Bálint Fekete

Does dermatitis herpetiformis result in bone loss as coeliac disease does?: a cross sectional study

INTRODUCTION AND OBJECTIVES coeliac disease (CD) and its cutaneous manifestation, dermatitis herpetiformis are both (DH) gluten-sensitive diseases. Metabolic bone disease is common among patients with CD, even in asymptomatic forms. Data are scarce about bone density in patients with dermatitis herpetiformis. The aim of our study was to compare bone mineral density (BMD) of celiac and dermatitis herpetiformis patients. METHODS 34 coeliac patients, 53 with dermatitis herpetiformis and 42 healthy controls were studied. The mean age was 38.0 +/- 12.1, 32.18 +/- 14.95, 35.33 +/- 10.41 years in CD, dermatitis herpetiformis, and healthy controls, respectively. Bone mineral density of the lumbar spine, the left femoral neck and radius were measured by dual-energy X-ray absorptiometry. Low bone density, osteopenia and osteoporosis were defined as a body mass density (BMD) T-score between 0 and -1, between -1 and -2.5, and under -2.5, respectively. RESULTS at lumbar region, consisting of dominantly trabecular compartment, a decreased BMD was detected in 49 % (n = 26) patients with dermatitis herpetiformis, 62 % (n = 21) of CD patients, and 29 % (n = 12) of healthy controls, respectively. Lower BMD were measured at the lumbar region in dermatitis herpetiformis and CD compared to healthy subjects (0.993 +/- 0.136 g/cm2 and 0.880 +/- 0.155 g/cm2 vs. 1.056 +/- 0.126 g/cm2; p < 0.01). Density of bones consisting of dominantly cortical compartment (femoral neck) did not differ in dermatitis herpetiformis and healthy subjects. CONCLUSIONS our results show that a low bone mass is also frequent among patients with dermatitis herpetiformis. Bone mineral content in these patients is significantly lower in those parts of the skeleton which contain more trabecular than cortical bone.

Vitamin D level in Hungarian patients with inflammatory bowel diseases

INTRODUCTION Vitamin D has an important role in the immune regulation. Vitamin D is essential for innate and adaptive immune systems and it plays a significant role in the formation of immune tolerance, as well. AIM Vitamin D deficiency has been observed in patients with inflammatory bowel diseases in Western Europe, but there is no data available from Eastern Europe. METHOD The study included 169 patients with inflammatory bowel disease. RESULTS The median vitamin D level was 22.7±10.6 ng/ml. Only 20% of the patients had adequate vitamin D level (>30 ng/ml), 52% had vitamin D insufficiency (15-30 ng/ml), and 28% of them had severe vitamin D deficiency (<15 ng/ml). Vitamin D concentration failed to correlate with clinical activity indexes (partial Mayo score: r = -0.143; Crohns disease activity index: r = -0.253) and with inflammatory parameters (C-reactive protein: r = 0.008; erythrocyte sedimentation rate: r = 0.012). CONCLUSIONS Since vitamin D deficiency can be frequently observed in Hungarian patients with inflammatory bowel disease, its level should be tested in these patients.

Implementation of personalized medicine in Central-Eastern Europe: pitfalls and potentials based on citizen’s attitude

ObjectiveNext-generation sequencing is increasingly utilized worldwide as a research and diagnostic tool and is anticipated to be implemented into everyday clinical practice. Since Central-Eastern European attitude toward genetic testing, especially broad genetic testing, is not well known, we performed a survey on this issue among Hungarian participants.MethodsA self-administered questionnaire was distributed among patients and patient relatives at our neurogenetic outpatient clinic. Members of the general population were also recruited via public media. We used chi-square testing and binary logistic regression to examine factors influencing attitude.ResultsWe identified a mixed attitude toward genetic testing. Access to physician consultation positively influenced attitude. A higher self-determined genetic familiarity score associated with higher perceived genetic influence score, which in turn associated with greater willingness to participate in genetic testing. Medical professionals constituted a skeptical group.ConclusionsWe think that given the controversies and complexities of the next-generation sequencing field, the optimal clinical translation of NGS data should be performed in institutions which have the unique capability to provide interprofessional health education, transformative biomedical research, and crucial patient care. With optimization of the clinical translational process, improvement of genetic literacy may increase patient engagement and empowerment.Relevance of the article for predictive, preventive, and personalized medicineThe paper highlights that in countries with relatively low-genetic literacy, a special strategy is needed to enhance the implementation of personalized medicine.

