ASSESSMENT OF THE SITUATION OF USE OF BLOOD PRESSURED DRUGS IN THE TREATMENT OF HIGH BLOOD PRESSURE FOR OUTCOME PATIENTS AT NAM DINH PROVINCIAL HOSPITAL IN JANUARY 2021

Hypertension is a disease that seriously affects the health and life expectancy of the community, playing a major etiological role in target organ damage. The selection of antihypertensive drugs to ensure reasonable safety and effectiveness is always a matter of concern of the medical industry. Applying the cross-sectional method on 2,640 patients being examined and treated for hypertension at Nam Dinh general hospital, it was found that 54.67% female patients accounted for the majority. The age of disease in both sexes is over 50 years old with a relatively high frequency of comorbidities. Most of them were prescribed drug combinations in treatment 77,9%. The group of ACE inhibitors + calcium blockers is the most common combination. ACE inhibitors are also the most commonly prescribed drugs in monotherapy. 11,4% of cases had adverse drug interactions, the most dangerous combination is UCMC + Potassium chloride and UCMC + Spironolactone causing hypokalemia. The most common interaction between beta-blockers and calcium blockers increases the antihypertensive effect.

Vitamin D Supplementation Replaced Catheter Ablation in a Patient with Frequent Premature Ventricular Contractions

A high premature ventricular contractions (PVC) burden can disturb the patient’s condition through fatigue during exercise or palpitations. Hence, researchers started to look for treatment options that decrease PVC burden without the side effects of antiarrhythmic drugs, and vitamin D could be a valuable solution and safe alternative to drugs or catheter ablation for high-burden PVCs. We present the case of a 24-year-old patient with high-burden PVC of >25,500/24 hours referred for urgent catheter ablation. Treatment with beta-blockers and calcium blockers did not reduce PVC burden. Under propafenone, there was a slight reduction in the number of PVCs to 21,200/24 hours, therefore the patient was referred for catheter ablation. As there was a vitamin D deficiency of 10.1 ng/mL, an attempt of vitamin D supplementation was done, with increase of vitamin D to 32.1 ng/mL and decrease of PVC burden to 9,600/24 hours. Further dietary supplementation increased 25-OH vitamin D to 50.2 ng/mL and decreased the PVC burden to 119/24 hours. Consequently, catheter ablation was canceled, and the patient remained free of antiarrhythmic drugs.

POS1319 RAYNAUD’S PHENOMENON IN A SINGLE CENTER COHORT OF TURKISH CHILDREN

Background:Raynaud’s phenomenon (RF) is a vasospastic condition characterized by episodic color changes of blanching, cyanosis, and hyperemia of the extremities of the bodyObjectives:We aim to examine the clinical presentation, capillaroscopic findings and disease associations of Raynaud’s phenomenon (RP) in pediatric patientsMethods:We retrospectively enrolled a single-center cohort of 247 consecutive pediatric patients with RP admitted to Umraniye Training and Research Hospital, Pediatric Rheumatology Clinic, Istanbul, Turkey, since 2016. Medical records were analyzed for clinical presentation, disease associations, and physical examination and laboratory findings.Results:We reported 247 patients (152 female, 95 male) with RP. Their mean age at disease onset was 14.5±2.55 years and median age at diagnosis was 15.4± 2.21 years. In patients with secondary RP syndrome (10.9%), the age of complaint was found to be lower than others (p=0.03). Although most patients have affected upper extremity (hand and fingers), lower extremity (toes) involvement was also detected in 50 (20%) patients. In both the patients with primary and secondary RP, main triggering factor was found as cold exposure. Biphasic (53.6%) color changes were more seen in primary RP, although triphasic (51.8%) color changes were more in patients with secondary RP (p=0.00). The presence of antinuclear antibodies and abnormal nailfold capillaries were more seen in patients with secondary RP (28% vs 74% and 35.3% vs 66.7, respectively p=0.00). Digital ulcer was detected 5.2% of patients (mostly secondary). Out of 247, 31 patients were treated with low-dose aspirin, 47 with calcium blockers, 25 with low-dose aspirin and calcium blockers, 16 with iloprost and/or bosentan, while the remaining 140 did not receive any drug.Conclusion:Similar to adults, RP is more common in girls without an underlying disease. In patients with secondary RP, the symptoms. It has been shown that in patients with secondary RP, symptoms begin at a younger age and the ANA positivity and abnormal nailfold capillaries correlate.References:[1]Jones G, et al. Arthritis Rheum 2003;48:3518–352[2]Garner R et al. BMJ Open. 2015; 5(3): e006389[3]Nigrovic PA et al. Pediatrics 2003, 111 (4) 715-721Disclosure of Interests:None declared

