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Folyovich A, Mátis R, Biczó D, Pálosi M, Béres-Molnár AK, Al-Muhanna N, Jarecsny T, Dudás E, Jánoska D, Toldi G, Páldy A. High average daily temperature in summer and the incidence of thrombolytic treatment for acute ischemic stroke. Encephale 2023:S0013-7006(23)00202-6. [PMID: 38040506 DOI: 10.1016/j.encep.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION Meteorological factors can increase stroke risk; however, their impact is not precisely understood. Heat waves during summer increase total mortality. Therefore, we hypothesized that the average daily temperature in summer may correlate with the incidence of thrombolytic treatment for acute ischemic stroke in Budapest and Pest County, Hungary. METHODS We analyzed the relationship between the average daily temperature in summer months and the daily number of thrombolytic treatments (TT) performed with the indication of acute ischemic stroke between 1st June and 31st August each year from 2007 to 2016. The analysis was also performed after the omission of the data of the last day of the months due to possible psychosocial impact reported in our previous study. Spearman's correlation was used for statistical analysis. RESULTS No significant correlation was found between the average summer daily temperature and the number of TT in the entire sample of the 10-year period. When omitting the data of the last day of each month, positive correlations were suspected in 2014 (r=0.225, P=0.034) and 2015 (r=0.276, P=0.009). CONCLUSION Our findings did not confirm an association between the average daily temperature in summer and the daily number of TT throughout the examined 10-year period. However, importantly, in 2014 and 2015, the years with the highest average daily temperatures in this period, a positive correlation was found. The level of correlation is modest, indicating that risk factors, both meteorological and non-meteorological, other than the average temperature, play equally important roles in determining the incidence of thrombolytic treatment for acute ischemic stroke on the population level.
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Affiliation(s)
- András Folyovich
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Réka Mátis
- Faculty of Public Governance and International Studies, University of Public Service, Budapest, Hungary
| | | | - Mihály Pálosi
- National Institute of Health Insurance Fund Management, Budapest, Hungary
| | | | - Nadim Al-Muhanna
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Tamás Jarecsny
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Eszter Dudás
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Dorottya Jánoska
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Gergely Toldi
- Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - Anna Páldy
- National Public Health Center, Budapest, Hungary
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Béres-Molnár AK, Simonné-Mátis RK, Al-Muhanna N, Jarecsny T, Dudás E, Jánoska D, Pálosi M, Toldi G, Folyovich A. Date of birth and the incidence of acute ischemic stroke in Hungary. Rev Neurol 2022; 75:143-147. [PMID: 36098448 PMCID: PMC10280756 DOI: 10.33588/rn.7506.2021479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The effect of the date of birth on the incidence of cardiovascular disease was confirmed in earlier studies. We aimed to determine whether the season of birth may be associated with a higher incidence of stroke in later life by analyzing thrombolysis numbers according over a ten-year period in Hungary. PATIENTS AND METHODS We analyzed daily thrombolysis numbers between 2007 and 2016 according to the patients' date of birth based on seasons. The correlation between cumulative thrombolysis numbers between 2007 and 2016 per month and birth numbers per month based on data of the 1949 census were also examined. RESULTS Our results indicate that being born in the spring and summer in the northern hemisphere may be associated with a higher frequency of ischemic stroke necessitating thrombolytic treatment. This equates to a higher risk when conception and early pregnancy occur in the summer and autumn months. CONCLUSIONS This, however, cannot be defined as a causal relationship if we consider the number of live births in 1949, as both measures change similarly during the year, as indicated by the strong positive correlation between thrombolysis frequency according to date of birth between 2007 and 2016 and the number of births in the 1949 census by month.
