bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of the Timing of Dexamethasone Administration in Patients with COVID-19 Pneumonia
Authors: Lee Hyun Woo , Park Jimyung , Lee Jung-Kyu , Park Tae Yeon , Heo Eun Young
Published: November 2020

Introduction: Despite the proven benefits of dexamethasone in hospitalized COVID-19 patients, the optimum time for the administration of dexamethasone is unknown. We investigated the progression of COVID-19 pneumonia based on the timing of dexamethasone administration.Methods: A single-center, retrospective cohort study based on medical record reviews was conducted between June 10 and September 21, 2020. We compared the risk of severe COVID-19, defined as the use of a high-flow nasal cannula or a mechanical ventilator, between groups that received dexamethasone either within 24 hours of hypoxemia (early dexamethasone group) or 24 hours after hypoxemia (late dexamethasone group). Hypoxemia was defined as room-air SpO2 <90%. Results: Among 59 patients treated with dexamethasone for COVID-19 pneumonia, 30 were in the early dexamethasone group and 29 were in the late dexamethasone group. There was no significant difference in baseline characteristics, the time interval from symptom onset to diagnosis or hospitalization, or the use of antiviral or antibacterial agents between the two groups. The early dexamethasone group showed a significantly lower rate of severe COVID-19 compared to the control group (75.9% vs 40.0%, P-value=0.012). Further, the early dexamethasone group showed a significantly shorter total duration of oxygen supplementation (10.45 d vs. 21.61 d, P-value=0.003) and length of stay in the hospital (19.76 d vs. 27.21 d, P-value=0.013). However, extracorporeal membrane oxygenation and in-hospital mortality rates were not significantly different between the two groups.Conclusions: Early administration of dexamethasone may prevent the progression of COVID-19 to a severe disease, without increased mortality.
Nomogram to Early Screen Multiparous Women for Preterm Birth in a Cohort Study
Authors: Traboulsi Mayssa , Talibi Zainab El Alaoui , Boussaid Abdellatif
Published: November 2020

Background: Preterm Birth (PTB) can negatively affect the health of mothers as well as infants. Prediction of this gynecological complication remains difficult especially in Middle and Low-Income countries because of limited access to specific tests and data collection scarcity. Multiparous women in our study presented a higher PTB prevalence compared to nulliparous women. Methods: In a cohort study from Northern Lebanon of 1996 women, 922 were multiparous presenting a PTB prevalence of 8%. We analyzed the personal, demographic, and health indicators available for this group of women. We compared 4 modified logistic regression models (up-sampling, lasso penalized regression) to develop a nomogram that can screen for preterm in multi-parous women. The models were trained and validated on different data sets.Results: The best PTB prediction of the Logistic regression model reached around 88%. This was obtained using a Logistic Regression Model trained on up-sampled datasets and LASSO (Least Absolute Shrinkage and Selection Operator) penalized. The regression coefficients of the 6 selected variables (Pre-hemorrhage, Social status, Residence, Age, BMI, and Weight gain) were used to create a nomogram to screen multiparous women for PTB risk. Conclusions: The nomogram based on readily available indicators for multiparous women reasonably predicted most of the at PTB risk women. This tool will allow physicians to screen women that represent a high risk for spontaneous preterm birth and run furthermore adequate additional tests leading to better medical surveillance that can reduce PTB incidence.
Risk Factors Associated with Infection Recurrence of Posttraumatic Osteomyelitis Treated with Ilizarov Bone Transport Technique—A Retrospective Study of 149 Cases
Authors: Ainizier Yalikun , Maimaiaili Yushan , Li WenQiang , Alimujiang Abulaiti , Ahemaitijiang Yusufu
Published: November 2020

Background: Post-traumatic tibial osteomyelitis is considered as complex clinical problem due to its unique characteristics such as prolonged course, multi-staged treatment and high recurrence rate. The purpose of this study is to identify and analyze the causes and risk factors associated with infection recurrence of tibial osteomyelitis treated with Ilizarov technique. Methods: From January 2011 to January 2019, a total of 149 patients with post-traumatic tibial osteomyelitis treated with Ilizarov bone transport technique were included in this study. Demographic and clinical data were collected and analyzed. Univariate analysis and logistic regression analysis were used to analyze the factors that may affect the recurrence or reinfection of post-traumatic tibial osteomyelitis after treated with Ilizarov bone transport technique.Results: All included patients were successfully followed up with an average of 37.5 month (18-78 month), among them, 17 patients (11.41%) occurred with recurrence or reinfection of tibial osteomyelitis in which 2 cases were in distraction area and 15 cases in docking site. Among them, 5 patients were treated successfully with sensitive intravenous antibiotic, the remaining 12 patients were intervened by surgical debridement or bone grafting after debridement. Univariate analysis showed that pseudomonas aeruginosa infection, bone exposure, number of previous operations (>3 times), blood transfusion during bone transport surgery, course of osteomyelitis >3 months, diabetes was associated with recurrence or reinfection of postoperative tibial osteomyelitis. According to the results of logistic regression analysis, pseudomonas aeruginosa infection, bone exposure, and the number of previous operations (>3 times) are risk factors for recurrence or reinfection of posttraumatic tibial osteomyelitis treated with Ilizarove bone transport technique, with odds ratios (OR) of 6.055, 7.413, and 1.753, respectively. Conclusion: The number of previous operations (>3 times), bone exposure, and pseudomonas aeruginosa infection are risk factors for infection recurrence of posttraumatic tibial osteomyelitis treated with Ilizarove bone transport technique.
Antimicrobial Peptide MPX Against Escherichia Coli O157:H7 Infection and Inhibiting inﬂammation, Enhancing Epithelial Barrier and Promoting Nutrient Absorption in the Intestine
Authors: Zhao Xue qin , Wang Lei , Zhu Chun ling , Xia Xiao jing , Zhang Shou ping , Wang Yi min , Zhang Hui hui , Xu Yan zhao , Chen Shi jun , Jiang Jin qing , He Yong hui , Zhang Gai ping , Bai Yue yu , Fotina Hanna , Hu Jian he
Published: November 2020

