Peculis R, Latkovskis G, Tarasova L, Pirags V, Erglis A, Klovins J. A nonsynonymous variant I248L of the adenosine A3 receptor is associated with coronary heart disease in a Latvian population. DNA Cell Biol. 2011 Nov;30(11):907-11. Epub 2011 Jun 15. PubMed PMID: 21675873.
http://www.ncbi.nlm.nih.gov/pubmed/21675873
Kopsavilkums
Adenosine plays an important part in the cardiac response to ischemia and reperfusion. The human adenosine receptor A3 (A3R), along with other adenosine receptors, is involved in mediation of those effects. The aim of the study was to ascertain whether the nonsynonymous single-nucleotide polymorphism (SNP) I248L (reference SNP ID: rs35511654) located in the A3R gene is associated with coronary heart disease (CHD). DNA samples from 683 individuals with CHD and from 826 control subjects selected from the Latvian Genome Database were successfully screened for rs35511654 using the TaqMan SNP Genotyping Assay. We observed a significantly decreased frequency of the rs35511654 C allele in a group of CHD patients compared with that in controls (p = 0.009). The association remained significant after adjustment for age, sex, and other nongenetic factors (p = 0.02). These results suggest that A allele of rs35511654 may predispose to CHD.
Ignatovica V, Latkovskis G, Peculis R, Megnis K, Schioth HB, Vaivade I, Fridmanis D, Pirags V, Erglis A, Klovins J. Single nucleotide polymorphisms of the purinergic 1 receptor are not associated with myocardial infarction in a Latvian population. Mol Biol Rep. 2011 Jun 4. [Epub ahead of print] PubMed PMID:21643756.
http://www.ncbi.nlm.nih.gov/pubmed/21643756
Kopsavilkums
The purinergic 1 receptor (P2RY1) has been implicated in development of heart disease and in individual pharmacodynamic response to anticoagulant therapies. However, the association of polymorphisms in the P2RY1 gene with myocardial infarction (MI), and its associated conditions, has yet to be reported in the literature. We evaluated seven known SNPs in P2RY1 for association with MI in a Latvian population. Seven independent parameters that are related to MI [body mass index (BMI), type 2 diabetes (T2D), angina pectoris, hypertension, hyperlipidemia, atrial fibrillation and heart failure] were investigated. No significant association with MI was observed for any of the polymorphisms. Those SNPs for which the P value was close to significance were located in coding or promoter regions. Intriguingly, carriers of the minor allele in the P2RY1 gene locus showed a tendency towards higher onset age for MI, suggesting a possible protective effect of these SNPs against MI or their contribution in progression as opposed to onset. Finally, a linkage disequilibrium (LD) plot was generated for these polymorphisms in the Latvian population. The results of this study suggest that the role of P2RY1 in individuals from Latvian population is likely to be principally involved in platelet aggregation and thromboembolic diseases, and not as a significant contributing factor to the global metabolic syndrome.
Licis N, Krivmane B, Latkovskis G, Erglis A. A common promoter variant of the gene encoding cyclooxygenase-1 (PTGS1) is related to decreased incidence of myocardial infarction in patients with coronary artery disease. Thromb Res. 2011 Jun;127(6):600-2. Epub 2011 Jan 21. PubMed PMID: 21256536.
http://www.ncbi.nlm.nih.gov/pubmed/21256536
Behan MW, Holm NR, Curzen NP, Erglis A, Stables RH, de Belder AJ, Niemelä M, Cooter N, Chew DP, Steigen TK, Oldroyd KG, Jensen JS, Lassen JF, Thuesen L, Hildick-Smith D. Simple or complex stenting for bifurcation coronary lesions: a patient-level pooled-analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study. Circ Cardiovasc Interv. 2011 Feb 1;4(1):57-64. Epub 2011 Jan 4. PubMed PMID: 21205942.
http://www.ncbi.nlm.nih.gov/pubmed/21205942
Kopsavilkums
Controversy persists regarding the correct strategy for bifurcation lesions. Therefore, we combined the patient-level data from 2 large trials with similar methodology: the NORDIC Bifurcation Study (NORDIC I) and the British Bifurcation Coronary Study (BBC ONE).
