CLINICAL EFFECTIVENESS OF ANTRAL IN PATIENTS WITH CHRONIC PANCREATITIS

The studies on the pathogenesis of chronic pancreatitis (CP) have proven the important role of systemic inflammation, factors of proteinase-inhibitory system with increasing damaging effects of systemic proteolysis, disturbance of oxidant-antioxidant homeostasis, changes in blood lipid and protein spectroscopic processes that collectively contribute to inhibition of reparative processes and the activation of pancreatic fibrosis processes. The aim of this study was to determine the effectiveness of applying Antral medicine in the treatment of CP in the exacerbation phase on the basis of a comprehensive assessment of clinical course of CP and structural and functional disorders of the pancreas. Material and methods. 52 patients with CP of mixed aetiology were examined in the exacerbation phase of moderate severity. The first group (group 1, control) included 24 people, who received standard treatment within 30 days. The main group (group 2) involved 28 people, who in addition to the standard therapy took Antral (Pharmak OAO, Kyiv) in a dose of 1 tablet (200 mg) 3 times a day for 30 days. The comparison group consisted of 30 healthy individuals of the same age and sex. Results. In 4 weeks since the beginning of the therapy, the astheno-vegetative syndrome was found as significantly less manifested in only 2 people (7.1%) of the 2 groups, whereas in the 1 group it remained in 17 patients. At the same time in all patients of group 2 (100.0%) the pain and feeling of heaviness in the epigastric region, pain in the left and right subcostal area were disappeared, they did not complain of nausea. The restoration of physical performance in 100.0% of patients in the 2 group can be regarded as a positive manifestation of the therapy efficacy. Analyzing the indicators, which characterize the phase of CP exacerbation, it is necessary to note the patients of the 2 group demonstrated higher efficacy of their treatment program. Thus, dynamic indicators of blood α-amylase activity against the background of hyperfermentemia diagnosed prior the treatment and in the phase of CP exacerbation significantly decreased in both groups of observation on the 30th day of the therapy; the syndrome of enzyme rejection in the blood was eliminated in 100% of patients of the 2 groups; whereas in group 1 this was observed only in 58.3% of the patients. The dynamic of indicators of the inflammation syndrome in patients with CP (by blood C-reactive protein content) indicates its complete elimination in 96.4% of the patients in group 2 vs. 29.2% of the patients in group 1. Analysis of the dynamic indicators of elastase-1 content in the faeces of the patients with CP on the 30th day of the therapy indicates a significant increase in this indicator in only group 2. Restoration of the secretory capacity of the pancreas was observed in 78.6% of patients in group 2 vs. 20.8% of the patients in group 1. Conclusions. Complex therapy of patients with chronic pancreatitis with applying Antral in addition to the integrated therapy has led to faster, when compared with only standard therapy, achieving clinical remission of chronic pancreatitis, elimination of inflammatory pancreatic oedema, hyperfermentemia and inflammation, restoration of the external secretion of the pancreas.

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Serum Neopterin Levels and the Clinical Presentation of COVID-19

Pteridines ◽

10.1515/pteridines-2020-0013 ◽

2020 ◽

Vol 31 (1) ◽

pp. 185-192

Author(s):

Deniz Öğütmen Koç ◽

Hande Sipahi ◽

Cemile Dilşah Sürmeli ◽

Mustafa Çalık ◽

Nilgün Bireroğlu ◽

...

Keyword(s):