Background: Escherichia coli can cause intestinal diseases in humans and livestock, destroy the intestinal barrier, exacerbate systemic inflammation, and seriously threaten human health and animal husbandry development. The antimicrobial peptide MPX is extracted from venom and possesses good antibacterial activity against gram-negative bacteria. The aim of this study was to investigate whether MPX could be effective against E. coli infection. Results: In this study, the CCK-8 and lactic dehydrogenase results showed that MPX exhibited no toxicity in IPEC-J2 cells even at a concentration of 128 µg/mL. Furthermore, MPX notably suppressed the levels of IL-2, IL-6, TNF-α, myeloperoxidase and LDH induced by E. coli and reduced inflammation by inhibiting the p-p38-, TLR4- and p-p65-dependent pathways. In addition, MPX improved the expression of ZO-1, occludin, and claudin and enhanced the wound healing ability of IPEC-J2 cells. The therapeutic effect of MPX was evaluated in a murine model, and the results showed that MPX could protect mice against lethal infection with E. coli, improve the survival rate of the mice, and reduce the colonization of E. coli in organs and feces. H&E staining showed that MPX increased the length of villi and reduced the infiltration of inflammatory cells into the jejunum, and the effect of MPX was better than that of enrofloxacin. The SEM and TEM results showed that MPX effectively ameliorated the damage caused by E. coli to the jejunum and increased the number and length of microvilli. In addition, real-time PCR revealed that MPX decreased the expression of IL-2, IL-6, and TNF-α in the jejunum and colon. Furthermore, immunohistochemistry and immunofluorescence studies revealed that MPX could reduce the expression of p-p38 and p-p65 in the jejunum, thereby reducing the secretion of inflammatory factors. Moreover, MPX increased the mRNA and protein expression of ZO-1, occludin and MUC2 in the jejunum and colon, improved the function of the intestinal barrier and promoted the absorption of nutrients. Conclusion: This study suggests that MPX may be an effective therapeutic agent against E. coli infection and other intestinal diseases, laying the foundation for the development of new drugs for bacterial infections.
Validity of the COPD-6® Device for COPD Screening in the Primary Care Setting of China
Authors: Chen Shuyun , Li Xiaochen , Wang Zihui , Zhou Yumin , Zhao Dongxing , Zhao Zhuxiang , Liu Sha , Ran Pixin
Published: November 2020

Background: The use of simple and affordable screening tools for chronic obstructive pulmonary disease (COPD) is limited. We aimed to assess the validity of a handheld expiratory flow meter (COPD-6®, Vitalograph Ltd., Ireland) for COPD screening in Chinese primary care settings.Methods: In our cross-sectional study, subjects were randomly selected in eight primary care settings. Testing with the Vitalograph-COPD-6® and conventional spirometry were sequentially performed on subjects. The correlation between COPD-6® and conventional spirometry was determined. Validity was analyzed by the area under the receiver operator characteristic curve (AUC) of the forced expiratory volume in one second (FEV1) / forced expiratory volume in six seconds (FEV6) that used to detect airway obstruction. The sensitivity, specificity, predictive values, and likelihood ratio were calculated according to different FEV1/FEV6 cut-off points.Results: 229 subjects (15.4%) were diagnosed with airflow limitation by standard spirometry. FEV1, FEV6, and FEV1/FEV6 measured by COPD-6® were correlated with FEV1, FVC, and FEV1/FVC measured by spirometry (r=0.889, 0.835and 0.647, p<0.001), respectively. AUC of the FEV1/FEV6 to determine airflow obstruction was 0.857 (95%CI: 0.826 to 0.888). No significant difference of AUC was observed between the symptomatic group and the asymptomatic population (AUC=0.869 vs. 0.843, P=0.425). A similar phenomenon was found in the AUC of smokers and never-smokers (AUC=0.862 vs.0.840; P=0.515). The value of AUC was largest (i.e., 0.80) when the cut-off point for FEV1/FEV6 was 0.77.Conclusions: The handheld COPD-6® could be used as a pre-screening device on early diagnosis of COPD in Chinese primary care settings.
WITHDRAWN: Evaluating the Five Escherichia coli Derivative Strains as Platform for Arginine Deiminase Overproduction
Authors: Abdollahi Sara , Morowvat Mohammad Hossein , Savardashtaki Amir , Irajie Cambyz , Najafipour Sohrab , Ghasemi Younes
Published: November 2020

