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One in four patients with gastrointestinal bleeding develops shock or hemodynamic instability:A systematic review and meta-analysis

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World Journal of Gastroenterology 2023年第28期29卷 4466-4480页

作者： mahmoud Obeidat Brigitta Teutsch Anett Rancz Edina Tari katalin márta Dániel Sándor Veres Nóra Hosszúfalusi Emese mihály Péter Hegyi Bálint Erőss Centre for Translational medicine Semmelweis UniversityBudapest 1085Hungary Institute for Translational medicine Medical SchoolUniversity of PécsPécs 7623Hungary Department of Internal medicine and Hematology Semmelweis UniversityFaculty of MedicineBudapest 1085Hungary Institute of Pancreatic Diseases Semmelweis UniversityBudapest 1083Hungary Department of Biophysics and Radiation Biology Semmelweis UniversityBudapest 1085Hungary

BACKGROUND Hemodynamic instability and shock are associated with untoward outcomes in gastrointestinal ***,there are no studies in the existing literature on the proportion of patients who developed these outcomes after gastrointestinal *** To determine the pooled event rates in the available literature and specify them based on the bleeding *** The protocol was registered on PROSPERO in advance(CRD42021283258).A systematic search was performed in three databases(Pubmed,EmBASE,and CENTRAL)on 14^(th) October *** 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 I^(2) *** Joanna Briggs Institute Prevalence Critical Appraisal Tool was used for the risk of bias *** Reference Citation Analysis(https://***/)tool was applied to obtain the latest highlight *** We identified 11589 records,of which 220 studies were eligible for data *** overall proportion of shock and hemodynamic instability in general gastrointestinal bleeding patients was 0.25(95%CI:0.17-0.36,I^(2)=100%).In non-variceal bleeding,the proportion was 0.22(95%CI:0.14-0.31,I^(2)=100%),whereas it was 0.25(95%CI:0.19-0.32,I^(2)=100%)in variceal *** proportion of patients with colonic diverticular bleeding who developed shock or hemodynamic instability was 0.12(95%CI:0.06-0.22,I^(2)=90%).The risk of bias was low,and heterogeneity was high in all *** 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.

关键词： Gastrointestinal bleeding Hemodynamic instability Shock meta-analysis Statistics Review

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Intralesional steroid is beneficial in benign refractory esophageal strictures:A meta-analysis

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World Journal of Gastroenterology 2018年第21期24卷 2311-2319页

作者： László Szapáry Benedek Tinusz Nelli Farkas katalin márta Lajos Szakó Agnes meczker Roland Hágendorn Judit Bajor Aron Vincze Zoltan Gyongyi Alexandra mikó Dezso Csupor Péter Hegyi Balint Eross Institute for Translational medicine Medical SchoolUniversity of PécsPécs 7624Hungary Institute of Bioanalysis Medical SchoolUniversity of PécsPécs 7624Hungary Department of Gastroenterology First Department of MedicineMedical SchoolUniversity of PécsPécs 7624Hungary Department of Public Health medicine Medical SchoolUniversity of PécsPécs 7624Hungary Department of Pharmacognosy Faculty of PharmacyUniversity of SzegedSzeged 6720Hungary

AIm To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory esophageal *** A comprehensive search was performed in three databases from inception to 10 April 2017 to identify trials, comparing the efficacy of endoscopic dilation to dilation combined with intralesional steroid injections. Following the data extraction, meta-analytical calculations were performed on measures of outcome by the randomeffects method of Der Simonian and Laird. Heterogeneity of the studies was tested by Cochrane's Q and I^2 statistics. Risk of quality and bias was assessed by the Newcastle Ottawa Scale and JADAD assessment *** Eleven articles were identified suitable for analyses, involving 343 patients, 235 cases and 229 controls in total. Four studies used crossover design with 121 subjects enrolled. The periodic dilation index(PDI) was comparable in 4 studies, where the pooled result showed a significant improvement of PDI in the steroid group(mD:-1.12 dilation/month, 95% CI:-1.99 to -0.25 P = 0.012; I^2 = 74.4%). The total number of repeat dilations(TNRD) was comparable in 5 studies and showed a non-significant decrease(mD:-1.17, 95%CI:-0.24-0.05, P = 0.057; I^2 = 0), while the dysphagia score(DS) was comparable in 5 studies and did not improve(SmD: 0.35, 95%CI:-0.38, 1.08, P = 0.351; I^2 = 83.98%) after intralesional steroid *** Intralesional steroid injection increases the time between endoscopic dilations of benign refractory esophageal strictures. However, its potential role needs further research.

