Vnitr̆ní lékar̆ství
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Vnitr̆ní lékar̆ství · Sep 2001
Clinical Trial[Non-cytostatic treatment of malignancies. Anti-CD20 monoclonal antibody (Rituximab, Mabthera) in the treatment of non-Hodgkin's lymphoma].
Some types of non-Hodgkin lymphomas cannot be treated by contemporary preparations. After repeated relapses and chemotherapy moreover damage of bone marrow occurs and further intense cytostatic treatment is not possible. Monoclonal antibodies against structures on tumour cells are an interesting alternative of cytostatic treatment. ⋯ Favourable therapeutic results were recorded in patients with follicular lymphoma (70% of the therapeutic responses), small lymphocyte lymphomas (64% of therapeutic responses) and in patients with a relapse after autologous transplantations (80% of therapeutic responses). Anti CD20 monoclonal antibody is a new effective alternative of cytostatic treatment. Its position in the therapeutic strategy in patients with non-Hodgkin lymphoma awaits elaboration.
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Weaning from mechanical ventilation is not complicated in the majority of patients, in some, however, this process is very complicated and lengthy. These patients are described as difficult to wean. A suitable weaning strategy and properly timed extubation or decannulation is important not only from the aspect of the patient's health status but also with regard to costs of care. ⋯ Promising seems the use of non-invasive ventilation but this was not proved unequivocally so far. The use of weaning protocols reduces the weaning period from mechanical ventilation. The authors summarize most recent findings on the weaning problem incl. the most frequently used ventilation regimes and prognostic indicators of successful weaning.
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Vnitr̆ní lékar̆ství · Sep 2001
[Relation between clinical severity of bronchial asthma and degree of airway inflammation assessed by the eosinophilic leukocyte count in induced sputum].
Airways inflammation, involving infiltration of bronchial wall with activated eosinophils, mast cells and T lymphocytes, is an established feature of asthma. Clinical assessment of disease severity is based upon pulmonary function tests, their variability and symptom score. The relationship between the degree of airway inflammation and disease control is probably not significant. ⋯ Specificity of clinical markers ranged from 0.43 to 0.94, diurnal variability of PEF having the highest specificity. Despite of good correlation of clinical markers of asthma severity with sputum eosinophils, pulmonary function test, diurnal variability of PEF and rescue salbutamol can hardly predict the degree of airway inflammation or the efficacy of antiinflammatory treatment in a particular patient. Percentage of sputum eosinophils seems to be a useful and promising marker for measuring the degree of airway inflammation in patients with bronchial asthma, especially in more severe cases.