1
|
Horváth O, Kovács P. [The importance and areas of modern supportive and early integrated palliative care in the treatment of brain tumor patients]. Magy Onkol 2024; 68:77-85. [PMID: 38484378] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/22/2023] [Indexed: 03/19/2024]
Abstract
During the care of brain tumor patients, supportive care and palliation are carried out in an individualized manner, accompanied by adequate communication, in a multidisciplinary professional environment. In the case of brain tumor patients, the burden of symptoms resulting from the progression of the disease and the complications of treatments occur in a particularly high proportion. The supportive care of patients in a modern approach covers the targeted treatment of physical and psychosocial problems and also includes integrated palliation. Palliative care is a form of care that can be used in addition to curative therapies, and it is advisable and necessary to introduce it as early as possible among brain tumor patients due to the significant deterioration of the quality of life. Dealing with seriously ill patients on a daily basis is also an emotional burden for the professional staff, and carries the risk of burnout. The support of the staff and family members, as well as the issues of adequate communication, are also part of the scope of the supportive care approach.
Collapse
Affiliation(s)
- Orsolya Horváth
- Rehabilitációs Részleg és Nemzeti Tumorbiológiai Laboratórium, Országos Onkológiai Intézet, Budapest, Hungary.
| | - Péter Kovács
- Rehabilitációs Részleg, Onkopszichológiai Munkacsoport és Nemzeti Tumorbiológiai Laboratórium, Országos Onkológiai Intézet, Budapest, Hungary
| |
Collapse
|
2
|
Váradi M, Horváth O, Módos O, Fazekas T, Grunewald CM, Niegisch G, Krafft U, Grünwald V, Hadaschik B, Olah C, Maráz A, Furka A, Szűcs M, Nyirády P, Szarvas T. Efficacy of immune checkpoint inhibitor therapy for advanced urothelial carcinoma in real-life clinical practice: results of a multicentric, retrospective study. Sci Rep 2023; 13:17378. [PMID: 37833455 PMCID: PMC10575904 DOI: 10.1038/s41598-023-44103-9] [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: 05/10/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
Clinical trials revealed significant antitumor activity for immune checkpoint inhibitors (ICI) in metastatic urothelial carcinoma (mUC). Due to their strict eligibility criteria, clinical trials include selected patient cohorts, and thus do not necessarily represent real-world population outcomes. In this multicentric, retrospective study, we investigated real-world data to assess the effectiveness of pembrolizumab and atezolizumab and to evaluate the prognostic value of routinely available clinicopathological and laboratory parameters. Clinical and follow-up data from mUC patients who received ICIs (01/2017-12/2021) were evaluated. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and duration of response (DOR) were used as endpoints. Patients' (n = 210, n = 76 atezolizumab and 134 pembrolizumab) median OS and PFS were 13.6 and 5.9 months, respectively. Impaired ECOG-PS, the presence of visceral, liver or bone metastases, and hemoglobin levels were independently associated with poor OS and DCR. Furthermore, Bellmunt risk factors and the enhanced Bellmunt-CRP score were shown to be prognostic for OS, PFS and DCR. In conclusion, ICIs are effective treatments for a broad range of mUC patients. Our results confirmed the prognostic value of numerous risk factors and showed that Bellmunt risk scores can further be improved when adding CRP to the model.
Collapse
Affiliation(s)
- Melinda Váradi
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Orsolya Horváth
- Department of Genitourinary Medical Oncology and Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Tamás Fazekas
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Camilla M Grunewald
- Department of Urology, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Günter Niegisch
- Department of Urology, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Ulrich Krafft
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Viktor Grünwald
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Csilla Olah
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Anikó Maráz
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - Andrea Furka
- Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Clinical Radiology, Institute of Practical Methodology and Diagnostics, Faculty of Health Care, University of Miskolc, Miskolc, Hungary
| | - Miklós Szűcs
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary.
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany.
| |
Collapse
|
3
|
Kelen K, Horváth O, Kis É, Mikes B, Sallay P, Prohászka Z, Szabó AJ, Reusz GS. Immunosuppressive Therapy of Antibody-Mediated aHUS and TTP. Int J Mol Sci 2023; 24:14389. [PMID: 37762692 PMCID: PMC10531618 DOI: 10.3390/ijms241814389] [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: 08/17/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
The recent classification of pediatric thrombotic microangiopathies (TMA) takes into consideration mechanisms of disease for guidance to targeted therapies. We present our experience with seven patients with antibody mediated atypical hemolytic uremic syndrome (aHUS) and thrombotic thrombocytopenic purpura (TTP). Five children had aHUS with antibodies against complement factor H (CFH-ab) and two with TTP with antibodies against metalloproteinase ADAMTS13. In the aHUS cases diagnosed and treated before the eculizumab era, CFH-ab was detected using the ELISA assay. Mutational analysis of selected complement genes was performed. TTP was diagnosed if, in addition to microangiopathic hemolytic anemia and thrombocytopenia, ischemic organ involvement and severe deficiency in ADAMTS13 activity were present. Treatment protocol consisted of plasma exchanges (PE) and steroid pulses, followed by the combination of cyclophosphamide and rituximab to achieve long-term immunosuppression. Four patients with CFH-ab and the TTP patients with ADAMTS13 antibodies came into sustained remission. After a median follow-up of 11.7 (range 7.7-12.9) years without maintenance therapy, no disease recurrence was observed; nevertheless, six patients, two had hypertension and two had proteinuria as a late consequence. One patient, with late diagnosis of CFH-ab and additional genetic risk factors who was treated only with PE and plasma substitution, reached end-stage renal disease and was later successfully transplanted using eculizumab prophylaxis. In the cases of antibody-mediated TMAs, PE and early immunosuppressive treatment may result in sustained remission with preserved kidney function. Further data are needed to establish optimal treatment of anti-FH antibody-associated HUS.
Collapse
Affiliation(s)
- Kata Kelen
- Bókay Street Unit, Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary; (K.K.); (O.H.); (B.M.); (P.S.); (A.J.S.)
| | - Orsolya Horváth
- Bókay Street Unit, Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary; (K.K.); (O.H.); (B.M.); (P.S.); (A.J.S.)
| | - Éva Kis
- Department of Pediatric Cardiology, Gottsegen György Hungarian Institute of Cardiology, 1096 Budapest, Hungary;
| | - Bálint Mikes
- Bókay Street Unit, Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary; (K.K.); (O.H.); (B.M.); (P.S.); (A.J.S.)
| | - Péter Sallay
- Bókay Street Unit, Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary; (K.K.); (O.H.); (B.M.); (P.S.); (A.J.S.)
| | - Zoltán Prohászka
- Research Laboratory, Department of Medicine and Hematology, Semmelweis University, 1083 Budapest, Hungary;
| | - Attila József Szabó
- Bókay Street Unit, Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary; (K.K.); (O.H.); (B.M.); (P.S.); (A.J.S.)
- Pediatric Center, MTA Center of Excellence, Semmelweis University, 1083 Budapest, Hungary
- ELKH-SE Pediatrics and Nephrology Research Group, 1052 Budapest, Hungary
| | - György S. Reusz
- Bókay Street Unit, Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary; (K.K.); (O.H.); (B.M.); (P.S.); (A.J.S.)
| |
Collapse
|
4
|
Horváth O, Szabó AJ, Reusz GS. Publisher Correction: How to define and assess the clinically significant causes of hematuria in childhood. Pediatr Nephrol 2023:10.1007/s00467-023-05978-y. [PMID: 37133804 PMCID: PMC10393873 DOI: 10.1007/s00467-023-05978-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Orsolya Horváth
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, 1083, Budapest, Hungary
| | - Attila J Szabó
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, 1083, Budapest, Hungary
| | - George S Reusz
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, 1083, Budapest, Hungary.
| |
Collapse
|
5
|
Horváth M, Horváth O, Kassa C, Kertész G, Goda V, Hau L, Stréhn A, Kállay K, Kriván G. Bone Turnover Marker for the Evaluation of Skeletal Remodelling in Autosomal Recessive Osteopetrosis after Haematopoietic Stem Cell Transplantation: A Case Report. Children 2023; 10:children10040675. [PMID: 37189924 DOI: 10.3390/children10040675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/24/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023]
Abstract
Background: Autosomal recessive osteopetrosis (ARO) is a rare genetic disorder of bone metabolism, primarily affecting the remodelling function of osteoclasts. Haematopoietic stem cell transplantation (HSCT) is the first-line treatment for ARO. Traditional tools for the assessment of therapeutic response, such as measuring donor chimerism, do not provide information on bone remodelling. The use of bone turnover markers (BTMs) might be ideal. Here, we report a case of a paediatric ARO patient undergoing successful HSCT. Methods: For the evaluation of donor-derived osteoclast activity and skeletal remodelling throughout the transplantation, the bone resorption marker β-CTX (β-C-terminal telopeptide) was used. Results: The low baseline level of β-CTX markedly increased after transplantation and remained in the elevated range even after 3 months. Donor-derived osteoclast activity reached its new baseline level around the 50th percentile range after 5 months and proved to be stable during the 15-month follow-up time. The apparent increase of the baseline osteoclast activity after HSCT was in consonance with the radiographic improvement of the disease phenotype and the correction of bone metabolic parameters. Despite the successful donor-derived osteoclast recovery, craniosynostosis developed, and reconstructive surgery had to be performed. Conclusions: The use of β-CTX may be of aid in assessing osteoclast activity throughout the transplantation. Further studies could help to establish the extended BTM profile of ARO patients using the available osteoclast- and osteoblast-specific markers.
