Efficacy and safety of Danhong injection on inflammatory factors and vascular endothelial function in patients with unstable angina pectoris: a systematic review and meta-analysis of randomized clinical trials
Zunqi Kan, Wenli Yan, Cong Chen
et al.
BackgroundInflammatory factors and vascular endothelial damage are significantly involved in the development of unstable angina pectoris (UAP). Danhong injection (DHI) is a compound injection composed of Salvia miltiorrhiza and Carthamus tinctorius extracts. Several clinical studies have demonstrated DHI’s efficacy for treating UAP, with potential pharmacological effects on inflammatory factors and vascular endothelial function. However, to date, the current evidence has not been systematically summarized and analyzed.PurposeThis study provides a comprehensive overview of the most recent clinical findings and systematically analyzes the impact of DHI on inflammatory factors and vascular endothelial function among individuals diagnosed with UAP.MethodsWe searched for randomized controlled trials (RCTs) conducted until January 2023 from two clinical trial registries and eight literature databases. The Cochrane Risk of Bias Tool 2.0 was utilized to assess the potential bias in the included trials, while the GRADE system was employed to evaluate the outcome quality.ResultsWe included 46 trials involving 4,601 patients with UAP. The meta-analysis results suggested that DHI significantly reduced the levels of high-sensitivity C-reactive protein (hs-CRP) (standard mean difference [SMD] = 1.34, 95% confidence interval [CI] [-1.77, −0.90], P < 0.00001), tumor necrosis factor-alpha (TNF-α) (SMD = −0.84, 95% CI [-1.54, −0.15], P = 0.02), interleukin-6 (IL-6) (SMD = −1.05, 95% CI [-1.86, −0.25], P = 0.01), endothelin/endothelin-1 (ET/ET-1) (SMD = −2.01, 95% CI [-2.57, −1.46], P < 0.00001), and homocysteine (Hcy) (SMD = −0.55, 95% CI [-0.71, −0.39], P < 0.00001) but increased the nitric oxide (NO) level (SMD = 1.51, 95% CI [1.04, 1.97], P < 0.00001) in patients with UAP. Twenty-one RCTs described adverse events.ConclusionDHI effectively and safely reduced hs-CRP, TNF-α, IL-6, ET/ET-1, and Hcy levels and increased the NO level in patients with UAP. However, considering the overall low quality of the original studies, future large-scale, high-quality RCTs are imperative to provide robust evidence for clinical practice.Systematic Review Registrationidentifier CRD42023391497.
Therapeutics. Pharmacology
Drug-induced Brugada syndrome: Case report
Yuri N. Fedulaev, Irina V. Makarova, Fatima G. Magomedova
et al.
Brugada syndrome (BrS) is an inherited clinical and electrocardiographic syndrome, related to ion channelopathies and associated with an increased risk of sudden cardiac death. The cornerstone in diagnosis remains a spontaneous type 1 Brugada-pattern on the electrocardiogram (ECG), including J point elevation of ≥ 2 mm, coved-type ST segment elevation and T wave inversion in right precordial leads. Similar ECG changes, induced by antiarrhythmic therapy, should be considered as diagnostic when combined with a documented polymorphic ventricular tachycardia or ventricular fibrillation episode, arrhythmogenic syncope, nocturnal agonal breathing or a family history of sudden cardiac death or BrS. The article represents a clinical case of drug-induced type 1 Brugada-pattern in the settings of antiarrhytmic treatment using 1C class sodium channel blocker ethacizine in a female without additional BrS criteria, with negative genetic testing results and the ECG normalization after drug withdrawal.
