Clinical efficacy of a personalized exercise program in the rehabilitation of patients with atrial fibrillation after radiofrequency ablation

Aim. To study the clinical efficacy and safety of a personalized exercise program in the rehabilitation of patients with paroxysmal atrial fibrillation (AF) after primary pulmonary vein radiofrequency ablation (RFA).Material and methods. Patients (n=48) with paroxysmal AF who underwent RFA were randomized into two groups: main (n=24) — patients involved in the exercise program and received standard therapy; control (n=24) — patients received standard therapy. The program included exercise complexes with the calculation of energy consumption, step training and walking. The program lasted 6 months, while the follow-up period — 12 months. All patients in the study underwent a faceto-face learning interview.Results. After 6-month exercise program, bicycle ergometer test revealed an increase in duration (by 18,6%, p<0,001) and power (by 24,8%, p<0,01) of the load, while these changes were not revealed in the control group. The positive aftereffect of training on these parameters persisted even after the completion of program. Left atrial and left ventricular end-diastolic dimension remained stable in exercise program group and significantly increased in the control group. In contrast to the control group, the following parameters significantly decreased in trained patients after 6 months: body mass index by 2,8% (p<0,05), systolic blood pressure by 2,1% (p<0,05), heart rate by 12,1% (p<0,05), low-density lipoprotein cholesterol concentration by 18,8% (p<0,001), high-sensitivity C-reactive protein by 22,9% (p<0,05), N-terminal pro-brain natriuretic peptide by 28,2% ( p<0,05), aldosterone by 41,5% (p<0,001) and angiotensin II by 41,3%, p<0,05). In addition, in the exercise program group an increase in high-density lipoprotein cholesterol by 20,6% (p<0,05) and physical activity level by 23,8% (p=0,001) was revealed. At the same time, both groups showed a significant decrease in the concentration of fibrinogen and transforming growth factor-β1. After 6 months, in the exercise program group versus the control group, there was a decrease in the number of registered supraventricular premature beats (p<0,01), episodes of supraventricular tachyarrhythmia (p<0,05), including AF (p<0,05).Conclusion. Involvement of patients with AF after catheter RFA in a cardiac rehabilitation program based on moderate-intensity aerobic training improves exercise tolerance, cardiac function, corrects thrombogenic factors, and reduces the likelihood of arrhythmia recurrence, including AF

COMPARATIVE PHARMACOKINETICS AND EFFECT ON THE HEMODYNAMICS OF ORIGINAL AND GENERIC NEBIVOLOL IN HEALTHY VOLUNTEERS

Beta-blockers are an important part of modern pharmacotherapy in cardiology. The introduction of generics into clinical practice requires clear evidence of bioequivalence to the original drug.Aim. To study the pharmacokinetics and effect on hemodynamic parameters of the original and a generic nebivolol in healthy volunteers in the fasting state. Material and methods. 18 healthy volunteers were included into the randomized open study on cross-balanced design. They received single dose (5 mg) of two compared preparations of nebivolol under fasting condition. The concentration of unchanged nebivolol in blood plasma was determined by gas chromatography-tandem mass spectrometry. Calculation of pharmacokinetic parameters and assessment of the hemodynamic were performed.Results. The concentrations of nebivolol after the original and generic drugs intake did not differ significantly in any time point (AUC0-∞ 41.09±46.82 vs 47.16±66.58 ng•hr/mL and T1/2 30.84±10.78 vs 29.59±12.08 hours, respectively). Blood pressure reduction was slightly more pronounced when taking generic nebivolol, while the reduction in heart rate at 2 and 4 hours – after original nebivolol intake.Conclusion. A comparative pharmacokinetic study of the genetic nebivolol showed its bioequivalence to the original drug. The effect on hemodynamic parameters with single dose (5 mg) of generic and original nebivolol in healthy volunteers was comparable

Improving Asthma Management: Patient–Pharmacist Partnership Program in Enhancing Therapy Adherence

Community pharmacist interventions can assist in improving adherence in patients with asthma. The objective of the study was to assess the feasibility of patient-centered counseling using the developed asthma-specific tools to identify barriers to adherence and identify their preliminary effect on adherence barrier score and asthma control. Adult patients with persistent asthma were invited to participate in a 3-month pre–post intervention study involving community pharmacist-provided patient-centered counseling. Bivariate analyses were conducted to determine whether there were changes in outcomes from the pre to post period. Of 36 recruited patients, 17 completed both pre and post surveys. At baseline, patients had a mean ACT score of 15.1 ± 3.5, with 94% having uncontrolled asthma, and an average of 4.2 ± 2.5 reported barriers. The following barriers were most common: not having an Asthma Action Plan (52.9%), use of inhaler more or less often than prescribed (47.1%) and forgetfulness (41.2%). The ACT score increased by 2.7 ± 5.4, which was not statistically significant; however, it might be clinically significant. Two barrier scores improved as a result of the intervention. Preliminary evidence on the feasibility of identifying and addressing patient-specific barriers to adherence delivered by pharmacists showed that it has the potential to resolve barriers and improve asthma outcomes

“Being in Control of My Asthma Myself” Patient Experience of Asthma Management: A Qualitative Interpretive Description

Asthma control can be achieved with effective and safe medication use; however, many patients are not controlled. Patients’ perceptions of asthma, asthma treatment, and pharmacist roles can impact patient outcomes. The purpose of this study was to explore patients’ experiences and patient⁻pharmacist relationships in asthma care. Qualitative Interpretive Description method guided the study. Semi-structured individual interviews were conducted with 11 patients recruited from personal contacts, pharmacies, and asthma clinics. Categories and themes were identified using inductive constant comparison. Themes indicated patients had a personalized common sense approach to asthma management, “go-to„ health care provider, and prioritized patient⁻pharmacist relationships. Patients described their illness experiences and asthma control based on personal markers similar to the common sense model of self-regulation. Patients chose a family physician, asthma specialist, respiratory therapist, or pharmacist as an expert resource for asthma management. Patient perceived pharmacists’ roles as information provider, adviser, or care provider. Pharmacists who develop a collaborative relationship with their asthma patients are better positioned to provide tailored education and self-management support. Inviting patients to share their perspective could increase patient engagement and uptake of personalised asthma action plans to achieve asthma control

Improving the Quality of Inclusive Education in Institutions of Physical Culture and Sports

The article describes the experience of study Russian sign language by healthy students in order to create an inclusive environment for stu-dents with hearing disabilities. The implementation of this project at the Kuban State University of Physical Culture, Sports and Tourism is described. Through a survey, a group of people wishing to learn Russian sign language was formed, training was conducted, the first results were obtained, acquired skills were successfully applied to a group of students of the Department of adaptive physical culture.В статье описывается опыт изучения русского жестового языка здоровыми студентами с целью создания инклюзивной среды для студентов с нарушением слуха. Описана реализация данного проекта в Кубанском государственном университете физической культуры, спорта и туризма. Путем опроса была сформирована группа желающих изучать русский жестовый язык, проведено обучение, получены первые результаты, освоенные навыки успешно применяются на группе студентов кафедры адаптивной физической культуры