Collapse
Affiliation(s)
- Máté Horváth
- Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Üllői út 26, H-1085 Budapest, Hungary
- Pediatric Haematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, H-1097 Budapest, Hungary
| | - Orsolya Horváth
- Pediatric Haematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, H-1097 Budapest, Hungary
| | - Csaba Kassa
- Pediatric Haematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, H-1097 Budapest, Hungary
| | - Gabriella Kertész
- Pediatric Haematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, H-1097 Budapest, Hungary
| | - Vera Goda
- Pediatric Haematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, H-1097 Budapest, Hungary
| | - Lidia Hau
- Pediatric Haematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, H-1097 Budapest, Hungary
| | - Anita Stréhn
- Pediatric Haematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, H-1097 Budapest, Hungary
| | - Krisztián Kállay
- Pediatric Haematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, H-1097 Budapest, Hungary
| | - Gergely Kriván
- Pediatric Haematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, H-1097 Budapest, Hungary
| |
Collapse
|
6
|
Váradi M, Horváth O, Fazekas T, Csizmarik A, Módos O, Széles Á, Kenessey I, Reis H, Oláh C, Hadaschik B, Krafft U, Ting S, Furka A, Nyirády P, Szarvas T. Molecular analysis of urothelial carcinoma to predict the efficacy of immune checkpoint inhibitor therapy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01202-2] [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: 02/12/2023]
|
7
|
Horváth O, Szabó AJ, Reusz GS. How to define and assess the clinically significant causes of hematuria in childhood. Pediatr Nephrol 2022:10.1007/s00467-022-05746-4. [PMID: 36260163 PMCID: PMC9580432 DOI: 10.1007/s00467-022-05746-4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/27/2022] [Accepted: 09/06/2022] [Indexed: 11/28/2022]
Abstract
Given the wide diversity of causes of hematuria, ranging from simple urinary tract infections with rapid recovery to severe glomerulonephritis with fast decline in kidney function, it is essential to recognize the underlying disease. The first objective of the assessment is to determine whether the cause of the hematuria is medically significant. The combination of hematuria with proteinuria, the presence of hypertension, or worsening kidney function can represent signs of progressive kidney disease. Differentiating the various causes of hematuria is often simple and obvious based on the clinical signs and gross appearance of the urine. However, in some instances, additional non-invasive investigations, such as ultrasound imaging, urinary red cell morphology, measurement of calcium and other solutes in the urine, evaluation of kidney function, and protein excretion, are needed to elucidate the nature of the hematuria. Taking a detailed family history can help in establishing the underlying cause in cases of familial hematuria. On the other hand, the decision to perform a kidney biopsy in children with asymptomatic hematuria remains a challenging issue for clinicians. Ultimately, the frequency of diagnosis of glomerular involvement causing hematuria may depend on the threshold for performing a kidney biopsy. The following review will focus on the diagnostics of hematuria, starting with difficulties regarding its definition, followed by various means to differentiate between urinary, glomerular, and other causes, and finally reviewing the most common diseases that, due to their frequency or their effect on kidney function, present a diagnostic challenge in everyday practice.
Collapse
Affiliation(s)
- Orsolya Horváth
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, Budapest, 1083 Hungary
| | - Attila J. Szabó
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, Budapest, 1083 Hungary
| | - George S. Reusz
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, Budapest, 1083 Hungary
| |
Collapse
|
8
|
Horváth O, Rácz K, Jakus N, Kegye A, Hegedűs K. A hospice-palliatív ellátás hatékony integrálása a hazai onkológiai és családorvosi gyakorlatba. Orv Hetil 2022; 163:1520-1527. [DOI: 10.1556/650.2022.32561] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/20/2022] [Indexed: 11/21/2022]
Abstract
Bevezetés: Magyarországon a hospice 1991 óta van jelen, mára az
otthonápolás és a fekvőbeteg-ellátás az egész országban elérhető. A Magyar
Hospice-Palliatív Egyesület felmérése szerint az ellátott betegek száma évről
évre nő, ugyanakkor továbbra is nagyon kevés ideig – 2020-ban csak átlagosan
26,7 napig – részesülnek otthoni hospice-szakellátásban a betegek az ideális 8,5
hónap helyett. Bizonyított tény, hogy a hospice-palliatív ellátások korai
bevonása az onkológiai betegek kezelésébe előnnyel jár mind a beteg
életminősége, mind a kezelés színvonala, mind a költséghatékonyság
szempontjából. Ezért létre kell hoznunk olyan betegellátási utakat, amelyek
segítségével a megfelelő betegek a megfelelő időben jutnak a speciális palliatív
ellátáshoz. Célkitűzés és módszer: Ebben a közleményben két
olyan ellátási formát mutatunk be, amely bizonyította, hogy a palliatív ellátás
korai integrációja hatékonyan megvalósítható a mai magyarországi egészségügyi
rendszerekben. Eredmények: Az Országos Onkológiai Intézet
Palliatív Mobil Team 2019 szeptemberétől konzultációs formában segíti az
Intézetben kezelt betegek optimális ellátását. A Szentendrei kistérség
háziorvosi praxisközösségében pedig 2, palliatívlicenc-vizsgával rendelkező
háziorvos a kollégáknak szervezett képzésekkel, a szemléletformáláson keresztül
érte el, hogy a terület betegei hamarabb és szélesebb körű palliatív ellátásban
részesüljenek. Következtetés: Jelenlegi anyagi és személyi
erőforrásainkat felhasználva, képzéssel és a szemléletformálással jelentősen
lehet emelni a hospice-palliatív ellátás színvonalát ma Magyarországon. Orv
Hetil. 2022; 163(38): 1520–1527.
Collapse
Affiliation(s)
- Orsolya Horváth
- Országos Onkológiai Intézet Budapest, Ráth György u. 7–9., 1122 Magyarország
| | | | - Nikoletta Jakus
- Országos Onkológiai Intézet Budapest, Ráth György u. 7–9., 1122 Magyarország
| | - Adrienne Kegye
- Semmelweis Egyetem, Általános Orvostudományi Kar, Magatartástudományi Intézet Budapest Magyarország
| | - Katalin Hegedűs
- Semmelweis Egyetem, Általános Orvostudományi Kar, Magatartástudományi Intézet Budapest Magyarország
| |
Collapse
|
9
|
Horváth O, Reusz GS, Goda V, Kelen K, Balogh I, Kardos M, Kállay K, Cseh Á, Szabó AJ, Kriván G. Correction to: Non-lupus full-house nephropathy-immune dysregulation as a rare cause of pediatric nephrotic syndrome: Answers. Pediatr Nephrol 2022; 37:1429. [PMID: 35211798 DOI: 10.1007/s00467-022-05437-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Orsolya Horváth
- 1St Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, Budapest, 1083, Hungary.,Pediatric Hematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - György S Reusz
- 1St Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, Budapest, 1083, Hungary.
| | - Veronika Goda
- Pediatric Hematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Kata Kelen
- 1St Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, Budapest, 1083, Hungary
| | - István Balogh
- Department of Laboratory Medicine, Division of Clinical Genetics, Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Magdolna Kardos
- 2Nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Krisztián Kállay
- Pediatric Hematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Áron Cseh
- 1St Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, Budapest, 1083, Hungary
| | - Attila J Szabó
- 1St Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, Budapest, 1083, Hungary
| | - Gergely Kriván
- Pediatric Hematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| |
Collapse
|
10
|
Horváth O, Reusz GS, Goda V, Kelen K, Balogh I, Kardos M, Kállay K, Cseh Á, Szabó AJ, Kriván G. Non-lupus full-house nephropathy-immune dysregulation as a rare cause of pediatric nephrotic syndrome: Questions. Pediatr Nephrol 2022; 37:1049-1051. [PMID: 34919149 PMCID: PMC9023410 DOI: 10.1007/s00467-021-05359-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Orsolya Horváth
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, 1083 Budapest, Hungary ,Pediatric Hematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - George S. Reusz
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, 1083 Budapest, Hungary
| | - Veronika Goda
- Pediatric Hematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Kata Kelen
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, 1083 Budapest, Hungary
| | - István Balogh
- Department of Laboratory Medicine, Division of Clinical Genetics, Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Magdolna Kardos
- 2Nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Krisztián Kállay
- Pediatric Hematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Áron Cseh
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, 1083 Budapest, Hungary
| | - Attila J. Szabó
- 1st Department of Pediatrics, Semmelweis University, 53-54 Bókay János Street, 1083 Budapest, Hungary
| | - Gergely Kriván
- Pediatric Hematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| |
Collapse
|
11
|
Horváth O, Földesi E, Hegedűs K. When and how to integrate oncology and palliative care? Orv Hetil 2021; 162:1769-1775. [PMID: 34718229 DOI: 10.1556/650.2021.32254] [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: 03/21/2021] [Accepted: 04/24/2021] [Indexed: 11/19/2022]
Abstract
Összefoglaló. A palliatív ellátások korai bevonása az onkológiai betegek ellátásába előnnyel jár mind a beteg életminősége, mind a kezelés színvonala, mind a költséghatékonyság szempontjából. Szükség van egy olyan modellre, mely alapján a megfelelő időben, a megfelelő beteg a megfelelő minőségű palliatív ellátásban részesül. Ebben a közleményben a palliatív ellátás korai integrációjának előnyei, szintjei és a speciális palliatív ellátás fogalmának ismertetése után a leginkább elterjedt beutalási modellek előnyeit és hátrányait mutatjuk be a nemzetközi szakirodalom alapján. A speciális palliatív ellátást igénylő betegek kiszűrésére szolgáló, prognózisalapú modellek hátránya, hogy nincs elég kapacitás az ilyen módon beutalt nagyszámú beteg ellátására, ezért széles körben nem terjedtek el. A tüneteken alapuló modellek sokszor bonyolultak és a mindennapi klinikai gyakorlatban nem használatosak. Az új kutatások alapján egyszerű, gyakorlatias kérdéssorokat alkalmaznak, melyekkel könnyen kiemelhetők, akik profitálnak a speciális palliatív intervencióból. Ezek közül a Yale egyetemi és a PALLIA -10 modellt ismertetjük részletesen. Amennyiben az aktív onkológiai ellátást végzők a megfelelő palliatív beutalási kritériumokat ismerik és alkalmazzák, a betegek időben jutnak a megfelelő komplex kezeléshez anélkül, hogy a palliatív ellátórendszer túlterhelődne. Orv Hetil. 2021; 162(44): 1769-1775. Summary. Early integration of palliative care into the trajectory of cancer care brings advantages into the patients' quality of life, the level of care and cost-efficiency, too. On the basis of a predefined model, the right patient may receive the right level of palliative care at the right time. Having defined the advantages, the levels of early integration of palliative care and the concept of special palliative care, we also aim to describe the advantages and disadvantages of the most common referral models on the basis of international literature in this article. The drawback of prognosis-based models to identify patients needing special palliative care is the lack of capacity to provide care for the large number of patients so recognised; therefore they have not become widespread. Needs-based models tend to be complicated and thus rarely applied in everyday clinical practice. On the basis of new researches, simple, pragmatic questionnaires are utilised through which the patients who could benefit from special palliative care interventions are easy to identify. Here we give a detailed report of the Yale University and PALLIA-10 models. On condition that appropriate palliative referral criteria are known and applied by active oncology care providers, patients may receive adequate complex care without the palliative care system being overloaded. Orv Hetil. 2021; 162(44): 1769-1775.
