PubMed | Grifols, Phthisis Diagnostics, University of Marburg, Victor Babes Hospital and 5 more.
Type: Journal Article | Journal: The clinical respiratory journal | Year: 2015
AlphaSubjects with respiratory symptoms that could be indicative of AATD provided blood samples as dried blood spot. The alphaFrom 13 countries, 11648 subjects were included. Genotyping of 1404 samples with AAT levels <1.70mg/dL revealed 71 (5.06%) PiS, 151 (10.8%) PiZ, 1 (0.071%) PiSS, 8 (0.57%) PiSZ and 32 (2.28%) PiZZ. Phenotyping of 1363 samples negative for the S and Z alleles or with PiS and PiZ genotype showed two (0.147%) PiZ(rare) and two (0.147%) Pi(null)(null). The countries with the highest rate of severe AATD were Croatia, Russia and Slovakia. By regions, the Baltic countries area showed the highest rate of both PiZ and severe AATD (2.45% and 1.20%, respectively) while the lowest rates were observed in the Balkan Peninsula (0.48% and 0.31%, respectively).This study confirms the need for targeted testing of symptomatic patients and provides AATD genotype data from countries for which only some estimates of prevalence were available until now.
PubMed | University of Pécs, Kaposi Mor Teaching Hospital, Hungarian Academy of Sciences and Zsigmondy Vilmos SPA Hospital
Type: Journal Article | Journal: In vivo (Athens, Greece) | Year: 2016
The signal-averaging (SA) technique is used to record high-resolution electrocardiograms (HRECGs) showing cardiac micropotentials. We aimed to develop a non-invasive signal-averaging-based portable bedside device to determine His-ventricle interval.After amplifying the HRECG recordings, signal duration and voltage can be measured up to four decimal precision. To validate our system, comparison of the invasively and non-invasively determined HV intervals has been performed in 20 patients.Our workgroup has developed a system capable of displaying and measuring cardiac micropotentials on storable ECG. Neither related paired-sample T-test (p=0.263) nor Wilcoxons non-parametric signed ranks test (p=0.245) showed significant deviations of the HV intervals. Furthermore, related paired-sample T-test showed strong correlation (corr=0.910, p<0.001) between HV intervals determined by electrophysiology (EP) and non-invasive measurements.Our research group managed to assemble and validate an easy to use device capable of determining HV intervals even under ambulatory conditions.
PubMed | Novartis, University Hospitals Leuven, Oncology, University of Bologna and 7 more.
Type: Journal Article | Journal: The Lancet. Oncology | Year: 2016
In the pivotal RESPONSE study, ruxolitinib, a Janus kinase (JAK)1 and JAK2 inhibitor, was superior to best available therapy at controlling haematocrit and improving splenomegaly and symptoms in patients with polycythaemia vera with splenomegaly who were inadequately controlled with hydroxyurea. In this study, we assessed the efficacy and safety of ruxolitinib in controlling disease in patients with polycythaemia vera without splenomegaly who need second-line therapy.RESPONSE-2 is a randomised, open-label, phase 3b study assessing ruxolitinib versus best available therapy in patients with polycythaemia vera done in 48 hospitals or clinics across 12 countries in Asia, Australia, Europe, and North America. Eligible patients (aged 18 years) with polycythaemia vera, no palpable splenomegaly, and hydroxyurea resistance or intolerance were stratified by their hydroxyurea therapy status (resistance vs intolerance) and randomly assigned (1:1) by an interactive response technology provider using a validated system to receive either oral ruxolitinib 10 mg twice daily or investigator-selected best available therapy (hydroxyurea [at the maximum tolerated dose], interferon or pegylated interferon, pipobroman, anagrelide, approved immunomodulators, or no cytoreductive treatment). Investigators and patients were not masked to treatment assignment; however, the