Therapeutic possibilities of using an expectorant mucolytic agent with antioxidant properties in COVID-19 infection

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.

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

Likarska sprava ◽

10.31640/vd.7-8.2018(14) ◽

2018 ◽

pp. 83-86

Author(s):

N. V. Zozuliak ◽

Z. V. Zozuliak ◽

V. Ye. Neiko ◽

I. B. Romash ◽

I. R. Romash ◽

...

Keyword(s):

Nitric Oxide ◽

Stable Angina ◽

Standard Therapy ◽

Therapy Group ◽

Reactive Hyperemia ◽

Antioxidant Properties ◽

Stiffness Index ◽

Standard Therapy Group ◽

Oxidation Stress ◽

Group I

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.

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Immunotherapy and probiotic treatment for allergic rhinitis in children

Paediatrica Indonesiana ◽

10.14238/pi58.6.2018.280-5 ◽

2018 ◽

Vol 58 (6) ◽

pp. 280-5

Author(s):

Sumadiono Sumadiono ◽

Cahya Dewi Satria ◽

Nurul Mardhiah ◽

Grace Iva Susanti

Keyword(s):

Allergic Rhinitis ◽

Standard Therapy ◽

Clinical Symptoms ◽

Therapy Group ◽

Controlled Trial ◽

Standard Therapy Group ◽

Persistent Allergic Rhinitis ◽

Probiotic Treatment ◽

Group A ◽

Group B

Background Allergic rhinitis is a global health problem that is increasing in prevalence. Many kinds of therapy have been tried, such as antihistamines, probiotics, and immunotherapy. Immunotherapy may restore the patient’s normal immunity against the specific allergen, while probiotics may modify the natural course of allergy. Objective To evaluate probiotics and immunotherapy for improving clinical symptoms of allergic rhinitis. Methods This randomized controlled trial (RCT) involved 64 patients, aged 3-18 years, and diagnosed with persistent allergic rhinitis in the Department of Child Health, Sardjito General Hospital from April 2016 until May 2017. Patients were randomly allocated into three therapy groups: group A (standard therapy/cetirizine only), group B (standard and probiotic therapy), and group C (standard therapy and immunotherapy). Clinical symptoms of allergic rhinitis including sneezing, rhinorrhea, and itchy nose, were evaluated for 7 weeks and classified as improved or not improved. The significance of the data was analyzed using proportion test. Results Sixty-four patients completed 7 weeks of therapy, 15 subjects in group A, 26 in group B, and 23 in group C. Group C showed significantly more improvement of sneezing and rhinorrhea compared to both group A (Z=5.71; Z=7.57, respectively) and group B (Z=2.82; Z=6.90, respectively). However, itchy nose was not significantly improved in group C compared to group B (Z=0.50), but was significantly improved in group C compared to group A (Z=10.91). Group B had significant improvement of sneezing, rhinorrhea, and itchy nose compared to group A (Z=3.81, Z=2.86, and Z=10.91, respectively). Conclusion The combined standard-immunotherapy group has significantly superior improvement compared to the combined standard-probiotic group and the standard therapy group, in terms of sneezing and rhinorrhea in children with persistent allergic rhinitis.

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

Likarska sprava ◽

10.31640/jvd.7-8.2018(14) ◽

2018 ◽

pp. 83-86

Author(s):

N. V. Zozuliak ◽

Z. V. Zozuliak ◽

V. Ye. Neiko ◽

I. B. Romash ◽

I. R. Romash ◽

...

Keyword(s):

Nitric Oxide ◽

Stable Angina ◽

Standard Therapy ◽

Therapy Group ◽

Reactive Hyperemia ◽

Antioxidant Properties ◽

Stiffness Index ◽

Standard Therapy Group ◽

Oxidation Stress ◽

Group I

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EFFICIENCY OF PROTEASE INHIBITOR ULINASTATIN IN PATIENTS WITH ACUTE PANCREATITIS

Pain anesthesia and intensive care ◽

10.25284/2519-2078.1(90).2020.193907 ◽

2020 ◽

pp. 33-38

Author(s):

О. М. Клигуненко ◽

Д. А. Кріштафор ◽

Г. І. Лаврова

Keyword(s):