Collapse
Affiliation(s)
- Orsolya Horváth
- 1 Országos Onkológiai Intézet, Budapest, Ráth György u. 7-9., 1122
| | - Enikő Földesi
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Magatartástudományi Intézet, Budapest
| | - Katalin Hegedűs
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Magatartástudományi Intézet, Budapest
| |
Collapse
|
12
|
Küronya Z, Fröhlich G, Ladányi A, Martin T, Géczi L, Gyergyai F, Horváth O, Kiszner G, Kovács Á, Dienes T, Lénárt E, Nagyiványi K, Szarvas T, Szőnyi M, Tóth A, Biró K. Low socioeconomic position is a risk factor for delay to treatment and mortality of testicular cancer patients in Hungary, a prospective study. BMC Public Health 2021; 21:1707. [PMID: 34538241 PMCID: PMC8451119 DOI: 10.1186/s12889-021-11720-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/31/2021] [Accepted: 09/02/2021] [Indexed: 01/03/2023] Open
Abstract
Background In Hungary, the mortality rate for testicular germ cell cancer (TGCC) is 0,9/100000 which is significantly higher than the EU average. We prospectively evaluated the effect of socioeconomic position on patient delay and therapy outcomes. Methods Questionnaires on subjective social status (MacArthur Subjective Status Scale), objective socioeconomic position (wealth, education, and housing data), and on patient’s delay were completed by newly diagnosed TGCC patients. Results Patients belonged to a relatively high socioeconomic class, a university degree was double the Hungarian average, Cancer-specific mortality in the highest social quartile was 1.56% while in the lowest social quartile 13.09% (p = 0.02). In terms of patient delay, 57.2% of deceased patients waited more than a year before seeking help, while this number for the surviving patients was 8.0% (p = 0.0000). Longer patient delay was associated with a more advanced stage in non-seminoma but not in seminoma, the correlation coefficient for non-seminoma was 0.321 (p < 0.001). For patient delay, the most important variables were the mother’s and patient’s education levels (r = − 0.21, p = 0.0003, and r = − 0.20, p = 0.0005), respectively. Since the patient delay was correlated with the social quartile and resulted in a more advanced stage in non-seminoma, the lower social quartile resulted in higher mortality in non-seminoma patients (p = 0.005) but not in seminoma patients (p = 0.36) where the patient delay was not associated with a more advanced stage. Conclusions Based on our result, we conclude that to improve survival, we should promote testicular cancer awareness, especially among the most deprived populations, and their health care providers. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11720-w.
Collapse
Affiliation(s)
- Zsófia Küronya
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary.
| | - Georgina Fröhlich
- Faculty of Science, Eötvös Loránd University, Budapest, Hungary.,Centre of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Andrea Ladányi
- Department of Surgical and Molecular Pathology, National Institute of Oncology, Budapest, Hungary
| | - Tamás Martin
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Lajos Géczi
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Fruzsina Gyergyai
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Orsolya Horváth
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Gergő Kiszner
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Ágnes Kovács
- Boehringer Ingelheim RCV GmbH & Co. KG Branch Office Budapest, Budapest, Hungary
| | - Tamás Dienes
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Enikő Lénárt
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Krisztián Nagyiványi
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University Budapest, Budapest, Hungary
| | - Mihály Szőnyi
- Semmelweis University Faculty of Medicine, Budapest, Hungary
| | | | - Krisztina Biró
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary
| |
Collapse
|
13
|
Oláh C, Váradi M, Horváth O, Nyirády P, Szarvas T. Oncological relevance of gut and urine microbiomes. Orv Hetil 2021; 162:579-586. [PMID: 33798103 DOI: 10.1556/650.2021.32052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/10/2020] [Accepted: 10/08/2020] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Az immunrendszer nem megfelelő működése meghatározó szerepet játszik a daganatok kialakulásában, progressziójában és az egyes terápiák hatékonyságában is. A bélrendszer baktériumai a szervezet immunitásán keresztül képesek befolyásolni a szervezet gyógyszeres terápiákra adott válaszreakcióját, kiváltképpen az immunellenőrzőpont-gátló kezelések hatását. Az újgenerációs nukleinsav-szekvenálási technológiák felhasználásával részletes képet kaphatunk a szervezetben jelen lévő baktériumok minőségi és mennyiségi viszonyairól. A közelmúltban összefüggést igazoltak a vastagbéldaganat, a melanoma, a vesesejtes carcinoma és a nem kissejtes tüdőrák esetén alkalmazott immunellenőrzőpont-gátló terápiák hatékonysága és a bél mikrobiom-összetétele között. Számos olyan baktériumot azonosítottak, melynek jelenlétéből, illetve mennyiségéből következtethetünk az egyes kezelésekkel szembeni egyéni érzékenységre. Ezzel összhangban, az antibiotikumkezelés által okozott dysbiosis növelte az immunellenőrzőpont-gátló terápia sikertelenségének kockázatát. Ezen eredmények tükrében a jövőben a mikrobiom-összetétel meghatározása is fontos tényező lehet az immunterápiák hatékonyságának előrejelzésében, illetve egyre inkább bizonyított, hogy a széles spektrumú antibiotikumkezelés a legtöbbször csökkenti a daganatellenes immunterápiák hatékonyságát. Jelenleg folyó klinikai vizsgálatok pedig a mikrobiom-összetétel mesterséges úton történő megváltoztatásának terápiás lehetőségeit tanulmányozzák. Bebizonyosodott, hogy a korábbi állásponttal szemben a vizelet nem steril. DNS-szekvenálás alkalmazásával számos olyan, a vizeletben előforduló baktériumot sikerült azonosítani, melynek jelenléte hozzájárulhat a húgyhólyagrák kialakulásához és progressziójához, illetve a húgyhólyagban lokálisan alkalmazott BCG-terápia hatékonyságához. Jelen munkában a közelmúlt publikációit feldolgozva összefoglaljuk, mely baktériumok jelenléte hozható összefüggésbe a különböző daganatok kialakulásával, progressziójával és terápiarezisztenciájával. Orv Hetil. 2020; 162(15): 579-586. Summary. Dysfunction of the immune system plays a crucial role in the development and progression of cancer as well as the effectiveness of antitumor therapies. Gut microbiota, due to their impact on the immune system, are able to influence response to anticancer drug therapies. Next-generation DNA-sequencing technologies enabled a comprehensive quantitative and qualitative exploration of the gut microbiome. An increasing body of evidence indicates the association between the efficacy of immune checkpoint inhibitor therapies and gut microbiome composition in colorectal cancer, malignant melanoma, renal cell carcinoma, and non-small cell lung cancer. Recently, several bacterial strains and species were shown to be associated with treatment efficacies. In accordance, dysbiosis caused by antibiotic treatment was found to increase the risk of failure to immune checkpoint inhibitor therapies. In the light of these results, examination of microbiome composition may become an important factor for the prediction of immunotherapies. Currently ongoing clinical trials are investigating the potential of therapeutic alteration of microbiome composition. Contrary to the previous view, urine has been shown not to be sterile. By using sensitive DNA-sequencing technologies, several urinary bacteria could be identified which may contribute to the development and progression of bladder cancer and may influence the efficacy of intravesical BCG therapy. In the present work, we summarize recent studies that identified the presence of certain bacteria associated with the development, progression, and therapy resistance of various cancers. Orv Hetil. 2020; 162(15): 579-586.
Collapse
Affiliation(s)
- Csilla Oláh
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika, Budapest, Üllői út 78/B, 1082
| | - Melinda Váradi
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika, Budapest, Üllői út 78/B, 1082
| | - Orsolya Horváth
- 2 Országos Onkológiai Intézet, Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Budapest
| | - Péter Nyirády
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika, Budapest, Üllői út 78/B, 1082
| | - Tibor Szarvas
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika, Budapest, Üllői út 78/B, 1082.,3 Duisburg-Essen Egyetem, Urológiai Klinika, Essen
| |
Collapse
|
14
|
Kovács P, Esperger Z, Horváth D, Lacsán K, Patyi D, Stefanovits N, Zsoldos L, Horváth O. [Psychological phenomena and symptoms in active and complex oncology care: challenges of interventions and rehabilitation opportunities.]. Magy Onkol 2021; 65:78-88. [PMID: 33730120] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
According to research, almost every second oncology patient experiences intense distress during their oncology treatment. The development of new medical treatment options in cancer care allows longer survival for cancer patients. Because of this, quality of life becomes an increasingly important factor during treatments. Psycho-oncological interventions include all psychosocial interventions that are designed to positively influence the patient's psychosocial adaptation and adjustment to diagnosis, treatment, and survivorship. Interventions also promote rehabilitation progress and help the emotional integration of disease-related crisis and trauma. Psycho-oncological therapies are supposed to manage cancer-related distress and other psychosocial problems by specific types of treatments or interventions. It is crucial for the medical system to deal with the psychosocial aspects of cancer care in order to identify and deal with patients' needs for better compliance and adherence to treatment. The key of personalized holistic rehabilitation is multidisciplinary teamwork during the whole healing process: sharing the emotional experience also helps to prevent healthcare workers' burnout.
