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Is the disease course predictable in inflammatory bowel diseases?

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World Journal of Gastroenterology 2010年第21期16卷 2591-2599页

作者： Peter Laszlo Lakatos lajos s kiss 1st Department of Medicine Semmelweis UniversityH-1083 BudapestKoranyi S 2AHungary

During the course of the disease,most patients with Crohn's disease(CD) may eventually develop a stricturing or a perforating complication,and a significant number of patients with both CD and ulcerative colitis will undergo *** recent years,research has focused on the determination of factors important in the prediction of disease course in inflammatory bowel diseases to improve stratification of patients,identify individual patient profiles,including clinical,laboratory and molecular markers,which hopefully will allow physicians to choose the most appropriate management in terms of therapy and intensity of *** review summarizes the available evidence on clinical,endoscopic variables and biomarkers in the prediction of short and long-term outcome in patients with inflammatory bowel diseases.

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Disease course Predictive markers Clinical serology Genetics

Frequency and prognostic role of mucosal healing in patients with Crohn's disease and ulcerative colitis after one-year of biological therapy

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World Journal of Gastroenterology 2014年第11期20卷 2995-3001页

作者： Klaudia Farkas Péter László Lakatos Mónika szcs va Pallagi-Kunstár Anita Bálint Ferenc Nagy Zoltán szepes Noémi Vass lajos s kiss Tibor Wittmann Tamás Molnár First Department of Medicine University of SzegedH6720 SzegedHungary First Department of Medicine Semmelweis UniversityH1088 BudapestHungary Department of Medical Physics and Informatics University of SzegedH6720 SzegedHungary Faculty of Medicine Pediatrics DepartmentUniversity of SzegedH6720 SzegedHungary

AIM: To assess the endoscopic activity before and after a one-year period of biological therapy and to evaluate the frequency of relapses and need for retreatment after stopping the biologicals in patients with Crohn... 详细信息

关键词： Crohn’ s disease, Ulcerative colitis, Biological therapy, Endoscopy, Mucosal healing

Is early limited surgery associated with a more benign disease course in Crohn's disease?

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World Journal of Gastroenterology 2013年第43期19卷 7701-7710页

作者： Petra Anna Golovics Laszlo Lakatos Attila Nagy Tunde Pandur Istvan szita Mihaly Balogh Csaba Molnar Erzsebet Komaromi Barbara Dorottya Lovasz Michael Mandel Gabor Veres lajos s kiss Zsuzsanna Vegh Peter Laszlo Lakatos First Department of Medicine Semmelweis UniversityH-1083 BudapestHungary Department of Medicine Csolnoky F Province HospitalH-8200 VeszpremHungary Department of surgery Csolnoky F Province HospitalH-8200 VeszpremHungary Department of Medicine Grof Eszterhazy HospitalH-8500 PapaHungary Department of Infectious Diseases Magyar Imre HospitalH-8400 AjkaHungary Department of Gastroenterology Municipal HospitalH-8100 VarpalotaHungary First Department of Pediatrics Semmelweis UniversityH-1083 BudapestHungary

AIM:To analyze the difference in disease course and need for surgery in patients with Crohn’s disease(CD).METHODs:Data of 506 patients with incident CD were analyzed(age at diagnosis:31.5±13.8 years).Both hospital and outpatient records were collected prospectively with a complete clinical follow-up and comprehensively reviewed in the population-based Veszprem province database,which includes incident CD patients diagnosed between January 1,1977 and December 31,***-up data were collected until December 31,*** patients included had at least 1year of follow-up *** with indeterminate colitis at diagnosis were excluded from the ***:Overall,73 patients(14.4%)required resective surgery within 1 year of *** exposure and need for biological therapy were lower in patients with early limited surgery(Psurgery rates during follow-up in patients with and without early surgery differed significantly after matching on propensity scores(Ps also lower in patients with early limited resective surgery(P=0.038,HR=0.42)in a Kaplan-Meier and multivariate Cox regression(P=0.04)***,this advantage was not observed after matching on propensity scores(PLogrank=0.656,PBreslow=0.498).CONCLUsION:Long-term surgery rates and overall exposure to steroids and biological agents were lower in patients with early limited resective surgery,but reoperation rates did not differ.

