scholarly journals Baricitinib in the Treatment of Patients with COVID-19: A Review of International Data and Analysis of Clinical Results in the Russian Population

2021 ◽  
Vol 66 (1-2) ◽  
pp. 47-56
Author(s):  
А. I. Zagrebneva ◽  
Е. А. Baryakh ◽  
Е. I. Zhelnova ◽  
N. G. Poteshkina ◽  
I. Р. Beloglazova ◽  
...  

The effects of baricitinib, a selective reversible inhibitor of Janus kinase 1 and 2, in the treatment of COVID-19 are associated with different aspects of pathogenesis — inhibition of viral endocytosis, reduction of excessive inflammatory response, and mitigation of vascular and pulmonary damage, which is a strong rationale for using baricitinib to treat patients with COVID-19. In the period from April to May 2020, City Clinical Hospital No. 52 obtained clinical experience of baricitinib clinical use in the therapy of 113 patients with COVID-19: 58 (51%) women and 55 (49%) men, whose average age was 57±12.6 years old. Analysis of the results of using baricitinib showed that therapy with baricitinib against the background of standard pathogenetic therapy was found to be effective in 95 (84%) patients and ineffective in 18 (16%). Significant positive changes were shown in comparison with the baseline level of the following indicators: body temperature (from 37.2±0.8˚C to 36, ±0.68˚C, P=0.000), blood oxygen saturation (from 95.5±3.0% to 96.5±2.2%, P=0.011), C-reactive protein (from 46.1±48.0 mg/L to 33.5±43.7 mg/L, P=0.010 ), National Early Warning Score (NEWS) (from 1.7±1.3 to 1.1±1.2, p=0.001). From the safety point of view, patients showed a slight decrease in the average value of the number of neutrophils — from (3.1±1.4)×109 to (3.0±2.0)×109 and lymphocytes — from (1.8±0,9)×109 to (1.7±0.9)×109, as well as minimal multidirectional changes in the mean values of transaminase activity — alanine aminotransferase changed from 33.9±23.6 U/L to 34.9±47.5 U/L, aspartate aminotransferase — from 40.6±49.0 U/L to 38.5±25.5 U/L. In general, the results obtained within the experience of the clinical use of baricitinib in 113 Russian patients with COVID-19 are consistent with the available data from foreign clinical studies and confirm the efficacy and safety of baricitinib.  

2021 ◽  
Vol 10 ◽  
Author(s):  
Cirino Botta ◽  
Alessia Indrieri ◽  
Eugenio Garofalo ◽  
Flavia Biamonte ◽  
Andrea Bruni ◽  
...  

Since SARS-CoV-2 outbreak in December 2019, world health-system has been severely impacted with increased hospitalization, Intensive-Care-Unit (ICU) access and high mortality rates, mostly due to severe acute respiratory failure and multi-organ failure. Excessive and uncontrolled release of proinflammatory cytokines (cytokine release/storm syndrome, CRS) have been linked to the development of these events. The recent advancements of immunotherapy for the treatment of hematologic and solid tumors shed light on many of the molecular mechanisms underlying this phenomenon, thus rendering desirable a multidisciplinary approach to improve COVID-19 patients’ outcome. Indeed, currently available therapeutic-strategies to overcome CRS, should be urgently evaluated for their capability of reducing COVID-19 mortality. Notably, COVID-19 shares different pathogenic aspects with acute graft-versus-host-disease (aGVHD), hemophagocytic-lymphohistiocytosis (HLH), myelofibrosis, and CAR-T-associated CRS. Specifically, similarly to aGVHD, an induced tissue damage (caused by the virus) leads to increased cytokine release (TNFα and IL-6) which in turn leads to exaggerated dendritic cells, macrophages (like in HLH) and lymphocytes (as in CAR-T) activation, immune-cells migration, and tissue-damage (including late-stage fibrosis, similar to myelofibrosis). Janus Kinase (JAK) signaling represents a molecular hub linking all these events, rendering JAK-inhibitors suitable to limit deleterious effects of an overwhelming inflammatory-response. Accordingly, ruxolitinib is the only selective JAK1 and JAK2-inhibitor approved for the treatment of myelofibrosis and aGVHD. Here, we discuss, from a molecular and hematological point of view, the rationale for targeting JAK signaling in the management of COVID-19 patients and report the clinical results of a patient admitted to ICU among the firsts to be treated with ruxolitinib in Italy.


