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Papers by Boglarka Brugos
Hematológia-transzfuziológia, Jun 19, 2024
Hematológia-transzfuziológia, Jul 18, 2023
A terhességi vagy gesztációs thrombocytopenia gyakori eltérés, többnyire nem igényel beavatkozást... more A terhességi vagy gesztációs thrombocytopenia gyakori eltérés, többnyire nem igényel beavatkozást, társulhat cholestasisszal (laboratóriumi jelekkel és viszketéssel), ismételt terhességnél pedig többnyire újra, hamarabb vagy jelentősebb mértékben lép fel, és a thrombocytopenia általában nem igényel a gondos követésen túl külön beavatkozást. A gesztációs thrombocytopenia a terhesség első felében csekély mértékű, a harmadik trimeszter végére jelentősebb, de az esetek több mint 95%-ában nem éri el a 100 G L À1 alatti értéket. Ha a thrombocytaszám 100 G L À1 alatti, vagy egyéb társuló tünetek indokolják, fontos a differenciáldiagnosztika, amelynek során több, komoly intervenciót igénylő eltérést számításba jöhet, mint a toxaemia-praeccalampsia (HELLP szindróma), akut terhességi zsírmáj, de novo immun thrombocytopeniás purpura vagy relapszus, antifoszfolipid szindróma, congenitalis vagy akut thrombotikus mikroangiopathia, disszeminált intravaszkuláris koaguláció. Ezek többnyire jellegzetes időpontban lépnek fel és sajátos klinikai tünetekkel társulnak, a diagnózisnak megfelelően kezelendők. A súlyossá váló gesztációs thrombocytopenia, azaz ha társuló tünetek nélkül a harmadik trimeszterben 100 G L À1 alatti thrombocytaszám jelenik meg, összetett kérdés, etiológiai vizsgálatok indokoltak, a terápia gyakran empirikus, de az esetek túlnyomó többsége jól befolyásolható, azonban oki kapcsolat főként az immun thrombocytopeniás purpura és thrombotikus mikroangiopathia tekintetében különösen izgalmas kérdés. KULCSSZAVAK gesztációs thrombocytopenia, differenciáldiagnosztika (ITP, thrombotikus mikroangiopathia), kezelés, szülészeti, magzati vonatkozások Pregnancy and platelets, focus on gestational thrombocytopenia. Differential diagnosis, approach to treatment
Hematológia–Transzfuziológia
Az autoimmun hemolitikus anémia (AIHA) ritka hematológiai kórkép, amelynek hátterében autoantites... more Az autoimmun hemolitikus anémia (AIHA) ritka hematológiai kórkép, amelynek hátterében autoantitest okozta vörösvérsejt-destrukció áll. Az esetek körülbelül 50%-a idiopátiás vagy primer AIHA, míg a szekunder esetek hátterében infekció, szisztémás autoimmun betegség, szolid tumorok, limfoproliferatív betegségek, gyógyszermellékhatás áll. A SARS-CoV-2 vírus okozta Covid-19-pandémia jelentkezése óta megnőtt azon AIHA-s betegek száma, ahol a SARS-CoV-2 vírus okozta infekció szerepel etiológiai tényezőként. Cikkünkben ismertetjük egy Covid–19 indukálta AIHA-s beteg esetét, illetve irodalmi áttekintést nyújtunk a témában.
Journal of Clinical Medicine
Hereditary hemorrhagic telangiectasia (HHT) is a rare germline vascular malformation syndrome wit... more Hereditary hemorrhagic telangiectasia (HHT) is a rare germline vascular malformation syndrome with a prevalence of 1:5000–1:10,000 [...]
A szisztemas lupus erythematosus poliszisztemas autoimmun betegseg, egyik legjelentősebb szervi s... more A szisztemas lupus erythematosus poliszisztemas autoimmun betegseg, egyik legjelentősebb szervi szovődmenye a lupus nephritis. A lupus nephritis időbeni, a kronikus szervi erintettseg kialakulasat megelőző felismerese, a shubok előrejelzese, a korai agressziv kezeles elkezdese es a terapia sikeressegenek lemerese kivanatos lenne. Ezert a kutatasok egy resze intenziven a legmegfelelőbb, aktivitast előre jelző biomarker megtalalasara iranyul. Jelen osszefoglalo celja a hagyomanyos szerologiai markerek megbeszelesen tul a legujabb, reszben meg kiserletes, a klinikai gyakorlatban nem hasznalt, de az SLE, illetve lupus nephritis aktivitasat jellemző specifikus biomarkerek bemutatasa. | Systemic lupus erythematosus is a polysystemic autoimmune disease. One of the most common and serious complication is lupus nephritis. Notification of these complications before organic disorder, prediction of flares, starting aggressive therapy as early as possible, and the follow-up of successful treatme...