关键词： Crohn’s disease Early surgery Disease course Disease behavior Treatment strategy

Prevalence and predictors of hospitalization in Crohn's disease in a prospective population-based inception cohort from 2000-2012

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World Journal of Gastroenterology 2015年第23期21卷 7272-7280页

作者： Petra A Golovics Laszlo Lakatos Michael D Mandel Barbara D Lovasz Zsuzsanna Vegh Zsuzsanna Kurti Istvan szita lajos s kiss Tunde Pandur Peter L Lakatos First Department of Medicine Semmelweis University Department of Medicine Csolnoky Ferenc Province Hospital

AIM: To analyze the prevalence, length and predictors of hospitalization in the biological era in the populationbased inception cohort from Veszprem ***: Data of 331 incident Crohn's disease(CD) patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed(median age at diagnosis: 28; IQR: 21-40 years). Both in- and outpatient records were collected and comprehensively ***: Probabilities of first CD-related hospitalization and re-hospitalization were 32.3%, 45.5%,53.7% and 13.6%, 23.9%, 29.8%, respectively after one, three and five years of follow-up in Kaplan-Meier analysis. First-year hospitalizations were related to diagnostic procedures(37%), surgery or disease activity(27% and 21%). Non-inflammatory disease behavior at diagnosis(HR = 1.32, P = 0.001) and perianal disease(HR = 1.47, P = 0.04) were associated with time to first CD-related hospitalization, while disease behavior change(HR = 2.38, P = 0.002) and need for steroids(HR = 3.14, P = 0.003) were associated with time to first re-hospitalization in multivariate *** CD-related hospitalization(within the year of diagnosis) was independently associated with need for immunosuppressives(OR = 2.08, P = 0.001) and need for surgeries(OR = 7.25, P sease ***: Hospitalization and re-hospitalization rates are still high in this cohort, especially during the first-year after the diagnosis. Non-inflammatory disease behavior at diagnosis was identified as the pivotal predictive factor of both hospitalization and rehospitalization.

关键词： Crohn's disease Hospitalization Recurrence Predictor Population-based Biological therapy

Prevalence and predictors of hospitalization in Crohn＇sdisease in a prospective population-based inception cohortfrom 2000-2012

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World Journal of Gastroenterology 2015年第23期21卷 7281-7288页

作者： Petra A Golovics, Laszlo Lakatos, Michael D Mandel, Barbara D Lovasz, Zsuzsanna Vegh, Zsuzsanna Kurti, Istvan szita, lajos s kiss, Tunde Pandur, and Peter L Lakatos Petra A Golovics Michael D Mandel Barbara D Lovasz Zsuzsanna Vegh Zsuzsanna Kurti Lajos S Kiss Peter L Lakatos First Department of Medicine Semmelweis University H-1083 Budapest Hungary Laszlo Lakatos Zsuzsanna Vegh Istvan Szita Tunde Pandur Department of Medicine Csolnoky Ferenc Province Hospital H-8200 Veszprem Hungary

Prevalence and predictors of hospitalization in Crohn＇sdisease in a prospective population-based inception cohortfrom 2000-2012 METHODs： This multicentric, prospective, open-labelstudy included patients with CRC previously untreatedwith chemotherapy. Patients were administeredbevacizumab in combination with XELOX. The primaryefficacy end-point was progression-free survival（PFs）. secondary end-points included time to overallresponse （TOR）, duration of response （DOR）, timeto treatment failure （TTF） and overall survival （Os）.The incidence and type of adverse events AEs andsevere AEs were evaluated. Also, the mutational statusof BRAF and KRAs was assessed by high resolutionmelting and direct sequencing, and quality of life （QoL）was measured by the EuroQoL EQ-5D questionnaire atbaseline and at the last ***： The intention-to-treat population included197 patients （mean age： 62.3 ± 9.9 years, 56.4%males）. At baseline, 16/34 evaluable subjects （47.1%）harbored a KRAs and/or a BRAF mutation; the meanQoL index was 80.2 ± 14.3. First-line therapy wasgiven for 223.7 ± 175.9 d, and after a mean followupof 387.7 ± 238.8 d all patients discontinued fromthe study mainly for disease progression （PD, 45.4%）and AEs （25.4%）. Median PFs was 9.7 mo （95%CI：8.4-10.5） and the median values for secondary endpointswere： TOR = 3.9 mo （95%CI： 2.6-4.7）, DOR= 8.5 mo （95%CI： 7.3-10.3）, TTF = 6.7 mo （95%CI：6.0-7.7） and Os = 23.2 mo （95%CI： 20.1-27.2）.Patients carrying at least one lesion had a loweroverall response rate （66.7% vs 88.9%） and a lowerprobability of achieving complete or partial responsethan those without mutations, but the differencein relative risk was not statistically significant （P =0.2）. Mean EQ-5D-3L raw index score significantlydecreased to 74.9 ± 19.1 at the last visit （signed-ranktest, P = 0.0076）, but in general the evaluation on QoLperceived by patients was ***： The efficacy of bevacizumab incombination with XELOX in terms of PFs in patientswith aCRC or

关键词： Bevacizumab Colorectal neoplasms Chemotherapy anti-Vascular endothelial growth factor XELOX

