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Intestinal alkaline phosphatase in the colonic mucosa of children with inflammatory bowel disease

World Journal of Gastroenterology 2012年第25期18卷 3254-3259页

作者： Kriszta Molnár dám Vannay Beáta Szebeni Nóra Fanni Bánki Erna Sziksz ron Cseh Hajnalka Gyrffy péter lászló lakatos Mária papp András Arató Gábor Veres First Department of pediatrics Semmelweis UniversityH-1083 BudapestHungary Research Group for pediatrics and Nephrology Semmelweis University and Hungarian Academy of SciencesH-1083 BudapestHungary SE-MTA "lendulet" Diabetes Research Group H-1083 BudapestHungary Second Department of pathology Semmelweis UniversityH-1091 BudapestHungary First Department of Medicine Semmelweis UniversityH-1083 BudapestHungary Second Department of Medicine University of Debrecen H-4032 Debrecen Hungary

AIM:To investigate intestinal alkaline phosphatase(iAp) in the intestinal mucosa of children with inflammatory bowel disease(IBD).METHODS:Colonic biopsy samples were taken from 15 newly diagnosed IBD patients and from 10 healthy *** IBD patients,specimens were obtainedboth from inflamed and non-inflamed *** iAp mRNA and protein expression was determined by reverse transcription-polymerase chain reaction and Western blotting analysis,*** localization of iAp and Toll-like receptor(TlR) 4 was investigated by immunofluorescent ***:The iAp protein level in the inflamed mucosa of children with Crohn's disease(CD) and ulcerative colitis(UC) was significantly decreased when compared with controls(both p larly,we found a significantly decreased level of iAp protein in the inflamed mucosa in CD compared with non-inflamed mucosa in CD(p p protein level in inflamed colonic mucosa in patients with UC was decreased compared with non-inflamed mucosa in patients with CD(p p protein levels in the non-inflamed mucosa of patients with CD were similar to *** mRNA expression in inflamed colonic mucosa of children with CD and UC was not significantly different from that in non-inflamed colonic mucosa with *** of iAp mRNA in patients with noninflamed mucosa and in controls were ***-localization of iAp with TlR4 showed intense staining with a dotted-like *** was present in the inflamed and non-inflamed mucosa of patients with CD,UC,and in control biopsy specimens,irrespective of whether it was present in the terminal ileum or in the ***,the fluorescent signal of TlR4 was more pronounced in the colon compared with the terminal ileum in all groups ***:lower than normal iAp protein levels in inflamed mucosa of IBD patients may indicate a role for iAp in inflammatory lesions in *** on our results,administration of exogenous iAp enzyme to pa

关键词：碱性磷酸酶肠道疾病肠黏膜儿童溃疡性结肠炎免疫荧光染色蛋白水平 Toll样受体

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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’s disease(CD)and ulcerative colitis(UC).METHODS:The data from 41 patients with CD and 22 patients with UC were ***-four CD patients received infliximab,and 17 received *** endoscopic severity of CD was quantified with the simplified endoscopic activity score for Crohn’s disease in CD and with the Mayo endoscopic subscore in ***:Mucosal healing was achieved in 23 CD and7 UC *** therapy had to be restarted in78%of patients achieving complete mucosal healing with CD and in 100%of patients with *** clinical remission nor mucosal healing was associated with the time to restarting the biological therapy in either CD or ***:Mucosal healing did not predict sustained clinical remission in patients in whom the biological therapies had been stopped.

关键词： Crohn’s disease Ulcerative colitis Biological ther

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Foreign body impaction in the sigmoid colon: A twenty euro bet

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World Journal of Gastroenterology 2013年第24期19卷 3892-3894页

作者： Katalin E Müller András Arató péter lászló lakatos Mária papp Gábor Veres 1~(st) Department of pediatrics Semmelweis University1083 Budapest Hungary 1~(st) Department of pediatrics Semmelweis University 1~(st) Department of Medicine Semmelweis University1083 Budapest Hungary 2~(nd) Department of Medicine University of Debrecen4032 Debrecen Hungary

