Vasiljko Vukoje: Zabranjena zaborav

Prikaz knjige: Vasiljko Vukoje: zabranjena zaborav, Vlastita naklada, Smederevo, 2019., 98 str

Vasiljko Vukoje: Zabranjena zaborav

Prikaz knjige: Vasiljko Vukoje: zabranjena zaborav, Vlastita naklada, Smederevo, 2019., 98 str

Katalonsko pitanje na izborima u studenom 2019.: analiza predizbornih sučeljavanja

Porast potpore pokretu za neovisnost u Kataloniji za posljedicu je imao institucijsku nestabilnost i promjenu španjolskoga stranačkog sustava. Ovaj rad istražuje razlike u interpretacijskim okvirima katalonskog pitanja na temelju izjava stranačkih čelnika koji su sudjelovali na četiri predizborna sučeljavanja za parlamentarne izbore u studenom 2019. Interpretacijski okviri definirani su s obzirom na tri pitanja: 1) jesu li stranački čelnici u predizbornim sučeljavanjima prikazali katalonski proces (Procés) kao neprijateljski, tj. kao onaj koji ruši ustavni poredak ili kao legitimno pravo građana na prosvjed; 2) kako stranački čelnici uokviruju španjolsku državu – kao izričito unitarnu zemlju ili višenacionalnu državu; 3) sma-traju li stranački čelnici da su nužne ustavne promjene da bi se riješilo katalonsko pitanje ili preferiraju status quo. Analiza provedena metodom uokvirivanja utvrdila je pet interpretacijskih okvira te pokazala da dva interpretacijska okvira koja podrazumijevaju afirmativno rješavanje katalonskog pitanja dijalogom s katalonskom vladom (Generalitat) uživaju većinu i na sučeljavanjima i nakon izbora

Učešće serotonergičkih mehanizama u antinociceptivnom dejstvu metformina

Metformin, a well-known antidiabetic drug, has been shown to possess analgesic properties in inflammatory pain models, but the mechanisms of its antinociceptive effects are not completely understood (1,2). We aimed to examine the involvement of serotonergic mechanisms in metformin-induced antinociception in a model of inflammatory pain, using the formalin test in mice. Firstly, we examined the antinociceptive effects of intraperitoneally administered metformin in the first and second phase of the test. Then, the involvement of serotonergic receptors was evaluated by intraperitoneally pretreating mice with a 5-HT1B/1D (GR127935) or 5-HT1A receptor antagonist (WAY100635). Further, we examined the effect of metformin after depletion of endogenous serotonin with a tryptophan-hydroxylase inhibitor (PCPA; applied intraperitoneally for 4 days). Additionally, to avoid misinterpretation of motor incoordination, we performed the rotarod test with the highest tested metformin dose. Metformin (50-200 mg/kg) produced significant and dose-dependent antinociceptive effects (17-81%) in the second (inflammatory) phase of the test. Pretreatment with antagonists significantly reduced the antinociceptive effect of metformin (150 mg/kg). GR127935 inhibited the effects of metformin by 67% (1 mg/kg) and 100% (3 mg/kg), whereas the inhibitory effects for WAY100635 were 19% (1 mg/kg) and 68% (3 mg/kg). Depletion of serotonin with PCPA (100 mg/kg/day) significantly reduced the antinociceptive effects of higher metformin doses (150 and 200 mg/kg). Metformin (200 mg/kg) had no influence on rotarod performance. This study demonstrates that 5-HT1B/1D and 5-HT1A receptors are involved in metformin’s antinociceptive effects and that metformin’s action on these receptors seems to be indirect (mediated by endogenous serotonin released by metformin).Metformin je dobro poznat antidijabetik, za koji je pokazano da poseduje analgetička svojstva u modelima inflamatornog bola. Međutim, mehanizmi njegovog antinociceptivnog dejstva nisu u potpunosti rasvetljeni (1,2). Cilj ovog rada je bio ispitati učešće serotonergičkih mehanizama u antinociceptivnom dejstvu metformina u inflamatornom modelu bola – korišćenjem formalinskog testa kod miševa. Inicijalno su ispitani antinociceptivni efekti metformina, nakon intraperitonealne primene, u prvoj i drugoj fazi testa. Uključenost serotoninskih receptora je procenjena nakon intraperitonealne primene antagonista 5-HT 1B/1D (GR127935) ili 5-HT1A (WAY100635) receptora. U nastavku eksperimenata, efekat metformina je ispitan nakon deplecije endogenog serotonina, primenom inhibitora triptofan-hidroksilaze (PCPA; primenjen intraperitonealno tokom 4 dana). Dodatno, efekat najveće testirane doze metformina je ispitan u rotarod testu, kako bi se isključila mogućnost pogrešnog tumačenja motorne inkoordinacije. Metformin (50-200 mg/kg) je pokazao značajno i dozno-zavisno antinociceptivno dejstvo (17-81%) u drugoj (inflamatornoj) fazi testa. Primena antagonista je značajno smanjila antinociceptivni efekat metformina (150 mg/kg). GR127935 je inhibirao efekte metformina za 67% (1 mg/kg) i 100% (3 mg/kg), dok su inhibitorni efekti WAY100635 bili 19% (1 mg/kg) i 68% (3 mg/kg). Deplecija serotonina korišćenjem PCPA (100 mg/kg/dan) je značajno smanjila antinociceptivne efekte metformina primenjenog u većim dozama (150 i 200 mg/kg). Metformin (200 mg/kg) nije imao značajan uticaj na performanse miševa u rotarod testu. Ova studija je pokazala uključenost 5-HT1B/1D i 5-HT1A receptora u antinociceptivnom dejstvu metformina, koje je verovatno posledica indirektnog uticaja leka na receptore (posredstvom oslobađanja endogenog serotonina od strane metformina).VIII Kongres farmaceuta Srbije sa međunarodnim učešćem, 12-15.10.2022. Beogra