THE CURRENT SITUATION OF USING DRUGS FOR HYPERTENSION OUTPATIENTS

Objectives: To assess the current situation of using hypertension drugs for outpatients at the examination department of Hau Nghia Regional General Hospital - Long An. Objects and methods: Study of Cross-sectional description, retrospection, non-intervention on 180 patients who came to examine and treat hypertension at the examination Department, stored on the software of the Hau Nghia Regional General Hospital - Long An. Results: Among the drug groups used to treat hypertension, the group of drugs used the most was calcium channel blockers (58.25%), the lowest was diuretics with 3.88%. The regimens used for patients, the number of regimens using one drug accounted for the largest proportion, accounting for 86.67%. The regimen using 2 drugs accounted for 12.22% and the lowest was the combination regimen of 3 drugs with only 2 patients, accounting for 1.11%. In monotherapy was preferred by the doctor over combination therapy, in which Amlodipine was the most prescribed drug. The number of times of drug use per day of some drugs did not comply with recommendations and drug interactions accounted for a high proportion. Conclusion: The treatment regimen of hypertension was mainly monotherapy with calcium blockers, the most common being Amlodipine. However, the number of drugs used per day of some drugs did not comply with recommendations and drug interactions accounted for a high proportion.

Circulating Galectin-1 and Galectin-3 in Sera From Patients With Systemic Sclerosis: Associations With Clinical Features and Treatment

Systemic Sclerosis (SSc) is a rheumatic disease characterized by fibrosis, microvascular damage and immune dysregulation. Two major subsets, limited cutaneous systemic sclerosis (lcSSc) and diffuse cutaneous systemic sclerosis (dcSSc) can be defined, according to the extent of skin involvement. Increasing evidence indicates a role for galectins in immune and vascular programs, extracellular matrix remodeling and fibrosis, suggesting their possible involvement in SSc. Here, we determined serum levels of galectin (Gal)-1 and Gal-3 in 83 SSc patients (dcSSc n = 17; lcSSc n = 64; ssSSc n = 2), and evaluated their association with clinical manifestations of the disease. Patients with dcSSc showed lower Gal-3 levels, compared to lcSSc (p = 0.003), whereas no considerable difference in Gal-1 levels was detected between groups. Remarkably, higher concentrations of Gal-1 were associated with the presence of telangiectasias (p = 0.015), and higher concentrations Gal-3 were associated with telangiectasias (p = 0.021), diarrhea (p = 0.039) and constipation (p = 0.038). Moreover, lower Gal-3 levels were associated with the presence of tendinous retractions (p = 0.005). Patients receiving calcium blockers (p = 0.048), methotrexate (p = 0.046) or any immunosuppressive treatment (p = 0.044) presented lower concentrations of Gal-3 compared to those not receiving such treatments. The presence of telangiectasia and the type of SSc maintained their statistical association with Gal-3 (β 0.25; p = 0.022 and β 0.26; p = 0.017, respectively) in multiple linear regression models. In conclusion, serum levels of Gal-3 are associated with clinical manifestations of SSc. Among them, the presence of telangiectasias could be explained by the central role of this lectin in the vascularization programs.

