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  • 1
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    Az onkohematológiai betegségek kezelésében használt tirozinkináz-gátló imatinib és nilotinib csonthatásainak irodalmi áttekintése és a saját kutatási eredmények bemutatása
    Akademiai Kiado Zrt. ; 2016
    In:  Orvosi Hetilap Vol. 157, No. 36 ( 2016-09), p. 1429-1437
    Details
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 157, No. 36 ( 2016-09), p. 1429-1437
    Abstract: Tyrosine kinase inhibitors are widely used for treatment of certain oncohematological diseases. Several clinical studies have confirmed that specific BCR-ABL tyrosine kinase inhibitors alter the physiological process of bone tissue in a complex and unclearly identified manner. Since these treatments are being given to more and more patients, and the therapy takes decades or lasts even lifelong, it is justifiable to obtain more detailed knowledge of the molecular background of these mechanisms. In this article the authors summarize preliminary research results and human clinical observations on imatinib and nilotinib which are related to bone metabolism, and present the results of their own experiments in in vitro osteoblast cultures. Based on the presented results, the effects of imatinib and nilotinib on bone cells depend on the concentration of imatinib and nilotinib, the maturation stage of the cells and the distribution ratio of receptor tyrosine kinase signaling pathways. In this study the authors firstly prepared a stop-gap, comprehensive review in the Hungarian literature, regarding the effects of tyrosine kinase inhibitors on bone metabolism. In addition they firstly performed whole transcriptome analysis on osteoblasts in order to obtain a better understanding of the cellular molecular mechanisms. Orv. Hetil., 2016, 157(36), 1429–1437.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/650.2016.30525
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2016
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  • 2
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    Changes in the epidemiology of inflammatory bowel diseases
    Akademiai Kiado Zrt. ; 2007
    In:  Orvosi Hetilap Vol. 148, No. 5 ( 2007-02), p. 223-228
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    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 148, No. 5 ( 2007-02), p. 223-228
    Abstract: Significant changes have been observed in the epidemiology of inflammatory bowel diseases (IBD) in the last two decades. Traditionally, the incidence of IBD was higher in the developed, industrialized countries, in contrast, nowadays it became more prevalent in the previously low incidence areas. In particular, the incidence of ulcerative colitis (UC) is similar to that observed in North America and Western Europe, while the incidence of Crohn’s disease (CD) in developing countries is still low, suggesting that the environmental factors may act faster or differently in UC than in CD. In Europe, the North to South gradient disappeared, and also the West to East gradient is diminishing. Smoking and appendectomy may be considered as important environmental factors in both UC and CD, however, with opposite effects. In addition, the use of oral contraceptives is associated to disease susceptibility in both diseases. The role of diet, perinatal events, stress and nonsteroidal anti-inflammatory drugs in the pathogenesis is still controversial.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/OH.2007.27906
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2007
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  • 3
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    Colonic diverticular: disease diagnosis and therapy
    Akademiai Kiado Zrt. ; 2012
    In:  Orvosi Hetilap Vol. 153, No. 6 ( 2012-02), p. 205-213
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    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 153, No. 6 ( 2012-02), p. 205-213
    Abstract: Colonic diverticular disease is one of the most common gastrointestinal disorders in the Western world, affecting approximately 50% of the population above the age of 70 years. Symptoms develop only in about one quarter of the affected individuals with complications in one-third of the symptomatic patients. Diagnosis is mostly confirmed by colonoscopy. Abdominal CT is the most sensitive for the diagnosis of complicated severe diverticulitis, while colonoscopy or in severe cases angiography may be performed in bleeding patients. Initial therapy of non-complicated symptomatic diverticulitis includes antibiotics and more recently non-absorbable antibiotics. In complicated cases should be treated with broad spectrum i.v. antibiotics, however surgery may became necessary in a minority of the cases. The proportion of patients needing acute surgical intervention has decreased in the last decades with the advancement of conservative management including medical therapy, endoscopy and imaging techniques and the indication of elective was also changed. Orv. Hetil., 2012, 153, 205–213.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/OH.2012.29311