Collapse
Affiliation(s)
- Péter Kovács
- Rehabilitációs Részleg, Országos Onkológiai Intézet, Onkopszichológiai Munkacsoport, Budapest, Hungary.
| | - Zsófia Esperger
- Rehabilitációs Részleg, Országos Onkológiai Intézet, Onkopszichológiai Munkacsoport, Budapest, Hungary.
| | - Dóra Horváth
- Rehabilitációs Részleg, Országos Onkológiai Intézet, Onkopszichológiai Munkacsoport, Budapest, Hungary.
| | - Katalin Lacsán
- Rehabilitációs Részleg, Országos Onkológiai Intézet, Onkopszichológiai Munkacsoport, Budapest, Hungary.
| | - Dániel Patyi
- Rehabilitációs Részleg, Országos Onkológiai Intézet, Onkopszichológiai Munkacsoport, Budapest, Hungary.
| | - Nóra Stefanovits
- Rehabilitációs Részleg, Országos Onkológiai Intézet, Onkopszichológiai Munkacsoport, Budapest, Hungary.
| | - Lili Zsoldos
- Rehabilitációs Részleg, Országos Onkológiai Intézet, Onkopszichológiai Munkacsoport, Budapest, Hungary.
| | - Orsolya Horváth
- Rehabilitációs Részleg, Országos Onkológiai Intézet, Onkopszichológiai Munkacsoport, Budapest, Hungary.
| |
Collapse
|
15
|
Kanaan R, Farkas N, Hegyi P, Soós A, Hegyi D, Németh K, Horváth O, Tenk J, Mikó A, Szentesi A, Balaskó M, Szakács Z, Vasas A, Csupor D, Gyöngyi Z. Rats sniff out pulmonary tuberculosis from sputum: a diagnostic accuracy meta-analysis. Sci Rep 2021; 11:1877. [PMID: 33479276 PMCID: PMC7820466 DOI: 10.1038/s41598-021-81086-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/18/2020] [Accepted: 12/29/2020] [Indexed: 01/29/2023] Open
Abstract
In Sub-Saharan Africa, African giant pouched rats (Cricetomys gambianus) are trained to identify TB patients by smelling sputum. We conducted a systematic review and meta-analysis of the data to see if this novel method is comparable to traditional laboratory screening and detection methods like Ziehl–Neelsen stain-based assays (ZN) and bacterial culture. The search and data processing strategy is registered at PROSPERO (CRD42019123629). Medline via PubMed, EMBASE, Web of Science, and Cochrane Library databases were systematically searched for the keywords “pouched rat” and “tuberculosis”. Data from 53,181 samples obtained from 24,600 patients were extracted from seven studies. Using sample-wise detection, the sensitivity of the studies was 86.7% [95% CI 80.4–91.2%], while the specificity was 88.4% [95% CI 79.7–93.7%]. For patient-wise detection, the sensitivity was 81.3% [95% CI 64.0–91.4%], while the specificity was 73.4% [95% CI 62.8–81.9%]. Good and excellent classification was assessed by hierarchical summary receiver-operating characteristic analysis for patient-wise and sample-wise detections, respectively. Our study is the first systematic review and meta-analysis of the above relatively inexpensive and rapid screening method. The results indicate that African giant pouched rats can discriminate healthy controls from TB individuals by sniffing sputum with even a higher accuracy than a single ZN screening.
Collapse
Affiliation(s)
- Reem Kanaan
- Department of Public Health Medicine, Medical School, University of Pécs, Szigeti út, 12, 7624, Pécs, Hungary
| | - Nelli Farkas
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary.,Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary.,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary.,Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
| | - Alexandra Soós
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Dávid Hegyi
- Department of Public Health Medicine, Medical School, University of Pécs, Szigeti út, 12, 7624, Pécs, Hungary
| | - Katalin Németh
- Department of Public Health Medicine, Medical School, University of Pécs, Szigeti út, 12, 7624, Pécs, Hungary
| | - Orsolya Horváth
- Department of Public Health Medicine, Medical School, University of Pécs, Szigeti út, 12, 7624, Pécs, Hungary
| | - Judit Tenk
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Mikó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Andrea Szentesi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
| | - Márta Balaskó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Zsolt Szakács
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Andrea Vasas
- Department of Pharmacognosy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary.,Interdisciplinary Centre of Natural Products, University of Szeged, Szeged, Hungary
| | - Dezső Csupor
- Department of Pharmacognosy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary.,Interdisciplinary Centre of Natural Products, University of Szeged, Szeged, Hungary
| | - Zoltán Gyöngyi
- Department of Public Health Medicine, Medical School, University of Pécs, Szigeti út, 12, 7624, Pécs, Hungary.
| |
Collapse
|
16
|
Horváth O, Kelen K, Prohászka Z, Hosszú Á, Szabó AJ, Reusz GS. Atypical HUS and Crohn's disease-interference of intestinal disease activity with complement-blocking treatment. Pediatr Nephrol 2021; 36:3277-3280. [PMID: 34328541 PMCID: PMC8445858 DOI: 10.1007/s00467-021-05167-9] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND In atypical hemolytic-uremic syndrome (aHUS), various defects of the complement system have been reported to explain pathophysiology. Therapeutic options for complement inhibition are well-recognized; however, the links between various immune-derived diseases and aHUS are unclear, and their interference with treatment efficacy during long-term complement-blocking therapy is scarcely known. CASE-DIAGNOSIS/TREATMENT We present a pediatric patient who developed aHUS with acute kidney injury in parallel with the onset of Crohn's disease (CD), and who required long-term complement-blocking therapy with eculizumab (ECU). Unexpectedly, during the 6-year ECU treatment, an important intra-patient variation of the degree of complement inhibition was observed. In spite of continuous and stable doses of complement-blocking therapy, periods of incomplete blockade were observed in strong association with relapses of CD. When conventional and later biological therapy with adalimumab was introduced, with CD going into remission, complement blockade became complete again. Despite periodically low ECU levels and insufficient complement inhibition, no clinical or hematological signs of aHUS recurrence were detected during CD relapses. CONCLUSION In aHUS cases secondary to CD, close monitoring of both complement inhibition and serum ECU levels is needed as intestinal disease can interfere with complement-blocking treatment. Increased doses of ECU may be necessary to maintain therapeutic blood levels of ECU and full complement blockade, especially if the intestinal disease is not under control.
Collapse
Affiliation(s)
- Orsolya Horváth
- First Department of Pediatrics, Semmelweis University, HU 1083 Budapest, Hungary ,Pediatric Hematology and Stem Cell Transplantation Unit, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Kata Kelen
- First Department of Pediatrics, Semmelweis University, HU 1083 Budapest, Hungary
| | - Zoltán Prohászka
- Research Laboratory, Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Ádám Hosszú
- First Department of Pediatrics, Semmelweis University, HU 1083 Budapest, Hungary
| | - Attila J Szabó
- First Department of Pediatrics, Semmelweis University, HU 1083 Budapest, Hungary
| | - George S Reusz
- First Department of Pediatrics, Semmelweis University, HU, 1083, Budapest, Hungary.
| |
Collapse
|
17
|
Mezö B, Horváth O, Sinkovits G, Veszeli N, Kriván G, Prohászka Z. Validation of Early Increase in Complement Activation Marker sC5b-9 as a Predictive Biomarker for the Development of Thrombotic Microangiopathy After Stem Cell Transplantation. Front Med (Lausanne) 2020; 7:569291. [PMID: 33117830 PMCID: PMC7574906 DOI: 10.3389/fmed.2020.569291] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 06/03/2020] [Accepted: 09/07/2020] [Indexed: 12/11/2022] Open
Abstract
Hematopoietic stem cell transplantation (HSCT)-associated thrombotic microangiopathy (TA-TMA) is a multifactorial complication. Complement dysregulation may play an important role in the pathogenesis of TA-TMA. Our previous observations suggested that early increase of soluble C5b-9 (sC5b-9), before the development of other complications, can predict the development of later TA-TMA. The present study aims to validate our earlier findings in an independent cohort enrolling 67 pediatric patients who underwent allogeneic HSCT during the study period (October 2015–January 2019). Five different TA-TMA diagnostic criteria were applied, and all important clinical and laboratory parameters of TA-TMA activity were registered. Complement pathway activities, components and sC5b-9 levels were systematically measured before transplantation and on days 28, 56, and 100 after HSCT. A strong and remarkable association still have been found between early increase of sC5b-9 (10 of 10 patients with TA-TMA vs. 27 of 57 without TA-TMA; P = 0.002) and the development of TA-TMA during 100 days post-transplantation. An increase in sC5b-9 concentration had 100% sensitivity and 53% specificity for TA-TMA in the cohort. All TA-TMA cases have been observed during cyclosporine immunosuppression, no TA-TMA was diagnosed during tacrolimus or mycophenolat mofetil therapy. In the majority of patients TA-TMA was mild and self-limiting, without any signs of organ damage. No additional complement parameters were closely associated with the development of TA-TMA. Early raise of the sC5b-9 activation marker was predictive for later development of TA-TMA throughout the whole study period. In patients with a marked increase, early and frequent monitoring of TA-TMA activity markers should be attempted, to facilitate subsequent therapy decisions in time. However, patients with TA-TMA were only identified during or after cyclosporine immunosuppression. Further studies enrolling higher number of patients are necessary to determine the role of immunosuppression in the pathogenesis of TA-TMA.
Collapse
Affiliation(s)
- Blanka Mezö
- Research Laboratory, MTA-SE Research Group of Immunology and Hematology, Department of Internal Medicine and Hematology, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Orsolya Horváth
- Pediatric Hematology and Bone Marrow Transplantation Unit, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - György Sinkovits
- Research Laboratory, MTA-SE Research Group of Immunology and Hematology, Department of Internal Medicine and Hematology, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Nóra Veszeli
- Research Laboratory, MTA-SE Research Group of Immunology and Hematology, Department of Internal Medicine and Hematology, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Gergely Kriván
- Pediatric Hematology and Bone Marrow Transplantation Unit, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Zoltán Prohászka
- Research Laboratory, MTA-SE Research Group of Immunology and Hematology, Department of Internal Medicine and Hematology, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| |
Collapse
|
18
|
Hau L, Kállay K, Kertész G, Goda V, Kassa C, Horváth O, Liptai Z, Constantin T, Kriván G. Allogeneic haematopoietic stem cell transplantation in a refractory case of neuromyelitis optica spectrum disorder. Mult Scler Relat Disord 2020; 42:102110. [PMID: 32408149 DOI: 10.1016/j.msard.2020.102110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Lídia Hau
- Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases Saint László Hospital Campus Pediatric Hematology and Stem Cell Transplantation Unit, Albert Flórián Street 5-7, Budapest, 1097, Hungary.
| | - Krisztián Kállay
- Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases Saint László Hospital Campus Pediatric Hematology and Stem Cell Transplantation Unit, Albert Flórián Street 5-7, Budapest, 1097, Hungary
| | - Gabriella Kertész
- Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases Saint László Hospital Campus Pediatric Hematology and Stem Cell Transplantation Unit, Albert Flórián Street 5-7, Budapest, 1097, Hungary
| | - Vera Goda
- Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases Saint László Hospital Campus Pediatric Hematology and Stem Cell Transplantation Unit, Albert Flórián Street 5-7, Budapest, 1097, Hungary
| | - Csaba Kassa
- Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases Saint László Hospital Campus Pediatric Hematology and Stem Cell Transplantation Unit, Albert Flórián Street 5-7, Budapest, 1097, Hungary
| | - Orsolya Horváth
- Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases Saint László Hospital Campus Pediatric Hematology and Stem Cell Transplantation Unit, Albert Flórián Street 5-7, Budapest, 1097, Hungary
| | - Zoltán Liptai
- Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases Saint László Hospital Campus Pediatric Infectology Unit, Albert Flórián Street 5-7, Budapest, 1097, Hungary
| | - Tamás Constantin
- Semmelweis University 2nd Department of Pediatrics Rheumatology Unit, Tűzoltó Street 7-9 Budapest, 1094, Hungary
| | - Gergely Kriván
- Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases Saint László Hospital Campus Pediatric Hematology and Stem Cell Transplantation Unit, Albert Flórián Street 5-7, Budapest, 1097, Hungary
| |
Collapse
|
19
|
Dienes T, Horváth O, Géczi L. [Adverse events of immune checkpoint inhibitors and their treatment]. Magy Onkol 2019; 63:246-255. [PMID: 31533145] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/10/2019] [Indexed: 06/10/2023]
Abstract
Therapy with immune checkpoint inhibitors (ICPis) has become widespread in medical oncology, becoming part of the routine treatment for various malignancies. These antibodies induce an anti-cancer immune activation by blocking the natural immunosuppression, which is supposed to protect the human body's healthy cells from destruction by the immune system, caused also by cancers, and as a result, allow the immune system to take part in destroying malignant cells. However, the immune activation created by these molecules is not selective against cancer tissues, therefore adverse events associated to these therapies are similar to the signs and symptoms of autoimmune diseases. Common adverse events affect the skin, liver, lungs, gastrointestinal and endocrine systems, less frequently the heart and the nervous system, occasionally causing life-threatening complications. Therapy of these adverse events requires rapid diagnosis and adequate treatment in the form of various immunosuppressants.
Collapse
Affiliation(s)
- Tamás Dienes
- C Belgyógyászati-Onkológiai és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
| | - Orsolya Horváth
- C Belgyógyászati-Onkológiai és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
| | - Lajos Géczi
- C Belgyógyászati-Onkológiai és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
| |
Collapse
|
20
|
Horváth O, Hegyi D, Balogh E, Mátrai P, Kiss I, Gyöngyi Z. PO-092 Sensitivity and specificity accurate of sniffing dogs to detect lung cancer. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.619] [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: 11/03/2022] Open
|
21
|
Abstract
In antithymocyte globulin (ATG) treated patients occasionally bradycardia has been noticed. Therefore, we retrospectively analyzed the occurrence of bradycardia in ATG-treated children. Using medical records between 2007 and 2012 we identified children undergoing a combined therapy with ATG and glucocorticoids (ATG group, n = 22). The incidence of bradycardia was compared to that registered in children treated with glucocorticoids alone (glucocorticoid alone group, n = 21). Heart rates (HR) were registered before and on days 0-3, 4-7 and 8-14 after the ATG or steroid administration. The rate of bradycardic episodes was higher during ATG therapy than in the steroid alone group, while severe bradycardia occurred only in the ATG group (97 versus 32, p = 0.0037, and 13 versus 0, p = 0.0029, respectively). There was an interaction between the time and treatment group on HR (p = 0.046). Heart rates in ATG and steroid alone groups differed significantly on day 0-3 and day 4-7 (p = 0.046, p = 0.006, respectively). Within the ATG group HR was lower on days 4-7 compared to the days before and the days 8-14 values (p < 0.001, 95%CI: 0.020-0.074). These findings indicate that transient asymptomatic bradycardia is probably more common with ATG therapy than previously reported. HR should be closely monitored during and after ATG therapy.
Collapse
Affiliation(s)
- Krisztián Kállay
- Pediatric Hematology and Stem Cell Transplantation Unit, United St. István and St. László Hospital, Albert Flórián street 5-7, Budapest, H-1097, Hungary.
| | - Dávid Zakariás
- Pediatric Hematology and Stem Cell Transplantation Unit, United St. István and St. László Hospital, Albert Flórián street 5-7, Budapest, H-1097, Hungary
| | - Katalin Csordás
- Pediatric Hematology and Stem Cell Transplantation Unit, United St. István and St. László Hospital, Albert Flórián street 5-7, Budapest, H-1097, Hungary
| | - Gábor Benyó
- Pediatric Hematology and Stem Cell Transplantation Unit, United St. István and St. László Hospital, Albert Flórián street 5-7, Budapest, H-1097, Hungary
| | - Csaba Kassa
- Pediatric Hematology and Stem Cell Transplantation Unit, United St. István and St. László Hospital, Albert Flórián street 5-7, Budapest, H-1097, Hungary
| | - János Sinkó
- Pediatric Hematology and Stem Cell Transplantation Unit, United St. István and St. László Hospital, Albert Flórián street 5-7, Budapest, H-1097, Hungary
| | - Anita Stréhn
- Pediatric Hematology and Stem Cell Transplantation Unit, United St. István and St. László Hospital, Albert Flórián street 5-7, Budapest, H-1097, Hungary
| | - Orsolya Horváth
- Pediatric Hematology and Stem Cell Transplantation Unit, United St. István and St. László Hospital, Albert Flórián street 5-7, Budapest, H-1097, Hungary
| | - Barna Vásárhelyi
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Gergely Kriván
- Pediatric Hematology and Stem Cell Transplantation Unit, United St. István and St. László Hospital, Albert Flórián street 5-7, Budapest, H-1097, Hungary
| |
Collapse
|
22
|
Kenessey I, Kói K, Horváth O, Cserepes M, Molnár D, Izsák V, Dobos J, Hegedűs B, Tóvári J, Tímár J. KRAS-mutation status dependent effect of zoledronic acid in human non-small cell cancer preclinical models. Oncotarget 2018; 7:79503-79514. [PMID: 27780929 PMCID: PMC5346731 DOI: 10.18632/oncotarget.12806] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 03/17/2016] [Accepted: 09/27/2016] [Indexed: 11/25/2022] Open
Abstract
Background In non-small cell lung cancer (NSCLC) KRAS-mutant status is a negative prognostic and predictive factor. Nitrogen-containing bisphosphonates inhibit prenylation of small G-proteins (e.g. Ras, Rac, Rho) and thus may affect proliferation and migration. In our preclinical work, we investigated the effect of an aminobisphosphonate compound (zoledronic acid) on mutant and wild type KRAS-expressing human NSCLC cell lines. Results We confirmed that zoledronic acid was unable to inhibit the prenylation of mutant K-Ras unlike in the case of wild type K-Ras. In case of in vitro proliferation, the KRAS-mutant human NSCLC cell lines showed resistance to zoledronic acid wild-type KRAS-cells proved to be sensitive. Combinatory application of zoledronic acid enhanced the cytostatic effect of cisplatin. Zoledronic acid did not induce significant apoptosis. In xenograft model, zoledronic acid significantly reduced the weight of wild type KRAS-EGFR-expressing xenograft tumor by decreasing the proliferative capacity. Futhermore, zoledronic acid induced VEGF expression and improved in vivo tumor vascularization. Materials and methods Membrane association of K-Ras was examined by Western-blot. In vitro cell viability, apoptotic cell death and migration were measured in NSCLC lines with different molecular background. The in vivo effect of zoledronic acid was investigated in a SCID mouse subcutaneous xenograft model. Conclusions The in vitro and in vivo inhibitory effect of zoledronic acid was based on the blockade of cell cycle in wild type KRAS-expressing human NSCLC cells. The zoledronic acid induced vascularization supported in vivo cytostatic effect. Our preclinical investigation suggests that patients with wild type KRAS-expressing NSCLC could potentially benefit from aminobisphosphonate therapy.