Pathology & Oncology Research, 2019
We aimed to answer the question whether the decreased expression of protein kinase C (PKC) isoenz... more We aimed to answer the question whether the decreased expression of protein kinase C (PKC) isoenzymes in the peripheral blood mononuclear cells (PBMC) of patients with systemic lupus erythematosus (SLE) is inherited or not. For this reason we examined the expression of PKC isoenzymes in a European white girl with acute SLE and in her healthy mother and father simultaneously in summer and winter during one year using western blotting and densitometry. We found that in the father the expression of PKC isoenzymes did not differ from that of eight healthy controls included women and men. However, in the "SLE-free" mother and in the patient arrived in July with acute symptoms of lupus, the expression of PKC isoenzymes showed a season dependent undulation in parallel. Namely, in summer the expression values were significantly lower, in winter they were significantly higher than those in the controls. Thus, the decreased expression of PKC isoenzymes in the PBMC of SLE patient is not a disease specific marker; it appears also in her lupus free mother. This phenomenon may be due to a season dependent female genetic background. However, the low PKC levels in summer can still decrease further the low production of IL-2 in T cells of lupus patients augmenting the existing AP-1 defects. This is the first report on the season and female dependent inherited changing of PKC expression in a European white patient with SLE and her mother. Further studies are needed to confirm these findings in other populations.
Journal of Biotechnology, 2019
Highlights FBN1 gene testing in individuals with Marfan syndrome and other fibrillinopathies. ... more Highlights FBN1 gene testing in individuals with Marfan syndrome and other fibrillinopathies. Identification of novel and recurrent causal and potentially causal FBN1 variants. Summary of molecular and clinical data of Hungarian Marfan syndrome patients.
A zsirban-oldodo vitaminok immunmodulans hatasat tanulmanyoztuk 25 primer Sjogren-szindromas (SS)... more A zsirban-oldodo vitaminok immunmodulans hatasat tanulmanyoztuk 25 primer Sjogren-szindromas (SS) betegben. Megallapitottuk, hogy a zsirban-oldodo vitaminoknak immunmodulans hatasa van, es szerepuk van az autoimmun betegsegek patogeneziseben.Az A es E vitamin szintje korrelal az immunregulatorikus sejtek szamaval es befolyasolhatja az autoimmun folyamatot. (Rheumatol 2010;49:211-17.) Megallapitottuk,hogy a Graves-betegseg es a Hashimoto thyreoiditis kialakulasa megelőzheti, de kovetheti is az SS jelentkezeset. Mivel a SS-val tarsult autoimmun thyreoiditisek korabbi eletkorban alakulnak ki fontos annak a tovabbi vizsgalata, hogy a SS valoban perdisponalo faktor-e az autoimmun thyreoiditis kifejlődeseben. (Thyroid 2009;19(1):39-45.) Meghataroztuk az Interferon omega (IFN omega) szerumkoncentraciojanak korrelaciojat az APSI es mas szisztemas autoimmun betegsegekkel.Az AIRE gen egy uj mutacioja, a c.1344 delC-t tudtuk kimutatni. Ugy tűnik, az anti-IFNomega antitestek a nagyon korai elet...
Pharmazie
Systemic lupus erythematosus (SLE) is a chronic relapsing systemic autoimmune disease; one of the... more Systemic lupus erythematosus (SLE) is a chronic relapsing systemic autoimmune disease; one of the. most serious complications is renal involvement, which is occurring in almost 50% of all patients at the beginning of the disease. The aim of the present study was to compare renal function, proteinuria, activity markers and treatment regimen of active and inactive SLE patients with renal involvement. We analyzed the correlation of serum blood urea nitrogen, creatinine level, glomerular filtration rate, urine total protein/serum creatinine (uTP/creat), CRP to classic activity markers of SLE (serum complement 3, -4 level, anti-dsDNA antibody). Moreover we analyzed the treatment modalities of patients with lupus nephritis (LN). Data of 418 SLE patients were analyzed, out of these patients 128 had biopsy proven lupus nephritis or had more than 3 + proteinuria by urine dipstick analysis (30% of all cases). Results: Data of 128 patients with lupus nephritis were analyzed (mean age 32.18 +/-...
