TY - JOUR AU - Juszt, Janka AU - Benedek, Noémi AU - Mohay, Gabriella AU - Herbert, Zsuzsanna AU - Győri, Ádám AU - Mosdósi, Bernadett TI - A gyermekkori hátfájdalom hátterében álló ritka kórkép: krónikus nem bakteriális osteomyelitis JF - ORVOSI HETILAP J2 - ORV HETIL VL - 165 PY - 2024 IS - 15 SP - 595 EP - 600 PG - 6 SN - 0030-6002 DO - 10.1556/650.2024.33021 UR - https://m2.mtmt.hu/api/publication/34804163 ID - 34804163 N1 - Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, József A. u. 7. Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Orvosi Képalkotó Klinika Pécs Magyarország Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ Export Date: 29 April 2024 LA - Hungarian DB - MTMT ER - TY - JOUR AU - Simon, Gábor AU - Angyal, Miklós AU - Dérczy, Katalin AU - Heckmann, Veronika TI - Egy büntetlenül maradt gyermekbántalmazás tanulságai JF - ORVOSI HETILAP J2 - ORV HETIL VL - 165 PY - 2024 IS - 14 SP - 553 EP - 559 PG - 7 SN - 0030-6002 DO - 10.1556/650.2024.33005 UR - https://m2.mtmt.hu/api/publication/34774906 ID - 34774906 N1 - Pécsi Tudományegyetem, Általános Orvostudományi Kar, Szigeti u. 12. 2 Baranya Vármegyei Rendőr-főkapitányság Pécs Magyarország Pécsi Tudományegyetem, Klinikai Központ, Orvosi Képalkotó Klinika Pécs Magyarország Export Date: 22 April 2024 AB - Magyarországon évente kb. 2000–2500, fizikailag bántalmazott gyermek kerül a gyermekjóléti szolgálatok látókörébe, a felderítetlen esetek száma azonban ennek a többszöröse is lehet. A testi sérüléssel vagy súlyos elhanyagolással járó eseteket gyakran az egészségügyi szolgáltatók látják elsőként, illetve sokszor egyedüliként. Az egészségügyi dolgozók jelzési hajlandósága kicsi, jelentési kötelezettségüknek gyakran nem tesznek eleget. Esetbemutatásunkkal – a jelentési kötelezettség elmulasztásának következményein túl – a jelzés prevenciós szerepére szeretnénk felhívni a figyelmet. A másfél éves leánygyermeket nevelőanyja vitte a helyi fogorvosi rendelőbe eszméletlen állapotban, étel félrenyelésére hivatkozva. A gyermeknél állapotromlást követően újraélesztés vált szükségessé, azután kórházi felvételre került sor. Ápolása alatt a gyermek végig agyhalálnak megfelelő állapotban volt. Felvételekor kétoldali homloktáji és többszörös mellkasi haematomát rögzítettek, a CT-vizsgálat agyödémát, valamint kétszeres koponyacsonttörést írt le. A gyermek az ápolása 6. napján elhunyt. Az esetnek a hatóság felé történő jelzése sem a gyermek ellátása során, sem a halál bekövetkeztekor nem történt meg. A kórboncolás során a két, különböző keletkezési idejű koponyacsonttörés mellett kemény burok alatti vérzés igazolódott. Az esetet követően 9 évvel történt meg a bejelentés a hatóság felé. A nyomozás megállapította, hogy a kislány halálához idegen kezű fejsérülés vezetett, melyet a nevelőszülők kiskorú fiúgyermeke okozott, aki azonban az elkövetéskori életkora miatt nem volt büntethető. A nevelőanya tekintetében felmerülő bűncselekmény az eljárás idejére elévült, így a nevelőanya büntetőjogi felelősségre vonása is elmaradt. Az eset rávilágít arra, hogy más szakterületeken is szükséges lenne az igazságügyi orvostani ismeretek erősítése, a legideálisabb megoldást azonban kétségtelenül a klinikai igazságügyi orvostannak a hazai klinikai gyakorlatba történő bevezetése jelenthetné. Orv Hetil. 