Cílem studie bylo zjistit, zda se změny proudové hustoty detekované standardizovanou mozkovou elektromagnetickou tomografií s nízkým rozlišením (sLORETA) mění v závislosti na odpovědi na léčbu prefrontální rTMS. Metody: Do studie bylo zařazeno 25 hospitalizovaných pacientů splňujících kritéria depresivní poruchy (dle DSM-IV), kteří neodpověděli minimálně na jednu antidepresivní léčbu, podrobili se 4týdenní léčbě rTMS (1 Hz, 100 % motorického prahu, 600 pulzů na sezení, 20 sezení) aplikované nad pravou dorzolaterální prefronální kůru. Účinek rTMS na změny proudové hustoty před léčbou a po 3 dnech od ukončení léčby rTMS byl hodnocen pomocí sLORETA separátně pro respondéry (pokles > 50 % MADRS) a non-respondéry. Výsledky: U devíti pacientů, kteří odpověděli na léčbu bylo zjištěno zvýšení proudové hustoty v pásmu alfa 1 ve frontální a limbické oblasti (Brodmanova area 6,8,9,32) oboustranně (p < 0,05, po korekci na mnohočetná srovnávání). Ve skupině non-respondérů nebyly po léčbě detekovány žádné signifikantní změny. Závěry: Naše nálezy ukazují, že antidepresivní efekt IHz rTMS je spojen se zvýšením alfa 1 aktivity v oblasti prefrontální kůry
The aim of our study was to examine whether the changes of current density detected by standardized low resolution brain electr omagnetic tomography (sLORETA) is different between responders and non-responders to prefrontal rTMS. Methods: A total of 25 inpatients with depressive disorder (DSM-IV criteria), who previously did not respond to at least one antidepres sant treatment underwent 4 weeks of rTMS treatment (1 Hz, 100 % of motor threshold, 600 pulses/session, 20 session) applied over th e right dor- solateral prefrontal cortex. The effect of rTMS on brain electrical activity (detected by the use of sLORETA) was measured befo re treatment and 3 days after rTMS treatment separately in responders (reduction of MADRS 50 %) and non-responders. Results: The current density in alpha 1 band increased in prefrontal and limbic cortex (Brodman areas 6, 8, 9, 32) bilaterally (p < 0.0 5, corrected) in a group of nine responders. No significant changes were detected in non-responders. Conclusion: Our findings implicate that the antidepressants effect of 1Hz rTMS is connected with an increased alfa 1 band current density i n the prefrontal cortex.
- Keywords
- zobrazovací metody, EEG, nízkofrekvenční stimulace,
- MeSH
- Alpha Rhythm MeSH
- Depressive Disorder physiopathology therapy MeSH
- Adult MeSH
- Electroencephalography statistics & numerical data utilization MeSH
- Electrophysiology MeSH
- Financing, Organized MeSH
- Inpatients MeSH
- Image Interpretation, Computer-Assisted methods instrumentation utilization MeSH
- Cohort Studies MeSH
- Middle Aged MeSH
- Humans MeSH
- Brain Mapping MeSH
- Retreatment utilization MeSH
- Prefrontal Cortex physiopathology MeSH
- Prognosis MeSH
- Statistics as Topic MeSH
- Transcranial Magnetic Stimulation instrumentation statistics & numerical data utilization MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
Despite new medical products introduced in multiple myeloma therapy, autologous stem cell transplant (ASCT) remains a standard procedure in younger patients with symptomatic disease. We analyzed a group of 190 patients who underwent ASCT at our clinic for multiple myeloma as primary therapy in years 1995–2008. The total number of transplants performed in this group was 291. 110 patients underwent one ASCT, 59 patients had double transplant, out of which 51 patients underwent tandem transplant, 21 patients underwent triple ASCT, out of which 15 patients were transplanted front-line throughout a clinical trial and 6 patients underwent follow-up transplants due to disease progression. The assessment of the best therapeutic effect of ASCT showed the total rates of patients with complete remission – 22%, very good partial remission (VGPR) – 8%, partial remission – 63%, stabilized disease – 6% and progression – 1%. The transplant related mortality (TRM) was 4.1%. With the median follow-up of surviving patients 2.6 years, the median progression-free survival (PFS) and overall survival (OS) were 21 and 54 months, respectively; the likelihood of a 7-year overall survival was 28%. Comparing tandem versus single transplants, there was a significant increase in the median PFS (25.8 versus 20.8 months, respectively); however, there was no difference in overall survivals. The IVE mobilization regimen was found to be more efficacious for PBPC collection than high-dosed cyclophosphamide.