Acute Pancreatitis ◽

Standard Therapy ◽

Therapy Group ◽

Control Group ◽

Blood Levels ◽

Duration Of Treatment ◽

Standard Therapy Group ◽

Left Shift ◽

Pathogenetic Therapy ◽

Group 2

Introduction. Acute pancreatitis is one of the most common acute gastroenterological diseases in the world. A key element of its pathogenesis is “pancreatic self-digestion” by pancreatic enzymes. In recent years, the use of protease inhibitors has attracted considerable interest as a pathogenetic therapy of acute pancreatitis.Objective: To study the effect of ulinastatin on the severity of acute pancreatitis.Materials and methods. A total of 50 patients with acute pancreatitis were examined. Group 1 (n = 25) received standard therapy, group 2 (n = 25) additionally received intravenous ulinastatin infusion in a dose of 100,000 IU 1 time per day for 3 days. Indicators of pancreatic inflammation and mortality were studied.Results and discussion. On admission, patients had enzymatic ascites, an acute increase in blood levels of α-amylase and diastase in the urine, neutrophilic leukocytosis with a left shift and relative lymphocytopenia. Compared to standard therapy, ulinastatin reduced the frequency of abdominal drainage from 68.0% to 40.0%. Blood α-amylase and urine diastase levels in the ulinastatin group decreased 2-6 times as compared with the control group and normalized on day 5, whereas in the control group they did not reach the norm. The number of leukocytes in the ulinastatin group on day 5 decreased by 38.1% from the baseline, and in the control group – only by 26.0%. On the 5th day the left shift, LII and lymphocytopenia decreased in the ulinastatin group, but not in the control group. In the first 3 days of the disease, the diagnosis of severe acute pancreatitis was confirmed in 80.0% of patients in the control group and 48.0% in the ulinastatin group. Mortality in the control group was 20.0%, and there were no fatal cases in ulinastatin group. Ulinastatin decreased duration of treatment in ICU from 3.6 ± 1.0 to 2.3 ± 0.9 days and did not affect total hospital stay.Conclusions. Ulinastatin has a significant anti-inflammatory effect in patients with acute pancreatitis. This is manifested by a rapid and reliable reduction of signs of inflammation in the pancreas, which prevents the development of pancreatic necrosis, reduces pancreatitis severity, accelerates SIRS resolving and reduces mortality.

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The Effects of Synbiotic “Bifidobacterium lactisB94 plus Inulin” Addition on Standard Triple Therapy ofHelicobacter pyloriEradication in Children

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2017/8130596 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 10

Author(s):

Gonca Handan Ustundag ◽

Halime Altuntas ◽

Yasemin Dilek Soysal ◽

Furuzan Kokturk

Keyword(s):

Triple Therapy ◽

Standard Therapy ◽

Therapy Group ◽

Symptom Relief ◽

Standard Therapy Group ◽

Bifidobacterium Lactis ◽

Standard Triple Therapy ◽

H Pylori ◽

Intent To Treat ◽

Infection Eradication

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.

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Efficacy of Atorvastatin Plus Pegylated Interferon and Ribavirin Versus Pegylated Interferon and Ribavirin Alone in Chronic Hepatitis C Patients with Genotype-3a

Pakistan BioMedical Journal ◽

10.52229/pbmj.v2i1.28 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Waqas Gulzar ◽

Zafar Niaz ◽

Sami Ullah Mumtaz ◽

Somia Iqtadar ◽

Tayyeba Komal ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Standard Therapy ◽

Therapy Group ◽

Pegylated Interferon ◽

Rapid Virological Response ◽

Standard Therapy Group ◽

The Mean ◽

Genotype 3A

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.

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Addition of the Oral NK1 Antagonist Aprepitant to Standard Antiemetics Provides Protection Against Nausea and Vomiting During Multiple Cycles of Cisplatin-Based Chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2003.10.128 ◽

2003 ◽

Vol 21 (22) ◽

pp. 4105-4111 ◽

Cited By ~ 111

Author(s):

R. de Wit ◽

J. Herrstedt ◽

B. Rapoport ◽

A.D. Carides ◽

G. Carides ◽

...

Keyword(s):

Standard Therapy ◽

Therapy Group ◽

Rescue Therapy ◽

Complete Response ◽

Nausea And Vomiting ◽

Cumulative Probability ◽

Pharmacokinetic Data ◽

Standard Therapy Group ◽

Nk1 Antagonist ◽

Multiple Cycles

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.

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Telavancin versus Standard Therapy for Treatment of Complicated Skin and Skin Structure Infections Caused by Gram-Positive Bacteria: FAST 2 Study

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.50.3.862-867.2006 ◽

2006 ◽

Vol 50 (3) ◽

pp. 862-867 ◽

Cited By ~ 121

Author(s):

Martin E. Stryjewski ◽

Vivian H. Chu ◽

William D. O'Riordan ◽

Brian L. Warren ◽

Lala M. Dunbar ◽

...

Keyword(s):

Standard Therapy ◽

Clinical Success ◽

Therapy Group ◽

Success Rates ◽

Standard Therapy Group ◽

Gram Positive ◽

Double Blind ◽

Skin Structure ◽

Complicated Skin ◽

Cure Rates

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.

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Controlled randomized clinical trial on using Ivermectin with Doxycycline for treating COVID-19 patients in Baghdad, Iraq

10.1101/2020.10.26.20219345 ◽

2020 ◽

Cited By ~ 4

Author(s):

Hashim A. Hashim ◽

Mohammed F. Maulood ◽

Anwar M. Rasheed ◽

Dhurgham F. Fatak ◽

Khulood K. Kabah ◽

...

Keyword(s):

Mortality Rate ◽

Standard Therapy ◽

Therapy Group ◽

Group Versus ◽

Controlled Study ◽

Control Group ◽

Advanced Stage ◽

Standard Therapy Group ◽

Curative Therapy ◽

Critical Patients

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.

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Comparison of the Sequential High-Dose Chemotherapy Followed by Autologous Stem Cell Support with and without Rituximab in Relapsed and Refractory Aggressive Non-Hodgkin’s Lymphoma.

Blood ◽

10.1182/blood.v104.11.919.919 ◽

2004 ◽

Vol 104 (11) ◽

pp. 919-919

Author(s):

Michal Sieniawski ◽

Jan Oliver Staak ◽

Helena Scheuss ◽

Jan Peter Glossmann ◽

Volker Diehl ◽

...

Keyword(s):

Stem Cell ◽

Standard Therapy ◽

Response Rate ◽

Therapy Group ◽

High Dose Chemotherapy ◽

Hodgkin's Lymphoma ◽

High Dose ◽

Standard Therapy Group ◽

Stem Cell Support ◽

Cell Support

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.

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