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  • 1
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    Online Resource
    Observational longitudinal multicentre investigation of acute pancreatitis (GOULASH PLUS): follow-up of the GOULASH study, protocol
    BMJ ; 2019
    In:  BMJ Open Vol. 9, No. 8 ( 2019-08), p. e025500-
    Details
    In: BMJ Open, BMJ, Vol. 9, No. 8 ( 2019-08), p. e025500-
    Abstract: Acute pancreatitis (AP) is an inflammatory condition that can lead to late consequences. Recurrent AP (RAP) develops in 20% of patients and chronic pancreatitis (CP) occurs in 7%–12.8%. However, we do not have sufficient information to establish an evidence-based statement to define early CP, or how to prevent its development. Aim The aim of this study was to understand the influencing factors and to determine which parameters should be measured or used as a biomarker to detect the early phase of CP. Methods/Design This is an observational prospective follow-up study of the GOULASH-trial (ISRTCN 63827758) in which (1) all severity of pancreatitis are included; (2) patients receive only therapeutic modalities which are accepted by the evidence based medicine (EBM) guideline; (3) whole blood, serum and plasma samples are stored in our biobank; and (4) large amount of variables are collected and kept in our electronic database including anamnestic data, physical examination, laboratory parameters, imaging, therapy and complications. Therefore, this fully characterised patient cohort are well suitable for this longitudinal follow-up study. Patients’ selection: patients enrolled in the GOULASH study will be offered to join to the longitudinal study. The follow-up will be at 1, 2, 3, 4, 5 and 6 years after the episode of AP. Anamnestic data will be collected by questionnaires: (1) diet history questionnaire, (2) 36-Item Short-Form Health Survey, (3) physical activity questionnaire and (4) stress questionnaire. Genetic tests will be performed for the genes associated with CP. The exocrine and endocrine pancreatic, liver and kidney functions will be determined by laboratory tests, stool sample analyses and imaging. Cost-effectiveness will be analysed to examine the relationship between events of interest and health-related quality of life or to explore subgroup differences. Conclusion This study will provide information about the risk and influencing factors leading to CP and identify the most useful measurable parameters. Trial registration number ISRCTN63396106
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2018-025500
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2599832-8
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  • 2
    Online Resource
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    Investigating the early phase of chronic pancreatitis: the Goulash-Plus trial protocol and the results of the first 10 months
    Elsevier BV ; 2019
    In:  Pancreatology Vol. 19 ( 2019-06), p. S138-
    Details
    In: Pancreatology, Elsevier BV, Vol. 19 ( 2019-06), p. S138-
    Type of Medium: Online Resource
    ISSN: 1424-3903
    URL: Article
    DOI: 10.1016/j.pan.2019.05.374
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2043694-4
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  • 3
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    Treatment of pituitary adenomas
    Akademiai Kiado Zrt. ; 2009
    In:  Orvosi Hetilap Vol. 150, No. 39 ( 2009-09-1), p. 1803-1810
    Details
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 150, No. 39 ( 2009-09-1), p. 1803-1810
    Abstract: Az agyalapi mirigy térfoglaló folyamatainak prevalenciája epidemiológiai vizsgálatok alapján 16,5%, túlnyomó többségük „incidentaloma”. A hypophysisbetegségek klinikai tünetei gyakran nem specifikusak, felismerésük a hypophysis hormontermelésének zavara, kompressziós tünetek, hypophysisapoplexia kapcsán vagy véletlen leletként történik. A laboratóriumi diagnosztika eltér a perifériás endokrin szerv betegségeiben megszokott algoritmustól. A prolactinomák ellátásában a dopaminagonista kezelés jelenti az első vonalbeli terápiát, a kezelés célja a prolaktinszint normalizálása, reproduktív korban a fertilitás visszaállítása, a tumortömeg megkisebbítése, a reziduális hypophysisműködés megőrzése vagy javítása és a betegség kiújulásának gátlása. A dopaminagonista készítmények közül hazánkban a bromocriptin és a quinagolid érhető el. A kezelésre jól reagáló tumoroknál 3–5 év múlva a gyógyszer elhagyható, ezen betegek kétharmadánál recidívára nem kell számítani. A GH-, ACTH- és TSH-termelő, valamint hormonálisan inaktív tumoroknál prioritása van az idegsebészeti megoldásnak. Az idegsebészeti technikák jelentősen fejlődtek az elmúlt évtizedekben, a