Die Pharmazie, 2014
We examined 416 patients with acute myocardial infarction. 249 patients had STEMI and 167 NSTEMI.... more We examined 416 patients with acute myocardial infarction. 249 patients had STEMI and 167 NSTEMI. 227 were men and 189 women. 142 men had STEMI and 85 men had NSTEMI. 107 women were diagnosed with STEMI and 82 with NSTEMI. 22.5% of patient with STEMI and 20.2% of patients with NSTEMI died (p = 0.58). We compared the effect of anticoagulant treatment, clopidogrel, salicylate, nitrate, beta-blocker, angiotensin-converting enzyme inhibitor, statin and trimetazidine therapy on mortality in function of the type of myocardial infarction. There were no differences between mortality of patients with STEMI and NSTEMI with respect of use of heparine, salicylate, nitrate, beta-blocker, ACE inhibitor, statin and trimetazidine. While examining the effect of clopidogrel, we observed a significantly lower mortality rate in patients with NSTEMI compared to the STEMI group (p = 0.005). These differences are due to the known variability in clopidogrel absorption and metabolism, which could be influen...
Die Pharmazie, 2014
Systemic lupus erythematosus (SLE) is a chronic relapsing systemic autoimmune disease; one of the... more Systemic lupus erythematosus (SLE) is a chronic relapsing systemic autoimmune disease; one of the most serious complications is renal involvement, which is occurring in almost 50% of all patients at the beginning of the disease. The aim of the present study was to compare renal function, proteinuria, activity markers and treatment regimen of active and inactive SLE patients with renal involvement. We analyzed the correlation of serum blood urea nitrogen, creatinine level, glomerular filtration rate, urine total protein/serum creatinine (uTP/creat), CRP to classic activity markers of SLE (serum complement 3, -4 level, anti-dsDNA antibody). Moreover we analyzed the treatment modalities of patients with lupus nephritis (LN). Data of 418 SLE patients were analyzed, out of these patients 128 had biopsy proven lupus nephritis or had more than 3 + proteinuria by urine dipstick analysis (30% of all cases). Data of 128 patients with lupus nephritis were analyzed (mean age 32.18 +/- 11.48 yea...
Die Pharmazie, 2012
Dyslipidaemia is a major risk factor of cardiovascular diseases, the role of serum total choleste... more Dyslipidaemia is a major risk factor of cardiovascular diseases, the role of serum total cholesterol (Chol) especially LDL-Chol is well established in the pathogenesis of atherosclerosis and ischemic heart disease. Use of cholesterol lowering drugs within the first 24 h of hospitalization for acute myocardial infarction (AMI) is associated with a lower rate of cardiogenic shock, arrhythmias, cardiac arrest and recurrent myocardial infarction. We assessed data of 416 patients admitted to hospital with AMI in a 2 year period (2001-2003) focusing on statin therapy. We have not found a correlation between serum lipid parameters and mortality of patients with AMI. Chronic statin treatment used before AMI (in 36 patients) did not influence mortality of patients. Chol level of patients with ST-elevation myocardial infarction (STEMI) was significantly higher (p = 0,043). Mortality of patients who did not receive statin treatment after AMI was significantly higher. These data highlight the i...
Die Pharmazie, 2012
Systemic lupus erythematosus (SLE) is a chronic, relapsing, polysystemic autoimmune disease with ... more Systemic lupus erythematosus (SLE) is a chronic, relapsing, polysystemic autoimmune disease with various clinical signs. The prognosis of SLE patients is influenced by neuropsychiatric and renal involvement. Lupus nephritis (LN) is present in 40-60% of patients. Classical laboratory parameters are not sensitive and specific in prediction renal flares, over the last few years there has been a growing interest in searching novel lupus biomarkers predicting future flares. Our goal was to detect serum and urinary level of cytokines in 36 patients with lupus nephritis (34 female and 2 male, mean age: 43.36 +/- 11.53 years), 23 patients with SLE without renal involvement (19 women and 4 men, mean age: 54 +/- 8.71) (both groups followed by the 3rd Department of Internal Medicine, Division of Clinical Immunology, University of Debrecen) and 30 healthy controls (23 female and 7 male, mean age: 45.5 +/- 12.4). Serum IL-1 (interleukin), IL-2 (both p < 0.05), IL-6, IL-13 and IFN-gamma (p <...
