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  • 1
    In: Gastroenterology, Elsevier BV, Vol. 124, No. 4 ( 2003-04), p. A384-A385
    Type of Medium: Online Resource
    ISSN: 0016-5085
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2003
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  • 2
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 155, No. 7 ( 2014-02), p. 270-276
    Abstract: Introduction: One of the most serious complications of liver cirrhosis is variceal bleeding. Early recognition of the oesophageal varices is of primary importance in the prevention of variceal bleeding. Endoscopy is the only means to directly visualize varices and measure their size, as one of the most important predictor of the risk of bleeding. During the course of cirrhosis repeated oesophago-gastro-bulboscopic examinations are recommended. As these interventions are expensive and often poorly accepted by patients who may refuse further follow-up, there is a need for non-invasive methods to predict the progression of portal hypertension as well as the presence and the size of oesophageal varices. After several combinations of biological and ultrasonographical parameters proposed for the detection of advanced fibrosis, it was suggested that liver stiffness measured by transient elastography, a novel non-invasive technology may reflect not only fibrosis and portal pressure but it may even predict the presence or absence of large oesophageal varices in patients with cirrhosis. Aim: The aim of the authors was to study the diagnostic accuracy of transient elastography using FibroScan for selecting patients who are at risk of bearing large (Paquet-grade ≥ II) oesophageal varices and high risk of bleeding. Method: The authors performed upper tract endoscopy and transient elastography in 74 patients with chronic liver disease (27 patients with chronic hepatitis and 47 patients with liver cirrhosis). The relationships between the presence of oesophageal varices (Paquet-grade 0–IV) and liver stiffness (kPa), as well as the hematological and biochemical laboratory parameters (prothrombine international normalized ratio, platelet count, aspartate aminotransferase, alanine aminotransferase, albumin, and aspartate aminotransferase/platelet ratio index) were investigated. The predictive role of liver stiffness for screening patients with varices and those who are at high risk of variceal bleeding was also analysed. Results: Liver stiffness values significantly correlated with the grade of oesophageal varices (Paquet-grade) (r = 0.67, p 〈 0.0001). The liver stiffness value of 19.2 kPa was highly predictive for the presence of oesophageal varices (AUROC: 0.885, 95% CI: 0.81–0.96) and for the presence of high grade varices (P≥II) (AUROC: 0.850, 95% CI: 0.754–0.94). Using the cut-off value of 19.2 kPa, the sensitivity of transient elastography was 85%, specificity was 87%, positive predictive value was 85%, negative predictive value was 87% and validity was 86% for the detection of varices. Liver stiffness values less than 19.2 kPa were highly predicitive for the absence of large (P≥II) varices (sensitivity, 95%; specificity, 70%; positive predictive value, 54%; negative predictive value, 97%). Conclusions: Transient elastography may help to screen patients who are at high risk of bearing large (P≥II) oesophageal varices which predict variceal bleeding and, therefore, need endoscopic screening. Lives stiffness values higher than 19.2 kPa indicate the need for oesophageal-gastro-bulboscopy, while liver stiffness values lower than 19.2 kPa make the presence of large oesophageal varices unlikely. Orv. Hetil., 2014, 155(7), 270–276.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2014
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  • 3
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    Online Resource
    Akademiai Kiado Zrt. ; 2015
    In:  Orvosi Hetilap Vol. 156, No. 47 ( 2015-11), p. 1898-1903
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 156, No. 47 ( 2015-11), p. 1898-1903
    Abstract: This review summarizes our current knowledge on the innate and adaptive immune responses induced by hepatitis C virus, and on the genetic polymorphisms that may determine the outcome of the disease. In addition, the authors discuss the role of reactive oxygen species and oxidative stress in hepatitis C virus-related pathogenic processess, such as hepatitis, fibrosis, hepatocellular carcinoma, steatosis and insulin resistance. Orv. Hetil., 2015, 156(47), 1898–1903.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2015
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  • 4
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    Online Resource
    Akademiai Kiado Zrt. ; 2017
    In:  Orvosi Hetilap Vol. 158, No. 23 ( 2017-06), p. 882-894
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 158, No. 23 ( 2017-06), p. 882-894