Foreign body ingestion is a common clinical problem in early childhood. However, it may occur even in adults, unknowingly. Most ingested foreign bodies entering the stomach pass through the gastrointestinal tract uneventfully. Here we report on a 13-year-old boy who presented with chronic abdominal pain, weight loss and occult gastrointestinal bleeding for 6 mo. Colonoscopy was negative; however, a ballpoint pen was impacted in the sigmoid region. Subsequently, the child admitted swallowing a pen as a 20-euro bet 6 mo previously. Crohn's disease is a chronic relaps-ing inflammatory gastrointestinal disease. It is often difficult to diagnose due to the fact that there is no single pathognomonic sign or symptom. This case is a description of an adolescent with chronic gastrointes-tinal symptoms due to a foreign body. Therefore, an ingested foreign body should be included in the differ-ential diagnostic procedure related to gastrointestinal symptoms.

关键词： Foreign bodies pen Differential diagnosis Crohn’s disease Child

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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 *** 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 *** 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 *** studies suggested that age-associated differences in the patterns of antibodies may be present,particularly in the youngest *** CD,most patients develop stricturing or perforating complications,and a significant numberof patients undergo surgery during the disease *** on recent knowledge,serum antibodies are qualitatively and quantitatively associated with complicated CD behavior and CD-related *** UC is characterized by extensive colitis and a high rate of *** patients with UC,high levels of antiCBir1 and pANCA are associated with the development of pouchitis after ileal pouch-anal ***,serologic markers for IBD can be applied to stratify IBD patients into more homogeneous subgroups with respect to disease *** 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 Ulcerat

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Real-world performance analysis of a novel computational method in the precision oncology of pediatric tumors

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World Journal of pediatrics 2023年第10期19卷 992-1008页

作者： Barbara Vodicska Júlia Déri Dóra Tihanyi Edit Várkondi EnikőKispéter Róbert Dóczi Dóra lakatos Anna Dirner Mátyás Vidermann péter Filotás Réka Szalkai-Dénes István Szegedi Katalin Bartyik Krisztina Míta Gábor Réka Simon péter Hauser György péter Csongor Kiss Miklós Garami István peták Oncompass Medicine Hungary Kft Retek Str.34Budapest 1024Hungary Division of pediatric Hematology-Oncology Department of PediatricsFaculty of MedicineUniversity of DebrecenDebrecenHungary Department of pediatrics Albert Szent-Györgyi Medical SchoolUniversity of SzegedSzegedHungary Onco-Hematology Department Velkey LászlóPaediatric Health CentreMiskolcHungary Department of paediatrics Semmelweis UniversityBudapestHungary Onco-Hematology Department Heim Pál Children’s HospitalBudapestHungary Department of pharmacology and pharmacotherapy Semmelweis UniversityBudapestHungary Department of pharmaceutical Sciences University of Illinois at ChicagoChicagoUSA Genomate Health CambridgeMAUSA

Background The utility of routine extensive molecular profiling of pediatric tumors is a matter of debate due to the high number of genetic alterations of unknown significance or low evidence and the lack of standardized and personalized decision support *** drug assignment(DDA)is a novel computational method to prioritize treatment options by aggregating numerous evidence-based associations between multiple drivers,targets,and targeted *** has been validated to improve personalized treatment decisions based on the outcome data of adult patients treated in the SHIVA01 clinical *** aim of this study was to evaluate the utility of DDA in pediatric *** Between 2017 and 2020,103 high-risk pediatric cancer patients(lved in our precision oncology program,and samples from 100 patients were eligible for further *** or blood samples were analyzed by whole-exome(WES)or targeted panel sequencing and other molecular diagnostic modalities and processed by a software system using the DDA algorithm for therapeutic decision ***,a molecular tumor board(MTB)evaluated the results to provide therapy *** Of the 100 cases with comprehensive molecular diagnostic data,88 yielded WES and 12 panel sequencing *** identified matching off-label targeted treatment options(actionability)in 72/100 cases(72%),while 57/100(57%)showed potential drug *** reached 88%(29/33)by 2020 due to the continuous updates of the evidence *** approved the clinical use of a DDA-top-listed treatment in 56 of 72 actionable cases(78%).The approved therapies had significantly higher aggregated evidence levels(AEls)than dismissed *** of WES results for targeted panels missed important mutations affecting therapy *** DDA is a promising approach to overcome challenges associated with the interpretation of extensive molecular profiling in the routine car

