Casopís lékar̆ů c̆eských
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Casopís lékar̆ů c̆eských · Jan 2007
Review[Ten years since the successful introduction of the first monoclonal antibody (rituximab) into the therapy of lymphomas].
Cancer treatment is based on combination of systemic chemotherapy and radiotherapy. The new methods of therapy based on biological priniciples have been introduced within last decade. The monoclonal antibody rituximab was launched ten years ago in 1997. ⋯ Rituximab has become the inevitable part of therapeutic regimens for other B-cell lymphomas, chronic lymphocytic leukaemia as well as for some non-malignant diseases. The important milestones, the therapeutic results of rituximab and other approved monoclonal antibodies (alemtuzumab, ibritumomab tiuxetan 90Y) is reviewed in this paper as well as short compendium of new antibodies is given. The cost effectiveness of the new therapy is discussed.
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Casopís lékar̆ů c̆eských · Jan 2006
Review[Role of Doppler echocardiography in the diagnostics and therapy of hypertrophic cardiomyopathy].
Hypertrophic cardiomyopathy (HCM) is a complex and relatively common genetic heart disease. HCM is caused by mutations of genes encoding sarcomeric contractile proteins and it is characterized by heterogeneous pattern of left ventricular hypertrophy with dynamic obstruction of left ventricular outflow tract. HCM is associated with both impaired left ventricular contractility and diastolic function. ⋯ The Tei index is a new Doppler index, combining systolic and diastolic time intervals as an expression of global myocardial performance ("index of myocardial performance"). Non-pharmacologic treatment of obstructive HCM (alcohol septal ablation) is associated with improvement of Tei index. Doppler echocardiography is an indispensable tool in the management of HCM.
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Acute vascular occlusion is a medical emergency and often a life threatening situation. It is caused by embolization into local arteries, by thrombosis or by occlusion of peripheral arterial bypass grafts. Percutaneous thrombectomy and local thrombolysis represent well established techniques for the treatment of acute limb ischemia and massive deep venous thrombosis especially for ileofemoral and ileocaval occlusion. The new techniques of thrombectomy allow very effective and minimally invasive therapy of acute vascular occlusions.
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Rare diseases are defined as those affected less than five in every 10 000 person in European Union. The purpose of this paper is to present activities, which make possible to stimulate research development and marketing of appropriate medicine for tretment of rare disease, named "Orphan" medicinal products. EU "Orphan" medicinal products legislation which entered into force in April 2000 is described. ⋯ Those incentives to industry are described, which are already five years very well implemented oh the European level mostly on the pre-authorisation phase of "Orphan" medicinal products development, but also in the registration process as well as the post-authorisation phase. Finaly, the first twenty "Orphan" medicinal products, which have been given positive opinion in the Community for the grant of a marketing authorisation till April 2005 are mentioned in this work. The real availability of "Orphan" medicinal products in the particular EU member states is analysed.
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Casopís lékar̆ů c̆eských · Jan 2005
Review[Treatment of the unresectable non small cell lung carcinoma].
In recent years, treatment of the locally advanced unresectable Non Small Cell Lung Cancer (NSCLC) has evolved from the radiotherapy alone to sequential therapy settings with induction chemotherapy followed by radiotherapy. During recent years, concomitant chemoradiotherapy has become the standard treatment for these patients. The addition of chemotherapy during the course of radiotherapy provides better locoregional control of the disease by killing the radioresistant cells, inhibition of the reparation processes in the sublethally damaged cells and accumulation of the cells in the G2/M phase, when the cells are sensitive to radiation. ⋯ When comparing survival time by meta-analysis, significantly longer survival time of the patients treated with gemcitabine combination was found in comparison with other treatment. Similarly, the progression-free survival is significantly longer in the patients treated with gemcitabine containing regimen. This data has proven good clinical efficacy of gemcitabine in the first-line therapy of advanced NSCLC.