Medicine (General), Therapeutics. Pharmacology
Proteomic analysis of synergetic neuroprotective effect of adenosine, thiamine, niacin and cyanocobalamin in pathophysiology of diabetic polyneuropathy
O. A. Gromova, I. Yu. Torshin, A. G. Moiseenok
Background. Neurotransmitter adenosine and B-group vitamins have neuroprotective, remyelinizing and anti-neuroinflammatory properties. Despite the studies of these molecules for decades, the molecular mechanisms of their synergistic effect on neuroinflammation processes are unexplored and not systematized.Objective: to establish the molecular mechanisms of synergism of adenosine, thiamine, niacin and cyanocobalamin in counteracting the pathology of diabetic polyneuropathy (DPN).Material and methods. The molecular mechanisms of action of adenosine, thiamine (vitamin B1), niacin (vitamin PP) and cyanocobalamin (vitamin B12) in the pathophysiology of DPN were determined using functional analysis of genomic and proteomic databases.Results. The analysis of 20,180 annotated proteins of the human proteome identified 504 vitamin-PP-dependent, 22 vitamin-B1-dependent, 24 vitamin-B12-dependent and 50 adenosine-dependent proteins. The proteins of the human proteome were detected, the activity or levels of which are important for reducing neuroinflammation, remyelination, neurogenesis, biosynthesis of neuronal adenosine triphosphate, myelin homeostasis, neuroplasticity, neutralization of homocysteine, regeneration of nerve fibers and maintaining the endothelium of the microvascular bed.Conclusion. The discovered molecular mechanisms of synergism of the studied molecules are of fundamental importance for comprehension of the processes of neuroinflammation regulation and remyelination to prevent diabetic polyneuropathy and other neurodegenerative diseases.
Therapeutics. Pharmacology, Economics as a science
Ginsenoside in the treatment of type 2 diabetes and its complications: a promising traditional chinese medicine
Yingying Liu, Yang Ju, Yanjun Wang
et al.
Type 2 diabetes mellitus (T2DM), a chronic condition commonly observed in adults, particularly among the elderly, is characterized by a dysfunctional insulin response that impairs blood glucose regulation, resulting in persistent hyperglycemia. Ginseng, a medicinal plant with significant economic value and a longstanding history of therapeutic use in Asia, has shown efficacy against various diseases. Extensive clinical and experimental studies highlight ginsenosides, its primary bioactive compounds, for their multiple therapeutic effects across a range of conditions, including endocrine, cardiovascular, and central nervous system disorders. Various ginsenoside types have demonstrated potential in lowering blood glucose levels, reducing insulin resistance, and alleviating complications through the modulation of key protein targets and signaling pathways. This review consolidates the pharmacological actions and mechanisms of distinct ginsenosides in managing diabetes and its complications, offering a theoretical foundation for further pharmacological research and novel drug development for T2DM treatment, while also providing robust theoretical support for future clinical applications.
Therapeutics. Pharmacology
Benefits of Purely Online Journals and the Challenges
Shaukat Ali Jawaid, Masood Jawaid
There are numerous well-established parameters to judge and evaluate the standard of a medical journal like quality of its contents and geographic distribution of manuscripts, it attracts for publication, indexation and coverage in important indexes and databases like Medline, Web of Sciences by Clarivate known for its Impact Factor (IF), PubMed Central, Scopus etc., journal visibility and readership, timely regular publication. Impact Factor is one of the criteria and not the only criteria, which should be used to judge the standard of a journal. However, too much importance being given to the Impact Factor by the regulatory bodies in Pakistan as well as by medical institutions, asking those doing PhD to publish their research work in Impact Factor journals has created a crisis like situation not only for the researchers but also made the life of the IF journal editors miserable. They are under tremendous pressure to accommodate more and more papers by the authors anxious for early publication to meet certain deadlines for the completion of their research project and award of degrees while the editors on their part are faced with a dilemma due to human resource and financial resource constraints. In an environment where political stability remains in short supply most of the time, law and order situation is unpredictable, not to forget the frequent breakdown of electricity and inefficient internet service, it is not possible to either increase the frequency of publications or plan some other measures which all call for additional investment. Finding trained human resource and then retaining those remains a constant problem.
A Zero-Valent Sulfur Transporter Helps Podophyllotoxin Uptake into Bacterial Cells in the Presence of CTAB
Honglei Liu, Huiyuan Yu, Rui Gao
et al.