Collapse
Affiliation(s)
- István Kenessey
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.,National Cancer Registry, National Institute of Oncology, Budapest, Hungary
| | - Krisztina Kói
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Orsolya Horváth
- Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - Mihály Cserepes
- Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary.,Institute of Enzymology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Dávid Molnár
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Vera Izsák
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | | | - Balázs Hegedűs
- Hungarian Academy of Sciences-Semmelweis University Molecular Oncology Research Group, Budapest, Hungary
| | - József Tóvári
- Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - József Tímár
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.,Hungarian Academy of Sciences-Semmelweis University Molecular Oncology Research Group, Budapest, Hungary
| |
Collapse
|
23
|
Horváth O, Kállay K, Csuka D, Mező B, Sinkovits G, Kassa C, Stréhn A, Csordás K, Sinkó J, Prohászka Z, Kriván G. Early Increase in Complement Terminal Pathway Activation Marker sC5b-9 Is Predictive for the Development of Thrombotic Microangiopathy after Stem Cell Transplantation. Biol Blood Marrow Transplant 2018; 24:989-996. [PMID: 29339271 DOI: 10.1016/j.bbmt.2018.01.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 10/13/2017] [Accepted: 01/08/2018] [Indexed: 12/17/2022]
Abstract
Hematopoietic stem cell transplantation (HSCT)-associated thrombotic microangiopathy (TA-TMA) is a multifactorial complication, and its prediction is largely unresolved. Our aim was to analyze changes of complement profile after HSCT to identify potential markers of TA-TMA development. Thirty-three consecutive pediatric patients (9.6 ± 4.4 years old) who underwent allogeneic HSCT due to malignant (n = 17) or nonmalignant (n = 16) indications were included in this study. Graft-versus-host disease (GVHD) was diagnosed using Glucksberg criteria, viral reactivation was monitored, 5 different TA-TMA diagnostic criteria were applied, and all important clinical and laboratory parameters of TA-TMA activity were registered. Complement pathway activities, components and terminal pathway activation marker (sC5b-9) levels were systematically measured before transplantation and on days 28, 56, and 100 after HSCT. During the first 100 days after HSCT, 1 of 33 patients died (day 50, multiple organ failure), whereas 10 subjects met the criteria for TA-TMA, typically on day 61 (range, 16 to 98 days). TA-TMA was preceded by acute GVHD in 3 of 10 patients, by viral reactivation in 2 of 10, or by both in 4 of 10 cases. Baseline sC5b-9 levels did not differ in patients without (200 [interquartile range, 144 to 266] ng/mL), or with (208 [interquartile range, 166 to 271] ng/mL) subsequent TA-TMA; however, on day 28 significant differences were observed (201 [interquartile range, 185 to 290] ng/mL versus 411 [interquartile range, 337 to 471] ng/mL; P = .004). Importantly, all 10 patients with TMA showed increase in sC5b-9 level from baseline level to day 28, whereas in patients without TMA the same tendency was observed for only 9 of 23 patients (P = .031). No additional complement parameters were closely associated with the development of TA-TMA. Development of TA-TMA occurred in 30% of our patients, typically after GVHD and/or viral reactivation. However, early raise of sC5b-9 activation marker was predictive for later development of TA-TMA, and should therefore be considered as an alarming sign necessitating a careful monitoring of all TA-TMA activity markers. Further studies enrolling a higher number of patients are necessary to determine if terminal pathway activation is an independent predictor of TA-TMA.
Collapse
Affiliation(s)
- Orsolya Horváth
- Department of Pediatric Hematology and Stem Cell Transplantation, United St.István and St. László Hospital, Budapest, Hungary; Doctoral School of Medicine, Semmelweis University, Budapest, Hungary.
| | - Krisztián Kállay
- Department of Pediatric Hematology and Stem Cell Transplantation, United St.István and St. László Hospital, Budapest, Hungary
| | - Dorottya Csuka
- Research Laboratory, IIIrd Department of Internal Medicine, and MTA-SE Research Group of Immunology and Hematology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Blanka Mező
- Research Laboratory, IIIrd Department of Internal Medicine, and MTA-SE Research Group of Immunology and Hematology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - György Sinkovits
- Research Laboratory, IIIrd Department of Internal Medicine, and MTA-SE Research Group of Immunology and Hematology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Csaba Kassa
- Department of Pediatric Hematology and Stem Cell Transplantation, United St.István and St. László Hospital, Budapest, Hungary
| | - Anita Stréhn
- Department of Pediatric Hematology and Stem Cell Transplantation, United St.István and St. László Hospital, Budapest, Hungary
| | - Katalin Csordás
- Department of Pediatric Hematology and Stem Cell Transplantation, United St.István and St. László Hospital, Budapest, Hungary
| | - János Sinkó
- Department of Hematology and Stem Cell Transplantation, United St. István and St. László Hospital, Budapest, Hungary
| | - Zoltán Prohászka
- Research Laboratory, IIIrd Department of Internal Medicine, and MTA-SE Research Group of Immunology and Hematology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Gergely Kriván
- Department of Pediatric Hematology and Stem Cell Transplantation, United St.István and St. László Hospital, Budapest, Hungary
| |
Collapse
|
24
|
Bagci I, Ruini C, Niesert A, Horváth O, Berking C, Ruzicka T, von Braunmühl T. 175 Effects of short-term moisturizer application in different ethnic skin types - non-invasive assessment with optical coherence tomography and reflectance confocal microscopy. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.485] [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: 10/18/2022]
|
25
|
Horváth O, Prohászka Z, Kállay K, Kassa C, Stréhn A, Csordás K, Sinkó J, Kriván G. [Changes in diagnostic criteria of thrombotic microangiopathy after stem cell transplantation]. Orv Hetil 2017; 158:1043-1050. [PMID: 28670985 DOI: 10.1556/650.2017.30786] [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] [Indexed: 11/19/2022]
Abstract
Hematopoietic stem cell transplantation associated thrombotic microangiopathy is a multifactorial complication, and has variable incidence in study populations due to different diagnostic criteria. The diversity of activity parameters, like elevated laktát-dehidrogenáz, hematological parameters and kidney function are not specific variables after stem cell transplantation. Dysregulation of the classical and alternative pathway can play an important role in the pathomechanism of thrombotic microangiopathy, but the understanding of the role of complement activation under transplantation conditions requires further investigation. Monitoring of complement parameters, including terminal complement pathway activation complex during transplantation may help physicians to improve diagnostic strategy, to evaluate therapeutical options and to predict and follow up efficacy of complement blockade methods and supportive therapy. This review focuses on the development of diagnostic criteria and therapeutical options in thrombotic microangiopathy, and presents some preliminary findings while using different diagnostic criteria in pediatric patients. Orv Hetil. 2017; 158(27): 1043-1050.
Collapse
Affiliation(s)
- Orsolya Horváth
- Doktori Iskola, Semmelweis Egyetem Budapest.,Gyermekhematológiai és Őssejt-transzplantációs Osztály, Egyesített Szent István és Szent László Kórház Budapest, Albert Flórián út 5-7. 11/4A, 1097
| | - Zoltán Prohászka
- Általános Orvostudományi Kar, III. Belgyógyászati Klinika, Semmelweis Egyetem Budapest
| | - Krisztián Kállay
- Gyermekhematológiai és Őssejt-transzplantációs Osztály, Egyesített Szent István és Szent László Kórház Budapest, Albert Flórián út 5-7. 11/4A, 1097
| | - Csaba Kassa
- Gyermekhematológiai és Őssejt-transzplantációs Osztály, Egyesített Szent István és Szent László Kórház Budapest, Albert Flórián út 5-7. 11/4A, 1097
| | - Anita Stréhn
- Gyermekhematológiai és Őssejt-transzplantációs Osztály, Egyesített Szent István és Szent László Kórház Budapest, Albert Flórián út 5-7. 11/4A, 1097
| | - Katalin Csordás
- Gyermekhematológiai és Őssejt-transzplantációs Osztály, Egyesített Szent István és Szent László Kórház Budapest, Albert Flórián út 5-7. 11/4A, 1097
| | - János Sinkó
- Hematológiai és Őssejt-transzplantációs Osztály, Egyesített Szent István és Szent László Kórház Budapest
| | - Gergely Kriván
- Gyermekhematológiai és Őssejt-transzplantációs Osztály, Egyesített Szent István és Szent László Kórház Budapest, Albert Flórián út 5-7. 11/4A, 1097
| |
Collapse
|
26
|
Kisfali M, Sólymos P, Nagy A, Rácz IA, Horváth O, Sramkó G. A morphometric and molecular study of the genus Pseudopodisma (Orthoptera: Acrididae). ACTA ZOOL ACAD SCI H 2017. [DOI: 10.17109/azh.63.3.293.2017] [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: 11/22/2022] Open
|
27
|
Sramkó G, Molnár V A, Tóth JP, Laczkó L, Kalinka A, Horváth O, Skuza L, Lukács BA, Popiela A. Molecular phylogenetics, seed morphometrics, chromosome number evolution and systematics of European Elatine L. (Elatinaceae) species. PeerJ 2016; 4:e2800. [PMID: 28028470 PMCID: PMC5180590 DOI: 10.7717/peerj.2800] [Citation(s) in RCA: 5] [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: 05/20/2016] [Accepted: 11/18/2016] [Indexed: 11/20/2022] Open
Abstract
The genus Elatine contains ca 25 species, all of which are small, herbaceous annuals distributed in ephemeral waters on both hemispheres. However, due to a high degree of morphological variability (as a consequence of their amphibious life-style), the taxonomy of this genus remains controversial. Thus, to fill this gap in knowledge, we present a detailed molecular phylogenetic study of this genus based on nuclear (rITS) and plastid (accD-psaI, psbJ-petA, ycf6-psbM-trnD) sequences using 27 samples from 13 species. On the basis of this phylogenetic analysis, we provide a solid phylogenetic background for the modern taxonomy of the European members of the genus. Traditionally accepted sections of this tree (i.e., Crypta and Elatinella) were found to be monophyletic; only E. borchoni—found to be a basal member of the genus—has to be excluded from the latter lineage to achieve monophyly. A number of taxonomic conclusions can also be drawn: E. hexandra, a high-ploid species, is most likely a stabilised hybrid between the main sections; E. campylosperma merits full species status based on both molecular and morphological evidence; E. gussonei is a more widespread and genetically diverse species with two main lineages; and the presence of the Asian E. ambigua in the European flora is questionable. The main lineages recovered in this analysis are also supported by a number of synapomorphic morphological characters as well as uniform chromosome counts. Based on all the evidence presented here, two new subsections within Elatinella are described: subsection Hydropipera consisting of the temperate species of the section, and subsection Macropodae including the Mediterranean species of the section.
