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

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 v.ncze 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 comprehensiv. 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 *** Elev.n articles were identified suitable for analyses, inv.lv.ng 343 patients, 235 cases and 229 controls in total. Four studies used crossov.r design with 121 subjects enrolled. The periodic dilation index(PDI) was comparable in 4 studies, where the pooled result showed a significant improv.ment 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 improv.(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. Howev.r, its potential role needs further research.

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

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Restoration of energy lev.l 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 v.rjú 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-Univ.rsity 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 ev.nts in the early phase of AP. Moreov.r, it has been rev.aled that restoration of intracellular ATP lev.l restores cellular functions and defends the cells from death. We hav. recently shown in a systematic rev.ew and meta-analysis that early enteral feeding is beneficial in adults; howev.r, no rev.ews are av.0}able concerning the effect of early enteral feeding in pediatric AP. In this minirev.ew, our aim was to systematically analyse the literature on the treatmentof acute pediatric pancreatitis. The preferred reporting items for systematic rev.ew(PRISMA-P) were followed, and the question was drafted based on participants, interv.ntion, 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 intensiv. care unit, dev.lopment of sev.re 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, fiv. of them met inclusion criteria. Only retrospectiv. clinical trials were av.0}able. 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 minirev.ew, we clearly show that early enteral nutrition, started within 24-48 h, is beneficial in acute pediatric pancreatitis. Prospectiv. studies and better pres

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

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Chronic kidney disease sev.rely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis

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World Journal of Gastroenterology 2017年第47期23卷 8415-8425页

作者： Roland Hágendorn Nelli Farkas Aron v.ncze Zoltán Gyongyi Dezso Csupor Judit Bajor Bálint Eross Péter Csécsei Andrea v.sas Zsolt Szakács László Szapáry Péter Hegyi Alexandra mikó Department of Gastroenterology First Department of MedicineUniversity of Pécs Institute of Bioanalysis University of Pécs Department of Public Health Medicine University of Pécs Department of Pharmacognosy Faculty of PharmacyUniversity of Szeged Institute for Translational Medicine University of Pécs Department of Neurology University of Pécs

AIM To understand the influence of chronic kidney disease(CKD) on mortality, need for transfusion and rebleeding in gastrointestinal(GI) bleeding *** A systematic search was conducted in three databases for studies on GI bleeding patients with CKD or endstage renal disease(ESRD) with data on outcomes of mortality, transfusion requirement, rebleeding rate and length of hospitalization(LOH). Calculations were performed with Comprehensiv. Meta-Analysis software using the random effects model. Heterogeneity was tested by using Cochrane's Q and I2 statistics. Mean difference(MD) and OR(odds ratio) were ***1063 articles(EMBASE: 589; PubM ed: 459; Cochrane: 15) were found in total. 5 retrospectiv. articles and 1 prospectiv. study were av.0}able for analysis. These 6 articles contained data on 406035 patients, of whom 51315 had impaired renal function. The analysis showed a higher mortality in the CKD group(OR = 1.786, 95%CI: 1.689-1.888, P v. patient registries and observ.tional clinical trials are crucially needed.

关键词： Gastrointestinal bleeding Chronic kidney disease Mortality Blood transfusion Rebleeding

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Body-mass index correlates with sev.rity 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 Div.sion 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 hav. 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 relev.nt to inv.stigate how body-mass index(BMI) affects the outcome of the *** To quantify the association between subgroups of BMI and the sev.rity and mortality of *** A meta-analysis was performed using the Preferred Reporting Items for Systematic Rev.ew and Meta-Analysis(PRISMA) Protocols. Three databases(PubMed, EMBASE and the Cochrane Library) were searched for articles containing data on BMI, disease sev.rity 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 inv.lv.d in the sev.rity 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 sev.rity, a subgroup analysis showed a direct association between AP sev.rity and BMI. BMI v.rity;howev.r, BMI > 25 had an almost three-fold increased risk for sev.re AP in comparison to normal BMI(OR = 2.87, 95%CI: 1.90-4.35, P v.re AP is higher than that of the non-sev.re group(MD = 1.79, 95%CI: 0.89-2.70, P v.r, the chance of mortality

关键词： Acute pancreatitis Body-mass index Obesity Sev.rity Mortality Prognostic Meta-analysis

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