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Affiliation(s)
- Anna K. Béres-Molnár
- Department of Neurology and Stroke Center. Szent János HospitalSzent János HospitalSzent János HospitalAucklandNew Zealand
| | - Réka K. Simonné-Mátis
- National Healthcare Service CentreNational Healthcare Service CentreNational Healthcare Service CentreAucklandNew Zealand
| | - Nadim Al-Muhanna
- Department of Neurology and Stroke Center. Szent János HospitalSzent János HospitalSzent János HospitalAucklandNew Zealand
| | - Tamás Jarecsny
- Department of Neurology and Stroke Center. Szent János HospitalSzent János HospitalSzent János HospitalAucklandNew Zealand
| | - Eszter Dudás
- Department of Neurology and Stroke Center. Szent János HospitalSzent János HospitalSzent János HospitalAucklandNew Zealand
| | - Dorottya Jánoska
- Department of Neurology and Stroke Center. Szent János HospitalSzent János HospitalSzent János HospitalAucklandNew Zealand
| | - Mihály Pálosi
- Department of Project Management and Reporting, National Institute of Health Insurance Fund ManagementNational Institute of Health Insurance Fund ManagementNational Institute of Health Insurance Fund ManagementAucklandNew Zealand
| | - Gergely Toldi
- Department of Laboratory Medicine. Semmelweis University. Budapest, HungarySemmelweis UniversityBudapest, HungaryAucklandNew Zealand
- Liggins Institute. University of Auckland. Auckland, New ZealandUniversity of AucklandwUniversity of AucklandAucklandNew Zealand
| | - András Folyovich
- Department of Neurology and Stroke Center. Szent János HospitalSzent János HospitalSzent János HospitalAucklandNew Zealand
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Folyovich A, Mátis R, Al-Muhanna N, Jarecsny T, Dudás E, Jánoska D, Pálosi M, Béres-Molnár AK, Toldi G. Christmas, acute ischemic stroke and stroke-related mortality in Hungary. Brain Behav 2021; 11:e02104. [PMID: 33687768 PMCID: PMC8119813 DOI: 10.1002/brb3.2104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/06/2021] [Accepted: 02/23/2021] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Risk factors for stroke include psychological effects, such as depression. Festive occasions (such as Christmas in Hungary) may carry a significant emotional impact and may therefore contribute to increased cardiovascular risk. Thrombolytic treatment of acute ischemic stroke has a narrow time window and allows for the precise assessment of stroke incidence. MATERIALS & METHODS We analyzed anonymized national data of the number of thrombolytic treatments for acute ischemic stroke and the number of stroke-related deaths between 1 January 2007 and 31 December 2016 in Hungary within 2-day, 5-day, and 1-month periods preceding and following 24 December each year. Analysis of subgroups based on age (below and over 65 years) and sex was also performed. RESULTS The number of thrombolytic treatments was higher in all three periods preceding Christmas compared to the corresponding period that follows the feast. This increase was particularly prominent in men below 65 years of age. While overall stroke-associated mortality was increased 1 month after Christmas, the death rate was higher a month before rather than after Christmas in men below 65 years of age and in women both below and over 65 years of age 5 days before Christmas. CONCLUSIONS These findings may predominantly relate to emotional and psychological factors. In case of women, the anxiety secondary to festive preparations, while in men below 65 years, the increased psychological stress of providing financial security for the celebration may play an important role.
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Affiliation(s)
- András Folyovich
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Réka Mátis
- Faculty of Public Governance and International Studies, University of Public Service, Budapest, Hungary
| | - Nadim Al-Muhanna
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Tamás Jarecsny
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Eszter Dudás
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Dorottya Jánoska
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | | | | | - Gergely Toldi
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
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Al-Muhanna N, Béres-Molnár AK, Jarecsny T, Folyovich A. [The first Hungarian patient with Guillain-Barre syndrome after COVID-19]. Ideggyogy Sz 2021; 74:64-66. [PMID: 33497053 DOI: 10.18071/isz.74.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Guillain-Barré syndrome (GBS) is a sporadic, relatively rare disease. In serious cases, it can lead to respiratory failure and death. The correlation between SARS-CoV-2 and the risk of GBS is not yet known. COVID-19-associated prolonged pulmonary complications could be worsened by the potential airway interference caused by GBS. The literature is inconsistent whether SARS-CoV-2 virus has direct or indirect effect on the onset of GBS. The authors describe the medical history of the first published GBS patient in Hungary with a preceding confirmed COVID-19 infection. The trigger role of COVID-19 infection is assumed because of the subsequent development of GBS after COVID-19 infection. So far none of the patients in the literature (including this patient) had positive PCR of SARS-CoV-2 virus from the cerebrospinal fluid.
