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Article: Reinfection, recontamination and revaccination for SARS-CoV-2.

Kullmann, Tamás / Drozgyik, András

World journal of methodology

2022 Volume 12, Issue 4, Page(s) 258–263

Abstract: The reports on coronavirus disease 2019 (COVID-19) describe the pandemic in waves. Similar to the ocean's waves, the frequency and amplitude of the number of new cases and the number of deaths were globally quite regular; nevertheless, they showed ... ...

Abstract	The reports on coronavirus disease 2019 (COVID-19) describe the pandemic in waves. Similar to the ocean's waves, the frequency and amplitude of the number of new cases and the number of deaths were globally quite regular; nevertheless, they showed important regional irregularities and the direction of spread has been generally rather unpredictable for COVID-19. One of the major reasons for the repeated outbreaks is the mutating capacity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that allows the virus to infect persons who have natural immunity or have been vaccinated. Vaccination began in vast campaigns from the second year of the pandemic that was supposed to decrease the magnitude of the waves. Although it reduced the complications, the expected attenuation of the disease expansion has not yet been met. This paper provides a short overview of the most recent data on the rate of reinfection in vaccinated and non-vaccinated individuals. It points out that testing positive for a second time for SARS-CoV-2 does not necessarily mean a reinfection; it can also be interpreted as recontamination. The symptom free outcome as well as the rapid reconversion of the polymerase chain reaction test may help to determine the difference between reinfection and recontamination. Awareness of this phenomenon may be valuable in times of human resource difficulties. The available evidence may suggest that the protective value of a prior infection could be better considered for vaccine distribution in the future.
Language	English
Publishing date	2022-07-20
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2222-0682
ISSN	2222-0682
DOI	10.5662/wjm.v12.i4.258
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Article ; Online: Optimisation of second line antihormonal treatment for castration resistant metastatic prostate cancer

Kullmann Tamás / Kocsis Károly / Ambrus Adél / Kránitz Noémi / Herczeg Ágnes / Szepesváry Zsolt

Journal of Men's Health, Vol 18, Iss 4, p

2022 Volume 93

Abstract: Background: The prognosis of castration resistant metastatic prostate cancer has been improved by several recently introduced therapeutic options, among others the second line antihormonal agents. Still, several questions related to the optimal use of ... ...

Abstract	Background: The prognosis of castration resistant metastatic prostate cancer has been improved by several recently introduced therapeutic options, among others the second line antihormonal agents. Still, several questions related to the optimal use of these new drugs have remained open. The following ones were addressed in this paper. (1) Is the use of abiraterone + hydrocortisone inferior to abiraterone + prednisone in terms of overall survival? (2) Is the treatment up to prostate specific antigen (PSA) progression inferior to the treatment up to radiological progression in terms of overall survival? (3) Does the level of initial PSA decrease have a predictive value for the duration of response? Methods: As part of our self-assessment the dataset of 62 patients with castration resistant metastatic prostate cancer who started second line antihormonal therapy at our outpatient clinic before 31st of December 2019 was analysed. Results: 35 patients received abiraterone with prednisone substitution, 12 patients received abireterone with hydrocortisone substitution and 15 patients received enzalutamide. 39 patients were treated until clinical or radiological progression and 23 patients were treated until biological progression. (1) Median overall survival of patients substituted with hydrocortisone was not inferior as compared to patients substituted with prednisone (31 months vs. 17 months). (2) Median overall survival of patients treated until PSA progression was not inferior as compared to patients treated until radiological progression (32 months vs. 17 months). (3) Median overall survival of patients whose first control PSA level was below the normal value was 50% higher than median survival of patients whose first control PSA level was over the normal value (25 months vs. 17 months). Median overall survival of patients treated with abiraterone or enzalutamide was similar (21 months vs. 24 months). Conclusions: The combination of abiraterone + hydrocortisone is not inferior to the combination of abiraterone + ...
Keywords	prostate cancer ; abiraterone ; enzalutamide ; hydrocortisone ; biological progression ; Medicine (General) ; R5-920
Subject code	610 ; 616
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	MRE Press
Document type	Article ; Online
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Article ; Online: A single centre pilot experience with 18F-JK-PSMA-7 PET-CT in the staging of prostate cancer

Szigeti András / Kocsis Károly / Ambrus Adél / Kránitz Noémi / Szepesváry Zsolt / Kullmann Tamás

Journal of Men's Health, Vol 18, Iss 2, p

2022 Volume 045

Abstract: Background: The sensitivity and specificity of bone scintigraphy and thoraco-abdominopelvic CT scans traditionally used for the staging of prostate cancer don’t meet clinical requirements. In 2020 18F-JK-PSMA-7 positron emission tomography-computed ... ...

