Kristof Nekam

Budai Irgalmasrendi Hospital Budapest,Hungary · Allergy and Immunology

Digital health is an umbrella term which encompasses eHealth and benefits from areas such as advanced computer sciences. eHealth includes mHealth apps, which offer the potential to redesign aspects of healthcare delivery. The capacity of apps to collect large amounts of longitudinal, real‐time, real‐world data enables the progression of biomedical...

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis.It strengthens the ARIA change management strategy in the prevention and manag...

Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body: As an example...

Pharmacists are trusted health professionals. Many patients use over‐the‐counter (OTC) medications and are seen by pharmacists who are the initial point of contact of allergic rhinitis management in most countries. The role of pharmacists in integrated care pathways (ICPs) for allergic diseases is important. This paper builds on existing studies an...

Background: Google Trends (GT) searches trends of specific queries in Google, which potentially reflect the real-life epidemiology of allergic rhinitis. We compared GT terms related to ragweed pollen allergy in American and European Union countries with a known ragweed pollen season. Our aim was to assess seasonality and the terms needed to perfor...

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases (CRD) as a model. The CRD action plan includes (i) AIRWAYS integrated care pathways (ICPs), (ii) the joint initiative between the...

Google Trends (GT) searches trends of specific queries in Google and reflects the real-life epidemiology of allergic rhinitis. We compared Google Trends terms related to allergy and rhinitis in all European Union countries, Norway and Switzerland from January 1, 2011 to December 20, 2016. The aim was to assess whether the same terms could be used t...

The Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) has proposed six Action Groups. After almost three years of activity, many achievements have been obtained through commitments or collaborative work of the Action Groups. However, they have often worked in silos and consequently synerg...

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initia...

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used glob...

[This corrects the article DOI: 10.1186/s13601-016-0116-9.].

Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and above all patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel Netw...

The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1)...

The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1)...

In North America and Europe, millions of patients experience symptoms of allergic rhinitis with or without conjunctivitis (AR/C) on exposure to ragweed pollen. The disease burden can be significant, with most patients relying on symptomatic medications without disease-modifying potential. However, novel sublingual immunomodulatory treatment options...

n/a

Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001). ARIA has reclassified AR as mild/moderate-severe and intermittent...

The links between asthma and rhinitis are well characterized. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines stress the importance of these links and provide guidance for their prevention and treatment. Despite effective treatments being available, too few patients receive appropriate medical care for both diseases. Most patients...

The links between asthma and rhinitis are well characterized. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines stress the importance of these links and provide guidance for their prevention and treatment. Despite effective treatments being available, too few patients receive appropriate medical care for both diseases. Most patients...

PREFACE Sublingual immunotherapy (SLIT) has gained wide acceptance in many European countries and has raised the level of interest in immunotherapy among practicing allergists and primary care physicians. Large pivotal double-blind, placebo- controlled, randomized clinical trials have confirmed the efficacy and safety of SLIT, although some negativ...

Food allergy and intolerance as a cause of IBS have been investigated by several studies. In five studies, DBPCFC were done to check the role of food in determining the syndrome (16–20). In one study, none of the IBS patients had adverse reactions to food ( 19). Only one study confirmed food allergy as a cause of the syndrome in three of the 27 pat...

Allergic rhinitis is a symptomatic disorder of the nose induced after allergen exposure by an IgE-mediated inflammation of the membranes lining the nose. It is a global health problem that causes major illness and disability worldwide. Over 600 million patients from all countries, all ethnic groups and of all ages suffer from allergic rhinitis. It...

Allergic rhinitis is a symptomatic disorder of the nose induced after allergen exposure by an IgE-mediated inflammation of the membranes lining the nose. It is a global health problem that causes major illness and disability worldwide. Over 600 million patients from all countries, all ethnic groups and of all ages suffer from allergic rhinitis. It...

Emedastine difumarate (2 mg b.i.d.) was compared to loratadine (10 mg o.d.) in a randomized, double-blind, multicentre trial for 4 weeks in 192 patients with idiopathic chronic urticaria. After one week of treatment significant differences were recorded: body skin involvement diminished to 0-10% in 57.1% of emedastine patients vs. 38.2% of loratadi...

Allergology and Clinical Immunology (ACI) is an area of clinical medicine with a precise identity, relevant recent scientific achievements and well-defined educational and professional needs. In spite of the high individual and socio-economic impact of allergic diseases in Europe, the organization of ACI services is imperfect and varies among count...

The pharmacologic treatment of allergic rhinitis proposed by ARIA is an evidence-based and step-wise approach based on the classification of the symptoms. The ARIA workshop, held in December 1999, published a report in 2001 and new information has subsequently been published. The initial ARIA document lacked some important information on several is...

