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1.

001-es BibID:BIBFORM101539
035-os BibID:(Cikkazonosító)7827 (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
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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2.

001-es BibID:BIBFORM070012
035-os BibID:e015874
Első szerző:Márta Katalin
Cím:High versus low energy administration in the early phase of acute pancreatitis (GOULASH trial) : protocol of a multicentre randomized double-blind clinical trial / Katalin Márta, Anikó Nóra Szabó, Dániel Pécsi, Péter Varjú, Judit Bajor, Szilárd Gódi, Patrícia Sarlós, Alexandra Mikó, Katalin Szemes, Mária Papp, Tamás Tornai, Áron Vincze, Zsolt Márton, Patrícia Anna Vincze, Erzsébet Lankó, Andrea Szentesi, Tímea Molnár, Roland Hagendorn, Faluhelyi Nándor, István Battyáni, Dezső Kelemen, Róbert Papp, Attila Miseta, Verzár Zsófia, Markus M. Lerch, Johan P. Neoptoleomos, Miklós Sain-Tóth, Ole H. Petersen, Peter Hegyi
Dátum:2017
ISSN:2044-6055
Megjegyzések:Introduction. Acute pancreatitis (AP) is an inflammatory disease with no specific therapy. Mitochondrial injury followed by ATP depletion in both acinar and ductal cells is a recently discovered early event in the pathogenesis. Importantly, preclinical research showed that intracellular ATP delivery restores the physiological function of the cells and protects from cell injury suggesting that restoration of energy levels in the pancreas is therapeutically beneficial. Despite several, high quality and experimental observations in this area, no randomized trials have been conducted to date to address the requirements for energy intake in the early phase of AP. Methods/Design. This is a randomized, controlled two-arms double-blind multicentre trial. Patients suffering from AP will be randomly assigned to groups A (30 kcal/kg/day energy administration starting within 24h of hospital admission) or B (low energy administration during the first 72h of hospital admission). Energy will be delivered with nasoenteric tube feeding with additional intravenous glucose supplementation or total parenteral nutrition if necessary. A combination of multi organ failure for more than 48h and mortality is defined as the primary endpoint, whereas several secondary endpoints such as length of hospitalization or pain will be determined to elucidate more detailed differences between the groups. The general feasibility, safety and quality checks required for high quality evidence will be adhered to.Ethics and Dissemination. The study has been approved by the relevant organization, The Scientific and Research Ethics Committee of the Hungarian Medical Research Council (55961- 2/2016/EKU). This study will provide evidence whether early high-energy nutritional support is beneficial in the clinical management of AP. The results of this trial will be published in an open access way and disseminated among medical doctors.Trial registration: The trial has been registered at the ISRCTN (ISRTCN 63827758).
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
acute pancreatitis
energy administration
enteral feeding
randomized clinical trial
Megjelenés:BMJ Open. - 7 : 9 (2017), p. 1-9. -
További szerzők:Szabó Anikó Nóra Pécsi Dániel Varjú Péter Bajor Judit Gódi Szilárd Sarlós Patrícia Mikó Alexandra Szemes Katalin Papp Mária (1975-) (belgyógyász, gasztroenterológus) Tornai Tamás István (1984-) (belgyógyász) Vincze Áron Márton Zsolt Vincze Patrícia Anna Lankó Erzsébet Szentesi Andrea Molnár Tímea Hágendorn Roland Faluhelyi Nándor Battyáni István Kelemen Dezső Papp Róbert Miseta Attila Verzár Zsófia Lerch, Markus M. Neoptoleomos, Johan P. Sain-Tóth, Miklós Petersen, Ole H. Hegyi Péter Jenő (belgyógyász)
Pályázati támogatás:GINOP-2.3.2-15-2016-00015
GINOP
KH-125678
NKFI
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3.