Activated Carbon/MoO3: Efficient Catalyst for Green Synthesis of Chromeno[d]pyrimidinediones and Xanthenones

Background: Nanoscale metal oxide catalysts have been extensively employed in organic reactions because they have been found to influence the chemical and physical properties of the bulk material. The chromene (benzopyran) nucleus constitutes the core structure in a major class of many biologically active compounds, and interest in their chemistry consequently continues because of their numerous biological activities. The xanthene (dibenzopyran) derivatives are classified as highly significant compounds which display a number of various bioactive properties. Pyrimidinones have also gained interest due to their remarkable biological utilization such as antiviral, antibacterial, antihypertensive, antitumor and calcium blockers effects. Objective: Our aim in the work presented herein was to prepare activated carbon/MoO3 nanocomposite and explore its role as a green and recyclable catalyst for the synthesis of chromeno[d]pyrimidinediones and xanthenones under ethanol-drop grinding at room temperature. Methods: The activated carbon/MoO3 nanocomposite was prepared successfully via a simple route in which carbonization of gums as new natural precursors was used for the synthesis of activated carbon. This nanocomposite was then effectively used in a reaction of 3,4- methylenedioxyphenol, aromatic aldehydes and active methylene compounds including 1,3-dimethylbarbituric acid and dimedone to synthesize a series of chromeno[d]pyrimidinediones and xanthenones in high yields. The synthesized catalyst was characterized by Fourier transform infrared spectroscopy (FT-IR), Powder x-ray diffractometry (XRD), Scanning electron microscope (SEM), Raman spectroscopy, and also by TGA analysis. Confirmation of the structures of compounds 5(a-g) and 6(a-g) were also established with IR, 1 H NMR and 13C NMR spectroscopic data and also by elemental analyses. Results: A number of 6,8-dimethyl-10-phenyl-6,10-dihydro-7H-[1,3]dioxolo[4΄,5΄:6,7]chromeno[2,3-d]pyrimidine-7,9(8H)-diones and 7,7- dimethyl-10-(4-methylphenyl)-6,7,8,10-tetrahydro-9H-[1,3]dioxolo[4,5-b]xanthen-9-ones were effectively synthesized using activated carbon/MoO3 nanocomposite (0.05 gr) as catalyst under ethanol-drop grinding at room temperature. The desired products were obtained in high yields (93-97%) within short reaction times (15-20 min). Conclusion: This paper investigates the catalytic potential of the synthesized activated carbon/MoO3 nanocomposite for the prepataion of chromeno[d]pyrimidinediones and xanthenones under ethanol-drop grinding procedure. The mildness of the reaction conditions, high yields of products, short reaction times, experimental simplicity, and avoid the use of harmful solvents or reagents makes this procedure preferable for the synthesis of these compounds.

259Higher risk of myocardial infarction in the first year following 5-fluorouracil treatment

Abstract Background 5-fluorouracil (5-FU) is the third most commonly used chemotherapeutic agent in the treatment of solid malignancies across the world. The most common manifestation of cardiotoxicity associated with 5-FU is chest pain, presenting as atypical chest pain, angina on exertion or rest and acute coronary syndromes including myocardial infarction and in worse case even death. Nevertheless, a widespread appreciation of 5-FU related cardiotoxicity including myocardial infarction is poorly understood. Purpose This study aims to examine risk of myocardial infarction in patients treated with 5-FU compared to age- and sex-matched population controls. Methods and results Methods: Individuals treated with 5-FU between 2004 and 2014 in the Danish National Patient Register were identified and risk set matching was used to find background population controls matched on age and sex in a 1:5 ratio. Furthermore, two years follow-up time were added with total 13 years. Neither 5-FU patients nor controls had prior ischemic disease. Aalen-Johansen and Kaplan-Meier estimates were used to report the cumulative incidence of myocardial infarction and all-cause mortality, respectively. A multivariable Shared Frailty Cox regression analysis (adjusted for patient age, sex, hypertension, hypercholesterolemia, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, heart failure and atrial fibrillation as well as selected anti-anginal medications including nitrates, beta- and calcium-blockers) was used to determine the association between 5-FU treatment and the one-year risk of myocardial infarction. Results A total of 9,012 5-FU patients and 45,060 controls formed the study population. Differences in comorbid conditions (diabetes, chronic obstructive pulmonary disease, chronic kidney disease, heart failure and atrial fibrillation) and selected anti-anginal medications (nitrates, beta- and calcium-blockers) were non-significant (all P>0.05). The one-year cumulative incidence of myocardial infarction is significantly higher for 5-FU patients at 0.8% versus 0.6% among population controls (Figure 1A), with a competing risk of death of 25.1% versus 1.2%. The risk diminishes beyond one year and becomes lower for 5-FU patients with time (Figure 1A), along with an increasing all-cause mortality (Figure 1B). The unadjusted and adjusted hazard ratio for the one-year risk of myocardial infarction were 1.38 [95% CI 1.07–1.78] and 1.54 [95% CI 1.19–1.99]. Conclusions Although the one-year risk of myocardial infarction is higher among 5-FU patients compared with population controls, the absolute risk is small and becomes insignificant beyond one year of follow-up.

