Neurometabolic Therapy in Patients with Encephalopathy Associated with COVID-19

The objective: to evaluate the effectiveness of neurometabolic therapy in patients with severe course of the new coronavirus infection of COVID-19 complicated by the development of encephalopathy.Subjects and Methods. A pilot prospective study was carried out with the participation of 61 patients with a severe course of COVID-19 complicated by encephalopathy. The patients were randomized into two groups: the study group (n = 34), the patients in which, in contrast to the control group (n = 27), received Cytoflavin in addition to the main therapy in a daily dose of up to 40 ml for 5 days. The dynamics of the general and neurological status was assessed on days 3‒4 and 6‒7 days of treatment using the NEWS (National Early Warning Score), Glasgow coma and ICDSC (Intensive Care Delirium Screening Checklist) scales. Additionally, the blood level of neuron-specific enolase (NSE) was investigated at baseline and on days 6‒7.Results. Patients in most cases were elderly or senile with a high comorbidity index (up to 4 points according to Charlson). The persistence of delirious symptoms correlated with their age and low SpO2 levels. In half of the cases (50.8%), the disease had an unfavorable outcome. In the study group, by the 6‒7th day of treatment, there was a significant positive dynamics of the general condition, assessed by the NEWS scale (p = 0.012), a tendency towards a faster recovery of the overall score on the Glasgow scale (p = 0.083), a tendency towards more rapid regression of delirious symptoms by ICDSC scale (p = 0.055) versus the comparison group.Conclusions. Given the high risk of an unfavorable outcome in patients with a severe course of COVID-19 complicated by the development of encephalopathy, the additional use of Cytoflavin is advisable since it contributes to the regression of the symptoms of encephalopathy and may have a positive effect on the course of the disease.

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A new look at the correction of COVID-19-mediated pulmonary gas exchange disorders

Kazan medical journal ◽

10.17816/kmj2021-362 ◽

2021 ◽

Vol 102 (3) ◽

pp. 362-372

Author(s):

I S Simutis ◽

G A Boyarinov ◽

M Yu Yuriev ◽

D S Petrovsky ◽

A I Kovalenko ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Gas Exchange ◽

Sodium Succinate ◽

Intensive Therapy ◽

Infusion Therapy ◽

Control Group ◽

Electrolyte Balance ◽

Study Group ◽

Coronavirus Infection

Aim. To assess the effect of meglumine sodium succinate on the effectiveness of basic therapy in correcting gas exchange abnormalities in patients with severe COVID-19 infection complicated by bilateral community-acquired pneumonia. Methods. The analysis of the effectiveness of therapy of 12 patients with a diagnosis of New coronavirus infection COVID-19 (confirmed), severe form U07.1. Complication: bilateral multifocal pneumonia was carried out. The patients were divided into two groups: 7 received, as part of standard therapy, a solution of meglumine sodium succinate in a daily dose of 5 ml/kg during stay in the intensive care unit; 5 patients received a similar volume of Ringer's solution and formed the control group. In the arterial and venous blood of all patients, the indicators of acid-base state and water-electrolyte balance, glycemia and lactatemia were measured at several stages: (1) at admission to the intensive care unit, (2) 24 hours after the start of intensive therapy, (3) after 812 hours, (4) after 24 hours. On the 28th day of observation, mortality, the duration of treatment in the intensive care unit and the incidence of thrombotic complications in the groups were assessed. The Friedman nonparametric hypothesis test was used to assess intragroup dynamics, and the nonparametric Mannhitney U test for intergroup comparisons. Results. In the group of patients who received meglumine sodium succinate, there was a significant decrease in the incidence of thromboembolic events during 28 days of treatment: myocardial ischemia event rate ratio from 0.89 [95% confidence interval (CI) 0.191.16] in the control group to 0.55 (95% CI 0.060.81) in the study group at p=0.043; pulmonary embolism event from 0.50 (95% CI 01.0) in the control group to 0.28 (95% CI 01.0) in the study group at p=0.041. There was also a decrease in the duration of intensive care unit length of stay to 6.11.1 days in the study group versus 8.91.3 days in the control group. Conclusion. Compared with standard infusion therapy, the use of meglumine sodium succinate leads to a faster normalization of ventilation-perfusion ratios in patients with severe coronavirus infection.