Podophyllotoxin (PTOX) is naturally produced by the plant Podophyllum species. Some of its derivatives are anticancer drugs, which are produced mainly by using chemical semi-synthesis methods. Recombinant bacteria have great potential in large-scale production of the derivatives of PTOX. In addition to introducing the correct enzymes, the transportation of PTOX into the cells is an important factor, which limits its modification in the bacteria. Here, we improved the cellular uptake of PTOX into <i>Escherichia coli</i> with the help of the zero-valent sulfur transporter YedE1E2 in the presence of cetyltrimethylammonium bromide (CTAB). CTAB promoted the uptake of PTOX, but induced the production of reactive oxygen species. A protein complex (YedE1E2) of YedE1 and YedE2 enabled <i>E. coli</i> cells to resist CTAB by reducing reactive oxygen species, and YedE1E2 was a hypothetical transporter. Further investigation showed that YedE1E2 facilitated the uptake of extracellular zero-valent sulfur across the cytoplasmic membrane and the formation of glutathione persulfide (GSSH) inside the cells. The increased GSSH minimized oxidative stress. Our results indicate that YedE1E2 is a zero-valent sulfur transporter and it also facilitates CTAB-assisted uptake of PTOX by recombinant bacteria.
Therapeutics. Pharmacology
Knowledge, Attitudes, and Practices in Antibiotic Dispensing amongst Pharmacists in Trinidad and Tobago: Exploring a Novel Dichotomy of Antibiotic Laws
Rajeev P. Nagassar, Amanda Carrington, Darren K. Dookeeram
et al.
The inappropriate consumption, use, and dispensing of antibiotics are problems faced globally, with a pattern of inappropriate consumption differing in higher-income countries due to the ease of accessibility of antibiotics. The main drivers of consumption and inappropriate use are the over-the-counter sales of antibiotics by pharmacies. Trinidad and Tobago (T&T), a twin island state in the Caribbean, has two Acts of Parliament that regulate antibiotics: the Antibiotics Act and the Food and Drug Act, yet the Over-the-Counter (OTC) sale of antibiotics still exists. This study sought to determine the knowledge, attitudes, and practices regarding the OTC dispensing of antibiotics in T&T. A cross-sectional study gathered data from pharmacists in both the private and public sectors of Trinidad over 7 months. The results showed that antibiotic resistance and antibiotic abuse were seen as significant problems. The level of experience, gender (female), and age (younger) were significantly associated with having good overall knowledge of good dispensing habits and antibiotic laws (<i>p</i> = 0.036, <i>p</i> = 0.047, and <i>p</i> = 0.001, respectively). Pharmacists generally agreed that antibiotics under the Food and Drug Act may have contributed to OTC dispensing in the private sector (<i>p</i> = 0.013) and that all antibiotics should be under the Antibiotic Act (<i>p</i> = 0.002). Additionally, it was found that the dispensing of antibiotics OTC in the private sector (<i>p</i> = 0.006) occurred: without doctors’ advice and without requesting prescriptions; because it was perceived as lawful (especially by older pharmacists); and because of the perceived motivation of profit. Regulation enforcement was perceived as deficient. OTC dispensing for reasons, such as misunderstanding of laws, occurs in T&T.
Therapeutics. Pharmacology
Prediction of the Effects of Empagliflozin on Cardiovascular and Kidney Outcomes Based on Short-Term Changes in Multiple Risk Markers
Sok Cin Tye, Sieta T. de Vries, Christoph Wanner
et al.
