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001-es BibID:BIBFORM065752
Első szerző:Papp Mária (belgyógyász, gasztroenterológus)
Cím:Presepsin teardown : pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis / Maria Papp, Tamas Tornai, Zsuzsanna Vitalis, Istvan Tornai, David Tornai, Tamas Dinya, Andrea Sumegi, Peter Antal-Szalmas
Dátum:2016
Megjegyzések:AIM: Bacterial infections are frequent complications in cirrhosis with significant mortality. Early laboratory diagnosis is essential but challenging. We aimed to evaluate the diagnostic and prognostic value of presepsin in cirrhosis associated bacterial infections. METHODS: 216 patients with cirrhosis were enrolled. At admission, presence of bacterial infections and level of plasma presepsin, serum CRP and PCT were evaluated. Patients were followed for three months to assess the possible association between presepsin level and short-term mortality. RESULTS: 34.7% of patients had bacterial infection. Presepsin levels were significantly higher in patients with infection than without (median, 1002 vs. 477 pg/mL, p<0.001), increasing with the severity of infection (organ failure[OF]Yes vs. No: 2358 vs. 710 pg/mL, p<0.001). Diagnostic accuracy of presepsin for severe infections was similar to PCT and superior to CRP (AUC-ROC: 0.85, 0.85 and 0.66, respectively, p=NS for presepsin vs. PCT and p<0.01 for presepsin vs. CRP). At the optimal cut-off value of presepsin>1206 pg/mL sensitivity, specificity, PPV and NPV were as follows: 87.5%, 74.5%, 61.8% and 92.7%. The accuracy of presepsin, however, decreased in advanced stage of the disease or in the presence of renal failure, most probably because of the significantly elevated presepsin levels in non-infected patients. 28-day mortality rate was higher among patients with >1277 pg/mL compared to those with ?1277 pg/mL (46.9% vs. 11.6%, p<0.001). In a binary logistic regression analysis, however, only PCT [OR: 1.81, (95%CI: 1.09?3.01), p=0.022] but neither presepsin and nor CRP were independent risk factor for 28-day mortality after adjusting with MELD score and leukocyte count.CONCLUSION: Presepsin is a valuable new biomarker for defining severe infections in cirrhosis proving same efficacy as PCT. However, it is not a useful marker of short-term mortality.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
presepsin
cirrhosis
bacterial infection
organ failure
mortality
Megjelenés:World Journal of Gastroenterology 22 : 41 (2016), p. 1-14. -
További szerzők:Tornai Tamás István (1984-) (belgyógyász) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Sümegi Andrea (1969-) (biológus) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos)
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:BIBFORM010925
Első szerző:Papp Mária (belgyógyász, gasztroenterológus)
Cím:Anti-microbial antibodies in celiac disease : trick or treat? / Maria Papp, Ildiko Foldi, Istvan Altorjay, Eszter Palyu, Miklos Udvardy, Judit Tumpek, Sandor Sipka, Ilma Rita Korponay-Szabo, Eva Nemes, Gabor Veres, Tamas Dinya, Attila Tordai, Hajnalka Andrikovics, Gary L. Norman, Peter Laszlo Lakatos
Dátum:2009
ISSN:1007-9327 (Print)
Megjegyzések:To determine the prevalence of a new set of anti-glycan and anti-outer membrane protein (anti-OMP) antibodies in a Hungarian cohort of adult Celiac disease (CD) patients. METHODS: 190 consecutive CD patients [M/F: 71/119, age:39.9 (SD:14.1) years], 100 healthy, and 48 gastrointestinal controls were tested for glycan anti-Saccharomyces cerevisiae (gASCA), anti-laminaribioside (ALCA), anti-chitobioside, anti-mannobioside, anti-OMP antibodies and major NOD2/CARD15 mutations. Thirty out of 82 CD patients enrolled at the time of diagnosis were re-evaluated for the same antibodies after longstanding gluten-free diet (GFD). RESULTS: 65.9% of the CD patients were positive for at least one of the tested antibodies at the time of the diagnosis. Except anti-OMP and ALCA, anti-microbial antibodies were exclusively seen in untreated CD; however, the overall sensitivity was low. Any glycan positivity (LR+: 3.13; 95% CI: 2.08-4.73) was associated with an increased likelihood ratio for diagnosing CD. Significant correlation was found between the levels of anti-glycan and anti-endomysial or anti-transglutaminase antibodies. Anti-glycan positivity was lost after longstanding GFD. Anti-glycan antibody titers were associated with symptoms at presentation, but not the presence of NOD2/CARD15 mutations. Patients with severe malabsorption more frequently had multiple antibodies at diagnosis (P = 0.019). CONCLUSION: The presence of anti-glycan antibodies in CD seems to be secondary to the impaired small bowel mucosa which can lead to increased antigen presentation. Furthermore, anti-glycan positivity may be considered an additional marker of CD and dietary adherence.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
egyetemen (Magyarországon) készült közlemény
Megjelenés:World Journal of Gastroenterology 15 : 31 (2009), p. 3891-3900. -
További szerzők:Földi Ildikó (1981-) (orvos) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Pályu Eszter (1983-) Udvardy Miklós (1947-) (belgyógyász, haematológus) Tumpek Judit (1944-) (orvosi laboratóriumi szakorvos) Sipka Sándor (1945-) (laboratóriumi szakorvos) Korponay-Szabó Ilma (1959-) (gyermekgyógyász) Nemes Éva (1957-) (csecsemő- és gyermekgyógyász, gasztroenterológus) Veres Gábor (1969-2020) (csecsemő- és gyermekgyógyász, gasztroenterológus) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Tordai Attila Andrikovics Hajnalka Norman, Gary L. Lakatos Péter (Semmelweis Egyetem)
Internet cím:DOI
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