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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 laka.o. 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： Inflammatory bowel disease Crohn's disease Ulcerative colitis Therapy Adherence Compliance 5-aminosalicylate Mesalazine Azathioprine

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 laka.o. 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

Risk for colorectal cancer in ulcerative colitis:Changes,causes and management strategies

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World Journal of Gastroenterology 2008年第25期14卷 3937-3947页

作者： peter laszlo laka.o. laszlo laka.o. 1st Department of Medicine Semmelweis University 1st Department of Medicine Csolnoky F. County Hospital

The risk of colorectal cancer for any patient with ulcer-ative colitis is known to be elevated, and is estimated to be 2% after 10 years, 8% after 20 years and 18% after 30 years of disease. Risk factors for cancer in-clude extent and duration of ulcerative colitis, primary sclerosing cholangitis, a family history of sporadic colorectal cancer, severity of histologic bowel inflam-mation, and in some studies, young age at onset of colitis. In this review, the authors discuss recent epide-miological trends and causes for the observed chang-es. Population-based studies published within the past 5 years suggest that this risk has decreased over time, despite the low frequency of colectomies. The crude annual incidence rate of colorectal cancer in ulcerative colitis ranges from approximately 0.06% to 0.16% with a relative risk of 1.0-2.75. The exact mechanism for this change is unknown; it may partly be explained by the more widespread use of maintenance therapy and surveillance colonoscopy.

关键词： Ulcerative colitis Colorectal cancer Riskfactors Surveillance Chemprevention

Recent trends in the epidemiology of inflammatory bowel diseases:Up or down?

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World Journal of Gastroenterology 2006年第38期12卷 6102-6108页

作者： peter laszlo laka.o. 1~(st) Department of Medicine Semmelweis University Budapest Hungary

Inflammatory bowel disease (IBD) is traditionally con- sidered to be common in the Western world, and its incidence has sharply increased since the early 1950s. In contrast, until the last decade, low prevalence and incidence rates have been reported from other parts of the world including Eastern Europe, South America, Asia and the Pacific region. Recent trends indicate a change in the epidemiology of IBD with previously low incidence areas now reporting a progressive rise in the incidence, while in West European and North American countries the figures have stabilized or slightly increased, with decreasing incidence rates for ulcerative colitis. Some of these changes may represent differences in diagnostic practices and increasing awareness of the disease. The quality of studies is also variable. Additional epidemio- logic studies are needed to better define the burden of illness, explore the mechanism of association with envi- ronmental factors, and identify new risk factors.

关键词： Inflammatory bowel diseases Ulcerative colitis Crohn's disease Incidence Epidemiology

Use of new once-daily 5-aminosalicylic acid preparations in the treatment of ulcerative colitis:Is there anything new under the sun?

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World Journal of Gastroenterology 2009年第15期15卷 1799-1804页

作者： peter laszlo laka.o. 1st Department of Medicine Semmelweis University

5-aminosalicylate(5-ASA)agents remain the mainstay treatment in ulcerative colitis(UC).A number of oral 5-ASA agents are commercially available,including azobond pro-drugs,as well as delayed-and controlledrelease forms of ***,poor adherence due to frequent daily dosing and a large number of tablets has been shown to be an important barrier to successful management of patients with ***, new,once-daily formulations of mesalazine,including the unique multi-matrix delivery system and mesalazine granules,were proven to be efficacious in inducing and maintaining remission in mild-to-moderate UC,with a good safety profile comparable to that of other oral mesalazine *** addition,they offer the advantage of a low pill burden and might contribute to increased long-term compliance and treatment success in clinical *** editorial summarizes the available literature on the short-and medium-term efficacy and safety of the new once-daily mesalazine formulations.

关键词： Ulcerative colitis 5-aminosalicylate Mesalazine Multi matrix system Therapy once-daily Compliance

Smoking in inflammatory bowel diseases:Good,bad or ugly?

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World Journal of Gastroenterology 2007年第46期13卷 6134-6139页

作者： peter laszlo laka.o. Tamas Szamosi laszlo laka.o. Department of Medicine Semmelweis UniversityBudapestHungary Department of Medicine Csolnoky F.County HospitalVeszpremHungary

Smoking is an important environmental factor in inflammatory bowel disease （IBD）, having different effects in ulcerative colitis （UC） and Crohn＇s disease （CD）. A recent meta-analysis partially confirmed previous findings that smoking was found to be protective against ulcerative colitis and, after onset of the disease, might improve its course, decreasing the need for colectomy. However, smoking increases the risk of developing Crohn＇s disease and worsens its course, increasing the need for steroids, immunosuppressants and re-operations. Smoking cessation aggravates ulcerative colitis and improves Crohn＇s disease. Data are however, largely conflictive as well as the potential mechanisms involved in this dual relationship are still unknown. In this review article, the authors review the role of smoking in inflammatory bowel diseases.

关键词： Smoking Crohn's disease Ulcerative colitis Phenotype

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 laka.o. 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

Current status of thiopurine analogues in the treatment in Crohn's disease

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World Journal of Gastroenterology 2011年第39期17卷 4372-4381页

作者： peter laszlo laka.o. Lajos S Kiss 1st Department of Medicine Semmelweis University

In the last decades,with the development of biological therapy,the treatment paradigms in patients with Crohn＇s disease have continuously *** studies focusing on the optimal use of both traditional immunosuppressants and biological therapy have been published,investigating conventional,accelerated stepup and top-down *** addition,much emphasis has been placed in recent years on the de-termination of important predictive factors that could enable early patient stratification,which would lead to a tailored management *** this review,the authors try to highlight new evidence on the optimal timing,benefits,and risks of immunosupressants alone,or in combination,in patients with Crohn＇s disease.

关键词： Crohn's disease Immunosuppressives Azathioprine Thiopurine methyltrans ferase Biologicals

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 laka.o. 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