Aims: The EMPA-REG OUTCOME trial demonstrated that the sodium-glucose cotransporter-2 inhibitor (SGLT2) empagliflozin reduces the risk of cardiovascular (CV) and kidney outcomes in patients with type 2 diabetes. We previously developed the parameter response efficacy (PRE) score, which translates drug effects on multiple short-term risk markers into a predicted long-term treatment effect on clinical outcomes. The main objective of this study was to assess the accuracy of the PRE score in predicting the efficacy of empagliflozin in reducing the risk of CV and kidney outcomes.Methods: Short-term (baseline to 6-months) changes in glycated hemoglobin (HbA1c), systolic blood pressure (SBP), urinary-albumin-creatinine-ratio (UACR), hemoglobin, body weight, high-density-lipoprotein (HDL) cholesterol, low-density-lipoprotein (LDL) cholesterol, uric acid, and potassium were determined among 7020 patients with type 2 diabetes and established CV disease in the EMPA-REG OUTCOME trial. The beta-coefficients, derived from a Cox proportional hazards model in a pooled database consisting of 6355 patients with type 2 diabetes, were applied to the short-term risk markers in the EMPA-REG OUTCOME trial to predict the empagliflozin-induced impact on CV (defined as a composite of non-fatal myocardial infarction, non-fatal stroke, or CV death) and kidney (defined as a composite of doubling of serum creatinine or end-stage kidney disease) outcomes.Results: Empagliflozin compared to placebo reduced HbA1c (0.6%), SBP (4.2 mmHg), UACR (13.0%), body weight (2.1 kg), uric acid (20.4 μmol/L), and increased hemoglobin (6.6 g/L), LDL-cholesterol (0.1 mmol/L) and HDL-cholesterol (0.04 mmol/L) (all p<0.01). Integrating these effects in the PRE score resulted in a predicted relative risk reduction (RRR) for the CV outcome of 6.4% (95% CI 1.4–11.7), which was less than the observed 14.7% (95% CI 1.3–26.4%) RRR. For the kidney outcome, the PRE score predicted a RRR of 33.4% (95% CI 26.2–39.8); the observed RRR was 46.9% (95% CI 26.8–61.5). In a subgroup of 2,811 patients with UACR ≥30 mg/g at baseline, the PRE score predicted RRR was 40.8% (95% CI 31.2–49.1) vs. the observed RRR of 40.8% (95% CI 12.4–60.0) for the kidney outcome.Conclusions: Integrating multiple short-term risk marker changes in the PRE score underestimated the effect of empagliflozin on CV and kidney outcomes, suggesting that the currently used risk markers do not fully capture the effect of empagliflozin. In patients with increased albuminuria, the PRE score adequately predicted the effect of empagliflozin on kidney outcomes.
Therapeutics. Pharmacology
Precise detection of CRISPR-Cas9 editing in hair cells in the treatment of autosomal dominant hearing loss
Chong Cui, Daqi Wang, Bowei Huang
et al.
Gene therapy would benefit from the effective editing of targeted cells with CRISPR-Cas9 tools. However, it is difficult to precisely assess the editing performance in vivo because the tissues contain many non-targeted cells, which is one of the major barriers to clinical translation. Here, in the Atoh1-GFP;Kcnq4+/G229D mice, recapitulating a novel mutation we identified in a hereditary hearing loss pedigree, the high-efficiency editing of CRISPR-Cas9 in hair cells (34.10% on average) was precisely detected by sorting out labeled cells compared with only 1.45% efficiency in the whole cochlear tissue. After injection of the developed AAV_SaCas9-KKH_sgRNA agents, the Kcnq4+/G229D mice showed significantly lower auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) thresholds, shorter ABR wave I latencies, higher ABR wave I amplitudes, increased number of surviving outer hair cells (OHCs), and more hyperpolarized resting membrane potentials of OHCs. These findings provide an innovative approach to accurately assess the underestimated editing efficiency of CRISPR-Cas9 in vivo and offer a promising strategy for the treatment of KCNQ4-related deafness.
Therapeutics. Pharmacology
Mitochondrial Superoxide Dismutase in Cisplatin-Induced Kidney Injury
Kranti A. Mapuskar, Emily J. Steinbach, Amira Zaher
et al.
Cisplatin is a chemotherapy agent commonly used to treat a wide variety of cancers. Despite the potential for both severe acute and chronic side effects, it remains a preferred therapeutic option for many malignancies due to its potent anti-tumor activity. Common cisplatin-associated side-effects include acute kidney injury (AKI) and chronic kidney disease (CKD). These renal injuries may cause delays and potentially cessation of cisplatin therapy and have long-term effects on renal function reserve. Thus, developing mechanism-based interventional strategies that minimize cisplatin-associated kidney injury without reducing efficacy would be of great benefit. In addition to its action of cross-linking DNA, cisplatin has been shown to affect mitochondrial metabolism, resulting in mitochondrially derived reactive oxygen species (ROS). Increased ROS formation in renal proximal convoluted tubule cells is associated with cisplatin-induced AKI and CKD. We review the mechanisms by which cisplatin may induce AKI and CKD and discuss the potential of mitochondrial superoxide dismutase mimetics to prevent platinum-associated nephrotoxicity.
