THE EXPERIENCE OF TREATMENT THE PATIENTS WITH COMPLICATED VIRAL RESPIRATORY TRACT INFECTIONS: ROLE OF HIGH-CONCENTRATED OXYGEN INHALATIONS ADDING CAMOMILE OIL

2021 ◽  
Vol 74 (7) ◽  
pp. 1642-1648
Author(s):  
Dina V. Shorikova ◽  
Eugene I. Shorikov

The aim: To study the clinical manifestations, capillary blood saturation, frequency of respiratory failure in patients with complicated forms of acute respiratory viral infections (ARVI). Materials and methods: The study included 70 patients with ARVI (mean age was 46.5±9.2 years). Patients observed were randomized into 2 groups. In group 1 (n=30), the only basic therapy was prescribed. In group 2 in addition to the basic therapy the inhalations with high concentrated oxygen with Camomile Oil were used. Results: It is proved that the use of highly concentrated oxygen with camomile oil in the inhalation treatment regimen significantly reduces the duration of local respiratory symptoms (p<0.001) and symptoms of general intoxication (p<0.001), prolonged hospital stay decreases by an average of 5 days (p<0.001). The relief of symptoms of RF in group 2 was noted for 10 days of hospitalization with an increase in capillary blood saturation (SatO2,%) to 95.2±2.91. Absolute therapeutic efficacy (absolute efficacy) of the correction of RF during complex treatment with the addition of highly concentrated oxygen was 88.0% versus 57.0% in group 1. Relative efficacy (RE) – 0.65 [0.46-0.90], odds ratio (OR) – 0.19 [0.06-0.61], p<0.05. The positive effect of highly concentrated oxygen for local immunity state – the level of secretory immunoglobulin A (p<0.001) and lysozyme (p<0.001) was established. Conclusions: High-concentrated oxygen inhalations adding camomile oil is effective in complex treatment at patients with complicated forms of acute respiratory viral infections.

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S941-S942 ◽  
Author(s):  
Fareed Khawaja ◽  
Marjorie V Batista ◽  
Patrick Chaftari ◽  
Jean Tayar ◽  
Roy F Chemaly ◽  
...  

Abstract Background The PD-1 inhibitors or check point inhibitors (CPI) are commonly used for the treatment of many solid tumors (ST) and hematological malignancies (HM). By blocking PD-1 in fatigued T cells, an increase in viral clearance may be noted as evidenced in cases of JC virus. Our objective was to assess the outcomes related to cancer patients with microbiologically documented acute respiratory viral infections while on CPI. Methods All patients who were infected with either influenza, respiratory syncytial virus (RSV), parainfluenza virus (PIV), and human metapneumovirus (HMPV) from 9/2016 to 6/2018 with prior or concurrent CPI therapy were included in this study. Demographics and clinical data were collected retrospectively. Comparisons were done between patients with concurrent (group 1) or prior (group 2) CPI therapy. Results A total of 92 cancer patients were identified and of those, 50 patients (54%) were on concurrent CPI therapy at the time of infection. Most patients had ST, mainly non-small cell lung cancer, and most were predominantly infected with Influenza (Figures 1 and 2). Side effects-related to CPI therapy and steroid use prior to infection were uncommon (13%). When compared with group 2, patients in group 1 had a trend toward less lower respiratory tract infections (24% vs. 40%, P = 0.11), decreased median length of stay (3 vs. 8 days, P = 0.1125) and lower 30-day mortality (4% vs. 12%, P = 0.2396). Conclusion Our data demonstrated trends toward improved outcomes in patients with respiratory viral infections on concurrent CPI therapy. Whether improved outcomes are related to enhanced immune responses to these viral infections need to be determined in a larger prospective observational cohort of patients. Disclosures Roy F. Chemaly, MD, MPH, FACP, FIDSA, Chimerix: Advisory Board, Research Grant; Clinigen: Advisory Board; Merck: Advisory Board, Consultant, Grant/Research Support, Research Grant, Speaker’s Bureau; Oxford immunotec: Consultant, Grant/Research Support; Shire: Research Grant, Speaker’s Bureau; Viracor: Grant/Research Support.


2006 ◽  
Vol 5 (2) ◽  
pp. 119-126
Author(s):  
Ye. I. Kondratieva ◽  
L. A. Matveeva ◽  
Ye. Yu. Tyuteva ◽  
N. A. Ryzhakova ◽  
A. A. Terentieva ◽  
...  

