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

CELEBREX IN TREATMENT OF VERTEBRAL PAIN SYNDROME IN SYSTEMICV LUPUS ERYTHEMATOSUS

Objective. То study of tizol efficacy for local therapy of rheumatoid arthritis (RA). Materials and methods. 90 pts with active RA (2-3 stage of activity) age 41-54 (m=18, f—72). The method оГ double blind controlled comparison of 10 - days therapy with pure tizol, tizol with diclophenac (1%) and placebo (vaseline) was used. In order to evaluate skin permeability of tizol mass-spectrometry of synovial liquid was used. Results. Positive dynamic of joint syndrome under tizol and tizol with diclophenac therapy were showed. There were reduction of arthalgia, decreasing of morning stiffness, increasing of grip strenght. Erythrocyte sedimentation rate didn’t change. Adding of diclophenac to tizol amplified it's analgetic properties. Mass spectrum analysis showed that concentration of titanium in synovial fluid came approximately 10 times higher after 10 days of tizol therapy. Conclusion. The efficacy of local tizol and it’s compounds in inflammatory joint syndrome was showed. Diclophenac intensified analgetic effect of tizol. Efficacy and convenience of treatment, absens of side-effects, low price allow to recommend tizol - gel compounds for local treatment of inflammatory joint diseases

For half of a century together

В течение второй половины 20 века и начала 21 века терапевтические клиники Ярославского государственного медицинского института (с 1994 года – Ярославская государственная медицинская академия) занимаются изучением клиники, патогенеза, диагностики и лечения ревматических заболеваний. Все эти годы работа проводилась в тесной связи с ведущим учреждением России в области ревматологии – Институтом ревматологии РАМН

CELEBREX IN TREATMENT OF VERTEBRAL PAIN SYNDROME IN SYSTEMICV LUPUS ERYTHEMATOSUS

Celebrex in dosage of 100-200mg/day for 14-20 days was prescribed to 36 SLE pts with symptoms of chronic painful vertebrogenic syndrome. Considerable or moderate lessening of pain syndrome was noticed in 91% of cases (up to 1-3 point by VAS with initial pain more than 4 points). Analgetic effect of the drug was demonstrated already on the 2nd day, the safety was good. Celebrex was recommended for long-term treatment of chronic painful vertebrogenic syndrome in pts with systemic lesions of connective tissue

THE CONTROLLER OF FUZZY LOGIC IN THE MANAGEMENT OF TECHNOLOGICAL PROCESSES

Introduction. The current stage of progress is associated with the development and implementation of intelligent systems and technologies that provide the formation of clear solutions based on fuzzy rules, fuzzy conclusion and fuzzy control. However, the classical control methods work well only with a completely deterministic control object and deterministic environment, but for fuzzy information systems and highly complex control object, fuzzy control methods are optimal. Material and methods. Moreover, the process of decision-making by a person in the management of technological processes is modeled and simulated by a fuzzy controller with a base of rules. In recent years, “fuzzy” control has been successfully used to manage and operate a number of systems. Discussion and results. Therefore, this article is devoted to the consideration of fuzzy logic controller’s application in management systems and existing research methods’ analysis in the field of intelligent control technologies for solving the problems of adaptation of applied models and algorithms to various objects and systems, particularly to the systems for maintaining the microclimate parameters of the building’s life support environment, and also to the basic parameters of increasing the economic efficiency of using the fuzzy logic controller in the control system.Conclusion. Analyzed control methods based on fuzzy logic are applicable to various technological objects and systems. As a further study, it is planned to consider the issues of fuzzy control of various life support systems of a modern building