关键词： Computational decision support pediatric tumors precision oncology Tumor board

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Serological biomarkers for management of primary sclerosing cholangitis

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World Journal of Gastroenterology 2022年第21期28卷 2291-2301页

作者： David Tornai peter laszlo Ven peter laszlo lakatos Maria papp Division of Gastroenterology Department of Internal MedicineFaculty of MedicineUniversity of DebrecenDebrecen H-4032Hajdu-BiharHungary European Reference Network on Hepatological Diseases ERN RARE-LIVERDebrecen H-4032Hajdu-BiharHungary The First Department of Medicine Division of GastroenterologyUniversity of PécsPécs H-7624BaranyaHungary Kálmán laki Doctoral School of Biomedical and Clinical Sciences Faculty of MedicineUniversity of DebrecenDebrecen H-4032Hajdu-BiharHungary Division of Gastroenterology McGill University Health CentreMontreal QC H4A 3J1QuebecCanada The First Department of Medicine Semmelweis UniversityBudapest H-1083PestHungary

Clinical manifestations and progression of primary sclerosing cholangitis(pSC)are heterogeneous,and its pathogenesis is poorly *** importance of gut-liver interactions in the pathogenesis has been clinically confirmed and highlighted in different *** advances regarding biomarkers of biliarygut crosstalk may help to identify clinically relevant pSC subgroups assisting everyday clinical work-up(e.g.,diagnosis,disease stratification,or surveillance)and the exploration of potential therapeutic *** phosphatase produced by the biliary epithelium is consistently associated with ***,its level shows natural fluctuation limiting its use in individual ***,cell activation,and tissue remodeling markers have been reported to predict clinical *** immunoglobulin(Ig)G4 level is associated with a shorter transplantation-free *** type atypical perinuclear anti-neutrophil cytoplasmic antibodies(p-ANCAs)are non-specific markers of various autoimmune liver diseases and may reflect an abnormal B-cell response to gut microbial *** type atypical p-ANCA identifies pSC patients with particular clinical and genetic(for human leukocyte antigens)*** presence of IgA type anti-F-actin antibody(AAA)may predict a progressive disease course,and it is associated with enhanced mucosal immune response to various microbial antigens and enterocyte *** type anti-glycoprotein 2(Gp2)antibodies identify patients with a severe disease phenotype and poor survival due to enhanced fibrogenesis or development of *** soluble vascular adhesion protein-1(sVAp-1)level is associated with adverse disease outcomes in *** sVAp-1 levels correlate with mucosal addressin cell adhesion molecule-1(MAdCAM-1)expression in the liver that contributes to gut activated T-cell homing to the hepatobiliary *** the present paper,we review the evidence on these possible serological ma

关键词： primary sclerosing cholangitis Hepatobiliary Serological biomarker Immunoglobulin Inflammatory Tissue remodeling

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Access to biologicals in Crohn's disease in ten European countries

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World Journal of Gastroenterology 2017年第34期23卷 6294-6305页

作者： Márta péntek peter l lakatos Talitha Oorsprong lászló Gulácsi Milena pavlova Wim Groot Fanni Rencz Valentin Brodszky petra Baji Crohn’s Disease Research Group department of health economics corvinus university of budapest mcgill university muhcmontreal general hospital 1st department of internal medicine semmelweis university department of health services research caphrimaastricht university medical centrefaculty of healthmedicine and life sciencesmaastricht university top institute evidence based education research (tier) teachers academymaastricht university 不详