The aim of the research was the investigation of prophylactic using the drug «Cycloferon». Influence of Cycloferon on acute respiratory viral infection and flu and on their clinical manifestations as well as on local immunity condition was assessed. We examined 124 children aged from 4 to 18 years. It was revealed that duration of acute respiratory viral infections as well as flu decreased and local immunity of the upper respiratory ways increased considerably in children taking Cycloferon. The abovementioned changes were observed both just after the treatment and in the follow-up period.


2021 ◽  
Vol 15 ◽  
pp. 175346662199505
Author(s):  
Alastair Watson ◽  
Tom M. A. Wilkinson

With the global over 60-year-old population predicted to more than double over the next 35 years, caring for this aging population has become a major global healthcare challenge. In 2016 there were over 1 million deaths in >70 year olds due to lower respiratory tract infections; 13–31% of these have been reported to be caused by viruses. Since then, there has been a global COVID-19 pandemic, which has caused over 2.3 million deaths so far; increased age has been shown to be the biggest risk factor for morbidity and mortality. Thus, the burden of respiratory viral infections in the elderly is becoming an increasing unmet clinical need. Particular challenges are faced due to the interplay of a variety of factors including complex multimorbidities, decreased physiological reserve and an aging immune system. Moreover, their atypical presentation of symptoms may lead to delayed necessary care, prescription of additional drugs and prolonged hospital stay. This leads to morbidity and mortality and further nosocomial spread. Clinicians currently have limited access to sensitive detection methods. Furthermore, a lack of effective antiviral treatments means there is little incentive to diagnose and record specific non-COVID-19 viral infections. To meet this unmet clinical need, it is first essential to fully understand the burden of respiratory viruses in the elderly. Doing this through prospective screening research studies for all respiratory viruses will help guide preventative policies and clinical trials for emerging therapeutics. The implementation of multiplex point-of-care diagnostics as a mainstay in all healthcare settings will be essential to understand the burden of respiratory viruses, diagnose patients and monitor outbreaks. The further development of novel targeted vaccinations as well as anti-viral therapeutics and new ways to augment the aging immune system is now also essential. The reviews of this paper are available via the supplemental material section.


2021 ◽  
Vol 30 ◽  
pp. 096368972110249
Author(s):  
G Adas ◽  
Z Cukurova ◽  
K Kart Yasar ◽  
R Yilmaz ◽  
N Isiksacan ◽  
...  

The aim of this clinical trial was to control the cytokine storm by administering mesenchymal stem cells (MSCs) to critically-ill COVID-19 patients, to evaluate the healing effect, and to systematically investigate how the treatment works. Patients with moderate and critical COVID-19 clinical manifestations were separated as Group 1 (moderate cases, n = 10, treated conventionally), Group 2 (critical cases, n = 10, treated conventionally), and Group 3 (critical cases, n = 10, treated conventionally plus MSCs transplantation therapy of three consecutive doses on treatment days 0, 3, and 6, (as 3 × 106 cells/kg, intravenously). The treatment mechanism of action was investigated with evaluation markers of the cytokine storm, via biochemical parameters, levels of proinflammatory and anti-inflammatory cytokines, analyses of tissue regeneration via the levels of growth factors, apoptosis markers, chemokines, matrix metalloproteinases, and granzyme-B, and by the assessment of the immunomodulatory effects via total oxidant/antioxidant status markers and the levels of lymphocyte subsets. In the assessment of the overall mortality rates of all the cases, six patients in Group-2 and three patients in Group-3 died, and there was no loss in Group-1. Proinflammatory cytokines IFNγ, IL-6, IL-17A, IL-2, IL-12, anti-inflammatory cytokines IL-10, IL-13, IL-1ra, and growth factors TGF-β, VEGF, KGF, and NGF levels were found to be significant in Group-3. When Group-2 and Group-3 were compared, serum ferritin, fibrinogen and CRP levels in Group-3 had significantly decreased. CD45 +, CD3 +, CD4 +, CD8 +, CD19 +, HLA-DR +, and CD16 + / CD56 + levels were evaluated. In the statistical comparison of the groups, significance was only determined in respect of neutrophils. The results demonstrated the positive systematic and cellular effects of MSCs application on critically ill COVID-19 patients in a versatile way. This effect plays an important role in curing and reducing mortality in critically ill patients.


