PubMed Health⌕ Search

Biomedical subjects

Péter Vargha

Publications and source records attributed to Péter Vargha.

11 recordsLinked to original sources
PubMed2006

Comparative evaluation of local and international reference databases for forearm densitometry: different impacts on diagnostic decisions.

Reference databases play a key role in the management of osteoporosis. The aim of this preliminary study was to compare the diagnostic consequences of using either an international or a local reference database in peripheral densitometry. For this purpose, standard curves for bone mineral density (measured by dual-energy X-ray absorptiometry at the distal and proximal forearm) were generated for healthy Hungarian men and women. In total, 303 healthy volunteers of both sexes (age range: 20-94 yr) were recruited from four osteoporosis centers. Subjects with medical conditions or taking medication affecting the bone metabolism were excluded. Bone densitometry was performed with pDEXA (Norland-Stratec, Fort Atkinson, WI) devices in each center after cross-calibration of the machines. The precision error of the forearm measurement was also determined (<1% in vitro, and 1.2-2.5% in vivo). In females, the peak forearm density was detected in the 30-39-yr group. The density decreased by 8% per 5 yr in early postmenopausal females, and by 10% per 10 yr in late postmenopausal females. In males, the highest bone mineral density was found in the 30-39-yr group for the distal forearm, but 1 decade later for the proximal site. Subsequently, a 5% decrease in density occurred per 10 yr, except in the 8th decade, in which a 20% decrease was demonstrated. One thousand four hundred thirty-four patients with suspected osteoporosis were classified according to the forearm density T-scores using both the new Hungarian reference database and the international database provided by the manufacturer. Comparison of the results measured at the distal forearm with the two different databases led to similar outcomes. However, at the proximal site, one fifth of the female patients were reclassified from the low-density group to the normal group using the domestic normative database. An opposite difference was observed for the males: use of the Hungarian reference data resulted in 40% more men being categorized in the low-density group than when the international normal database was applied. Our results suggest that not only geographic differences, but also the reference database used, can influence the prevalence of the diagnosis of osteoporosis. Further data are currently being collected to increase the statistical power of the study.

Absorptiometry, Photon↗
PubMed2006

[Risk factors for ulcerative colitis associated colorectal cancers in a Hungarian cohort of ulcerative colitis patients].

BACKGROUND: There is an increased risk of colorectal cancer (CRC) in ulcerative colitis (UC). The prevalence of UC associated CRC is different in various geographical regions. The risk depends primarily on the duration and extent of disease. AIM: The aim of the study was to identify risk factors for and epidemiology of CRC in UC patients in Veszprem province. PATIENTS AND METHODS: From our thirty-year IBD database we retrospectively studied the relevant epidemiological and clinical data of all UC patients in Veszprem province. The data of 723 UC patients (m/f: 380/343) were evaluated. The rate of familial disease was 5.2%, the rate of non-CRC related colectomies was 3.7% in our UC patients. RESULTS: CRC was diagnosed in 13 patients (m/f: 6/7, 13/8564 person year duration) during follow-up. The onset of UC in the 13 patients with UC-CRC was 34.5 (13-61) years, 4.1 years younger compared to UC patients without CRC. Mean age of UC-CRC patients at diagnosis of CRC was 50.9 (27-70) years (duration of UC: 16.5 +/- 8.2 years), almost 15 years younger than the average in sporadic CRC population in Hungary. Eight patients are still alive (survival: 67.9 (10-163) months), four patients died because of CRC (survival: 8.0 months), one died due to unrelated cause after 10 years of the diagnosis of CRC. Longer disease duration, chronic continuous disease, more extensive colitis, the presence of iron deficiency or chronic anaemia, primary sclerosing cholangitis (PSC) and dysplasia in the biopsy were identified as risk factors for developing CRC. In a logistic regression model longer disease duration, extensive colitis, PSC and dysplasia were still associated with increased risk. The cumulative risk for developing CRC after a disease duration of 10 years was 0.6% (95% CI: 0.2-1.0%), at 20 years 5.4 % (95% CI: 3.7-7.1%) and at 32 years 12.6% (95% CI: 7.0-18.2%). CRC diagnosed at surveillance colonoscopy was associated with longer survival (p = 0.04). CONCLUSION: The cumulative risk of CRC was high in our UC patients, however it was lower compared to that reported in Western European and North American studies. CRC developed approximately fifteen years earlier compared to the sporadic CRC cases. Long disease duration, extensive colitis, the presence of iron deficiency or chronic anaemia, dysplasia and primary sclerosing cholangitis (PSC) seem to be important risk factor for developing CRC in UC patients.