Die Pharmazie, 2008
Thrombolytic agents activate plasminogen and induce a systemic fibrinolytic and anticoagulant sta... more Thrombolytic agents activate plasminogen and induce a systemic fibrinolytic and anticoagulant state. Two thrombolytic drugs are used frequently in practice: streptokinase (SK) and alteplase (t-PA). Streptokinase mainly undergoes renal elimination with a half-life of 11-17 min, while alteplase is eliminating by the liver with a half-life of 4-6 min. Our goal was to examine whether renal and hepatic function influence the elimination and metabolism of thrombolytics and the efficacy of percutaneous coronary intervention (PCI) after using alteplase or streptokinase. 416 patients with myocardial infarction (MI) were treated from January 2001 to December 2003 (228 male and 189 female). Alteplase was used in 9 men and 6 women (mean age: 53.88 +/- 9.61 vs. 65.33 +/- 9.87 years, p = 0.07). Patients who underwent rescue PCI after administration of alteplase had slightly higher hepatic enzyme levels/alanine transaminase (ALT): 47.85 vs. 41.4 U/l; gamma-glutamyl transpeptidase (GGT): 69.5 vs. 4...
Pharmaceutical research, 2004
Modulatory actions on morphine-induced effects, such as tolerance and withdrawal, have been noted... more Modulatory actions on morphine-induced effects, such as tolerance and withdrawal, have been noted for dynorphin A(1-13) [Dyn A(1-13)] and similar peptides. These are currently of limited therapeutic potential due to extensive metabolism by human metabolic enzymes resulting in a half-life of less than 1 min in human plasma. The purpose of this study was to identify stabilized dynorphin A (Dyn A) derivatives, to determine their metabolic routes in human plasma, and to assess whether the pharmacodynamic activity is retained. The stability of peptides in human plasma was tested using in vitro metabolism studies with and without enzyme inhibitors. Identification of the generated metabolites was performed by mass spectrometry after high performance liquid chromatography (HPLC) separation. The in vivo activity of a stabilized dynorphin was tested by tail-flick assay in morphine-tolerant rats. Though amidation of the Dyn A(1-13) was able to stop the majority of C-terminal degradation, metab...
Die Pharmazie, 2004
Dynorphin A(1-13), a tridecapeptide of the endogenous opioid peptides, has modest effects in redu... more Dynorphin A(1-13), a tridecapeptide of the endogenous opioid peptides, has modest effects in reducing mild opiate withdrawal in humans. Previous studies revealed that dynorphin also potentiates the analgesic effect of morphine in morphine-tolerant rats and mice. The therapeutic potential of dynorphin A(1-13) is limited due to extensive metabolism by human metabolic enzymes resulting in an in vivo half-life of less than one minute. Chemical modifications of dynorphin A(1-13), such as N-methylation of Tyr1 and amidation of the C-terminus have been shown to be effective in protecting against the proteolytic enzymes in human plasma. This article is a general review of the metabolism of dynorphin A(1-13) in human plasma and CSF.
The aim of this study was to review the development, histological type and outcome of 117 patient... more The aim of this study was to review the development, histological type and outcome of 117 patients with lupus nephritis managed and followed by the Division of Clinical Immunology, 3rd Department of Internal Medicine, University of Debrecen, Debrecen, Hungary. The method used was a retrospective study in 117 patients with lupus nephritis followed between 1974 and 2004. The average occurrence of lupus nephritis was 3 (women) and 4.4 (men) years later after the diagnosis of systemic lupus erythematosus, 43 (46.2%) patients had class IV lupus nephritis. The initial therapy was intravenous cyclophosphamide treatment for 6 months in 37 (31.6%) patients. End-stage renal disease had developed in nine (7.6%) patients. The 5-year survival rate was 99.1%. Despite the well-known and proved risk factors like hypertension, high serum creatinine, renal failure at onset or membranous glomerulonephritis, the outcome of the disease in our patient population was more favourable than one would expect according to the data available in the literature. The authors would like to draw attention to the importance of systematic care of patients with systemic lupus erythematosus, which may lead to a better clinical outcome.