Analysis of Ca(2+)signaling mechanisms – our experience on the intercellular communication in muscle remodeling

The aim of this study was to evaluate cell diversity by considering how Ca(2+) signaling has been adapted in skeletal muscle cell function. We characterized single C2C12 myoblasts through intracellular Ca(2+) signaling kinetics after exposure to specific drugs and calcium blockers using fast fluorescence microspectrofluorimetry followed by ATP effect analysis, which confirmed the expression of functional purinergic adenosine and P2 receptors. Further, we found that glutamate sensitivity of C2C12 cells was mediated by ionotropic glutamate receptors; on the other hand, most cells were responsive to cyclopiazonic acid, which inhibits the sarco-endoplasmic reticulum Ca(2+)-ATPase pump. These results suggest that C2C12 cells possess functional L- and P/Q-type voltage-operated Ca2+ channels, ryanodine receptors and functional sarcoplasmic reticulum Ca2+ stores (typical for muscle cells), adenosine and P2 purinergic receptors, as well as ionotropic glutamate receptors. The evaluation of intracellular Ca2+ signaling is a promising approach towards a better understanding and control of the physiopathological properties of myogenic cells that could be used as a predictive factor in the selection of optimal cells for scaffold recellularization or for tissue engineered constructs used in stem cell therapy.

Pharmacotherapy Evaluation and Utilization in Coronary Artery Bypass Grafting Patients in Kosovo during the Period 2016-2017

BACKGROUND: Coronary Artery Bypass Grafting (CABG) is realized in patients with critical or advanced disease of coronary arteries. There are different pharmacotherapeutic approaches which are used as management, treatment and preventive therapy in cardiovascular disease or related comorbidities. Performing a successful surgery, pharmacotherapy, and increase of bypass patency rate still remains a serious challenge.AIM: The aim of this study is to analyze the patient characteristics undergoing CABG and eval-uation of their drug utilization rate and daily dosages in the perioperative period.MATERIAL AND METHODS: Data were collected from 102 patients in the period 2016-2017 and detailed therapeutic prescription and dosages, patient characteristics were analyzed before the operation, after the operation and visit after operation in the Clinic of Cardiac surgery-University Clinical Center of Kosovo.RESULTS: Our findings have shown that patients provided to have normal biochemical parameters in the clinic before the operation, and were related to cardiovascular diseases and comorbidities and risk factors with mainly elective intervention. However higher utilization of cardiovascular drugs such as beta blockers, diuretics, anticoagulants, statins and lower calcium blockers, ACEi, ARBs, hydrochlorothiazide, amiodarone were founded. ARBs, beta blockers, statins, nitrates and nadroparin utilization decreased after operation and visit after the operation, whereas amiodarone only in the visit after the operation. Diuretics are increased after the operation which decreases in the visit after the operation. Regarding the daily dosage, only metoprolol was increased in the visit after operation (P < 0.001) and visit after operation (P < 0.05) whereas losartan and furosemide were increased (P < 0.01) and (P < 0.05) respectively.CONCLUSION: The study showed that beta blockers, statins, aspirin, nitrates (before the operation), furosemide and spironolactone are the most utilized drugs. However, we found low utilization rate for ACEi, ARBs, clopidogrel, nadroparin, warfarin, xanthines, amiodarone, calcium blockers. Daily dosages were different compared to before CABG only in metoprolol, losartan, and furosemide.