Disease Activity ◽

Clinical Presentation ◽

Serum Levels ◽

Neutrophil Lymphocyte Ratio ◽

Serum Neopterin ◽

Protein Levels ◽

Reactive Protein ◽

Group 2 ◽

Immune Activation Marker ◽

Group 1

AbstractIn Coronavirus disease 2019 (COVID-19), it is important to evaluate disease activity and investigate possible biomarkers. Therefore, in this study, we investigated the relationship between disease activity and serum levels of possible immune activation marker neopterin in patients with COVID-19. The study enrolled 45 patients (23 females, 51.1%) treated for COVID-19. The patients were divided into two groups according to their clinical presentation: those who recovered quickly (Group 1) and those who worsened progressively (Group 2). The neopterin and C-reactive protein levels were high in all patients on admission. In Group 1, neopterin concentrations and serum neopterin/creatinine ratios were significantly higher on admission compared to Day 14 of the disease, whereas in Group 2, levels were significantly higher at Day 14 of the disease than on admission. Neopterin levels at admission were significantly higher in Group 1. The serum neopterin concentrations at admission were markedly higher in patients with a derived neutrophil–lymphocyte ratio (dNLR) > 2.8 compared to those with a dNLR ≤ 2.8 (p < 0.05). Serum neopterin levels can be used as a prognostic biomarker in predicting disease activity in COVID-19.

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Fever as a predictor of adverse outcomes in COVID-19

QJM ◽

10.1093/qjmed/hcab023 ◽

2021 ◽

Author(s):

N W Chew ◽

J N Ngiam ◽

S M Tham ◽

Z Y Lim ◽

T Y W Li ◽

...

Keyword(s):

Tertiary Hospital ◽

Adverse Outcomes ◽

C Reactive Protein ◽

Reactive Protein ◽

End Point ◽

Group 4 ◽

Group 3 ◽

Group 2 ◽

Design And Methods ◽

Group 1

Summary Background/Introduction There are little data on outcomes of COVID-19 patients with the presence of fever compared to the presence of symptoms. Aim We examined the associations between symptomology, presence of fever and outcomes of a COVID-19 cohort. Design and Methods Between 23 January and 30 April 2020, 554 COVID-19 patients were admitted to a tertiary hospital in Singapore. They were allocated into four groups based on symptomology and fever—Group 1: asymptomatic and afebrile, Group 2: symptomatic but afebrile, Group 3: febrile but asymptomatic and Group 4: symptomatic and febrile. The primary outcomes were intensive care unit (ICU) admissions and mortality. The composite end-point included ICU admissions, mortality or any COVID-19 related end-organ involvement. Results There were differences in ferritin (P=0.003), C-reactive protein (CRP) levels (P<0.001) and lymphopenia (P=0.033) across all groups, with the most favourable biochemical profile in Group 1, and the least in Group 4. Symptomatic groups (Groups 2 and 4) had higher ICU admissions (1.9% and 6.0%, respectively, P=0.003) than asymptomatic groups (Groups 1 and 3). Composite end-point was highest in Group 4 (24.0%), followed by Group 3 (8.6%), Group 2 (4.8%) and Group 1 (2.4%) (P<0.001). The presence of fever (OR 4.096, 95% CI 1.737–9.656, P=0.001) was associated with the composite end-point after adjusting for age, pulse rate, comorbidities, lymphocyte, ferritin and CRP. Presence of symptoms was not associated with the composite end-point. Discussion/Conclusion In this COVID-19 cohort, presence of fever was a predictor of adverse outcomes. This has implications on the management of febrile but asymptomatic COVID-19 patients.

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Experience of using heliox in the treatment of viral pneumonia in COVID-19

MedAlliance ◽

10.36422/23076348-2021-9-2-8-14 ◽

2021 ◽

Vol 9 (2) ◽

pp. 8-14

Keyword(s):