Escherichia coli is one of the most preferred host microorganisms for the production of recombinant proteins due to its well-characterized genome, availability of various expression vectors and host strains. Choosing a proper host strain for the overproduction of a desired recombinant protein is very important because of the diversity of genetically modified expression strains. This study attempted to evaluate the five host strains including BL21 (DE3), Rosetta (DE3), DH5α, XL1-BLUE and SHuffle in terms of arginine deiminase (ADI) production and enzyme activity. Arginine deiminase (ADI) was chosen a bacterial enzyme which degrades L-arginine. It is effective in treatment of some types of human cancers like melanoma and hepatocellular carcinoma (HCC) which are arginine-auxotrophic. Five mentioned E. coli strains were cultivated. The pET-3a was used as the expression vector. The competent E. coli cells were obtained through CaCl 2 method. It was then transformed with the construct of pET3a-ADI using heat shock strategy. The ADI production levels were examined by 10% SDS-PAGE analysis. The ability of host strains for expression of the requested recombinant protein was compared. The enzymatic activity of the obtained recombinant ADI from each studied strain was assessed by a colorimetric 96-well microtiter plate assay. All the five strains exhibited a significant band at 46 kDa. BL21 (DE3) produced the highest amount of ADI protein followed by Rosetta (DE3). The following activity assay showed that ADI from BL21 (DE3) and Rosetta (DE3) had the most activity. There are some genetic and metabolic differences among the various E. coli strains, leading to differences in the amount of recombinant protein production. The results of this study can be used for the efficacy evaluation of the five studied strains for the production of similar pharmaceutical enzymes. The strains also could be analyzed in terms of proteomics.
The Effect of Quality of Medical Service on Patient Satisfaction and Intent to Revisit: For Public Hub Hospitals in Republic of Korea
Authors: WOO SELIN , CHOI MANKYU
Published: November 2020

Background: The purpose of this study was to construct and test structural equation modeling of the causal relationship between quality of healthcare, patient satisfaction, and intent to revisit perceived by patients using regional hub public hospitals.Methods: In this study, data of 2,951 outpatients and 3,135 inpatients were collected using the “2018 Regional Hub Public Hospital Operational Evaluation.” A structural equation model was used to understand the relationship between patient satisfaction and intent to revisit, and bootstrap analysis was performed.Results: In the direct effect, outpatients were presented in the order of doctor's communication, hospital environment, and patient satisfaction. Inpatients are doctor’s communication, staff consideration, and patient satisfaction are shown in this order. In the indirect effect, the outpatients were presented in the order of doctor's communication, staff consideration, and the hospital's environment. Inpatients were presented in the order of staff consideration, nurse’s communication, doctor’s communication, and patient satisfaction.Conclusions: Regional hub public hospitals need high-quality medical services and efforts from all departments to treat patients with sincerity to improve patient satisfaction and increase intent to revisit.
The Potentials of Three Writing Modalities in Development and Sustained Development of Grammatical and Lexical Accuracy of Writing Performance
Authors: Zenouzagh Zohre Mohamadi
Published: November 2020

This study investigated the development and sustained development of grammatical and lexical accuracy in three writing modalities of individual, collaborative and e-collaborative writing. To this end, 90 Iranian Intermediate EFL learners were selected according to the participants' scores on a writing pretest.. Participants were assigned into the research groups e on the basis of convenient sampling. The writing performances in three groups of individual, collaborative and e-collaborative writing performance were measured on pretest, posttest and delayed posttests. Multivariate analysis of variance (MANOVA) indicated that participants’ writing performance in individual writing F (5, 38) = 16.06, p = .000, partial η2 = .679 representing a large effect size) and collaborative writing (F (5, 38) = 17.64, p = .000, partial η2 = .699 representing a large effect size) were sustainably improved in terms of grammatical and lexical accuracy. MANOVA results also indicated that participants writing performances in E-collaborative writing (F (5, 38) = 8.64, p = .000, partial η2 = .532 representing a large effect size) were improved and the improvement was sustained with respect to grammatical accuracy but not lexical accuracy. The post hoc comparison indicated that that collaborative writing was the most effective mode of writing as far as grammatical and lexical accuracy were concerned. The results have significant implications for teaching practitioners.
Risk of stroke after unilateral or bilateral TKA (simultaneous and staged without discharge) in 327,438 matched patients using data from the National Health Insurance Claims for South Korea
Authors: Han Seung-Beom , Yoon Jung-Ro , Cheong Ji-Young , Shin Young-Soo
Published: November 2020

Background: Limited data is available regarding the incidence rate and risk factors for stroke associated with unilateral total knee arthroplasty (TKA) and bilateral TKA. This study aims to investigate the incidence rate and risk factors of stroke in patients treated with bilateral TKA compared with patients with unilateral TKA.Methods: In this retrospective nationwide cohort study, we compared patients undergoing unilateral TKA or bilateral TKA using data from the Korean National Health Insurance claims database between January 1, 2009 and August 31, 2017 and included patients older than 40 years of age who underwent primary TKA by the index date as documented primary diagnosis and first additional diagnosis without a history of stroke during the preceding 1 year. We used matched Cox regression models to compare the incidence rate and risk factors of newly acquired stroke among patients treated with unilateral TKA or bilateral TKA after propensity score (PS) matching.Results: In the present study, 163,719 patients who received unilateral TKA were matched to 163,719 patients with bilateral TKA (simultaneous and staged without discharge) based on PS. The risk of stroke during the study period was lower in patients treated with bilateral TKA than in patients with unilateral TKA (adjusted hazard ratio [HR] 0.79; P<0.001). Patients who received bilateral TKA were at decreased risk of stroke when the following variables were present: advanced age (70-79 years, HR 0.76; P<0.001), female sex (HR 0.75; P<0.001), rural area (HR 0.77; P<0.001), small- or medium-sized hospital (HR 0.75; P<0.001), health insurance (HR 0.77; P<0.001), history of hypertension drug use (HR 0.75; P<0.001), congestive heart failure (HR 0.70; P=0.032), connective tissue disease (HR 0.71; P=0.01), diabetes (HR 0.77; P<0.001), and diabetes with complication (HR 0.76; P=0.034).Conclusions: The risk of stroke was lower in patients treated with bilateral TKA (simultaneous and staged without discharge) than in patients with unilateral TKA. Patients treated with bilateral TKA were at decreased risk of stroke when the following variables were present: age (70-79 years), female sex, health insurance, history of hypertension drug use, and comorbidities, such as congestive heart failure, connective tissue disease, and diabetes. More importantly, we do state that those with simultaneous bilateral TKA and staged bilateral TKA without discharge could have been healthier. This is precisely what the guidelines will implement by South Korea for patient selection aim to do and our data show that the risk of stroke is not increased in selected patients undergoing simultaneous bilateral TKA (SiBTKA) and staged bilateral TKA (StBTKA) without discharge.
Clinical Analysis of Classification for Tibial Plateau Fractures and Popliteal Artery Injury
Authors: Yao Yilun , Wu Xiaoshu , Wu Lei , Yang Lei , Jiang Chunzhi , Yang Wengbo
Published: November 2020

Background To explore the association between the classification for tibial plateau fractures (TPF) and the popliteal artery injury (PAI).Methods 22 TPF patients accompanied by PAI who were treated from May 2012 to July 2019 were retrospectively analyzed. There were 19 males and 3 females with an average age of 49.43 years. The Schatzker classification and three-column classification were performed for TPF. The severity of extremity injury was evaluated using the mangled extremity severity score (MESS). Except 3 patients treated with amputation, the remaining patients underwent surgical repair of popliteal artery and fracture external fixation. The outcome was evaluated using the Rasmussen score for tibial head fractures.Results There were 10 cases of Schatzker type IV fractures, 1 case of type V fractures and 11 cases of type VI fractures. Based on the three-column classification, the posterior column was involved in 22 cases, 2 columns in 15 cases and 3 columns in 6 cases. The MESS was 6-10 points, with an average of 7.59 points. Except 1 case directly receiving amputation, 3 cases of segment P1 injury was observed via preoperative DSA + intraoperative exploration, while segment P2 in 6 cases and segment P3 in 12 cases. Popliteal artery was found completely ruptured in 11 cases, partially ruptured in 1 case, and severely contused with thrombosis in 10 cases. The Rasmussen score was given to 19 patients at the last follow-up, except for the cases undergoing amputation. The outcome was satisfied in 14 cases, unsatisfied in 5 cases.Conclusion: In patients with complex TPF, the risk of PAI becomes higher with the increase of Schatzker classification level. Knee CT scan is helpful in determining the severity of fractures and evaluating PAI. Based on the three-column classification, PAI should be suspected when the fractures involve the medial and posterior column.PAI is mainly in the segment P3, and artery rupture or severe contusion with extensive thrombosis may occur.
Near-optimal rotation of colour space by zebrafish cones in vivo
Authors: Baden Tom , Yoshimatsu Takeshi , Bartel Philipp , Schroeder Cornelius , Janiak Filip , St-Pierre Francois , Berens Philipp
Published: November 2020

For colour vision, retinal circuits must separate information about intensity and wavelength. This requires circuit-level comparison of at least two spectrally distinct photoreceptors. However, many vertebrates use four or more, and in those cases the nature and implementation of this computation remains poorly understood. Here, we establish the complete circuit architecture and function of outer retinal circuits underlying colour processing in the tetrachromatic larval zebrafish. Our findings reveal that the specific spectral tunings of the four cone types near optimally rotate the encoding of natural daylight in a principal component analysis (PCA)-like manner to yield one primary achromatic axis, two colour-opponent axes as well as a secondary UV-achromatic axis for prey capture. We note that fruit flies – the only other tetrachromat species where comparable circuit-level information is available - use essentially the same strategy to extract spectral information from their relatively blue-shifted terrestrial visual world. Together, our results suggest that rotating colour space into achromatic and chromatic axes at the eye’s first synapse may be a fundamental principle of colour vision when using more than two spectrally well-separated photoreceptor types.
Flame-retardant properties of particleboard made from coconut fibre using modified potato starch as a binder
Authors:   Universiti Sains Malaysia, Owodunni Amina Adedoja
Published: November 2020

This study seeks to evaluate the flame-retardant characteristics of experimental particleboard manufactured from coconut fibre using modified potato starch as a green binder. The coconut fibre was used as a replacement for the wood as a raw material in particleboard production. The adhesives used in the process were made by modifying potato starch with citric acid and glutardialdehyde. No flame-retardant additive was added during the processing, and this was done to evaluate the flame-retardant potential of the experimental coconut fibre-based particleboards. The limited oxygen index (LOI) test, the bomb calorimetry, the differential scanning calorimetry (DSC) and the dynamic mechanical analysis (DMA) were used to evaluate the thermal properties and flame retardancy rate of such particleboards. The result of the DMA showed that the coconut fibre-based particleboards had good storage modulus with heat. The bomb calorimeter and LOI results also supported the flame-retardant performance of the panels. Based on the evaluations, it could be prescribed that the coconut fibre particleboard made with citric acid modified potato starch (CAMPS) exhibited the best flame-retardant properties.
Mapeamento sistemático da literatura para compras públicas sustentáveis
Authors: Oliveira Vanessa de , Conceição Roberta Dalvo Pereira da
Published: November 2020

Toda pesquisa tem seu início com a construção de uma base de conhecimento a respeito de determinado assunto, para isso, o pesquisador realiza uma análise de publicações científicas e literárias, que embasam seu estudo. O Mapeamento Sistemático da Literatura é um estudo secundário, que foi utilizado para esse trabalho com o intuito de buscar uma literatura que identificasse pesquisas relacionadas a abordagens de apoio para a rastreabilidade de temas que envolvam, de uma forma geral, compras públicas sustentáveis e responder questões sobre tendências de pesquisas na área. Sendo assim, objetivo deste artigo é relatar os resultados do estudo realizado. O intuito era criar uma base inicial para fundamentar a pesquisa com tema específico sobre compras públicas sustentáveis, assim como, elaborar um catálogo de pesquisas que poderão servir de base para futuras pesquisas sobre algum tema dentro do assunto relacionado ao desenvolvimento sustentável. Para uma utilização correta do mapeamento sistemático (MS), foi necessário o desenvolvimento de três etapas que são: planejamento da revisão, condução da revisão e o relatório da revisão. As publicações foram analisadas e as que se destacavam em relação aos assuntos referentes ao desenvolvimento sustentável e gestão sustentável, de maneira a contribuir, assim como relacionados a compras ou contratações sustentáveis, compras e contratações públicas sustentáveis e que de alguma forma geravam um desafio para o estudo, foram selecionados. Foram apresentados os resultados, onde o processo de busca retornou 6.763 estudos, dos quais 306 estudos relevantes inicialmente foram selecionados. Esses estudos, após a extração, diminuíram para 111 estudos classificadas como relevantes e de qualidade, que formaram uma base inicial para a pesquisa. Os estudos selecionados apresentaram alguns desafios e apresentaram investigações sobre economia circular e gerenciamento de cadeia de suprimentos verdes, os quais apresentaram imaturidade em suas áreas de pesquisa e podem ser temas para futuros trabalhos.
A role of thiamphenicol glycinate acetylcysteinate for therapy of respiratory diseases (a review)
Authors: Chikina S. Yu.
Published: November 2020

This article is a review of published studies on the clinical application of thiamphenicol glycinate acetylcysteinate (TGA) in the treatment of acute and chronic upper and lower respiratory tract diseases. Search for literature in Medline and eLibrary databases was performed. The special place that the drug holds in clinical practice, due to the specific properties of its components - mucolytic N-acetylcysteine (NAC) and antibiotic tiamphenicol. In addition to the usual mucolytic effects, NAC has antioxidant properties, which extends the range of its clinical effectiveness. The antibiotic thiamphenicol has antimicrobial activity against staphylococci, streptococci and gram-negative microorganisms. TGA can be administered by parenteral and inhalation routes. Inhalation route of drug injection is preferable in the treatment of acute and chronic bronchopulmonary diseases, because it allows to create a higher concentration of the drug in the respiratory tract, is associated with much less systemic effects and less often accompanied by the development of side effects. The results of TGA application in the treatment of both acute and chronic upper respiratory diseases (rhinosinusitis, otitis, pharyngotonsillitis) and bronchopulmonary diseases (chronic obstructive pulmonary disease, bronchoectasis) are considered in this review. It has been shown that the drug is quite effective in most patients and its effectiveness sometimes exceeds that of standard oral antibiotics. TGA also allows you to effectively combat biofilms, which have high antibacterial resistance. Thus, the published data allow us to speak about the high antibacterial effectiveness of TGA in acute and chronic infectious diseases of the upper and lower respiratory tract, including cases with the formation of biofilms.
Chronic cough: differential diagnosis and treatment
Authors: Orlova N. V.
Published: November 2020

Cough is one of the most common symptoms and is present in diseases of the respiratory, cardiovascular, digestive, endocrine and other systems. Cough is a reflex act, therefore it is caused by stimulation of cough receptors due to pathological influences. The diagnosis takes into account the nature of the cough, its duration, the results of laboratory and instrumental examination methods. The most attention is required to diagnose chronic cough and exclude life-threatening causes. Symptoms of anxiety are hemoptysis, prolonged resistant cough, prolonged intoxication syndrome, weight loss, etc. In diagnostically unclear cases, the examination schedule must include computed tomography of the chest, magnetic resonance imaging and bronchoscopy. A dry, painful intense cough can lead to the development of complications: a decrease in the quality of life, hemorrhages, pneumothorax, etc., therefore, requires symptomatic treatment. A common cause of unproductive cough is viral diseases, whooping cough, diseases leading to overactive cough receptors. The variety of coughs determines a differentiated approach to its therapy. The main efforts should be directed to the treatment of the underlying disease. In the case of a productive cough, mucoactive drugs are used. To stop unproductive cough, antitussive drugs of central and peripheral action are used. The recommendations of the European Respiratory Society present the results of clinical trials assessing the efficacy and safety of antitussive drugs with morphine-like action. The study identified side effects that limit their use. One of the most effective and safe drugs is a non-opioid drug with a central action Sinekod. The effectiveness and safety of the drug is confirmed by clinical studies.
Allergic rhinitis during a coronavirus pandemic: difficulties of diagnosis and features of therapy
Authors: Sebekina O. V. , Peredkova E. V. , Nenasheva N. M. , Grebennikova Yu. V.
Published: November 2020

