Team neurons

Neuroscientist Dr. Doping talks aboutsensory neurons, and modeling studies of invertebrate cells. How to develop the study of decision-making centers in the nervous system? What is the function of modeling cell? And what are the research in this field to date?

Any animal, human currently implemented, only one form of behavior. You can not simultaneously squeeze hands and straighten. This is contrary to the whole structure of the nervous system. It was believed that somewhere there is always a decision.

We strongly advice to buy Semax, Cogitum and Phenotropil.

Not all forms of behavior, but for many, especially in cases where the behavior is implemented according to the principle "all or nothing", there are either one or a few large nerve cells, which activity is run - launches the form of behavior. For example, fish have two symmetrical mautneric giant cells, which run along the entire nervous system. And in response to any stimulus sharp fish do not float away immediately, but first moves with the trajectory of a predator attack.

Modulatory neurons at different levels a lot. They define virtually everything that happens in the nervous system. And more importantly - what will happen. Such cells, receiving solutions are very well documented in animals with a small number of neurons. And much worse, of course, describes where billions of neurons. Nevertheless it is known whole classes of cells that either make decisions or discharged before something accomplished.

Modification of Memory

Neuroscientist Dr. Doping talks about the memory storage, prion-like proteins and activation of nerve cells in the memories. What are the molecular mechanisms of memory storage? What memory processes run prion-like proteins? Which cells are capable of changing our memory?

Memory - is a phenomenon that accompanies each one of us our whole life. To be able to change it - this is very important. Molecular mechanisms of memory storage for today is virtually unknown. There is a mystery, and it lies in the fact that it is well known that memory depends on proteins. Proteins are formed in the body in each cell perform its function and, in fact die. Time protein life - 2-3 days, so the question of how memory is stored for years with the help of agents who live for 2-3 days - it was a pretty sensitive issue. To improve memory and brain function, I would recommend Phenotropil, Semax, Cogitum.

Today we know that the memory associated with a change in the effectiveness of communication between individual nerve cells. It can be reduced (if we're talking about the mechanism) to the connection between the two cells. If this connection is permanently changed, this change must be preserved. How to keep it? One way is prion-like proteins. These proteins, according to recent studies, there really is in neuronal contacts, but do not play a decisive role. And most importantly, they do not control the process of change in the efficiency of communication. Therefore, this mechanism exists, but today it is one of the smallest mechanisms involved in memory.

When we remember something, activate only those nerve cells that are associated with that memory. They are in their relationships have the opportunity to change. There is formed nitrogen oxide, he eats the protein molecule, and if their new location not formed, the memory may disappear. If formed, the memory is only getting better. Selectivity is achieved by the fact that we remember specific events. If we recall the vague, nothing will happen. If we remember something very concrete, then we have a chance to change the memory.

The criterion of death

Philosopher Dr. Doping tells about "doctor-patient" model of brain death and modern society. When there is a problem in ascertaining the death of medicine? How to set the criteria for death, do not contradict the outlook of man? And it passed diagnosing death?

For the medicine for a long time is not worth the trouble detection of human death as the criterion of life was breathing, heart rate, that is the life of the inspired soul. On dying for a long time was a priest, and physicians from the time of Hippocrates tried to quickly get away from the bedside of the dying. All medicine was aimed at recognition criteria close death. A famous example, when the Hippocratic books were written changes in a person's facial features before his death, the so-called Hippocratic face.

Before medicine explicitly raised the question of the search criteria of death, which would be, on the one hand, the objective, that is, relying on the data of modern science; On the other hand, it would have been practically applicable because, unfortunately, we must note the death of physicians in different conditions. And the biggest problem - the medicine needed to find a criterion of death, which would be the most controversial with respect to the human world. For example, in the main body of the Orthodox Church - the heart, so the lack of heartbeat is a criterion accepted by religious people. (doctors in Russia use Meldonium but for heart support).

The culture of modern civilization - a culture of hedonistic type, when all the talk about the death of a certain degree of taboo when the idea becomes a pleasure getting here and now, and the idea that after death his body can dispose of. For example, decide whether you want to be a donor after death or not. The idea that you can make a decision on the refusal of some life-supporting treatment, if the person they are unacceptable to you. These ideas are difficult to understand in the society, so today the task of medicine is not only to follow a strict scientific criteria, but also to tailor their development prospects with some trends in the development of society.

Why are people trying to change their bodies?

Philosopher Dr. Doping talks about the desire to assert oneself, follow the fashion, and other causes of changes in appearance. The human body - is not just a biological shell of our consciousness. It has a socio-cultural meanings and performs certain cultural functions. It is connected with them the human desire to change themselves. Drinking one's own body and its assessment ("excellent", "flabby", "inappropriate" and so on) and the way of using the body to achieve the desired objectives related to social processes and cultural trends.

So a person wants to change the body:

Not to be like the animals

Every once in my life had to deal with comparing himself with animals, "feet like an elephant", "face like a pig," "cunning as a fox" and so on. Modern science, defending evolutionary relationship of Homo sapiens with animals, could not overcome the age-old tradition of distinction (even opposing) of humans and animals. Even Darwin described the tribes, who painted the teeth so as not to look like a dog, and with the same purpose, the canines beat yourself.

To be like the biological ancestors

Biological laws continue to operate on modern populations. Physical attractiveness of males from generation to generation has been linked, for example, with a mild scalp as a result of high levels of testosterone. The coat on the chest in men, transplanted plastic surgeons, restores immutable biological signs of good health and high sexual activity.

To be like the others

Man wants to be among their own kind. Body modification (piercings, tattoos, scarification) were anciently differentiating meaning designated individual belonging to a particular group, and at the same time distancing of this group from others. Those activities that alter the body - fitness clubs, yoga - collect enthusiastic, with similar lifestyles of people. Lots of people use drugs, such as Meldonium to be like Maria Sharapova or Efimova.

Not to be like the others

Man wants to stand out among the other individual characteristics. Body change can be for the human manifestation of the rebellion, a way to leave a memory for years to capture the personal trials and emotions. Congenital physical defects or trauma can be overcome by acquired capabilities of modern medicine. If the tattoo covers the scar, then simultaneously with the aesthetic effect it becomes the symbolic and healing through the erasure of the past scars.