Hematológia-transzfuziológia, Jun 19, 2024
Hematológia-transzfuziológia, Jul 18, 2023
A terhességi vagy gesztációs thrombocytopenia gyakori eltérés, többnyire nem igényel beavatkozást... more A terhességi vagy gesztációs thrombocytopenia gyakori eltérés, többnyire nem igényel beavatkozást, társulhat cholestasisszal (laboratóriumi jelekkel és viszketéssel), ismételt terhességnél pedig többnyire újra, hamarabb vagy jelentősebb mértékben lép fel, és a thrombocytopenia általában nem igényel a gondos követésen túl külön beavatkozást. A gesztációs thrombocytopenia a terhesség első felében csekély mértékű, a harmadik trimeszter végére jelentősebb, de az esetek több mint 95%-ában nem éri el a 100 G L À1 alatti értéket. Ha a thrombocytaszám 100 G L À1 alatti, vagy egyéb társuló tünetek indokolják, fontos a differenciáldiagnosztika, amelynek során több, komoly intervenciót igénylő eltérést számításba jöhet, mint a toxaemia-praeccalampsia (HELLP szindróma), akut terhességi zsírmáj, de novo immun thrombocytopeniás purpura vagy relapszus, antifoszfolipid szindróma, congenitalis vagy akut thrombotikus mikroangiopathia, disszeminált intravaszkuláris koaguláció. Ezek többnyire jellegzetes időpontban lépnek fel és sajátos klinikai tünetekkel társulnak, a diagnózisnak megfelelően kezelendők. A súlyossá váló gesztációs thrombocytopenia, azaz ha társuló tünetek nélkül a harmadik trimeszterben 100 G L À1 alatti thrombocytaszám jelenik meg, összetett kérdés, etiológiai vizsgálatok indokoltak, a terápia gyakran empirikus, de az esetek túlnyomó többsége jól befolyásolható, azonban oki kapcsolat főként az immun thrombocytopeniás purpura és thrombotikus mikroangiopathia tekintetében különösen izgalmas kérdés. KULCSSZAVAK gesztációs thrombocytopenia, differenciáldiagnosztika (ITP, thrombotikus mikroangiopathia), kezelés, szülészeti, magzati vonatkozások Pregnancy and platelets, focus on gestational thrombocytopenia. Differential diagnosis, approach to treatment
Hematológia–Transzfuziológia
Az autoimmun hemolitikus anémia (AIHA) ritka hematológiai kórkép, amelynek hátterében autoantites... more Az autoimmun hemolitikus anémia (AIHA) ritka hematológiai kórkép, amelynek hátterében autoantitest okozta vörösvérsejt-destrukció áll. Az esetek körülbelül 50%-a idiopátiás vagy primer AIHA, míg a szekunder esetek hátterében infekció, szisztémás autoimmun betegség, szolid tumorok, limfoproliferatív betegségek, gyógyszermellékhatás áll. A SARS-CoV-2 vírus okozta Covid-19-pandémia jelentkezése óta megnőtt azon AIHA-s betegek száma, ahol a SARS-CoV-2 vírus okozta infekció szerepel etiológiai tényezőként. Cikkünkben ismertetjük egy Covid–19 indukálta AIHA-s beteg esetét, illetve irodalmi áttekintést nyújtunk a témában.
Journal of Clinical Medicine
Hereditary hemorrhagic telangiectasia (HHT) is a rare germline vascular malformation syndrome wit... more Hereditary hemorrhagic telangiectasia (HHT) is a rare germline vascular malformation syndrome with a prevalence of 1:5000–1:10,000 [...]
A szisztemas lupus erythematosus poliszisztemas autoimmun betegseg, egyik legjelentősebb szervi s... more A szisztemas lupus erythematosus poliszisztemas autoimmun betegseg, egyik legjelentősebb szervi szovődmenye a lupus nephritis. A lupus nephritis időbeni, a kronikus szervi erintettseg kialakulasat megelőző felismerese, a shubok előrejelzese, a korai agressziv kezeles elkezdese es a terapia sikeressegenek lemerese kivanatos lenne. Ezert a kutatasok egy resze intenziven a legmegfelelőbb, aktivitast előre jelző biomarker megtalalasara iranyul. Jelen osszefoglalo celja a hagyomanyos szerologiai markerek megbeszelesen tul a legujabb, reszben meg kiserletes, a klinikai gyakorlatban nem hasznalt, de az SLE, illetve lupus nephritis aktivitasat jellemző specifikus biomarkerek bemutatasa. | Systemic lupus erythematosus is a polysystemic autoimmune disease. One of the most common and serious complication is lupus nephritis. Notification of these complications before organic disorder, prediction of flares, starting aggressive therapy as early as possible, and the follow-up of successful treatme...
Pathology & Oncology Research, 2019
We aimed to answer the question whether the decreased expression of protein kinase C (PKC) isoenz... more We aimed to answer the question whether the decreased expression of protein kinase C (PKC) isoenzymes in the peripheral blood mononuclear cells (PBMC) of patients with systemic lupus erythematosus (SLE) is inherited or not. For this reason we examined the expression of PKC isoenzymes in a European white girl with acute SLE and in her healthy mother and father simultaneously in summer and winter during one year using western blotting and densitometry. We found that in the father the expression of PKC isoenzymes did not differ from that of eight healthy controls included women and men. However, in the "SLE-free" mother and in the patient arrived in July with acute symptoms of lupus, the expression of PKC isoenzymes showed a season dependent undulation in parallel. Namely, in summer the expression values were significantly lower, in winter they were significantly higher than those in the controls. Thus, the decreased expression of PKC isoenzymes in the PBMC of SLE patient is not a disease specific marker; it appears also in her lupus free mother. This phenomenon may be due to a season dependent female genetic background. However, the low PKC levels in summer can still decrease further the low production of IL-2 in T cells of lupus patients augmenting the existing AP-1 defects. This is the first report on the season and female dependent inherited changing of PKC expression in a European white patient with SLE and her mother. Further studies are needed to confirm these findings in other populations.
Journal of Biotechnology, 2019
Highlights FBN1 gene testing in individuals with Marfan syndrome and other fibrillinopathies. ... more Highlights FBN1 gene testing in individuals with Marfan syndrome and other fibrillinopathies. Identification of novel and recurrent causal and potentially causal FBN1 variants. Summary of molecular and clinical data of Hungarian Marfan syndrome patients.
A zsirban-oldodo vitaminok immunmodulans hatasat tanulmanyoztuk 25 primer Sjogren-szindromas (SS)... more A zsirban-oldodo vitaminok immunmodulans hatasat tanulmanyoztuk 25 primer Sjogren-szindromas (SS) betegben. Megallapitottuk, hogy a zsirban-oldodo vitaminoknak immunmodulans hatasa van, es szerepuk van az autoimmun betegsegek patogeneziseben.Az A es E vitamin szintje korrelal az immunregulatorikus sejtek szamaval es befolyasolhatja az autoimmun folyamatot. (Rheumatol 2010;49:211-17.) Megallapitottuk,hogy a Graves-betegseg es a Hashimoto thyreoiditis kialakulasa megelőzheti, de kovetheti is az SS jelentkezeset. Mivel a SS-val tarsult autoimmun thyreoiditisek korabbi eletkorban alakulnak ki fontos annak a tovabbi vizsgalata, hogy a SS valoban perdisponalo faktor-e az autoimmun thyreoiditis kifejlődeseben. (Thyroid 2009;19(1):39-45.) Meghataroztuk az Interferon omega (IFN omega) szerumkoncentraciojanak korrelaciojat az APSI es mas szisztemas autoimmun betegsegekkel.Az AIRE gen egy uj mutacioja, a c.1344 delC-t tudtuk kimutatni. Ugy tűnik, az anti-IFNomega antitestek a nagyon korai elet...
Pharmazie
Systemic lupus erythematosus (SLE) is a chronic relapsing systemic autoimmune disease; one of the... more Systemic lupus erythematosus (SLE) is a chronic relapsing systemic autoimmune disease; one of the. most serious complications is renal involvement, which is occurring in almost 50% of all patients at the beginning of the disease. The aim of the present study was to compare renal function, proteinuria, activity markers and treatment regimen of active and inactive SLE patients with renal involvement. We analyzed the correlation of serum blood urea nitrogen, creatinine level, glomerular filtration rate, urine total protein/serum creatinine (uTP/creat), CRP to classic activity markers of SLE (serum complement 3, -4 level, anti-dsDNA antibody). Moreover we analyzed the treatment modalities of patients with lupus nephritis (LN). Data of 418 SLE patients were analyzed, out of these patients 128 had biopsy proven lupus nephritis or had more than 3 + proteinuria by urine dipstick analysis (30% of all cases). Results: Data of 128 patients with lupus nephritis were analyzed (mean age 32.18 +/-...
Die Pharmazie, 2014
We examined 416 patients with acute myocardial infarction. 249 patients had STEMI and 167 NSTEMI.... more We examined 416 patients with acute myocardial infarction. 249 patients had STEMI and 167 NSTEMI. 227 were men and 189 women. 142 men had STEMI and 85 men had NSTEMI. 107 women were diagnosed with STEMI and 82 with NSTEMI. 22.5% of patient with STEMI and 20.2% of patients with NSTEMI died (p = 0.58). We compared the effect of anticoagulant treatment, clopidogrel, salicylate, nitrate, beta-blocker, angiotensin-converting enzyme inhibitor, statin and trimetazidine therapy on mortality in function of the type of myocardial infarction. There were no differences between mortality of patients with STEMI and NSTEMI with respect of use of heparine, salicylate, nitrate, beta-blocker, ACE inhibitor, statin and trimetazidine. While examining the effect of clopidogrel, we observed a significantly lower mortality rate in patients with NSTEMI compared to the STEMI group (p = 0.005). These differences are due to the known variability in clopidogrel absorption and metabolism, which could be influen...
Die Pharmazie, 2014
Systemic lupus erythematosus (SLE) is a chronic relapsing systemic autoimmune disease; one of the... more Systemic lupus erythematosus (SLE) is a chronic relapsing systemic autoimmune disease; one of the most serious complications is renal involvement, which is occurring in almost 50% of all patients at the beginning of the disease. The aim of the present study was to compare renal function, proteinuria, activity markers and treatment regimen of active and inactive SLE patients with renal involvement. We analyzed the correlation of serum blood urea nitrogen, creatinine level, glomerular filtration rate, urine total protein/serum creatinine (uTP/creat), CRP to classic activity markers of SLE (serum complement 3, -4 level, anti-dsDNA antibody). Moreover we analyzed the treatment modalities of patients with lupus nephritis (LN). Data of 418 SLE patients were analyzed, out of these patients 128 had biopsy proven lupus nephritis or had more than 3 + proteinuria by urine dipstick analysis (30% of all cases). Data of 128 patients with lupus nephritis were analyzed (mean age 32.18 +/- 11.48 yea...
Die Pharmazie, 2012
Dyslipidaemia is a major risk factor of cardiovascular diseases, the role of serum total choleste... more Dyslipidaemia is a major risk factor of cardiovascular diseases, the role of serum total cholesterol (Chol) especially LDL-Chol is well established in the pathogenesis of atherosclerosis and ischemic heart disease. Use of cholesterol lowering drugs within the first 24 h of hospitalization for acute myocardial infarction (AMI) is associated with a lower rate of cardiogenic shock, arrhythmias, cardiac arrest and recurrent myocardial infarction. We assessed data of 416 patients admitted to hospital with AMI in a 2 year period (2001-2003) focusing on statin therapy. We have not found a correlation between serum lipid parameters and mortality of patients with AMI. Chronic statin treatment used before AMI (in 36 patients) did not influence mortality of patients. Chol level of patients with ST-elevation myocardial infarction (STEMI) was significantly higher (p = 0,043). Mortality of patients who did not receive statin treatment after AMI was significantly higher. These data highlight the i...
Die Pharmazie, 2012
Systemic lupus erythematosus (SLE) is a chronic, relapsing, polysystemic autoimmune disease with ... more Systemic lupus erythematosus (SLE) is a chronic, relapsing, polysystemic autoimmune disease with various clinical signs. The prognosis of SLE patients is influenced by neuropsychiatric and renal involvement. Lupus nephritis (LN) is present in 40-60% of patients. Classical laboratory parameters are not sensitive and specific in prediction renal flares, over the last few years there has been a growing interest in searching novel lupus biomarkers predicting future flares. Our goal was to detect serum and urinary level of cytokines in 36 patients with lupus nephritis (34 female and 2 male, mean age: 43.36 +/- 11.53 years), 23 patients with SLE without renal involvement (19 women and 4 men, mean age: 54 +/- 8.71) (both groups followed by the 3rd Department of Internal Medicine, Division of Clinical Immunology, University of Debrecen) and 30 healthy controls (23 female and 7 male, mean age: 45.5 +/- 12.4). Serum IL-1 (interleukin), IL-2 (both p < 0.05), IL-6, IL-13 and IFN-gamma (p <...
