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Fesu D, Polivka L, Barczi E, Foldesi M, Horvath G, Hidvegi E, Bohacs A, Muller V. Post-COVID interstitial lung disease in symptomatic patients after COVID-19 disease. Inflammopharmacology 2023; 31:565-571. [PMID: 36961666 PMCID: PMC10037361 DOI: 10.1007/s10787-023-01191-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/25/2023]
Abstract
COVID-19 is often associated with long-lasting pulmonary symptoms. Data are scarce about interstitial lung disease (ILD) in patients following COVID-19 hospitalization with persistent symptoms. We retrospectively reviewed all cases sent to pulmonary post-COVID evaluation due to persistent symptoms between February 2021 and February 2022 (N = 318). All patients with suspected ILD (N = 44) were reviewed at the multidisciplinary discussion. Patient characteristics, symptoms, time since hospitalization, detailed lung function measurements and 6-min walk test (6MWT) were evaluated. The post-COVID ILD suspected group included more men (68.2 vs. 31.8%) with significantly older age compared to the control group (64.0 ± 12.3 vs. 51.3 ± 14.9 years). Most patient needed hospital care for COVID-19 pneumonia (68.6% of all patients and 84.1% of ILD suspected group) and average time since hospitalization was 2.4 ± 2.3 months. Persisting symptoms included fatigue (34%), dyspnoea (25.2%), cough (22.6%), and sleep disorders (insomnia 13.2%; sleepiness 8.2%). Post-COVID ILD presented more often with new symptoms of cough and sleepiness. Functional impairment, especially decreased walking distance and desaturation during 6-min walk test (6MWT) were detected in the ILD-suspected group. Respiratory function test in the post-COVID ILD group showed slight restrictive ventilatory pattern (FVC: 76.7 ± 18.1%, FEV1: 83.5 ± 19.1%, TLC: 85.6 ± 28.1%) and desaturation during 6MWT were detected in 41% of patients. LDCT changes were mainly ground glass opacities (GGO) and/or reticular abnormalities in most cases affecting < 10% of the lungs. Our data indicate that suspected post-COVID ILD is affecting 13.8% of symptomatic patients. High resolution chest CT changes were mainly low extent GGO/reticulation, while long-term lung structural changes need further evaluation.
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Affiliation(s)
- Dorottya Fesu
- Department of Pulmonology, Semmelweis University, Tömő u. 25-29, 1083, Budapest, Hungary
| | - Lorinc Polivka
- Department of Pulmonology, Semmelweis University, Tömő u. 25-29, 1083, Budapest, Hungary
| | - Eniko Barczi
- Department of Pulmonology, Semmelweis University, Tömő u. 25-29, 1083, Budapest, Hungary
| | - Marcell Foldesi
- Neumann Medical Ltd, Buday László u. 12, 1024, Budapest, Hungary
| | - Gabor Horvath
- Department of Pulmonology, Semmelweis University, Tömő u. 25-29, 1083, Budapest, Hungary
| | - Edit Hidvegi
- Department of Pulmonology, Semmelweis University, Tömő u. 25-29, 1083, Budapest, Hungary
| | - Aniko Bohacs
- Department of Pulmonology, Semmelweis University, Tömő u. 25-29, 1083, Budapest, Hungary
| | - Veronika Muller
- Department of Pulmonology, Semmelweis University, Tömő u. 25-29, 1083, Budapest, Hungary.