Both randomized trials compared simple (provisional T-stenting) versus complex techniques, using drug-eluting stents. In the simple group (n=457), 129 patients had final kissing balloon dilatation in addition to main vessel stenting, and 16 had T-stenting. In the complex group (n=456), 272 underwent crush, 118 culotte, and 59 T-stenting techniques. A composite end point at 9 months of all-cause death, myocardial infarction, and target vessel revascularization occurred in 10.1% of the simple versus 17.3% of the complex group (hazard ratio 1.84 [95% confidence interval 1.28 to 2.66], P=0.001). Procedure duration, contrast, and x-ray dose favored the simple approach. Subgroup analysis revealed similar composite end point results for true bifurcations (n=657, simple 9.2% versus complex 17.3%; hazard ratio 1.90 [95% confidence interval 1.22 to 2.94], P=0.004), wide-angled bifurcations >60 to 70° (n=217, simple 9.6% versus complex 15.7%; hazard ratio 1.67 [ 95% confidence interval 0.78 to 3.62], P=0.186), large (≥2.75 mm) diameter side branches (n=281, simple 10.4% versus complex 20.7%; hazard ratio 2.42 [ 95% confidence interval 1.22 to 4.80], P=0.011), longer length (>5 mm) ostial side branch lesions (n=464, simple 12.1% versus complex 19.1%; hazard ratio 1.71 [95% confidence interval 1.05 to 2.77], P=0.029), or equivalent sized vessels (side branch <0.25 mm smaller than main vessel) (n=108, simple 12.0% versus complex 15.5%; hazard ratio 1.35 [95% confidence interval 0.48 to 3.70], P=0.57).
For bifurcation lesions, a provisional single-stent approach is superior to systematic dual stenting techniques in terms of safety and efficacy. A complex approach does not appear to be beneficial in more anatomically complicated lesions.
Niemelä M, Kervinen K, Erglis A, Holm NR, Maeng M, Christiansen EH, Kumsars I, Jegere S, Dombrovskis A, Gunnes P, Stavnes S, Steigen TK, Trovik T, Eskola M, Vikman S, Romppanen H, Mäkikallio T, Hansen KN, Thayssen P, Aberge L, Jensen LO, Hervold A, Airaksinen J, Pietilä M, Frobert O, Kellerth T, Ravkilde J, Aarøe J, Jensen JS, Helqvist S, Sjögren I, James S, Miettinen H, Lassen JF, Thuesen L; Nordic-Baltic PCI Study Group. Randomized comparison of final kissing balloon dilatation versus no final kissing balloon dilatation in patients with coronary bifurcation lesions treated with main vessel stenting: the Nordic-Baltic Bifurcation Study III. Circulation. 2011 Jan 4;123(1):79-86. Epub 2010 Dec 20. PubMed PMID: 21173348.
http://www.ncbi.nlm.nih.gov/pubmed/21173348
Kopsavilkums
It is unknown whether the preferred 1-stent bifurcation stenting approach with stenting of the main vessel (MV) and optional side branch stenting using drug-eluting stents should be finalized by a kissing balloon dilatation (FKBD). Therefore, we compared strategies of MV stenting with and without FKBD.
We randomized 477 patients with a bifurcation lesion to FKBD (n=238) or no FKBD (n=239) after MV stenting. The primary end point was major adverse cardiac events: cardiac death, non-procedure-related index lesion myocardial infarction, target lesion revascularization, or stent thrombosis within 6 months. The 6-month major adverse cardiac event rates were 2.1% and 2.5% (P=1.00) in the FKBD and no-FKBD groups, respectively. Procedure and fluoroscopy times were longer and more contrast media was needed in the FKBD group than in the no-FKBD group. Three hundred twenty-six patients had a quantitative coronary assessment. At 8 months, the rate of binary (re)stenosis in the entire bifurcation lesion (MV and side branch) was 11.0% versus 17.3% (P=0.11), in the MV was 3.1% versus 2.5% (P=0.68), and in the side branch was 7.9% versus 15.4% (P=0.039) in the FKBD versus no-FKBD groups, respectively. In patients with true bifurcation lesions, the side branch restenosis rate was 7.6% versus 20.0% (P=0.024) in the FKBD and no-FKBD groups, respectively.
