@article{MTMT:34434496, title = {Discharge protocol in acute pancreatitis: an international survey and cohort analysis}, url = {https://m2.mtmt.hu/api/publication/34434496}, author = {Nagy, Rita and Ocskay, Klementina and Sipos, Zoltán and Szentesi, Andrea Ildikó and Vincze, Áron and Czakó, László and Izbéki, Ferenc and Shirinskaya, Natalia V and Poluektov, Vladimir L and Zolotov, Alexandr N and Zhu, Yin and Xia, Liang and He, Wenhua and Sutton, Robert and Szatmary, Peter and Mukherjee, Rajarshi and Burridge, Isobel Saffron and Wauchope, Emma and Francisco, Elsa and Aparicio, David and Pinto, Bruno and Gomes, António and Nunes, Vitor and Tantau, Vasile Marcel and Sagau, Emanuela Denisa and Tantau, Alina Ioana and Suceveanu, Andra Iulia and Tocia, Cristina and Dumitru, Andrei and Pando, Elizabeth and Alberti, Piero and Cirera, Arturo and Molero, Xavier and Lee, Hong Sik and Jung, Min Kyu and Kim, Eui Joo and Lee, Sanghyub and Rebollo, María Lourdes Ruiz and Nistal, Reyes Busta and Santervas, Sandra Izquierdo and Lesko, Dusan and Soltes, Marek and Radonak, Jozef and Zatorski, Hubert and Małecka-Panas, Ewa and Fabisiak, Adam and Yaroslav, M Susak and Mykhailo, V Maksymenko and Olekcandr, A Tkachenko and Barauskas, Giedrius and Simanaitis, Vytautas and Ignatavicius, Povilas and Jinga, Mariana and Balaban, Vasile-Daniel and Patoni, Cristina and Gong, Liang and Song, Kai and Li, Yunlong and Gonçalves, T Cúrdia and Freitas, Marta and Macedo, Vítor and Vornhuelz, Marlies and Klauss, Sarah and Beyer, Georg and Koksal, Aydin Seref and Tozlu, Mukaddes and Eminler, Ahmet Tarik and Monclús, Nuria Torres and Comas, Eva Pijoan and Oballe, Juan Armando Rodriguez and Nawacki, Łukasz and Głuszek, Stanisław and Rama-Fernández, Alberto and Galego, Marco and de la Iglesia, Daniel and Aykut, Umut Emre and Duman, Deniz Güney and Aslan, Rahmi and Gherbon, Adriana and Deng, Lihui and Huang, Wei and Xia, Qing and Poropat, Goran and Radovan, Anja and Vranić, Luka and Ricci, Claudio and Ingaldi, Carlo and Casadei, Riccardo and Negoi, Ionut and Ciubotaru, Cezar and Iordache, Florin Mihail and Constantinescu, Gabriel and Sandru, Vasile and Altintas, Engin and Balci, Hatice Rizaoglu and Constantino, Júlio and Aveiro, Débora and Pereira, Jorge and Gunay, Suleyman and Misirlioglu Sucan, Seda and Dronov, Oleksiy and Kovalska, Inna and Bush, Nikhil and Rana, Surinder Singh and Chooklin, Serge and Chuklin, Serhii and Saizu, Ionut Adrian and Gheorghe, Cristian and Göltl, Philipp and Hirth, Michael and Mateescu, Radu Bogdan and Papuc, Geanina and Minkov, Georgi Angelov and Enchev, Emil Tihomirov and Mastrangelo, Laura and Jovine, Elio and Chen, Weiwei and Zhu, Quping and Gąsiorowska, Anita and Fabisiak, Natalia and Bezmarevic, Mihailo and Litvin, Andrey and Mottes, Martina Cattani and Choi, Eun Kwang and Bánovčin, Peter and Nosáková, Lenka and Kovacheva-Slavova, Mila Dimitrova and Kchaou, Ali and Tlili, Ahmed and Marino, Marco V and Kusnierz, Katarzyna and Mickevicius, Artautas and Hollenbach, Marcus and Molcan, Pavol and Ioannidis, Orestis and Tokarev, Mark Valerievich and Ince, Ali Tüzün and Semenenko, Ivan Albertovich and Galeev, Shamil and Ramírez-Maldonado, Elena and Sallinen, Ville and Pencik, Petr and Bajor, Judit and Sarlós, Patrícia and Hágendorn, Roland and Gódi, Szilárd and Szabó, Imre and Czimmer, József and Pár, Gabriella and Illés, Anita and Faluhelyi, Nándor and Kanizsai, Péter László and Nagy, Tamás and Mikó, Alexandra and Németh, Balázs and Hamvas, József and Bod, Barnabás and Varga, Márta and Török, Imola and Novák, János and Patai, Árpád and Sümegi, János and Góg, Csaba and Papp, Mária and Erőss, Bálint Mihály and Váncsa, Szilárd and Teutsch, Brigitta and Márta, Katalin and Hegyi, Péter Jenő and Tornai, Tamás and Lázár, Balázs and Hussein, Tamás and Tarján, Dorottya and Lipp, Mónika Bernadett and Kovács, Beáta and Urbán, Orsolya and Fürst, Emese Rita and Tari, Edina and Kocsis, Ibolya and Maurovich-Horvat, Pál and Tihanyi, Balázs and Eperjesi, Orsolya and Kormos, Zita and Deák, Pál Ákos and Párniczky, Andrea and Hegyi, Péter}, doi = {10.1038/s41598-023-48480-z}, journal-iso = {SCI REP}, journal = {SCIENTIFIC REPORTS}, volume = {13}, unique-id = {34434496}, issn = {2045-2322}, abstract = {There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) p < 0.001), and a lower rate of readmission due to recurrent AP episodes (p = 0.005). There was no difference in median discharge CRP level among the international cohorts (p = 0.586). HPSG-protocol resulted in the shortest LOH (6 (5;9) days) and highest median CRP (35.40 (13.78; 68.40) mg/l). Safety was confirmed by the low rate of readmittance (n = 35; 5%). Discharge protocol is necessary in AP. The discharge protocol used in this study is the first clinically proven protocol. Developing and testifying further protocols are needed to better standardize patients' care.