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Nagy A, Nagy T, Kolonics-Farkas AM, Eszes N, Vincze K, Barczi E, Tarnoki AD, Tarnoki DL, Nagy G, Kiss E, Maurovich-Horvat P, Bohacs A, Müller V. Autoimmune Progressive Fibrosing Interstitial Lung Disease: Predictors of Fast Decline. Front Pharmacol 2021; 12:778649. [PMID: 35002713 PMCID: PMC8727590 DOI: 10.3389/fphar.2021.778649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/28/2021] [Indexed: 12/23/2022] Open
Abstract
A subset of interstitial lung diseases (ILDs) with autoimmune traits-including connective tissue disease-associated ILD (CTD-ILD) and interstitial pneumonia with autoimmune features (IPAF)-develops progressive fibrosing (PF)-ILD. The aim of our study was to evaluate the clinical characteristics and predictors of longitudinal lung function (LF) changes in autoimmune PF-ILD patients in a real-world setting. All ILD cases with confirmed or suspected autoimmunity discussed by a multidisciplinary team (MDT) between January 2017 and June 2019 (n = 511) were reviewed, including 63 CTD-ILD and 44 IPAF patients. Detailed medical history, LF test, diffusing capacity of the lung for carbon monoxide (DLCO), 6-min walk test (6MWT), blood gas analysis (BGA), and high-resolution computer tomography (HRCT) were performed. Longitudinal follow-up for functional parameters was at least 2 years. Women were overrepresented (70.1%), and the age of the IPAF group was significantly higher as compared to the CTD-ILD group (p < 0.001). Dyspnea, crackles, and weight loss were significantly more common in the IPAF group as compared to the CTD-ILD group (84.1% vs. 58.7%, p = 0.006; 72.7% vs. 49.2%, p = 0.017; 29.6% vs. 4.8%, p = 0.001). Forced vital capacity (FVC) yearly decline was more pronounced in IPAF (53.1 ± 0.3 vs. 16.7 ± 0.2 ml; p = 0.294), while the majority of patients (IPAF: 68% and CTD-ILD 82%) did not deteriorate. Factors influencing progression included malignancy as a comorbidity, anti-SS-A antibodies, and post-exercise pulse increase at 6MWT. Antifibrotic therapy was administered significantly more often in IPAF as compared to CTD-ILD patients (n = 13, 29.5% vs. n = 5, 7.9%; p = 0.007), and importantly, this treatment reduced lung function decline when compared to non-treated patients. Majority of patients improved or were stable regarding lung function, and autoimmune-associated PF-ILD was more common in patients having IPAF. Functional decline predictors were anti-SS-A antibodies and marked post-exercise pulse increase at 6MWT. Antifibrotic treatments reduced progression in progressive fibrosing CTD-ILD and IPAF, emphasizing the need for guidelines including optimal treatment start and combination therapies in this special patient group.
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Affiliation(s)
- Alexandra Nagy
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Tamas Nagy
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | | | - Noemi Eszes
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Krisztina Vincze
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Eniko Barczi
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | | | | | - György Nagy
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
- Department of Rheumatology and Clinical Immunology, Semmelweis University, Budapest, Hungary
| | - Emese Kiss
- Department of Clinical Immunology, Adult and Pediatric Rheumatology, National Institute of Locomotor Diseases and Disabilities, Budapest, Hungary
- 3rd Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | | | - Aniko Bohacs
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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Kolonics-Farkas AM, Kovats Z, Bohacs A, Odler B, Benke K, Agg B, Szabolcs Z, Müller V. Airway obstruction can be better predicted using Global Lung Function Initiative spirometry reference equations in Marfan syndrome. Physiol Int 2021. [PMID: 33769955 DOI: 10.1556/2060.2021.00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/29/2020] [Indexed: 11/19/2022]
Abstract
Marfan syndrome is a genetic disorder of the connective tissue, including involvement of the lungs.Pulmonary function test was performed in 32 asymptomatic adult Marfan patients using European Community for Coal and Steel (ECCS) and Global Lung Function Initiative (GLI) reference values.Using GLI equations for reference, significantly lower lung function values were noted for forced vital capacity (FVC) (87.0 ± 16.6% vs. 97.1 ± 16.9%; P < 0.01) and forced expiratory volume in the first second (FEV1) (79.6 ± 18.9% vs. 88.0 ± 19.1%; P < 0.01) predicted compared to ECCS. Obstructive ventilatory pattern was present in 25% of the cases when calculating with GLI lower limit of normal (LLN), and it was significantly more common in men as compared to women (n = 6, 50% vs. n = 2, 10%; P = 0.03).GLI is more suitable to detect early ventilatory changes including airway obstruction in young patients with special anatomic features, and should be used as a standard way of evaluation in asymptomatic Marfan population.
