8 research outputs found
Zofenopril or irbesartan plus hydrochlorothiazide in elderly patients with isolated systolic hypertension untreated or uncontrolled by previous treatment: a double-blind, randomized study
No full textObjective: To compare zofenoprilRhydrochlorothiazide
(ZRH) vs. irbesartanRhydrochlorothiazide (IRH) efficacy
on daytime SBP in elderly (>65 years) patients with
isolated systolic hypertension (ISH), untreated or
uncontrolled by a previous monotherapy.
Methods: After a 1-week run-in, 230 ISH patients (office
SBP140mmHg and DBP<90mmHgRdaytime
SBP135mmHg and daytime DBP<85 mmHg) were
randomized double-blind to 18-week treatment with ZRH
(30R12.5 mg) or IRH (150R12.5 mg) once daily, in an
international, multicenter study. Z and I doses could be
doubled after 6 and 12 weeks, and nitrendipine 20mg
added at 12 weeks in nonnormalized patients.
Results: In the full analysis set (n1⁄4216) baseline-adjusted
average (95% confidence interval) daytime SBP reductions
after 6 weeks (primary study end point) were similar
(P1⁄40.888) with ZRH [7.7 (10.7, 4.6) mmHg, n1⁄4107] and
IRH [7.9 (10.7, 5.0) mmHg, n1⁄4109]. Daytime SBP
reductions were sustained during the study, and larger
(P1⁄40.028) with low-dose ZRH at study end [16.2 (20.0,
12.5)mmHg vs. 11.2 (14.4, 7.9)mmHg IRH]. Daytime SBP
normalization (<135 mmHg) rate was similar under ZRH
and IRH at 6 and 12 weeks, but more common under
ZRH at 18 weeks (68.2 vs. 56.0%, P1⁄40.031). Both drugs
equally reduced SBP in the last 6 h of the dosing interval
and homogeneously reduced SBP throughout the 24 h. The
proportion of patients reporting drug-related adverse
events was low (ZRH: 4.4% vs. IRH: 6.0%; P1⁄40.574).
Conclusion: Elderly patients with ISH respond well to both
low and high-dose Z or I combined with H
Heavy Metal Ion Detection Using TiO2 Nanotubes and Self-Reduced TiO2 Nanotube Electrodes
No full textTiO2 nanotubes and self-reduced TiO2 nanotube semiconductor electrodes were used for electrochemical metal ion detection in an open circuit under photo-accumulation conditions. Due to their surface properties, the electrodes showed different responses towards metal ions at different wavelengths of light radiation. Using TiO2 nanotube-based electrodes, Pb(II) and Cu(II) ions were detected at irradiation wavelengths of 389 nm and 426 nm. Detection limits of 8 × 10−9 M and 5 × 10−9 M for Pb(II) and 3 × 10−8 and 7 × 10−9 M for Cu(II) were obtained at the two wavelengths, respectively. The self-reducing electrode showed a response to Pb(II) and Cu(II) ions when irradiated with light at 389 nm, while at 426 nm, Hg(II) ions along with Pb(II) and Cu(II) ions were detected. The obtained detection limits with self-reduced TiO2 nanotube electrodes for Pb(II) and Cu(II) at 389 nm were 2 × 10−7 M and 8 × 10−9 M, respectively. At a wavelength of 426 nm, the detection limits were 1 × 10−7 M, 3 × 10−9, and 4 × 10−9 M for Pb(II), Cu(II), and Hg(II), respectively
Improving the Voltammetric Determination of Hg(II): A Comparison Between Ligand-Modified Glassy Carbon and Electrochemically Reduced Graphene Oxide Electrodes
No full textA new thiosemicarbazone ligand was immobilized through a Cu(I)-catalyzed click reaction on the surface of glassy carbon (GC) and electrochemically reduced graphene oxide (GC-ERGO) electrodes grafted with phenylethynyl groups. Using the accumulation at open circuit followed by anodic stripping voltammetry, the modified electrodes showed a significant selectivity and sensibility for Hg(II) ions. A detection limit of 7 nM was achieved with the GC modified electrodes. Remarkably, GC-ERGO modified electrodes showed a significantly improved detection limit (0.8 nM), sensitivity, and linear range, which we attribute to an increased number of surface binding sites and better electron transfer properties. Both GC and GC-ERGO modified electrodes proved their applicability for the analysis of real water samples
State of the European Territory: ESPON contribution to the debate on Cohesion Policy post 2020
No full textUrban DesignSpatial Planning and Strateg
Cystic Echinococcosis in Hospitalized Adult Patients from Western Romania: 2007–2022