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OPIOID-FREE ANESTHESIA FOR EXTRACRANIAL BYPASS SURGERIES IN PATIENTS WITH POLYVASCULAR DISEASE

Complex Issues of Cardiovascular Diseases ◽

10.17802/2306-1278-2018-7-3-94-101 ◽

2018 ◽

Vol 7 (3) ◽

pp. 94-101

Author(s):

M. A. Evseev ◽

E. D. Chumachenko ◽

G. P. Plotnikov ◽

D. L. Shukevich

Keyword(s):

Neuropsychological Testing ◽

S100 Protein ◽

Group Versus ◽

Early Mobilization ◽

Perioperative Period ◽

Study Groups ◽

Neurological Status ◽

Cognitive Status ◽

Control Group ◽

Study Group

Aim. To assess safety and effectiveness of opioid-free anesthesia in patients with polyvascular disease undergoing carotid endarterectomy for early mobilization and hemodynamic stability in the perioperative period.Methods. 28 consecutive male patients with polyvascular disease and internal carotid artery stenoses were included in a single-center, randomized observational study. The control group (n = 12) received conventional intravenous anesthesia of fentanyl 0.1 mg bolus every 20 minutes with continuous sedation with propofol at a rate of 4 mg / kg / h. The study group (n = 16) received conventional anesthesia followed by introvenous nefopam 20 mg with continuous infusion of 40 mg/h. Invasive monitoring of blood pressure, sedation depth, and the analgesia nociception index were measured. The marker of brain damage, S100 protein, was measured in blood plasma. All patients underwent neuropsychological testing in the perioperative period.Results. There were no reliable hemodynamic derangements during anesthesia in both study groups. There were no cases with worsening of the initial coronary circulation according to the ECG. No alterations in the initial neurological status were registered. BIS values were maintained at 56±19 in both groups without increasing the dose of propofol. All patients in the study group versus 5 patients (41.7%) in the control group were extubated in the OR unit.Conclusion. Opioid-free anesthesia in patients with polyvascular disease undergoing CEA allows achieving adequate pain management in the perioperative period, ensuring early extubation in the OR unit and postoperative mobilization while maintaining stable hemodynamic parameters and ensuring safe cognitive status.

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Impact of combined hazardous production factors on the development of comorbidal pathology in men working in a large industrial enterprise of Tyumen

Medical Science And Education Of Ural ◽

10.36361/1814-8999-2021-22-2-120-123 ◽

2021 ◽

Vol 22 (2) ◽

pp. 120-123

Author(s):

T. F. Blaginina ◽

◽

K. A. Semenova ◽

T. V. Bolotnova ◽

◽

...

Keyword(s):

Clinical Laboratory ◽

Electrical Equipment ◽

Static Stress ◽

Industrial Enterprise ◽

Control Group ◽

Control Panel ◽

Study Group ◽

Industrial Noise ◽

Production Factors ◽

Comorbidity Index

Aim. To establish the strength and direction of the correlation between the comorbidity index depending on the combined impact of harmful production factors in men working at a large industrial enterprise in Tyumen. Materials and methods. A single-stage retrospective cohort study of working men in industrial conditions was carried out. Anamnestic, clinical, laboratory, biochemical, instrumental methods were used. Diagnoses were made on the basis of modern clinical guidelines criteria. The groups were comparable in age and formed depending on the number of harmful production factors. Study group n = 52 – men with multiple 3-5 harmful production factors (industrial noise, general vibration, height at work, exposure to welding aerosol, night shifts, static stress) as the number of the following professions increases: crane operators, bulldozer operators, and compressor installations, fitters, electricians for maintenance of electrical equipment, batchers of concrete components. mixtures, electric and gas welders, Kamaz drivers of the 2nd class, locksmiths, repairmen, molders of reinforced concrete products and structures, loaders, operators of the equipment control panel, installers, plumber on duty; their average age in the group was 44.8 ± 14.7. Control group n = 50 – men with 1-2 harmful production factors (industrial noise, static stress) as the number increases in the presence of the following professions: site managers, janitor, auxiliary workers, class 1 bus drivers, construction and installation work foremen, fitters for the repair and maintenance of gas equipment, concrete workers, carpenters; their average age in the group was 43.8 ± 16.2. Results. Between the combined effects of harmful production factors with the comorbidity index, a direct strong correlation was established r = 0.841 ***, p < 0.001 (95% CI 0.672-0.926) according to the Pearson method in the study group, whose experience was 2.2 years longer, then as in the control group, no statically significant correlation was found r = 0.339, p > 0.05 (95% CI -0.065-0.647) according to Pearson’s method. Conclusion. The combined effect of 3-5 harmful production factors is statistically significant with an increase in length of service increases the risk of developing comorbid pathology in men of working age working at a large industrial enterprise, which increases the 10-year risk of fatal complications.

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Ozone Therapy in Patients with the New Coronavirus Infection COVID-19

Journal of restorative medicine and rehabilitation ◽

10.38025/2078-1962-2020-99-5-94-100 ◽

2020 ◽

Vol 99 (5) ◽

pp. 94-100

Author(s):

E.V. Hammad ◽

I.G. Nikitin ◽

K.V. Fedorova

Keyword(s):

Clinical History ◽

Solution Concentration ◽

Physiological Solution ◽

Control Group ◽

Study Group ◽

Imaging Data ◽

Ozone Therapy ◽

Physiological Processes ◽

Coronavirus Infection ◽

Therapy Protocol

Aim. In our work we seek to develop new approaches for treating patients with COVID-19. The first reports about new coronavirus infection, COVID-19, came out in China in 2019. It was recognized by WHO as a pandemic crisis on March 11, 2020. Currently, there is no standard therapy protocol for COVID-19 and the drugs are used off label. Materials and methods. We have implemented ozone therapy into clinical practice as an adjuvant treatment regimen for patients with SARS-CoV-2 infection. In our study, 19 patients received ozone therapy and 18 patients were members of the control group. All patients had a positive PCR test for SARS-CoV-2 infection and were matched by the following features: sex, age, severity of symptoms, imaging data and clinical history. Patients in the study group received ozone therapy in the form of daily intravenous infusions of ozonized physiological solution (concentration: 2.2-2.4 mg/l). Conclusion. We observed a statistically significant improvement in laboratory, radiological and clinical tests of patients in the study group compared to the control group on the 14th day. Thus, we have demonstrated the benefits of using ozone therapy in patients with the new coronavirus infection COVID-19. Taking into consideration the physiological processes underlying such approach, ozone therapy should be justified for both phases: the beginning and at the peak of the disease.

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Pathogenetically-oriented therapy for novel coronavirus infection

Russian Medical Inquiry ◽

10.32364/2587-6821-2020-4-4-192-198 ◽

2020 ◽

Vol 4 (4) ◽

pp. 192-198

Author(s):

L.R. Mukhamadieva ◽

◽

G.A. Mavzyutova ◽

E.B. Tyurina ◽

O.Z. Kuzovkina ◽

...

Keyword(s):

Standard Therapy ◽

Laboratory Tests ◽

Symptom Relief ◽

Lung Parenchyma ◽

Helical Computed Tomography ◽

Control Group ◽

Study Group ◽

Complex Treatment ◽

Coronavirus Infection ◽

Novel Coronavirus

Aim: to assess clinical efficacy of azoximer bromide in the complex inpatient treatment for COVID-19. Patients and Methods: the study included 20 patients aged 16–65 years with verified moderate novel coronavirus infection who received inpatient care. All patients were divided into two groups. Study group patients (n=10) received complex treatment that included azoximer bromide. Control group patients (n=10) received standard therapy only. The criterion of treatment efficacy was the improvement of major disease symptoms, radiographic manifestations, and pro-inflammatory laboratory tests. Results: azoximer bromide as a component of the treatment for novel coronavirus infection provides more rapid symptom relief (i.e., cough, sputum, fever, respiratory rate) compared to the standard therapy (p<0.05). azoximer bromide also provides more rapid radiographic improvement as demonstrated by helical computed tomography, i.e., by day 14, the percentage of lung parenchyma involved was 5% in the study group and 10–12% in the control group (p<0.05). In addition, the improvement of pro-inflammatory laboratory tests (i.e., normal WBC count, decrease in ESR) was revealed as well (p<0.05). Conclusion: azoximer bromide as a component of the complex treatment for novel coronavirus infection is associated with the clinical improvement that manifests with more rapid relief of inflammation and lung parenchyma involvement as compared with the standard therapy. No adverse reactions were reported. KEYWORDS: coronavirus infection, SARS-CoV2, COVID-19, pneumonia, immune correction, pathogenetically-oriented therapy, azoximer bromide. FOR CITATION: Mukhamadieva L.R., Mavzyutova G.A., Tyurina E.B., Kuzovkina O.Z. Pathogenetically-oriented therapy for novel coronavirus infection. Russian Medical Inquiry. 2020;4(4):192–198. DOI: 10.32364/2587-6821-2020-4-4-192-198.

