Reduced costs with bisoprolol treatment for heart failure - An economic analysis of the second Cardiac Insufficiency Bisoprolol Study (CIBIS-II)

Background Beta-blockers, used as an adjunctive to diuretics, digoxin and angiotensin converting enzyme inhibitors, improve survival in chronic heart failure. We report a prospectively planned economic analysis of the cost of adjunctive beta-blocker therapy in the second Cardiac Insufficiency BIsoprolol Study (CIBIS II). Methods Resource utilization data (drug therapy, number of hospital admissions, length of hospital stay, ward type) were collected prospectively in all patients in CIBIS . These data were used to determine the additional direct costs incurred, and savings made, with bisoprolol therapy. As well as the cost of the drug, additional costs related to bisoprolol therapy were added to cover the supervision of treatment initiation and titration (four outpatient clinic/office visits). Per them (hospital bed day) costings were carried out for France, Germany and the U.K. Diagnosis related group costings were performed for France and the U.K. Our analyses took the perspective of a third party payer in France and Germany and the National Health Service in the U.K. Results Overall, fewer patients were hospitalized in the bisoprolol group, there were fewer hospital admissions perpatient hospitalized, fewer hospital admissions overall, fewer days spent in hospital and fewer days spent in the most expensive type of ward. As a consequence the cost of care in the bisoprolol group was 5-10% less in all three countries, in the per them analysis, even taking into account the cost of bisoprolol and the extra initiation/up-titration visits. The cost per patient treated in the placebo and bisoprolol groups was FF35 009 vs FF31 762 in France, DM11 563 vs DM10 784 in Germany and pound 4987 vs pound 4722 in the U.K. The diagnosis related group analysis gave similar results. Interpretation Not only did bisoprolol increase survival and reduce hospital admissions in CIBIS II, it also cut the cost of care in so doing. This `win-win' situation of positive health benefits associated with cost savings is Favourable from the point of view of both the patient and health care systems. These findings add further support for the use of beta-blockers in chronic heart failure

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Технологія виробництва полімерпіщаної

The production process begins with the preparation of components and heating equipment. For the production of polymer materials used the following components: river sand medium-grained, polymer waste Bayer and dye. Basic equipment: blade-drying unittype drying sand mixer for mixing sand with waste polymersand dye smelting - a heating unit for heating and meltingthe same extrusion molding material, and press molding forpressing the hot molding compound.Процесс производства начинается с подготовки компонентов и нагрева оборудования. Для производства полимерпесчаных материалов используют следующие компоненты: песок речной среднезернистый, отходы полимерные и краситель Вауег. Основное оборудование: сушильный агрегат лопастноготипа для сушки песка, смеситель для перемешивания песка с отходами полимеров и красителем, плавильно - нагревательный агрегат для нагрева и плавления, так же выдавливания формовочной массы, и пресс формовочный для прессования горячей формовочной массы.Процес виробництва починається з підготовки компонентів і нагріву обладнання. Для виробництва полімерпіщаної матеріалів використовують наступні компоненти: пісок річковий середньозернистий, відходи полімерні і барвник Вауег. Основне обладнання: сушильний агрегат лопастного типу для сушіння піску, змішувач для перемішування піску з відходами полімеріві барвником, плавильно - нагрівальний агрегат для нагрівання і плавлення, так само видавлювання формувальної маси, і прес формувальний для пресування гарячої формувальної маси

When Architect Draws Monuments: March 1918 in the Works of S. V. Dombrovsky

Статья поступила в редакцию 14.01.2019 г.В научный оборот вводится несколько рисунков архитектора Сигизмунда Владиславовича Домбровского (1883–1953), чье более позднее творчество сформировало существенную часть городского пространства Свердловска-Екатеринбурга. Авторы реконструируют социокультурный и эмоциональный контекст марта 1918 г., когда С. В. Домбровский еще до появления ленинского плана монументальной пропаганды создает большое количество эскизов памятников борцам революции и монументальных «просветительских» объектов. Показана необходимость семиотического анализа иконографии архитектора как пути понимания мотивов творчества в период политической и социально-экономической неопределенности.The drawings corpus by the architect Sigismund Vladislavovich Dombrovsky (1883–1953), whose later work has formed a substantial part of the SverdlovskYekaterinburg urban space, is being examined. The authors reconstruct the sociocultural and emotional context of March 1918, when S. V. Dombrovsky created a large number of sketches of monuments to the fighters of the revolution and monumental “educational” objects before the appearance of the Leninist plan of monumental propaganda. The necessity of semiotic analysis of the architect`s iconography as a way of understanding the creative motives during the era of political and socioeconomic uncertainty is shown.Работа выполнена при финансовой поддержке РФФИ, проект 17-22-07001 «Комплексный алгоритм культуральной регенерации малых индустриальных городов в контексте агломерационных процессов России и Европы»

The dynamics of victimization of the Russian population: A sociological evaluation

Today Russia takes serious measures to reduce victimization though most of them are based on the analysis of official sources, which significantly reduces the effectiveness of the fight against crime. The research aims at identifying victimological trends in Russia for the period of 2009-2015. The empirical basis of the work are the results of the monitoring of personal security and activities of the internal affairs bodies of Russia, which was commissioned by the Ministry of Internal Affairs. In 2014-2015, the monitoring was conducted by the Russian State Social University by the standardized personal interview at the respondents’ places of residence in 85 subjects of the Russian Federation: the adults aged 18 and over were interviewed according to the all-Russian combined three-stage sample of households. 48,800 respondents were interviewed - citizens of Russia permanently residing at the places of registration at the time of the survey and representing the adult population of Russia by sex, age and place of residence (city-village) for each subject and for the Russian Federation as a whole. The article indicates the general level of victimization and the structure of criminal attacks, the rating of crimes and the dynamics of the victims’ recourses to the bodies of internal affairs; the reasons for non-coming to the police; the indicators of citizens’ concerns with criminal attacks on life, health and property; the dynamics of crime fears, and the social portrait of the victim. The results of the study reveal a significant increase in the number of crimes involving computer technologies, which is almost not shown by the official statistics. The main ways to prevent crimes should be improvement of the mechanisms for re-socialization of victims, reduction in the potential victimization, prevention of recidivist victimization, and the restoration of social justice

Association between toenail selenium and risk of acute myocardial infarction in European men. The EURAMIC Study. European Antioxidant Myocardial Infarction and Breast Cancer.

The association between selenium status and risk of acute myocardial infarction was examined in a multicenter case-control study in 10 centers from Europe and Israel in 1991-1992. Selenium in toenails was assessed for 683 nonfatal male cases with first acute myocardial infarction and 729 controls less than 70 years of age. Median toenail selenium content was 0.553 μg/g for cases and 0.590 μg/g for controls. After adjustment for age, center, and smoking, the odds ratio for myocardial infarction in the highest quintile of selenium as compared with the lowest was 0.63 . The observed inverse trend was somewhat stronger when the authors adjusted for vitamin E status (p = 0.05). Analysis stratified for smoking habits showed an inverse association in former smokers (odds ratio for the 75th-25th percentile contrast = 0.63 (95 percent confidence interval 0.43-0.94)), but not in current smokers (odds ratio = 0.97 ( 0.71-1.32)) or in those who had never smoked (odds ratio = 1.55 (0.87-2.76)). Analysis stratified by center showed a significant inverse association between selenium levels and risk of myocardial infarction for Germany (Berlin) only (75th to 25th percentile odds ratio = 0.62 (95 percent confidence interval 0.42-0.91)), which was the center with the lowest selenium levels. It appears that the increased risk of acute myocardial infarction at low levels of selenium intake is largely explained by cigarette smoking; selenium status does not appear to be an important determinant of risk of myocardial infarction at the levels observed in a large part of Europe. Am J Epidemiol 1997; 145: 373-