}, year = {2023}, eissn = {2045-2322}, orcid-numbers = {Nagy, Rita/0000-0002-2663-4912; Ocskay, Klementina/0000-0001-5848-2506; Sipos, Zoltán/0000-0001-7845-8116; Szentesi, Andrea Ildikó/0000-0003-2097-6927; Vincze, Áron/0000-0003-2217-7686; Czakó, László/0000-0002-6331-0802; Izbéki, Ferenc/0000-0001-7767-4319; Sarlós, Patrícia/0000-0002-5086-9455; Czimmer, József/0000-0001-7831-3523; Kanizsai, Péter László/0000-0001-7896-2857; Nagy, Tamás/0000-0001-5437-1411; Németh, Balázs/0000-0001-5338-7577; Papp, Mária/0000-0003-3662-4010; Erőss, Bálint Mihály/0000-0003-3658-8427; Váncsa, Szilárd/0000-0002-9347-8163; Teutsch, Brigitta/0000-0002-9530-7886; Márta, Katalin/0000-0002-2213-4865; Tari, Edina/0000-0002-8540-0614; Kocsis, Ibolya/0000-0003-3128-2832; Maurovich-Horvat, Pál/0000-0003-0885-736X; Hegyi, Péter/0000-0003-0399-7259} } @article{MTMT:34103678, title = {One in four patients with gastrointestinal bleeding develops shock or hemodynamic instability : A systematic review and meta-analysis}, url = {https://m2.mtmt.hu/api/publication/34103678}, author = {Obeidat, Mahmoud Mohammadnour Suleiman and Teutsch, Brigitta and Rancz, Anett and Tari, Edina and Márta, Katalin and Veres, Dániel and Hosszúfalusi, Nóra and Mihály, Emese and Hegyi, Péter and Erőss, Bálint Mihály}, doi = {10.3748/wjg.v29.i28.4466}, journal-iso = {WORLD J LGASTROENTEROL}, journal = {WORLD JOURNAL OF GASTROENTEROLOGY}, volume = {29}, unique-id = {34103678}, issn = {1007-9327}, abstract = {Hemodynamic instability and shock are associated with untoward outcomes in gastrointestinal bleeding. However, there are no studies in the existing literature on the proportion of patients who developed these outcomes after gastrointestinal bleeding.To determine the pooled event rates in the available literature and specify them based on the bleeding source.The protocol was registered on PROSPERO in advance (CRD42021283258). A systematic search was performed in three databases (PubMed, EMBASE, and CENTRAL) on 14th October 2021. Pooled proportions with 95%CI were calculated with a random-effects model. A subgroup analysis was carried out based on the time of assessment (on admission or during hospital stay). Heterogeneity was assessed by Higgins and Thompson's I2 statistics. The Joanna Briggs Institute Prevalence Critical Appraisal Tool was used for the risk of bias assessment. The Reference Citation Analysis (https://www.referencecitationanalysis.com/) tool was applied to obtain the latest highlight articles.We identified 11589 records, of which 220 studies were eligible for data extraction. The overall proportion of shock and hemodynamic instability in general gastrointestinal bleeding patients was 0.25 (95%CI: 0.17-0.36, I2 = 100%). In non-variceal bleeding, the proportion was 0.22 (95%CI: 0.14-0.31, I2 = 100%), whereas it was 0.25 (95%CI: 0.19-0.32, I2 = 100%) in variceal bleeding. The proportion of patients with colonic diverticular bleeding who developed shock or hemodynamic instability was 0.12 (95%CI: 0.06-0.22, I2 = 90%). The risk of bias was low, and heterogeneity was high in all analyses.One in five, one in four, and one in eight patients develops shock or hemodynamic instability on admission or during hospitalization in the case of non-variceal, variceal, and colonic diverticular bleeding, respectively.