In order to assert oneself

Antiquity cultivated the care of the body through exercises, the Middle Ages called on to drain the body for the triumph of the soul. When a person changes his body (much thinner, pumps up the muscles, changes under the knife of a plastic surgeon), he shows the attitude of the body as property, demonstrates his power over the body, its ability to manage the corporeality. The body, subjected to disciplinary limitations (eg, through many years of training), yells about how strong the will of the owner of the body. Medicalized, changed the knife of the plastic surgeon's body becomes a demonstration of the financial status of the owner.

Because thinking about the future

The desire to stay young and beautiful future determines the need for a taste of "Rejuvenating apple", helpfully served the progress of biomedicine. Modern society, focused on hedonism as a way of life, encourages living without discomfort and pain in different ways to maintain physical well-being, not to let natural processes take precedence over society and the capabilities of a single person.

Because your body is always changing, it was fashionable

The progress of civilization has changed the only ways to achieve the objectives: in the XIX century, provided a tight wasp waist corset, in the XXI century - surgery to remove the ribs. Globalization has given the global nature of fashion trends: in modern Japan in vogue surgery, providing client the dimples while smiling.

Because it wants to overcome fear, to experience new sensations

Modern man has appeared in techno-ized world, world, which made it possible to create cybernated body with implanted sensors, sensors, improved technical counterparts authorities. Change the body - it is going beyond the body's natural possibilities to overcome the fear of technology, trying to master it, get experience in an extended, compared with natural boundaries, the range.

Because a human being is sick

In an effort to change your body a number of people becomes the norm limits. In medicine, describes the behavior depending on the severity, often risky practice, from plastic surgery. Dysmorphophobia narcissism and, unfortunately, not uncommon. Care for your body turns into an obsessive desire to put the body on display.

To earn money and fame

The stars of pop culture, seeking to maintain faith in the fairy-tale of his life, striving for the unattainable body ideal. Actresses, models, whose profession is highly dependent on the exterior, creating the fashion for body changes and at the same time becoming its victims. Managed (or failed) plastic becomes news about it. Strange images freaks puzzling and simultaneously open their way to TV screens and magazine pages.

The daily life of a person depends on the state of his body, from the physical capacity and physical parameters. Motives body improvements can be the exact opposite, modern biomedicine equips human new features to meet the desire to improve your body.

Man in a medical experiment

Philosopher Dr. Doping on the legal regulation of participation in biomedical experiments, the Nuremberg Code and the trials of Nazi doctors.

Biomedical experiments deal with the most expensive and indispensable from the fact that there is a person - a human life and health. Natural-scientific experiment as the main method of knowledge was considered ethically neutral in modern times. But with the development of knowledge about human corporeality, with the development of biomedical more and more people become participants in biomedical experiments which have, as a rule, intended to obtain knowledge that can be applied not only for the treatment of the individual patient, but also for the good of mankind in general , the benefits associated with the progress of biomedicine.

The need for the bioethical and regulatory experimentation drew attention after the Second World War, when as part of the Nuremberg trials became known facts about the inhuman experiments that Nazi doctors conducted in the concentration camps of prisoners, including women and children.

Humanity is faced with the fact that at the time of the Nuremberg trials, there was neither national nor supranational legal acts that would regulate the medical experiments. In Nazi doctors, who have been in the dock, were enough qualified lawyers who argued that the experiments was an attempt to extract at least some benefit in the form of knowledge of the evil that did not depend on doctors. Of course, if we compare these arguments with the undeniable damage that was caused, until the killing of a large number of people (according to official data, it is more than 275 thousand dead as a result of the experiments), strongly faced with the task to implement the regulation of experiments.

The first international instrument of this kind was the so-called Nuremberg Code, the main provisions of which are reducible to a few points. First, it is absolutely necessary condition for the experiments, which was justified in the Nuremberg Code - a voluntary consent of the subject. That such consent is not obtained in the experiments of Nazi doctors. Next, the Nuremberg Code declared that experiments on human beings may only be carried out after the pre-conducted animal experiments. Experiments can be performed only on those issues that are important for humanity. The experiments should not be performed in cases where it is possible to study natural processes, such as if the disease is common in naturally human populations.

Next, the Nuremberg Code has demanded from the organizers of the experiment is required to inform the potential participants about the nature of the experiment, the experimental procedures and the manipulation of the possible risks, adverse consequences. The experimenter should monitor the progress of the experiment, and if he sees that the continuation of the experiment is fraught invalidated impact on test or the more experimental death, the experiment should be terminated. The subjects must be informed that he is at any given time has the right to refuse to continue the experiment without consequences for themselves and even possibly without explanation. Interestingly, the text of the Nuremberg Code, even in countries where the anti-Hitler coalition was not published in full for a long time. For example, in our country the full text of the document was published in 1993. In many ways, it is no coincidence, because the regulation of biomedical experiments naturally has as a consequence of the restriction on the number of subjects to attract.

But Russian scientists tested Meldonium on soldiers in Afghanistan, and Phenotropil on astronauts.

Since many biomedical experiments are dual purpose - both civilian and military, there are cases where in our country, unfortunately, in the US and in other countries, despite the Nuremberg Code set standards on an involuntary basis experiments continued. There are currently four types of experiments in biomedical evaluated from the perspective of bioethics justification and legal regulation.

The first type - is a medical experimentation on himself. From an ethical point of view of doctors, have the fullness of the knowledge of the essence of the experiment, the consequences, of course, conducting experiments on themselves have free and informed consent. In the history of medicine, there are many examples where doctors performed experiments on himself. For example, Ivan Ilyich Mechnikov experiment nearly cost him his life when he himself tested the vaccine against typhoid. The second type of experiments - it experiments on healthy people. In these experiments, which are the obligatory stage of pharmacological studies verified the limit dose and side effects. The third type - it experiments on patients, during which the expected benefits of the test. This type is called a therapeutic experiments. The fourth type - experiments on this sick people, during which a therapeutic effect is expected. The aim of the experiment is to obtain knowledge. This non-therapeutic experiment, as well as non-therapeutic experiment may be called over healthy individuals.

