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F Salajka

Publications and source records attributed to F Salajka.

At least 19 recordsLinked to original sources
PubMed2004

[New and old definitions and COPD terminology].

Terminology of the disease currently known as chronic obstructive pulmonary disease has gone through a long and non-uniform development. Various definitions have been gradually developed and chronic bronchitis was separated from pulmonary emphysema. Various umbrella names have been suggested to unite this group of diseases. At present a classification based on World strategy for diagnosing, treatment and prevention of the chronic obstructive pulmonary disease from 2000 which has been published in our country too is used.

Humans↗
PubMed2003

Palliative treatment of cancer anorexia with oral suspension of megestrol acetate.

Megestrol acetate (MA) is a progestational agent, currently known as one of the most effective appetite stimulants in patients suffering from cancer anorexia/cachexia syndrome. Oral suspension of this drug may be particularly useful in patients with far advanced disease, where taking larger amount of pills may lead to the decrease of patient compliance. The influence of oral MA suspension on quality of life and nutritional status was evaluated in 22 patients with far advanced cancer suffering from anorexia and more than 5 per cent weight loss, all beyond the scope of anticancer treatment. Most patients had lung or gastrointestinal cancer. QLQ-C30 questionnaire, visual analogue scale (VAS) for appetite, anthropometry, maximal handgrip strength and laboratory data were obtained before treatment and then after 2, 4, and 8 weeks of therapy. Despite of a known high mortality in this prognostically unfavorable group of patients (36% within two months in this study), overall quality of life after the daily dose of 480-840 mg of MA was improved in 63, 56, and 55% of patients remaining on therapy after 2, 4, and 8 weeks, respectively. Appetite was the most successfully influenced parameter with an improvement in VAS in 95% of cases after 2 weeks of therapy (p=0.0001). The drug was well tolerated by the great majority of patients. Oral suspension of megestrol acetate maybean effective palliative treatment for many patients with far advanced cancer suffering from anorexia/cachexia syndrome.

Administration, Oral↗
PubMed2002

[Quality of life and tolerance of maintenance therapy in patients with multiple myeloma].

Questionnaires on the quality of life and tolerance of different parts of maintenance treatment were sent to a total of 83 patients with multiple myeloma. All patients were for more than one year on maintenance treatment which involved either interferon alpha monotherapy (I), 3 million u. three times per week till signs of relapse developed or sequence administration of interferon alpha and dexamethazone 40 mg on day 1 to 4, 10 to 13 and 20 to 23 and then after a four-week interval again interferon alpha, again till progression of the disease occurred. The patients evaluated the presence or absence of different undesirable effects of treatment during the first two weeks of treatment and throughout the year and listed their intensity into four categories defined in the questionnaire. The quality of life was evaluated by means of a basic module of the questionnaire of the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire version 3.0 (EORTC QLQ-C30). The results of the questionnaire are to a certain extent surprising as from the patients' answers ensues that this maintenance treatment is associated with more numerous undesirable effects than the physicians realized when in contact with the patient. In this summary we can list only the most frequent effects (deterioration of eyesight, impaired sleep, depressions, irritability and unrest, chill, pain in muscles and joints, general weakness and dyspnoea). From the questionnaires on the quality of life ensues a markedly poorer quality of life of these patients as compared with the healthy population. There are however no basic differences between individual groups. The questionnaires were handed only to patients who had maintenance treatment for more than one year and thus patients were eliminated where maintenance treatment was discontinued because of undesirable effects. To give a general idea of the tolerance of the above maintenance treatment the authors mention that to the date of Aug. 31, 2001 113 patients were randomized into one of the branches of maintenance treatment. Maintenance treatment had to be discontinued in 6% patients (in two instances on account of severe hypothyroidism, in one case on account of hallucinations, in three instances on account of severe mental depression caused by this treatment). Reduction of interferon doses in 20% patients usually because of cytopenia but also on account of psychic problem. To the question what length of prolongation of life compensates the undesirable effects of maintenance treatment the following replies were obtained from patients receiving ID, possibly I: 3 months--47.6 and 38.3%, 6 months--4.3 and 10.6%, 9 months--0 and 4.3%, 12 months--47.6 and 46.8% of the addressed patients. In reply to the question whether the patients would prefer, assuming equal effectiveness, a maintenance monotherapy with interferon alpha or dexamethazone more patients preferred interferon to dexamethasone. For practice ensues from this article informing on undesirable effects of maintenance treatment and the effect of maintenance treatment on the quality of life: 1. the necessity of thorough knowledge of physicians of all possible undesirable effects as only a doctor knowing possible undesirable effects of treatment can recognize them, 2. regular monitoring not only of the activity of the basic disease, but also undesirable effects of maintenance treatment and the influence of treatment on the patients' quality of life, 3. the necessity to assess the quality of life in clinical trials as an important parameter for deciding on the way of treatment.

