1
|
Mészáros B, Veres DS, Nagyistók L, Kovács BG, Kukor Z, Valent S. A meta-analysis on first-trimester blood count parameters-is the neutrophil-to-lymphocyte ratio a potentially novel method for first-trimester preeclampsia screening? Front Med (Lausanne) 2024; 11:1336764. [PMID: 38633299 PMCID: PMC11021791 DOI: 10.3389/fmed.2024.1336764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 03/11/2024] [Indexed: 04/19/2024] Open
Abstract
Objective Meta-analysis focusing on the role of first-trimester neutrophil-to-lymphocyte ratio (NLR) in the prediction of preeclampsia. Data sources PubMed, Scopus, Web of Science, Cochrane Library, and Embase databases were queried from inception up to December 31, 2022. Study eligibility criteria The study included all types of original research that was conducted in humans and values of NLR were measured during the first trimester, among patients who later developed preeclampsia, compared to the values of control groups. Study appraisal and synthesis methods Two reviewers independently performed data abstraction and quality appraisal, and disagreements were resolved by consensus and, if necessary, by the opinion of a third reviewer. During the analysis, PRISMA and MOOSE guidelines were followed. All statistical analyses were made with R. Results For the research on the predictive role of NLR values in the first trimester for preeclampsia, a total of 6 studies were selected for analysis, covering 2,469 patients. The meta-analysis revealed a 95% confidence interval (CI) for the effect size of 0.641 to 1.523, with a prediction interval of 0.027 to 2.137. Conclusion Based on the analysis, NLR is a promising biochemical marker for future pieces of research that try to find new screening methods for first-trimester preeclampsia. We encourage other researchers to examine NLR's predictive value combined with other markers in preeclampsia screening, this way being able to find new and affordable protocols for first-trimester preeclampsia screening. Systematic review registration identifier CRD42023392663.
Collapse
Affiliation(s)
- Balázs Mészáros
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Dániel S. Veres
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - Luca Nagyistók
- Dél-Pest Centrum Hospital National Hematology and Infectious Diseases Institute, Budapest, Hungary
| | - Bence G. Kovács
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Zoltán Kukor
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Sándor Valent
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
2
|
Supák D, Mészáros B, Turi B, Herold Z, Kukor Z, Valent S. Predicting Potentially Fatal COVID-19 Disease in Pregnant Patients Using the Neutrophil-to-Lymphocyte Ratio (NLR). J Clin Med 2023; 12:6896. [PMID: 37959361 PMCID: PMC10649139 DOI: 10.3390/jcm12216896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE To evaluate the neutrophil-to-lymphocyte ratio (NLR) values' possible predictive role in fatal and severe cases of COVID-19 disease in pregnant women. Design and data collection: A case-control study was conducted with the inclusion of 45 pregnant COVID-19 patients. All the data were obtained from the hospital information system of Semmelweis University by two of the authors. RESULTS Statistical analyses showed that NLR values were significantly higher in patients with fatal COVID-19 compared to those who survived the disease, with or without mechanical ventilation. The study also assessed whether NLR values measured on the first day of hospitalization or at their peak provided better markers of disease severity. While both the first-day and peak NLR values were evaluated in patients who did not survive the disease, only the peak NLR values had predictive value regarding patient death. CONCLUSION Based on our results, the peak NLR values appear to be useful markers of COVID-19 severity, with a cut-off value of 18.05. However, the authors suggest and hope that larger sample size studies will be conducted to further validate the findings of their research.
