35 research outputs found
Gene polymorphisms in primary biliary cirrhosis: association with the disease and hepatic osteopathy
Genetic factors have been implicated in the pathogenesis of osteoporosis, a common disorder in primary biliary cirrhosis (PBC). Estrogen receptor-alpha gene (ER-ïżœ), vitamin-D-receptor gene (VDR) and IL-1-receptor-antagonist gene (IL-1RN) are all attractive candidates for osteoporosis susceptibility. Furthermore insulin-like growth factor-I (IGF-I) gene microsatellite repeat polymorphism was found to be associated with osteoporosis in some studies and collagen-Iïżœ1 (COLIA1) Sp1 s allele was associated with lower bone mineral density (BMD) in one study in PBC. IGF-I treatment restored osteopenia and reduced fibrogenesis in experimental cirrhosis. In this study we summarize our results on polymorphisms of the above genes and bone disease in Hungarian PBC patients.
Patients and methods: 70 female patients with PBC were enrolled (age:57.6yrs, range:37-76yrs, each AMA-M2 positive, stage II-IV). 139 age-matched female subjects served as controls (age: 55.9 yrs, range:43-72 yrs). COLIA1 Sp1 and IGF-I microsatellite polymorphisms were determined by PCR in all patients and controls. VDR BsmI, IL-1RN variable-number tandem repeat (VNTR) and ER-ïżœ PvuII and XbaI polymorphisms were detected in 33 patients and controls. BMD was measured by dual energy x-ray absorptiometry (Lunar,Prodigy,USA) in lumbar spine (LS) and femoral neck (FN).
Results: There was no difference in IGF-I microsatellite repeat polymorphism (192/192=34.2%, 194/192=28.6%, other=37.2%) and COLIA1 Sp1 polymorphism (SS=72.9%, Ss=22.8% and ss=4.3%) and IL-1 VNTR polymorphism between PBC
patients and controls, however, the COLIA1 Sp1 s allele was significantly less frequent in patients with PBC (p=0.038). The genotype frequency of VDR BsmI (BB=57.5%, Bb=33.3%, bb=9.1%, p=0.01) and ER-a PvuII (PP=18.2%, Pp=75.6%, pp=6.2%, p=0.03) and XbaI (XX=9.1%, Xx=90.9%, xx=0%, p=0.0003) of the patients was different from that of the control group, with higher frequency of the BB, Pp and Xx
genotypes in PBC. Osteoporosis (t score<-2.5) was detected in 22 patients (31.4%). Osteoporotic patients were elder and had longer disease history (p=0.01 for both). An
association was found between the IGF-I genotypes and ODM data, the 192/192 genotype was associated with higher FN Z-score compared to other genotypes (p=0.036).
Conclusions: In contrast to previous studies the COLIA1 Sp1 s allele was less frequent in patients with PBC, and its presence was not associated with BMD. We confirmed previous findings on higher frequency of VDR BsmI BB genotype in patients with PBC. The ER-α PvuII and XbaI Pp and Xx genotypes were more frequent in PBC patients, while IL-1RN VNTR and IGF-I microsatellite repeat polymorphism was not
different. Since IGF-I polymorphism was associated to BMD, it may be hypothesized that not COLIA1 but IGF-I together with other genetic and environmental factors may be involved in the complex regulation of BMD in PBC
A szĂvinfarktusĂ©rt felelĆs Ă©r prognosztikus jelentĆsĂ©gĂ©nek vizsgĂĄlata ST-elevĂĄciĂłs szĂvinfarktusos betegekben | Prognostic significance of the culprit vessel in patients with ST-elevation myocardial infarction treated with primary coronary intervention
Absztrakt
BevezetĂ©s: A szĂvinfarktust okozĂł Ă©r prognosztikai jelentĆsĂ©gĂ©re
vonatkozĂłan kevĂ©s irodalmi adat ĂĄll rendelkezĂ©sre, kĂŒlönösen azokban az
esetekben, amikor a betegeknél katéteres revascularisatio történt.