Therapeutics. Pharmacology
Network Pharmacology-Based Validation of the Efficacy of Huiyangjiuji Decoction in the Treatment of Experimental Colitis
Wei Yu, Hongju Cheng, Baoliang Zhu
et al.
Ulcerative colitis (UC) is the major type of inflammatory bowel disease (IBD) characterized by an overactive immune responses and destruction of the colorectal epithelium with intricate pathological factors. In China, Huiyangjiuji decoction (HYJJ) has been widely administered against inflammation, but the underlying mechanical mechanisms are not known. A murine model of colitis was established by orally feeding 4% dextran sodium sulfate for 5 days. Intestinal organoids (IOs) were treated with TNFα (Tumor necrosis factor-α) as an ex-vivo UC model. A scratch assay combined with a co-culture system that incubated murine epithelial cell line (IEC-6) with macrophages (Mφs) was utilized to assess epithelial recovery under inflammatory conditions. Network pharmacology analysis was performed to elucidate the mechanism of HYJJ decoction. In the present study, we confirmed that HYJJ considerably alleviated of DSS-induced colitis, as evidenced by the improved intestinal injury and fecal albumin, as well as feces blood. Network pharmacology analysis identified the active components in HYJJ formula, and KEGG enrichment analysis indicated that HYJJ-target genes were enriched in pathogen-induced infections, cancer-related as well as inflammatory pathways. Consistently, RNA-sequencing demonstrated that HYJJ treated inhibited cytokine-cytokine interaction, IBD as well as TNF signaling pathways, confirming the anti-inflammatory and anti-neoplastic role of HYJJ decoction. In-vitro experimental evidence confirmed the suppression of pro-interleukins by HYJJ, including IL-2, IL-10 and IL-12. Moreover, the contribution of HYJJ to mucosal healing was corroborated by ex-vivo experiments, in which HYJJ rescued TNFα-compromised IOs functions, i.e., elevated mitochondrial stress (MOS) and impaired regeneration capacity. IEC-6 cells co-culture with Mφs from HYJJ-treated experimental colitis mice showed an improved migration capacity as compared to those incubated with Mφs from untreated colitis mice. We conclude that HYJJ re-establishes homeostasis of the gut epithelium during colitis by suppressing inflammation and orchestrating cytokines interaction.
Therapeutics. Pharmacology
Safety and immunogenicity of an intranasal sendai virus-based vaccine for human parainfluenza virus type I and respiratory syncytial virus (SeVRSV) in adults
Felicia Scaggs Huang, David I. Bernstein, Karen S. Slobod
et al.
SeVRSV is a replication-competent Sendai virus (SeV)-based vaccine carrying the respiratory syncytial virus (RSV) fusion protein (F) gene. Unmanipulated, non-recombinant SeV is a murine parainfluenza virus type 1 (PIV-1) and serves as a Jennerian vaccine for human PIV-1 (hPIV-1). SeV protects African green monkeys (AGM) from infection after hPIV-1 challenge. The recombinant SeVRSV additionally targets RSV and protects AGM from lower respiratory infections after RSV challenge. The present study is the first to report on the safety, viral genome detection, and immunogenicity following SeVRSV vaccination of healthy adults. Seventeen and four healthy adults received intranasal SeVRSV and PBS, respectively, followed by six months of safety monitoring. Virus genome (in nasal wash) and vaccine-specific antibodies (in sera) were monitored for two and four weeks, respectively, post-vaccination. The vaccine was well-tolerated with only mild to moderate reactions that were also present in the placebo group. No severe reactions occurred. As expected, due to preexisting immunity toward hPIV-1 and RSV in adults, vaccine genome detection was transient. There were minimal antibody responses to SeV and negligible responses to RSV F. Results encourage further studies of SeVRSV with progression toward a clinical trial in seronegative children. Abbreviations: AE-adverse event; SAE-serious adverse event; SeV-Sendai virus; RSV-respiratory syncytial virus; PIV-1-parainfluenza virus-type 1; hPIV-1-human parainfluenza virus-type 1; F-RSV fusion protein; SeVRSV-recombinant SeV carrying the RSV F gene; Ab-antibody; MSW-medically significant wheezing; NOCMC-new onset chronic medical condition, mITT-modified Intent to Treat; ALRI-acute lower respiratory tract infection.
