Качество профилактики сердечно-сосудистых заболеваний у больных сахарным диабетом 2-го типа в амбулаторных условиях

The retrospective medical charts review of 1146 patients with type II diabetes mellitus was done in outpatients clinics. The minimal attention was observed towards main risk factors, as well of the frequency of diagnostic procedures was insufficient for adequate control of diabetes mellitus and cardiovascular disease. The prognosis of diabetes mellitus could be improved by the aggressive treatment and correction of cardiovascular risk factors implemented by doctors of different specialties

Analysis of changes in pharmacotherapy of stable angina over the five-year period at specialized out-patient level of medical care (pharmacoepidemiological study)

Investigate the dynamics of drug prescription rates in patients with stable angina over the five-year period on the example of routine clinical practice of outpatient cardiology institution of Moscow for the purpose of further eliminating the prescribing gap for guideline recommended pharmacological strategies. Our research work was performed as a retrospective pharmacoepidemiological study including two stages with five-year interval using cross-section metho

Medication adherence in patients with stable coronary artery disease in primary care

Medication non-adherence in coronary outpatients exceeded 50%. High adherence was associated with more frequent use of fixed dose combinations and fewer pills taken by patien

Critical aspects of the management of stable coronary artery disease in primary care practice or how to increase the efficacy of evidence-based pharmacological therapy?

The publication describes a fragment of the pharmacoepidemiologic study conducted to review the quality of management of patients with stable coronary artery disease (SCAD) in primary care over a 12-year period. The aim of the study was to justify the application of standard operating procedures (SOPs). Such determinants of pharmacotherapy as non-pharmacological modification of cardiovascular risk factors (RFs) and medication adherence were analyze

Фармакокинетика нового отечественного антитромбоцитарного препарата из группы ингибиторов гликопротеиновых IIb/IIIa-рецепторов

Relevance. As part of the conducted open non-randomized phase I clinical trial the pharmacokinetics (PK) of the first Russian novel antiplatelet agent Angipur (nonpeptide glycoprotein IIb/IIIa receptor inhibitor) was studied.Aim of the research was to evaluate PK parameters of Angipur in healthy volunteers after single dose ascending infusions.Methods. 20 male healthy volunteers were enrolled in this phase I trial. Angipur (0.02% concentrate solution for infusion) was administered to every subject in single doses 0.015, 0.05, 0.09 mg/kg for 3 consecutive days. PK parameters were evaluated.Results. After single intravenous administration of doses 0.015, 0.05, 0.09 mg/kg to healthy volunteers the peak plasma concentration of Angipur was reached at the end of the infusion, and then the plasma concentration rapidly decreased 15 minutes after the end of the infusion followed by slow decrease for 12 hours. Dose proportionality for key PK parameters was established. After single infusions of doses 0.015, 0.05, 0.09 mg/kg mean AUC0-t was 27.11, 92.04 and 180.39 ng× h/ml; mean AUC0-¥ – 37.03, 125.76 and 239.61 ng×h/ml; mean Сmax – 12.44, 46.1 and 92.48 ng/ml; mean Vd – 304.01, 299.67 and 252.96 l; mean Т1/2 – 6.72, 6.84 and 6.06 h; Сl – 32.19, 32.29 and 31.55 l/h; kel – 0.1073, 0.1109 and 0.1257 l/h; MRT – 8.94, 8.93 and 8.18 h.Conclusion. Pharmacokinetics of Angipur in studied doses demonstrated linearity, rapid reaching of Сmax immediately after the infusion and the high distribution of the drug in tissues and biological fluids of the human organism..Актуальность. В рамках проведённого открытого нерандомизированного клинического исследования I фазы изучена фармакокинетика (ФК) первого отечественного оригинального антитромбоцитарного препарата Ангипур из группы непептидных ингибиторов гликопротеиновых IIb/IIIa-рецепторов.Целью работы было определение ФК параметров препарата Ангипур при внутривенном введении здоровым добровольцам в однократных разовых дозах.Методы. В клиническое исследование I фазы было включено 20 здоровых добровольцев мужского пола. Препарат Ангипур (0,02 % концентрат для приготовления раствора для инфузий) вводился каждому добровольцу 3 дня подряд последовательно в разовых однократных дозах 0,015; 0,05 и 0,09 мг/кг. Далее оценивались основные ФК параметры исследуемого препарата.Результаты. Установлено, что после однократного внутривенного введения доз 0,015; 0,05 и 0,09 мг/кг здоровым добровольцам максимальная концентрация препарата Ангипур в плазме крови отмечалась после окончания введения, а через 15 минут она быстро снижалась с последующим медленным снижением в течение 12 ч. Выявлена прямая пропорциональная зависимость основных ФК параметров от величины дозы. После введения исследуемого препарата в дозах 0,015; 0,05 и 0,09 мг/кг AUC0-t составляла в среднем 27,11; 92,04 и 180,39 нг×ч/мл; AUC0-¥ — 37,03; 125,76 и 239,61 нг×ч/мл; Сmax — 12,44; 46,1 и 92,48 нг/мл; Vd — 304,01; 299,67 и 252,96 л. После введения указанных доз Т1/2 в среднем был равен 6,72; 6,84 и 6,06 ч; Сl — 32,19; 32,29 и 31,55 л/ч; kel — 0,1073; 0,1109 и 0,1257 1/ч; MRT — 8,94; 8,93 и 8,18 ч, соответственно.Заключение. ФК препарата Ангипур в изученных дозах показала свой линейный характер, быстрое достижение значения Сmax сразу после введения и способность препарата интенсивно распределяться в ткани и биологические жидкости организма

Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Quality of preventive outpatient measures for cardiovascular disease in patients with type ii diabetes mellitus

The retrospective medical charts review of 1146 patients with type II diabetes mellitus was done in outpatients clinics. The minimal attention was observed towards main risk factors, as well of the frequency of diagnostic procedures was insufficient for adequate control of diabetes mellitus and cardiovascular disease. The prognosis of diabetes mellitus could be improved by the aggressive treatment and correction of cardiovascular risk factors implemented by doctors of different specialties