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Masszi R, Zsigmond EJ, Ehrenberger R, Turan C, Fehérvári P, Teutsch B, Molnár Z, Drobni Z, Vágó H, Hegyi P, Merkely B, Kosztin A. Evaluating the predictive value of late gadolinium enhancement assessed by cardiac magnetic resonance on sudden cardiac death in patients selected for implantable cardioverter defibrillator and cardiac resynchronization therapy implantation: a systematic review and meta-analysis. Clin Res Cardiol 2024:10.1007/s00392-024-02441-2. [PMID: 38587562 DOI: 10.1007/s00392-024-02441-2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/19/2024] [Indexed: 04/09/2024]
Abstract
AIMS Late gadolinium enhancement (LGE) assessed by cardiovascular magnetic resonance (CMR) can evaluate myocardial scar associated with a higher risk of sudden cardiac death (SCD), which can guide the selection between cardiac resynchronization therapy with or without a defibrillator (CRT-P/CRT-D). Our aim was to investigate the association between LGE and SCD risk in patients with CRT using the LGE-CMR technique. METHODS AND RESULTS We performed a systematic literature search using four databases. The target population was CRT candidates. The primary endpoint was SCD. The risk of bias was assessed using the QUIPS tool. Fifteen eligible articles were included with a total of 2494 patients, of whom 27%, 56%, and 19% had an implantable cardioverter defibrillator (ICD), CRT-D, and CRT-P, respectively. Altogether, 54.71% of the cohort was LGE positive, who had a 72% higher risk for SCD (HR 1.72; 95% CI 1.18-2.50) compared to LGE negatives. In non-ischemic patients, the proportion of LGE positivity was 46.6%, with a significantly higher risk for SCD as compared to LGE negatives (HR 2.42; 95% CI 1.99-2.94). The subgroup of CRT-only patients showed no difference between the LGE-positive vs. negative candidates (HR 1.17; 95% CI 0.82-1.68). Comparable SCD risk was observed between articles with short- (OR 7.47; 95% CI 0.54-103.12) vs. long-term (OR 6.15; 95% CI 0.96-39.45) follow-up time. CONCLUSION LGE-CMR positivity was associated with an increased SCD risk; however, in CRT candidates, the difference in risk reduction between LGE positive vs. negative patients was statistically not significant, suggesting a role of reverse remodeling. LGE-CMR before device implantation could be crucial in identifying high-risk patients even in non-ischemic etiology.
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Affiliation(s)
- Richárd Masszi
- Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Hungary
- Heart and Vascular Center, Semmelweis University, 68 Városmajor Street, Budapest, 1122, Hungary
| | - Előd-János Zsigmond
- Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Hungary
- Department of Cardiology, Military Hospital - State Health Centre, Budapest, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Réka Ehrenberger
- Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Hungary
- Heart and Vascular Center, Semmelweis University, 68 Városmajor Street, Budapest, 1122, Hungary
| | - Caner Turan
- Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Hungary
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Hungary
- Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, 7623, Hungary
| | - Zsolt Molnár
- Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Hungary
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Zsófia Drobni
- Heart and Vascular Center, Semmelweis University, 68 Városmajor Street, Budapest, 1122, Hungary
| | - Hajnalka Vágó
- Heart and Vascular Center, Semmelweis University, 68 Városmajor Street, Budapest, 1122, Hungary
- Department of Sports Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, 7623, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, 1083, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, 68 Városmajor Street, Budapest, 1122, Hungary.
| | - Annamária Kosztin
- Heart and Vascular Center, Semmelweis University, 68 Városmajor Street, Budapest, 1122, Hungary
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Gulyás E, Horváth IL, Engh MA, Bunduc S, Dembrovszky F, Fehérvári P, Bánvölgyi A, Csupor D, Hegyi P, Karvaly GB. Assessment of the practical impact of adjusting beta-lactam dosages based on therapeutic drug monitoring in critically ill adult patients: a systematic review and meta-analysis of randomized clinical trials and observational studies. Sci Rep 2024; 14:7793. [PMID: 38565898 PMCID: PMC10987621 DOI: 10.1038/s41598-024-58200-w] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
An estimated 70% of critically ill patients receive antibiotics, most frequently beta-lactams. The pharmacokinetic properties of these substances in this patient population are poorly predictable. Therapeutic drug monitoring (TDM) is helpful in making personalized decisions in this field, but its overall impact as a clinical decision-supporting tool is debated. We aimed to evaluate the clinical implications of adjusting beta-lactam dosages based on TDM in the critically ill population by performing a systematic review and meta-analysis of available investigations. Randomized controlled trials and observational studies were retrieved by searching three major databases. The intervention group received TDM-guided beta-lactam treatment, that is, at least one dose reconsideration based on the result of the measurement of drug concentrations, while TDM-unadjusted dosing was employed in the comparison group. The outcomes were evaluated using forest plots with random-effects modeling and subgroup analysis. Eight eligible studies were identified, including 1044 patients in total. TDM-guided beta-lactam treatment was associated with improved clinical cure from infection [odds ratio (OR): 2.22 (95% confidence interval (CI): 1.78-2.76)] and microbiological eradication [OR: 1.72 (CI: 1.05-2.80)], as well as a lower probability of treatment failure [OR: 0.47 (CI: 0.36-0.62)], but the heterogeneity of studies was remarkably high, especially in terms of mortality (70%). The risk of bias was moderate. While the TDM-guided administration of beta-lactams to critically ill patients has a favorable impact, standardized study designs and larger sample sizes are required for developing evidence-based protocols in this field.
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Affiliation(s)
- Eszter Gulyás
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, Budapest, Hungary
- Department of Laboratory Medicine, Semmelweis University, 4 Nagyvarad ter, Budapest, 1089, Hungary
| | - István László Horváth
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, Budapest, Hungary
| | - Marie Anne Engh
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Stefania Bunduc
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Fundeni Clinical Institute, Bucharest, Romania
| | - Fanni Dembrovszky
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- First Department of Medicine, University of Pécs, Pécs, Hungary
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary
| | - András Bánvölgyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Dezső Csupor
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Department of Clinical Pharmacy, University of Szeged, Szeged, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Gellért Balázs Karvaly
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
- Department of Laboratory Medicine, Semmelweis University, 4 Nagyvarad ter, Budapest, 1089, Hungary.
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3
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Galajda NÁ, Meznerics FA, Mátrai P, Fehérvári P, Lengyel AS, Kolonics MV, Sipos Z, Kemény LV, Csupor D, Hegyi P, Bánvölgyi A, Holló P. Reducing cardiovascular risk in immune-mediated inflammatory diseases: Tumour necrosis factor inhibitors compared to conventional therapies-A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2024. [PMID: 38433519 DOI: 10.1111/jdv.19900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/19/2024] [Indexed: 03/05/2024]
Abstract
Immune-mediated inflammatory disease (IMID) patients including psoriasis, inflammatory arthritides and bowel diseases have a higher risk of developing cardiovascular (CV) diseases compared to the general population. The increased CV risk may be promoted by tumour necrosis factor (TNF)-α-mediated immunological processes, which are present both in the pathomechanism of IMIDs and atherosclerosis. Our objective was to comprehensively investigate the effect of TNF inhibitors (TNFi) on CV risk compared with conventional therapies in IMIDs. The systematic literature search was conducted in three databases (MEDLINE, EMBASE, Cochrane Library) on 14 November 2022. Randomized controlled trials, cohort and case-control studies were eligible for inclusion. Outcomes consisted of the incidence of CV events, with major adverse cardiovascular events (MACE) as a main endpoint. A random-effects meta-analysis was performed by pooling fully adjusted multivariate hazard ratios (HR) and incidence rate ratios (IRR) with a 95% confidence interval (CI) comparing TNFis with conventional systemic non-biologicals (CSNBs). Of a total of 8724 search results, 56 studies were included overall, of which 29 articles were eligible for the meta-analysis, and 27 were involved in the systematic review. Including all IMIDs, the TNFi group showed a significantly reduced risk of MACE compared with the CSNB group (HR = 0.74, 95% confidence interval (CI) 0.58-0.95, p = 0.025; IRR = 0.77, 95% CI 0.67-0.88, p < 0.001). Subgroup analysis of Pso, PsA patients by pooling IRRs also confirmed the significantly decreased risk of MACE in TNFi-treated patients compared with CSNB groups (IRR = 0.79, 95% CI 0.64-0.98). The observational nature of most included studies leading to high heterogeneity represents a limitation. Based on the results, TNFis may reduce the risk of CV events compared to CSNBs. Therefore, earlier use of TNFis compared to conventional systemic agents in the therapeutic sequence may benefit CV risk in IMID patients.
