Lege Artis Medicinae

[On the Market]

dr. RIESZ Tamás

JANUARY 20, 2007

Lege Artis Medicinae - 2007;17(01)

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Lege Artis Medicinae

[Gastrointestinal stromal tumour in the stomach causing acute bleeding]

HUSSAM Saleh, DANCS Nóra, KÁRÁSZ Tibor, ERÉNYI Ákos, HORVÁTH Viktor, PAUKOVICS Ágnes, RÁCZ István

Lege Artis Medicinae

[OUR EXPERIENCE WITH BORTEZOMIB-BASED THERAPY OF MULTIPLE MYELOMA BASED ON THE FIRST 60 PATIENTS]

MIKALA Gábor, BÁTAI Árpád, CEGLÉDI Andrea, CSUKLY Zoltán, DOLGOS János, HALM Gabriella, JÁNOSI Judit, KAPÁS Balázs, LOVAS Nóra, LUEFF Sándor, PETŐ Mónika, REMÉNYI Péter, SIPOS Andrea, TÓTH Zsuzsanna

[INTRODUCTION - Bortezomib, a first-in-itsclass proteasome-inhibitor drug was registered in 2004 for the salvage treatment of relapsed and/or refractory multiple myeloma. We have been using this drug in our department for the treatment of myeloma patients since 2005. PATIENTS AND METHODS - In this retrospective study, treatment results (response rate, response duration, survival) as well as the complications and side effects were analysed based on 60 myeloma patients treated over a period of 18 months. The patients received at least one full cycle of non-first-line bortezomib-based (predominantly combinational) therapy. RESULTS - At least minimal laboratory and/or clinical response was observed in 47 of the 56 patients who could be analysed. Clinically meaningful (at least partial remission) response was seen in 41 of 56 patients. Immune-fixation negative complete remission was achieved in six patients. Median progression-free survival of our patient population was 13 months (10.8-14.8 months, n=49, adjusted for patients lost in the first 6 weeks and for those with less than 6 weeks of follow-up). As for overall survival, the median has not been reached, while treated patients had an 80.3% probability of survival at one year. CONCLUSIONS - Based on the treatment results of 60 myeloma patients, bortezomibbased therapy is clearly effective in relapsed and/or refractory myeloma.]

Lege Artis Medicinae

[LAM Awards 2006]

Lege Artis Medicinae

[TIGECYCLINE, A NEW ANTIBIOTIC]

SZALKA András

[Glycylcyclines are a new class of antimicrobial agents, of which tigecycline is the first to have reached the final stage of clinical trials. It is the 9-t-butylglycylamido derivative of minocycline. The addition of a side-chain into position 9 overcomes the problem of the development of resistance typical to tetracyclines. Tigecycline inhibits translation of bacterial proteins through its effect on the 30S ribosomal subunit. The efficacy of tigecycline is impressive against multiresistant Gram-positive bacteria, including methicillin- resistant Staphylococcus aureus, penicillin- resistant Streptococcus pneumoniae, and vancomycin-resistant enterococci, against most genera of Enterobacteriaceae, including extended- spectrum β-lactamase-producing strains, and against most strains of Bacteroides fragilis, as well as atypical pathogens. Clinical studies showed good results in parenteral treatment for complicated skin, soft tissue and intraabdominal infections. Tigecycline will be most useful as empirical monotherapy in infections with suspected polymicrobial etiology and/or multidrugresistant agents.]