Prevalence of gastric polypoid lesions at an endoscopic facility

Bevezetes: A gyomor polypoid elvaltozasainak hazai előfordulasi gyakorisaga nem ismert. Cel: A szerzők celul tűztek ki a Semmelweis Egyetem, II. Belgyogyaszati Klinika endoszkopos centrumaban a gyomorpolip gyakorisaganak es az azt befolyasolo koroki tenyezőknek a vizsgalatat. Modszerek: 16 honap alatt vegzett felső panendoszkopiak egyseges szovettani es klinikai adatait ertekeltek. Eredmenyek: 4174 gasztroszkopia soran 193 (4,62%) polipot eszleltek. A betegek atlageletkora a diagnoziskor 65,9±12,7 ev volt. A polipok 33,67%-a hyperplasticus, 31,09%-a fundusmirigypolip, 2,07%-a malignus volt. A fundusmirigypolipos betegek koreben gyakoribb volt a protonpumpagatlo-hasznalat (p = 0,007), mig a hyperplasticus polipos csoportban gyakrabban talaltunk idult gastritist (p = 0,032). A Helicobacter pylori-fertőzottseg egyik szovettanu polip jelenletevel sem fuggott ossze. Kovetkeztetes: Hazai betegek koreben gyakoribb a gyomorpolip, mint az az irodalmi adatok alapjan varhato lenne. A fundusmirigypolipok gyakoribbak tartos protonpumpagatlo-hasznalo betegekben, a hyperplasticus polipok előfordulasa pedig az idult gastritisek gyakorisagaval mutat osszefuggest. Orv. Hetil., 2013, 154, 770–774. | Background: The prevalence of gastric polyps is unknown in Hungary. Aim: The aim of the authors was to assess the prevalence of polypoid lesions of the stomach in the endoscopic centre of the 2nd Department of Medicine, Semmelweis University. Methods: Results of upper gastrointestinal endoscopies carried out between March 2010 and June 2011 were analysed. Results: 193 cases with polyps were diagnosed in 4174 endoscopies (4.62%). Hyperplastic polyps, fundic gland polyps and malignant lesion were detected in 33.67%, 31.09% and 2.07% of the cases, respectively. Proton pump inhibitor use was more frequent among patients diagnosed with fundus gland polyps (p = 0.007), while hyperplastic polyps were diagnosed more frequently in patients with chronic gastritis (p = 0.032). Conclusions: The frequency of gastric polyps was higher than expected from data published in the literature. Long-term proton pump-inhibitor use and chronic gastritis were associated with fundus gland and hyperplastic polyps, respectively. Orv. Hetil., 2013, 154, 770–774.BACKGROUND The prevalence of gastric polyps is unknown in Hungary. AIM The aim of the authors was to assess the prevalence of polypoid lesions of the stomach in the endoscopic centre of the 2nd Department of Medicine, Semmelweis University. METHODS Results of upper gastrointestinal endoscopies carried out between March 2010 and June 2011 were analysed. RESULTS 193 cases with polyps were diagnosed in 4174 endoscopies (4.62%). Hyperplastic polyps, fundic gland polyps and malignant lesion were detected in 33.67%, 31.09% and 2.07% of the cases, respectively. Proton pump inhibitor use was more frequent among patients diagnosed with fundus gland polyps (p = 0.007), while hyperplastic polyps were diagnosed more frequently in patients with chronic gastritis (p = 0.032). CONCLUSIONS The frequency of gastric polyps was higher than expected from data published in the literature. Long-term proton pump-inhibitor use and chronic gastritis were associated with fundus gland and hyperplastic polyps, respectively.