Lactate Dehydrogenase ◽

Viral Pneumonia ◽

P Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Number Of Patients ◽

Helium Mixture ◽

Ct Data ◽

Group 2 ◽

Group 1

SummaryIntroduction. With the ongoing COVID-19 pandemic, finding new treatments is an extremely important issue. The effectiveness of heliox was previously demonstrated in the complex treatment of patients with various bron-chopulmonary pathologies. Therefore, this method has been recommended for the treatment of pneumonia associated with COVID-19. Purpose. To study the safety and efficacy of inhaled heliox therapy in the treatment of pneumonia in COVID-19. Materials and methods. A sing-le-center prospective study was carried out for the period from 01.12.2020 to 15.02.2021. The study included 91 pa-tients. The patients were divided into two groups: group 1 (using heliox) included 46 people, and group 2 (con-trol) — 45. Inhalations of a heated oxygen-helium mixture heliox (70% helium, 30% oxygen) were carried out using “Ingalit-B2-01” inhaler. Objective (saturation, O2 flow) and laboratory parameters (lactate dehydrogenase, C-reactive protein), as well as chest organs CT data were studied. Differences between groups were determined using the χ2 test, as well as the Mann–Whitney U-test. The p value <0.05 was considered significant. Results. In group 1, side effects developed in 5 (11.3%) patients. These patients refused to further participate in the study. Final number of patients in group 1 — 41. Among patients of group 1, there was a tendency towards a more rapid normalization of lactate dehydrogenase and C-reactive protein, as well as a decrease in oxygen dependence. In group 1, according to CT data, no progression of pneumonia was recorded. In group 2, progression was observed in 6 (13.3%) patients. The overall effectiveness of treatment among patients in group 1 was 100%, among patients in group 2 — 86.7%. The differences between the groups are statistically sig-nificant (p=0.02). Conclusion. The use of inhalations with a heated oxygen-helium mixture heliox (30% oxygen, 70% helium) has shown its effectiveness and safety in the treatment of viral pneumonia (CT1- 2) associated with COVID-19.

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No Effect of Rapamycin on Cardiac Adhesion Formation: A Drug-Loaded Bioresorbable Polylactone Patch in a Porcine Cardiac Surgical Model

European Surgical Research ◽

10.1159/000441914 ◽

2016 ◽

Vol 56 (1-2) ◽

pp. 76-85

Author(s):

Saddiq Qazi ◽

Benedict Kjaergaard ◽

Fei Yang ◽

Hong Shen ◽

Shenguo Wang ◽

...

Keyword(s):

Adhesion Formation ◽

Clinical Effectiveness ◽

Pathological Examination ◽

Control Group ◽

En Bloc ◽

Matrix Deposition ◽

Increased Risk ◽

Group 3 ◽

Group 2 ◽

Group 1

Background: The fusing of the epicardium and sternum due to adhesion is a common problem during repeated cardiac surgery and carries with it an increased risk of bleeding. The use of barriers and patches has been tested to prevent the formation of adhesions, but the very presence of a patch can provoke adhesion formation. The objective of this study was, therefore, to investigate both biodegradable and bioresorbable polylactone patches [(polycaprolactone-poly(ethylene oxide)-polycaprolactone tri-block copolymer (PCE)]. The patches were also tested with a controlled release of rapamycin, which prevents cell migration and extracellular matrix deposition. The clinical effectiveness of rapamycin in pericardial patches has not previously been examined. Materials and Methods: Three groups of 6 female Danish Landrace pigs underwent sternotomy and abrasion of the epicardium, before being randomized to either group 1 - the control group (with no patch), group 2 - PCE patch implanted between the sternum and epicardium, or group 3 - PCE patch and slow-release 1.6-mg rapamycin. After a median time period of 26 days, the pigs were euthanized and their hearts removed en bloc with the sternum, for macroscopic, histological and pathological examination. Results: Upon macroscopic examination, a significantly lower degree of adhesion in group 2, as compared to group 1 (p < 0.05), was found. Histological analysis of the tissues showed significantly more fibrosis, inflammation and foreign body granulomas (p < 0.05) in both group 2 and group 3, when compared to group 1. Conclusion: A PCE patch following sternotomy in animal subjects reduces postoperative macroscopic adhesions without reducing microscopic fibrosis or inflammation. Loading the patch with rapamycin was found not to increase the antifibrotic effect.

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Replacement of Stuttering with Normal Speech: III. Clinical Effectiveness

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.3904.416 ◽

1974 ◽

Vol 39 (4) ◽

pp. 416-428 ◽

Cited By ~ 40

Author(s):

William H. Perkins ◽

Joanna Rudas ◽

Linda Johnson ◽

William B. Michael ◽

Richard F. Curlee

Keyword(s):