关键词： Intralesional steroid meta-analysis Benign refractory esophageal stricture Dilation

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Body-mass index correlates with severity and mortality in acute pancreatitis: A meta-analysis

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World Journal of Gastroenterology 2019年第6期25卷 729-743页

作者： Dalma Dobszai Péter mátrai Zoltan Gyongyi Dezso Csupor Judit Bajor Balint Eross Alexandra mikó Lajos Szakó Agnes meczker Roland Hágendorn katalin márta Andrea Szentesi Péter Hegyi on behalf of the Hungarian Pancreatic Study Group Institute for Translational medicine Medical SchoolUniversity of PécsPécs 7624Hungary Clinical medicine Doctoral School University of SzegedSzeged 6720Hungary Institute for Bioanalysis Medical SchoolUniversity of PécsPécs 7624Hungary Department of Public Health medicine Medical SchoolUniversity of PécsPécs 7624Hungary Department of Pharmacognosy University of SzegedSzeged 6720Hungary Division of Gastroenterology First Department of MedicineUniversity of PécsMedical SchoolPécs 7624Hungary János Szentágothai Research Center University of PécsPécs 7624 Hungary mTA-SZTE momentum Translational Gastroenterology Research Group University of SzegedSzeged 6720Hungary 不详

BACKGROUND Obesity rates have increased sharply in recent decades. As there is a growing number of cases in which acute pancreatitis(AP) is accompanied by obesity, we found it clinically relevant to investigate how body-mass index(BmI) affects the outcome of the *** To quantify the association between subgroups of BmI and the severity and mortality of *** A meta-analysis was performed using the Preferred Reporting Items for Systematic Review and meta-Analysis(PRISmA) Protocols. Three databases(Pubmed, EmBASE and the Cochrane Library) were searched for articles containing data on BmI, disease severity and mortality rate for AP. Englishlanguage studies from inception to 19 June 2017 were checked against our predetermined eligibility criteria. The included articles reported all AP cases with no restriction on the etiology of the disease. Only studies that classified AP cases according to the Atlanta Criteria were involved in the severity analyses. Odds ratios(OR) and mean differences(mD) were pooled using the random effects model with the DerSimonian-Laird estimation and displayed on forest plots. The meta-analysis was registered in PROSPERO under number *** A total of 19 articles were included in our meta-analysis containing data on 9997 patients. As regards severity, a subgroup analysis showed a direct association between AP severity and BmI. BmI mI > 25 had an almost three-fold increased risk for severe AP in comparison to normal BmI(OR = 2.87, 95%CI: 1.90-4.35, P mportantly,the mean BmI of patients with severe AP is higher than that of the non-severe group(mD = 1.79, 95%CI: 0.89-2.70, P mortality, death rates among AP patients are the highest in the underweight and obese subgroups. A BmI most two-fold increase in risk of mortality compared to normal BmI(OR = 1.82, 95%CI: 1.32-2.50, P mortality

关键词： Acute pancreatitis Body-mass index Obesity Severity mortality Prognostic meta-analysis

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Restoration of energy level in the early phase of acute pediatric pancreatitis

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World Journal of Gastroenterology 2017年第6期23卷 957-963页

