P R Health Sci J
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The therapy of chronic myeloid leukemia (CML), characterized by the presence of the Philadelphia chromosome in the clonal hematopoietic stem cells, has changed dramatically in the last year with the development of a specific inhibitor of the BCR-ABL tyrosine kinase. This medication, STI571 or imatinib, was recently approved by the Food and Drug Administration for CML patients refractory or intolerant to interferon. ⋯ STI571 is the first agent in Oncology that directly targets the molecular basis of a malignant disease, changing the way that we will treat these conditions in the future. This new field of molecular and cellular biology has the possibility of controlling not only malignant conditions but also diseases treated by other medical specialties.
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Review Comparative Study
The sixth Carlos E. Rubio Memorial Lecture. Prevention and treatment of variceal hemorrhage.
The medical treatment of portal hypertension has experienced a marked progress in the past decade due to the introduction of effective portal hypotensive therapy. This has been possible because of the better understanding of the pathophysiological mechanisms leading to portal hypertension. A major step forward was the introduction of beta-blockers for the prevention of bleeding and rebleeding from gastroesophageal varices. ⋯ There is an increasing trend for initiating therapy with a pharmacological agent, followed by semi-emergency endoscopic therapy as soon as a well trained endoscopist is available (within 12-24 hours), while maintaining drug therapy for 5 days. Failures of medical therapy may be treated by a second session of endoscopic treatment, but if this fails TIPS of emergency surgery should be done. In high-risk situations, such as bleeding from gastric varices or in patients with advanced liver failure, the decision for TIPS or surgery should be done earlier, after failure of the initial treatment.