Publications by authors named "Aron Vincze"
Patients with gastrointestinal bleeding (GIB) exhibit varying tolerances to acute blood loss. We aimed to investigate the effect of relative Hb decrease (ΔHb%) on GIB outcomes. Participants enrolled in the Hungarian GIB Registry between 2019 and 2022 were analyzed.
View Article and Find Full Text PDFThe CEL-HYB1 hybrid allele of the carboxyl ester lipase (CEL) gene and its pseudogene (CELP) has been associated with chronic pancreatitis (CP). Recent work indicated that amino acid positions 488 and 548 in CEL-HYB1 determined pathogenicity. Haplotype Thr488-Ile548 was associated with CP while haplotypes Thr488-Thr548 and Ile488-Thr548 were benign.
View Article and Find Full Text PDFIntroduction And Aims: Acute pancreatitis (AP) can rapidly progress from a stable condition to multiple organ failure with high mortality. We aimed to describe the characteristics of AP patients requiring admission to a critical care facility and to identify predictors of disease progression.
Methods: We conducted a post-hoc analysis using prospectively collected data from AP patients admitted to the high dependency unit (HDU) and intensive care unit (ICU) at the University of Pécs, Hungary, from 2016 to 2019.
Background: Endoscopic retrograde cholangiopancreatography (ERCP) is essential for the minimally invasive management of biliary and pancreatic disorders. Under certain indications, performing ERCP without delay during the weekend can be important for improving outcomes.
Objectives: To compare the outcomes of ERCP performed on weekends and holidays with those of regular weekday ERCPs.
Long-term data on ustekinumab in real-life Crohn's disease patients are still missing, though randomized controlled trials demonstrated it as a favorable therapeutic option. We aimed to evaluate ustekinumab's clinical efficacy, drug sustainability, and safety in a prospective, nationwide, multicenter Crohn's disease patient cohort with a three-year follow-up. Crohn's disease patients on ustekinumab treatment were consecutively enrolled from 9 Hungarian Inflammatory Bowel Disease centers between January 2019 and May 2020.
View Article and Find Full Text PDFConcomitant medications may alter the effect of biological therapy in inflammatory bowel disease. The aim was to investigate the effect of proton pump inhibitors on remission rates in patients with inflammatory bowel disease treated with the gut-selective vedolizumab. Patients from the Hungarian nationwide, multicenter vedolizumab cohort were selected for post hoc analysis.
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- There is a lack of discharge protocols for acute pancreatitis (AP) patients, which the Hungarian Pancreatic Study Group (HPSG) aims to address with a new, validated protocol based on laboratory data and symptoms.
- An international survey revealed that 87.5% of participating medical centers do not have discharge protocols, but those that do see shorter hospital stays and lower readmission rates.
- The HPSG discharge protocol resulted in the lowest average length of hospital stay and demonstrated safety through a low readmission rate, highlighting the need for developing and validating more standardized discharge protocols for AP care.
Article Synopsis
- - The study investigates the prevalence of acute cholangitis (AC) and cholecystitis (CC) among patients diagnosed with biliary acute pancreatitis (AP), using the 2018 Tokyo guidelines, highlighting a potential for overdiagnosis and overuse of medical interventions.
- - Results show that around 70% of biliary AP patients met the criteria for AC/CC; antibiotic use was high (77.4%), with low mortality in mild cases but significantly higher rates in severe cases.
- - The authors conclude that existing diagnostic criteria often overlap and may misclassify AP conditions, suggesting a need for clearer, disease-specific guidelines and randomized trials on antibiotic necessity in these patients.
Detailed Characteristics of Post-discharge Mortality in Acute Pancreatitis.
Gastroenterology
September 2023
Article Synopsis
- Patients discharged after acute pancreatitis (AP) face a significantly higher mortality risk than the general population, with a first-year mortality rate almost double that of in-hospital mortality.
- Key risk factors for post-discharge mortality include age, existing medical conditions, severity of illness, and certain lab results upon admission.
- Major causes of death in the first 90 days post-discharge are cardiac failure and AP-related infections, while later deaths are often linked to cancer-related issues and other infections, highlighting the need for comprehensive follow-up care.
In developed countries, diseases of the gallbladder and the biliary tract count as some of the most frequent gastrointestinal disorders. The inflammation of the gallbladder/biliary tree is a potentially severe, even lethal condition that requires rapid diagnosis and early multidisciplinary approach to be treated. Although the frequency of these diseases is high, the treatment is not unified in Hungary yet.
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- - Patients with inflammatory bowel disease in Hungary were studied after switching from original anti-TNF drugs to biosimilars, focusing on their feelings about efficacy and adverse events.
- - The study found that patients rated the subjective effectiveness of the IFX biosimilar lower than the original IFX, while the ADA biosimilar was rated higher than the original ADA.
