Наукове узагальнення міжнародних засад розвитку рецептури ліків аптечного виготовлення

Aim. To generalize the international principles of the organization of the extemporaneous compounding for the purpose of its development in Ukraine.Materials and methods. The works of domestic and foreign authors, international professional web sites, databases, national formularies, methods of analysis, systematization, generalization, analytical and review were used.Results. The international experience has shown that the extemporaneous compounding of medicines is used and developed in all developed countries of the world, while in Ukraine this area of pharmacy regresses. In the conditions of modern scientific and technological progress the key to the safe, effective, rational, affordable pharmacotherapy is continuous professional development and access to relevant information. Professional organizations have been created for continuous training in extemporaneous compounding in other countries. All over the world, pharmaceutical information sources are represented by official formularies and pharmacopoeias, scientific journals and online databases. In Ukraine, the main reference sources for the magistral formula are the information letters of the Ministry of Health and 2 professional journals.Conclusions. Since there is no professional organization in Ukraine (such as foreign ones) that would be engaged in the development of extemporaneous compounding, medical prescriptions have remained almost unchanged for a decade. In this regard, specialists of compounding pharmacies, as well as doctors, can use data from reference sources of information from international organizations of other countries to increase their level of competence. The analysis conducted has shown that most countries of the world widely use the pharmacoeconomic principles for selecting magistral formulas for extemporaneous medicines. The results of the analysis give grounds to develop domestic compounding pharmacies in order to provide the availability, rationality and safety of patients’ pharmacotherapy on the way of European integrationof Ukraine.Цель: обобщение международных принципов организации экстемпоральной рецептуры с целью ее развития в Украине.Материалы и методы: труды отечественных и зарубежных авторов, международные профессиональные веб-сайты, базы данных, национальные формуляры; использованы методы анализа, систематизации, обобщения, аналитические и обзорные.Результаты исследования. Международный опыт показал, что во всех развитых странах мира используется и развивается аптечное изготовление лекарственных средств, тогда как в Украине эта область фармации регрессирует. В условиях современного научно-технического прогресса залогом безопасной, эффективной, рациональной, доступной фармакотерапии является постоянноепрофессиональное развитие и доступ к актуальной информации. Для непрерывного обучения экстемпоральной рецептуре в других странах созданы профессиональные организации. Во всем мире фармацевтические источники информации представлены официальными формулярами и фармакопеями, научными журналами и он-лайн базами данных. В Украине основными справочными источниками по экстемпоральной рецептуре являются информационные письма Министерства здравоохранения и два профессиональных журнала.Выводы. Поскольку в Украине не существует профессиональной организации (вроде зарубежных), которая занималась бы развитием экстемпоральной рецептуры, врачебные прописи остаются практически неизменными на протяжении десятка лет. Поэтому специалисты производственных аптек, а также врачи могут использовать данные справочных источников информации международных организаций других стран для повышения уровня своей компетентности. Проведенный анализ показал, что большинство стран мира широко используют фармакоэкономические принципы выбора рецептурных назначений екстемпоральних лекарств. Результаты анализа дают основания развивать отечественные производственные аптеки с целью обеспечения доступности,  рациональности и безопасности фармакотерапии пациентов на пути евроинтеграции Украины.Мета: узагальнення міжнародних засад організації екстемпоральної рецептури з метою її розвитку в Україні.Матеріали та методи: праці вітчизняних та зарубіжних авторів, міжнародні професійні вебсайти, бази даних, національні формуляри; використані методи аналізу, систематизації, узагальнення, аналітичні й оглядові.Результати дослідження. Міжнародний досвід показав, що в усіх розвинених країнах світу використовується і розвивається аптечне виготовлення лікарських засобів, тоді як в Україні ця галузь фармації регресує. В умовах сучасного науково-технічного прогресу запорукою безпечної, ефективної, раціональної, доступної фармакотерапії є постійний професійний розвиток і доступ до актуальної інформації. Для безперервного навчання екстемпоральній рецептурі в інших країнах створені професійні організації. В усьому світі фармацевтичні джерела інформації представлені офіційними формулярами і фармакопеями, науковими журналами та он-лайн базами даних. В Україні основними довідковими джерелами з екстемпоральної рецептури є інформаційні листи Міністерства охорони здоров’я і два фахових журнали.Висновки. Оскільки в Україні не існує професійної організації (на зразок закордонних), яка б опікувалась розвитком екстемпоральної рецептури, лікарські прописи залишаються практично незмінними впродовж десятка років. Через це фахівці виробничих аптек, а також лікарі можуть використовувати дані довідкових джерел інформації міжнародних організацій інших країн для підвищення рівня своєї компетентності. Проведений аналіз показав, що більшість країн світу широко використовують фармакоекономічні принципи вибору рецептурних призначень екстемпоральнихліків. Результати аналізу дають підстави розвивати вітчизняні виробничі аптеки з метою забезпечення доступності, раціональності та безпечності фармакотерапії пацієнтів на шляху євроінтеграції України

StopCOVID cohort : An observational study of 3,480 patients admitted to the Sechenov University hospital network in Moscow city for suspected COVID-19 infection

© 2020 Oxford University Press. This is a pre-copyedited, author-produced PDF of an article accepted for publication in Clinical Infectious Diseases following peer review. The version of record is available online at: https://doi.org/10.1093/cid/ciaa1535.BACKGROUND: The epidemiology, clinical course, and outcomes of COVID-19 patients in the Russian population are unknown. Information on the differences between laboratory-confirmed and clinically-diagnosed COVID-19 in real-life settings is lacking. METHODS: We extracted data from the medical records of adult patients who were consecutively admitted for suspected COVID-19 infection in Moscow, between April 8 and May 28, 2020. RESULTS: Of the 4261 patients hospitalised for suspected COVID-19, outcomes were available for 3480 patients (median age 56 years (interquartile range 45-66). The commonest comorbidities were hypertension, obesity, chronic cardiac disease and diabetes. Half of the patients (n=1728) had a positive RT-PCR while 1748 were negative on RT-PCR but had clinical symptoms and characteristic CT signs suggestive of COVID-19 infection.No significant differences in frequency of symptoms, laboratory test results and risk factors for in-hospital mortality were found between those exclusively clinically diagnosed or with positive SARS-CoV-2 RT-PCR.In a multivariable logistic regression model the following were associated with in-hospital mortality; older age (per 1 year increase) odds ratio [OR] 1.05 (95% confidence interval (CI) 1.03 - 1.06); male sex (OR 1.71, 1.24 - 2.37); chronic kidney disease (OR 2.99, 1.89 - 4.64); diabetes (OR 2.1, 1.46 - 2.99); chronic cardiac disease (OR 1.78, 1.24 - 2.57) and dementia (OR 2.73, 1.34 - 5.47). CONCLUSIONS: Age, male sex, and chronic comorbidities were risk factors for in-hospital mortality. The combination of clinical features were sufficient to diagnoseCOVID-19 infection indicating that laboratory testing is not critical in real-life clinical practice.Peer reviewe

2020 Clinical practice guidelines for Pulmonary hypertension, including chronic thromboembolic pulmonary hypertension

Russian Society of Cardiology (RSC)With the participation: Association of Cardiovascular Surgeons of Russia, Russian Respiratory Society, Federation of Anesthesiologists and Resuscitators, Association of Rheumatologists of Russia, National Congress of Radiation Diagnosticians

Genome-wide significant association with seven novel multiple sclerosis risk loci

Objective: A recent large-scale study in multiple sclerosis (MS) using the ImmunoChip platform reported on 11 loci that showed suggestive genetic association with MS. Additional data in sufficiently sized and independent data sets are needed to assess whether these loci represent genuine MS risk factors. Methods: The lead SNPs of all 11 loci were genotyped in 10 796 MS cases and 10 793 controls from Germany, Spain, France, the Netherlands, Austria and Russia, that were independent from the previously reported cohorts. Association analyses were performed using logistic regression based on an additive model. Summary effect size estimates were calculated using fixed-effect meta-analysis. Results: Seven of the 11 tested SNPs showed significant association with MS susceptibility in the 21 589 individuals analysed here. Meta-analysis across our and previously published MS case-control data (total sample size n=101 683) revealed novel genome-wide significant association with MS susceptibility (p<5×10−8) for all seven variants. This included SNPs in or near LOC100506457 (rs1534422, p=4.03×10−12), CD28 (rs6435203, p=1.35×10−9), LPP (rs4686953, p=3.35×10−8), ETS1 (rs3809006, p=7.74×10−9), DLEU1 (rs806349, p=8.14×10−12), LPIN3 (rs6072343, p=7.16×10−12) and IFNGR2 (rs9808753, p=4.40×10−10). Cis expression quantitative locus effects were observed in silico for rs6435203 on CD28 and for rs9808753 on several immunologically relevant genes in the IFNGR2 locus. Conclusions: This study adds seven loci to the list of genuine MS genetic risk factors and further extends the list of established loci shared across autoimmune diseases

Genome-wide significant association with seven novel multiple sclerosis risk loci

Objective: A recent large-scale study in multiple sclerosis (MS) using the ImmunoChip platform reported on 11 loci that showed suggestive genetic association with MS. Additional data in sufficiently sized and independent data sets are needed to assess whether these loci represent genuine MS risk factors. Methods: The lead SNPs of all 11 loci were genotyped in 10 796 MS cases and 10 793 controls from Germany, Spain, France, the Netherlands, Austria and Russia, that were independent from the previously reported cohorts. Association analyses were performed using logistic regression based on an additive model. Summary effect size estimates were calculated using fixed-effect meta-analysis. Results: Seven of the 11 tested SNPs showed significant association with MS susceptibility in the 21 589 individuals analysed here. Meta-analysis across our and previously published MS case-control data (total sample size n=101 683) revealed novel genome-wide significant association with MS susceptibility (p<5×10−8) for all seven variants. This included SNPs in or near LOC100506457 (rs1534422, p=4.03×10−12), CD28 (rs6435203, p=1.35×10−9), LPP (rs4686953, p=3.35×10−8), ETS1 (rs3809006, p=7.74×10−9), DLEU1 (rs806349, p=8.14×10−12), LPIN3 (rs6072343, p=7.16×10−12) and IFNGR2 (rs9808753, p=4.40×10−10). Cis expression quantitative locus effects were observed in silico for rs6435203 on CD28 and for rs9808753 on several immunologically relevant genes in the IFNGR2 locus. Conclusions: This study adds seven loci to the list of genuine MS genetic risk factors and further extends the list of established loci shared across autoimmune diseases

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

ARTERIAL HYPERTENSION AT SPORT ACTIVITIES IN MIDDLE AGE AND ELDERLY SPORTSMEN

Aim. To analyze the changes of systemic arterial pressure (BP) before and after sport load, incl. the diagnosis of arterial hypertension (AH) and antihypertensive treatment, in veteran sportsmen.Material and methods. Questionnaires were applied for the main cardiovascular risk factors assessment, and BP measurement upright resting (before warming up exercises) and just after the load in 108 competitive sportsmen 40-72 y.o. In the study, the previously set diagnosis of systemic hypertension was taken in consideration and its treatment type.Results. Among all participants, 41% had increased systolic BP (SBP) and 29,6% — diastolic (DBP) at baseline. After exercises, increase of SBP was found in 41% and DBP — in 50,9%. During competition, baseline increase of SBP had 61,8% of all participants, increased DBP — 35,3%. After competition, increase of SBP was found in 67,6% sportsmen, of DBP — 41,2%. Among those with no AH diagnosis, 30,6% had SBP &gt;139 mmHg at baseline, and 42% — after warming up. In sportsmen with already diagnosed AH, raised SBP before warming up was found in 56%, after — 60%. The tendency was even more prominent during competitions. In AH sportsmen, the characteristics of BP change at sport loads did not differ significantly by the type and regularity of antihypertension drugs intake.Conclusion. Almost a half of adult and elderly sportsmen have AH diagnosis, and of those less than a half do take regular antihypertensive therapy. Most of veteran sportsmen experience raised BP before and after sport load, including those taking regular therapy and a third of those not diagnosed with AH

Fosinopril – a drug of choice in chronic heart failure prevention and treatment

Aim. To study ACE inhibitor fosinopril effects on remodeling, diastolic filling of left and right ventricles (LV, RV), ectopic myocardial activity, heart rate variability, endothelial function, and microcirculation in patients with arterial hypertension (AH) and LV diastolic dysfunction (LVDD). To study fosinopril effects on clinical status, central hemodynamics, remodeling, LV and RV diastolic filling in patients with chronic heart failure (CHF) and LV systolic dysfunction (LVSD). Material and methods. In total, 40 patients with Functional Class II-IV CHF (NYHA), and LV ejection fraction below 40%, as well as 72 patients with AH and LVDD, were examined. Echocardiography, 24-hour ECG monitoring, duplex ultrasonography, laser Doppler flowmetry were performed. Results. In patients with CHF and LVSD, fosinopril treatment improved clinical status, central hemodynamics, remodeling parameters, normalized LV and RV diastolic filling. In patients with AH and LVDD, the drug beneficially influenced heart remodeling, LV and RV diastolic filling, endothelial function, microcirculation, as well as reduced sympathetic tonus and ectopic myocardial activity, decreasing sudden arrhythmic death risk. Conclusion. Fosinopril is a drug of choice in CHF and LVSD treatment, as well as for CHF prevention in patients with AH and LVDD

Референтне ціноутворення на біотерапевтичні препарати: моніторинг оптово-відпускних цін на інсуліни в Україні

The article presents methodological approaches to the monitoring of wholesale prices for insulin, and the results of its holding in Ukraine in comparison with EU countries. It has been found that over a third of 17 (40.47 %) from 42 trade names of domestic insulin have the highest (maximum) price in relation to the reference countries. The differences in prices for the groups are quite significant from 22.5 % to 94.26 %. The necessity of introduction of effective government price regulation system for insulins was shown, especially the reference pricing.Представлены методические подходы к мониторингу оптово-отпускных цен на препараты инсулина, а также результаты его проведения в Украине в сравнении со странами ЕС, на основании которых установлено, что более 17 (40,47 %) из 42 торговых наименований отечественных препаратов инсулина имеют высокие (максимальные) цены по отношению к референтным странам. Расхождения цен по группам довольно значительны от 22,5 % до 94,26 %. Показана необходимость внедрения системы эффективного государственного регулирования цен на инсулины, прежде всего референтного ценообразования.Представлені методичні підходи до моніторингу оптово-відпускних цін на препарати інсуліну, а також результати його проведення в Україні у порівнянні з країнами ЄС, на підставі яких встановлено, що більше третини 17 (40,47 %) з 42 торгових найменувань вітчизняних препаратів інсуліну мають найвищі (максимальні) ціни по відношенню до референтних країн. Розбіжності цін за групами є досить значними від 22,5 % до 94,26 %. Показана необхідність впровадження системи ефективного державного регулювання цін на інсуліни, перш за все, референтного ціноутворення