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Affiliation(s)
- N Á Galajda
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - F A Meznerics
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - P Mátrai
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - P Fehérvári
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary
| | - A S Lengyel
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- HCEMM-SU Translational Dermatology Research Group, Department of Physiology, Semmelweis University, Budapest, Hungary
| | - M V Kolonics
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Z Sipos
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - L V Kemény
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- HCEMM-SU Translational Dermatology Research Group, Department of Physiology, Semmelweis University, Budapest, Hungary
| | - D Csupor
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - P Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - A Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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Madár I, Szabó A, Vleskó G, Hegyi P, Ács N, Fehérvári P, Kói T, Kálovics E, Szabó G. Diagnostic Accuracy of Transvaginal Ultrasound and Magnetic Resonance Imaging for the Detection of Myometrial Infiltration in Endometrial Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:907. [PMID: 38473269 DOI: 10.3390/cancers16050907] [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: 01/15/2024] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
In endometrial cancer (EC), deep myometrial invasion (DMI) is a prognostic factor that can be evaluated by various imaging methods; however, the best method of choice is uncertain. We aimed to compare the diagnostic performance of two-dimensional transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) in the preoperative detection of DMI in patients with EC. Pubmed, Embase and Cochrane Library were systematically searched in May 2023. We included original articles that compared TVS to MRI on the same cohort of patients, with final histopathological confirmation of DMI as reference standard. Several subgroup analyses were performed. Eighteen studies comprising 1548 patients were included. Pooled sensitivity and specificity were 76.6% (95% confidence interval (CI), 70.9-81.4%) and 87.4% (95% CI, 80.6-92%) for TVS. The corresponding values for MRI were 81.1% (95% CI, 74.9-85.9%) and 83.8% (95% CI, 79.2-87.5%). No significant difference was observed (sensitivity: p = 0.116, specificity: p = 0.707). A non-significant difference between TVS and MRI was observed when no-myometrium infiltration vs. myometrium infiltration was considered. However, when only low-grade EC patients were evaluated, the specificity of MRI was significantly better (p = 0.044). Both TVS and MRI demonstrated comparable sensitivity and specificity. Further studies are needed to assess the presence of myometrium infiltration in patients with fertility-sparing wishes.
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Affiliation(s)
- István Madár
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
| | - Anett Szabó
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Gábor Vleskó
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary
| | - Nándor Ács
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Stochastics Department, Budapest University of Technology and Economics, 1111 Budapest, Hungary
| | - Emma Kálovics
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
| | - Gábor Szabó
- Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
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Csirzó Á, Kovács DP, Szabó A, Fehérvári P, Jankó Á, Hegyi P, Nyirády P, Sipos Z, Sára L, Ács N, Szabó I, Valent S. Robot-assisted laparoscopy does not have demonstrable advantages over conventional laparoscopy in endometriosis surgery: a systematic review and meta-analysis. Surg Endosc 2024; 38:529-539. [PMID: 38062181 PMCID: PMC10830624 DOI: 10.1007/s00464-023-10587-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/04/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Endometriosis is a chronic condition affecting 6-10% of women of reproductive age, with endometriosis-related pain and infertility being the leading symptoms. Currently, the gold standard treatment approach to surgery is conventional laparoscopy (CL); however, the increasing availability of robot-assisted surgery is projected as a competitor of CL. This study aimed to compare the perioperative outcomes of robot-assisted laparoscopy (RAL) and CL in endometriosis surgery. OBJECTIVES We aimed to compare the effectiveness and safety of these two procedures. METHODS A systematic search was conducted in three medical databases. Studies investigating different perioperative outcomes of endometriosis-related surgeries were included. Results are presented as odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CI). RESULTS Our search yielded 2,014 records, of which 13 were eligible for data extraction. No significant differences were detected between the CL and RAL groups in terms of intraoperative complications (OR = 1.07, CI 0.43-2.63), postoperative complications (OR = 1.3, CI 0.73-2.32), number of conversions to open surgery (OR = 1.34, CI 0.76-2.37), length of hospital stays (MD = 0.12, CI 0.33-0.57), blood loss (MD = 16.73, CI 4.18-37.63) or number of rehospitalizations (OR = 0.95, CI 0.13-6.75). In terms of operative times (MD = 28.09 min, CI 11.59-44.59) and operating room times (MD = 51.39 min, CI 15.07-87.72;), the RAL technique remained inferior. CONCLUSION RAL does not have statistically demonstrable advantages over CL in terms of perioperative outcomes for endometriosis-related surgery.
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Affiliation(s)
- Ádám Csirzó
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1082, Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Dénes Péter Kovács
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1082, Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Anett Szabó
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1082, Budapest, Hungary
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1082, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Árpád Jankó
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1082, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1082, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Péter Nyirády
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1082, Budapest, Hungary
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Zoltán Sipos
- Medical School, Institute for Translational Medicine, University of Pécs, Pecs, Hungary
- Medical School, Institute of Bioanalysis, University of Pécs, Pecs, Hungary
| | - Levente Sára
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1082, Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Nándor Ács
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1082, Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - István Szabó
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Sándor Valent
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1082, Budapest, Hungary.
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.
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Horváth IL, Kleiner D, Nagy R, Fehérvári P, Hankó B, Hegyi P, Csupor D. Nafamostat Reduces the Incidence of post-ERCP Pancreatitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clin Pharmacol Ther 2024; 115:206-212. [PMID: 38032816 DOI: 10.1002/cpt.3118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). As the management of pancreatitis is limited, clinical approaches focus on the prevention of post-ERCP pancreatitis (PEP). In theory, the serine protease inhibitor nafamostat can reduce circulating inflammatory mediators in pancreatitis. We aimed to investigate the effect of nafamostat in the prevention of PEP in this systematic review and meta-analysis. The protocol for this review was registered in PROSPERO (CRD42022367988). We systematically searched 5 databases without any filters on September 26, 2022. The eligible population was adult patients undergoing ERCP. We compared the PEP preventive effect of nafamostat to placebo. The main outcome was the occurrence of PEP. We calculated the pooled odds ratios (ORs), mean differences, and corresponding 95% confidence intervals (95% CIs) and multilevel model. The risk of bias was assessed using the Rob2 tool. Seven randomized controlled trials involving 2,962 patients were eligible for inclusion. Nafamostat reduced the overall incidence rate of PEP (20 mg, OR: 0.50, 95% CI: 0.30-0.82 and 50 mg, OR: 0.48, 95% CI: 0.24-0.96). However, the occurrence of mild PEP was significantly reduced only in the subgroup receiving 20 mg nafamostat (OR, 0.49, 95% CI: 0.31-0.77). Overall, nafamostat therapy reduced moderate PEP in high-risk patients (OR: 0.18, 95% CI: 0.0.4-0.84) and mild PEP in low-risk patients (OR: 0.32, 95% CI: 0.17-0.61). Nafamostat is an effective therapy in the prevention of mild post-ERCP pancreatitis. Further research is required to determine the cost-effectiveness of this therapy.
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Affiliation(s)
- István László Horváth
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- University Pharmacy, Department of Pharmacy Administration, Semmelweis University, Budapest, Hungary
| | - Dénes Kleiner
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- University Pharmacy, Department of Pharmacy Administration, Semmelweis University, Budapest, Hungary
| | - Rita Nagy
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary
| | - Balázs Hankó
- University Pharmacy, Department of Pharmacy Administration, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Dezső Csupor
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
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Vleskó G, Meznerics FA, Hegyi P, Teutsch B, Unicsovics M, Sipos Z, Fehérvári P, Ács N, Várbíró S, Keszthelyi M. Comparison of Combined Parenteral and Oral Hormonal Contraceptives: A Systematic Review and Meta-Analysis of Randomized Trials. J Clin Med 2024; 13:575. [PMID: 38276081 PMCID: PMC10816843 DOI: 10.3390/jcm13020575] [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: 11/30/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Delivering contraceptive hormones through a transdermal patch or a vaginal ring might have advantages over the traditional oral route. OBJECTIVES To compare the effectiveness, compliance, and side effect profile of oral and parenteral drug administration methods. METHODS We performed a systematic literature search in four medical databases-MEDLINE (via PubMed), Cochrane Library (CENTRAL), Embase, and Scopus-from inception to 20 November 2022. Randomized controlled trials assessing the efficacy, compliance, and adverse event profile of combined parenteral and oral hormonal contraceptives were included. RESULTS Our systematic search provided 3952 records; after duplicate removal, we screened 2707 duplicate-free records. A total of 13 eligible studies were identified after title, abstract, and full-text selection. We observed no significant difference in contraceptive efficacy (Pearl Index) between oral and parenteral drug administration (MD = -0.06, CI: -0.66-0.53; I2 = 0%). We found significant subgroup differences between parenteral methods in terms of compliance (χ2 = 4.32, p =0.038, I2 = 80%) and certain adverse events: breast discomfort (χ2 = 19.04, p =0.001, I2 = 80%), nausea (χ2 = 8.04, p =0.005, I2 = 75%), and vomiting (χ2 = 9.30, p =0.002; I2 = 72%). CONCLUSION Both parenteral and oral contraceptives can be used as an effective contraceptive method, and the route of administration should be tailored to patient needs and adverse event occurrence.
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Affiliation(s)
- Gábor Vleskó
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (G.V.); (M.U.); (N.Á.); (M.K.)
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
| | - Fanni Adél Meznerics
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 1082 Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
- Institute for Translational Medicine, Medical School, University of Pécs, 7621 Pécs, Hungary;
- Institute of Pancreatic Diseases, Semmelweis University, 1085 Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
- Institute for Translational Medicine, Medical School, University of Pécs, 7621 Pécs, Hungary;
| | - Márkó Unicsovics
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (G.V.); (M.U.); (N.Á.); (M.K.)
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
| | - Zoltán Sipos
- Institute for Translational Medicine, Medical School, University of Pécs, 7621 Pécs, Hungary;
- Institute of Bioanalysis, Medical School, University of Pécs, 7621 Pécs, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
- Department of Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (G.V.); (M.U.); (N.Á.); (M.K.)
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (G.V.); (M.U.); (N.Á.); (M.K.)
- Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary
| | - Márton Keszthelyi
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (G.V.); (M.U.); (N.Á.); (M.K.)
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
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Kerek Á, Szabó Á, Dobra PF, Bárdos K, Ózsvári L, Fehérvári P, Bata Z, Molnár-Nagy V, Jerzsele Á. Determining the In Vivo Efficacy of Plant-Based and Probiotic-Based Antibiotic Alternatives against Mixed Infection with Salmonella enterica and Escherichia coli in Domestic Chickens. Vet Sci 2023; 10:706. [PMID: 38133257 PMCID: PMC10747687 DOI: 10.3390/vetsci10120706] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
Restrictions on the use of antimicrobial compounds have led to a surge of interest in alternative solutions, such as natural, plant-based compounds. In our study, we investigated the efficacy of three feed supplements containing different additives, namely, probiotics (Lactobacillus spp., "Test substance A"), turmeric (Curcuma longa L., "Test substance B"), and fenugreek (Trigonella foenum graecum, "Test substance C"). In the experiment, we tested 180 birds of the Bábolna Tetra-SL laying hybrid breed that were infected with Salmonella enteritidis strains. The birds were randomly divided into six groups: three groups treated with the different additives, a negative control group, a positive control group, and an antibiotic-treated group using enrofloxacin. We examined the maturation and the time course of shedding of Salmonella; at the end of rearing, pathological and histopathological examinations were performed. When Salmonella was isolated from the cloacal swab samples, the enrofloxacin-treated group had a high number of animals shedding Salmonella by day 9, which was like the group treated with test material C. The greatest reduction in Salmonella shedding was observed in the groups treated with test materials A and B. In terms of pathological parameters, villus length and crypt depth were significantly better in the group treated with test material C compared to the positive and negative controls, and when comparing the body weight of the tested animals, the group treated with test material B had a significantly larger absorption surface area compared to the positive control group. Overall, the supplement with test material C proved to be the most effective. In the future, it is worthwhile to investigate the combination of the tested active substances for their possible synergistic effects and to perform a dose-response study to select the optimal dosage.
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Affiliation(s)
- Ádám Kerek
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, István Street 2, 1078 Budapest, Hungary; (Á.S.); (Á.J.)
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine, 1078 Budapest, Hungary; (K.B.); (L.Ó.)
| | - Ábel Szabó
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, István Street 2, 1078 Budapest, Hungary; (Á.S.); (Á.J.)
| | - Péter Ferenc Dobra
- Department of Pathology, University of Veterinary Medicine, 1078 Budapest, Hungary;
| | - Krisztina Bárdos
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine, 1078 Budapest, Hungary; (K.B.); (L.Ó.)
- Department of Veterinary Forensics and Economics, Institute of Economics and Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - László Ózsvári
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine, 1078 Budapest, Hungary; (K.B.); (L.Ó.)
- Department of Veterinary Forensics and Economics, Institute of Economics and Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - Péter Fehérvári
- Department of Biostatistics, Institute of Economics and Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary;
| | - Zsófia Bata
- Dr. Bata Zrt., 2364 Ócsa, Hungary; (Z.B.); (V.M.-N.)
| | | | - Ákos Jerzsele
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, István Street 2, 1078 Budapest, Hungary; (Á.S.); (Á.J.)
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine, 1078 Budapest, Hungary; (K.B.); (L.Ó.)
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Ács J, Szabó A, Fehérvári P, Harnos A, Skribek B, Tenke M, Szarvas T, Nyirády P, Ács N, Hegyi P, Majoros A. Safety and Efficacy of Vaginal Implants in Pelvic Organ Prolapse Surgery: A Meta-analysis of 161 536 Patients. Eur Urol Focus 2023:S2405-4569(23)00243-2. [PMID: 37968187 DOI: 10.1016/j.euf.2023.11.001] [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: 09/20/2023] [Accepted: 11/02/2023] [Indexed: 11/17/2023]
Abstract
CONTEXT Among the many surgical treatments for pelvic organ prolapse (POP), better results can be achieved with the use of vaginal implants. However, owing to perceived complications, vaginal implant surgeries have been restricted or banned in many countries. OBJECTIVE To assess the real value of vaginal implants in POP surgery and compare the safety and efficacy of operations with and without implants. EVIDENCE ACQUISITION A systematic search was performed in three medical databases. Randomised controlled trials and observational studies comparing the safety and efficacy of vaginal POP surgery with implants versus native tissue were included. Safety outcomes were defined as different types of complications (functional and non-functional) and reoperations for complications. Efficacy outcomes were parameters of anatomical success and the rate of reoperations due to recurrence. A multivariate meta-analysis framework was used to estimate pooled odds ratios (ORs) with confidence intervals (CIs) with simultaneous control for study correlations and estimation of multiple correlated outcomes. EVIDENCE SYNTHESIS We included 50 comparative studies in the analysis. Rates of reoperation for complications (OR 2.15, 95% CI 1.20-3.87), vaginal erosion (OR 14.05, 95% CI 9.07-21.77), vaginal bleeding (OR 1.67, 95% CI 1.25-2.23), and de novo stress urinary incontinence (OR 1.44, 95% CI 1.18-1.75) were significantly higher in the implant group. Rates of anatomical success (OR 3.22, 95% CI 2.06-5.0) and reoperation for recurrence (OR 0.55, 95% CI 0.36-0.85) were superior in the implant group. CONCLUSIONS POP surgeries with vaginal implants are more effective than surgeries without implants, with acceptable complication rates. Therefore, the complete prohibition of implants for POP surgeries should be reconsidered. PATIENT SUMMARY We compared vaginal surgery with and without implants for repair of pelvic organ prolapse. Despite higher complication rates, vaginal implants provide better long-term results overall than surgery without implants.
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Affiliation(s)
- Júlia Ács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Urology, Semmelweis University, Budapest, Hungary
| | - Anett Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Urology, Semmelweis University, Budapest, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Andrea Harnos
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Benjamin Skribek
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Martin Tenke
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary; Department of Urology, University of Duisburg-Essen and German Cancer Consortium, Essen, Germany
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, University of Pécs Medical School, Pécs, Hungary
| | - Attila Majoros
- Department of Urology, Semmelweis University, Budapest, Hungary.
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Papp M, Kiss N, Baka M, Trásy D, Zubek L, Fehérvári P, Harnos A, Turan C, Hegyi P, Molnár Z. Procalcitonin-guided antibiotic therapy may shorten length of treatment and may improve survival-a systematic review and meta-analysis. Crit Care 2023; 27:394. [PMID: 37833778 PMCID: PMC10576288 DOI: 10.1186/s13054-023-04677-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Appropriate antibiotic (AB) therapy remains a challenge in the intensive care unit (ICU). Procalcitonin (PCT)-guided AB stewardship could help optimize AB treatment and decrease AB-related adverse effects, but firm evidence is still lacking. Our aim was to compare the effects of PCT-guided AB therapy with standard of care (SOC) in critically ill patients. METHODS We searched databases CENTRAL, Embase and Medline. We included randomized controlled trials (RCTs) comparing PCT-guided AB therapy (PCT group) with SOC reporting on length of AB therapy, mortality, recurrent and secondary infection, ICU length of stay (LOS), hospital LOS or healthcare costs. Due to recent changes in sepsis definitions, subgroup analyses were performed in studies applying the Sepsis-3 definition. In the statistical analysis, a random-effects model was used to pool effect sizes. RESULTS We included 26 RCTs (n = 9048 patients) in the quantitative analysis. In comparison with SOC, length of AB therapy was significantly shorter in the PCT group (MD - 1.79 days, 95% CI: -2.65, - 0.92) and was associated with a significantly lower 28-day mortality (OR 0.84, 95% CI: 0.74, 0.95). In Sepsis-3 patients, mortality benefit was more pronounced (OR 0.46 95% CI: 0.27, 0.79). Odds of recurrent infection were significantly higher in the PCT group (OR 1.36, 95% CI: 1.10, 1.68), but there was no significant difference in the odds of secondary infection (OR 0.81, 95% CI: 0.54, 1.21), ICU and hospital length of stay (MD - 0.67 days 95% CI: - 1.76, 0.41 and MD - 1.23 days, 95% CI: - 3.13, 0.67, respectively). CONCLUSIONS PCT-guided AB therapy may be associated with reduced AB use, lower 28-day mortality but higher infection recurrence, with similar ICU and hospital length of stay. Our results render the need for better designed studies investigating the role of PCT-guided AB stewardship in critically ill patients.
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Affiliation(s)
- Márton Papp
- Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1082, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Saint John's Hospital, Budapest, Hungary
| | - Nikolett Kiss
- Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1082, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Máté Baka
- Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1082, Budapest, Hungary
| | - Domonkos Trásy
- Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1082, Budapest, Hungary
| | - László Zubek
- Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1082, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1082, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary
| | - Andrea Harnos
- Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1082, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary
| | - Caner Turan
- Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1082, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1082, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Zsolt Molnár
- Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1082, Budapest, Hungary.
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary.
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Poznan University of Medical Sciences, Poznan, Poland.
