scholarly journals COVID-19: well-known drugs, new opportunities

2020 ◽  
pp. 170-180
Author(s):  
A.Kh. Ashirmetov ◽  
◽  
I.R. Mavlyanov ◽  
Z.I. Mavlyanov ◽  
G.Zh. Zharylkasynova ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Combined Therapy ◽  
Clinical Practices ◽  
Management Procedures ◽  
A Cell ◽  
Coronavirus Infection ◽  
Anti Inflammatory ◽  
The Moment ◽  
Treatment Procedures ◽  
Based Medicine

Up to now, coronavirus infection that causes an acute respiratory syndrome has been detected almost in all countries worldwide. Global spread of SARS-CoV-2 virus has become a world pandemic and there is no efficient and commonly accepted conventional therapy against COVID-19. Due to the existing emergency most drugs that can potentially be used to treat COVID-19 are allowed to be applied only basing on certain data probing their safety and efficiency against SARS-CoV. At present only Lopinavir/Ritonavir and Remdesivir are the only anti-virus drugs that are included into well-recognized management procedures for COVID-19 treatment; an acceptable alternative could probably be combined therapy that includes Hydroxychloroquine and Azithromycin. Given the existing situation, a lot of drugs that are usually used to treat other diseases are now being suggested as probable ways to treat COVID-19 taking into account all the available knowledge on pathophysiology of the infection. In this review, basing on available data on how SARA-CoV-2 virus enters a cell and pathophysiological aspects of cytokine storm development, we have strived to highlight certain prospects related to applying anti-viral medications, anti-inflammatory and immune-suppressing drugs, vitamins and microelements that are widely used to treat and prevent various diseases. Most tested drugs as well as zinc preparations, and vitamins С and D3 turned out to have not only immune-modulating but also anti-inflammatory properties; or either they were able to block ways for the virus to enter a cell or disrupt SARS-CoV-2 intracellular replication. Having leant from previous experience in fighting against SARS and MERS, doctors have applied some existing drugs to treat COVID-19 infections in their clinical practices; clinical tests aimed at confirming their safety and efficiency in treating COVID-19 are still being performed at the moment. Although a lot of various treatment procedures have been suggested, it is necessary to perform specifically planned randomized clinical trials based on evidence-based medicine principles, if we want to determine the most suitable ones.

scholarly journals COVID-19: well-known drugs, new opportunities

2020 ◽  
pp. 170-180
Author(s):  
A.Kh. Ashirmetov ◽  
◽  
I.R. Mavlyanov ◽  
Z.I. Mavlyanov ◽  
G.Zh. Zharylkasynova ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Combined Therapy ◽  
Clinical Practices ◽  
Management Procedures ◽  
A Cell ◽  
Coronavirus Infection ◽  
Anti Inflammatory ◽  
The Moment ◽  
Treatment Procedures ◽  
Based Medicine

Up to now, coronavirus infection that causes an acute respiratory syndrome has been detected almost in all countries worldwide. Global spread of SARS-CoV-2 virus has become a world pandemic and there is no efficient and commonly accepted conventional therapy against COVID-19. Due to the existing emergency most drugs that can potentially be used to treat COVID-19 are allowed to be applied only basing on certain data probing their safety and efficiency against SARS-CoV. At present only Lopinavir/Ritonavir and Remdesivir are the only anti-virus drugs that are included into well-recognized management procedures for COVID-19 treatment; an acceptable alternative could probably be combined therapy that includes Hydroxychloroquine and Azithromycin. Given the existing situation, a lot of drugs that are usually used to treat other diseases are now being suggested as probable ways to treat COVID-19 taking into account all the available knowledge on pathophysiology of the infection. In this review, basing on available data on how SARA-CoV-2 virus enters a cell and pathophysiological aspects of cytokine storm development, we have strived to highlight certain prospects related to applying anti-viral medications, anti-inflammatory and immune-suppressing drugs, vitamins and microelements that are widely used to treat and prevent various diseases. Most tested drugs as well as zinc preparations, and vitamins С and D3 turned out to have not only immune-modulating but also anti-inflammatory properties; or either they were able to block ways for the virus to enter a cell or disrupt SARS-CoV-2 intracellular replication. Having leant from previous experience in fighting against SARS and MERS, doctors have applied some existing drugs to treat COVID-19 infections in their clinical practices; clinical tests aimed at confirming their safety and efficiency in treating COVID-19 are still being performed at the moment. Although a lot of various treatment procedures have been suggested, it is necessary to perform specifically planned randomized clinical trials based on evidence-based medicine principles, if we want to determine the most suitable ones.

