scholarly journals Standard therapy potentiation of patients with Stable Angina FC III with concomitant Hypertension through nitric oxide donator L-arginine administration

2018 ◽  
pp. 83-86
Author(s):  
N. V. Zozuliak ◽  
Z. V. Zozuliak ◽  
V. Ye. Neiko ◽  
I. B. Romash ◽  
I. R. Romash ◽  
...  

The purpose of the study was to improve treatment of patients with Stable Angina  functional class III (FC) with concomitant arterial hypertension (AH) through a combination of standard therapy with L-arginine. There were examined63 patients with Stable Angina III FK with AH. All patients in the clinic were analyzedby the test with reactive hyperemia, were measured levels of cardio-ankle vascular index, pulse wave velocity, aortic stiffness index and the thickness of the complex "intima-media". It has been established that in studied patients with L-arginine significantly improves endothelium dependent vasodilatation, presumably due to the supply of substrate for the synthesis of nitric oxide, as well as due to antioxidant properties, which prevents the excessive formation of toxic peroxynitrite in conditions of high oxidation stress. Endothelial-independent vasodilation in the standard therapy group was significantly lowered, while in the L-arginine group, the incidence of changes was unreliable, which may indicate a decrease in sensitivity to nitrates in Group I. Thus, the inclusion to antianginal and antihypertensive therapyof L-arginine is more pronouncedaffects subclinical parameters of arterial rigidity, than in the background of treatment with standard therapy.

2018 ◽  
pp. 83-86
Author(s):  
N. V. Zozuliak ◽  
Z. V. Zozuliak ◽  
V. Ye. Neiko ◽  
I. B. Romash ◽  
I. R. Romash ◽  
...  

The purpose of the study was to improve treatment of patients with Stable Angina  functional class III (FC) with concomitant arterial hypertension (AH) through a combination of standard therapy with L-arginine. There were examined63 patients with Stable Angina III FK with AH. All patients in the clinic were analyzedby the test with reactive hyperemia, were measured levels of cardio-ankle vascular index, pulse wave velocity, aortic stiffness index and the thickness of the complex "intima-media". It has been established that in studied patients with L-arginine significantly improves endothelium dependent vasodilatation, presumably due to the supply of substrate for the synthesis of nitric oxide, as well as due to antioxidant properties, which prevents the excessive formation of toxic peroxynitrite in conditions of high oxidation stress. Endothelial-independent vasodilation in the standard therapy group was significantly lowered, while in the L-arginine group, the incidence of changes was unreliable, which may indicate a decrease in sensitivity to nitrates in Group I. Thus, the inclusion to antianginal and antihypertensive therapyof L-arginine is more pronouncedaffects subclinical parameters of arterial rigidity, than in the background of treatment with standard therapy.


2021 ◽  
Vol 5 (7) ◽  
pp. 473-478
Author(s):  
G.L. Ignatova ◽  
◽  
V.N. Antonov ◽  
E.V. Sheklanova ◽  
M.A. Korotkaya ◽  
...  