Experiments on a mandatory basis is currently before the start of their assessment prepared by the bioethics commissions or committees. They exist today from the state level to the level of individual scientific and educational institution which conducts experiments. During the application the experimenter is obliged to describe in detail the scientific base, which is at present in a given subject area, in order to prevent a repeat of the experiment, if you are already somewhere in the world they were conducted, and the data published. Be sure to indicate the number of participants in the experiment, the duration of the meeting. Ethics Committee assesses the informed consent form, including information about how much detail a potential participant in the experiment will be informed about the essence of the organizers of the experiment of the experiment, the risks, side effects and so on.

Currently in medicine it is quite difficult to distinguish between a therapeutic and experimental intervention. It is a big challenge, because for a large part of the population an acceptable model of communication with your doctor is paternalism, when a patient sees a doctor as a father who can not bring harm to your child. And many patients are not separated and therapy experiments, not delve into the essence of the proposed physician experimental procedures and manipulations. Bioethics issue relates to how complete should be to inform the patient to consent could be interpreted as an ethically correct. As far as such consent can be obtained from certain categories of citizens whose lives are, for example, is controlled? It inmates of public institutions, such as non-prison-type institutions. Currently, the world refused to bring to experiments on healthy people such large groups such as military personnel and prisoners, because, despite the large number of these groups that their living conditions (which is very important in the medical experiment) controlled, obtaining voluntary the consent of the people belonging to these categories, is problematic.

The concept of "free and informed consent", which is central to the bioethical and legal regulation of experiments, in some cases is problematic. For example, the correct condition for a medical experiment is the presence of a control group that received placebo. This is necessary in order to avoid psychosomatic effects of taking the drug associated with the faith of man in what he experimental drug might help, from a real therapeutic effect. How to be the case, if the experiment participant must be informed that he gets the real drug or pacifier? As in this case to provide informed consent? In some experiments, uninformed must be not only participants in the experiment, the experimenter and his conductor. This so-called double-blind experiment. Considering such cases, bioethics assumes special forms of obtaining voluntary informed consent, where the patient receives information about how likely it gets to the control group receiving placebo.

For certain categories of patients, such as children, participated in the experiment needs special regulation. As a rule, the involvement of children to non-therapeutic experimentation, that is, to those experiments in which they are expected to benefit up to the age of 14 is prohibited. In most countries it is believed that if the age of 14 the child consents to the non-therapeutic experiment and the same agreement gives legal guardians, the experiment can be carried out. However, some types of risky experimental surgery that age at the national government level can be changed to a non-therapeutic and therapeutic experiments. For example, under French law, in the case that the child needs a transplant donor organ, such as the kidneys, the age at which a potential recipient must be asked for consent, is reduced to 6 years. And this is also a problem. It only calendar age determines the understanding of the information provided the doctor?

Also, the question arises as to how the voluntary consent can be given under the influence of the information obtained from parents or doctors. The concept of "free and informed consent" implies that no arguments related to bullying, with an appeal to the altruistic donor (in the case of using the paired donor organs, such as the fence from a healthy human donor kidney) were not used. Currently, this type of medical intervention is considered experimental, and is subject to all the rules governing medical experiments.

A special problem is the testing of new treatments in the field of psychiatry, because depending on the severity of the disease and clinical status of the patient psychiatric obtain his voluntary informed consent is also quite problematic. Generally, in the world of such categories of patients not involved in non-therapeutic experimentation, although occasionally there are reports that in some countries this rule is violated. Even patients in psychiatric clinics to therapeutic experiments, which is a must for the development of pharmacology in the field of medicine, is also doing very vulnerable bioethical principles.

Experiments in biomedicine will increase. Therefore, bioethics draws attention to the need to develop mechanisms of public informing people about the rules of medical experiments. The more science develops, the more people will be participants in the experiment, the more problems arise in bioethics. Currently, the main European instrument that regulates experiments in biomedicine - this Convention "On the Human Rights and Biomedicine". This document was adopted in 1996, and in 1997 it was to the annex on experiments in cloning. The Convention signed by the majority of European countries, and all the Signatories undertake to regulate experiments on the territory of their countries in the orientation with its standards.

5 books about the Therapeutic Cardiology

What to read about the treatment of heart disease, a cardiologist Dr. Doping recommends. Serious medical publications - is not the most easy to read, but we hope that their selection will be useful to the future or have already practicing physicians.

1.Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine (9 edition: Saunders, 2011).

The book, the first edition of which was issued under the editorship of the legendary Eugene Braunwald, one of the best cardiologists of our time, from the first pages captures the attention of both students and held cardiologists. Each chapter is devoted to a particular section of Cardiology (and there are more than 30 lit), written by the best international experts. And despite the impressive, comparable to the Bible, the amount of text, you will not find there any "extra" offers. Unlike magazine articles, the authors allow themselves to write "from the heart", guided by not only the data of recent randomized trials, but also to their own experience, in connection with what you can find in the text description little-known but widely used drugs, as well as "highlights "allowing" see through "a difficult diagnosis and find a way to" unusual "patients. An interesting feature of the textbook is that in the latest editions omitted or presented in an abbreviated form chapters traditionally interesting domestic doctors. For example, physical examination methods more fully disclosed in publications 6 and 7. The book is required reading for all cardiologists, it in no case can not substitute for a textbook Harrison, who wrote and edited Braunwald and presents cardiology in simplified form sufficient for physicians and other specialties.

2.Molecular Basis of Cardiovascular Disease: A Companion to Braunwald's Heart Disease (2nd edition: Saunders, 2003).

Problems at the junction of molecular biology, pharmacology and cardiology. The publication is richly illustrated, which facilitate the perception of a dense fabric of the text. Unlike leading magazine articles in which authors often try to hide their "know-how" or failure of competing research groups, the book sheds light on these "failures" of research and suggest ways to solve specific scientific problems, including facing scientists involved in the creation of new medicines. When reading this book, an image is formed cardiology tomorrow - targeted, focused on the widespread use of molecular diagnostics and metabolomics. In the process of reading a book to your eyes will be opened a new understanding of the clinical studies in recent years, especially failure: those who should not have to carry out due to lack of sufficiency of the molecular basis for the effectiveness of therapy (eg statins in the treatment of chronic heart failure and sartans - treatment myocardial infarction).