2024; 165(14): 553–559. LA - Hungarian DB - MTMT ER - TY - JOUR AU - Naidoo, P. AU - Botz, Bálint TI - Evaluation of the cardiopulmonary size on slot-scanning full-spine radiographs JF - IMAGING J2 - IMAGING PY - 2024 SN - 2732-0960 DO - 10.1556/1647.2024.00180 UR - https://m2.mtmt.hu/api/publication/34756435 ID - 34756435 N1 - Export Date: 27 March 2024 LA - English DB - MTMT ER - TY - JOUR AU - Borbély, Ruben Zsolt AU - Szalai, Eszter AU - Philip, Bryan Mangalath AU - Dobszai, Dalma AU - Teutsch, Brigitta AU - Zolcsák, Ádám AU - Veres, Dániel AU - Erőss, Bálint Mihály AU - Gellért, Bálint AU - Hegyi, Péter Jenő AU - Hegyi, Péter AU - Faluhelyi, Nándor TI - The risk of developing splanchnic vein thrombosis in acute pancreatitis increases 3 days after symptom onset: A systematic review and meta-analysis JF - UNITED EUROPEAN GASTROENTEROLOGY JOURNAL J2 - UEG JOURNAL PY - 2024 SN - 2050-6406 DO - 10.1002/ueg2.12550 UR - https://m2.mtmt.hu/api/publication/34682498 ID - 34682498 N1 - Export Date: 25 April 2024 Correspondence Address: Hegyi, P.; MAE Institute of Pancreatic Diseases, Tömő utca 25-29, Hungary; email: hegyi2009@gmail.com AB - Abstract Background Splanchnic vein thrombosis is a complication of acute pancreatitis (AP) and is likely often underdiagnosed. Objectives We aimed to understand the time course and risk factors of splanchnic vein thrombosis in the early phase of AP. Methods A systematic search was conducted using the PRISMA guidelines (PROSPERO registration CRD42022367578). Inclusion criteria were appropriate imaging techniques in adult AP patients, studies that reported splanchnic vein thrombosis data from the early phase, and reliable information on the timing of imaging in relation to the onset of pancreatitis symptoms or hospital admission. The proportion of patients with thrombosis with 95% confidence intervals (CI) was calculated using random-effects meta-analyses, and multiple subgroup analyses were performed. Results Data from 1951 patients from 14 studies were analyzed. The proportion of patients with splanchnic vein thrombosis within 12 days after symptom onset was 0.13 (CI 0.07?0.23). The occurrence was lowest at 0.06 (CI 0.03?0.1) between 0 and 3 days after symptom onset, and increased fourfold to 0.23 (CI 0.16?0.31) between 3 and 11 days. On hospital admission, the proportion of patients affected was 0.12 (CI 0.02?0.49); it was 0.17 (CI 0.03?0.58) 1?5 days after admission. The prevalence in mild, moderate, and severe AP was 0.15 (CI 0.05?0.36), 0.26 (CI 0.15?0.43), and 0.27 (CI 0.17?0.4), respectively. Alcoholic etiology (0.31, CI 0.13?0.58) and pancreatic necrosis (0.55, CI 0.29?0.78, necrosis above 30%) correlated with increased SVT prevalence. Conclusion The risk of developing splanchnic vein thrombosis is significant in the early stages of AP and may affect up to a quarter of patients. Alcoholic etiology, pancreatic necrosis, and severity may increase the prevalence of splanchnic vein thrombosis. LA - English DB - MTMT ER - TY - JOUR AU - Magyari, Balázs AU - Kittka, Bálint AU - Goják, Ilona AU - Schönfeld, Kristóf AU - Szapáry, László Botond AU - Simon, Mihály AU - Kiss, Rudolf AU - Bertalan, Andrea AU - Várady, Edit AU - Gyimesi, András AU - Szokodi, István AU - Horváth, Iván TI - Learning Curve for Starting a Successful Single-Centre TAVR Programme with Multiple Devices: Early and Mid-Term Follow-Up JF - JOURNAL OF CLINICAL MEDICINE J2 - J CLIN MED VL - 13 PY - 2024 IS - 4 PG - 18 SN - 2077-0383 DO - 10.3390/jcm13041088 UR - https://m2.mtmt.hu/api/publication/34609144 ID - 34609144 N1 - Heart Institute, Medical School, University of Pécs, Pécs, 7624, Hungary Szentágothai Research Centre, University of Pécs, Pécs, 7624, Hungary Department of Medical Imaging, Medical School, University of Pécs, Pécs, 7624, Hungary EconNet Research Group, Faculty of Business and Economics, University of Pécs, Pécs, 7624, Hungary Export Date: 11 March 2024 