műtéti mortalitás csökkent. A műtéttel nem gyógyítható acromegaliás betegek kezelésében lényeges haladást hoztak a szomatosztatinanalógok, és kezdeti tapasztalatok vannak a GH-receptor-antagonista pegvisomant alkalmazásával. A Cushing-kór gyógyszeres kezelése továbbra is a mellékvese-működés gátlásán alapszik, klinikai vizsgálat fázisában van egy új szomatosztatinanalóg, a pasireotid. A ritka TSH-termelő adenomák dopaminagonista és szomatosztatinanalóg kezelésre egyaránt reagálhatnak. A hypophysistumorok hagyományos irradiációs kezelése háttérbe szorult, invazív, inoperábilis vagy malignus tumoroknál jön szóba. A sugársebészet és a frakcionált stereotaxiás sugárkezelés helye a hypophysistumorok ellátásában még további vizsgálatokat igényel.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/oh.2009.28584
    Language: Unknown
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2009
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  • 4
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    Online Resource
    Vitamin D level in Hungarian patients with inflammatory bowel diseases
    Akademiai Kiado Zrt. ; 2013
    In:  Orvosi Hetilap Vol. 154, No. 46 ( 2013-11), p. 1821-1828
    Details
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 154, No. 46 ( 2013-11), p. 1821-1828
    Abstract: Introduction: Vitamin D has an important role in the immune regulation. Vitamin D is essential for innate and adaptive immune systems and it plays a significant role in the formation of immune tolerance, as well. Aim: Vitamin D deficiency has been observed in patients with inflammatory bowel diseases in Western Europe, but there is no data available from Eastern Europe. Method: The study included 169 patients with inflammatory bowel disease. Results: The median vitamin D level was 22.7±10.6 ng/ml. Only 20% of the patients had adequate vitamin D level ( 〉 30 ng/ml), 52% had vitamin D insufficiency (15–30 ng/ml), and 28% of them had severe vitamin D deficiency ( 〈 15 ng/ml). Vitamin D concentration failed to correlate with clinical activity indexes (partial Mayo score: r = –0.143; Crohn’s disease activity index: r = –0.253) and with inflammatory parameters (C-reactive protein: r = 0.008; erythrocyte sedimentation rate: r = 0.012). Conclusions: Since vitamin D deficiency can be frequently observed in Hungarian patients with inflammatory bowel disease, its level should be tested in these patients. Orv. Hetil., 154(46), 1821–1828.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    URL: Article
    DOI: 10.1556/OH.2013.29750
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2013
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  • 5
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    Hepatocellularis carcinomás beteg sikeres májátültetése TACE- és sorafenibkezeléssel elért tumorméret-csökkentés után. Társszakmák sikeres együttmûködése
    Lege Artis Medicinae ; 2023
    In:  Lege Artis Medicinae Vol. 33, No. 4 ( 2023), p. 183-187
    Details
    In: Lege Artis Medicinae, Lege Artis Medicinae, Vol. 33, No. 4 ( 2023), p. 183-187
    Abstract: Egy hosszan túlélô primer májrákos nôbeteg tanulságos esetét mutatjuk be. Ap pen - dectomia során transzfúziót kapott, 9 év múlva derült ki hepatitis C-vírus- (HCV-) po zitivitása. Az antivirális kezelés akkor sikertelen volt, májcirrhosis alakult ki. A fel tételezett HCV-infekciót követôen, 24 év vel késôbb hepatocellularis carcinomát állapítottak meg a májban szoliter tumor formájában. Két ciklus transzarteriális kemoembolizáció (transarterial chemoembolization, TACE) után exploratív laparatomiára került sor, azonban a tumoros májhilusi infiltráció miatt a folyamat sebészileg irreszekábilisnak bizonyult. Ezt figyelembe véve a multidiszciplináris onkoteam sorafenibkezelést javasolt. A beteg 2,5 évig kapta a sorafenibet, amit jól tolerált, a tumor megkisebbedett. Ezután még egy alkalommal történt TACE-kezelés. A beteg ezt követôen alkalmassá vált a májtranszplantációra. Az alkalmazott bridging terápiával, két sikertelen donorriasztás után a májátültetés sikeresen megtörtént. A hosszú túlélést végül a cirrhosist és a HCC problémát is megoldó májátültetés biztosította. Az újabb direkt ható antivirális gyógyszerek hatására a beteg tartósan HCV-negatív lett, és jelenleg csak hepatológiai gondozás alatt áll. Az eset példa arra, hogy inoperábilis hepatocellularis májrák (HCC) esetén lehetséges a tumor megkisebbítése és a májátültetés. Hangsúlyozzuk, hogy a HCC-ben szen - vedô betegek ellátásában fontos a társ szak - mák együttmûködése. Lényeges, hogy olyan intézetekbe irányítsák a beteget, ahol a potenciálisan szóba jövô kezelések teljes skálája elérhetô, valamint az alap májbetegség követése, ellátása is megtörténik.
