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4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
Analyses of Pediatric Pancreatitis    
CLINICAL TRIALS ORGANIZED BY HPSG
Analyses of Pediatric Pancreatitis    
APPLE
PINEAPPLE
Andrea Párniczky
BUDAPEST, HUNGARY
on behalf of the Hungarian Pancreatic Study Group
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
2
4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
Analyses of Pediatric Pancreatitis    
BACKGROUND
CHILDREN
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
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4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
Analyses of Pediatric Pancreatitis    
PRELIMINARY SETTINGS

• The protocols have been discussed in our latest
  international meeting held in Szeged in November
  2014, where expert pediatric pancreatologists
  attended. (http//pancreas.hu/sites/info/files/con
  ferences/ALPD2014-Program.pdf)
• The studies have received the relevant ethical
  approval (No. ad.52499-3/2014) issued by the
  National Hungarian Ethical Authority (ETT TUKEB).
• The trial has been registered at the ISRCTN
  registry (ISRCTN89664974) which is a primary
  clinical trial registry recognized by WHO and
  ICMJE.
• The study is open for all pediatric centers
  throughout the world.
• Electronic CRF has been developed.
• The IAP Scientific Committee has approved the
  study and advertised worldwide among its 4000
  members (16.06.2015)
• The TRIAL article (prestudy protocol)
• is accepted, will be published in
  Digestion

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4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
Analyses of Pediatric Pancreatitis    
Number of centres 12
NYÍREGYHÁZA
BALASSAGYARMAT
PINEAPPLE
DEBRECEN
BUDAPEST
SZÉKESFEHÉRVÁR
APPLE
ZALAEGERSZEG
SZEKSZÁRD
SZEGED
PÉCS
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
5
4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
APPLE
Analyses of Pediatric Pancreatitis    
AIM
APPLE-R
Patients with HISTORY of pancreatitis under 18 ys
Understand our EARLIER PRACTICE in pediatric
pancreatitis
Specify the GENETIC BACKGROUND of pediatric
pancreatitis
Understand the FAMILY HISTORY in pediatric
pancreatitis
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
6
4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
APPLE
Analyses of Pediatric Pancreatitis    
PROTOCOL
APPLE-R
Details from the medical history
Acute Pancreatitis (AP) Acute Recurrent
Pancreaitis (ARP) Chronic Pancreatitis (CP)
Autoimmune Pancreatitis (AIP) Pancreatic Cancer
(PC) Other diseases
Etiology
Genetic Test if available
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
7
4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
APPLE
Analyses of Pediatric Pancreatitis    
FOR GENETIC ANALYSES
PROTOCOL
Storage - 20 ?C
SHIP TO SZEGED
It has to be cost effective
We can offer an unbeatable cost effective way
for you
2 TUBES (EDTA) OF BLOOD
WE WILL DO IT FOR FREE!
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
8
4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
APPLE
Analyses of Pediatric Pancreatitis    
AIM
APPLE-P
NEWLY diagnosed patient under 18 ys with
pancreatitis (PINEAPPLE CAN HELP)
GET MORE DETAILS and RECOGNIZE BETTER the course
of the pediatric pancreatitis
Specify the GENETIC BACKGROUND of pediatric
pancreatitis
Identify EARLY RISK FACTORS (etc smoking-first,
second-hand)
Establishment of the SEVERITY at admission
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
9
4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
Analyses of Pediatric Pancreatitis    
PROTOCOL
AT ADMISSION!
Amylase (U/l)
Lipase (U/l) (only obligatory if amylase is not measured)
White blood cell (WBC) count (G/l)
Red blood cell (RBC) count (T/l)
Hemoglobin (g/l)
Hematocrit ()
Thrombocyte (G/l)
Serum glucose (mmol/l)
Blood urea nitrogen (mmol/l)
Creatinine (umol/l)
eGFR
C-reactive protein (mg/l)
ASAT/GOT (U/l)
Lactate dehydrogenase LDH (U/l)
Calcium (mmol/l)
Details from the medical history
Complains, symptoms
Admission details, status
OBLIGATORY
Laboratory parameters at admission
Imaging at admission
Abdominal US
Abdominal CT
Abdominal X-ray
Chest CT
Chest X-ray
Immediate therapy at admission
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
Complications
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4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
APPLE
Analyses of Pediatric Pancreatitis    
PROTOCOL
FOR EVERY DAY!
Every day of the hospitalization the APPLE-P
FORM-B Questionnaire daily needs to be filled
out.
General medical treatment
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
11
4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
Analyses of Pediatric Pancreatitis    
Thank you for joining to us!
We are waiting for more centres!
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport
12
4th Conference of the Hungarian 2nd Conference
of the Eastern and Central European Pancreatic
Study Groups
APPLE
Analyses of Pediatric Pancreatitis    
Thank you for your attention!
THE HUNGARIAN PANCREATIC STUDY GROUP IS COMMITTED
TO IMPROVING THE LIVE OF PATIENTS SUFFERING FROM
PANCREATIC DISEASES!
www.pancreas.hu
Hungarian Pancreatic Study Group Magyar
Hasnyálmirigy Munkacsoport