Prevalence of gastric polypoid lesions in a single endoscopic centre

Bevezetes: A gyomor polypoid elvaltozasainak hazai előfordulasi gyakorisaga nem ismert. Cel: A szerzők celul tűztek ki a Semmelweis Egyetem, II. Belgyogyaszati Klinika endoszkopos centrumaban a gyomorpolip gyakorisaganak es az azt befolyasolo koroki tenyezőknek a vizsgalatat. Modszerek: 16 honap alatt vegzett felső panendoszkopiak egyseges szovettani es klinikai adatait ertekeltek. Eredmenyek: 4174 gasztroszkopia soran 193 (4,62%) polipot eszleltek. A betegek atlageletkora a diagnoziskor 65,9±12,7 ev volt. A polipok 33,67%-a hyperplasticus, 31,09%-a fundusmirigypolip, 2,07%-a malignus volt. A fundusmirigypolipos betegek koreben gyakoribb volt a protonpumpagatlo-hasznalat (p = 0,007), mig a hyperplasticus polipos csoportban gyakrabban talaltunk idult gastritist (p = 0,032). A Helicobacter pylori-fertőzottseg egyik szovettanu polip jelenletevel sem fuggott ossze. Kovetkeztetes: Hazai betegek koreben gyakoribb a gyomorpolip, mint az az irodalmi adatok alapjan varhato lenne. A fundusmirigypolipok gyakoribbak tartos protonpumpagatlo-hasznalo betegekben, a hyperplasticus polipok előfordulasa pedig az idult gastritisek gyakorisagaval mutat osszefuggest. Orv. Hetil., 2013, 154, 770–774. | Background: The prevalence of gastric polyps is unknown in Hungary. Aim: The aim of the authors was to assess the prevalence of polypoid lesions of the stomach in the endoscopic centre of the 2nd Department of Medicine, Semmelweis University. Methods: Results of upper gastrointestinal endoscopies carried out between March 2010 and June 2011 were analysed. Results: 193 cases with polyps were diagnosed in 4174 endoscopies (4.62%). Hyperplastic polyps, fundic gland polyps and malignant lesion were detected in 33.67%, 31.09% and 2.07% of the cases, respectively. Proton pump inhibitor use was more frequent among patients diagnosed with fundus gland polyps (p = 0.007), while hyperplastic polyps were diagnosed more frequently in patients with chronic gastritis (p = 0.032). Conclusions: The frequency of gastric polyps was higher than expected from data published in the literature. Long-term proton pump-inhibitor use and chronic gastritis were associated with fundus gland and hyperplastic polyps, respectively. Orv. Hetil., 2013, 154, 770–774.BACKGROUND The prevalence of gastric polyps is unknown in Hungary. AIM The aim of the authors was to assess the prevalence of polypoid lesions of the stomach in the endoscopic centre of the 2nd Department of Medicine, Semmelweis University. METHODS Results of upper gastrointestinal endoscopies carried out between March 2010 and June 2011 were analysed. RESULTS 193 cases with polyps were diagnosed in 4174 endoscopies (4.62%). Hyperplastic polyps, fundic gland polyps and malignant lesion were detected in 33.67%, 31.09% and 2.07% of the cases, respectively. Proton pump inhibitor use was more frequent among patients diagnosed with fundus gland polyps (p = 0.007), while hyperplastic polyps were diagnosed more frequently in patients with chronic gastritis (p = 0.032). CONCLUSIONS The frequency of gastric polyps was higher than expected from data published in the literature. Long-term proton pump-inhibitor use and chronic gastritis were associated with fundus gland and hyperplastic polyps, respectively.