    Type of Medium: Online Resource
    ISSN: 0866-4811 , 2063-4161
    URL: Article
    DOI: 10.33616/lam.33.0183
    Language: Unknown
    Publisher: Lege Artis Medicinae
    Publication Date: 2023
    detail.hit.zdb_id: 2622084-2
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  • 6
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    Predictors of post-traumatic pituitary failure during long-term follow-up
    Springer Science and Business Media LLC ; 2014
    In:  HORMONES ( 2014-12-22)
    Details
    In: HORMONES, Springer Science and Business Media LLC, ( 2014-12-22)
    Type of Medium: Online Resource
    ISSN: 1109-3099
    Uniform Title: Predictors of post-traumatic pituitary failure during long-term follow-up
    URL: Journal
    URL: Article
    DOI: 10.14310/horm.2002
    DOI: 10.14310/horm.2002.1564
    Language: Unknown
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2014
    detail.hit.zdb_id: 2581819-3
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  • 7
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    The Management of COVID-19-Related Coagulopathy: A Focus on the Challenges of Metabolic and Vascular Diseases
    MDPI AG ; 2023
    In:  International Journal of Molecular Sciences Vol. 24, No. 16 ( 2023-08-14), p. 12782-
    Details
    In: International Journal of Molecular Sciences, MDPI AG, Vol. 24, No. 16 ( 2023-08-14), p. 12782-
    Abstract: The course of COVID-19 is highly dependent on the associated cardiometabolic comorbidities of the patient, which worsen the prognosis of coronavirus infection, mainly due to systemic inflammation, endothelium dysfunction, and thrombosis. A search on the recent medical literature was performed in five languages, using the PubMed, Embase, Cochrane, and Google Scholar databases, for the review of data regarding the management of patients with a high risk for severe COVID-19, focusing on the associated coagulopathy. Special features of COVID-19 management are presented, based on the underlying conditions (obesity, diabetes mellitus, and cardiovascular diseases), emphasizing the necessity of a modern, holistic approach to thromboembolic states. The latest findings regarding the most efficient therapeutic approaches are included in the article, offering guidance for medical professionals in severe, complicated cases of SARS-CoV-2 infection. We can conclude that severe COVID-19 is closely related to vascular inflammation and intense cytokine release leading to hemostasis disorders. Overweight, hyperglycemia, cardiovascular diseases, and old age are important risk factors for severe outcomes of coronavirus infection, involving a hypercoagulable state. Early diagnosis and proper therapy in complicated SARS-CoV-2-infected cases could reduce mortality and the need for intensive care during hospitalization in patients with cardiometabolic comorbidities.
    Type of Medium: Online Resource
    ISSN: 1422-0067
    URL: Article
    DOI: 10.3390/ijms241612782
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2019364-6
    SSG: 12
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  • 8
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    Dynamics of Metabolic and Inflammatory Parameters in Overweight Patients Undergoing Knee or hip Arthroplasty
    Revista de Chimie SRL ; 2018
    In:  Revista de Chimie Vol. 69, No. 6 ( 2018-7-15), p. 1441-1446
    Details
    In: Revista de Chimie, Revista de Chimie SRL, Vol. 69, No. 6 ( 2018-7-15), p. 1441-1446
    Abstract: Osteoarthritis is a common problem in overweight and obese individuals and may lead to severe forms located especially at the knee and hip joints. Arthroplasty in these cases represents the appropriate treatment to solve the pain and to improve joint mobility. This intervention influences the laboratory parameters in different ways. The aim of the study was to compare pre- and postoperative values of metabolic and inflammatory parameters related to joint replacement surgery in patients suffering from advanced stages of knee and hip osteoarthritis, and to assess the relationship between different laboratory findings, taking into consideration the main cardio-metabolic comorbidities. The study was conducted at the Clinic of Orthopaedics and Traumatology of the Clinical County Hospital Mures between 2016-2017 on 57 overweight patients having severe knee or hip osteoarthritis undergoing total knee or hip arthroplasty. Plasma metabolic tests (uricemia, glycemia, triglycerides, cholesterol) and inflammatory markers (fibrinogen, high sensitive C-reactive protein - hsCRP) were followed in the studied overweight patients in the morning just before arthroplasty and 24 h after surgery. Dynamics of the measured laboratory tests and the relationship between them were assessed. Body mass index, waist circumference and cardio-metabolic associated diseases have also been evaluated. Significant decrease of uricemia, cholesterolemia, plasma triglyceride concentration and significant increase of hsCRP could be observed after joint replacement surgery compared to the previous values measured before the intervention. Glycemia was slightly higher after the arthroplasty, but the difference is not quite significant. Negative correlation could be found between preoperative HDL-cholesterol and plasma triglyceride level, while triglyceride concentration showed positive correlation with LDL-cholesterol and uricemia. BMI showed positive correlation with postoperative fibrinogen values. Hypertension was the most frequent cardio-metabolic comorbidity in the studied group. Significant difference occured in the level of a sensitive inflammatory marker and several biochemical laboratory tests suffered notable changes before and after arthroplasty in the studied group. Metabolic status was deeply affected by such an intervention during the first day after surgery. Laboratory components of the metabolic syndrome were present in close relationship in several patients. Further studies need to be performed for the dynamic assessment of more complex metabolic and inflammatory parameters in patients with similar pathology in order to evaluate the postoperative evolution and to provide appropriate support for these patients in the recovery process.