Selective inhibitors of cyclo-oxygenase-2 (COX-2) appear to be safer than conventional NSAIDs on the gastrointestinal (GI) tract. Amtolmetin guacyl (AMG), a NSAID that inhibits both COX-1 and COX-2, has an anti-inflammatory effect comparable to that of traditional NSAIDs, with a better GI safety profile. The primary end-point of this study was to e...

We are all aware today of the growing interest in continuing medical education (CME) programmes in many European Countries and it is important to understand why and how CME could become an international reality. It is obvious that patients need a good doctor--the best possible--as far as medical knowledge, attention to the patient's quality of life...

Allergic rhinitis is a frequent disease, accompanied by significant social-economic costs and a negative impact on the quality of life. Phototherapy has a profound immunosuppressive effect and is effectively used in the treatment of several immune mediated skin diseases such as atopic dermatitis. The authors investigated the efficacy of intranasal...

Collected and archived serum samples could be important sources for genetic studies, once DNA suitable for molecular genetic studies could be obtained from them. DNA was isolated from 54 archived sera samples, collected previously from the participants of a Hungarian allergy study, with commercially available isolation kit. The authors have determi...

At present, the double blind placebo controlled foodchallenge(DBPCFC)representstheonlywaytoestablishorruleoutanadversereactiontoafoodinolderchildrenand adults, whereas an open challenge controlled bytrained personnel is sufficient in infants and youngchildren (1). The challenge procedure is not, however,C.Bindslev-Jensen

Humoral immune response seems to play a role in the pathogenesis of multiple sclerosis (MS) and in the central nervous system (CNS) complications of systemic lupus erythematosus (SLE). The aim of the present study was to compare the levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and IL-10 in the cerebrospinal fluid of femal...

Táplálékallergiás és táplálékaverziós személyeknek placebotablettákat adtunk, amelyet egy hónapig kel­lett szedniük. A tablettát olyan gyógyszernek állítottuk be, amelyet az Egyesült Államokban fejlesztettek ki, és amely nagyon hatékonynak bizonyul a táplálékallergia gyógyításában. A vizsgálat során mértük, hogy történik-e objektív orvosi javulás,...

In the paper some documents on clinical research have been presented. Declaration of Helsinki WHO documents are suggested as a basic papers in this field. Some "delicate" problems are pointed and discussed in question about placebo and "moral obligations".

The use of nebulization for the administration of inhaled steroids plays an important role in asthma patients who are unable to use pressurized aerosol or dry-powder inhalers effectively. Moreover, the type of nebulizer used may affect how much drug is delivered to the lungs. The objective of this multinational, multicentre, randomized, active-cont...

The aim of the present study was to investigate the serum and cerebrospinal fluid (CSF) concentrations of tumor necrosis factor alpha (TNF-alpha) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in patients with primary progressive form of multiple sclerosis (MS) and in patients with connective tissue diseases (CTDs) complicated with central...

The aim of the present study was to investigate the role of soluble adhesion molecules in the pathogenesis of multiple sclerosis (MS) and systemic lupus erythematosus (SLE) with demyelinating syndrome. Paired cerebrospinal fluid (CSF) and serum samples were analysed by an ELISA method to determine the concentrations of sVCAM-1, sICAM-1 and sL-selec...

Soluble L-selectin (sL-selectin) concentrations were measured in paired samples of serum and cerebrospinal fluid by an ELISA method. Patients with several forms of multiple sclerosis (MS) and systemic lupus erythematosus with central nervous system involvement (SLE-CNS) were investigated. Elevated CSF sL-selectin concentrations were found in patien...

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 nasa...

Knowledge about cross reactivities among food proteins of plant or animal origin is getting more and more important. Cross reaction provoking often clinical symptoms may be based on close taxonomical relations or on the presence of "archaic", ubiquiter protein structures preserved during phylogenesis. The most significant cross reactivities charact...

The concentration of soluble vascular cell adhesion molecules (sVCAM-1) of serum and cerebrospinal fluid (CSF) was measured in clinically selected multiple sclerosis (MS) and systemic lupus erythematosus (SLE) patients, using an ELISA assay. The mean sVCAM-1 concentration in the serum of SLE patients was higher than normal. The mean CSF sVCAM-1 con...

Extensive epidemiological investigations on allergy are still missing in Hungary. This makes health care planning, education, environment protective activities, etc. ineffective, sometimes apparently unjustified. Recently published data on the prevalence of hay fever, asthma or atopic dermatitis [1, 2]are not only below usual European figures [3, 4...