MV stenting strategies with and without FKBD were associated with similar clinical outcomes. FKBD reduced angiographic side branch (re)stenosis, especially in patients with true bifurcation lesions. The simple no-FKBD procedures resulted in reduced use of contrast media and shorter procedure and fluoroscopy times. Long-term data on stent thrombosis are needed. Clinical Trial Registration- URL: http://clinicaltrials.gov. Unique identifier: NCT00914199.
Lacis A, Erglis A. Intramyocardial administration of autologous bone marrow mononuclear cells in a critically ill child with dilated cardiomyopathy. Cardiol Young. 2011 Feb;21(1):110-2. Epub 2010 Oct 27. PubMed PMID: 20977823.
http://www.ncbi.nlm.nih.gov/pubmed/20977823
Kopsavilkums
Almost half of the children with symptomatic dilated cardiomyopathy receive a transplant or die within 2 years; however, cardiac stem cell transplantation has become a promising therapeutic option. The present case demonstrates for the first time, to our knowledge, the intramyocardial administration of autologous bone marrow mononuclear cells in a critically ill 4-month-old child with severe dilated cardiomyopathy. Left ventricular ejection fraction increased from 20% before stem cell transplantation to 41% at 4 months of follow-up.
Meredith I, Rothman M, Erglis A, Parikh K, Lotan C; E-Five Investigators. Extended follow-up safety and effectiveness of the Endeavor zotarolimus-eluting stent in real-world clinical practice: two-year follow-up from the E-Five Registry. Catheter Cardiovasc Interv. 2011 Jun 1;77(7):993-1000. doi:10.1002/ccd.22803. Epub 2010 Dec 3. PubMed PMID: 20853351.
http://www.ncbi.nlm.nih.gov/pubmed/20853351
Kopsavilkums
To present data from the cohort of patients in the all-comers Endeavor zotarolimus-eluting stent (ZES) registry (E-Five) who underwent 2-year follow-up.
The Endeavor ZES has been shown to be safe and efficacious for treatment of single, de novo lesions in patients with stable coronary artery disease. E-Five evaluated the ZES in over 8,000 real-world patients, at 188 sites followed to 1 year. A subset of sites continued follow-up through 2 years to evaluate late-term safety and effectiveness of the ZES in this population with diverse clinical and lesion characteristics.
E-Five, a prospective, multicenter, nonrandomized global registry, collected 2-year outcomes for 2,116 patients from 26 centers. Sites were selected for participation based on patient accrual rates and the ability to continue follow-up activities for an additional year. Complete data was available for 2,054 patients. To observe whether or not a sustained benefit was achieved, data for all patients from the selected sites were included in the analysis.
The outcomes in the 2-year cohort tracked with the results of randomized controlled trials using the Endeavor ZES. One year results were MACE 7.5%, TLR 4.5%, and ARC definite/probable stent thrombosis 0.6%. Outcomes at 2 years for MACE, TLR, and ARC definite/probable stent thrombosis were 8.5, 5.1, and 0.7%, respectively.
Long-term efficacy and safety outcomes were maintained between 1 and 2 years for the 2-year patient cohort, with only a small number of additional MACE, TLR, and very late stent thrombosis events.
Prugger C, Keil U, Wellmann J, de Bacquer D, de Backer G, Ambrosio GB, Reiner Z, Gaita D, Wood D, Kotseva K, Heidrich J; EUROASPIRE III Study Group. Blood pressure control and knowledge of target blood pressure in coronary patients across Europe: results from the EUROASPIRE III survey. J Hypertens. 2011 Aug;29(8):1641-8. PubMed PMID: 21720270.
http://www.ncbi.nlm.nih.gov/pubmed/21720270
Kopsavilkums
Blood pressure management is a key issue among patients with coronary heart disease (CHD). The present study aimed to identify particular patient groups that may need to be specifically targeted in secondary prevention of CHD.
EUROASPIRE III is a cross-sectional study conducted in 2006-2007 among patients up to 80 years of age hospitalized for CHD. Patients from 76 centres in 22 European regions were examined on average 15 months after hospitalization. Logistic regression analysis was applied to investigate factors associated with blood pressure control and knowledge of target blood pressure using the cut-point of less than 140/90 mmHg.