Collapse
Affiliation(s)
- Dorina Supák
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (D.S.); (B.M.); (B.T.); (S.V.)
| | - Balázs Mészáros
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (D.S.); (B.M.); (B.T.); (S.V.)
| | - Balázs Turi
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (D.S.); (B.M.); (B.T.); (S.V.)
| | - Zoltán Herold
- Division of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, 1082 Budapest, Hungary;
| | - Zoltán Kukor
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, 1094 Budapest, Hungary
| | - Sándor Valent
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (D.S.); (B.M.); (B.T.); (S.V.)
| |
Collapse
|
3
|
Mészáros B, Kukor Z, Valent S. Recent Advances in the Prevention and Screening of Preeclampsia. J Clin Med 2023; 12:6020. [PMID: 37762960 PMCID: PMC10532380 DOI: 10.3390/jcm12186020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Throughout the history of medicine, preeclampsia has remained an enigmatic field of obstetrics. In 2023, despite its prevalence and impact, preeclampsia's exact cause and effective treatment remain elusive; the current options are limited to delivery. The purpose of this review is to summarize the knowledge of the possible novel prophylactic therapies and screening methods for preeclampsia, thereby providing valuable insights for healthcare professionals and researchers. Aspirin and LMWH have already been widely used; meanwhile, calcium, vitamin D, and pravastatin show promise, and endothelin receptor antagonists are being explored. Stress reduction, dietary changes, and lifestyle modifications are also being investigated. Another interesting and fast-growing area is AI- and software-based screening methods. It is also key to find novel biomarkers, which, in some cases, are not only able to predict the development of the disease, but some of them hold promise to be a potential therapeutic target. We conclude that, while a definitive cure for preeclampsia may not be eligible in the near future, it is likely that the assessment and enhancement of preventive methods will lead to the prevention of many cases. However, it is also important to highlight that more additional research is needed in the future to clarify the exact pathophysiology of preeclampsia and to thus identify potential therapeutic targets for more improved treatment methods.
Collapse
Affiliation(s)
- Balázs Mészáros
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary
| | - Zoltán Kukor
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, 1082 Budapest, Hungary
| | - Sándor Valent
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary
| |
Collapse
|
4
|
Mészáros B, Veres DS, Nagyistók L, Somogyi A, Rosta K, Herold Z, Kukor Z, Valent S. Pravastatin in preeclampsia: A meta-analysis and systematic review. Front Med (Lausanne) 2023; 9:1076372. [PMID: 36714131 PMCID: PMC9880057 DOI: 10.3389/fmed.2022.1076372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/30/2022] [Indexed: 01/15/2023] Open
Abstract
Objective To review of the efficacy and safety of pravastatin use for prophylaxis and treatment of preeclampsia. Design Systematic review and meta-analysis of clinical studies evaluating pravastatin for treatment and/or prophylaxis of preeclampsia. Data collection Two independent reviewers systematically searched data from PubMed, Scopus, Web of Science, Cochrane, Embase, and clinicaltrials.gov databases, for studies evaluating pravastatin for prevention of pre-eclampsia. Results Fourteen studies were identified, including 1,570 pregnant women who received either pravastatin or placebo, published between 2003 and 2022. From these studies, 5 studies were identified for inclusion in the meta-analysis to evaluate the role of pravastatin use prior to 20 weeks of gestation, to prevent pre-eclampsia, Pravastatin treatment reduced the incidence of preeclampsia by 61% and premature birth by 45%. Among the newborns, there was a 45% reduction in intrauterine growth retardation (IUGR) in the treated group, as well as a 77% reduction in those receiving neonatal intensive care unit (NICU) admissions. Conclusion Prophylactic treatment with pravastatin appears to reduce risk of developing pre-eclampsia as well as potentially lowering risk of IUGR, preterm birth, and NICU admission in neonates.
