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Epidemiology, comorbidities and quality of life in patients with psoriasis
Hugo, Jan ; Gkalpakiotis, Spyridon (advisor) ; Kodet, Ondřej (referee) ; Slonková, Veronika (referee)
Psoriasis is a complex systemic disease included among the Immune-Mediated Inflammatory Diseases (IMID). Although not life-threatening in itself, it has a dramatic impact on patients' quality of life and is associated with a risk of developing a number of comorbidities. Therefore, considering that it is one of the most common chronic dermatoses, affecting more than 100 million people worldwide, the WHO has designated psoriasis as a major global health problem. The goal of the treatment is to get the disease under long-term control, to achieve the fewest visible manifestations and minimal activity of new ones, while in patients with severe psoriasis, systemic therapy is necessary. However, this has been very difficult for a long time, because conventional systemic therapies were often not sufficiently effective, and due to side effects and the need for frequent laboratory tests, they were also not appropriate for long-term administration. Nevertheless, intensive research and a better understanding of the aetiopathogenesis of psoriasis have led to the development of targeted biological therapy, which represents a significant advance in both efficacy and safety. But it is a new therapy, so many questions are not yet answered, especially with newer generations of biological therapy. Therefore, our work...
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Evaluation of adjuvant treatment of malignant melanoma by real time RT-PCR
Gkalpakiotis, Spyridon ; Arenberger, Petr (advisor) ; Resl, Vladimír (referee) ; Pánková, Růžena (referee)
Melanoma is one of the tumors, characterized by considerable heterogeneity of expression of tumor-specific protein. Monitoring two or more markers can significantly increase the efficiency of detection. In our study, we concentrated to 5 marker: Melan-A/MART-1, gp 100, MAGE-3, MIA and Tyrosinase. Another potential tumor marker was telomerase. The most sensitive marker of progression proved to MAGE-3 (17 of 18 patients), followed by the positive marker gp100 (10 of 18 patients), MIA (9 of 18) and Tyrosinase (1 of 18). The Melan-A there was no statistically significant increase over the cutoff for all monitored patients with progression. Tyrosinase as a marker for circulating melanoma cells used in the past most frequently. Her role as a marker is highly debated and varies in different publications. For example The effectiveness of investigations Tyrosinase as the only marker of progression ranged from 6% to 59%. The reason may be technical error, a high percentage of false positives such as because of contamination or reduce expression Tyrosinase in advanced stages, which is associated with reducing the differentiation of tumor cells and decrease tumor melanization. Given that our work with progressive disease, most often found at the same time three positive markers, supports the detection of several marker...
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Monitoring of long-term efficacy and safety of the biological therapy in psoriasis
Adenubiová, Elizabeth ; Gkalpakiotis, Spyridon (advisor) ; Buchvald, Dušan (referee) ; Kojanová, Martina (referee)
Psoriasis is a chronic inflammatory skin disease affecting about 2-4% Central-European population. Treatment options include topical or systemic, often in combination. Among conventional systemic therapies we include phototherapy (UVB, PUVA), methotrexate, cyclosporine and acitretin. The newest drugs are so-called biologics: drugs blocking tumor necrosis factor alpha (TNF alpha) - adalimumab, etanercept, infliximab, drugs blocking interleukin-12 and 23 (IL-12/23) - ustekinumab and newly drugs blocking interleukin 17 - secukinumab, ixekizumab, brodalumab and recently as well IL-23 blockers - guselkumab, risankizumab.. The aim of this paper is to describe the long-term efficacy and safety of treatment of patients with moderate to severe psoriasis with adalimumab, a fully human monoclonal antibody against TNF-alpha. Retrospectively we analyzed all patients with moderate to severe psoriasis who between 2008 and 2016 were treated with adalimumab in the center of biological therapy in Dermatovenereology clinic of Faculty hospital of Kralovske Vinohrady. Although the average PASI patients assigned to treatment was 22.5, the results shows a rapid onset of adalimumab, where after 3 months of treatment PASI75 was observed in 85.6% of patients. The efficacy persisted long-term when PASI75 after two years was...
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Evaluation of adjuvant treatment of malignant melanoma by real time RT-PCR
Gkalpakiotis, Spyridon ; Arenberger, Petr (advisor) ; Resl, Vladimír (referee) ; Pánková, Růžena (referee)
Melanoma is one of the tumors, characterized by considerable heterogeneity of expression of tumor-specific protein. Monitoring two or more markers can significantly increase the efficiency of detection. In our study, we concentrated to 5 marker: Melan-A/MART-1, gp 100, MAGE-3, MIA and Tyrosinase. Another potential tumor marker was telomerase. The most sensitive marker of progression proved to MAGE-3 (17 of 18 patients), followed by the positive marker gp100 (10 of 18 patients), MIA (9 of 18) and Tyrosinase (1 of 18). The Melan-A there was no statistically significant increase over the cutoff for all monitored patients with progression. Tyrosinase as a marker for circulating melanoma cells used in the past most frequently. Her role as a marker is highly debated and varies in different publications. For example The effectiveness of investigations Tyrosinase as the only marker of progression ranged from 6% to 59%. The reason may be technical error, a high percentage of false positives such as because of contamination or reduce expression Tyrosinase in advanced stages, which is associated with reducing the differentiation of tumor cells and decrease tumor melanization. Given that our work with progressive disease, most often found at the same time three positive markers, supports the detection of several marker...
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