Correspondence Address: Magyari, B.; Heart Institute, Hungary; email: magyari.balazs@pte.hu AB - We report 30-day, 1-year, and 3-year outcomes for a new TAVR programme that used five different transcatheter heart valve (THV) systems. Methods: From 2014 to 2020, 122 consecutive patients with severe aortic stenosis (AS) received TAVR based on the Heart Team decision. Outcomes were analysed for the whole study population and in addition the first 63 patients (Cohort A, 2014 to 2019) were compared to the last 59 patients (Cohort B, 2019 to 2020). Outcomes included VARC-2 definitions and device performance assessed via transthoracic echocardiography by independent high-volume investigators. Results: The mean patient age was 77.9 ± 6.1 years old, and 48 (39.3%) were male. The mean logistic Euroscore II was 4.2 ± 4.5, and the mean STS score was 6.9 ± 4.68. The systems used were as follows: Medtronic Corevalve Evolute R/PRO (82 patients—67.2%); Abbott Portico (13—10.6%); Boston Scientific Lotus (10—8.2%); Meril Myval (11—9%); and Boston Scientific Neo Accurate (6—5%). Access was transfemoral (95.9% of patients); surgical cut down (18% vs. percutaneous 77.8%); subclavian (n = 2); trans-axillary (n = 2); and direct aorta (n = 1). VARC-2 outcomes were as follows: device success rate 97.5%; stroke rate 1.6%; major vascular complication 3.3%; permanent pacemaker implantation 12.4%. At discharge, the incidences of grade I and II aortic regurgitation were 39.95 and 55.5%, respectively. At one year, all-cause mortality was 7.4% without admissions for valve-related dysfunction. The 3-year all-cause mortality and all-stroke rates were 22.9% and 4.1%, respectively. Between the 1-year and 3-year follow-ups, valve-related dysfunction was detected in three patients; one had THV system endocarditis that led to death. There was a remarkable but statistically non-significant decrease in mortality from Cohort A to Cohort B [four (6.3%) vs. one patient (1.7%), p = 0.195] and major vascular complications occurred at a significantly higher rate in the Cohort B [zero (0%) vs. four (6.8% patient, p = 0.036)]. Overall, we found that using multiple devices was safe and allowed for a learning team to achieve a high device success rate from the beginning (97.5%). Conclusions: TAVR with different THV systems showed acceptable early and mid-term outcomes for survival, technical success, and valve-related adverse events in high-risk patients with significant AS, even in the learning curve phase. LA - English DB - MTMT ER - TY - JOUR AU - Járay, Ákos AU - Farkas, Péter István AU - Semjén, Dávid AU - Botz, Bálint TI - The Predictive Power of Bosniak 3 and 4 Cystic Renal Lesion Categorization Using Contrast-Enhanced Ultrasound JF - JOURNAL OF ULTRASOUND IN MEDICINE J2 - J ULTRAS MED VL - 43 PY - 2024 IS - 5 SP - 933 EP - 949 PG - 17 SN - 0278-4297 DO - 10.1002/jum.16424 UR - https://m2.mtmt.hu/api/publication/34561498 ID - 34561498 AB - Contrast-enhanced ultrasound (CEUS) is increasingly utilized for the noninvasive assessment of renal cystic lesions, using the Bosniak grading system. Bosniak 3-4 lesions require surgical referral, which allows correlation with the histopathological outcome.In this single-center, retrospective study we evaluated renal CEUS exams conducted with SonoVue® with a diagnosis of a Bosniak 3 or 4 lesion between 2019 and 2022. A total of 49 patients and 50 lesions met the inclusion criteria, 31 lesions had available histopathological results. Patient demographics, cyst morphology, and dominant imaging features were registered. The histopathological diagnosis was considered