Terapevt Arkh
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Observational Study
[The role of structure-modifying agents in the treatment of back pain].
Back pain is currently one of the most urgent problems within pain syndromes. Inadequate treatment of nonspecific back pain, even with a relatively favorable prognosis, leads to its chronicity and decreases the patient's quality of life. The most common cause of vertebrogenic dorsopathies is spinal osteochondrosis. The etiopathogenetic basis of spinal osteochondrosis is degenerative and dystrophic changes in the intervertebral discs involving adjacent vertebrae, joints, and ligaments. Considering the experience of many years of using chondroprotective therapy in clinical practice, we performed an observational study using Ambene Bio to assess the change of pain severity over time in patients with osteochondrosis and back pain. ⋯ The study results confirmed the high efficacy of Ambene Bio in patients with dorsopathies with an alternating treatment regimen (10 IM injections 2 mL every other day).
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A review of publications devoted to the analysis of genetic polymorphisms and features of the functioning of genes that affect the pharmacokinetics and pharmacodynamics of sodium-glucose cotransporter-2 inhibitors (SGLT2i) is presented. Objective of the study was to reveal information about genes whose polymorphism may affect the effectiveness of SGLT2i. The review was carried out in accordance with the PRISMA 2020 recommendations, the search for publications was carried out in the PubMed databases (including Medline), Web of Science, as well as Russian scientific electronic libraries eLIBRARY. ⋯ Polymorphisms in the structure of several genes (SLC5A2, UGT1A9, ABCB1, PNPLA3) have been described that may affect the treatment of type 2 diabetes mellitus complicated by diseases such as chronic heart failure, chronic kidney disease, or non-alcoholic fatty liver disease. The information found on the genetic features of the development of the effects of SGLT2i is limited to a description of the differences in their pharmacokinetics. The relevance of currently available pharmacogenetic studies is largely constrained by small sample sizes.
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Review
[Current status and prospects of using the prokinetic acotiamide in gastroenterology: A review].
Acotiamide is a prokinetic with a novel mechanism of action - an antagonist of muscarinic M1 and M2 receptors and an acetylcholinesterase inhibitor. Acetylcholine is the central mediator of the tone of the muscular components of the gastrointestinal tract, increasing its motor activity. ⋯ Currently, the clinical efficacy of acotiamide in the population of patients with functional dyspepsia is demonstrated in more than 10 clinical studies in different regions of the world, demonstrating a reduction of the symptoms of the disease during treatment with this agent and an improvement in the quality of life of patients. In addition, the combination of acotiamide with proton pump inhibitors optimizes the management of patients with gastroesophageal reflux disease.
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Anxiety and anxiety disorders are important modifiable risk factors for cardiovascular and other common chronic non-communicable diseases and complications. Anxiety disorders significantly reduce the motivation and adherence of patients to lifestyle changes and drug therapy, significantly worsen the quality of life, and increase the risk of disability and the costs of the health care system. The issues of diagnosis and therapy of anxiety are relevant for the practice of physicians and cardiologists due to the high incidence of anxiety disorders in patients with cardiovascular diseases, a decrease in the quality of life and an increase in adverse outcomes, and also due to the insufficient awareness of the risks associated with the psycho-emotional state of patients. ⋯ Sedative and anti-anxiety drugs, including non-benzodiazepine tranquilizers, are more commonly used. The most studied drug from this class in therapeutic and cardiological practice is fabomotizole. The efficacy and safety of fabomotizole, including long-term use, have been studied in numerous studies in patients with cardiovascular diseases and a wide range of anxiety disorders.
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The problem of recurrent urinary tract infections (UTI) in patients with type 2 diabetes mellitus (DM 2) is relevant, especially when there is a combination of predisposing factors, such as female gender, history of UTI episodes, and therapy with sodium glucose cotransporter type 2 (SGLT-2) inhibitors, and the choice of effective and safe means could cause some difficulties, including ina terms of the burden of antibiotic resistance. ⋯ Thus, the herbal drug Canephron® N can be used for accompanying therapy and prophylactic treatment in patients with recurrent cystitis on the background of DM 2, taking SGLT-2 inhibitors. The course of therapy should last at least 3 months.