- - A higher number of patients reported new adverse events after switching to the ADA biosimilar compared to the IFX biosimilar, indicating varying experiences with the treatments.
Gastric cancer is the fifth most common cause of cancer related deaths worldwide. Despite advancement in endoscopic techniques, the majority of the cases are diagnosed at late stage, when the curative treatment options are very limited. The early gastric cancer (EGC) on the other side is potentially curable, and in selected cases endoscopic resection techniques offer similar survival rates then surgical resection.
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- Non-alcoholic fatty liver disease (NAFLD) has been redefined as metabolic-associated fatty liver disease (MAFLD), which is linked to an increased risk of acute pancreatitis (AP).
- In a study involving over 2,000 patients, 39% had MAFLD, which raised the odds of developing moderate-to-severe AP, although it didn't significantly impact in-hospital mortality.
- The severity of AP was influenced by the specific metabolic risk factors present, with a dose-dependent relationship observed—more criteria correlated with increased severity and outcomes for the disease.
Background And Study Aims: Endoscopic biliary stent placement is a minimally invasive intervention for patients with biliary strictures. Stent patency and function time are crucial factors. Suprapapillary versus transpapillary stent positioning may contribute to stent function time, so a meta-analysis was performed in this comparison.
View Article and Find Full Text PDFBackground: In 2015, in Csongrád County (Hungary), a general practitioner based colorectal screening model program was implemented by the financial support of the European Union. Our aim was to evaluate the indicators of screening program and to analyze the experiences and attitude of participants of colorectal screening pilot program.
Methods: The colon cancer screening pilot programme was carried out in 2015 involving an average-risk population aged 50-69 in Csongrád county, Hungary (invited 22 130 persons).
Introduction: COVID–19 significantly affects endoscopic labs’ workflow. Endoscopic examinations are considered high-risk for virus transmission. Objectives: To determine impact of COVID–19 pandemic on Hungarian endoscopic labs’ workflow and on infection risk of endoscopic staff.
View Article and Find Full Text PDFPancreatic family history does not predict disease progression but connotes alcohol consumption in adolescents and young adults with acute pancreatitis: Analysis of an international cohort of 2,335 patients.
Front Med (Lausanne)
September 2022
Article Synopsis
- In pediatric patients with acute pancreatitis (AP), having a family history of pancreatic diseases is linked to an earlier onset of recurrent acute pancreatitis (ARP) and chronic pancreatitis (CP), particularly peaking in children aged 6-17 years.
- Analysis of data from the Hungarian Pancreatic Study Group showed that those with a positive family history had a significantly higher rate of ARP/CP and a greater tendency for idiopathic AP in early childhood, along with increased alcohol and smoking rates in adolescence and early adulthood.
- Contrary to beliefs about adults, positive family history does not predict ARP or CP in adults; therefore, it should not be treated as a prognostic factor for them
Background: Decades of debate surround the use of intraoperative cholangiography (IOC) during cholecystectomy. To the present day, the role of IOC is controversial as regards decreasing the rate of bile duct injury (BDI). We aimed to review and analyse the available literature on the benefits of IOC during cholecystectomy.
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- Acute pancreatitis (AP) is a serious inflammation of the pancreas, and identifying patients at high risk of severe complications early is essential to prevent organ failure and death.
- The study developed a machine learning prediction model called EASY, using data from over 4,700 patients to offer quick assessments of severity through algorithms like XGBoost, achieving an average accuracy of 89.1%.
- The model identifies key risk factors such as respiratory rate, body temperature, and glucose level, and includes a user-friendly web application for easy access to its predictions.
Article Synopsis
- Excessive alcohol consumption is a major cause of recurrent acute pancreatitis (AP), but effective treatments to prevent its recurrence, like psychological therapies, are not widely implemented in practice.
- A study analyzed 99 patients with alcohol-induced AP, where a 30-minute brief intervention (BI) by a physician led to significant reductions in alcohol consumption and related blood markers (GGT and MCV).
- After one month, 79% of patients reported being alcohol-free, indicating that BI could be a promising method to help prevent future cases of AP, though further research is needed to optimize its use.
Pancreatic necrosis is a consistent prognostic factor in acute pancreatitis (AP). However, the clinical scores currently in use are either too complicated or require data that are unavailable on admission or lack sufficient predictive value. We therefore aimed to develop a tool to aid in necrosis prediction.
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- Noninvasive ventilation (NIV) shows promise in reducing mortality and intubation rates in adults with pneumonia-associated respiratory failure compared to not using NIV, although overall hospital mortality differences were not statistically significant.
- In intensive care settings, NIV significantly lowered mortality rates, demonstrating its effectiveness, especially among patients with overlapping conditions like COPD.
- The results suggest that NIV should be considered in treatment guidelines for pneumonia-related respiratory failure due to its substantial benefits in critical care outcomes.