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Affiliation(s)
- Nadim Al-Muhanna
- Észak-Közép-budai Centrum Új Szent János Kórház és Szakrendelô Neurológiai Osztály - Stroke Centrum, Budapest
| | - Anna Katalin Béres-Molnár
- Észak-Közép-budai Centrum Új Szent János Kórház és Szakrendelô Neurológiai Osztály - Stroke Centrum, Budapest
| | - Tamás Jarecsny
- Észak-Közép-budai Centrum Új Szent János Kórház és Szakrendelô Neurológiai Osztály - Stroke Centrum, Budapest
| | - András Folyovich
- Észak-Közép-budai Centrum Új Szent János Kórház és Szakrendelô Neurológiai Osztály - Stroke Centrum, Budapest
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Pozsegovits K, Szabó G, Szupera Z, Nagy P, Németh L, Kondákor I, Tusa C, Berente L, Salacz P, Vécsei L, Sas K, Semjén J, Nikl J, Szapáry L, Kakuk A, Rózsa C, Horváth M, Imre P, Köves Á, Balogh I, Molnár S, Folyovich A, Al-Muhanna N, Béres-Molnár AK, Hahn K, Kristóf P, Szász AS, Szűcs A, Bereczki D. Utilization of acute vascular imaging and neurointervention for acute ischaemic stroke patients in 20 Hungarian stroke centers. Ideggyogy Sz 2019; 72:407-412. [PMID: 31834684 DOI: 10.18071/isz.72.0407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background and purpose Acute mortality rate of stroke in Hungary is significantly higher than in Western Europe, which is likely to be partially attributable to suboptimal treatment. Methods We examined the use of acute vascular imaging and mechanical thrombectomy for acute ischaemic stroke patients. We collected data on 20 consecutive patients from Hungarian stroke centers before 31st August 2016. Results Out of the reported 410 patients, 166 (40.4%) underwent CT angiography and 44 (10.7%) had mechanical thrombectomy. Conclusion Only about 1/3 of acute ischaemic stroke patients eligible for thrombectomy actually had it. The underlying reasons include long onset-to-door time, low utilization of acute vessel imaging and a limited neuro-intervention capacity needing improvement.
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Affiliation(s)
| | - Géza Szabó
- Department of Neurology, Dr. Kenessey Albert Hospital, Balassagyarmat
| | - Zoltán Szupera
- Szent Imre Teaching Hostpital, Department of Neurology, Budapest
| | - Péter Nagy
- Felsô-Szabolcsi Hospital, Department of Neurology, Kisvárda
| | - László Németh
- Kanizsai Dorottya Hospital, Department of Neurology, Nagykanizsa
| | - István Kondákor
- Balassa János Teaching Hospital of Tolna County, Department of Neurology, Szekszárd
| | - Csaba Tusa
- Balassa János Teaching Hospital of Tolna County, Department of Neurology, Szekszárd
| | - László Berente
- Dr. Bugyi István Hospital of Csongrád County, Department of Neurology, Szentes
| | - Pál Salacz
- Péterfy Sándor Utcai Hospital, Department of Neurology, Budapest
| | - László Vécsei
- University of Szeged, Faculty of Medicine, Department of Neurology, Szeged
| | - Katalin Sas
- University of Szeged, Faculty of Medicine, Department of Neurology, Szeged
| | - Judit Semjén
- Markhot Ferenc Teaching Hospital, Department of Neurology, Eger
| | - János Nikl
- Szent Rafael Hospital of Zala County, Department of Neurology, Zalaegerszeg
| | - László Szapáry
- University of Pécs, Faculty of Medicine, Department of Neurology, Pécs
| | - Anikó Kakuk
- Szabolcs-Szatmár-Bereg County Hospitals, Department of Neurology, Mátészalka
| | - Csilla Rózsa
- Jahn Ferenc Dél-pesti Hospital, Department of Neurology, Budapest