Clinical Effectiveness ◽

Behavioral Management ◽

Group 2 ◽

Normal Speech ◽

Group 1

Two forms of behavioral management of stuttering were tested for effectiveness, efficiency, and permanence. The emphasis with 27 clients in Method 1 was on control of rate to maintain fluency. The emphasis with 17 clients in Method 2 was on control of rate to facilitate normal management of the breathstream, phrasing, and prosody, as well as fluency. Stuttering was reduced for all clients with both methods. Ninety-two percent of Group 1 (Method 1) and all of Group 2 (Method 2) retained some improvement six months after treatment. Seventy percent of both groups had reduced their stuttering by 85% or more at the termination of treatment. Six months later, only 30% of Group 1 retained that level of improvement, in contrast with 53% of Group 2. Coupling an 85% reduction in stuttering with a criterion for normal (225+ syllables per minute), only 44% of Group 1, as compared with 65% of Group 2, achieved normal speech during treatment. Listeners judged Group 1 as being slower and less expressive than normal speakers but not different in fluency. Group 2 was judged as more fluent but otherwise no different from normals.

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Efficacy of Clopidrogel on Reperfusion and High-Sensitivity C-Reactive Protein in Patients with Acute Myocardial Infarction

Mediators of Inflammation ◽

10.1155/2009/932515 ◽

2009 ◽

Vol 2009 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Mehmet Akbulut ◽

Makbule Kutlu ◽

Yılmaz Ozbay ◽

Veli Polat ◽

Mehmet Nail Bilen ◽

...

Keyword(s):

Therapy Group ◽

High Sensitivity ◽

Reperfusion Therapy ◽

Early Reperfusion ◽

Unfractioned Heparin ◽

Reactive Protein ◽

St Segment ◽

Group 2 ◽

Hs Crp ◽

Group 1

We investigated the effects of clopidogrel on reperfusion and inflammatory process in STEMI. A total of 175 STEMI patients with similar clinical characteristics were included to this study. One was the standard pharmacological reperfusion therapy group (group 1,n: 90), who received 300 mg aspirin, 70 U/kg bolus, and 12 U/kg/hr continuous infusion of unfractioned heparin and accelerated t-PA. Clopidogrel 450 mg loading and 75 mg/d thereafter was added to standard reperfusion therapy in the other group (group 2,n: 85). The ST-segment resolution, CK-MB, and high-sensitive CRP (hs-CRP) parameters were measured. Complete ST resolution was observed in 32 patients (36.8%) in group 1 and 53 patients (63.8%) in group 2 (). Also in the first 24 hours, the CK-MB levels of patients in group 1 were significantly higher than those of group 2 (). The hs-CRP values were greater in group 1 than group 2 at 48th hour (gruop 1: mg/L, group 2: mg/L; ). We concluded that adding clopidogrel to standard treatment in STEMI patients provided early reperfusion and suppression of inflammatory response.

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Biomarkers during intensive care for sepsis

Wounds and wound infections The prof B M Kostyuchenok journal ◽

10.25199/2408-9613-2018-6-1-34-38 ◽

2019 ◽

Vol 6 (1) ◽

pp. 34-38 ◽

Cited By ~ 2

Author(s):

A. A. Zvyagin ◽

V. S. Demidova ◽

G. V. Smirnov

Keyword(s):

Clinical Trial ◽

Intensive Therapy ◽

Average Level ◽

P Value ◽

Standard Laboratory ◽

Single Center ◽

C Reactive Protein ◽

Reactive Protein ◽

Group 2 ◽

Group 1

The article presents the results of a prospective, single-center observational clinical trial, in which biomarker levels were compared in patients with sepsis.Objective: to evaluate the dynamics of the level of presepsin, procalciotonin and C-reactive protein in two groups - the dead and the surviving patients with sepsis.Materials and methods. The study consistently included 41 patients with a diagnosis of sepsis (based on the concept of "Sepsis-3"), divided into two groups: group 1 (21 people) – survivors, group 2 (20 people) – dead. Patients in both groups received conventional intensive therapy for sepsis. In addition to the standard laboratory and instrumental examination, patients in the dynamics were monitored for the level of presepsin, procalcitonin, C-reactive protein.Results. The average level of presepsin in group 1 and group 2 was 1718.00 and 3266.50 pg/ml, respectively, with half of the values being within (Me (25.75) 1021.00–3231.00 and 1618.50–7469.00 pg/ml. The average level of procalcitonin in group 1 and group – 0.995 and 4.465 ng/ml, respectively, while Me (25.75) 0.49–4.44 and 1.625–19.30 ng/ml. The average level of C-reactive protein in group No. 1 and group No. 2 is 95.5 and 215.0 mg/l, respectively, with Me (25.75) 64.00–155.00 and 155.00–264.00 mg/l. When comparing the values of biomarkers in the two groups of patients, significant differences were found (p-value for presepsin, procalсitonina and C-reactive protein are, respectively 0.000008, 0.000242, 0.0000001).

