THE PRACTICAL VALUE OF OXIDANT-ANTIOXIDANT PARAMETERS INPATIENTS TREATED WITH HEMODIALYSIS

The work is dedicated to the practical application of oxidant-antioxidant parameters and the possibility of using them for monitoring and optimize the treatment hemodialysis

Search interactive regional game as a metod of developing general competencies

The article presents the possibility of using regional interactive quest game as the pedagogical technology aimed to formation of the general competences of studentsВ статье рассматривается возможность использования краеведческой интерактивной игры-квеста, как педагогической технологии, направленной на формирование общих компетенций обучающихс

Clinical estimation of efficiency of application of terpene-containing preparation in complex treatment of chronic generalized parodontitis

The article presents the comparative analysis of application of terpene-containing medicine Antiran (1:3 solution) and 0.06% chlorhexidine bigluconate solution in a complex therapy of patients with chronic generalized parodontitis. According to the curative effect, these drugs are comparable with antibacterial and antiseptic agents, but they act more gently and, as a rule, do not cause side effects. Currently, as a etiotropic therapy of periodontitis, a wide range of drugs affecting the parodontal pathogenic microflora, irrational use of antibacterial agents has acquired the status of a global problem of modern medicine, since it leads to the emergence of resistant strains of microorganisms that are poorly sensitive or resistant to treatment. The medicaments were used in ultrasonic scaling and for passive ultrasonic irrigation of periodontal pockets during curettage process. The results were evaluated according to the PMA, SBI, PI indexes, an extravazation time formation and periodontal pockets depth. The first total time period of clinical observation established that inflammation process was eliminated earlier when Antiran was used. Thus our study demonstrated and substantiated the successful experience of Antiran application in periodontal practice

Results of application of terpenoid-containing drugs in therapy of chronic parodontitis

The therapeutic effect of the drug Antiran containing terpenoid isobornyl acetate on the inflammation in the parodontium in 30 patients with chronic parodontitis of mild severity was investigated. It was used a 30% solution of the drug Antiran as the irrigating liquid with ultrasound scaling and closed curettagein the main group (15 patients), and 0.06% chlorhexidine solution in the comparison group (15 patients). Then, all patients were dialyzed by the solution of the drug Antiran in the parodontal tissues for 20 minutes daily. The dynamics of treatment was assessed by index and functional indicators. It was found that on the 7 th day of treatment, almost all the measurable indicators were differed statistically significantly in the study groups and indicated the best result of treatment in the main group.Исследовано терапевтическое действие препарата Антиран, содержащего терпеноид изоборнилацетат, на воспалительный процесс в пародонте у 30 пациентов с хроническим пародонтитом легкой степени тяжести. Основной группе (15 пациентов) в качестве орошающей жидкости при ультразвуковом скейлинге и закрытом кюретаже применяли 30% раствор препарата Антиран, а группе сравнения (15 пациентов) — 0,06% раствор хлоргексидина. Затем всем пациентам проводили диализ раствора препарата Антиран в ткани пародонта по 20 минут ежедневно. Динамику лечения оценивали по индексным и функциональным показателям. Установлено, что на 7-е сутки лечения почти все измеряемые показатели в исследуемых группах отличались статистически значимо и свидетельствовали о лучшем результате лечения в основной группе

Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m 2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years