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Chudzicka A.,Military Institute of Health Services in Warsaw
Polski Merkuriusz Lekarski | Year: 2010

Idiopathic pulmonary fibrosis (IPF) is the most common of interstitial lung diseases and is characterised by a significant mortality rate. That is way both clinicists and patients are interested to identify factors that may influence outcome of disease. This factors are named biological markers or biomarkers. Their usefulness in diagnostic, monitoring and prognosis of interstitial pneumonia, and idiopathic pulmonary fibrosis was estimated in many researches. The most of them was concerned to serum biomarkers, such as surfactant proteins, mucin-connected proteins, Clara cells proteins, cytoceratines and cytokines.

Inhaled bronchodilators are a basic element of the pharmacologic management of asthma and COPD. Long-acting β 2-agonists (LABAs) are recommended for use by a majority of recent guidelines as a maintenance treatment in asthma and COPD. It was documented that these medications improve objective measures of lung function and reduce main symptoms of diseases. However inhaled LABAs have been reported to increase some cardiovascular diseases and contribute to the occurrence of arrhythmias. Few studies have documented the sufficient observations to show that LABAs are safe in clinical practice and are still an essential in therapy in patients with obstructive diseases.

Motzer R.J.,Sloan Kettering Cancer Center | Porta C.,University of Pavia | Vogelzang N.J.,Comprehensive Cancer Centers of Nevada | Sternberg C.N.,San Camillo and Forlanini Hospitals | And 17 more authors.
The Lancet Oncology | Year: 2014

Background: An unmet medical need exists for patients with metastatic renal cell carcinoma who have progressed on VEGF-targeted and mTOR-inhibitor therapies. Fibroblast growth factor (FGF) pathway activation has been proposed as a mechanism of escape from VEGF-targeted therapies. Dovitinib is an oral tyrosine-kinase inhibitor that inhibits VEGF and FGF receptors. We therefore compared dovitinib with sorafenib as third-line targeted therapies in patients with metastatic renal cell carcinoma. Methods: In this multicentre phase 3 study, patients with clear cell metastatic renal cell carcinoma who received one previous VEGF-targeted therapy and one previous mTOR inhibitor were randomly assigned through an interactive voice and web response system to receive open-label dovitinib (500 mg orally according to a 5-days-on and 2-days-off schedule) or sorafenib (400 mg orally twice daily) in a 1:1 ratio. Randomisation was stratified by risk group and region. The primary endpoint was progression-free survival (PFS) assessed by masked central review. Efficacy was assessed in all patients who were randomly assigned and safety was assessed in patients who received at least one dose of study drug. This study is registered with ClinicalTrials.gov, number NCT01223027. Findings: 284 patients were randomly assigned to the dovitinib group and 286 to the sorafenib group. Median follow-up was 11·3 months (IQR 7·9-14·6). Median PFS was 3·7 months (95% CI 3·5-3·9) in the dovitinib group and 3·6 months (3·5-3·7) in the sorafenib group (hazard ratio 0·86, 95% CI 0·72-1·04; one-sided p=0·063). 280 patients in the dovitinib group and 284 in the sorafenib group received at least one dose of study drug. Common grade 3 or 4 adverse events included hypertriglyceridaemia (38 [14%]), fatigue (28 [10%]), hypertension (22 [8%]), and diarrhoea (20 [7%]) in the dovitinib group, and hypertension (47 [17%]), fatigue (24 [8%]), dyspnoea (21 [7%]), and palmar-plantar erythrodysaesthesia (18 [6%]) in the sorafenib group. The most common serious adverse event was dyspnoea (16 [6%] and 15 [5%] in the dovitinib and sorafenib groups, respectively). Interpretation: Dovitinib showed activity, but this was no better than that of sorafenib in patients with renal cell carcinoma who had progressed on previous VEGF-targeted therapies and mTOR inhibitors. This trial provides reference outcome data for future studies of targeted inhibitors in the third-line setting. Funding: Novartis Pharmaceuticals Corporation. © 2014 Elsevier Ltd.

Stec R.,Military Institute of Health Services in Warsaw | Bodnar L.,Military Institute of Health Services in Warsaw | Szczylik C.,Military Institute of Health Services in Warsaw
Journal of Cancer Research and Clinical Oncology | Year: 2010

Purpose A retrospective analysis was conducted to compare the tolerability and efficacy of single-agent capecitabine and 5-fluorouracil/leucovorin/ irinotecan (FOLFIRI) in the first-line treatment of patients aged ≥65 years with metastatic colorectal cancer (mCRC). Methods Consecutive patients with mCRC treated at the Military Medical Institute, Warsaw, between January 2003 and June 2008 were eligible. A total of 123 patients were identified (FOLFIRI, n = 67; capecitabine, n = 56). Results The overall response rate with FOLFIRI was 28.1 versus 16.4% with capecitabine (P = 0.1398). Median time to disease progression with FOLFIRI was 8.8 versus 7.5 months with capecitabine (P = 0.20), and median overall survival was 19.0 versus 15.4 months (P = 0.93). In the FOLFIRI group, neutropenia and anaemia were significantly more frequent than in the capecitabine group. The main non-haematological toxicity was hand-foot syndrome found only in the capecitabine group. Conclusion Single-agent capecitabine and FOLFIRI are effective first-line regimens in patients aged ≥65 years with mCRC. © Springer-Verlag 2009.

Owczarek W.,Military Institute of Health Services in Warsaw | Kozera-Zywczyk A.,Military Institute of Health Services in Warsaw | Paluchowska E.,Military Institute of Health Services in Warsaw | Majewski S.,Military Institute of Health Services in Warsaw | Patera J.,Military Institute of Health Services in Warsaw
Polski Merkuriusz Lekarski | Year: 2010

Annular erythema is a term used to identify skin lesions, in which the rash is erythema burgeoning peripherally and outgoing In the center, in this paper we present the case of 71-year old woman in whom diagnosis of possible causes of the development of annular erythema, led the team to identify primary Sjögren's syndrome (SS). Annular erythema was diagnosed on the basis of characteristic clinical picture and histopathological examination. Primary Sjögren's syndrome was diagnosed based on diagnostic criteria for primary SS and the exclusion of other autoimmune diseases. The patient in the study were the presence of characteristic subjective symptoms such as eye occurring for many years dry eyes and periodic feeling of sand in the eyes and dry mouth symptoms requiring frequent drinking of liquids to help swallow food. Changes within the eye was confirmed Schirmer's test, and the seizure of the salivary glands Saxon test. The serum showed the presence of autoantibodies Ro (SS-A) titer> 600 U/ml. The treatment recommended substitution of tears in order to protect the eye and the occasional use of preparations moisturizing mucous membrane of the nose and mouth. Due to the few reports of coexistence of annular erythema with primary Sjögren syndrome among Caucasians this case deserves special attention and calls for the implementation of diagnostic tests in each case, clinical suspicion of annular erythema in order to determine possible causes for its development.

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