a reference standard.Positive predictive power (PPV) for neoplastic lesions was comparable in the Bosniak 3 and 4 categories (75 vs 93.3%, P = .33), while PPV for histopathologically malignant lesion was considerably higher in the latter group (25 vs 93.33%, P = .0002). None of the lesions which had vividly enhancing thin septa as their dominant CEUS feature were malignant. Oncocytoma, multilocular cystic renal neoplasm of low malignant potential, and cystic nephroma were the major benign entities among Bosniak 3 lesions. Localized cystic kidney disease and hemorrhagic cysts were found to be the primary mimickers leading to false positive imaging findings.CEUS has a high predictive power for malignancy in the Bosniak 4 category, which is not maintained in the Bosniak 3 group due to the large proportion of benign lesions. Adherence to rigorous rule-in criteria and active surveillance strategies need to be considered for equivocal CEUS Bosniak 3 lesions. LA - English DB - MTMT ER - TY - JOUR AU - Tarján, Dorottya AU - Szalai, Eszter AU - Lipp, Mónika Bernadett AU - Verbói, Máté AU - Kói, Tamás AU - Erőss, Bálint Mihály AU - Teutsch, Brigitta AU - Faluhelyi, Nándor AU - Hegyi, Péter AU - Mikó, Alexandra TI - Persistently High Procalcitonin and C-Reactive Protein Are Good Predictors of Infection in Acute Necrotizing Pancreatitis: A Systematic Review and Meta-Analysis JF - INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES J2 - INT J MOL SCI VL - 25 PY - 2024 IS - 2 PG - 14 SN - 1661-6596 DO - 10.3390/ijms25021273 UR - https://m2.mtmt.hu/api/publication/34530314 ID - 34530314 N1 - * Megosztott szerzőség AB - Infected necrotizing pancreatitis (INP) is associated with an increased risk of organ failure and mortality. Its early recognition and timely initiation of antibiotic therapy can save patients’ lives. We systematically searched three databases on 27 October 2022. In the eligible studies, the presence of infection in necrotizing pancreatitis was confirmed via a reference test, which involved either the identification of gas within the necrotic collection through computed tomography imaging or the examination of collected samples, which yielded positive results in Gram staining or culture. Laboratory biomarkers compared between sterile necrotizing pancreatitis and INP were used as the index test, and our outcome measures included sensitivity, specificity, the receiver operating characteristic (ROC) curve and area under the ROC curve (AUC). Within the first 72 hours (h) after admission, the AUC of C-reactive protein (CRP) was 0.69 (confidence interval (CI): 0.62–0.76), for procalcitonin (PCT), it was 0.69 (CI: 0.60–0.78), and for white blood cell count, it was 0.61 (CI: 0.47–0.75). After the first 72 h, the pooled AUC of CRP showed an elevated level of 0.88 (CI: 0.75–1.00), and for PCT, it was 0.86 (CI: 0.60–1.11). The predictive value of CRP and PCT for infection is poor within 72 h after hospital admission but seems good after the first 72 h. Based on these results, infection is likely in case of persistently high CRP and PCT, and antibiotic initiation may be recommended. LA - English DB - MTMT ER - TY - JOUR AU - Magyari, Balázs AU - Kittka, Bálint AU - Goják, Ilona AU - Schönfeld, Kristóf AU - Szapáry, László Botond AU - Simon, Mihály AU - Kiss, Rudolf AU - Bertalan, Andrea AU - Várady, Edit AU - Gyimesi, András AU - Szokodi, István AU - Horváth, Iván TI - Single-Center Experience with the Balloon-Expandable Myval Transcatheter Aortic Valve System in Patients with Bicuspid Anatomy: Procedural and 30-Day Follow-Up JF - JOURNAL OF CLINICAL MEDICINE