Csilla Molnár - Academia.edu (original) (raw)
Papers by Csilla Molnár
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Journal of Clinical Ultrasound, Oct 1, 2009
PurposeDiabetes mellitus (DM) is one of the leading risk factors for cerebrovascular diseases. Bo... more PurposeDiabetes mellitus (DM) is one of the leading risk factors for cerebrovascular diseases. Both macro‐ and microvascular damage may occur. The aim of the present work was to assess intima‐media thickness as well as cerebral vasoreactivity in patients suffering from type 1 diabetes mellitus (IDDM).MethodsIntima‐media thickness and resting middle cerebral artery blood flow velocity was measured in 33 IDDM patients and 31 healthy controls. After baseline investigations, 30 seconds of breath holding (BH) and 60 seconds of voluntary hyperventilation (HV) were performed by the subjects. Transcranial Doppler measurements were performed in each case after vasodilatory (BH) and vasoconstrictor (HV) stimuli. Cerebrovascular reactivity was expressed as the percentage of change of the middle cerebral mean blood flow velocity after BH or HV.ResultsIDDM patients showed a significantly larger intima‐media thickness (0.1 ± 0.02 mm) than healthy controls (0.06 ± 0.006 mm, p < 0.001). Cerebrovascular reactivity after BH was less intensive in diabetic patients (19.3 ± 16.1%) than that of the control subjects (38.7 ± 22.8%, p < 0.01). Similarly, HV induced a less‐pronounced decrease of cerebral blood flow velocity in diabetic subjects (–30.1 ± 13.2%) than in nondiabetics (–37.6 ± 17.0%, p < 0.05).ConclusionOur results refer to early macro‐ and microangiopathic involvement of the cerebral vessels, which develop in parallel with angiopathies of the other organs, such as nephropathy and retinopathy. Further prospective studies are needed to clarify the role of these macro‐ and microangiopathic changes in the development of cerebrovascular complications in patients suffering from DM. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009
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Research Square (Research Square), Jun 11, 2019
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Orvosi Hetilap, 2020
The coronavirus epidemic that is spreading around our world poses a number of challenges for heal... more The coronavirus epidemic that is spreading around our world poses a number of challenges for healthcare workers. The virus is spread by droplet infection and has a high virulence, so any intervention that generates airway aerosol formation potentially endangers the health of those involved in care. Severe forms of coronavirus infection are associated with progressive respiratory failure, for the treatment of which early endotracheal intubation and invasive mechanical ventilation are essential. There is an increased risk of airway aerosol formation during intubation, resulting in a high risk of infection for care personnel. In addition to the above, difficult airway insurance is relatively common in these patients. The aim of our article is to provide a practice-oriented overview of the specialties of airway insurance in patients infected with coronavirus, with particular reference to aspects of infection control and patient safety. Orv Hetil. 2020; 161 (17): 696-703.
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Orvosi Hetilap, 2020
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Critical Care, Feb 1, 2011
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Current Anesthesiology Reports, Oct 3, 2022
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Orvosi Hetilap, May 1, 2020
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PubMed, Apr 1, 2001
Collateral capacity of the Willisian arteries is of clinical importance during and after carotid ... more Collateral capacity of the Willisian arteries is of clinical importance during and after carotid endarterectomies. Aims: Assessment of cerebral hemodynamics using a flow circulation model based on a mathematical formula. Patients and methods: Four patients suffering from ischemic stroke in moribund stage were investigated using transcranial color-coded duplex sonography. By compressing the common carotid arteries, the function of the Willisian collaterals was assessed. After the death of the patients, the circles were removed, the diameters and lengths of the arterial segments were measured. The data were analysed with the mentioned circulation model. Results: The diameters of non-functioning collateral arteries were 0.4 mm, while that of the functional ones were 0.7 and 0.8 mm, respectively. In the two cases where the anterior communicating arteries did not function, a near-critical hemodynamical status was found in the end-arteries. This was especially true if the mean arterial blood pressure was 70 mmHg. The most critical hemodynamical status developed in case 4, where internal carotid occlusion on one side, a contralateral severe carotid stenosis and a non-functioning anterior communicating artery were observed. Conclusions: A special flow circulation model based on mathematical formula enables the calculation of the cerebral blood flow in the different arterial segments of the circle of Willis. Further studies are needed to clarify whether the method can be used for preoperative modeling of the cross-clamping phase of carotid endarterectomy.