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Affiliation(s)
| | - Z Kovats
- 1Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - A Bohacs
- 1Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - B Odler
- 1Department of Pulmonology, Semmelweis University, Budapest, Hungary
- 2Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - K Benke
- 3Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- 4Hungarian Marfan Foundation, Budapest, Hungary
| | - B Agg
- 3Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- 4Hungarian Marfan Foundation, Budapest, Hungary
- 5Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
| | - Z Szabolcs
- 3Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- 4Hungarian Marfan Foundation, Budapest, Hungary
| | - V Müller
- 1Department of Pulmonology, Semmelweis University, Budapest, Hungary
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Barczi E, Nagy T, Starobinski L, Kolonics‐Farkas A, Eszes N, Bohacs A, Tarnoki AD, Tarnoki DL, Müller V. Impact of interstitial lung disease and simultaneous lung cancer on therapeutic possibilities and survival. Thorac Cancer 2020; 11:1911-1917. [PMID: 32401433 PMCID: PMC7327688 DOI: 10.1111/1759-7714.13481] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Fibrosing interstitial lung diseases (ILDs) are associated with poor survival and an increased risk of developing lung cancer (LC). Patient and LC characteristics, therapeutic possibilities and survival in this rare patient population are not well established. METHODS Fibrosing ILD patients treated at the Department of Pulmonology Semmelweis University were reviewed retrospectively between 2012-2018 (N = 160). All patients with concomitant LC (N = 23) underwent detailed pulmonary evaluation. Cancer characteristics including driver mutation data, as well as therapy and survival were analyzed. RESULTS ILD-LC patients (56% men, mean age 73 ± 6 years) had mild-moderate lung functional impairment (forced vital capacity [FVC]: 80 ± 24%ref., forced expiratory volume in one second [FEV1]: 76 ± 27%ref.; transfer factor of the lung for carbon monoxide [TLCO]: 62 ± 25% reference). In 56% of cases histology confirmed adenocarcinoma followed by squamous cell carcinoma in 26%. Lobectomy could only be performed in one case; driver mutation was present in one patient. Chemotherapy was most commonly administered; however, 26% could only receive supportive palliative care. Four idiopathic pulmonary fibrosis patients received concomitant nintedanib to their LC treatment. Median survival of ILD-LC patients was only 321 days. CONCLUSIONS Diagnosis and therapy of ILD-LC is challenging and patients have a very limited survival. A significant proportion of patients could only receive palliative care indicating the need for better management strategies in this special patient population. The evaluation of the effect of cotreatment with antifibrotics needs further study. KEY POINTS Interstitial lung diseases are often associated with lung cancer Diagnosis is challenging and therapy often limited due to underlying lung disease. Patients received platinum based chemotherapy or only supportive care.
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MESH Headings
- Adenocarcinoma of Lung/complications
- Adenocarcinoma of Lung/mortality
- Adenocarcinoma of Lung/pathology
- Adenocarcinoma of Lung/therapy
- Aged
- Carcinoma, Non-Small-Cell Lung/complications
- Carcinoma, Non-Small-Cell Lung/mortality
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Non-Small-Cell Lung/therapy
- Carcinoma, Squamous Cell/complications
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/therapy
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Lung Diseases, Interstitial/complications
- Lung Diseases, Interstitial/mortality
- Lung Diseases, Interstitial/pathology
- Lung Diseases, Interstitial/therapy
- Lung Neoplasms/complications
- Lung Neoplasms/mortality
- Lung Neoplasms/pathology
- Lung Neoplasms/therapy
- Male
- Prognosis
- Retrospective Studies
- Small Cell Lung Carcinoma/complications