Adult↗
PubMed2006

[Analysis of vascular complications of IABP therapy in open-heart surgery patients 1999-2004].

Intraaortic balloon pump (IABP) is being used in cardiac surgery in an increased ratio. IABP therapy involves considerable risk, mainly vascular complications, postoperative bleeding and infection can represent danger. Between 1999 and 2004 out of 4443 open heart surgery operations we have performed intraaortic balloon pump treatment in case of 75 patients. The mean age was 64 years, 23 patients had diabetes mellitus, 47 patients had hypertension, 20 patients had peripheral vascular disease as well. We performed IABP therapy most frequently during isolated coronary bypass operations (42 cases), but also combined operations (implantation of valve prosthesis + coronary bypass) represent a significant part (implantation of aortic valve prosthesis + CABG: 5 cases, implantation of mitral valve prosthesis + CABG: 8 cases). Vascular complications occurred in 10 cases--13.3%--out of 75 patients, including 7 fatal ones. Three cases are due to the IABP treatment itself: Crush syndrome was developed leading to the loss of the patient. Applying the multiple logistic regression model we have examined the effect of the following factors on the occurrence of vascular complications: gender, age, body surface, accompanying diseases (hypertension, diabetes, peripheral vascular disease), the method and timing of insertion. Peripheral vascular disease (p < 0.005) and hypertension (p = 0.01) represent independent risk factors regarding the occurrence of complications. Having performed chi-square test we have not identified significant correlations between mortality and vascular complications. In case of prevailing peripheral vascular disease, the application of alternative insertion techniques--via the ascending aorta, the axillary artery--are recommended.

Aged↗
PubMed2005

Influence of switching to travoprost on intraocular pressure of uncontrolled chronic open-angle glaucoma patients compliant to previously-used topical medication.

OBJECTIVE: To investigate the influence of switching to travoprost on intraocular pressure (IOP) of chronic open-angle glaucoma (COAG) patients. RESEARCH DESIGN AND METHODS: Multicentre, open-label, non-comparative, 12-week, phase IV study conducted at 10 academic and hospital centres in Hungary. Patients' compliance to use of the pre-study medication was confirmed at a visit 10 days before the baseline measurements, and compliance was monitored throughout the study period. RESULTS: Of the 203 COAG patients three (1.48%) ceased travoprost medication due to ocular hyperaemia, and one subject was lost from follow-up. Self-reported compliance was optimal except for two patients. For the per-protocol analysis 197 patients were evaluable. IOP of the 37 per-protocol patients receiving additional travoprost medication decreased from 23.1 +/- 3.2 mmHg (mean +/- SD) to 17.3 +/- 2.6 mmHg at week 12 (p < 0.001). Switching the 121 per-protocol patients from latanoprost to travoprost IOP decrease from 20.8 +/- 3.5 mmHg to 17.7 +/- 2.4 mmHg (p < 0.001). IOP of the 11 patients switched from topical nonselective beta-blockers to travoprost decreased from 20.1 +/- 2.1 mmHg to 15.7 +/- 1.5 mmHg (p < 0.001). For the whole per-protocol population (n = 197) IOP decreased from 21.0 +/- 3.4 mmHg to 17.4 +/- 2.4 mmHg (p < 0.001). Defining responders as having an IOP decrease > 2.0 mmHg or >or= 5 mmHg at week 12, the responder rate was respectively 62.9% or 31% for the total study population; 86.5% or 54.1% when travoprost was added to the established therapy; 54.5% or 24.0% if latanoprost was switched to travoprost; and 90.9% or 36.4% for those who switched from beta-blockers. CONCLUSION: Travoprost provided a clinically and statistically significant IOP decrease in uncontrolled COAG patients whose self-reported compliance to their previous topical medication was optimal. Our results suggest that the IOP reduction found after switching to travoprost is not explainable by improved compliance due to the clinical study situation.

Administration, Topical↗
PubMed2004

Hungarian cohort-controlled trial of periconceptional multivitamin supplementation shows a reduction in certain congenital abnormalities.