Among 7649 patients using antihypertensive medication 50.4% achieved blood pressure control and 49.4% provided accurate knowledge of target blood pressure. Obese patients were less likely to show controlled blood pressure [odds ratio (OR) 0.72, 95% confidence interval (CI) 0.65-0.80] and accurate knowledge of blood pressure target values (OR 0.80, 95% CI 0.72-0.90). Dyslipidaemia was negatively associated with blood pressure control and accurate target knowledge. Patients with diabetes mellitus less frequently achieved blood pressure control (OR 0.89, 95% CI 0.79-0.99). Accurate knowledge of target blood pressure was positively related to blood pressure control (OR 1.12, 95% CI 1.00-1.24). Patients who received advice by a health professional to reduce salt intake, to reduce weight, and to increase physical activity more frequently showed accurate knowledge of blood pressure target values.
Blood pressure control and knowledge of target blood pressure are inappropriate in the European high-risk population of coronary patients. Particularly CHD patients with obesity, diabetes, and dyslipidaemia need better management and control of elevated blood pressure.
McCollum PT, Bush JA, James G, Mason T, O'Kane S, McCollum C, Krievins D, Shiralkar S, Ferguson MW. Randomized phase II clinical trial of avotermin versus placebo for scar improvement. Br J Surg. 2011 Jul;98(7):925-34. doi:10.1002/bjs.7438. Epub 2011 Mar 29. PubMed PMID: 21618480.
http://www.ncbi.nlm.nih.gov/pubmed/21618480
Kopsavilkums
Scarring is a major problem following skin injury. In early clinical trials, transforming growth factor β3 (avotermin) improved scar appearance. The aim of this study was to determine whether an injection of avotermin at the time of wound closure is effective in improving scar appearance.
Study RN1001-0042, a double-blind, randomized, within-patient, placebo-controlled trial, investigated the efficacy and safety of four doses of avotermin given once. Patients undergoing bilateral surgery to remove varicose leg veins by saphenofemoral ligation and long saphenous vein stripping were enrolled at 20 European centres. A total of 156 patients were randomized to receive one of four doses of avotermin (5, 50, 200 or 500 ng per 100 µl, at 100 µl per linear cm of wound margin), administered by intradermal injection to the groin and distal wound margins of one leg; placebo was administered to the other leg. Scar appearance was evaluated by an independent panel of lay people (lay panel), investigators and patients. The primary efficacy variable was lay panel Total Scar Score (ToScar), derived from visual analogue scale scores for groin scars between 6 weeks and 7 months.
Avotermin 500 ng significantly improved groin scar appearance compared with placebo (mean lay panel ToScar difference 16·49 mm; P = 0·036).
Avotermin 500 ng per 100 µl per linear cm of wound margin given once is well tolerated and significantly improves scar appearance.
Committee for Orphan Medicinal Products and the European Medicines, Westermark K, Holm BB, Söderholm M, Llinares-Garcia J, Rivière F, Aarum S, Butlen-Ducuing F, Tsigkos S, Wilk-Kachlicka A, N'Diamoi C, Borvendég J, Lyons D, Sepodes B, Bloechl-Daum B, Lhoir A, Todorova M, Kkolos I, Kubáčková K, Bosch-Traberg H, Tillmann V, Saano V, Héron E, Elbers R, Siouti M, Eggenhofer J, Salmon P, Clementi M, Krieviņš D, Matulevičiene A, Metz H, Vincenti AC, Voordouw A, Dembowska-Bagińska B, Nunes AC, Saleh FM, Foltánová T, Možina M, Torrent I, Farnell J, Beerman B, Mariz S, Evers MP, Greene L, Thorsteinsson S, Gramstad L, Mavris M, Bignami F, Lorence A, Belorgey C. European regulation on orphan medicinal products: 10 years of experience and future perspectives. Nat Rev Drug Discov. 2011 May;10(5):341-9. PubMed PMID: 21532564.
http://www.ncbi.nlm.nih.gov/pubmed/21532564
Kopsavilkums
In 2000, regulation on orphan medicinal products was adopted in the European Union with the aim of benefiting patients who suffer from serious, rare conditions for which there is currently no satisfactory treatment. Since then, more than 850 orphan drug designations have been granted by the European Commission based on a positive opinion from the Committee for Orphan Medicinal Products (COMP), and more than 60 orphan drugs have received marketing authorization in Europe. Here, stimulated by the tenth anniversary of the COMP, we reflect on the outcomes and experience gained in the past decade, and contemplate issues for the future, such as catalysing drug development for the large number of rare diseases that still lack effective treatments.
