The improvement of the therapy of the metabolic syndrome, obesity, and type 2 diabetes is an important task which may be realized through the co-administration of herbal and synthetic medicines. The tincture and extract obtained from the aerial part of goutweed (Aegopodium podagraria L.) have been shown to possess antidiabetic and organoprotective properties. Goutweed tincture exerts a permissive effect on the action of metformin in dexamethasone-treated diabetic rats. Aim. The objective of this study is to determine the efficacy of the combined use of goutweed tincture and extract with metformin on the model of the primary disorder of the lipid metabolism. Materials and Methods. The model was used that presupposed administration of protamine sulfate to rats (10 mg/kg per day intramuscularly) against the background of atherogenic diet with the additional administration of cholestrol. Goutweed extract and tincture (1 g/kg and 1 ml/kg intragastrically, respectively), metformin (50 mg/kg intragastrically) and their combinations were administered during the whole period of model development. The lipid composition of the liver and blood plasma, as well as the content of glycogen in the liver were studied, and, as this model is accompanied with insulin resistance, glucose tolerance test was carried out. Results. It has been shown that all studied drugs and their combinations normalize the lipid composition of the liver, reducing the content of cholesterol and triglycerides and increasing the level of phospholipids. They do not significantly influence on the lipid spectrum of the blood plasma, tend to elevate the level of liver glycogen, their efficacy does not change in combined use. Goutweed tincture and metformin in combination, but not per se, completely normalize area under glucose curve that is significantly increased in the untreated group, the extract does not change this value. Conclusions. Goutweed extract and tincture normalize the lipid composition of the liver in rats with lipid and carbohydrate metabolism disorders caused by protamine sulfate and atherogenic diet, the tincture also exerts a permissive effect on the action of metformin on glucose metabolism, but not on lipid metabolism. (For citation: Tovchiga OV, Gorbatch TV, Shtrygol’ SYu, et al. The effects of goutweed (Aegopodium podagraria L.) preparations and their combinations with metformin in rats with the disorders of the lipid and carbohydrate metabolism induced by protamine sulphate. Reviews on Clinical Pharmacology and Drug Therapy. 2017;15(2):31-41. doi: 10.17816/RCF15231-41).
Abstract.The aim of study is to evaluate antidepressant-like activity of the new peptidergic neuroprotector acetyl-(D-Lys) -Lys-Arg-Arg-amide, homologous of ACTH 15-18 primary amino acids sequence, that demonstrates nootropic and neuroprotective properties.Using Porsolt swimming test (PST) efficacy of tetrapeptide neuroprotector KK-1 at a single dose of 0.02 mg/kg was investigated on 16 white random bred male rats (body mass equaled 180-220 grams). Imipramine (15 mg/ kg i.p.) was used as a reference drug. Then depression was induced in these rats by reserpine (4 mg/kg, i.p.).The KK-1 (intranasally, i.n.) and imipramine were administered once a day during 3 days until the reserpineinduced depression was reproduced. The indices of rats behavior under the conditions of open-field test (OFT) and PST were evaluated. The influence of both drugs on specific reserpine-induced depressions symptoms (hypothermia and blepharoptosis) was also registered. The results were processed statistically.The tetrapeptide neuroprotector KK-1 reduced immobilization time of rats at PST (statistically significant differences compared with control group), exceeding efficacy of reference drug imipramine. Normalizing of locomotor and exploratory activity in the OFT, decreasing indices of rats helplessness behavior in PST by tetrapeptide neuroprotector KK-1 demonstrates its antagonism with depressive action of reserpine. The tetrapeptide KK-1 showed antidepressant-like action both in intact rats and in rats with the model of reserpineinduced depression. It reduced specific symptoms of depression -hypothermia and blepharoptosis, exceeding the activity of reference drug imipramine.
Objectives: Describe incidence of severe chronic kidney disease (CKD) and comorbidity profiles by patient body mass index (BMI) using real-world claims and electronic health records (EHR) database. Methods: Adults age $18 newly diagnosed with severe CKD (stage 4, 5, and end stage) between 6/30/2007 and 6/3/2017 were identified in the IBM® MarketScan® Explorys® Claims-EHR Data Set, which includes detailed medical and pharmacy claims data and clinical information in patient health records. Incidence of severe CKD were stratified by BMI measured during 1-year prior to CKD diagnosis (index event). The following BMI categories were used (kg/ m 2): Underweight ,18.5, normal weight 18.5 to 24.9, overweight 25 to 29.9, obese 30 to 39.9, morbidly obese $ 40. Comorbid conditions and hemoglobin A1C (HbA1c) level during the 1-year pre-index were stratified by BMI. Patients with evidence of pregnancy or primary cancers were excluded. Results: 7,724 patients were newly diagnosed with severe CKD, with 2% underweight, 22% normal weight, 30% overweight, 36% obese, and 10% morbidly obese (Mean age 71; 52% male). Prevalent of comorbid conditions increasing from underweight to morbidly obese categories were type 2 diabetes (T2DM) from 28% to 77%, dyslipidemia 45% to 68%, hypertension 80% to 92%, and congestive heart failure 38% to 47%. Depression (18-19%), COPD (36-37%), and pain (77-78%) were similar between underweight and morbidly obese categories but higher than normal (16%, 29%, 71%), overweight (13%, 27%, 70%) and obese (14%, 29%, 72%). Among a subset with HbA1c results, the mean HbA1c increased from 6.7 in normal weight to 7.2 in morbidly obese categories. Conclusions: While incidence of severe CKD diagnosis were higher in obese patients, patient BMI categories revealed different comorbidity profiles. Prevalence of T2DB and other metabolic syndrome conditions increased with BMI, while other conditions were highest among patients at the opposite ends of BMI spectrum.
formula. Prescription drug cost and activity trends were analysed at a drug-class (BNF chapter) and regional level. Regions were defined by sustainability and transformation plan (STP) area. Risk-adjustment helped determine what cost we would 'expect' based on each STP's risk profile compared to the English average. Costs were projected over a five-year period under various scenarios, using expected changes in population size and structure published by the NHS. Results: The reduction in expenditure is driven by a combination of lower average costs (3.83% decrease) and lower levels of activity (0.92% decrease). These decreases in total cost are slightly offset by the 1.19% increase in the English population size. The research highlights particular BNF chapters and STP regions that are driving these trends as well as how STP regions' experience compares to the English average on a risk-adjusted basis. The projection model shows that prescription drug costs can be expected to decrease by 3.6% p.a. over the next five years if historical trends persist. Conclusions: The insights provided by this research can help stakeholders with experience analysis and planning by identifying cost and activity drivers on a population risk-adjusted basis as well as having a view of how demand may develop over the projection period.
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