CĂ©lkitƱzĂ©s: A szerzĆk cĂ©lul tƱztĂ©k ki annak vizsgĂĄlatĂĄt,
hogy a szĂvinfarktusĂ©rt felelĆs Ă©rnek (culprit vessel) van-e prognosztikus
jelentĆsĂ©ge ST-elevĂĄciĂłs myocardialis infarctusos betegekben, akiknĂ©l sikeres
katéteres érmegnyitås (percutan coronariaintervenció) történt.
MĂłdszer: RetrospektĂv vizsgĂĄlatukban 10 763 beteg adatait
elemeztĂ©k. A szĂvinfarktusĂ©rt felelĆs Ă©r alapjĂĄn nĂ©gy betegcsoportot alakĂtottak
ki: fĆtörzs, bal leszĂĄllĂł ĂĄg, bal körbefutĂł ĂĄg Ă©s jobb koszorĂșĂ©r. Az adatok
Ă©rtĂ©kelĂ©sekor egyvĂĄltozĂłs tĂșlĂ©lĂ©si görbĂ©ket konstruĂĄltak, illetve elvĂ©geztĂ©k a
tĂșlĂ©lĂ©si idĆ többvĂĄltozĂłs modellezĂ©sĂ©t Cox-regressziĂłval, az Ă©letkor, a nem Ă©s a
tårsbetegségek figyelembevételével. Eredmények: Leggyakrabban a
bal leszĂĄllĂł ĂĄg (44,3%), ezt követte a jobb koszorĂșĂ©r (40,9%), majd a bal
körbefutĂł ĂĄg (13,7%), mĂg a fĆtörzs 1%-ban volt felelĆs az infarktus
kialakulĂĄsĂĄĂ©rt. Az egyĂ©ves tĂșlĂ©lĂ©s szempontjĂĄbĂłl a szĂvinfarktusĂ©rt felelĆs Ă©r
szignifikĂĄns prognosztikai jelentĆsĂ©ggel bĂrt (p<0,0001): a jobb koszorĂșĂ©r
esetĂ©n a hazard ratio 0,69 (95%-os CI: 0,61â0,79, p<0,0001), a fĆtörzs esetĂ©n
1,56 (95%-os CI: 1,04â2,35, p = 0,0321) volt a referenciaĂ©rhez (bal leszĂĄllĂł ĂĄg)
viszonyĂtva. KövetkeztetĂ©s: A vizsgĂĄlat eredmĂ©nyei igazoljĂĄk a
szĂvinfarktusĂ©rt felelĆs Ă©r prognosztikai jelentĆsĂ©gĂ©t. Orv. Hetil., 2016,
157(32), 1282â1288.
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Abstract
Introduction: To the best of the authorsâ knowledge, very few
publications are available which report on the prognostic significance of the
culprit vessel in patients with ST elevation myocardial infarction treated with
successful primary percutaneous coronary intervention. Aim: The
aim of the authors was to obtain data on the significance of the culprit vessel
in patients with ST elevation myocardial infarction treated successfully by
primary percutaneous coronary intervention. Method: The authors
performed a retrospective study in 10,763 patients with ST elevation myocardial
infarction who underwent successful primary percutaneous coronary intervention.
