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| 1 | Body-mass index correlates with severity and mortality in acute pancreatitis: A meta-analysis显示文摘BACKGROUND Obesity rates have increased sharply in recent decades. As there is a growing number of cases in which acute pancreatitis(AP) is accompanied by obesity, we found it clinically relevant to investigate how body-mass index(BMI) affects the outcome of the disease.AIM To quantify the association between subgroups of BMI and the severity and mortality of AP.METHODS A meta-analysis was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA) Protocols. Three databases(PubMed, EMBASE and the Cochrane Library) were searched for articles containing data on BMI, disease severity and mortality rate for AP. Englishlanguage studies from inception to 19 June 2017 were checked against our predetermined eligibility criteria. The included articles reported all AP cases with no restriction on the etiology of the disease. Only studies that classified AP cases according to the Atlanta Criteria were involved in the severity analyses. Odds ratios(OR) and mean differences(MD) were pooled using the random effects model with the DerSimonian-Laird estimation and displayed on forest plots. The meta-analysis was registered in PROSPERO under number CRD42017077890.RESULTS A total of 19 articles were included in our meta-analysis containing data on 9997 patients. As regards severity, a subgroup analysis showed a direct association between AP severity and BMI. BMI < 18.5 had no significant effect on severity;however, BMI > 25 had an almost three-fold increased risk for severe AP in comparison to normal BMI(OR = 2.87, 95%CI: 1.90-4.35, P < 0.001). Importantly,the mean BMI of patients with severe AP is higher than that of the non-severe group(MD = 1.79, 95%CI: 0.89-2.70, P < 0.001). As regards mortality, death rates among AP patients are the highest in the underweight and obese subgroups. A BMI < 18.5 carries an almost two-fold increase in risk of mortality compared to normal BMI(OR = 1.82, 95%CI: 1.32-2.50, P < 0.001). However, the chance of mortality is almost equal in the normal BMI and BMI 25-30 subgroups. A BMI >30 results in a three times higher risk of mortality in comparison to a BMI < 30(OR = 2.89, 95%CI: 1.10-7.36, P = 0.026).CONCLUSION Our findings confirm that a BMI above 25 increases the risk of severe AP, while a BMI > 30 raises the risk of mortality. A BMI < 18.5 carries an almost two times higher risk of mortality in AP. | Dalma Dobszai Péter Mátrai Zoltan Gyongyi Dezso Csupor Judit Bajor Balint Eross Alexandra Mikó Lajos Szakó Agnes Meczker Roland Hágendorn Katalin Márta Andrea Szentesi Péter Hegyi on behalf of the Hungarian Pancreatic Study Group | 2019 | World Journal of Gastroenterology2019，25，6： | 11 |
| 2 | Intralesional steroid is beneficial in benign refractory esophageal strictures:A meta-analysis显示文摘AIM To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory esophageal strictures.METHODS A comprehensive search was performed in three databases from inception to 10 April 2017 to identify trials, comparing the efficacy of endoscopic dilation to dilation combined with intralesional steroid injections. Following the data extraction, meta-analytical calculations were performed on measures of outcome by the randomeffects method of Der Simonian and Laird. Heterogeneity of the studies was tested by Cochrane's Q and I^2 statistics. Risk of quality and bias was assessed by the Newcastle Ottawa Scale and JADAD assessment tools.RESULTS Eleven articles were identified suitable for analyses, involving 343 patients, 235 cases and 229 controls in total. Four studies used crossover design with 121 subjects enrolled. The periodic dilation index(PDI) was comparable in 4 studies, where the pooled result showed a significant improvement of PDI in the steroid group(MD:-1.12 dilation/month, 95% CI:-1.99 to -0.25 P = 0.012; I^2 = 74.4%). The total number of repeat dilations(TNRD) was comparable in 5 studies and showed a non-significant decrease(MD:-1.17, 95%CI:-0.24-0.05, P = 0.057; I^2 = 0), while the dysphagia score(DS) was comparable in 5 studies and did not improve(SMD: 0.35, 95%CI:-0.38, 1.08, P = 0.351; I^2 = 83.98%) after intralesional steroid injection.CONCLUSION Intralesional steroid injection increases the time between endoscopic dilations of benign refractory esophageal strictures. However, its potential role needs further research. | László Szapáry Benedek Tinusz Nelli Farkas Katalin Márta Lajos Szakó Agnes Meczker Roland Hágendorn Judit Bajor Aron Vincze Zoltan Gyongyi Alexandra Mikó Dezso Csupor Péter Hegyi Balint Eross | 2018 | World Journal of Gastroenterology2018，24，21： | 7 |