The aim of the study was to determine the fetal and neonatal outcomes of pregnancies conceived during the inactive phase of systemic lupus erythematosus (SLE). Fetal and neonatal outcomes in 75 pregnancies of 33 patients with SLE were analyzed. In 19 patients (57.6%) the SLE also had hematological autoimmune presentations prior to gestation, such a...

Our present options for the management of food allergy are avoidance and pharmacotherapy. There are, however, many promising perspectives for better future management such as the more extensive use of hydrolyzed and elemental formulas for therapy and prevention, or greater emphasis on diagnosis and treatment of accompanying diseases linked with inc...

Food and food additive triggers play an important role in approximately 5-8% of all asthma cases. Exact epidemiological data are lacking, partly because the etiological link is not always obvious, the diagnosis of food hypersensitivity is often complicated and ambiguous, food triggers usually act in concert with other trigger(s), and intraspecies a...

Our knowledge on food allergy and intolerance has expanded in the last years, except data of convincing epidemiological surveys still missing. These, although supposed so, cannot be replaced by the use of questionnaires. Answers reflect only that public belief overestimates the prevalence (though not the importance) of Food allergy, as compared to...

Superoxide dismutase activity and expression of the erythrocytes and lymphocytes of patients suffering from chronic alcoholic liver disease and those of healthy controls were investigated after in vitro incubation with silymarin. It was concluded that silymarin treatment in a concentration achievable by in vivo treatment (10 micrograms/ml) signific...

The hepatoprotective and immunomodulatory effects of silymarin and amino-imidazol-carboxamid-phosphate were studied in 60 patients with compensated alcoholic cirrhosis of the liver in a one month double blind clinical trial. Treatment with both drugs normalized the elevated levels of aspartate aminotransferase, alanine aminotransferase and serum bi...

The effects of the hepatoprotective, antioxidant drug silymarin (Legalon) on some cellular immune parameters of patients with histologically proven chronic alcoholic liver disease were studied in a six month double blind study. The lectin induced proliferative activity of the lymphocytes got enhanced, the originally low T cell percentage and the or...

The in vivo effects of two hepatoprotective antioxidants (silymarin, and 4-amino-5-imidazole-carboxamide-phosphate) on the expression and activity of superoxide dismutase (SOD) enzyme were studied in erythrocytes from patients with alcoholic cirrhosis. In vivo treatment with any of the drugs markedly increased the SOD expression of lymphocytes as m...

The hepatoprotective and immunomodulatory effects of silymarin and amino-imidazole-carboxamide-phosphate were studied in 40 patients with alcoholic cirrhosis of the liver in a one-month double-blind clinical trial. Treatment with either of the drugs normalized the elevated levels of aspartate aminotransferase, alanine aminotransferase and serum bil...

A double blind study. Antioxidant and antiperoxidative effects of the free radical scavenger agent silymarin (Legalon) were investigated in patients with chronic alcoholic liver disease in a double blind clinical trial. Six month treatment (at a daily dose of 420 mg) with silymarin significantly enhanced the originally low superoxide dismutase acti...

Antioxidant effects of a newly developed hepatoprotective agent 4-amino-5-imidazole-carboxamide-phosphate (Aica-P) were studied in an in vitro test system using isolated peripheral blood cells from patients with chronic alcoholic liver disease and from healthy controls. In vitro incubation with the drug in a concentration corresponding to the usual...

The effect of the hepatoprotective agent and protein synthesis stimulator 4-amino-5-imidazole-carboxamide-phosphate on the resynthesis of the "E" receptors of T lymphocytes and on certain immunological functions was investigated in vitro. Aica-P treatment enhanced the resynthesis of the "E" receptors after trypsin digestion and inhibited the blasti...

Oxidative and autoaggressive immune processes are supposed to be involved in the pathogenesis of certain chronic liver diseases. In this study the effects of two naturally occurring antioxidant flavonoids, (+)cyanidanol-3 and silymarin, were determined on T and active T cell percentages, antigen-dependent (ADCC), lectin-dependent (LDCC) and natural...

The effects of silymarin (Legalon) therapy on liver function tests, serum procollagen III peptide level and liver histology were studied in 36 patients with chronic alcoholic liver disease in a six month double blind clinical trial. During silymarin treatment serum bilirubin, aspartate aminotransferase and alanin-aminotransferase values have been n...

The in vitro and in vivo effects of three hepatoprotective antioxidants (silymarin, (+)cyanidanol-3 and 4-amino-5-imidazole-carboxamide-phosphate) on the expression and activity of superoxide dismutase (SOD) enzyme were studied in erythrocytes and lymphocytes from patients with alcoholic cirrhosis. In vitro incubation with the drugs in a concentrat...

