55 research outputs found
Impact of the beta 1-Adrenoceptor Arg389Gly Polymorphism on Heart-Rate Responses to Bisoprolol and Carvedilol in Heart-Failure Patients
No full textThis pharmacogenetic substudy of the prospective, double-blind, randomized CIBIS-ELD trial determined the impact of the beta 1-adrenoceptor Arg189Gly polymorphism on heart-rate responses to bisoprolol or carvedilol in elderly patients with heart failure (421 with sinus rhythm, 107 with atrial fibrillation). Patients were randomized 1:1 to bisoprolol or carvedilol with a fortnightly dose-doubling scheme and guideline target doses. Patients with sinus rhythm responded essentially identically to bisoprolol and carvedilol, independent of genotype. Atrial fibrillation patients homozygous for Arg389 had a much smaller response to carvedilol than carriers of at least one Gly389 allele (mean difference 12 bpm, P < 0.00001). Carvedilol up to 2 x 12.5 mg did not reduce heart rate in Arg389Arg homozygotes at all. Interestingly, the immediate response to carvedilol did not differ between genotypes. The Arg389Gly polymorphism has a major impact on the heart-rate response to carvedilol (but not bisoprolol) in patients with heart failure plus atrial fibrillation
Antihypertensive effect of indapamide given in conjunction with captopril in severe hypertension
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P175 Results of application of levosimendan in patients with acute heart failure during acute myocardial infarction
No full textParathyroid hormone response to vitamin D insufficiency in elderly: Males with chronic heart failure
No full textSecondary hyperparathyroidism (SHPT) may contribute to the systemic illness that accompanies chronic heart failure (CHF). Healthy elderly with vitamin D deficiency who did not develop hyperparathyroidism (functional hypoparathyroidism, FHPT) had lower mortality than those who did. This study was designed to examine determinants of the PTH response in the vitamin D insufficient CHF patients. Sixty five vitamin D insufficient males with NYHA class II and III and 20 control subjects age ≥ 55 years were recruited. Echocardiography, physical performance, NT-pro-BNP, PTH, 25-hydroxyvitamin D (25(OH)D), adiponectin and bone activity surrogate markers (OPG, RANKL, OC, β-CTx) were assessed. Increased NYHA class was associated with SHPT, while physical performance was inferior compared to FHPT. SHPT was associated with lower left ventricular ejection fraction (LVEF) and flow mediated dilatation, but with higher left heart dimensions, left ventricular mass index and right ventricular systolic pressure. CHF patients with SHPT had increased NT-pro-BNP, adiponectin and bone markers, but decreased 25(OH)D compared to those with FHPT. Independent determinants for SHPT in CHF patients with vitamin D insufficiency were LVEF, adiponectin and β-CTx, irrespective of renal function and serum vitamin D levels. In conclusion, increased PTH levels, but not low vitamin D, demonstrated close relation to CHF severity
Markers of Oxidative Stress and Endothelial Dysfunction Predict Haemodialysis Patients Survival
No full textIntroduction: Overall survival of patients with end-stage renal disease (ESRD) remains poor. Oxidative stress is one of the major risk factors associated with mortality in this patient group. As glutathione S-transferases (GST) are well-established antioxidants, we hypothesized that a model including GST gene polymorphisms, oxidative damage byproducts and cell adhesion markers has a prognostic role in ESRD patient survival. Methods: A prospective study of 199 patients with ESRD on haemodialysis was conducted. GST genotype, oxidative stress byproducts and cell adhesion molecules were measured in plasma. Multivariate Cox regression and Kaplan-Meier survival analyses were performed to test the predictive ability of these parameters in the 8-year follow-up period. Results: GSTM1-null genotype was associated with significantly shorter overall (HR 1.6, p = 0.018) and cardiovascular-specific (HR 2.1, p = 0.010) survival. Oxidative stress byproducts (advanced oxidation protein products [AOPP], prooxidant-antioxidant balance [PAB], malondialdehyde [MDA]) and cell adhesion molecules (soluble vascular cell adhesion molecule-1 [sVCAM-1] and soluble intercellular adhesion molecule-1 [sICAM-1]) demonstrated a significant predictive role in terms of overall and cardiovascular survival. When 6 biomarkers (GSTM1 genotype, high AOPP/PAB/MDA/-sVCAM-1/sICAM-1) were combined into a scoring model, a significantly shorter overall and cardiovascular survival was observed for patients with the highest score (p lt 0.001). Conclusion: We identified a novel panel of biomarkers that can be utilized in predicting survival in ESRD patients. This biomarker signature could enable better monitoring of patients and stratification into appropriate treatment groups
