scholarly journals Use of Remdesivir in The Treatment of COVID-19 Infection Among Sudanese Patients - Case Series

2021 ◽  
Author(s):  
Maysoun Ahmed Awad Yousif ◽  
Ghada Omer Hamad Abd El-Raheem ◽  
Doaa Salih Ibrahim Mohamed
Keyword(s):  
Side Effects ◽  
Liver Enzymes ◽  
Case Series ◽  
The Other ◽  
Elevated Liver Enzymes ◽  
Case Series Study ◽  
Profound Hypotension ◽  
Series Study

Abstract Introduction: COVID-19 infection is a viral pandemic started in 2019, all societies have the susceptibility of getting infected. Remdesivir is an anti-retroviral agent, with a broad spectrum of activity. Remdesivir activity against COVID-19 had been studied in both in vitro and in vivo, but still considered new for COVID-19 treatment and not available in all countries. The aim of our study was to report the use of remdesivir among Sudanese population and report the adverse events related to the course of treatment. Methods: case series study was conducted in Imperial Hospital reporting the three cases who received Remdesivir for treating COVID-19 infection.Cases presentation: Three cases had received remdesivir for treating COVID-19 infection, side effects reported were elevated liver enzymes, profound hypotension and hypoalbuminemia. Discussion: All three patients were severe cases of COVID-19 admitted to the ICU. Unexpectedly, severe resistant hypotension was the cause of death in 2 cases who received remdesivir. Increased liver enzymes was noticed in one case. In the other hand, hypoalbuminemia was noticed in one case as well.

scholarly journals Use of remdesivir in the treatment of coronavirus disease 2019 (COVID-19) infection among Sudanese patients: a case series

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 512
Author(s):  
Maysoun Yousif ◽  
Ghada Abd El-Raheem ◽  
Doaa Mohamed
Keyword(s):  
Side Effects ◽  
Liver Enzymes ◽  
Case Series ◽  
Supportive Therapy ◽  
First Case ◽  
Case Series Study ◽  
New Treatment ◽  
Series Study

Introduction: The coronavirus disease 2019 (COVID-19) pandemic is affecting populations worldwide. Remdesivir is an anti-retroviral agent, with a broad spectrum of usage. Remdesivir usage against COVID-19 had been studied both in vitro and in vivo but is still considered a new treatment for COVID-19 and is not available in all countries. The aim of our study was to report several cases of the use of remdesivir in Sudanese patients and report the adverse events related to the course of treatment. Methods: A case series study was conducted in Imperial Hospital, Khartoum, Sudan reporting two cases who received remdesivir for treating COVID-19 besides other treatments such as steroids and supportive therapy in December 2020. Cases were males aged over 65 years. Cases presentation: Both patients were severe cases of COVID-19 admitted to the intensive care unit (ICU), who received remdesivir for treating COVID-19 infection. Several side effects were reported: the first case had increased liver enzymes and then unexpectedly died from severe resistant hypotension; and hypoalbuminemia was noticed in the second case. Conclusions: Remdesivir use among patients in Sudan must be studied extensively in order to determine the unexpected fatal event and assess the association of this event to remdesivir use, as well as to report the frequency of the side effects.

scholarly journals Opioid-free anesthesia for patients with joint hypermobility syndrome undergoing craneo-cervical fixation: a case-series study focused on anti-hyperalgesic approach

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Carlos Ramírez-Paesano ◽  
Albert Juanola Galceran ◽  
Claudia Rodiera Clarens ◽  
Vicenҫ Gilete García ◽  
Bartolomé Oliver Abadal ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Hospital Discharge ◽  
Case Series ◽  
Ehlers Danlos Syndrome ◽  
Painful Condition ◽  
Discharge Data ◽  
Gastrointestinal Complications ◽  
Case Series Study ◽  
Series Study