    Type of Medium: Online Resource
    ISSN: 0034-7752 , 2668-8212
    URL: Article
    DOI: 10.37358/RC.18.6.6342
    Language: English
    Publisher: Revista de Chimie SRL
    Publication Date: 2018
    detail.hit.zdb_id: 2488208-2
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  • 9
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    Study on Chemical Composition of Urinary and Salivary Gland Stones in Relationship with Laboratory Parameters and Lifestyle Habits of Patients with Lithiasis
    Revista de Chimie SRL ; 2017
    In:  Revista de Chimie Vol. 68, No. 4 ( 2017-5-15), p. 680-682
    Details
    In: Revista de Chimie, Revista de Chimie SRL, Vol. 68, No. 4 ( 2017-5-15), p. 680-682
    Abstract: Lithiasis is a disease with increasing incidence, may occur in the urinary tract, salivary glands and bile ducts. Genetic susceptibility, diet, low fluid intake, endocrine disorders, infections and other factors can influence the development of the disease and its recurrences. The aim of the study was to reveal the relationship between chemical composition of the stones, lifestyle and dietary habits and the results of laboratory analysis in patients with urinary tract and salivary gland lithiasis. The data of 258 patients with urinary tract and salivary gland lithiasis collected between September 2009 � May 2016 were studied. The subjects were from the Urology and Oral Surgery Hospital, and from the Marmed and Procardia medical units in Tirgu Mures. We evaluated the lifestyle habits using a questionnaire, microscopical examination, size measurement and chemical analysis of the stones were made and we processed the results of urinary strip analysis and sediment. In a subgroup of patients (48 samples) calciuria, phosphaturia, serum uric acid, calcium, phosphate, alkaline phosphatase and parathormone (PTH) levels were determined; in case of pathological values calcitonin measurement and endocrinology consultation were performed. The most frequent composition was the combination of calcium oxalate and phosphate in case of both urinary and salivary gland stones, in several uroliths we detected uric acid/xanthine crystals, rarely cystine and carbonate were found. The incidence of hematuria and leukocyturia exceeded 70%. Excessive calcium intake was observed in the diet of the several patients having calcium oxalate stones. In the subgroup tested for biochemical and hormonal analyses we found increased serum PTH concentration in 20.83% of the patients. Some of the subjects had pathological serum calcium, uric acid and alkaline phosphatase results, or the elimination of minerals in the urine was out of the normal range. We found pathological laboratory results in several patients suffering from lithiasis. Proper diet and medical treatment in many cases could prevent the recurrences of stone formation, but first a complex investigation of the patients is necessary to adapt the treatment plan to individual requirements.
    Type of Medium: Online Resource
    ISSN: 0034-7752 , 2668-8212
    URL: Article
    DOI: 10.37358/RC.17.4.5529
    Language: English
    Publisher: Revista de Chimie SRL
    Publication Date: 2017
    detail.hit.zdb_id: 2488208-2
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  • 10
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    Formulation and characterization of pramipexole containing buccal films for using in Parkinson's disease
    Elsevier BV ; 2023
    In:  European Journal of Pharmaceutical Sciences Vol. 187 ( 2023-08), p. 106491-
    Details
    In: European Journal of Pharmaceutical Sciences, Elsevier BV, Vol. 187 ( 2023-08), p. 106491-
    Type of Medium: Online Resource
    ISSN: 0928-0987
    URL: Article
    DOI: 10.1016/j.ejps.2023.106491
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 1483522-8
    SSG: 15,3
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