BACKGROUND: The 1984-1991 Hungarian randomized controlled trial (RCT) of periconceptional multivitamin supplementation containing folic acid (0.8 mg) showed a significant reduction in the first occurrence of neural tube defects (NTDs), and of urinary tract and cardiovascular abnormalities, but no reduction in orofacial clefts. A controlled cohort trial was designed to confirm or deny these results. METHODS: Supplemented women were recruited from the Hungarian Periconceptional Service using the same multivitamin as the Hungarian RCT. Unsupplemented pregnant women were recruited in the standard regional antenatal care clinics and were matched to each supplemented pregnant woman on the basis of age, socioeconomic status, place of residence, and year of pregnancy. RESULTS: A total of 3056 informative offspring were evaluated in each cohort. The occurrence of congenital cardiovascular malformations (31 vs. 50) was reduced (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.38-0.96) in the supplemented cohort, accounted for mainly by ventricular septal defects (5 vs. 19; OR, 0.26; 95% CI, 0.09-0.72). There was no significant difference (14 vs. 19) in the occurrence of urinary tract defects between the two cohorts, but stenosis/atresia of pelvic-ureteric junction (2 vs. 13) showed a significant reduction (OR, 0.19; 95% CI, 0.04-0.86). The protective effect of the folic acid-containing multivitamin for NTDs (one offspring in the supplemented vs. nine in the unsupplemented cohort) was confirmed (OR, 0.11; 95% CI, 0.01-0.91). There was, however, no protective effect on orofacial clefts or on multiple congenital abnormalities. CONCLUSIONS: The results of this cohort-controlled trial support the findings of the previous Hungarian RCT. The primary prevention of some major structural birth defects by multivitamins containing folic acid or by folic acid has great public health importance.

Adult↗
PubMed2003

[Glaucoma-screening with the Heidelberg Retina Tomograph II].

BACKGROUND: To investigate the clinical usefulness of the Heidelberg Retina Tomograph II (HRT II) in glaucoma-screening. MATERIAL AND METHODS: HRT II measurements were performed on 53 glaucomatous, 33 normal and 24 glaucoma suspect eyes. HRT II classification ("glaucoma", "borderline" and "normal") was compared to the classification of clinical examination (biomicroscopic indirect papilla examination, applanation tonometry, threshold perimetry) as well as to the classifications determined with threshold perimetry or GDx nerve fibre analysis simulating a screening examination. RESULTS: HRT II measurements were successful in 82.7 % of the eyes investigated. The diagnostic sensitivity of the HRT II was 60 %. Specificity was 88.8 % and 100 % at different criteria for "disease". HRT II classification corresponded the biomicroscopic classification in 63.7 %. The accordance of the HRT II classification with the GDx and visual field classification was 65.4 % and 64.8 %, respectively. GDx classification corresponded with the clinical and visual field classification in 41 % and 44 %. Significant (p < 0.05) positive correlation was between HRT II parameters cup/disc area ratio, linear C/D ratio and visual field indices MD and PSD. The HRT II parameter: Retinal Nerve Fibre Layer Cross Sectional Area and visual field index MD correlated in a significant negative manner. CONCLUSIONS: Though patient examination was fast using the HRT II instrument, the technique with the present software cannot be considered suitable for glaucoma screening, since its sensitivity is low. The HRT II seems to be useful when added to other diagnostic techniques.

Adult↗
PubMed2003

Expression of tumor necrosis factor (TNF)-alpha protein in the subcutaneous and visceral adipose tissue in correlation with adipocyte cell volume, serum TNF-alpha, soluble serum TNF-receptor-2 concentrations and C-peptide level.