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Association of Haemoglobin and C-Reactive Protein level with Different Risk Factors among Acute Coronary Syndrome Patients

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v5i2.43022 ◽

2019 ◽

Vol 5 (2) ◽

pp. 156-160

Author(s):

Md Mahboob Morshed ◽

Md Joynul Islam ◽

ATM Ashadullah ◽

Khondker Shaheed Hussain ◽

Mohammad Ahtashamul Haque

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Reactive Protein ◽

Coronary Syndrome ◽

Group 4 ◽

History Of ◽

Study Population ◽

Group 3 ◽

Group 2 ◽

Group 1

Background: Different risk factors may be related with the haemoglobin and CRP level among the acute coronary syndrome patients. Objective: The purpose of the present study was to see the association of haemoglobin and CRP level with different type of risk factors among the acute coronary syndrome patients. Methodology: This cross-sectional study was conducted in the Department of Cardiology at Mymensingh Medical College, Mymensingh, Bangladesh from December 2010 to November 2011 for a period of two (02) years. Patients of ACS who were presented within 12 hours of chest pain were included as study population. Study population were categorized in four groups according to the level of hemoglobin and C-reactive protein. Age, cardiovascular risks factor, history, family history of cardiovascular disease, treatment history and ECG were taken during admission. Blood sample was collected for baseline laboratory investigations like Troponin-I, Random Blood Sugar (RBS), Blood urea, Serum creatinine, lipid profile, Hemoglobin & CRP level. Sample were then send to standard laboratory/Biochemistry department of MMCH. Result: The mean age of the population was 52.18±8.88 years. Smoking was the highest percentage in Group 1 which was 54(50.0%) cases (P=0.001). Hypertension was found most common in group 1 (47.6%), Group 2 (33.3%), Group 3 (10.7%) and Group 4 (8.3%). Smoking (p=0.001) and hypertension (p=0.016) was found statistically significant. Diabetes was found in Group 1 (37.7%), Group 2 (43.5%), Group 3 (11.6%) and Group 4 (7.2%). Group 1 (50%) and Group 2 (50%) patients were dyslipidaemic. Family history of IHD was present group-1 (36.8%), Group 2 (44.7%), Group 3 (73.2%) and Group 4 (53%). Among the smoker patient 65.6% cases had CRP level ˃12 mg/l; 39.8% cases had CRP level ˂12mg/L. Among the nonsmoker 34.4% cases had CRP level ˃12mg/l and 60.2% cases had CRP level ˂12mg/L. The finding was statistically significant. Conclusion: In conclusion haemoglobin and CRP level is associated with different type of risk factors among the acute coronary syndrome patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 156-160

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Bacteriophage use in the focus of hospital-acquired shigellosis

Kazan medical journal ◽

10.17750/kmj2017-917 ◽

2017 ◽

Vol 98 (6) ◽

pp. 917-921

Author(s):

E S Kurakin

Keyword(s):