Krievins DK, Holden A, Savlovskis J, Calderas C, Donayre CE, Moll FL, Katzen B, Zarins CK. EVAR using the Nellix Sac-anchoring endoprosthesis: treatment of favourable and adverse anatomy. Eur J Vasc Endovasc Surg. 2011 Jul;42(1):38-46. Epub 2011 Apr 15. PubMed PMID: 21497521.
http://www.ncbi.nlm.nih.gov/pubmed/21497521
Kopsavilkums
The study aimed to review the results of endovascular aneurysm repair (EVAR) using a novel sac-anchoring endoprosthesis in patients with favourable and adverse anatomy.
This is a prospective, multicentre, clinical trial.
The Nellix endoprosthesis consists of dual, balloon-expandable endoframes, surrounded by polymer-filled endobags, which obliterate the aneurysm sac and maintain endograft position.
The study reviewed worldwide clinical experience and Core Lab evaluation of computed tomography (CT) scans.
From 2008 to 2010, 34 patients (age 71 ± 8 years, abdominal aortic aneurysm (AAA) diameter 5.8 ± 0.8 cm) were treated at four clinical sites. Seventeen patients (50%) met the inclusion criteria for Food and Drug Administration (FDA)-approved endografts (favourable anatomy); 17 (50%) had one or more adverse anatomic feature: neck length <10 mm (24%), neck angle >60° (9%) and iliac diameter >23 mm (38%). Device deployment was successful in all patients; iliac aneurysm treatment preserved hypogastric patency. Perioperative mortality was 1/34 (2.9%); one patient died at 10 months of congestive heart failure (CHF); one patient had a secondary procedure at 15 months. During 15 ± 6 months follow-up, there were no differences in outcome between favourable and adverse anatomy patients. Follow-up CT extending up to 2 years revealed no change in aneurysm size or endograft position and no new endoleaks.
Favourable and adverse anatomy patients can be successfully treated using the Nellix sac-anchoring endoprosthesis. Early results are promising but longer-term studies are needed.
Donayre CE, Zarins CK, Krievins DK, Holden A, Hill A, Calderas C, Velez J, White RA. Initial clinical experience with a sac-anchoring endoprosthesis for aortic aneurysm repair. J Vasc Surg. 2011 Mar;53(3):574-82. Epub 2011 Jan 6. PubMed PMID: 21211931.
http://www.ncbi.nlm.nih.gov/pubmed/21211931
Kopsavilkums
All current aortic endografts depend on proximal and distal fixation to prevent migration. However, migration and rupture can occur, particularly in patients with aortic necks that are short or angulated, or both. We present our initial clinical experience with a new sac-anchoring endoprosthesis designed to anchor and seal the device within the aneurysm sac.
The initial worldwide experience using a new endoprosthesis for the treatment of aortic aneurysms (Nellix Endovascular, Palo Alto, Calif) was reviewed. The endoprosthesis consists of dual balloon-expandable endoframes surrounded by polymer-filled endobags designed to obliterate the aneurysm sac and maintain endograft position. Clinical results and follow-up contrast computed tomography (CT) scans at 30 days and 6 and 12 months were reviewed.
The endograft was successfully deployed in 21 patients with infrarenal aortic aneurysms measuring 5.7 ± 0.7 cm (range, 4.3-7.4 cm). Two patients with common iliac aneurysms were treated with sac-anchoring extenders that maintained patency of the internal iliac artery. Infusion of 71 ± 37 mL of polymer (range, 19-158 mL) into the aortic endobags resulted in complete aneurysm exclusion in all patients. Mean implant time was 76 ± 35 minutes, with 33 ± 17 minutes of fluoroscopy time and 180 ± 81 mL of contrast; estimated blood loss was 174 ± 116 mL. One patient died during the postoperative period (30-day mortality, 4.8%), and one died at 10 months from non-device-related causes. During a mean follow-up of 8.7 ± 3.1 months and a median of 6.3 months, there were no late aneurysm- or device-related adverse events and no secondary procedures. CT imaging studies at 6 months and 1 year revealed no increase in aneurysm size, no device migration, and no new endoleaks. One patient had a limited proximal type I endoleak at 30 days that resolved at 60 days and remained sealed. One patient has an ongoing distal type I endoleak near the iliac bifurcation, with no change in aneurysm size at 12 months.
