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001-es BibID:BIBFORM078868
035-os BibID:(PMID)31464790
Első szerző:Janka Tamás
Cím:Deleterious effect of proton pump inhibitors on the disease course of cirrhosis / Tamas Janka, Tamas Tornai, Brigitta Borbely, David Tornai, Istvan Altorjay, Maria Papp, Zsuzsanna Vitalis
Dátum:2020
Megjegyzések:OBJECTIVES: Proton pump inhibitors (PPIs) are widely prescribed to patients with liver cirrhosis. We hypothesized that long-standing PPI use is associated with spontaneous bacterial peritonitis (SBP) and accelerated development of disease-specific complications and liver-related death. METHODS: A 5-year follow-up observational cohort study assessed the impact of long-standing PPI use on the clinical course of cirrhosis in a large referral patient cohort. 350 patients with cirrhosis (males: 188, females: 162, ages: 56?6 years, alcohol: 242 [69.1%], Child-Pugh stage A/B/C: 206/108/36) were assigned to two groups: regular PPI users (n=196) and non-users (n=154). Occurrence of SBP, decompensation events (development of ascites, hepatic encephalopathy and variceal bleeding), and liver-related death were assessed. RESULTS: Regular PPI use was associated with an increased cumulative probability of SBP compared to non-users [CP: 55% vs 24.8%, HR: 4.25 (95%CI: 1.42-12.67), p=0.05], but only in patients who had no previous SBP episode (n=84). A similar association was found between regular PPI use and decompensation events. The risk of the development of a first decompensation event (ascites, HE or VB) was higher in regular PPI users compared to non-users, in patients with compensated clinical stage at enrollment (HR: 2.81, 95%CI: 1.31-6.01, p=0.008, n=146). The risk of liver-related death was also significantly increased among regular PPI users (p<0.001). In multivariate Cox-regression analysis, regular PPI use (HR: 2.81, 95%CI: 1.43-5.51, p=0.003) and MELD score (HR: 1.21, 95%CI: 1.08-1.35, p<0.001) was an independent predictor of mortality. In the present follow-up cohort study, long-term PPI use was associated with the development of SBP and a progressive disease course in patients with cirrhosis that may have been caused by enhanced pathologic BT, accelerated development of BT-dependent disease-specific complications, and liver-related death.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
proton pump inhibitors
bacterial translocation
spontaneous bacterial peritonitis
disease progression
mortality
Megjelenés:European Journal of Gastroenterology & Hepatology. - 32 : 2 (2020), p. 257-264. -
További szerzők:Tornai Tamás István (1984-) (belgyógyász) Borbély Brigitta Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Papp Mária (1975-) (belgyógyász, gasztroenterológus) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus)
Pályázati támogatás:GINOP-2.3.2-15-2016-00048
GINOP
EFOP-3.6.1-16-2016-00022
EFOP
EFOP-3.6.2-16-2017-00006
EFOP
BO/00232/17/5
Egyéb
ÚNKP-17-4
Egyéb
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
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2.

001-es BibID:BIBFORM013661
Első szerző:Vitális Zsuzsanna (belgyógyász, gasztroenterológus)
Cím:Phenotypic polymorphism of haptoglobin : a novel risk factor for the development of infection in liver cirrhosis / Vitális Zsuzsanna, Altorjay István, Tornai István, Palatka Károly, Kacska Sándor, Pályu Eszter, Tornai Dávid, Udvardy Miklós, Hársfalvi Jolán, Dinya Tamás, Veres Gábor, Lakatos Péter László, Papp Mária
Dátum:2011
ISSN:0198-8859
Megjegyzések:The ?-chain alleles 1 and 2 of haptoglobin(Hp) molecule account for three phenotypes, which have biologically important differences in their antioxidant, scavenging, and immunomodulatory properties and may thereby influence the course of inflammatory diseases. A follow-up observational study was conducted to assess the association between haptoglobin phenotype and the development of clinically significant bacterial infections in patients with liver cirrhosis. Sera of 336 patients with liver cirrhosis of various etiologies and 384 healthy subjects were investigated. Haptoglobin phenotypes were determined by gel electrophoresis and assigned corresponding genotype. Haptoglobin phenotype distributions of patients and controls was similar (Hp1-1: 10.7% vs. 11.5%, Hp2-1: 47.9% vs. 46.1% and Hp2-2: 41.4% vs. 42.4%). The probability of clinically significant bacterial infections was calculated for each haptoglobin phenotype (Hp1-1: 50.0%, Hp2-1: 36.0% and Hp2-2: 26.6%, p=0.039). In a logistic regression analysis, Hp1-1 phenotype (p=0.015, OR:2.74, 95%CI:1.22-6.13), Child-Pugh stage (p=0.038, OR:1.40, 95%CI:1.02-1.91) and presence of co-morbidities (p?0.001, OR:2.64, 95%CI:1.63-4.27) were independently associated with infections. In a Cox-regression analysis, Hp1-1 phenotype (p=0.014), Child-Pugh stage C (p<0.001), and presence of co-morbidities (p=0.004) were associated with time to first infectious episode. Phenotypic hHaptoglobin polymorphism was independent predictor for risk and time to first clinically significant bacterial infectious episode.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
egyetemen (Magyarországon) készült közlemény
Megjelenés:Human Immunology. - 72 : 4 (2011), p. 348-354. -
További szerzők:Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Palatka Károly (1961-) (belgyógyász, gasztroenterológus) Kacska Sándor (1975-) (belgyógyász) Pályu Eszter (1983-) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Udvardy Miklós (1947-) (belgyógyász, haematológus) Hársfalvi Jolán (1949-) (klinikai biokémikus) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Veres Gábor (1969-2020) (csecsemő- és gyermekgyógyász, gasztroenterológus) Lakatos Péter (Semmelweis Egyetem) Papp Mária (1975-) (belgyógyász, gasztroenterológus)
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