![]() The main goal of the Kosovar Albanian movement was the independence of Kosova, but its methods were carefully chosen and it sought support from the international community. The Albanian political movement, which emerged at the end of the 1990s under the leadership of Ibrahim Rugova, took the path of non-violent resistance, of not responding to force in kind. The shift that happened in Kosova also contributed to this development. The sudden shift of the crisis from the margins (Kosova) to the center (Serbian-Croatian conflict) was not caused only by the maneuvers of the Serbian regime. The aim of the wars was to remove en masse populations of the “wrong ethnicity” from the territories” considered to belong to Serbs ( Rat u Hrvatskoj i BIH, p. The aim of the wars was not the defense of the federation, but the realization of a Greater Serbian state based on the platform of the so-called Memorandum of the Serbian Academy of Sciences and Arts ( SANU, 1986 ). 42-43.), it started in Slovenia, as an episode, and then spread into Croatia and Bosnia-Herzegovina. Īlthough analyses were predicting that war would erupt in Kosova first ( The Kosova Report, p. Yugoslavia since it creation (1918) was a “fragile state” because of the “contradictions between Serbian and Croatian understanding of Yugoslavia.” Kosova in the 1980s served as a “catalyst” and generator of Serbian irredentism ( Maliqi 1989: 69, 178). The disintegration of the federation was a complex process rooted in inherited antagonisms. However, the real cause of the federation’s disintegration was not in Kosova. Further studies are needed to determine the optimal combination therapy in PAH based upon efficacy, safety and cost.Kosova and the disintergration of YugoslaviaĪt the end of the 1980s and the beginning of the 1990s the crisis of the ex-Yugoslav federation revolved around the Kosova question. An optimal combination drug therapy regimen remains debatable and should be customized for individual PAH patients. ![]() Therefore, clinicians should consider ease of administration, cost, and tolerability when choosing specific combination therapies.Ĭombination therapy appears promising for patients who are refractory to treatment or whose disease progression is not well controlled with monotherapy. The preferred combination treatment among several PAH drug therapies remain controversial. Several studies evaluating several combination therapies have been published. However, suggestions for combination therapy in refractory PAH patients are lacking. Published guidelines provide evidence-based recommendations for monotherapy. Overall, combination therapy is relatively safe and well tolerated. Adjunctive therapy was well tolerated by most patients. Most trials were uncontrolled with small sample sizes investigating the acute effects of combination therapy and lacking long-term clinical outcomes. Overall, the majority of trials demonstrated clinical efficacy in improving functional class, reducing pulmonary pressure, or increasing exercise capacity. Overall, 22 studies met inclusion criteria. ![]() Searches were limited to English, human and clinical trial using the terms sildenafil, tadalafil, vardenafil, phosphodiesterase inhibitor, prostacyclin, prostaglandin, epoprostenol, treprostinil, iloprost, beraprost, endothelin receptor antagonist, bosentan, ambrisentan, sitaxsentan and pulmonary hypertension. The purpose of this review was to evaluate the safety and efficacy of various combination PAH therapies.Ī systematic search was conducted using the MEDLINE database (1966 and June 2012) for relevant clinical studies. Although these agents have demonstrated clinical safety and efficacy, some patients may require additional drug therapy due to a lack of response or disease progression. Over the past decades, several therapeutic advances have been developed for the management of PAH. Pulmonary arterial hypertension (PAH) is a progressive disease without a cure, which can lead to right heart failure and death. ![]()
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