Immunologic diseases. Allergy, Therapeutics. Pharmacology
Emerging SARS-CoV-2 variants: impact on vaccine efficacy and neutralizing antibodies
Khan Sharun, Ruchi Tiwari, Kuldeep Dhama
et al.
The genetic variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been emerging and circulating in different parts of the world from the beginning of the coronavirus disease (COVID-19) pandemic. Variants are divided into three classes: variant of interest, variant of concern, and variant of high consequence depending on its impact on the transmission, disease severity, diagnostics, vaccines, and therapeutics. The variants of concern include the United Kingdom variant (B.1.1.7), South Africa variant (B.1.351), two related California variants (B.1.427 and B.1.429), and Brazil variant (P.1). These SARS-CoV-2 variants have a direct impact on the available COVID-19 vaccines and immunotherapeutics as they can alter the neutralizing activity of vaccine-elicited antibodies and monoclonal antibodies resulting in mild-to-substantial loss of efficacy. There is a need to establish surveillance systems that can monitor the emergence of novel SARS-CoV-2 variants worldwide.
Immunologic diseases. Allergy, Therapeutics. Pharmacology
Lack of time and dependence on significant others: Occupational therapists´ experiences of prescribing time assistive technology for persons with dementia
Ann-Christine Persson, Inga-Lill Boman, Lena Dahlberg
et al.
Abstract Background: There is lack of knowledge on how occupational therapists (OTs) assess daily time management (DTM) for persons with dementia (PwDs) and on which aspects affect prescription of time assistive technology (AT). Aim: To explore OTs’ experiences of assessing the need for and prescribing time AT for PwDs. Material and methods: Focus group interviews with OTs that prescribe time AT for PwDs analyzed via qualitative content analysis. Results: A main category and four categories were identified. The categories illustrated a complex and time-consuming prescription process, which was facilitated if the PwD was supported by a significant other (SO). Support from a SO was especially important during implementation and follow-up. OTs had to take individual responsibility for staying informed about time AT. Organizational limitations and time constraints were barriers for OTs striving to work according to national prescription guidelines. Conclusions and significance: High demands are made on SO’s participation during the prescription process. PwDs with no support from SOs are at risk not receiving or fully benefitting from time AT. To avoid inequalities, specific forms of support need to be developed and targeted at PwDs without SOs to ensure that they have sufficient opportunities to access and use time AT.
Internal medicine, Therapeutics. Pharmacology
Acute antioxidant and cytoprotective effects of sulforaphane in brain endothelial cells and astrocytes during inflammation and excitotoxicity
Jianxiong Liu, Giri K. Chandaka, Rong Zhang
et al.
Abstract Sulforaphane (SFN), a bioactive phytochemical isothiocyanate, has a wide spectrum of cytoprotective effects that involve induction of antioxidant genes. Nongenomic antioxidant effects of SFN have not been investigated. Brain oxidative stress during inflammation and excitotoxicity leads to neurovascular injury. We tested the hypothesis that SNF exhibits acute antioxidant effects and prevents neurovascular injury during oxidative stress. In primary cultures of cerebral microvascular endothelial cells (CMVEC) and cortical astrocytes from the newborn pig brain, a pro‐inflammatory cytokine TNF‐α and an excitotoxic glutamate elevate reactive oxygen species (ROS) and cause cell death by apoptosis. Nox4 NADPH oxidase is the main Nox isoform in CMVEC and cortical astrocytes that is acutely activated by TNF‐α and glutamate leading to ROS‐mediated cell death by apoptosis. The Nox4 inhibitor GKT137831 blocked NADPH oxidase activity and overall ROS elevation, and prevented apoptosis of CMVEC and astrocytes exposed to TNF‐α and glutamate, supporting the leading role of Nox4 in the neurovascular injury. Synthetic SFN (10−11‐10−6 mol/L) inhibited NADPH oxidase activity and reduced overall ROS production in CMVEC and astrocytes within 1‐hour exposure to TNF‐α and glutamate. Furthermore, in the presence of SFN, the ability of TNF‐α and glutamate to produce apoptosis in CMVEC and cortical astrocytes was completely prevented. Overall, SFN at low concentrations exhibits antioxidant and antiapoptotic effects in cerebral endothelial cells and cortical astrocytes via a via a nongenomic mechanism that involves inhibition of Nox4 NADPH oxidase activity. SFN may prevent cerebrovascular injury during brain oxidative stress caused by inflammation and glutamate excitotoxicity.