Aim: to study the effect of N-acetylcysteine (NAC) on the dynamics of clinical and radiological changes in patients with COVID-19. Patients and Methods: the study included 111 patients with moderate and severe forms of COVID-19 pneumonia of the 2nd and 3rd stage according to computed tomography (CT). The median age was 49,25 years. Group 1 (n=55) received standard therapy: favipiravir, enoxaparin sodium according to the regimen, dexamethasone. Antibacterial therapy was conducted according to the indications. In addition to standard therapy, group 2 (n=56) was prescribed with NAC at a daily dose of 1200 mg, intravenously, divided into two doses. All patients underwent a comprehensive examination: WBC count, C-reactive protein (CRP), ferritin, fibrinogen, multispiral computed tomography and ultrasound of the chest organs were determined at admission, on the 7th-10th day of hospitalization, at discharge and 8 weeks after discharge. Results: initially, patients from both groups were comparable in terms of demographic indicators and condition severity. NAC prescription to the standard therapy showed a more positive trend both in terms of clinical symptoms and laboratory indicators. Respiratory rate, heart rate, and body temperature were statistically significantly lower in group 2 already on the 7th-10th day of follow-up. The levels of CRP, ferritin and fibrinogen also normalized faster in group 2. The periods of stay in the hospital were 15.3 days and 12.2 days, respectively, in patients from groups 1 and 2 (p<0,05). Conclusions: early prescription with N-acetylcysteine to patients with a moderate course of COVID-19 allowed statistically significantly reducing the volume of lung tissue damage, reducing the level of inflammatory markers (CRP, ferritin, fibrinogen) and contributed to an earlier discharge of the patient. KEYWORDS: COVID-19, N-acetylcysteine, pneumonia, acute respiratory distress syndrome, cytokine storm. FOR CITATION: Ignatova G.L., Antonov V.N., Sheklanova E.V. et al. Therapeutic possibilities of using an expectorant mucolytic agent with antioxidant properties in COVID-19 infection. Russian Medical Inquiry. 2021;5(7):473–478 (in Russ.). DOI: 10.32364/2587-6821-2021- 5-7-473-478.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Gonca Handan Ustundag ◽  
Halime Altuntas ◽  
Yasemin Dilek Soysal ◽  
Furuzan Kokturk

Aim. The aim of this study is to evaluate the effects of the synbioticBifidobacterium lactisB94 plus inulin addition to the standard triple therapy onHelicobacter pylori (H. pylori)infection eradication rates.Methods. Children aged 6–16 years who had biopsy provenH. pyloriinfection were randomly classified into two groups. The first group received the standard triple therapy consisting of amoxicillin + clarithromycin + omeprazole. The second group was treated with the standard triple therapy andBifidobacterium lactisB94 (5 × 109 CFU/dose) plus inulin (900 mg) for 14 days, concurrently. Eradication was determined by14C-urea breath test 4–6 weeks after therapy discontinuation.Results. From a total of 69H. pyloriinfected children (F/M = 36/33; mean ± SD = 11.2 ± 3.0 years), eradication was achieved in 20/34 participants in the standard therapy group and 27/35 participants in the synbiotic group. The eradication rates were not significantly different between the standard therapy and the synbiotic groups [intent-to-treat, 58.8% and 77.1%, resp.,p= 0.16; per-protocol, 64.5% and 81.8%, resp.,p= 0.19]. There was no difference between the groups in terms of symptom relief (p= 0.193). The reported side effects were ignorable.Conclusion. Considering the eradication rates, synbiotic addition to therapy showed no superiority over the standard triple therapy conducted alone. This trial is registered withNCT03165253.


2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Waqas Gulzar ◽  
Zafar Niaz ◽  
Sami Ullah Mumtaz ◽  
Somia Iqtadar ◽  
Tayyeba Komal ◽  
...  

Chronic hepatitis C infection has created a huge burden of disease causing serious healtheffects. The combination therapy used to treat hepatitis C virus (HCV) infection includes Pegylatedinterferon and Ribavirin. As cholesterol biosynthesis plays a pivotal role in HCV replication, the use ofvarious statins has been associated with higher sustained viral response Objective: To compare theefficacy of atorvastatin plus pegylated interferon and ribavirin versus pegylated interferon and ribavirinalone in patients of chronic hepatitis C with genotype-3a Methods: This Randomized controlled trial wasconducted at outpatient department, Mayo Hospital Lahore for six months i.e. May to November 2017.After ethical approval, 60 patients of ages 25 to 55 years of either gender with chronic hepatitis C withgenotype 3a were included in the study. Informed consent was taken from all patients. Then patients wererandomly allocated into two groups “A” and “B” using random number table. Patients in Group A receivedstandard of care treatment for chronic hepatitis C i.e. pegylated interferon and ribavirin while the patientsin Group B also received tab atorvastatin along with the standard treatment. Patients were follow up for 4week. Blood samples were collected and HCV RNA detection. All this information were entered inproforma Results: In standard therapy group, the mean age of patients was 39.50±8.39years. Inatorvastatin plus standard therapy group, the mean age of patients was 34.30±6.78years. In standardtherapy group, there were 25 (83.3%) males and 5 (16.7%) females. In atorvastatin plus standard therapygroup, there were 16 (53.3%) males and 14 (46.7%) females. After 4 weeks, Rapid Virological Response(RVR) was achieved in 4 (13.3%) patients in standard therapy group while in 14 (46.7%) in atorvastatin plusstandard therapy group. The difference was significant (p<0.05) Conclusions: Atorvastatin incombination with Pegylated interferon and ribavirin have better efficacy as compared to Pegylatedinterferon & ribavirin alone in chronic hepatitis C-3a.