Lege Artis Medicinae

[The 19th General Assembly of the Hungarian Society on Geriatrics and Gerontology Zalakaros, 9-11 November 2006]

RUSZWURM Andrea

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[“Vires unitae agunt” - way of the unification: medical professionalization in 18-19. centuries Hungary]

SIMON Katalin

[European and Hungarian medicine and its representatives changed a lot between the sixteenth and nineteenth centuries. The varied ’medical market’ altered significantly from the eighteenth century. The acts of the enlightened absolutism, which were attentive to the health of the citizens and the public, set up those processes, which led to modern medical education and medical professionalization. During this process, some kind of healers were raised out of craftsmen, folk healers (such as surgeons, pharmacists, midwives, veterinarians), others were supplanted (for Example sellers of essential oils). After the initiation from above, doctors of medicine and masters of surgery became self-conscious in the Hungarian Reform Era, first forms of self-organization, as so the demand of professional retraining and discussions appeared via the new journals, associations and assemblies. The biggest question was the liquidation and the unification of the dual education of doctors of medicine and masters of surgery, which descended from the Middle Ages, but became obsolete, thanks to the new achievements of the medicine and surgery. The two were united in 1872, when the title doctor medicinae universalis set up. The Public Health Act of Hungary in 1876 (Art. XIV) and the independent la­bour organizations of doctors (for Example the Associations of Doctors in Budapest and in the countryside, which were established in 1897) promoted the formation of the modern medical profession. ]

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KISS István

[The original patent drugs appear immediately on expiry of all rights in generic and biosimilar drugs in the pharmaceutical market, favorable supply option which helps in the rational management of medicines, mainly for generic drugs cheaper to allow more patient care. Of course, this is a well-organized legal and regulatory framework, thoughtful strategy can be successful in every respect. In another non-identical molecular structure biosimilar drugs in different immunogenicity of knowledge and risk is not defined in clinical practice and therefore the risk is still underestimated and not well regulated in the world, and increasing the number reported is the antibody formation case of a biosimilar erythropioetin also. The immunogenicity of original biological and of biosimilar drugs in identifying, defining a prominent role in the post-marketing surveillance, pharmacovigilance, and the special methods of control of immunogenicity. The original and the biosimilar medicines interchangeability, marketability of the assets relating to the regulations are not uniform in Europe or the European registration scheme is an important new biosimilar medicinal products, is that the medicinal product, the documentation is not expected to be accompanied by a risk management plan, as well as action to ensure the safety (pharmacovigilance) as part of the collection and reporting of adverse reactions to the official. It is important that the professional management of renal anemia guidelines - the practice of nephrology erythropoietin therapy - clearly define the biological medicines (originator and biosimilar erythropoietin) application requirements and suggestions. Consequently, this summary wants to draw attention to the therapeutic potential of biosimilar drugs, generic drugs to distinguish between explicit and the potential risks and the need to reduce the risks of professional and health policy decisions.]

Lege Artis Medicinae

[THE PROBLEM OF SMOKING]

RODÉ Magdolna

[Smoking causes a health catastrophy all over the world. Its importance is increasing in the less developed countries. More and more young people (especially women) have started smoking recently. Its devastating effect on women carries on to the next generations. Prevention should already begin in childhood. In Hungary, there is a wide network to assist for those who want to give up smoking - especially in the national network of lung health care clinics. Peer supporters have a prominent role in helping these patients. The market-strategy and publicity campaign of major tobacco producers also deserves intensive attention.]

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[Psychiatry or an Alternative?]

ZÖRGŐ Szilvia

[Complementary and alternative medicine (CAM) use is increasing in the plural healthcare market of our globalized world. Aside from a healthcare market, we may also speak of a “worldview market” in which various concepts of health and illness compete with each other and in which patients strive to orient themselves. In a milieu of prolific information production, “facts” are increasingly under subjective judgement. Thus topics such as mechanisms underlying the appraisal of information sources regarding healthcare, as well as processes behind decision-making and building or losing trust have risen in significance. Orientation in the sea of information is largely determined by global trends, societal-level phenomena, as well as cultural dispositions or preferences that take root in the individual; these factors also influence therapy choice. Such preferences include that of “holism” and the “natural”, as well as a desire for initiation; these dispositions play a vital role in information processing and decision-making, for example when the patient is weighing whether to turn to a psychiatrist or a CAM specialist. ]

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