Aktivacija perifernih serotoninskih 5‐HT1A i 5‐HT 1B/1D receptora doprinosi antinociceptivnom dejstvu metformina

Several lines of (pre)clinical evidence have emerged that the antidiabetic drug metformin can alleviate inflammatory/neuropathic pain (1). Although the mechanism is not completely understood, there are reports that metformin can affect neurotransmitters involved in pain modulation, such as its ability to increase peripheral serotonin release (2). Here, we evaluated metformin’s efficacy following local peripheral administration in an inflammatory pain model and examined the potential involvement of serotonin receptors. We used the formalin test in mice, where we measured duration of nociceptive behavior in the first and second phase of the test. First, we examined the metformin’s antinociceptive effects following intraplantar administration. Additionally, the highest tested metformin dose was applied contralateral to the formalin-injected side, to exclude possible systemic effects. In the second part, we evaluated the effects of a 5-HT1A (WAY100635) and 5-HT1B/1D antagonist (GR127935) on the antinociceptive effects of a fixed, effective dose of metformin (antagonists were co-administered intraplantarly with metformin). Metformin (0.1-2 mg/paw) produced significant and dose-dependent antinociceptive effects (32-72%) in the second (inflammatory) phase. Contralateral application of metformin (2 mg/paw) had no significant antinociceptive effects. Both antagonists significantly reduced the antinociceptive effects of metformin (1 mg/paw). The levels of inhibition of metformin’s antinociceptive effect produced by WAY100635 were 56% (5 μg/paw) and 82% (7.5 μg/paw), whereas GR127935 inhibited metformin’s efficacy by 24% (3.75 μg/paw) and 80% (5 μg/paw). This study demonstrates that peripheral metformin application can produce antinociceptive effects against inflammatory pain and that activation of peripheral 5-HT 1A and 5-HT1B/1D receptors contributes to these effects.Postoje brojni dokazi iz (pre)kliničkih studija da metformin, lek iz grupe antidijabetika, može ublažiti inflamatorni/neuropatski bol (1). Iako mehanizam dejstva nije u potpunosti razjašnjen, podaci ukazuju da metformin može uticati na neurotransmitere uključene u modulaciju bola, poput sposobnosti da poveća oslobađanje serotonina na periferiji (2). U ovom radu je ispitana efikasnost metformina nakon lokalne periferne primene u modelu inflamatornog bola, kao i potencijalna uključenost serotoninskih receptora. Korišćen je formalinski test kod miševa, u kome je mereno vreme provedeno u nociceptivnom ponašanju, u prvoj i drugoj fazi testa. Prvo su ispitani antinociceptivni efekti metformina nakon intraplantarne primene. Dodatno, najveća testirana doza metformina je primenjena kontralateralno u odnosu na mesto injektovanja formalina, kako bi se isključili mogući sistemski efekti. U drugom delu studije, ispitani su efekti antagoniste 5-HT 1A (WAY100635) i 5-HT1B/1D (GR127935) receptora na antinociceptivno dejstvo fiksne, efektivne doze metformina (antagonisti su primenjeni intraplantarno, istovremeno sa metforminom). Metformin (0,1-2 mg/šapi) je ispoljio značajan i dozno-zavisan antinociceptivni efekat (32-72%) u drugoj (inflamatornoj) fazi testa. Kontralateralna primena metformina (2 mg/šapi) nije imala značajan antinociceptivni efekat. Primenjeni antagonisti su značajno smanjili antinociceptivne efekte metformina (1 mg/šapi). Stepeni inhibicije antinociceptivnog dejstva metformina koje je postigao WAY100635 su bili 56% (5 μg/šapi) i 82% (7,5 μg/šapi), dok je GR127935 inhibirao efikasnost metformina za 24% (3,75 μg/šapi) i 80% (5 μg/šapi). Ova studija je pokazala da periferna primena metformina proizvodi antinociceptivni efekat kod inflamatornog bola i da aktivacija perifernih 5-HT1A i 5- HT1B/1D receptora doprinosi ovom efektu.VIII Kongres farmaceuta Srbije sa međunarodnim učešćem, 12-15.10.2022. Beogra

Sex and age differences and outcomes in acute coronary syndromes

Background: There is conflicting information about sex differences in presentation, treatment, and outcome after acute coronary syndromes (ACS) in the era of reperfusion therapy and percutaneous coronary intervention. The aim of this study was to examine presentation, acute therapy, and outcomes of men and women with ACS with special emphasis on their relationship with younger age ( lt = 65 years). Methods: From January 2010 to June 2015, we enrolled 5140 patients from 3 primary PCI capable hospitals. Patients were registered according to the International Survey of Acute Coronary Syndrome in Transitional Countries (ISACS-TC) registry protocol (ClinicalTrials.gov: NCT01218776). The primary outcome was the incidence of in-hospital mortality. Results: The study population was constituted by 2876 patients younger than 65 years and 2294 patients older. Women were older than men in both the young (56.2 +/- 6.6 vs. 54.1 +/- 7.4) and old (74.9 +/- 6.4 vs. 73.6 +/- 6.0) age groups. There were 3421 (66.2%) patients with ST elevation ACS (STE-ACS) and 1719 (33.8%) patients without ST elevation ACS (NSTE-ACS). In STE-ACS, the percentage of patients who failed to receive reperfusion was higher in women than in men either in the young (21.7% vs. 15.8%) than in the elderly (35.2% vs. 29.6%). There was a significant higher mortality in women in the younger age group (age-adjusted OR 1.52, 95% CI: 1.01-2.29), but there was no sex difference in the older group (age-adjusted OR 1.10, 95% CI: 0.87-1.41). Significantly sex differences in mortality were not seen in NSTE-ACS patients. Conclusions: In-hospital mortality from ACS is not different between older men and women. A higher short-term mortality can be seen only in women with STEMI and age of 65 or less

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden