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  1. Article ; Online: Precision Medicine in Pancreatitis: The Future of Acute Pancreatitis Care.

    Garami, Andras / Hegyi, Peter

    Function (Oxford, England)

    2023  Volume 4, Issue 3, Page(s) zqad015

    Abstract: Acute pancreatitis (AP) continues to present a substantial burden to patients and healthcare personnel. Despite its occasionally severe progression and high mortality rate, there is no specific therapy that could be routinely applied in patients with AP. ...

    Abstract Acute pancreatitis (AP) continues to present a substantial burden to patients and healthcare personnel. Despite its occasionally severe progression and high mortality rate, there is no specific therapy that could be routinely applied in patients with AP. Here, we review treatment possibilities in AP, describe how the treatment approaches have changed in pancreatic cancer as an analogy, and point out potential causes for the failure of clinical trials on AP. We highlight that instead of attempting to discover generalized treatment options that could be used in any AP patient, it is time for a paradigm shift in the treatment of AP, which would help to focus more on individual patients or specific patient subpopulations when designing clinical trials and therapeutic approaches (similarly as in pancreatic cancer). Since the recruitment of specific patient subpopulations with AP could take excessive time if clinical centers work separately, the development of precision medicine in AP would require to establish an expert committee, eg, Pancreatitis Precision Medicine Interest Group, which could organize and coordinate the activities of the joined centers. With the joined forces of expert clinicians and leading centers, a new era could start in the treatment of AP, in which personalized treatment options could be discovered and introduced to efficiently reduce the burden of the disease on patients and healthcare workers.
    MeSH term(s) Humans ; Pancreatitis/diagnosis ; Precision Medicine/adverse effects ; Acute Disease ; Pancreatic Neoplasms/complications ; Pancreatic Neoplasms
    Language English
    Publishing date 2023-04-05
    Publishing country England
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ISSN 2633-8823
    ISSN (online) 2633-8823
    DOI 10.1093/function/zqad015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Lactated Ringer's Solution Reduces Severity, Mortality, Systemic and Local Complications in Acute Pancreatitis: A Systematic Review and Meta-Analysis.

    Ocskay, Klementina / Mátrai, Péter / Hegyi, Péter / Párniczky, Andrea

    Biomedicines

    2023  Volume 11, Issue 2

    Abstract: Fluid therapy is the cornerstone of early supportive therapy in acute pancreatitis (AP). Regrettably, the type of fluid is still debated among clinicians, despite recent evidence from randomized controlled trials (RCTs). We aimed to incorporate all ... ...

    Abstract Fluid therapy is the cornerstone of early supportive therapy in acute pancreatitis (AP). Regrettably, the type of fluid is still debated among clinicians, despite recent evidence from randomized controlled trials (RCTs). We aimed to incorporate all evidence from RCTs comparing lactated Ringer's solution (LR) with normal saline (NS) in adult and pediatric AP patients, with particular emphasis on clinically relevant outcomes. We evaluated RCTs comparing intravenous fluid resuscitation with LR to NS in adult or pediatric AP patients according to a prospectively registered protocol (CRD42021224542). Moderate-to-severe AP (MSAP), mortality, length of hospitalization (LoH), need for intensive care, the incidence of systemic (organ failure, OF) and local complications (in total), necrosis and pseudocyst formation were analyzed separately. Risk ratio (RR) and median difference (MD) were calculated with 95% confidence intervals (CI) using a random effect model. Risk of bias and quality of evidence were assessed. Altogether, 8 eligible RCTs were found, including 557 patients (LR: 278; NS: 279). LR reduced the risk of MSAP by 31% (RR: 0.59, 95% CI: 0.36-0.97, high quality) and the risk of death by 62% (RR: 0.48; 95% CI: 0.24-0.98, very low quality). LR was associated with a significantly lower risk of need for intensive care (RR: 0.50, 95% CI: 0.33-0.77), OF (RR: 0.78, 95% CI: 0.61-0.99) and local complications (RR: 0.64, 95% CI: 0.46-0.89). No significant risk reduction was observed for LoH (MD: -0.57 days, CI: -1.33-0.19), necrosis, pseudocyst and inflammatory parameters by LR compared to NS. LR reduces severity, mortality, need of intensive care and systemic and local complications in AP.
    Language English
    Publishing date 2023-01-23
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2720867-9
    ISSN 2227-9059
    ISSN 2227-9059
    DOI 10.3390/biomedicines11020321
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  3. Article ; Online: Necrotic amplification loop in acute pancreatitis: pancreatic stellate cells and nitric oxide are important players in the development of the disease.

    Hegyi, Péter

    The Journal of physiology

    2018  Volume 596, Issue 14, Page(s) 2679–2680

    MeSH term(s) Acinar Cells ; Calcium ; Humans ; Nitric Oxide ; Pancreas, Exocrine ; Pancreatic Stellate Cells ; Pancreatitis
    Chemical Substances Nitric Oxide (31C4KY9ESH) ; Calcium (SY7Q814VUP)
    Language English
    Publishing date 2018-04-19
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 3115-x
    ISSN 1469-7793 ; 0022-3751
    ISSN (online) 1469-7793
    ISSN 0022-3751
    DOI 10.1113/JP275930
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Morphology of the papilla can predict procedural safety and efficacy of ERCP-a systematic review and meta-analysis.

    Tari, Edina / Gagyi, Endre Botond / Rancz, Anett / Veres, Dániel Sándor / Váncsa, Szilárd / Hegyi, Péter Jenő / Hagymási, Krisztina / Hegyi, Péter / Erőss, Bálint

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 7341

    Abstract: Endoscopic Retrograde Cholangiopancreatography (ERCP) is the primary therapeutic procedure for pancreaticobiliary disorders, and studies highlighted the impact of papilla anatomy on its efficacy and safety. Our objective was to quantify the influence of ... ...

    Abstract Endoscopic Retrograde Cholangiopancreatography (ERCP) is the primary therapeutic procedure for pancreaticobiliary disorders, and studies highlighted the impact of papilla anatomy on its efficacy and safety. Our objective was to quantify the influence of papilla morphology on ERCP outcomes. We systematically searched three medical databases in September 2022, focusing on studies detailing the cannulation process or the rate of adverse events in the context of papilla morphology. The Haraldsson classification served as the primary system for papilla morphology, and a pooled event rate with a 95% confidence interval was calculated as the effect size measure. Out of 17 eligible studies, 14 were included in the quantitative synthesis. In studies using the Haraldsson classification, the rate of difficult cannulation was the lowest in type I papilla (26%), while the highest one was observed in the case of type IV papilla (41%). For post-ERCP pancreatitis, the event rate was the highest in type II papilla (11%) and the lowest in type I and III papilla (6-6%). No significant difference was observed in the cannulation failure and post-ERCP bleeding event rates between the papilla types. In conclusion, certain papilla morphologies are associated with a higher rate of difficult cannulation and post-ERCP pancreatitis.
    MeSH term(s) Humans ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Catheterization/methods ; Ampulla of Vater/surgery ; Sphincterotomy, Endoscopic/adverse effects ; Pancreatitis/etiology
    Language English
    Publishing date 2024-03-28
    Publishing country England
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-57758-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Reply.

    Erőss, Bálint / Hegyi, Péter

    Gastroenterology

    2021  Volume 160, Issue 7, Page(s) 2628–2629

    Language English
    Publishing date 2021-02-10
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2021.02.018
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    Zs.MO 572: Show issues

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  6. Article ; Online: CFTR-beyond the airways: Recent findings on the role of the CFTR channel in the pancreas, the intestine and the kidneys.

    Hegyi, Peter / Seidler, Ursula / Kunzelmann, Karl

    Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

    2023  Volume 22 Suppl 1, Page(s) S17–S22

    Abstract: With increased longevity of patients suffering from cystic fibrosis, and widespread lung transplantation facilities, the sequelae of defective CFTR in other organs than the airways come to the fore. This minireview highlights recent scientific progress ... ...

    Abstract With increased longevity of patients suffering from cystic fibrosis, and widespread lung transplantation facilities, the sequelae of defective CFTR in other organs than the airways come to the fore. This minireview highlights recent scientific progress in the understanding of CFTR function in the pancreas, the intestine and the kidney, and explores potential therapeutic strategies to combat defective CFTR function in these organs.
    MeSH term(s) Humans ; Cystic Fibrosis/genetics ; Cystic Fibrosis/metabolism ; Cystic Fibrosis Transmembrane Conductance Regulator/genetics ; Intestines ; Kidney ; Pancreas
    Chemical Substances CFTR protein, human ; Cystic Fibrosis Transmembrane Conductance Regulator (126880-72-6)
    Language English
    Publishing date 2023-01-06
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2084724-5
    ISSN 1873-5010 ; 1569-1993
    ISSN (online) 1873-5010
    ISSN 1569-1993
    DOI 10.1016/j.jcf.2022.12.017
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  7. Article ; Online: Acute Pancreatitis Severity Prediction

    Dorottya Tarján / Péter Hegyi

    Journal of Clinical Medicine, Vol 12, Iss 1, p

    It Is Time to Use Artificial Intelligence

    2022  Volume 290

    Abstract: The clinical course of acute pancreatitis (AP) can be variable depending on the severity of the disease, and it is crucial to predict the probability of organ failure to initiate early adequate treatment and management. Therefore, possible high-risk ... ...

    Abstract The clinical course of acute pancreatitis (AP) can be variable depending on the severity of the disease, and it is crucial to predict the probability of organ failure to initiate early adequate treatment and management. Therefore, possible high-risk patients should be admitted to a high-dependence unit. For risk assessment, we have three options: (1) There are univariate biochemical markers for predicting severe AP. One of their main characteristics is that the absence or excess of these factors affects the outcome of AP in a dose-dependent manner. Unfortunately, all of these parameters have low accuracy; therefore, they cannot be used in clinical settings. (2) Score systems have been developed to prognosticate severity by using 4–25 factors. They usually require multiple parameters that are not measured on a daily basis, and they often require more than 24 h for completion, resulting in the loss of valuable time. However, these scores can foresee specific organ failure or severity, but they only use dichotomous parameters, resulting in information loss. Therefore, their use in clinical settings is limited. (3) Artificial intelligence can detect the complex nonlinear relationships between multiple biochemical parameters and disease outcomes. We have recently developed the very first easy-to-use tool, EASY-APP, which uses multiple continuous variables that are available at the time of admission. The web-based application does not require all of the parameters for prediction, allowing early and easy use on admission. In the future, prognostic scores should be developed with the help of artificial intelligence to avoid information loss and to provide a more individualized risk assessment.
    Keywords machine learning ; albumin ; CRP ; WBC ; BISAP ; mortality ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-12-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Bile as a key aetiological factor of acute but not chronic pancreatitis: a possible theory revealed.

    Hegyi, Péter

    The Journal of physiology

    2016  Volume 594, Issue 21, Page(s) 6073–6074

    Language English
    Publishing date 2016-11-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 3115-x
    ISSN 1469-7793 ; 0022-3751
    ISSN (online) 1469-7793
    ISSN 0022-3751
    DOI 10.1113/JP273108
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  9. Article ; Online: Blockade of calcium entry provides a therapeutic window in acute pancreatitis.

    Hegyi, Péter

    The Journal of physiology

    2016  Volume 594, Issue 2, Page(s) 257

    MeSH term(s) Acute Disease ; Calcium/metabolism ; Calcium Signaling ; Humans ; Pancreatitis/drug therapy
    Chemical Substances Calcium (SY7Q814VUP)
    Language English
    Publishing date 2016-01-15
    Publishing country England
    Document type Comment ; Journal Article
    ZDB-ID 3115-x
    ISSN 1469-7793 ; 0022-3751
    ISSN (online) 1469-7793
    ISSN 0022-3751
    DOI 10.1113/JP271710
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  10. Article: ChatGPT for scientific writing - The coexistence of opportunities and challenges.

    Zhou, Liangbin / Wu, Alex Chao / Hegyi, Péter / Wen, Chunyi / Qin, Ling

    Journal of orthopaedic translation

    2024  Volume 44, Page(s) A1–A3

    Language English
    Publishing date 2024-02-06
    Publishing country Singapore
    Document type Editorial
    ZDB-ID 2747531-1
    ISSN 2214-031X
    ISSN 2214-031X
    DOI 10.1016/j.jot.2024.01.005
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