Efficacy of tofacitinib as a «rescue therapy» in patients with severe ulcerative colitis

AIM: to evaluate the effectiveness of tofacitinib as a second line treatment.PATIENTS AND METHODS: the study included 12 patients, 4 (33.34%) males and 8 (66.66%) females. The median age was 41 ± 5 years. All patients admitted to the hospital with a severe flare-up of ulcerative colitis, which was the inclusion criterion in this study. Clinical manifestations, laboratory parameters, and colonoscopy were done at the time of administration of tofacitinib, on days 3 and 7, and after 12 weeks.RESULTS: a fast clinical response on 3 day of treatment, reduction in stool frequency, decrease blood in stool was noted in 10 (83.3%) patients. After 7 days from the start of TFCS therapy, all patients showed a decrease from severe activity to mild activity, as well as a decrease in inflammatory blood markers and hemoglobin levels. During the follow-up for 12 weeks, 100% of patients showed positive clinical and laboratory changes. In 10 (83.4%) patients, remission or maintenance of negligible minimal activity was noted.CONCLUSION: the results obtained show that the use of TFTB in hormone-resistant patients can be effective as a second line of “rescue therapy”.

Efficacy of tofacitinib as a «rescue therapy» in patients with severe ulcerative colitis

AIM: to evaluate the effectiveness of tofacitinib as a second line treatment.PATIENTS AND METHODS: the study included 12 patients, 4 (33.34%) males and 8 (66.66%) females. The median age was 41 ± 5 years. All patients admitted to the hospital with a severe flare-up of ulcerative colitis, which was the inclusion criterion in this study. Clinical manifestations, laboratory parameters, and colonoscopy were done at the time of administration of tofacitinib, on days 3 and 7, and after 12 weeks.RESULTS: a fast clinical response on 3 day of treatment, reduction in stool frequency, decrease blood in stool was noted in 10 (83.3%) patients. After 7 days from the start of TFCS therapy, all patients showed a decrease from severe activity to mild activity, as well as a decrease in inflammatory blood markers and hemoglobin levels. During the follow-up for 12 weeks, 100% of patients showed positive clinical and laboratory changes. In 10 (83.4%) patients, remission or maintenance of negligible minimal activity was noted.CONCLUSION: the results obtained show that the use of TFTB in hormone-resistant patients can be effective as a second line of “rescue therapy”.

Sex, mating and repeatability of Drosophila melanogaster longevity

Costs of reproduction are seemingly ubiquitous across the animal kingdom, and these reproductive costs are generally defined by increased reproduction leading to decreases in other fitness components, often longevity. However, some recent reports question whether reproductive costs exist in every species or population. To provide insight on this issue, we sought to determine the extent to which genetic variation might play a role in one type of reproductive cost—survival—using Drosophila melanogaster . We found, surprisingly, no costs of reproduction nor sex differences in longevity across all 15 genetic backgrounds in two cohorts. We did find significant variation within some genotypes, though these were much smaller than expected. We also observed that small laboratory changes lead to significant changes in longevity within genotypes, suggesting that longevity repeatability in flies may be difficult. We finally compared our results to previously published longevities and found that reproducibility is similar to what we saw in our own laboratory, further suggesting that stochasticity is a strong component of fruit fly lifespan. Overall, our results suggest that there are still large gaps in our knowledge about the effects of sex and mating, as well as genetic background and laboratory conditions on lifespan reproducibility.

MULTIPLE INFLAMMATORY SYNDROME IN CHILDREN (MIS-C) ASSOCIATED WITH COVID-19

There is a difference between MIS-C and KD. This is probably a postinfectious inflammatory response manifested with elevation of inflammatory markers and signs of myocardial damage. So, MIS-C could be an analogue of late phase COVID-19, which we are seeing in adult patients. This phase is also characterized by “cytokine storm” and can include severe myocardial disfunction, renal damage and laboratory changes consistent with MAS. Despite growing numbers of children with MIS-C, it still remains as rare condition and has good outcome in majority of cases. Children with MIS-C need special care of rheumatologist, infectious disease and intensive disease specialist collaboration.

Longitudinal assessment of associated factors with mortality in paraquat poisoning

In Colombia, paraquat poisoning (PQ) is one of the main causes of self-inflicted pesticide poisoning. There is not antidotal treatment against its toxicity, influencing an uncertain prognosis and changeful survival. Objective: To describe the prognosis of patients with PQ poisoning treated in a high-level hospital and to evaluate the association of mortality with clinical and laboratory test variables, considering its variation over time. Methods: Retrospective study between 2011 and 2018 at the Hospital San Vicente Fundación (Medellín, Colombia). Included cases diagnosed with PQ poisoning, of any age and sex. Diagnoses of concomitant intake of other toxins, underlying lung disease, and trauma were excluded. Sociodemographic and clinical characteristics were described, the effect on mortality and variation over time were analyzed, to search for prognostic research candidates. Results: Cohort of 67 patients, mostly single men, under 30 years of age, located in rural area was recruited. A mortality of 37.3% (95% CI 36.9 to 37.7%) was found, median time to death of 117 h (IQR 62h-238h). The instantaneous risk of dying for the male sex was 1.93; 95% CI 1.44 to 10.26; p = 0.007. Laboratory changes over time: AST (HR = 1.009; 95% CI; 1.007-1.012; p≤0.001), ALT (HR = 1.008; 95% CI 1.006-1.01; p≤0.001), total bilirubin (HR = 1.23; 95% CI 1,173-1.29; p≤0.001), creatinine (HR = 1.53; 95% CI 1,398-1,667; p≤0.001). Conclusion: Factors associated with mortality in PQ poisoning: ingested dose, intentional intake, male sex, and age. The change over time of AST, ALT, creatinine, and total bilirubin is related to death. Design dynamic models with clinical and laboratory test variables that include their evolution during the hospital stay can optimize the prognosis prediction.

