TY - JOUR AU - Dobszai, Dalma AU - Mátrai, Péter AU - Gyöngyi, Zoltán AU - Csupor, Dezső AU - Bajor, Judit AU - Erőss, Bálint Mihály AU - Mikó, Alexandra AU - Szakó, Lajos AU - Meczker, Ágnes AU - Hágendorn, Roland AU - Márta, Katalin AU - Szentesi, Andrea Ildikó AU - Hegyi, Péter TI - Body-mass index correlates with severity and mortality in acute pancreatitis: A meta-analysis JF - WORLD JOURNAL OF GASTROENTEROLOGY J2 - WORLD J LGASTROENTEROL VL - 25 PY - 2019 IS - 6 SP - 729 EP - 743 PG - 15 SN - 1007-9327 DO - 10.3748/wjg.v25.i6.729 UR - https://m2.mtmt.hu/api/publication/30434617 ID - 30434617 N1 - Institute for Translational Medicine, Medical School, University of Pécs, 12 Szigeti Street, Pécs, H- 7624, Hungary Clinical Medicine Doctoral School, University of Szeged, Szeged, 6720, Hungary Institute for Bioanalysis, Medical School, University of Pécs, Pécs, 7624, Hungary Department of Public Health Medicine, Medical School, University of Pécs, Pécs, 7624, Hungary Department of Pharmacognosy, University of Szeged, Szeged, 6720, Hungary Division of Gastroenterology, First Department of Medicine, University of Pécs, Medical School, Pécs, 7624, Hungary János Szentágothai Research Center, University of Pécs, Pécs, 7624, Hungary MTA-SZTE Momentum Translational Gastroenterology Research Group, University of Szeged, Szeged, 6720, Hungary Cited By :58 Export Date: 26 January 2024 CODEN: WJGAF Correspondence Address: Hegyi, P.; Institute for Translational Medicine, 12 Szigeti Street, Hungary; email: hegyi2009@gmail.com LA - English DB - MTMT ER - TY - JOUR AU - Szakács, Zsolt AU - Gede, Noémi AU - Pécsi, Dániel AU - Izbéki, Ferenc AU - Papp, Mária AU - Kovács, György AU - Fehér, Eszter AU - Dobszai, Dalma AU - Kui, Balázs AU - Márta, Katalin AU - Kónya, Klára AU - Szabó, Imre AU - Török, Imola AU - Gajdán, László AU - Takács, Tamás AU - Sarlós, Patrícia AU - Gódi, Szilárd AU - Varga, Márta AU - Hamvas, József AU - Vincze, Áron AU - Szentesi, Andrea Ildikó AU - Párniczky, Andrea AU - Hegyi, Péter TI - Aging and Comorbidities in Acute Pancreatitis II.: A Cohort-Analysis of 1203 Prospectively Collected Cases JF - FRONTIERS IN PHYSIOLOGY J2 - FRONT PHYSIOL VL - 9 PY - 2019 PG - 9 SN - 1664-042X DO - 10.3389/fphys.2018.01776 UR - https://m2.mtmt.hu/api/publication/30636781 ID - 30636781 N1 - Institute for Translational Medicine, University of Pecs, Medical School, Pecs, Hungary Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary First Department of Internal Medicine, Szent Gyorgy University Hospital in Fejer County, Szekesfehervar, Hungary Department of Internal Medicine, Division of Gastroenterology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary First Department of Medicine, University of Szeged, Szeged, Hungary University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania Division of Gastroenterology, First Department of Medicine, University of Pecs, Medical School, Pecs, Hungary Emergency County Hospital Targu Mures, Targu Mure, Romania Bekes Megyei Kozponti Korhaz Dr. Rethy Pal Tagkorhaz Hospital, Gastroenterology, Bekescsaba, Hungary Bajcsy-Zsilinszky Hospital, Budapest, Hungary Heim Pal National Institute of Pediatrics, Budapest, Hungary Division of Translational Medicine, First Department of Medicine, University of Pecs, Medical School, Pecs, Hungary Hungarian Academy of Sciences, Momentum Gastroenterology Multidisciplinary Research Group, University of Szeged, Szeged, Hungary Cited By :21 Export Date: 26 January 2024 Correspondence Address: Hegyi, P.; Institute for Translational Medicine, Hungary; email: hegyi2009@gmail.com LA - English DB - MTMT ER - TY - JOUR AU - Kiss, Lóránd AU - Fűr, Gabriella AU - Mátrai, Péter AU - Hegyi, Péter AU - Ivány, Emese AU - Cazacu, IM AU - Szabó, Imre AU - Habon, Tamás AU - Alizadeh, Hussain AU - Gyöngyi, Zoltán AU - Vigh, Éva AU - Erőss, Bálint Mihály AU - Erős, Adrienn AU - Ottoffy, M AU - Czakó, László AU - Rakonczay, Zoltán TI - The effect of serum triglyceride concentration on the outcome of acute pancreatitis : systematic review and meta-analysis JF - SCIENTIFIC REPORTS J2 - SCI REP VL - 8 PY - 2018 IS - 1 PG - 14 SN - 2045-2322 DO - 10.1038/s41598-018-32337-x UR - https://m2.mtmt.hu/api/publication/3422217 ID - 3422217 N1 - * Megosztott szerzőség AB - Elevated serum triglyceride concentration (seTG, >1.7 mM or >150 mg/dL) or in other words hypertriglyceridemia (HTG) is common in the populations of developed countries. This condition is accompanied by an increased risk for various diseases, such as acute pancreatitis (AP). It has been proposed that HTG could also worsen the course of AP. Therefore, in this meta-analysis, we aimed to compare the effects of various seTGs on the severity, mortality, local and systemic complications of AP, and on intensive care unit admission. 16 eligible studies, including 11,965 patients were retrieved from PubMed and Embase. The results showed that HTG significantly elevated the odds ratio (OR = 1.72) for severe AP when compared to patients with normal seTG (<1.7 mM). Furthermore, a significantly higher occurrence of pancreatic necrosis, persistent organ failure and renal failure was observed in groups with HTG. The rates of complications and mortality for AP were significantly increased in patients with seTG >5.6 mM or >11.3 mM versus <5.6 mM or <11.3 mM, respectively. We conclude that the presence of HTG worsens the course and outcome of AP, but we found no significant difference in AP severity based on the extent of HTG. LA - English DB - MTMT ER - TY - JOUR AU - Mikó, Alexandra AU - Borbásné Farkas, Kornélia AU - Garami, András AU - Szabó, Imre AU - Vincze, Áron AU - Veres, Gábor AU - Bajor, Judit AU - Alizadeh, Hussain AU - Rakonczay, Zoltán AU - Vigh, Éva AU - Márta, Katalin AU - Kiss, Z AU - Hegyi, Péter AU - Czakó, László TI - Preexisting Diabetes Elevates Risk of Local and Systemic Complications in Acute Pancreatitis: Systematic Review and Meta-analysis JF - PANCREAS J2 - PANCREAS VL - 47 PY - 2018 IS - 8 SP - 917 EP - 923 PG - 7 SN - 0885-3177 DO - 10.1097/MPA.0000000000001122 UR - https://m2.mtmt.hu/api/publication/3407191 ID - 3407191 N1 - * Megosztott szerzőség AB - The prevalence of diabetes mellitus (DM) and acute pancreatitis (AP) increases continuously, therefore, to understand the effects of preexisting diabetes on AP is crucially needed. Here, we performed a systematic review and meta-analysis in which AP patients including DM and non-DM groups were sorted. Several outcome parameters were analyzed, and the odds ratio (OR) and standardized mean difference with 95% confidence intervals (CIs) were calculated.We found 1417 articles, of which 9 articles involving 354,880 patients were analyzed. More complications were seen in diabetic patients than in non-DM patients (OR, 1.553 [95% CI, 1.266-1.904]; P < 0.001). Intensive care unit admission (OR, 1.799 [95% CI, 1.442-2.243]; P < 0.001) and renal failure (OR, 1.585 [95% CI, 1.278-1.966]; P < 0.001) were more frequent in DM patients. There was a tendency of higher mortality and local complications (OR, 1.276 [95% CI, 0.991-1.643]; P = 0.059; and OR, 1.267 [95% CI, 0.964-1.659]; P = 0.090, respectively) in preexisting DM. Length of hospitalization was longer in DM patients (standardized mean difference, 0.217 [95% CI, 0.075-0.360]; P = 0.003). Preexisting DM negatively influences the outcome of AP and increases the risk of renal failure, local complications, and mortality. LA - English DB - MTMT ER - TY - JOUR AU - Márta, Katalin AU - Szabó, Anikó Nóra AU - Pécsi, Dániel AU - Varjú, Péter AU - Bajor, Judit AU - Gódi, Szilárd AU - Sarlós, Patrícia AU - Mikó, Alexandra AU - Szemes, Kata AU - Papp, Mária AU - Tornai, Tamás AU - Vincze, Áron AU - Márton, Zsolt AU - Vincze, PA AU - Lanko, E AU - Szentesi, Andrea Ildikó AU - Molnar, T AU - Hágendorn, Roland AU - Faluhelyi, Nándor AU - Battyáni, István AU - Kelemen, Dezső AU - Papp, Róbert AU - Miseta, Attila János AU - Verzár, Zsófia AU - Lerch, MM AU - Neoptolemos, JP AU - Sahin-Tóth, Miklós AU - Petersen, OH AU - Hegyi, Péter TI - High versus low energy administration in the early phase of acute pancreatitis (GOULASH trial): protocol of a multicentre randomised double-blind clinical trial JF - BMJ OPEN J2 - BMJ OPEN VL - 7 PY - 2017 IS - 9 PG - 10 SN - 2044-6055 DO - 10.1136/bmjopen-2017-015874 UR - https://m2.mtmt.hu/api/publication/3267063 ID - 3267063 N1 - Funding Agency and Grant Number: University of Pecs; Hungarian Academy of Sciences [LP2014-10/2014]; Economic Development and Innovation Operative Programme Grant; National Research, Development and Innovation Office [GINOP-2.3.2-15-2016-00015, KH-125678]; National Healthcare System; MRC [MR/J002771/1] Funding Source: UKRI; Medical Research Council [MR/J002771/1] Funding Source: researchfish Funding text: Centre costs (IT, biostatistics, trial organization, etc) are covered by the University of Pecs, Momentum Grant of the Hungarian Academy of Sciences (LP2014-10/2014); and Economic Development and Innovation Operative Programme Grant and Highly Cited Publication Grant of the National Research, Development and Innovation Office (GINOP-2.3.2-15-2016-00015, KH-125678). Since no additional treatment is necessary for the study, the general healthcare costs are covered by the National Healthcare System. AB - INTRODUCTION: Acute pancreatitis (AP) is an inflammatory disease with no specific treatment. Mitochondrial injury followed by ATP depletion in both acinar and ductal cells is a recently discovered early event in its pathogenesis. Importantly, preclinical research has shown 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 experimental observations in this area, no randomised trials have been conducted to date to address the requirements for energy intake in the early phase of AP. METHODS/DESIGN: This is a randomised controlled two-arm double-blind multicentre trial. Patients with AP will be randomly assigned to groups A (30 kcal/kg/day energy administration starting within 24 hours of hospital admission) or B (low energy administration during the first 72 hours of hospital admission). Energy will be delivered by nasoenteric tube feeding with additional intravenous glucose supplementation or total parenteral nutrition if necessary. A combination of multiorgan failure for more than 48 hours and mortality is defined as the primary endpoint, whereas several secondary endpoints such as length of hospitalisation 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 organisation, the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (55961-2/2016/EKU). This study will provide evidence as to 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). LA - English DB - MTMT ER - TY - JOUR AU - Párniczky, Andrea AU - Mosztbacher, Dóra AU - Zsoldos, F AU - Tóth, Anna AU - Lasztity, N AU - Hegyi, Péter TI - Analysis of Pediatric Pancreatitis (APPLE Trial): Pre-Study Protocol of a Multinational Prospective Clinical Trial JF - DIGESTION J2 - DIGESTION VL - 93 PY - 2016 IS - 2 SP - 105 EP - 110 PG - 6 SN - 0012-2823 DO - 10.1159/000441353 UR - https://m2.mtmt.hu/api/publication/2977076 ID - 2977076 N1 - Funding Agency and Grant Number: MTA-SZTE Momentum Grant [LP2014-10/2014] Funding text: Supported by the MTA-SZTE Momentum Grant (LP2014-10/2014). The authors are grateful for the useful advice and suggestions from the international experts who attended the 3rd HPSG meeting in November 2014, especially to Maisam Abu-El-Haija (USA), Mark Lowe (USA), Grzegorz Oracz (Poland), Jonas Rosendahl (Leipzig, Germany), Miklos Sahin-Toth (Boston, USA), Aliye Uc (USA), Heiko Witt (Germany) and David Whitcomb (Pittsburgh, USA). We are also thankful for the administrative help from Andrea Szentesi and Peter Nagy. AB - BACKGROUND: Single-centered studies show increased number of acute pancreatitis (AP) in children. Here, the Pediatric Section of the Hungarian Pancreatic Study Group introduces an international observational clinical trial (APPLE) to collect a critical mass of clinical data and biomedical research samples in a uniform prospective manner. SUMMARY: The APPLE-R is for patients under 18 years of age with a history of pancreatitis. The study primarily provides information on possible genetic variants behind the disease and their impact on the prognosis. The APPLE-P is for patients under 18 years of age with a diagnosis of AP. Children with AP diagnosed based on the fulfillment of '2 out of 3' of the Atlanta criteria will be selected. This subtrial requests detailed information from the medical history, etiology, complains and symptoms, physical examinations, laboratory parameters, imaging, immediate therapy at admission and complications of the disease. The APPLE trial has been registered at the ISRCTN registry and has received the relevant ethical approval. The study is open for all pediatric centers throughout the world. Key Message: This is the first worldwide study tracking earlier (APPLE-R) and ongoing episodes (APPLE-P) of pancreatitis. LA - English DB - MTMT ER - TY - JOUR AU - Zsoldos, F AU - Párniczky, Andrea AU - Mosztbacher, Dóra AU - Tóth, Anna AU - Lasztity, N AU - Hegyi, Péter TI - Pain in the Early Phase of Pediatric Pancreatitis (PINEAPPLE Trial): Pre-Study Protocol of a Multinational Prospective Clinical Trial JF - DIGESTION J2 - DIGESTION VL - 93 PY - 2016 IS - 2 SP - 121 EP - 126 PG - 6 SN - 0012-2823 DO - 10.1159/000441352 UR - https://m2.mtmt.hu/api/publication/2980969 ID - 2980969 N1 - Funding Agency and Grant Number: MTA-SZTE Momentum Grant [LP2014-10/2014] Funding text: This study was supported by the MTA-SZTE Momentum Grant (LP2014-10/2014). The authors are grateful for the useful advice and suggestions of the international experts who attended the 3rd HPSG meeting in November 2014, especially to Maisam Abu-El-Haija (USA), Mark Lowe (USA), Grzegorz Oracz (Poland), Jonas, Rosendahl (Leipzig, Germany), Miklos Sahin-Toth (Boston, USA), Aliye Uc (USA), Heiko Witt (Germany) and David Whitcomb (Pittsburgh, USA). We are also thankful for the administrative help of Andrea Szentesi and Peter Nagy. AB - BACKGROUND: There are unexpectedly large differences between the incidences of acute pancreatitis (AP) as indicated by different hospitals. Retrospective studies suggest that the reason behind this is the large differences that exist between the local managements of abdominal pain at emergency units. Unfortunately, no evidence-based medicine (EBM) guidelines are available to give proper instruction concerning the necessity of serum pancreatic enzyme measurement during abdominal pain. SUMMARY: Pain in Early Phase of Pediatric Pancreatitis (PINEAPPLE) is an observational, multinational observational clinical trial to explore the route from the first sign of abdominal pain to the diagnosis of pancreatitis (PINEAPPLE trial). The PINEAPPLE-R subtrial is a retrospective review on the records of children (patients under 18) appearing at emergency units - a review of their clinical symptoms, results of imaging examinations and laboratory parameters. The PINEAPPLE-P subtrial is a prospective trial designed to develop a fast and simple EBM guideline that helps to evaluate (in a reliable and cost-efficient way) the necessity of pancreatic enzyme test and abdominal ultrasonography (or even computed tomography) when a child has abdominal pain. The trial has been registered at the ISRCTN registry and has received the relevant ethical approval. Key Message: The PINEAPPLE trial will help to recognize AP in children in a highly efficient manner. LA - English DB - MTMT ER - TY - JOUR AU - Dubravcsik, Zsolt AU - Madácsy, László AU - Gyökeres, Tibor Zoltán AU - Vincze, Áron AU - Szepes, Zoltán AU - Hegyi, Péter AU - Hritz, István AU - Szepes, A TI - Preventive pancreatic stents in the management of acute biliary pancreatitis (PREPAST trial): Pre-study protocol for a multicenter, prospective, randomized, interventional, controlled trial JF - PANCREATOLOGY J2 - PANCREATOLOGY VL - 15 PY - 2015 IS - 2 SP - 115 EP - 123 PG - 9 SN - 1424-3903 DO - 10.1016/j.pan.2015.02.007 UR - https://m2.mtmt.hu/api/publication/2861419 ID - 2861419 N1 - Department of Gastroenterology and Endoscopy, Bács-Kiskun County Hospital, Nyíri út 38, Kecskemét, 6000, Hungary 2nd Department of Internal Medicine, Semmelweis University, Szentkirályi u. 46, Budapest, 1088, Hungary Department of Gastroenterology, State Health Centre, Podmaniczky u. 111, Budapest, 1062, Hungary 1st Department of Internal Medicine, University of Pécs, Rákóczi út 2, Pécs, 7622, Hungary 1st Department of Internal Medicine, University of Szeged, Korányi fasor 8-10, Szeged, 6720, Hungary MTA-SZTE Lendület Translational Gastroenterology Research Group, Korányi fasor 8-10, Szeged, 6720, Hungary Cited By :17 Export Date: 26 January 2024 CODEN: PANCC Correspondence Address: Dubravcsik, Z.; Department of Gastroenterology and Endoscopy, Nyíri út 38, Hungary; email: dubravcsikzs@gmail.com AB - BACKGROUND: The outcome of the most common biliary form of acute pancreatitis has not changed even with the better described indications for early endoscopic intervention. It may be due to the fact that this intrevention theoretically can cause further pancreatic injury or cannot always relieve the pancreatic duct obstruction. We hypothesize that maintaining the outflow of the pancreatic duct with preventive pancreatic stents at the early ERCP improves the outcome of acute biliary pancreatitis. METHODS/DESIGN: PREPAST is a prospective, randomized, controlled, multicenter trial. Patients with acute biliary pancreatitis with coexisting cholangitis are randomized to undergo urgent endoscopic intervention with or without pancreatic stenting within 48 h from the onset of pain, and in addition patients without signs of cholangitis but cholestasis are randomly allocated to recieve conservative treatment or early endoscopic intervention with or without pancreatic stenting within 48 h from the onset of pain. Patients without acute cholangitis and signs of cholestasis recieve conservative treatment. 230 patients are planned to be enrolled during a 48 months period from different centers. The primary endpoint is the outcome of acute biliary pancreatitis as described by the latest guidelines. Secondary endpoints include mortality data, and other variables not analyzed as a primary endpoint but related to the pancreatitis or the pancreatic stenting. DISCUSSION: The PREPAST trial is designed to show whether early endoscopic intervention with the usage of preventive pancreatic stenting improves the outcome of acute biliary pancreatitis. The study has been registered at the International Standard Randomised Controlled Trial Number (ISRCTN) Register (trial ID: ISRCTN13517695). LA - English DB - MTMT ER - TY - JOUR AU - Hritz, István AU - Hegyi, Péter TI - Early Achievable Severity (EASY) index for simple and accurate expedite risk stratification in acute pancreatitis. JF - JOURNAL OF GASTROINTESTINAL AND LIVER DISEASES J2 - J GASTROINTEST LIVER VL - 24 PY - 2015 IS - 2 SP - 177 EP - 182 PG - 6 SN - 1841-8724 DO - 10.15403/jgld.2014.1121.242.easy UR - https://m2.mtmt.hu/api/publication/2913239 ID - 2913239 N1 - 1st Department of Medicine, University of Szeged, Szeged, Hungary Bacs-Kiskun County University Teaching Hospital, Kecskemét, Hungary MTA-SZTE Lendulet Translational Gastroenterology Research Group, Szeged, Hungary Cited By :12 Export Date: 16 October 2023 Correspondence Address: Hegyi, P.; 1st Department of Medicine, Korányi fasor 8, Hungary; email: hegyi.peter@med.u-szeged.hu Chemicals/CAS: amylase, 9000-90-2, 9000-92-4, 9001-19-8; aspartate aminotransferase, 9000-97-9; C reactive protein, 9007-41-4; calcium, 7440-70-2, 14092-94-5; creatinine, 19230-81-0, 60-27-5; glucose, 50-99-7, 84778-64-3; lactate dehydrogenase, 9001-60-9; nitrogen, 7727-37-9; potassium, 7440-09-7; sodium, 7440-23-5 AB - BACKGROUND: Acute pancreatitis (AP) is one of the most common diseases of the gastrointestinal tract associated with significant morbidity and mortality. The assessment of severity is crucial in the management of the disease. Current methods of risk stratification in AP have a limited value, as they provide little additional information thus delaying appropriate patient care. Early recognition of severe disease may prevent serious adverse events and improve patient management as well as overall clinical outcome. METHODS/DESIGN: The EASY trial is an observational, multicenter, prospective cohort study for establishing a simple, easy and accurate clinical scoring system for early prognostication of AP. Evaluation of simple attainable potential prognostic parameters obtained at admission (or not later than 6-12 hours afterwards) from patients diagnosed with AP will be performed to assess their potential correlation with the disease severity. The selected parameters that show the strongest correlation with severe disease course will be further utilized as potential early severity prognostic markers for prospective new patient stratification. Comparison of patients' clinical course with the obtained results of early risk stratification may validate the utilized parameters as prognostic markers. The trial has been (i) discussed and (ii) accepted in a distinguished international scientific meeting, (ii) receiving the relevant ethical approval (TUKEB: 30595-1/2014/EKU), (ii) registered at the ISRCTN registry which is a primary clinical trial registry recognized by WHO (Trial registration number: ISRCTN10525246). CONCLUSION: The EASY trial is designed to develop a simple and accurate clinical scoring system that can stratify patients with AP during the first 6-12 hours of hospitalization according to their risk for severe disease course. LA - English DB - MTMT ER - TY - JOUR AU - Marc, Besselink AU - Hjalmar, van Santvoort AU - Martin, Freeman AU - Timothy, Gardner AU - Julia, Mayerle AU - Santhi, Swaroop Vege AU - Jens, Werner AU - Peter, Banks AU - Colin, McKay AU - Carlos, Fernandez-del Castillo AU - Jeremy, French AU - Hein, Gooszen AU - Colin, Johnson AU - Mike, Sarr AU - Tadahiro, Takada AU - John, Windsor AU - Ashok, Saluja AU - Rodger, Liddle AU - Georgios, Papachristou AU - Vijay, Singh AU - Michael, Rünzi AU - Vikesh, Singh AU - Peter, Banks AU - Thomas, Bollen AU - Desiree, Morgan AU - Koenraad, Mortele AU - Anubhav, Mittal AU - Mao, En-qiang AU - Timothy, Gardner AU - Jan, de Waele AU - Maxim, Petrov AU - Patchen, Dellinger AU - Marc, Besselink AU - Markus, M. Lerch AU - Roland, Anderson AU - Stephen, McClave AU - Werner, Hartwig AU - Hjalmar, van Santvoort AU - Martin, Freeman AU - Marco, Bruno AU - Alejandro, Oria AU - Peter, Banks AU - Hein, Gooszen AU - Todd, Baron AU - Carlos, Fernandez-del Castillo AU - Peter, Fagenholz AU - Karen, Horvath AU - Koenraad, Mortele AU - Mark, van Baal AU - William, Nealon AU - Ake, Andren-Sandberg AU - Olaf, Bakker AU - Claudio, Bassi AU - Markus, Buchler AU - Marja, Boermeester AU - Ed, Bradley AU - Suresh, Chari AU - Richard, Charnley AU - Saxon, Connor AU - Christos, Dervenis AU - Jacques, Deviere AU - Vikas, Dudeja AU - Paul, Fockens AU - Chris, Forsmark AU - Helmut, Friess AU - Shuji, Isaji AU - Rainer, Isenmann AU - Ernst, Klar AU - Philippe, Lévy AU - Keith, Lillemoe AU - Xubao, Liu AU - Chengdu, Matthias Löhr AU - Toshihiko, Mayumi AU - Joachim, Mossner AU - John, Neoptolemos AU - Isto, Nordback AU - Oláh, Attila AU - Roy, Padbury AU - Rowan, Parks AU - Dejan, Radenkovic AU - Bettina, Rau AU - Vinciane, Rebours AU - Stefan, Seewald AU - Hans, Seifert AU - Tooru, Shimosegawa AU - Ajith, Siriwardena AU - William, Steinberg AU - Robert, Sutton AU - Masao, Tanaka AU - Kazunori, Takeda AU - Francis, Tse AU - Harry, van Goor AU - Andrew, Warshaw AU - Chunyou, Wang AU - David, Whitcomb AU - Yupei, Zhao AU - Nicholas, Zyromski TI - IAP/APA evidence-based guidelines for the management of acute pancreatitis JF - PANCREATOLOGY J2 - PANCREATOLOGY VL - 13 PY - 2013 IS - 4 SP - 1 EP - 15 PG - 15 SN - 1424-3903 DO - 10.1016/j.pan.2013.07.063 UR - https://m2.mtmt.hu/api/publication/2987981 ID - 2987981 LA - English DB - MTMT ER - TY - JOUR AU - Czakó, László AU - Hegyi, Péter AU - Rakonczay, Zoltán AU - Wittmann, Tibor AU - Otsuki, M TI - Interactions between the endocrine and exocrine pancreas and their clinical relevance JF - PANCREATOLOGY J2 - PANCREATOLOGY VL - 9 PY - 2009 IS - 4 SP - 351 EP - 359 PG - 9 SN - 1424-3903 DO - 10.1159/000181169 UR - https://m2.mtmt.hu/api/publication/1244823 ID - 1244823 N1 - First Department of Medicine, University of Szeged, PO Box 427, HU-6701 Szeged, Hungary Department of Gastroenterology and Metabolism, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan Cited By :102 Export Date: 26 January 2024 CODEN: PANCC Correspondence Address: Czakó, L.; First Department of Medicine, PO Box 427, HU-6701 Szeged, Hungary; email: czal@in1st.szote.u-szeged.hu AB - In consequence of the close anatomical and functional links between the exocrine and endocrine pancreas, any disease affecting one of these parts will inevitably affect the other. Pancreatic conditions which might cause diabetes mellitus include acute and chronic pancreatitis, pancreatic surgery, cystic fibrosis and pancreatic cancer. The development of diabetes greatly influences the prognosis and quality of life of patients with exocrine pancreatic diseases. It may cause life-threatening complications, such as hypoglycemia, due to the lack of glucagon and the impaired absorption of nutrients, or the micro- and macrovascular complications may impair the organ functions. Diabetes mellitus is an independent risk factor of mortality in those with exocrine pancreatic diseases. The treatment of pancreatic diabetes, a distinct metabolic and clinical form of diabetes, requires special knowledge. Diet and pancreatic enzyme replacement therapy may be sufficient in the early stages. Oral antidiabetic drugs are not recommended. If the diet proves inadequate to reach the glycemic goals, insulin treatment with multiple injections is required. Impairments of the exocrine pancreatic function and morphology in diabetic patients are frequent and well known. Atrophy of the exocrine tissue may be caused by the lack of trophic insulin, whereas pancreatic fibrosis can result from activation of stellate cells by hyperglycemia, or from microangiopathy and neuropathy. The regulation of the exocrine pancreatic function is also damaged because of the impaired effect of islet hormones. In the event of a proven impairment of the pancreatic exocrine function in diabetes mellitus, pancreatic enzyme replacement therapy is indicated. This may improve the nutritional condition of the patient and decrease the metabolic instability. and IAP. LA - English DB - MTMT ER - TY - JOUR AU - Takács, Tamás AU - Hegyi, Péter AU - Pintér Olivérné Jármay, Katalin AU - Czakó, László AU - Góg, C AU - Rakonczay, Zoltán AU - Németh, J AU - Lonovics, János TI - Cholecystokinin fails to promote pancreatic regeneration in diabetic rats following the induction of experimental pancreatitis JF - PHARMACOLOGICAL RESEARCH J2 - PHARMACOL RES VL - 44 PY - 2001 IS - 5 SP - 363 EP - 372 PG - 10 SN - 1043-6618 DO - 10.1006/phrs.2001.0843 UR - https://m2.mtmt.hu/api/publication/1073461 ID - 1073461 AB - The aim of the present study was to investigate the spontaneous and cholecystokinin-octapeptide (CCK-8)-promoted laboratory changes and morphological alterations in rats with arginine (Arg)induced pancreatitis in which diabetes had been induced with streptozotocin (STZ). Male Wistar rats were used in our experiments. Pancreatitis was induced by arginine, diabetes by STZ and regeneration was promoted by CCK-8. The serum amylase, glucose and insulin levels, the pancreatic contents of protein, DNA, amylase, trypsinogen and lipase, the pancreatic weight/body-weight ratio (pw/bw) and the plasma glucagon level were examined 1, 3, 7, 14 and 28 days after pancreatitis induction. Pancreatic tissue samples were examined by light microscopy and immunostaining on paraffin-embedded sections. The insulin and glucagon-containing cells were visualized by using monoclonal antibodies. The administration of low doses of CCK-8 accelerated the processes of regeneration following Arg-induced pancreatitis, but in rats that were also diabetic, pancreatic regeneration was not