Al-Risalah ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. 126-148
Author(s):  
Ay Maryani

This study describes the religious behavior of UIN Syarif Hidayatullah Jakarta students. The variables used are internal and external environment as independent variable and religious behavior as dependent variable. The internal environment variable consists of gender factor, (male and female). The external environmental variables comprise the faculty environment, the present resident and the place to grow. The present resident consist of dormitories, boarding houses and parents' homes and the place to grow consist of urban and rural environment. Religious behavior variables consist of habluminallah behavior and habluminannas behavior. Habluminallah's behavior measured by (1) knowledge of faith and worship, (2) attitudes toward faith and worship, and (3) practice of faith and worship. The habluminannas variable measured by (1) Islamic behavior for them self, like honest, discipline and good work / studyethics, trust and concern on legality, (2) Islamic behavior with others, like generous, cooperation, caring, respect to the people's rights and tolerance and (3) Islamic behavior for the natural surroundings, like love of nature and nature conservation efforts. The methodology used was (1) Statistical descriptive, (2) MANOVA (Multivariate Analysis of Variance) and (3) Independent sample t-test. The results showed the religious behavior UIN Syarif Hidayatullah Jakarta students has a very good category. This is indicated by the mean values for the behavior of haluminallah and habluminannas of 158.85 and 178.76,  espectively. The average value of habluminallah behaviour in the range of values "145-180" with the category of "very good" and habluminannas behavior in the range value "165-205" with the category "very good. Habluminallah and habluminannas behavior are different for each faculty. This is indicated by the significance level of Pillai Trace, Wilk Lambda, Hotelling Trace, Roy's Largest Root of 0.00 (<0.05). Habluminallah and habluminannas behavior are the same for respondents who live in dormitories, boarding houses, and parents' homes. This is indicated by the value of F test and significance at Wilk's Lambda respectively for 2.055 and 0.085 (>0.05). Habluminallah and habluminannas behaviors are similar for urban and rural respondents. This is known from the sig level. (2-tailed) for habluminallah and habluminannas behavior of 0.317 and 0.245 (> 0.05), respectively. Habluminallah and habluminannas behaviors are similar for male and female. This is known from the sig level. (2-tailed) for habluminallah and habluminannas behavior of 0.950 and 0.307 (> 0.05),respectively. The results of this study are expected to be used to develop university policies that can enhance the Islamic values of UIN Syarif Hidayatullah Jakarta.


Atmosphere ◽  
2021 ◽  
Vol 12 (4) ◽  
pp. 467
Author(s):  
Rocío Baró ◽  
Christian Maurer ◽  
Jerome Brioude ◽  
Delia Arnold ◽  
Marcus Hirtl

This paper demonstrates the environmental impacts of the wildfires occurring at the beginning of April 2020 in and around the highly contaminated Chernobyl Exclusion Zone (CEZ). Due to the critical fire location, concerns arose about secondary radioactive contamination potentially spreading over Europe. The impact of the fire was assessed through the evaluation of fire plume dispersion and re-suspension of the radionuclide Cs-137, whereas, to assess the smoke plume effect, a WRF-Chem simulation was performed and compared to Tropospheric Monitoring Instrument (TROPOMI) satellite columns. The results show agreement of the simulated black carbon and carbon monoxide plumes with the plumes as observed by TROPOMI, where pollutants were also transported to Belarus. From an air quality and health perspective, the wildfires caused extremely bad air quality over Kiev, where the WRF-Chem model simulated mean values of PM2.5 up to 300 µg/m3 (during the first fire outbreak) over CEZ. The re-suspension of Cs-137 was assessed by a Bayesian inverse modelling approach using FLEXPART as the atmospheric transport model and Ukraine observations, yielding a total release of 600 ± 200 GBq. The increase in both smoke and Cs-137 emissions was only well correlated on the 9 April, likely related to a shift of the focus area of the fires. From a radiological point of view even the highest Cs-137 values (average measured or modelled air concentrations and modelled deposition) at the measurement site closest to the Chernobyl Nuclear Power Plant, i.e., Kiev, posed no health risk.


2020 ◽  
Vol 65 (4) ◽  
pp. 477-484
Author(s):  
Christoph Thorwächter ◽  
Matthias Woiczinski ◽  
Inês Santos ◽  
Florian Schmidutz ◽  
Alexander Paulus ◽  
...  