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Transplantation Proceedings, Jun 1, 2021
The aim of the present work was to assess the knowledge and attitudes of different health care wo... more The aim of the present work was to assess the knowledge and attitudes of different health care workers and laypeople toward the donation and transplantation procedure. A survey consisting of questions regarding brain death diagnosis, legal organization or organ donation, and the transplantation procedure were sent to participants: 56 intensive care unit (ICU) doctors, 76 ICU nurses, 188 sixth-year medical students, and 320 general practitioners (GPs). Laypeople were also asked to complete the survey. The majority of participants reported being aware of legal regulations for organ donation in Hungary (88.5%). Roughly 25% of GPs and 60% of laypeople were unaware of the opt-out system effective in the country. Less than one-third of ICU physicians (26.9%) and nurses (34.7%) were able to list the organs that may be transplanted from a deceased donor; GPs (22.4%) and medical students (20%) performed even worse on this item. The willingness of ICU specialists (57%) and ICU nurses (45%) to support donating their own organs was moderate. The results of this survey indicate a need for graduate and postgraduate education and regular teaching programs regarding organ donation and transplantation. More active use of modern media is proposed to improve public awareness and acceptance of organ donation.
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Cambridge University Press eBooks, Apr 28, 2016
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Research Square (Research Square), May 20, 2019
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Neurosurg Rev, 1998
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Reviews in Cardiovascular Medicine
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Magyar sebészet, 2001
Collateral capacity of the Willisian arteries is of clinical importance during and after carotid ... more Collateral capacity of the Willisian arteries is of clinical importance during and after carotid endarterectomies. Assessment of cerebral hemodynamics using a flow circulation model based on a mathematical formula. Four patients suffering from ischemic stroke in moribund stage were investigated using transcranial color-coded duplex sonography. By compressing the common carotid arteries, the function of the Willisian collaterals was assessed. After the death of the patients, the circles were removed, the diameters and lengths of the arterial segments were measured. The data were analysed with the mentioned circulation model. The diameters of non-functioning collateral arteries were 0.4 mm, while that of the functional ones were 0.7 and 0.8 mm, respectively. In the two cases where the anterior communicating arteries did not function, a near-critical hemodynamical status was found in the end-arteries. This was especially true if the mean arterial blood pressure was 70 mmHg. The most cr...
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Orvosi hetilap, Jan 26, 1998
Previously numerous investigators reported about impairment of cerebrovascular reserve capacity i... more Previously numerous investigators reported about impairment of cerebrovascular reserve capacity in Type I, diabetes mellitus. However, no similar data are available about patients suffering from Type II diabetes. The goal of the study was to assess cerebrovascular reserve in Type II diabetic patients. 14 NIDDM patients and 20 healthy controls were studied. Middle cerebral artery mean blood flow velocity was measured at rest and during 20 minutes after i.v. administration of 1 g. acetazolamide. Velocities measured after acetazolamide were compared to resting values and were expressed as the percent increase of the mean velocity. Data obtained in diabetics and healthy persons were compared using Student's t-test. The correlation between age of the patients, diabetes duration, actual blood glucose-, insulin-, glycosylated hemoglobin-, urine microalbumin concentrations and resting blood flow velocity and cerebrovascular reserve capacity was assessed using linear regression analysis....
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Orvosi hetilap, Jan 12, 1995
Diabetes mellitus results in macro- and microangiopathies. Early diagnosis and preventive treatme... more Diabetes mellitus results in macro- and microangiopathies. Early diagnosis and preventive treatment of the cerebral vessel complications may influence the prognosis of the disease. The aim of the present work is to summarize the recent results of the cerebral hemodynamic studies in diabetics. A suitable, non-invasive screening method for diagnosis of the altered cerebral arteriolar function is discussed.
