Создание монумента «Возрождение крымскотатарского народа» как культурное явление в жизни крымского общества

В статье автором охарактеризован градостроительный объект Монумент «Возрождение крымскотатарского народа» как культурное явление в жизни крымского общества, призванное внести вклад в процесс воспитания духовности и культуры в молодых людях.У статті автором охарактеризовано містобудівельний об’єкт Монумент «Відродження кримськотатарського народу» як культурне явище у житті кримського суспільства, що призвание донести внесок у процес виховання духовності та культури молоді.The author describes a monument „Rebirth of the Crimean Tatars” as a cultural phenomenon in the life of the Crimean society, which can contribute in the process of spiritual and cultural upbringing of young people

Етнологія релігії – актуальна сфера українського релігієзнавства

Background: Inhaled long-acting beta-2-adrenoceptor agonists (LABA) are frequently used in patients suffering from asthma and chronic obstructive pulmonary disease (COPD). For evaluation of real-life data, drug consumption studies are needed but results might be widely influenced due to methodological differences in particular regarding inter-country comparisons. Objectives: This study aims to compare the LABA prescribing in the general population and specifically in patients suffering from asthma and/or COPD in five European countries. Methods: Crude and age- and sex-standardized (European 2008 reference population) annual period prevalence rates per 10,000 persons were calculated for the period 2002-2009 based on seven European electronic health record databases (Denmark, Germany, Spain, the Netherlands (2), and the United Kingdom (2)). Stratification by sex, age, and indication were performed for the annual period prevalence rates. Results: In all databases, we observed an increase in LABA prescriptions during the study period for the general population and for patients suffering from asthma and/or COPD. In 2008, the highest standardized period prevalence was observed in the Dutch Mondriaan-AHC and the Spanish BIFAP database (443.3 and 395.5 per 10,000 persons), and the lowest in the German Bavarian Claims and Dutch Mondriaan- NPRCD database (278.7 and 290.6 per 10,000 persons). Prevalence rates for LABA increased with age and were highest in patients over 70 years. Patients with a combined diagnosis of asthma and COPD had higher prevalence rates of LABA compared to patients with a single diagnosis of asthma or COPD. The proportion of patients with one inhaled LABA prescription only ranged from 14% (UK databases) to 35% (Spanish BIFAP database) in 2008 in the general population. Conclusions: By using a standardized protocol, we demonstrated inter- and intra-country differences in LABA prescriptions. A general increase of LABA prescriptions during the study period was observed in all databases

Experience of safety monitoring in the context of a prospective observational study of artemether-lumefantrine in rural Tanzania: lessons learned for pharmacovigilance reporting

<p>Abstract</p> <p>Objectives</p> <p>To identify and implement strategies that help meet safety monitoring requirements in the context of an observational study for artemether-lumefantrine (AL) administered as first-line treatment for uncomplicated malaria in rural Tanzania.</p> <p>Methods</p> <p>Pharmacovigilance procedures were developed through collaboration between the investigating bodies, the relevant regulatory authority and the manufacturer of AL. Training and refresher sessions on the pharmacovigilance system were provided for healthcare workers from local health facilities and field recorders of the Ifakara Health Demographic Surveillance System (IHDSS). Three distinct channels for identification of adverse events (AEs) and serious adverse events (SAEs) were identified and implemented. Passive reporting took place through IHDSS and health care facilities, starting in October 2007. The third channel was through solicited reporting that was included in the context of a survey on AL as part of the ALIVE (<b>A</b>rtemether-<b>L</b>umefantrine <b>I</b>n <b>V</b>ulnerable patients: <b>E</b>xploring health impact) study (conducted only in March-April 2008).</p> <p>Results</p> <p>Training was provided for 40 healthcare providers (with refresher training 18 months later) and for six field recorders. During the period 1^stSeptember 2007 to 31^stMarch 2010, 67 AEs were reported including 52 under AL, five under sulphadoxine-pyrimethamine, one under metakelfin, two after antibiotics; the remaining seven were due to anti-pyretic or anti-parasite medications. Twenty patients experienced SAEs; in 16 cases, a relation to AL was suspected. Six of the 20 cases were reported within 24 hours of occurrence.</p> <p>Discussion</p> <p>Safety monitoring and reporting is possible even in settings with weak health infrastructure. Reporting can be enhanced by regular and appropriate training of healthcare providers. SMS text alerts provide a practical solution to communication challenges.</p> <p>Conclusion</p> <p>Experience gained in this setting could help to improve spontaneous reporting of AEs and SAEs to health authorities or marketing authorization holders.</p

Case-only designs for studying the association of antidepressants and hip or femur fracture.

The purpose of this study is to evaluate the performance and validity of the case-crossover (CCO) and self-controlled case-series (SCCS) designs when studying the association between hip/femur fracture (HF) and antidepressant (AD) use in general practitioner databases. In addition, comparability with cohort and case-control designs is discussed. Adult patients with HF and who received an AD prescription during 2001-2009 were identified from UK's The Health Improvement Network (THIN) and the Dutch Mondriaan databases. AD exposure was classified into current, recent and past/non-use (reference). In the CCO, for each patient, a case moment (date of HF) and four prior control moments at -91, -182, -273 and -365 days were defined. In SCCS, incidence of HF was compared between exposure states. Conditional logistic regression was used in the CCO and Poisson regression in the SCCS to compute odds ratios and incidence rate ratios, respectively. In CCO, we adjusted for time-varying co-medication and in SCCS for age. Adjusted estimates for the effect of current AD exposure on HF were higher in the CCO (co-medication-adjusted odds ratio, THIN: 2.24, 95% confidence interval [CI]: 2.04-2.47; Mondriaan: 2.57, 95%CI [1.50, 4.43]) than in the SCCS (age-adjusted incidence rate ratio, THIN: 1.41, 95%CI [1.32, 1.49]; Mondriaan: 2.14, 95%CI [1.51, 3.03]). The latter were comparable with the traditional designs. Case-only designs confirmed the association between AD and HF. The CCO design violated assumptions in this study with regard to exchangeability and length of exposure, and transient effects on outcome. The SCCS seems to be an appropriate design for assessing AD-HF association. Copyright © 2016 John Wiley &amp; Sons, Ltd

Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference

Rhabdomyolysis in association with simvastatin and amiodarone

OBJECTIVE To report a case of severe myopathy associated with concomitant simvastatin and amiodarone therapy. CASE SUMMARY A 63-year-old white man with underlying insulin-dependent diabetes, recent coronary artery bypass surgery, and postoperative hemiplegia was treated with aspirin, metoprolol, furosemide, nitroglycerin, and simvastatin. Due to recurrent atrial fibrillation, oral anticoagulation with phenprocoumon and antiarrhythmic treatment with amiodarone were initiated. Four weeks after starting simvastatin 40 mg/day and 2 weeks after initiating amiodarone 1 g/day for 10 days, then 200 mg/day, he developed diffuse muscle pain with generalized muscular weakness. Laboratory investigations revealed a significant increase of creatine kinase (CK) peaking at 40 392 U/L. Due to a suspected drug interaction of simvastatin with amiodarone, both drugs were stopped. CK normalized over the following 8 days, and the patient made an uneventful recovery. An objective causality assessment revealed that the myopathy was probably related to simvastatin. DISCUSSION Myopathy is a rare but potentially severe adverse reaction associated with statins. Besides high statin doses, concomitant use of fibrates, defined comorbidities, and concurrent use of inhibitors of cytochrome P450 are important additional risk factors. This is especially relevant if statins predominantly metabolized by CYP3A4 are combined with inhibitors of this isoenzyme. Amiodarone is a potent inhibitor of several different CYP isoenzymes, including CYP3A4. CONCLUSIONS Avoiding the concomitant use of drugs with the potential to inhibit CYP-dependent metabolism (eg, amiodarone) or elimination of statins may decrease the risk of statin-associated myopathy. Alternatively, if drug therapy with a potent CYP inhibitor is inevitable, choosing a statin without relevant CYP metabolism (eg, pravastatin) should be considered