AbstractThreaded cups show good clinical results when implanted correctly. In clinical use, multiple cases with an incomplete placement of the EcoFit threaded cup (implantcast) were observed. This behaviour could not be explained intra- and postoperatively. The aim of this study was to compare and optimise the drill-in-behaviour of the EcoFit cup in a biomechanical investigation. EcoFit cup sizes 46, 50 and 54 mm were compared with the SC cup (Aesculap) size 50 mm. Foam blocks (Sawbones) of density 0.16 g/ml (pcf 10), 0.32 g/ml (pcf 20) and 0.48 g/ml (pcf 30) were used. After standardised placement using a universal testing system (n = 8 per group), the primary stability, the overhang of the cups and the drill-in behaviour were measured. Overreamings of 1 and 2 mm were performed (pcf 20, n = 8) for the EcoFit cup size 50 and the primary stability as well as the overhang measurements were examined. Measurements of the cup diameter, thread depth and thread pitch were performed on three-dimensional (3D) images of the cup size 50 mm. The drill-in behaviour was different between the EcoFit and the SC cups. Even with maximum torque, the EcoFit cup could not be positioned as deep as the SC cup in standard reaming conditions (overhang of 1.1 ± 0.4 mm for the EcoFit size 50 in pcf 20 and of −0.01 ± 0.2 mm for the SC cup). The primary stability was lower for the EcoFit cup in comparison to the SC cup (128.8 ± 3.2 Nm vs. 138.6 ± 9.1 Nm, p = 0.0291). With overreaming to 51 mm, a deeper positioning of the EcoFit was possible (overlap of −0.3 ± 0.1, comparable to the SC cup). The overreaming of the cavity also led to a significantly higher primary stability of 143.4 ± 3.7 Nm (p < 0.001) comparable to the unaltered condition (128.8 ± 3.2 Nm). Overreaming to 52 mm had no further advantage in terms of primary stability or overhang. The geometric measurements showed significant differences as well. The previously clinically observed difficulties in inserting the cup were confirmed by this study. By overreaming to 51 mm, the drill-in behaviour, the primary stability and the measured overhang were comparable to the reference cup. The obtained results suggest that the extension of the acetabulum cavity to 51 mm while using the implantcast EcoFit size 50 should be implemented in clinical applications.


Author(s):  
Bandi Usman ◽  
Khairil Akbar ◽  
Kurnia Dyah Anggorowati

Abstrak: This study aims to increase student learning motivation in the field of physical education, sports and health. The learning model used is the application of the learning model through cooperative jigsaw to increase learning motivation in the field of physical education, sports and healthfor fifth grade students. Classroom action research (PTK) is carriedout using data collection techniques, namely motivation tests and questionnaires. The results of this study showed that in cycle 1, the average value of student learning motivation was 73% in the motivated category but not yet complete. Then in cycle II obtained a percentage of learning motivation of 90% categorized as motivated according to the success criteria and seen from the point of view of the maximum completeness criteria (KKM) students are said to be complete. The percentage of increasing learning motivation from cycle I to cycle II was 17%. The jigsaw cooperative learning model can increase student motivation, especially in sports and health physical education subjects.Keywords: learning Model, motivation to learn physical education sports and health.Abstrak: Penelitian ini bertujuan untuk meningkatkan motivasi belajar siswa pada bidang studi Pendidikan Jasmani Olahraga dan Kesehatan. Model pembelajaran yang digunakan adalah penerapan model pembelajaran melalui kooperatif Jigsaw untuk meningkatkan motivasi belajar pada bidang studi Pendidikan Jasmani Olahraga dan Kesehatan pada siswa kelas V, dilakukan penelitian tindakan kelas (PTK) dengan teknik pengumpulan data yakni tes dan angket motivasi. Hasil penelitian ini diperoleh siklus I nilai rata-rata motivasi belajar siswa presentase sebesar 73% kategori termotivasi tetapi belum tuntas. Kemudian pada siklus II diperoleh presentase motivasi belajar sebesar 90% dikategorikan termotivasi sesuai kriteria keberhasilan dan dilihat dari sudut pandang kriteria ketuntasan maksimal (KKM) siswa sudah dikatakan tuntas. Presentase peningkatan motivasi belajar siklus I ke siklus II yaitu 17%. Model pembelajaran kooperatif jigsaw dapat meningkatkan motivasi belajar siswa, terutama pada mata pelajaran Pendidikan Jasmani Olahraga dan Kesehatan.Kata Kunci: Model Pembelajaran, Motivasi Belajar Pendidikan Jasmani Olahraga dan Kesehatan