Ibuprofen safety at the golden anniversary. A commentary and recent developments

2020 ◽  
Keyword(s):  
The World ◽  
Recent Developments ◽  
Inflammatory Drugs ◽  
Coronavirus Infection ◽  
Interesting Story ◽  
Anti Inflammatory ◽  
Short Comment ◽  
Published Paper

Ibuprofen is a long lasting non-steroidal anti-inflammatory drugs (NSAIDs) and still represents one of the most diffused analgesics around the world. It has an interesting story started over 50 years ago. In this short comment to an already published paper, the authors try to focus some specific important point. On top, they illustrate the recent, confusing and fake assertion on the potentially dangerous influence that ibuprofen could have, increasing the risk of Coronavirus infection. This is also better illustrated in a previously published paper, where the readers could find more clear responses to eventual doubts.

Testosterone exerts selective anti-inflammatory effects on human skin mast cells in a cell subset dependent manner

2012 ◽  
Vol 21 (11) ◽  
pp. 878-880 ◽  
Author(s):  
Sven Guhl ◽  
Metin Artuc ◽  
Torsten Zuberbier ◽  
Magda Babina
Keyword(s):  
Mast Cells ◽  
Human Skin ◽  
Cell Subset ◽  
Dependent Manner ◽  
A Cell ◽  
Anti Inflammatory

Microskills of Clinical Supervision: Scaffolding Skills

2008 ◽  
Vol 22 (1) ◽  
pp. 29-36 ◽  
Author(s):  
Ian Andrew James ◽  
Derek Milne ◽  
Rachel Morse
Keyword(s):  
Clinical Supervision ◽  
Cognitive Behavioral ◽  
Clinical Practices ◽  
Effective Learning ◽  
The Moment

This article examines some of the microskills associated with the moment-to-moment decisions and actions of supervisors within cognitive-behavioral supervision. Through a theoretical review and practice illustration, the article outlines the role of supervisors’ dialogue and questioning styles in promoting effective learning. The article also provides a potential guide to the training of supervisors and thereby attempts to benefit clinical practices in general.

scholarly journals December 2021 Pulmonary Case of the Month: Interstitial Lung Disease with Red Knuckles

2021 ◽  
Vol 23 (6) ◽  
pp. 151-154
Author(s):  
Richard Robbins ◽  
◽  
Stephen Klotz
Keyword(s):  
Interstitial Lung Disease ◽  
Inpatient Care ◽  
Rna Viruses ◽  
Specific Binding ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
Dipeptidyl Peptidase 4 ◽  
A Cell ◽  
Coronavirus Infection

No abstract available. Article truncated after 150 words. We thought a follow-up to our original brief review of COVID-19 in February, 2020 might be useful. As we write this in early December 2021, we again caution that this area is rapidly changing and what is true today will likely be outdated tomorrow. We again borrowed heavily from the Centers for Disease Control (CDC) CDC website and the NIH website which have extensive discussions over numerous pages covering COVID-19. Our hope is to condense those recommendations. We do not discuss inpatient care in any detail. COVID-19 Variants The initial steps of coronavirus infection involve the specific binding of the coronavirus spike (S) protein to the cellular entry receptors which are normally on a cell. These include human aminopeptidase N (APN; HCoV-229E), angiotensin-converting enzyme 2 (ACE2; HCoV-NL63, SARS-CoV and SARS-CoV-2) and dipeptidyl peptidase 4 (DPP4; MERS-CoV). All viruses, but especially simple single-stranded RNA viruses like COVID-19, constantly change through mutation …

scholarly journals Enseñanza clínica en enfermería: escenario del aprendizaje y sus actores

2015 ◽  
Vol 4 (7) ◽  
pp. 44
Author(s):  
Norma Ivette Beltran Lugo ◽  
Betsy Flores Atilano ◽  
Dulce María Guillén Cadena
Keyword(s):  
Actual World ◽  
Clinical Teaching ◽  
Clinical Settings ◽  
Clinical Practices ◽  
Continuous Formation ◽  
Great Responsibility ◽  
Health Institutions ◽  
Personnel Needs ◽  
The Moment ◽  
Sobre Todo

<div>La ense&ntilde;anza se concibe como la tarea m&aacute;s peculiar de la escuela, cuyas funciones educativas deben estructurarse (P&eacute;rez G&oacute;mez, 1992) en torno a dos funciones. El acto de ense&ntilde;ar no es responsabilidad totalmente del docente universitario, sino que involucra al personal operativo de las instituciones de salud. La ense&ntilde;anza cl&iacute;nica es el momento donde se tiene contacto con el mundo real y los diferentes ambientes que se generan para la construcci&oacute;n de nuevos h&aacute;bitos profesionales, el desarrollo de la empat&iacute;a con la disciplina y hasta el gusto de ser enfermero. La problem&aacute;tica que tenemos actualmente es que a veces el personal de Enfermer&iacute;a da por hecho que los y las estudiantes ya tienen los conocimientos pero sobre todo las habilidades pr&aacute;cticas para ejecutar intervenciones que implican gran responsabilidad, pero cuando la alumna demuestra que no tiene esas habilidades es desplazada y limitada a la observaci&oacute;n. El profesorado debe tener una formaci&oacute;n continua y tambi&eacute;n debe salir a hacer pr&aacute;cticas cl&iacute;nicas para que de esta forma no pierda las habilidades y destrezas en la ejecuci&oacute;n de diversos procedimientos de Enfermer&iacute;a. Aunque existe el programa de estancias cl&iacute;nicas para profesores, &eacute;stos deben ser comprometidos a ejecutarlas independientemente de que laboren en alg&uacute;n otro lugar, ya que de &eacute;sta forma se pueden actualizar en las nuevas tecnolog&iacute;as del cuidado y tendr&aacute;n herramientas muy &uacute;tiles durante su ense&ntilde;anza.</div><div><br /></div><div><div>Teaching is conceived as the most peculiar task of the school, which educative functions must be structured (P&eacute;rez G&oacute;mez, 1992) around two functions. The act of teaching isn&rsquo;t the universitarian teacher&rsquo;s responsibility completely, but also the health institutions&rsquo; personnel&acute;s. Clinical teaching is the moment when contact is had with the actual world and the different environments created to construct new professional habits, development of empathy and even the joy of being a nurse. The issue we currently have is that sometimes nursing personnel take for granted that students already have all the knowledge, but mostly all the practical abilities to perform interventions that imply great responsibility, but when the student shows the lack those skills, they&rsquo;re set aside and limited to observation only. Teaching personnel needs to have a continuous formation and they also have to do clinical practices so this way they won&acute;t lose the abilities and dexterities on the execution of different nursing procedures. Even though there&rsquo;s the clinical settings program for teachers, they have to be committed to execute it, whether they work or not at other place, so this way caring technologies can be updated and they&rsquo;ll have very useful tools for teaching.</div></div><div><br /></div>

scholarly journals PREDISPOSING FACTORS AND TREATMENT OF OSTEOARTHRITIS AFTER SURGERIES PERFORMED FOR TIBIAL FRACTURES

World Science ◽  
2019 ◽  
Vol 1 (12(52)) ◽  
pp. 16-19
Author(s):  
Dudko O. G. ◽  
Glubochenko O. V. ◽  
Pickula V. V. ◽  
Marchuk O. F. ◽  
Shayko-Shaykovskiy O. G.
Keyword(s):  
Surgical Treatment ◽  
Healing Process ◽  
Joint Stiffness ◽  
Tibial Fractures ◽  
Joint Surface ◽  
Aseptic Necrosis ◽  
Intraarticular Fractures ◽  
Rehabilitation Period ◽  
The Moment ◽  
Treatment Procedures

Tibial fractures are very common injuries that require surgical management. For many cases, when the fracture involves the joint further complications occur, such as joint stiffness, osteoarthritis, aseptic necrosis of articular surfaces, ankylosis, infection complications, etc. To prevent joint stiffness open reduction and internal fracture fixation is used. That allows better positioning of fracture fragments forming joint surface and improve outcome. The article analyses results of surgical treatment of intraarticular fractures as well as biomechanical factors that are affecting the joint within the healing process and in later outcome period. Various treatment procedures are suggested to prevent development of osteoarthritis or to decrease its severity. The following options are used on all stages of treatment starting since the moment of injury, primary surgical procedures, rehabilitation period, and further non-surgical treatment in the internal medicine department. Important roles are assigned for use of chondroprotective drugs, intraarticular injections of Hyaluronic acid, physiotherapy and physical activity.