2003 ◽  
Vol 21 (22) ◽  
pp. 4105-4111 ◽  
Author(s):  
R. de Wit ◽  
J. Herrstedt ◽  
B. Rapoport ◽  
A.D. Carides ◽  
G. Carides ◽  
...  

Purpose: This analysis evaluated whether the antiemetic efficacy of the NK1 receptor antagonist aprepitant (EMEND™, Merck, Whitehouse Station, NJ) plus standard antiemetics could be sustained for up to six cycles of cisplatin-based chemotherapy. Patients and Methods: Patients receiving cisplatin ≥ 70 mg/m2 were blindly assigned to receive one of the following three regimens: (1) aprepitant 375 mg 1 hour before cisplatin on day 1 and aprepitant 250 mg on days 2 to 5 (n = 35); (2) aprepitant 125 mg before cisplatin and aprepitant 80 mg on days 2 to 5 (n = 81); or (3) placebo before cisplatin on days 2 to 5 (n = 86). All groups received ondansetron 32 mg and dexamethasone 20 mg before cisplatin, and dexamethasone 8 mg on days 2 to 5. The primary end point was complete response (no emesis and no rescue therapy) over 5 days following cisplatin in up to six cycles. A cumulative probability analysis using a model for transitional probabilities was used to analyze the data. The aprepitant 375/250-mg regimen was discontinued early in light of new pharmacokinetic data. Results: In the first cycle, 64% of patients in the aprepitant group and 49% in the standard therapy group had a complete response. Thereafter, complete response rates for the aprepitant group were still 59% by cycle 6, but decreased to 34% by cycle 6 for the standard therapy group. Reasons for discontinuation were similar across treatment groups. Conclusion: Compared with patients who received standard therapy, those who received only the aprepitant regimen had better and more sustained protection against chemotherapy-induced nausea and vomiting over multiple cycles.


2006 ◽  
Vol 50 (3) ◽  
pp. 862-867 ◽  
Author(s):  
Martin E. Stryjewski ◽  
Vivian H. Chu ◽  
William D. O'Riordan ◽  
Brian L. Warren ◽  
Lala M. Dunbar ◽  
...  

ABSTRACT Telavancin is a bactericidal lipoglycopeptide with a multifunctional mechanism of action. We conducted a randomized, double blind, active-control phase II trial. Patients ≥18 years of age with complicated skin and skin structure infections caused by suspected or confirmed gram-positive organisms were randomized to receive either telavancin at 10 mg/kg intravenously every 24 h (q24h) or standard therapy (antistaphylococcal penicillin at 2 g q6h or vancomycin at 1 g q12h). A total of 195 patients were randomized and received at least one dose of study medication. Clinical success rates were similar in all analysis populations at test of cure. In microbiologically evaluable patients with Staphylococcus aureus at baseline (n = 91), 96% of the telavancin group and 90% of the standard-therapy group were cured. Among patients with methicillin-resistant S. aureus (MRSA) at baseline (n = 45), clinical cure rates were also 96% for telavancin and 90% for standard therapy. Microbiologic eradication in patients with S. aureus infection was better with telavancin compared to standard therapy (92% versus 78%, P = 0.07) and significantly better in patients with MRSA (92% versus 68%; P = 0.04). Therapy was discontinued for an adverse event (AE) in 6% and 3% of the patients receiving telavancin and standard therapy, respectively. Except for two cases of rash in the telavancin group, these AEs were similar in type and severity in the two groups. The overall incidences and severities of AEs and laboratory abnormalities were similar between the two groups. These data support the ongoing studies assessing the efficacy and safety of telavancin in the treatment of serious gram-positive infections, particularly involving MRSA.