    Abstract: Abstract: Non alcoholic fatty liver disease is the hepatic manifestation of metabolic syndrome, and the most common liver disease. Its more aggressive form is the non alcoholic steatohepatitis. Multiple genetic and environmental factors lead to the accumulation of triglicerides and the inflammatory cascade. High fat diet, obesity, adipocyte dysfunction with cytokine production, insulin resistance and increased lipolysis with free fatty acid flux into the liver – all are the drivers of liver cell injury. Activation of inflammasome by damage- or pathogen-associated molecular patterns results in “steril inflammation” and immune response, while the hepatic stellate cells and progenitor cells lead to fibrogenesis. Small intestinal bacterial overgrowth and gut dysbiosis are also of pivotal importance in the inflammation. Among the susceptible genetic factors, mutations of patatin-like phospholipase domain containing 3 and the transmembrane 6 superfamily 2 genes play a role in the development and progression of the disease, similarly as do epigenetic regulators such as microRNAs and extracellular vesicles. Better understanding of the pathogenesis of non alcoholic fatty liver disease may identify novel therapeutic agents that improve the outcome of the disease. Orv Hetil. 2017; 158(23): 882–894.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2017
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  • 5
    In: PLoS ONE, Public Library of Science (PLoS), Vol. 8, No. 7 ( 2013-7-9), p. e67770-
    Type of Medium: Online Resource
    ISSN: 1932-6203
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2013
    detail.hit.zdb_id: 2267670-3
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  • 6
    Online Resource
    Online Resource
    Akademiai Kiado Zrt. ; 2013
    In:  Orvosi Hetilap Vol. 154, No. 29 ( 2013-07), p. 1124-1134
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 154, No. 29 ( 2013-07), p. 1124-1134
    Abstract: Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, the hepatic manifestations of metabolic syndrome with close association with inzulin resistance and obesity, are the most common liver diseases, affecting up to a third of the population worldwide. They confer increased risk for hepatocellular carcinoma as well as cardiovascular diseases. The review aims to summarize advances in epidemiology, pathogenesis and clinical management of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Besides liver biopsy and biomarkers, a novel non-invasive diagnostic tool the called “controlled attenuation parameter” measuring the attenuation of ultrasound generated by the transient elastography transducer, can quantitatively assess the hepatic fat content and differentiate between steatosis grades. At the same time, liver stiffness (fibrosis) can also be evaluated. The authors present their own results obtained with the latter procedure. In non-alcoholic fatty liver disease, the lifestyle intervention, weight loss, diet and exercise supported by cognitive behavioural therapy represent the basis of management. Components of metabolic syndrome (obesity, dyslipidaemia, diabetes and arterial hypertension) have to be treated. Although there is no approved pharmacological therapy for NASH, it seems that long lasting administration of vitamin E in association with high dose ursodeoxycholic acid may be beneficial. In addition, omega-3 polyunsaturated fatty acid substitution can also decrease liver fat, however, the optimal dose is not known yet. Further controlled clinical studies are warranted to establish the real value of any suggested treatment modalities for non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, although these are in experimental phase yet. Orv. Hetil., 2013, 154, 1124–1134.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2013
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  • 7
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 154, No. 32 ( 2013-08), p. 1261-1268
    Abstract: Introduction: In chronic hepatitis C-virus infection the possible role of gene variants encoding cytokines has become the focus of interest. Aim: The aim of the study was to investigate the effect of IL28B polymorphisms on the outcome of chronic hepatitis C-virus genotype 1 infection in the Hungarian population. In addition, the association between IL28B genotypes and the Th1/Th2 cytokine production of activated peripheral blood monocytes and lymphocytes was evaluated. Method: Total of 748 chronic hepatitis C-virus genotype 1 positive patients (365 males and 383 females, aged between 18 and 82 years; mean age, 54±10 years) were enrolled, of which 420 patients were treated with pegylated interferon plus ribavirin for 24–72 weeks. Of the 420 patients, 195 patients (46.4%) achieved sustained virological response. The IL28B rs12979860 polymorphism was determined using Custom Taqman SNP Genotyping Assays (Applied Biosystems, Life Technologies, Foster, CA, USA). For cytokine studies, tumour necrosis factor-α, interleukin-2, interferon-γ, interleukin-2 and interleukin-4 production by LPS-stimulated monocytes and PMA-ionomycine activated lymphocytes were measured from the supernatant of the cells obtained from 40 hepatitis C-virus infected patients, using FACS-CBA Becton Dickinson test. The cytokine levels were compared in patients with different (CC, CT, TT) IL28B genotypes. Results: The IL28B rs12979860 CC genotype occurred in lower frequency in hepatitis C-virus infected patients than in healthy controls (26.1% vs 51.4%, OR 0.333, p 〈 0.001). Patients carried the T allele with higher frequency than controls (73.9%, vs 48.6%, OR 3.003, p 〈 0.001). Pegylated interferon plus ribavirin treated patients with the IL28B CC genotype achieved higher sustained virological response rate than those with the CT genotype (58.6% vs 40.8%, OR 2.057, p = 0.002), and those who carried the T allele (41.8%, OR1.976, p = 