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Veres B, Fehérvári P, Engh MA, Hegyi P, Gharehdaghi S, Zima E, Duray G, Merkely B, Kosztin A. Time-trend treatment effect of cardiac resynchronization therapy with or without defibrillator on mortality: a systematic review and meta-analysis. Europace 2023; 25:euad289. [PMID: 37766466 PMCID: PMC10585357 DOI: 10.1093/europace/euad289] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
AIMS This study aimed to investigate the impact of cardiac resynchronization therapy with a defibrillator (CRT-D) on mortality, comparing it with CRT with a pacemaker (CRT-P). Additionally, the study sought to identify subgroups, evaluate the time trend in treatment effects, and analyze patient characteristics, considering the changing indications over the past decades. METHODS AND RESULTS PubMed, CENTRAL, and Embase up to October 2021 were screened for studies comparing CRT-P and CRT-D, focusing on mortality. Altogether 26 observational studies were selected comprising 128 030 CRT patients, including 55 469 with CRT-P and 72 561 with CRT-D device. Cardiac resynchronization therapy with defibrillator was able to reduce all-cause mortality by almost 20% over CRT-P [adjusted hazard ratio (HR): 0.85; 95% confidence interval (CI): 0.76-0.94; P < 0.01] even in propensity-matched studies (HR: 0.83; 95% CI: 0.80-0.87; P < 0.001) but not in those with non-ischaemic aetiology (HR: 0.95; 95% CI: 0.79-1.15; P = 0.19) or over 75 years (HR: 1.08; 95% CI 0.96-1.21; P = 0.17). When treatment effect on mortality was investigated by the median year of inclusion, there was a difference between studies released before 2015 and those thereafter. Time-trend effects could be also observed in patients' characteristics: CRT-P candidates were getting older and the prevalence of ischaemic aetiology was increasing over time. CONCLUSION The results of this systematic review of observational studies, mostly retrospective with meta-analysis, suggest that patients with CRT-D had a lower risk of mortality compared with CRT-P. However, subgroups could be identified, where CRT-D was not superior such as non-ischaemic and older patients. An improved treatment effect of CRT-D on mortality could be observed between the early and late studies partly related to the changed characteristics of CRT candidates.
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Affiliation(s)
- Boglárka Veres
- Heart and Vascular Center, Semmelweis University, Városmajor Str. 68, 1122 Budapest, Hungary
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Fehérvári
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary
| | - Marie Anne Engh
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Sara Gharehdaghi
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
- Gottsegen György National Cardiovascular Institute, Budapest, Hungary
| | - Endre Zima
- Heart and Vascular Center, Semmelweis University, Városmajor Str. 68, 1122 Budapest, Hungary
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Gábor Duray
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
- Central Hospital of Northern Pest-Military Hospital, Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Városmajor Str. 68, 1122 Budapest, Hungary
| | - Annamária Kosztin
- Heart and Vascular Center, Semmelweis University, Városmajor Str. 68, 1122 Budapest, Hungary
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
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12
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Tóth-Mészáros A, Garmaa G, Hegyi P, Bánvölgyi A, Fenyves B, Fehérvári P, Harnos A, Gergő D, Nguyen Do To U, Csupor D. The effect of adaptogenic plants on stress: A systematic review and meta-analysis. J Funct Foods 2023; 108:105695. [DOI: 10.1016/j.jff.2023.105695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
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13
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Kulyassa P, Engh MA, Vámosi P, Fehérvári P, Hegyi P, Merkely B, Édes IF. Drug-coated balloon therapy is more effective in treating late drug-eluting stent in-stent restenosis than the early occurring one-a systematic review and meta-analysis. Front Cardiovasc Med 2023; 10:1062130. [PMID: 37342438 PMCID: PMC10277682 DOI: 10.3389/fcvm.2023.1062130] [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: 10/05/2022] [Accepted: 05/02/2023] [Indexed: 06/22/2023] Open
Abstract
Drug-eluting stent in-stent restenosis (DES-ISR) remains one of the important assignments to be resolved in interventional cardiology, as it is present in 5%-10% of total percutaneous coronary intervention cases. Drug-coated balloon (DCB) utilization is promising, as it comes with long-term protection from recurrent restenosis in optimal conditions without the hazard of higher risk for stent thrombosis and in-stent restenosis. We aim to reduce the need for recurrent revascularization in DES-ISR, specifying the population in which the DCB therapy should be used. In this meta-analysis, the results of studies containing data on the time frame between drug-eluting stent implantation and the clinical presentation of in-stent restenosis and concomitant drug-coated balloon treatment were summarized. A systematic search was performed in Medline, Central, Web of Science, Scopus and Embase databases on November 11th, 2021. The QUIPS tool was used to assess the risk of bias in the included studies. The occurrence of a major cardiac adverse events (MACE) composite endpoint, containing target lesion revascularization (TLR), myocardial infarction, and cardiac death, and each of these separately, was assessed at 12 months after the balloon treatment. Random effects meta-analysis models were used for statistical analysis. Data of 882 patients from four studies were analyzed. Across the included studies, a 1.68 OR (CI 1.57-1.80, p < 0.01) for MACE and a 1.69 OR (CI 1.18-2.42 p < 0.01) for TLR were observed, both in favor of late DES-ISR. The main limitation of the study is the relatively low patient number. Nevertheless, this analysis shows the first statistically significant results for the effect of DCB treatment in the early or late presentation of DES-ISR. As to date, intravascular imaging (IVI) remains limitedly accessible, other landmarks as the time frame of in-stent restenosis development are to be pursued to advance therapeutic outcomes. In consideration of other biological, technical and mechanical factors, time frame of occurrence as a prognostic factor could reduce the burden of recurrent revascularization in patients at an already high risk. Systematic Review Registration: identifier [CRD42021286262].
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Affiliation(s)
- Péter Kulyassa
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Marie Anne Engh
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Vámosi
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Fehérvári
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Budapest, Hungary
| | - István Ferenc Édes
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Budapest, Hungary
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14
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Kubik A, das Virgens IPA, Szabó A, Váradi M, Csizmarik A, Keszthelyi A, Majoros A, Fehérvári P, Hegyi P, Ács N, Nyirády P, Szarvas T. Comprehensive Analysis of the Prognostic Value of Circulating MMP-7 Levels in Urothelial Carcinoma: A Combined Cohort Analysis, Systematic Review, and Meta-Analysis. Int J Mol Sci 2023; 24:ijms24097859. [PMID: 37175566 PMCID: PMC10178327 DOI: 10.3390/ijms24097859] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/29/2023] [Accepted: 04/08/2023] [Indexed: 05/15/2023] Open
Abstract
Lymph node (LN) status is the most significant prognostic factor for invasive urothelial bladder cancer (UBC); however, the optimal extent of LN dissection (LND) is debated. We assessed circulating matrix metalloproteinase-7 (MMP-7) as a prognostic factor and decision-making marker for the extent of LND. Preoperative serum MMP-7 levels were determined in two independent UBC cohorts (n = 188; n = 68) and in one control cohort (n = 97) by using the ELISA method. A systematic review and meta-analysis on the prognostic role of circulating pretreatment MMP-7 levels were performed. Serum MMP-7 levels were higher in patients compared to controls (p < 0.001) with the highest levels in LN-positive cases. Half of LN-positive UBC patients had low MMP-7 levels, whereas the survival of LN-negative patients with high serum MMP-7 findings was poor. MMP-7 levels were independently associated with poor survival in both cohorts (p = 0.006, p < 0.001). Accordingly, our systematic review of six eligible publications revealed a 2.5-fold higher mortality risk in patients with high MMP-7 levels. In conclusion, preoperative MMP-7 level is a validated and independent prognostic factor in urothelial cancer. It cannot be used to decide between regional or extended LND but may be useful in identifying LN-negative high-risk patients with potentially undetected metastases.
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Affiliation(s)
- András Kubik
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
| | | | - Anett Szabó
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
| | - Melinda Váradi
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Attila Keszthelyi
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Attila Majoros
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Péter Fehérvári
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - Péter Hegyi
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, 1083 Budapest, Hungary
| | - Nándor Ács
- Center for Translational Medicine, Semmelweis University, 1082 Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK), 45147 Essen, Germany
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15
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Illés K, Gergő D, Keresztély Z, Dembrovszky F, Fehérvári P, Bánvölgyi A, Csupor D, Hegyi P, Horváth T. Factors influencing successful reconstruction of tympanic membrane perforations: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2023; 280:2639-2652. [PMID: 36811654 PMCID: PMC10175362 DOI: 10.1007/s00405-023-07831-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/13/2022] [Accepted: 01/09/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Based on a systematic review and meta-analysis, our study aimed to provide information about the factors that influence the success of tympanic membrane reconstruction. METHODS Our systematic search was conducted on November 24, 2021, using the CENTRAL, Embase, and MEDLINE databases. Observational studies with a minimum of 12 months of follow-up on type I tympanoplasty or myringoplasty were included, while non-English articles, patients with cholesteatoma or specific inflammatory diseases, and ossiculoplasty cases were excluded. The protocol was registered on PROSPERO (registration number: CRD42021289240) and PRISMA reporting guideline was used. Risk of bias was evaluated with the QUIPS tool. A random effect model was used in the analyses. Primary outcome was the rate of closed tympanic cavities. RESULTS After duplicate removal, 9454 articles were found, of which 39 cohort studies were included. Results of four analyses showed significant effects: age (OR: 0.62, CI 0.50; 0.78, p value: 0.0002), size of the perforation (OR: 0.52, CI 0.29; 0.94, p value: 0.033), opposite ear condition (OR: 0.32, CI 0.12; 0.85, p value: 0.028), and the surgeon's experience (OR: 0.42, CI 0.26; 0.67, p value: 0.005), while prior adenoid surgery, smoking, the site of the perforation, and discharge of the ear did not. Four factors: etiology, Eustachian tube function, concomitant allergic rhinitis, and duration of the ear discharge were analyzed qualitatively. CONCLUSIONS The age of the patient, the size of the perforation, the opposite ear status, and the surgeon's experience have a significant effect on the success of tympanic membrane reconstruction. Further comprehensive studies are needed to analyze the interactions between the factors. LEVEL OF EVIDENCE Not applicable.