}, keywords = {review; statistics; Meta-analysis; shock; Gastrointestinal bleeding; Hemodynamic instability}, year = {2023}, eissn = {2219-2840}, pages = {4466-4480}, orcid-numbers = {Teutsch, Brigitta/0000-0002-9530-7886; Tari, Edina/0000-0002-8540-0614; Márta, Katalin/0000-0002-2213-4865; Veres, Dániel/0000-0002-9687-3556; Hosszúfalusi, Nóra/0000-0002-9469-372X; Mihály, Emese/0000-0003-3046-7341; Hegyi, Péter/0000-0003-0399-7259; Erőss, Bálint Mihály/0000-0003-3658-8427} } @article{MTMT:34072590, title = {Invalidity of Tokyo guidelines in acute biliary pancreatitis : A multicenter cohort analysis of 944 pancreatitis cases}, url = {https://m2.mtmt.hu/api/publication/34072590}, author = {Juhász, Márk Félix and Tóháti, Rebeka and Jászai, Viktória Adrienn and Molnár, Regina and Borbásné Farkas, Kornélia and Czakó, László and Vincze, Áron and Erőss, Bálint Mihály and Szentesi, Andrea Ildikó and Izbéki, Ferenc and Papp, Mária and Hegyi, Péter and Párniczky, Andrea}, doi = {10.1002/ueg2.12402}, journal-iso = {UEG JOURNAL}, journal = {UNITED EUROPEAN GASTROENTEROLOGY JOURNAL}, volume = {11}, unique-id = {34072590}, issn = {2050-6406}, abstract = {There is a noteworthy overlap between the clinical picture of biliary acute pancreatitis (AP) and the 2018 Tokyo guidelines currently used for the diagnosis of cholangitis (AC) and cholecystitis (CC). This can lead to significant antibiotic and endoscopic retrograde cholangiopancreatography (ERCP) overuse.We aimed to assess the on-admission prevalence of AC/CC according to the 2018 Tokyo guidelines (TG18) in a cohort of biliary AP patients, and its association with antibiotic use, ERCP and clinically relevant endpoints.We conducted a secondary analysis of the Hungarian Pancreatic Study Group's prospective multicenter registry of 2195 AP cases. We grouped and compared biliary cases (n = 944) based on the on-admission fulfillment of definite AC/CC according to TG18. Aside from antibiotic use, we evaluated mortality, AC/CC/AP severity, ERCP performance and length of hospitalization. We also conducted a literature review discussing each criteria of the TG18 in the context of AP.27.8% of biliary AP cases fulfilled TG18 for both AC and CC, 22.5% for CC only and 20.8% for AC only. Antibiotic use was high (77.4%). About 2/3 of the AC/CC cases were mild, around 10% severe. Mortality was below 1% in mild and moderate AC/CC patients, but considerably higher in severe cases (12.8% and 21.2% in AC and CC). ERCP was performed in 89.3% of AC cases, common bile duct stones were found in 41.1%.Around 70% of biliary AP patients fulfilled the TG18 for AC/CC, associated with a high rate of antibiotic use. Mortality in presumed mild or moderate AC/CC is low. Each of the laboratory and clinical criteria are commonly fulfilled in biliary AP, single imaging findings are also unspecific-AP specific diagnostic criteria are needed, as the prevalence of AC/CC are likely greatly overestimated. Randomized trials testing antibiotic use are also warranted.}, keywords = {MORTALITY; Antibiotic use; cholangitis; endoscopic retrograde cholangiopancreatography; cholecystitis; ERCP; STONES; Biliary acute pancreatitis; 2018 Tokyo guidelines}, year = {2023}, eissn = {2050-6414}, pages = {767-774}, orcid-numbers = {Molnár, Regina/0009-0009-7067-1647; Borbásné Farkas, Kornélia/0000-0002-5349-6527; Czakó, László/0000-0002-6331-0802; Vincze, Áron/0000-0003-2217-7686; Erőss, Bálint Mihály/0000-0003-3658-8427; Szentesi, Andrea Ildikó/0000-0003-2097-6927; Izbéki, Ferenc/0000-0001-7767-4319; Papp, Mária/0000-0003-3662-4010; Hegyi, Péter/0000-0003-0399-7259; Váncsa, Szilárd/0000-0002-9347-8163; Márta, Katalin/0000-0002-2213-4865; Nagy, Rita/0000-0002-2663-4912; Imrei, Marcell/0000-0003-0175-7462; Maurovich-Horvat, Pál/0000-0003-0885-736X; Doros, Attila/0000-0002-6496-9895; Zubek, László/0000-0003-0583-3290; Gál, János/0000-0001-9160-6478} } @article{MTMT:33864451, title = {Detailed characteristics of post-discharge mortality in acute pancreatitis}, url = {https://m2.mtmt.hu/api/publication/33864451}, author = {Turcsiné Czapári, Dóra and Váradi, Alex and Borbásné Farkas, Kornélia and Nyári, Gergely Róbert and Márta, Katalin and Váncsa, Szilárd and Nagy, Rita and Teutsch, Brigitta and Bunduc, Stefania and Erőss, Bálint Mihály and Czakó, László and Vincze, Áron and Izbéki, Ferenc and Papp, Mária and Merkely, Béla Péter and Szentesi, Andrea Ildikó and Hegyi, Péter}, doi = {10.1053/j.gastro.2023.05.028}, journal-iso = {GASTROENTEROLOGY}, journal = {GASTROENTEROLOGY}, volume = {165}, unique-id = {33864451}, issn = {0016-5085}, abstract = {The in-hospital survival of patients suffering from acute pancreatitis (AP) is 95-98%. However, there is growing evidence that patients discharged after AP may be at risk of serious morbidity and mortality. Here, we aimed to investigate the risk, causes, and predictors of the most severe consequence of the post-AP period: mortality.2,613, well-characterized