Rhinitis can be of various etiologies. More often it is an infectious process (bacterial, viral) or clinical manifestations of an immediate allergic reaction. Other factors that provoke the development of rhinitis, for example, irritating substances, a number of drugs, hormonal imbalance, neurovegetative dysfunction, viruses are known. Doctors of various specialties are familiar with allergic rhinitis (AR) in their practice. In a number of cases there can be some difficulties in the differential diagnosis of rhinitis, the correct diagnosis and the appointment of adequate therapy. The COVID-19 epidemic (“coronavirus disease 2019”) has already been imprinted in the global history as an emergency of international importance. Scientific medical communities continue to study the characteristics of this epidemic, which is regarded by WHO as a pandemic. In a short period (from January 2020), there has been accumulated enough information about the etiology, features of the clinical manifestations of this disease, diagnostic methods have been developed, and clinical approaches and treatment regimens continue to be developed. The pandemic coincided with successive pollen seasons of trees, grasses and weeds. At the beginning of the pollen season, doctors were concerned about the possible difficulty in differential diagnosis of allergic rhinitis, manifestations of coronavirus and other viral infections. In the process of monitoring patients, more and more data has been accumulated, indicating the features of the clinical characteristics of COVID-19, influenza, acute respiratory infections, seasonal allergic rhinitis (rhinoconjunctivitis). Undoubtedly, information is still being accumulating and enriching day by day. AR is not only the most common form of rhinitis, but one of the most common diseases in children and adults. It is known about the pronounced negative effect of AR symptoms on the patient’s quality of life: normal daily activity, cognitive functions, mood, sleep. The severity of AR symptoms varies from minimal clinical manifestations to severe. Therapy should be directed towards the general control of AR symptoms. Over the past decades, the concept of phenotyping (definition of a disease by its clinical manifestations) and endotyping (based on the pathobiological mechanisms of the disease) has been developed. The belonging of AR in a particular patient to a certain phenotype plays a key role in choosing the most effective therapy and requires a personalized approach to treatment. The article provides frequently asked questions regarding AR treatment during the COVID-19 pandemic. The role of intranasal corticosteroids (InHCS), which are the most effective drugs in AR therapy, is discussed, due to their pronounced anti-inflammatory effect and influence on all stages of the pathogenesis of the disease. Mometasone furoate nasal spray has the widest indications among all InHCS drugs registered in our country.
The value of the medicine fenoterol + ipratropium bromide in the treatment of exacerbations of bronchial asthma and chronic obstructive pulmonary disease
Authors: Tsvetkova О. A. , Voronkova O. O.
Published: November 2020

The purpose of the article is to determine the place of the combined bronchodilator fenoterol + ipratropium bromide in the treatment of exacerbations of bronchial asthma, COPD and recommendations on various delivery methods. The treatment of exacerbations of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) is of interest to a general practitioner. Although this concept has lost most of its gloomy colors in the last decade thanks to the new concept of diagnosing and treating patients, the problem of providing qualified timely assistance at the time of an exacerbation remains acute and not always solvable. Often the basis for the treatment of exacerbation of asthma and COPD is repeated administration of a fast-acting inhaled short-acting b2-agonist or an anticholinergic drug, or their combination, early administration of systemic corticosteroids and oxygen inhalation. Exacerbation therapy should be as safe as possible for patients. Following the recommendations for the treatment of asthma and COPD exacerbations both on an outpatient basis and in a hospital can significantly reduce the frequency of asthma and COPD exacerbations. Medical care that a patient can receive at home depends on the experience of the physician and the patient, as well as on the possibilities of medicine and instrumental provision. Ideally, the level of peak expiratory flow (PEF) should be a measure of control over one’s well-being, both in remission and in an exacerbation.
Inhaled surfactant in patients with covid-19 who took high-flow oxygen: the results of a retrospective analysis
Authors: Averyanov A. V. , Klypa T. V. , Balionis O. I. , Bychinin M. V. , Cherniak A. V. , Troitskiy A. V. , Trifonova E. V.
Published: November 2020

The article presents a comparative retrospective analysis of clinical, laboratory data and outcomes in 39 patients with severe COVID-19 complicated by acute respiratory distress syndrome, who received high-flow oxygen therapy. Of which, 19 patients additionally received 75 mg of inhaled surfactant BL twice daily for 5 days using a nebulizer. As a result, mortality rate in the group of patients receiving surfactant was 10.5%, while in the standard therapy group — 50%; the number of patients transferred to the mechanical ventilation was 21% and 70%, respectively. As the patients receiving the surfactant were injected with COVID-19 hyperimmune convalescent plasma and monoclonal antibodies to interleukin-6 receptors more often than those from the control group, we recalculated the results regardless of these patients. However, a significant difference between the mechanical ventilation rate (2.5 times less often in the surfactant group) and mortality rate (3.5 times less in the surfactant group) was observed. The duration of hospitalization and stay at the intensive care unit was not significantly different between patients with and without surfactant treatment. Inhalation therapy with surfactant BL was well tolerated even by patients with chronic obstructive pulmonary disease. In no case did therapy have to be stopped due to side effects, the most common of which was coughing during inhalation. This retrospective analysis shows that the prescription of an inhaled surfactant prior to transferring patients to mechanical ventilation can prevent the progression of respiratory failure, put down mechanical ventilation, and improve survival.
Interstitial lung diseases with progressive pulmonary fibrosis: pathogenetic features and approaches to therapy
Authors: Kuzubova N. A. , Titova O. N. , Skliarova D. B.
Published: November 2020