Author(s):  
Hashim A. Hashim ◽  
Mohammed F. Maulood ◽  
Anwar M. Rasheed ◽  
Dhurgham F. Fatak ◽  
Khulood K. Kabah ◽  
...  

AbstractObjectivesCOVID-19 patients suffer from the lack of curative therapy. Hence, there is an urgent need to try repurposed old drugs on COVID-19.MethodsRandomized controlled study on 70 COVID-19 patients (48 mild-moderate, 11 severe, and 11 critical patients) treated with 200ug/kg PO of Ivermectin per day for 2-3 days along with 100mg PO doxycycline twice per day for 5-10 days plus standard therapy; the second arm is 70 COVID-19 patients (48 mild-moderate and 22 severe and zero critical patients) on standard therapy. The time to recovery, the progression of the disease, and the mortality rate were the outcome-assessing parameters.Resultsamong all patients and among severe patients, 3/70 (4.28%) and 1/11 (9%), respectively progressed to a more advanced stage of the disease in the Ivermectin-Doxycycline group versus 7/70 (10%) and 7/22 (31.81%), respectively in the control group (P>0.05). The mortality rate was 0/48 (0%), 0/11 (0%), and 2/11 (18.2%) in mild-moderate, severe, and critical COVID-19 patients, respectively in Ivermectin-Doxycycline group versus 0/48 (0%), and 6/22 (27.27%) in mild-moderate and severe COVID-19 patients, respectively in standard therapy group (p=0.052). Moreover, the mean time to recovery was 6.34, 20.27, and 24.13 days in mild-moderate, severe, and critical COVID-19 patients, respectively in Ivermectin-Doxycycline group versus 13.66 and 24.25 days in mild-moderate and severe COVID-19 patients, respectively in standard therapy group (P<0.01).ConclusionsIvermectin with doxycycline reduced the time to recovery and the percentage of patients who progress to more advanced stage of disease; in addition, Ivermectin with doxycycline reduced mortality rate in severe patients from 22.72% to 0%; however, 18.2% of critically ill patients died with Ivermectin and doxycycline therapy. Taken together, the earlier administered Ivermectin with doxycycline, the higher rate of successful therapy.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 919-919
Author(s):  
Michal Sieniawski ◽  
Jan Oliver Staak ◽  
Helena Scheuss ◽  
Jan Peter Glossmann ◽  
Volker Diehl ◽  
...  

Abstract Introduction: Combination chemotherapy can cure patients (pts) with Non-Hodgkin’s lymphoma (NHL), but those with relapse still have a poor prognosis. High-dose chemotherapy (HDCT) with autologous stem cell support (ASCT) can improve the outcome of these pts. Rituximab demonstrated encouraging activity in aggressive NHL and showed low toxicity in the setting of combined immunochemotherapy. To investigate the influence of addition of rituximab to the intensified salvage program followed by a final myeloablative course with stem cell reinfusion we compared the group of patients treated with this program - immuntherapy group (IT) with the standard therapy group (ST) of patients treated with the same program without rituximab. Patients and methods: Eligibility criteria for both groups were as follows: age 18–67 years, eligibility for HDCT, histologically proven CD20+ relapsed or progressive NHL. Treatment program starts with two cycles DHAP (dexamethasone, cytarabine, cisplatin); pts with PR or CR receive cyclophosphamide (4g/m2) followed by PBSC harvest; methotrexate 8g/m2 and vincristine 1,4mg/m2; and etoposide 2g/m2. The final myeloablative course is BEAM followed by ASCT. Pts in IT received additionally rituximab (375mg/m²) to the each chemotherapy cycle. Results: In the immuntherapy and standard therapy group were enrolled 23 and 57 pts, respectively. There were 18 (78%) IT and 34 (60%) ST pts with relapsed and 5 (22%) IT and 23 (40%) ST pts with refractory disease. The majority of pts in both groups received CHOP-like regimens as first line treatment (91% IT vs. 79% ST). The response rate at the final evaluation for all patients was in IT 61% (52% CR and 9% PR) and in ST 43% (32% CR and 11% PR). The overall response rate (OR) for patients who responded to 2 cycles DHAP was in IT 83% (71% CR and 12% PR) and in ST 59% (44% CR and 15% PR). The therapy toxicity was tolerable and comparable in both groups. Conclusion: The preliminary results suggest better therapy outcome in patient with sequential high-dose chemotherapy with rituximab compared to pts treated with the same therapy regimen without additional antibody. The combination regimen allows effective mobilization of stem cells. The tolerability of the final myeloablative BEAM was in both groups not affected by rapid sequential administration of DHAP and high doses of cyclophosphamide, methotrexate, etoposide and rituximab. The toxicity was tolerable in both groups. The full results of match pair and multivariate analysis as well as OS and FF2F will be presented.


