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001-es BibID:	BIBFORM013679
Első szerző:	Altorjay István (belgyógyász, gasztroenterológus, onkológus)
Cím:	Mannose-binding lectin deficiency confers risk for bacterial infections in a large Hungarian cohort of patients with liver cirrhosis / Altorjay Istvan, Vitalis Zsuzsanna, Tornai Istvan, Palatka Karoly, Kacska Sandor, Farkas Gyula, Udvardy Miklos, Harsfalvi Jolan, Dinya Tamas, Orosz Peter, Lombay Bela Jr., Par Gabriella, Par Alajos, Csak Timea, Osztovits Janos, Szalay Ferenc, Csepregi Antal, Lakatos Peter Laszlo, Papp Maria
Dátum:	2010
ISSN:	0168-8278
Megjegyzések:	Mannose-binding lectin (MBL) is a serum lectin synthesized by the liver and involved in innate host defense. MBL deficiency increases the risk of various infectious diseases mostly in immune-deficient conditions. Bacterial infections are a significant cause of morbidity and mortality in liver cirrhosis due to the relative immuncompromised state. Methods: Sera of 929 patients with various chronic liver diseases[autoimmune liver diseases (ALD), 406; viral hepatitis C (HCV), 185; and liver cirrhosis (LC) with various etiologies, 338] and 296 healthy controls (HC) were assayed for MBL concentration. Furthermore, a follow-up, observational study was conducted to assess MBL level as a risk factor for clinically significant bacterial infections in cirrhotic patients. Results:MBL level and the prevalence of absolute MBL deficiency (<100 ng/ml) was not significantly different between patients and controls (ALD: 14.5%, HCV: 11.9%, LC: 10.7%, HC: 15.6%). In cirrhotic patients, the risk for infection was significantly higher among MBL deficient subjects as compared to non-deficient ones (50.0% vs. 31.8%, p = 0.039). In a logistic regression analysis, MBL deficiency was an independent risk factor for infections (OR: 2.14 95% CI: 1.03?4.45, p = 0.04) after adjusting for Child?Pugh score, co-morbidities, gender, and age. In a Kaplan?Meier analysis, MBL deficiency was associated with a shorter time to develop the first infectious complication (median days: 579 vs. 944, pBreslow = 0.016, pLogRank = 0.027) and was identified as an independent predictor in a multivariate Cox-regression analysis (p = 0.003, OR: 2.33, 95% CI: 1.34?4.03). Conclusions:MBL deficiency is associated with a higher probability and shorter time of developing infections in liver cirrhosis, further supporting the impact of the MBL molecule on the host defense.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Mannose-binding lectin Chronic liver diseases Liver cirrhosis Bacterial infection egyetemen (Magyarországon) készült közlemény
Megjelenés:	Journal of Hepatology. - 53 : 3 (2010), p. 484-491. -
További szerzők:	Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Palatka Károly (1961-) (belgyógyász, gasztroenterológus) Kacska Sándor (1975-) (belgyógyász) Farkas Gyula Udvardy Miklós (1947-) (belgyógyász, haematológus) Hársfalvi Jolán (1949-) (klinikai biokémikus) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Orosz Péter (Miskolc) Lombay Béla Jr. Pár Gabriella Pár Alajos Csak Timea Osztovits János Szalay Ferenc (belgyógyász) Csepregi Antal Lakatos Péter (Semmelweis Egyetem) Papp Mária (1975-) (belgyógyász, gasztroenterológus)
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001-es BibID:	BIBFORM013687
Első szerző:	Papp Mária (belgyógyász, gasztroenterológus)
Cím:	Presence of Anti-Microbial Antibodies in Liver Cirrhosis : a Tell-Tale Sign of Compromised Immunity? / Papp Maria, Norman Gary L., Vitalis Zsuzsanna, Tornai Istvan, Altorjay Istvan, Földi Ildikó, Udvardy Miklos, Shums Zakera, Dinya Tamas, Orosz Peter, Lombay Bela, Par Gabriella, Par Alajos, Veres Gabor, Csak Timea, Osztovits Janos, Szalay Ferenc, Lakatos Peter Laszlo
Dátum:	2010
ISSN:	0163-2116
Megjegyzések:	Bacterial translocation plays important role in the complications of liver cirrhosis. Antibody formation against various microbial antigens is common in Crohn's disease and considered to be caused by sustained exposure to gut microflora constituents. We hypothesized that anti-microbial antibodies are present in patients with liver cirrhosis and may be associated with the development of bacterial infections. Methodology/Principal Findings: Sera of 676 patients with various chronic liver diseases (autoimmune diseases:266, viral hepatitis C:124, and liver cirrhosis of different etiology:286) and 100 controls were assayed for antibodies to Saccharomyces cerevisiae(ASCA) and to antigens derived from two intestinal bacterial isolates (one gram positive, one gram negative, neither is Escherichia coli). In patients with liver cirrhosis, we also prospectively recorded the development of severe episodes of bacterial infection. ASCA and anti-OMP PlusTM antibodies were present