- Small Cell Lung Carcinoma/mortality
- Small Cell Lung Carcinoma/pathology
- Small Cell Lung Carcinoma/therapy
- Survival Rate
- Vital Capacity
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Affiliation(s)
- Eniko Barczi
- Department of PulmonologySemmelweis UniversityBudapestHungary
| | - Tamas Nagy
- Department of PulmonologySemmelweis UniversityBudapestHungary
| | | | | | - Noemi Eszes
- Department of PulmonologySemmelweis UniversityBudapestHungary
| | - Aniko Bohacs
- Department of PulmonologySemmelweis UniversityBudapestHungary
| | | | | | - Veronika Müller
- Department of PulmonologySemmelweis UniversityBudapestHungary
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Barczi E, Meszaros M, Bohacs A, Geczi L, Vereczkey I, Müller V. Testicular Cancer in a Lung Transplant Patient With Cystic Fibrosis: A Case Report. Transplant Proc 2019; 51:1293-1295. [PMID: 31101217 DOI: 10.1016/j.transproceed.2019.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) is one of the most common genetic disorders that develops from a mutation of the cystic fibrosis transmembrane regulator gene. Patients with CF are known to be at risk for malignancies, and lung transplantation-associated immunosuppression further increases this risk. CASE REPORT We describe a case of a 29-year-old male patient with CF who developed testicular cancer 14 months after a lung transplantation. Immunosuppressive therapy included antithymocyte globulin induction and tacrolimus, mycophenolate, and prednisolone maintenance therapy as compared to standard alemtuzumab induction, followed by tacrolimus and prednisolone, as used in our center. He underwent semicastration and refused chemotherapy. Immunosuppressive treatment was changed to tacrolimus, everolimus, and prednisolone, which did not influence excellent graft function. This case report highlights the importance of uro-oncological observation of patients with CF following lung transplantations.
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Affiliation(s)
- Eniko Barczi
- Department of Pulmonology, Semmelweis University, Budapest, Hungary.
| | - Martina Meszaros
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Aniko Bohacs
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Lajos Geczi
- National Institute of Oncology, Budapest, Hungary
| | | | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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Tarnoki DL, Tarnoki AD, Skakun V, Karlinger K, Barczi E, Bohacs A, Muller V. Relationship between HRCT changes and clinical parameters in patients with scleroderma. Imaging 2018. [DOI: 10.1183/13993003.congress-2018.pa859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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7
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Vincze K, Kolonics-Farkas A, Bohacs A, Müller V. Peripheral CD4+ T-cell changes in connective tissue diseases. Cytokine Growth Factor Rev 2018; 43:16-24. [PMID: 29853252 DOI: 10.1016/j.cytogfr.2018.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/10/2018] [Accepted: 05/16/2018] [Indexed: 10/16/2022]
Abstract
Connective tissue diseases (CTDs) are all characterized by changes in the adaptive immune system. In the last few decades several CD4 + T lymphocytes and their products have been associated with the development, progression, organ involvement, or therapeutic response of different CTDs. The T helper (Th) T-cell subsets are easy to measure in the peripheral blood, however changes are difficult to interpret. This review summarizes data about Th1/Th2/Th17 and regulatory T-cell (Treg) changes in the most common CTDs. Concordance and divergence of data might help in the better understanding of the common processes of these different systemic autoimmune disorders and might give future clues for differences in disease behavior and treatment response.
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Affiliation(s)
- Krisztina Vincze
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | | | - Aniko Bohacs
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary.
