Tunde Pal

Dr. Tunde Pal

orcid

Research Focus & Metrics

Academic Career Length

5Years (2022-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

View All Publications
13 September 2024 in Frontiers in Public Health
Verified
Journal Article
Open access
PDF file
TPTunde Pal
Tunde Pal
Laszlo Barna IantovicsLaszlo Barna Iantovics
Laszlo Barna Iantovics
ZPZoltan Preg
Zoltan Preg
ENEniko Nemes-Nagy
Eniko Nemes-Nagy
KNKinga-Ilona Nyulas
Kinga-Ilona Nyulas
MGMarta German-Sallo
Marta German-Sallo
Background: The impact of cardiovascular diseases on cognition raises important research questions. The study aimed to investigate the relationship between demographic data, cardiovascular diseases, kidney disease and depressive symptoms on cognition.Methods: A cross-sectional study of patients with cardiovascular diseases was performed. The Montreal Cognitive Assessment (MoCA) was applied for cognitive evaluation. Based on MoCA three groups were defined: preserved cognition, mild, and advanced cognitive dysfunction (CD). Data were analyzed using Cronbach alpha (Cα) and McDonald’s ω (Mω) for internal consistency. The Chi-square test, Cramer’s V test, and correlation analyses were also applied.Results: Of 628 patients, 55.2% had mild CD, and the mean age was 67.95 (SD 9.53) years. Cα and Mω were 0.7, indicating good internal consistency. We found a moderate positive correlation between depression and the severity of CD (r = 0.25, p = 0.0001). A weak association between CD and female gender (p = 0.016), atrial fibrillation (p = 0.03), stroke (p = 0.009), and a moderate association for age group (p < 0.0001), education level (p < 0.0001), smoking (p < 0.0001), and renal dysfunction (p < 0.0001) was found. Age ≥ 70 years, eGFR 30–59 mL/min/1.73m2 significantly increased the likelihood for mild and advanced CD, while smoking and > 9 classes decreased it. Female gender, history of atrial fibrillation, and stroke significantly increased the likelihood of advanced CD.Conclusion: Mild CD was the most common in patients with cardiovascular diseases. Older age, lower education, being a non-smoker, and renal dysfunction were risk factors for both mild and advanced CD. Female gender, previous diagnosis of atrial fibrillation, and stroke are risk factors for advanced CD.

3 November 2024 in Medicina
Verified
Journal Article
Open access
PDF file
BBBabaDragos-Florin Baba
BabaDragos-Florin Baba
HSHoratiu Suciu
Horatiu Suciu
ACAvram Calin
Avram Calin
MHMarius Harpa
Marius Harpa
Mircea StoianMircea Stoian
Mircea Stoian
ASAnca Ileana Sin
Anca Ileana Sin
Background and Objectives: Cardiac transplantation represents the option for patients with end-stage heart failure (HF), providing the best survival rate. However, the postoperative complications of transplant patients remain a challenge for clinicians. The objective of our study was to evaluate the effect of preoperative chronic HF treatment on the occurrence of in-hospital complications. Materials and Methods: We retrospectively included a total of 50 patients who underwent cardiac transplantation between January 2011 and December 2023 from the Emergency Institute for Cardiovascular Diseases and Transplantation of Targu Mures. We correlated the preoperative chronic HF treatment with the postoperative complications by Spearmen’s correlation coefficient, respectively. With logistic regression, the associations between the treatment and specific complications were determined. Results: Significant negative correlations were found between Carvedilol treatment with 2-month mortality (r = −0.30; 95% CI: −0.53–−0.02; p = 0.03), Ramipril with hospital stay (r = −0.38; 95% CI: −0.60–-0.12; p < 0.01) and intensive care unit (ICU) stay (r = −0.37; 95% CI: −0.59–−0.11; p = 0.01), and Spironolactone usage with hospitalization duration (r = −0.28; 95% CI: −0.52–−0.01; p = 0.04). Furthermore, Carvedilol treatment represented a protective factor against early acute kidney injury (AKI) (OR: 0.22; 95% CI: 0.05–0.91; p = 0.03). Spironolactone treatment was a protective factor against AGR (OR: 0.12; 95% CI: 0.02–0.66; p = 0.01) treatment, in contrast to angiotensin-converting enzyme inhibitor (ACEI) therapy (OR: 5.30; 95% CI: 1.03–27.17; p = 0.04). Conclusions: Pre-transplant Carvedilol treatment was negatively correlated with the 2-month mortality rate. Ramipril and Spironolactone therapy were negatively correlated with hospitalization duration, and Ramipril was additionally correlated with ICU stay. Moreover, Carvedilol therapy represented a protective factor against early AKI. Pre-transplant Spironolactone was associated with lower event rates of AGR, in contrast to ACEI treatment. Prospective studies with larger cohorts are needed in order to draw drastic conclusions.