study sponsor was masked to treatment assignment until database lock. The primary endpoint was the proportion of patients achieving haematocrit control at week 28. Analyses were done according to an intention-to-treat principle, including data from all patients randomly assigned to treatment. This study is registered with ClinicalTrials.gov (NCT02038036) and is ongoing but not recruiting patients.Between March 25, 2014, and Feb 11, 2015, of 173 patients assessed for eligibility, 74 patients were randomly assigned to receive ruxolitinib and 75 to receive best available therapy. At randomisation, best available therapy included hydroxyurea (37 [49%] of 75 in the best available therapy group), interferon or pegylated interferon (ten [13%] of 75), pipobroman (five [7%] of 75), lenalidomide (one [1%] of 75), no treatment (21 [28%] of 75), and other (one [1%] of 75). Haematocrit control was achieved in 46 (62%) of 74 ruxolitinib-treated patients versus 14 (19%) of 75 patients who received best available therapy (odds ratio 728 [95% CI 343-1545]; p<00001). The most frequent haematological adverse events of any grade were anaemia (ten [14%] of 74 in the ruxolitinib group vs two [3%] of 75 in the best available therapy group) and thrombocytopenia (two [3%] vs six [8%]). No cases of grade 3-4 anaemia or thrombocytopenia occurred with ruxolitinib; one patient (1%) reported grade 3-4 anaemia and three patients (4%) reported grade 3-4 thrombocytopenia in the group receiving best available therapy. Frequent grade 3-4 non-haematological adverse events were hypertension (five [7%] of 74 vs three [4%] of 75) and pruritus (0 of 74 vs two [3%] of 75). Serious adverse events occurring in more than 2% of patients in either group, irrespective of cause, included thrombocytopenia (none in the ruxolitinib group vs two [3%] of 75 in the best available therapy group) and angina pectoris (two [3%] of 74 in the ruxolitinib group vs none in the best available therapy group). Two deaths occurred, both in the best available therapy group.RESPONSE-2 met its primary endpoint. The findings of this study indicate that ruxolitinib could be considered a standard of care for second-line therapy in this post-hydroxyurea patient population.Novartis.
Veress G.,Kaposi Mor Teaching Hospital |
Veress G.,Debrecen University |
Meszar Z.,Debrecen University |
Muszil D.,Debrecen University |
And 4 more authors.
Brain Structure and Function | Year: 2013
The cannabinoid 1 (CB1) receptor is expressed by a sub-population of primary sensory neurons. However, data on the neurochemical identity of the CB1 receptor-expressing cells, and CB1 receptor expression by the peripheral and central terminals of these neurons are inconsistent and limited. We characterised CB1 receptor expression in dorsal root ganglia (DRG) and spinal cord at the lumbar 4-5 level, as well as in the urinary bladder and glabrous skin of the hindpaw. About 1/3 of DRG neurons exhibited immunopositivity for the CB1 receptor, the majority of which showed positivity for the nociceptive markers calcitonin gene-related peptide (CGRP) or/and Griffonia (bandeiraea) simplicifolia IB4 isolectin-binding. Virtually all CB1 receptor-immunostained fibres showed immunopositivity for CGRP in the skin, while very few did in the urinary bladder. No CB1 receptor-immunopositive nerve fibres were IB4 positive in either peripheral tissue. Spinal laminae I and II-outer showed the highest density of CB1 receptor-immunopositive punctae, the majority of which showed positivity for CGRP or/and IB4 binding. These data indicate that a major sub-population of nociceptive primary sensory neurons expresses CB1 receptors that are transported to both peripheral and central terminals of these cells. Therefore, the present data suggest that manipulation of endogenous CB1 receptor agonist levels in these areas may significantly reduce nociceptive input into the spinal cord. © 2012 Springer-Verlag.