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2012
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  • 4
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    Predictors of efficacy, mucosal healing and dose intensification during the first year of adalimumab therapy in patients with luminal and fistulizing Crohn’s disease. National data from Hungary
    Akademiai Kiado Zrt. ; 2011
    In:  Orvosi Hetilap Vol. 152, No. 36 ( 2011-09), p. 1433-1442
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    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 152, No. 36 ( 2011-09), p. 1433-1442
    Abstract: Adalimumab is a fully human monoclonal antibody targeting tumor necrosis factor with proven efficacy in the treatment of Crohn’s disease in clinical trials. The aim of the present study was to investigate the predictors of medium term clinical efficacy and mucosal healing during adalimumab therapy in patients with Crohn’s disease in specialized centers approved for biological therapy in Hungary. Methods: Data of 201 Crohn’s disease patients were prospectively captured (male/female: 112/89, median age: 24 years, duration: 8 years). Previous infliximab therapy was given in 97 (48.3%) patients, concomitant steroids in 41.3% and azathioprine in 69.2% (combined: 26.4%) of patients. Results: Overall clinical response and remission rates at 24 and 52 weeks were 78% and 52%, and 69.4% and 44.4%, respectively. Endoscopic improvement and healing was achieved in 43.1% and 23.6%, respectively. In a logistic regression model, clinical efficacy and normalized C-reactive protein at week 12, need for combined immunosuppression at induction, shorter disease duration and smoking were identified as independent predictors for 12-month clinical outcome, while normalized C-reactive protein at week 12, clinical remission at week 24, frequency of previous relapses and smoking were associated to endoscopic improvement/healing. Dose intensification to weekly dosing was needed in 16.4%. Parallel azathioprine therapy and clinical remission at week 12 was inversely associated to dose escalation to weekly dosing. Conclusion: Clinical efficacy and normalized C-reactive protein at week 12, need for combined immunosuppression, luminal disease and smoking are predictors for medium term clinical efficacy/mucosal healing during adalimumab therapy, while parallel azathioprine therapy may decrease the probability for dose escalation. Orv. Hetil., 2011, 152, 1433–1442.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/OH.2011.29200
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2011
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  • 5
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    The effect of early immunosuppressive therapy on the rate of resections performed in patients with Chron’s disease, in Veszprém county, Hungary, a population-based cohort study
    Akademiai Kiado Zrt. ; 2012
    In:  Orvosi Hetilap Vol. 153, No. 14 ( 2012-04), p. 541-552
    Details
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 153, No. 14 ( 2012-04), p. 541-552
    Abstract: Medical therapy for Crohn’s disease has changed significantly over the past 20 years with the increasing use of immunosuppressants. In contrast, surgery rates are still high and evidence about the the changes in the outcome of Crohn’s disease over the past decades is scarce. Aims: The objective of this study was to analyze the evolution of the surgical rates and medical therapy in the population-based Veszprém county database. Methods: Data of 506 Crohn’s disease patients were analyzed (age at diagnosis: 31.5 years, SD: 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed. The study population was divided into three groups based on the year of diagnosis (cohort A: 1977–1989, cohort B: 1990–1998 and cohort C: 1999–2008). Results: Overall azathioprine, systemic steroid, and biological (only available after 1998) exposure was 45.8, 68.6, and 9.5%, respectively. The 1 and 5-year probabilities of azathioprine use were 3.2 and 6.2% in cohort A, 11.4 and 29.9% in cohort B, and 34.8 and 46.2% in cohort C. In multivariate analysis, decade of diagnosis (P 〈 0.001), age at onset (P = 0.008), disease behavior at diagnosis (P 〈 0.001), and need for systemic steroids (P 〈 0.001) were significantly associated with the time to initiation of azathioprine therapy. Early azathioprine use was significantly associated with the time to intestinal surgery in Crohn’s disease patients; in a multivariate Cox analysis (HR: 0.43, 95% confidence interval (CI): 0.28–0.65) and after matching on propensity scores for azathioprine use (HR: 0.42,95% CI:0.26–0.67). Conclusions: This population-based inception cohort showed that reduction in surgical rates was independently associated with increased and earlier azathioprine use. Orv. Hetil., 2012, 153, 541–552.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/OH.2012.29331
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2012
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  • 6
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    A D-vitamin metabolizmusa humán hepatocellularis carcinomában és az azt körülvevő tumormentes májszövetben
    Akademiai Kiado Zrt. ; 2016
    In:  Orvosi Hetilap Vol. 157, No. 48 ( 2016-11), p. 1910-1918
    Details
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 157, No. 48 ( 2016-11), p. 1910-1918
    Abstract: Introduction: 1,25-Dihydroxy vitamin D 3 mediates antitumor effects in hepatocellular carcinoma. Aim: We examined mRNA and protein expression differences in 1,25-Dihydroxy vitamin D 3 -inactivating CYP24A1, mRNA of activating CYP27B1 enzymes, and that of VDR between human hepatocellular carcinoma and surrounding non-tumorous liver. Methods: Snap-frozen tissues from 13 patients were studied for mRNA and protein expression of CYP24A1. Paraffin-embedded tissues from 36 patients were used to study mRNA of VDR and CYP27B1. mRNA expression was measured by RT-PCR, CYP24A1 protein was detected by immunohistochemistry. Results: Expression of VDR and CYP27B1 was significantly lower in hepatocellular carcinoma compared with non-tumorous liver (p 〈 0.05). The majority of the HCC samples expressed CYP24A1 mRNA, but neither of the non-tumorous liver. The gene activation was followed by CYP24A1 protein synthesis. Conclusions: The presence of CYP24A1 mRNA and the reduced expression of VDR and CYP27B1 mRNA in human hepatocellular carcinoma samples indicate decreased bioavailability of 1,25-Dihydroxy vitamin D 3 , providing an escape mechanism from the anti-tumor effect. Orv. Hetil., 2016, 157(48), 1910–1918.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/650.2016.30592
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2016
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  • 7
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    Novel mutation in a patient with Carney complex
    Akademiai Kiado Zrt. ; 2011
    In:  Orvosi Hetilap Vol. 152, No. 20 ( 2011-05), p. 802-804
    Details
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 152, No. 20 ( 2011-05), p. 802-804
    Abstract: Carney complex is a rare disease inherited in an autosomal dominant manner. It is mostly caused by inactivating mutations of the subunit of protein kinase A. Carney complex is associated with atrial myxoma, nevi or myxomas of the skin, breast tumors and endocrine overactivity. Primary pigmented nodular adrenocortical disease is the specific endocrine manifestation. The authors present the history of a 53-year-old female patient who had undergone surgery for atrial myxomas, thyroid tumor and breast cancer. She was also operated for an adrenal adenoma causing Cushing’s syndrome. Genetic study revealed a mutation in the regulatory subunit of protein kinase A (ivs2-1G 〉 A splice mutation in intron 2). Her heterozygous twins were also genetically screened and one of them carried the same mutation. The authors emphasize that despite the absence of specific treatment for patients with Carney complex, confirmation of the diagnosis by genetic studies is important for the close follow-up of the patient and early identification of novel manifestations. Orv. Hetil., 2011, 152, 802–804.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/OH.2011.29117
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2011
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  • 8
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    Cardiovascular side effects of non-steroidal anti-inflammatory drugs in the light of recent recommendations. Diclofenac is not more dangerous
    Akademiai Kiado Zrt. ; 2015
    In:  Orvosi Hetilap Vol. 156, No. 13 ( 2015-03), p. 516-520
    Details
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 156, No. 13 ( 2015-03), p. 516-520