patients from twenty-five centers were collected and followed by the Hungarian Pancreatic Study Group between 2012 and 2021. A general and a hospital-based population was used as the control group.After an AP episode patients have an approximately three-fold higher incidence rate of mortality than the general population (0.0404vs.0.0130 person-years). First-year mortality after discharge was almost double than in-hospital mortality (5.5%vs.3.5%), with 3.0% occurring in the first 90-day period. Age, comorbidities, and severity were the most significant independent risk factors for death following AP. Furthermore, multivariate analysis identified creatinine, glucose, and pleural fluid on admission as independent risk factors associated with post-discharge mortality. In the first 90-day period, cardiac failure and AP-related sepsis were among the main causes of death following discharge, while cancer-related cachexia and non-AP-related infection were the key causes in the later phase.Almost as many patients in our cohort die in the first 90-day period after discharge as during their hospital stay. Evaluation of cardiovascular status, follow-up of local complications, and cachexia-preventing oncological care should be an essential part of post-AP patient care. Future study protocols in AP must include at least a 90-day follow-up period after discharge.}, year = {2023}, eissn = {1528-0012}, pages = {682-695}, orcid-numbers = {Váradi, Alex/0000-0001-8229-6340; Borbásné Farkas, Kornélia/0000-0002-5349-6527; Márta, Katalin/0000-0002-2213-4865; Váncsa, Szilárd/0000-0002-9347-8163; Nagy, Rita/0000-0002-2663-4912; Teutsch, Brigitta/0000-0002-9530-7886; Erőss, Bálint Mihály/0000-0003-3658-8427; Czakó, László/0000-0002-6331-0802; Vincze, Áron/0000-0003-2217-7686; Izbéki, Ferenc/0000-0001-7767-4319; Papp, Mária/0000-0003-3662-4010; Merkely, Béla Péter/0000-0001-6514-0723; Szentesi, Andrea Ildikó/0000-0003-2097-6927; Hegyi, Péter/0000-0003-0399-7259; Imrei, Marcell/0000-0003-0175-7462; Németh, Balázs/0000-0001-5338-7577; Tiszlavicz, László/0000-0003-1134-6587; Oláh, Orsolya/0000-0002-5731-4030; Vitális, Zsuzsanna/0000-0001-8198-5312; Doros, Attila/0000-0002-6496-9895} } @article{MTMT:33807171, title = {Polymorphic variants involved in methylation regulation : a strategy to discover risk loci for pancreatic ductal adenocarcinoma}, url = {https://m2.mtmt.hu/api/publication/33807171}, author = {Corradi, Chiara and Lencioni, Giulia and Gentiluomo, Manuel and Felici, Alessio and Latiano, Anna and Kiudelis, Gediminas and van Eijck, Casper H J and Márta, Katalin and Lawlor, Rita T and Tavano, Francesca and Boggi, Ugo and Dijk, Frederike and Cavestro, Giulia Martina and Vermeulen, Roel C H and Hackert, Thilo and Petrone, Maria Chiara and Uzunoğlu, Faik Güntac and Archibugi, Livia and Izbicki, Jakob R and Morelli, Luca and Zerbi, Alessandro and Landi, Stefano and Stocker, Hannah and Talar-Wojnarowska, Renata and Di Franco, Gregorio and Hegyi, Péter and Sperti, Cosimo and Carrara, Silvia and Capurso, Gabriele and Gazouli, Maria and Brenner, Hermann and Bunduc, Stefania and Busch, Olivier and Perri, Francesco and Oliverius, Martin and Hegyi, Péter Jenő and Goetz, Mara and Scognamiglio, Pasquale and Mambrini, Andrea and Arcidiacono, Paolo Giorgio and Kreivenaite, Edita and Kupcinskas, Juozas and Hussein, Tamás and Ermini, Stefano and Milanetto, Anna Caterina and Vodicka, Pavel and Kiudelis, Vytautas and Hlaváč, Viktor and Soucek, Pavel and Theodoropoulos, George E and Basso, Daniela and Neoptolemos, John P and Nóbrega Aoki, Mateus and Pezzilli, Raffaele and Pasquali, Claudio and Chammas, Roger and Testoni, Sabrina Gloria Giulia and Mohelnikova-Duchonova, Beatrice and Lucchesi, Maurizio and Rizzato, Cosmeri and Canzian, Federico and Campa, Daniele}, doi = {10.1136/jmg-2022-108910}, journal-iso = {JMG}, journal = {JOURNAL OF MEDICAL GENETICS}, volume = {60}, unique-id = {33807171}, issn = {0022-2593}, abstract = {Only a small number of risk factors for pancreatic ductal adenocarcinoma (PDAC) has been established. Several studies identified a role of epigenetics and of deregulation of DNA methylation. DNA methylation is variable across a lifetime and in different tissues; nevertheless, its levels can be regulated by genetic variants like methylation quantitative trait loci (mQTLs), which can be used as a surrogate.We