[Comparative efficacy and safety of direct oral anticoagulants in patients with atrial fibrillation and chronic kidney disease].

Aim To compare efficacy and safety of direct oral anticoagulants (DOACs) for prevention of stroke in patients with nonvalvular atrial fibrillation and reduced creatinine clearance.Material and methods Systematic search for literature and indirect comparison of DOACs were performed.Results The indirect comparison included five randomized clinical trials. The DOACs were comparable by the efficacy of preventing stroke and systemic embolism. The safety profiles had differences. Apixaban significantly decreased the relative risk of major bleeding compared to rivaroxaban by 27 % (relative risk (RR) 0.73; 95 % confidence interval (CI): 0.55-0.98). The apixaban advantage was even greater in the group of patients with a creatinine clearance <50 ml/min: RR was reduced by 48 % compared to rivaroxaban (RR=0.52; 95 % CI: 0.32-0.84), by 50 % compared to dabigatran 300 mg/day (RR=0.50; 95 % CI: 0.31-0.81), and by 48 % compared to dabigatran 220 mg/day (RR=0.52; 95 % CI: 0.32-0.85)Conclusion The indirect comparison of DOACs showed that their efficacy was comparable. With respect of safety, apixaban is the preferrable DOAC for patients with atrial fibrillation and creatinine clearance below 50 ml/min.

[Idiopathic hypercalciuria. Diagnosis and treatment].

Most patients with idiopathic hypercalciuria and calcium nephrolithiasis have a family history of the disease. Idiopathic hypercalciuria is a metabolic abnormality with various causes and developmental pathways. The systematic review describes specific mutations associated with idiopathic hypercalciuria and nephrolithiasis. Detection of these mutations may provide a better understanding of the pathogenesis of this heterogeneous disease and personalize patient management depending on the detected polymorphisms. A promising treatment option for a mutation in the vitamin D receptor gene is thiazide diuretics in combination with bisphosphonates. Among bisphosphonates, the drug of choice which has been most strongly supported by research evidence is alendronate.

[The place of novel oral anticoagulants in prevention and treatment of venous thromboembolism]. / Mesto novykh peroral'nykh antikoaguliantov v profilaktike i lechenii venoznykh tromboémbolii

The notion "venous thromboembolism" combines two processes: thrombosis of deep veins and pulmonary artery thromboembolism. The necessity in long-term adequate anticoagulant therapy as the basic treatment of patients with deep vain thrombosis does not give rise to doubts, it should be started prior to instrumental verification of the diagnosis. The past decade was marked by the appearance on the pharmaceutical market of a new oral anticoagulant: selective blocker of the Xa factor of blood coagulation system - rivaroxaban. According to the data of large-scale randomized clinical trials, the efficacy and safety of rivaroxaban are comparable to those of traditional conventional anticoagulant therapy (non-fractionated/low-molecular-weight heparin NFH/LMW + warfarin). Indisputable advantages of new agents are as follows: the lack of the necessity in laboratory monitoring, no interaction with foodstuff, minimal interaction with other drugs, minimal risk for the development of haemorrhage, and simplicity of dosing.

[A method for creating fuzzy neural-network models using the MATLAB package for biomedical applications].

Problems of MATLAB-based simulation of hybrid neural networks for data classification in biomedical applications are considered. The neural-network structure is used as a defuzzifier. Graphic interfaces for constructing fuzzy neural-network models are suggested. Methods for merging models constructed using different MATLAB packages and an algorithm for constructing a fuzzy neural-network model are suggested. The algorithm includes both modules for tuning membership functions of the fuzzy system fuzzifier, and modules for tuning the parameters of the defuzzifier implemented as a two-layer neural-network structure of the perceptron type.