001-es BibID:BIBFORM090171
Első szerző:Mikó Alexandra
Cím:Early Phase of Chronic Pancreatitis : results of the First 20 Months of the GOULASH-PLUS Clinical Study / A. Mikó, D. Kato, V. Lillik, L. Gajdán, M. Papp, I. Földi, B. Bodis, N. Faluhelyi, P. Sarlos, Á. Vincze, Z. Szepes, G. Elsayed, P. Mosler, B. Erős, L. Czakó, P. Hegyi
Dátum:2020
ISSN:1424-3903
Megjegyzések:Purpose: Acute pancreatitis (AP) is a severe inflammatory disease that can lead to irreversible complications such as recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP). CP is often diagnosed in an advanced form, though it could be effectively managed at an early stage. However, parameters indicative of early CP are still unknown. We aim to find measurable biomarkers and clinical signs of this early phase through the GOULASH-PLUS follow-up study. Materials and methods: GOULASH-PLUS is a longitudinal study of AP with a 6-year follow-up of patients with a well documented episode of AP. Imaging, physical and laboratory testing is performed annually. To detect endocrine function, blood glucose, HbA1C were measured, and oral glucose tolerance test (OGTT) was performed; exocrine parameters were measured by a stool elastase test. Chi-square test and Fisher exact test were used for statistical analysis. Results: Of the first 133 patients, 57 (43%)were women, 76 (57%)were men, and the average age was 55. 27 (20%) patients had moderate AP, 6 (5%) had severe AP, and 15 (14%) had RAP in the first year. 13 (16%) patients were diagnosed with severe exocrine pancreas insufficiency, 17 (15%) were diagnosed with diabetes and 23 (20%) with impaired glucose tolerance (IGT). Exocrine abnormalities were present in 70% of patients with RAP, compared with only 18% in the group without RAP (p <0.001). There was no difference in endocrine function between RAP and non-RAP groups. Based on OGTT, hyperinsulinemia was detected in IGT and diabetic groups, and endocrine disruption (IGT, DM) was not associated with AP severity. Conclusions: One year after AP, exocrine and endocrine insufficiency can be measured in the majority of patients. In RAP, exocrine abnormalities appear earlier, while the endocrine function is not affected. The development of IGT and DM is independent of the severity of AP.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
folyóiratcikk
Megjelenés:Pancreatology. - 20 (2020), p. S29. -
További szerzők:Kató D. Lillik V. Gajdán László Papp Mária (1975-) (belgyógyász, gasztroenterológus) Földi Ildikó (1981-) (orvos) Bódis Beáta Faluhelyi Nándor Sarlós Patrícia Vincze Áron Szepes Zoltán Elsayed, G. Mosler, P. Erős Bálint Czakó László Hegyi Péter Jenő (belgyógyász)
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4.

001-es BibID:BIBFORM078557
035-os BibID:(cikkazonosító)e025500
Első szerző:Mikó Alexandra
Cím:Observational longitudinal multicentre investigation of acute pancreatitis. (GOULASH PLUS) : follow-up of the GOULASH-study, protocol / Alexandra Mikó, Bálint Erőss, Patrícia Sarlós, Péter Hegyi Jr., Katalin Márta, Dániel Pécsi, Áron Vincze, Beáta Bódis, Orsolya Nemes, Nándor Faluhelyi, Orsolya Farkas, Róbert Papp, Dezső Kelemen, Andrea Szentesi, Eszter Hegyi, Mária Papp, László Czakó, Ferenc Izbéki, László Gajdán, János Novák, Miklós Sahin-Tóth, Markus M. Lerch, John P. Neoptolemos, Ole H. Petersen, Péter Hegyi
Dátum:2019
ISSN:2044-6055
