged, Semmelweis u. 1., 6725, Szeged, Hungary.
| | - Andrea Surányi
- Division of Urogynaecology, Department of Obstetrics and Gynaecology, University of Szeged, Semmelweis u. 1., 6725, Szeged, Hungary
| | - Lórand Rénes
- Division of Urogynaecology, Department of Obstetrics and Gynaecology, University of Szeged, Semmelweis u. 1., 6725, Szeged, Hungary
| | - Gábor Németh
- Division of Urogynaecology, Department of Obstetrics and Gynaecology, University of Szeged, Semmelweis u. 1., 6725, Szeged, Hungary
| | - Zoltan Kozinszky
- Department of Obstetrics and Gynaecology, Blekinge Hospital, Karlskrona, Sweden
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Módis L, Németh G, Szalai E, Flaskó Z, Seitz B. Scanning-slit topography in patients with keratoconus. Int J Ophthalmol 2017; 10:1686-1692. [PMID: 29181311 DOI: 10.18240/ijo.2017.11.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/06/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the anterior and posterior corneal surfaces using scanning-slit topography and to determine the diagnostic ability of the measured corneal parameters in keratoconus. METHODS Orbscan II measurements were taken in 39 keratoconic corneas previously diagnosed by corneal topography and in 39 healthy eyes. The central minimum, maximum, and astigmatic simulated keratometry (K) and anterior axial power values were determined. Spherical and cylindrical mean power diopters were obtained at the central and at the steepest point of the cornea both on anterior and on posterior mean power maps. Pachymetry evaluations were taken at the center and paracentrally in the 3 mm zone from the center at a location of every 45 degrees. Receiver operating characteristic (ROC) analysis was used to determine the best cut-off values and to evaluate the utility of the measured parameters in identifying patients with keratoconus. RESULTS The minimum, maximum and astigmatic simulated K readings were 44.80±3.06 D, 47.17±3.67 D and 2.42±1.84 D respectively in keratoconus patients and these values differed significantly (P<0.0001 for all comparisons) from healthy subjects. For all pachymetry measurements and for anterior and posterior mean power values significant differences were found between the two groups. Moreover, anterior central cylindrical power had the best discrimination ability (area under the ROC curve=0.948). CONCLUSION The results suggest that scanning-slit topography and pachymetry are accurate methods both for keratoconus screening and for confirmation of the diagnosis.
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Affiliation(s)
- László Módis
- Department of Ophthalmology, University of Debrecen, Medical and Health Science Center, Debrecen 4032, Hungary
| | - Gábor Németh
- Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc 3526, Hungary
| | - Eszter Szalai
- Department of Ophthalmology, University of Debrecen, Medical and Health Science Center, Debrecen 4032, Hungary
| | - Zsuzsa Flaskó
- Department of Ophthalmology, University of Debrecen, Medical and Health Science Center, Debrecen 4032, Hungary
| | - Berthold Seitz
- Department of Ophthalmology, Homburg Keratoconus Center, University of Saarland, Homburg/Saar 66424, Germany
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Pásztor N, Sikovanyecz J, Keresztúri A, Kozinszky Z, Németh G. Evaluation of the relation between placental weight and placental weight to foetal weight ratio and the causes of stillbirth: a retrospective comparative study. J OBSTET GYNAECOL 2017; 38:74-80. [DOI: 10.1080/01443615.2017.1349084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Norbert Pásztor
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - Attila Keresztúri
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
| | - Zoltan Kozinszky
- Department of Obstetrics and Gynecology, Blekinge Hospital, Karlskrona, Sweden
| | - Gábor Németh
- Department of Obstetrics and Gynecology, University of Szeged, Szeged, Hungary
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Abstract
INTRODUCTION The tendency of increasing cesarean section rate has drawn worldwide attention. The vaginal birth after cesarean section is a useful method to decrease cesarean section rate at defined cases. AIM Retrospective overview of factors resulting successful vaginal birth, labor/induction's condition, criterias, short and long term benefits and consequences. METHOD Overview recommendations of international guidelines and publications' results concerned vaginal birth after cesarean section in "PubMed", "MEDLINE", "Cochrane" databases from 1996 to 2016. RESULTS Reviewing results of recommendations and publications we can declare that statements are inconsistent, however the option of vaginal birth after cesarean section is appropriate for decrease complications and trend of increasing cesarean section rate. CONCLUSIONS It would be important in our country to define a uniform recommendation regarding vaginal birth after cesarean section, with supporting evidence in obstetrical and gynecological practice. Orv Hetil. 2017; 158(30): 1168-1174.
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Affiliation(s)
- Gábor Németh
- Szent-Györgyi Albert Klinikai Központ, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Semmelweis u. 1., 6725
| | - András Molnár
- Szent-Györgyi Albert Klinikai Központ, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Semmelweis u. 1., 6725
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Molnár A, Surányi A, Jakó M, Nyári T, Németh G. [Examination of placental three-dimensional power Doppler indices and perinatal outcome in pregnancies complicated by intrauterine growth restriction]. Orv Hetil 2017. [PMID: 28651459 DOI: 10.1556/650.2017.30784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Development of intrauterine growth restriction (IUGR) can be traced back to maternal or fetal factors, but in many cases we find placental factors (reduced placental circulation) in the background. AIM Our aim was to examine whether the reduced placental bloodperfusion and vascularity show any correlation with cesarean section frequency and the clinical outcome in IUGR pregnancies. The aim of the present study was also to use a properly calibrated and reproducible method for evaluating placental blood flow, that can later be incorporated into the routine examination. METHOD 254 women were recruited in our prospective case-control study. The 3 dimensional power Doppler (3DPD) ultrasound indices; vascularisation index (VI), flow index (FI) and vascularization flow index (VFI) were measured on each participant. RESULTS Median VI was 3.7% (interquartile range [IQR] 3.2%-4.2%) in the IUGR group and 10.1% (IQR 8.6%-10.9%) in the control group (p = 0.001). Median FI value was 40.0 (IQR 39.7-42.5) in the IUGR group and 45.1 (IQR 44.1-53.1) in the control group (p = 0.012). Median VFI was 2.2 (IQR 2.1-2.4) in the IUGR group and 4.8 (IQR 4.4-5.3) in the control. CONCLUSIONS The 3DPD indices may be useful for examining changes in circulation in IUGR pregnancies to characterize the underlying pathology. Orv Hetil. 2017; 158(26): 1008-1013.