Collapse
Affiliation(s)
- Gábor Sramkó
- Department of Botany, University of Debrecen, Debrecen, Hungary; MTA-DE "Lendület" Evolutionary Phylogenomics Research Group, Debrecen, Hungary
| | - Attila Molnár V
- Department of Botany, University of Debrecen, Debrecen, Hungary; MTA-DE "Lendület" Evolutionary Phylogenomics Research Group, Debrecen, Hungary
| | - János Pál Tóth
- MTA-DE "Lendület" Behaviourial Ecology Research Group, University of Debrecen , Debrecen , Hungary
| | - Levente Laczkó
- Department of Botany, University of Debrecen , Debrecen , Hungary
| | - Anna Kalinka
- Molecular Biology and Biotechnology Center, Department of Cell Biology, University of Szczecin , Szczecin , Poland
| | - Orsolya Horváth
- Department of Botany, University of Debrecen , Debrecen , Hungary
| | - Lidia Skuza
- Molecular Biology and Biotechnology Center, Department of Cell Biology, University of Szczecin , Szczecin , Poland
| | - Balázs András Lukács
- MTA Centre for Ecological Research, Danube Research Institute, Department of Tisza Research , Debrecen , Hungary
| | - Agnieszka Popiela
- Department of Botany and Nature Conservation, University of Szczecin , Szczecin , Poland
| |
Collapse
|
28
|
Molnár V A, Tóth JP, Sramkó G, Horváth O, Popiela A, Mesterházy A, Lukács BA. Flood induced phenotypic plasticity in amphibious genus Elatine (Elatinaceae). PeerJ 2015; 3:e1473. [PMID: 26713235 PMCID: PMC4690399 DOI: 10.7717/peerj.1473] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 08/08/2015] [Accepted: 11/14/2015] [Indexed: 11/24/2022] Open
Abstract
Vegetative characters are widely used in the taxonomy of the amphibious genus Elatine L. However, these usually show great variation not just between species but between their aquatic and terrestrial forms. In the present study we examine the variation of seed and vegetative characters in nine Elatine species (E. brachysperma, E. californica, E. gussonei, E. hexandra, E. hungarica, E. hydropiper, E. macropoda, E. orthosperma and E. triandra) to reveal the extension of plasticity induced by the amphibious environment, and to test character reliability for species identification. Cultivated plant clones were kept under controlled conditions exposed to either aquatic or terrestrial environmental conditions. Six vegetative characters (length of stem, length of internodium, length of lamina, width of lamina, length of petioles, length of pedicel) and four seed characters (curvature, number of pits / lateral row, 1st and 2nd dimension) were measured on 50 fruiting stems of the aquatic and on 50 stems of the terrestrial form of the same clone. MDA, NPMANOVA Random Forest classification and cluster analysis were used to unravel the morphological differences between aquatic and terrestrial forms. The results of MDA cross-validated and Random Forest classification clearly indicated that only seed traits are stable within species (i.e., different forms of the same species keep similar morphology). Consequently, only seed morphology is valuable for taxonomic purposes since vegetative traits are highly influenced by environmental factors.
Collapse
Affiliation(s)
- Attila Molnár V
- Department of Botany, University of Debrecen, Debrecen, Hungary
| | - János Pál Tóth
- MTA-DE, "Lendület" Behavioural Ecology Research Group, University of Debrecen, Debrecen, Hungary
| | - Gábor Sramkó
- Department of Botany, University of Debrecen, Debrecen, Hungary.,MTA-ELTE-MTM Ecology Research Group, Budapest, Hungary
| | - Orsolya Horváth
- Department of Botany, University of Debrecen, Debrecen, Hungary
| | - Agnieszka Popiela
- Department of Botany and Nature Conservation, University of Szczecin, Szczecin, Poland
| | | | - Balázs András Lukács
- Department of Tisza Research, MTA Centre for Ecological Research, Debrecen, Hungary
| |
Collapse
|
29
|
Cserkész T, Aczél-Fridrich Z, Hegyeli Z, Sugár S, Czabán D, Horváth O, Sramkó G. Rediscovery of the Hungarian birch mouse (Sicista subtilis trizona) in Transylvania (Romania) with molecular characterisation of its phylogenetic affinities. MAMMALIA 2014. [DOI: 10.1515/mammalia-2013-0167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractThe Southern birch mouse (
Collapse
|
30
|
Abstract
Malignant tumors are often accompanied by increased risk for procoagulant activity, thrombosis and embolism. As a marker indicating such disturbancies is D-dimer, a product of fibrinolysis. In this retrospective study almost 300 patients with malignant tumors were evaluated. During LMWH treatment (as thromboprophylaxis) the highest frequency of VTE with worst prognosis occurred in pancreatic cancer (partly due to the late discovery) followed by ovarian, colonic and breast cancers. Also, increased D-dimer level correlated with progression (stages) and high mortality rate. Furthermore, D-dimer showed very similar or better prognostic activity than the clinically widely used classic tumor markers and suggested to use it as an additional value..
Collapse
Affiliation(s)
- Zsuzsanna Nagy
- Department Clinical Oncology, St Imre Hospital, Tétényi út 12-15, 1116 Budapest, Hungary.
| | | | | | | | | | | | | |
Collapse
|
31
|
Csikos M, Horváth O, Petri A, Szendrényi V, Oláh T. [Surgical treatment of acquired, benign esophago-respiratory fistulas]. Zentralbl Chir 2004; 129:104-7. [PMID: 15106040 DOI: 10.1055/s-2004-816284] [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] [Indexed: 10/26/2022]
Abstract
BACKGROUND Acquired, benign esophago-respiratory fistula occurs as a rare complication of different disorders. STUDY DESIGN Over a period of 30 years, 37 patients with acquired, benign esophago-respiratory fistulas were treated at the authors' institutions. 35 of the 37 patients were operated upon. Acute operation involved primary repair of the trachea and esophagus, or intubation of the gullet and/or gastrostomy. Elective operations were performed on 13 patients. RESULTS Complications were observed in 14 patients. There were 4 cases with anastomotic leakage (all of them on the neck). Direct closure was carried out in 2 patients; the remaining 2 cases healed spontaneously. None of the 4 patients died. Seven of the 37 patients died (18.9%). This seems acceptable in view of the severity of the cases and the extension of the operations. CONCLUSIONS 1. The causes of a majority of the esophago-respiratory fistulas in this material are connected with the complications of corrosive injury and peptic stricture of the esophagus. 2. The well-known fact that most of these fistulas occur in the right chest is confirmed. 3. Gastrostomy and/or intubation of the gullet seems to be the best solution for this lesion in the acute cases and in severely ill patients. 4. In elective cases, reconstruction is suggested, if possible in one step.
Collapse
Affiliation(s)
- M Csikos
- Surgical Department, Géza Hetényi County Hospital, Szolnok, Hungary
| | | | | | | | | |
Collapse
|
32
|
Pospíšil M, Horváth O, Fiserová A, Vannucci L, Rossmann P, Bezouška K. NK/T cell endogenous C-type lectin receptor[s] and possible relevance to the cancer immunotherapy. Immunol Lett 1997. [DOI: 10.1016/s0165-2478(97)86560-1] [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: 11/28/2022]
|
33
|
Černý J, Fišerová A, Horváth O, Bezouška K, Pospíšil M, Hořejší V. Association of human NK cell surface receptors NKR-P1 and CD94 with Src-family protein kinases. Immunol Lett 1997. [DOI: 10.1016/s0165-2478(97)86399-7] [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: 11/28/2022]
|
34
|
Cerný J, Fiserová A, Horváth O, Bezouska K, Pospísil M, Horejsí V. Association of human NK cell surface receptors NKR-P1 and CD94 with Src-family protein kinases. Immunogenetics 1997; 46:231-6. [PMID: 9211750 DOI: 10.1007/s002510050267] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Human natural killer (NK) cells express on their surface several members of the C-type lectin family such as NKR-P1, CD94, and NKG2 that are probably involved in recognition of target cells and delivery of signals modulating NK cell cytotoxicity. To elucidate the mechanisms involved in signaling via these receptors, we solubilized in vitro cultured human NK cells by a mild detergent, Brij-58, immunoprecipitated molecular complexes containing the NKR-P1 or CD94 molecules, respectively, by specific monoclonal antibodies, and performed in vitro kinase assays on the immunoprecipitates. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis, autoradiography, and phospho-amino acid analysis revealed the presence of in vitro tyrosine phosphorylated proteins that were subsequently identified by re-precipitation (and/or by western blotting) as the respective C-type lectin molecules and Src family kinases Lck, Lyn, and Fyn. The NKR-P1 and the CD94-containing complexes were independent of each other and both very large, as judged by Sepharose 4B gel chromatography. Crosslinking of NKR-P1 on the cell surface induced transient in vivo tyrosine phosphorylation of cellular protein substrates. These results indicate involvement of the associated Src-family kinases in signaling via the NKR-P1 and CD94 receptors.
Collapse
Affiliation(s)
- J Cerný
- Institute of Molecular Genetics, Academy of Sciences of the Czech Republic, Vídenská 1083, 142 20 Prague 4, Czech Republic
| | | | | | | | | | | |
Collapse
|
35
|
Abstract
Methods of microwave and vacuum-accelerated fixation, dehydration, and paraffin embedding are described, using a new type of vacuum and temperature stabilizable microwave histoprocessor: MFX-800. The whole histoprocessing cycle lasts 3.5-5.5 h, depending on the thickness of the tissue blocks. Well-preserved structural detail, intense staining, and good antigen preservation were achieved with various tissues. This new histoprocessing facility is recommended for routine pathology laboratories in speeding up their processing procedures.