Therapeutics. Pharmacology
TREATMENT ADHERENCE AND QUALITY OF LIFE OF PATIENTS WITH STABLE ISCHEMIC HEART DISEASE IN TREATMENT WITH NICORANDIL: INTERRELATION AND INTERACTION (ACCORDING TO THE RESULTS OF THE OBSERVATIONAL STUDY NIKEA)
S. Yu. Martsevich, Yu. V. Lukina, N. P. Kutishenko
et al.
Aim. To assess quality of life (QoL) and its dynamics during nicorandil treatment in patients with stable ischemic heart disease, to study the relationship of treatment adherence and QoL indicators when treated with nicorandil.Material and methods. Observational program NIKEA included 590 patients with angina pectoris. Seattle Angina Questionnaire (SAQ) was used to assess QoL. Patients completed SAQ at the visit of inclusion (V0) and at the visit after 3 months of observation (V3). Potential and actual adherence to therapy was assessed by medical interviews at visits V0, V1 (1 month of observation) and V3. During the visit V0 417 people (from 590 ones enrolled into the study) completed SAQ (71% response); after 3 months (V3) SAQ was filled in by 454 of 552 people who came to this visit (82% response). According to the results of medical interviews, potential adherence (visit V0) was determined in all 590 patients, actual adherence to nicorandil (visits V1 and V3) was assessed in 552 patients who came to these visits. In accordance with the degree of adherence, all patients were divided into 3 groups: (1) adherent to treatment (taking nicorandil for the first three months), (2) non-adherent (who refused to take nicorandil), and (3) partially non-adherent (who started nicorandil, but for various reasons stopped taking the drug).Results. In all patients, regardless of their adherence to the recommended drug, there was an increase in QoL according to all five scales of the SAQ after 3 months of follow-up. Statistically significant positive dynamics of all SAQ indicators was found only in adherent patients (p<0.0001 for all aspects). Patients, who showed good adherence to nicorandil at V1, had more severe angina at the beginning of treatment (according to “Angina Stability” and “Angina Frequency” indicators). These patients also had lower QoL “Disease Perception” score and more confidence in the doctor (“Treatment Satisfaction” score) than non-adherent patients (p<0.05). In non-adherent patients a mild degree of angina was determined 2 times more often according to “Angina Frequency” indicator (p=0.03).Conclusion. The results of the study confirm the interrelation and mutual influence of the QoL indicators and treatment adherence to nicorandil. Effective treatment with nicorandil in patients with lower health-related QoL indicators could increase treatment adherence. On the other hand, the mild degree of angina, the low level of confidence in the treating doctor, the side effects of the new drug reduce medication adherence of patients, which, as a result, negatively affects the QoL of these patients
Therapeutics. Pharmacology, Diseases of the circulatory (Cardiovascular) system
Comparação dos parâmetros de força e propriocepção entre indivíduos com e sem instabilidade funcional de tornozelo
Fernanda Cristina Milanezi, Nise Ribeiro Marques, Adalgiso Coscrato Cardozo
et al.
Após a entorse de tornozelo, 40% dos indivíduos continuam a relatar uma sensação de instabilidade articular que está relacionada à disfunção músculo-esquelética denominada instabilidade funcional do tornozelo (IFT). Contudo, o mecanismo como ocorre esta disfunção músculo-esquelética ainda permanece desconhecido. Nesse sentido, o conhecimento das alterações músculo-esqueléticas que ocorrem em indivíduos com IFT pode ser um fator importante para traçar intervenções preventivas mais efetivas. Dessa forma, o objetivo deste estudo foi comparar o pico de torque (PT) concêntrico de inversão (INV) e eversão (EVE), a razão convencional (EVE/INV) e o reposicionamento articular passivo em indivíduos com e sem IFT em atletas recreacionais do gênero feminino. A amostra foi composta por 22 voluntárias na faixa etária entre 18 e 25 anos que foram divididas em grupo controle e grupo com IFT. A avaliação do torque foi realizada em um dinamômetro isocinético com cinco contrações máximas concêntricas a velocidades de 60 e 120 graus.s-1 no movimento de INV e EVE e reposicionamento articular passivo com ângulo-alvo de 10° e 20° de inversão. Foram analisados os dados de PT, razão convencional e média do erro absoluto do ângulo-alvo. A análise estatística foi feita com o teste t-Student para amostras independentes. Foi encontrado que indivíduos com IFT apresentaram diminuição da força eversora comparados aos indivíduos controle, bem como desequilíbrio da razão muscular, que podem aumentar a predisposição deste grupo a entorses de tornozelos.