作者： Dóra mosztbacher Nelli Farkas margit Solymár Gabriella Pár Judit Bajor ákos Szucs József Czimmer katalin márta Alexandra mikó Zoltán Rumbus Péter Varjú Péter Hegyi Andrea Párniczky First Department of Pediatrics Semmelweis University Institute for Translational medicine University of Pécs Institute for Bioanalyses University of Pécs Department of Gastroenterology First Department of MedicineUniversity of Pécs Department of Translational medicine First Department of MedicineUniversity of Pécs First Department of Surgery Semmelweis University Hungarian Academy of Sciences-University of Szeged Momentum Gastroenterology Multidisciplinary Research Group Heim Pál Children’s Hospital

Acute pancreatitis (AP) is a serious inflammatory disease with rising incidence both in the adult and pediatric populations. It has been shown that mitochondrial injury and energy depletion are the earliest intracellular events in the early phase of AP. moreover, it has been revealed that restoration of intracellular ATP level restores cellular functions and defends the cells from death. We have recently shown in a systematic review and meta-analysis that early enteral feeding is beneficial in adults; however, no reviews are available concerning the effect of early enteral feeding in pediatric AP. In this minireview, our aim was to systematically analyse the literature on the treatmentof acute pediatric pancreatitis. The preferred reporting items for systematic review(PRISmA-P) were followed, and the question was drafted based on participants, intervention, comparison and outcomes: P: patients under the age of twenty-one suffering from acute pancreatitis; I: early enteral nutrition (per os and nasogastric- or nasojejunal tube started within 48 h); C: nil per os therapy; O: length of hospitalization, need for treatment at an intensive care unit, development of severe AP, lung injury (including lung oedema and pleural effusion), white blood cell count and pain score on admission. Altogether, 632 articles (Pub med: 131; EmBASE: 501) were found. After detailed screening of eligible papers, five of them met inclusion criteria. Only retrospective clinical trials were available. Due to insufficient information from the authors, it was only possible to address length of hospitalization as an outcome of the study. Our mini-meta-analysis showed that early enteral nutrition significantly(SD = 0.806, P = 0.034) decreases length of hospitalization compared with nil per os diet in acute pediatric pancreatitis. In this minireview, we clearly show that early enteral nutrition, started within 24-48 h, is beneficial in acute pediatric pancreatitis. Prospective studies and better pres

关键词： pediatric pancreatitis enteral nutrition nil per os diet ATP restoration length of hospitalization

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New serological markers in pediatric patients with inflammatory bowel disease

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World Journal of Gastroenterology 2014年第17期20卷 4873-4882页

作者： márta Kovács katalin Eszter müller mária Papp Péter László Lakatos mihály Cs?ndes Gábor Veres Department of Pediatrics Petz Aladár County and Teaching Hospital9023 Gy?rHungary 1~(st) Department of Pediatrics Semmelweis University1083 BudapestHungary 2~(nd) Department of medicine University of Debrecen4032 DebrecenHungary 1~(st) Department of medicine Semmelweis University1083 BudapestHungary Department of Gastroenterology Petz Aladár County and Teaching Hospital9023 Gy?rHungary

The spectrum of serological markers associated with inflammatory bowel disease (IBD) is rapidly growing. Due to frequently delayed or missed diagnoses, the application of non-invasive diagnostic tests for IBD, as well as differentiation between ulcerative colitis (UC) and Crohn’s disease (CD), would be useful in the pediatric population. In addition, the combination of pancreatic autoantibodies and antibodies against Saccharomyces cerevisiae antibodies/perinuclear cytoplasmic antibody (pANCA) improved the sensitivity of serological markers in pediatric patients with CD and UC. Some studies suggested that age-associated differences in the patterns of antibodies may be present, particularly in the youngest children. In CD, most patients develop stricturing or perforating complications, and a significant number of patients undergo surgery during the disease course. Based on recent knowledge, serum antibodies are qualitatively and quantitatively associated with complicated CD behavior and CD-related surgery. Pediatric UC is characterized by extensive colitis and a high rate of colectomy. In patients with UC, high levels of anti-CBir1 and pANCA are associated with the development of pouchitis after ileal pouch-anal anastomosis. Thus, serologic markers for IBD can be applied to stratify IBD patients into more homogeneous subgroups with respect to disease progression. In conclusion, identification of patients at an increased risk of rapid disease progression is of great interest, as the application of early and more aggressive pharmaceutical intervention could have the potential to alter the natural history of IBD, and reduce complications and hospitalizations.

关键词： Inflammatory bowel disease, Crohn’ s disease, Ulcerative colitis, Pediatric, Serologic markers, Antimicrobial antibodies, Anti-glycan antibodies, Pancreatic antibodies, Inflammatory bowel disease

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Knowledge explosion for monogenic skin diseases

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World Journal of Dermatology 2015年第1期4卷 44-49页

作者： Nikoletta Nagy katalin Farkas Lajos Kemény márta Széll Dermatological Research Group of the Hungarian Academy of Sciences University of Szeged Department of Dermatology and Allergology University of Szeged Department of medical Genetics University of Szeged Dermatological Research Group of the Hungarian Academy of Sciences University of Szeged

During the past few decades, the investigative technologies of molecular biology- especially sequencing-underwent huge advances, leading to the sequencing of the entire human genome, as well as the identification of several candidate genes and the causative geneticvariations that are responsible for monogenic skin diseases. These advances provided a solid basis for subsequent studies elucidating mechanisms of monogenic skin diseases and improving our understanding of common skin diseases. Furthermore, these discoveries also contributed to the development of novel therapeutic modalities for monogenic skin diseases. In this review, we have used the disease spectrum caused by mutations in the CYLD gene- Brooke-Spiegler syndrome, familial cylindromatosis and multiple familial trichoepithelioma type 1- as a model for demonstrating the knowledge explosion for this group of diseases.

关键词： Familial trichoepitheliomatosis Familial cylindromatosis Brooke-Spiegler syndrome monogenic skin diseases

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Nonlinear forced vibration in a subcritical regime of a porous functionally graded pipe conveying fluid with a retaining clip

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Applied mathematics and mechanics(English Edition) 2025年第1期46卷 101-122页

作者： m.GHOLAmI m.EFTEKHARI Department of mechanical Engineering Shahid Bahonar University of Kerman

This study examines the nonlinear behaviors of a clamped-clamped porous pipe made of a functionally graded material(FGm) that conveys fluids and is equipped with a retaining clip, focusing on primary resonance and subcritical dynamics. The nonlinear governing equations for the FGm pipe are derived by the extended Hamilton's principle, and subsequently discretized through the application of the Galerkin *** direct method of multi-scales is then used to solve the derived equations. A thorough analysis of various parameters, including the clip stiffness, the power-law index, the porosity, and the clip location, is conducted to gain a comprehensive understanding of the system's nonlinear dynamics. Through the analysis of the first natural frequency, the study highlights the influence of the flow velocity and the clip stiffness, while the comparisons with metallic pipes emphasize the role of FGm composition. The examination of the forced response curves reveals saddle-node bifurcations and their dependence on parameters such as the detuning parameter and the power-law index, offering valuable insights into the system's nonlinear resonant behavior. Furthermore, the frequency-response curves illustrate the hardening nonlinearities influenced by factors such as the porosity and the clip stiffness, revealing nuanced effects on the system response and resonance characteristics. This comprehensive analysis enhances the understanding of nonlinear behaviors in FGm porous pipes with a retaining clip, providing key insights for practical engineering applications in system design and optimization.

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No association of the cytotoxic T-lymphocyte associated gene CTLA4 +49A/G polymorphisms with Crohn's disease and ulcerative colitis in Hungarian population samples

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World Journal of Gastroenterology 2007年第15期13卷 2205-2208页

作者： Lili magyari Bernadett Faragó Judit Bene katalin Horvatovich Lilla Lakner márta Varga mária Figler Beáta Gasztonyi Gyula mózsik Béla melegh Department of medical Genetics and Child Development University of Pécs PécsHungary mTA PTE Clinical Genetics Research Group of the Hungarian Academy of Sciences at the University of Pécs Pécs Hungary markusovszky Hospital Department of medicine and Gastroenterology SzombathelyHungary Réthy Pál Hospital 3rd Department of medicine and Gastroenterology BékéscsabaHungary Department of medicine School of medicine University of PécsPécsHungary Department of Gastroenterology Zala County Hospital ZalaegerszegHungary