Abstract Background Patients with Ehlers-Danlos Syndrome/Hypermobility Type (EDS-HT/JHS) and Craneo-Cervical Instability frequently suffer from severe widespread pain which is difficult to control. Chronic neuroinflammation, opioid-induced hyperalgesia, and central sensitization may explain this painful condition. The aim of this study was to determine if opioid-free anesthesia plus the postoperative administration of lidocaine, ketamine and dexmedetomidine can reduce postoperative pain and the need of methadone rescues in comparison with opioid-based management in these patients undergoing Craneo-Cervical Fixation (CCF). The secondary aim was to assess the needs of opioids at hospital-discharge, incidence of gastrointestinal complications and the requirement of anxiolytic. Methods A retrospective, consecutive case series study was designed. 42 patients with EDS-HT/JHS undergoing CCF were enrolled in two groups: an OFA-plus Group that received opioid-free anesthesia with propofol, lidocaine, ketamine and dexmedetomidine, and OP Group, opioid-based anesthesia-analgesia. The main variables: Preoperative Visual Analogue Score (VAS), postoperative VAS on the 1st, 2nd, 4th and 6th days, sufentanil or morphine requirements, need for methadone rescue, and VAS at hospital-discharge. Data was presented by mean ± SD, percentage, median or interquartile range. Chi-squared or Fisher’s test. 95% C.I and P values < 0.05. Results Nineteen patients in OFA-plus, and 23 patients in OP group. VAS was lower in OFA-plus on the postoperative days evaluated (p < 0.001).VAS at hospital-discharge was lower in OFA-plus: 4.96 (4.54–5.37) vs. OP 6.39 (6.07–6.71) (p < 0.001). Methadone requirement was lower in the OFA-plus (p < 0.001). 78% of patients in OFA-plus didn’t need methadone rescue. 95% in OP group needed methadone rescues at high doses(> 15 mg/day). No differences regarding equivalent doses of sufentanil or morphine consumption on the 2nd, 4th, and 6th postoperative days were found. OFA-plus decreased ileus, nausea and vomiting (p < 0.001). 60.9% in OFA-plus group decreased opioid requirements at hospital-discharge compared with preoperative values. A 77% reduction of anxiolytics requirements was shown. Conclusion OFA-plus management for patients undergoing CCF with EDS-HT/JHS shows significant reduction in postoperative pain and at hospital-discharge compared with opioid-based anesthesia. OFA-plus management decreases the total doses of methadone rescues, reduces anxiolytic requirements and gastrointestinal side-effects, except for constipation. OFA-plus management is a feasible option to improve postoperative pain control, reducing the opioids’ use and their postoperative side-effects in patients undergoing CCF with EDS-HT/JHS.

scholarly journals Possible Future Monoclonal Antibody (mAb)-Based Therapy against Arbovirus Infections

2013 ◽  
Vol 2013 ◽  
pp. 1-21 ◽  
Author(s):  
Giuseppe Sautto ◽  
Nicasio Mancini ◽  
Giacomo Gorini ◽  
Massimo Clementi ◽  
Roberto Burioni
Keyword(s):  
Monoclonal Antibody ◽  
Monoclonal Antibodies ◽  
Side Effects ◽  
Antiviral Activity ◽  
The Other ◽  
Viral Escape ◽  
Passive Immunotherapy ◽  
Medical Need

More than 150 arboviruses belonging to different families are known to infect humans, causing endemic infections as well as epidemic outbreaks. Effective vaccines to limit the occurrence of some of these infections have been licensed, while for the others several new immunogens are under development mostly for their improvements concerning safety and effectiveness profiles. On the other hand, specific and effective antiviral drugs are not yet available, posing an urgent medical need in particular for emergency cases. Neutralizing monoclonal antibodies (mAbs) have been demonstrated to be effective in the treatment of several infectious diseases as well as in preliminaryin vitroandin vivomodels of arbovirus-related infections. Given their specific antiviral activity as well-tolerated molecules with limited side effects, mAbs could represent a new therapeutic approach for the development of an effective treatment, as well as useful tools in the study of the host-virus interplay and in the development of more effective immunogens. However, before their use as candidate therapeutics, possible hurdles (e.g., Ab-dependent enhancement of infection, occurrence of viral escape variants) must be carefully evaluated. In this review are described the main arboviruses infecting humans and candidate mAbs to be possibly used in a future passive immunotherapy.

