[Pharmacokinetic features of sildenafil spray in healthy men depending on food intake].

AIM: In order to evaluate the bioequivalence and benefits of a new dosage form of the type 5 phosphodiesterase inhibitor, sildenafil, two open-label studies in healthy male volunteers were carried out. MATERIALS AND METHODS: An open, randomized, crossover study to compare the pharmacokinetics after a single dose of sildenafil at a dosage of 50 mg on an empty stomach in a new spray form (test drug) and in a traditional tablet form (comparison drug) on 44 volunteers (18 to 43 years old) was done. To assess the effect of food intake on pharmacokinetics, an open, non-randomized study was conducted on 6 healthy male volunteers (from 23 to 35 years old) who received sildenafil (50 mg) after a meal in timely fashion: 1) spray, under the tongue, without drinking, 2) spray , in the mouth, drinking water and 3) the tablet form, drinking water. For pharmacokinetic analysis, blood was analyzed for 24 hours. Plasma concentration of sildenafil was determined by high performance liquid chromatography with tandem mass spectrometric detection (HPLC/TM/SD). The main parameters were the rate (maximum concentration; Cmax) and the degree of absorption (area under the pharmacokinetic curve "concentration-time" during the observation period; AUC0-t) after a single dose of drugs. In addition, the pharmacokinetic profiles of the bioavailability of sildenafil and its active metabolite, N-desmethyl sildenafil, as well as the safety of the different dosage forms, were evaluated. RESULTS: When comparing taking drugs on an empty stomach, the 90% confidence intervals (CI) of the ratios of the mean Cmax and AUC0-t values of sildenafil were 82-106% and 82-101%, respectively. An earlier achievement of the maximum concentration of sildenafil was detected when taking the test drug compared with the standard form (51 and 62 minutes, respectively, Z-value=-2.25, p-value=0.0244). In addition, it was shown that when taking Viagra after a meal, the determination of sildenafil in plasma was delayed (after 30 minutes) compared to the tested drugs (after 10 minutes), however, significant differences in Tmax between the dosage forms were not seen. In two studies, most adverse events were mild to moderate and resolved uneventfully. DISCUSSION: The bioavailability of the new dosage form, the sildenafil spray, is equivalent to the traditional form, however, it has an advantage in terms of onset of action. For example, when taking a spray, an earlier achievement of the maximum concentration of sildenafil and an earlier detection of sildenafil in plasma are shown compared to the traditional tablet form. CONCLUSIONS: Our results suggest that the new dosage form of sildenafil is a reliable alternative therapeutic option for the treatment of erectile dysfunction.

Long-term outcomes of ruxolitinib therapy in steroid-refractory graft-versus-host disease in children and adults.

Acute and chronic steroid-refractory graft-versus-host disease (srGVHD) is a life-threatening complication of allogeneic stem cell transplantation. There are a number of reports on case series describing efficacy of ruxolitinib in both acute and chronic srGVHD. We conducted a prospective study (NCT02997280) in 75 patients with srGVHD (32 acute, 43 chronic, 41 adults, and 34 children). Patients with chronic GVHD had severe disease in 83% of cases, and acute GVHD patients had grade III-IV disease in 66% of cases. The overall response rate (ORR) was 75% (95% CI 57-89%) in acute GVHD and 81% (95% CI 67-92%) in chronic. Overall survival was 59% (95% CI 49-74%) in acute group and 85% (95% CI 70-93%). The major risk factors for lower survival were grade III-IV gastrointestinal involvement (29% vs 93%, p = 0.0001) in acute form and high disease risk score in chronic (65% vs 90%, p = 0.038). Toxicity was predominantly hematologic with 79% and 44% of grade III-IV neutropenia in acute and chronic groups, respectively. There was no difference between adults and children in terms of ORR (p = 0.31, p = 0.35), survival (p = 0.44, p = 0.12) and toxicity (p > 0.93). The study demonstrated that ruxolitinib is an effective option in acute and chronic srGVHD and can be used both in adults and children.

[THE CHROMATOGRAPHY-MASS SPECTROMETRY ANALYSIS OF MICROBIAL FATTY ACIDS IN HUMAN BIOLOGICAL FLUIDS AND THEIR CLINICAL SIGNIFICANCE].