Author(s):  
Е.Е. Краснова ◽  
В.В. Чемоданов ◽  
Е.Г. Кузнецова

Пневмония – острое инфекционно-воспалительное заболевание легких преимущественно бактериальной этиологии, характеризующееся выраженной в разной степени дыхательной недостаточностью, токсическими и респираторными нарушениями, локальными физикальными симптомами, а также инфильтративными изменениями на рентгенограмме. Заболеваемость внебольничными пневмониями повышается в октябре-декабре, достигая максимума в январе-апреле, коррелируя с сезонным повышением уровня острых респираторных вирусных инфекций. Схожесть симптомов дебюта пневмонии с проявлениями острых респираторных вирусных инфекций может привести к несвоевременной ее диагностике и, как следствие, к отсроченному началу лечения. Поэтому в период сезонной заболеваемости респираторными инфекциями должна повышаться настороженность врачей-педиатров в отношении внебольничной пневмонии. Антибактериальная терапия оказывает решающее влияние на прогноз пневмонии, поэтому при достоверном диагнозе или у больного в тяжелом состоянии с вероятным диагнозом ее следует начать незамедлительно. Выбор антибиотика в каждом случае внебольничной пневмонии проводят индивидуально с учетом природной активности препаратов в отношении предполагаемого возбудителя и их возможной приобретенной резистентности, тяжести и течения заболевания, наличия у пациента противопоказаний к использованию тех или иных антибиотиков. В статье приводятся сведения о диагностических критериях внебольничных пневмоний. Рассмотрены вопросы антибактериального лечения типичной нетяжелой пневмонии у детей разных возрастных групп амоксициллином с клавулановой кислотой и показана его эффективность. Результаты проведенного исследования позволяют заключить, что пероральное использование одного курса защищенного аминопенициллина эффективно при лечении типичной внебольничной нетяжелой пневмонии у детей разного возраста, о чем свидетельствует ликвидация основных клинических проявлений болезни в короткие сроки. Pneumonia is an acute infectious and inflammatory lung disease of predominantly bacterial etiology, characterized by respiratory failure, toxic and respiratory disorders, local physical symptoms, and infiltrative changes on the roentgenogram. The incidence of community-acquired pneumonia increases in October-December, reaching a maximum in January-April, correlating with the seasonal increase in the level of acute respiratory viral infections. The similarity of the symptoms of the onset of pneumonia with the manifestations of acute respiratory viral infections can lead to its untimely diagnosis and, as a consequence, to a delayed start of treatment. Therefore, during the period of seasonal morbidity with respiratory infections, the alertness of pediatricians in relation to community-acquired pneumonia should increase. Antibiotic therapy has a decisive influence on the prognosis of pneumonia, therefore, with a reliable diagnosis or in a patient in serious condition with a probable diagnosis, it should be started immediately. The choice of antibiotic in each case of community-acquired pneumonia is carried out individually, taking into account the natural activity of the drugs in relation to the alleged pathogen and their possible acquired resistance, the severity and course of the disease, the patient's contraindications to the use of certain antibiotics. The article provides information on the diagnostic criteria for community-acquired pneumonia. The issues of antibacterial treatment of typical non-severe pneumonia in children of different age groups with amoxicillin with clavulanic acid are considered and its effectiveness is shown. The results of the study allow us to conclude that the oral use of one course of protected aminopenicillin is effective in the treatment of typical community-acquired non-severe pneumonia in children of different ages, as evidenced by the elimination of the main clinical manifestations of the disease in a short time.


2019 ◽  
pp. 194-198 ◽  
Author(s):  
G. Yu. Evstifeeva ◽  
O. Yu. Trusova ◽  
E. I. Danilova ◽  
V. V. Sumenko

Cough is one of the most common reasons why parents bring their children to the pediatrician. The article presents the results of a study of the clinical efficacy of treatment of dry cough using Sinecod syrup. A total of 60 children aged 3–15 years with the upper respiratory tract infections and complaints of dry (non-productive) cough were enrolled in the study. In Group 1 (the main group), the children received Sinecod syrup in addition to the standard therapy, in Group 2 (the comparison group) children received Stoptussin-Phyto syrup. The effectiveness of treatment was evaluated based on the clinical examination findings. On Day 8–11 after the first examination, Group 2 showed a decrease in the severity of day and night cough according to VAS by more than 4 points compared with Group 2. Significant regression of the severity of day and night cough in the studied groups was only observed in patients from Group 1. Sleep disorders of the patients normalized.


