An analysis of formalized efficacy indicators (increase in the absolute and relative value, odds ratio (OR) etc.) has demonstrated the advantages of cytoflavin. Group combination has increased the statistical power of the meta-analysis. Two models with fixed (Mantel-Haenszel amendment) and random effects were used. All the estimation protocols in different clinical groups of patients with neurologic diseases provided similar results and confirmed the stability of calculated values irrespective of heterogeneity of data arrays. OR of positive outcomes in neuropathologies treated with cytoflavin was 3,02 with χ2 heterogeneity 427,3 and p = 0,000…, I2= 85,7% (82%; 88%).
Кафедра судебной медицины (зав.-д.м.н., проф. А. Е. Мальцев) ФГБОУ ВО Кировский ГМУ Минздрава России, Киров Аннотация: Целью исследования явился анализ самоубийств в Кировской области на рабочих местах. Объем исследований составил 880 анкет катамнеза суицидентов, собранных путем опроса их ближайших родственников. Суициды произошли на территории Кировской области в 2006-2012 годах. Проведенный анализ показал, что ежегодно в Кировской области около 2 % завершенных самоубийств были совершены на рабочих местах. Самоубийства на рабочих местах были отмечены только среди мужчин. Основными факторами риска самоубийств на рабочих местах являются: профессии физического труда, мужской пол, невысокий образовательный уровень, возраст 50-59 лет, время суток с 6 до 12 часов, наличие конфликтов на работе, соматических заболеваний и алкоголизма. Ключевые слова: завершенное самоубийство, факторы риска самоубийств, мотивы совершения самоубийств
The data of experimental and clinical evaluation and the results of pharmacoeconomic analysis of the effects of regulators of energy metabolism attest to their multiple pharmacodynamics during correction of pathological processes in systems differing by their structure, function, and metabolism. Polyorgan energy protection of regulators of energy metabolism improves organism's resistance, accelerates sanogenesis, and reduces the costs per unit of clinically significant effect. Here we discuss the creation of pharmacotherapeutic technologies based on principles of bioenergetic pharmacology. Sciences. Address for correspondence: vkh@pharm.tsu.ru. V. A. Khazanov Efforts of classical pharmacology are traditionally aimed at the search for preparations correcting certain pathogenetic elements and at the development of "pathogenetic schemes" of pharmacotherapy of various diseases. Dysregulation of functions, accumulation of entropy, and development of energy deficiency are considered to be typical pathological processes [5]. Most drugs are xenobiotics; they can draw away considerable energy resources of the organism for their biotransformation and elimination and can disturb the function of cell energyproducing systems. This can complicate treatment and delay sanogenesis.In healthy organism, energy processes are balanced according to demands for optimal functioning of organs and systems. Optimization of utilization of energy resources in the organism and regulation of their supply and distribution in favor of most needing tissues and organsis are a way for natural (not xenobiotic) counteraction of entropy and dysregulation promoting recovery of functions and convalescence. Systemic approach to multidimensional energy protection was realized in the form of pharmacological construction of regulators of energy metabolism (REM) [11][12][13][14]. The idea of a new class of drugs containing low doses of energy substrates is based on the concept on homeostatic role of mitochondria and principles of bioenergetic pharmacology [4,16]. The pathological process can be thus alleviated via correction of functions of cell energy-producing systems under conditions of energy deficiency [16]. Here we present the results of systemic analysis of clinical and pharmacoeconomic efficiency of REM during treatment of some prevalent diseases as a prerequisite for the creation of new medical technologies characterized by high efficiency and low costs of treatment.
MATERIALS AND METHODSSystemic approach to evaluation of the effects of REM was realized though step-by-step clinical and economic analysis of the results of randomized
The authors carried out a systematic review and subsequent meta-analysis of randomized clinical trials evaluating the efficacy of the immunomodulator agent cycloferon as tablets in adults and children with viral respiratory diseases. A total estimate of its clinical efficacy was obtained in terms of compared heterogeneous groups and response variables. The data published in 16 articles were used to calculate the formal parameters of the clinical efficacy of cycloferon (increased absolute and relative benefits, odds ratio (OR); the number of patients needed to be additionally treated with cycloferon to achieve a favorable outcome or to prevent a poor outcome in one patient, etc.). High heterogeneity hampered the unequivocal interpretation of results; however, combining the compared homogeneous groups in the meta-analysis (with adjustments for fixed and random effects) increased the statistical power of the investigation. In children aged 6 to 18 years, the OR for the positive effect of the drug (no new cases after its preventive administration) was 5.3 (95% confidence interval (CI), 4.8-5.9), heterogeneity test, χ = 249.5; p=0.000...; I = 94.8% (95% CI, 92.7-96.3%). This suggested the heterogeneity of clinical trial data and extrapolated this estimate to medical practice. The use of cycloferon in adults to treat acute respiratory viral infection enhanced their chances of enduring the disease in a mild form and avoiding serious complications: the OR for positive outcomes was 9.7 (95% CI, 7.0-13.0), while the effect was more homogeneous than in children (heterogeneity test, χ = 7.4; p=0.061...; I = 59.4% (95% CI, 0-86.5). Thus, the use of cycloferon to treat and prevent acute viral respiratory infections showed a more than 5-fold increase in the probability of avoiding the disease or enduring the latter in a mild form.
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