AIm： The goal of the current work was to analyse the prevalence of the ＋49A/G variant of the cytotoxic T-lymphocyte antigen 4 gene （CTLA4） in Hungarian patients with Crohn＇s disease （CD） and ulcerative colitis （UC）. mETHODS： A total of 130 unrelated subjects with CD and 150 with UC, and 170 matched controls were genotyped for the single nucleotide polymorphism （SNP）. The genotypes were determined by using PCR/RFLP test. RESULTS： The G allele frequency and the prevalence of the GG genotype were 38.1% and 12.3% in the CD group, 40.6% and 18.6% in the UC patients, and 37.4% and 15.9% in the control group, respectively. CONCLUSION： The results of the current study show that carriage of the ＋49G SNP in heterozygous or in homozygous form does not confer risk either for CD or for UC in the Hungarian population.

关键词： Cytotoxic T-lymphocyte antigen 4 Crohn's disease Ulcerative colitis Inflammatory bowel disease

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The Story of the Century

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英语学习 1995年第8期 34-35页

作者： mrta Tikkanen

玛尔塔·蒂坎恩是芬兰本世纪七十至八十年代女权主义运动中著名作家和诗人。她的散文诗《本世纪的故事》严肃地反映了妇女婚姻家庭矛盾,诗中那位妇女发出"Love me less,respect me more"的心声,不难读出作者及那个时代的芬兰女性已渐鲜... 详细信息

玛尔塔·蒂坎恩是芬兰本世纪七十至八十年代女权主义运动中著名作家和诗人。她的散文诗《本世纪的故事》严肃地反映了妇女婚姻家庭矛盾,诗中那位妇女发出"Love me less,respect me more"的心声,不难读出作者及那个时代的芬兰女性已渐鲜明的自我意识。

关键词：女权主义家庭矛盾散文诗 The Story of the Century 玛尔塔自我意识

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Neurogenesis dynamics in the olfactory bulb:deciphering circuitry organization, function, and adaptive plasticity

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Neural Regeneration Research 2025年第6期20卷 1565-1581页

作者： moawiah m.Naffaa Department of Psychology and Neuroscience Duke UniversityDurhamNCUSA Department of Cell Biology Duke University School of MedicineDurhamNCUSA

Adult neurogenesis persists after birth in the subventricular zone, with new neurons migrating to the granule cell layer and glomerular layers of the olfactory bulb, where they integrate into existing circuitry as inhibitory interneurons. The generation of these new neurons in the olfactory bulb supports both structural and functional plasticity, aiding in circuit remodeling triggered by memory and learning processes. However, the presence of these neurons, coupled with the cellular diversity within the olfactory bulb, presents an ongoing challenge in understanding its network organization and function. moreover,the continuous integration of new neurons in the olfactory bulb plays a pivotal role in regulating olfactory information processing. This adaptive process responds to changes in epithelial composition and contributes to the formation of olfactory memories by modulating cellular connectivity within the olfactory bulb and interacting intricately with higher-order brain regions. The role of adult neurogenesis in olfactory bulb functions remains a topic of debate. Nevertheless, the functionality of the olfactory bulb is intricately linked to the organization of granule cells around mitral and tufted cells. This organizational pattern significantly impacts output, network behavior, and synaptic plasticity, which are crucial for olfactory perception and memory. Additionally, this organization is further shaped by axon terminals originating from cortical and subcortical regions. Despite the crucial role of olfactory bulb in brain functions and behaviors related to olfaction, these complex and highly interconnected processes have not been comprehensively studied as a whole. Therefore, this manuscript aims to discuss our current understanding and explore how neural plasticity and olfactory neurogenesis contribute to enhancing the adaptability of the olfactory system. These mechanisms are thought to support olfactory learning and memory, potentially through increased

关键词： network adaptability neurogenesis neuronal communication olfactory bulb olfactory learning olfactory memory synaptic plasticity

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