Borka P.,Health-U |
Gyurkovits K.,Kaposi Mor Teaching Hospital |
Bodis J.,University of Pécs
Acta Physiologica Hungarica | Year: 2012
The objective of the study was to investigate the effect of positive expiratory pressure (PEP) and Flutter on expectoration in cystic fibrosis (CF) patients. Data was gathered through 260 treatments with 10 patients (5 female; 19.2 years; BMI: 18.0). Two methods were used alternately, first the patients started with Flutter and proceeded with PEP, and the next occasion they exercised in the reverse order, starting with PEP then continuing with Flutter. During each phase, 5 sets of 10 exhalations were performed. Sputum weight was measured after the use of the first device, and at the end of the treatment. During sessions starting with Flutter 4.0 ± 4.0 g sputum was expectorated, continuing with PEP, an additional 5.2 ± 5.0 g was produced, altogether 9.2 ± 8.2 g. At sessions starting with PEP 7.4 ± 3.7 g was expectorated, continuing with Flutter an additional 0.8 ± 1.4 g, that is 8.2 ± 4.1 g. Comparing the two devices by themselves, PEP proved to be significantly more efficient then Flutter. Comparing the two treatment types it is statistically not proven, which one is preferable using both devices. Conclusively, PEP is significantly more efficient than the Flutter in sputum expectoration among CF patients. The Flutter is a useful supplementary device. © 2012 Akadémiai Kiadó, Budapest.
Ludwig H.,Center for Oncology and Hematology |
Adam Z.,Masaryk University |
Tothova E.,University Hospital steur |
Hajek R.,Masaryk University |
And 8 more authors.
Haematologica | Year: 2010
Background Thalidomide maintenance therapy after stem cell transplantation resulted in increased progression- free survival and overall survival in a few trials, but its role in non-transplant eligible patients with multiple myeloma remains unclear. This study assessed the impact of thalidomide- interferon in comparison to interferon maintenance therapy in elderly patients with multiple myeloma. Design and Methods Of 289 elderly patients with multiple myeloma who were randomized to thalidomide-dexamethasone or melphalan-prednisolone induction therapy, 137 finally completed 9 cycles of induction therapy with stable disease or better and thereby qualified for maintenance treatment. Of these, 128 have been randomized to either thalidomide-interferon or interferon alone. Primary study endpoints were progression-free survival and response rates; secondary endpoints were overall survival, toxicity and quality of life. Results Thalidomide-interferon maintenance therapy led to a significantly longer progression-free survival compared to interferon (27.7 vs. 13.2 months, P=0.0068), but overall survival was similar in both groups (52.6 vs. 51.4 months, P=0.81) and did not differ between patients aged 75 years or older, or younger patients (P=0.39). Survival after disease progression tended to be shorter in patients on thalidomide-interferon maintenance therapy (P=0.056). Progression-free survival and overall survival tended to be shorter in patients with adverse cytogenetic (FISH) findings compared to the standard risk group but differences were not significant (P=0.084 and P=0.082, respectively). Patients on thalidomide-interferon presented with more neuropathy (P=0.0015), constipation (P=0.0004), skin toxicity (P=0.0041) and elevated creatinine (P=0.026). Conclusions Thalidomide plus interferon maintenance therapy increased progression-free survival but not overall survival and was associated with slightly more toxicity than maintenance with interferon alone. (ClinicalTrials.gov Identifier: NCT00205751). ©2010 Ferrata Storti Foundation.
Sulkowski M.S.,Johns Hopkins University |
Cooper C.,Ottawa Hospital |
Hunyady B.,Kaposi Mor Teaching Hospital |
Jia J.,Beijing Friendship Hospital |
And 5 more authors.
Nature Reviews Gastroenterology and Hepatology | Year: 2011
HCV infects approximately 2-3% of the global population and is a leading cause of end-stage liver disease and hepatocellular carcinoma. Treatment of HCV infection with Peg-IFN in combination with ribavirin can eradicate HCV infection in 40-90% of patients; however, a major barrier to treatment uptake and delivery is the association of this therapy with frequent and, at times, serious adverse effects. Recognition and effective management of these adverse effects are critical components of the successful treatment of chronic HCV infection. In clinical trials, approximately 10-15% of patients discontinue Peg-IFN and ribavirin therapy due to adverse effects; however, in clinical practice, the rate of treatment discontinuation has been reported to be substantially higher. The off-target effect of Peg-IFN and ribavirin impacts most, if not all, organ systems; the most common adverse effects are hematologic, dermatologic, neurologic, immunologic, gastrointestinal, pulmonary, cardiovascular, and ocular. Regional and global variability exists in the nature of these adverse effects and the strategies employed to ameliorate their impact. This article provides a comprehensive literature review that systematically describes the adverse effects of Peg-IFN-α and ribavirin on various organ systems and, more importantly, recommends consensus approaches to managing those effects. © 2011 Macmillan Publishers Limited. All rights reserved.