scholarly journals Absent vagina a description of cases with varied ages, presentations and reconstructions

2019 ◽  
Vol 10 (3) ◽  
pp. 1741-1745
Author(s):  
Ali Adwal Ali ◽  
Khalida M. Amin ◽  
Emil N. AZZO ◽  
Ayla K. Kahya
Keyword(s):  
Adolescent Girls ◽  
Reproductive Tract ◽  
Case Series ◽  
The Other ◽  
Vaginal Agenesis ◽  
Young Females ◽  
The Third ◽  
Case Series Study ◽  
Series Study

The aim is to describe cases of vaginal agenesis of varied ages presentations and managements and report the outcome of interventions regarding restoration of continuity of reproductive tract and normal sexual activity. A prospective descriptive case series study.  Five female patients with vaginal agenesis were recruited from November 2005 to November 2016. Three were adolescents and had a functioning uterus. Three patients underwent vaginoplasty using McIndoe method, one had vagino-vaginal anastomosis, and the other had hysterectomy to remove source of menstruation. Age ranged from 12 to 24 years. The outcome of vaginoplasties to the 2 young females and to one of the adolescent girls was adequate vagina, whereas the other 2 adolescent girls had failed redo vaginoplasty and ended with a patent narrowed vagina in one and a closed vagina in the other which required a hysterectomy. On Follow up (range 5 - 42 months) 2 of the adolescent’s girls had regular menstruation with no pain and pelvic collection, while the third one had amenorrhoea following a hysterectomy. The 3 patients who had successful vaginoplasty got married and enjoyed satisfactory intercourse. Patients with absent vagina presents at variable ages depending on whether a functioning uterus is present or not. The success of vaginoplasty is less when it has to be done in adolescence than when it is done in adulthood when patient is grown-up. Best outcomes require accumulative experience, ideally with the aid of doctors of other specialties.

scholarly journals Opioid-free Anesthesia for Patients With Joint Hypermobility Syndrome Undergoing Craneo-cervical Fixation: a Case-series Study Focused on Anti-hyperalgesic Approach

2020 ◽  
Author(s):  
Carlos R Ramirez-Paesano ◽  
Albert Juanola Galcerán ◽  
Claudia Rodiera Clarens ◽  
Vicenç Gilete García ◽  
Bartolomé Oliver Abadal ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Hospital Discharge ◽  
Case Series ◽  
Joint Hypermobility Syndrome ◽  
Ehlers Danlos Syndrome ◽  
Discharge Data ◽  
Gastrointestinal Complications ◽  
Case Series Study ◽  
Series Study