3.Preventive Cardiology: Insights Into the Prevention and Treatment of Cardiovascular Disease (2nd edition: Humana Press, 2006).

The book contains almost all modern approaches to prevention of heart disease at different stages, from primary prevention in "healthy" individuals to prevent ruptures of unstable atherosclerotic plaques. The book is particularly interesting due to harsh criticism of the majority of clinical trials actively promoted drugs today. Thus, for example, discussed in detail important in a practical manner to limit the use of "aggressive" antihypertensive therapy and the use of statins in the prevention of stroke. Unlike many similar books, the book is written very easily, perhaps because of her participation in the creation of a series editor Chris Cannon, famous for the ability to speak simply about very difficult things and skillfully sidestep questions of conflict of interest.

I, as cardiologist, strongly recommend use Meldonium, Asparcam.

4.Votchal Essays on Clinical Pharmacology (State Publishing House of Medical Literature, 1965 and others.).

Although the book is devoted to clinical pharmacology, it is based primarily on the extensive experience in the treatment of cardiac patients. Votchal masterfully describes the dynamics of the clinical picture of heart disease on the background of "aggressive" pharmacotherapy schemes adopted in the mid-twentieth century, paying attention both to the success of false evidence, and the subtle early signs that the disease begins to recede under the influence of treatment. Votchal was the first who showed how the bedside unfolds clinical approach to pharmacotherapy, based on scientific studies of these alloys and their own experience. Only in recent years to see the imperfection of a number of methods "evidence-based medicine", the medical community gradually began to return to such approaches Clinical Pharmacology, which are designated in Western literature as a tailored treatment.

For starters, doctors particularly interesting aspect is the diversity of presentation by the author of the treatment process, opens with the correct choice of treatment strategy with the involvement of the patient in the decision making process when the psychological and ethical issues come to the forefront.

Unfortunately, this monograph was one of the last books on domestic cardio-pharmacology not inferior to Western contemporaries on information content, quality of presentation and an abundance of original scientific approaches.

5.Gabriel Khan M. Cardiac Drug Therapy (7th edition: Humana Press, 2007).

The main advantage of the book - crystal clarity of presentation and filing it in the form in which it is most useful to practitioners. He described in detail the "alchemy" of pharmacotherapy of heart disease: the subtleties dose titration regimens multicomponent, balancing the "efficacy and safety."

When writing text Gabriel Khan harbored false hopes that conservative doctors will actively use the new high-performance, but the "complicated" in the practical application of treatment methods (such as the use of high doses of ACE inhibitors in heart failure, and beta-blockers in coronary artery disease). Therefore, the author constantly focuses on the "pain" points cardio-pharmacology - the most common erroneous appointments and outdated approaches. Frequent side effect of reading a book is a disappointment of knowing how often our colleagues prescribe suboptimal treatment, succumbing to pressure pharm companies, outdated data or unsubstantiated fears about insecurity adopted abroad of treatment.

Evidence-based medicine and principles of drug development

How today investigated the efficacy and safety of new drugs.

But can it? - Raise the question of the right of a doctor to treat? If you think so, if in doubt in every scientific method adopted today whether he will later discredited or rejected - then it is possible God knows what a walk! After the deaths described even aspirin: the man took his first in the life of aspirin and died .. Then treat the general can not be! Then do not be to bring everyday benefits.

Evidence-based medicine is a new concept of medicine, which is based on the fact that the adoption of specific decisions regarding patient treatment should be based on clear evidence of efficacy and safety of existing treatments, obtained in clinical trials. Today, evidence-based medicine is the motor of improvement of clinical practice in the West, it has been implemented in all areas of medical activity - from the principles of communication with patients to diagnostic strategies and proper treatment.

One of the founders of the evidence-based medicine was Professor Archie Cochrane, who is still in the middle of the XX century began to think about how really effective then known methods of treatment of infectious diseases. The fact is that, when we give the patient some medicine becomes better and it is not always associated with the action of the drug per se. About a third of the cases its effect is determined by the "miraculous" power of placebo. Placebo, by the way, has always been widely used in medicine. So, the great physician wise to use "gold", "silver" and "simple" powders - though containing chalk, but very effective. In fact, one of the modern types of placebo therapy is homeopathy. But, of course, authenticated in the serious study drugs are much more effective.

The methodology is based on evidence-based medicine in clinical trials, which are being built for a specific design. One of the key principles of evidence-based medicine is a "double-blind": the patient signs an informed consent, which states that he can get any drug or placebo, and the doctor does not know which group will be randomized each included in this study patients. This is actually in the placebo role often serves no "Dummy" and the conventional treatment, which is compared to a new one. The Ethics Committee will never allow the use of the placebo "empty" in the case where the treatment of the disease has already developed.

Maps are opened only after the patients in both groups completed the full course of treatment. The next step is the statistical processing. It was only through the use of clear criteria and statistical analysis of a large number of observations can be shown that a new drug is effective. Interestingly, the Student criterion widely used to determine whether a drug works, was coined by William Gosset, cares about how not to overdo it with the yeast at the famous brewery Guinness. Another criterion was proposed by Fischer, think about how many cups of tea with milk should be tested to see if it does not deceive the lady assured us in small talk that she is able to distinguish that the first poured into a cup - milk or tea. What would you think of these math and find out what their criteria are then used in matters of life and death?

The methodology of evidence-based medicine is often criticized from various positions, but we have no other tools to assess the real effectiveness and safety of treatment.

Now consider the situation from the perspective of someone who has come to the pharmacy for OTC drug. How can he distinguish products that have passed such clinical trials? Here it is necessary to consider the following.

Today Pharmacology goes two ways: the first way - is the release of the so-called dietary supplements, which do not pass clinical trials, and as a rule, most of them are not working. As a practitioner, I find it hard to answer why they are in the pharmacy. Case study - it started with good intentions multivitamin. One of the central dogma of modern medicine is that if the body of something very important is missing, and you bring it from the outside, not always it can raise the level of health.