No full textCystic echinococcosis (CE) is a neglected parasitic disease caused by the tapeworm Echinococcus granulosus. The aim of this study was to assess the epidemiological features of human cystic echinococcosis in patients from Western Romania. We retrospectively investigated the medical records of patients hospitalized with CE between 1 January 2007 and 1 September 2022. A total of 366 patients (range 18–90 years) were recorded. The number of hospitalized individuals was higher in patients aged 50–59 years (83/366, 22.7%), in females (194/366, 53%), and in residents of rural areas (225/366, 61.5%). The liver was the most common localization of the cysts (302/366, 82.5%). Ninety-eight patients (26.8%) presented complications, including biliary fistula, allergies, and infection of the cyst. Patients with complications had a longer mean hospital stay (15.7 ± 8.3 days) compared to patients without complications (11.5 ± 7.3 days) (p < 0.001). The results of this study revealed that patients diagnosed with CE required hospitalization and extended medical care, indicating that this zoonotic disease remains a significant public health problem in Western Romania. Public health authorities should enhance CE surveillance by implementing control programs and mandatory notification of new cases
Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial
No full textInternational audienceBACKGROUND:Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications.METHODS:This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90. After a 30-day run-in period, patients were randomly assigned (1:1:1) to receive oral rivaroxaban (2·5 mg twice a day) plus aspirin (100 mg once a day), rivaroxaban twice a day (5 mg with aspirin placebo once a day), or to aspirin once a day (100 mg and rivaroxaban placebo twice a day). Randomisation was computer generated. Each treatment group was double dummy, and the patient, investigators, and central study staff were masked to treatment allocation. The primary outcome was cardiovascular death, myocardial infarction or stroke; the primary peripheral artery disease outcome was major adverse limb events including major amputation. This trial is registered with ClinicalTrials.gov, number NCT01776424, and is closed to new participants.FINDINGS:Between March 12, 2013, and May 10, 2016, we enrolled 7470 patients with peripheral artery disease from 558 centres. The combination of rivaroxaban plus aspirin compared with aspirin alone reduced the composite endpoint of cardiovascular death, myocardial infarction, or stroke (126 [5%] of 2492 vs 174 [7%] of 2504; hazard ratio [HR] 0·72, 95% CI 0·57-0·90, p=0·0047), and major adverse limb events including major amputation (32 [1%] vs 60 [2%]; HR 0·54 95% CI 0·35-0·82, p=0·0037). Rivaroxaban 5 mg twice a day compared with aspirin alone did not significantly reduce the composite endpoint (149 [6%] of 2474 vs 174 [7%] of 2504; HR 0·86, 95% CI 0·69-1·08, p=0·19), but reduced major adverse limb events including major amputation (40 [2%] vs 60 [2%]; HR 0·67, 95% CI 0·45-1·00, p=0·05). The median duration of treatment was 21 months. The use of the rivaroxaban plus aspirin combination increased major bleeding compared with the aspirin alone group (77 [3%] of 2492 vs 48 [2%] of 2504; HR 1·61, 95% CI 1·12-2·31, p=0·0089), which was mainly gastrointestinal. Similarly, major bleeding occurred in 79 (3%) of 2474 patients with rivaroxaban 5 mg, and in 48 (2%) of 2504 in the aspirin alone group (HR 1·68, 95% CI 1·17-2·40; p=0·0043).INTERPRETATION:Low-dose rivaroxaban taken twice a day plus aspirin once a day reduced major adverse cardiovascular and limb events when compared with aspirin alone. Although major bleeding was increased, fatal or critical organ bleeding was not. This combination therapy represents an important advance in the management of patients with peripheral artery disease. Rivaroxaban alone did not significantly reduce major adverse cardiovascular events compared with asprin alone, but reduced major adverse limb events and increased major bleeding
Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial
No full textЭтиотропная терапия COVID-19: критический анализ и перспективы