A gyomor polypoid képleteinek gyakorisága egy endoszkópos centrumban

Bevezetes: A gyomor polypoid elvaltozasainak hazai előfordulasi gyakorisaga nem ismert. Cel: A szerzők celul tűztek ki a Semmelweis Egyetem, II. Belgyogyaszati Klinika endoszkopos centrumaban a gyomorpolip gyakorisaganak es az azt befolyasolo koroki tenyezőknek a vizsgalatat. Modszerek: 16 honap alatt vegzett felső panendoszkopiak egyseges szovettani es klinikai adatait ertekeltek. Eredmenyek: 4174 gasztroszkopia soran 193 (4,62%) polipot eszleltek. A betegek atlageletkora a diagnoziskor 65,9±12,7 ev volt. A polipok 33,67%-a hyperplasticus, 31,09%-a fundusmirigypolip, 2,07%-a malignus volt. A fundusmirigypolipos betegek koreben gyakoribb volt a protonpumpagatlo-hasznalat (p = 0,007), mig a hyperplasticus polipos csoportban gyakrabban talaltunk idult gastritist (p = 0,032). A Helicobacter pylori-fertőzottseg egyik szovettanu polip jelenletevel sem fuggott ossze. Kovetkeztetes: Hazai betegek koreben gyakoribb a gyomorpolip, mint az az irodalmi adatok alapjan varhato lenne. A fundusmirigypolipok gyakoribbak tartos protonpumpagatlo-hasznalo betegekben, a hyperplasticus polipok előfordulasa pedig az idult gastritisek gyakorisagaval mutat osszefuggest. Orv. Hetil., 2013, 154, 770–774. | Background: The prevalence of gastric polyps is unknown in Hungary. Aim: The aim of the authors was to assess the prevalence of polypoid lesions of the stomach in the endoscopic centre of the 2nd Department of Medicine, Semmelweis University. Methods: Results of upper gastrointestinal endoscopies carried out between March 2010 and June 2011 were analysed. Results: 193 cases with polyps were diagnosed in 4174 endoscopies (4.62%). Hyperplastic polyps, fundic gland polyps and malignant lesion were detected in 33.67%, 31.09% and 2.07% of the cases, respectively. Proton pump inhibitor use was more frequent among patients diagnosed with fundus gland polyps (p = 0.007), while hyperplastic polyps were diagnosed more frequently in patients with chronic gastritis (p = 0.032). Conclusions: The frequency of gastric polyps was higher than expected from data published in the literature. Long-term proton pump-inhibitor use and chronic gastritis were associated with fundus gland and hyperplastic polyps, respectively. Orv. Hetil., 2013, 154, 770–774.BACKGROUND The prevalence of gastric polyps is unknown in Hungary. AIM The aim of the authors was to assess the prevalence of polypoid lesions of the stomach in the endoscopic centre of the 2nd Department of Medicine, Semmelweis University. METHODS Results of upper gastrointestinal endoscopies carried out between March 2010 and June 2011 were analysed. RESULTS 193 cases with polyps were diagnosed in 4174 endoscopies (4.62%). Hyperplastic polyps, fundic gland polyps and malignant lesion were detected in 33.67%, 31.09% and 2.07% of the cases, respectively. Proton pump inhibitor use was more frequent among patients diagnosed with fundus gland polyps (p = 0.007), while hyperplastic polyps were diagnosed more frequently in patients with chronic gastritis (p = 0.032). CONCLUSIONS The frequency of gastric polyps was higher than expected from data published in the literature. Long-term proton pump-inhibitor use and chronic gastritis were associated with fundus gland and hyperplastic polyps, respectively.

Mo1379 Vitamin D Level Doesn't Correlate With Disease Extent and Severity in Hungarian Patients With Inflammatory Bowel Diseases

Background: Many patients with inflammatory bowel disease (IBD) face multiple problems, including medical, surgical, nutritional, social, psychiatric related to their disease and require a holistic approach to care. To address this need, a multidisciplinary, prompt access IBD clinic was established at McMaster University Medical Centre, Hamilton, Canada. The prevalence of anxiety and depression among the patients attending the clinic is not known. Methods: Interdisciplinary team members consisting of gastroenterologists, surgeon, psychiatrists, nurse practitioner and dietitian providing prompt access holistic care for patients with IBD. All patients with IBD were assessed for demographic characteristics, quality of life using the Short Form-12 (SF-12), and psychological morbidity using the Hospital Anxiety and Depression Scale (HADS). The SF-12 has two components; physical composite score (PCS) and mental composite score (MCS); if either score is ,50 it was considered abnormal. HADS score can range from 0-42 and a score of .11 was considered abnormal. Results: The mean (SD) age of the 67 patients (males, 36%) was 35 (13) yrs. The majority (63%) had received college education. Of them, 40% had full-time employment, 18% had parttime employment, 24% were unemployed and 18% were on disability/sick leave. Of the 67 patients, 45% were in a stable marital relationship, 43% were single and 10% were either divorced or separated. The mean (SD) PCS was 41 (11) and MCS was 43 (12). The PCS was abnormal in 73% and MCS in 65% of the patients. HADS scores indicated that 75% were anxious/ depressed, while 8% had borderline anxiety/depression and 17% had normal scores. HADS scores showed a high degree of correlation with MCS (r=-0.717; p ,0.001) but no relationship to PCS, ESR or CRP. HADS scores were lower in those with higher income (.60,000

D-vitamin-szint mérése hazai gyulladásos bélbetegekben | Vitamin D level in Hungarian patients with inflammatory bowel diseases

/yr) than those with lower income (15±8 vs 21±6; p=0.037); and in those who had full time employment compared to those without (13±7.6 vs 17±8; p=0.05). The PCS showed a negative correlation with ESR (rho=-0.25; p=0.048) and CRP (rho=-0.25; p= 0.05). Only 27% (13/49) of the patients with abnormal HADS score received professional psychiatric help. Conclusions: Patients with IBD have a high prevalence of anxiety and depression. Anxiety and depression was found more often in those with lower income and no full time employment.. HADS score did not show any relationship to disease activity or physical functional capability. Patients with IBD need active evaluation for presence of underlying anxiety or depression.