[Budesonide (Turbuhaler) at a dosage of 400 micrograms per day is at least as effective as a double dose of beclomethasone (MDI) in patients with mild to moderately severe bronchial asthma]. / Budesonid (Turbuhaler) v dávce 400 micrograms denne je alespon tak úcinný jako dvojnásobná dávka beclometasonu (MDI) u nemocných s lehkým az stredne tezkým bronchiálním astmatem.

BACKGROUND: Recent investigations revealed that in patients with bronchial asthma the same anti-inflammatory effect is achieved by inhalation of half the dose of budesonide by a Turbuhaler (i.e. by using corticosteroid in powder form) as by a full dose of beclomethasone driven into the lungs by compressed chlorofluorocarbons (i.e. MDI = pressure dosage inhalator). The objective was to assess whether there is a difference between 12-week treatment with budesonide Turbuhaler in a smaller dose of 400 micrograms/day and treatment with beclomethasone dipropionate MDI 800 micrograms/day. METHODS AND RESULTS: After an initial two-week period of the 227 patients with mild or medium severe asthma who had not taken corticosteroids for three months, into the budesonide Turbuhaler group 94 patients were included and into the beclomethasone MDI group 99 patients. Characteristics: group treated with budesonide (46 men, 48 women, mean age 38 years, FEV1 78% of appropriate values). Group treated with beclomethasone (51 men, 48 women, mean age 39 years, FEV1 81.5% of appropriate values). Morning and evening values of the peak expiration rate (PEF) increased significantly after budesonide treatment 2 x 200 micrograms/day) as compared with beclomethasone treatment (2 x 400 micrograms/day). Differences of morning PEF between budesonide and beclomethasone: 47:28 l/min, p < 0.05, differences of evening PEF: 32:10 l/min., p < 0.027. The number of dyspnoic attacks declined after both types of treatment, as well as the amount of inhaled bronchodilatating substances (terbutalin Turbuhaler). The differences between drugs were however not statistically significant. CONCLUSIONS: Budesonide Turbuhaler, 400 micrograms/day when administered to patients with bronchial asthma was at least as effective as beclomethasone MDI, 800 micrograms/day. The increase of morning and evening PEF values was after budesonide significantly higher than after beclomethasone.

[Pneumocystis carinii pneumonia in a HIV-positive patient]. / Pneumocystis carinii pneumonia HIV pozitív betegben.

The authors publish a case report of a young man, who have got a severe pneumonia, which did not recover after antibiotics treatment. When the cause of the immunosuppression was investigated, HIV positivity was found, and Pneumocystis carinii was recognised in the bronchoalveolar lavage fluid. The diagnosis of the lung complications and the possibilities of the treatment are discussed.

[Spiro-ergometry in chronic obstructive lung diseases]. / Spiroergometria krónikus obstruktív tüdöbetegségben.

The relationship of ventilatory function (FEV1, RV) with ergospirometric parameters (VO2max, VEmax/MVV) and arterial blood gas changes (delta paO2, delta paCO2) was investigated in 52 COPD patients. After exercise group I patients (n = 32) had better oxygenation (paO2: 62.6 +/- 7.2-->78.2 +/- 11.2 mmHg, P < 0.001), while paO2 in group II (n = 20) deteriorated (60.9 +/- 7.3-->54.1 +/- 5.4 mmHg, p < 0.001). Significant correlation have been found only in group II between FEV1 and VO2max (r = 0.65, p < 0.01) and RV and VO2max (r = -0.64, p < 0.01). Of the 41 patients who reached anaerobic threshold (AT), only 8 showed worse paO2 after exercise. Our results suggest that simultaneous observation of metabolic (AT) and respiratory (paO2) parameters during exercise are necessary to select those COPD patients who could have benefit from high intensity regular physical training. Those, who are able to reach AT and paO2 does not deteriorate during exercise are the best candidates for this kind of treatment.

[Immunomodulation therapy in chronic bronchitis (multicenter study)]. / Immunmodulációs terápia idült hörghurutban (multicentrikus vizsgálat).

(A multicentre clinical trial) The authors treated 120 patients showing the symptoms of chronic bronchitis with BV or placebo for 6 months during the winter period of 1992-93 in a multicentre double-blind clinical trial. The status of the patients was evaluated monthly and the data were analyzed at an independent computer company. The clinical symptoms were significantly milder in the BV group as compared with the placebo group and antibiotics consumption in the BV group was almost half of that recorded in the placebo group. These findings confirm that BV can be effective in the prophylaxis of the exacerbation of chronic bronchitis.

[Lymphoid infiltrates in the lung]. / A tüdö lymphoid infiltratumairól.