AIM To analyze access(availability, affordability and acceptability) to biologicals for Crohn's disease(CD) in ten European countries and to explore the associations between these dimensions, the uptake of biologicals and economic *** A questionnaire-based survey combined with desk research was carried out in May 2016. Gastroenterologists from the Czech Republic, France, Germany, Hungary, latvia, poland, Romania, Slovakia, Spain and Sweden were invited to participate and provide data on the availability of biologicals/biosimilars, reimbursement criteria, clinical practice and prices, and use of biologicals. An availability score was developed to evaluate the restrictiveness of eligibility and administrative criteria applied in the countries. Affordability was defined as the annual cost of treatment as a share of gross domestic product(GDp) per capita. Correlations with the uptake of biologicals, dimensions of access and GDp per capita were *** At the time of the survey, infliximab and adalimumab were reimbursed in all ten countries, and vedolizumab was reimbursed in five countries(France, Germany, latvia, Slovakia, Sweden). Reimbursement criteria were the least strict in Sweden and Germany, and the strictest in Hungary, poland and Slovakia. Between countries, the annual cost of different biological treatments differed 1.6-3.3-fold. Treatments were the most affordable in Sweden(13%-37% of the GDp per capita) and the least affordable in the Central and Eastern European countries, especially in Hungary(87%-124%) and Romania(141%-277%). Biosimilars made treatments more affordable by driving down the annual costs. The number of patients with CD on biologicals per 100000 population was strongly correlated with GDp per capita(0.91), although substantial differences were found in the uptake among countries with similar economic development. Correlation between the number of patients with CD on biologicals per 100000 population and the availabi

关键词： Crohn’s disease Biological therapy Access Inequality Europe

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prediction of disease course in inflammatory bowel diseases

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World Journal of Gastroenterology 2010年第21期16卷 2589-2590页

作者： peter laszlo lakatos 1st Department of Medicine Semmelweis UniversityH-1083 BudapestKoranyi S 2AHungary

Clinical presentation at diagnosis and disease course of both Crohn's disease(CD) and ulcerative colitis are heterogeneous and variable over *** most patients have a relapsing course and most CD patients develop complications(*** and/or perforation),much emphasis has been placed in the recent years on the determination of important predictive *** identification of these factors may eventually lead to a more personalized,tailored *** this TOpIC HIGHlIGHT series,we provide an update on the available literature regarding important clinical,endoscopic,fecal,serological/routine laboratory and genetic *** aim is to assist clinicians in the everyday practical decisionmaking when choosing the treatment strategy for their patients suffering from inflammatory bowel diseases.

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

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prevalence,predictors,and clinical consequences of medical adherence in IBD:How to improve it?

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World Journal of Gastroenterology 2009年第34期15卷 4234-4239页

作者： peter laszlo lakatos 1st Department of Medicine Semmelweis University

Inflammatory bowel diseases(IBD)are chronic diseases with a relapsing-remitting disease course necessitating lifelong ***,non-adherence has been reported in over 40%of patients,especially those in remission taking maintenance therapies for IBD. The economical impact of non-adherence to medical therapy including absenteeism,hospitalization risk, and the health care costs in chronic conditions,is *** causes of medication non-adherence are complex,where the patient-doctor relationship, treatment regimen,and other disease-related factors play key ***,subjective assessment might underestimate *** adherence may result in more frequent relapses,a disabling disease course, in ulcerative colitis,and an increased risk for colorectal *** medication adherence in patients is an important challenge for *** the different patient types,the reasons given by patients for non-adherence,simpler and more convenient dosage regimens,dynamic communication within the health care team,a self-management package incorporating enhanced patient education and physician-patient interaction,and identifying the predictors of nonadherence will help devise suitable plans to optimize patient *** editorial summarizes the available literature on frequency,predictors,clinical consequences,and strategies for improving medical adherence in patients with IBD.

关键词：传染性法氏囊病医疗费用预测临床患病率溃疡性结肠炎药物治疗慢性疾病

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Clinical relevance of changes in bone metabolism in inflammatory bowel disease

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World Journal of Gastroenterology 2010年第44期16卷 5536-5542页

作者： pal Miheller Katalin lrinczy peter laszlo lakatos 1st Department of Medicine Semmelweis University

low bone mineral density is an established, frequent, but often neglected complication in patients with inflammatory bowel disease (IBD). Data regarding the diagnosis, therapy and follow-up of low bone mass in IBD has been partially extrapolated from postmenopausal osteoporosis; however, the pathophysiology of bone loss is altered in young patients with IBD. Fracture, a disabling complication, is the most important clinical outcome of low bone mass. Estimation of fracture risk in IBD is difficult. Numerous risk factors have to be considered, and these factors should be weighed properly to help in the identification of the appropriate patients for screening. In this editorial, the authors aim to highlight the most important clinical aspects of the epidemiology, prevention, diagnosis and treatment of IBD-related bone loss.

关键词： Inflammatory bowel disease Crohn’s disease Osteoporosis Osteopenia prevention

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