Initial clinical experience with this novel intrasac anchoring prosthesis is promising, with successful aneurysm exclusion and good short-term results. This new device platform has the potential to address the anatomic restrictions and limitations of current endografts. Further studies with a longer follow-up time are needed.
Dzerve VY, Pozdnyakov YM. Exercise capacity in patients with coronary heart disease and peripheralartery disease, receiving long-term mildronate therapy. RUSSIAN JOURNAL OF CARDIOLOGY 2011;1(87):48-55.WOS:000287823900007
http://cardio.medi.ru/66_110107a.htm
https://apps.webofknowledge.com/full_record.do?product=WOS&search_mode=…
Kopsavilkums
The paper presents the results of 3 prospective, randomised, double-blind, placebo-controlled trials of patients with coronary heart disease (CHD) and peripheral artery disease (PAD). The aim was to compare veloergometry parameters and skeletal muscle strength in CAD patients, as well as exercise capacity dynamics in PAD patients, during long-term standard therapy with or without additional administration of mildronate (M).
According to 3- and 12-month results for CAD patients, M groups demonstrated substantial increases in veloergometry exercise duration and maximal workload, as well as skeletal muscle strength, compared to placebo groups. In PAD patients, 24-week M therapy was associated with substantial increase in absolute claudication distance (ACD) during treadmill test, compared to placebo. Long-term M therapy was effective and safe. Positive effects on ACD were observed even one month after the end of M treatment.
Narbute I, Jegere S, Kumsars I, Mintale I, Zakke I, Bumeitere K, Sondore D, Grave A, Erglis A. Are Paclitaxel-Eluting Stents Better than Bare Metal Stents in Unprotected Left Main? Three-Year Clinical and Intravascular Imaging Results From a Randomized Study. Medicina (Kaunas)
http://medicina.kmu.lt/1110/1110-03e.pdf
Kopsavilkums
Background and Objective. Recent publications have demonstrated superior outcomes in unprotected left main patients after paclitaxel-eluting stent (PES) implantation. Long-term data in these patients are limited. The aim of this study was to evaluate if intravascular ultrasound (IVUS)-guided PES implantation is superior to bare metal stent (BMS) implantation in unprotected left main disease after lesion pretreatment with cutting balloon during long-term follow-up.
Material and Methods. Unprotected left main patients were randomized to BMS (n=50) or PES implantation (n=53). All interventions were IVUS-guided and cutting balloon pretreatment before stenting was performed in all patients. All patients were scheduled for 6-month and 3-year follow-up. Subgroups of patients who underwend IVUS and OCT imaging at 3-year follow-up were analyzed. The primary endpoint was the major adverse cardiac events (MACEs) defined as death, Q-wave myocardial infarction, or target lesion revascularization.
Results. Baseline characteristics were similar in both the groups with a mean SYNTAX score of 31.4±14.5 in BMS and 32.6±11.7 in PES patients (P=0.718). At 3 years, MACEs occurred in 18 patients (36.0%) in the BMS and 7 patients (13.2%) in the PES group (P=0.011). By IVUS, percent neointimal volume obstruction at 3 years was reduced from 18.1%±8.7% with BMSs to 10.0%±5.4% with PESs (P<0.001). The total number of uncovered stent struts per OCT image and IVUS image was 0.4±0.8 and 1.2±1.5, respectively (P<0.001).
Conclusions. The current study demonstrated that IVUS-guided PES implantation was superior to BMS implantation after cutting balloon pretreatment in unprotected left main disease at 3 years. If compared with IVUS, OCT was more precise in the assessment of stent endothelization.
Vilnis Dzerve, Dace Matisone, Indulis Kukulis, Iveta Mintale, Edvins Lietuvietis, Dainis Krievins et al. Partial inhibition of fatty acid oxydation increases the exercise tolerance of patients with peripheral arterial disease: the Mildronate Study. Seminars in Cardiovascular Medicine, 2011; 17:3, 1-8.
http://www.seminarsincardiology.com/pdf/SeminarsCVMed-2011-17-3.pdf
Kopsavilkums
The objective of the study was to assess the efficacy and safety of the treatment with mildronate (1 g/day) in combination with standard therapy for the exercise tolerance of patients with peripheral arterial disease (PAD).