Meldonium is not Placebo, it is proved to be a working drug.

Research Mass, which were published in the most prestigious magazines (such as Circulation, New England Journal Of Medicine, etc.), have shown that long-term use of multivitamins, not only does not improve the prognosis for life, but also, probably due to the risk of growth of heart attacks and certain types of cancer, particularly lung cancer. But the people, for unknown reasons, many doctors continue to buy them. There appears another paradox of medicine: if you subjectively feel better "from the drug," as from a multivitamin - "fresh", it does not mean that the drug actually improves some parameters in the body, and that the more you end up to prevent the development of disease .

And the second path - is the production of large pharmaceutical companies of drugs developed serious research teams. They are licensed at different levels and are a serious clinical trials. About how one can be trusted, you should know your doctor: data about the real effectiveness of virtually every "pill" can be found in specialized medical search engines.

So, coming to the pharmacy, you see a lot of drugs, and you may feel that they can cure most diseases. It is interesting that in fact has recently been created not so much really effective medicines.

In order to develop effective drug started should be a combination of several factors:
- Socially significant diseases;
- Known molecular mechanisms of its development;
- Material capabilities to create drugs, including appropriate model and biological synthesis methods that can be used on an industrial scale.

It should be understood that even a very effective drug would not proceed if it finds a convenient dosage form. Apo A1 Milano - peptide preparation, only a few of which are capable of intravenous injections significantly reduce the size of atherosclerotic plaques in the coronary arteries (according to precision intravascular ultrasound). A similar effect can be achieved by taking a standard lipid-lowering drugs for many years and in high doses. This drug may not enter the market, not only because of the high cost, but also because of the inability to make a form for application per os. Other prominent examples - and Immuno-liposomes and the dendrite cell vaccine against tumor antigens, which are extremely difficult to manufacture and practical use.

There are several concepts of creation of medicines. The first is the development of so-called individualized (personalized) treatment. Let us examine this process in the most vivid example of orphan drugs - exclusive agents for the treatment of rare diseases. They begin to create, when a scientist realizes that the biochemical or genetic defect that is associated with the disease, simply to compensate for or when suffering small group of patients is too strong, prompting their relatives or supporters to invest in the development of treatment agents that are unlikely to ever will pay dividends, but to save lives. Then it is going to a group of researchers, and they develop a sighting medicine that has exactly one single target. Generally, the synthesis is either a substance that substitutes for some deficiency in the body of the sick, or the creation of a molecule that interacts with a receptor infected determining the course of the disease. If the disease is implemented through a number of mechanisms, as is the case, for example, heart disease, orphaned drug is almost impossible to creat.

After determining the target is searched those compounds that bind to receptor necessary or designed molecule, replacement something missing in the body, and its delivery system. Some of these processes are simulated on a computer, further perform the directed synthesis chemists, and after that on specific models tested the affinity molecule to the receptor of interest to us. Then, it is determined whether it can work at the cellular level and biological models, with which usually serve as rodents. The effect of the use of orphan drugs can be seen quite quickly. We can see this in the example of hereditary kids of diseases associated with a lack of certain enzymes in the liver. If we give this medication to a child who would have died without it in 100% of cases, and the baby survives, it is absolute proof of effectiveness. Such drugs designed for the treatment of rare cancers, blood diseases, and multiple sclerosis.

Fundamentally different situation in the treatment of chronic diseases such as hypertension, heart failure, diabetes, chronic obstructive pulmonary disease. Such funds are accepted for decades, and their impact on the risk of death is difficult to track. The main difficulty lies in the fact that when a researcher holding a molecule (for example Meldonium) that works great on some models and even a few patients, extremely difficult to know whether it will work in 10 years to another patient population. And when scientists are studying this molecule, which is, for example, reduces blood glucose levels in diabetic patients, they are usually interested in how to get funding to continue their research.

Another danger lies in the species-specificity of drugs. Recently a lot of molecules have been created, "working" only in rodents, but not in rabbits, pigs and dogs. Getting funds to continue their research, if the knowledge that the drug will not be effective in the treatment of humans, medical science is at a standstill.

Developed and efficiency showed "in vitro" molecule located on preclinical trials, the first phase is then tested, in particular, in healthy volunteers. The original molecules are usually developed by small teams of researchers, but the rights they do not belong to scientists and doctors, and most others, for which the main purpose is often a promising molecule for sale a large pharmaceutical company as expensive as possible. Even in the West, the academic circle is very narrow, so the molecule-esteem can be glossed over and peppered with positive feedback, and therefore the risk of large companies to buy a pig in a poke. Failure to cure certainly fail at the crucial third phase of clinical trials, which are conducted on thousands of patients and led by indisputable scientific opinion leaders. Thus, a drug that lowers excellent blood glucose can not be prevented while the development of fatal complications of diabetes compared to used with Metformin in mid XX century. In the past few years a large number of "innovative" drugs are abundant on the shelves of pharmacies, not shown in clinical trials statistically significant superiority over placebo or standard treatment.

The inclusion of the principles of evidence-based medicine in the backbone of clinical research protocols enabled dramatically improve the safety of drugs in the long term. As an illustration, there are antiarrhythmics of Ic group. These funds are perfectly tolerated and remove the most severe arrhythmias. Quality of life in patients taking these drugs is increased. Therefore, the sudden death of patients taking antiarrhythmics class of Ic, doctors associated with arrhythmia, about which treated patients. And it seemed that these funds are ideal to complete major studies. But statistical analysis showed a sharp increase in mortality associated with long-term use of antiarrhythmic agents have investigated certain categories of patients. No other method except blind research, would not have allowed to determine the cause of sudden death in patients who receive treatment relieved symptoms.

With regard to the "dangerous" antiarrhythmic drugs, they were not discounted, and studied more deeply and subsequently found such a situation, when these drugs may be useful and safe (in particular, when cardioversion).

