Publications by authors named "Miko A"

Background: Acute pancreatitis (AP) is a major health threat, with a high mortality rate in severe forms. Though alcohol and bile-induced factors are the most common causes, increasing evidence suggests that viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human immunodeficiency virus (HIV) may also trigger AP development. Our study aims to explore this association in greater detail.

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Background: Combining antegrade stenting (AGS) and hepaticogastrostomy (HGS) is an increasingly used endoscopic ultrasound-guided intervention when stenting by endoscopic retrograde cholangiopancreatography is impossible.

Objectives: We comprehensively assessed the benefits and downsides of combined AGS and HGS (HGS procedure with AGS, HGAS).

Data Sources And Methods: From 788 HGS and 295 HGAS cases, a random-effects meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol.

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Hereditary breast and ovarian cancer is a well-known genetic condition, inherited mainly in an autosomal dominant way, which elevates the risk of developing malignancies at a young age in heterozygous carriers. Advances in new generation sequencing have enabled medical professionals to determine whether a patient is harbouring mutations in moderate- or high penetrance susceptibility genes. We conducted a retrospective analysis among 275 patients who underwent genetic counselling and multigene panel testing for hereditary breast and ovarian cancer syndrome in our department.

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Heterozygous mutations in the gene (OMIM#605515) are responsible for a well-characterized neurodevelopmental syndrome known as "intellectual developmental disorder with language impairment with or without autistic features" (OMIM#613670) or FOXP1 syndrome for short. The main features of the condition are global developmental delay/intellectual disability; speech impairment in all individuals, regardless of their level of cognitive abilities; behavioral abnormalities; congenital anomalies, including subtle dysmorphic features; and strabismus, brain, cardiac, and urogenital abnormalities. Here, we present two siblings with a de novo heterozygous variant, namely, a four-year-old boy and 14-month-old girl.

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Article Synopsis
  • - Infected necrotizing pancreatitis (INP) is a severe condition that increases the risk of organ failure and death, making early diagnosis and antibiotic treatment crucial for patient survival.
  • - A systematic review of studies revealed that infection confirmation involved imaging or positive lab tests, with the best laboratory biomarkers for distinguishing between sterile and infected cases being C-reactive protein (CRP) and procalcitonin (PCT).
  • - The study found that CRP and PCT levels were not great indicators of infection in the first 72 hours post-admission, but their predictive value improved significantly after that period, suggesting that high levels warrant the start of antibiotics.
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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.
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Pancreatic cancer (PC) is one of the most lethal cancers worldwide. Recently, fatty pancreas (FP) has been studied thoroughly, and although its relationship to PC is not fully understood, FP is suspected to contribute to the development of PC. We aimed to assess the association between PC and FP by conducting a systematic review and meta-analysis.

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Article Synopsis
  • 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.
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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.

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ABCC6 promotes ATP efflux from hepatocytes to bloodstream. ATP is metabolized to pyrophosphate, an inhibitor of ectopic calcification. Pathogenic variants of ABCC6 cause pseudoxanthoma elasticum, a highly variable recessive ectopic calcification disorder.

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The coronavirus disease (COVID-19) pandemic caused unprecedented research activity all around the world but publications from Central-Eastern European countries remain scarce. Therefore, our aim was to characterise the features of the pandemic in the intensive care units (ICUs) among members of the SepsEast (Central-Eastern European Sepsis Forum) initiative. We conducted a retrospective, international, multicentre study between March 2020 and February 2021.

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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.
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Extensive research is focused on the role of liquid biopsy in pancreatic cancer since reliable diagnostic and follow-up biomarkers represent an unmet need for this highly lethal malignancy. We performed a systematic review and meta-analysis on the prognostic value of exosomal biomarkers in pancreatic ductal adenocarcinoma (PDAC). MEDLINE, Embase, Scopus, Web of Science, and CENTRAL were systematically searched on the 18th of January, 2021 for studies reporting on the differences in overall (OS) and progression-free survival (PFS) in PDAC patients with positive vs negative exosomal biomarkers isolated from blood.

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Összefoglaló. Az arthrogryposis-renalis diszfunkció-cholestasis (ARC) szindróma igen rossz prognózisú autoszomális recesszív kórkép. A három vezető tünethez társulhat központi idegrendszeri érintettség, siketség, cardiovascularis anomália (pitvari és kamrai sövényhiány), thrombocytafunkció-zavar, rekurrens szepszisek, ichthyosis, valamint súlyfejlődésben való elmaradás.

