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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.

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Absztrakt

Bevezetés: A légzőszervi manifesztációval kapcsolatos komplex pulmonalis vizsgálat spondylitis ankylopoeticában szenvedő betegekben hozzájárulhat a megfelelő rehabilitációs program kialakításához. Célkitűzés: A légzésfunkciós, terhelés-élettani változók és a rehabilitációt követő életminőség-változás közötti kapcsolat vizsgálata. Módszer: A vizsgálatba 5 fő Seyfried II. stádiumú és 11 fő Seyfried III. stádiumú beteget vontak be, akik spinalis fizioterápiás, ultrahangos, masszázs- és parafinpakolásos kezelésben részesültek, személyenként 15 alkalommal, majd 8 héten keresztül, heti 3 alkalommal nagy intenzitású kerékpár-kondicionálás történt. A rehabilitáció előtt és után Bath Ankylosing Spondylitis Disease Activity Index és Bath Ankylosing Spondylitis Functional Index felvételére került sor. A rehabilitációt követően elvégezték a légzésfunkciós paraméterek és a terhelés-élettani változók vizsgálatát. Eredmények: Mindkét index jelentős, kezelés utáni változást mutatott az eredeti eredményekhez képest (p<0,05). Ezek a funkcionális mutatók összefüggést mutattak a nyugalmi légzésfunkciós és a terhelés-élettani változókkal (p<0,05). Következtetések: A vizsgálat alapján lehetséges, hogy az előzetes pulmonalis felmérés a spondylitis ankylopoetica kezelésére irányuló hatékonyabb program kidolgozásának alapjául szolgálhat. Orv. Hetil., 2016, 157(28), 1126–1132.

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Abstract

Background

Near-infrared spectroscopy (NIRS) technology can evaluate muscle metabolism and oxygenation. NIRS-based oximeters can measure skeletal muscle oxygen delivery and utilization during static and dynamic work non-invasively. Our goal was to assess the value and usability of NIRS technology in chronic obstructive pulmonary disease (COPD) rehabilitation program.

Methods

Forty patients with COPD participated in a 4-week inpatient rehabilitation program that included breathing exercises and personalized cycle/treadmill training adjusted to the functional capacity, physical activity and comorbidities of the patients. A NIRS muscle oxygen monitor was used to measure tissue oxygenation and hemoglobin levels. Total hemoglobin index, average muscle oxygenation, minimal and maximal muscle oxygenation were recorded before and after the rehabilitation program.

Results

Rehabilitation resulted improvement in 6 min walking distance (6MWD:335.3 ± 110. vs. 398.3 ± 126.2 m; P < 0.01), maximal inspiratory pressure (MIP: 57.7 ± 22.7 vs. 63.6 ± 18.0 cmH2O; P < 0.01), chest wall expansion (CWE: 2.84 ± 1.26 vs, 4.00 ± 1.76 cm; P < 0.01), breath hold time (BHT: 25.8 ± 10.6 vs. 29.2 ± 11.6 s; P < 0.01) and grip strength (GS: 24.9 ± 11.9 vs. 27.0 ± 11.4 kg; P < 0.01). Quality of life improvement was monitored by COPD Assessment Test (CAT: 17.00 ± 8.49 vs. 11.89 ± 7.3, P < 0.05). Total hemoglobin index (tHb: 12.8 ± 1.3% vs. 12.8 ± 1.4), average muscle oxygenation (SmO2: 67.5 ± 14.4% vs. 65.2 ± 20.4%) showed a tendency for improvement. Maximal muscle oxygenation decreased (SmO2 max: 98.0 ± 20.5% vs. 90.1 ± 14.3%; P < 0.01). Minimal muscle oxygenation increased (SmO2 min: 42.6 ± 12.6% vs. 54.8 ± 14.3%; P < 0.01).

Conclusions

NIRS results showed that muscle oxygenation and microcirculation can be described as a high-risk factor in COPD patients. The 4-week rehabilitation improves functional parameters, quality of life and tissue oxygenation levels in COPD patients.

Open access

We set up an agent-based macro-model that focuses on the consumption-saving decision. Agents do not maximize utility, but their behaviour features certain “rational” aspects of human choice based on the idea of ecological rationality. Three qualitatively different saving strategies are defined: 1, buffer stock saving (prudent and forward looking); 2, permanent income saving (forward looking without prudence); and 3, myopic saving (caring only about immediate consumption). It is found that prudent saving behaviour becomes prevalent when the selection pressure is very high, but an economy comprising only prudent households tends to accumulate capital in excess of what is implied by the Golden Rule. Lowering the intensity of evolutionary forces results in more diversity in saver types, and, somewhat puzzlingly, may be socially beneficial in some sense.