2019 ◽  
pp. 10-17

The purpose of this study is to analyze real-life data in order to characterize patients with RA and cardiovascular diseases that are treated with biological agents. Material and Methods: In a retrospective study, data from real clinical practice were analyzed in 195 patients with seropositive RA, which are being treated with biological agents. Results: In patients with existing CVD, significantly higher mean ESR values ​​(23.95 vs. 19.31, p = 0.031) and CRP (6.41 vs. 3.36, p = 0.004) were detected over the period of the study period of treatment. In contrast to the laboratory parameters, mean values of clinical parameters of RA - TJC, SJC and VAS clinical sings did not show a significant difference in patients with and without CVD. The time average value of DAS28 (ESR) during the study period was significantly higher in patients with CVD (3.7 vs. 3.39, p = 0.002) compared to those without CVD. DAS28 (CRP) shows the same trend. In patients with CVD, the time average value of the follow-up indicator was 3.21, and in patients without CVD, 2.88 (p <0.001). Conclusion: The results of this study, in PA patients conducting treatment with biological agents in the real life, outside of the clinical study conditions, demonstrate that independently of treatment, patients with CVD continue to maintain higher background inflammation. An optimization of therapeutic behavior in real life is necessary to improve the long-term prognosis of these patients.


GANEC SWARA ◽  
2021 ◽  
Vol 15 (1) ◽  
pp. 874
Author(s):  
NURUL AULIA DEWI ◽  
MUHAMMAD IRHAM ◽  
SARWO EDY WIBOWO

      This study aims to determine the effect of the Type STAD Cooperative Learning model on mathematical problem solving abilities. The data collection technique was obtained by means of a test in the form of description questions and documentation in the form of a list of student names. The research instrument used was 3 pre-test and post-test questions. The data analysis technique used is the normality test, homogeneity, t test with the technique of paired samples t-test and independent t-test.      The results showed that, the paired sample t-test on the problem solving ability before and after treatment with STAD obtained an average value of 50.29 to 83.71 with a significance of 0.000 <0.05. This means that the students' scores before and after STAD learning have differences in the average mathematical problem solving abilities. Based on the results of the paired sample t-test on the ability to solve mathematical problems before and after treatment using conventional learning models, the average value was 44.57 to 75.79 with a significance of 0.000 <0.05. This means that there is a significant increase before and after conventional learning. Based on the results of the independent samples t-test, the mean values were 83.71 and 75.79 with a significance value of 0.009 <0.05. This means that there is a difference in the average problem-solving ability of students in STAD learning with students in conventional learning. It can be concluded that the STAD type of cooperative learning model has an effect on students' problem solving abilities in mathematics.


2021 ◽  
Vol 6 ◽  
pp. 4-17
Author(s):  
V.V Koval ◽  
D.V. Miroshnichenko ◽  
O.V. Bogoyavlenska

The article substantiates the importance and problems of determining of such an indicator of the quality of solid fossil fuels, as mechanical strength. The strength of coal depends on a large number of factors (viscosity, brittleness, properties of structural bonds, etc.), the change of which is impossible to take into account. Therefore, the strength of coal in the sample, piece, pack and formation must be represented by some integral index, which inevitably fluctuates around a certain average value and can be determined only approximately. The evaluation of the strength properties of coal should be carried out on the basis of mass tests using statistical methods that allow to calculate the average value and coefficient of variation. Since the strength dispersion is mainly due to the natural inhomogeneity of the coal, the excessive accuracy of the measuring instruments has almost no effect on the statistical characteristics. Laboratory methods of mechanical tests of mine samples, in comparison with full-scale, as a rule, are very accessible and, at qualitative performance of tests, are highly reliable. The properties of coal as an object of enrichment and use are largely related to its physical properties. The physical properties of coal and mineral impurities significantly affect the formation of the main parameters that characterize the particle size distribution and fractional composition, it`s changes during the mining, transportation and enrichment processes. The basic physical and mechanical properties of solid fuels from the point of view of their industrial processing have been listed, the review has been made of the most widespread methods of study of coals mechanical durability and the equipment used for these purposes. The main advantages and disadvantages have been summarized of these methods, as well as their relationship. The factors have been Indicated tinfluencing the mechanical strength of coal. The expediency of using existing methods from the point of view of informativeness for thesphere of its application has been estimated. The methods common in the coal processing industry are considered in more detail. Keywords: coal, solid fuel mining, mechanical strength, determination methods, influencing factors, grinding strength, crushing index. Corresponding author V.V. Koval, e-mail: [email protected]