| 3 | Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis显示文摘AIM To understand the influence of chronic kidney disease(CKD) on mortality, need for transfusion and rebleeding in gastrointestinal(GI) bleeding patients.METHODS A systematic search was conducted in three databases for studies on GI bleeding patients with CKD or endstage renal disease(ESRD) with data on outcomes of mortality, transfusion requirement, rebleeding rate and length of hospitalization(LOH). Calculations were performed with Comprehensive Meta-Analysis software using the random effects model. Heterogeneity was tested by using Cochrane's Q and I2 statistics. Mean difference(MD) and OR(odds ratio) were calculated.RESULTS1063 articles(EMBASE: 589; PubM ed: 459; Cochrane: 15) were found in total. 5 retrospective articles and 1 prospective study were available for analysis. These 6 articles contained data on 406035 patients, of whom 51315 had impaired renal function. The analysis showed a higher mortality in the CKD group(OR = 1.786, 95%CI: 1.689-1.888, P < 0.001) and the ESRD group(OR = 2.530, 95%CI: 1.386-4.616, P = 0.002), and a rebleeding rate(OR = 2.510, 95%CI: 1.521-4.144, P < 0.001) in patients with impaired renal function. CKD patients required more unit red blood cell transfusion(MD = 1.863, 95%CI: 0.812-2.915, P < 0.001) and spent more time in hospital(MD = 13.245, 95%CI: 6.886-19.623, P < 0.001) than the controls.CONCLUSION ESRD increases mortality, need for transfusion, rebleeding rate and LOH among GI bleeding patients. Prospective patient registries and observational clinical trials are crucially needed. | Roland Hágendorn Nelli Farkas Aron Vincze Zoltán Gyongyi Dezso Csupor Judit Bajor Bálint Eross Péter Csécsei Andrea Vasas Zsolt Szakács László Szapáry Péter Hegyi Alexandra Mikó | 2017 | World Journal of Gastroenterology2017，23，47： | 3 |
| 4 | Qualitative and quantita- tive analysis of acontitine-type and lipo-alkaloids of Aconitum car- michaeli roots 显示文摘 | Csupor D Wenzig ME Zupko I | 2009 | J Chromatogr A2009，1216，11： | 1 |
| 5 | Bisnorditerpene, norditerpene, and lipo-alkaloids from Aconitum toxicum显示文摘 | Csupor D Forgo P Wenzig EM | 2008 | J Natu Prod2008，71，10： | 1 |
| 6 | C19and C20 diterpene alkaloids from Aconitum toxicum RcHB 显示文摘 | Csupor D Forgo P Csedo K | 2006 | Helv Chim Acta2006，89，12： | 1 |
| 7 | Qualitative and quantitative analysis of aconitine-type and lipo-alkaloids of Aconitum carmichaelii roots 显示文摘 | Dezsfi Csupor Eva MariaWenzig Istvtin Zupk6 ei al | 2009 | J Chromatography A2009，，1216： | 1 |
| 8 | The effect of intranasal salmon calcitonin therapy on bone mineral density in idiopathic male osteoporosis without vertebral fractures-an open label study 显示文摘 | Toth E Csupor E Me'sza'ros S | 2005 | Bone2005，36，1： | 1 |
| 9 | C-19 and C-20 diterpene alkaloids from Aconitum toxicum Rchb 显示文摘 | Csupor D Forgo P Csedo' K | 2006 | Helvetica Chimica Acta2006，89，12： | 1 |
| 10 | The effect ofintranasal salmon calcitonin ther- apy on bone mineral density in idiopathic male osteoprosis without vertebral fractu- res-An open label study显示文摘 | Toth E Csupor E Maszros S | 2005 | Bone2005，36，1： | 1 |
| 11 | 查看详情显示文摘 | Borcsa B Windowitz U Csupor D Forgo P Bauer R Hoh- mann J | | 0，，： | 1 |
| 12 | The effect of intranasal salmoncalcitonin therapy on bone mineral density in idiopathic maleosteoprosis without vertebral fractures, An open label study 显示文摘 | Toth E Csupor E Maszros S | 2005 | Bone2005，36，1： | 1 |
| 13 | The effect of intranasalsalmon calcitonin therapy on bone mineral density in idio-pathic male osteoporosis without vertebral fractures-anopen label study显示文摘 | Tóth E Csupor E Mészáros S | 2005 | Bone2005，36，1： | 1 |
| 14 | The effect of intranasal Alendr- onate therapy on bone mineral density in idiopathic male osteoporosis without vertebral fractures--an open label study 显示文摘 | T6th E Csupor E Meszros S | 2005 | Bone2005，36，1： | 1 |
| 15 | Semisynthesis and phar- macological investigation of lipo-alkaloids prepared fi'om aconitine 显示文摘 | Borcsa B Widowitz U Csupor D | 2011 | Fitoterapia2011，82，3： | 1 |
| 16 | Bisnorditer- pene, norditerpene, and lipo-alkaloids from Aconitum toxi- eum 显示文摘 | CSUPOR D FORGO P WENZIG EM | 2008 | Natu Prod2008，71，10： | 1 |
| 17 | The effect of intranasal salmon calcitonin therapy on bone mineral density in idiopathic male osteoprosis without vertebral fractures-An open label study显示文摘 | Toth E Csupor E Mészaros S | 2005 | Bone2005，36，1： | 1 |
| 18 | The effect of intranasal salmon calcitonin therapy on bone mineral density in idiopathic male osteoprosis without vertebral fractures-An open label study 显示文摘 | Toth E Csupor E Mesz ros S | 2005 | Bone2005，36，1： | 1 |
| 19 | Bisnorditerpene, norditer- pene,and lipo-alkaloids from Aconitum toxicum 显示文摘 | Csupor D Forgo P Wenzig E M | 2008 | J Natu Prod2008，71，10： | 1 |
| 20 | The effect of intranasal salmon calcitonin therapy on bone mineral density in idiopathic male osteop rosis without vertebral fractures-an open label study显示文摘 | Toth E Csupor E Meszaros S | 2005 | Bone2005，36，1： | 1 |
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