Належна фармацевтична практика: імплементація протоколів провізора / фармацевта у післядипломну освіту спеціалістів фармації

The article deals with the current state of implementation of the protocols of provisor/pharmacists in practical activities of of pharmacy specialists as an important component of good pharmacy practice in Ukraine. The authors summarize the experience of short cycles of thematic improvement in the form of workshops and seminars as a promising form of continuing professional education, most adapted to modern conditions of existence of the pharmaceutical sector, the health care industry. The successful combination of initiatives of governmental regulatory bodies, in particular the Ministry of Health, with the latest educational technologies, leading specialists practitioners, teachers can become real method to improving the quality of pharmaceutical care.Статья освещает современное состояние внедрения протоколов провизора/фармацевта в практическую деятельность аптечных учреждений как важной составляющей надлежащей фармацевтической практики в Украине. Авторами обобщен опыт проведения краткосрочных циклов тематического усовершенствования в форме научно-практических семинаров как перспективной формы непрерывного профессионального образования, наиболее адаптированной для современных условий существования фармацевтического сектора отрасли здравоохранения. Удачное сочетание инициативы государственных регуляторных органов, в частности Министерства здравоохранения Украины, с новейшими образовательными технологиями, привлечением ведущих специалистов-практиков, педагогов может стать реальным путем повышения качества фармацевтической помощи населению.Стаття висвітлює сучасний стан впровадження протоколів провізора/фармацевта у практичну діяльність аптечних закладів як важливої складової належної фармацевтичної практики в Україні. Авторами узагальнено досвід проведення короткотривалих циклів тематичного удосконалення у формі науково-практичних семінарів як перспективної форми безперервної професійної освіти, найбільш адаптованої для сучасних умов існування фармацевтичного сектору галузі охорони здоров’я. Вдале поєднання ініціативи державних регуляторних органів, зокрема міністерства охорони здоров’я України з новітніми освітніми технологіями, залученням провідних фахівців-практиків, освітян може стати  реальним шляхом підвищення якості фармацевтичної допомоги населенню

Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe

Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p&lt;0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (&lt;1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (&lt;1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

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 &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 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

Using methods of DNA-analysis in the examination of the illegal timber trade

Illegal timber harvesting and traffic is one of the most pressing environmental and economic problems worldwide. According to some estimates, between 15 to 30 % of the world’s timber market are of illegal origin. At present it is becoming increasingly important to conduct an independent examination to confirm the legality of the origin of forest products. One of the effective approaches that allow such verification is genetic analysis. This paper presents the results of genetic examination of 34 timber samples of Scots pine Pinus sylvestris L., collected in the framework of a model experiment from the logged area and from the timber storage site. Genetic analysis was performed on the basis of ten microsatellite loci of DNA. Electrophoretic separation of amplification products was carried out in a polyacrylamide gel. The images indicating the identity or difference in DNA of timber samples collected from the logged area and timber samples collected from timber storage site were obtained by gel electrophoresis. 26 combinations of multilocus genotypes were identified in the analysis. Four variants of the genotypes indicated the identity of timber samples collected from the logged area and timber samples collected from the timber storage site. Thus, within the framework of this experiment the efficiency of using the methods of molecular genetic analysis of timber samples to determine the degree of their identity is confirmed. It was revealed that the microsatellite loci of DNA (SSR-analysis) can reliably verify the place of origin of samples. The results of these works can be used to create a national system of harvested timber control and identification of forest products

ENDOTHELIAL DYSFUNCTION AND NEUROHUMORAL REGULATION OF BLOOD PRESSURE IN PATIENTS WITH SYSTEMIC SCLEROSIS

Objective: to investigate the effect of endothelial dysfunction, catecholamines, and renin on the diurnal blood pressure (BP) profile in patients with systemic sclerosis (SS).Subjects and methods. Twenty-five patients with SS underwent determination of the blood count of desquamated endotheliocytes by the method described by J. Hladovec (1978), the plasma levels of endothelin-1 (ET-1), adrenaline, norepinephrine, and renin by enzyme immunoassay. All the patients underwent 24-hour BP monitoring with calculating the time index, daily index, the magnitude and rate of a morning rise in BP, as well as its daily variability.Results and discussion. Hypertension was detected in 8 (32%) patients with SS. All the patients with SS showed signs of endothelial dysfunction, as evidenced by considerable differences in endothelial activation measures compared with the control group: the mean level of ET-1 was 5.8±2.3 and 0.48±0.21 fmol/ml (p&lt;0.05); the number of desquamated endotheliocytes was 4.50 [3.00; 7.00] and 2.10 [1.00; 3.20] • 104/l, respectively (p&lt;0.05). The levels of adrenaline and norepinephrine in SS were significantly higher than those in the control. There were positive correlations between endothelial dysfunction and the degree of an increase in BP. Endothelial dysfunction was found to have a negative impact on the diurnal BP profile in the presence of pathological types of night-peaker and non-dipper. Conclusion. Two mechanisms, such as endothelial dysfunction and sympathoadrenal activation, are responsible for the pathogenesis of clinical symptoms of SS, including hypertension

DNA diagnostic results of forest nurseries phytopathogenic fungi of Krasnoyarsk Krai and the Republic of Khakassia

The DNA-diagnostic results of phytopathogens in 26 forest nurseries of Krasnoyarsk Krai and the Republic of Khakassia in the period from 2014 to 2016 were presented. The objects of research were the plants of conifer species Pinus sylvestris L., Pinus sibirica Du Tour and Picea obovata Ledeb. aged from 1 to 6 years. According to the data of molecular genetic analysis in the forest nurseries of the studied areas, the representatives of 13 genera of pathogenic and conditionally pathogenic fungi that cause diseases of conifers were revealed: Phoma Sacc., Didymella Sacc., Alternaria Nees, Cladosporium Link, Rhizoctonia DC., Lophodermium Chevall., Gremmenia Korf. (Phacidium Fr.), Sclerophoma Höhn. (teleomorph – Sydowia Bres.), Typhula (Pers.) Fr., Botrytis P. Micheli ex Pers., Gremmeniella M. Morelet (Scleroderris (Fr.) Bonord.), Septorioides Quaedvl., Verkley & Crous and Epicoccum Link. Seven genera of micromycetes are found in all three surveyed forest zones: taiga, forest-steppe and Southern-Siberian mountain. The most frequently occurred lesions were caused by the sac fungi. Some of the identified diseases practically had not been diagnosed before. In each of the nurseries, the pathogenic microflora was represented by 1–7 species of microscopic fungi, several pathogens were often presented simultaneously on the infected seedlings. In the process of working, the dominant pathogens, connection of pathogens with certain species and with the seedlings age composition have been identified. Such diseases as Phoma blight and Lophodermium needle cast predominated the frequency of occurrence, their relative abundance was 30 % and 28 % respectively of all identified fungal infections of plants. Also, given the climatic conditions of the region, attention should be paid to the phytopathogens – Gremmenia infestans (P. Karst.) Crous and Typhula sp

Належна фармацевтична практика: імплементація протоколів провізора / фармацевта у післядипломну освіту спеціалістів фармації

The article deals with the current state of implementation of the protocols of provisor/pharmacists in practical activities of of pharmacy specialists as an important component of good pharmacy practice in Ukraine. The authors summarize the experience of short cycles of thematic improvement in the form of workshops and seminars as a promising form of continuing professional education, most adapted to modern conditions of existence of the pharmaceutical sector, the health care industry. The successful combination of initiatives of governmental regulatory bodies, in particular the Ministry of Health, with the latest educational technologies, leading specialists practitioners, teachers can become real method to improving the quality of pharmaceutical care.Статья освещает современное состояние внедрения протоколов провизора/фармацевта в практическую деятельность аптечных учреждений как важной составляющей надлежащей фармацевтической практики в Украине. Авторами обобщен опыт проведения краткосрочных циклов тематического усовершенствования в форме научно-практических семинаров как перспективной формы непрерывного профессионального образования, наиболее адаптированной для современных условий существования фармацевтического сектора отрасли здравоохранения. Удачное сочетание инициативы государственных регуляторных органов, в частности Министерства здравоохранения Украины, с новейшими образовательными технологиями, привлечением ведущих специалистов-практиков, педагогов может стать реальным путем повышения качества фармацевтической помощи населению.Стаття висвітлює сучасний стан впровадження протоколів провізора/фармацевта у практичну діяльність аптечних закладів як важливої складової належної фармацевтичної практики в Україні. Авторами узагальнено досвід проведення короткотривалих циклів тематичного удосконалення у формі науково-практичних семінарів як перспективної форми безперервної професійної освіти, найбільш адаптованої для сучасних умов існування фармацевтичного сектору галузі охорони здоров’я. Вдале поєднання ініціативи державних регуляторних органів, зокрема міністерства охорони здоров’я України з новітніми освітніми технологіями, залученням провідних фахівців-практиків, освітян може стати  реальним шляхом підвищення якості фармацевтичної допомоги населенню

Autoimmunity and autoinflammation in pathogenesis of immunoinflammatory diseases

Rheumatic diseases relate to the group of the immunoinflammatory diseases (IID), in pathogenesis of which have a value both autoimmune and autoinflammatory processes. Aim.To present the heterogeneous pathogenesis of inflammation in IID. Materials and methods.It is inspected 260 patients (pts) with IID: 242 pts with systemic autoimmune diseases (SAD): 65 systemic lupus erythematosis, 50 systemic sclerosis, 127 systemic vasculitides (SV) and 18 patients with autoinflammatory diseases (AID): 8 Behcets disease, 2 periodic disease, 5 familial cold fever, 2 idiopathic lobular panniculitis and 1 relapsing polychondritis. Is carried out a study of complement, antigen of von Willebrand factor (FW:AG), antinuclear antibodies, antibodies to DNA, anti-endothelial antibodies, antibodies to topoizomeraze I (anti-Scl-70), antineutrophilic cytoplasmic antibodies (ANCA), anticardiolipin antibodies (aCL IgG and aCL IgM), cryoglobulins, VS, CRP. Results.SAD were characterized by the synthesis of wide antibodies spectrum. As the basic serological marker at the screening it follows to consider antinuclear antibodies (75%). Practically in all groups it took place hypcomlemetemia with reduction of C3 and C4 complement. With systemic lupus erythematosis are revealed antibodies to DNA (71%), with ANCA-associated SV-ANCA (94%), aKL (14%); with SSD aScl-70 (17%). At Wegener granulomatosis ANCA are determined in 94% patients in the active stage. It is noted correlation ANCA with the index of the clinical activity of vasculitis. In the remaining SV groups ANCA were separated in the single cases. Cryoglobulins are noted in all patients with cryoglobulinemic vasculitis. aCL IgG and aCL IgM were the markers of antiphospholipid syndrome. Аnti-endothelial antibodies had significant oscillation spectrum. High indices FW:AG are noted with all above nosologic forms indicated, especially with Wegener granulomatosis and vasculitis hemorrhagic. Among the laboratory tests of inflammatory activity should be considered the determination of VS, CRP and FV:AG, which is also considered the marker of vascular wall defeat. Is given clinical characteristic and changes in the laboratory indices at AID: Conclusion.Isolation from the group IID of patients with AID serves as indication for a genetic study of this contingent with the approval of use for their treatment of biological therapy. Isolation from the group SAD patients with AID serves as indication for a genetic study of this contingent with the approval of use for their treatment of biological therapy