J2 - J CLIN MED VL - 13 PY - 2024 IS - 2 PG - 20 SN - 2077-0383 DO - 10.3390/jcm13020513 UR - https://m2.mtmt.hu/api/publication/34519804 ID - 34519804 N1 - Heart Institute, Medical School, University of Pécs, 13 Ifjuság Str., Pécs, H-7624, Hungary Szentágothai Research Centre, University of Pécs, Pécs, H-7624, Hungary Department of Medical Imaging, Medical School, University of Pécs, Pécs, H-7624, Hungary EconNet Research Group, Faculty of Business and Economics, University of Pécs, Pécs, H-7624, Hungary Export Date: 6 February 2024 Correspondence Address: Magyari, B.; Heart Institute, 13 Ifjuság Str., Hungary; email: magyari.balazs@pte.hu AB - Aims: To report our single-center data regarding the initial 52 consecutive patients with a bicuspid aortic valve who underwent a Transcatheter Aortic Valve Implantation (TAVI) procedure using the new balloon-expandable MYVAL system. The focus is on reporting procedural details and outcomes over the 30-day postoperative period. Methods: From December 2019 to July 2023, 52 consecutive patients underwent a TAVI procedure with bicuspid anatomy. All patients had moderate to-high surgical risk or were unsuitable for surgical aortic valve replacement based on the Heart Team’s decision. Outcomes were analyzed according to the VARC-2 criteria. The results of bicuspid patients were compared to patients with tricuspid anatomy in the overall study group, and further analysis involved a comparison between 52 pairs after propensity score matching. The device performance was evaluated using transthoracic echocardiography. Data collection was allowed by the Local Ethical Committee. Results: The mean age was 71 ± 7.1 years, and 65.4% were male. The mean Euroscore II and STS score were 3.3 ± 3.2 and 5.2 ± 3.3, respectively. Baseline characteristics and echocardiographic parameters were well balanced even in the unmatched comparison. Procedures were significantly longer in the bicuspid group and resulted in a significantly higher ARI index. All relevant anatomic dimensions based on the CT scans were significantly higher in bicuspid anatomy, including a higher implantation angulation, a higher rate of horizontal aorta and a higher proportion of patients with aortopathy. In the unmatched bicuspid vs. tricuspid comparison, postprocedural outcomes were as follows: in-hospital mortality 0% vs. 1.4% (p = 0.394), device success 100% vs. 99.1% (p = 0.487), TIA 1.9% vs. 0% (p = 0.041), stroke 1.9% vs. 0.9% (p = 0.537), major vascular complication 3.8% vs. 2.3% (p = 0.530), permanent pacemaker implantation 34% vs. 30.4% (p = 0.429), and cardiac tamponade 0% vs. 0.5% (p = 0.624). In the propensity-matched bicuspid vs. tricuspid comparison, postprocedural outcomes were as follows: in-hospital mortality 0% vs. 0%, device success 100% vs. 100%, TIA 1.9% vs. 0% (p = 0.315), stroke 1.9% vs. 0.9% (p = 0.315), major vascular complication 3.8% vs. 0% (p = 0.475), permanent pacemaker implantation 34% vs. 24% (p = 0.274), and cardiac tamponade 0% vs. 0%. There was no annular rupture nor need for second valve or severe aortic regurgitation in both the unmatched and matched comparison. The peak and mean aortic gradients did not differ at discharge and at 30-day follow-up between the two groups regardless of whether the comparison was unmatched or matched. There were no paravalvular leakages (moderate or above) in the bicuspid patients. Intermediate and extra sizes of the Myval THV system used a significantly higher proportion in bicuspid anatomy with a significantly higher oversize percentage in tricuspid anatomy. Conclusions: The TAVI procedure using the