0.002). LPS-induced TLR-4 activation of monocytes resulted in higher tumour necrosis factor-α production in patients with the IL28B CC genotype compared to non-CC individuals (p 〈 0.01). Similarly, increased tumour necrosis factor-α, interleukin-2 and interferon-γ production by lymphocytes was found in the IL28B CC carriers (p 〈 0.01) Conclusions: The IL28B CC genotype exerts protective effect against chronic hepatitis C-virus infection and may be a pretreatment predictor of sustained virological response during interferon-based antiviral therapy. The IL28B CC polymorphism is associated with increased Th1 cytokine production of activated peripheral blood monocytes and lymphocytes, which may play a role in interferon-induced rapid immune control and sustained virological response of pegylated interferon plus ribavirin treated patients. Orv. Hetil., 2013, 154, 1261–1268.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2013
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  • 8
    Online Resource
    Online Resource
    Akademiai Kiado Zrt. ; 2022
    In:  Orvosi Hetilap Vol. 163, No. 21 ( 2022-05-22), p. 815-825
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 163, No. 21 ( 2022-05-22), p. 815-825
    Abstract: A nem alkoholos zsírmájbetegség (NAFLD) ma a leggyakoribb májbetegség, a világ népességének 25%-át érinti. A kórkép és progresszív formája, a nem alkoholos steatohepatitis gyakran társul obesitassal és 2-es típusú cukorbetegséggel. NAFLD-ben 2–3-szoros a diabetes kockázata, ami párhuzamosan nő a májbetegség súlyosságával. Mivel komplex kapcsolat van a két kórkép között, a zsírmáj és a diabetes szinergikusan hat a kedvezőtlen klinikai kimenetelre. Cukorbetegekben gyakori a zsírmáj, és a diabetes NAFLD-ben prediktora a steatohepatitisbe, fibrosisba, cirrhosisba való progressziónak. A genetikai faktorok mellett a túlzott kalóriabevitel, a zsírszövet diszfunkciója, az inzulinrezisztencia, a szabad zsírsavak és gyulladásos citokinek, valamint a lipo- és glükotoxicitás szerepe meghatározó a NAFLD és a diabetes kialakulásában. A dolgozatban áttekintjük a két kórképet összekötő patomechanizmusokat. Orv Hetil. 2022; 13(21): 815–825.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    Language: Unknown
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2022
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  • 9
    Online Resource
    Online Resource
    Akademiai Kiado Zrt. ; 2019
    In:  Orvosi Hetilap Vol. 160, No. 14 ( 2019-04), p. 524-532
    In: Orvosi Hetilap, Akademiai Kiado Zrt., Vol. 160, No. 14 ( 2019-04), p. 524-532
    Abstract: Abstract: The pathogenesis of alcoholic liver disease depends not only on the toxic effects of alcohol, but also on the complex interaction of host’s and environmental factors. Thus, the genetic pre-disposition, co-morbidities and behavioral factors all play a role in the individual variations in the disease outcomes. On the other hand, the essential part of the therapeutic strategy is the complete withdrawal of the harmful etiological agent. The present paper is devoted to overview the genetics, the environmental factors and the effects of abstinence in alcoholic liver disease. Genetic variants in two enzymes involved in the metabolism of ethanol, alcohol-dehydrogenase ADH1B *2 and aldehyde-dehydrogenase ALDH2 *2 through increasing the blood level of acetaldehyde, may play a “protective” role against alcoholism. The P450 CYP2E1 *5 c2, an inducible microsomal oxidase, upregulated by ethanol and by formation of acetaldehyde and reactive oxygen species, increases liver toxicity. Three novel gene polymorphisms – such as the patatin-like phospholipase domain-containing 3 (PNPLA3 I148M C 〉 G), the transmembrane 6 superfamily member 2 (TM6SF2 E167K), and the membrane-bound O-acyltransferase domain-containing 7 (MB0AT7 rs641738 C 〉 T) – have been proven as risk factors of steatosis, fibrosis and even hepatocellular carcinoma in both alcoholic and non-alcoholic fatty liver disease patients. Alcohol-induced epigenetic effects, reversible but inheritable gene expression alterations – as histon modulations, DNA methylation and micro-RNA-s – are of importance in the pathogenesis as well, and in the future, they may serve as diagnostic markers and therapeutic targets. Women are at greater risk of developing alcoholic cirrhosis, furthermore, malnutrition, obesity, diabetes, smoking, and hepatitis virus infections are also risk factors. Alcoholic liver disease should be regarded as a preventable disease. Several clinical studies revealed that abstinence may result in the regression of steatohepatitis and fibrosis, compensation of cirrhosis, improving disease outcome and increasing survival even in patients with advanced stages. Early diagnosis and multidisciplinary interventions are highly required to achieve long-term abstinence and to prevent alcoholic cirrhosis. Orv Hetil. 2019; 160(14): 524–532.
    Type of Medium: Online Resource
    ISSN: 0030-6002 , 1788-6120
    Language: Hungarian
    Publisher: Akademiai Kiado Zrt.
    Publication Date: 2019
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  • 10
    In: Journal of Hepatology, Elsevier BV, Vol. 53, No. 3 ( 2010-09), p. 484-491
    Type of Medium: Online Resource
    ISSN: 0168-8278
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2010
    detail.hit.zdb_id: 2027112-8
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