New coronavirus infection, hemostasis and heparin dosing problems: It is important to say now

2020 ◽  
Author(s):  
А.Ю. Буланов ◽  
Е.В. Ройтман
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight ◽  
Evidence Based ◽  
Low Molecular Weight Heparins ◽  
Heparin Resistance ◽  
Hospital Patients ◽  
Expert’S Opinion ◽  
Coronavirus Infection ◽  
Based Medicine ◽  
D Dimer

В отсутствие достаточной базы доказательной медицины самым ценным становится мнение экспертов, опирающихся на свой опыт и опыт коллег. COVID-19-ассоциированная коагулопатия имеет характер тромбовоспаления. Назначение гепаринов — нефракционированного или, главным образом, низкомолекулярного (НМГ) призвано преодолеть его, поскольку гепарин обладает не только антикоагулянтным эффектом, но и оказывает непрямое и прямое противовоспалительное дейст вие. Поэтому назначение НМГ как минимум в профилактических дозах показано всем госпитализированным пациентам. Система гемостаза у пациентов с COVID-19, прежде всего у тяжелых, требует лабораторной оценки количества тромбоцитов, содержания Д-димера, протромбинового отношения или процентов протромбина по Квику и концентрации фибриногена. Анализ данных показал, что своеобразие коронавирусного гемостаза формирует гиперфибриногенемия, которая становится явным фактором гепаринорезистентности. Для преодоления последней назначение увеличенных (промежуточных или лечебных) доз НМГ выглядит перспективным решением. Достаточность назначения уместно определить либо по анти- Ха активности или (как экспресс-оценка) по тромбоэластрограмме. In the absence of a suffi cient base of evidence-based medicine, the most valuable becomes the expert’s opinion as a mirror of both personal and collegial experience. COVID-19-associated coagulopathy has a character of a thromboinfl ammation. The heparins — unfractionated or mainly low molecular weight heparins (LMWH) are intended to overcome it, since heparins have not only an anticoagulant effect but both an indirect and direct anti-infl ammatory effects as well. So that LMWH are indicated for all in-hospital patients. Patients with COVID-19, especially in severe cases, require laboratory testing of platelet count, D-dimer, prothrombin ratio or prothrombin percents by Quick and fi brinogen. Data analysis showed that a feature of coronavirus hemostasis is hyperfibrinogenemia that becomes an overt factor for heparin resistance. To overcome the latter, an adjusting doses of LMWH toward intermediate or therapeutic looks like a promising way. The suffi ciency of the adjusted LMWH dose is appropriate determining either with anti- Xa activity or thromboelastographically as express testing. Key words: hemostasis, COVID-19-associated coagulopathy, fibrinogen, low molecular weight heparins

Heparin inhalation in patients with new coronavirus infection (review)

2020 ◽  
Author(s):  
Н.А. Воробьева ◽  
Е.В. Ройтман ◽  
Е.Ю. Мельничук
Keyword(s):  
Lipoprotein Lipase ◽  
Medical Staff ◽  
Systemic Effects ◽  
Microvascular Thrombosis ◽  
Prevention And Treatment ◽  
Individual Protection ◽  
Coronavirus Infection ◽  
Anti Inflammatory ◽  
Inflammatory Effect

Гепарин используется в клинической практике преимущественно как антикоагулянт. Однако спектр его эффектов значительно шире: противовоспалительный, антипролиферативный, гиполипидемический (как прямой, так и посредством повышения активности липопротеинлипазы), антикоагулянтный, противоотечный и др. Именно на противовоспалительное действие гепарина сделан акцент при терапии COVID-19. Одним из патогенетически обоснованных методов профилактики и терапии микрососудистого тромбоза в тканях легких может быть использование ингаляций нефракционированного гепарина, что позволяет реализовать как местное, так и системное действие этого препарата. Терапия ингаляциями гепарина не будет значительно увеличивать риск контаминации вирусом SARS-CoV-2 медицинского персонала при неукоснительном соблюдении стандартов и рекомендуемых мер индивидуальной защиты. Heparin is considered traditionally as an anticoagulant although it has anti-inflammatory, antiproliferative, hypolipidemic (both direct and by increasing the activity of lipoprotein lipase), anticoagulative, anti-edema effects as well. The anti-inflammatory effect of heparin is in the focus of COVID-19 therapy. Inhaled (nebulized) heparin performs local and systemic effects. This way is pathogenetically justified for the prevention and treatment of microvascular thrombosis in lung tissues. Procedures of heparin inhalation should not significantly increase the risk for medical staff to become infected with SARS-CoV-2 when individual protection is fully observed.

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