Myval THV system in patients with significant aortic stenosis and bicuspid aortic valve anatomy is safe and effective. Hemodynamic parameters do not differ between tricuspid and bicuspid patients. However, the permanent pacemaker implantation rate is higher than expected; its relevance on long-term survival is controversial. LA - English DB - MTMT ER - TY - BOOK AU - Botz, Bálint TI - EFSUMB Course Book 2nd Edition PB - European Federation of Societies for Ultrasound in Medicine and Biology CY - London PY - 2023 UR - https://m2.mtmt.hu/api/publication/34512351 ID - 34512351 LA - English DB - MTMT ER - TY - JOUR AU - Makk, Evelin AU - Bohonyi, Noémi AU - Oszter, Angéla AU - Éles, Klára AU - Tornóczky, Tamás AU - Tóth, Arnold AU - Kálmán, Endre AU - Kovács, Krisztina TI - Comparative analysis of EZH2, p16 and p53 expression in uterine carcinosarcomas JF - PATHOLOGY AND ONCOLOGY RESEARCH J2 - PATHOL ONCOL RES VL - 29 PY - 2023 PG - 11 SN - 1219-4956 DO - 10.3389/pore.2023.1611547 UR - https://m2.mtmt.hu/api/publication/34477404 ID - 34477404 N1 - Department of Pathology, University of Pécs Medical School, Pécs, Hungary Department of Obstretrics and Gynaecology, University of Pécs Medical School, Pécs, Hungary Department of Medical Imaging, University of Pécs Medical School, Pécs, Hungary Export Date: 8 January 2024 CODEN: POREF Correspondence Address: Makk, E.; Department of Pathology, Hungary; email: makk.evelin@gmail.com AB - Introduction: The role of p16 and p53 immunohistochemistry in the diagnosis of rare and aggressive uterine carcinosarcoma (UCS) has been well established. However, enhancer of zeste homolog 2 (EZH2), a histone methyltransferase and a member of the polycomb group family is a relatively new biomarker, with limited published data on its significance in this tumor type. The goal of this study was to examine EZH2 expression in UCS and its components, in correlation with morphological features, and p16 and p53 staining patterns. Methods: Twenty-eight UCSs were included in the study. EZH2, p16 and p53 immunoreactivity were assessed independently by two pathologists in both tumor components (epithelial and mesenchymal). EZH2 and p16 immunostains were scored semiquantitatively: based on the percentage and intensity of tumor cell staining a binary staining index ("high- or low-expressing") was calculated. The p53 staining pattern was evaluated as wild-type or aberrant (diffuse nuclear, null, or cytoplasmic expression). Statistical tests were used to evaluate the correlation between staining patterns for all three markers and the different tumor components and histotypes. Results: High EZH2 and p16 expression and aberrant p53 patterns were present in 89.3% 78.6% and 85.7% of the epithelial component and in 78.6%, 62.5% and 82.1% of the mesenchymal component, respectively. Differences among these expression rates were not found to be significant (p > 0.05). Regarding the epithelial component, aberrant p53 pattern was found to be significantly (p = 0.0474) more frequent in the serous (100%) than in endometrioid (66.6%) histotypes. Within the mesenchymal component, p53 null expression pattern occurred significantly (p = 0.0257) more frequently in heterologous sarcoma components (71.4%) compared to the homologous histotype (18.8%). Conclusion: In conclusion, EZH2, p16 and p53 seem to play a universal role in the pathogenesis of UCS; however, a distinctive pattern of p53 expression appears to exist between the serous and endometrioid carcinoma components and also between the homologous and heterologous sarcoma components. LA - English DB - MTMT ER -