Antineoplastic Agents↗
PubMed2002

[Relation between pulmonary ventilation parameters, exercise tolerance and quality of life in patients with chronic obstructive lung disease].

Patients with chronic obstructive pulmonary disease (COPD) do usually have decreased tolerance of exercise capacity and impaired quality of life. Several studies have shown that exercise capacity is related relatively weakly to lung functions in this group of patients. The aim of the present study was to find parameter which could better reflect or predict maximal exercise capacity. 19 patients with the diagnosis COPD with mean value of forced expiratory volume in one second (FEV1) 46% predicted (range 21-79%) entering pulmonary rehabilitation program were included into the study. Enrolled patients were chosen to cover the whole range of airway obstruction severity. Post-bronchodilator static and dynamic ventilation parameters were used for evaluation and calculation. Quality of live was measured using St. George's respiratory questionnaire (SGRQ), evaluating symptoms, activity and impact of the disease with range from 0 (the best level) to 100 (the worst level). Values of FEV1 (p < 0.001) and ratio of FEV1 to vital capacity (FEV1/VC, p < 0.001) were significantly positively correlated with 6 minute walking distance (6MWD). FEV1/VC were closely related to 6MWD then FEV1. The degree of hyperinflation expressed by residual volume (RV, p < 0.005) and by ratio of residual volume to total lung capacity (RV/TLC, p < 0.001) significantly negatively correlated with 6MWD. Maximal occlusion mouth pressures (PImax, p < 0.05) were positively related to 6MWD. Total score of SGRQ correlated significantly to maximal exercise capacity. Pulmonary function tests and respiratory muscle function have important impact on exercise tolerance in patients with COPD. Tolerance of exercise capacity is significantly reflected by total score of quality of life in this group of patients.

Aged↗
PubMed2001

Quality of Life Evaluation and Survival Study: a 3-yr prospective multinational study on patients with chronic respiratory failure.

Therapy of patients with chronic respiratory failure is mainly directed at minimizing symptoms in order to improve, or at least to prevent a deterioration of, patients' well-being. Under such circumstances, the perceived effect of therapies on patients' well-being and daily life represents the most important subjective outcome of treatment. Therefore, there is a need to provide a global estimate of health in patients on long term oxygen therapy or overnight home mechanical ventilation. The Maugeri Foundation Respiratory Failure Questionnaire (MRF28) is the first health status ("quality of life") questionnaire specifically developed for use in CRF and its items were selected to be applicable to patients with both obstructive and restrictive diseases. The Quality of Life Evaluation and Survival Study (QuESS) is a multinational study with the aim of re-evaluating the natural history of chronic respiratory failure in about 300 patients. To the authors knowledge, the Quality of Life Evaluation and Survival Study is the first study to evaluate the natural history of chronic respiratory failure in such a large number of subjects and with a complete set of data. In fact, both pathophysiologic and health status assessments will be made. Moreover, by collecting data on mortality, disease exacerbations and hospitalization, it will also be possible to verify the predictive ability of health status versus pathophysiology in terms of mortality and healthcare utilization.

Chronic Disease↗
PubMed2001

High dose rate intraluminal brachytherapy in the treatment of malignant airway obstructions.

Endobronchial brachytherapy has been increasingly used in an effort to improve local control and relieve symptoms of malignant airway obstructions. Results of the high dose rate (HDR) intraluminal brachytherapy in 67 patients with inoperable endobronchial tumor treated by combination of teletherapy and brachytherapy with curative (group A ) or palliative (group B) intent, patients with recurrent tumors after previous radiotherapy treated by endobronchial brachytherapy alone (group C), and patients treated by brachytherapy without teletherapy (group D) are presented. Symptomatic improvement was achieved in 66%, 74%, 64% and bronchoscopic response in 70%, 85%, 78% of patients in groups A, B and C, respectively. Median survival was 365, 242 and 884 days from diagnosis and 245, 151 and 153 days from the first brachytherapy application in groups A, B and C, respectively. In group D complete bronchoscopic response was achieved in 3 of 4 patients with early tumor and partial response in 6 of 7 patients with advanced disease. We observed 4 acute and 9 late complications. Brachytherapy is an effective palliative treatment of malignant airway stenosis, but the effect on survival is not apparent.