A number of patients with interstitial lung diseases (ILD) of various etiologies, including hypersensitive pneumonitis, diffuse connective tissue diseases (rheumatoid arthritis, systemic scleroderma, dermatomyositis), sarcoidosis, idiopathic non-specific interstitial pneumonia (NSIP) and unclassified ILD develop rapid deterioration of lung ventilation function due to the progression of fibrotic changes, accompanied by a decrease in physical performance and quality of life. It is proposed to distinguish a progressive fibrotic phenotype from those with similar pathogenetic mechanisms, radiologic pattern, clinical course, and prognosis. The progressive course of the fibrotic process is assessed by reducing the forced vital capacity of the lungs (FVC), increasing the severity of signs of pulmonary fibrosis according to computed tomography (CT) and worsening respiratory symptoms. There are several risk factors for the progression of ILD, such as male gender, older age, lower initial pulmonary function, and radiological or pathological picture of usual interstitial pneumonia (UIP). Currently, the role of antifibrotic drugs in the treatment of this pathology is being actively studied. Previously, the common approach was to use this group of drugs in patients with idiopathic pulmonary fibrosis (IPF) and immunosuppressive drugs in patients with other fibrotic subtypes of IL. However, the results of clinical studies have shown a favorable response to antifibrotic therapy for a wider range of fibrotic ILD, manifested in a decrease in the annual rate of FVC reduction. And in 2020, the use of the first anti-fibrotic drug was approved for the treatment of patients with advanced pulmonary fibrosis, NOT related to idiopathic pulmonary fibrosis (IPF).
Guillermo Buitrago: precursor de la música vallenata
Authors: Caballero Elías Édgar
Published: November 2020

Buitrago es la punta del iceberg de una tradición musical. Una matriz, culta y popular a la vez, en la que coexistían sin estorbarse la guitarra, el piano, la caja, la guacharaca y el acordeón, el invitado más tardío a la fiesta. Encontró en su región de origen –el antiguo Magdalena Grande-, al iniciarse en la música, una matriz facilitadora, en etapa de síntesis de influencias y acoples. Esta plantilla le ofreció géneros, acompañantes, maestros del pentagrama, competidores de primera línea, medios de difusión y letras de insuperable gracia. Él aportó a la misma un buen número de composiciones, además de un estilo de interpretación único, que el conocedor público colombiano acogió como se acogen los materiales de buena ley. “La piña madura”, de Eulalio Meléndez; “Dame tu mujer, José”, de su maestro y amigo Andrés Paz Barros; “La capuchón”, de su otro paisano Humberto Daza; “La varita de caña”, de Rafael Camacho Sánchez; “La hija de mi comadre”, de César Bermúdez Támara; y “El grito vagabundo”, de Buenaventura Díaz; o temas de sobra conocidos como “La gota fría”, de Emiliano Zuleta; “Zorro cucho”, de Lorenzo Morales; “La víspera de año nuevo”, de Tobías Enrique Pumarejo, y “El testamento”, de Rafael Escalona, son algunos ejemplos de excepción de esa tradición regional -mestiza en distintos sentidos- que el rubio muchacho de Ciénaga honró y potenció con su voz, su guitarra y sus pícaros arreglos, en una elemental devolución de favores. Buitrago construyó una carrera artística sorprendente en un periodo de pocos años. Murió, igualmente, de manera prematura, a los 29 años. Su obra le marcó un camino difícil de borrar a otros músicos populares de la región, como documenta Edgar Caballero Elías en este libro pionero sobre Buitrago.
Nanoparticles in Gastric Cancer Management
Authors: Avgustinovich Alexandra V. , Bakina Olga V. , Afanas’ev Sergey G. , Cheremisina Olga V. , Spirina Liudmila V. , Dobrodeev Alexey Y. , Buldakov Michail , Choynzonov Evgeny L.
Published: November 2020

Gastric cancer is the second most common cause of cancer-related deaths in the world. The surgical
management of the tumor is the best therapeutic option for gastric cancer patients. A combination of a heterogeneous
distribution of genetic and environmental factors appears to be required to explain patients' poor prognosis.
A search for targeted and molecular-based approaches is affected by the optimal gastric cancer drug
management. The modern multidisciplinary approach to treating the pathology used worldwide prolongs the
overall patient survival and decreases the rate of recurrence. An understanding of the mechanisms that underlie
therapies will provide new insights into gastric cancer treatment. The improvement in medicine will probably
be associated with a study of tumor biology, followed by a personalized and molecular-based approach development
in anticancer drugs administration. The modern perspective in gastric cancer detection and treatment is
the application of nanoparticles. Nanoparticles affecting the intensity of biological processes in cancer cells can
be used to treat cancers to increase the effectiveness of anti-tumor therapy. Their cytotoxicity involves a wide
range of pathological events. Their targets are the extracellular matrix degradation, epithelial-mesenchymal
transition, tumor angiogenesis, tumor microenvironment modulation. These are accompanied by lipid peroxidation,
apoptosis, and autophagic flux. Preliminary studies on the efficacy of the use of nanoparticles in cultured
gastric cancers open new opportunities for anti-tumor treatment to overcome the toxicity of therapeutic agents
and decrease the rate of resistance to anticancer drugs and therapies.
Implications of Klotho Protein for Managing Kidney Disease - An Emerging Role in Therapeutics and Molecular Medicine
Authors: Ray Suman K. , Masarkar Neha , Mukherjee Sukhes
Published: November 2020

Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) are a growing
public health problem. There is a paucity of sensitive biomarkers to detect AKI, early
CKD, and ameliorate extra-renal complications. Klotho protein, detected mainly in the
kidneys, regulates renal health and functions as a co-receptor for fibroblast growth factor
23 (FGF-23) signaling. It is now coming to be known for its extreme pleiotropic actions.
These include cytoprotection via anti-oxidation, anti-senescence, anti-apoptosis,
renoprotective effects, promotion of angiogenesis and vascularisation, inhibition of
fibrogenesis, and stem cell preservation. Emerging clinical studies suggest kidney
damage to be a perpetual state of renal Klotho deficiency. In AKI, Klotho levels in
plasma and/or urine possibly will serve as an initial biomarker for kidney parenchymal
injury. In CKD, Klotho levels may also be an indicator of early disease as well as predict
the rate of progression. Earlier studies using ELISA as a technique reveal a correlation
between plasma Klotho, eGFR, serum creatine, and Blood Urea Nitrogen (BUN) levels.
Thereby preventing the decline of Klotho levels by various mechanisms can retard CKD
advancement and improve renal function. Substantial data indicate Klotho can be
therapeutically included as an individualized regimen for managing CKD patients.
Considerable research is required in investigating the role of soluble Klotho as a
biomarker in patients with different types and severity of kidney diseases, which will be
highlighted in our review.
Adherence to Treatment, Arterial Stiffness and Cognitive Function in Irbesartan- Treated Newly Diagnosed Hypertensive Patients
Authors: Kalaitzidis Rigas G. , Balafa Olga , Dounousi Evangelia , Stagikas Dimitrios , Tsimihodimos Vasilios
Published: November 2020

Objective:

Non-adherence to antihypertensive agents leads to reduced blood pressure
(BP) control. Data supporting the correlation of adherence with arterial stiffness (AS) are few. Furthermore,
the causal relationship between AS and cognitive dysfunction (CO/DY) has not been
clearly established. It is suggested that angiotensin II receptor blockers (ARBs) exhibit the lowest
discontinuation rate among antihypertensive drugs.

Design and Methods:

We followed up with patients receiving monotherapy with irbesartan.
CO/DY was assessed with the Mini-Mental State Examination (MΜSE) and other tests.

Results:

Patients [n=77; mean age: 56±11 years; 39 men (50.6%)] were followed-up for 16.1±10.9
months. At the end of follow up, significant reductions were observed in mean peripheral systolic
BP (135±117 vs 153±11 mmHg; p<0.005), mean peripheral diastolic BP (85±11 vs 95±10 mmHg;
p<0.005), mean central systolic BP (130±11 vs 142±12 mmHg; p<0.005) as well as in mean central
diastolic BP (85±8 vs 95±97 mmHg; p<0.005).

:

AS indices [carotid-femoral pulse wave velocity and augmentation index] also improved significantly:
7.7±1.4 vs 8.2±1.4 m/sec (p<0.005), and 29.1±8.3 vs 32.3±9.1 (p<0.005), respectively.

:

At the end of the study, a significant improvement was observed in the MMSE test (29.7±0.7 vs.
29.2±0.9; p<0.02), as well as a significant reduction in 24h urine albumin (94±82 vs. 204±112
mg/24h, p<0.005).

:

The level of adherence was high in 60/77 (77.9%), medium in 9/77 (11.6%) and low in 8/77
(10.38%) patients.

Conclusions:

Hypertensive patients receiving mono-therapy with an ARB showed reduced AS, cognitive
improvement, significant reductions in BP (peripheral and central) and decreased 24h urinary
albumin excretion.
Nutrition, Health Behaviour Changes, and Eating Behaviours of Adults During the COVID 19 Pandemic Period
Authors: DEMİR Gülperi
Published: November 2020

Aim: The aim of this study was to examine the changes in the health behaviours, food consumption, meal patterns and eating behaviours of adults during the COVID-19 pandemic, which globally poses a major public health threat. Method: The research designed as descriptive and cross-sectional type was conducted on 330 voluntary adults aged 20 and over, between May and July 2020 (mean age: 33.1±11.5 years). Data were collected through an online survey method. The questionnaire included questions to identify the changes in participants' health behaviours, food consumption, meal patterns, and an eating disorder rating scale to evaluate their eating behaviours. SPSS 21.0 software was used for the evaluation of the data. Results: During the pandemic period, while smoking (p<.05), alcohol (p>.05) consumption, physical activity (p<.05) rates decreased; sleep duration and body mass indexes increased (p<.05). During the pandemic, the rate of those consuming one main meal a day increased, while the rate of those consuming three main meals decreased (p<.05). In addition, the rate of eating at night increased during the pandemic (p<.05). During the pandemic period, the adults’ consumption of cereals and sweets which are rich in carbohydrates, and their fat, tea, coffee consumptions increased, while their fish consumption decreased. The average global eating disorder rating scale score of adults during the pandemic period was 2.4±1.4, and it was determined that the risk of possible eating disorders was low. However, during the pandemic process, it was determined that they displayed negative behaviours such as consuming more food than usual, feeling losing control while eating, experiencing excessive eating attacks, and obsessive exercise. Conclusion: As a result of the study, it was revealed that the pandemic process negatively affected the nutrition and health behaviours of individuals in general. It is thought that adults should be made aware of the effects of nutrition and lifestyle on sensitivity to COVID-19 and recovery.