Megjegyzések:Background: Acute pancreatitis (AP) is an inflammatory condition, which can lead to late consequences. In 20% of patients recurrent AP (RAP) develops and in 7-12.8% chronic pancreatitis (CP) will occur. However, we do not have sufficient information to establish an evidence-based statement to define early CP, or how to prevent its development. Aim: The aim of this study is to understand the influencing factors and to determine, which parameters should be measured or used as a biomarker to detect the early phase of CP. Methods/Design: This is an observational prospective follow-up study of the GOULASH-trial (ISRTCN 63827758) in which i) all severity of pancreatitis are included, ii) patients receive only therapeutic modalities which are accepted by the EBM guideline, iii) whole blood, serum and plasma are stored in our biobank and iv) large amount of variables are collected and kept in our electronic database including anamnestic data, physical examination, laboratory parameters, imaging, therapy and complications, therefore this fully characterized patient-cohort are well suitable for this longitudinal follow up study. Patients' selection: patients enrolled in the GOULASH study will be offered to join to the longitudinal study. The follow-up will be at 1-2-3-4-5 and 6 years after the episode of AP. Anamnestic data will be collected by questionnaires: i) Diet History Questionnaire ii) SF-36 iii) physical activity questionnaire iv) stress questionnaire. Genetic tests will be performed for the genes associated with CP. The exocrine and endocrine pancreatic, liver and kidney functions will be determined by laboratory tests, stool sample analyses, and imaging. Cost-effectiveness will be analyzed to examine the relationship between events of interest and health-related quality of life or to explore subgroup differences. Conclusion: This study will provide information about the risk factors and influencing factors and measurable parameters of CP.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
acute pancreatitis
follow-up
chronic pancreatitis
risk factor
Megjelenés:BMJ Open. - 9 : 8 (2019), p. 1-9. -
További szerzők:Erőss Bálint Sarlós Patrícia Hegyi Péter Jr. (belgyógyász) Márta Katalin Pécsi Dániel Vincze Áron Bódis Beáta Nemes Orsolya Faluhelyi Nándor Farkas Orsolya Papp Róbert Kelemen Dezső Szentesi Andrea Hegyi Eszter Papp Mária (1975-) (belgyógyász, gasztroenterológus) Czakó László Izbéki Ferenc Gajdán László Novák János Sahin-Tóth Miklós Lerch, Markus M. Neoptoleomos, Johan P. Petersen, Ole H. Hegyi Péter Jenő (belgyógyász)
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5.

001-es BibID:BIBFORM095975
Első szerző:Nagy Anikó
Cím:Glucose levels show independent and dose-dependent association with worsening acute pancreatitis outcomes: Post-hoc analysis of a prospective, international cohort of 2250 acute pancreatitis cases / Aniko Nagy, Mark Félix Juhász, Anikó Görbe, Alex Váradi, Ferenc Izbéki, Áron Vincze, Patrícia Sarlós, József Czimmer, Zoltán Szepes, Tamás Takács, Mária Papp, Eszter Fehér, József Hamvas, Klaudia Kárász, Imola Török, Davor Stimac, Goran Poropat, Ali Tüzün Ince, Bálint Erőss, Katalin Márta, Dániel Pécsi, Dóra Illés, Szilárd Váncsa, Mária Földi, Nándor Faluhelyi, Orsolya Farkas, Tamás Nagy, Péter Kanizsai, Zsolt Márton, Andrea Szentesi, Péter Hegyi, Andrea Párniczky
Dátum:2021
ISSN:1424-3903
Megjegyzések:Background: Metabolic risk factors, such as obesity, hypertension, and hyperlipidemia are independent risk factors for the development of various complications in acute pancreatitis (AP). Hypertriglyceridemia dose-dependently elicits pancreatotoxicity and worsens the outcomes of AP. The role of hyperglycemia, as a toxic metabolic factor in the clinical course of AP, has not been examined yet. Methods: We analyzed a prospective, international cohort of 2250 AP patients, examining associations between (1) glycosylated hemoglobin (HbA1c), (2) on-admission glucose, (3) peak in-hospital glucose and clinically important outcomes (mortality, severity, complications, length of hospitalization (LOH), maximal C-reactive protein (CRP)). We conducted a binary logistic regression accounting for age, gender, etiology, diabetes, and our examined variables. Receiver Operating Characteristic Curve (ROC) was applied to detect the diagnostic accuracy of the three variables. Results: Both on-admission and peak serum glucose are independently associated with AP severity and mortality, accounting for age, gender, known diabetes