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Student Researchers' Society Topics

A simple audit of cardiovascular risk factor management: SUrvey of Risk Factors in Coronary Heart Disease (SURF CHD) II – A magyar adatok és tapasztalatok értékelése. 

Rheological factors and increased platelet aggregation are convincingly implicated in the development of micro- and macrovascular diseases associated with diabetes mellitus. Glycemic control seems to be a major factor to  determine the hemorheological consequences of diabetes. Positive associations have been found between parameters of glycemic control, fibrinogen levels and red blood cell aggregation; fibrinogen levels are also correlated to insulin resistance. The binding of fibrinogen to the GP IIb-IIIa receptor is increased in diabetic patients; and they also have a higher ratio of platelets expressing activation-dependent adhesion molecules such as activated GPIIb-IIIa, lysosomal Gp53, thrombospondin and P-selectin; plasma fibrinogen levels are also increased in diabetes. Platelets may interact with glycosylated low density lipoproteins, von Willebrand factor or immune complexes, and platelet turnover may be shortened in diabetes, thereby contributing to the observation that antiplatelet agents such as aspirin and clopidogrel have a diminished effect in these patients. We aim to study the effects of impaired glucose metabolism on hemorheological parameters, platelet activation and aggregation in patients treated with different antidiabetic regimens. 

Co-supervisor: Dr. TÓTH, András

Chronobiology is the scientific discipline concerned with the definition, mechanisms, and significance of the so-called time structure of life forms. Seasonal variations in death rates with the highest levels occurring during the colder winter months have been described in many countries. Cardiovascular disease related deaths account for the majority of excess winter deaths.  Circannual rhythms have been described in parameters as fibrinogen, hematocrit, platelet count, hormones, serum lipids, and glucose. We aim to investigate whether hemorheological parameters and platelet aggregabiliy show seasonal differences in a population with established vascular disease. We plan to investigate a possible association with certain meteorological factors as ambient temperature, daily amount of sunshine hours, relative humidity and simultaneous changes in air pressure.

Hemorheology concerns both the global flow properties of blood and the unique properties of certain components. Ektacytometry is used to describe erythrocyte deformability. It measures the extent of deformation that various known stresses cause to cells. Results are not only affected by the physical properties of the intact cells but may be biased by changes due to manipulation with the cells and measurement circumstances as well. The study aims to uncover methodical pitfalls. We aim to set up measurement standards where bias of results is minimal. We also seek transformation methods to make results of measurements performed among different circumstances comparable.

Co-supervisor: Dr. RÁBAI, Miklós

Hematological malignancies are accompanied with the clonal overproliferation of a blood component and the suppression of others. The composition of blood may be drastically different from the healthy one that may lead to macro- and microcirculatory consequences. Therapeutic methods aim to reduce pathologically high cell numbers and substitute scarce ones. We aim to study the hemorheological consequence of the diseases and applied therapies. We investigate what support hemorheological methods may provide to assess the risk for certain complications, the effectiveness of therapy or to schedule therapy.

Co-supervisor: Dr. TÓTSIMON, Kinga

Our knowledge about the hemorheological changes in thyroid disorders is diffuse. In patients with hypothyroidism we experience increased bleeding risk, in hyperthyroidism we see the elevation of the incidence of thromboembolic events. The cause of death in hyperthyroidism is in 18% pulmonal embolism. An other common endocrine disorder which is accompanied by obviously increased risk for cardiovascular death is the exogenous and endogenous glucocorticoid overproduction. Our study wishes to investigate the non-genomic effect of thyroid hormones on platelet aggregation, and the in vitro effect of glucocorticoids on rheological parameters in healthy volunteers.