The technique of mass-spectrometric microbial markers is known for almost 20 years. The technique is described in a number of research publications, dissertations and methodological literature. It passed the registration in Roszdravnadzor and is permitted for implementation as a new medical technology in medical institutions on the territory of the Russian Federation ("The evaluation of microecological human status using technique of mass-spectrometry" license FS No 2010/038 of 24.02.2010). The technique of mass-spectrometric microbial markers began to be developed as instrument of clinical routine analysis and monitoring of microecological status, infection and disbiosises in clinical and out-patient practice. The description of technology of mass- spectrometric microbial markers in this aspect requires different than before approach to introduction of clinical laboratory assistants and physicians into technique application. The substantiation given concerning species specificity of composition of fatty acids and (fatty) aldehydes of cellular wall of microorganisms as a basis of their species differentiation in pure culture. The choice is explained concerning molecular markers for their detection in blood and other clinical material with the purpose of further reconstruction of composition of human microbial cenosis (microecology) on blood or calculation of composition of mixed infection in organs om samples of inflammation focus--urine, liquor, phlegm, exudate, drainage, and similar samples containing chemical information about microbes.

[Mechanisms of damage of internal ear capsules labyrinths at head injury, caused by non-lethal kinetic weapon].

Structural, physical, chemical and micromechanical properties capsules labyrinths of an internal ear are studied at influence of the shock wave caused by wound of a head by not lethal kinetic weapon. It is established, that under the influence of a shock wave in bone plates capsules labyrinths processes remodeling, and accompanied osteolysis amplify. Hydroxyapatites capsules labyrinths tests polymorphic phase transitions and depending on an initial condition is exposed amorphizationor increases the crystallinity. As a result of change of micromechanical properties in capsules labyrinths there are cracks, ruptures matrix and bone cavities.

Involvement of dopaminergic processes in the striatum during the effects of corticoliberin on the behavior of active and passive rats.

The effects of intranasal corticoliberin on behavior in the open field test were studied in rats with active and passive behavioral strategies (lines KHA and KLA); levels of dopamine and noradrenaline and their metabolites were measured in the striatum and hypothalamus. In KLA rats, administration of the neurohormone led to increases in motor and investigative activity, while decreases were seen in KHA rats. There were no interline differences in catecholamine levels in the hypothalamus, while dopamine levels in the KLA striatum nearly doubled and metabolite levels (DOPAC, HVA) were significantly lower than in KHA rats. Corticoliberin increased dopamine and noradrenaline levels in the hypothalamus of both rat lines, with significant decreases in the striatum. This decrease was more marked in KLA rats, probably due to the faster metabolism of transmitters in the presence of neurohormones, as indicated by the increase in metabolite levels in this structure.

[Dopaminergic processes in the striatum mediating corticoliberin effect on behavior of active and passive rats]. / Uchastie dofaminergicheskikh protsessov v striatume v deistvii kortikoliberina na povedenie aktivnykh i passivnykh krys.

The action of intranasal corticotropin-releasing hormone (CRH) administration on open field behavior and striatal and hypothalamic levels of dopamine, noradrenaline and their metabolites has been studied in rats with different behavior strategies (KHA and KLA strains). In KLA rats, CRH administration resulted in increased locomotor and exploratory activity, while KHA rats demonstrated decreased that. The analysis of catecholamine levels did not detect any strain differences in hypothalamus, but in striatum the dopamine levels have been twice higher, while the metabolite levels (DOPAC and HVA) were significantly lower in KLA rats as compared to KHA rats. The CRH administration led to increased dopamine and noradrenaline levels in hypothalamus and decreased those in striatum in rats of both strains, but in KLA the decrease was more evident. It is probably a result of intensified mediator turnover induced by the neurohormone in KLA rats, as supported by a fact of increased dopamine metabolite levels in this structure.

[The study of some mechanisms of injurious effects of low-frequency noises]. / Issledovanie nekotorykh mekhanizmov povrezhdaiushchikh éffektov nizkochastotnykh shumov.

Low-frequency noise has been shown to cause certain functional changes in the organism of laboratory animals that manifest in changes of the state of the regulatory systems and metabolic disturbances at cellular and subcellular levels. The obtained data support the hypothesis of the mechanism of injurious effect of this physical factor including two basically correlated ways, i.e. the central mechanism associated with overexcitation of the hypotalamohypophysis-adrenal system and mediating the homeostatic parameters of the body, and the local one which is determined by a direct effect of low-frequency noise on highly organized structure of membraneous and genetic apparatus of cells.

[Clinical and laboratory grounds for using solcoseryl in high-risk patients]. / Kliniko-laboratornoe obosnovanie ispol'zovaniia solkoserila u bol'nykh vysokogo riska.

In 56 patients aged from 58 to 82 years with the III and IV degrees of risk operated upon for malignant tumors of organs of the thoracic and abdominal organs Solcoseryl was included in the complex of anesthesia measures. It was given intravenously or as inhalation in dosage of 1000 mg. It was found that using Solcoseryl considerably reduced the amount of postoperative complications in high risk patients. It led to lower level of lipid peroxidation and activation of the antioxidant system and thus may be considered as an important component of therapy at the intra- and postoperative periods.