#76
|
||||
|
||||
FAST-Mag (ââåäåíèå ìàãíåçèè â ïåðâûå 2 ÷ ïîñëå èíñóëüòà) òðèàë åùå íå çàêîí÷åí, ìàãíåçèåâûå ýíòóçèàñòû ãîâîðÿò, ÷òî îíà ëó÷øå áóäåò ïîìîãàòü îäíîâðåìåííî ñ ãèïîòåðìèåé:
Stroke. 2009 Jun;40(6):2236-40. In search of clinical neuroprotection after brain ischemia: the case for mild hypothermia (35 degrees C) and magnesium. Meloni BP, Campbell K, Zhu H, Knuckey NW. Òàê ÷òî ìíîãî âîäû (âðåìåíè) óòå÷åò, ïîêà îïðåäåëÿòñÿ ðàáîòàåò ìàãíèé ïðè èíñóëüòå èëè íåò...
__________________
Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#77
|
|||
|
|||
Öèòàòà:
|
#78
|
|||
|
|||
Ãèíêî Áèëîáå òî æå íå íîîòðîï (ñ ñîæàëåíèåì).
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#79
|
|||
|
|||
Óâàæàåìû Êîíñòàíòèí Ïàíêîâ, ñîãëàñíî ïðèâåä¸ííûõ âàìè äàííûõ, ýôôåêò íåéðîïðîòåêòîðîâ ëèáî îòñóòñòâóåò, ëèáî ñîìíèòåëåí. Ñòîèìîñòü áîëüøèíñòâà èç íèõ âåñüìà âûñîêà. Ó÷èòûâàÿ ñêàçàííîå, õîòåë-áû óñëûøàòü âàøå ìíåíèå ïî-ïîâîäó: ïðèìåíÿòü ïðè ÎÍÌÊ èëè íåò?
Ñ óâàæåíèåì, Âèòàëèé. |
#80
|
|||
|
|||
 îòíîøåíèè êàðäèîìàãíèëà-ðàññòàâèì òî÷êè-2 ñîåäèíåíèÿ(àñïèðèí+îêñèä ìàãíèÿ,êîòîðûé ñîâåðøåííî ïðàâèëüíî-àíòàöèä). Òàê îñíîâíîå äåéñòâóþùåå-íå îêñèä ìàãíèÿ, à àñïèðèí. Ïðîòèâ àñïèðèíà ó Âàñ æå âîçðàæåíèé íåò?È â öåëÿõ ïðîôèëàêòèêè è â öåëÿõ ëå÷åíèÿ èøåìè÷åñêîãî èíñóëüòà. Ïî îêñèäó-îí ïðåäíàçíà÷åí äëÿ çàùèòû ñëèçèñòîé æåëóäêà, ò.å. äëÿ âûðàáîòêè ÏÃÅ2, êîãäà àñïèðèí âñîñàâøèñü â êðîâîòîê-âîçìîæíî äåéñòâèå íà ñëèçèñòóþ, òî òàì áëàãîäàðÿ àíòàöèäó-óæå åñòü ÏÃÅ2. Òàê æå õîðîøî ÷òî àñïèðèí(êàê îáûêíîâåííûé àñïèðèí)-ìèíóåò ïå÷åíü, èíà÷å áû êàê êèøå÷íîðàñòâîðèìûå òåðÿë îïðåäåëåííûé ïðîöåíò ýôôåêòèâíîñòè ïðè äåàöèëèîâàíèè â ïå÷åíè.
|
#81
|
|||
|
|||
Ýòî ê ñîîáùåíèþ 14.11.2006, 23:07
DocDen |
#82
|
||||
|
||||
Öèòàòà:
Aspirin is rapidly absorbed in the stomach and upper intestine. Peak plasma levels occur 30 to 40 min after aspirin ingestion, and inhibition of platelet function is evident by 1 h. In contrast, it can take up to 3 to 4 h to reach peak plasma levels after administration of enteric-coated aspirin. If only enteric-coated tablets are available, and a rapid effect is required, the tablets should be chewed. The oral bioavailability of regular aspirin tablets is approximately 40 to 50% over a wide range of doses. A considerably lower bioavailability has been reported for enteric-coated tablets and sustained-release, microencapsulated preparations. Lower bioavailability of some enteric-coated preparations and poor absorption from the higher pH environment of the small intestine may result in inadequate platelet inhibition, particularly in heavier subjects... The plasma concentration of aspirin decays with a half-life of 15 to 20 min. Despite the rapid clearance of aspirin from the circulation, the platelet-inhibitory effect lasts for the life span of the platelet because aspirin irreversibly inactivates platelet COX-1. Aspirin also acetylates the enzyme in megakaryocytes before new platelets are released into the circulation. The mean life span of human platelets is approximately 8 to 10 days. Therefore, about 10 to 12% of circulating platelets are replaced every 24 h. --- Antiplatelet Drugs//American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
__________________
Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#83
|
|||
|
|||
Ñïàñèáî çà ññûëêó, â îòíîøåíèè èíàêòèâàöèè èìåííî â ïå÷åíè îáû÷íîãî àñïèðèíà âñå òàêè â ññûëêå íå íàøåë(ïåðåâîä?), à âòî òî ÷òî õîòåëîñü ïîä÷åðêíóòü ðàçíèöó ìåæäó îáû÷íûì à. è êèøå÷íîðàñòâîðèìûì- òî ÷òî òó÷íûì ëþäÿì, îáû÷íûå äîçû ê.à. ìîãóò áûòü íåýôôåêòèâíûìè(îá ýòîì ãîâîðèòñÿ â ññûëêå)-òî åñòü åñëè èì ïðîïèñûâàþò Ê.À. òî äîçó íàäî óâåëè÷èâàòü-òî åñòü â îäèíàêîâîé äîçå îáû÷íûé à.(è êàðäèîìàãíèë) áîëåå ýôôåêòèâíû ÷åì Ê.À. Èëè ÿ íåïðàâ?