Burden of Clostridium difficile infection between 2010 and 2013:Trends and outcomes from an academic center in Eastern Europe

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World Journal of Gastroenterology 2015年第21期21卷 6728-6735页

作者： Zsuzsanna Kurti Barbara D Lovasz Michael D Mandel Zoltan Csima Petra A Golovics Bence D Csako Anna Mohas Lorant Gnczi Krisztina B Gecse lajos s kiss Miklos szathmari Peter L Lakatos 1~(st) Department of Medicine Semmelweis University Institute of Health Care Development and Clinical Methodology Semmelweis University

AIM:To analyze the incidence and possible risk factors in hospitalized patients treated with Clostridium difficile infection(CDI).METHODs:A total of 11751 patients were admitted to our clinic between 1 January 2010 and 1 *** hundred and forty-seven inpatients were prospectively diagnosed with *** the risk analysis a 1:3 matching was *** of 732 patients matched for age,sex,and inpatient care period and unit were compared to those of the CDI *** records were collected from an electronic hospital database and comprehensively ***:Incidence of CDI was 21.0/1000 admissions(2.1%of all-cause hospitalizations and 4.45%of total inpatient days).The incidence of severe CDI was 12.6%(2.63/1000 of all-cause hospitalizations).Distribution of CDI cases was different according to the unit type,with highest incidence rates in hematology,gastroenterology and nephrology units(32.9,25 and24.6/1000 admissions,respectively) and lowest rates in 1.4%(33/2312) in endocrinology and general internal medicine(14.2 and 16.9/1000 admissions)*** of CDI was 11.3%within 12 wk after *** of hospital stay was longer in patients with CDI compared to controls(17.6 ± 10.8d vs 12.4 ± 7.71 d).CDI accounted for 6.3%of allinpatient deaths,and 30-d mortality rate was 21.9%(54/247 cases).Risk factors for CDI were antibiotic therapy[including third-generation cephalosporins or fluoroquinolones,odds ratio(OR) = 4.559;P se of proton pump inhibitors(OR = 2.082,Ps hospitaiization within 12 mo(OR = 3.167,P s CDI(OR = 15.32;P sence of diabetes mellitus was associated with a decreased risk for CDI(OR = 0.484;Pses was significantly different from primary infections with more frequent use of vancomycin alone or in combination(P s longer(P severity,mortality and outcome of primary infections and relapsing

关键词： Clostridium difficile infection Hospitalization Antibiotics Proton pump inhibitors

NKX2-3 and IRGM variants are associated with diseasesu sceptibility to IBD in Eastern European patients

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World Journal of Gastroenterology 2010年第41期16卷 5233-5240页

作者： Nora Meggyesi lajos s kiss Magdalena Koszarska Martin Bortlik Dana Duricova Laszlo Lakatos Tamas Molnar Martin Lenicek Libor Vítek Istvan Altorjay Maria Papp Zsolt Tulassay Pal Miheller Janos Papp Attila Tordai Hajnalka Andrikovics Milan Lukas Peter Laszlo Lakatos Department of Molecular Diagnostics Hun-garian National Blood Transfusion Service H-1113 BudapestHungary 1st Depart-ment of Medicine Semmelweis University H-1083 BudapestHungary IBD Clinicaland Research Centre ISCARE IVF and 1st Medical FacultyCharles University 170 04 Prague Czech Republic 1st Department of Medicine Csolnoky F.County Hospital H8200 Veszprem Hungary 1st Department of Medicine University ofSzeged H6720 Szeged Hungary Department of Biochemistry andLaboratory Diagnostics 1st Medical Faculty Charles Univer-sity 170 04 Prague Czech Republic 2nd Department of Medicine University of Debrecen H4032 Debrecen Hungary 2nd Department of Medicine Semmelweis University H1085 Budapest Hungary

AIM: To investigate variants of immunity-related GT-Pase family M (IRGM) and NKX2-3 genes and genotype-phenotype in Eastern European patients with inflammatory bowel disease (IBD).METHODs: We analyzed 1707 Hungarian and Czech subjects with Crohn’s disease (CD) (n = 810, age: 37.1 ± 12.6 years, duration: 10.7 ± 8.4 years) and ulcerative colitis (UC) (n = 428, age: 43.7 ± 15.0 years, duration: 12.6 ± 9.9 years), as well as 469 healthy controls. IRGM rs13361189, NKX2-3 rs10883365 and ECM1 rs13294 polymorphisms were tested by LightCy-cler allele discrimination. Detailed clinical phenotypes were determined by reviewing the medical charts. REsULTs: NKX2-3 rs10883365 variant allele was as-sociated with increased risk for CD (P = 0.009, OR = 1.24, 95% CI = 1.06-1.48) and UC (P = 0.001, OR = 1.36, 95% CI = 1.13-1.63), whereas variant IRGM allele increased risk for CD (P = 0.029, OR = 1.36, 95% CI = 1.03-1.79). In contrast, ECM1 rs13294 was not associat-ed with either CD or UC. In CD, the variant IRGM allele was associated with a colon-only location (P = 0.02, OR = 1.62, 95% CI = 1.07-2.44), whereas in UC, the ECM1 variant was associated with cutaneous manifestations (P = 0.002, OR = 3.36, 95% CI = 1.48-7.63). Variant alleles did not predict resistance to steroids or azathio-prine, efficacy of infliximab, or need for surgery. CONCLUsION: NKX2-3 and IRGM are susceptibility locifor IBD in Eastern European patients. Further studies are needed to confirm the reported phenotype-genotype associations.