Abstract	Background: The sensitivity and specificity of bone scintigraphy and thoraco-abdominopelvic CT scans traditionally used for the staging of prostate cancer don’t meet clinical requirements. In 2020 18F-JK-PSMA-7 positron emission tomography-computed tomography (PET-CT) became available in our country for routine clinical diagnostics. Methods: As part of our self-assessment, we retrospectively analysed the results of 24 PSMA PET-CTs realised for our patients up to 31 December 2020. Results: The indication of the examination was biochemical recurrence after radical prostatectomy (prostate specific antigen (PSA) >0.2 ng/mL) for 16 patients and primary staging (PSA range: 5.2–70 ng/mL) for 8 patients. Biochemical recurrence was related to local relapse in 2 cases, regional lymph node involvement in 5 cases, oligo- and multi-metastatic spread in 1 and 3 cases respectively. 5 patients had no detectable lesion. Patients with PSA <1 ng/mL showed no extrapelvic enhancement. At primary staging 3 patients presented distant metastases. There was no correlation between PSA level and disease extent. In total PSMA PET-CT results changed the treatment strategy for 7 patients. Conclusions: 18F-JK-PSMA-7 PET-CT is a useful diagnostic tool. The examination can lead to change the treatment decision at primary staging as well as at biochemical recurrence. The results of this pilot study may support the strategy that patients with biochemical recurrence following radical prostatectomy receive salvage radiotherapy to the prostate bed and the pelvic lymphatic regions without any imaging examination when PSA <1 ng/mL.
Keywords	prostate cancer ; psma pet-ct ; biochemical relapse ; therapy optimisation ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	MRE Press
Document type	Article ; Online
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Article: A páciensek véleményének figyelembevétele az egészségügyi ellátás tervezése és értékelése során. A páciensek egészségértékelése.

Kullmann, Lajos / Kullmann, Tamás

Orvosi hetilap

2018 Volume 159, Issue 6, Page(s) 215–222

Abstract: Provision of patient-centred health care is impossible without the knowledge of the patient's perceptions, feelings and expectations. In contrast, participants feel the available time limited for satisfactory communication. This shortage may partially be ...

Title translation	Taking patients' views into consideration at planning and evaluating care. Patient Reported Outcomes.
Abstract	Provision of patient-centred health care is impossible without the knowledge of the patient's perceptions, feelings and expectations. In contrast, participants feel the available time limited for satisfactory communication. This shortage may partially be compensated by measurements belonging to the concept of Patient Reported Outcomes. Concept definition, invention circle and use of the methods are largely diverse, eventually leading to misinterpretation of outcomes. For this reason, some organizations developed instructions, guidelines supporting uniform interpretation and application. Measures so far have rather served research goals yet may be applied in the clinical practice as well. They are not only appropriate for the evaluation of outcomes, judgement of adequacy and safety of care on systemic or institutional level, but also for the planning of individual patient care and supporting communication and co-operation. The present paper aims to provide general information and references for introducing the details. Orv Hetil. 2018; 159(6): 215-222.
MeSH term(s)	Humans ; Patient Reported Outcome Measures ; Patient Satisfaction ; Patient-Centered Care/organization & administration ; Physician-Patient Relations
Language	Hungarian
Publishing date	2018-02
Publishing country	Hungary
Document type	Journal Article ; Review
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2018.30976
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Article ; Online: Variability of breath condensate pH may contribute to the better understanding of non-allergic seasonal respiratory diseases.

Kullmann, Tamás / Szipőcs, Annamária

International journal of biometeorology

2017 Volume 61, Issue 9, Page(s) 1703–1708

Abstract: The seasonal variability of certain non-allergic respiratory diseases is not clearly understood. Analysis of the breath condensate, the liquid that can be collected by breathing into a cold tube, has been proposed to bring closer to the understanding of ... ...