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Journal of Clinical Ultrasound, Oct 1, 2009
PurposeDiabetes mellitus (DM) is one of the leading risk factors for cerebrovascular diseases. Bo... more PurposeDiabetes mellitus (DM) is one of the leading risk factors for cerebrovascular diseases. Both macro‐ and microvascular damage may occur. The aim of the present work was to assess intima‐media thickness as well as cerebral vasoreactivity in patients suffering from type 1 diabetes mellitus (IDDM).MethodsIntima‐media thickness and resting middle cerebral artery blood flow velocity was measured in 33 IDDM patients and 31 healthy controls. After baseline investigations, 30 seconds of breath holding (BH) and 60 seconds of voluntary hyperventilation (HV) were performed by the subjects. Transcranial Doppler measurements were performed in each case after vasodilatory (BH) and vasoconstrictor (HV) stimuli. Cerebrovascular reactivity was expressed as the percentage of change of the middle cerebral mean blood flow velocity after BH or HV.ResultsIDDM patients showed a significantly larger intima‐media thickness (0.1 ± 0.02 mm) than healthy controls (0.06 ± 0.006 mm, p < 0.001). Cerebrovascular reactivity after BH was less intensive in diabetic patients (19.3 ± 16.1%) than that of the control subjects (38.7 ± 22.8%, p < 0.01). Similarly, HV induced a less‐pronounced decrease of cerebral blood flow velocity in diabetic subjects (–30.1 ± 13.2%) than in nondiabetics (–37.6 ± 17.0%, p < 0.05).ConclusionOur results refer to early macro‐ and microangiopathic involvement of the cerebral vessels, which develop in parallel with angiopathies of the other organs, such as nephropathy and retinopathy. Further prospective studies are needed to clarify the role of these macro‐ and microangiopathic changes in the development of cerebrovascular complications in patients suffering from DM. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009
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Research Square (Research Square), Jun 11, 2019
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Orvosi Hetilap, 2020
The coronavirus epidemic that is spreading around our world poses a number of challenges for heal... more The coronavirus epidemic that is spreading around our world poses a number of challenges for healthcare workers. The virus is spread by droplet infection and has a high virulence, so any intervention that generates airway aerosol formation potentially endangers the health of those involved in care. Severe forms of coronavirus infection are associated with progressive respiratory failure, for the treatment of which early endotracheal intubation and invasive mechanical ventilation are essential. There is an increased risk of airway aerosol formation during intubation, resulting in a high risk of infection for care personnel. In addition to the above, difficult airway insurance is relatively common in these patients. The aim of our article is to provide a practice-oriented overview of the specialties of airway insurance in patients infected with coronavirus, with particular reference to aspects of infection control and patient safety. Orv Hetil. 2020; 161 (17): 696-703.
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Orvosi Hetilap, 2020
Bookmarks Related papers MentionsView impact
Critical Care, Feb 1, 2011
Bookmarks Related papers MentionsView impact
Current Anesthesiology Reports, Oct 3, 2022
Bookmarks Related papers MentionsView impact
Orvosi Hetilap, May 1, 2020
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
PubMed, Apr 1, 2001
Collateral capacity of the Willisian arteries is of clinical importance during and after carotid ... more Collateral capacity of the Willisian arteries is of clinical importance during and after carotid endarterectomies. Aims: Assessment of cerebral hemodynamics using a flow circulation model based on a mathematical formula. Patients and methods: Four patients suffering from ischemic stroke in moribund stage were investigated using transcranial color-coded duplex sonography. By compressing the common carotid arteries, the function of the Willisian collaterals was assessed. After the death of the patients, the circles were removed, the diameters and lengths of the arterial segments were measured. The data were analysed with the mentioned circulation model. Results: The diameters of non-functioning collateral arteries were 0.4 mm, while that of the functional ones were 0.7 and 0.8 mm, respectively. In the two cases where the anterior communicating arteries did not function, a near-critical hemodynamical status was found in the end-arteries. This was especially true if the mean arterial blood pressure was 70 mmHg. The most critical hemodynamical status developed in case 4, where internal carotid occlusion on one side, a contralateral severe carotid stenosis and a non-functioning anterior communicating artery were observed. Conclusions: A special flow circulation model based on mathematical formula enables the calculation of the cerebral blood flow in the different arterial segments of the circle of Willis. Further studies are needed to clarify whether the method can be used for preoperative modeling of the cross-clamping phase of carotid endarterectomy.