关键词： Crohn’s disease Ulcerative colitis NKX2-3 Immunity-related GTPase family M ECM1 Genotype Phenotype Pharmacogenetics

Network meta-analysis of randomized controlled trials on esophagectomies in esophageal cancer:The superiority of minimally invasive surgery

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World Journal of Gastroenterology 2022年第30期28卷 4201-4210页

作者： lajos szakó Dávid Németh Nelli Farkas szabolcs kiss Réka Zsuzsa Domotor Marie Anne Engh Péter Hegyi Balint Eross András Papp Institute of Translational Medicine University of PécsMedical SchoolPécs 7624Hungary János szentágothai Research Centre University of PécsMedical SchoolPécs 7624Hungary Institute for Translational Medicine University of PécsMedical SchoolPécs 7624Hungary of Bioanalysis University of PécsMedical SchoolPécs 7624Hungary Insittute of Translational Medicine University of PécsMedical SchoolPécs 7624Hungary Doctoral school of Clinical Medicine University of SzegedMedical SchoolSzeged 6720Hungary First Department of Medicine University of SzegedMedical SchoolSzeged 6725Hungary Institute of Translational Medicine University of PecsMedical SchoolPecs 7624Hungary Department of surgery Clinical CenterUniversity of PécsMedical SchoolPécs 7624Hungary

BACKGROUND Previous meta-analyses,with many limitations,have described the beneficial nature of minimal invasive *** To compare all modalities of esophagectomies to each other from the results of randomized controlled trials(RCTs)in a network meta-analysis(NMA).METHODs We conducted a systematic search of the MEDLINE,EMBAsE,Reference Citation Analysis(https://***/)and CENTRAL databases to identify RCTs according to the following population,intervention,control,outcome(commonly known as PICO):P:Patients with resectable esophageal cancer;I/C:Transthoracic,transhiatal,minimally invasive(thoracolaparoscopic),hybrid,and robot-assisted esophagectomy;O:survival,total adverse events,adverse events in subgroups,length of hospital stay,and blood *** used the Bayesian approach and the random effects *** presented the geometry of the network,results with probabilistic statements,estimated intervention effects and their 95% confidence interval(CI),and the surface under the cumulative ranking curve to rank the *** We included 11 studies in our *** found a significant difference in postoperative pulmonary infection,which favored the minimally invasive intervention compared to transthoracic surgery(risk ratio 0.49;95%CI:0.23 to 0.99).The operation time was significantly shorter for the transhiatal approach compared to transthoracic surgery(mean difference-85 min;95%CI:-150 to-29),hybrid intervention(mean difference-98 min;95%CI:-190 to-9.4),minimally invasive technique(mean difference-130 min;95%CI:-210 to-50),and robot-assisted esophagectomy(mean difference-150 min;95%CI:-240 to-53).Other comparisons did not yield significant *** Based on our results,the implication of minimally invasive esophagectomy should be favored.

关键词： surgery Esophageal cancer Esophagectomy Network meta-analysis Minimally invasive Laparoscopy

semi-blind Adaptive Beamforming for High-throughput Quadrature Amplitude Modulation systems

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International Journal of Automation and computing 2010年第4期7卷 565-570页

作者： lajos Hanzo school of Electronics and Computer science University of Southampton

A semi-blind adaptive beamforming scheme is proposed for wireless systems that employ high-throughput quadrature amplitude modulation signalling. A minimum number of training symbols, equal to the number of receiver antenna arrayts elements, are first utilised to provide a rough initial least squares estimate of the beamformer＇s weight vector. A concurrent constant modulus algorithm and soft decision-directed scheme is then applied to adapt the beamformer. This semi-blind adaptive beamforming scheme is capable of converging fast to the minimum mean-square-error beamforming solution, as demonstrated in our simulation study.

关键词： Beamforming minimum mean square error quadrature amplitude modulation semi-blind adaptive algorithm constant modulus algorithm soft decision-directed scheme.