| | - Melinda Horváth
- Jahn Ferenc Dél-pesti Hospital, Department of Neurology, Budapest
| | - Piroska Imre
- Csolnoky Ferenc Hospital, Department of Neurology, Veszprém
| | - Ágnes Köves
- Bajcsy-Zsilinszky Hospital, Department of Neurology, Budapest
| | - István Balogh
- Kiskunhalasi Semmelweis Hospital, Department of Neurology, Kiskunhalas
| | - Sándor Molnár
- Soproni Erzsébet Hospital, Department of Neurology, Sopron
| | - András Folyovich
- Szent János Hospital and Észak-budai United Hospitals, Department of Neurology, Budapest
| | - Nadim Al-Muhanna
- Szent János Hospital and Észak-budai United Hospitals, Department of Neurology, Budapest
| | | | - Katalin Hahn
- Markusovszky Egyetemi Oktatókórház, Department of Neurology, Szombathely
| | - Piroska Kristóf
- Hetényi Géza Hospital of Jász-Nagykun-Szolnok County, Department of Neurology, Szolnok
| | - Attila Sándor Szász
- Hetényi Géza Hospital of Jász-Nagykun-Szolnok County, Department of Neurology, Szolnok
| | - Anna Szűcs
- National Institute of Clinical Neuurosciences, Budapest
| | - Dániel Bereczki
- Semmelweis University, Faculty of Medicine, Department of Neurology, Budapest
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Folyovich A, Biczó D, Al-Muhanna N, Béres-Molnár AK, Fejős Á, Pintér Á, Bereczki D, Fischer A, Vadasdi K, Pintér F. Anomalous equivalent potential temperature: an atmospheric feature predicting days with higher risk for fatal outcome in acute ischemic stroke-a preliminary study. Environ Monit Assess 2015; 187:547. [PMID: 26233665 DOI: 10.1007/s10661-015-4722-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 07/01/2015] [Indexed: 06/04/2023]
Abstract
Acute stroke is a life-threatening condition. Fatal outcome is related to risk factors, some of these affected by climatic changes. Forecasting potentially harmful atmospheric processes may therefore be of practical importance in the acute care of stroke patients. We analyzed the history of all patients with acute ischemic stroke (N = 184) confirmed by neuroimaging including those who died (N = 35, 15 males) at our hospital department in the winter months of 2009. Patient data were anonymized, and the human meteorologists were only aware of patients' age, gender, and exact time of death. Of the meteorological parameters, equivalent potential temperature (EPT) has been chosen for analysis. EPT is generally used for forecasting thunderstorms, but in the case of synoptic scale airflow (10(6) m), it is suitable for characterizing the air mass inflowing from different regions. The behavior of measured EPT values was compared to the climatic (30 years) averages. We developed meteorological criteria for anomalous periods of EPT and tested if such periods are associated with higher rate of fatal outcome. The duration of anomalous and non-anomalous periods was nearly equal during the studied 3 months. Stroke onset distributed similarly between anomalous and non-anomalous days; however, of the 35 deaths, 27 occurred during anomalous periods: on average, 0.56 deaths occurred on anomalous days and 0.19 on non-anomalous days. Winter periods meeting the criteria of anomalous EPT may have a significant adverse human-meteorological impact on the outcome in acute ischemic stroke.
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Affiliation(s)
- András Folyovich
- Department of Neurology and Stroke Center, Szent János Hospital, Budapest, Hungary
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