The culprit vessels were the left main artery, left anterior descendent artery,
left circumflex artery, and right coronary artery. The authors constructed
univariate survival curves for different culprit vessels and also performed
multivariate modelling of time-to-death, controlling for age, sex, and
comorbidities. Results: The majority of the culprit lesions
were found in the left anterior descendent artery (44.3%), the right coronary
artery (40.9%), and the left circumflex artery (13.7%). The culprit vessel was
overall a highly significant (p<0.0001) factor of survival, with right
coronary artery exhibiting a highly significantly better prognosis (hazard ratio
0.69, 95% CI 0.61â0.79, p<0.0001) and left main artery exhibiting a
significantly worse prognosis (hazard ratio 1.56, 95% CI 1.04â2.35, p
= 0.0321) than the reference vessel (left anterior descendent
artery). Conclusion: These data demonstrate that the culprit
vessel has independent prognostic significance. Orv. Hetil., 2016,
157(32), 1282â1288
NĂ©pegĂ©szsĂ©gĂŒgyi problĂ©mĂĄk szĂĄmĂtĂłgĂ©pes modellezĂ©se
A dolgozat a Budapesti MƱszaki Ă©s GazdasĂĄgtudomĂĄnyi Egyetem IrĂĄnyĂtĂĄstechnika Ă©s Informatika TanszĂ©kĂ©nek Orvosinformatikai LaboratĂłriumĂĄban folyĂł, nĂ©pegĂ©szsĂ©gĂŒgyi szempontbĂłl jelentĆs betegsĂ©gek szĂĄmĂtĂłgĂ©pes modellezĂ©sĂ©ben Ă©s szabĂĄlyozĂĄsĂĄban elĂ©rt aktuĂĄlis kutatĂĄsi eredmĂ©nyeket foglalja össze. HĂĄrom tĂ©makörben â cukorbetegsĂ©g (mestersĂ©ges hasnyĂĄlmirigy), elhĂzĂĄs (elhĂzĂĄs Ă©s laboreredmĂ©nyek összefĂŒggĂ©sei) Ă©s angiogenĂ©zist gĂĄtlĂł tumorterĂĄpia â fejlesztettĂŒnk ki optimĂĄlis szabĂĄlyozĂĄsi algoritmusokat, valamint prediktĂv modell-alapĂș eljĂĄrĂĄsokat. Jelen publikĂĄciĂł eddig elĂ©rt eredmĂ©nyeinket foglalja össze
Toll-like receptor 4 and NOD2/CARD15 mutations in Hungarian patients with Crohn's disease: Phenotype-genotype correlations
AIM: To determine common NOD2/CARD15 mutations and TLR4 D299G polymorphism in Hungarian patients with CD.
METHODS: A total of 527 unrelated patients with CD (male/female: 265/262, age: 37.1 (SD 7.6) years) and 200 healthy subjects were included. DNA was screened for possible NOD2/CARD15 mutations by denaturing high-performance liquid chromatography (confirmed by direct sequencing). TLR4 D299G was tested by PCR-RFLP.
RESULTS: NOD2/CARD15 mutations were found in 185 patients (35.1%) and in 33 controls (16.5%, P< 0.0001). SNP8/R702W (10.8% vs 6%, P = 0.02), SNP13/3020insC (19.4% vs 5%, P< 0.0001) and exon4 R703C (2.1% vs 0%, P = 0.02) mutations were more frequent in CD, while the frequency of SNP12/G908R was not increased. The frequency of TLR4 D299G was not different (CD: 9.9% vs controls: 12.0%). Variant NOD2/CARD15 allele was associated with an increased risk for CD (OR(het) = 1.71, 95% CI = 1.12-2.6, P = 0.0001, OR(two-risk alleles) = 25.2, 95% CI = 4.37-, P< 0.0001), early disease onset (carrier: 26.4 years vs non-carrier: 29.8 years, P = 0.0006), ileal disease (81.9% vs 69.5%, OR = 1.99, 95% CI = 1.29-3.08, P = 0.02, presence of NOD2/CARD15 and TLR4: 86.7% vs 64.8%), stricturing behavior (OR = 1.69, 95% CI = 1.13-2.55, P = 0.026) and increased need for resection (OR= 1.71, 95% CI: 1.13-2.62, P = 0.01), but not with duration, extraintestinal manifestations, familial disease or smoking. TLR4 exhibited a modifier effect: age of onset in wt/TLR4 D299G carriers: 27.4 years vs NOD2mut/TLR D299G: 23 years (P = 0.06), in NOD2mut/wt: 26.7 years.