Abstract	The seasonal variability of certain non-allergic respiratory diseases is not clearly understood. Analysis of the breath condensate, the liquid that can be collected by breathing into a cold tube, has been proposed to bring closer to the understanding of airway pathologies. It has been assumed, that (1) airway lining fluid was a stable body liquid and (2) the breath condensate samples were representative of the airway lining fluid. Research was focussed on the identification of biomarkers indicative of respiratory pathologies. Despite 30 years of extended investigations breath condensate analysis has not gained any clinical implementation so far. The pH of the condensate is the characteristic that can be determined with the highest reproducibility. The present paper shows, that contrary to the initial assumptions, breath condensate is not a representative of the airway lining fluid, and the airway lining fluid is not a stable body liquid. Condensate pH shows baseline variability and it is influenced by drinking and by the ambient temperature. The changes in condensate pH are linked to changes in airway lining fluid pH. The variability of airway lining fluid pH may explain seasonal incidence of certain non-allergic respiratory diseases such as the catching of a common cold and the increased incidence of COPD exacerbations and exercise-induced bronchoconstriction in cold periods.
MeSH term(s)	Breath Tests ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Respiratory Tract Diseases/epidemiology ; Respiratory Tract Diseases/metabolism ; Seasons
Language	English
Publishing date	2017-07-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	280324-0
ISSN	1432-1254 ; 0020-7128
ISSN (online)	1432-1254
ISSN	0020-7128
DOI	10.1007/s00484-017-1397-y
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Zs.A 998: Show issues

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Article ; Online: Neuroendocrine Cancer of the Prostate.

Kránitz, Noémi / Szepesváry, Zsolt / Kocsis, Károly / Kullmann, Tamás

Pathology oncology research : POR

2019 Volume 26, Issue 3, Page(s) 1447–1450

Abstract: Neuroendocrine cancer of the prostate is considered to be a rare entity with bad prognosis and limited therapeutic options. We performed a prospective analysis of the patients treated in our hospital for prostate cancer between 1st January 2015 and 31rd ... ...

Abstract	Neuroendocrine cancer of the prostate is considered to be a rare entity with bad prognosis and limited therapeutic options. We performed a prospective analysis of the patients treated in our hospital for prostate cancer between 1st January 2015 and 31rd December 2018. Neuroendocrine phenomena were tested by immunohistochemistry and laboratory chemistry on the request of the clinicians in the cases when a positive diagnosis was suspected. Clinical tableaux of high suspicion of neuroendocrine cancer included radiological progression of a metastatic disease without PSA rise, relatively extended metastatic disease associated to a low PSA, disease with non-pulmonary visceral metastases. 10 patients were diagnosed with neuroendocrine tumour out of 521 prostate cancers. Half of the patients had a survival over a year. 3 patients received 3 lines of efficacious palliative chemotherapy. 1 patient underwent prostatectomy after neoadjuvant chemotherapy for a localised disease. The incidence of neuroendocrine tumours among prostate cancer patients was higher than expected. Some of the patients had a relatively good outcome.
MeSH term(s)	Aged ; Humans ; Incidence ; Male ; Middle Aged ; Neuroendocrine Tumors/epidemiology ; Neuroendocrine Tumors/pathology ; Neuroendocrine Tumors/therapy ; Prostatic Neoplasms/epidemiology ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/therapy
Language	English
Publishing date	2019-08-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1375979-6
ISSN	1532-2807 ; 1219-4956
ISSN (online)	1532-2807
ISSN	1219-4956
DOI	10.1007/s12253-019-00712-2
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Zs.A 4936: Show issues

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Article ; Online: Complex oncologic therapy for loco-regionally advanced breast cancer associated with long-lasting SARS-CoV-2 PCR-positivity

Drozgyik, András / Kollár, Dániel / Knausz, Márta / Sipőcz, István / Molnár, F Tamás / Kullmann, Tamás

Orvosi hetilap

2021 Volume 162, Issue 16, Page(s) 611–614

Abstract: Összefoglaló. A COVID-19 mortalitását a súlyos társbetegségek, közöttük bizonyos daganatos betegségek is növelik. Immunszuppresszív hatásuk miatt felmerülhet a citotoxikus kezelések rizikónövelő hatása is. Ugyanakkor az onkológiai terápia megszakítása ... ...

Title translation	Tartós SARS-CoV-2-PCR-pozitivitáshoz társuló, lokoregionálisan előrehaladott emlődaganat komplex onkológiai kezelése.
Abstract	Összefoglaló. A COVID-19 mortalitását a súlyos társbetegségek, közöttük bizonyos daganatos betegségek is növelik. Immunszuppresszív hatásuk miatt felmerülhet a citotoxikus kezelések rizikónövelő hatása is. Ugyanakkor az onkológiai terápia megszakítása vagy halasztása, különösen az agresszívebb, kiterjedtebb és fiatalkorban jelentkező daganatok esetében ronthatja a kórjóslatot. Egy 39 éves nőbeteg esetét ismertetjük. A járvány során késlekedve felismert, lokoregionálisan kiterjedt emlődaganat miatt primer szisztémás kemoterápiában részesült. A kezelés 5. ciklusa során enyhe légúti tünetek kapcsán, az onkológiai ambulancián SARS-CoV-2-fertőzése igazolódott. Kemoterápiás kezelését felfüggesztettük. A diagnózistól számított 3. napon tünetmentessé vált, ám SARS-CoV-2-PCR-pozitivitása még a 43. napon is fennállt. A 19. napon hormongátló kezelést indítottunk. Az 51. napon mastectomia és axillaris block dissectio történt. A 82. napon a megszakított kemoterápiát a hormongátló kezelés leállítását követően G-CSF-profilaxis mellett újraindítottuk. A kezelés során fertőzéses szövődményt nem észleltünk. Kemoterápia és műtét SARS-CoV-2-fertőzött, tünetmentes daganatos betegnél szövődménymentesen végezhető elhúzódó virológiai pozitivitás esetén, felszabadító vizsgálat nélkül is. A daganatos betegek koronavírus-fertőzése esetén az onkológiai protokolltól történő eltérés egyénre szabott optimalizálásával és a multidiszciplináris team szorosabb együttműködésével az infektológiai és az onkológiai kockázat együttes alacsonyan tartása is megvalósítható. Orv Hetil. 2021; 162(16): 611-614. Summary. Mortality of COVID-19 is increased when certain co-morbidities, among others advanced malignancies are present. Deleterious effect of cytotoxic therapy, related to its immunosuppressive effect, may also be hypothesised. However, postponing or cancelling oncologic treatment, especially in younger patients with advanced and more aggressive tumors may worsen the prognosis. The case of a 39-year-old female patient is presented, who was diagnosed with loco-regionally advanced breast cancer during the pandemic. Primary systemic chemotherapy was started. The patient presented with acute respiratory tract symptoms during the fifth cycle and subsequently SARS-CoV-2 infection was diagnosed. Chemotherapy was cancelled. Symptoms resolved in three days after diagnosis. SARS-CoV-2 PCR remained positive up to day 43. Antihormonal therapy was introduced on day 19 and she underwent mastectomy with axillary lymph node dissection on day 51. Chemotherapy was reset postoperatively on day 82 with prophylactic G-CSF protection. No adverse event was observed throughout the treatment. Cytotoxic chemotherapy and surgery can be successfully delivered in breast cancer patients with prolonged asymptomatic SARS-CoV-2 PCR positivity, even without negative swab result. Individual optimisation of the therapy may require deviations from standard protocols. Closer multidisciplinary cooperation may contribute to the minimisation of both oncologic and infectious risks. Orv Hetil. 2021; 162(16): 611-614.
MeSH term(s)	Adult ; Breast Neoplasms/therapy ; COVID-19/complications ; COVID-19/diagnosis ; Female ; Humans ; Mastectomy ; Polymerase Chain Reaction ; SARS-CoV-2/genetics ; SARS-CoV-2/isolation & purification ; Treatment Outcome
Language	Hungarian
Publishing date	2021-04-07
Publishing country	Hungary
Document type	Case Reports ; Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2021.32192
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Article: Sarcoidosis.

