Recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia

This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2012, Issue 3. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.BACKGROUND: Recombinant factor VIIa (rFVIIa) is licensed for use in patients with haemophilia and inhibitory allo-antibodies and for prophylaxis and treatment of patients with congenital factor VII deficiency. It is also used for off-license indications to prevent bleeding in operations where blood loss is likely to be high, and/or to stop bleeding that is proving difficult to control by other means. This is the third version of the 2007 Cochrane review on the use of recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia, and has been updated to incorporate recent trial data. OBJECTIVES: To assess the effectiveness of rFVIIa when used therapeutically to control active bleeding or prophylactically to prevent (excessive) bleeding in patients without haemophilia. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and other medical databases up to 23 March 2011. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing rFVIIa with placebo, or one dose of rFVIIa with another, in any patient population (except haemophilia). Outcomes were mortality, blood loss or control of bleeding, red cell transfusion requirements, number of patients transfused and thromboembolic adverse events. DATA COLLECTION AND ANALYSIS: Two authors independently assessed potentially relevant studies for inclusion, extracted data and examined risk of bias. We considered prophylactic and therapeutic rFVIIa studies separately. MAIN RESULTS: Twenty-nine RCTs were included: 28 were placebo-controlled, double-blind RCTs and one compared different doses of rFVIIa. In the 'Risk of bias' assessment, most studies were found to have some threats to validity although therapeutic RCTs were found to be less prone to bias than prophylactic RCTs.Sixteen trials involving 1361 participants examined the prophylactic use of rFVIIa; 729 received rFVIIa. There was no evidence of mortality benefit (risk ratio (RR) 1.04; 95% confidence interval (CI) 0.55 to 1.97). There was decreased blood loss (mean difference (MD) -297 mL; 95% CI -416 to -178) and decreased red cell transfusion requirements (MD -261 mL; 95% CI -367 to -154) with rFVIIa treatment; however, these values were likely overestimated due to the inability to incorporate data from trials (four RCTs in the outcome of blood loss and three RCTs in the outcome of transfusion requirements) showing no difference of rFVIIa treatment compared to placebo. There was a trend in favour of rFVIIa in the number of participants transfused (RR 0.85; 95% CI 0.72 to 1.01). However, there was a trend against rFVIIa with respect to thromboembolic adverse events (RR 1.35; 95% CI 0.82 to 2.25).Thirteen trials involving 2929 participants examined the therapeutic use of rFVIIa; 1878 received rFVIIa. There were no outcomes where any observed advantage or disadvantage of rFVIIa over placebo could not have been observed by chance alone. There was a trend in favour of rFVIIa for reducing mortality (RR 0.91; 95% CI 0.78 to 1.06). However, there was a trend against rFVIIa for increased thromboembolic adverse events (RR 1.14; 95% CI 0.89 to 1.47).When all trials were pooled together to examine the risk of thromboembolic events, a significant increase in total arterial events was observed (RR 1.45; 95% CI 1.02 to 2.05). AUTHORS' CONCLUSIONS: The effectiveness of rFVIIa as a more general haemostatic drug, either prophylactically or therapeutically, remains unproven. The results indicate increased risk of arterial events in patients receiving rFVIIa. The use of rFVIIa outside its current licensed indications should be restricted to clinical trials

Analysis of management functions and changes in a particular organisation

The main objective of the thesis was analysis of management functions and changes in a particular organisation. The partial objective was examination of the questions of euro introduction and adoption in the Czech republic, explaining particular legislative steps or plans, where CNB acts as an advisory body of the Government. Further, the thesis examines the changes {--} effects (advantages, disadvantages) of euro adoption on the particular organisation and other subjects

Comparison of Macroprudential and Monetary policy in the Czech Republic and in selected countries in years 2007-2018

