EFFICACY AND SAFETY OF THERAPY WITH ATORVASTATIN IN HIGH DOSES

Large epidemiological trails shown that hypercholesterolemia is one of the main risk factor of ischemic heart disease (IHD). Correction of the hypercholesterolemia with GmGKoA reductase inhibitors (statins) essentially reduces IHD morbidity and mortality. The lower serum level of low density lipoprotein is - the lower risk of cardiovascular diseases and their complications are. Efficacy and safety of atorvastatin therapy in high doses is discussed in patients with IHD and dyslipidemia. Atorvastatin in high doses is more effective than standard therapy for prevention of cardiovascular complications. Atorvastatin is also effective in patients with recurrent cardiovascular events. Atorvastatin in high doses is safe and well tolerated. Serious side effects due to atorvastatin use (myopathy and rhabdomyolysis) are very rare. Generic atorvastatin 80 mg OD in ATLANTIC study was effective and safe. However efficacy and safety of other atorvastatin generics in dose of 80 mg OD is not well studied and it is necessary further studies

Production of para-- and orthopositronium at relativistic heavy ion colliders

We consider the ortho-- and parapositronium production in the process $AA \to AA+$ Ps where A is a nucleus with the charge number Z. The inclusive cross section and the energy distribution of the relativistic Ps are calculated which are of primary interest from the experimental point of view. The accuracy of the corresponding cross sections is given by omitting terms $\sim (Z\alpha )^2/L^2$ for the para--Ps and $\sim (Z\alpha)^2/L$ for the ortho--Ps production where $L=\ln{\gamma^2} \approx 9$ and 16 for the RHIC and the LHC. Within this accuracy the multiphoton (Coulomb) corrections are taken into account. We show that the RHIC and the LHC will be Ps factories with a productions rate of about $10^5 \div 10^8$ relativistic Ps per day. The fraction of the ortho--Ps is expected to be of the same order as that of the para--Ps for Au--Au and Pb--Pb collisions.Comment: 22 pages, 5 figures, RevTeX, misprint correcte

Production of relativistic positronium in collisions of photons and electrons with nuclei and atoms

We consider the production of ultrarelativistic positronium (Ps) in $\gamma A \to Ps + A$ and $e A \to Ps + e A$ processes where $A$ is an atom or a nucleus with charge $Ze$. For the photoproduction of para- and ortho-Ps and the electroproduction of para-Ps we obtain the most complete description compared with previous works. It includes high order $Z \alpha$ corrections and polarization effects. The accuracy of the obtained cross sections is determined by omitted terms of the order of the inverse Ps Lorentz factor squared. The studied high order multi-photon electroproduction of ortho-Ps dominates for the collision of electrons with heavy atoms over the bremsstrahlung production from the electron via a virtual photon proposed by Holvik and Olsen. Our results complete and correct the studies of those authors.Comment: 19 pages, 9 figures, RevTex; v2: minor corrections for the accuracy of the results, a discussion of the literature added in a footnote, one additional reference; v3: diagram of Fig.2 correcte

A number-conserving linear response study of low-velocity ion stopping in a collisional magnetized classical plasma

The results of a theoretical investigation on the low-velocity stopping power of the ions moving in a magnetized collisional plasma are presented. The stopping power for an ion is calculated employing linear response theory using the dielectric function approach. The collisions, which leads to a damping of the excitations in the plasma, is taken into account through a number-conserving relaxation time approximation in the linear response function. In order to highlight the effects of collisions and magnetic field we present a comparison of our analytical and numerical results obtained for a nonzero damping or magnetic field with those for a vanishing damping or magnetic field. It is shown that the collisions remove the anomalous friction obtained previously [Nersisyan et al., Phys. Rev. E 61, 7022 (2000)] for the collisionless magnetized plasmas at low ion velocities. One of major objectives of this study is to compare and contrast our theoretical results with those obtained through a novel diffusion formulation based on Dufty-Berkovsky relation evaluated in magnetized one-component plasma models framed on target ions and electrons.Comment: Submitted to Phys. Rev. E, 17 pages, 4 figure

