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Kodmon C.,U.S. Center for Disease Control and Prevention | Szabo N.,National Koranyi Institute for TB and Pulmonology | Nagy E.,University of Szeged
Lege Artis Medicinae | Year: 2012

In the past decade, the epidemiological status of tuberculosis has significantly improved in Hungary. The incidence is today lower than 20 per 100 000 inhabitant, therefore, the laboratory network performing diagnosis needs to look for new challenges. As the yearly number of cases decreases, less examinations will be needed, but a greater emphasis should be placed on shortening the time needed for diagnosis, more efficient culturing, resistance tests and molecular typing performed for epidemiological purposes. Our aim is to provide an overview of the status of the diagnostic network of tuberculosis in Hungary and the future challenges it faces, on the basis of data published by the National Korányi Institute of TBC and Pulmonology and the European Centre for Disease Prevention and Control.

Bikov A.,Semmelweis University | Lazar Zs.,Semmelweis University | Schandl K.,Semmelweis University | Antus B.M.,National Koranyi Institute for TB and Pulmonology | And 2 more authors.
Acta Physiologica Hungarica | Year: 2011

Exercise-caused metabolic changes can be followed by monitoring exhaled volatiles; however it has not been previously reported if a spectrum of exhaled gases is modified after physical challenge. We have hypothesized that changes in volatile molecules assessed by an electronic nose may be the reason for the alkalization of the exhaled breath condensate (EBC) fluid following physical exercise.Ten healthy young subjects performed a 6-minute running test. Exhaled breath samples pre-exercise and post-exercise (0 min, 15 min, 30 min and 60 min) were collected for volatile pattern ("smellprint") determination and pH measurements (at 5.33 kPa CO2), respectively. Exhaled breath smellprints were analyzed using principal component analysis and were related to EBC pH.Smellprints (p=0.04) and EBC pH (p=0.01) were altered during exercise challenge. Compared to pre-exercise values, smellprints and pH differed at 15 min, 30 min and 60 min following exercise (p<0.05), while no difference was found at 0 min post-exercise. In addition, a significant correlation was found between volatile pattern of exhaled breath and EBC pH (p=0.01, r=-0.34).Physical exercise changes the pattern of exhaled volatiles together with an increase in pH of breath. Changes in volatiles may be responsible for increase in EBC pH. © 2011 Akadémiai Kiadó, Budapest.

Varga J.,National Koranyi Institute for TB and Pulmonology
Acta Physiologica Hungarica | Year: 2015

Expiratory flow limitation can develop in parallel with the progression of COPD, and as a consequence, dynamic hyperinflation and lung mechanical abnormalities can develop. Dynamic hyperinflation can cause increased breathlessness and reduction in exercise tolerance. Achievement of critical inspiratory reserve volume is one of the main factors in exercise intolerance. Obesity has specific lung mechanical effects. There is also a difference concerning gender and dyspnoea. Increased nerve activity is characteristic in hyperinflation. Bronchodilator therapy, lung volume reduction surgery, endurance training at submaximal intensity, and heliox or oxygen breathing can decrease the degree of dynamic hyperinflation. © 2015 Akadémiai Kiadó, Budapest.

Varga J.,University of Szeged | Varga J.,National Koranyi Institute for TB and Pulmonology | Palinkas A.,Elisabeth Hospital | Lajko I.,University of Szeged | And 3 more authors.
Open Respiratory Medicine Journal | Year: 2016

Background: The non-invasive assessment of pulmonary haemodynamics during exercise provides complementary data for the evaluation of exercise tolerance in patients with COPD. Methods: Exercise echocardiography in the semi-supine position was performed in 27 patients with COPD (C) with a forced expiratory volume in one second (FEV1) of 36±12% predicted and 13 age and gender-matched non-COPD subjects (NC). COPD patients also underwent cardiopulmonary exercise testing with gas exchange detection (CPET). Furthermore, serum high sensitive C-reactive protein (hsCRP), a marker of systemic inflammation, was also measured. Results: The maximal work rate (WRmax) and aerobic capacity (VO2peak) were significantly reduced (WRmax: 77±33 Watt, VO2peak: 50±14%pred) in COPD. Pulmonary arterial systolic pressure (PAPs) was higher in COPD versus controls both at rest (39±5 vs. 31±2 mmHg, p<0.001), and at peak exercise (72±12 vs. 52±8 mmHg, p<0.001). In 19 (70%) COPD patients, the increase in PAPs was above 22 mmHg. The change in pressure (dPAPs) correlated with hsCRP (r2=0.53, p<0.0001) and forced vital capacity (FVC) (r2=0.18, p<0.001). Conclusion: PAPs at rest and during exercise were significantly higher in COPD patients and correlated with higher hsCRP. This may indicate a role for systemic inflammation and hyperinflation in the pulmonary vasculature in COPD. The study was registered at ClinicalTrials.gov webpage with NCT00949195 registration number. © 2016, Varga et al.; Licensee Bentham Open.

Antus B.,National Koranyi Institute for TB and Pulmonology | Horvath I.,Semmelweis University | Barta I.,National Koranyi Institute for TB and Pulmonology
Respiratory Medicine | Year: 2010

Background: Fractional exhaled nitric oxide (FENO) has been implicated as a pulmonary biomarker. The aim of this study was to compare the performance of a new hand-held device to a standard chemiluminescence analyzer and to another portable device. Methods: FENO levels measured by NObreath (Bedfont) were compared to those of (1) a chemiluminescence detector (Logan, Logan Research) and (2) the electrochemical portable NIOX MINO (Aerocrine) in 18 healthy volunteers on three consecutive occasions: in the morning, 1 h and 24 h later. Results: Comparing FENO levels obtained by NObreath to those by Logan values were similar and a very close linear relationship was found between the two devices (r = 0.923, p < 0.001). The mean inter-device difference in FENO level was -3.45 ppb and the limits of agreement (Bland-Altman test) were -10.98 and 4.08 ppb. In the second series FENO levels obtained by NObreath were found to be slightly higher compared to those of NIOX MINO, but still showed a close correlation (r = 0.681, p < 0.001). The mean inter-device difference in FENO level was 4.36 ppb and the limits of agreement were -7.38 and 16.1 ppb. Analyzing the repeated FENO measurements, the mean coefficient of variation using NObreath tended to be lower than that of NIOX MINO (16.9 vs. 24.7%, p = 0.059), while it was similar as the value obtained with Logan (11.8 vs. 9.0%, p = 0.342). Conclusions: FENO values measured with NObreath are reproducible and in good agreement with those obtained by NIOX MINO and Logan indicating that NObreath is suitable for use in clinical practice. © 2010 Elsevier Ltd. All rights reserved.

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