Therapeutics. Pharmacology
XVII CONGRESS OF PEDIATRICIANS OF RUSSIA “RELEVANT ISSUES OF PEDIATRICS” II EURASIAN FORUM ON RARE DISEASES I ALL-RUSSIAN CONFERENCE “EMERGENCY PEDIATRIC SURGERY AND TRAUMATOLOGY” III FORUM OF PEDIATRIC NURSES
article Editorial
.
Pediatrics, Therapeutics. Pharmacology
Foot posture in basketball players with history of the shin splint
Saeed Forghany, Sajjad Bagherian Dehkordi, Hossein Montazeri Sanech
et al.
Introduction: Shin splint is one of the common injuries in most athletes. Although the relationship between abnormal foot posture and shin splint has been reported previously but, the relation between foot posture and shin splint has not been well documented. The aim of this study was to explore the relationship between foot postures in basketball players and the history of shin splint.
Materials and Methods: Thirty Iranian male basketball players who had experience of shin splint during last three months were participated in this study. Foot Posture Index (FPI-6) was used as the measure of foot posture. Talar head palpation, curvature at the lateral malleoli, inversion/eversion of the calcaneus, prominence in the region of the talonavicular joint, congruence of the medial longitudinal arch, abduction /adduction of the forefoot on the rear foot were 6 items which were assessed with FPI in the standing position. Foot posture was defined as ‘normal’, ‘supinated’ or ‘pronated. Data were collected and analyzed by SPSS, version16.
Results: Most participants showed abnormal foot posture (%80). Fifty-three percent of subjects had pronated foot (%53) and 10% did hyper-pronation. The foot postures of 17% of participants were in supination. The results of this study did not show a significant difference in foot posture between right and left foot (P > 0.05).
Conclusion: abnormal foot posture were common (%80) in basketball players with the history of shin splints. These findings could support this idea that the footwear and orthotic prescription both can prevent and treat basketball players with history of shin splints.
Keywords: Foot posture, Shin splints, Basketball
Medicine, Therapeutics. Pharmacology
CLINICAL CORRELATIONS BETWEEN GASTROESOPHAGEAL REFLUX DISEASE AND CHILDREN'S THROAT AND LARYNX CONDITION
Yu.L. Soldatskiy, I.E. Pogosova, T.G. Zaviktorina
et al.
In order to study the impact exerted by the gastroesophageal reflux disease (GERB) on the throat and larynx status, the authors examined 39 children (main group), suffering from GERB, and 15 patients (control group), suffering from the chronic gastrointestinal tract pathology, who did not confirm GERB. All the patients underwent a 24'hour рН-monitoring of the esophagus and laryngeal part of the throat and upper airways endoscopy. They discovered that for the children, suffering from the extraesophageal GERB (i.e. regurgitation of the sourreflux substance above the upper esophageal sphincter into the hypopharynx), it is also typical for chronic throat and larynx pathology: the endoscopy identified the accompanied pathology among 80%, chronic pharyngitis among 62,5%, and their combination among 48% of patients. Normalization of an mucous membrane of esophagus is highly likely to correlate (r = 0,54, р<0,01) with the throat and larynx status normalization. Thus, it is very likely that GERB and its extraesophageal variant in particular plays a great role in pathogenesis of the throat and larynx disease development. This circumstance should be consider both in therapy of the patients with GERB and detection of pathologies in the ENT organs.Key words: gastroesophageal reflux, chronic pharyngitis, chronic laryngitis, children.
Pediatrics, Therapeutics. Pharmacology