Characteristics of cerebrospinal fluid under tuberculosis in patients with HIV-infection

Purpose. To carry out an analysis of characteristics and to reveal the peculiarities of laboratory changes of cerebrospinal fluid (CSF) in patients with tuberculosis of central nervous system associated with HIV-infection.Materials and methods. Analysis of 206 patients with CNS tuberculosis associated with HIV-infection who were treated in State Budgetary Healthcare Institution «City tuberculosis hospital No. 2» of Saint Petersburg during the period from 2006 to 2018 was conducted.Results and discussion. It was concluded that a mean protein level in CSF was 1,6±0,1 g/l and was significantly increased in patients with tubercular meningoencephalomyelitis. When decreasing the amount of CD4-lymphocytes, increasing of protein level in cerebrospinal fluid is observed. As cytosis increases, the amount of neutrophils increases too. Patients with tuberculous meningitis showed remarkable pleocytosis in comparison with patients with meningocephalitis. In 47% of cases, neutrophilic cell composition of CSF was registered. Therewith, the rate of neutrophils in CSF increased as the rate of lymphocytes decreased. Reducing of glucose in CSF was observed in the majority of patients with CNS tuberculosis independently of severity of immunosuppression and extent of brain injury.

Atypical respiratory distress in eastern Democratic Republic of the Congo prior to the COVID-19 pandemic. A case report

Background Predictions have been made that Africa would be the most vulnerable continent to the novel Coronavirus disease 2019 (COVID-19). Interestingly, the spread of the disease in Africa seems to have been delayed and initially slower than in many parts of the world. Here we report on two cases of respiratory distress in our region before the official declaration of the disease in December 2019, cases which in the present times would be suspect of COVID-19. Case presentation These two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress secondary to atypical pneumonia were seen in Bukavu, in Eastern Democratic Republic of the Congo (DRC), between September and December 2019. One patient had returned from China and the other had close contacts with travellers from China in the 2 weeks prior to the onset of symptoms. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea, preceded by dry cough and fever) and laboratory changes (procalcitonin within the normal range, slight inflammation, and lymphopenia) compatible with a viral infection. The chest X-ray series of the first patient showed lesions (reticulations, ground glass, and nodules ≤6 mm) similar to those currently found in COVID-19 patients. In addition, unlike the 25-year-old female patient who had no comorbidity, the 55-year-old male patient who had hypertension as comorbidity, developed a more severe acute respiratory distress which progressed to death. Conclusion These cases bring to the attention the fact that COVID-19-like syndromes may have already been present in the region months before the official beginning of the pandemic. This also brings to question whether a prior presence of the disease or infections with related virus may account for the delayed and less extensive development of the pandemic in the region.

Clinical and laboratory changes in the hemostasis system in patients with optic nerve vasculitis

Purpose. Clinical and laboratory studies of the hemostasis system in patients with optic nerve vasculitis. Materials and methods. Medical records and case history of 45 people (49 eyes) were analyzed, of which pathology in two eyes was detected in 4 people (8 eyes). The study involved 24 men and 21 women aged 17 to 35 years. The follow-up period ranged from 3 months to 5 years. Standard ophthalmic research methods and special research methods were used. Laboratory methods for the study of hemostasis included the detection of lupus anticoagulant was carried out using poison tests, as well as confirmatory tests with donor plasma and corrective phospholipids. Results. Retinopathy of the type of venous stasis was found in 30 people, neuropathy of the type of stagnant disc – in 15 people. In young patients after a viral infection with damage to the optic nerve in clinical form, retinopathy such as venous stasis and congestive optic nerve head with lupus anticoagulant was found in 73.4% of cases. In patients with vasculitis of the optic nerve with lupus anticoagulant, disturbances in the vascular-platelet and plasma-coagulation links in the hemostatic system were revealed. Conclusion. Lupus anticoagulant significantly reduces thromboresistance of the endothelium of the retinal microvasculature and enhances hypercoagulation, breaks the natural regulation of the hemostasis system and aggravates ischemia of the retina, optic nerve, participates in the pathogenesis of clinical forms of optic nerve vasculitis. Key words: hemostatic system, lupus anticoagulant, thrombophilia, optic nerve vasculitis.

Efficacy of Oral Sarolaner for the Treatment of Feline Otodectic Mange

Otodectes cynotis is a mite with a cosmopolitan distribution that is the primary agent for the development of otitis externa in feline species. The aim of this study was to evaluate the efficacy of the oral administration of sarolaner for the treatment of feline otodectic mange. We used 20 adult cats of both sexes that were naturally infested with O. cynotis. The mite infestation scoring was performed by video-otoscopy before treatment. The cats were randomized according to the infestation score and divided into two groups (treated and control). The treated group underwent oral administration of sarolaner in a single dose of 2–4 mg/kg. The evaluations were performed by video-otoscopy to evaluate the reduction of infestation score 2, 4, 6, 24 and 48 h and 7, 14, 21 and 28 days after medication. At the end of the study, the cats were sedated to enable the recovery of live and dead mites to determine efficacy. No adverse effects or laboratory changes were observed in these cats. Sarolaner showed 100% efficacy 48 h after treatment. Based on the results, a single oral dose of sarolaner was effective in controlling otodectic mange in naturally infested cats.