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001-es BibID:	BIBFORM116951
035-os BibID:	(scopus)85119325898 (wos)000718879000001
Első szerző:	Földi Mária
Cím:	The characteristics and prognostic role of acute abdominal on-admission pain in acute pancreatitis : A prospective cohort analysis of 1432 cases / Földi Mária, Gede Noémi, Kiss Szabolcs, Vincze Áron, Bajor Judit, Szabó Imre, Szepes Zoltán, Izbéki Ferenc, Gervain Judit, Hamvas József, Vitális Zsuzsanna, Fehér Eszter, Crai Stefan, Sallinen Ville, Ramirez-Maldonado Elena, Meczker Ágnes, Varjú Péter, Poropat Goran, Stimac Davor, Faluhelyi Nándor, Miseta Attila, Nagy Tamás, Márton Zsolt, Vereczkei András, Jenő Hegyi Péter, Párniczky Andrea, Hegyi Péter, Szentesi Andrea, Hungarian Pancreatic Study Group
Dátum:	2021
ISSN:	1090-3801
Megjegyzések:	Introduction Pain is the most common symptom in acute pancreatitis (AP) and is among the diagnostic criteria. Therefore, we aimed to characterize acute abdominal pain in AP. Methods The Hungarian Pancreatic Study Group prospectively collected multicentre clinical data on 1435 adult AP patients between 2012 and 2017. Pain was characterized by its intensity (mild or intense), duration prior to admission (hours), localization (nine regions of the abdomen) and type (sharp, dull or cramping). Results 97.3% of patients (n = 1394) had pain on admission. Of the initial population with acute abdominal pain, 727 patients answered questions about pain intensity, 1148 about pain type, 1134 about pain localization and 1202 about pain duration. Pain was mostly intense (70%, n = 511/727), characterized by cramping (61%, n = 705/1148), mostly starting less than 24 h prior to admission (56.7%, n = 682/1202). Interestingly, 50.9% of the patients (n = 577/1134) had atypical pain, which means pain other than epigastric or belt-like upper abdominal pain. We observed a higher proportion of peripancreatic fluid collection (19.5% vs. 11.0%; p = 0.009) and oedematous pancreas (8.4% vs. 3.1%; p = 0.016) with intense pain. Sharp pain was associated with AP severity (OR = 2.481 95% CI: 1.550?3.969) and increased mortality (OR = 2.263, 95% CI: 1.199?4.059) compared to other types. Longstanding pain (>72 h) on admission was not associated with outcomes. Pain characteristics showed little association with the patient's baseline characteristics. Conclusion A comprehensive patient interview should include questions about pain characteristics, including pain type. Patients with sharp and intense pain might need special monitoring and tailored pain management. Significance Acute abdominal pain is the leading presenting symptom in acute pancreatitis; however, we currently lack specific guidelines for pain assessment and management. In our cohort analysis, intense and sharp pain on admission was associated with higher odds for severe AP and several systemic and local complications. Therefore, a comprehensive patient interview should include questions about pain characteristics and patients with intense and sharp pain might need closer monitoring.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	European Journal Of Pain. - 26 : 3 (2021), p. 610-623. -
További szerzők:	Gede Noémi Kiss Szabolcs Vincze Áron Bajor Judit Szabó Imre Szepes Zoltán Izbéki Ferenc Gervain Judit Hamvas József Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Fehér Krisztina Eszter (1991-) (orvos) Crai, Stefan Sallinen, Ville Ramírez-Maldonado, Elena Meczker Ágnes Varjú Péter Poropat, Goran Štimac, Davor Faluhelyi Nándor Miseta Attila Nagy Tamás (1977-) (vegyész, orvosi laboratóriumi analitikus) Márton Zsolt Vereczkei András Hegyi Péter Jenő (belgyógyász) Párniczky Andrea (gyermekgyógyász) Hegyi Péter (pszichológus) Szentesi Andrea Hungarian Pancreatic Study Group
Pályázati támogatás:	GINOP-2.3.2-15-2016-00048-STAY?ALIVE GINOP GINOP-2.3.2-15-2016-00015-I-KOM GINOP ÚNKP-20-3 Egyéb
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001-es BibID:	BIBFORM101539
035-os BibID:	(WOS)000795163100024 (Scopus)85130054194 (PMID)35552440
Első szerző:	Kiss Szabolcs
Cím:	Early prediction of acute necrotizing pancreatitis by artificial intelligence : a prospective cohort-analysis of 2387 cases / Szabolcs Kiss, József Pintér, Roland Molontay, Marcell Nagy, Nelli Farkas, Zoltán Sipos, Péter Fehérvári, László Pecze, Mária Földi, Áron Vincze, Tamás Takács, László Czakó, Ferenc Izbéki, Adrienn Halász, Eszter Boros, József Hamvas, Márta Varga, Artautas Mickevicius, Nándor Faluhelyi, Orsolya Farkas, Szilárd Váncsa, Rita Nagy, Stefania Bunduc, Péter Jenő Hegyi, Katalin Márta, Katalin Borka, Attila Doros, Nóra Hosszúfalusi, László Zubek, Bálint Erőss, Zsolt Molnár, Andrea Párniczky, Péter Hegyi, Andrea Szentesi, Hungarian Pancreatic Study Group
Dátum:	2022
ISSN:	2045-2322