observed. The administration of low doses of CCK-8 seems to reduce the pancreatic beta -cell number and function in diabetic rats. The pancreatic endocrine function was further deteriorated by simultaneous Arg-induced pancreatitis. The diabetic state appeared to shift the normal pancreatic enzyme content (decreased amylase and increased trypsinogen) in this study. LA - English DB - MTMT ER - TY - JOUR AU - Hegyi, Péter AU - Takács, Tamás AU - Pintér Olivérné Jármay, Katalin AU - Nagy, I AU - Czakó, László AU - Lonovics, János TI - Spontaneous and cholecystokinin-octapeptide-promoted regeneration of the pancreas following L-arginine-induced pancreatitis in rat JF - INTERNATIONAL JOURNAL OF PANCREATOLOGY J2 - INT J PANCREATOL VL - 22 PY - 1997 IS - 3 SP - 193 EP - 200 PG - 8 SN - 0169-4197 DO - 10.1007/BF02788384 UR - https://m2.mtmt.hu/api/publication/1073045 ID - 1073045 AB - Conclusion. In L-arginine (Arg)-induced pancreatitis, evidence of acute inflammation was observed on d 1-3. Continuous tissue atrophy became visible at the sites of previous pancreatic necrosis, with simultaneous regeneration of the pancreas, mainly around the Langerhans islets, Administration of low doses of cholecystokinin-octapeptide (CCK-8) increased the inflammatory signs of pancreatitis in the early phase, but subsequently diminished the level of atrophy and accelerated the processes of regeneration in this model of pancreatitis. Background. The aim of this work was to study the regenerative processes following Arg-induced pancreatitis in rats. Besides the spontaneous regeneration, the effects of low doses of CCK-8 on the laboratory and morphologic parameters in this type of experimental pancreatitis were investigated. Methods. Male Wistar rats were divided into three groups. In group I, the rats received 200 mg/100 g body weight of Arg ip twice, at an interval of 1 h, and 0.5 mt saline was administered sc twice daily. In group II, besides the same amount of Arg, the rats received 1 mu g/kg of CCK-8 sc in 0.5-mL saline twice daily (7 AM and 7 PM). In the control animals (group III), an identical amount of glycine was administered ip instead of Arg at the same times. The rats were examined on d 1, 3, 7, 14, and 28 after pancreatitis induction. The pancreatic weight/body weight ratio (pw/bw) was calculated in each case. The serum levels of amylase, and glucose and the pancreatic contents of soluble protein, trypsin, amylase and DNA were determined, and histologic examinations were performed. Results. In groups I and II, both pw/bw (3.5 +/- 0.2 mg/g and 4.1 +/- 0.28 mg/g, respectively) and the serum amylase level (8900 +/- 560 IU/L and 11100 +/- 1390 IU/L, respectively) were significantly elevated on d 1 vs group III (2.1 +/- 0.06 mg/g and 5562 +/- 373 IU/L, respectively). Pw/bw was significantly decreased in groups I (0.96 +/- 0.12 mg/g, 0.8 +/- 0.1 mg/g, and 1.8 +/- 0.1 mg/g, respectively) and II (1.4 +/- 0.15 mg/g, 1.7 +/- 0.2 mg/g, and 1.95 +/- 0.1 mg/g, respectively) on d 7, 14, and 28 vs group III (2.6 +/- 0.3 mg/g, 3.1 +/- 0.15 mg/g, and 2.7 +/- 0.1 mg/g, respectively), whereas in group II it was significantly elevated vs. group I on d 7 and 14. The pancreatic contents of soluble protein, DNA, trypsin and amylase were significantly decreased on d 3-14 in groups I and II vs group III. The pancreatic DNA level was significantly elevated in group LT (1.23 +/- 0.2 mg/pancreas) vs group I (0.7 +/- 0.1 mg/pancreas) on d 7. In group II, the soluble protein (73.1 +/- 15.5 mg/pancreas) and amylase (1104 +/- 160 IU/pancreas) levels were significantly elevated on d 14 as was that of trypsin (27.2 +/- 3.1 IU/pancreas) on d 28, vs group I (26.4 +/- 5.3 mg/p, 525 +/- 111 IU/pancreas, and 16.3 +/- 1.1 IU/pancreas, respectively). On histologic sections, the signs of acute inflammation of the pancreas were more pronounced in group II than in group I on d 1-3. After that lime, in spite of the progressive atrophy of the pancreas, the signs of tis sue repair were more expressed in group II. LA - English DB - MTMT ER -