38 research outputs found
A Crohn-betegség epidemiológiájának változásai a Veszprém megyei populációs adatbázis feldolgozása alapján
First prospective European study for the feasibility and safety of magnetically controlled capsule endoscopy in gastric mucosal abnormalities
A székletkalprotektin meghatározásának szerepe a bélbetegségek diagnosztikájában és kezelésében
Absztrakt:
Az elmúlt évtizedben a gastrointestinalis kórképek diagnosztikája sokat
változott. Az endoszkópos és képalkotó módszerek mellett előtérbe kerültek a
gyorsan elvégezhető laboratóriumi diagnosztikus vizsgálatok is. Külön előnynek
számít, ha a vizsgálat könnyen ismételhető, így a krónikus betegségek
követésére, az esetleges fellángolások időben történő felismerésére is alkalmas
lehet. A székletkalprotektin meghatározása, mely más országokban már a
mindennapi diagnosztika része, hazánkban is egyre több helyen hozzáférhető.
Összefoglaló közleményünkben bemutatjuk a székletkalprotektin-vizsgálat szerepét
és megbízhatóságát a gasztroenterológiai kórképekben, különös tekintettel a
gyulladásos bélbetegségekre, a bélrendszeri fertőzésekre, az
irritábilisbél-szindrómára és egyes gyermek gasztroenterológiai kórképekre. A
különböző betegségekben és helyzetekben használatos határértékeknek és az
ezekhez tartozó specificitásnak és szenzitivitásnak a bemutatásával szeretnénk
segíteni a klinikai orvosokat a helyes döntéshozatalban. Orv Hetil. 2019;
160(9): 322–328.
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Abstract:
The diagnostics of gastrointestinal diseases have evolved significantly in the
past few decades. Besides endoscopy and conventional imaging modalities, there
is a growing interest for rapid point-of-care laboratory tests to help
discriminate between diseases with similar clinical symptoms and/or help the
follow-up of chronic conditions, predicting relapses. The fecal calprotectin
testing is a routine diagnostic tool in many countries. It is also more and more
accessible in Hungary as well. We aim to present a short review on the role and
performance of fecal calprotectin test in the diagnosis and follow-up of
gastrointestinal diseases, especially inflammatory bowel diseases,
gastrointestinal infections, irritable bowel syndrome and pediatric conditions.
By presenting the different cut-off values, sensitivity and specificity rates
representative for each disease, we hope to further aid clinicians in
decision-making regarding these conditions. Orv Hetil. 2019; 160(9):
322–328
Therapeutic preferences and outcomes in newly diagnosed patients with Crohn’s diseases in the biological era in Hungary: a nationwide study based on the National Health Insurance Fund database
Abstract Background Accelerated treatment strategy, including tight disease control and early aggressive therapy with immunosuppressives (IS) and biological agents have become increasingly common in inflammatory bowel disease (IBD). The aim of the present study was to estimate the early treatment strategy and outcomes in newly diagnosed patients with Crohn’s disease (CD) between 2004 and 2008 and 2009–2015 in the whole IBD population in Hungary based on the administrative database of the National Health Insurance Fund (OEP). Methods We used the administrative database of the OEP, the only nationwide state-owned health insurance provider in Hungary. Patients were identified through previously reported algorithms using the ICD-10 codes for CD in the out-, inpatient (medical, surgical) non-primary care records and drug prescription databases between 2004 and 2015. Patients were stratified according to the year of diagnosis and maximum treatment steps during the first 3 years after diagnosis. Results A total of 6173 (male/female: 46.12%/53.87%) newly diagnosed CD patients with physician-diagnosed IBD were found in the period of 2004–2015. The use of 5-ASA and steroids remained common in the biological era, while immunosuppressives and biologicals were started earlier and became more frequent among patients diagnosed after 2009. The probability of biological therapy was 2.9%/6.4% and 8.4%/13.7% after 1 and 3 years in patients diagnosed in 2004–2008/2009–2015. The probability of hospitalization in the first 3 years after diagnosis was different before and after 2009, according to the maximal treatment step (overall 55.7%vs. 47.4% (p = 0.001), anti-TNF: 73%vs. 66.7% (p = 0.103), IS: 64.6% vs. 56.1% (p = 0.001), steroid: 44.2%vs. 36.8% (p < 0.007), 5-ASA: 32.6% vs. 26.7% p = 0.157)). In contrast, surgery rates were not significantly different in patients diagnosed before and after 2009 according to the maximum treatment step (overall 16.0%vs.15.3%(p = 0.672) anti-TNF 26.7%vs.27.2% (p = 0.993), IS: 24.1%vs22.2% (p = 0.565), steroid 8.1%vs.7.9% (p = 0.896), 5-ASA 10%vs. 11% (p = 0.816)). Conclusions IS and biological exposure became more frequent, while hospitalization decreased and surgery remained low but constant during the observation period. Use of steroids and 5-ASA remained high after 2009. The association between the maximal treatment step and hospitalization/surgery rates suggests that maximal treatment step can be regarded as proxy severity marker in patients with IBD
Risk matrix for prediction of disease progression in a referral cohort of patients with Crohn's disease
The burden of Clostridium difficile infection between 2010 and 2013: trends and outcomes from an academic center in Eastern Europe
Modeling is now an essential ingredient in business process management and information systems development. The general usefulness of models in these areas is therefore generally accepted. It is also undisputed that the quality of the models has a significant impact on their usefulness. In the literature we can find any number of quality metrics, but hardly any study that investigates their relation with (perceived) usefulness and none that considers their relative impact on usefulness. We take a look at some of the most frequent quality dimensions and their relative impact on the perceived usefulness of models
Evolution of disease phenotype in adult and pediatric onset Crohn’s disease in a population-based cohort.
Is early limited surgery associated with a more benign disease course in Crohn’s disease?
AIM:
To analyze the difference in disease course and need for surgery in patients with Crohn's disease (CD).
METHODS:
Data of 506 patients with incident CD were analyzed (age at diagnosis: 31.5 ± 13.8 years). Both hospital and outpatient records were collected prospectively with a complete clinical follow-up and comprehensively reviewed in the population-based Veszprem province database, which includes incident CD patients diagnosed between January 1, 1977 and December 31, 2008. Follow-up data were collected until December 31, 2009. All patients included had at least 1 year of follow-up available. Patients with indeterminate colitis at diagnosis were excluded from the analysis.
RESULTS:
Overall, 73 patients (14.4%) required resective surgery within 1 year of diagnosis. Steroid exposure and need for biological therapy were lower in patients with early limited surgery (P < 0.001 and P = 0.09). In addition, surgery rates during follow-up in patients with and without early surgery differed significantly after matching on propensity scores (P < 0.001, HR = 0.23). The need for reoperation was also lower in patients with early limited resective surgery (P = 0.038, HR = 0.42) in a Kaplan-Meier and multivariate Cox regression (P = 0.04) analysis. However, this advantage was not observed after matching on propensity scores (P(Logrank) = 0.656, P(Breslow) = 0.498).
CONCLUSION:
Long-term surgery rates and overall exposure to steroids and biological agents were lower in patients with early limited resective surgery, but reoperation rates did not differ