in 38.5% and 62.6% of patients with cirrhosis and in 16% and 20% of controls, respectively (p,0.001). Occurrence of these antibodies was more frequent in cases of advanced cirrhosis (according to Child-Pugh and MELD score; p,0.001) or in the presence of ascites (p,0.001). During the median follow-up of 425 days, 81 patients (28.3%) presented with severe bacterial infections. Anti-microbial antibody titers (p = 0.003), as well as multiple seroreactivity (p = 0.036), was associated with infectious events. In logistic regression analysis, the presence of ascites (OR:1.62, 95%CI:1.16?2.25), co-morbidities (OR:2.22, 95%CI:1.27?3.86), and ASCA positivity (OR:1.59, 95%CI:1.07?2.36) were independent risk factors for severe infections. A shorter time period until the first infection was associated with the presence of ASCA (p = 0.03) and multiple seropositivity (p = 0.037) by Kaplan-Meier analysis, and with Child-Pugh stage (p = 0.018, OR:1.85) and co-morbidities (p,0.001, OR:2.02) by Cox-regression analysis. Conclusions/Significance: The present study suggests that systemic reactivity to microbial components reflects compromised mucosal immunity in patients with liver cirrhosis, further supporting the possible role of bacterial translocation in the formation of anti-microbial antibodies.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Haptoglobin polymorphism Crohn's disease Disease behavior Th1/Th2 orientation Primary sclerosing cholangitis egyetemen (Magyarországon) készült közlemény
Megjelenés:	PloS One. - 5 : 9 (2010), p. e12957-1-e12957-9. -
További szerzők:	Norman, Gary L. Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Földi Ildikó (1981-) (orvos) Udvardy Miklós (1947-) (belgyógyász, haematológus) Shums, Zakera Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Orosz Péter (Miskolc) Lombay Béla Jr. Pár Gabriella Pár Alajos Veres Gábor (1969-2020) (csecsemő- és gyermekgyógyász, gasztroenterológus) Csak Timea Osztovits János Szalay Ferenc (belgyógyász) Lakatos Péter (Semmelweis Egyetem)
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001-es BibID:	BIBFORM034948
Első szerző:	Szalay Ferenc
Cím:	Serum leptin, soluble leptin receptor, free leptin index and bone mineral density in patients with primary biliary cirrhosis / Ferenc Szalay, Aniko Folhoffer, Andrea Horváth, Timea Csak, Gabor Speer, Zsolt Nagy, Peter Lakatos, Csaba Horváth, Andrzej Habior, István Tornai, Peter Laszlo Lakatos
Dátum:	2005
ISSN:	0954-691X
Megjegyzések:	The pathophysiology of osteoporosis in chronic liver diseases is unknown. Recent data suggest that serum leptin is associated with bone mineral density (BMD). In animal studies leptin was found to be a potent inhibitor of bone formation. We investigated the relationship between serum leptin levels, soluble leptin receptor (sOB-R), free leptin index (FLI) and BMD in patients with primary biliary cirrhosis (PBC). PATIENTS AND METHODS: Ninety-four female patients with PBC were included in this study; 122 healthy women served as controls. Serum leptin levels were measured by radioimmunoassay, sOB-R by enzyme-linked immunosorbent assay. BMD was measured by dual energy X-ray absorptiometry in the lumbar spine and femoral neck. RESULTS: Serum leptin was significantly lower in patients with PBC compared with healthy controls. No difference was found between the body mass index (BMI) of patients and controls. There was a strong positive correlation between leptin and BMI. In PBC no association was found between leptin, sOB-R and liver function tests, histological stages or the presence of osteoporosis. Osteoporosis was present in 38 patients. A positive correlation was found between serum leptin and femoral neck z-score even after adjustment for BMI, whereas serum sOB-R correlated inversely with the serum leptin level. There was no difference in FLI between the subgroups of PBC patients according to the stages of the disease. CONCLUSIONS: We found a lower serum leptin level and a higher sOB-R in patients with PBC, which could not be explained by the difference in BMI. As leptin was associated with BMD, it may be hypothesized that leptin is involved in the complex regulation of bone metabolism in PBC.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban free leptin index hepatic osteopathy leptin osteoporosis primary biliary cirrhosis soluble leptin receptor egyetemen (Magyarországon) készült közlemény
Megjelenés:	European Journal Of Gastroenterology & Hepatology. - 17 : 9 (2005), p. 923-928. -
További szerzők:	Folhoffer Anikó Horváth Andrea Csak Timea Speer Gábor Nagy Zsolt (orvos) Lakatos Péter (belgyógyász) Horváth Csaba (mérnök) Habior, Andrzej Tornai István (1954-) (belgyógyász, gasztroenterológus) Lakatos Péter (Semmelweis Egyetem)
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