CONCLUSION: These results confirm that variant NOD2/CARD15 (R702W, R703C and 3020insC) alleles are associated with earlier disease onset, ileal disease, stricturing disease behavior in Hungarian CD patients. In contrast, although the frequency of TLR4 D299G polymorphism was not different from controls, NOD2/TLR4 mutation carriers tended to present at earlier age. (C) 2005 The WJG Press and Elsevier Inc. All rights reserved
Bexsero, egy Ășj, meningococcus elleni vakcina
Absztrakt
A meningococcusok közĂŒl MagyarorszĂĄgon többnyire a B szerocsoportĂș okozza a
legtöbb megbetegedést. Az ellene kifejlesztett egyik oltås (Bexsero) 2014
nyarĂĄtĂłl MagyarorszĂĄgon is kaphatĂł. A szerzĆk összefoglaljĂĄk a betegsĂ©ggel Ă©s az
oltĂĄssal kapcsolatos legfontosabb ismereteket, illetve tĂĄrgyaljĂĄk a vakcinĂĄval
kapcsolatos jelenleg még nyitott kérdéseket irodalmi åttekintés alapjån. Az
immunolĂłgiai adatokon alapulĂł elĆzetes vĂĄrakozĂĄsok alapjĂĄn a Bexsero vĂ©delmet
adhat e ritka, de igen sĂșlyos megbetegedĂ©s ellen. Az oltĂĄs azonban rendkĂvĂŒl
költséges, klinikai hatékonysåga még tisztåzatlan, és szokatlanul gyakran okoz
lĂĄzreakciĂłt, fĆleg csecsemĆkorban, amikor a legnagyobb szĂŒksĂ©g lenne rĂĄ. A
szerzĆk vĂ©lemĂ©nye szerint a hazai ajĂĄnlĂĄs megfogalmazĂĄsĂĄval cĂ©lszerƱ lenne
megvĂĄrni, amĂg a mĂĄsutt szerzett tapasztalatok alapjĂĄn jobban meg lehet ĂtĂ©lni
az oltås hasznåt, kockåzatait, költséghatékonysågåt. Lép- vagy komplementhiånyos
Ă©s egyĂ©b immunszupprimĂĄlt betegeknĂ©l, valamint kiemelkedĆen magas egyĂ©ni
kockåzat esetén a Bexsero alkalmazåsa mår most is indokolt. Orv. Hetil., 2016,
157(7), 242â246
SzĂvinfarktust tĂșlĂ©lt betegek lipidcsökkentĆ kezelĂ©se MagyarorszĂĄgon a Nemzeti SzĂvinfarktus Regiszter adatai alapjĂĄn = Lipid-lowering therapy of patients surviving myocardial infarction in Hungary â the data of the National Myocardial Infarction Registry
A kĂłrhĂĄzi felvĂ©tel idejĂ©n rögzĂtett EKG jelentĆsĂ©ge a szĂvinfarktus miatt kezelt betegek prognĂłzisĂĄnak meghatĂĄrozĂĄsĂĄban = The significance of ECG recorded at hospitalization in determining the prognosis of patients treated with myocardial infarction
Absztrakt:
BevezetĂ©s Ă©s cĂ©lkitƱzĂ©s: A szerzĆk a Nemzeti SzĂvinfarktus
Regiszter adatbĂĄzisĂĄt felhasznĂĄlva vizsgĂĄljĂĄk azon, heveny szĂvinfarktus miatt
kezelt betegek prognĂłzisĂĄt, akiknĂ©l a felvĂ©teli EKG-n Ășj vagy feltehetĆen Ășj
bal-Tawara-szĂĄr-blokk (ĂșBTSZB) volt. MĂłdszer: A Nemzeti
SzĂvinfarktus Regiszterben 2014. 01. 01. Ă©s 2015. 06. 30. között 18 091, heveny
szĂvinfarktus (AMI) miatt kezelt beteg adatait rögzĂtettĂŒk; 8334 betegnĂ©l
ST-elevĂĄciĂłval jĂĄrĂł (STEMI), 9757 esetben nem ST-elevĂĄciĂłval jĂĄrĂł infarktus
(NSTEMI) volt a klinikai diagnĂłzis. A STEMI-csoportban vizsgĂĄltuk az
ST-elevĂĄciĂłs (n = 7937), illetve az ĂșBTSZB-s betegek (n = 397) klinikai
jellemzĆit Ă©s prognĂłzisĂĄt. A halĂĄlozĂĄs vizsgĂĄlatĂĄra többvĂĄltozĂłs regressziĂłs
modellt (Cox-regressziót) hasznåltunk. Eredmények: Az
AMI-betegcsoportban 1274 esetben (7%) talĂĄltunk BTSZB-t. STEMI klinikai
diagnĂłzisa esetĂ©n az ĂșBTSZB-s alcsoportba tartozĂł betegek (n = 397) idĆsebbek