2019 ◽  
Vol 11 (3) ◽  
pp. 38-45
Author(s):  
S. A. Khmilevskaya ◽  
N. I. Zryachkin ◽  
V. E. Mikhailova

The aim: to study the etiological structure of acute respiratory infections in children aged 3 to 12 hospitalized in the early stages of the disease in the department of respiratory infections of the children’s hospital, and to reveal the features of their clinical course and the timing of DNA / RNA elimination of respiratory viruses from nasal secretions, depending on the method of therapy. Materials and methods: 100 children with acute respiratory infections aged 3 to 12 years were monitored. The nasal secrets on the DNA / RNA of respiratory viruses were studied by PCR. Depending on the method of therapy, patients were divided into 2 groups: patients of group 1 (comparison) received basic treatment (without the use of antiviral drugs), in patients of the 2nd group (main), along with basal therapy, the drug was used umifenovir in a 5-day course at the ageappropriate dosage. Results: In the etiologic structure of ARVI in children from 3 to 12 years, the leading place was taken by rhinovirus, influenza and metapneumovirus infections (isolated – 18%, 19% and 20% respectively, in the form of a mixed infection – 11%). The main syndromic diagnosis at the height of the disease was rhinopharyngitis. Complications were observed in 42% of cases, as often as possible with flu – 53% of cases. Features of metapneumovirus infection in children of this age group were: predominance of non-severe forms of the disease in the form of acute fever with symptoms of rhinopharyngitis, as well as a small incidence of lower respiratory tract infections. The use of the drug umiphenovir in children with acute respiratory viral infections of various etiologies contributed to significantly faster elimination of viral DNA / RNA from the nasal secretion, which was accompanied by a ecrease in the duration of the main clinical and hematological symptoms of the disease, a decrease in the incidence of complications, and reduced the duration of stay in hospital. Conclusion: application of modern molecular genetic methods of diagnostics made it possible to identify the leading role of influenza, metapneumovirus and rhinovirus infections in the etiology of acute respiratory viral infection in patients aged 3 to 12 years, and to determine a number of clinical features characteristic of this age group. The results of the study testify to the effectiveness of umiphenovir in the treatment of children with acute respiratory viral infections of various etiologies and allow us to recommend this drug as an effective and safe etiotropic agent.


2020 ◽  
Vol 10 (2) ◽  
pp. 368-374
Author(s):  
I. V. Nesterova ◽  
M. N. Mitropanova ◽  
G. A. Chudilova ◽  
S. V. Kovaleva ◽  
E. O. Khalturina

It is known that children with congenital cleft lip and palate are suffering from recurrent respiratory infections, which worsen the state of their health, and also complicate the results of reconstructive surgical treatment. The aim of the study was to detect defects of mucosal immunity in children with congenital cleft lip and palate, suffering from recurrent respiratory infections, and to create the program of local interferon corrective therapy with an assessment of its effectiveness. The studies included 56 children from the age of 1 to 3 years. Three groups of children were formed: group 1 – 26 children with congenital cleft lip and palate (antibiotic therapy); group 2 — 30 children with congenital cleft lip and palate (antibiotic therapy + local interferon therapy), group 3 — the control group. The clinical examination included a medical history, an assessment of the symptoms of recurrent episodes of acute respiratory infections and exacerbations of chronic infections. Microbiological studies were performed using standard methods. The status of local immunity was detected: the concentrations of secretory IgA, cytokines IL-17, IL-4, IL-6, IL-1β, IFNγ in the oral fluid were tested by ELISA. Results of the study established that in group 1 and group 2 clinical criteria of immunodeficiency with an infectious syndrome were revealed: repeated acute respiratory viral infections from 10 or more times a year, complicated by frequent exacerbations of chronic bacterial infection (up to 10 or more per year). Assessment of the state of local immunity in children with congenital cleft lip and palate revealed a lack of sIgA compared with the control group. Before treatment in group 2 oral fluid level of IL-17, IL-6 were statistically significant increase (p < 0.05); the results of the study also established increase in the level of IL-1β and a decrease in anti-inflammatory IL-4 and regulatory IFNγ relative to the control group (p > 0.05). After complex treatment with the inclusion of local interferon therapy in group 2 the appearance of sIgA, increase in the concentration of IL-4, IL-1β and a decrease IL-17 in oral fluid were observed (p > 0.05). The concentrations of IL-6, IFNγ did not change (p > 0.05). After treatment in group 2 there were a decrease in exacerbations of chronic upper respiratory tract infection and in frequency of acute respiratory viral infections compared with group 1 (p < 0.05). Positive clinical efficacy of local interferon therapy (the gel of recombinant IFNα2b in combination with oxidants — Viferon gel) in the process of staged rehabilitation of children with congenital cleft lip and palate has a protective clinical effect in reducing the frequency of acute respiratory viral infections, reducing the number of postoperative complications, reducing hospital stay, duration of antibacterial therapy and the number of exacerbations of chronic bacterial infection.