Clinical Pharmacy and Pharmaceutical Care: Patient-Oriented Application of Pharmaceutical Expertise

Clinical Pharmacy is a health speciality describing the activities and services of the clinical pharmacist to develop and promote the rational and appropriate use of drugs, medicinal products, and devices by the individual as well as by the society. Very closely related to the term of clinical pharmacy is the concept of pharmaceutical care. This means a new pharmacy practice paradigm which puts the patient into the centre. In the course of this practice, a pharmacist takes responsibility for a patient's drug-related needs with the aim of achieving definite outcomes that improve a patient's quality of life. At the University of Basel, clinical pharmacy and pharmaceutical care have developed constantly over the last twenty years. Examples from research and practice are given in this article, and areas for future work are outlined

No impact of adjusting for lifestyle factors or general practice on risk estimates for the association between antidepressants and hip/femur fracture

Background: Routinely collected data from electronic health record databases often lack information on relevant risk factors, like lifestyle-factors (LSF, smoking, alcohol use, body mass index) or socioeconomic factors that may be needed for confounder adjustment in epidemiogical studies. Objectives: In the context of the Pharmacoepidemiological Research on Outcomes of Therapeutics by a European Consortium (PROTECT) project, the impact of confounder adjustment on the risk of antidepressant (AD) use on hip/femur fracture (HF) and compared results across three primary care databases was assessed. Methods: We conducted a case-control study nested within 3 new AD user cohorts of adult patients (2001-2009) in three databases (Spanish BIFAP, Dutch Mondriaan and UK THIN. Cases were defined as a first HF during the study period. Up to 4 controls were matched by sex, age (+/-2 years) and time since cohort entry (+/- 6 months). Exposure to AD was classified into current, recent and past use. We adjusted for comedication and comorbidities, using same models for all data sources. The impact of matching on practice (marker for socioeconomic factors) and additional adjustment for LSF was done in THIN. Odds ratios (OR) were estimated using conditional logistic regression analysis. Results: Current use of AD was associated with an significantly increased risk of HF in all data sources. Adjusted ORs were 1.52 in BIFAP (1535 cases), 1.59 in THIN (3756 cases) and 3.32 in Mondriaan (79 cases). In BIFAP/THIN, adjustment resulted i

Impact of varying control moment selection in a case-crossover (CCO) study on antidepressant drug (AD) use and hip/femur fracture (HFF) in protect

Background: The CCO design is appealing because it eliminates time-invariant person related confounding. A prerequisite is that exposure in real life drug use is sufficiently transient to allow for independence of exposure states. The impact of variation in time of control moment selection is relatively unknown. Objectives: To assess the influence of selection of control moments at different times in a CCO study of AD and HFF on variation in effect estimates. Methods: Adult patients with HFF who received an AD prescription during 2001-2009 were identified from the Dutch Mondriaan GP database. For each patient, a case moment (the date of HFF) and four control moments at 3, 6, 9, and 12 months before the HFF (M3, M6, M9, M12) were defined. Each AD prescription had a pre-defined duration of 90 days.AD treatment episodes were constructed and divided into current, recent (0-2 months following current use) and past use (>2months follow current use).We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals CI between AD use and HFF. Results: Pairwise (1:1) comparisons of 82 case moments to varied control moments for current versus no use resulted in ORs for HFF-M3 of 16.3 (95%CI: 2.2-123), M6: 7.8 (2.3-26), M9: 5.9 (2.1-16.1), and M12: 4.1 (1.8-9.4). Including all (1:4),M3-M12, resulted in OR 7.0 (3.2-15.2). For recent use even higher ORs were found; M3: 49.7 (3.9-637), M6: 17.6 (2.5-136), M9: 2.6 (0.7-9.5), M12: 3.7 (0.7-20), All 8.6 (2.7-27). Discordancy of exposure and thus number of strata contributing to the analyses increased from 32% in M3 to 50% in M12. Conclusions: Selection of control moments at different times in CCO has considerable impact on effect estimates in this particular setting. CCO studies should be designed with sufficient time between case and control moments to allow for sufficient discordancy in exposure to get reliable estimates