Clinical pharmacist interventions in patients with mental health disorders
No full textDespite positive evidence for the impact of clinical pharmacy interventions on patients’ health outcome, the benefits of clinical
pharmacist placed within multidisciplinary psychiatric team are still not recognized in our country. The aim of the present study was to
highlight the role of clinical pharmacists in our healthcare system and evaluate the extent to which they contribute in reducing the incidence
of medication-related problems (MRPs). The study included total of 82 patients hospitalized at the Department of Psychiatry at the Prilep
General Hospital it the period from October 2022 to October 2023. MRPs were recognized in 70 (85.36%) patients. MRPs categories
associated with medication selection (34.74%) and medication safety (16.43) followed by drug monitoring (14.55%) and patient compliance
(14.08%) were found most prevalent. Clinical pharmacist made 213 recommendations (3.04 per patient). Most frequently recommended
clinical interventions referred to: monitoring of laboratory parameters (9.86%), adherence to the pharmacotherapy (8.45%), prevention of
use of too many medications for non-existing indication(s) or for a certain indication (7.98%) and recommendations for temporary or
permanent discontinuation of medication (7.51%). Nearly 58% of all clinical pharmacist interventions aimed at preventing complications
and morbidity that could arose from MRPs, of which 35% were graded as major in severity. The psychiatrists accepted 90.61% (193 of
213) of the suggested recommendations. Our findings highlight the opportunity for more targeted approaches to identifying and managing
MRPs in tertiary care where tailored clinical pharmacist-led interventions may be of value. Implementation of clinical pharmacist led
services, such as medication therapy management (MTM), in routine clinical practice can have a positive impact on the efficient and safe
use of medicines in this patient’s group
Oxidative Stress and Trace Elements in Patients with Non-Diabetic Hemodialysis
No full textSeveral evidences show that oxidative stress is high among patients with hemodialysis. This study was aimed to investigate the oxidative stress and serum level of zinc and copper in patients with non-diabetic hemodialysis. In a case - control study 60 non-diabetic hemodialysis patients referred to hospital hemodialysis 1387 were studied. Lipid profile, glucose, creatinine, urea, total protein, albumin, zinc, copper, malondialdehyde, total antioxidant capacity and superoxide dismutase and glutathione peroxidase enzymes were measured in both groups. The results using the software T test and Pearson correlation coefficient was used to measure the dependence between variables in the SPSS 16 statistical was used. The amount of blood sugar, cholesterol, triglycerides, total protein, albumin Significantly less than the control group. Superoxide dismutase and glutathione peroxidase enzyme activity of red blood cells serum total antioxidant capacity in hemodialysis patients was significantly higher than healthy individuals. Concentrations of the Copper and malondialdehyde in the two groups did not differ significantly.This study shows that in non-diabetic hemodialysis patients, increased activity of antioxidant enzymes prevent oxidative stress is increased. Zinc deficiency was also observed in these patients
Korrelieren C-reaktives Protein und Verkalkungsinhibitoren bei Hämodialyse-Patienten mit kardiovaskulären Parametern und Risikofaktoren?
No full textFP511EFFECT OF HEMODIALYSIS MODALITY ON ALL CAUSE MORTALITY OF DIABETIC PATIENTS− 36 MONTHS FOLLOW UP
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