Open access

Three new serotypes were found among Rhodococcus equi strains, which could not be assigned into any of the seven serotypes of Prescott’s system. Fortythree R. equi strains out of 44 previously nontypable ones isolated in Hungary could be allocated into one of the three new serotypes using the agar gel immunodiffusion (AGID) test. The three new suggested serotypes are serotype 8 (proposed reference strain: HNCMB-138003), serotype 9 (proposed reference strain: HNCMB-138004) and serotype 10 (proposed reference strain: HNCMB-138005). Hyperimmune sera produced in rabbits against the new serotypes and reference strains gave precipitation only with their homologous antigens, and no crossreactions were observed. All of the previously nontypable isolates from clinical samples of horses (lung abscesses, intestinal lymph nodes, mediastinal lymph nodes) proved to be serotype 8, while strains of serotypes 8, 9 and 10 could be isolated from nasal and rectal swabs of horses and from the soil. Serotype 9 dominated among the previously nontypable strains of swine origin. One of the previously nontypable human strains was serotype 10. This serotype was also isolated from pigs, horses and the soil. The description of the three new serotypes can help us reveal new correlations between the host species, geographical origin and serotype of R. equi isolates.

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Extrém nagy hasfali sérvek előkészítése preoperatív pneumoperitoneum képzésével

Preoperative progressive pneumoperitoneum in the treatment of giant abdominal hernias

Magyar Sebészet
Authors: Pál Szekeres, Ildikó Krémer, Róbert Bukovácz, and János Varga

Absztrakt

A kifejezetten nagy hasfali sérvek gondos preoperatív előkészítésével megelőzhetők olyan posztoperatív szövődmények, mint az abdominal compartment syndroma, légzési elégtelenség, befolyásolhatatlan keringési elégtelenség. Osztályaink évek óta foglalkoznak az extrém nagy hasfali sérvekhez társuló kóros állapotok (eventration disease) vizsgálatával és a rekonstrukció okozta kóros zsigeri következmények-szövődmények megelőzésével. Két eset kapcsán mutatjuk be a progresszív preoperatív pneumoperitoneumképzés indikációját, technikáját és eredményeit.

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Two hundred and twelve Rhodococcus equi strains were isolated from soil, nasal and rectal swabs of horses and immunocompromised human patients in Hungary and serotyped using Prescott’s serotyping system. One hundred and forty-seven strains (69.3%) belonged to serotype 1, 22 strains (10.4%) to serotype 2, 6 strains (2.8%) to serotype 3 and 1 strain (0.5%) to serotype 4. Serotypes 5, 6 and 7 were not found and 36 strains (17%) could not be typed. Serotype 1 (72%) was the type most commonly isolated from clinical samples of foals or from the soil of horse facilities. Six out of 8 R. equi strains from humans belonged to serotype 2, and two human strains were untypable. The data show that the prevalence of R. equi serotypes varies in different geographic areas of the country.

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Abstract  

We studied the effect of variations in the composition of the 3D polymer matrix on the water adsorption properties of poly(N-isopropylacrylamide-co-acrylamide) [abbreviated as poly(NIPAAm-co-AAm)]-based gels containing fillers of diverse hydrophilicities (Na-montmorillonite and hydrophobized montmorillonite). The hydrophilicity of the polymer matrix was modified by varying the ratio of the initial monomers, since acrylamide (AAm) is hydrophilic, whereas N-isopropylacrylamide (NIPAAm) is relatively hydrophobic. Filler content was varied in the range of 1–25 wt%. The water content of polymers, fillers and composites, a parameter determined by their different hydrophilicities was characterized by gravimetry and/or thermoanalytical methods (TG, DSC). The water content of the samples was found to be controllable by varying the hydrophilicity of the polymer matrix and/or the amount and hydrophilicity of the fillers added. Swelling of the relatively hydrophobic poly(NIPAAm) can be increased by the addition of hydrophobic fillers, whereas that of the hydrophilic poly(AAm) can be enhanced by the addition of hydrophilic fillers. The effect of changes in composition on the desorption enthalpies of the samples was determined. The water content of the copolymer increases with increasing the ratio of the hydrophilic monomer, which is due to an increase in the so-called free water content. In the case of the hydrophobic poly(NIPAAm) it is primarily hydrophobic association interactions that dominate the interaction between the polymer matrix and the lamellae of the filler, whereas in the case of the hydrophilic poly(AAm) hydrophilic interactions are dominant.

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Cereal Research Communications
Authors: István Fekete, Csaba Varga, Zsolt Kotroczó, Zsolt Krakomperger, and János Tóth
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