OBJECTIVE: The aim of the study was to evaluate the expression of tumor necrosis factor (TNF)-alpha protein in the subcutaneous and visceral adipose tIssue in correlation with adipocyte cell Volume, serum TNF-alpha, soluble TNF-receptor-2 (sTNFR-2) and indirect parameters of insulin resistance in overweight/obese and lean healthy persons. DESIGN: A cross-sectional case-control study was used. PATIENTS: Twenty-eight overweight/obese probands with normal glucose tolerance (BMI>27 kg/m(2)) and 15 lean people (BMI<25 kg/m(2)), all of them undergoing planned surgical operation, participated in the study. METHODS: Two to four grams of subcutaneous and visceral adipose tIssue were removed and studied using semi-quantitative immunohistochemical staining of the TNF-alpha protein. Serum TNF-alpha, sTNFR-2 (ELISA) and fasting C-peptide (RIA) were measured. RESULTS: TNF-alpha protein was expressed in adipocytes of both depots. The expression was evaluated visually and found to be greater in the obese patients. Significantly higher serum TNF-alpha (5.58+/-0.87 pg/ml vs 4.21+/-0.55, mean+/-s.d., P<0.01, Mann-Whitney) and sTNFR-2 levels (7.84+/-3.56 ng/ml vs 4.59+/-1.35, P=0.005) were found in the obese subgroup in correlation with the fasting C-peptide level (r=0.49, P=0.003; and r=0.74, P=0.001) and the C-peptide/ blood glucose ratio (r=0.47, Spearman, P=0.005; and r=0.70, P=0.001). The cell Volume of both adipocyte depots was found to have a significant positive correlation with serum TNF-alpha and sTNFR-2 levels in the total group of patients (subcutaneous: r=0.52, P=0.0003; r=0.69, P<0.0001; visceral: r=0.65, P<0.0001; r=0.63, P<0.0001) and in both subgroups. CONCLUSIONS: Adipocyte cell Volume of both the subcutaneous and visceral fat depots may be determinants of TNF-alpha, sTNFR-2 production and obesity-linked insulin resistance.

Adipocytes↗
PubMed2002

Tumor necrosis factor system in insulin resistance in gestational diabetes.

OBJECTIVE: The aim of the study was to investigate the pathophysiological role of the tumor necrosis factor (TNF) system in insulin resistance in patients with gestational diabetes (GDM) and during the course of normal pregnancy. PATIENTS AND METHODS: Thirty women with GDM (16-39 gestational weeks), 35 healthy pregnant women (15 first, nine second and 11 third trimester) and 25 healthy age-matched non-pregnant women were studied. Serum TNF-alpha, and its soluble receptors 1 and 2 (sTNFR-1 and -2) were measured. RESULTS: In non-diabetic pregnant women in the third trimester all measures were significantly higher (P<0.05 or less) than in the first trimester and in non-pregnant women (BMI 27.6 +/- 4.1 (+/- S.D.), 24.1 +/- 2.6, 22.4 +/- 2.4 kg/m(2)), serum TNF-alpha (4.6 +/- 0.6, 4.1 +/- 0.4, 4.1 +/- 0.4 ng/l), sTNFR-1 (2.7 +/- 0.9, 2.0 +/- 0.5, 2.0 +/- 0.1 microg/l), sTNFR-2 (5.6 +/- 2.6, 4.6 +/- 2.1, 3.3 +/- 0.2 microg/l), C-peptide (3.1 +/- 1.7, 1.1 +/- 0.7, 1.1 +/- 0.8 microg/l), and C-peptide:blood glucose ratio (0.6 +/- 0.2, 0.2 +/- 0.1, 0.2 +/- 0.1 microg/mmol). In GDM these measures were even higher than in any subgroup of healthy pregnant women (BMI) (33.4 +/- 6.4 kg/m(2), TNF-alpha) (6.3 +/- 0.6 microg/l), sTNFR-1 (3.0 +/- 0.5 microg/l), sTNFR-2 (10.0 +/- 6.9 microg/l, C-peptide 6.0 +/- 2.7 microg/l, C-peptide:blood glucose ratio: 1.2 +/- 0.5 microg/mmol, P<0.01). Significant (P<0.01) positive linear correlations were found in gestational diabetic and non-diabetic women between serum TNF-alpha, C-peptide levels, and BMI. In gestational diabetic women, in multivariate analysis studying the dependency of C-peptide only BMI remained significant (r(2)=0.67, P=0.01). CONCLUSIONS: Our observation emphasizes the obesity-related component of insulin resistance driven by adipocytokines, such as TNF-alpha and its receptors during the course of normal pregnancy and GDM.

Antigens, CD↗
PubMedDate not supplied

Endothelin-A receptor antagonist BQ-485 protects against intraocular pressure spike induced by laser trabeculoplasty in the rabbit.