The hepatoprotective and immunomodulatory effects of silymarin and amino-imidazole-carboxamide-phosphate were studied in 40 patients with alcoholic cirrhosis of the liver in a one-month double-blind clinical trial. Treatment with either of the drugs normalized the elevated levels of aspartate aminotransferase, alanine aminotransferase and serum bil...

The in vitro and in vivo effects of the naturally occuring flavolignan hepatoprotective agent silibinin on the expression and activity of superoxide dismutase (SOD) enzyme were studied in lymphocytes from patients with chronic alcoholic liver disease. In vitro incubation with silibinin in a concentration corresponding to the usual therapeutic dosag...

Immunological and antioxidant effects of the widely used hepatoprotective agent (+)cyanidanol-3 were studied in a complex in vitro test system using isolated peripheral blood lymphocytes of patients with chronic alcoholic liver disease and of healthy donors. In both groups in vitro treatment with (+)cyanidanol-3 inhibited lectin-induced lymphocyte...

The effects of cyclosporin A, prostaglandin E1 and indomethacin were studied on lectin-dependent cell-mediated cytotoxicity (LDCC) against adherent HEp-2 human epipharynx carcinoma target cells. LDCC activity by human peripheral blood lymphocytes was evaluated by detachment from the monolayer of [3H]thymidine-prelabelled HEp-2 cells in a 24-h assay...

The role of larger granular-enriched and depleted lymphocytes was studied in lectin-dependent cell-mediated cytotoxicity (LDCC) against adherent HEp-2 human epipharynx carcinoma target cells. LDCC was evaluated by detachment from the monolayer of 3H-thymidine-prelabelled HEp-2 cells in a 24 h assay at effector-target cell ratios of 25:1 and 50:1 in...

In vitro and in vivo effects of four hepatoprotective agents: silymarin (LegalonR), (+)-cyanidanol-3 (CatergenR), 6,6-methylene-bis(2,2,4-trimethyl-1, 2-dihydroquinoline) (MTDQ), and 4,5-amino-imidazole-carboxamide-phosphate (Aica-P) on the expression and activity of superoxide dismutase enzyme and on certain cellular immune reactions were studied...

The effect of thymopoietin penta- (TP-5), tetra-(TP-4), and tripeptides (TP-3) was studied on the depressed lectin-dependent cell-mediated cytotoxicity (LDCC) against adherent HEp-2 target cells by peripheral blood mononuclear cells from patients with active systemic lupus erythematosus (SLE). LDCC activity was evaluated by detachment from the mono...

The effect of histamine (H) and H1-, H2-receptor blocking agents was studied on natural (NCMC) and lectin-dependent cell-mediated cytotoxicity (LDCC) of peripheral blood lymphocytes (PBL) from eight healthy subjects on HEP-2 adherent human epipharynx carcinoma target cells. Cytotoxicity was measured by detachment from the monolayer of 3H-TdR-prelab...

Ketoconazole at concentrations of 1–10 μg/ml dose dependently inhibits mitogen-induced blastogenesis, antibody-dependent and spontaneous cytotoxic (natural killer) activity of human lymphocytes and random migration of human leukocytes. Lectin-dependent cytotoxic activity is not affected by the drug.

The effect of glutaurine, a newly discovered parathyroid substance, on human NK cell activity and on lymphocyte markers was studied. Both in vivo and in vitro treatment with glutaurine markedly enhanced the depressed natural lymphocytotoxicity of tumor patients without influencing their lymphocyte subpopulations. On the other hand it had no effect...

DNA synthesis of human peripheral blood lymphocytes increases if Con A is added to the culture after 24 h preincubation at 37 degrees C. During preincubation the mitogen reactive lymphocytes lose their sensitivity to the suppressive effect of autologous mitomycin-treated mononuclear leukocytes, and of supernatants of autologous preincubated cells....

The effects of in vivo and in vitro treatment with human dialyzable leukocyte extracts (DLE) on natural killer (NK) cell activity were studied in 12 patients with malignancies in an allogenic test system using K-562 target cells. A marked increase in NK cell activity was observed in 7 patients with originally low cytotoxic capacity, while originall...

Guinea pig T lymphocytes have receptors of different affinity for rabbit red blood cells (RRBC): those binding RRBC immediately are termed "active" T cells; the remainder, which bind RRBC only after longer incubation times, are "non-active" or "late-rosetting" T cells. We have found that these two subpopulations have different functional characteri...

Lysates of peripheral blood T lymphocytes from healthy individuals were found to contain a low molecular-weight peptide that inhibited phytohaemagglutinin-induced DNA synthesis in vitro by autologous or allogeneic peripheral blood mononuclear cells. The peptide was dialysable, partially heat stable, resistant to trypsin, RNase, and DNase but not to...