scanned the whole genome for mQTLs and performed an association study in 14 705 PDAC cases and 246 921 controls. The methylation data were obtained from whole blood and pancreatic cancer tissue through online databases. We used the Pancreatic Cancer Cohort Consortium and the Pancreatic Cancer Case-Control Consortium genome-wide association study (GWAS) data as discovery phase and the Pancreatic Disease Research consortium, the FinnGen project and the Japan Pancreatic Cancer Research consortium GWAS as replication phase.The C allele of 15q26.1-rs12905855 showed an association with a decreased risk of PDAC (OR=0.90, 95% CI 0.87 to 0.94, p=4.93×10-8 in the overall meta-analysis), reaching genome-level statistical significance. 15q26.1-rs12905855 decreases the methylation of a 'C-phosphate-G' (CpG) site located in the promoter region of the RCCD1 antisense (RCCD1-AS1) gene which, when expressed, decreases the expression of the RCC1 domain-containing (RCCD1) gene (part of a histone demethylase complex). Thus, it is possible that the rs12905855 C-allele has a protective role in PDAC development through an increase of RCCD1 gene expression, made possible by the inactivity of RCCD1-AS1.We identified a novel PDAC risk locus which modulates cancer risk by controlling gene expression through DNA methylation.}, keywords = {GENETICS; Genetic Variation; Molecular Epidemiology; DNA methylation; Germ-Line Mutation}, year = {2023}, eissn = {1468-6244}, pages = {980-986}, orcid-numbers = {Márta, Katalin/0000-0002-2213-4865; Hegyi, Péter/0000-0003-0399-7259} } @article{MTMT:33761635, title = {Metabolic-associated fatty liver disease is associated with acute pancreatitis with more severe course : Post hoc analysis of a prospectively collected international registry}, url = {https://m2.mtmt.hu/api/publication/33761635}, author = {Váncsa, Szilárd and Sipos, Zoltán and Váradi, Alex and Nagy, Rita and Ocskay, Klementina and Juhász, Márk Félix and Márta, Katalin and Teutsch, Brigitta and Mikó, Alexandra and Hegyi, Péter Jenő and Vincze, Áron and Izbéki, Ferenc and Czakó, László and Papp, Mária and Hamvas, József and Varga, Márta and Török, Imola and Mickevicius, Artautas and Erőss, Bálint Mihály and Párniczky, Andrea and Szentesi, Andrea Ildikó and Pár, Gabriella and Hegyi, Péter}, doi = {10.1002/ueg2.12389}, journal-iso = {UEG JOURNAL}, journal = {UNITED EUROPEAN GASTROENTEROLOGY JOURNAL}, volume = {11}, unique-id = {33761635}, issn = {2050-6406}, abstract = {Non-alcoholic fatty liver disease (NAFLD) is a proven risk factor for acute pancreatitis (AP). However, NAFLD has recently been redefined as metabolic-associated fatty liver disease (MAFLD). In this post hoc analysis, we quantified the effect of MAFLD on the outcomes of AP.We identified our patients from the multicentric, prospective International Acute Pancreatitis Registry of the Hungarian Pancreatic Study Group. Next, we compared AP patients with and without MAFLD and the individual components of MAFLD regarding in-hospital mortality and AP severity based on the revised Atlanta classification. Lastly, we calculated odds ratios (ORs) with 95% confidence intervals (CIs) using multivariate logistic regression analysis.MAFLD had a high prevalence in AP, 39% (801/2053). MAFLD increased the odds of moderate-to-severe AP (OR = 1.43, CI: 1.09-1.89). However, the odds of in-hospital mortality (OR = 0.89, CI: 0.42-1.89) and severe AP (OR = 1.70, CI: 0.97-3.01) were not higher in the MAFLD group. Out of the three diagnostic criteria of MAFLD, the highest odds of severe AP was in the group based on metabolic risk abnormalities (OR = 2.68, CI: 1.39-5.09). In addition, the presence of one, two, and three diagnostic criteria dose-dependently increased the odds of moderate-to-severe AP (OR = 1.23, CI: 0.88-1.70, OR = 1.38, CI: 0.93-2.04, and OR = 3.04, CI: 1.63-5.70, respectively) and severe AP (OR = 1.13, CI: 0.54-2.27, OR = 2.08, CI: 0.97-4.35, and OR = 4.76, CI: 1.50-15.4, respectively). Furthermore, in patients with alcohol abuse and aged ≥60 years, the effect of MAFLD became insignificant.MAFLD is associated with AP severity, which varies based on the components of its diagnostic criteria. Furthermore, MAFLD shows a dose-dependent effect on the outcomes of AP.}, keywords = {MORTALITY; Prognosis; metabolic syndrome; SEVERITY; Acute pancreatitis; STEATOSIS; Non-Alcoholic Fatty Liver Disease; NAFLD; MAFLD; Metabolic-associated fatty liver disease}, year = {2023}, eissn = {2050-6414}, pages = {371-382}, orcid-numbers = {Váncsa, Szilárd/0000-0002-9347-8163; Sipos, Zoltán/0000-0001-7845-8116; Váradi, Alex/0000-0001-8229-6340; Nagy, Rita/0000-0002-2663-4912; Ocskay, Klementina/0000-0001-5848-2506; Márta, Katalin/0000-0002-2213-4865; Teutsch, Brigitta/0000-0002-9530-7886; Vincze, Áron/0000-0003-2217-7686; Izbéki, Ferenc/0000-0001-7767-4319; Czakó, László/0000-0002-6331-0802; Papp, Mária/0000-0003-3662-4010; Erőss, Bálint Mihály/0000-0003-3658-8427; Szentesi, Andrea Ildikó/0000-0003-2097-6927; Hegyi, Péter/0000-0003-0399-7259; Imrei, Marcell/0000-0003-0175-7462; Németh, Balázs/0000-0001-5338-7577; Maurovich-Horvat, Pál/0000-0003-0885-736X; Doros, Attila/0000-0002-6496-9895; Zubek, László/0000-0003-0583-3290; Gál, János/0000-0001-9160-6478; Tari, Edina/0000-0002-8540-0614} } @article{MTMT:33636629, title = {Suprapapillary Biliary Stents Have Longer Patency Times than Transpapillary Stents-A Systematic Review and Meta-Analysis.}, url = {https://m2.mtmt.hu/api/publication/33636629}, author = {Kovács, Norbert and Pécsi, Dániel and Sipos, Zoltán and Borbásné Farkas, Kornélia and Földi, Mária and Hegyi, Péter and Bajor, Judit and Erőss, Bálint Mihály and Márta, Katalin and Mikó, Alexandra and Rakonczay, Zoltán and Sarlós, Patrícia and Ábrahám, Szabolcs and Vincze, Áron}, doi = {10.3390/jcm12030898}, journal-iso = {J CLIN MED}, journal = {JOURNAL OF CLINICAL MEDICINE}, volume = {12}, unique-id = {33636629}, abstract = {Endoscopic biliary stent placement is a minimally invasive intervention for patients with biliary strictures. Stent patency and function time are crucial factors. Suprapapillary versus transpapillary stent positioning may contribute to stent function time, so a meta-analysis was performed in this comparison.A comprehensive literature search was conducted in the CENTRAL, Embase, and MEDLINE databases to find data on suprapapillary stent placement compared to the transpapillary method via endoscopic retrograde cholangiopancreatography in cases of biliary stenosis of any etiology and any stent type until December 2020. We carried out a meta-analysis focusing on the following outcomes: stent patency, stent migration, rate of cholangitis and pancreatitis, and other reported complications.Three prospective and ten retrospective studies involving 1028 patients were included. Suprapapillary stent placement appeared to be superior to transpapillary stent positioning in patency (weighted mean difference = 50.23 days, 95% CI: 8.56, 91.98; p = 0.0.018). In a subgroup analysis of malignant indications, suprapapillary positioning showed a lower rate of cholangitis (OR: 0.34, 95% CI: 0.13, 0.93; p = 0.036). Another subgroup analysis investigating metal stents in a suprapapillary position resulted in a lower rate of pancreatitis (OR: 0.16, 95% CI: 0.03, 0.95; p = 0.043) compared to transpapillary stent placement. There was no difference in stent migration rates between the two groups (OR: 0.67, 95% CI: 0.17, 2.72; p = 0.577).Based on our results, suprapapillary biliary stenting has longer stent patency. Moreover, the stent migration rate did not differ between the suprapapillary and transpapillary groups.}, keywords = {endoscopy; Stent; ERCP; intraductal; inside}, year = {2023}, eissn = {2077-0383}, orcid-numbers = {Pécsi, Dániel/0000-0003-0499-6004; Sipos, Zoltán/0000-0001-7845-8116; Borbásné Farkas, Kornélia/0000-0002-5349-6527; Hegyi, Péter/0000-0003-0399-7259; Erőss, Bálint Mihály/0000-0003-3658-8427; Márta, Katalin/0000-0002-2213-4865; Rakonczay, Zoltán/0000-0002-1499-3416; Sarlós, Patrícia/0000-0002-5086-9455; Ábrahám, Szabolcs/0000-0002-2191-1714; Vincze, Áron/0000-0003-2217-7686} } @article{MTMT:32127261, title = {Increased risk of adverse events in patients with low-on clopidogrel platelet reactivity after percutaneous coronary intervention : A systematic review and meta-analysis}, url = {https://m2.mtmt.hu/api/publication/32127261}, author = {Bálint, Alexandra and Hanák, Lilla and Hegyi, Péter and Szakács, Zsolt and Eitmann, Szimonetta and Garami, András and Varjú-Solymár, Margit and Márta, Katalin and Rumbus, Zoltán and Komócsi, András}, doi = {10.5603/CJ.a2021.0084}, journal-iso = {CARDIOL J}, journal = {CARDIOLOGY JOURNAL}, volume = {30}, unique-id = {32127261}, issn = {1897-5593}, abstract = {Clinical evidence has been controversial regarding the influence of low platelet reactivity (LPR), ischemic and bleeding outcomes among patients receiving coronary stent implantation. Hence, the present study performed a meta-analysis to systematically evaluate the significance of LPR on adverse cardiovascular events.MEDLINE, EMBASE and CENTRAL databases were searched up to November 2020 for relevant studies including patients with acute coronary syndrome undergoing percutaneous coronary intervention. LPR was the exposed arm while the non-LPR group represented the control. The primary outcome of interest was bleeding risk including major and minor bleeding events. Secondary outcomes included all-cause mortality, repeated revascularization, nonfatal myocardial infarction, and stent thrombosis. Study-level outcomes were evaluated in random-effect models.A total of 20 studies with 19,064 patients were included. Pooled analysis showed that LPR was associated with an increased bleeding risk (relative risk [RR] 2.80, 95% confidence interval [CI] 1.95-4.02, p < 0.01). Patients with LPR had a lower risk of non-fatal myocardial infarction (RR 0.59, 95% CI 0.38-0.91, p < 0.05) and of serious vascular events (RR 0.50, 95% CI 0.30-0.84, p < 0.01).LPR is associated with an increased bleeding risk of patients who underwent coronary stent implantation. The results suggest possible benefits of this marker in risk stratification, with potential improvement in risk prediction. There are potential advantages using combinations with other factors in prediction models, however, they require further study. PROSPERO registration number: CRD42019136393).}, keywords = {percutaneous coronary intervention; Clopidogrel; acute coronary syndrome; Bleeding risk; Low platelet reactivity}, year = {2023}, eissn = {1898-018X}, pages = {391-400}, orcid-numbers = {Bálint, Alexandra/0000-0002-7267-8633; Hegyi, Péter/0000-0003-0399-7259; Szakács, Zsolt/0000-0002-7035-941X; Garami, András/0000-0003-2493-0571; Varjú-Solymár, Margit/0000-0001-6667-6263; Márta, Katalin/0000-0002-2213-4865} } @article{MTMT:32865751, title = {EASY-APP: An artificial intelligence model and application for early and easy prediction of severity in acute pancreatitis}, url = {https://m2.mtmt.hu/api/publication/32865751}, author = {Kui, Balázs and Pintér, József and Molontay, Roland and Nagy, Marcell and Borbásné Farkas, Kornélia and Gede, Noémi and Vincze, Áron and Bajor, Judit and Gódi, Szilárd and Czimmer, József and Szabó, Imre and Illés, Anita and Sarlós, Patrícia and Hágendorn, Roland and Pár, Gabriella and Papp, Mária and Vitális, Zsuzsanna and Kovács, György and Fehér, Eszter and Földi, Ildikó and Izbéki, Ferenc and Gajdán, László and Fejes, Roland and Németh, Balázs and Török, Imola and Farkas, Hunor and Mickevicius, Artautas and Sallinen, Ville and Galeev, Shamil and Ramírez-Maldonado, Elena and Párniczky, Andrea and Erőss, Bálint Mihály and Hegyi, Péter Jenő and Márta, Katalin and Váncsa, Szilárd and Sutton, Robert and Szatmary, Peter and Latawiec, Diane and Halloran, Chris and de-Madaria, Enrique and Pando, Elizabeth and Alberti, Piero and Gómez-Jurado, Maria José and Tantau, Alina and Szentesi, Andrea Ildikó and Hegyi, Péter}, doi = {10.1002/ctm2.842}, journal-iso = {CLIN TRANSL MED}, journal = {CLINICAL AND TRANSLATIONAL MEDICINE}, volume = {12}, unique-id = {32865751}, issn = {2001-1326}, abstract = {Acute pancreatitis (AP) is a potentially severe or even fatal inflammation of the pancreas. Early identification of patients at high risk for developing a severe course of the disease is crucial for preventing organ failure and death. Most of the former predictive scores require many parameters or at least 24 h to predict the severity; therefore, the early therapeutic window is often missed.The early achievable severity index (EASY) is a multicentre, multinational, prospective and observational study (ISRCTN10525246). The predictions were made using machine learning models. We used the scikit-learn, xgboost and catboost Python packages for modelling. We evaluated our models using fourfold cross-validation, and the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), and accuracy metrics were calculated on the union of the test sets of the cross-validation. The most critical factors and their contribution to the prediction were identified using a modern