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Effect of abiraterone combined with prednisone on serum CgA and NSE in metastatic castration-resistant prostate cancer without previous chemotherapy

Tropical Journal of Pharmaceutical Research ◽

10.4314/tjpr.v18i3.27 ◽

2021 ◽

Vol 18 (3) ◽

pp. 631-637

Author(s):

Ke Yang ◽

Tieqiu Li ◽

Zhiyong Gao ◽

Weiwei Zhang

Keyword(s):

Prostate Cancer ◽

Specific Antigen ◽

Neuron Specific Enolase ◽

Progression Free Survival ◽

Control Group ◽

Study Group ◽

Castration Resistant Prostate Cancer ◽

Castration Resistant ◽

Psa Progression

Purpose: To investigate the influence of a combination of abiraterone and prednisone on serum chromogranin A (CgA) and neuron-specific enolase (NSE) in patients with metastatic castrationresistant prostate cancer (mCRPC) without previous chemotherapy, so as to provide reference data for drug therapy of prostate cancer. Methods: A total of 103 mCRPC patients without chemotherapy from January 2013 to March 2017 were included in this retrospective study. Seventy-one (71) patients received prednisone combined with abiraterone (study group), while 32 patients accepted prednisone (control group). The CgA, NSE and prostate-specific antigen (PSA) in the two groups were monitored, while PSA progression-free survival (PSA-PFS), radiographic PFS (rPFS), and overall survival (OS) were determined during follow-up. Results: PSA-PFS, rPFS and OS in the study group were significantly higher than those in the control group (p < 0.05). The increased proportion of CgA or NSE in the study group was significantly lower than that in the control group at 6 months of treatment (p < 0.05). The occurrences of NED before treatment and 6 months after treatment were both independent predictors of PSA and radiographic progression in the study group (p < 0.05). Conclusion: The combination of prednisone and abiraterone is helpful for prognosis in mCRPC patients that are not on chemotherapy. The occurrence of NED predicts mostly poor prognosis of mCRPC patients on a combination of abiraterone and prednisone

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Соматические дисфункции у детей с задержкой речи

Russian Osteopathic Journal ◽

10.32885/2220-0975-2017-3-4-61-65 ◽

2017 ◽

pp. 61-65

Author(s):

E. L. Kuznetsova ◽

L. A. Dultsev ◽

E. V. Safin

Keyword(s):

Standard Treatment ◽

Control Group ◽

Complex Therapy ◽

Osteopathic Treatment ◽

Positive Effect ◽

Experimental Group

Goal of research - the study aims to examine the osteopathic proﬁ le of children with dysarthria and to develop recommendations for osteopathic correction of somatic dysfunctions in 2-3 year old children presenting this pathology.Materials and methods. 30 2-3 year old children with the symptoms of dysarthria took part in the research. All the children were divided into 2 groups: the control group of 15 children received standard treatment, and the experimental group of 15 children received both standard and osteopathic treatment. The dysarthria severity and the osteopathic proﬁ le were evaluated with account of the number of somatic dysfunctions at global, regional, and local levels.Results. The osteopathic correction was shown to have a positive effect on dysarthria severity. The study established a correlation between the dysarthria severity in children and the number of somatic dysfunctions at the local level.Conclusion. The study suggests using osteopathic correction of somatic dysfunctions in the complex therapy of dysarthria in children.

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Pretreatment with Methylprednisolone Improves Myocardial Protection during On-Pump Coronary Artery Bypass Surgery

The Heart Surgery Forum ◽

10.1532/hsf.1367 ◽

2015 ◽

Vol 18 (4) ◽

pp. 171 ◽

Cited By ~ 1

Author(s):

Tolga Demir ◽

Mehmet Umit Ergenoglu ◽

Hale Bolgi Demir ◽

Nursen Tanrikulu ◽

Mazlum Sahin ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass ◽

Myocardial Protection ◽

Troponin T ◽

Artery Bypass ◽

Control Group ◽

Study Group ◽

Cabg Surgery ◽

Anti Inflammatory ◽

Pump Coronary Artery Bypass

Background: This study was undertaken to determine whether methylprednisolone could improve myocardial protection by altering the cytokine profile toward an anti-inflammatory course in patients undergoing elective coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB). Methods: Forty patients who were scheduled for elective CABG surgery were randomized into two groups: the study group (n = 20), who received 1 g of methylprednisolone intravenously before CPB, and the control group (n = 20), who underwent a standard CABG surgery without any additional medication. Blood samples were withdrawn prior to surgery (T1) and then 4 hours (T2), 24 hours (T3), and 36 hours (T4) after CPB. Plasma levels of interleukin (IL)-6, IL-10, creatine kinase isoenzyme MB (CK-MB), cardiac troponin-t (cTnT), and blood glucose as well as neutrophil counts were measured at each sampling time. Results: A comparison of patients between both groups revealed significantly high levels of IL-6 in the control group at T2, T3, and T4 with respect to T1 (T2: P < .001; T3: P < .001; T4: P < .001). IL-10 levels were significantly higher in the study group at T2 compared with the control group (P = .007). CK-MB levels were significantly lower in the study group than in the control group at T4 (P = .001). The increase of cTnT was higher in the control group at T3 and T4 compared with the study group (T3: P = .002; T4: P = .001). Conclusions: This study demonstrates that methylprednisolone is effective for ensuring better myocardial protection during cardiac surgery by suppressing the inflammatory response via decreasing the levels of IL-6 and by increasing anti-inflammatory activity through IL-10.

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Pragmatic instruction in L2-Russian

Instructed Second Language Acquisition ◽

10.1558/isla.39864 ◽

2020 ◽

Vol 4 (1) ◽

pp. 62-95

Author(s):

Daniele Artoni ◽

Valentina Benigni ◽

Elena Nuzzo

Keyword(s):

Foreign Language ◽

Speech Acts ◽

Control Group ◽

Written Discourse ◽

Instructional Treatment ◽

Completion Task ◽

Positive Effect ◽

Experimental Group ◽

National Corpus ◽

Pragmatic Instruction

Over the last three decades, a growing number of studies have investigated the effects of instruction on the acquisition of pragmatic features in L2. The bulk of this research has focused mainly on the teaching of English as a second/foreign language. However, instructional pragmatic studies in L2-Russian are lacking. The main purpose of our study is to contribute towards filling this gap by analysing the effects of pragmatic instruction on the acquisition of two speech acts by Italian learners of Russian. Furthermore, we aim to explore whether the Multimodal Russian Corpus (MURCO), a multimedia subcorpus of the Russian National Corpus, can be an effective tool for teaching speech acts in L2-Russian. Our research was composed of one experimental group (n = 18) and one control group (n = 11); each was composed of two intact classes of Italian university students at an intermediate level of L2-Russian, who were pre- and post-tested using a written discourse completion task. The experimental group was subjected to a programme of pragmatic instruction – eight thirty-minute MURCO-based lessons devoted to requests and advice, while the control group was taught according to the standard syllabus, that is, with no pragmatic instruction. The results revealed that the use of the target pragmatic features varied significantly in the experimental group, but not in the control group, thus showing a general positive effect of the instructional treatment based on the MURCO corpus. However, some limitations were identified with regard to the usability of this tool by teachers and learners.

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CARDIOVASCULAR RISK FACTORS PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION AND CHRONIC INFLAMMATORY LUNG DISEASES

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2020-22-9-21-25 ◽

2020 ◽

pp. 21-25

Author(s):

Tupitsyn V.V. ◽

Bataev Kh.M. ◽

Men’shikova A.N. ◽

Godina Z.N.

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Heart Disease ◽

Cardiovascular Risk ◽

Digestive System ◽

Control Group ◽

Study Group ◽

Type I ◽

Internal Organs ◽

History Of

Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.

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