No full textThe COVID-19 outbreak started in December 2019 in China has spread over all countries of the world within few month acquiring a pandemic nature, the incident population counting millions. The pathogenic mechanisms of the new coronaviral infection caused by never-before-seen virus SARS-CoV2 are yet to be studied. Various drugs are used for COVID-19 treatment and guidelines are continuously revised as new experience is acquired. In the current pandemic situation, it is important to provide specialists with latest information concerning efficacy and safety drugs for COVID-19 patients and promising research in this field.The purpose of the review is to critically analyze published data on outcomes of COVID-19 treatment with various drugs including potentially promising drugs.The search has been carried out through such databases as PubMed, Scopus, Cyberleninka, https://www.globalclinicaltrialsdata.com, https://clinicaltrials.gov, Cochrane Library; mostly, randomized clinical trials-2020 and papers dedicated to candidate drugs have been considered. The paper is structured based on the drug’s action mechanism and contains parts dedicated to antiviral, immunomodulatory, and antibacterial therapies. Looking for a new promising target in COVID-19 treatment, the authors focus their attention on matrix metalloproteinases (MMP), which abundance results in the destruction of extracellular matrix, epithelial and endothelial basal membranes and leads to secondary lung tissue injury. The paper provides a theoretic justification of MMP inhibitor use by an example of doxycycline and offers an efficacy study protocol for the new approach to COVID-19 therapy.Conclusion: as of now, there are no drugs which efficacy for COVID 19 has been proven. Drugs possessing multiple mechanisms of action are employed beside their specified indications, often in combinations; in this situation, additive side effects with adverse consequences for the patient can hardly be avoided. Administration of drugs with unproven efficacy may be justified only in clinical trials followed by subsequent analysis and publication of findings demonstrating that in case of success, recommendations for a majority of COVID-19 patients could be confidently issued.Эпидемия COVID-19, начавшаяся в декабре 2019 года в Китае, за несколько месяцев распространилась на все страны мира, приняв характер пандемии, число заболевших исчисляется миллионами. Механизмы патогенеза новой коронавирусной инфекции, вызванной неизвестным ранее вирусом SARS-CoV2, остаются недостаточно изученными. Для лечения COVID-19 применяют препараты разных групп, по мере появления опыта рекомендации регулярно пересматриваются. В условиях текущей пандемии важно предоставить специалистам актуальную информацию об эффективности и безопасности лечебных препаратов, применяемых для лечения пациентов с COVID-19, и о перспективных исследованиях в этой области. Цель обзора — критический анализ опубликованных результатов лечения COVID-19 с использованием различных групп препаратов для выбора наиболее перспективных лекарственных средств.Поиск источников провели по базам данных PubMed, Scopus, Cyberleninka, Clinical Trials, Cochrane Library и др., рассматривали преимущественно рандомизированные клинические исследования 2020 года, а также работы по изучению препаратов-претендентов. Материал статьи структурирован по механизму действия препаратов, содержит разделы противовирусной, иммуномодулирующей, антибактериальной терапии. В поиске новой перспективной мишени в лечении COVID-19 концентрировали внимание на матриксных металлопротеиназах (ММР), избыток которых ведет к разрушению внеклеточного матрикса, базальных мембран эпителия и эндотелия, способствует вторичному повреждению легочной ткани. В работе теоретически обосновали применение ингибиторов MMP на примере доксициклина, предложили протокол исследования для оценки эффективности нового подхода к лечению COVID-19.Заключение. Лекарственных средств с доказанной эффективностью в отношении COVID 19 в настоящее время нет. Препараты с разными механизмами действия применяются не по показаниям, часто в комбинациях, в этих условиях трудно избежать суммирования побочных эффектов с неблагоприятными последствиями для пациента. Применение препаратов с недоказанной эффективностью оправдано лишь в рамках клинических исследований с последующим анализом и публикацией результатов, чтобы в случае успеха с уверенностью рекомендовать их большинству пациентов с COVID-19. Ключевые слова: COVID-19; противомалярийные средства; ингибиторы вирусных протеаз; противопаразитарные препараты; ингибиторы интерлейкинов; ингибиторы янус-киназ; интерфероны; плазма реконвалесцентов; кортикостероиды; прокальцитонин; антибиотики; новая мишень; матриксные металлопротеиназы, доксициклин