PURPOSE: We have previously shown in rabbits that the intraocular pressure (IOP) spike caused by argon laser trabeculoplasty (ALT) is associated with an acute endothelin-1 (ET-1) release from the uveal tissue into the aqueous humour. In this study we investigated whether pretreatment with an ET(A) receptor antagonist (BQ-485) protects against the pressure spike induced by ALT, in the rabbit model. METHODS: Under general anaesthesia, 10 microl of 10(-5) M BQ-485 was injected into the anterior chamber of the right eye, and 10 microl of balanced salt solution (BSS) into the contralateral anterior chamber, for 12 pigmented rabbits. Five minutes later ALT (1,000 mW, 0.1 s, 100 spots over 360 degrees focused on the iris pillars) was performed on both eyes of each animal. IOP was measured before the injections (baseline value), and also 30 min afterwards using a Tono-Pen XL tonometer. Immediately after the second IOP measurement aqueous humour was aspirated for measurement of ET-1 concentration. RESULTS: The baseline IOP (mean +/- SD) was 8.08 +/- 1.73 mm Hg and 7.92 +/- 1.78 mm Hg for the right and left eyes, respectively (Duncan test, p > 0.05). At 25 min after ALT the IOP of the BQ-485-pretreated right eyes remained unchanged (7.83 +/- 2.44 mm Hg, p > 0.05) but the IOP of the BSS-pretreated left eyes at 30 min increased significantly to 10.67 +/- 4.70 mm Hg (p < 0.05 for comparisons both with the corresponding baseline value for the same eye, and with the IOP of the contralateral eye at 30 min). There was no difference in aqueous humour ET-1 concentration between the corresponding right and left eyes (paired t test, p > 0.05). CONCLUSION: Intracameral BQ-485 pretreatment protected against the ALT-induced acute IOP elevation, but did not influence the laser-induced ET-1 release. This suggests that ET(A )receptor antagonists may potentially have a therapeutic role in the prevention of laser-induced IOP spikes.

Administration, Topical↗
PubMedDate not supplied

Unoprostone isopropyl pretreatment decreases endothelin-1 release and the intra-ocular pressure spike induced by laser trabeculoplasty in the rabbit.

PURPOSE: We have previously shown that the intra-ocular pressure (IOP) spike due to argon laser trabeculoplasty (ALT) is caused by an acute endothelin-1 (ET-1) release from the uveal tissue into the aqueous humour of rabbit eyes. In this study we investigated whether pretreatment with topical unoprostone isopropyl, a functional antagonist of ET-1, protects against the pressure spike due to ALT in the rabbit model. METHODS: IOP of both eyes of 17 pigmented rabbits was measured with a TonoPen XL tonometer under general anaesthesia (baseline measurement). Then the right eyes were treated with topical unoprostone isopropyl 0.12% BID for 6 days, and the left eyes similarly received balanced salt solution (BSS) twice daily. After the last morning instillation, IOP for both eyes was measured under general anaesthesia after 2 h in group 1 and after 3 h in group 2 animals. Then, for both groups, ALT was performed on both eyes. Thirty minutes after laser treatment (and still under general anaesthesia), IOP was measured again. Then the aqueous humour was aspirated for measurement of ET-1 concentration. RESULTS: Baseline individual IOP differences (left eye minus right eye) were not significant in both groups: mean +/- SD 0.25 +/- 1.16 and -0.33 +/- 0.71 mm Hg, respectively (paired t test, p > 0.05 for both groups). On day 6, 2 h (group 1) and 3 h (group 2) after the last instillation but before laser trabeculoplasty, the difference (BSS-pretreated left eye minus unoprostone-pretreated right eye) increased to 2.13 +/- 2.10 mm Hg (p = 0.024) and 1.33 +/- 0.71 mm Hg (p = 0.0005), respectively. Thirty minutes after ALT, the IOP difference was 2.63 +/- 2.67 mm Hg in group 1 (p = 0.027), but no difference was seen in group 2 (0.67 +/- 1.94 mm Hg, p = 0.332). In group 1, postoperative aqueous humour ET-1 concentration for the unoprostone-pretreated right eye was significantly lower than that for the BSS-pretreated left eye (paired t test, p = 0.01); but in group 2 no inter-ocular difference in ET-1 concentration was found (p = 0.976). CONCLUSION: Topical unoprostone pretreatment decreases laser-induced ET-1 release and diminishes the IOP spike caused by ALT in vivo within 2 h after instillation, when the concentration of unoprostone in the aqueous humour is high.

Animals↗