and AP etiology. They show a dose-dependen association with severity (p < 0.001 in both), mortality (p < 0.001), LOH (p < 0.001), maximal CRP (p < 0.001), systemic (p < 0.001) and local complications (p < 0.001). Patients with peak glucose >7 mmol/l had a 15 times higher odds for severe AP and a five times higher odds for mortality. We found a trend of increasing HbA1c with increasing LOH (p < 0.001), severity and local complications. Conclusions: On-admission and peak in-hospital glucose are independently and dose-dependently associated with increasing AP severity and mortality. In-hospital laboratory control of glucose and adequate treatment of hyperglycemia are crucial in the management of AP. ? 2021 Published by Elsevier B.V. on behalf of IAP and EPC.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Pancreatology. - 21 : 7 (2021), p. 1237-1246. -
További szerzők:Juhász Márk Félix Görbe Anikó Váradi Alex (1991-) (biológus) Izbéki Ferenc Vincze Áron Sarlós Patrícia Czimmer József Szepes Zoltán Takács Tamás (Szeged) Papp Mária (1975-) (belgyógyász, gasztroenterológus) Fehér Eszter Hamvas József Kárász Klaudia Török Imola Štimac, Davor Poropat, Goran Ince, Ali Tüzün Erőss Bálint Márta Katalin Pécsi Dániel Illés Dóra Váncsa Szilárd Földi Mária Faluhelyi Nándor Farkas Orsolya Nagy Tamás Kanizsai Péter Márton Zsolt Szentesi Andrea Hegyi Péter Jenő (belgyógyász) Párniczky Andrea (gyermekgyógyász)
Pályázati támogatás:EFOP-3.6.2-16-2017-00006
EFOP
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6.

001-es BibID:BIBFORM103700
035-os BibID:(scopus)85121564971 (wos)000731322900016 (cikkazonosító)24158
Első szerző:Ocskay Klementina
Cím:Hypoalbuminemia affects one third of acute pancreatitis patients and is independently associated with severity and mortality / Ocskay Klementina, Vinkó Zsófia, Németh Dávid, Szabó László, Bajor Judit, Gódi Szilárd, Sarlós Patrícia, Czakó László, Izbéki Ferenc, Hamvas József, Papp Mária, Varga Márta, Török Imola, Mickevicius Artautas, Sallinen Ville, Maldonado Elena Ramirez, Galeev Shamil, Mikó Alexandra, Erőss Bálint, Imrei Marcell, Hegyi Péter Jenő, Faluhelyi Nándor, Farkas Orsolya, Kanizsai Péter, Miseta Attila, Nagy Tamás, Hágendorn Roland, Márton Zsolt, Szakács Zsolt, Szentesi Andrea, Hegyi Péter, Párniczky Andrea
Dátum:2021
ISSN:2045-2322
Megjegyzések:The incidence and medical costs of acute pancreatitis (AP) are on the rise, and severe cases still have a 30% mortality rate. We aimed to evaluate hypoalbuminemia as a risk factor and the prognostic value of human serum albumin in AP. Data from 2461 patients were extracted from the international, prospective, multicentre AP registry operated by the Hungarian Pancreatic Study Group. Data from patients with albumin measurement in the frst 48 h (n= 1149) and anytime during hospitalization (n= 1272) were analysed. Multivariate binary logistic regression and Receiver Operator Characteristic curve analysis were used. The prevalence of hypoalbuminemia (<35 g/L) was 19% on admission and 35.7% during hospitalization. Hypoalbuminemia dose-dependently increased the risk of severity, mortality, local complications and organ failure and is associated with longer hospital stay. The predictive value of hypoalbuminemia on admission was poor for severity and mortality. Severe hypoalbuminemia (<25 g/L) represented an independent risk factor for severity (OR 48.761; CI 25.276?98.908) and mortality (OR 16.83; CI 8.32?35.13). Albumin loss during AP was strongly associated with severity (p< 0.001) and mortality (p= 0.002). Hypoalbuminemia represents an independent risk factor for severity and mortality in AP, and it shows a dose-dependent relationship with local complications, organ failure and length of stay.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Scientific Reports. - 11 : 1 (2021), p. 1-12. -