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Affiliation(s)
- Kata Illés
- Center for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary. .,Department of Otorhinolaryngology, Head and Neck Surgery, Bajcsy-Zsilinszky Hospital, Maglódi út 89-91, Budapest, 1106, Hungary.
| | - Dorottya Gergő
- Center for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Department of Pharmacognosy, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Keresztély
- Department of Otorhinolaryngology, Head and Neck Surgery, Bajcsy-Zsilinszky Hospital, Maglódi út 89-91, Budapest, 1106, Hungary
| | - Fanni Dembrovszky
- Center for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Fehérvári
- Center for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - András Bánvölgyi
- Center for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Dezső Csupor
- Center for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,Faculty of Pharmacy, Institute of Clinical Pharmacy, University of Szeged, Szeged, Hungary
| | - Péter Hegyi
- Center for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Tamás Horváth
- Center for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary. .,Department of Otorhinolaryngology, Head and Neck Surgery, Bajcsy-Zsilinszky Hospital, Maglódi út 89-91, Budapest, 1106, Hungary.
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16
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Kleiner D, Horváth IL, Bunduc S, Gergő D, Lugosi K, Fehérvári P, Hegyi P, Csupor D. Nabiximols is Efficient as Add-On Treatment for Patients with Multiple Sclerosis Spasticity Refractory to Standard Treatment: A Systematic Review and Meta-Analysis of Randomised Clinical Trials. Curr Neuropharmacol 2023; 21:2505-2515. [PMID: 37519000 PMCID: PMC10616923 DOI: 10.2174/1570159x21666230727094431] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/15/2022] [Accepted: 12/17/2022] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Spasticity affects 54% of multiple sclerosis (MS) patients at disease onset, but this rate gradually increases with disease progression. Spasticity does not fully respond to standard treatment in one-third of the patients. OBJECTIVE Our systematic review and meta-analysis assessed whether add-on nabiximols, can improve MS-associated refractory spasticity. METHODS The systematic literature search was performed in Web of Science, MEDLINE, Scopus, CENTRAL, and Embase, on 15/10/2021, without restrictions. We included in the review blinded, randomized, placebo-controlled trials evaluating the efficacy of nabiximols in adult MS patients with refractory spasticity, by comparison with placebo. The primary outcome was responder rate by spasticity numerical rating scale (NRS). Secondary outcomes were spasticity-related parameters. We used random effect models to calculate odds ratios (OR) or mean differences and the corresponding 95% CI. Bias-factors were assessed with Cochrane risk of bias tool (RoB2). (PROSPERO ID: CRD42021282177). RESULTS We identified 9 eligible articles, of which 7 (1128 patients) were included in the meta-analysis. The spasticity numerical rating scale (NRS) was significantly higher in the nabiximols group than in the placebo group (OR 2.41 (95% CI 1.39; 4.18)). Secondary outcomes were in accordance with our primary results. At least some concerns were detected in the risk of bias analysis. CONCLUSION Our results indicate that nabiximols is efficient in MS associated spasticity, refractory to standard treatment and it may be considered as add-on symptomatic therapy. Nevertheless, further studies are needed to establish the optimal treatment protocol - dose, duration, moment of initiation, disease type.
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Affiliation(s)
- Dénes Kleiner
- University Pharmacy, Department of Pharmacy Administration, Semmelweis University, Hőgyes Endre utca 7-9., 1092 Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 , Budapest, Hungary
| | - István László Horváth
- University Pharmacy, Department of Pharmacy Administration, Semmelweis University, Hőgyes Endre utca 7-9., 1092 Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 , Budapest, Hungary
| | - Stefania Bunduc
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 , Budapest, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Dionisie Lupu Street 37, 020021, Bucharest, Romania
- Center of Digestive Disease and Liver Transplant, Fundeni Clinical Institute, Fundeni Street 258, 022328, Bucharest, Romania
| | - Dorottya Gergő
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 , Budapest, Hungary
- Department of Pharmacognosy, Semmelweis University, Üllői út 26., 1085 Budapest, Hungary
| | - Katalin Lugosi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 , Budapest, Hungary
- Department of Neurology, Bajcsy-Zsilinszky Hospital, Maglódi Road 89-91, 1106 Budapest, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 , Budapest, Hungary
- Budapest Department of Biostatistics, University of Veterinary Medicine, István utca 2., 1078 Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 , Budapest, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary
- János Szentágothai Research Center, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
| | - Dezső Csupor
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 , Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
- Institute of Clinical Pharmacy, University of Szeged, Szikra utca 8, 6725 Szeged, Hungary
- Department of Pharmacognosy, University of Szeged, Eötvös u. 6, 6720 Szeged, Hungary
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17
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Meznerics FA, Fehérvári P, Dembrovszky F, Kovács KD, Kemény LV, Csupor D, Hegyi P, Bánvölgyi A. Platelet-Rich Plasma in Chronic Wound Management: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Clin Med 2022; 11:jcm11247532. [PMID: 36556151 PMCID: PMC9785167 DOI: 10.3390/jcm11247532] [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: 11/14/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Chronic wounds place a heavy burden on the healthcare system due to the prolonged, continuous need for human resources for wound management. Our aim was to investigate the therapeutic effects of platelet-rich plasma on the treatment of chronic wounds. METHODS The systematic literature search was performed in four databases. Randomized clinical trials reporting on patients with chronic wounds treated with platelet-rich plasma (PRP) were included, comparing PRP with conventional ulcer therapy. We pooled the data using the random effects model. Our primary outcome was the change in wound size. RESULTS Our systematic search provided 2688 articles, and we identified 48 eligible studies after the selection and citation search. Thirty-three study groups of 29 RCTs with a total of 2198 wounds showed that the odds for complete closure were significantly higher in the PRP group than in the control group (OR = 5.32; CI: 3.37; 8.40; I2 = 58%). CONCLUSIONS PRP is a safe and effective modality to enhance wound healing. By implementing it in clinical practice, platelet-rich plasma could become a widely used, valuable tool as it could not only improve patients' quality of life but also decrease the healthcare burden of wound management.
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Affiliation(s)
- Fanni Adél Meznerics
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine, 1085 Budapest, Hungary
| | - Fanni Dembrovszky
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs, 7624 Pécs, Hungary
| | - Kata Dorottya Kovács
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Lajos Vince Kemény
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary
- HCEMM-SU Translational Dermatology Research Group, Department of Physiology, Semmelweis University, 1094 Budapest, Hungary
| | - Dezső Csupor
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs, 7624 Pécs, Hungary
- Institute of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs, 7624 Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, 1085 Budapest, Hungary
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary
- Correspondence:
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18
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Meznerics F, Illés K, Dembrovszky F, Fehérvári P, Kemény L, Kovács K, Wikonkál N, Csupor D, Hegyi P, Banvolgyi A. 588 Platelet-rich plasma in alopecia areata – a steroid-free treatment modality. A systematic review and meta-analysis of randomized clinical trials. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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19
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Fehér OE, Fehérvári P, Tolnai CH, Forgách P, Malik P, Jerzsele Á, Wagenhoffer Z, Szenci O, Korbacska-Kutasi O. Epidemiology and Clinical Manifestation of West Nile Virus Infections of Equines in Hungary, 2007-2020. Viruses 2022; 14:v14112551. [PMID: 36423160 PMCID: PMC9694158 DOI: 10.3390/v14112551] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/06/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
West Nile virus (WNV) is an emerging pathogen in Hungary, causing severe outbreaks in equines and humans since 2007. The aim of our study was to provide a comprehensive report on the clinical signs of West Nile neuroinvasive disease (WNND) in horses in Hungary. Clinical details of 124 confirmed equine WNND cases were collected between 2007 and 2019. Data about the seasonal and geographical presentation, demographic data, clinical signs, treatment protocols, and disease progression were evaluated. Starting from an initial case originating from the area of possible virus introduction by migratory birds, the whole country became endemic with WNV over the subsequent 12 years. The transmission season did not expand significantly during the data collection period, but vaccination protocols should be always reviewed according to the recent observations. There was not any considerable relationship between the occurrence of WNND and age, breed, or gender. Ataxia was by far the most common neurologic sign related to the disease, but weakness, behavioral changes, and muscle fasciculation appeared frequently. Apart from recumbency combined with inappetence, no other clinical sign or treatment regime correlated with survival. The survival rate showed a moderate increase throughout the years, possibly due to the increased awareness of practitioners.
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Affiliation(s)
- Orsolya Eszter Fehér
- Institute for Animal Breeding, Nutrition and Laboratory Animal Science, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
- Correspondence:
| | - Péter Fehérvári
- Department of Biomathematics and Informatics, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Csenge Hanna Tolnai
- University Equine Clinic, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Wien, Austria
| | - Petra Forgách
- Department of Microbiology and Infectious Diseases, University of Veterinary Medicine, Hungária Krt. 23-25, 1143 Budapest, Hungary
| | - Péter Malik
- National Food Chain Safety Office, Veterinary Diagnostic Directorate, Tábornok u. 2., 1143 Budapest, Hungary
| | - Ákos Jerzsele
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine Budapest, István utca 2, 1078 Budapest, Hungary
| | - Zsombor Wagenhoffer
- Institute for Animal Breeding, Nutrition and Laboratory Animal Science, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
| | - Otto Szenci
- Department of Obstetrics and Food Animal Medicine Clinic, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
| | - Orsolya Korbacska-Kutasi
- Institute for Animal Breeding, Nutrition and Laboratory Animal Science, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
- University Equine Clinic, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Wien, Austria
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20
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Horváth IL, Bunduc S, Fehérvári P, Váncsa S, Nagy R, Garmaa G, Kleiner D, Hegyi P, Erőss B, Csupor D. The combination of ulinastatin and somatostatin reduces complication rates in acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials. Sci Rep 2022; 12:17979. [PMID: 36289288 PMCID: PMC9606296 DOI: 10.1038/s41598-022-22341-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/13/2022] [Indexed: 01/30/2023] Open
Abstract
Currently, there is no specific pharmaceutical agent for treating acute pancreatitis (AP). Somatostatin and its analogues have been used to prevent the autolysis of the pancreas in AP, however, their effectiveness has not been confirmed. This investigation aimed to examine the efficacy of ulinastatin, a protease inhibitor, combined with somatostatin analogues in the treatment of AP. We conducted a systematic database search in 4 databases to identify randomized controlled trials in which the efficacy of ulinastatin in combination with somatostatin analogue was compared to somatostatin analogue alone in patients with AP. Since the patient populations of analysed papers were slightly different, we used random effect models to pool odds ratios (OR) and mean differences (MD) and the corresponding 95% confidence intervals (CI). A total of 9 articles comprising 1037 patients were included in the meta-analysis. The combination therapy significantly reduced the complication rates for acute respiratory distress syndrome, acute kidney injury, and multiple organ dysfunction. Symptoms were relieved threefold with the combination therapy compared to somatostatin alone, and combination therapy significantly shortened the length of hospital stay. The decrease in mortality was not statistically significant..
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Affiliation(s)
- István László Horváth
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,University Pharmacy Department of Pharmacy Administration, Hőgyes Endre utca 7-9, 1092 Budapest, Hungary
| | - Stefania Bunduc
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.11804.3c0000 0001 0942 9821Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary ,grid.8194.40000 0000 9828 7548Carol Davila University of Medicine and Pharmacy, Dionisie Lupu Street 37, 020021 Bucharest, Romania ,grid.415180.90000 0004 0540 9980Fundeni Clinical Institute, Fundeni Street 258, 022328 Bucharest, Romania
| | - Péter Fehérvári
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.483037.b0000 0001 2226 5083Budapest Department of Biomathematics and Informatics, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
| | - Szilárd Váncsa
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.11804.3c0000 0001 0942 9821Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary
| | - Rita Nagy
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary ,grid.413987.00000 0004 0573 5145Heim Pál National Pediatric Institute, Üllői út 86, 1089 Budapest, Hungary
| | - Gantsetseg Garmaa
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.11804.3c0000 0001 0942 9821Institute of Translational Medicine, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary
| | - Dénes Kleiner
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,University Pharmacy Department of Pharmacy Administration, Hőgyes Endre utca 7-9, 1092 Budapest, Hungary
| | - Péter Hegyi
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary ,grid.11804.3c0000 0001 0942 9821Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479János Szentágothai Research Center, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
| | - Bálint Erőss
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary ,grid.11804.3c0000 0001 0942 9821Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479János Szentágothai Research Center, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
| | - Dezső Csupor
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary ,grid.9008.10000 0001 1016 9625Institute of Clinical Pharmacy, University of Szeged, Szikra utca 8, 6725 Szeged, Hungary
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Illés K, Meznerics FA, Dembrovszky F, Fehérvári P, Bánvölgyi A, Csupor D, Hegyi P, Horváth T. Mastoid Obliteration Decreases the Recurrent and Residual Disease: Systematic Review and Meta-analysis. Laryngoscope 2022; 133:1297-1305. [PMID: 36169349 DOI: 10.1002/lary.30413] [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: 05/04/2022] [Revised: 08/18/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Our study aims to evaluate the effectiveness of mastoid obliteration compared to the canal wall up (CWU) technique in cholesteatoma surgery based on the systematic review of the literature and the meta-analysis of the data. METHODS The systematic search was performed in four major databases (MEDLINE, Web of Science, Embase, and CENTRAL) on October 14, 2021. Studies comparing the CWU technique and mastoid obliteration were included. The exclusion criteria were less than 12 months follow-up, congenital cholesteatoma, indefinite description of the surgical method, and animal studies. The protocol was registered on Prospero (registration number: CRD42021282485). The risk of bias was evaluated with the ROBINS-I tool. Residual and recurrent disease proportions as primary outcomes, quality of life, ear discharge, infection rates, hearing results, and operation time as secondary outcomes were analyzed. In the quantitative synthesis, the random effect model was used, and heterogeneity was identified. RESULTS A total of 11 articles with 2077 operations' data were found eligible. All the identified studies were retrospective cohorts. The odds of pooled residual and recurrent disease proportion were significantly lower in the obliteration group compared to CWU (OR = 0.45, CI:0.28;0.80, p = 0.014). However, when separated, the proportion of ears with recurrent (OR = 0.41, CI:0.11;1.57, p = 0.140) or residual (OR = 0.59, CI:0.23, 1.50, p = 0.207) disease did not show a significant difference, even though the odds were quite similar. The qualitative synthesis identified no significant difference in the secondary outcomes, but obliteration elongated the operation time. CONCLUSION Mastoid obliteration significantly decreased the proportion of residual and recurrent cholesteatoma in pooled analyses compared to the CWU technique with low-quality of data. LEVEL OF EVIDENCE NA Laryngoscope, 2022.
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Affiliation(s)
- Kata Illés
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.,Department of Otorhinolaryngology, Head and Neck Surgery, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
| | - Fanni Adél Meznerics
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.,Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Fanni Dembrovszky
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.,Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.,Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - András Bánvölgyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.,Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Dezső Csupor
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.,Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.,Institute of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.,Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.,Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Tamás Horváth
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.,Department of Otorhinolaryngology, Head and Neck Surgery, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
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22
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Kulyassa P, Németh BT, Ehrenberger R, Ruzsa Z, Szük T, Fehérvári P, Engh MA, Becker D, Merkely B, Édes IF. The Design and Feasibility of the: Radial Artery Puncture Hemostasis Evaluation – RAPHE Study, a Prospective, Randomized, Multicenter Clinical Trial. Front Cardiovasc Med 2022; 9:881266. [PMID: 35694680 PMCID: PMC9184438 DOI: 10.3389/fcvm.2022.881266] [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: 02/23/2022] [Accepted: 04/27/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction and Aim Radial artery approach angiography is the current gold standard for coronary status diagnostics and eventual percutaneous revascularization (PCI). Currently, application of adequate, patent hemostasis based physical torniquets are used for puncture site control, to avoid bleeding, radial artery occlusion and damage (RAO and RAD). The Radial Artery Puncture Hemostasis Evaluation (RAPHE) is a prospective, randomized, multicenter clinical trial designed to investigate new, simplified techniques of radial artery hemostasis utilizing physical compression free methods. Methods and Results The RAPHE study has been designed to evaluate the efficacy and safety of two non-compression based radial artery hemostasis methods: a 100% chitosan bioactive hemostatic dressing and a purpose-built radial potassium-ferrate based topical hemostasis disc. These devices will be investigated in a standalone configuration. Control group is a standard pneumatic airbladder-based compression device. A total of 600 patients will be enrolled in a three-way randomization (1:1:1) with two study and one control groups. Safety and efficacy endpoints are RAO, puncture site hematoma formation and RAD respectively, consisting of dissection, (pseudo)aneurism and/or fistula formation, measured post-procedure and at sixty days. Conclusion The results from this trial will provide valuable information on new, simplified methods of radial artery hemostasis options and possibly simplify post-puncture management of patients. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [NCT04857385].
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Affiliation(s)
- Péter Kulyassa
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Balázs T. Németh
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Réka Ehrenberger
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Zoltán Ruzsa
- Invasive Cardiology Division, Department of Internal Medicine, University of Szeged, Szeged, Hungary
| | - Tibor Szük
- Department of Cardiology and Cardiac Surgery, University of Debrecen, Debrecen, Hungary
| | - Péter Fehérvári
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - Marie Anne Engh
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Dávid Becker
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - István F. Édes
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- *Correspondence: István F. Édes,
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23
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Kiss S, Pintér J, Molontay R, Nagy M, Farkas N, Sipos Z, Fehérvári P, Pecze L, Földi M, Vincze Á, Takács T, Czakó L, Izbéki F, Halász A, Boros E, Hamvas J, Varga M, Mickevicius A, Faluhelyi N, Farkas O, Váncsa S, Nagy R, Bunduc S, Hegyi PJ, Márta K, Borka K, Doros A, Hosszúfalusi N, Zubek L, Erőss B, Molnár Z, Párniczky A, Hegyi P, Szentesi A. Early prediction of acute necrotizing pancreatitis by artificial intelligence: a prospective cohort-analysis of 2387 cases. Sci Rep 2022; 12:7827. [PMID: 35552440 PMCID: PMC9098474 DOI: 10.1038/s41598-022-11517-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/14/2021] [Accepted: 04/07/2022] [Indexed: 12/21/2022] Open
Abstract
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. The XGBoost machine learning algorithm processed data from 2387 patients with AP. The confidence of the model was estimated by a bootstrapping method and interpreted via the 10th and the 90th percentiles of the prediction scores. Shapley Additive exPlanations (SHAP) values were calculated to quantify the contribution of each variable provided. Finally, the model was implemented as an online application using the Streamlit Python-based framework. The XGBoost classifier provided an AUC value of 0.757. Glucose, C-reactive protein, alkaline phosphatase, gender and total white blood cell count have the most impact on prediction based on the SHAP values. The relationship between the size of the training dataset and model performance shows that prediction performance can be improved. This study combines necrosis prediction and artificial intelligence. The predictive potential of this model is comparable to the current clinical scoring systems and has several advantages over them.
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Affiliation(s)
- Szabolcs Kiss
- Doctoral School of Clinical Medicine, Faculty of Medicine, University of Szeged, Szeged, 6720, Hungary.,Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary.,Heim Pál National Pediatric Institute, Üllői út 86, Budapest, 1089, Hungary
| | - József Pintér
- Human and Social Data Science Lab, Budapest University of Technology and Economics, Műegyetem rkp. 3, Budapest, 1111, Hungary
| | - Roland Molontay
- Human and Social Data Science Lab, Budapest University of Technology and Economics, Műegyetem rkp. 3, Budapest, 1111, Hungary.,Stochastics Research Group, Hungarian Academy of Sciences, Budapest University of Technology and Economics, Egry József u. 1, Budapest, 1111, Hungary
| | - Marcell Nagy
- Human and Social Data Science Lab, Budapest University of Technology and Economics, Műegyetem rkp. 3, Budapest, 1111, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary.,Institute of Bioanalysis, Medical School, University of Pécs, Honvéd u. 1, Pécs, 7624, Hungary
| | - Zoltán Sipos
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary
| | - Péter Fehérvári
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary.,Department of Biomathematics and Informatics, University of Veterinary Medicine, István u. 2, Budapest, 1078, Hungary
| | - László Pecze
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary
| | - Mária Földi
- Doctoral School of Clinical Medicine, Faculty of Medicine, University of Szeged, Szeged, 6720, Hungary.,Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary.,Heim Pál National Pediatric Institute, Üllői út 86, Budapest, 1089, Hungary
| | - Áron Vincze
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Ifjúság út 13, Pécs, 7624, Hungary
| | - Tamás Takács
- Department of Medicine, University of Szeged, Kálvária sgt. 57, Szeged, 6725, Hungary
| | - László Czakó
- Department of Medicine, University of Szeged, Kálvária sgt. 57, Szeged, 6725, Hungary
| | - Ferenc Izbéki
- Department of Internal Medicine, Szent György Teaching Hospital of County Fejér, Seregélyesi út 3, Székesfehérvár, 8000, Hungary
| | - Adrienn Halász
- Doctoral School of Clinical Medicine, Faculty of Medicine, University of Szeged, Szeged, 6720, Hungary.,Department of Internal Medicine, Szent György Teaching Hospital of County Fejér, Seregélyesi út 3, Székesfehérvár, 8000, Hungary
| | - Eszter Boros
- Department of Internal Medicine, Szent György Teaching Hospital of County Fejér, Seregélyesi út 3, Székesfehérvár, 8000, Hungary
| | - József Hamvas
- Bajcsy-Zsilinszky Hospital, Maglódi út 89-91, Budapest, 1106, Hungary
| | - Márta Varga
- Department of Gastroenterology, BMKK Dr Rethy Pal Hospital, Gyulai út 18, Békéscsaba, 5600, Hungary
| | - Artautas Mickevicius
- Vilnius University Hospital Santaros Clinics, Clinics of Abdominal Surgery, Nephrourology and Gastroenterology, Faculty of Medicine, Vilnius University, Santariškių g. 2, 08410, Vilnius, Lithuania
| | - Nándor Faluhelyi
- Department of Medical Imaging, Medical School, University of Pécs, Ifjúság út 13, Pécs, 7624, Hungary
| | - Orsolya Farkas
- Department of Medical Imaging, Medical School, University of Pécs, Ifjúság út 13, Pécs, 7624, Hungary
| | - Szilárd Váncsa
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary.,Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
| | - Rita Nagy
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary.,Heim Pál National Pediatric Institute, Üllői út 86, Budapest, 1089, Hungary.,Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
| | - Stefania Bunduc
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Doctoral School, Carol Davila University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, 050474, Bucharest, Romania
| | - Péter Jenő Hegyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross u. 23, Budapest, 1082, Hungary
| | - Katalin Márta
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross u. 23, Budapest, 1082, Hungary
| | - Katalin Borka
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,2nd Department of Pathology, Semmelweis University, Üllői út 93, Budapest, 1091, Hungary
| | - Attila Doros
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Department of Transplantation and Surgery, Semmelweis University, Baross u. 23, Budapest, 1082, Hungary
| | - Nóra Hosszúfalusi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Department of Internal Medicine and Hematology, Semmelweis University, Szentkirályi u. 46, Budapest, 1088, Hungary
| | - László Zubek
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest, 1082, Hungary
| | - Bálint Erőss
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross u. 23, Budapest, 1082, Hungary
| | - Zsolt Molnár
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest, 1082, Hungary.,Department of Anaesthesiology and Intensive Therapy, Poznan University of Medical Sciences, ul. św. Marii Magdaleny 14, 61861, Poznan, Wielkopolska, Poland
| | - Andrea Párniczky
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary.,Heim Pál National Pediatric Institute, Üllői út 86, Budapest, 1089, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary.,Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.,Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross u. 23, Budapest, 1082, Hungary
| | - Andrea Szentesi
- Doctoral School of Clinical Medicine, Faculty of Medicine, University of Szeged, Szeged, 6720, Hungary. .,Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12., II. Emelet, Pécs, 7624, Hungary.
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24
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Piross IS, Siliwal M, Kumar RS, Palatitz P, Solt S, Borbáth P, Vili N, Magonyi N, Vas Z, Rózsa L, Harnos A, Fehérvári P. Sex interacts with age-dependent change in the abundance of lice-infesting Amur Falcons (Falco amurensis). Parasitol Res 2020; 119:2579-2585. [PMID: 32556537 PMCID: PMC7366564 DOI: 10.1007/s00436-020-06753-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/02/2020] [Indexed: 11/24/2022]
Abstract
Sex-biassed and age-biassed parasite infections are common in nature, including ectoparasites-vertebrate host systems. We investigated the effect of Amur Falcons’ sex, age and body size on the abundance of their lice at a migratory stopover site, where the falcons’ habitat use and behaviour are more homogeneous across sex and age categories than during the breeding season. We sampled Amur Falcons in Nagaland, India at major roosting sites in 2016. We applied generalized linear models (with negative binomial distribution and log-link) to model the abundance of their two most numerous lice (Colpocephalum subzerafae and Degeeriella rufa) using the host age category (juvenile or adult) and wing length, both in interaction with sex, as explanatory variables. The abundance of C. subzerafae was only affected by host age, being nearly four times higher on juveniles than on adults. Juveniles were also more infested with D. rufa than the adults. Additionally, the abundance of the latter species was lower on adult male Falcons as compared to adult females. A juvenile bias in ectoparasite infestations is common in nature, probably due to juveniles being immunologically naïve, more resource-limited and may be inexperienced in body maintenance behaviours like preening and grooming. On the other hand, female-biassed infestations are much rarer than male-biassed infestations. We briefly discuss the possible causes of female-biassed infestations on Amur Falcons reported here, and in the closely related Red-footed Falcon and Lesser Kestrel as reported in the literature.
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Affiliation(s)
- Imre Sándor Piross
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary.,Balaton Limnological Institute, Centre for Ecological Research, Tihany, Hungary
| | - Manju Siliwal
- Department of Animal Ecology and Conservation Biology, Wildlife Institute of India, Dehradun, India
| | - R Suresh Kumar
- Department of Endangered Species Management, Wildlife Institute of India, Dehradun, India
| | - Péter Palatitz
- MME BirdLife Hungary, Red-footed Falcon Workgroup, Budapest, Hungary
| | - Szabolcs Solt
- MME BirdLife Hungary, Red-footed Falcon Workgroup, Budapest, Hungary
| | | | - Nóra Vili
- Conservation Genetics Research Group, Department of Ecology, Institute for Biology, University of Veterinary Medicine, Budapest, Hungary
| | - Nóra Magonyi
- Conservation Genetics Research Group, Department of Ecology, Institute for Biology, University of Veterinary Medicine, Budapest, Hungary.,Doctoral School of Biology and Sportbiology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Zoltán Vas
- Hungarian Natural History Museum, Budapest, Hungary
| | - Lajos Rózsa
- GINOP Evolutionary Systems Research Group, Institute of Evolution, Centre for Ecological Research, Tihany, Hungary
| | - Andrea Harnos
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - Péter Fehérvári
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary.
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25
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Piross IS, Solt S, Horváth É, Kotymán L, Palatitz P, Bertók P, Szabó K, Vili N, Vas Z, Rózsa L, Harnos A, Fehérvári P. Sex-dependent changes in the louse abundance of red-footed falcons (Falco vespertinus). Parasitol Res 2020; 119:1327-1335. [PMID: 32179987 PMCID: PMC7176593 DOI: 10.1007/s00436-020-06634-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/18/2020] [Indexed: 11/15/2022]
Abstract
Permanent ectoparasites live in stable environments; thus, their population dynamics are mostly adapted to changes in the host life cycle. We aimed to investigate how static and dynamic traits of red-footed falcons interplay with the dynamics of their louse subpopulations during breeding and how they affect the colonisation of new hosts by lice. We sampled red-footed falcon (Falco vespertinus) nestlings (two breeding seasons) and adults (one breeding season) in southern Hungary. The mean abundance of Colpocephalum subzerafae and Degeeriella rufa lice on the nestlings was modelled with generalized linear mixed models using clutch size and host sex in interaction with wing length. For adults, we used wing length and the number of days after laying the first egg, both in interaction with sex. D. rufa abundances increased with the nestlings' wing length. In one year, this trend was steeper on females. In adult birds, both louse species exhibited higher abundances on females at the beginning, but it decreased subsequently through the breeding season. Contrarily, abundances were constantly low on adult males. Apparently, D. rufa postpones transmission until nestlings develop juvenile plumage and choose the more feathered individual among siblings. The sexual difference in the observed abundance could either be caused by the different plumage, or by the females' preference for less parasitized males. Moreover, females likely have more time to preen during the incubation period, lowering their louse burdens. Thus, sex-biased infestation levels likely arise due to parasite preferences in the nestlings and host behavioural processes in the adult falcons.
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Affiliation(s)
- Imre Sándor Piross
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
- Balaton Limnological Institute, MTA Centre for Ecological Research, Tihany, Hungary
| | - Szablocs Solt
- MME BirdLife Hungary, Red-footed Falcon Workgroup, Budapest, Hungary
| | - Éva Horváth
- MME BirdLife Hungary, Red-footed Falcon Workgroup, Budapest, Hungary
| | | | - Péter Palatitz
- MME BirdLife Hungary, Red-footed Falcon Workgroup, Budapest, Hungary
| | | | - Krisztián Szabó
- Conservation Genetics Research Group, Department of Ecology, Institute for Biology, University of Veterinary Medicine, Budapest, Hungary
| | - Nóra Vili
- Conservation Genetics Research Group, Department of Ecology, Institute for Biology, University of Veterinary Medicine, Budapest, Hungary
| | - Zoltán Vas
- Hungarian Natural History Museum, Budapest, Hungary
| | - Lajos Rózsa
- GINOP Evolutionary Systems Research Group, Institute of Evolution, MTA Centre for Ecological Research, Tihany, Hungary
| | - Andrea Harnos
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - Péter Fehérvári
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary.
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26
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Magonyi NM, Mátics R, Szabó K, Fehérvári P, Solt S, Palatitz P, Vili N. Characterization of novel microsatellite markers for the red-footed falcon (Falco vespertinus) and cross-species amplification in other Falco species. EUR J WILDLIFE RES 2019. [DOI: 10.1007/s10344-019-1300-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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27
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Soltész Z, Erdélyi K, Bakonyi T, Barna M, Szentpáli-Gavallér K, Solt S, Horváth É, Palatitz P, Kotymán L, Dán Á, Papp L, Harnos A, Fehérvári P. West Nile virus host-vector-pathogen interactions in a colonial raptor. Parasit Vectors 2017; 10:449. [PMID: 28962629 PMCID: PMC5622512 DOI: 10.1186/s13071-017-2394-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 09/19/2017] [Indexed: 11/12/2022] Open
Abstract
Background Avian host species have different roles in the amplification and maintenance of West Nile virus (WNV), therefore identifying key taxa is vital in understanding WNV epidemics. Here, we present a comprehensive case study conducted on red-footed falcons, where host-vector, vector-virus and host-virus interactions were simultaneously studied to evaluate host species contribution to WNV circulation qualitatively. Results Mosquitoes were trapped inside red-footed falcon nest-boxes by a method originally developed for the capture of blackflies and midges. We showed that this approach is also efficient for trapping mosquitoes and that the number of trapped vectors is a function of host attraction. Brood size and nestling age had a positive effect on the number of attracted Culex pipiens individuals while the blood-feeding success rate of both dominant Culex species (Culex pipiens and Culex modestus) markedly decreased after the nestlings reached 14 days of age. Using RT-PCR, we showed that WNV was present in these mosquitoes with 4.2% (CI: 0.9–7.5%) prevalence. We did not detect WNV in any of the nestling blood samples. However, a relatively high seroprevalence (25.4% CI: 18.8–33.2%) was detected with an enzyme-linked immunoabsorbent assay (ELISA). Using the ELISA OD ratios as a proxy to antibody titers, we showed that older seropositive nestlings have lower antibody levels than their younger conspecifics and that hatching order negatively influences antibody levels in broods with seropositive nestlings. Conclusions Red-footed falcons in the studied system are exposed to a local sylvatic WNV circulation, and the risk of infection is higher for younger nestlings. However, the lack of individuals with viremia and the high WNV seroprevalence, indicate that either host has a very short viremic period or that a large percentage of nestlings in the population receive maternal antibodies. This latter assumption is supported by the age and hatching order dependence of antibody levels found for seropositive nestlings. Considering the temporal pattern in mosquito feeding success, maternal immunity may be effective in protecting progeny against WNV infection despite the short antibody half-life measured in various other species. We conclude that red-footed falcons seem to have low WNV host competence and are unlikely to be effective virus reservoirs in the studied region.
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Affiliation(s)
- Zoltán Soltész
- Lendület Ecosystem Services Research Group, MTA Centre for Ecological Research, Vácrátót, Hungary. .,Hungarian Natural History Museum, Budapest, Hungary.
| | - Károly Erdélyi
- National Food Chain Safety Office, Veterinary Diagnostic Directorate, Budapest, Hungary
| | - Tamás Bakonyi
- Department of Microbiology and Infectious Diseases, University of Veterinary Medicine, Budapest, Hungary.,Viral Zoonoses, Emerging and Vector-Borne Infections Group, Institute of Virology, University of Veterinary Medicine, Vienna, Austria
| | - Mónika Barna
- Department of Microbiology and Infectious Diseases, University of Veterinary Medicine, Budapest, Hungary
| | | | - Szabolcs Solt
- MME/BirdLife Hungary, Red-footed Falcon Conservation Working Group, Budapest, Hungary
| | - Éva Horváth
- MME/BirdLife Hungary, Red-footed Falcon Conservation Working Group, Budapest, Hungary
| | - Péter Palatitz
- MME/BirdLife Hungary, Red-footed Falcon Conservation Working Group, Budapest, Hungary
| | | | - Ádám Dán
- National Food Chain Safety Office, Veterinary Diagnostic Directorate, Budapest, Hungary
| | - László Papp
- Hungarian Academy of Sciences, Biological Section, Budapest, Hungary
| | - Andrea Harnos
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - Péter Fehérvári
- Hungarian Natural History Museum, Budapest, Hungary.,Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
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Vas Z, Fuisz TI, Fehérvári P, Reiczigel J, Rózsa L. Avian brood parasitism and ectoparasite richness-scale-dependent diversity interactions in a three-level host-parasite system. Evolution 2013; 67:959-68. [PMID: 23550748 DOI: 10.1111/j.1558-5646.2012.01837.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Brood parasitic birds, their foster species and their ectoparasites form a complex coevolving system composed of three hierarchical levels. However, effects of hosts' brood parasitic life-style on the evolution of their louse (Phthiraptera: Amblycera, Ischnocera) lineages have never been tested. We present two phylogenetic analyses of ectoparasite richness of brood parasitic clades. Our hypothesis was that brood parasitic life-style affects louse richness negatively across all avian clades due to the lack of vertical transmission routes. Then, narrowing our scope to brood parasitic cuckoos, we explored macroevolutionary factors responsible for the variability of their louse richness. Our results show that taxonomic richness of lice is lower on brood parasitic clades than on their nonparasitic sister clades. However, we found a positive covariation between the richness of cuckoos' Ischnoceran lice and the number of their foster species, possibly due to the complex and dynamic subpopulation structure of cuckoo species that utilize several host species. We documented diversity interactions across a three-level host parasite system and we found evidence that brood parasitism has opposing effects on louse richness at two slightly differing macroevolutionary scales, namely the species richness and the genera richness.
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Affiliation(s)
- Zoltán Vas
- Department of Biomathematics and Informatics, Faculty of Veterinary Sciences, Szent István University, Budapest, H-1078, István Str. 2., Hungary.
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Fehérvári P, Solt S, Palatitz P, Barna K, Ágoston A, Gergely J, Nagy A, Nagy K, Harnos A. Allocating active conservation measures using species distribution models: a case study of red-footed falcon breeding site management in the Carpathian Basin. Anim Conserv 2012. [DOI: 10.1111/j.1469-1795.2012.00559.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - S. Solt
- Red-footed Falcon Conservation Working Group; MME/BirdLife Hungary; Budapest; Hungary
| | - P. Palatitz
- Red-footed Falcon Conservation Working Group; MME/BirdLife Hungary; Budapest; Hungary
| | - K. Barna
- Bird Protection and Study Society of Serbia; Novi Sad; Serbia
| | - A. Ágoston
- Bird Protection and Study Society of Serbia; Novi Sad; Serbia
| | - J. Gergely
- Bird Protection and Study Society of Serbia; Novi Sad; Serbia
| | - A. Nagy
- Milvus Group; Tirgu Mures; Romania
| | - K. Nagy
- Red-footed Falcon Conservation Working Group; MME/BirdLife Hungary; Budapest; Hungary
| | - A. Harnos
- Department of Biomathematics and Informatics, Faculty of Veterinary Sciences; Szent István University; Budapest; Hungary
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