Megjegyzések:	Pancreatic necrosis is a consistent prognostic factor in acute pancreatitis (AP). However, the clinical scores currently in use are either too complicated or require data that are unavailable on admission or lack sufficient predictive value. We therefore aimed to develop a tool to aid in necrosis prediction. The XGBoost machine learning algorithm processed data from 2,387 patients with AP. The confidence of the model was estimated by a bootstrapping method and interpreted via the 10th and the 90th percentiles of the prediction scores. Shapley Additive exPlanations (SHAP) values were calculated to quantify the contribution of each variable provided. Finally, the model was implemented as an online application using the Streamlit Python-based framework. The XGBoost classifier provided an AUC value of 0.757. Glucose, C-reactive protein, alkaline phosphatase, gender and total white blood cell count have the most impact on prediction based on the SHAP values. The relationship between the size of the training dataset and model performance shows that prediction performance can be improved. This study combines necrosis prediction and artificial intelligence. The predictive potential of this model is comparable to the current clinical scoring systems and has several advantages over them.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk artificial intelligence
Megjelenés:	Scientific Reports. - 12 : 1 (2022), p. 1-1. -
További szerzők:	Pintér József (1930-) (urológus) Molontay Roland Nagy Marcell Farkas Nelli Sipos Zoltán (1988-) (vegyész, angol-magyar szakfordító) Fehérvári Péter Pecze László Földi Mária Vincze Áron Takács Tamás (Szeged) Czakó László Izbéki Ferenc Halász Adrienn Boros Eszter Hamvas József Varga Márta Mickevicius, Artautas Faluhelyi Nándor Farkas Orsolya Váncsa Szilárd Nagy Rita Bunduc, Stefania Hegyi Péter Jenő (belgyógyász) Márta Katalin Borka Katalin Doros Attila Hosszúfalusi Nóra Zubek László (1970-) (aneszteziológus és intenzív terápiás, kardiológus, oxyológus) Erőss Bálint Molnár Zsolt (Pécs, aneszteziológus) Párniczky Andrea (gyermekgyógyász) Hegyi Péter (pszichológus) Szentesi Andrea Papp Mária (1975-) (belgyógyász, gasztroenterológus) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Hungarian Pancreatic Study Group
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001-es BibID:	BIBFORM136206
035-os BibID:	(wos)001710787300001
Első szerző:	Márta Katalin
Cím:	High versus gradually increasing energy nutrition in the early phase of acute pancreatitis (GOULASH) : a multicentre double-blind randomised clinical trial / Katalin Márta, Marie Anne Engh, Áron Vincze, Bálint Erőss, Péter J. Hegyi, Alexandra Mikó, Ferenc Izbéki, Mária Papp, Péter Mátrai, Zsolt Abonyi-Tóth, Nándor Faluhelyi, Andrea Szentesi, Péter Hegyi, the Goulash Trial Group
Dátum:	2026
ISSN:	0017-5749
Megjegyzések:	ABSTRACT Background Acute pancreatitis (AP) is among the most common gastrointestinal diseases requiring hospitalisation, often with severe outcomes and no disease-specific therapy. Nutritional support has been proven to improve outcome, but little is known regarding optimal timing and composition. Objective This clinical trial aimed to compare high (30 kcal/kg/day, high energy (HE)) versus gradually increasing energy (0 increased to 30 kcal/kg/day over 4 days, low energy (LE)) strategies for enteral nutritional support in AP. Design This was a multicentric, double-blind, randomised clinical trial, enrolling patients with AP regardless of predicted severity (January 2017 to April 2023). The primary outcome was a combination of mortality and severe acute pancreatitis (Revised Atlanta Criteria); secondary outcomes included severity, rate of infection, organ failure and pain relapse. Interim analysis was planned after 50% enrolment. The Benjamini-Hochberg false discovery rate (FDR) method was used to correct p value for multiple testing. Results The trial was stopped early after enrolling 636 patients. Interim analysis showed that the primary outcome showed no difference between groups in the modified intention-to-treat (mITT) population (HE: 28/312, 9.0% vs LE: 18/307, 5.7%, p(uncorrected/ corrected)=0.19/0.42). Secondary outcomes showed no difference in the mITT analysis. Without correction for multiplicity testing, results favoured a low gradual energy strategy in terms of organ failure (HE: 52/312, 16.7% vs LE: 28/307, 9.1%, p(uncorrected)=0.007) and pain relapse (80/312, 27.1% vs 54/307, 19.0% p(uncorrected)=0.03) but showed no differences between groups after correction for multiple testing (p=0.13 and p=0.23, respectively). It was determined that the superiority of the intervention would not be shown even with an increased sample size, and thus the trial was terminated based on a post hoc decision on ethics and futility. Conclusion Based on this early terminated trial, a high-energy strategy for early nutrition in pancreatitis does not decrease mortality/severity, but potentially increases organ failure and pain relapse rate.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Gut. - [Epub ahead of print] (2026). -
További szerzők:	Engh, Marie Anne Vincze Áron Erőss Bálint Hegyi Péter Jenő (belgyógyász) Mikó Alexandra Izbéki Ferenc Papp Mária (1975-) (belgyógyász, gasztroenterológus) Mátrai Péter Abonyi-Tóth Zsolt Faluhelyi Nándor Szentesi Andrea Hegyi Péter Jr. (belgyógyász) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Fehér Krisztina Eszter (1991-) (orvos) the Goulash Trial Group
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