    Abstract: Among their beneficial effects, non-steroidal anti-inflammatory drugs may also exert several side effects which depend on the dosage and the type of these medications. The most frequent gastrointestinal side effects usually develop shortly after the beginning of their administration, but others such as cardiovascular interactions (which are present much less frequently than gastrointestinal side effects) can also occur after the beginning of drug administration without a latency period. For a long-term treatment, non-steroidal anti-inflammatory drugs are most frequently used in the elderly population where patients typically have high cardiovascular risk and take other medicines, e.g. low dose acetylsalicylic acid that can interact with non-steroidal anti-inflammatory drugs; in this aspect diclofenac may cause less side effects. In this review, the authors briefly review cardiovascular side effects of non-steroidal anti-inflammatory drugs, the processes which potentially influence them, therapeutic consequences and their interaction with acetylsalicylic acid. Orv. Hetil., 2015, 156(13), 516–520.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/OH.2015.30120
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2015
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  • 9
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    Role of pulse oximetric monitoring during gastrointestinal endoscopy. Prospective multicenter study of the Gastroenterological Working Group of the Veszprém Regional Committee of the Hungarian Academy of Sciences (VEAB)
    Akademiai Kiado Zrt. ; 2013
    In:  Orvosi Hetilap Vol. 154, No. 21 ( 2013-05), p. 825-833
    Details
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 154, No. 21 ( 2013-05), p. 825-833
    Abstract: Introduction: Recent guidelines recommend routine pulse oximetric monitoring during endoscopy, however, this has not been the common practice yet in the majority of the local endoscopic units. Aims: To draw attention to the importance of the routine use of pulse oximetric recording during endoscopy. Method: A prospective multicenter study was performed with the participation of 11 gastrointestinal endoscopic units. Data of pulse oximetric monitoring of 1249 endoscopic investigations were evaluated, of which 1183 were carried out with and 66 without sedation. Results: Oxygen saturation less than 90% was observed in 239 cases corresponding to 19.1% of all cases. It occurred most often during endoscopic retrograde cholangiopancreatography (31.2%) and proximal enteroscopy (20%). Procedure-related risk factors proved to be the long duration of the investigation, premedication with pethidine (31.3%), and combined sedoanalgesia with pethidine and midazolam (34.38%). The age over 60 years, obesity, consumption of hypnotics or sedatives, severe cardiopulmonary state, and risk factor scores III and IV of the American Society of Anestwere found as patient-related risk factors. Conclusion: To increase the safety of patients undergoing endoscopic investigation, pulse oximeter and oxygen supplementation should be the standard requirement in all of the endoscopic investigation rooms. Pulse oximetric monitoring is advised routinely during endoscopy with special regard to the risk factors of hypoxemia. Orv. Hetil., 2013, 154, 825–833.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/OH.2013.29613
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2013
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  • 10
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    A dirofilariosis – fonalféreg-fertőzés – ritka esete fej-nyak sebészeti területen
    Akademiai Kiado Zrt. ; 2018
    In:  Orvosi Hetilap Vol. 159, No. 45 ( 2018-11), p. 1844-1847
    Details
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 159, No. 45 ( 2018-11), p. 1844-1847
    Abstract: Abstract: Dirofilariasis refers to an infection caused by a specific parasitic roundworm. Dirofilaria repens – transmitted by mosquito bites – accounts for most human cases. The parasite forms a subcutaneous mass called cutaneous dirofilariasis near the original site of intrusion. The incidence of human infections shows an increasing tendency. We report a case of a 35-year-old woman presenting with three-week history of a painful swelling in the temporal region. The initial diagnostic work-up revealed a roundworm embedded in the subcutaneous fat tissue and temporal muscle. Differential diagnosis included erysipelas, herpes zoster, temporal arteritis. The final diagnosis of helminthiasis was established by ultrasound examination. A multidisciplinary consultation including infectious diseases specialist suggested surgical removal of the lesion. The microbiological examination of the specimen confirmed the presence of a female Dirofilaria repens. Orv Hetil. 2018; 159(45): 1844–1847.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/650.2018.31216
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2018
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