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Two guinea pigs (Cavia porcellus) with clinical signs of anorexia, weight loss, depression and abdominal enlargement were examined. During ultrasound examination, a fluid-filled anechogenic structure 3–4 cm in diameter, with echogenic spots and a highly echogenic thick wall, was found in the pelvic region in one case and connected to the liver in the other case. An abscess or a cyst was suspected and surgical treatment including laparotomy was performed. By histopathological examination performed after surgery, a liver abscess was diagnosed in one guinea pig and an abscess in the pelvic region in the other animal.

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The second part of the review dealing with the diagnostic radiology of pet and wild birds discusses the indications of radiological examination, the interpretation of radiographs taken of pathological lesions, and the differential diagnosis of such lesions. Radiology has paramount importance in the diagnosis of diseases affecting the skeletal, digestive, respiratory, urogenital and cardiovascular systems. Certain diseases (shortage of grits, ovarian cysts) cannot be recognised without radiography. Other conditions (e.g. Macaw Wasting Disease, renal tumours, egg retention) require this complementary diagnostic method for confirmation of a suspicion based upon the clinical signs. Radiographic examination is also indicated for follow-up of the surgical management of bone fractures and for facilitating the implantation of transponders aimed at individual identification of the birds.

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Acta Veterinaria Hungarica
Authors:
A. Beregi
,
Cs. Székely
,
L. Békési
,
Judit Szabó
,
V. Molnár
, and
K. Molnár

Radiodiagnostic methods have not been used previously for studying the anatomy and diseases of the swimbladder of freshwater fish species. In this study, the radiographic anatomy of the swimbladder and species-related differences in swimbladder structure were studied on plain radiographs taken of 12 Hungarian fish species of major economic importance. Changes observed by radiography were also studied by conventional parasitological methods. The radiodiagnostic method reported here appears to be a useful complement to diagnostic examinations that have been based merely on dissection so far. It enables evaluation of the pathological lesions in live condition, without causing damage to the fish.

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Acta Physiologica Hungarica
Authors:
G. Nyírő
,
G. Inczédy-Farkas
,
V. Reményi
,
A. Gál
,
Zs Pál
, and
Mária Molnár

Clopidogrel is an inhibitor of platelet-aggregation used in the prevention of secondary stroke. The molecule is activated by the cytochrome P450 2C19 (CYP2C19) enzyme. The frequent CYP2C19*2 point mutation causes loss of enzyme function, a decreased (heterozygous form) or blocked (homozygous form) formation of the active molecule. Thus, for a patient harboring a mutated allele, clopidogrel does not provide effective protection against stroke. Multiple drugs inhibit the CYP2C19 enzyme and their simultaneous use with clopidogrel is especially hazardous for patients with genetically decreased enzyme activity. Frequency of the CYP2C19*2 is variable in different populations, highest rates were detected in some Asian groups. In our study the CYP2C19 genotype was determined in one Hungarian sample of 354 stroke patients and 221 healthy controls. Frequency of the minor allele was found to be 12.87% (12.85% in stroke patients, 12.89% in healthy controls). The proportion of the homozygous CYP2C19*2 variant causing total loss of gene function was 1.74%, rate of the heterozygous allele causing reduced enzyme activity was 22.26% in the total population. Our results for the allele frequencies of the CYP2C19*2 gene are similar to those found in other Caucasian populations. In conclusion, the homozygous mutation, causing ineffectiveness of clopidogrel is relatively rare. However, the heterozygous form in which interaction of CYP2C19 inhibitors causes further decrease in the genetically impaired enzyme activity is present in every fifth drug-taking patient. Based on our findings, we would like to emphasize that it is important to adjust individually antiplatelet treatment in ischemic stroke patients and to take into consideration genetic factors as well as drugs taken for comorbid conditions.

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Acta Physiologica Hungarica
Authors:
G.Zs. Toth
,
Adam Tarnoki
,
D.L. Tarnoki
,
A. Racz
,
Z. Szekelyhidi
,
L. Littvay
,
K. Karlinger
,
A. Lannert
,
A.A. Molnar
,
Zs. Garami
,
V. Berczi
,
I. Suveges
, and
J. Nemeth

Spherical equivalent (SE) has not been linked to increased cardiovascular morbidity.

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Interventional Medicine and Applied Science
Authors:
H. Vágó
,
P. Takács
,
A. Tóth
,
L. Gellér
,
Sz. Szilágyi
,
L. Molnár
,
V. Kutyifa
,
T. Simor
, and
Béla Merkely

Abstract

Cardiac electromechanical resynchronisation therapy (CRT) is an effective non-pharmacological treatment of patients suffering from drug refractory heart failure. However, approximately 20–30% of patients are non-responder. Cardiac magnetic resonance imaging (CMR) may play significant role in clarifying many questions in this patient population. Forty-five patients, suffering from severe drug refractory heart failure, underwent CMR before applying CRT. Left ventricular end-diastolic, end-systolic volumes, ejection fraction, myocardial mass, wall motion disturbances, localisation of non-viable myocardium were determined. Left ventricular dyssynchrony was determined by illustrating wall-time thickening in short-axis slices of left ventricle from basis to apex. CMR-proved underlying heart disease were postinfarction heart failure, dilated cardiomyopathy and non-compaction cardiomyopathy in 62, 27 and in 11%, respectively. Mean left ventricular ejection fraction was 24.5±10%, intraventricular dyssynchrony was 200±78 ms. In four patients, requiring surgical revascularisation after unsuccessful coronary sinus electrode implantation, optimal position for epicardial screw-in electrode was selected. According to the results of CMR, biventricular device was not implanted in 7 patients. During the follow-up of the 38 patients, 5 patients (13.16%) were non-responders, despite the approximately 22% non-responder ratio in our whole patient population treated by CRT but without performing previous CMR examination. In this patient population CMR may have a significant role in the selection of responder patient population.

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Physiology International
Authors:
G. Molnár
,
V. A. Gyarmathy
,
J. Takács
,
S. Sándor
,
B. Kiss
,
J. Fazakas
, and
P. L. Kanizsai

Abstract

Objectives

Conditions that have similar initial presentations as sepsis may make early recognition of sepsis in an emergency room (ER) difficult. We investigated whether selected physiologic and metabolic parameters can be reliably used in the emergency department to differentiate sepsis from other disease states that mimic it, such as dehydration and stroke.

Methods

Loess regression on retrospective follow-up chart data of patients with sepsis-like symptoms (N = 664) aged 18+ in a large ER in Hungary was used to visualize/identify cutoff points for sepsis risk. A multivariate logistic regression model based on standard triage data was constructed with its corresponding receiver operating characteristic (ROC) curve and compared with another model constructed based on current sepsis guidelines.

Results

Age, bicarbonate, HR, lactate, pH, and body temperature had U, V, W, or reverse U-shaped associations with identifiable inflexion points, but the cutoff values we identified were slightly different from guideline cutoff values. In contrast to the guidelines, no inflexion points could be observed for the association of sepsis with SBP, DPB, MAP, and RR and therefore were treated as continuous variables. Compared to the guidelines-based model, the triage data-driven final model contained additional variables (age, pH, bicarbonate) and did not include lactate. The data-driven model identified about 85% of sepsis cases correctly, while the guidelines-based model identified only about 70% of sepsis cases correctly.

Conclusion

Our findings contribute to the growing body of evidence for the necessity of finding improved tools to identify sepsis at early time points, such as in the ER.

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