The authors reviewed material of 10 year period (1980-1990) of the Department of Pulmonology, Albert Szent-Györgyi University of Medicine, Deszk, Hungary, and selected 14 patients from the files who considered to belong in one of the lymphoproliferative conditions (4 low grade and 4 high grade lymphomas of B-cell type, 1 angiocentric, 1 mediastinal lymphoblastic non-Hodgkin's lymphoma, 3 Hodgkin's lymphoma cases and 1 pleural pseudolymphoma). Every patient admitted with prominent pulmonary symptoms. The diagnoses were based on histology and immunohistochemistry of tissue samples and autopsy. One high grade B-cell and the angiocentric malignant lymphoma proved to be primary pulmonary process. No specific radiomorphological signs were found, which could be characteristic for the pulmonary lympho-reticular infiltrations and also to distinct the primary and secondary ones. The lung infiltrations in the most of the non-Hodgkin's lymphoma cases with low grade malignancy appeared imitating tuberculosis, while the high grade group and Hodgkin's lymphomas displayed confusion with any primary or multiple tumors.

[Effectiveness and tolerability of the glucocorticoid mometasone furoate given as nasal spray in seasonal allergic rhinitis]. / A glükokortikoid mometazon furoát orrspray formában való adásának hatása szezonális allergiás rhinitisben.

The clinical effect and tolerance of momethasone furoate (MF) glucocorticoid nasal spray (MFNS) were studied in 14-70 year-old patients suffering from seasonal allergic rhinitis. The patients administered daily one (morning) dose, 100 micrograms each, of MF into both nostrils, for a period of 14 days. They did not use other medicines affecting nasal symptoms. Nasal symptoms (nasal discharge, nasal obstruction, nasal itching, sneezing) and non-nasal symptoms (lacrimation, eye itching/burning sensation, palatal itching, ear itching, general itching), scored 0 to 3, and serving as a basis for evaluating the effect, were registered before treatment (day 1) and at visits on 3, 7 and 14th day. Of the 196 patients involved in the open multicentric study, 188 completed the study. The total average nasal symptom scores decreased, already after 3 days of treatment, from 8.7 to 4.1 and to 1.6 by the 14th day. Decrease of non-nasal symptoms was also conspicuous, however, lacrimation persisted in 57 of 188 cases, while eye itching--mainly in moderate and mild form--in 90 cases. The general condition of rhinitis before the treatment was evaluated by the examiners as severe or very severe in 155 cases (82%), as symptom-free (99 cases) on day 14 in, and mild (71 cases), in 170 cases (90%). The therapeutic effect was considered by both, patients and physician, as excellent, in 106 (56%) and 115 (61%) cases, resp. and as good in 63 (34%) and 56 cases (30%). Side-effects were mostly mild and transitory. Treatment was not discontinued due to side-effect in any of the cases. Based on the results, MFNS, administered in a single daily dose of 200 micrograms, has proved to be an effective and safe glucocorticoid preparation, also easy to use locally, in the treatment of allergic rhinitis.

[Grotto climate therapy in obstructive bronchitic syndrome]. / Grottensklimatherapie beim obstruktiven bronchitischen Syndrom

In the "Beke" grotto of Jósvafö 222 patients with an obstructive syndrome (respiratory blast value below 70) wer examined for the therapeutic results of therapy, with treatment made for five hours a day and for an overall period of three weeks. After climatotherapy, an increase in the FEV value by more than 15% was observed in 30% of the patients and in 36% of the hyperergic-allergic group. The respiratory function was found to have changed for the worse in 8%. The whistling nosie observed at the beginning of treatment disappeared in 51%, and coughing and suffocation improved in one half of the case. During treatment the consumption of drugs decreased in 52% and showed and increased in 4.7%. With the comparable group of patients treated in the hospital, improvement of the respiratory function was less conspicuous, whereas the symptomatic rate of improvement was twice as high. The mechansim of action of climatotherapy in the grotto and the indication of treatment are discussed.

Molecular genetic and traditional methods for detection of Mycobacterium tuberculosis complex (discrepancy analysis).

In the past six and half years, 862 different clinical samples [sputum, bronchoalveolar lavage, thorax puncture, cerebrospinal fluid and skin samples] were tested by Gen-probe amplified Mycobacterium tuberculosis direct test (MTD) or ligase chain reaction (LCR) or polymerase chain reaction (PCR). 239 parallel clinical samples were cultivated, and some samples were stained with Ziehl-Neelsen staining. 1-4 samples were tested per patient. 29 (12.13%) samples were positive and 177 (74.05%) samples were negative with both cultivation and molecular genetic methods. 2 (0.83%) samples were positive only on cultivation, and 31 (12.97%) samples were positive only with the molecular diagnostic methods. The differences are undoubtedly explained by the sensitivity of the molecular diagnostic methods.