Lege Artis Medicinae

[THE USE OF EARLY BIOMARKERS IN PREVENTION. - THE MARKERS OF THE EXPOSITION, EARLY EFFECT AND INDIVIDUAL SENSITIVITY]

EMBER István, KISS István, SÁNDOR János, FEHÉR Katalin, NÉMETH Katalin, LUKÁCS Péter

OCTOBER 20, 2003

Lege Artis Medicinae - 2003;13(07)

[The molecular and predictive epidemiology plays more and more important role in the prevention of cancer. With the help of early biomarkers, high risk population could be identified for primary preventive intervention modalities. It uses both molecular biological methods and elements of risk assessment plus a testing system based on animal experiments. Its specificity is not high enough to establish the diagnosis but it can be used to monitor the disease and to follow the effectivity of the therapy (e.g. "minimal residual disease") and the preventive interventions. It is also suitable for risk assessment with the markers of individual susceptibility. As to everyday practice there are many problems because of limited therapeutic possibilities, but we hope that the molecular and predictive epidemiology becomes an important part of medicine in the near future.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Antibiotic Treatment of Community-Acquired Respiratory Infections: Strategies Intended to Ensure Optimal Outcome and to Minimize the Development of Resistance]

BALL P., BAQUERO F., CARS O., FILE T., GARAU J., KLUGMAN K., LOW E. D., RUBINSTEIN E., WISE R.

Lege Artis Medicinae

[The 18th International Conference on Allergy and Clinical Immunology 7-12 September 2003, Vancouver]

HIRSCHBERG Andor

Lege Artis Medicinae

[NEW MODALITIES IN THE TREATMENT OF CHRONIC VIRAL HEPATITIS C: PEGYLATED INTERFERONS]

GERVAIN Judit, NEMESÁNSZKY Elemér, CSEPREGI Antal

[Interferon-α proved to be the most effective therapy of chronic hepatitis C. Its combination with ribavirin enhances the antiviral activity and this modality has become the therapeutic standard recommended worldwide during the past few years. Metaanalysis of the international studies revealed that only 12-19% of the patients became virus-free following a 48-week long course of α interferon monotherapy. The combination treatment with ribavirin for 48 weeks increased the proportion of sustained responders to 35-45%. The introduction of pegylated interferons resulted in significantly higher response rates. The new therapeutic possibilities are due to the modified pharmacokinetic characteristics of the drug by changing the size and the structure of the molecules. Multicentre studies investigating the clinical effectiveness of the 40 kD sized pegylated interferon α-2a as well as the 12 kD sized pegylated interferon α-2b in combination with ribavirin reported 56% and 54% response rate, respectively. However, there is significant heterogeneity in the results according to the type of drug administered and to the genotype of the hepatitis C virus, as well as in the basal viral level and the stage of hepatic fibrosis, respectively. The message and the conclusion of the viral kinetic studies are worth remembering: if the result of the HCV nucleic acid test is still positive at week 12 or 24, therapy should be ceased due to the patient non-responder status. Since pegylated interferons are also available in Hungary the authors felt useful to give an overview of the current knowledge, summarizing the results of the relevant studies and provide a suggested state-of-the-art therapeutic protocol based on international consensus.]

Lege Artis Medicinae

[ACCESS]

MATOS Lajos

Lege Artis Medicinae

[ASCOT-LLA ]

MATOS Lajos

All articles in the issue

Related contents

Lege Artis Medicinae

[Similarities and differences of the most significant international guidelines for the treatment of hypertension]

KÉKES Ede, VÁLYI Péter

[Guidelines of diagnosing and treating hypertension play pre-eminent role in maintaining health in our World. Based on reliable estimates we have to take in ac­count more than 1.6 billion individuals suffering from hypertension by 2025. Ad­he­rence to the guidelines is a vital issue for all high blood pressure patients, however, also the economically developed countries have a disappointing share of well-controlled hypertension. Unfortunately, on the 5 continents of the world, the guidelines provide different or very different recommendations for measuring blood pressure, making diagnosis, estimating cardiovascular risk, and setting a target value, although an attempt has been made in the recent years for developing “consensus” in specific issues. This study presents the different opinions and resolutions by analysing the ACC/AHA, ESC/ESH, NICE, Canadian and Australian guidelines. WHO and ISH resolutions were also concerned. We describe the mutual ad­justment in theoretical and practical terms of the guidelines and the consensus that have already been estab­lished.]

Journal of Nursing Theory and Practice

[Role of Atrial Fibrillation in Stroke Prevalence: Implementation of CHA2DS2 – Vasc Risk Stratifi­cation Scale]

PAPP László, VIDA Nóra, BENGŐ Szilvia, KIS Tamás , GAÁL Gabriella, PETŐ Zsófia

[Introduction: Stroke is one of the leading causes of death and disability, therefore is an important public health concern. 20% of ischaemic cerebrovascular diseases are casued by cardiac-related embolism, wiith non-valvular atrial fibrillation (AF) as a major cause, and results in approximately 3-5-fold risk improvement. The aim of this study is to introduce the CHADS2-VASc scoring system, as an important tool in the estimation of stroke risk in AF patients. Recognition of AF and initiation of adequate therapy is a crucial step in the prevention of serious complications. The best-known indexes for AF’s vascular effects are HAS-BLED and CHADS2-VASc. According to European Society of Cardiology, CHADS2-VASc is recommended to use in every AF case with stroke risk, when direct anticoagulant therapy could be implemented. A nurse can work on stroke risk reduction among AF patients in various levels and competences. Primary prevention and health promotion is a responsibility for every health care worker, but at the same time, Advenced Practice Nurse could have a role either in diagnostics or initiating proper therapy.]

Lege Artis Medicinae

[Vascular biomarkers ]

BENCZÚR Béla

[While risk scores are invaluable tools for adapted preventive strategies, a significant gap exists between predicted and actual event rates. Additional tools to further refine the risk stratification of patients at an individual level are biomarkers. A surrogate endpoint is a biomarker that is intended as a substitute for and being realized earlier than a clinical hard endpoint. In order to be suitable as a surrogate endpoint of cardiovascular events, a biomarker should meet several well-defined criteria. It has been proposed that a plenty of potential vascular biomarkers would have a role in primary and secondary cardiovascular prevention. Most of the biomarkers examined fit within the concept of early vascular aging. The only biomarkers that fulfill most of the criteria and, therefore, are close to being considered a clinical surrogate endpoint are carotid ultrasonography, ankle-brachial index and carotid-femoral pulse wave velocity. ]

Hypertension and nephrology

[Sex-specific clinical and exercise based risk assessment of the total mortality risk]

KÉKES Ede

[In both sexes combining different types clinical questionnaire and results of exercise test in a point system can more reliably predict 10 years mortality or survival. The method in both sexes is reliably suitable for the screening of highly endangered individuals in everyday practice.]

Lege Artis Medicinae

[Risk assessment for child sexual abuse in the American legal practice]

KÓRÁSZ Krisztián

[The paper gives introspection into the child sexual abuse risk assessment practice in the USA by reviewing the literature. According to the definition of the World Health Organization, sexual assault is considered to be any act involving a child in a sexual activity if he or she can not be considered as prepared for the child's age or development. The author also makes an attempt to present some issues and pos­sible solutions regarding the current practice. ]