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Article Synopsis
  • The rising incidence of acute pancreatitis (AP) has led to increased medical costs and a concerning 30% mortality rate in severe cases.
  • A study involving 2461 patients revealed that hypoalbuminemia (low albumin levels) is common in AP, affecting 19% on admission and 35.7% during hospitalization.
  • Severe hypoalbuminemia significantly increases the risk of complications and mortality, with a clear dose-dependent relationship to severity and hospital stay.
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This systematic review and meta-analysis evaluated the prognostic role of cell-free DNA (cfDNA) in pancreatic ductal adenocarcinoma (PDAC). Eligible studies reported differences in overall (OS) and progression-free survival (PFS) by cfDNA status. The random effect model yielded the pooled hazard ratios (HRs) and 95 % confidence intervals (CI).

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Cholecystokinin (CCK) increases core body temperature via CCK receptors when administered intracerebroventricularly (icv). The mechanisms of CCK-induced hyperthermia are unknown, and it is also unknown whether CCK contributes to the fever response to systemic inflammation. We studied the interaction between central CCK signaling and the cyclooxygenase (COX) pathway.

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School leaders' experiences and perceptions of students' domestic violence experiences and trauma-informed school interventions have been overlooked. This semi-structured qualitative study aimed to investigate three areas regarding school leaders' perceptions regarding domestic violence-exposed students: 1) the experiences of school leaders in dealing with these students; 2) the barriers and strengths associated with managing these students; and 3) school leaders' recommendations for overcoming any barriers related to this issue in schools. Interviews conducted with 15 school leaders were analysed using thematic analysis.

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  • Multiple tissues in the gastrointestinal tract, including periodontal structures, are essential for food delivery, but they are difficult to regenerate once damaged, leading to reliance on traditional treatments for periodontal disease like scaling and root planning.
  • Probiotics have been suggested as a new way to improve oral health by potentially reducing harmful bacteria through their anti-inflammatory properties, although research results on their effectiveness have been mixed.
  • A meta-analysis was conducted analyzing nine studies, which showed that probiotics significantly decreased certain bacterial counts after 4 weeks, but did not have a lasting impact or a significant effect on overall bacterial counts in higher-risk areas of the mouth.
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The lips and the mouth play an indispensable role in vocalization, mastication and face aesthetics. Various noxious factors may alter and destruct the original structure, and appearance of the lips and the anatomical area surrounding the mouth. The application of hyaluronic acid (HA) may serve as a safe method for lip regeneration.

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We aimed to identify incompletely penetrant (IP) variants and interallelic interactions in autosomal recessive disorders by a population-genetic approach. Genotype and clinical data were collected from 9038 patients of European origin with ASL, ATP7B, CAPN3, CFTR, CTNS, DHCR7, GAA, GALNS, GALT, IDUA, MUT, NPHS1, NPHS2, PAH, PKHD1, PMM2, or SLC26A4-related disorders. We calculated the relative allele frequency of each pathogenic variant (n = 1936) to the loss-of-function (LOF) variants of the corresponding gene in the patient ( ) and the general population ( ) and estimated the penetrance of each variant by calculating their ratio: (V/LOF ratio).

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Minor physical anomalies (MPAs) may reflect basic neurobiological features underlying bipolar disorders (BPD), as they are sensitive physical indicators of morphogenetic failure of the brain. Despite several researches about the presence of MPAs in BPD, the results are still controversial. The aim of the present meta-analysis was to assess the standardized weighted mean effect sizes of MPAs in BPD and to examine if MPAs may be found predominantly in the head and/or facial regions in BPD patients compared to controls (HC).

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It is often assumed that distracting attention from unpleasant body sensations evoked by physical exertion can alleviate perceived fatigue and increase physical performance. Also, the higher acuity of perception of heartbeats was associated with less physical performance in one study with sedentary participants. The current study was designed to shed more light on these associations.

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Background: Pseudocysts being the most frequent local complications of acute pancreatitis (AP) have substantial effect on the disease course, hospitalization and quality of life of the patient. Our study aimed to understand the effects of pre-existing (OLD-P) and newly developed (NEW-P) pseudocysts on AP.

Methods: Data were extracted from the Acute Pancreatitis Registry organized by the Hungarian Pancreatic Study Group (HPSG).

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