Die Pharmazie, 2008
Thrombolytic agents activate plasminogen and induce a systemic fibrinolytic and anticoagulant sta... more Thrombolytic agents activate plasminogen and induce a systemic fibrinolytic and anticoagulant state. Two thrombolytic drugs are used frequently in practice: streptokinase (SK) and alteplase (t-PA). Streptokinase mainly undergoes renal elimination with a half-life of 11-17 min, while alteplase is eliminating by the liver with a half-life of 4-6 min. Our goal was to examine whether renal and hepatic function influence the elimination and metabolism of thrombolytics and the efficacy of percutaneous coronary intervention (PCI) after using alteplase or streptokinase. 416 patients with myocardial infarction (MI) were treated from January 2001 to December 2003 (228 male and 189 female). Alteplase was used in 9 men and 6 women (mean age: 53.88 +/- 9.61 vs. 65.33 +/- 9.87 years, p = 0.07). Patients who underwent rescue PCI after administration of alteplase had slightly higher hepatic enzyme levels/alanine transaminase (ALT): 47.85 vs. 41.4 U/l; gamma-glutamyl transpeptidase (GGT): 69.5 vs. 4...
Pharmaceutical research, 2004
Modulatory actions on morphine-induced effects, such as tolerance and withdrawal, have been noted... more Modulatory actions on morphine-induced effects, such as tolerance and withdrawal, have been noted for dynorphin A(1-13) [Dyn A(1-13)] and similar peptides. These are currently of limited therapeutic potential due to extensive metabolism by human metabolic enzymes resulting in a half-life of less than 1 min in human plasma. The purpose of this study was to identify stabilized dynorphin A (Dyn A) derivatives, to determine their metabolic routes in human plasma, and to assess whether the pharmacodynamic activity is retained. The stability of peptides in human plasma was tested using in vitro metabolism studies with and without enzyme inhibitors. Identification of the generated metabolites was performed by mass spectrometry after high performance liquid chromatography (HPLC) separation. The in vivo activity of a stabilized dynorphin was tested by tail-flick assay in morphine-tolerant rats. Though amidation of the Dyn A(1-13) was able to stop the majority of C-terminal degradation, metab...
Die Pharmazie, 2004
Dynorphin A(1-13), a tridecapeptide of the endogenous opioid peptides, has modest effects in redu... more Dynorphin A(1-13), a tridecapeptide of the endogenous opioid peptides, has modest effects in reducing mild opiate withdrawal in humans. Previous studies revealed that dynorphin also potentiates the analgesic effect of morphine in morphine-tolerant rats and mice. The therapeutic potential of dynorphin A(1-13) is limited due to extensive metabolism by human metabolic enzymes resulting in an in vivo half-life of less than one minute. Chemical modifications of dynorphin A(1-13), such as N-methylation of Tyr1 and amidation of the C-terminus have been shown to be effective in protecting against the proteolytic enzymes in human plasma. This article is a general review of the metabolism of dynorphin A(1-13) in human plasma and CSF.
The aim of this study was to review the development, histological type and outcome of 117 patient... more The aim of this study was to review the development, histological type and outcome of 117 patients with lupus nephritis managed and followed by the Division of Clinical Immunology, 3rd Department of Internal Medicine, University of Debrecen, Debrecen, Hungary. The method used was a retrospective study in 117 patients with lupus nephritis followed between 1974 and 2004. The average occurrence of lupus nephritis was 3 (women) and 4.4 (men) years later after the diagnosis of systemic lupus erythematosus, 43 (46.2%) patients had class IV lupus nephritis. The initial therapy was intravenous cyclophosphamide treatment for 6 months in 37 (31.6%) patients. End-stage renal disease had developed in nine (7.6%) patients. The 5-year survival rate was 99.1%. Despite the well-known and proved risk factors like hypertension, high serum creatinine, renal failure at onset or membranous glomerulonephritis, the outcome of the disease in our patient population was more favourable than one would expect according to the data available in the literature. The authors would like to draw attention to the importance of systematic care of patients with systemic lupus erythematosus, which may lead to a better clinical outcome.