2021 ◽  
pp. 76-83
Author(s):  
S. V. Tikhonov ◽  
V. D. Dekkanova ◽  
S. A. Vinnichuk ◽  
T. S. Fil ◽  
N. V. Bakulina

The pandemic of COVID-19 is changing the usual clinical practice. Most of the drugs used for the etiotropic and pathogenetic therapy of COVID-19 do not have a sufficient evidence base, approaches to therapy of liver, gastrointestinal tract and other body systems damage in the structure of COVID-19 and post COVID-19 syndrome are under development. Coronavirus infection is more severe in  obese patients with associated diseases; the  liver plays an important role in  this process. Retrospective analysis of  the  medical histories of  patients with a  new coronavirus infection hospitalized in  the  clinic of North-Western State Medical University named after I.I. Mechnikov identified that 34.7% of patients were overweight, 51.3% obese, 77% abdominal obesity (alanine aminotransferase (ALAT) was on average 76.2 ± 58.8 U/L, aspartate aminotransferase (ACAT) 60.7 ± 48.6 U/L). At the time of hospitalization, increased transaminases was detected in 71% of patients and correlated with markers of the severe course of COVID-19 (the level of C-reactive protein, ferritin, % of blood oxygen saturation). In patients with severe new coronavirus infection, receiving therapy with JAK-kinase inhibitors and/or biological drugs, often was a  significant increase of  ALAT and ASAT up to 5–10  upper limits of  the  norm. In  the  process of  histological examination of the liver tissue of patients who died of extremely severe course of infection, characteristic fatty degeneration of hepatocytes was revealed. Therapy with a multicomponent drug containing inosine, meglumine, methionine, nicotinamide and succinic acid contributed to a dynamic decrease of transaminases and an improvement in the course of the new coronavirus infection. 


2004 ◽  
Vol 47 (4) ◽  
pp. 367-375 ◽  
Author(s):  
T. Kisiel ◽  
J. M. Książkiewicz

Abstract. In two Polish conservative flocks of Miniduck (K2) and Pekin (P33), registered by FAO as domestic genetic resources (World Watch List, 2000) the mean values of physical (tissue components) and qualitative traits of meat (pH15, pH24, colour of meat) were determined. The experimental flocks showed significant variations in body weight at 7 weeks of age (1540 vs 2088 in drakes and 1395 vs 1986 g in ducks), in the proportion of breast and leg muscles and skin with subcutaneous fat in eviscerated carcass. K2 ducks are characterized by outstanding musculature of breast and P33 ducks by that of lower leg and by low fatness. pH15 values of breast and leg muscles in K2 and P33 birds were greater than pH24 of these muscles. In both flocks pH15 values of 6.09 to 6.33 and pH24 values of 5.90 to 6.05 in breast muscles were lower than in leg muscles (6.33 to 6.46 and 6.12 to 6.37, respectively). A significantly lower L* value (darker colour) of breast muscle was characteristic of K2 birds (43.7 in males and 40.5 in females) compared to P33 males and females. Furthermore, breast muscles of K2 drakes and ducks had significantly higher redness (a*) and yellowness values (b*) than P33. In pectoralis superficialis muscle of K2 and P33 females, a significantly lower diameter was found for white muscle fibres (αW) (30.0 to 30.5 μm) and for red muscle fibres (βR) (16.9 to 17.6 μm) than in biceps femoris muscle (αW from 48.3 to 54.2; βR from 36.0 to 37.1 μm). Muscle fibres of K2 compared to P33 ducks were characterized by significantly greater diameters of βR muscle fibre in pectoralis superficialis muscle, and by lower αW and βR fibre diameters in biceps femoris muscle. The experiment showed that meat of ducks from the conservative flocks studied is valuable from the consumer’s point of view.


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