Abstract Background. Patients with Ehlers-Danlos Syndrome/Hypermobility Type (EDS-HT/JHS) and Craneo-Cervical Instability frequently suffer from severe widespread pain which is difficult to control. Chronic neuroinflammation, opioid-induced hyperalgesia, and central sensitization may explain this painful condition.The aim of this study was to determine if opioid-free anesthesia plus the postoperative administration of lidocaine, ketamine and dexmedetomidine can reduce postoperative pain and the need of methadone rescues in comparison with opioid-based management in these patients undergoing Craneo-Cervical Fixation(CCF). The secondary aim was to assess the needs of opioids at hospital-discharge, incidence of gastrointestinal complications and the requirement of anxiolytic.Methods. A retrospective, consecutive case series study was designed. 42 patients with EDS-HT/JHS undergoing CCF were enrolled in two groups: an OFA-plus Group that received opioid-free anesthesia with propofol, lidocaine, ketamine and dexmedetomidine, and OP Group, opioid-based anesthesia-analgesia. The main variables: Preoperative Visual Analogue Score (VAS), postoperative VAS on the 1st, 2nd, 4th and 6th days, sufentanil or morphine requirements, need for methadone rescue, and VAS at hospital-discharge. Data was presented by mean ± SD, percentage, median or interquartile range. Chi-squared or Fisher’s test. 95% C.I and P values <0.05 . Results. Nineteen patients in OFA-plus, and 23 patients in OP group. VAS was lower in OFA-plus on the postoperative days evaluated (p<0.001).VAS at hospital-discharge was lower in OFA-plus: 4.96 (4.54-5.37) vs. OP 6.39 (6.07-6.71) (p<0.001). Methadone requirement was lower in the OFA-plus (p<0.001). 78% of patients in OFA-plus didn’t need methadone rescue. 95% in OP group needed methadone rescues at high doses(>15mg/day). No differences regarding equivalent doses of sufentanil or morphine consumption on the 2nd, 4th, and 6th postoperative days were found. OFA-plus decreased ileus, nausea and vomiting (p<0.001). 60.9% in OFA-plus group decreased opioid requirements at hospital-discharge compared with preoperative values. A 77% reduction of anxiolytics requirements was shown. Conclusion: OFA-plus management for patients undergoing CCF with EDS-HT/JHS shows significant reduction in postoperative pain and at hospital-discharge compared with opioid-based anesthesia. OFA-plus management decreases the total doses of methadone rescues, reduces anxiolytic requirements and gastrointestinal side-effects, except for constipation. OFA-plus management is a feasible option to improve postoperative pain control, reducing the opioids’ use and their postoperative side-effects in patients undergoing CCF with EDS-HT/JHS.

scholarly journals Systemic Minoxidil Accidental Exposure in a Paediatric Population: A Case Series Study of Cutaneous and Systemic Side Effects

2021 ◽  
Vol 10 (18) ◽  
pp. 4257
Author(s):  
Manuel Sánchez-Díaz ◽  
David López-Delgado ◽  
Trinidad Montero-Vílchez ◽  
Luis Salvador-Rodríguez ◽  
Alejandro Molina-Leyva ◽  
...  
Keyword(s):  
Side Effects ◽  
Treatment Time ◽  
Case Series ◽  
Paediatric Population ◽  
High Dose ◽  
Retrospective Case ◽  
Case Series Study ◽  
High Doses ◽  
Initial Zone ◽  
Series Study

Oral minoxidil is an approved treatment for high blood pressure which is also used as an off-label drug for alopecia. Knowledge about the effects of systemic minoxidil in the paediatric population is limited. A retrospective case series study of paediatric patients with history of systemic minoxidil intake due to contaminated sets of omeprazole was performed to describe side effects of high dose oral minoxidil intake in children. Twenty patients aged between 2 months and 13 years joined the study. They had received high doses of oral minoxidil (mean dose 0.90 mg/kg/day) during a mean time of 38.3 days. Hypertrichosis appeared in 65%, with a mean latency time of 24.31 days. Treatment time was associated with the appearance of hypertrichosis (p < 0.05). Most common initial zone of hypertrichosis was the face. Systemic effects developed in 15%, with no cases of severe disorders. The present study shows a novel insight into the side effects of high doses of oral minoxidil in children.

Combined in vivo reflectance confocal microscopy and digital dermoscopy for follow up of patients at high risk of malignant melanoma: A prospective case series study

2017 ◽  
Vol 44 (6) ◽  
pp. 681-689 ◽  
Author(s):  
Uxúa Floristán Muruzábal ◽  
Reyes Gamo Villegas ◽  
Ana Pampín Franco ◽  
Fernando Pinedo Moraleda ◽  
Elia Pérez Fernández ◽  
...  
Keyword(s):  
High Risk ◽  
Malignant Melanoma ◽  
Confocal Microscopy ◽  
Case Series ◽  
Case Series Study ◽  
Prospective Case Series ◽  
Series Study ◽  
Digital Dermoscopy
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