|
#84
|
||||
|
||||
The majority of platelet COX-1 acetylation may occur presystemically as platelets pass through gut capillaries, before the hydrolyses of aspirin to salicylate in the portal circulation...
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
__________________
Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#85
|
||||
|
||||
Ïðåáûâàþ ïðîñòî â íåäîóìåíèè ïîñëå ïðî÷èòàííîãî! Çà÷åì æå íàñ âî âðåìÿ ó÷¸áû êàê â èíñòèòóòå òàê è èíòåðíàòóðå ó÷èëè ïðèìåíÿòü ýòè ïðåïàðàòû, óæàñ, òîëüêî çðÿ çàáèâàëè ãîëîâó, ëó÷øå áû ó÷èëè ïðèíöèïàì äîê.ìåäèöèíû!
Õîðîøî ÷òî ÿ íàøëà âàø ñàéò âíà÷àëå ñâîåé âðà÷åáíîé äåÿòåëüíîñòè è åù¸ íå ìíîãèì óñïåëà íàçíà÷èòü ýòè ïðåïàðàòû (à ñðåäè ïàöèåíòîâ áûëè è ðîäñòâåííèêè è äàæå 3-õ ìåñ. ñûí )! Òåïåðü äåéñòâèòåëüíî òðóäíî áóäåò ïåðåóáåäèòü êàê "óìíûõ" ïàöèåíòîâ òàê è çàêîðåíåëûõ íåâðîëîãîâ â íåýôôåêòèâíîñòè "ïðåïàðàòîâ óëó÷øàþùèõ ïèòàíèå ãîë.ìîçãà". Ïîëó÷àåòñÿ åñëè è áûëî ëó÷øå ïàöèåíòàì ïîñëå òàêîãî ëå÷åíèÿ, òàê ýòî ëèáî ïëàöåáî ëèáî ñàìî âñ¸ âîññòàíîâèëîñü? È ëó÷øå ìåäèêàìåíòîçíîãî , õîòÿ áû â óñëîâèÿõ ïîëèêëèíèêè , íè÷åãî íå íàçíà÷àòü? |
#86
|
|||
|
|||
Ïåðåóáåäèòü âîîáùå íå ïðåäñòàâëÿåòñÿ âîçìîæíûì,îñîáåííî ëüãîòíèêîâ,êîòîðûå òðåáóþò ïðåïàðàòû ïîòîìó,÷òî èì "ïëîæåíî" âûïèñûâàòü ,ò.ê. âàì â ïîëèêëèíèêó çà íàñ êàæäûé ìåñÿö äåíüãè ïåðå÷èñëÿþò è âîîáùå îò âèíïîöåòèíà ìû âñå äóìàåì ëó÷øå,ãîëîâà íå êðóæèòñÿ è ñïèòñÿ õîðîøî,à ïèêàìèëîí æèçíü ïðîäëåâàåò ,à åñëè âû äîêòîð ýòîãî íå çíàåòå è íå âûïèøèòå,òî ìû íà âàñ æàëîáó íàïèøåì â äåïàðòàìåíò".Òàê ÷òî è íå ïûòàéòåñü ïåðåóáåäèòü è ïîëó÷åííûå çíàíèÿ è ïðèîáðåò¸ííûé îïûò èñïîëüçóéòå äëÿ ñåáÿ ëè÷íî è ñâîèõ ðîäíûõ è áëèçêèõ
|
#87
|
|||
|
|||
Êîìó íà Ðóñè æèòü õîðîøî.. Ãîðå îò óìà.. Íî÷íîé Äîçîð.. - ÷òî íîâîãî?