További szerzők:Vinkó Zsófia Németh Dávid Szabó László Bajor Judit Gódi Szilárd Sarlós Patrícia Czakó László Izbéki Ferenc Hamvas József Papp Mária (1975-) (belgyógyász, gasztroenterológus) Varga Márta Török Imola Mickevicius, Artautas Sallinen, Ville Maldonado, Elena Ramirez Galeev, Shamil Mikó Alexandra Erőss Bálint Imrei Marcell Hegyi Péter Jenő (belgyógyász) Faluhelyi Nándor Farkas Orsolya Kanizsai Péter Miseta Attila Nagy Tamás Hágendorn Roland Márton Zsolt Szakács Zsolt Szentesi Andrea Hegyi Péter (pszichológus) Párniczky Andrea (gyermekgyógyász)
Pályázati támogatás:EFOP-3.6.2-16-2017-00006
EFOP
GINOP-2.3.2-15-2016-00015
GINOP
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DOI
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7.

001-es BibID:BIBFORM094178
035-os BibID:(WOS)000727779500019 (Scopus)85106978919
Első szerző:Szakó Lajos
Cím:Early occurrence of pseudocysts in acute pancreatitis - A multicenter international cohort analysis of 2275 cases / Lajos Szakó, Noémi Gede, Alex Váradi, Benedek Tinusz, Nóra Vörhendi, Dóra Mosztbacher, Áron Vincze, Tamás Takács, László Czakó, Ferenc Izbéki, László Gajdán, Veronika Dunás-Varga, József Hamvas, Mária Papp, Krisztina Eszter Fehér, Márta Varga, Artautas Mickevicius, Imola Török, Klementina Ocskay, Márk Félix Juhász, Szilárd Váncsa, Nándor Faluhelyi, Orsolya Farkas, Attila Miseta, András Vereczkei, Alexandra Mikó, Péter Jenő Hegyi, Andrea Szentesi, Andrea Párniczky, Bálint Erőss, Péter Hegyi
Dátum:2021
ISSN:1424-3903
Megjegyzések:BACKGROUND Pseudocysts being the most frequent local complications of acute pancreatitis (AP) have substantial effect on the disease course, hospitalization and quality of life of the patient. Our study aimed to understand the effects of pre existing (OLD-P) and newly developed (NEW-P) pseudocysts on AP. METHODS Data were extracted from the Acute Pancreatitis Registry organized by the Hungarian Pancreatic Study Group (HPSG). 2275 of 2461 patients had uploaded information concerning pancreatic morphology assessed by imaging technique. Patients were divided into "no pseudocyst" (NO-P) group, "old pseudocyst" (OLD-P) group, or "newly developed pseudocyst" (NEW-P) groups. RESULTS The median time of new pseudocyst development was nine days from hospital admission and eleven days from the beginning of the abdominal pain. More NEW-P cases were severe (15.9% vs 4.7% in the NO-P group p<0.001), with longer length of hospitalization (LoH) (median: 14 days versus 8 days, p<0.001), and were associated with several changed laboratory parameters. OLD-P was associated with male gender (72.2% vs. 56.1%, p=0.0014), alcoholic etiology (35.2% vs. 19.8% in the NO-P group), longer hospitalization (median: 10 days, p<0.001), a previous episode of AP (p<0.001), pre-existing diagnosis of chronic pancreatitis (CP) (p<0.001), current smoking (p<0.001), and increased alcohol consumption (unit/week) (p=0.014). CONCLUSION Most of the new pseudocysts develop within two weeks. Newly developing pseudocysts are associated with a more severe disease course and increased length of hospitalization. Pre-existing pseudocysts are associated with higher alcohol consumption and smoking. Because CP is more frequently associated with a pre-existing pseudocyst, these patients need closer attention after AP.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Pancreatology. - 21 : 6 (2021), p. 1161-1172. -
További szerzők:Gede Noémi Váradi Alex (1991-) (biológus) Tinusz Benedek Vörhendi Nóra Mosztbacher Dóra Vincze Áron Takács Tamás (Szeged) Czakó László Izbéki Ferenc Gajdán László Dunás-Varga Veronika Hamvas József Papp Mária (1975-) (belgyógyász, gasztroenterológus) Fehér Krisztina Eszter Varga Márta Mickevicius, Artautas Török Imola Ocskay Klementina Juhász Márk Félix Váncsa Szilárd Faluhelyi Nándor Farkas Orsolya Miseta Attila Vereczkei András Mikó Alexandra Hegyi Péter Jr. (belgyógyász) Szentesi Andrea Párniczky Andrea (gyermekgyógyász) Erőss Bálint Hegyi Péter Jenő (belgyógyász)
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8.

001-es BibID:BIBFORM103702
035-os BibID:(cikkazonosító)671917 (scopus)85114319818 (wos)000692562300001
Első szerző:Tod Pál
Cím:Initial Renal Function (eGFR) Is a Prognostic Marker of Severe Acute Pancreatitis : a Cohort-Analysis of 1,224 Prospectively Collected Cases / Tod Pál, Farkas Nelli, Németh Dávid, Szénási Gábor, Vincze Áron, Hágendorn Roland, Czakó László, Illés Dóra, Izbéki Ferenc, Dunás-Varga Veronika, Papp Mária, Hamvas József, Varga Márta, Gombos Katalin, Nagy Tamás, Márton Zsolt, Faluhelyi Nándor, Török Imola, Ince Ali Tüzün, Galeev Shamil, Hegyi Péter Jenő, Szentesi Andrea, Párniczky Andrea, Szakács Zsolt, Hegyi Péter, Hamar Péter
Dátum:2021
ISSN:2296-858X
Megjegyzések:Background: Acute pancreatitis (AP) is a life-threatening disease. We aimed to explore the prognostic relevance of renal function based on estimated glomerular filtration rate (eGFR). Methods: A prospective registry of AP patients was established by the Hungarian Pancreatic Study Group. Data of 1,224 consecutive patients were collected between 2012 and 2017. Patients were divided into 3 groups according to their eGFR measured within 24 h of hospitalization: normal renal function: >90 mL/min, mild to moderate renal functional impairment: 30?90 mL/min and severe renal dysfunction: <30 mL/min. Associations of eGFR with outcome (survival, length of hospitalization, AP severity, blood glucose), inflammatory markers (erythrocyte sedimentation rate, white blood cell count), anemia and organ failure (heart, kidney, liver) were analyzed. Results: Death, longer hospitalization and severe AP, but not the cause of AP, were significantly associated with lower eGFR. The inflammatory markers (CRP, WBC count) but not anemia (Hb, Htk) were closely associated with severe renal dysfunction. Renal function was associated with heart and renal failure but not with other complications of AP such as respiratory failure, local pancreatic complications, diabetes or peptic ulcer. eGFR was not associated with liver damage (ALAT, ?-GT) or liver function (serum bilirubin) although biliary complications, alcohol and metabolic syndrome were the most common etiologies of AP. Tod et al. eGFR in Severe Acute Pancreatitis Conclusions: Our study suggests a useful prognostic value of initial eGFR in AP patients. Even mild eGFR reduction predicted mortality, severity of AP and the length of hospitalization. Thus, precise evaluation of renal function should be considered for assessing AP severity and outcome.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
AP severity and mortality
renal dysfunction
CKD-EPI
EGFR
human retrospective cohort
Megjelenés:Frontiers in Medicine. - 8 (2021), p. 1-10. -
További szerzők:Farkas Nelli Németh Dávid Szénási Gábor Vincze Áron Hágendorn Roland Czakó László Illés Dóra Izbéki Ferenc Dunás-Varga Veronika Papp Mária (1975-) (belgyógyász, gasztroenterológus) Hamvas József Varga Márta Gombos Katalin Nagy Tamás (1977-) (vegyész, orvosi laboratóriumi analitikus) Márton Zsolt Faluhelyi Nándor Török Imola Ince, Ali Tüzün Galeev, Shamil Hegyi Péter Jenő (belgyógyász) Szentesi Andrea Párniczky Andrea (gyermekgyógyász) Szakács Zsolt Hegyi Péter (pszichológus) Hamar Péter
Pályázati támogatás:EFOP-3.6.2-16-2017-00006
EFOP
GINOP-2.3.2-15-2016-00048
GINOP
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
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9.

001-es BibID:BIBFORM082674
Első szerző:Zádori Noémi
Cím:EarLy elimination of fatty acids iN hypertriglyceridemia-induced acuTe pancreatitis (ELEFANT trial) : protocol of an open-label, multicenter, adaptive randomized clinical trial / Noémi Zádori, Noémi Gede, Judit Antal, Andrea Szentesi, Hussain Alizadeh, Áron Vincze, Ferenc Izbéki, Mária Papp, László Czakó, Márta Varga, Enrique de-Madaria, Ole H. Petersen, Vijay P. Singh, Julia Mayerle, Nándor Faluhelyi, Attila Miseta, István Reiber, Péter Hegyi
Dátum:2020
ISSN:1424-3903
Megjegyzések:Introduction: Acute pancreatitis (AP) is a life-threatening inflammatory disease, with no specific pharmacologi- cal treatment. However, concerning some etiologies, early specific intervention (such as ERCP in biliary AP) has proven to be remarkably beneficial. Hypertriglyceridemia (HTG) induces severe pancreatic damage by several direct (cellular damage) and indirect (deterioration of microcirculation) mechanisms. Published data suggest that early removal of triglycerides (TGs) and toxic free fatty acids (FFAs) may be advantageous; however, high-quality evidence is still missing in the literature. Methods: /Design: ELEFANT is a randomized controlled, multicenter, international trial testing the concept that early elimination of TGs and FFAs from the blood is beneficial in HTG-AP. The study will be performed with the adaptive "drop-the-loser" design, which supports the possibility of dropping the inferior treatment arm, based on the results of the interim analysis. Patients with HTG-AP defined by TG level over 11.3 mmol/l (1000 mg/dL) are randomized into three groups: (A) patients who undergo plasmapheresis and receive aggressive fluid resuscita- tion; (B) patients who receive insulin and heparin treatment with aggressive fluid resuscitation; and (C) patients with aggressive fluid resuscitation. Please note that all intervention must be started within 48 h from the onset of abdominal pain. Exclusion criteria are designed logically to decrease the possibility of any distorting effects of other diseases. The composite primary endpoint will include both severity and mortality.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Acute pancreatitis
Hypertriglyceridemia
Plasmapheresis
Free fatty acids
Heparin
Insulin
Randomized clinical trial
Megjelenés:Pancreatology. - 20 : 3 (2020), p. 369-376. -
További szerzők:Gede Noémi Antal Judit Szentesi Andrea Alizadeh, Hussain Vincze Áron Izbéki Ferenc Papp Mária (1975-) (belgyógyász, gasztroenterológus) Czakó László Varga Márta de-Madaria, Enrique Petersen, Ole H. Singh, Vijay P. Mayerle, Julia Faluhelyi Nándor Miseta Attila Reiber István Hegyi Péter (pszichológus)
Pályázati támogatás:GINOP-2.3.2-15-2016-00048
GINOP
KH-125678
Egyéb
EFOP-3.6.2-16-2017-00006
EFOP
LP2014-10/2014
Egyéb
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
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