tool of explainable artificial intelligence called SHapley Additive exPlanations (SHAP).The prediction model was based on an international cohort of 1184 patients and a validation cohort of 3543 patients. The best performing model was an XGBoost classifier with an average AUC score of 0.81 ± 0.033 and an accuracy of 89.1%, and the model improved with experience. The six most influential features were the respiratory rate, body temperature, abdominal muscular reflex, gender, age and glucose level. Using the XGBoost machine learning algorithm for prediction, the SHAP values for the explanation and the bootstrapping method to estimate confidence, we developed a free and easy-to-use web application in the Streamlit Python-based framework (http://easy-app.org/).The EASY prediction score is a practical tool for identifying patients at high risk for severe AP within hours of hospital admission. The web application is available for clinicians and contributes to the improvement of the model.}, keywords = {Artificial intelligence; Acute pancreatitis; severity prediction}, year = {2022}, eissn = {2001-1326}, orcid-numbers = {Molontay, Roland/0000-0002-0666-5279; Borbásné Farkas, Kornélia/0000-0002-5349-6527; Vincze, Áron/0000-0003-2217-7686; Czimmer, József/0000-0001-7831-3523; Sarlós, Patrícia/0000-0002-5086-9455; Papp, Mária/0000-0003-3662-4010; Vitális, Zsuzsanna/0000-0001-8198-5312; Izbéki, Ferenc/0000-0001-7767-4319; Németh, Balázs/0000-0001-5338-7577; Erőss, Bálint Mihály/0000-0003-3658-8427; Márta, Katalin/0000-0002-2213-4865; Váncsa, Szilárd/0000-0002-9347-8163; Szentesi, Andrea Ildikó/0000-0003-2097-6927; Hegyi, Péter/0000-0003-0399-7259} } @article{MTMT:32849790, title = {In-Hospital Patient Education Markedly Reduces Alcohol Consumption after Alcohol-Induced Acute Pancreatitis.}, url = {https://m2.mtmt.hu/api/publication/32849790}, author = {Nagy, Rita and Ocskay, Klementina and Váradi, Alex and Papp, Mária and Vitális, Zsuzsanna and Izbéki, Ferenc and Boros, Eszter and Gajdán, László and Szentesi, Andrea Ildikó and Erőss, Bálint Mihály and Hegyi, Péter Jenő and Vincze, Áron and Bajor, Judit and Sarlós, Patrícia and Mikó, Alexandra and Márta, Katalin and Pécsi, Dániel and Párniczky, Andrea and Hegyi, Péter}, doi = {10.3390/nu14102131}, journal-iso = {NUTRIENTS}, journal = {NUTRIENTS}, volume = {14}, unique-id = {32849790}, abstract = {Although excessive alcohol consumption is by far the most frequent cause of recurrent acute pancreatitis (AP) cases, specific therapy is still not well established to prevent recurrence. Generally, psychological therapy (e.g., brief intervention (BI)) is the cornerstone of cessation programs; however, it is not yet widely used in everyday practice. We conducted a post-hoc analysis of a prospectively collected database. Patients suffering from alcohol-induced AP between 2016 and 2021 received 30 min BI by a physician. Patient-reported alcohol consumption, serum gamma-glutamyl-transferase (GGT) level, and mean corpuscular volume (MCV) of red blood cells were collected on admission and at the 1-month follow-up visit to monitor patients' drinking habits. Ninety-nine patients with alcohol-induced AP were enrolled in the study (mean age: 50 ± 11, 89% male). A significant decrease was detected both in mean GGT value (294 ± 251 U/L vs. 103 ± 113 U/L, p < 0.001) and in MCV level (93.7 ± 5.3 U/L vs. 92.1 ± 5.1 U/L, p < 0.001) in patients with elevated on-admission GGT levels. Notably, 79% of the patients (78/99) reported alcohol abstinence at the 1-month control visit. Brief intervention is an effective tool to reduce alcohol consumption and to prevent recurrent AP. Longitudinal randomized clinical studies are needed to identify the adequate structure and frequency of BIs in alcohol-induced AP.}, keywords = {Recurrence; ALCOHOL; Acute pancreatitis; Brief intervention; gamma-glutamyl transferase}, year = {2022}, eissn = {2072-6643}, orcid-numbers = {Nagy, Rita/0000-0002-2663-4912; Ocskay, Klementina/0000-0001-5848-2506; Váradi, Alex/0000-0001-8229-6340; Papp, Mária/0000-0003-3662-4010; Vitális, Zsuzsanna/0000-0001-8198-5312; Szentesi, Andrea Ildikó/0000-0003-2097-6927; Erőss, Bálint Mihály/0000-0003-3658-8427; Vincze, Áron/0000-0003-2217-7686; Sarlós, Patrícia/0000-0002-5086-9455; Márta, Katalin/0000-0002-2213-4865; Pécsi, Dániel/0000-0003-0499-6004; Hegyi, Péter/0000-0003-0399-7259} }