Adenocarcinoma↗
PubMed2001

The causes of massive hemoptysis.

In a group of 656 patients examined for hemoptysis of unknown etiology the average amount of expectorated blood in individual diagnostic groups was evaluated and the patients with massive hemoptysis (> 100 ml/24 hrs) were selected. The hemoptysis was evaluated as massive in 53 patients (8%), being most frequent in patients with chronic anatomical changes of lung parenchyma (22/64) and active tuberculosis (4/26). The fact that massive hemoptysis endangers above all patients with bronchiectasis and other anatomical disorders of the lung parenchyma was evident through the comparison of the average maximal amount of expectorated blood, which was significantly higher in this group (78 ml/24 hrs) than in the majority of other diagnoses (total average 22 ml/24 hrs). In conclusion, the risk of sudden massive hemoptysis should be kept in mind in these patients even if only minimal bleeding occurs and energetic cautionary measures should be implemented right from the onset of bloody expectoration.

Female↗
PubMed2001

[Bronchoscopic diagnosis of lung tumours].

The role of diagnostic bronchoscopy in patients with lung tumours is to evaluate the presence, extent and character of endobronchial tumourous changes. Videobronchoscopes and ultrathin bronchoscopes introduced recently into clinical practice make more accurate evaluation of larger areas of the bronchial tree possible. The clinical impact of methods based on the principle of (auto)fluorescence is searched for. From sites affected with the tumour samples are taken for histological or cytological examination which in addition to evidence of a tumourous etiology specify the type of tumour. An integral part of the examination is staging when the extent of the tumour proper and the regional lymph nodes within the framework of the TNM classification is evaluated optically and by aimed sampling. Examination by endobronchial ultrasound makes it possible to assess more accurately the extent of tumourous affection in the bronchial wall or extrabronchially. The task of the brochologist is also to evaluate the possbility of bronchological intervention (laser, brachytherapy, stent etc.) for palliation of symptoms. Virtual bronchoscopy is the arteficial construction of the image of central airways created from CT scans which makes it possible to visualize sections of the central airways which are not accessible by bronchoscopy. Bronchoscopy is a method of fundamental importance for the diagnosis, therapy and control of complications and palliation of symptoms of lung tumours. This method cannot be replaced at the moment by any other method and its importance is apparent from the fact that the spectrum of bronchoscopic examinations in patients with lung tumours is steadily increasing.

Bronchoscopy↗
PubMed2000

Commercial polymerase chain reaction test (Amplicor set) in the diagnosis of smear-negative pulmonary tuberculosis from sputum and bronchoalveolar lavage.

The study presents experience with polymerase chain reaction (PCR) in the diagnosis of tuberculosis (TB) and compares the results obtained in sputum and bronchoalveolar lavage fluid (BALF). A total of 1,097 samples from 846 smear-negative patients with suspected TB was examined using PCR and culture during a period of 40 months. TB was the final diagnosis in 160 patients, based on the evidence of mycobacteria in 90 patients and on clinical criteria in the remaining 70. The PCR test had high specificity (98% and 99%, respectively) but poor sensitivity (37% and 34%, respectively) regardless of whether sputum or BALF was examined. Surprisingly, the sensitivity of culture (44% and 35% in sputum and BALF, respectively) was higher than that of PCR in this group. The contribution of BAL to establishing the diagnosis of tuberculosis was rather limited, yet substantial in some patients. The results obtained in this study were compared with the results published in the literature, and it was concluded that further clinical studies are necessary to establish an appropriate role for the polymerase chain reaction in the diagnosis of tuberculosis.

Bronchoalveolar Lavage Fluid↗
PubMed2000

HDR intraluminal brachytherapy in the treatment of malignant bronchial obstructions.