2021 ◽  
Vol 13 (1) ◽  
pp. 57-66
Author(s):  
V. V. Kovalchuk

COVID-19 worsens the course of cerebrovascular diseases (CVD), including chronic cerebral ischaemia (CCI). The Actovegin drug, which has long been widely used in CCI treatment, has an antioxidant and endothelium protective effect. It makes sense to study the effect of Actovegin therapy on the clinical manifestations of CCI in patients with a recent experience of COVID-19.Objective: to evaluate Actovegin efficacy in the treatment of CCI in patients with a recent experience of COVID-19.Patients and methods. The study included 440 patients (234 female; 206 male) with a recent experience of COVID-19, suffering from CCI, their average age being 67.8 years (from 54 to 85 years). All patients were broken down into two groups of 220 people (the patients in Group 1 were administrated Actovegin, the ones in Group 2 – were not). All patients were followed up for 90 days; their condition was assessed by the severity of clinical manifestations of CCI, using special scales and questionnaires.Results and discussion. After 90 days of follow-up, the frequency of complaints of cognitive impairment, sleep disorder, dizziness, fatigue, emotional disorders, and headache in Group 1 was significantly lower than in Group 2 (p<0.05). According to Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), Multidimensional Fatigue Inventory (MFI-20), and Spiegel Sleep Questionnaire (SSQ), the average indicators improved significantly more in Group 1 than in Group 2 (p<0.05). The absence of quality of life impairment and their minimal severity were observed in Group 1 in 77.9%; in Group 2 – in 33.7% (p<0.001). Statistically significant differences between the groups of patients were also observed in relation to emotional state recovery according to the Wakefield Questionnaire and the Spielberger State Trait Anxiety inventory.Conclusion. The observational study demonstrated the efficacy of Actovegin in the treatment of main clinical manifestations of CCI in patients with recent COVID-19 experience.


Author(s):  
Анна Александровна Зуйкова ◽  
Ольга Николаевна Красноруцкая ◽  
Юлия Александровна Котова ◽  
Даниил Юрьевич Бугримов

Острые респираторные вирусные инфекции (ОРВИ) представляют собой серьезную проблему для общественного здравоохранения во всем мире, вызывая значительную заболеваемость и смертность среди людей всех возрастных групп. Дети заражаются в среднем в два-три раза чаще, чем взрослые. Целью исследования является оценка эффективности препарата Деринат в комплексном лечении острых респираторных вирусных инфекций у детей дошкольного возраста в условиях амбулаторно-поликлинического приема. В исследование были включены дети в возрасте от 3 до 7 лет (включительно) не являющиеся школьниками, с клиническим диагнозом острая респираторная вирусная инфекция (ОРВИ), с симптомами, проявляющимися не длительнее 48 часов, не подвергавшихся противовирусной и иммуномодулирующей терапией в течение 30 дней до текущего посещения врача. В результате проведенного исследования установлено, что комплексное лечение ОРВИ у детей дошкольного возраста с применением препарата Деринат с первого дня терапии позволяет устранить отдельные симптомы ОРВИ значительно быстрее и эффективнее, чем при стандартных схемах терапии: ринорея и заложенность носа купируется на 2 день терапии, а гиперемия ротоглотки и отечность миндалин - на 3 день. Назначение изучаемого препарата в комплексном лечении ОРВИ в 2,4 раза повышает «Индекс здоровья» у дошкольников по сравнению с показателем при стандартных схемах лечения Acute respiratory viral infections are a serious public health problem worldwide, causing significant morbidity and mortality among people of all age groups. Children are infected on average two to three times more often than adults. The aim of the study is to evaluate the effectiveness of the drug Derinat in the complex treatment of acute respiratory viral infections in preschool children in outpatient settings. The study included children aged 3 to 7 years (inclusive) who are not schoolchildren, with a clinical diagnosis of acute respiratory viral infection, with symptoms that manifest no longer than 48 hours, who were not subjected to antiviral and immunomodulatory therapy for 30 days before the current doctor's visit. As a result of the study, it was found that the complex treatment of acute respiratory viral infections in preschool children with the use of the drug Derinat from the first day of therapy can eliminate individual symptoms of ARVI much faster and more effectively than with standard therapy regimens: rhinorrhea and nasal congestion are stopped on day 2 of therapy, and oropharyngeal hyperemia and tonsillar edema - on day 3. The administration of the studied drug in the complex treatment of acute respiratory viral infections increases the "Health Index" in preschool children by 2.4 times compared to the indicator for standard treatment regimens


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