Collapse
Affiliation(s)
- Balázs Mészáros
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Dániel Sándor Veres
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - Luca Nagyistók
- Dél-Pest Centrum Hospital National Hematology and Infectious Diseases Institute, Budapest, Hungary
| | - Anikó Somogyi
- Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Klára Rosta
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Zoltán Herold
- Division of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Zoltán Kukor
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary,*Correspondence: Zoltán Kukor,
| | - Sándor Valent
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
5
|
Supák D, Mészáros B, Nagy M, Gáspár D, Wagner LJ, Kukor Z, Valent S. Case report: COVID-19 infection in a pregnant 33-year-old kidney transplant recipient. Front Med (Lausanne) 2022; 9:948025. [PMID: 36111115 PMCID: PMC9468219 DOI: 10.3389/fmed.2022.948025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/21/2022] [Indexed: 01/08/2023] Open
Abstract
Patients facing severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infections with comorbidities, especially patients whose immune system is weakened have higher chances to face severe outcomes. One of the main reasons behind the suppression of the immune system is iatrogenic, in patients who have autoimmune diseases and/or had an organ transplant. Although there are studies that are examining immunocompromised and/or transplanted patients with COVID-19 infection, furthermore there is a limited number of studies available which are dealing with COVID-19 in pregnant women; however, it is unique and is worth reporting when these factors are coexisting. In this study, we present the case of a 33-year-old Caucasian pregnant woman, who had a kidney transplant in 2009 and contracted the SARS-CoV-2 virus on the 26th gestational week, in 2021. After her infection, superimposed preeclampsia was diagnosed and due to the worsening flowmetric parameters, she gave birth to a premature male newborn with cesarean section. Our kidney transplant patient’s case highlights how COVID-19 disease can lead to preeclampsia and artificial termination of gestation.
Collapse
Affiliation(s)
- Dorina Supák
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Balázs Mészáros
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Márta Nagy
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Dániel Gáspár
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - László J. Wagner
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary
| | - Zoltán Kukor
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
- *Correspondence: Zoltán Kukor,
| | - Sándor Valent
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
6
|
Field AR, Dunai D, Gaffka R, Ghim YC, Kiss I, Mészáros B, Krizsanóczi T, Shibaev S, Zoletnik S. Beam emission spectroscopy turbulence imaging system for the MAST spherical tokamak. Rev Sci Instrum 2012; 83:013508. [PMID: 22299952 DOI: 10.1063/1.3669756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A new beam emission spectroscopy turbulence imaging system has recently been installed onto the MAST spherical tokamak. The system utilises a high-throughput, direct coupled imaging optics, and a single large interference filter for collection of the Doppler shifted D(α) emission from the ~2 MW heating beam of ~70 keV injection energy. The collected light is imaged onto a 2D array detector with 8 × 4 avalanche photodiode sensors which is incorporated into a custom camera unit to perform simultaneous 14-bit digitization at 2 MHz of all 32 channels. The array is imaged at the beam to achieve a spatial resolution of ~2 cm in the radial (horizontal) and poloidal (vertical) directions, which is sufficient for detection of the ion-scale plasma turbulence. At the typical photon fluxes of ~10(11) s(-1) the achieved signal-to-noise ratio of ~300 at the 0.5 MHz analogue bandwidth is sufficient for detection of relative density fluctuations at the level of a few 0.1%. The system is to be utilised for the study of the characteristics of the broadband, ion-scale turbulence, in particular its interaction with flow shear, as well as coherent fluctuations due to various types of MHD activity.
Collapse
Affiliation(s)
- A R Field
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, Oxon, United Kingdom
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Ilkei T, Bede O, Madeleine S, Aiello A, Baross T, Ghidersa BE, Grunda G, Hajek P, Keller D, Kosek L, Mészáros B, Nagy D, Németh J, Nitti F, Tulipán S, Wagrez J. European test blanket ancillary equipment unit development. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2010.12.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
8
|
Daood H, Illés V, Gnayfeed M, Mészáros B, Horváth G, Biacs P. Extraction of pungent spice paprika by supercritical carbon dioxide and subcritical propane. J Supercrit Fluids 2002. [DOI: 10.1016/s0896-8446(02)00022-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
9
|
Mészáros B. [Treatment of mandibular fractures by extra-oral pin-fixation]. Fogorv Sz 1966; 59:11-5. [PMID: 5217031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|