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Kováts Z, Bohacs A, Komlosi Z, Bikov A, Süttö Z, Lang G, Losonczy G, Müller V. Diagnostic Value of Peripheral and Bronchoalveolar Leukocyte Profile in Lung Transplant Recipients After Alemtuzumab Induction Therapy. A Single Center Experience. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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9
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Bocskei RM, Eszes N, Sutto Z, Csiszer E, Losonczy G, Muller V, Lang G, Renyi-Vamos F, Cziraki A, Bohacs A. Arterial stiffness measurement on lung transplanted patients. Transplantation 2017. [DOI: 10.1183/1393003.congress-2017.pa2464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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10
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Tarnoki DL, Tarnoki AD, Fejer B, Barczi E, Eszes N, Bohacs A, Muller V, Karlinger K. Ultrasound assessment of diaphragmatic motion in patients with interstitial lung disease. Imaging 2017. [DOI: 10.1183/1393003.congress-2017.pa3735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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11
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Kovats Z, Bohacs A, Sutto Z, Vincze K, Lukacsovits J, Losonczy G, Müller V. Seasonal changes of lower respiratory tract infections in lung transplant recipients during the first post-transplant year: The Hungarian experience. Transpl Infect Dis 2017; 19. [PMID: 28164439 DOI: 10.1111/tid.12671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/08/2016] [Accepted: 10/23/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND After lung transplantation (LuTX) a high level of immunosuppression is needed to prevent rejection of the graft. Together with earlier colonization by pathogens, immunosuppression makes recipients more susceptible to infections, especially during the first postoperative year. As seasonality of lower respiratory tract infections (LRTI) is well-known in chronic lung diseases, we assessed seasonal changes of pathogen spectrum and number of infections in the first postoperative year in LuTX recipients. METHODS LRTI were analyzed in 28 Hungarian adult LuTX patients. Incidence and spectrum of microorganism causing LRTI were evaluated according to post-transplant time and seasonal temperature and humidity changes. RESULTS A total of 69 cases of LRTI were registered (average: 1.9 cases/patient; range: 0-14). Gram-negative=59, gram-positive=26, and fungal=31 pathogens were detected, with polymicrobial samples in 46% of all cases. Increased number of LRTI was observed in the cold season (1.68±1.54 vs 0.79±0.92 case/month/patient, P<.01) and significant negative correlations were identified between the incidence of polymicrobial and bacterial infections and temperature (r2 =0.1535, P<.05, r2 =0.3144, P<.01, respectively). In addition, positive correlation was observed between polymicrobial infections and humidity (r2 =0.1403, P<.05). Higher incidence of LRTI was also noted in the cold season, when accounting for the differences in immunosuppression. CONCLUSION Seasons influenced the incidence of LRTI in the first postoperative year in LuTX recipients. More intensive vigilance for possible gram-negative and polymicrobial infections is needed in these patients in cold and wet seasons in the continental climate zone, regardless of underlying disease.
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Affiliation(s)
- Zsuzsanna Kovats
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Aniko Bohacs
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Zoltan Sutto
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Krisztina Vincze
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | | | - Gyorgy Losonczy
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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Marietta Bocskei R, Tamasi L, Benczur B, Cziraki A, Losonczy G, Bohacs A. 7.8 ARTERIAL STIFFNESS AND SYSTEMIC INFLAMMATION IN COPD PATIENTS. Artery Res 2016. [DOI: 10.1016/j.artres.2016.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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13
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Bikov A, Bocskei R, Eszes N, Bohacs A, Losonczy G, Rigo J, Horvath I, Tamasi L. Circulating survivin levels in healthy and asthmatic pregnancy. Reprod Biol Endocrinol 2014; 12:93. [PMID: 25248821 PMCID: PMC4189549 DOI: 10.1186/1477-7827-12-93] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 09/18/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Asthma is one of the most common conditions which complicate pregnancy. Pro- and anti-apoptotic mechanisms can be modulated by asthma accompanying pregnancy. Survivin, an anti-apoptotic protein has been implicated in the pathomechanism of asthma and also in the development of pathological pregnancies; however survivin has not been studied in pregnant asthmatics. METHODS Twenty-eight asthmatic pregnant (AP), 25 asthmatic non-pregnant (ANP), 21 healthy pregnant (HP) and 29 healthy non-pregnant (HNP) women were enrolled in this cross-sectional study. Plasma survivin concentration was determined by ELISA. RESULTS Plasma survivin was significantly lower in HP (1.64 /0-74.9/ pg/ml) than in HNP (24.6 /0-333.3/ pg/ml, p = 0.01). However, this difference was not observed between the asthmatic groups (p = 0.64). Similarly, there was no difference either between HNP and ANP (10.5 /0-215.4/ pg/ml, p = 0.23) or between HP and AP (13.9 /0-364.1/ pg/ml, p = 0.30) groups. CONCLUSIONS Decreased plasma survivin levels in physiological but not in asthmatic pregnancy may suggest that the normal apoptotic mechanisms are compromised in asthmatic gestation.