Diplomová práce zkoumá problematiku měnové a makroobezřetnostní politiky, jak se obě politiky využívají ze strany centrálních bank v zahraničí a jaké mají jednotlivé výhody a nevýhody. Závěrem práce je, že by v kontextu vysoké poptávky po úvěrech bylo v České republice vhodné částečně nahradit měnovou politiku makroobezřetnostní politikou. Teoretická část práce řeší vymezení makroobezřetnostní politiky, jejích dostupných nástrojů a v čem se liší od měnové politiky. Práce rozebírá možnosti konkrétních makroobezřetnostních nástrojů hypotečního trhu, které mají zahraniční centrální banky k dispozici, a jaké mají výhody a nevýhody v porovnání s měnovou politikou. Analytická část porovnává přístup k problematice u nás a v zahraničí ve smyslu syntézy získaných poznatků a zkušeností. Práce v dalších částech analyzuje dosavadní praxi ve světě a kritiku makroobezřetnostní politiky. V závěru práce nabízí návrh nejvhodnějšího způsobu využití makroobezřetnostní politiky v podmínkách České republiky.The aim of the diploma thesis is to analyse Monetary and Macroprudential policy issues, whether the Czech National Bank should, in the context of high demand for mortgage loans, replace Monetary policy and implement Macroprudential policy instead. The thesis concludes that in the context of high demand for mortgage loans it would be beneficial to partly replace Monetary policy with Macroprudential policy. The theoretical part examines unique features of the Macroprudential policy and discusses differences between the two types of policies. Furthermore, the thesis focuses in detail on Macroprudential tools of the mortgage loans market available to foreign central banks, and their advantages and disadvantages. Based on collected data and knowledge, the analytical section compares different practices on the Czech and international financial markets. In addition, the thesis analyses both a contemporary experience of the foreign central banks and the criticism of the Macroprudential policies. In conclusion, the thesis offers a solution for the best possible use of Macroprudential policy in the Czech Republic

Disposition with real property in comparison with czech and finnish legal regulation

7 Abstract Disposition with real estate falls within the scope of present diploma thesis. The main goal of the thesis is the comparison of two legal orders which are, in many ways, similar; nevertheless, there might be found some differences which are described in textual matter. The thesis itself is divided into six chapters redundant, reflects a reform of Czech private law in progress and compares Czech doctrine with relevant case law. It is focused mainly on real estate disposition from the point of view of private law (however, some aspects of public law had to be taken into account) and lays emphasis on legal terms such as "thing", "immovable", "property", "ownership", "disposition" in their broader meaning, and "purchase agreement" (and other topics related to them). The introduction contains the outline of the structure, main goals of the thesis and a definition of the term "disposition". Disposition is perceived, as mentioned above, in largo sensu meaning and includes not only the right to make a legal act concerning the thing but also the owner's rights to use, posses, gain benefits and destroy the thing. Chapter two deals with the historical development of Finnish land law. General legal history is also taken into consideration. The following chapter discusses various kinds of things which may be..

Selected topics concerning immovable property and its disposition in amended Czech civil law legislation

The present doctoral thesis is aimed at selected questions related to the specification of real estate and the property rights associated with it. Taking into consideration legal acts of obligational character (e.g. rent), it profoundly analyzes the European dimension affecting the management of immovable property as well as provides a comparison of the recent case law, a topic covered in individual parts of the text, while evaluating the applicability of these judgments in the future, that is, in relation to the current Civil law. Following an introduction defining the main objectives of the paper, the second chapter is dedicated to the characterization of some basic questions associated with individual kinds of immovable property, which, apart from taking account of the individual innovations (some of them re-established) contained in the Code, allow for the impact of previous derogated legal rules on the application of individual amendments proposed by the law (e.g. the re-establishement of the superficies principle). The next chapter examines, besides the basic components and kinds of possession, the essential innovation of the Civil Code, that is, the possessory protection. In relation to this, the chapter also gives an interpretation of two related institutes, namely the institutes of unauthorised..

Expropriation in order to protect the cultural heritage

The aim of the following paper is to identify and critically analyze the situation related to the possibility of protection of cultural monuments using the institute of expropriation. In the first part I will define the basic concepts from which the paper will continue to develop. In the next section for completeness I will give a brief interpretation of the development with the historical development of ownership. Next, I will mention how the deficiencies of expropriation are grounded on both international and national levels. The fifth chapter sets out the formal requirements and the course of the expropriation procedure. All the knowledge with the preceding chapters is applied to the last chapter of the example of a conflict related to monuments in Grandmother's Valley. The conclusion of the last chapter is devoted to the shortcomings found in the examination of the problem and to the argued proposals for their solution

Selected topics concerning immovable property and its disposition in amended Czech civil law legislation

The present doctoral thesis is aimed at selected questions related to the specification of real estate and the property rights associated with it. Taking into consideration legal acts of obligational character (e.g. rent), it profoundly analyzes the European dimension affecting the management of immovable property as well as provides a comparison of the recent case law, a topic covered in individual parts of the text, while evaluating the applicability of these judgments in the future, that is, in relation to the current Civil law. Following an introduction defining the main objectives of the paper, the second chapter is dedicated to the characterization of some basic questions associated with individual kinds of immovable property, which, apart from taking account of the individual innovations (some of them re-established) contained in the Code, allow for the impact of previous derogated legal rules on the application of individual amendments proposed by the law (e.g. the re-establishement of the superficies principle). The next chapter examines, besides the basic components and kinds of possession, the essential innovation of the Civil Code, that is, the possessory protection. In relation to this, the chapter also gives an interpretation of two related institutes, namely the institutes of unauthorised..