Design and Methods: The study was a prospective, randomized, double-blind, placebo controlled phase II study with two treatment groups. The study totally included 62 male and female patients with PAD and intermittent claudication as a limiting factor for physical load (the treadmill test). The follow-up time comprised 33 weeks: a 5-week run-in period plus 24 weeks of randomized therapy followed by a 4-week follow-up period.
Results: The mean value of the change in the absolute claudication distance (ACD) during the treadmill test in themildronate group after 24 weeks of treatment was 231.22±179.02 meters, while the placebo group patients had the mean value of 126.67 ± 120.72 meters. The difference between the treatment groups was significant (p-value = 0.026).
The mean value of the change in the initial claudication distance (ICD) before and after 24 weeks of doubleblind therapy during the treadmill test in the mildronate group was 123.93 ±114.73 meters, while the placebo group patients had the mean value of 50.30 ±62.56 meters. The difference between the treatment groups was significant (p-value = 0.033).
The mean value of the change in the ACD from visit T24 (24 weeks of treatment) till one month after the discontinuation of the treatment (visit PT) during the treadmill test in the mildronate group was 19.68±85.58 meters, while the placebo group patients had the mean value - 31.43 ±79.17 meters. The difference between the treatment groups was significant (p-value = 0.032).
Conclusions: The study confirms the superiority of treatment with mildronate (1 g/day) versus placebo in combination with standard therapy for the improvement of exercise tolerance in patients with PAD. The 4 weeks interruption of the mildronate course without loosing the effect could be acceptable in cases of the long-term use of mildronate.
Logina L, Krievins D, Drevinska K, Auzans R, Timuhins A, Svabe L. Ultrasound velocity in bone after acute disruption of blood circulation. Latvian Journal of Physics and Technical Sciences. 2011.
http://versita.metapress.com/content/x6m116t701118q71/
Kopsavilkums
The reported ultrasonic velocity measurements have been performed using a device in which the transmitter and the detector of sound vibrations are rigidly mounted at a constant distance from each other to avoid statistical errors at measuring the distance travelled by acoustic waves. The accuracy of measurements was thus dependent only on the resolution of the device determined by the frequency of time reference signals, its stability, the travelled distance, and the sound velocity.
The velocities measured in six objects exhibit a common behaviour with time, reaching a maximum between the 9-th and 33-rd hour after complete disruption in the blood supply and remaining higher compared with the initial value at least for 80 h after disruption. The obtained values of sound velocity are consistent with the results found by other authors, while the rise after disruption in the blood supply - with the increase in elasticity of the bone tissue.
Iveta Pudule, Anita Villeruša, Daiga Grīnberga, Biruta Velika, Māris Taube, Daiga Behmane, Vilnis Dzērve, Ritva Prättälä Latvijas iedzīvotāju veselību ietekmējošo paradumu pētijums, 2010 (Health Behaviour among Latvian Adult Population, 2010) Veselības ekonomikas centrs, Rīga, 2011, 32 lpp.
http://vec.gov.lv/lv/petijumi-un-zinojumi/veselibu-ietekmejoso-paradumu…
Kopsavilkums
The FINBALT Health Monitor is a collaborative system for monitoring health behaviour in Estonia, Finland, Latvia and Lithuania. Health behaviour researches enable to gain the information on health attitudes and distribution of health risk factors in the population.
This health behaviour survey has taken place annually in Finland since 1978. Estonia joined the FINBALT project in 1990, Lithuania - in 1994 and Latvia - in 1998. In 2010 it was the seventh time that the FINBALT study was carried out in Latvia.
The research purpose is to collect information about individual health behaviour, to evaluate actual and potential public health problems associated with health behaviour, to investigate demographic and geographic distribution, and to gain accurate evidence-based information for future health promotion and health education programs.
This publication summarizes the results of the FINBALT 2010 survey in Latvia. The information on health-related behaviour: smoking, alcohol consumption, nutrition, physical activity, oral hygiene, and traffic safety among the Latvian adult population aged 15 - 64 is displayed in this publication. Also the data on self-assessed health status and the utilization of health services: frequency of doctor and dentist visits, trends in vaccination, assessment of blood pressure and cholesterol levels are shown.
This publication could be useful to policy makers, government officials, personnel in health and social service organizations at various levels, public health specialists, and health promotion/health education professionals.