Infection Prevention ◽

Clinical Effect ◽

Shigella Flexneri ◽

Clinical Effectiveness ◽

Antibacterial Treatment ◽

Clinical Recovery ◽

Study Evaluation ◽

Group 2 ◽

Hospital Acquired ◽

Group 1

Aim. Evaluation of epidemiologic effectiveness of polyvalent dysentery bacteriophage use for management of infection outbreak caused by Shigella flexneri. Methods. Investigation was performed in Tula psychoneurological hospital where the persistent focus of shigellosis was formed by Sh. flexneri 2a. As part of the study, evaluation of efficacy of antibacterial treatment (ciprofloxacin 250 mg per day for 7 days - group 1) was performed by evaluating duration of bacterial excretion in 18 patients with mild, 21 with moderate and 2 with severe Shigella infection. At the same time efficacy of Shigella bacteriophage (group 2) was assessed during treatment of 19 patients with mild and 17 with moderate form of the infection. Prevention of hospital-acquired shigellosis was provided for all patients in the departments where the infection was diagnosed. In this case bacteriophage was administered as following: first 5 days - 2 pills of bacteriophage 4 times a day, then 2 pills once a day during the whole period of hospitalization. This scheme was administered also to all patients newly admitted to the involved departments from day 1 of hospital stay. Results. Treatment with antibiotics led to fast and full recovery not in all cases. Insufficient clinical effect (persistence of disease signs and bacterial excretion for more than 7 days) in the treatment of mild, moderate and severe forms of Shigella infection was 16.7, 61.9 and 50.0%, respectively. High clinical effectiveness was noted in the treatment of patients with the use of Shigella bacteriophage. Ratio of insufficient clinical recovery from mild and moderate forms of the disease was 5.3 and 17.6%, respectively. In the course of anti-epidemiological measures aimed at localization and elimination of the focus, about 1000 patients were exposed to mentioned regimen of prevention. No patients had manifested infection or bacterial excretion registered. Conclusion. The study confirmed clinical and epidemiological effectiveness of polyvalent dysentery bacteriophage use for management of outbreak caused by Sh. flexneri 2a.

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Anti-relapse therapy of endometriosis: possible variations

Reproductive Endocrinology ◽

10.18370/2309-4117.2021.57.38-42 ◽

2021 ◽

pp. 38-42

Author(s):

N.F. Zakharenko ◽

S.I. Regeda ◽

I.P. Manoliak ◽

V.S. Solskyy

Keyword(s):

Hormonal Treatment ◽

Clinical Effectiveness ◽

Pathological Process ◽

Average Score ◽

Extragenital Endometriosis ◽

Group 2 ◽

High Level ◽

Relapse Therapy ◽

Group 1

Research aim: to determine the clinical efficacy and safety of bioavailable curcumin Longimin® in the complex anti-relapse therapy of patients with extragenital endometriosis after surgery.Materials and methods. Study involved 45 women with a mean age of 29.3 ± 3.6 years with a diagnosis of extragenital endometriosis. After surgical treatment of this disease all patients were prescribed dienogest 2 mg/day for 6 months with anti-relapse purpose. After that, 22 patients did not receive drug treatment (group 1) and other 23 women started a six-month course of 400 mg bioavailable curcumin (group 2).Results. After 12 months of observation 3 cases (13.6%) of newly formed foci of endometriosis were found among patients of group 1, two of which were multi-endometriomas, and the third was retrocervical heterotopia. There were no signs of recurrence in the group of sequential use of dienogest and bioavailable curcumin. In addition, 6 months after completion of hormonal treatment the number of women with chronic pelvic pain in group 1 was increased and average score on a visual analogue scale (VAS) was increased by 80% (p ≤0.05). It was accompanied by a stable moderately high level of anxiety throughout the observation period. At the same time the number of women who complained of intermenstrual pain in group 2 decreased from 15 to 13, and the average VAS score decreased by 13% (p ≥0.05) during the treatment period. Patients in group 2 noted an improvement in emotional control during treatment, which resulted in the average score decrease on the scale of personal and situational anxiety of the Spielberg-Hanin's questionnaire (25% and 30% respectively, p ≤0.05).Conclusions. The nature of the endometriosis development and progression is multipathogenetic. Blocking only its hormonal link, especially in cases of extragenital forms, may not be sufficient to stop the pathological process and prevent recurrence in the long term. Оbtained results of sequential course of dienogest and bioavailable curcumin Longimin® with anti-relapse purpose showed the wider clinical effectiveness of this therapy, which is probably based on additional inhibition of systemic inflammation, proliferation, stroma and psychogenic component of disease.

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