Symptomatology of malignant intrabronchial obstructions has a serious negative effect on the quality of patients' life. Intrabronchial brachytherapy can play an important role in the palliation of these symptoms. Between December 1996 and September 1998 48 patients suffering from malignant intrabronchial obstructions were treated with intraluminal brachytherapy in the Dept. of Radiation Oncology at the University Maternity Hospital in Brno. Gammamed HDR automatical afterloading equipment was used to treat all patients. The first group (23 patients) was treated with a combination of intraluminal brachytherapy and external radiotherapy. The second group (18 patients who had relapsed after previous external radiotherapy) was given intraluminal radiotherapy only. A third group (7 patients) underwent intraluminal brachytherapy only. In the first group 17 patients (77%) showed symptomatic relief with tumor regression on X-ray in 16 patients and with bronchoscopic regression in 19 patients. Seven patients died before October 1998 having survived 1-6 months after the first brachytherapy application. Sixteen patients are still alive (1-14 months). In the second group, 10 patients (56%) reported significant improvement of symptoms, with endoscopic regression in 12 patients. Twelve patients died before October 1998 surviving 1-6 months after the first brachytherapy session, 6 patients are still alive 1-5 months after the first brachytherapy fraction. In the third group, bronchoscopy confirmed a complete disappearance of intrabronchial lesion in two cases with early intrabronchial tumor. Five patients reported symptomatic improvement with endoscopic regression of the tumor. There was only one complication recorded: bronchospasm in one patient. The short follow up and limited number of patients does not allow comment on the late effects and survival, yet. In conclusion, intraluminal brachytherapy is an effective and safe approach for palliation of malignant bronchial obstructions.

Airway Obstruction↗
PubMed1999

The role of local anaesthetic inhalation during premedication before bronchoscopy.

In a prospective randomized study, the efficacy of local anaesthetic inhalation during premedication before bronchoscopic examination was evaluated. Eighty patients with chronic nonproductive cough were inhaling either nebulized anaesthetics (10 ml of 1% trimecain; 40 patients--group A) or an isotonic chlorine solution (40 patients--group B). This was followed by topical anaesthesia using spray and laryngeal syringe. Comparing the score of cough and episodes of gagging, the inhalation of local anaesthetics appeared to make the procedure slightly more comfortable for some patients. Additional anaesthesia was less frequently needed in group A than in group B (12 vs. 19 patients). However, none of the observed differences reached statistical significance. In conclusion, the inhalation of local anaesthetics at the beginning of premedication before bronchoscopy was not confirmed as a useful method that made the examination more comfortable for patients with chronic non-productive cough, but did produce a moderately beneficial effect in some of them.

Administration, Inhalation↗
PubMed1999

Occurrence of haemoptysis in patients with newly diagnosed lung malignancy.

AIM: To evaluate the correlation of the histological type of tumour and the bronchoscopic finding with the occurrence of haemoptysis in patients with pulmonary malignancy. METHODS: In a retrospective study the records of all patients with proven lung tumours were reviewed with emphasis on histological type, location of endobronchial tumour, TNM stage in relation to the presence of haemoptysis in the patient's history. RESULTS: Out of 536 patients with pulmonary malignancy, haemoptysis was present in 113, being more frequent in patients with NSCLC than SCLC and in patients with primary pulmonary tumour than those with pulmonary metastases (both p < 0.05). According to the location of endobronchial tumours, haemoptysis occurred in 31% of patients with a central process, in 13% of patients with intermedial and 12% with peripheral locations, respectively. According to the TNM classification the portion of patients with haemoptysis increased with tumour size. CONCLUSION: Haemoptysis as the initial sign of pulmonary malignancy occurs mostly in patients with centrally located tumours. However, in individual patients the onset of bleeding is influenced by the histological type of tumour and the tumour size.

Bronchoscopy↗
PubMed1999

[Duration of anamnesis in patients with hemoptysis].

The duration of anamnesis and its dependence on the amount of expectorated blood and on concomitant complaints was evaluated in 774 patients examined for hemoptysis in the Department of Respiratory Diseases and Tuberculosis, Faculty Hospital, Brno, with the aim to detect the factors hastening the visiting the physician by the patient. The longest anamnesis in average was in patients with COPD (123 days) and lung cancer (58 days). The patients coming too late to the physician originated mostly from these 2 groups as well--the anamnesis was longer than 2 months in 27% out of COPD patients and in 25% out of cancer patients. After including the influence of the amount of expectorated blood and of the concomitant complaints, the conclusion was reached that the bloody expectoration alone especially when streaks of blood only are present in sputum represent in many patients the motive not important enough for consulting the physician.

Female↗
PubMed1999

[Why evaluate the quality of life in patients with bronchial obstruction?].

Quality of life, more precisely health related quality of life, is gaining basic importance in evaluating of patient's health status and results of medical interventions. On the example of patients with bronchial obstruction is demonstrated that quality of life evaluation, although not usually used in clinical practice yet, is in significant correlation with some of usual clinical measures; moreover, it brings otherwise inaccessible information about patient's subjective assessment of his disease and his health situation.

Humans↗