Pankovics P.,ANTSZ Regional Institute of State Public Health Service |
Boros A.,ANTSZ Regional Institute of State Public Health Service |
Szabo H.,Kaposi Mor Teaching Hospital |
Szekely G.,Kaposi Mor Teaching Hospital |
And 2 more authors.
Acta Microbiologica et Immunologica Hungarica | Year: 2012
Human enterovirus 109 (EV109) is a recently identified recombinant enterovirus in family Picornaviridae from acute paediatric respiratory illness in Nicaragua. EV109 have not been reported elsewhere. Our aims were the molecular detection and genetic analysis of EV109 from acute childhood respiratory infections in Hungary. Nasopharyngeal aspirates were collected from children under age of 10 years with acute respiratory infections treated in Department of Pulmonology, Kaposi Mór Teaching Hospital, Mosdós, Hungary. Samples were taken from 15 October to 15 May in two respiratory seasons 2005/2006 and 2006/2007. Samples were tested using EV109 specific VP1 primers by RT-PCR method. One (1.1%) of the 92 nasopharyngeal aspirates was positive for EV109 collected from a 2.5-year-old child in January, 2007. The main symptoms were dropping nose, fever (38.1°C), hard cough and wheezing associated with bronchitis and pneumonia. Based upon the VP1 gene region EV109 (L87/HUN/2007, JN900470) has 93% nucleotide identity and identical recombinant pattern to the prototype EV109. This is the first detection of the novel recombinant enterovirus, EV109, in Hungary (in Europe). This study supports the possibility that EV109 is able to cause acute respiratory infections, in addition, it might be plays a part in lower respiratory disease with hospitalization in children. © 2012 Akadémiai Kiadó, Budapest.
Outcome of 3 pregnancies in a patient with chronic myeloid leukemia who received 3 types of tyrosine kinase inhibitors each in different pregnancy: Follow-up of the case with a review of published reports
Alizadeh H.,Kaposi Mor Teaching Hospital |
Alizadeh H.,Tawam Hospital |
Jaafar H.,Tawam Hospital |
Kajtar B.,University of Pécs
Annals of Saudi Medicine | Year: 2015
The management of patients with chronic myeloid leukemia (CML) during pregnancy remains a matter of continuous debate. Tyrosine kinase inhibitors (TKIs) have become the standard of care in managing patients with CML. These drugs have a good safety profile, but animal studies have shown that they are potentially teratogenic. Therefore, these drugs are not recommended for use during pregnancy or if a female patient plans to conceive. Despite the extensive clinical experience with TKIs, the available information about the effects of TKIs on fertility, pregnancy, and outcome of babies who were exposed to TKIs during pregnancy and lactation is limited. We reported on 1 female CML patient who conceived 3 times while being on different types of TKIs in each pregnancy. All 3 pregnancies were uneventful, and only 1 of the babies was diagnosed with a minor cardiac malformation at the age of 30 months, which was corrected surgically. © 2015 Annals of Saudi Medicine.
Lelovics Z.,Kaposi Mor Teaching Hospital |
Dee K.,Kaposi Mor Teaching Hospital
CAB Reviews: Perspectives in Agriculture, Veterinary Science, Nutrition and Natural Resources | Year: 2013
Residents at long-term residential institutions (nursing homes, homes for the elderly and social housing) find supported livelihood, full board and peace of mind. However, malnutrition is very frequent among institutionalized elderly. This article systematically reviews the currently available literature on malnutrition, factors that influence nutritional status and also the possible ways of prevention. Avoiding malnutrition in this group is a very difficult task for the staff of the institutions. These elderly people need special attention. We reviewed the screening tools, catering, food intake and the factors that lead to malnutrition and possible solutions for them. The review only deals with factors that were reported during the last 3 years. The conclusions could offer useful guidelines for institutions to develop a special, local protocol that is best for the residents, thus avoiding malnutrition. © CAB International 2013.