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Affiliation(s)
- András Molnár
- Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem Szeged, Semmelweis u. 1., 6725
| | - Andrea Surányi
- Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem Szeged, Semmelweis u. 1., 6725
| | - Mária Jakó
- Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem Szeged, Semmelweis u. 1., 6725
| | - Tibor Nyári
- Orvosi Fizika és Informatikai Tanszék, Szegedi Tudományegyetem Szeged
| | - Gábor Németh
- Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika, Szegedi Tudományegyetem Szeged, Semmelweis u. 1., 6725
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Altorjay ÁT, Surányi A, Nyári T, Németh G. Use of placental vascularization indices and uterine artery peak systolic velocity in early detection of pregnancies complicated by gestational diabetes, chronic or gestational hypertension, and preeclampsia at risk. Croat Med J 2017; 58:161-169. [PMID: 28409499 PMCID: PMC5410734 DOI: 10.3325/cmj.2017.58.161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM We aimed to investigate correlations between uterine artery peak systolic velocity (AUtPSV), and placental vascularization in groups of normal blood pressure (NBP) and hypertensive disorders of pregnancy (chronic hypertension (CHT), gestational hypertension (GHT) and preeclampsia (PE)) alone or in combination with gestational diabetes mellitus (GDM), and hypothesized that AUtPSV rises when GDM complicates pregnancy hypertension. METHODS Placental 3-dimensional power Doppler indices, such as vascularization index (VI), flow index (FI), and vascularization-flow index (VFI), and uterine artery peak systolic velocity (AUtPSV) were measured in CHT (N=43), CHT+GDM (N=15), GHT (N=57), GHT+GDM (N=23) and PE (N=17) pregnancies, and compared to NBP (N=109). Correlations were analyzed between vascularization indices, AUtPSV, pregestational BMI and adverse pregnancy outcome rates. RESULTS In our results VI was higher in CHT (P=0.010), while FI was lower in CHT (P=0.009), GHT and PE (P=0.001) compared to NBP. In case of VFI, significant difference was found between CHT and GHT (P=0.002), and NBP and PE (P=0.001). FI was found prognostic for umbilical pH and neonatal birth weight. Pre-gestational BMI was significantly higher in GHT+GDM compared to GHT, and in CHT+GDM compared to the CHT group. As for AUtPSV, significant difference was found between NBP and CHT (P=0.012), NBP and CHT+GDM (P=0.045), NBP and GHT+GDM (P=0.007), NBP and PE (P=0.032), and GHT and GHT+GDM (P=0.048) groups. CONCLUSION Our study revealed that vascularization indices and AUtPSV show significant differences due to gestational pathology, and can be useful in detection of pregnancies at risk.
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Affiliation(s)
| | - Andrea Surányi
- Andrea Surányi, Semmelweis str. 1., Szeged, Csongrád, H-6725, Hungary,
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Varga-Tóth A, Maróti-Nagy Á, Németh G, Paulik E. Menarche as a predictor of risk-taking behavior in a sample of Hungarian adolescent girls. Int J Adolesc Med Health 2017; 31:ijamh-2016-0135. [PMID: 28599382 DOI: 10.1515/ijamh-2016-0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 02/12/2017] [Indexed: 06/07/2023]
Abstract
Background The age at the time of the first sexual intercourse is declining, and the prevalence of smoking is increasing in adolescent girls in developed countries. Objective To assess the relationship between menarche and tobacco smoking and sexual activity in adolescent girls. Subjects Girls between 14 and 18 years, attending primary or secondary school. Methods Socio-demographic characteristics (age, living place, educational level of parents, self-estimated financial background), onset and parameters of periods, and risk behaviors (smoking, sexual activity) were measured by self-administered questionnaires. A multivariate logistic regression analysis was used to assess the relationship between tobacco use and sexual activity and socio-demographic characteristics, menarche and presence of other risk behaviors. Results Adolescent girls who had an earlier onset of their periods were about twice as likely to smoke as girls with later onset of their first period [odds ratio (OR): 2.28, confidence interval (CI): 1.14-4.55]. Being sexually active meant more than 7-fold odds of being a regular tobacco user (OR: 7.24, CI: 4.39-11.94). Regarding sexual activity, increasing age (OR: 4.42, CI: 3.45-5.67) and regular smoking (OR: 7.07, CI: 4.24-11.80) increased, while poor financial status decreased (OR: 0.35, CI: 0.13-0.97) the odds of being sexually active. Conclusion In light of these findings, the reconsideration of health and sexual education in Hungary is needed. Implementation of these programs at an earlier age should be desirable to avoid unfavorable consequences, such as early pregnancy.
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Affiliation(s)
- Andrea Varga-Tóth
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Ágnes Maróti-Nagy
- Department of Public Health, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Edit Paulik
- Department of Public Health, Faculty of Medicine, University of Szeged, Szeged, Dóm tér 10 H-6720, Hungary, Phone: +36 62 545119, Fax: +36 62 545120
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