Co-supervisor: Dr. KOLTAI, Katalin

Peripheral artery disease (PAD) is the progressive stenosis, occlusion or aneurysmatic dilatation of the aorta and its non-coronary vessels. Until now the medical care of PAD has been in the background compared to coronary artery disease (CAD) or cerebrovascular disease, despite that the number of limb amputation is 3-4 times higher compared to Western-Europe, meaning that most of these procedures can be prevented. Screening and diagnosis of PAD is important, because only 10% of PAD-patients have the well-known claudication intermittens. PAD also has a negative prognostic value: 55% of them die due to CAD. In our study we measure tissue oxygen tension and hemorheological parameters in PAD and also monitor their changes during treatment in order to find the most effective therapy.

The ischemic heart disease (IHD) is the state of inadequate oxygen supply of the myocardium, in most cases caused by coronary artery disease. In the low-industrialised regions IHD is the 4th, while in the medium to high-industrialised countries it is the 1st most common cause of deaths, thus its early diagnosis is essential. Coronary CT is a new and well established method in the diagnosis of IHD. It is able to visualise the lumen and wall of the coronary vessels and the structure of the heart. In this topic we examine the changes of hemorheological parameters in different stages of coronary artery disease.

Diabetic angiopathy is one of the late consequence of diabetes mellitus, which affects both small (microangiopathy) and large vessels (macroangiopathy). Diabetic macroangiopathy results in faster atherogenesis thus arteriolosclerosis and atherosclerosis appears more rapidly. Diabetic microangiopathy has three forms: neuropathy, nephropathy and retinopathy. Diabetic retinopathy is the 1st or 2nd most common cause of blindness in the developed world, its presence may be detected after 15 years of diabetes mellitus. Our aim is to screen patients suffering from diabetic retinopathy for silent – but instrumentally detectable – peripheral artery disease. The screening includes hemorheological and oxygen tissue tension measurements.

Co-supervisor:

Peripheral vasospastic disorders are episodic, painful attacks of the acral parts caused by a local, diminished blood supply. The secondary form (Raynaud’s syndrome) can be associated with a number of different diseases, while the primary form (Raynaud’s disease) is idiopathic. During angiology consultation blood will be taken from patients suffering from peripheral vasospastic disorders. Detailed laboratory examinations will be performed, such as: cold agglutinin, cryoglobulin and hemorheological parameters. Tissue oxygen tension will also be measured.

Co-supervisor: Dr. RÁBAI, Miklós

Hemorheology concerns both the global flow properties of blood and the unique properties of certain components. Ektacytometry is used to describe erythrocyte deformability. It measures the extent of deformation that various known stresses cause to cells. Results are not only affected by the physical properties of the intact cells but may be biased by changes due to manipulation with the cells and measurement circumstances as well. The study aims to uncover methodical pitfalls. We aim to set up measurement standards where bias of results is minimal. We also seek transformation methods to make results of measurements performed among different circumstances comparable.

Co-supervisor: Dr. KENYERES, Péter

Critically ill patients treated in intensive care units often have impaired circulation, increased peripheral vascular resistance and diminished microcirculation. In such conditions hemorheological properties (viscosity, red blood cell deformation and aggregation) may have increased significance. We study the prognostic value of the monitoring of invasively or non-invasively measured hemodynamic and hemorheological parameters in various patients, and investigate what additional prognostic information they may add to standard intensive care prognostic scores (e.g. APACHE, SAPS).

Co-supervisor: Dr. ENDREI, Dóra

Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolism. VTE is a common, potentially fatal, often recurring disease. As a complication, infarct pneumonia, chronic venous insufficiency, pulmonary hypertension, ulcus cruris, and disability can occur. The importance of VTE is not only a health issue but also of economic importance, with frequent complications leading to chronic conditions. The risk of developing the first VTE increases with age. The risk of recurrence depends on the etiology in patients who previously underwent VTE. It is highest in patients with unprovoked VTE or in patients with a high risk thrombophilia. The aim of our study is to assess the symptoms, diagnosis, risk factors, therapy, and follow-up of our VTE patients both in inpatient and outpatient care in regard to the appearance of complications.

Co-supervisor: Dr. ENDREI, Dóra

Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolism. VTE is a common, potentially fatal, often recurring disease. As a complication, infarct pneumonia, chronic venous insufficiency, pulmonary hypertension, ulcus cruris, and disability can occur. The importance of VTE is not only a health issue but also of economic importance, with frequent complications leading to chronic conditions. The risk of developing the first VTE increases with age. The risk of recurrence depends on the etiology in patients who previously underwent VTE. It is highest in patients with unprovoked VTE or in patients with a high risk thrombophilia. The aim of our study is to assess the symptoms, diagnosis, risk factors, therapy, and follow-up of our VTE patients both in inpatient and outpatient care in regard to the appearance of complications.

Current evidence in the background of the management of acute heart failure
(three students) 

Current evidence in the background of the nonpharmacological management of acute heart failure

Current evidence in the background of the pharmacological management of acute heart failure, the role of mineralocorticoid receptorblockers

Current evidence in the background of the pharmacological management of acute heart failure, the role of nesiritide

Differentiation between valvular and non-valvular atrial fibrillation and the choice of anticoagulant therapy (one student)

Effect of compression elastic bandage on lower limb circulation in diseases of various etiology

Co-supervisor: Dr. KOLTAI, Katalin

A significant part of the population suffers from peripheral arterial diseases but the awareness of these diseases is much lower, the secondary prevention and even the symptomatic treatment are inappropriate frequently compared to the cardiovascular disorders. Therefore we are aiming to investigate those factors which can affect the blood and oxygen supplementation of the extremities performing cardiological, angiological, haemorheological and tissue oxygen tension examinations in order to be able to salvage the limbs and improve life quality. We examine the effects of the various pharmacological and non-pharmacological therapies on these variables and limb survival.

Co-supervisor: Dr. BIRÓ, Katalin

A significant part of the population suffers from peripheral arterial diseases but the awareness of these diseases is much lower, the secondary prevention and even the symptomatic treatment are inappropriate frequently compared to the cardiovascular disorders. Therefore we are aiming to investigate those factors which can affect the blood and oxygen supplementation of the extremities performing cardiological, angiological, haemorheological and tissue oxygen tension examinations in order to be able to salvage the limbs and improve life quality. We examine the effects of the various pharmacological and non-pharmacological therapies on these variables and limb survival.

Evidence based medicine top level (A cathegory) suggestions are not available, mainly retrospective results suggest safety level of medical treatment modalities. International databases (FDA-USA etc.) collect these information. Our goal is to process therapeutical results of our patients and highlight specific and non-specific situations and solvations and compare international guidelines in the issue.

Capsule enteroscopy le tus to visualize „white spots” of the gastrointestinal tract, main part of small bowel. Results highlighted novel correlations between harmful drugs and diseases and higher prevalency of GI lesions. The system is cost-effective when used correctly. There are systems for visualization of esopagus, small bowel and large bowel. We process our results year-to-year and compare to the literature data and novel methods. This topic is adviced mainly for thesis topic.

Hemorheological parameters in neonatological disorders

Co-supervisor: Dr. CSISZÁR, Beáta

Blood flow properties and blood cell characteristics can be altered in several diseases: they can provoke symptoms in a part of diseases or they can be co-factors in other ones. The haemorheological parameters could be valuable in risk stratification and diagnostics. In our laboratory haemorheological investigations are performed at various patient populations: plasma and whole blood viscosity, red blood cell aggregation and deformability, platelet aggregation are measured and they are analysed in respect of clinical parameters. The clinical usefulness of a novel variable, haematocrit and blood viscosity ratio characterising the oxygen carrying capacity of blood is evaluated.

Co-supervisor: Dr. KOLTAI, Katalin

Non-invasive angiological tests in patients at high risk for peripheral artery disease

Proarrhythmic effects and arrhythmic complications of the pharmacological treatment of atrial fibrillation

The implementation of the therapeutic guidelines for the treatment of atrial fibrillation, with emphasis on the new oral anticoagulants (one student)

The importance of amiodarone-associated adverse effects in the treatment of patients with atrial fibrillation (one student)

The role of insulin resistance in the development of hypothyroidism