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Biomedical subjects

G Jermendy

Publications and source records attributed to G Jermendy.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Delayed sulfonylurea resistance in non-insulin-dependent diabetes mellitus].

Non-insulin-dependent diabetes mellitus is one of the most common non-infectious diseases in Hungary. Oral hypoglycaemic agents, especially sulfonylurea drugs are basic therapeutic tools in the treatment of the disease. The cellular effects of sulfonylurea drugs are continuously investigated as their mode of hypoglycaemic action remains controversial despite the large number of experimental trials. According to the immediate or progressive nature of its insufficient blood glucose lowering effect, early (primary) and late (secondary) sulfonylurea failure can be distinguished. There are no exact criteria for the secondary sulfonylurea failure state. Having excluded causes other than drug failure, blood glucose profiles, and, if possible, serum or urinary C-peptide measurements should be carried out. Once sulfonylurea failure has been established other classes of antihyperglycaemic drugs in combination with insulin therapy or insulin therapy alone are to be introduced, respectively.

Diabetes Mellitus, Type 2↗
PubMed1997

[Screening for microalbuminuria in diabetic patients in the primary health care system].

In order to detect the prevalence of microalbuminuria, a screening procedure was carried out in 1016 adult (age > 14 years) diabetic patients registered in primary health care system at the 17st district of the capital. The clinical characteristics of patients were investigated and microalbuminuria was measured by immunoturbidimetric method using first void morning urinary samples. In this way, the urinary albumin/creatinine ratio was calculated (abnormal value in men > or = 2.5 mg/mmol, in women > or = 3.5 mg/mmol). Moreover, serum creatinine, blood glucose, serum cholesterol and triglycerides were measured in fasting blood samples. After applying exclusion criteria data of 933 diabetic patients [129 insulin-dependent (IDDM) and 804 non-insulin-dependent (NIDDM) patients; 424 men, 509 women] were analysed. Abnormal urinary albumin/creatinine ratio was found in 315 (33.8%) patients. Microalbuminuria was detected in 32 (24.8%) IDDM and in 201 (25.0%) NIDDM patients. Macroalbuminuria was found in 13 (10.1%) IDDM and in 69 (8.6%) NIDDM patients. Abnormal urinary albumin/creatinine ratio was more often found in men than in women (IDDM men 41.3%, IDDM women 28.8%; NIDDM men 38.0%, NIDDM women 30.0%). Significant difference was found between diabetic patients with (n = 315) and without (n = 618) abnormal urinary albumin/creatinine ratio regarding age (64.3 +/- 0.7 years vs. 61.4 +/- 0.5 years; p < 0.001), duration of diabetes (10.3 +/- 0.5 years vs 7.9 +/- 0.3 years; p < 0.001) systolic blood pressure (151 +/- 1 mmHg vs 146 +/- 1 mmHg; p < 0.01), serum creatinine (99 +/- 2 mumol/l vs 88 +/- 1 mumol/l; p < 0.001) and blood glucose (10.4 +/- 0.2 mmol/l vs 9.4 +/- 0.1 mmol/l; p < 0.001). One third (33.8%) of diabetic patients in primary health care setting exhibited signs or were at risk of renal involvement of diabetes. Diabetic patients with micro- or macroalbuminuria should be carefully controlled in order to prevent or to decrease deterioration of renal function due to diabetic nephropathy.

Adult↗
PubMed1996

Day-night blood pressure variation in normotensive and hypertensive NIDDM patients with asymptomatic autonomic neuropathy.

In order to assess the characteristics of day-night blood pressure (BP) variation in normotensive and hypertensive non-insulin-dependent diabetic (NIDDM) patients with asymptomatic autonomic neuropathy, 54 NIDDM patients and 13 healthy control subjects were studied by casual BP measurements and 24-h ambulatory blood pressure monitoring. Signs but not symptoms of autonomic neuropathy were documented by results of standard cardiovascular function tests in each patient. Daytime (06:00-22:00) and nighttime (22:00-06:00) BP values were separately analyzed and delta day-night BP values and diurnal index were determined. Patients were classified as being normotensive or having hypertension according to the casual BP values and medical history. In normotensive NIDDM patients (n = 30), nighttime systolic BP was significantly higher, whereas delta day-night systolic and delta day night diastolic BP values as well as diurnal index were considerably lower than those in control subjects (n = 13). In hypertensive NIDDM patients (n = 24), similar alterations were found at higher BP levels. No significant difference was found in BP values if normoalbuminuric and microalbuminuric NIDDM patients were compared. 'Non-dipper' phenomenon could be found in normotensive and hypertensive NIDDM patients with asymptomatic autonomic neuropathy, suggesting that relative sympathetic overdrive due to incipient and predominantly parasympathetic impairment of cardiovascular innervation might play a role in early alterations of circadian BP variation.