2020 ◽  
Vol 64 (5) ◽  
Author(s):  
K. F. Walsh ◽  
K. McAulay ◽  
M. H. Lee ◽  
S. C. Vilbrun ◽  
L. Mathurin ◽  
...  

ABSTRACT This study was conducted in treatment-naive adults with drug-susceptible pulmonary tuberculosis in Port-au-Prince, Haiti, to assess the safety, bactericidal activity, and pharmacokinetics of nitazoxanide (NTZ). This was a prospective phase II clinical trial in 30 adults with pulmonary tuberculosis. Twenty participants received 1 g of NTZ orally twice daily for 14 days. A control group of 10 participants received standard therapy over 14 days. The primary outcome was the change in time to culture positivity (TTP) in an automated liquid culture system. The most common adverse events seen in the NTZ group were gastrointestinal complaints and headache. The mean change in TTP in sputum over 14 days in the NTZ group was 3.2 h ± 22.6 h and was not statistically significant (P = 0.56). The mean change in TTP in the standard therapy group was significantly increased, at 134 h ± 45.2 h (P < 0.0001). The mean NTZ MIC for Mycobacterium tuberculosis isolates was 12.3 μg/ml; the mean NTZ maximum concentration (Cmax) in plasma was 10.2 μg/ml. Negligible NTZ levels were measured in sputum. At the doses used, NTZ did not show bactericidal activity against M. tuberculosis. Plasma concentrations of NTZ were below the MIC, and its negligible accumulation in pulmonary sites may explain the lack of bactericidal activity. (This study has been registered at ClinicalTrials.gov under identifier NCT02684240.)


2010 ◽  
Vol 104 (07) ◽  
pp. 86-91 ◽  
Author(s):  
Alexander Cohen ◽  
Bruce Davidson ◽  
Herve Decousus ◽  
Alexander Gallus ◽  
Michael Gent ◽  
...  

SummaryStandard treatment with heparin followed by vitamin K antagonists is frequently complicated by bleeding and recurrent venous thromboembolism (VTE) in cancer patients with VTE. To compare the efficacy, safety and overall survival of long-term idraparinux treatment to standard therapy in cancer patients we conducted a post-hoc analysis in the subgroup of non-active and active cancer patients included in the Van Gogh DVT clinical trial. The cancer patients with deep venous thrombosis (DVT) and without pulmonary embolism (PE) were randomised to standard treatment or a once-weekly subcutaneous injection of idraparinux (2.5 mg), a synthetic pentasaccharide. 421 cancer patients were included. A total of 220 patients received idraparinux and 201 were allocated to standard therapy for three months (8%) or six months (92%). A recurrent VTE was observed during the first six months in 2.5% (n=5) of the idraparinux recipients compared to 6.4% (n=12) in the standard therapy group (hazard ratio 0.39, 95% confidence interval [CI]; 0.14–1.11). The rate of bleeding was comparable (odds ratio 0.89, 95% CI; 0.50–1.59). The outcomes were similar at three months after randomisation in all patients. Of the idraparinux recipients, 22.7% (n=50) died during the study period compared to 48 patients (23.9%) in the standard treatment group (hazard ratio 0.99, 95% CI; 0.66–1.48). In conclusion, no significant safety or survival differences were observed between cancer patients with DVT treated with idraparinux for six months compared to standard therapy. Fewer recurrent VTEs were observed in the idraparinux group; however, this was not statistically significant and also because of study limitations this should be interpreted with caution.


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