Relationships between geomagnetic Ар-indeх and parameters of the immunity in patients with neuroendocrine-immune complex dysfunction in former sportsmen

Background. The effect of geomagnetism on human immunity has so far been studied through long-term observations. Recently, we have been detected the immediate immunotropic effects of the disturbances of the geomagnetic field (Ap-index) at multiple sclerosis patients. The aim of this study was to identify the immunotropic effects of geomagnetism on another contingent of people. Material and methods. The object of observation were 21 men (24-63 y) and 20 women (33-62 y) with neuroendocrine-immune complex dysfunction. Each patient was tested twice with an interval of 4 days. Observations were carried out on 09.06. and 13.06. 2015, 14.09 and 18.09. 2015, 27-28.03. and 04-05.04. 2018, 28.01. and 01.02. 2019. Retrospectively we recorded the geomagnetic Ap-Index on the day of testing and during the previous 7 days, using resource https://www.spaceweatherlive.com/. The content of subpopulations of lymphocytes expressing CD3, CD4, CD25, CD8, CD22 and CD56 receptors as well as the serum concentration of circulating immune complexes, immunoglobulins classes M, G, A, C-reactive protein and IL-1β was determined. The state of phagocytic function of neutrophils estimated by microbial count and phagocytic and killing indices against Staphylococcus aureus and Escherichia coli. Results. During the week, the average level of Ap-index ranged from 7 to 13 nT. Maximum coefficients of multiple correlation with immunity parameters were detected for Ap-index on the eve of blood sampling (R=0,768) and 5 days before it (R=0,758) while the minimum on 3 (R=0,541) and 2 (R=0,479) days before sampling. The canonical correlation between Ap-indices for 7 days before and on the day of testing, on the one hand, and the immunity parameters - on the other hand, was very strong: R=0,921; R2=0,849; χ2(200)=375; p<10-6. Conclusion. Disturbances of the geomagnetic field (Ap-index) has a significant immediate modulating effect on the immune parameters, mostly phagocytosis completeness, Igg A and M serum concentration, T-helper and B lymphocytes as well as eosinophils, rod-shaped neutrophils and monocytes blood level

Edoxaban versus warfarin in patients with atrial fibrillation

Contains fulltext : 125374.pdf (publisher's version ) (Open Access)BACKGROUND: Edoxaban is a direct oral factor Xa inhibitor with proven antithrombotic effects. The long-term efficacy and safety of edoxaban as compared with warfarin in patients with atrial fibrillation is not known. METHODS: We conducted a randomized, double-blind, double-dummy trial comparing two once-daily regimens of edoxaban with warfarin in 21,105 patients with moderate-to-high-risk atrial fibrillation (median follow-up, 2.8 years). The primary efficacy end point was stroke or systemic embolism. Each edoxaban regimen was tested for noninferiority to warfarin during the treatment period. The principal safety end point was major bleeding. RESULTS: The annualized rate of the primary end point during treatment was 1.50% with warfarin (median time in the therapeutic range, 68.4%), as compared with 1.18% with high-dose edoxaban (hazard ratio, 0.79; 97.5% confidence interval [CI], 0.63 to 0.99; P<0.001 for noninferiority) and 1.61% with low-dose edoxaban (hazard ratio, 1.07; 97.5% CI, 0.87 to 1.31; P=0.005 for noninferiority). In the intention-to-treat analysis, there was a trend favoring high-dose edoxaban versus warfarin (hazard ratio, 0.87; 97.5% CI, 0.73 to 1.04; P=0.08) and an unfavorable trend with low-dose edoxaban versus warfarin (hazard ratio, 1.13; 97.5% CI, 0.96 to 1.34; P=0.10). The annualized rate of major bleeding was 3.43% with warfarin versus 2.75% with high-dose edoxaban (hazard ratio, 0.80; 95% CI, 0.71 to 0.91; P<0.001) and 1.61% with low-dose edoxaban (hazard ratio, 0.47; 95% CI, 0.41 to 0.55; P<0.001). The corresponding annualized rates of death from cardiovascular causes were 3.17% versus 2.74% (hazard ratio, 0.86; 95% CI, 0.77 to 0.97; P=0.01), and 2.71% (hazard ratio, 0.85; 95% CI, 0.76 to 0.96; P=0.008), and the corresponding rates of the key secondary end point (a composite of stroke, systemic embolism, or death from cardiovascular causes) were 4.43% versus 3.85% (hazard ratio, 0.87; 95% CI, 0.78 to 0.96; P=0.005), and 4.23% (hazard ratio, 0.95; 95% CI, 0.86 to 1.05; P=0.32). CONCLUSIONS: Both once-daily regimens of edoxaban were noninferior to warfarin with respect to the prevention of stroke or systemic embolism and were associated with significantly lower rates of bleeding and death from cardiovascular causes. (Funded by Daiichi Sankyo Pharma Development; ENGAGE AF-TIMI 48 ClinicalTrials.gov number, NCT00781391.)