22 January 2023 in Life
Verified
Journal Article
Open access
PDF file
KNKinga-Ilona Nyulas
Kinga-Ilona Nyulas
MGMárta Germán-Salló
Márta Germán-Salló
ZFZita Fazakas
Zita Fazakas
ZPZoltán Preg
Zoltán Preg
TPTunde Pal
Tunde Pal
ENEniko Nemes-Nagy
Eniko Nemes-Nagy
(1) Background: Cognitive dysfunction is a major concern in hypertensive patients. Lifestyle habits and nutrition influence laboratory parameters, with an impact on clinical course. The objective of the study was to evaluate nutrition and lifestyle habits in hypertensive patients with/without cognitive dysfunction and establish correlations to laboratory parameters. Material and Methods: 50 patients admitted to the Cardiovascular Rehabilitation Clinic in Târgu Mureș were enrolled in this study between March–June 2021. We evaluated their cognitive function, and they filled in a questionnaire about lifestyle and nutrition. Biochemical blood tests were performed using a Konelab Prime 60i analyzer. IBM-SPSS22 and GraphPad InStat3 were used for statistics. Results: Mean age of hypertensive patients (n = 50) was 70.42 ± 4.82 (SD) years, half of them had cognitive dysfunction. Zinc deficiency was present in 74% of the subjects. The subgroup with cognitive dysfunction had significantly higher BMI (p = 0.009) and microalbuminuria (p = 0.0479), as well as significantly lower magnesium intake (p = 0.032) and cholesterol intake (p = 0.022), compared to those with normal cognitive status. Conclusions: Nutrition is in a close relationship with laboratory parameters; significant differences (microalbuminuria, cholesterol intake, BMI, etc.) are present between hypertensive patients with/without cognitive dysfunction. A healthy diet is important for the maintenance of metabolic balance, the achievement of optimal body weight, and the prevention of complications.

1 December 2022 in Journal of Interdisciplinary Medicine
Verified
Journal Article
Open access
PDF file
KNKinga-Ilona Nyulas
Kinga-Ilona Nyulas
ZSZsuzsánna Simon-Szabó
Zsuzsánna Simon-Szabó
ZPZoltán Preg
Zoltán Preg
SPSándor Pál
Sándor Pál
ASArundhati Sharma
Arundhati Sharma
ENEniko Nemes-Nagy
Eniko Nemes-Nagy
Sciendo provides publishing services and solutions to academic and professional organizations and individual authors. We publish journals, books, conference proceedings and a variety of other publications.

Verified
Journal Article
Open access
PDF file
TPTunde Pal
Tunde Pal
BBBabaDragos-Florin Baba
BabaDragos-Florin Baba
ZPZoltán Preg
Zoltán Preg
ENEniko Nemes-Nagy
Eniko Nemes-Nagy
KNKinga-Ilona Nyulas
Kinga-Ilona Nyulas
MGMarta German-Sallo
Marta German-Sallo
Objectives: Our study investigated the inverse relationship between cognitive decline (CD) and the presence of documented atrial fibrillation (AFib), ischemic stroke, heart failure, lower extremity peripheral artery disease, and diabetes mellitus. Methods: We conducted a retrospective cross-sectional study between December 2016 and November 2019. A total of 469 patients were enrolled who underwent cognitive evaluation with three cognitive tests (Montreal Cognitive Assessment—MOCA, Mini-Mental State Examination—MMSE, and General Practitioner Assessment of Cognition—GPCOG). We used the standard cut-off values, and the optimal thresholds were obtained from the receiver operating characteristic curves. Results: The standard cut-off level of the MOCA (<26 points) was associated with the presence of AFib (OR: 1.83, 95% CI: 1.11–3.01) and the optimal cut-off level with <23 points with ischemic stroke (OR: 2.64, 95% CI: 1.47–4.74; p = 0.0011). The optimal cut-off value of the MMSE (<28 points) was associated with the presence of ischemic stroke (OR: 3.07, 95% CI: 1.56–6.07; p = 0.0012), AFib (OR: 1.65, 95% CI: 1.05–2.60; p = 0.0287), and peripheral artery disease (OR: 2.72, 95% CI: 1.38–5.36; p = 0.0039). GPCOG < 8 points were associated with ischemic stroke (OR: 2.18, 95% CI: 1.14–4.14; p = 0.0176) and heart failure (OR: 1.49, 95% CI: 1.01–2.21; p = 0.0430). Conclusions: Our research highlighted the broader utility of cognitive assessment. The MOCA and MMSE scores proved to be associated with documented AFib. Higher cognitive test results than the standard threshold for CD of the MMSE, GPCOG, and lower MOCA scores represented risk factors for the presence of previous ischemic stroke.

30 July 2025 in Healthcare
Verified
Journal Article
Open access
PDF file
TPTunde Pal
Tunde Pal
ZPZoltán Preg
Zoltán Preg
BBBabaDragos-Florin Baba
BabaDragos-Florin Baba
DBDalma Balint-Szentendrey
Dalma Balint-Szentendrey
APAttila Polgar
Attila Polgar
MGMarta German-Sallo
Marta German-Sallo
Background/Objectives: Psychosocial (PS) factors and cognitive dysfunction (CD) in patients with atrial fibrillation (AF) may negatively impact treatment compliance. The PS profile covers multiple psychological and socio-economic factors, although research is mostly limited to depression, anxiety, and work stress. This study assessed the prevalence of a broad range of PS factors in patients with AF and their relationship with cognitive decline. Methods: We retrospectively analyzed data from patients referred to a cardiovascular rehabilitation clinic between March 2017 and April 2023 who underwent standardized assessments of PS factors, cognition, and quality of life. Results: Of the 798 included patients, 230 (28.8%) had AF, with a mean age of 68.07 years (SD 9.60 years). Six of nine PS factors were present in more than half of the overall sample. Compared to non-AF patients, those with AF showed significantly higher levels of social isolation, depression, and hostility, whereas low socioeconomic status, family and work-related stress, and other mental disorders were more frequent in the non-AF group. CD was present in 67.4% of the total cohort and was more prevalent in AF patients with a higher PS burden. Patients with permanent AF reported the poorest health status. Conclusions: Integrating assessments of PS factors and cognition in cardiac rehabilitation is feasible and supports a more comprehensive, patient-centred model of care in AF.