- MeSH
- Survival Analysis MeSH
- Transplantation, Autologous methods utilization MeSH
- Cyclophosphamide administration & dosage adverse effects therapeutic use MeSH
- Financing, Organized MeSH
- Humans MeSH
- Multiple Myeloma drug therapy blood therapy MeSH
- Recovery of Function immunology drug effects MeSH
- Retreatment methods statistics & numerical data utilization MeSH
- Disease Progression MeSH
- Antineoplastic Agents administration & dosage adverse effects therapeutic use MeSH
- Antineoplastic Combined Chemotherapy Protocols administration & dosage adverse effects therapeutic use MeSH
- Retrospective Studies MeSH
- Statistics as Topic MeSH
- Thalidomide administration & dosage adverse effects therapeutic use MeSH
- Hematopoietic Stem Cell Transplantation methods trends utilization MeSH
- Outcome and Process Assessment, Health Care MeSH
- Check Tag
- Humans MeSH
Cílem této práce bylo shrnout možné příčiny selhání primární endodontické terapie, posoudit důvody pro opakované endodontické léčení a vyhodnotit jeho úspěšnost. Sledovaný soubor tvořilo 41 zubů u pacientů, kteří byli v roce 2007 doporučeni na konzervační oddělelení Kliniky zubního lékařství LF UP v Olomouci k provedení reendodoncie. Dosažené výsledky jsme srovnávali s podobnou studií provedenou na témže pracovišti v roce 1997. Ve srovnání souborů z let 2007 a 1977 můžeme konstatovat, že hlavním důvodem potřeby opakovaného léčení je nedokonalé zaplnění kořenových kanálků v celé jeho délce a nenalezení některého z kořenových kanálků.
The aim of this work was to sum possible reasons of primary endodontic therapy, to judge causes of frequent endodontic treatment and evaluate its success. The collection consisted of 41 teeth from patients, who were recommended to our clinic to perform the reendodontic therapy in 2007. Final findings were compared to similar study, which was performed on the same workplace in 1997. This comparison formed the result – the main reason of repeated treatment is incomplete filling of root canals and impossibility to find one of the root canals.
Background: High doses of chemotherapy followed by autologous transplantation has become widespreadly indicated as upfront therapy for patients with multiple myeloma (MM) during last decade, with very good tolerance and low mortality (2-3%).Therapy of relapsing MM is still considered experimental. Design of study: The principle of T2 model is repeated transplantation therapy with testing different experimental approaches in patients with MM relapsing/progressing after the 1st autologous transplantation (AT). The patients (pts) are treated with ″the same + something more″ - same or very similar induction and reinduction treatment, same myeloablative regimen in the first and the second transplantation and a different maintenance, experimental therapy after the 2nd transplantation. The evaluation of the results of each therapeutic approach uses intra-individual analysis – the comparison of event free survival I (EFS I) (after the 1st AT) and EFS II (after the 2nd transplantation) in one patient. In T2 model is EFS I and EFS II compared in one patient, therefore the inter-individual differences are excluded. Subjects: 20 pts with relapsing/progressing MM after the 1st AT were included in the pilot study between January 1997 and May 2001. Methods and results: Pts were matched to the following groups of experimental therapy: autologous transplantation with IL-2 activated PBSC-10 pts (50%), pamidronate– 4 pts (20%), mini-allogeneic transplantation –2 pts (10%), thalidomide –3pts (15%), consolidation chemotherapy CED- 1 pt (5%). A sensitivity to reinduction chemotherapy C-VAD (4x) was more than 90%, the response to the 2nd transplantation acording to the 1st one was in 45 % better (9 pts), in 35% same (7 pts) and in 20 % worse (4 pts). The toxicity of the 1st and second transplantation was similar and usually did not exceed gr. II (SWOG criteria), there were no significant differences instead of clinically irrelevant hematotoxicity. Transplant-related mortality was 5% (1/20). In 15 pts MM had relapsed till 31st May 2001 (15/20). 5 pts have achieved prolongation of EFS II vs EFS I, 2 in IL-2 activated graft group, 1 in pamidronate group and 2 in allogeneic transplantation. Completed data from the analysis of the first – IL-2 group are listed here, in 20% pts (2/10) was EFS II > EFS I, curative effect was not confirmed. In the whole group median of EFS I was 15,2 months, median of EFS II was 9,9 months, median of overall survival (OS) was 62,8 months, 95% (19/20) were allive (till 31st May 2001) . Conclusions: Repeated transplantation is one of the most powerful approaches in treatment of relapsing MM; toxicity is acceptable, also engraftment is similar to the 1st AT. Testing of new perspective approaches by T2 model may bring a fundamental benefit, although our first results were negative. Key words: multiple myeloma, autologous stem cell transplantation
- Keywords
- udržovací léčba,
- MeSH
- Transplantation, Autologous utilization MeSH
- Diphosphonates therapeutic use MeSH
- Cyclophosphamide therapeutic use MeSH
- Dexamethasone therapeutic use MeSH
- Doxorubicin therapeutic use MeSH
- Financing, Organized MeSH
- Interleukin-2 therapeutic use MeSH
- Humans MeSH
- Melphalan therapeutic use MeSH
- Multiple Myeloma therapy MeSH
- Retreatment methods trends utilization MeSH
- Pilot Projects MeSH
- Recurrence MeSH
- Secondary Prevention MeSH
- Statistics as Topic MeSH
- Thalidomide therapeutic use MeSH
- Vincristine therapeutic use MeSH
- Outcome and Process Assessment, Health Care MeSH
- Check Tag
- Humans MeSH