Öèòàòà:
Çà äîëãèå ãîäû êëèíè÷åñêîé ðàáîòû - ìíîãîå â ëå÷åíèå ìîäèôèöèðóåòñÿ è ïðèáëèæàåòñÿ ê ÅÂÌ, ïðè ýòîì óñëîâíî ÷àñòü ëå÷åíèÿ ïðåäïîëîãàåòñÿ êàê "ïëàöåáî-òåðàïèÿ", êîãäà íåëüçÿ íå íàçíà÷èòü. Çíàíèÿ îñíîâàííûå íà ìèðîâîì îïûòå è äîêàçàòåëüíûõ ìåòîäàõ áåñöåííû äëÿ ìîëîäîãî âðà÷à, êîòîðîìó ïðîùå îðèåíòèðîâàòüñÿ âî âñåé èíôîðìàöèè. Öèòàòà:
Íåëüçÿ çàáûâàòü î êîìïëåêñå ïðîáëåì ñî çäîðîâüåì ó ïàöèåíòà, è âìåñòî "çàäóìûâàíèÿ" ïðèìåíèòü ïðåïàðàòû, êîòîðûå íå äàäóò ãàðàíòèðîâàííûé ïîëîæèòåëüíûé ýôôåêò, çàòðàòèòü ýòî âðåìÿ íà áåñåäó î íåîáõîäèìîñòè ïðåêðàùåíèÿ êóðåíèÿ, ñòàáèëèçàöèè ÀÄ, ïîäáîðå ïðè íåîáõîäèìîñòè àíòèàãðåãàíòîâ è ò.ä. Äîïîëíèòåëüíî íåâåðíî ïðèìåíåíèå "ïðåïàðàòîâ, ñ íåäîêàçàííîé ýôôåêòèâíîñòüþ" â òåõ ñëó÷àÿõ, êîãäà ýòî ïðèíîñèò áîëü è íåãàòèâ îò ëå÷åíèÿ ó äåòåé (âàðâàðñòâî ýòî), èëè îòòÿãèâàåò íà ñåáÿ ôèíàíñû, êîòîðûå íåîáõîäèìû, íà äîêàçàííî ýôôåêòèâíûå ìåòîäû. |
#88
|
|||
|
|||
Âû ãîâîðèòå òîëüêî ÀÑÊ. Ãëàâíîå íå íàâðåäè, äà è ýôôåêò ïëàöåáî íå òàê óæ è ïëîõ, áåç íîîòðîïà è ýòîãî íå áóäåò. È Â/ - èíà÷å íå ïðîõîäèò, ìåæäó ñëîâàìè è äåéñòâèÿìè ïðîïàñòü.
|
#89
|
|||
|
|||
à ÷òî ó íàñ ñ çàÿâëåííûì èñïûòàíèåì 3 ôàçû ïî ôåíîòðîïèëó 3 ãîäà íàçàä?
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] èçâèíÿþñü çà ïðåäûäóùåå âûñêàçûâàíèå, îò áåçûñõîäíîñòè, ÊÒ, ÌÐÒ - íåò âîçìîæíîñòè, òðîìáîëèçèñ òåì áîëåå |
#90
|
||||
|
||||
" íàñòîÿùåå âðåìÿ îòñóòñòâóþò ðåêîìåíäàöèè ïî ëå÷åíèþ îñòðîãî èøåìè÷åñêîãî èíñóëüòà ïðè ïîìîùè íåéðîïðîòåêòèâíûõ ïðåïàðàòîâ (Êëàññ I, óðîâåíü A).
Íåéðîïðîòåêöèÿ Íåéðîïðîòåêòèâíîé ïðîãðàììû, ïðîäåìîíñòðèðîâàâøåé äîñòîâåðíîå óëó÷øåíèå èñõîäà çàáîëåâàíèÿ, íå ñóùåñòâóåò. Ðåçóëüòàòû íåäàâíèõ èññëåäîâàíèé RCTs ýôôåêòèâíîñòè ëîâóøåê ñâîáîäíûõ ðàäèêàëîâ [432] è ñóëüôàòà ìàãíåçèè [433] îêàçàëèñü íåãàòèâíûìè. Ïðîäîëæàåòñÿ III ôàçà ðàíäîìèçèðîâàííîãî ïëàöåáî-êîíòðîëèðóåìîãî èññëåäîâàíèÿ àíòèîêñèäàíòíîé òåðàïèè ñ èñïîëüçîâàíèåì ìî÷åâîé êèñëîòû, íàçíà÷àåìîé ïîñëå ñèñòåìíîãî òðîìáîëèçèñà rtPA. II ôàçà èñïûòàíèÿ ïîêàçàëà áåçîïàñíîñòü òåðàïèè [434]. Ìåòà-àíàëèç ðåçóëüòàòîâ èññëåäîâàíèé âûÿâèë óìåðåííóþ ýôôåêòèâíîñòü öèòèêîëèíà [435]; êëèíè÷åñêèå èññëåäîâàíèÿ ýôôåêòèâíîñòè ýòîãî ïðåïàðàòà ïðîäîëæàþòñÿ" [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |