scholarly journals AUTOMATIC PLASMAPHERESIS IN PATIENTS WITH COVID-19-ASSOCIATED PNEUMONIA. THE FIRST EXPERIENCE OF APPLICATION

2021 ◽  
Vol 29 (1) ◽  
pp. 62-66
Author(s):  
D.S. Tratsiak ◽  
◽  
K.A. Abdin ◽  
A.A. Makarov ◽  
A.P. Trukhan ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Blood Test ◽  
Antihypertensive Drugs ◽  
Blood Pressure Reduction ◽  
Clinical Effectiveness ◽  
Blood Parameters ◽  
Hemodynamic Parameters ◽  
Positive Effects ◽  
Complex Therapy

Objective. To determine the possibility of using automatic plasmapheresis in patients with COVID-19- associated bilateral polysegmental pneumonia. Methods. The treatment of three patients with COVID-19-associated pneumonia with application of the Autopheresis-C™ automatic plasmapheresis machine (the USA) has been analyzed. The patients’ age was 47. 49 and 55 years. The patients’ case histories included factors aggravating the course of pneumonia (diabetes mellitus, chronic cardiovascular pathology with heart failure, obesity). The condition of all patients was severe. The effectiveness estimation of the given technique was carried out 6 hours after the manipulation and included a general clinical blood test, a biochemical blood test, hemodynamic parameters, and objective data. Results. After the first application of automatic plasmapheresis, all patients occurred a decrease in temperature and the level of respiratory failure, which was accompanied by an increase in hemoglobin saturation; a decrease in the severity of dyspnea was also reported, which was the reason for the changing patient position from prone to supine. All patients had a blood pressure reduction. Positive changes in the hemodynamic situation were the basis for reducing the dosage of antihypertensive drugs. Along with this, in the course of manipulation, a gradual decrease in the severity of tachycardia was noted in all patients: a reduction of heart rate was recorded. On the second day after the manipulation, the main blood parameters (leukocytosis, c-reactive protein) decreased. The observed positive effects contributed to the early transfer (by 10-15 days) of patients from the intensive care unit to the general somatic departments. Conclusion. The early inclusion of automatic plasmapheresis in the complex therapy of patients with COVID-19- associated bilateral polysegmental pneumonia leads to the stabilization of hemodynamic parameters, decline of the severity of respiratory failure, which made it possible to avoid the mechanical ventilation. What this paper adds For the first time, the clinical effectiveness of the method of automatic plasmapheresis in the framework of the complex therapy of COVID-19- associated polysegmental pneumonia is shown, which is expressed in a decrease in the manifestations of functional and metabolic disorders of vital systems for maintaining homeostasis. It was found that the inclusion of this technology in the complex therapy contributed to the stabilization of respiratory and hemodynamic parameters, which made it possible to avoid the mechanical ventilation.

scholarly journals Imidazoline receptors agonists: possible mechanisms of endothelioprotection

2018 ◽  
Vol 4 (2) ◽  
pp. 11-19 ◽  
Author(s):  
Vladislav O. Soldatov ◽  
Elena A. Shmykova ◽  
Marina A. Pershina ◽  
Andrey O. Ksenofontov ◽  
Yaroslav M. Zamitsky ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Blood Pressure Reduction ◽  
Cardiovascular Effects ◽  
Vascular Wall ◽  
Imidazoline Receptors ◽  
Peripheral Tissues ◽  
Imidazoline Receptor ◽  
Receptor Agonists ◽  
Positive Effects

Imidazoline receptor agonists are one of the groups of contemporary antihypertensive drugs with the pleiotropic cardiovascular effects. In this review, the historical, physiological, pathophysiological aspects concerning imidazoline receptor agonists and possible mechanisms for their participation in endothelioprotection were considered. Illuminated the molecular biology of each subtype of imidazoline receptors and their significance in the pharmacological correction of cardiovascular disease. IR type 1 are localized in the brain nucleus, carrying out the descending tonic control of sympathetic activation, as well as in the endothelial cells of the vessels and kidneys. Their activation leads to a decrease in blood pressure, slowing the remodeling of the vascular wall and increasing sodium nares. IR type 2 is expressed predominantly in the adrenal gland, fat and muscle tissues. The physiological effects of their stimulation are associated with an increase in glucose utilization by peripheral tissues. IR type 3 are mainly present in pancreatic cells and are associated with the regulation of insulin secretion. Their stimulation leads to an increase in insulin liberation. Thus, IR agonists are able to improve endothelial function through various mechanisms, including blood pressure reduction, improvement in metabolic profile, and direct positive effects on the vascular wall. Current information on the pharmacological effects of this group compounds allows us to conclude that they are a promising group for correcting endothelial dysfunction and complications associated with it.

scholarly journals Evaluation of the effectiveness of the drug «Forvet»® in the complex therapy of infectious rhinotracheitis in cats

2020 ◽  
Vol 2020 (3) ◽  
pp. 20-27
Author(s):  
Svetlana Schepetkina ◽  
Oksana Rishko ◽  
Veronika Matveeva ◽  
Aleksey Kiselev ◽  
Natal'ya Lahova
Keyword(s):  
Clinical Signs ◽  
Clinical Effectiveness ◽  
Blood Parameters ◽  
Test Body ◽  
Controlled Study ◽  
Antibacterial Drug ◽  
Saint Petersburg ◽  
Complex Therapy ◽  
Group 2 ◽  
Group 1

The article presents the results of a multicenter randomized placebo-controlled study of the effectiveness of the drug «Forvet»®. Purpose of research. To determine the effectiveness of the drug «Forvet»® in the complex therapy of infectious rhinotracheitis (herpes virus infection FHV-1) in cats. Materials and methods. The effectiveness of the drug was investigated in a multicenter randomized placebo-controlled study, which was conducted in two veterinary clinics of the Heliet network (Saint Petersburg) in the period from 09.01.2019 to 31.12.2019. The experiment included 120 cats aged 5 to 6 months, weight 1.5... 2 kg, with a diagnosis of «infectious cat rhinotracheitis», based on the results of diagnostic studies (anamnesis, PCR, clinical blood test, body temperature, discharge from the eyes and nasal cavity, the presence of lesions on the mucous membranes). PCR and clinical blood tests were performed on the day of the animal's treatment (to confirm the diagnosis), on the 5th and 10th days of treatment. During the study, the animals were examined by a veterinary specialist with documented clinical signs on the 1st, 3rd, 5th, 7th and 10th days of treatment. The treatment regimen was the same for all animals and included the use of an antibacterial drug (sinulox) for 10 days according to the instructions; eye treatment with lotion (chamomile), eye ointment (tetracycline 1 %) ― 2 times a day,7 days. Group 1 (placebo) was administered an isotonic solution of sodium chloride, group 2 (experimental) was administered the drug «Forvet»®― in a dose of 1 ml, once a day, hypodermically for 10 days. Animals in a serious condition were additionally injected with a 5 % glucose solution ― 50 ml intravenously, once or twice a day, until the appearance of appetite. Results. Based on the analysis of the results of a multicenter randomized placebo-controlled study, the clinical effectiveness of the drug «Forvet»® ― a polysaccharide complex of the class of hexose glycosides as part of the complex therapy of cat herpesvirus infection (FHV pathogen) was established. In the treatment of rhinotracheitis in the group of animals that were used «Forvet»® observed faster elimination of the virus, the return of blood parameters to the limits of the physiological norm, a decrease in the severity of clinical signs of the disease by the fifth day and almost complete clinical recovery by the seventh day of treat

The rationale for the combined use of osteopathic methods of correction and reflexology in the complex treatment of patients with dorsopathy at the cervico-thoracic level

2020 ◽  
pp. 82-94 ◽  
Author(s):  
V. O. Belash ◽  
L. R. Urazgalieva ◽  
R. I. Fayzullina ◽  
L. G. Agasarov
Keyword(s):  
Drug Therapy ◽  
Drug Treatment ◽  
Pain Syndrome ◽  
Clinical Effectiveness ◽  
Complex Treatment ◽  
Standard Drug ◽  
Treatment Methods ◽  
Thoracic Level ◽  
Combined Use ◽  
Complex Therapy

Introduction. Degenerative-dystrophic changes in the spine are the most common chronic human diseases. Pronounced clinical manifestations of vertebrogenic diseases are observed during active labor activity and represent one of the most frequent causes of temporary disability. It is also known that any pain syndromes are accompanied by the development of psychovegetative disorders, which reduces the effectiveness of treatment. In recent years, there has been a reasonable increase in the interest of the medical community to the non-drug treatment methods. It is caused by the polypharmacotherapy side effects, an increased numbers of allergic reactions, problems with polypragmasia, and a low level of compliance. At the same time, the question of the possibility of various non-drug treatment methods combining is quite acute.The goal of research is to substantiate the clinical effectiveness of the combined application of osteopathic correction and reflexotherapy in the complex treatment of patients with dorsopathy at the cervical-thoracic level.Materials and methods. A prospective controlled randomized study was conducted on the basis of the medical clinics of LLC «Family Health» (Kazan) and ANO «Center for SEB assistance» (Kazan) from April 2018 to May 2019. The study involved 52 people with dorsopathy at the cervical-thoracic level, aged from 25 to 45 years. In accordance with the exclusion criteria, 7 people dropped out of the study. The remaining patients (45 people), depending on the used treatment method, were divided by a simple randomization method using a random number generator into three groups of 15 people. The first group (main group) received osteopathic correction and reflexotherapyon the background of standard drug therapy; the second and the third groups (control groups) received only osteopathic correction orreflexotherapy, respectively, on the background of standard drug therapy. The osteopathic examination was performed for all patients regardless of the group, before and after the course of therapy, with the formation of an osteopathic conclusion.Also there was the estimation of the degree of pain syndrome severity,the asthenia, and the degree of accumulated emotional and energy charge that does not get out in a person.Results. It was found in the course of the study that the inclusion of osteopathic correction and reflexotherapy in the complex therapy of patients with dorsopathy at the cervical-thoracic level is clinically more effective than the isolated use of these methods. Such complex therapy allows to achieve a more significant reduction in the severity of the pain syndrome by VAS (p<0,05), relief of internal emotional tension (p<0,05), and increase the effectiveness of correction of dominant somatic dysfunction. Based on the obtained data, it could be assumed that reflexotherapy potentiates the effects of osteopathic correction.Conclusion. Based on the study, it can be concluded that the combination of osteopathic correction and reflexotherapy in the treatment of patients with dorsopathy at the cervical-thoracic level increases the clinical effectiveness of the standard drug therapy. At the same time, it is worth noting the potentiating effect of the combined use of two non-medicinal methods. The question of combining of various non-drug treatment methods is quite acute today, so this study will be continued. 

THE USE OF MEDICINES IN TREATING HYPERTENSION IN HUE UNIVERSITY HOSPITAL

2016 ◽  
pp. 76-84
Author(s):  
Khoa Bao Chau Thai ◽  
Thi Hong Phuong Vo
Keyword(s):  
Blood Pressure ◽  
Channel Blocker ◽  
Enzyme Inhibitor ◽  
Antihypertensive Drugs ◽  
Good Prognosis ◽  
Target Blood Pressure ◽  
University Hospital ◽  
Key Words Hypertension ◽  
Cross Sectional ◽  
Positive Effects

Background: Hypertension is a common condition in the world as well as in Viet Nam. If hypertension isn’t treated well, it can cause many serious complications. Controlling target blood pressure will bring positive effects on reducing mortality rate and also disabilities caused by diseases related to hypertension. Objectives: (1) Analyzing the use of medicines in treating hypertension. (2) Evaluating the effects of medicine usage in treating hypertension at the hospital of Hue University of Medicine and Pharmacy. Materials and methods: 388 patients were diagnosed as having hypertension with inpatient care at the Cardiovascular Department of Hue University of Medicine and Pharmacy’s hospital, using cross-sectional descriptive study methods. Results: All antihypertensive drugs in the research were contained in the antihypertensive list recommended by Vietnamese Society of Cardiology. Angiotensin converting enzyme inhibitor and calcium channel blocker were the two most popular drug groups (96.6% and 71.4%, respectively). The rate of using multi-therapy regimens was higher than the rate of using uni-therapy regimens in both initial therapies (64.7%>35.3%) and final therapies (61.9%>38.1%). The rate of patients having interactions between antihypertensive drugs and the other kinds of drugs was 7.5%. The rate of patients having reasonable prescriptions was 84.3%. Evaluating the effects of medicine usage in treatments showed that the rate of patients reaching target blood pressure before leaving the hospital was 67.3%. Most patients were evaluated as having good prognosis after treatment, up to 81.7%. Conclusions: All antihypertensive drugs in the research were contained in the antihypertensive list recommended by Vietnamese Society of Cardiology. The rate of using multi-therapy regimens was higher than the rate of using uni-therapy regimens. The rate of drug interactions was quite low; most patients were evaluated as having good prognosis after treatment. Key words: hypertension, antihypertensive drugs.

scholarly journals A multicenter randomized trial to assess the efficacy of CONvalescent plasma therapy in patients with Invasive COVID-19 and acute respiratory failure treated with mechanical ventilation: the CONFIDENT trial protocol

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Benoît Misset ◽  
Eric Hoste ◽  
Anne-Françoise Donneau ◽  
David Grimaldi ◽  
Geert Meyfroidt ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Neutralizing Antibodies ◽  
Ethical Issues ◽  
High Titer ◽  
Passive Immunization ◽  
University Hospital ◽  
Optimal Time ◽  
Relative Reduction ◽  
Number Of Patients

Abstract Background The COVID-19 pandemic reached Europe in early 2020. Convalescent plasma is used without a consistent evidence of efficacy. Our hypothesis is that passive immunization with plasma collected from patients having contracted COVID-19 and developed specific neutralizing antibodies may alleviate symptoms and reduce mortality in patients treated with mechanical ventilation for severe respiratory failure during the evolution of SARS-CoV-2 pneumonia. Methods We plan to include 500 adult patients, hospitalized in 16 Belgian intensive care units between September 2020 and 2022, diagnosed with SARS-CoV-2 pneumonia, under mechanical ventilation for less than 5 days and a clinical frailty scale less than 6. The study treatment will be compared to standard of care and allocated by randomization in a 1 to 1 ratio without blinding. The main endpoint will be mortality at day 28. We will perform an intention to treat analysis. The number of patients to include is based on an expected mortality rate at day 28 of 40 percent and an expected relative reduction with study intervention of 30 percent with α risk of 5 percent and β risk of 20 percent. Discussion This study will assess the efficacy of plasma in the population of mechanically ventilated patients. A stratification on the delay from mechanical ventilation and inclusion will allow to approach the optimal time use. Selecting convalescent plasmas with a high titer of neutralizing antibodies against SARS-CoV-2 will allow a homogeneous study treatment. The inclusion in the study is based on the consent of the patient or his/her legal representative, and the approval of the Investigational Review Board of the University hospital of Liège, Belgium. A data safety monitoring board (DSMB) has been implemented. Interim analyses have been planned at 100, 2002, 300 and 400 inclusions in order to decide whether the trail should be discontinued prematurely for ethical issues. We plan to publish our results in a peer-reviewed journal and to present them at national and international conferences. Funding and registration The trial is funded by the Belgian Health Care Knowledge Center KCE # COV201004 Trial registration Clinicaltrials.gov registration number NCT04558476. Registered 14 September 2020—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04558476

scholarly journals Surgical tracheostomy in a cohort of COVID-19 patients

HNO ◽  
2021 ◽  
Author(s):  
Patrick J. Schuler ◽  
Jens Greve ◽  
Thomas K. Hoffmann ◽  
Janina Hahn ◽  
Felix Boehm ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Prolonged Mechanical Ventilation ◽  
Tertiary Care ◽  
Lung Compliance ◽  
Hypoxemic Respiratory Failure ◽  
Surgical Tracheostomy ◽  
Increased Risk ◽  
Open Surgical Tracheostomy ◽  
Sedative Drugs

Abstract Background One of the main symptoms of severe infection with the new coronavirus‑2 (SARS-CoV-2) is hypoxemic respiratory failure because of viral pneumonia with the need for mechanical ventilation. Prolonged mechanical ventilation may require a tracheostomy, but the increased risk for contamination is a matter of considerable debate. Objective Evaluation of safety and effects of surgical tracheostomy on ventilation parameters and outcome in patients with COVID-19. Study design Retrospective observational study between March 27 and May 18, 2020, in a single-center coronavirus disease-designated ICU at a tertiary care German hospital. Patients Patients with COVID-19 were treated with open surgical tracheostomy due to severe hypoxemic respiratory failure requiring mechanical ventilation. Measurements Clinical and ventilation data were obtained from medical records in a retrospective manner. Results A total of 18 patients with confirmed SARS-CoV‑2 infection and surgical tracheostomy were analyzed. The age range was 42–87 years. All patients received open tracheostomy between 2–16 days after admission. Ventilation after tracheostomy was less invasive (reduction in PEAK and positive end-expiratory pressure [PEEP]) and lung compliance increased over time after tracheostomy. Also, sedative drugs could be reduced, and patients had a reduced need of norepinephrine to maintain hemodynamic stability. Six of 18 patients died. All surgical staff were equipped with N99-masks and facial shields or with powered air-purifying respirators (PAPR). Conclusion Our data suggest that open surgical tracheostomy can be performed without severe complications in patients with COVID-19. Tracheostomy may reduce invasiveness of mechanical ventilation and the need for sedative drugs and norepinehprine. Recommendations for personal protective equipment (PPE) for surgical staff should be followed when PPE is available to avoid contamination of the personnel.

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