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Affiliation(s)
- Andras Bikov
- Department of Pulmonology, Semmelweis University, 1/C Dios arok, Budapest, H-1125 Hungary
| | - Renata Bocskei
- Department of Pulmonology, Semmelweis University, 1/C Dios arok, Budapest, H-1125 Hungary
| | - Noemi Eszes
- Department of Pulmonology, Semmelweis University, 1/C Dios arok, Budapest, H-1125 Hungary
| | - Aniko Bohacs
- Department of Pulmonology, Semmelweis University, 1/C Dios arok, Budapest, H-1125 Hungary
| | - Gyorgy Losonczy
- Department of Pulmonology, Semmelweis University, 1/C Dios arok, Budapest, H-1125 Hungary
| | - Janos Rigo
- First Department of Obstetrics and Gynecology, Semmelweis University, 27 Baross utca, Budapest, H-1085 Hungary
| | - Ildiko Horvath
- Department of Pulmonology, Semmelweis University, 1/C Dios arok, Budapest, H-1125 Hungary
| | - Lilla Tamasi
- Department of Pulmonology, Semmelweis University, 1/C Dios arok, Budapest, H-1125 Hungary
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Bikov A, Bohacs A, Eszes N, Weiszhar Z, Ivancso I, Muller V, Rigo J, Losonczy G, Tamasi L, Horvath I. Circulating and exhaled vascular endothelial growth factor in asthmatic pregnancy. Biomarkers 2012; 17:648-54. [PMID: 22900522 DOI: 10.3109/1354750x.2012.713004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
CONTEXT Vascular endothelial growth factor (VEGF) plays a role in asthma and pathological pregnancies. OBJECTIVE This is the first study assessing plasma and exhaled breath condensate VEGF levels in asthmatic pregnancy. MATERIAL AND METHODS Thirty-one asthmatic pregnant, 29 asthmatic nonpregnant, 28 healthy pregnant and 22 healthy nonpregnant women were enrolled. Plasma was collected in all subjects, EBC in 57 volunteers for VEGF measurements. RESULTS Plasma VEGF decreased in both pregnant groups (p < 0.01), without any differences between the asthmatic and the respective nonasthmatic groups (p > 0.05). VEGF was undetectable in EBC. CONCLUSION Concomitant asthma does not affect plasma VEGF during pregnancy.
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Affiliation(s)
- Andras Bikov
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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15
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Kovats Z, Sütto Z, Muraközy G, Bohacs A, Czebe K, Lang G, Renyi-Vamos F, Klepetko W, Müller V. Airway pathogens during the first year after lung transplantation: a single-center experience. Transplant Proc 2011; 43:1290-1. [PMID: 21620113 DOI: 10.1016/j.transproceed.2011.03.075] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
After lung transplantation, a high level of immunosuppression is needed to prevent rejection. This demand renders recipients more sensitive to infections. As pulmonary infections are a major clinical problem during the first postoperative year after lung transplantation, preventive treatment and regular surveillance examinations are needed for immediate, adequate therapy. We describe the airway pathogens registered during the first posttransplantation year among our 12 lung transplant recipients since December 2008. Samples were obtained for microbiologic analysis from the upper and lower respiratory tracts and from serum as part of routine care. During the first year after transplantation the most frequent pathogens were fungi (Candida albicans 82%; Aspergillus 50%), Pneumocystis (8%), gram-negative bacteria (Pseudomonas spp 60%; Klebsiella 25%, Acinetobacter 17%; Escherichia Coli 17%; and Enterococcus faecalis 25%), and Staphylococcus aureus (50%, including methicillin-resistant strains 25%). This pathogen spectrum in the first postoperative year after lung transplantation was similar to other centers. Colonization with Pseudomonas or fungi presented early and was prevalent among our patients.
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Affiliation(s)
- Z Kovats
- Department of Pulmonology, Semmelweis University, Budapest, Hungary.
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Mathe C, Bohacs A, Duffek L, Lukacsovits J, Komlosi ZI, Szondy K, Horvath I, Muller V, Losonczy G. Cisplatin nephrotoxicity aggravated by cardiovascular disease and diabetes in lung cancer patients. Eur Respir J 2010; 37:888-94. [DOI: 10.1183/09031936.00055110] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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