Treatment of Vertigo: A Randomized, Double-Blind Trial Comparing Efficacy and Safety of Ginkgo biloba

A multicenter clinical trial was performed to compare the efficacy and safety of Ginkgo biloba extract EGb 761 and betahistine at recommended doses in patients with vertigo. One hundred and sixty patients (mean age 58 years) were randomly assigned to double-blind treatment with EGb 761 (240 mg per day) or betahistine (32 mg per day) for 12 weeks. An 11-point numeric analogue scale, the Vertigo Symptom Scale—short form, the Clinical Global Impression Scales and the Sheehan Disability Scale were used as outcome measures. Both treatment groups were comparable at baseline and improved in all outcome measures during the course of treatment. There was no significant intergroup difference with regard to changes in any outcome measure. Numerically, improvements of patients receiving EGb 761 were slightly more pronounced on all scales. Clinical global impression was rated “very much improved” or “much improved” in 79% of patients treated with EGb 761 and in 70% receiving betahistine. With 27 adverse events in 19 patients, EGb 761 showed better tolerability than betahistine with 39 adverse events in 31 patients. In conclusion, the two drugs were similarly effective in the treatment of vertigo, but EGb 761 was better tolerated. This trial is registered with controlled-trials.com ISRCTN02262139

Healing springs of Volyn region

Досліджено теоретичні основи формування природних водних джерел. Проведено аналіз природних водних джерел Волинської області, що мають історичне й сакральне значення для людини, обґрунтовано можливість їх використання в туристично-рекреаційній сфері.The theoretical basis for the formation of natural water sources. The analysis of natural water sources Volyn region with historical and sacred value for the person reasonable possibility of their use in tourism and recreation

Recreational Value of the Territory of the National Nature Park «Pripyat−Stokhid»

Досліджено придатність Національного природного парку «Прип’ять−Стохід» для здійснення різних видів рекреційно-туристської діяльності. Обґрунтовано оціночну шкалу й складники рекреаційної цінності території. Визначено рекреаційну цінність території Національного природного парку «Прип’ять−Стохід». Investigated the suitability of the National Nature Park «Pripyat−Stokhid» to engage in various recreational and tourist activities. Substantiated assessment scale and composite recreational value territory. Recreational values of the area studied in the National Nature Park «Pripyat-Stokhid».Роботу виконано на кафедрі географії ВНУ ім. Лесі Українк

Сучасний стан розвитку туристично-рекреаційного комплексу Волинської області

У монографії представлені результати дослідження сучасного стану туристично-рекреаційного комплексу Волинської області, виявлено загальні тенденції та особливості. Здійснено аналіз основних показників функціонування туристично-рекреаційного комплексу Волинської області в структурі західного регіону України та його позиціонування на основі оцінки рівня розвитку регіонів України. Результатипроведеногодослідженнябудутькориснінауковцям, фахівцям туристично-рекреаційноїсфери, представникам державних органів управління, викладачам, студентам

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Theoretical-methodological approaches to the determination of the recreational loadings on the territories and objects of the natural-protected fund

Досліджено правові засади рекреаційного використання територій природних національних парків. Розглянуто наукові підходи вітчизняних та зарубіжних вчених трактування поняття рекреаційні навантаження. Досліджено методики визначення рекреаційного навантаження. Обґрунтовано власні підходи, щодо удосконалення цих методик.Legal aspects of the territories recreational usage of the natural national parks have been already examined. The definition of the notion recreational loadings has been examined by home and foreign scientists according to the scientific approaches. The methods of the recreational loading determination have been examined. Own approaches of these methods improvement have been substantiated

Evaluation of the Recreation Digression of the Shats’k National Nature Park “Lissova Pisnya” Ecological Path

Викладено результати польових досліджень екологічної стежки “Лісова пісня” Шацького національного природного парку щодо її рекреаційної дигресії. Запропоновано критерії виділення стадій рекреаційної дигресії, за якими в межах стежки визначено ділянки другої і третьої стадій рекреаційної дигресії.The results of the field studies of the recreation digression of the Shats’k National Nature Park “Lissova Pisnya” ecological path are exposed in the article. New categories to distinguish stages of the recreation digression were suggested. According to them areas of the second and third level of recreational digression were determined within the limits of the path

Students-Teachers’ Attitude to the Physical Education Process at the Higher Educational Establishment

У статті представлено результати дослідження відношення студентів до процесу фізичного виховання у стінах педагогічного університету на сучасному етапі розвитку нашої держави. Аналіз анонімного анкетування вказує, що для покращення процесу фізичного виховання у вищому педагогічному навчальному закладі необхідно застосовувати низку факторів, представлених до розгляду авторами опитування, серед яких респонденти виділили, на їхню думку, найбільш значущі, а саме: підвищення фізичного навантаження, використання різноманітного спортивного інвентаря та обладнання, створення належних умов для різноманітної рухової активності, постійного оновлення матеріально-технічної бази.The study results of the students’ attitude to the physical education process at the pedagogical university at the present stage of our state development are presented in the article. As to the issue of youth health, that is studied at higher education institutions, is always a matter for physical education of professionals, because physical culture is an important means for increasing people’s social and labor activity, satisfying their moral, aesthetic and creative demands, and the vital needs of mutual communication. Identifying the students’ attitude to the discipline “Physical education” is necessary for specialists to make adjustments to the departments’ curriculum, which will enable teachers to individually approach each group, in order to provide students with the least cost for their health, to undergo a thorny path of study at the university. In addition, it is necessary to constantly involve the younger generation in a healthy lifestyle, to be interested in the forms of physical education that are popular nowadays among young people, to conduct among them a wide range of propaganda activities like competitions in which young people directly participate, and to invite them for viewing teammasters’ competitions, qualified athletes’ demonstrative performances. The anonymous questionnaire analysis has shown that most university students correctly understand the significance of the physical education process for personal health, formation and acquisition of vital motor skills and special knowledge. Accordingly in order to improve the physical education process at the higher education institution it is necessary: to increase the young organism’s adaptive capacity to conduct classes with moderate and significant physical activity; to use various sports equipment; to create proper conditions for different motor activity, for physical education and sports, to update constantly the material and technical base for development of physical qualities necessary for future professional activity, to carry out constantly an explanatory work about the professional-applied value of physical exercises used during physical education classes at higher educational establishments

Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure

BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)