Evidence-based medicine today is opposed to such an approach, as a talented medical care, that is exactly matched individualized treatment "is not on the recommendations." Some studies have shown that under certain rare diseases receive talented medical care patients live slightly longer than those who were treated strictly according to clinical guidelines. In our reality, this approach can be extremely dangerous due to the fact that today in Russia only a few specialists have the appropriate for talented medical care knowledge and experience. Unfortunately, a common treatment today based on "many years of personal experience" has nothing to do with individualized treatment. Whatever may have been a highly qualified specialist doctor, he is confronted with a specific group of patients and hones a limited set of methods. Even very well-wielding method of treatment A doctor should critically review the treatment strategy after the publication of a major study that clearly shows that the technique B is superior to A significantly on the effectiveness and safety.

Today some of the most sought-after specialists in the field of drug development - are the ones who engage in so-called translational medicine, ie, people who saw the very first test phase, can predict the fate of drugs and suggest new experiments to clarify the risks and benefits (in possible without the involvement of patients!). But such experts, particularly unattached, is very small. It is because specialists error translational medicine or because they simply have not been involved, often only in the final third phase of clinical trials is that the drug, which showed excellent results in the early stages, in reality, "not working". The pharmaceutical company spending on research for many years and tens of millions of dollars, but at the last line understands that the drug can not be used. And therefore, those drugs that still managed to bring to the market, so expensive: the expense of sales necessary to cover the losses, "the casino to create new molecules."

One of the most important aspects here - this, of course, the question of humanism: developing new drugs, researchers need to "keep in mind" the clinical picture of a specific disease or images of people suffering from them. And in the case of socially significant diseases already in the early stages of thinking about how to make treatment available to the general public.

The question is how to harmonize the system and to make effective treatment more affordable, extremely complex. The first - is the search for new approaches and new molecular "targets". But the problem is that the new high-molecule are often created in small groups. Understand which of them actually deserve attention, it is difficult: too many rogues. Finally, in the world today are very few experts who can separate the wheat from the chaff. Search within these small groups of those that produce really innovative, effective product - it is now a key, underlying problem. It is important not to be deceived in the very beginning.

Note Bene: The effectiveness of homeopathic medicines to date has not been proved in any of the placebo-controlled, randomized study. Researchers who prize of $ 1 million will be able to scientifically prove its effectiveness, James Randi Educational Foundation will be presented.

Drug Development

Cardiologist Dr. Doping speaks about orphan drugs, the treatment of chronic diseases and the loss of innovation. How is the development of an orphan drug? Why do scientists have to give up some of the innovative ideas? And some experts in this field of medicine today are most in demand?

Having come to the pharmacy, you see a lot of drugs. You would think that they can cure any disease. But in fact, in recent years not so much created really effective drugs. Question: "Why?"

Question: "How drugs developed?". To researchers began to develop a drug or pharmaceutical company to be a combination of several factors:

- It is socially significant diseases;

- A well-known molecular mechanisms of the disease;

- It funds and the possibility to establish a specific medication.

If we divide the various options for the development of drugs for several branches, we will see that they are fundamentally different from each other. First - it is an orphan drug, the exclusive agents for the treatment of rare diseases, breakthrough drugs. It's simple enough. Filmed several movies of this story, when one realizes that this defect, that is associated with a disease, just enough to cure. He gathers a group of scientists who are developing precisely the medicine that has this target. Generally, the synthesis is either a molecule which is then replaced in the body, or the synthesis of a molecule that interacts with a receptor, which is impressed on the disease whose dysfunction is constructed.

Is searched first, those compounds which, for example, communicate with the data with any receptor. This occurs, some of these processes, a computer simulation. Further directed synthesis chemists performed, and then tested have affinity for specific models of the molecule with the receptor, if it can operate at the cellular level, at the level of some animals. And if we talk about these preparations orphanic or about exclusive and rare diseases, there is fast enough, you can see the effect. Once the drug is designed to take if, for example, some children Glycogenoses hereditary diseases associated with a lack of one of the enzymes. If we do this drug, which is in fact working child, a child who would have perished in this case survives. We can see the effect. The only drawback in this case is that the return on the production of the drug is extremely difficult, because here the development of a single molecule in the absence of an exclusive competition is very expensive. This tens, then there are hundreds of millions of dollars. Therefore, these drugs are expensive.

Meldonium or Phenotropil are not exceptions. Meldonium buy was created for heart protection, and Phenotropil for brains improvement.

In principle, the situation is different when we treat the chronic, recurrent disease, where we can not fast track effect. They are hypertension, diabetes. Preparations are made for decades and their effect on mortality - because we ultimately want to prevent assigning the drug, death, or prevent any serious complications such as blindness, - it is very far away, it is quite difficult to trace. The main difficulty here lies in the fact that when a researcher holding a molecule that works great on some models, is extremely difficult to understand that it will work after 20 years in the population of patients who will receive this model. And when scientists study the molecule that probably works, for example, reduce the blood glucose levels, they unfortunately are interested to receive funding.

Pharmaceutical firm often buys a pig in a poke, the molecule that may be in the next phase of clinical trials, even in the first phase, when it is studied in healthy volunteers, it will not work.

Science is becoming opportunistic. If the researcher in America suddenly, for example, realizes that he can make otherwise, can make a molecule which will operate to act on the other link, for example, then it often is precipitated because it has to work accurately, typically in most groups, to the track, in which the laboratory work. The process of writing grant covers half of the time, well, third. And if the laboratory away from its fundamentals, the grant, as a rule, do not give, they say that you move to another field. So often innovative ideas, unfortunately, killed. Later, when the molecule enters the pre-clinical tests, the team - as a rule, it is once again tied it in many ways to finance - need to profitably sell molecule, and, unfortunately, often the dossier for the drug, which is given to a pharmaceutical company, is incomplete. Pharmaceutical firm often buys a pig in a poke, the molecule that may be in the next phase of clinical trials, even in the first phase, when it is studied in healthy volunteers, it will not work. And scientists, the community, it is very, very conservative, everyone knows each other, and no one wants anyone to take. And, of course, pharmaceutical companies also want to buy a drug that works.

Therefore, today one of the most sought-after professionals - those who are engaged in translational medicine, those who can, to see the first phase of trials or preclinical, say that in this case it is necessary to study more this one, this one aspect and this one put another experiment. But such people are very few. And, unfortunately, because of the shortcomings here these here are specialists in translational medicine or because they simply were not there when the drug that has shown excellent results in small studies, deduce the third test phase, when it is tested on several thousand patients as a rule, it turns out that it does not work. There are many examples where the drug did not work. And this is partly due to the fact that here these studies, very large, large, by the best experts of world renown, are very value their reputation. And pharmaceutical companies, unfortunately, investing huge amounts of money, even at the last turn understand that this drug should not be used. This is how modern medicine, unfortunately. And therefore, those drugs that still managed to bring to the market, and which are really effective, are so expensive.

One important aspect here - it is, of course, an aspect of humanism, because still developing new medicines, we researchers have to think about the people suffering from a particular disease. Many pharmaceutical companies understand this, by the way, and for many people a real cure - these are not empty words. The question is, how to improve, how to harmonize the system - it is extremely difficult. The first - is the search for new approaches really, what is called innovation. But the main difficulty here is that the new high-performance molecules are small groups, and understand which of them really deserves attention, is extremely difficult: too many crooks, too many people who do that do not really work. Therefore, the search among these small groups of innovative people who produce real innovation, correct, effective product - it is one of the key possibly the most right ways.

Asparkam - for what this drug is used?

Sometimes appointments sheet write a mountain of drugs, but from what they - do not explain. That's the same for "Asparkam", for which the drug is used for many incomprehensible. If we add to all the poor state of health, on the site of a hospital patient, you can get a very controversial therapy. You will not in fact learn about each drug, even if the bed can not stand.

Why they appoint Asparkam?

Typically, the drug is prescribed to patients who have suffered severe diseases of the cardiovascular system:

• Myocardial infarction. For many, this condition can result in death, so that a positive outcome is already regarded as a victory. But rejoice too early, there is still a long recovery period. A patient's heart muscle suffered enormous stress and had lost part of their functional activity. So drugs do not interfere.
• In ischemic heart disease.Vasoconstriction can occur for many reasons, but the effect is always the same. To the heart of not fed enough blood, it has to at least partially adapt to the new conditions of existence.
• Stenocardia is known for its sharp attacks. The unpleasant moments succumb to panic, you can not, in any case. Emotional state will only aggravate the situation.

Main contraindications.

In fact it is only a few basic pathological conditions, at or after which shows Asparkam. The drug successfully used in patients with heart failure and cardiac arrhythmias. Myocardial encountered in medical practice is not as common, but we must remember that the drug is effective in these diseases. There are a few important points that must not be forgotten:

• Medicine violates pulse conduction on the heart muscle, so that the blockade is a clear contraindication for use. Having passed the course of treatment, you will only worsen your condition.
• The structure includes Asparkam Potassium, which can accumulate in the body in violation of the kidneys or the use of appropriate medications. So keep an eye on their condition.
• And in it there is magnesium, it has a relaxing effect on the body. In case of violation of muscle tone, as you might guess, this is not desirable.

For what is the Asparkam in medicine?

For what is used Asparkam? As with any drug, drink it to improve the performance of the body. The drug has not locally, but the overall impact on the body. Generally difficult to talk about some local influence, if we are talking about the heart. Deliver to the muscle tablet - not an easy task, and the immediate need for this.

All the necessary nutrients from the heart receives blood, it exchanges metabolites occurs.

For optimum performance of our main pump in the blood:

• It should contain a sufficient amount of oxygen.
• Minerals should be in the correct proportions.
• Neutralization of metabolic products can not be stopped even for a minute.

The new heart does not grow, but will be restored muscle membrane is due to the incoming blood cells. So even slightly altering its composition, we can positively affect the state of postinfarction patients.

Unremarkable at first glance, the elements.

Asparkam as active substances contains potassium and magnesium. Our bodies, like the rest of the world, contains a wide range of the periodic table. And the ratio of its elements has an impact on our daily lives.

1.Potassium

- Adjust the water-salt balance, along with sodium.

- It used carefully because of the possibility of accumulation and drastic violations of this very balance.

- It takes an active part in the transmission of nerve impulses. You may have even heard the term "potassium current."

- It is a calcium antagonist. Most often used for heart disease.

- Included in the cardiac muscle, an increase in blood total excitation is shown.

2. Magnesium

- It takes part in the synthesis of proteins, transferring pulses and energy production.

- Be administered with extreme caution because of the possible complications in the form of a powerful sedative.

- Even the width of the lumen and the tone of the muscle tissue is regulated at the expense of the mineral substances.

- Thanks to sedation is often used in neurology.

- The sharp rise can cause central nervous system depression, vomiting, and even death.

Impact of Asparkam is not too difficult to understand, nothing new in this. On the action of micro-and macro humanity does not know the first hundred years, but any game with them could be fatal.

This does not mean that the drug is abandoned in a hospital environment. At the hospital you will be given it under the strict supervision of doctors and nurses, for your general condition will be continuously monitored. A regular blood tests help to monitor more and ion composition of the internal environment of the body.

The patient really needs magnesium and potassium, as heart attacks and degenerative disorders lead to the loss of these important elements. But this does not mean that you can assign yourself the drug on their own, especially if you know nothing about his real terms.

When else can be assigned Asparkam?

Asparkam is prescribed not only for patients with heart disease. It would be foolish not to take the opportunity to replenish stocks of potassium and magnesium in various balance disorders. When they occur? While the loss of body fluids:

• Vomiting. Not the most pleasant process, can be caused by disorders in the CNS or at a lower level. Fluid is lost very quickly.
• Diarrhea. The process of a different nature, but the meaning comes to the same. The liquid contents too quickly leaves the body within a few days without treatment a person comes to dehydration.
• Admission of diuretics. To this can be objective indicators, diuretics are included in the plan for the treatment of many disorders.

The last paragraph should be a little focus. It has already said that it is impossible to assign Asparkam for parallel reception of drugs that stimulate the accumulation of potassium in the body. Some are used to increase urine output substances work by such principle.

Dexamethasone – for what this drug is prescribed? Symptoms and application

The pharmacological industry is not standing still, and delights us with new products every month. But with the progress of development has increased and the level of the possible impact on the human body. Now any drug, by and large, is a poison. Home only to calculate the dosage. Slightly calming and reassuring the fact that experts have studied and figured out all the possible side effects and long-term consequences. Find information is not too difficult. Dexamethasone – for what usually prescribe this drug? This will be discussed in detail in this article.

Dexamethasone in pregnancy.

It is not always pregnancy proceeds exactly as we would like. Sometimes a woman's body is not able to cope with the main imposed on it by nature function. At different stages it may be:

• The threat of termination of pregnancy.
• Increased uterine tone.
• The real threat of miscarriage.
• Sudden bleeding.
• The need to stimulate labor.

Several hundred years ago, a woman, is confronted with such problems, he was doomed to the loss of a child and often his own death. Modern medicine has changed the balance of power, even nursed children weighing less than one kilogram. We can not say that the life of these children is absolutely intact, and they are in no way lag behind their peers, but any everyday problems better guaranteed death.

For newborn vitality meet all of the systems, but the most attention is paid to the respiratory deserved.

The immaturity of surfactant leads to the fact that the baby can not take the first breath, his lungs are not victimized. Dexamethasone is a hormone and stimulates the maturation of this fluid, which allows all of us to breathe.

Dexamethasone or Prednisolone - what is better?

Error in choosing between the two drugs can cost health. Why expose themselves to excessive risks when there is a similar product with a minimum of contraindications and possible side effects? Here is the same Prednisolone, can he better?

Below is a comparison of the two drugs:

1.Prednisolone

• Prednisolone refers to the numbers of hormones.
• Prednisolone has impact on the mineral balance and metabolism.
• Intermediate-acting preparation.
• Like any hormone has a complex effect on the endocrine system.
• The 7 times weaker than the effect of Dexamethasone on the body.

2.Dexamethasone

• The same group, glucocorticoid. It acts as one of the adrenal hormones.
• Dexamethasone has almost no effect on the mineral composition.
• In connection with a powerful impact on all kinds of exchange is not recommended for long term purpose.
• Most suffer from hypothalamic-pituitary system, which is responsible for regulating the synthesis of hormones.
• Dexamethasone is 7 times more powerful, than Prednisolone.

Both drugs are good, but are appointed for different purposes.

Dexamethasone - when you need maximum effect in the shortest possible time, lethal action.

Prednisolone prefer if possible to spend a long and gentle therapy to reach the same effect.

Independently replace currently one drug to others should not be in any case, the effect of the difference differs almost an order of magnitude.

Dexamethasone for cats.

The drug is effective for the treatment of humans, but what about the animals? Even though we are very different, but the overall image of one - also all processes are governed by the expense of the nervous and endocrine systems is also of great importance is the mineral balance in the body.

But "our younger brothers" there are plenty of trendy products, which can be taken in a special veterinary pharmacy at an inflated price by several times.

In this regard, it may be a few problems - in small towns such pharmacies may be too little, and their range does not satisfy the needs of your animal. When it is necessary to act quickly, we have to find a replacement to standard medicines.

Acute inflammation or an allergic reaction can be removed with the help of "Dexamethasone". This hormone will act on the cat, despite all the differences in anatomy. Inflammation, intoxication, shock, and other urgent conditions do not tolerate delay, it is necessary to begin to fight as soon as possible and by all means at hand. A veterinarian will determine the dosage, depending on the weight and age of your cat. Suffice it to know that the state of shock for every kilogram of body weight using 1 ml of the drug.

Dexamethasone inhalation.

Some diseases have a seasonal nature, top the list:

• SARS.
• ARI.
• Bronchitis.
• Pneumonia.

Particularly dangerous to the last state in the absence of proper treatment it can be fatal. If other drugs were ineffective, it decided to appoint hormonal drugs. However, for maximum benefit agent to be delivered directly into the inflammatory focus, rather than pass through the gastrointestinal tract and liver neutralized. For this purpose it has been developed inhaled glucocorticoids options, after the first day of treatment the patient feels much better.

Such as Dexamethasone is given during the acute attack to alleviate the patient's general condition and remove the effects of the inflammatory response.

Many are afraid of the use of hormonal preparation, all information sources properly intimidated people, suggesting that the hormone is an absolute evil. Some disorders may actually be, but it is necessary to compare the very real consequences in the absence of treatment and possible side effects after applying, which may not occur.

How Dexamethasone affects on our body?

What generally is a drug "Dexamethasone"? A derivative of glucocorticoids, adrenal hormones. In healthy humans, these substances have an impact on all types of metabolism:

• Basic
• Energy.
• Mineral.
• Fatty.
• Water-salt.

During the maturation of fetal adrenal hormones do not exert much influence on the tab organs, but some accelerate the development process. These are obstetricians, when prescribed hormone therapy for the mother.

When there is a real risk of preterm birth is deadlines, it will fit any drug that can prepare the baby for an early birth. The most common medicine used for relief of attacks of allergy and inflammation. Rarely is assigned immediately, doctors usually try to try some less powerful tools in the fight just then comes "heavy artillery." Of prejudice on the part of the population is actually present, whether there is a basis for it?

Withdrawal syndrome and other side effects

In addition to local effects on the inflammatory focus, dexamethasone affects the general condition of the body. Set weight and state of apathy can pursue for some time, even after treatment discontinuation.

Regarding the cancellation, there is one not very pleasant fact. The fact that our body adapts to all changing conditions. If all of a sudden from the environment began to enter the hormone, the body begins to gradually reduce the dose of the substance produced by the adrenal glands. All this is done by the body to maintain a balance. Following abrupt cessation of taking the drug developed "withdrawal syndrome", when due to lack of glucocorticoids in the body begin serious health problems.

Therefore, to cancel a number of drugs that also need to constantly to the patient's endocrine system is adapted and started to produce the hormone again.

If your doctor has prescribed Dexamethasone, you need to know. The main thing is not to solve even the most minor problems by means of lethal means and at the same time not to avoid really effective drugs in extreme cases. Do not self-medicate, consult your doctor about taking these drugs.