Collapse
Affiliation(s)
- L Kovács
- Department of Pathology in Central Railway Hospital, Budapest, Hungary
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Kovács L, Szende B, Elek G, Lapis K, Horváth O, Hiszek I, Tamási A, Schmidt O. [Experiences with a new vacuum-accelerated microwave histoprocessor]. Orv Hetil 1996; 137:1479-83. [PMID: 9173370] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Methods of microwave and vacuum accelerated fixation, dehydration and paraffin embedding are described. They can be carried out in a new type of vacuum and temperature stabilizable microwave histoprocessor: MFX-800. The whole histoprocessing lasts 3.5-5.5 hours depending on the thickness of the tissue blocks. Preserved structural detail, intensive staining and good antigen preservation were achieved with various tissues. This new histoprocessing facility can be highly recommended for pathology laboratories interested in speeding up the processing procedure, as well as in immunohistochemistry.
Collapse
Affiliation(s)
- L Kovács
- MAV Kórház Patológiai Osztály, Budapest
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Bezouska K, Nepovím A, Horváth O, Pospísil M, Hamann J, Feizi T. CD 69 antigen of human lymphocytes is a calcium-dependent carbohydrate-binding protein. Biochem Biophys Res Commun 1995; 208:68-74. [PMID: 7887967 DOI: 10.1006/bbrc.1995.1306] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
CD69 is a signal transducing molecule of hematopoietic cells. Previous molecular cloning of CD69 has revealed a type II transmembrane orientation and the presence of an extracellular domain related to the Ca(2+)-dependent (C-type) animal lectins. As the predicted amino acid sequence for the lectin-like domain is highly divergent from those of other C-type lectin-like proteins - a feature shared with NKR-P1 of natural killer cells - CD69 and NKR-P1 are among proteins assigned to a separate group, group V. To initiate ligand identification studies, we have prepared soluble forms of CD69 protein by bacterial expression of its extracellular portion. We show that cysteine 68 located in the short membrane-proximal neck region of CD69 which adjoins the C-terminal lectin-like domain is a critical element for dimerization. We have evidence that the soluble dimeric CD69 has a tight association with calcium, a feature shared with NKR-P1, and that it is a carbohydrate-binding protein with N-acetyl-D-glucosamine and N-acetyl-D-galactosamine as the best inhibitors: 4-8 x 10(-5) M giving 50% inhibition of binding to N-acetyl-D-glucosamine neoglycoprotein. Thus, the tight association with calcium and high affinities for carbohydrate binding appear to be features of at least two members of the C-type lectin group V.
Collapse
MESH Headings
- Acetylglucosamine/analogs & derivatives
- Acetylglucosamine/metabolism
- Amino Acid Sequence
- Antigens, CD/biosynthesis
- Antigens, CD/isolation & purification
- Antigens, CD/metabolism
- Antigens, Differentiation, T-Lymphocyte/biosynthesis
- Antigens, Differentiation, T-Lymphocyte/isolation & purification
- Antigens, Differentiation, T-Lymphocyte/metabolism
- Calcium/metabolism
- Chromatography, Gel
- Cloning, Molecular
- Electrophoresis, Polyacrylamide Gel
- Escherichia coli
- Humans
- Killer Cells, Natural/metabolism
- Kinetics
- Lectins/metabolism
- Lectins, C-Type
- Lymphocytes/metabolism
- Molecular Sequence Data
- Molecular Weight
- Monosaccharides/pharmacology
- Recombinant Proteins/biosynthesis
- Recombinant Proteins/isolation & purification
- Recombinant Proteins/metabolism
- Serum Albumin, Bovine/metabolism
Collapse
Affiliation(s)
- K Bezouska
- Department of Biochemistry, Faculty of Science, Charles University Prague, Czech Republic
| | | | | | | | | | | |
Collapse
|
38
|
Bezouska K, Vlahas G, Horváth O, Jinochová G, Fiserová A, Giorda R, Chambers WH, Feizi T, Pospísil M. Rat natural killer cell antigen, NKR-P1, related to C-type animal lectins is a carbohydrate-binding protein. J Biol Chem 1994; 269:16945-52. [PMID: 8207018] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Natural killer receptor protein 1 (NKR-P1, a family of proteins), which is a dimeric transmembrane protein predominantly on rat and murine natural killer cells, contains an extracellular motif related to calcium-dependent animal lectins. The domain architecture of this protein and the finding that its cross-linking with antibody results in activation of natural killer cells make it a promising candidate for a receptor function. We have expressed a full-length NKR-P1 protein of the rat in COS cells and prepared soluble extracellular fragments by controlled proteolysis or by expression of truncated cDNA in bacteria. Dimerization of soluble NKR-P1 is predominantly dependent on the presence of an intact juxta-membrane stalk region and independent of N-glycosylation. Binding and inhibition studies using monosaccharides and neoglycoconjugates indicate that NKR-P1 is a lectin with a preference order of GalNAc > GlcNAc >> Fuc >> Gal > Man. At neutral pH, Ca2+ is tightly associated with the protein such that only a proportion can be removed by 10 mM EGTA. However, NKR-P1 can be decalcified completely at pH 10 with a total loss of carbohydrate binding. After recalcification at pH 8, carbohydrate binding is completely restored. Thus, NKR-P1 differs from other calcium-dependent animal lectins investigated so far in its pattern of monosaccharide recognition and in the tightness of Ca2+ binding.
Collapse
Affiliation(s)
- K Bezouska
- Institute of Biotechnology, Charles University Prague, Czech Republic
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Bezouska K, Vlahas G, Horváth O, Jinochová G, Fiserová A, Giorda R, Chambers W, Feizi T, Pospísil M. Rat natural killer cell antigen, NKR-P1, related to C-type animal lectins is a carbohydrate-binding protein. J Biol Chem 1994. [DOI: 10.1016/s0021-9258(19)89481-4] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
40
|
Horváth A, Horváth O, Stevenson K. Time resolved studies of the photoinduced electron transfer in aqueous solutions of chloro- and cyanocuprate(I) complexes. J Photochem Photobiol A Chem 1992. [DOI: 10.1016/1010-6030(92)85179-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
41
|
Oláh T, Horváth O, Zentai G. [Emergency treatment of corrosive gastrointestinal injuries]. Orv Hetil 1992; 133:1099-102. [PMID: 1579349] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Authors discuss their experience of management for caustic gastrointestinal injury. Importance of urgent endoscopy in establishing the extend of injury is emphasized. In eight out of 12 surgical intervention an esophagogastrectomy were performed. According to their experience in case of serious caustic burn the only hope to save the patients life is the early radical operation.
Collapse
Affiliation(s)
- T Oláh
- Sebészeti Klinika, Szent-Györgyi Albert Orvostudományi Egyetem, Szeged
| | | | | |
Collapse
|
42
|
Rácz I, Pécsi G, Tóth E, Téri N, Horváth O, Goda M. [Morphologic and clinical aspects of chronic gastric erosions]. Orv Hetil 1989; 130:773-6. [PMID: 2710543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Chronic erosions of the stomach are mostly papular lesions of the gastric mucosa with large base, 0.5-1 cm in diameter, often with superficial central depression covered with fibrin, less frequently without it. The typical site of lesion is the antrum the chronic erosions are here manifold, solitary forms are infrequent. In the course of 5694 gastroduodenoscopies the authors observed in 198 patients (5.2%) typical endoscopic picture of chronic erosions. In biopsy samples volcano-type lesions of the mucous membrane characteristic of the disease were found. According to the results the chronic erosions of the stomach are lesions of aspecific symptomatology, the disturbance of the mucosal barrier cannot be made probable. It is important to know the morphological characteristics of the rather frequent independent entity also for separating it from adenomas. Malignant transformation was not found in the material of the authors.
Collapse
|
43
|
|
44
|
Csíkos M, Horváth O, Petri A, Petri I, Imre J. Late malignant transformation of chronic corrosive oesophageal strictures. Langenbecks Arch Chir 1985; 365:231-8. [PMID: 4087989 DOI: 10.1007/bf01459611] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The number of patients with scar carcinoma of the oesophagus developing on the basis of a corrosive stricture seems to have been rising in the past two decades. 36 patients of this kind were treated surgically between 1965 and 1984; this is the second largest series in the literature. The patients with scar cancer comprised 7.2% of the overall oesophageal carcinoma cases; this ratio is currently the highest of all in the literature. The interval between the caustic burn and the diagnosis of scar carcinoma was found to be 46.1 years; this is higher than the 30-35 years generally accepted so far. It was 50.9 years in those patients who drank lye before the age of 12, but 14 years less when it happened in adulthood. The long-term survival time proved to be excellent: 45.6% of the resected cases were alive after 5 years and 14.4% after 10 years. The explanation of the good prognosis lies in the fact that carcinoma developing in a lye stricture is at first surrounded by a rigid scar which allows only its intraluminal growth, and it causes early dysphagia through luminal obstruction. Early dissemination is prevented for the same reason. One-stage resection and replacement is suggested in the radically operable cases. In patients with oesophageal corrosive stricture which needs operation, both a by-pass procedure and resection can be adopted, but it should be pointed out that malignancy may develop even years after the operation in the remaining part of the gullet. Total oesophagectomy is therefore suggested instead of bypass.
Collapse
|
45
|
Horváth O, Csikos M, Petri I, Petri A, Szontágh E, Imre J. [Possible etiologic factors in the development of esophageal cancer]. Orv Hetil 1982; 123:971-6. [PMID: 7078953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
46
|
Petri I, Horváth O, Csikos M, Petri A, Imre J. [Life expectancy of patients operated on for stomach cancer]. Orv Hetil 1981; 122:2703-7. [PMID: 7322567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
47
|
Horváth O, Imre J. [Surgical treatment of an esophagotracheal fistula caused by roentgen therapy for mediastinal Hodgkin's disease]. Orv Hetil 1980; 121:1023-5. [PMID: 7383677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
48
|
Horváth O, Csíkos M, Imre J. [Peptic esophageal strictures of atypical etiology]. Orv Hetil 1979; 120:1365-72. [PMID: 492676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
49
|
Rózsa Z, Fráter L, Horváth O, Imre J. [Intramural esophageal perforation]. Orv Hetil 1979; 120:197-201. [PMID: 760051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
50
|
Horváth O, Pepó J, Fráter L, Imre J. [Treatment of hemorrhaging esophageal varices by cardia resection]. Orv Hetil 1977; 118:1241-2. [PMID: 301259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|