Adult↗
PubMed1995

[Experience with microbiological studies of the diabetic foot].

In order to determine the microbiological characteristics of diabetic foot infection, 60 diabetic patients (21 women, 39 men; age between 43 and 89 years with a duration of diabetes from 0.5 to 37 years) were investigated. Immediately after the hospitalisation specimens from infected foot lesions were taken using Port-A-Cul special transport medium. Aerobic cultures were done in all cases according to conventional methods while anaerobic cultures were carried out when clinical signs indicated to perform it. Out of 60 lesions only 2 proved to be sterile. In the remaining 58 patients a total of 138 isolates were found resulting in an average of 2.3 organisms per lesions. Only aerobic isolates were identified in 45 patients whereas anaerobic species were also found in 12 patients. Only Candida was found in 1 patient while Candida in combination with bacterial strains was observed in 3 patients. In antimicrobial susceptibility testing beta-lactamase-stable antibiotics with broad spectrum, covering enterococcus and anaerobic organisms proved to be most effective. Diabetic foot infections have a polymicrobial nature. Antibiotic treatment of infections should be based on the results of microbiological investigation of diabetic foot.

Adult↗
PubMed1995

[Factitious hypoglycemia--Munchausen syndrome in diabetes mellitus].

The medical history of a 43-year-old non-insulin-dependent diabetic patient is presented. The exact diagnosis of the cause of repetitive and severe hypoglycaemic episodes proved to be difficult. Finally, high serum insulin and low C-peptide values were found in peripheral venous blood during hypoglycaemia resulting in an elevated (> 1.0) molar ratio of insulin to C-peptide. The laboratory findings were assessed as consequences of surreptitious insulin administration. Factitious hypoglycaemia could be considered as a clinical manifestation of Munchhausen syndrome. Confronting the patient with evidences of surreptitious insulin injections, hypoglycaemic episodes abruptly discontinued to occur.

Adult↗
PubMed1993

[Variability of the circadian heart rate in diabetes mellitus-related autonomic neuropathy].

For assessing the alterations of circadian heart rate variability 66 diabetic patients (age: 52.9 +/- 1.0 years; x +/- SEM) and 23 control subjects (age: 52.7 +/- 1.7 years) were investigated using 24 hours Holter monitoring. Autonomic neuropathy (AN) was evaluated by tests for cardiovascular reflexes and patients were classified as being without AN (n = 26), having mild (n = 25) or definitive (n = 15) signs of AN. Minimal heart rates were significantly higher while maximal heart rates were considerably lower in patients with than without AN (60 +/- 2 min-1 versus 54 +/- 1, min-1, p < 0.05 and 125 +/- 4 min-1 versus 146 +/- 4 min-1, p < 0.01). Diabetic groups were comparable regarding values of averaged heart rates. The difference between the mean waking and sleeping averaged heart rates was the smallest in diabetic patients with definitive signs of AN (9 +/- 2 min-1) differing from those of control subjects (17 +/- 1 min-1, p < 0.01) and diabetic patients without (17 +/- 1 min-1, p < 0.001) or with mild (15 +/- 1 min-1, p < 0.05) signs of AN. Characteristic alteration, i.e. a reduction in circadian heart rate variability could be found in diabetic patients with signs of AN. This phenomenon has primarily been a consequence of more frequent sleeping heart rates due to dominant impairment in cardiac parasympathetic innervation.

Analysis of Variance↗
PubMed1993

[Connection between painless abnormal ST-deflection and autonomic neuropathy in diabetes mellitus].

In order to assess the relationship between abnormal but silent ST-segment depression and autonomic neuropathy 63 diabetic patients (age: 40-71 years, duration of diabetes: 2-32 years) without a history of angina pectoris were investigated. Transient ST-segment depression was assessed by 24 hours Holter monitoring and, in addition, dynamic exercise on bicycle ergometer was also performed in all but 7 patients. Autonomic neuropathy was evaluated by cardiovascular function tests (deep breathing, Valsalva manoeuvre and lying-to-standing). Abnormal ( > or = 2 mm) ST segment depression was observed in 11 patients (18%) while signs of autonomic neuropathy were found in 37 diabetics (59%). Signs of autonomic neuropathy were significantly (p < 0.01) more often documented in patients with (11/11) than without (26/52) abnormal ST-segment depression. It was concluded that autonomic neuropathy could be a possible explanation for lacking symptoms from abnormal ST-segment depression in diabetic patients.

Adult↗