Kullmann, Tamás

Orvosi hetilap

2007 Volume 148, Issue 39, Page(s) 1864–1865

Title translation	Sarcoidosis.
MeSH term(s)	Diagnosis, Differential ; Humans ; Prognosis ; Sarcoidosis/complications ; Sarcoidosis/diagnosis ; Sarcoidosis/therapy ; Sarcoidosis, Pulmonary/complications ; Sarcoidosis, Pulmonary/diagnosis ; Sarcoidosis, Pulmonary/therapy
Language	Hungarian
Publishing date	2007-09-30
Publishing country	Hungary
Document type	Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/OH.2007.28222
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Article: Meghatározza-e az oldaliság az irreszekábilis metasztatikus colorectalis carcinoma első vonalbeli kezelését?

Kullmann, Tamás / Sipőcz, István / Pintér, Tamás

Orvosi hetilap

2017 Volume 158, Issue 9, Page(s) 340–344

Abstract: Introduction and aim: Median life expectancy of non-resectable metastatic colorectal cancer may surpass three years. However, several points of the treatment strategy are subject of ongoing debate. Optimal sequence of targeted agents is not elucidated ... ...

Title translation	Does the sidedness determine the first line treatment of irresectable metastatic colorectal cancer?
Abstract	Introduction and aim: Median life expectancy of non-resectable metastatic colorectal cancer may surpass three years. However, several points of the treatment strategy are subject of ongoing debate. Optimal sequence of targeted agents is not elucidated either. Based on retrospective analyses of six clinical studies and a metaanalysis, the superiority of anti-EGFR agents such as cetuximab and panitumumab over anti-VEGF bevacizumab has been proposed in the treatment of left sided tumours. Method: The results of the six major clinical trials were analysed. Insufficiencies of the meta-analysis are pointed: the lack of homogeneity among control groups, the omission of later lines of therapy, the inconsistency between progression free and overall survival benefit and the high proportion of excluded patients. Results: The trials confirm the worse prognosis of right sided versus left sided colorectal cancers. Conclusion: To date the data are not strong enough to support the preference of any of the available targeted agents at the first line setting in the treatment of left sided metastatic RAS and BRAF wild type colorectal cancers. Several trials suggest that anti-EGFR treatment has no additional benefit as compared to chemotherapy alone in the treatment of right-sided tumours. Orv. Hetil., 2017, 158(9), 340-344.
MeSH term(s)	Antibodies, Monoclonal/therapeutic use ; Antineoplastic Agents/therapeutic use ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/pathology ; Disease-Free Survival ; Female ; Humans ; Male ; Neoplasm Metastasis ; Randomized Controlled Trials as Topic
Chemical Substances	Antibodies, Monoclonal ; Antineoplastic Agents
Language	Hungarian
Publishing date	2017-03
Publishing country	Hungary
Document type	Journal Article ; Meta-Analysis
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2017.30682
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Article: Emlőtumor intracranialis metasztázisainak eredményes szisztémás palliatív kemoterápiája.

Sipőcz, István / Pintér, Tamás / Skaliczky, Zoltán / Kullmann, Tamás

Orvosi hetilap

2016 Volume 157, Issue 45, Page(s) 1809–1813

Abstract: The authors present the history of two patients. The first patient, a 69-year-old woman was diagnosed with locally invasive triple negative breast cancer with pulmonary and cerebral metastases. Complete radiological remission of the clinically ... ...

Title translation	Effective systemic palliative chemotherapy for intracranial metastases of breast cancer.
Abstract	The authors present the history of two patients. The first patient, a 69-year-old woman was diagnosed with locally invasive triple negative breast cancer with pulmonary and cerebral metastases. Complete radiological remission of the clinically asymptomatic cerebral metastases was detected under systemic chemotherapy with carboplatin-docetaxel (75 mg/m
MeSH term(s)	Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Breast Neoplasms/pathology ; Carcinoma, Ductal, Breast/pathology ; Carcinoma, Lobular/pathology ; Disease-Free Survival ; Female ; Humans ; Meningeal Carcinomatosis/drug therapy ; Meningeal Carcinomatosis/secondary ; Methotrexate/therapeutic use ; Middle Aged ; Palliative Care/methods
Chemical Substances	Methotrexate (YL5FZ2Y5U1)
Language	Hungarian
Publishing date	2016-11
Publishing country	Hungary
Document type	Case Reports ; Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2016.30557
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