Economic aspects of the cardiology program expansion of additional drugs provision by effective lipidlowering drugs for hypercholesterolemia control

The federal program of preferential drug provision in cardiology shows its effectiveness. However, hypercholesterolemia (HCH) remains a significant problem in patients in whom high-dose statin therapy does not provide the target level of low-density lipoprotein cholesterol (LDL cholesterol). The solution to the problem lies in the plane of prescribing lipid-lowering drugs of a different mechanism of action, for example, inhibitors of the PCSK9 enzyme. To recommend the inclusion of such kind drugs in the program, it is necessary not only to have evidence of their life-saving effect, but also the economic feasibility of their use. Aim: to evaluate the economic efficacy of alirocumab (INN) including in the federal program for patients who have suffered an acute coronary event, are receiving statins and have an LDL CH level of 5.0 mmol/l and higher.Materials and methods. Modeling was applied in a target group of 3029 patients of working age who had undergone ACS during the previous 12 months with severe, including familial, HCH, with LDL cholesterol 5.0 mmol/l and higher, receiving statins taking into account previously determined outcomes when using alirocumab + statins for 5 years. Direct medical and non-medical costs, as well as indirect costs, are identified. The cost-effectiveness analysis was applied from the point of view of the effectiveness of treatment (effects on mortality, temporary disability, disability) and direct health care costs (additional drug provision and outpatient follow-up, specialized, including high-tech, medical care in a 24‑hour hospital). Two healthcare technologies were compared: statin therapy and use of alirocumab + statins. The calculations used according to domestic methods used the cost of medical treatment, temporary disability, hospitalizations, loss of GDP and other parameters.Results. Modeling has shown a decrease in mortality, morbidity and disability when using alirocumab in even the first year of use. The economic effect of alirocumab from a decrease in temporary disability in the 1st year is 304.5 mln rub., in the 2nd — 301.5 mln rub., in the 3rd — 321.1 mln rub., in the 4th — 333.1 mln rub. The estimated amount of prevented GDP losses from mortality in the target group for 4 years in the case of alirocumab use amounted to 1,260.2 mln rub. The annual amount of avoidable GDP losses from mortality in the target group in the case of alirocumab is 27–30 %. The annual average savings per patient in the case of alirocumab use are from 7 to 17 %. The greatest impact on reducing losses from disability and mortality of the target group is noted in the group of people aged 40–59 years. Only for this group, if alirocumab is used, it is possible to reduce losses from disability and mortality by 159.2 million rubles per year (83 % of the total economic effect). Starting from the 4th year of alirocumab use, it is possible to obtain a positive economic effect in terms of hospitalization costs.Conclusion. When alirocumab is included in the program of additional drug provision in cardiology, the share of costs for the purchase of alirocumab for the target group may be only 0.01 %. At the same time, the economic effect of inclusion in the first year alone will amount to at least 393.4 million rubles of budget funds. The total amount of avoidable losses due to the alirocumab usage may amount to 1,638 million rubles over 4 years

Rayleigh-Taylor instability of crystallization waves at the superfluid-solid 4He interface

At the superfluid-solid 4He interface there exist crystallization waves having much in common with gravitational-capillary waves at the interface between two normal fluids. The Rayleigh-Taylor instability is an instability of the interface which can be realized when the lighter fluid is propelling the heavier one. We investigate here the analogues of the Rayleigh-Taylor instability for the superfluid-solid 4He interface. In the case of a uniformly accelerated interface the instability occurs only for a growing solid phase when the magnitude of the acceleration exceeds some critical value independent of the surface stiffness. For the Richtmyer-Meshkov limiting case of an impulsively accelerated interface, the onset of instability does not depend on the sign of the interface acceleration. In both cases the effect of crystallization wave damping is to reduce the perturbation growth-rate of the Taylor unstable interface.Comment: 8 pages, 2 figures, RevTe