voltak, s nagyobb volt a fĂ©rfiak rĂ©szarĂĄnya Ă©s a tĂĄrsbetegsĂ©gek elĆfordulĂĄsa,
mint azoknål, akiknél a felvételi EKG-n ST-elevåció volt. A BTSZB-s csoport
halĂĄlozĂĄsa mind a 30 napos (25,4% versus 12,4%), mind az 1 Ă©ves idĆpontban
(47,3% versus 19,9%) magasabb volt, mint az ST-elevĂĄciĂłs betegcsoportban. A
percutan coronariaintervenció (PCI) mindkét csoportban lényegesen alacsonyabb
halĂĄlozĂĄssal jĂĄrt egyĂŒtt. Többfaktoros elemzĂ©s sorĂĄn a BTSZB önĂĄllĂł
prognosztikai jelentĆsĂ©gĂ©t igazoltuk: az ST-elevĂĄciĂłhoz viszonyĂtott
hazĂĄrdhĂĄnyadosa 1,33 (95%-os konfidenciaintervallum: 1,10â1,62), kontrollĂĄlva
nemre, Ă©letkorra, PCI megtörtĂ©ntĂ©re, szisztolĂ©s vĂ©rnyomĂĄsra, szĂvfrekvenciĂĄra,
szĂ©rumkreatinin-eltĂ©rĂ©sre Ă©s öt kĂłrelĆzmĂ©nyi/tĂĄrsbetegsĂ©gi adatra.
KövetkeztetĂ©s: Az akut szĂvinfarktus miatt kezelt betegek
prognózisåt a felvételi EKG is befolyåsolja: BTSZB esetén az életkilåtåsok
rosszabbak, mint ST-elevĂĄciĂłnĂĄl. Orv Hetil. 2018; 159(17): 677â681.
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Abstract:
Introduction and aim: By using the database of the National
Registry of Myocardial Infarction, the authors examine the prognosis of patients
treated with acute myocardial infarction, in case of whom there was new or
presumably new left bundle branch block (nLBBB) on the ECG recorded at
hospitalization. Method: We recorded the details of 18 091
patients treated with acute myocardial infarction (AMI) between 1 January 2014
and 30 June 2015 in the National Registry of Myocardial Infarction. In case of
8334 patients, the clinical diagnosis was ST-elevation myocardial infarction
(STEMI), whereas in 9757 cases it was non-ST elevation myocardial infarction
(NSTEMI). In the STEMI population we examined the clinical characteristics and
prognosis of patients with ST-elevation (n = 7937) and nLBBB (n = 397). We used
the proportional hazards regression model (Cox-regression) to examine mortality.
Results: In the AMI patient population, we found LBBB in
1274 cases (7%). In case of STEMI clinical diagnosis, the patients belonging to
the nLBBB subpopulation (n = 397) were older, and the proportion of men and the
occurrence of co-morbidities was higher than in case of those who had
ST-elevation on their ECG recorded at hospitalization. The mortality rate of the
LBBB population was higher than that of the ST-elevation patient population in
both the 30-day (25.4% versus 12.4%) and the 1-year period (47.3 versus 19.9%).
Percutaneous coronary intervention (PCI) had significantly lower mortality in
both populations. In the course of a multifactorial analysis we verified the
independent prognostic significance of LBBB: the hazard ratio compared to
ST-elevation was 1.33 (95% confidence interval: 1.10â1.62), checked for gender,
age, occurrence of PCI, systolic blood pressure, cardiac frequency, serum
creatinine difference, and the details of five anamneses/co-morbidities.
Conclusion: The admission ECG has prognostic significance.
Patients with LBBB have poorer prognosis compared to patients with ST-elevation
on admission ECG. Orv Hetil. 2018; 159(17): 677â681