Bookmarks Related papers MentionsView impact
Transplantation Proceedings, Jun 1, 2021
The aim of the present work was to assess the knowledge and attitudes of different health care wo... more The aim of the present work was to assess the knowledge and attitudes of different health care workers and laypeople toward the donation and transplantation procedure. A survey consisting of questions regarding brain death diagnosis, legal organization or organ donation, and the transplantation procedure were sent to participants: 56 intensive care unit (ICU) doctors, 76 ICU nurses, 188 sixth-year medical students, and 320 general practitioners (GPs). Laypeople were also asked to complete the survey. The majority of participants reported being aware of legal regulations for organ donation in Hungary (88.5%). Roughly 25% of GPs and 60% of laypeople were unaware of the opt-out system effective in the country. Less than one-third of ICU physicians (26.9%) and nurses (34.7%) were able to list the organs that may be transplanted from a deceased donor; GPs (22.4%) and medical students (20%) performed even worse on this item. The willingness of ICU specialists (57%) and ICU nurses (45%) to support donating their own organs was moderate. The results of this survey indicate a need for graduate and postgraduate education and regular teaching programs regarding organ donation and transplantation. More active use of modern media is proposed to improve public awareness and acceptance of organ donation.
Bookmarks Related papers MentionsView impact
Cambridge University Press eBooks, Apr 28, 2016
Bookmarks Related papers MentionsView impact
Research Square (Research Square), May 20, 2019
Bookmarks Related papers MentionsView impact
Neurosurg Rev, 1998
Bookmarks Related papers MentionsView impact
Reviews in Cardiovascular Medicine
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Magyar sebészet, 2001
Collateral capacity of the Willisian arteries is of clinical importance during and after carotid ... more Collateral capacity of the Willisian arteries is of clinical importance during and after carotid endarterectomies. Assessment of cerebral hemodynamics using a flow circulation model based on a mathematical formula. Four patients suffering from ischemic stroke in moribund stage were investigated using transcranial color-coded duplex sonography. By compressing the common carotid arteries, the function of the Willisian collaterals was assessed. After the death of the patients, the circles were removed, the diameters and lengths of the arterial segments were measured. The data were analysed with the mentioned circulation model. The diameters of non-functioning collateral arteries were 0.4 mm, while that of the functional ones were 0.7 and 0.8 mm, respectively. In the two cases where the anterior communicating arteries did not function, a near-critical hemodynamical status was found in the end-arteries. This was especially true if the mean arterial blood pressure was 70 mmHg. The most cr...
Bookmarks Related papers MentionsView impact
Orvosi hetilap, Jan 26, 1998
Previously numerous investigators reported about impairment of cerebrovascular reserve capacity i... more Previously numerous investigators reported about impairment of cerebrovascular reserve capacity in Type I, diabetes mellitus. However, no similar data are available about patients suffering from Type II diabetes. The goal of the study was to assess cerebrovascular reserve in Type II diabetic patients. 14 NIDDM patients and 20 healthy controls were studied. Middle cerebral artery mean blood flow velocity was measured at rest and during 20 minutes after i.v. administration of 1 g. acetazolamide. Velocities measured after acetazolamide were compared to resting values and were expressed as the percent increase of the mean velocity. Data obtained in diabetics and healthy persons were compared using Student's t-test. The correlation between age of the patients, diabetes duration, actual blood glucose-, insulin-, glycosylated hemoglobin-, urine microalbumin concentrations and resting blood flow velocity and cerebrovascular reserve capacity was assessed using linear regression analysis....
Bookmarks Related papers MentionsView impact
Orvosi hetilap, Jan 12, 1995
Diabetes mellitus results in macro- and microangiopathies. Early diagnosis and preventive treatme... more Diabetes mellitus results in macro- and microangiopathies. Early diagnosis and preventive treatment of the cerebral vessel complications may influence the prognosis of the disease. The aim of the present work is to summarize the recent results of the cerebral hemodynamic studies in diabetics. A suitable, non-invasive screening method for diagnosis of the altered cerebral arteriolar function is discussed.
Bookmarks Related papers MentionsView impact